As COVID-19, colloquially known as the “coronavirus,” spreads around the world, people are starting to use words like “epidemic” and “pandemic” to describe it.
While the risk to otherwise healthy people is limited, the virus presents a very real danger to those who have a compromised immune system such as seniors. In response, many countries are imposing quarantines, lockdowns or travel restrictions to prevent the spread of infection. Santa Clara County just imposed a moratorium on large events. However, slowing transmission among the general population is not the only issue.
Another critical issue that has been missing from the conversation is how to protect vulnerable communities. The media has already recognized the impact on seniors and those with compromised immune systems, but as San José Spotlight columnist Ray Bramson pointed out, another group that will be disproportionately impacted is the poor and homeless population. We should also not forget communities of color and LGBTQ communities.
The most significant factor that leaves these communities vulnerable is that they are more likely to experience difficulties accessing health care services. The trans community, in particular, not only lacks access to health care, but also has difficulty finding providers with the required training or knowledge to provide it. This lack of access leads to disparate outcomes in health and longevity for marginalized groups. One particularly relevant example is that LGBTQ Americans are almost twice as likely to have a compromised immune system, which could make them especially susceptible to COVID-19 infection.
Vulnerable communities are also more likely to be ignored or forgotten in the run up to and aftermath of a public panic. The history of the HIV epidemic offers a good example of how this happens. In June 1981, the first public reports begin to emerge about a strange “pneumonia,” which would eventually be designated Human Immunodeficiency Virus (HIV). Infection rates first rose sharply among vulnerable communities, such as gay men, hemophiliacs and injection drug users. As long as the infections were limited to “undesirables,” the government response was dismissive.
It was not until the general public began to panic that the issue was taken seriously. By 1987, two-thirds of the public believed HIV/AIDs was the most pressing public health threat faced by the country. Around the same time, the U.S. government finally opened an HIV/AIDs funding program, and the first drugs designed to treat the virus were rolled out. Ten years later, however, the public had moved on with just 29% of Americans saying it was the most urgent health issue. Significant decreases in domestic funding soon followed, even as foreign aid rose during the George W. Bush administration.
HIV/AIDs didn’t disappear, however. While the general public turned to other issues, HIV/AIDs continued ravaging communities of color. Despite new funding under the Obama administration, Black Americans account for 44% of new infections, and half of all black men under the age of 30 say they are “very concerned” about infection. Among whites, just 11% are “very concerned” about infection today. To be sure, 80% of the American public still considers HIV/AIDs a public health concern, but only one-third believes it is serious, and just 7% say that disease, including HIV/AIDs, is the greatest threat we face. So long as HIV/AIDs is primarily limited to LGBTQ and Black communities, the general public seems content to ignore it.
Vulnerable communities are not always ignored during an epidemic, but when they do get attention, it’s not always the good kind. During the HIV/AIDs panic of the 1980s, gay people became “the new untouchables” as an “HIV hysteria” gripped the nation. Fifty percent of Americans wanted to quarantine infected people, and a horrifying 15% of Americans even supported branding or tattooing HIV-positive people.
Asian-American communities are now experiencing similar treatment with spread of COVID-19. When COVID-19 jumped from China to the U.S., the media almost immediately began reporting an increase in acts of discrimination and violence toward people of Asian descent. Sadly, certain government officials are not helping the situation by mislabeling COVID-19 as the “Chinese coronavirus.”
As COVID-19 continues to spread, it is vitally important that we not repeat the mistakes of the past. It is great to see Santa Clara County and local cities providing regular updates and working to lower transmission rates.
But where is the plan for our at-risk communities? What are we doing to protect those who lack access to health care and health insurance? How are we supporting Black and brown communities that are also high risk for infection? How do we maintain this momentum when the (healthy) general public loses interest? How are we preventing and responding to panic-motivated discrimination? These questions still need answers.
Michael Vargas is a business and securities lawyer and a part-time professor at Santa Clara University Law School. Vargas also chairs the American Bar Association’s committee on Business Law Education and serves on the executive board of the Santa Clara County Democratic Party, and on the boards of BAYMEC and the Rainbow Chamber of Commerce.