Friday, June 5, 2020

Public Heath Experts Have Undermined Their Own Case


Public Health Experts Have 
Undermined Their Own Case for 
the COVID-19 Lockdowns

Police violence is a metaphorical disease. Coronavirus is a literal disease.


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(Michael Brochstein/ZUMA Press/Newscom) 


In theory, the mass protests following the alleged murder of George Floyd put public health officials who have ceaselessly inveighed against mass gatherings in a difficult position. They have called for a moratorium on most types of public activities, but particularly gathering in large crowds where increased aerosolization from loud talking and yelling could spread the COVID-19 virus to massive groups.

But when it comes to the protests against police brutality, many medical experts think there should be an exemption to the COVID-19 lockdown logic.

More than a thousand public health experts signed an open letter specifically stating that "we do not condemn these gatherings as risky for COVID-19 transmission. We support them as vital to the national public health and to the threatened health specifically of Black people in the United States."

The letter conceded that mass protests carried the risk of spreading coronavirus, and offered some good—if naive—advice for people who are going out anyway: wear masks, stay home if sick, attempt to maintain six feet of distance from other protesters. Many protesters are wearing masks, but others are not. And while we can blame the police for forcefully corralling people into close quarters, it's a bit rich for public health experts to endorse protesting under conditions that they know are impossible for protesters to meet.

Indeed, for the purposes of offering health care advice, the only thing that should matter to doctors is whether their harm-reduction recommendations are being followed: how big is the event, is it outdoors, are masks being worn, etc. However, the letter distinguishes police violence protesters from "white protesters resisting stay-home orders," as if the virus could distinguish between the two types of events. While I am not a doctor, my understanding is that it cannot.

The letter led a Slate writer to claim that "Public Health Experts Say the Pandemic Is Exactly Why Protests Must Continue." The argument here is that coronavirus is more deadly for black people because of systemic racism and that protesting systemic racism is a sort of medical intervention.

"White supremacy is a lethal public health issue that predates and contributes to COVID-19," the letter continues.

There is much truth to this! Black people in America do have worse health outcomes, but so do low-income people of every race and ethnicity. Is it medically acceptable for a poor person to protest against lockdown-induced economic insecurity? For people who live paycheck to paycheck to protest looming evictions and foreclosures? What about people experiencing loneliness, depression, and bereavement? Again, my understanding is that the virus does not think and thus does not choose to infect us based on what we're protesting.

Many people all over the country were prevented from properly mourning lost loved ones because policymakers and health officials limited public funerals to just 10 people. For months, public health officials urged people to stay inside and avoid gathering in large groups; at their behest, governments closed American businesses, discouraged non-essential travel, and demanded that we resist the basic human instinct to seek out companionship, all because COVID-19 could hurt us even if we were being careful, even if we were going to a funeral rather than a nightclub. All of us were asked to suffer a great deal of second-order misery for the greater good, and many of us complied with these orders because we were told that failing to slow the spread of COVID-19 would be far worse than whatever economic impact we would suffer as a result of bringing life to a complete standstill.

People who failed to follow social distancing orders have faced harsh criticism and even formal sanction for violating these public health guidelines. To take just one extreme example, New York City Mayor Bill de Blasio threatened to use law enforcement to break up a Jewish funeral.

After saying no to so many things, a significant number of public health experts have determined that massive protests of police brutality are an exception to the rules of COVID-19 mitigation. Yes, these protests are outdoors, and yes, these experts have encouraged protesters to wear masks and observe six feet of social distance. But if you watch actual footage of protests—even the ones where cops are behaving badly themselves—you will see crowds that are larger and more densely packed than the public beaches and parks that many mayors and governors have heavily restricted. Every signatory to the letter above may not have called for those restrictions, but they also didn't take to a public forum to declare them relatively safe under certain conditions.

"For many public health experts who have spent weeks advising policymakers and the public on how to reduce their risk of getting or inadvertently spreading the coronavirus, the mass demonstrations have forced a shift in perspective," The New York Times tells us.

But they could have easily kept the same perspective: Going out is dangerous, here's how to best protect yourself. The added well, this cause is important, though, makes the previous guidance look rather suspect. It also makes it seem like the righteousness of the cause is somehow a mitigating factor for spreading the disease.

Examples of this new framing abound. The Times interviewed Tiffany Rodriguez, an epidemiologist "who has rarely left her home since mid-March," but felt compelled to attend a protest in Boston because "police brutality is a public health epidemic." NPR joined in with a headline warning readers not to consider the two crises—racism and coronavirus—separately. Another recent New York Times article began: "They are parallel plagues ravaging America: The coronavirus. And police killings of black men and women."

Police violence, white supremacy, and systemic racism are very serious problems. They produce disparate harms for marginalized communities: politically, economically, and also from a medical standpoint. They exacerbate health inequities. But they are not epidemics in the same way that the coronavirus is an epidemic, and it's an abuse of the English language to pretend otherwise. Police violence is a metaphorical plague. COVID-19 is a literal plague.

These differences matter. You cannot contract racism if someone coughs on you. You cannot unknowingly spread racism to a grandparent or roommate with an underlying health condition, threatening their very lives. Protesting is not a prescription for combatting police violence in the same way that penicillin is a prescription for a bacterial infection. Doctors know what sorts of treatments cure various sicknesses. They don't know what sorts of protests, policy responses, or social phenomena will necessarily produce a less racist society, and they shouldn't leverage their expertise in a manner that suggests they know the answers.

It's clear that we've come to the point where people can no longer be expected to stay at home no matter what. Individuals should feel empowered to make choices about which activities are important enough to incur some exposure to COVID-19 and possibly spreading it to someone else, whether that activity is reopening a business, going back to work, socializing with friends, or joining a protest against police brutality. Health experts can help inform these choices. But they can't declare there's just one activity that's worth the risk.