Before COVID-19 hit, odds were already stacked against the people living in St. John the Baptist Parish in Louisiana. Its population of 43,000 is 58% African American, many of whom are low income, and all of whom live along a toxic stretch of communities along the Mississippi River known as “Cancer Alley.” The area is heavily dotted with fossil fuel and petrochemical facilities, with ExxonMobil, Koch Industries and Shell operating 150 of these sites alone. It is also home to several nuclear sites, including Waterford 3 Steam Electric Station, Monsanto’s Luling plant, and Dow Chemical Co’s St. Charles Operations facility.
Already dealing with years of weakened immune systems from the heavy pollution, St. John’s residents were at high risk when the coronavirus pandemic hit. In early April, the parish (equivalent to a county) had the highest death rate per capita for the coronavirus in the country. A report published by Tulane University found that across Louisiana, “higher per capita COVID-19 death rates at the parish level were associated with increased pollution burdens and with larger percentages of African Americans in the population.”
“The pandemic literally ravaged the little town I grew up in,” said Michelle Thomas, who is black. Her mother, Canedia Thomas, was diagnosed with COVID-19 on April 9 at St. Charles Parish Hospital in Luling, Louisiana. “I think the pandemic hit so fast that nobody had a chance to think about it, with most people having been exposed to toxicity all their lives and not having the best health care,” Michelle said. “Many people probably had conditions they didn’t even know about until they contracted COVID-19 and it made things even worse for them.”
What happened to her community and family is not only an example of the heavy toll the coronavirus is taking on African Americans, it also illuminates some of the factors that have put the black community most at risk when facing COVID-19: poor health conditions brought on by environmental racism, lack of access to good health care, and biased treatment — all of which may be contributing factors to the high number of deaths.
Thomas, who now lives in Los Angeles, says staff members at the Luling Living Center, where her mother is a resident patient, notified her when her mother had stopped eating and showed signs of lethargy. Canedia, 76, was transferred to St. Charles Parish Hospital, where she tested negative twice for COVID-19 before testing positive the third time within 48 hours.
“They were basically ushering her to the funeral home,” she said. “They were saying things like, ‘Your mom is a senior, not in the best of health, so we’re going to get you on the phone with palliative care.’”
Michelle did not accept this. Her mother was diagnosed with dementia at the age of 67, the same time several other family members in the area were diagnosed with the disease. “A lot of people in the community have suffered from the toxicity and I’m pretty sure it had something to do with it,” she said. Other than dementia, Canedia did not suffer from any other diseases. “I’ve nicknamed her ‘la cucaracha’ because she’s so resilient. She’s a fighter. I told those doctors that I expect them to give her the same chance they would give to a 21-year-old. I told him it’s not for him to decide to let this ravage her body.”
Michelle stayed in constant contact with Canedia’s doctors and nurses, calling several times a day and demanding details of her mother’s treatment and progress. She was told her mother was being given hydroxychloroquine, a controversial drug used to treat malaria. President Donald Trump has endorsed the drug for treating COVID-19, despite little scientific evidence to back its efficacy.
“We are not using hydroxychloroquine on patients on a routine basis with COVID-19,” said Fatima Cody Stanford, a doctor at Massachusetts General Hospital and Harvard Medical School, who is not involved with Canedia’s care.
“All of the current clinical studies suggest that this is not an ideal choice. I think she was likely in a vulnerable situation with a physician who was willing to try any potential intervention.”
After 10 days in the hospital, Michelle’s mother broke her fever and was released back to the living center where she was placed in a COVID-19 unit and given antibiotics. She tested negative for the virus on Memorial Day.
In addition to her mother, Michelle said five other members of her family who live in St. John were diagnosed with the virus. “My uncle died from COVID-19, and his wife passed away from it shortly after him,” she said. “If you have a loved one with the virus you have to fight. If you don’t, they will fall to the bottom of priority.”
Other African Americans are familiar with having to advocate for quality health care for themselves and loved ones.
“I can say even as a physician who has four degrees, working on my fifth, that when I’m often in the health care setting and people are unaware of what my stature is — whatever that means — that I’m treated like a second-class or third-class citizen.”
Fatima Cody Stanford, a doctor at Massachusetts General Hospital and Harvard Medical School, from Race and Coronavirus podcast. (see below)
David Carlisle, president and CEO of Charles R. Drew University of Medicine and Science in South Los Angeles, who was also on the podcast, agreed: “There’s a lot of implicit racism in medicine.” He said he went to medical school so he could provide care for his community.
Carlisle and Stanford cataloged how racism — and the stress that goes along with being subjected to it — and socioeconomic issues manifest themselves in common health problems among African Americans: asthma, chronic obstructive pulmonary disease (COPD), obesity, heart disease, kidney disease.
Those are some of the underlying conditions that contribute to why in 32 states and Washington, D.C., African Americans are dying at disproportionate rates, according to an NPR analysis of data from the COVID Racial Data Tracker.
For example, when it comes to getting healthy food, “in the middle of Watts, Willowbrook (in Los Angeles), you can’t call your four-star sushi restaurant and have them deliver your dinner every day to your house,” Carlisle said. “You can’t even find a grocery store to go to.”
The problems of inadequate health care, pollution, food deserts, lack of affordable housing, wage gaps and more may seem even more hopeless during a pandemic and a time of mass unemployment that’s hitting brown and black people harder. The most recent available jobless numbers that include racial breakdowns are from April: African American unemployment was 16.7%, while unemployment among white people was 14.2%.
“George Floyd … is a casualty of the coronavirus pandemic,” Carlisle said. “He is a man who lost his job because the restaurant he worked at closed because of coronavirus. And one thing led to another and he lost his life, as a product of the very society that we’re talking about.” Floyd was killed during his arrest by four Minnesota police officers on Memorial Day, sparking days of widespread protests against his killing and a continuing pattern of police brutality, which have left this nation reeling and have added to concerns about a second wave of coronavirus infections.
The doctors say it’s important to talk about these issues, collect data and take the next steps, especially as shelter-in-place restrictions are loosened and businesses start to reopen.
“The measurement of disparities is critical to eliminating disparities,” Carlisle said. “You can’t find a fever if you don’t take a temperature.”
Stanford and her parents know plenty of people who have died of COVID-19. “We have real stories,” she said. “These are not things we just see on TV.” She added that beyond collecting data, it must be analyzed and there must be action on health disparities, their underlying causes and racism.
“Have we done anything with that to really lead to any significant change in our communities with black and brown folk?” she asked. “If we don’t act now, then when?”
Podcast
In this week’s podcast, we discuss African American health and coronavirus, plus bias and racism, with doctors Fatima Cody Stanford of Massachusetts General Hospital and Harvard Medical School, and David Carlisle, president and CEO of Charles R. Drew University of Medicine and Science in South Los Angeles.