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Hey, Code Switch Family Cherine here. By now you've seen the statistics about covid-19 deaths and how they break down by race. In the nearly four years of doing this podcast, we've brought you countless stories that point to the health and wealth inequities in this country. So if you're a regular code switch listener, these statistics probably didn't surprise you. But if you're anything like me, they made you really upset and incredibly frustrated on this bonus episode. Mary Harris, host of Slate's Daily News podcast What's Next?

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Talks with Akela Johnson from ProPublica about race and covid-19. And a warning. There's some foul language in this episode. All right, here's Mary. For a reporter, uncovering the face of the coronavirus feels a little like watching film develop in a dark room. First, we learned the elderly were at risk, but children seemed to be safer than it seemed like men were getting sicker than women.

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The question that that that I think is driving me as a reporter and I think that is largely driving a lot of us is how do we get closer to the ground.

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The stories from people in power tend to be easier to access.

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They have a bigger megaphone.

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They have a bigger megaphone. They're on social media. They have access to more, you know, not just medical care, but then the ability to get the story out.

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Some cities begin breaking down their infection rate by zip code to show who is more at risk and then they begin breaking down the coronavirus caseload by race.

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New statistics from the governor's office showed that the majority of covid-19 deaths in Louisiana have involved African-American patients. And high blood pressure is the number one underlying. That's right.

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The health commissioner says that a large number of those cases are on Milwaukee's northwest side in predominantly African-American neighborhoods.

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It is breathtaking. When I first saw these numbers, I had a hard time thinking about anything else because I knew that this was going to land like a bomb and that one of the arguments that you hear and has made is that we're all being affected by this, right?

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That covid-19 is it doesn't discriminate.

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You know, you've got everybody from Fort Thompson in the UK who is severely affected by this to bus drivers and transportation workers in the US who are affected by it.

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However, the difference is not everybody is affected the same. Right. The size of suffering varies depending upon who you are and your circumstances and life.

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And so, as with so much, when it comes to race and poverty, particularly in the U.S., they're very uncomfortable conversations to have.

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But this uncomfortable conversation, we are about to have it, like it or not, so today on the show, Akela is going to lay out what we know and what we don't know about the coronavirus and race and why public health experts are saying we can't afford to take a race neutral approach in this pandemic. Let's talk about what we know, because I feel like in the last few days, we just keep getting more information that's pointing in the same direction.

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Like Louisiana, 70 percent of covid-19 deaths are black patients or Chicago. Sixty one of the eighty six recorded deaths. Again, 70 percent were black residents. I know that you took a really close look at Milwaukee. Why did you want to go there?

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Milwaukee was interesting because they were so transparent with the data about who was dying and why they were dying. So it's not just the fact that they were releasing race and ethnic demographics, but then they were also listing various comorbidities. And so what does that mean? That means if people also had diabetes, hypertension, chronic heart disease, lung disease. So they were listing those factors in addition to age and race and ethnicity. So it was very much like a case study and a window into at least a municipality that was trying to be very clear eyed about what was happening and the way that they were approaching it when there are so few who were doing at the time.

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So it was just a window into that.

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What were the numbers they were finding in Milwaukee?

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So, you know, in Milwaukee, they were finding early on. At first, everybody who died in Milwaukee was black, all of all of the initial deaths up. And Phil, I want to say they had 10, like all the first 10 deaths were all black eye. And then after that, it became disproportionate numbers, which is concerning when I believe the city of Milwaukee is thirty eight percent black in the county is twenty six percent black. And all of your deaths and a disproportionate number of your infection rates are of African-Americans.

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And as the number of cases, not just of infections, but also of deaths have grown, that disparity has also continued. Not everybody who has died in Milwaukee now is African-American. However, the disproportionate number of deaths are.

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Milwaukee's coronavirus outbreak followed the same pattern as other cities. At first, testing was really limited, mostly reserved for people who had traveled internationally or were showing symptoms.

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Achilles's that made the city's health commissioner, Janet Kovalik, really nervous.

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She's watching what's happening in New York. She's watching what's happening in California. And as a public health official, she's thinking to herself, it's only a matter of time before this happens in Milwaukee. But I am not in a position to test, to see if people in my community have it, if it's already here because of these testing limitations and restrictions. So why was she so concerned about the possibility of there already being community spread in Milwaukee or the possibility and potential of it?

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She said it's a very commuter heavy city. You've got people who are coming in and out, and we were traveling down daily from Chicago who were coming in from suburban areas to work and Milwaukee. And that's actually how the first case entered the city. The first case in the area from was a neighboring affluent, predominantly white suburb.

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And someone had contact with that person in the suburbs, someone who lived in Milwaukee and came home and then tested positive for Kovik by the fourth case. This is all happening kind of in rapid succession. She determined it was community spread because the cases weren't entering Milwaukee from international travel. And then to reiterate, within the span of a week, it went from one case to 40.

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Having a lot of commuters was one factor. But there was something else that made black residents in Milwaukee and elsewhere especially vulnerable, persistent rumors they couldn't get sick.

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You know, in the beginning, there were a lot of kind of bogus conspiracy theories that were floating around that African-Americans and black folks were somehow immune to covid-19 PolitiFact because of this.

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There have been several stories debunking this, but it was definitely something that was populating on social media.

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And that is a concern that I heard repeated from everybody, from city councilors and rural communities in South Carolina to the public health commissioner and Milwaukee, to infectious diseases doctors in Washington, D.C.. You know, Idris Elba did a whole video debunking that claim because it was definitely out there at the beginning.

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My people, black people. Black people, please, please, please understand the corona virus is you can get it all right, there are so many stupid, ridiculous conspiracy cancer conspiracy theories about black people not being able to get it. That's dumb. Stupid. All right. That is the quickest way to get more black people killed.

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And these kinds of conspiracy theories, they're dangerous and confusing, but they aren't the whole story. There are layers upon layers of history making it harder for black communities to defend themselves against this virus. Achilles's in Milwaukee, that looks like access to quality care, even housing. You talked about how the health commissioner herself and talk to you about how her parents had trouble finding a place to buy a home. And home ownership is quite low in black communities. But then what that means, as you said, is that.

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Black individuals might be living in a situation where they are running up against other people just by default.

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Well, absolutely. So Health Commissioner, quality care story with me.

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So she is biracial. Her mother is African-American, her father's Polish.

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And she shared a story that growing up in Milwaukee, when her parents went to go buy a home, her father had to go to the bank without her mother in order to secure the loan. So again, because he was white, because he's white and her mother was black. So, again, the not too distant past, you know, this is very much kind of recent history and so home ownership in Milwaukee. And in the black community, the numbers were vast.

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It was something like seven percent of the black community owns a home compared to over 80 percent of the white community owns their home.

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And so that speaks to generational wealth, but that also speaks to your autonomy to control your environment and have more control over your environment.

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So not only can you shelter in place, but you can determine how long you can be there, how many people are going to be there with you. But it also speaks to your ability and some ways to not just control your environment, but it speaks to your income level and income status to be able to make sure there's food in that house and the water is running and there are cleaning supplies in it. And it is very layered and multidimensional. And so I think sometimes it can be kind of confusing to what's the significance of owning a home.

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But home ownership has been very much the bedrock of the gateway to the American middle class and financial stability and generational wealth in this country.

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And here is a community that largely through no fault of its own, that it's not a possibility.

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Hmm. And I imagine you could go right down the line like look at car ownership rates and whether you're reliant on traveling with other people on a subway or a bus and health insurance rates, like whether you feel comfortable walking into a medical facility in Milwaukee, I mean, there's even some evidence that pollution might make people more vulnerable to infection. And of course, there's years and years of reporting showing that communities of color are more likely to live in places that are more polluted.

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Yes. Historic redlining and residential segregation.

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And so you can't go down the line and you can go down the line in Milwaukee and you could go down the line in a variety of name and American city almost.

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And you'll see very similar gaps in wealth and homeownership, access to insurance, access to medical care, access to clean air.

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I mean, it affects the air you breathe and it being, you know, our country's history of discriminatory policies when it comes to economics, housing, health care, education, it creates the types of conditions and in breeding ground that result in just very kind of unequal impact when it in managing pandemics.

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I want to spend a little bit of time talking about something else, which is who is considered an essential worker. I keep thinking back to that video that the bus driver made in Detroit. Did you see it?

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I know what you were talking about.

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I haven't been able to bring myself to watch the video. Yeah, it's a it's a bus driver. He's black. And he was driving the bus and someone started coughing on his bus and wasn't covering her mouth. And he just kind of lets loose on her Facebook live saying, you can't do this.

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I'm an essential worker. I have to be here. Please don't put me at risk.

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This is real. I'm out here. We are here. We move in the city around back and forth, trying to do our jobs and be professional about what we do. Again, I blame me. Nobody, nobody. Not not the city. Not the mayor. Not the department. Not the state of Michigan. Not the government. Nobody. Not the president. I blame Nadworny, who stood on this fucking bus and call it hell for its people like her who don't take shit for real.

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Why this shit is still existing and still spread.

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And then he passed away from covid-19. Do we have any good information about the racial breakdown of essential workers? Not that I have seen, to be honest, I don't know if anybody is collecting statistics along those lines, but I can say if you look historically at who holds the positions that are now being deemed essential workers, and I think traditionally we think of essential workers as law enforcement, firefighters, which they are. But this pandemic has has widened the aperture of that lens to include folks in the food chain supply.

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So your grocery store workers and MTA workers and transportation workers, it includes a lot of a variety of government workers, the post office and post office workers. Traditionally, these roles and these jobs have been the pathway for African-Americans into the middle class.

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If you look at specific industries and there are large numbers of African-Americans and brown and black folks who hold those positions, exposure risk is higher for a pandemic because these are people who can't work from home.

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To understand how this virus is disproportionately affecting people around the country, there's got to be data about these essential workers, about everyone who's getting sick as they collect information about coronavirus tests. The CDC is collecting information about race and ethnicity, too. They just haven't been releasing it. Some say this data is incomplete, so it isn't reliable, but other public health officials, they disagree. They say even some information is better than nothing. One of the more powerful arguments I saw for releasing this data just right away was a policy wonk person who basically said we learned this with Hurricane Katrina and with the financial crisis, that if we don't understand who's most impacted, we're not going to put in place the policies that help the people who need it.

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And I just thought, oh, of course. And I hadn't thought to compare this particular crisis in this way, like with the racial breakdown to the financial crisis or Katrina. But it made perfect sense when I heard someone else do it all.

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And that's the argument that you're hearing from public health officials. That's what they're saying in terms of and they're looking for much through a public health lens. Right.

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But what have we learned from history and why are we not applying those lessons to our current crisis? Why make these things an afterthought is a question that's being raised. There is an increasing national push and there is an increasing a lot.

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You know, an alarm is being sounded from federal lawmakers, national civil rights organizations, physicians on the ground to release this data and not just to release it for the sake of releasing it, but to release it so that resources can be deployed adequately and in places where they are most needed and various mitigation strategies can begin in earnest.

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Interesting. I just I keep thinking about the delicacy of this data and how it needs to be handled with such care, because in the wrong hands, it could be used in such a toxic way where people could say, oh, this is a disease of certain people or certain people are sick.

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And it makes me feel really divided, I guess, because of the world that we live in right now.

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Well, that is not an unrealistic concern. So one of the things that. I I can just speak that I was very conscious of and remain conscious of, and I believe my colleagues at ProPublica are conscious of as we continue to report on this issue, is making sure that we're not unnecessarily or unduly and unfairly rationalizing a disease, if that makes any sense.

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Right. Because covid-19 as an entity, there is no race that that is not like this is something that only black people get, are more black people get, period. There are myriad of circumstances that are creating circumstances where African-Americans, early data showing are disproportionately impacted who are more likely to have, you know, more significant health outcomes because of a variety of a disproportionate number of chronic health conditions.

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But I do share the concern of too easy or too quick of a causation and a link. But I think if you and I think what we are beginning to see as more and more people are beginning to tell the story and as different municipalities are beginning to share this information, that it is necessary information and it is needed information and that these conversations are never easy, but they are necessary and they are nuanced.

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Yeah, it's just I was just looking at an interview that a senator gave on the radio this morning, and he did exactly what I feared. This is Senator Bill Cassidy, a Republican who looked at the same information we are and apparently said that there was some kind of physiological difference that was causing black patients to die with more frequency from covid-19.

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Now, as a physician, I would say we need to address the obesity epidemic, which disproportionately affects African-Americans. But all in all, Americans, we need to address it. That would lower the prevalence of the diabetes, of hypertension, of the ace receptors, etc. And that would bring benefit.

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Well, I mean, as we heard in that report, I mean, some underlying health conditions and disparities are part of the issue here. But I mean, we heard Congressman Cedric Richmond say as well that this is rooted in years of systemic racism. Aren't there other forces at work here?

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Well, you know, that's rhetoric and it may be. But as a physician, I'm looking at science.

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You're saying that's just rhetoric. I mean, there are more. It's a very similar debate that you hear sometimes when when you hear people talk about, oh, personal responsibility, personal choice. And take, for instance, the issue of African-Americans being disproportionately affected by diabetes. And the conversation can quite often distill to these very general well, just control your diet, go exercise more.

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It's a matter of personal responsibility. If you stopped eating these things, if you stop doing these things, your health would improve. And because those folks are not doing that, then they clearly like they don't care.

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There's a lack of personal responsibility without really getting to some of the systemic failures. Well, how am I going to buy healthy food if I can't afford it? Where am I going to buy fresh produce?

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If I live in a food desert, how am I going to manage and maintain my chronic health condition if there are barriers to health care? I mean, just physically getting to a physician in terms of there may not be a hospital nearby, you may live in a health care desert, there's always another question. I know why, but that takes time and that takes nuance. And it is not neat, neatly wrapped up in quick sound bites and discussions.

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And so sometimes, too, oftentimes conversations stop at the surface level and that surface level. And the quickest thing for people to wrap their minds around are this concept of like, well, therefore it is a personal choice.

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Akeelah Johnson, thank you so much for joining me. Thank you. It was my pleasure. Akeelah Johnson is a narrative health care reporter at ProPublica. And that's the show we want to thank you for calling us and leaving messages about how you're getting through this really weird period. Here's a call that we really loved. Hey, my name is Charles, I'm a paramedic on the East Coast, so I'm not going be more specific than that because the hip but I run 911 as well as take patients to the hospital discharges.

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Yesterday, we were discharging the 90 year old female, taking her back to the nursing home. And miraculously, the patient's daughter was able to catch us in the 20 feet from the back of my ambulance to the front doors of the nursing home. The daughter hadn't been able to see her mom for weeks in the hospital. She wasn't going to be able to see her in the nursing home, the patients on the fifth floor. So she wasn't going to be able to see her through a window in her room for the daughter able to catch up.

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And she was able to say hello to her mom, let her know that she's still thinking about, hasn't forgotten about. And one of the hardest parts of this pandemic is the fact that normally I know what to do. If you get shot, I can plug the hole, get you to the bright lights and cold steel like I know to do. But with this pandemic, it's like we just kind of sit. Wait. So to have the small victory where I was able to just hang out with a patient for a few minutes, let the daughter in, the patient talk to the daughter, I mean, she kept about 12 feet away, really, but just had a small victory meant so much to me in this time of year where we don't know what's going to happen next.

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Thank you. Our number is two zero two eight eight eight two five eight eight. Your voicemail could inform our reporting or get played on the show. So give us a ring. What Next is produced by Mary Wilson, Jason de Leon, Danielle Hewitt and Mara Silvers. Thanks for listening. I'm Mary Harris.