Covid-19 coronavirus advice and guidelines haven’t always accounted for differences among the … [+]
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Giving vague general advice is easy. Do what you love. Surround yourself with good people. Find a mentor. YOLO. Don’t stick your tongue into an electric socket.
But offering specific advice that actually fits a person’s particular life context? That’s a lot more difficult to do and thus much less common. And that’s been yet another problem with the response to this ongoing Covid-19 coronavirus pandemic.
After all, our society is not a level playing field. Not everyone has the same situation, resources, and opportunities. As Richard Besser, MD, President and CEO of the Robert Wood Johnson Foundation (RWJF), explained, “A lot of the guidance out there has been disconnected from reality.” He added that, “Not all communities have been hit equally by the pandemic. For example, Blacks, Latinos, and Native Americans have died at rates higher than their representation in the population.” One big reason for these disparities has been advice, guidance, and approaches that haven’t really been appropriately tailored to different communities.
Dr. Richard Besser, while he was Acting director of the Centers for Disease Control and Prevention, … [+]
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Besser knows a little about pandemic preparedness and response. Correction, he knows lots, having worked at the Centers for Disease Control and Prevention (CDC) for 13 years, including running emergency response there for 4 years and serving as acting Director of the whole CDC. “You have to work with different communities so that you understand their needs,” he said. “Equity is recognizing that people have different needs, and then creating the appropriate systems responses.”
Instead, during the Covid-19 coronavirus pandemic, there’s been plenty of vague advice that can be difficult to follow, especially for people of certain socio-demographic groups. Here are 10 examples:
1. Stay at home.
Staying at home and away from others may not be so difficult if you’ve got several vacation homes, your own yacht, your own island, or other luxurious get away spots to spend time social distancing. It’s a completely different story when you’ve got a cramped living space where your only “get away spot” is the toilet and potentially the shower, assuming that someone else is not on the toilet.
The same applies to the neighborhood around you. You may have the luxury of walking outside and only having to deal with trees and possibly rabbits doing unspeakable things in front of you. Alternatively, walking outside may mean having to dodge people left and right, making distancing every day feel like a Mario Brothers Nintendo video game.
2. Isolate yourself when you are infected with the Covid-19 coronavirus.
Similarly, staying isolated is easier if you have no need to interact with others or have others around to help. Things are quite different when you need others to care for you or have to care for others. “Isolation may be high risk for many of the elderly,” Besser explained. “Or the housing situation may make it absolutely impossible for people to self-isolate.” Besser gave an example, “Among indigenous communities, there are high rates of multi-generational households with many different people living together.”
3. Don’t go to work.
Not everyone can work from home. First of all, your job has to allow the possibility. For example, meat packing is not typically something that you can do at home. Secondly, you have to have the means such as a working Internet connection and apartment or house mates willing to leave you alone.
Even when both of these are in place, your employer may still want you at the workplace. The phrase “come to work or you’re bleeping fired,” can be a pretty powerful motivator, even if the word bleeping is not included. Many people, especially essential workers, have to go to work to maintain an income. The words “stimulus check” and “well-oiled machine” haven’t exactly gone together, unless by well-oiled you mean a can of sardines. Significant delays in delivering the checks, which typically aren’t even enough to cover most expenses, has left not working not an option for many.
4. It is OK to go back to work.
Re-opening of businesses has presented many with a terrible choice. As Besser related, “Many people, especially those who live who live pay check to pay check are being forced to choose income versus safety.” What if your workplace isn’t maintaining proper precautions or isn’t offering you the resources to stay safe?
5. Home school your kids while schools are closed.
School closings may not affect you as much if you don’t have kids or don’t acknowledge that those toilet paper-using little people are actually your kids. However, if you do have kids and take responsibility for them, you may be feeling a bit overwhelmed. Schools can provide not only education but also regular meals, emotional and social support, and other services. What if you don’t have the time or the resources to offer all of these?
6. Call your doctor or other health care professional.
This advice can sound like, “call nobody” or “call Thor.” What if you don’t have a regular doctor or the means to pay for one? Besser mentioned that before the start of the pandemic around, “28 million people didn’t have health insurance,” which probably meant that most of them didn’t really have a doctor to call.
“Countries that have done better during this pandemic have a much larger safety net,” Besser added. “Everyone in those countries has access to health care. People are provided with safe and secure places.”
Even if you do have health insurance and a doctor, what if you don’t really know or trust your current doctor? You could have been assigned a doctor through some kind of clinic, hospital, or insurance roulette wheel. Or the always promising algorithm of this doctor doesn’t have enough patients and therefore can be your doctor.
7. Postpone non-essential health care visits.
OK. Maybe that health care problem doesn’t need attention today. How about next week or next month? At some point, non-urgent health issues could become urgent if neglected long enough.
8. Don’t take public transit.
Typically taking public transit is a good thing. It can be convenient, better for the environment, and encourage good things like mixing among people and physical activity. However, some have suggested not taking public transit during the pandemic as a social distancing measure. One problem with that advice. As Besser asked, “If you are telling people to not use public transit, what are you telling people who don’t have cars?” This also assumes that people have parking available at the workplaces.
9. Get tested for Covid-19.
Simply stating the number of tests that have been done can be like stating the total number of Gucci bags that have been sold. Just because a test is available, doesn’t mean that it is available to everyone, convenient and affordable. Additionally, Besser pointed out that many testing stations are drive-through locations that may be readily accessible for those who don’t have cars. This is not just because carrying a steering wheel in your hand while walking through such stations could look ridiculous. What if you can’t even reach the testing location?
10. Avoid mass gatherings.
There’s a difference between holding a political rally and protesting years of systemic discrimination that are affecting the pandemic as well. “The protests have been calling out structural racism, which affects health as well,” Besser explained. Since the Covid-19 coronavirus may be spreading among and affecting persons of color to a greater degree, a proper response to the pandemic should include addressing differences in what persons of color have to face. Until political leaders fully acknowledge that structural racism exists and establish concrete steps to change the systems that perpetuate them, people may have to rely on protests. “The protests have been critically important,” added Besser. “Mass gatherings can lead to spread of the coronavirus but there are things you can do to reduce risk such as using alcohol sanitizer and keeping at least six feet apart from each other.”
Again public health advice and available services and resources need to be appropriately tailored to different communities. “You’ve got to reach out networks in different communities and engage them in real conversation on how to do public health and meet their needs,” said Besser. “Until you go in with openness you won’t be meeting their needs.”
Besser emphasized that “Data is needed for situational awareness.” He added that you have to also break the data down as much as possible by different socio-demographic and other characteristics, “If you are not breaking the data down, you can miss significant differences in terms of impact and for prevention. The data collection has to be conducted at the state and local levels, but this has to roll all the way up to the Federal government. But this really hasn’t been done.”
One thing that is clear in a pandemic is we are all dependent on each other to protect our health. There are things that we can do individually, but then everyone within society is at increased risk. With a pandemic, the economic consequences are profound. It’s impacted everyone and impacted low income Americans the hardest. One of the reasons has been the inability for everyone to take steps to minimize transmission. We are all in this together.”