COVID, reproduction, & race

Why being Black and giving birth in New York during the pandemic is so dangerous.

NYT, August 6, 2020

By Emily Bobrow

The pandemic has laid bare the role race plays in the health of New Yorkers. In this highly segregated city, which has long had significant racial disparities in everything from cancer deaths to life expectancy, it is now well-established that Black and Latino New Yorkers die of Covid-19 at more than twice the rate that white people do.

It’s often difficult to know why any one patient receives what she believes to be substandard care. But the statistics show that pregnant women of color are more likely to face undesirable outcomes for reasons that public health experts are trying to understand.

Across the United States, Black women are three to four times more likely to die of childbirth-related causes than white women. In New York City, however, Black women are eight to 12 times more likely to die. Black infants in the city are also three times more likely to die than white newborns — a gap that is nearly 50 percent greater than the national average. Researchers say most of these deaths are preventable.

Whatever the underlying causes, it seems clear that Covid-19 is making things worse. “Black birthing people are already more likely to die, regardless of their income or education,” said Joia Crear-Perry, an obstetrician and president of the National Birth Equity Collaborative, a nonprofit dedicated to eliminating racial disparities in birth outcomes. “Now, with Covid, resources are scarce and hospitals don’t have what they need. Who bears the brunt? The people least likely to be listened to.”

COVID Fears Masking

Hygiene Theater Is a Huge Waste of Time

July 27, 2020

The Atlantic, July 27, 2020

Derek Thompson

In May, the Centers for Disease Control and Prevention updated its guidelines to clarify that while COVID-19 spreads easily among speakers and sneezers in close encounters, touching a surface “isn’t thought to be the main way the virus spreads.” Other scientists have reached a more forceful conclusion. “Surface transmission of COVID-19 is not justified at all by the science,” Emanuel Goldman, a microbiology professor at Rutgers New Jersey Medical School, told me. He also emphasized the primacy of airborne person-to-person transmission.

By funneling our anxieties into empty cleaning rituals, we lose focus on the more common modes of COVID-19 transmission and the most crucial policies to stop this plague. “My point is not to relax, but rather to focus on what matters and what works,” Goldman said. “Masks, social distancing, and moving activities outdoors. That’s it. That’s how we protect ourselves. That’s how we beat this thing.”


COVID and birth outcomes

Hospitals in several countries saw dips in premature births, which could be a starting point for future research.

NYT, July 19, 2020

This spring, as countries around the world told people to stay home to slow the spread of the coronavirus, doctors in neonatal intensive care units were noticing something strange: Premature births were falling, in some cases drastically.

It started with doctors in Ireland and Denmark. Each team, unaware of the other’s work, crunched the numbers from its own region or country and found that during the lockdowns, premature births — especially the earliest, most dangerous cases — had plummeted. When they shared their findings, they heard similar anecdotal reports from other countries.

They don’t know what caused the drop in premature births, and can only speculate as to the factors in lockdown that might have contributed. But further research might help doctors, scientists and parents-to-be understand the causes of premature birth and ways to prevent it, which have been elusive until now.

Essential Workers

“Essential Workers” and Worker Protections?

St. Louis custodians share coronavirus concerns, react to reopening plans

“We have been working throughout the pandemic and all summer long. We want to get the schools ready, but I still think it’s too soon for the kids.”

KDSK News 5, July 11, 2020

‘We’re heroes, too:’ Hospital janitors risk lives to stop spread of COVID-19

USA Today, June 12, 2020

School Custodians Are Essential Frontline Workers For Our Students

NEA Today, May 28, 2020

Custodial Staff Protect Us From The Novel Coronavirus, But Who Is Protecting Them?

Health Affairs Blog, March 27, 2020

COVID Violence

Attacks on public health officials

‘The Death Threats Started Last Month’: Public Health Officials Targeted By Some Frustrated Americans

Kaiser Health News, June 23, 2020

The public health experts who have in many places become the face of the state or local response to the pandemic are becoming targets of public frustration to the point of receiving death threats. “They’re becoming villainized for their guidance. In normal times, they’re very trusted members of their community,” said Lori Tremmel Freeman, the chief executive of the National Association of County and City Health Officials.

Some public health officials are resigning amid threats during the Covid-19 pandemic

CNN, June 23, 2020

During a live public briefing on Facebook last month, “someone very casually suggested” the Los Angeles County’s public health director should be shot, the director said.

“I didn’t immediately see the message, but my husband did, my children did, and so did my colleagues,” Dr. Barbara Ferrer said Monday in a statement.

Another coronavirus danger: Harassment of public health leaders poses new threat

USA Today, June 17, 2020

Amid a global pandemic and a long overdue recognition of racism’s harmful effects on health, public health officials have a new reason for concern: their own safety. 

In recent weeks, threats have led to protective details for the nation’s top infectious disease expert, Dr. Anthony Fauci, and Georgia’s commissioner of the Department of Public Health, Dr. Kathleen Toomey. Personal attacks, including aggressive protests in front of their homes, have driven Dr. Nichole Quick from her position as health officer of Orange County, California, and pushed Dr. Amy Acton to step down as Ohio’s health director.

Kaiser Health News and The Associated Press found that as harassment has become more common, 27 state and local health officials in 13 states have “resigned, retired or been fired” since April

Masking Reopening

Masking: Complaints about workers

Face masks ‘touchy subject’ for local restaurants, but still required for employees under pandemic rules

Pittsburgh Post-Gazette, June 26, 2020

Since restaurants began swinging open their dining room doors again three weeks ago under the state’s green reopening phase, the Allegheny County Health Department has received some 80 complaints from the public about restaurant workers not wearing face masks.

On Monday, county health inspectors cited the popular Italian restaurant Il Pizzaiolo in Mt. Lebanon because none of the workers there were wearing masks.

“Manager stated that employees were not wearing masks because they find them uncomfortable,” the inspection report said.

COVID Violence Masking

Masking: Angry customers

Customer screams at CNY ice cream shop workers who told her to wear mask: ‘It was honestly very scary for us’, July 8, 2020

Chittenango, N.Y. — Two teenage employees at a Chittenango ice cream stand got the full brunt of one customer’s tirade after she refused to wear a face mask and lashed out after she was denied service.

A woman and a man, neither of whom were wearing the required face masks, approached the counter at The North Pole just before 7:30 p.m. Tuesday.

Tori Broniszewski, 18, and Morgan Baldwin, 16, were working the counter when the customers approached.

Customers ‘aggressive’ over face mask policies force fed-up restaurants to close

Miami Herald, June 30, 2020

Restaurants across the country are reportedly closing as coronavirus cases rise and employees test positive for COVID-19.

Recently, there have been announcements from restaurants saying they’re closing dine-in services after customers “disrespected” and insulted staff members when asked to wear masks, per company policies, according to news reports.

This week, Mexican Fiesta in Dearborn Heights, Michigan, announced it would close its dining room and only offer carry-out following “multiple situations where our staff was disrespected and treated rudely,” according to a Facebook post from the company. The restaurant’s manager told the Detroit Free Press that most of the run-ins involved people disagreeing with the company’s mask policy.
Read more here:

3 McDonald’s workers hurt after customer attack over coronavirus limits, Oklahoma police say

Two were injured by gunfire and a third was hurt in a scuffle, police said. Two suspects have been arrested.

NBC News, May 27, 2020


A running list of links on COVID & birth rates

Coronavirus pandemic could lead to up to 500,000 fewer US births, study suggests

CNN, June 23, 2020

The Baby Business Will Take The Next Big Hit From COVID-19

Forbes, June 18, 2020

Half a Million Fewer Children? The Coming COVID Baby Bust

Brookings Institute, June 15, 2020

With Couples Rethinking Children, We Might See the Opposite of a COVID-19 Baby Boom

Rolling Stone, May 21, 2020

COVID Fears Rural

On The Brink, Rural Hospitals Brace For New Surge In COVID-19 Cases

NPR, July 3, 2020

In the Idaho mountain town of Grangeville, population 3,200, signs in windows on Main Street advertise that Border Days “is on.”

Up the street, at the 16-bed Syringa Hospital and Clinic, CEO Abner King says his staff is prepared for a possible surge in coronavirus infections in a couple of weeks.

“It’s pretty hard to do an egg toss in a socially distancing manner,” he chuckles.

Syringa doesn’t have an intensive care unit or even a ventilator. Most patients in need of critical care are transferred to larger regional hospitals, which so far during the pandemic have not been overwhelmed themselves as first feared.

Syringa staff members have been preparing and instituting precautions for months, yet to date they’ve not treated a single COVID-19 patient.

“That’s the tough part about all this, because you get all ready for this big emergency and then nothing happens and then you have to fight complacency a little bit,” King says. “We prepared for a flood, and then we were hit with a drought.”

That “drought” has severely affected Syringa’s bottom line. The irony is that small-town hospitals like this one are now on the brink of going broke during the pandemic. King says people just stopped coming into the hospital, its clinic and even its emergency room. All elective procedures were canceled. Since the pandemic took hold in March, revenue here has dropped by half.

Across the U.S., rural “critical access” hospitals were already closing at an alarming rate before the pandemic. Twelve have shuttered since the start of this year alone.

“Even without the pandemic, there’s not a lot of room for surprises and errors,” King said.

One of the main reasons that the hospital has stayed afloat since March is because of federal relief money. Among other things, it has helped pay for personal protective gear and other supplies as well as the construction of a temporary isolation ward for COVID-19 patients.


Imagining Rural Immunity

Anthropology News, June 2020

Thurka Sangaramoorthy and Adia Benton

Political myth-making about America’s rural “heartland” is doubly pernicious, increasing rural vulnerability to COVID-19 and ignoring the disintegration of rural health services.

In March 2020, Fairmont Regional Medical Center, the only hospital in Fairmont County, West Virginia, closed its doors amid increasing financial strains. Later that month, an ambulance was called to take an 88-year-old woman infected with COVID-19 to the hospital. Instead of making the usual two-minute drive to Fairmont Regional, the ambulance had to drive 25 minutes to the next-nearest facility. Days later, the woman became West Virginia’s first reported coronavirus death (Healy et al. 2020). While some may point to the woman’s age as a deciding factor in her declining health and eventual death, her fate more aptly underscores how the public health infrastructure in rural regions is potentially the most fragile aspect of the rural health care continuum.   The imagined immunity of rural America omits entire swathes of rural land in the South and Midwest, where many Black and Latino people reside and work; they do not include the rural residents of Native reservations; they do not recognize the vast influence of prison economies throughout rural America.

As the total number of COVID-19 cases in the United States surges past 1.5 million, much of the focus in news media and discussions among national experts has long been on large, urban metropolitan areas. The rationale is that their dense populations engaging in frequent interpersonal contact are at heightened risk of contracting the disease. When rural areas have been the focus of stories of community spread, the vectors of infection were often wealthy urbanites fleeing rising case counts in the city. The county commissioner of Tillamook County, Oregon, for example, took to the pages of the Washington Post opinion section to convey what he described as a “plea from rural America,” urging “COVID-19 urban refugees” to stay home. “Thousands of urban visitors descended on our villages, with cars lined up for miles on highways to the coast,” he wrote.