CommentsNORMALCY? - Even as the U.S. continues to exceed 2,000 deaths a day from COVID-19,
Governors in liberal states—including those from New York, New Jersey, California, and Massachusetts—are lifting mask mandates, joining conservative states that long ago dropped them or even banned them. The mantra that it is time to "live" with the virus is drowning out all voices to the contrary.
In guest commentaries in TIME magazine and the Washington Post, physicians and public health experts hold up ultrawealthy Marin County, California, and tony Hopkinton, Massachusetts, as examples of how to begin ending school and community mask mandates and scaling back school surveillance testing, even during surges of COVID-19. One commentary said it was fine to drop mandates because "everyone now has tools" to protect themselves.
There is an odious common omission to these calls. The call to drop the mask is not generally being made by Black, Latino and Indigenous experts in medicine or public health. The call does not acknowledge or account for vulnerable households in communities devastated by COVID. In the rare situations when they are asked for their opinion on scaling back COVID restrictions, Black epidemiologists and pediatricians are generally far more measured in their response.
For example, Mercedes Carnethon, one of the few Black experts cited in the national press, urged caution in the New York Times when asked about school mask mandates, recognizing the broader community risk involved in removing these measures. She noted that "children who catch the virus at school could also pass it on to more vulnerable adults," and added that winter was the wrong time to ease up on masking in schools, because of increased time spent indoors.
Instead, the calls to get back to "normal" are saturated with White privilege, especially as it intersects with class dynamics. It is much easier for families to consider normalcy when they had much more of an ability throughout the pandemic to keep life as normal as possible. At the outset of the pandemic, white-collar White families had disproportionate privilege to work from home until the arrival of vaccines.
When the vaccines and boosters came, those families had more time to score shots online and more car ownership to get to mass vaccination sites. At some schools, parents' associations were able to privately pay for school surveillance testing before public funding was available. And of course, such households have a baseline of better COVID-19 treatment and fewer comorbidities that might increase risk of poor COVID-19 outcomes.
We cannot humanely entertain the concept of "normal" unless it factors in the continuing and devastating impact COVID-19 is still having in communities of color. As of September 2021, 1 in 1300 white people had died of COVID-19, as compared to 1 in 480 Black people, 1 in 390 Latinos, and 1 in 240 Indigenous people. Black and Indigenous children respectively have been 2.7 and 3.5 times more likely than white children to die from COVID-19.
We cannot use the word "normal" with a straight face until vaccine and booster equity is achieved. We remain far from such equity. Consider the Chicago Public Schools where at the end of 2021, just before teachers briefly went on strike, only 28% of students in predominantly Black high schools were fully vaccinated. In Hopkinton, Massachusetts, and Marin County, California, respectively, 95% and 93% of children five and up are fully vaccinated. Some governments have invested in closing the equity gap. Los Angeles public schools, for example, mandated surveillance testing for all children and vaccination for children 12 and older. Although Los Angeles had to back off of its initial vaccination deadline, the school district still achieved nearly 90% compliance in students 12 and older by the end of 2021.
The push to make masks optional and discontinue surveillance testing is particularly dangerous for vulnerable communities that need all the tools possible to stop community spread. At the outset of the pandemic, communities of color were hit hard, partially because Black, Latino, and Indigenous people are more likely to serve as low-wage essential workers and to live in multigenerational families where the disease more easily got to elders. Two years into the pandemic, because of comorbidities, environmental injustice, and other factors, Black, Latino, and Indigenous people remain more likely to diefrom COVID-19 if infected.
Equity demands that careful relaxation of measures should be considered, if and when communities achieve a sustained period of low case counts and more equitable vaccination rates. We must continue to close these disparities by mandating mitigation strategies to improve equity, with participation of community leaders. What is particularly jarring is that this push for normalcy is overlooking equity at a time of enormous deaths in the current surge, and in the context of the U.S. death toll from COVID-19 (as of February 16) almost continuously exceeding 1000 deaths a day for more than half a year.
One year after our country supposedly experienced a "racial reckoning," the drumbeats for normalcy during a COVID-19 surge indicate a disturbing lack of true solidarity shaped by an epidemiological, racial, and moral blind spot. Instead of unilaterally declaring an end to public health interventions, these commentators should lend their voice to ensuring equitable access to these tools for everyone—so that we can all move forward together, rather than having the privileged leave everyone else behind.
(Ramnath Subbaraman is an infectious diseases physician and an assistant professor at the Tufts University School of Medicine.) (Michelle Holmes is an associate professor of medicine and epidemiology at Harvard University.). (Lakshmi Ganapathi is an infectious diseases physician and an instructor of pediatrics at Harvard Medical School.). This article was published in Common Dreams.
