Why COVID-19 Is Worse For Poor People (and How to Fix It)
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Back in September I talked about the paper describing the Sturgis Motorcycle Rally as a “superspreader” event in which a bunch of idiots came together during a pandemic, drank and shouted and partied together, then went back to their respective hometowns where they infected their neighbors. (If you missed it, Jamie Bernstein had a fantastic follow-up on that in which she pointed out the statistical problems contained in that paper that mean that the rally wasn’t as bad as the paper suggested.)
Well, now we have some more research on superspreaders that is probably more relevant to your day-to-day life than one that says “maybe don’t go to motorcycle rallies right now.” And it’s “maybe don’t go to restaurants or churches right now.”
At least, that’s the summary that I first saw while scrolling through Reddit, where the headline was “A small minority of “superspreader” points of interest (POIs) such as restaurants and religious establishments account for a large majority of COVID-19 infections and restricting maximum occupancy at each POI is more effective than uniformly reducing mobility.” When I first saw that, I honestly scrolled right on by because, well, no shit. We already have extensive data showing that COVID-19 spreads most easily when people are indoors, unmasked, and speaking to each other, and restaurants absolutely fit that (since people can’t eat while wearing a mask, they’re usually with someone else they want to talk to, and many restaurants are, unfortunately, still operating indoors), and many churches can fit that when they stay inside, allow worshippers to go maskless, and encourage singing and speaking.
But I went back to that headline to underscore a point I made on social media — I stumbled across someone on Facebook asking which local restaurants were offering indoor seating. That’s bad enough, and the #stayinside label on their profile pic was a nice touch of irony, but one of the replies read, “Take advantage of indoor dining while you can. Cases are rising and San Francisco will be losing ALL their inside dining on Friday because of a 250% increase in their cases.”
“Hey, can anyone recommend an unlicensed skydiving school?”
“Try my cousin Jimbo’s operation, it’s great! But do it while you can because on Friday all the unlicensed operations are being shut down by the state due to them noticing a 250% increase in deaths due to falling 10,000 feet from a plane.”
“Does anyone know of any good orgies that don’t require condoms?”
“Yes, my rumpus room is open but get in there while you can because on Friday we need to close due to the county experiencing a 250% increase in syphilis.”
Like, what the fuck is wrong with people? They see that the city is shutting down restaurants and just think of it as, what, a punishment for a rise in cases? As opposed to a cause? Like, cases are up so San Francisco needs to teach us a lesson. It was either “close the restaurants” or “take away our Playstations.” They flipped a coin. Sorry, restaurants.
Anyway back to the study. When I went back to take the screenshot, I clicked through to the study and noticed something interesting. In Mobility network models of COVID-19 explain inequities and inform reopening, Stanford computer scientists used anonymized cell phone data to pinpoint where people went while COVID-19 was spreading around their city and how long they spent there. Then they used that data to build a model that let them change certain factors to see what impact it had on the pandemic, like making more people stay at home, or reducing capacity at restaurants, for instance. As that Reddit post correctly stated, they did find that a few points of interest were superspreaders. Full-service restaurants were by far the worst, and they found that reopening them fully on May 1 (they were using data from March) would have had a predicted increase of nearly 10,000 new infections per 100,000 people. Which, scientifically speaking, is BONKERS.
Other bad PoIs were, in descending order, fitness centers, cafes, hotels, limited-service restaurants, and religious organizations. After that came two essential services: doctors’ offices and grocery stores. Then thrift stores, pet stores, sporting good stores, general stores, toy stores, hardware stores, auto parts stores, and department stores. Finally the “safest” reopenings would be gas stations, pharmacies, convenience stores, and new car dealers, probably mostly based on how little time people tend to stay inside any of those places. Except pharmacies. I’ve spent entire lifetimes waiting for prescriptions to be filled, so I don’t know what happened there.
All that is interesting but like I say, not exactly headline news. What the study’s authors actually found most notable is revealed in the title they chose and which the Redditor who submitted it missed: their model highlighted and helped explain the inequity we’ve been seeing in the spread of COVID-19.
For quite awhile now it’s been pretty clear that there is a stark inequality in who contracts and dies from COVID-19. A team of researchers published a paper in September that found “counties with higher proportion with disability and poverty rates had a higher death rate,” and “African Americans were more vulnerable to COVID-19 than other ethnic groups” with “1,981 African American infected cases versus 658 Whites per million.”
But why is that, exactly? The mobility network models suggest that, in the authors’ conclusion, “people from lower-income (census block groups) have higher infection rates in part because they tend to visit denser POIs and because they have not reduced mobility by as much (likely because they cannot as easily work from home)”.
So how do we protect these vulnerable populations? The authors go on to say very directly that policymakers should take note that “infection disparities are not the unavoidable consequence of factors that are difficult to address in the short term, like differences in preexisting conditions; on the contrary, short-term policy decisions can substantially affect infection outcomes by altering the overall amount of mobility allowed and the types of POIs reopened.”
And just to be super helpful, they offer a few examples of how policymakers can stop the spread of COVID-19 in marginalized communities. They recommend, “(1) more stringent
caps on POI occupancies, (2) emergency food distribution centers to reduce densities in high-risk stores, (3) free and widely available testing in neighborhoods predicted to be high risk (especially given known disparities in access to tests), (4) improved paid leave policy or income supports that allow essential workers to curtail mobility when sick, and (5) improved workplace infection prevention for essential workers, such as high-quality PPE, good ventilation, and distancing when possible.”
There it is in simple black and white: the social safety net that scientists recommend be put in place to stop this virus.
Obviously, this will not happen at the national level for at least another two months. But city, county, and state representatives can do this right now. I’m making this video in the hope that at least one person in a position of power can see this research, trust the science, and save lives.
And for christ’s sake, stop eating inside restaurants during a pandemic you dipshits.
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The part of this article that talks about research on “Point of Infection” is interesting.
But the part that your title refers to is old news. Back in April or May, people were talking about how Covid-19 was hitting poor people and/or African-Americans particularly hard, and most of the recommendations you cite were being made then, too. Another issue for poor people, at least in the NYC area, is that health care facilities are much more limited and of poorer quality in poor neighborhoods, and in fact New York State and the corporations that run the hospitals have been eliminating hospitals and hospital beds and other health care facilities in poor neighborhoods, thus making the problem worse — in poor neighborhoods, sick people were being turned away at emergency rooms because the hospitals were overloaded, and people were dying at home because they knew they wouldn’t get treatment if they went to the ER.
As I say, all this was well-publicized as early as six months ago, but I have seen no evidence that those with the power to do anything are taking any of the obvious steps. In fact, one of our local majority-Black cities is fighting plans (by Montefiore Hospital, IIRC) to shut down the one remaining hospital in the city. One might think that, in the view of the people who run the State government, the health-care systems, and most local governments, Black and Brown (and other POC) lives don’t matter.
White Supremacy is alive and well, everywhere.
When you look at the generally very low COVID death rates in the continent of Africa itself, the contrast is even more stark.
I am forced to conclude that there is something particularly toxic going on in America, where “the social safety net that scientists recommend be put in place to stop this virus” is regarded as a Communist plot by half the population.
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