TREATING PATIENTS in Boston’s busiest emergency room has taught me a lot about the intersection of COVID-19 with race, class, and inequity. From ER visits to protests, black and Latinx people are enduring one of the most challenging moments in recent history. The dual pandemic of coronavirus and racism has taken over America while emotionally exhausting those of us involved. As an ER physician and elected official who is often the only person of color in both worlds, the relationship between both scourges has never been more intertwined.
Let us start with a primer. COVID-19 sees no race or class. It only sees opportunity. And conditions that disproportionately impact communities of color – poverty, lack of access to health care, increased air pollution – create an invitation to wreak havoc. From Chelsea to Brockton, and communities in between, scores of immigrants, essential workers, and people of color have borne the highest rates of coronavirus cases, hospitalizations, and deaths.
But what began as a public health crisis has now morphed into the worst economic crisis since the Great Depression. Unemployment rates are higher in communities of color. Black and Latinx businesses have been shut out from large federal stimulus programs. Desperation is beginning to creep in and hope is quickly vanishing.
In medicine, the social determinants of health drive up to 80 percent of health outcomes. Whether I’m treating a heart attack, a case of coronavirus, or a young person shot in the ER, these acute issues are directly tied to the inequity found in urban America.
The socioeconomic injustice faced by people of color, codified in law over centuries, has not only led to gross health disparities, but has propped up a criminal justice system where an innocent black man could be murdered by a policeman coldly kneeling on his neck. George Floyd’s death is fundamentally about the systemic racism that has haunted this country since its founding. And so is COVID-19’s impact on communities of color. They are inextricably linked and evidence of coronavirus infection discovered during Mr. Floyd’s autopsy underscores this sad truth.
So when people peacefully demonstrate across the country, it’s not just to honor the life and legacy of George Floyd. It is not solely to reject the sanctioned violence that killed Eric Garner or Breonna Taylor. But rather, it is to protest the conditions that have created a system where the value and dignity of people of color are considered inferior. The millions of protesters – diverse in color, age, and experience – exercising their free speech are critiquing the political, economic, and social systems that have laid the foundation for these two plagues.
Many of us have stood with and encouraged demonstrators to speak up and express their indignation and desire for change. The protests have been solution-oriented, constructive, and predominantly peaceful. The demonstrations are as American as those associated with the founding of this country, from the Boston Tea Party to the March on Washington for Jobs and Freedom. And while I share the concern that large protests may lead to a second coronavirus surge, I cannot in good faith tell a young black man to not speak up when he feels that he is more likely to die from police brutality than COVID-19.
I urge mask wearing, social distancing when possible, and encourage virtual protesting as an alternative. I stand near the back of the protests, separated six feet away with my own mask, lost in moments of reflection. I do my best to explain to my colleagues in government and healthcare why we cannot address COVID-19 and racism without transforming minds and laws that govern society.
And despite the continued loss of life from both epidemics, I remain inspired by the awakening and growing pains our country is undergoing. I feel it in the patients I care for who have shown incredible resolve in the face of an unrelenting virus. I feel it in discussions with legislative colleagues who recognize now is the time to tackle structural inequities with boldness and urgency. For if America has proven anything, it is our capacity to change and desire to fight for a more perfect union. And that moment has arrived.
Dr. Jon Santiago is a state representative from Boston and an emergency room physician at Boston Medical Center. Follow him on Twitter @iamjonsantiago.