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Over the past week, we’ve seen editors and reporters, looking for a new angle on the pandemic, start to suggest—with the help of some experts—that protests risk fueling a resurgence of Covid-19 around the United States. Are these gatherings, large and small, something we should be worrying about? Anywhere people assemble in close proximity for extended periods presents some risk of viral transmission, so these protests are certainly not risk-free, even if they are outdoors, where the risk from SARS-COV-2 is far less than in indoor environments. But as Howard Markel, a historian of science and medicine at the University of Michigan, reminds us, outdoor events can carry great epidemiological significance. The Liberty Loan parades in Philadelphia and Detroit likely helped to spread influenza in 1918. In most cases, bringing thousands of people together for several hours in cities and towns across the country as we have seen over the past week wouldn’t be advisable. But this is not “most cases.”
First, what most if not all of the articles linking protests to the pandemic fail to mention are the major events and situations that present a far greater ongoing risk of amplifying SARS-COV-2 transmission in the United States. Foremost among these are the decisions by many governors to reopen their states without their seeing case numbers in decline or having sufficient testing in place. Reopening in the context of uncontrolled local outbreaks presents opportunities day after day for the virus to spread. In addition, we already know that prisons and jails, ICE detention facilities, meatpacking plants, and Amazon warehouses are sites for super-spreader events; these all remain settings with a high risk of transmission of SARS-COV-2. Instead of being invoked to put the protests in context, these larger drivers of infection have just been erased from the discussion. There is a distinct “out with the old, in with the new” flavor to this focus on the protests across the country against police violence—it’s as if the media has become bored with the sustained catastrophe of our national response to Covid-19 and needs something fresh to highlight.
Another fact absent from many of these stories is that police violence is itself a public health issue. In 2019, there were only 27 days when police didn’t kill someone in the United States. Beyond police violence, homicide and suicide among young African Americans, particularly young men, are off the charts. Furthermore, each year in this country, there are between 75,000 and 100,000 excess premature deaths for African Americans compared with their white counterparts. As scientists who have studied the issue have said, “Race-based differences in health and longevity remain large and race remains a predominant social factor in American life.” In other words, racism and white supremacy kill.
The Astroturf protests to “liberate” states that we saw several weeks ago, with lots of guns and no masks, didn’t attract nearly as much focus on the threat to public health from either the actions of those assembled or the policies they advocated. In fact, many of those rallies were explicitly about defying public health advice and denying the seriousness of the pandemic, with participants carelessly endangering those who were protesting with and near them and advocating the immediate lifting of disease control efforts. Of course, the anger and frustration about the economic impact of Covid-19 and disruptions to people’s lives was both real and understandable. But the protesters’ response was grounded in the president’s own antipathy to protecting the public health. In contrast, the recent protests against police violence, despite the risks of transmission of SARSARS-COV-2 involved, can be thought of as pro–public health in some ways: ending police violence and confronting racism require political action, as these excess causalities are more than anything else deaths by public policy and require a public response.
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What is also different about these marches are the ways that protesters are trying to take care of themselves and others. Look at the photos. Many are wearing masks and telling police to put them on as well. No one has to remind many of these protesters about the risk of Covid-19: The epidemic is killing African Americans and Latinos at far greater rates than others in the United States. Harm reduction guidelines—from epidemiologists and even the New York City Department of Health and Mental Hygiene—are circulating for how to more safely protest in an epidemic: by wearing masks and goggles or other eye protection; hanging out with a small group of friends rather than moving in and out of the crowd alone; using drums or noisemakers rather than shouting, which spreads droplets that could carry SARS-COV-2; trying to maintain separation between yourself and others if possible; using hand sanitizer regularly,; and staying hydrated. In addition, these informal guidelines urge people who feel sick to stay home, and suggest that those who do protest consider self-isolation afterwards, and seek SARS-COV-2 testing.
But the recommendations for harm reduction go further here too by addressing the dangers that police are adding to the protests. Rubber bullets, which have been commonly used over the past week to disperse crowds, can maim, blind, or kill—thus recommendations to “wear thick clothing, like denim or even leather, that doesn’t leave much skin exposed,” “layer clothes, wear protective pads made for athletes,” “wear goggles made with ‘ballistic grade glassware.’” Tear gas, which has been banned in warfare since 1925, and which can cause asthma-like conditions and other kinds of chemical lung injury, has been used frequently by police and other law enforcement on American citizens over the past few days as well. Some guidelines recommend heat-resistant gloves—in addition to extra protective eyewear and clothing—to throw tear gas canisters away from the crowds, or, using a technique perfected by protesters in Hong Kong, to otherwise minimize the effects of tear gas by covering canisters with traffic cones and dousing them with water through the narrow opening on top. But the best way to reduce harm from tear gas is to leave the area, flush your eyes well with cold water, and when you can, get out of your clothes and shower with cool water.
What is going on right now is that communities are confronting what epidemiologists call “competing risks,” where someone is exposed to more than one mutually exclusive hazard, the prospect of death from different causes. Covid-19 is a pandemic ravaging communities of color, but the virus of racism in America has been with us since 1619. We can and must fight both. Egging on further violence, escalating to military-style crowd control, by the president of the United States has made things worse. Donald Trump is a public health menace—in more ways than one. Covid-19. Police violence. Using rubber bullets and tear gas against Americans. He’s fueled all three. He’s a versatile, triple threat.