America’s history of racism was a preexisting condition for COVID-19

A Louisiana pastor prays as his parishioners die, first from cancer and now from COVID-19. An Indigenous community in New Mexico lacks adequate health care as the death toll mounts. A sick hospital worker in New Jersey frets about infecting others in her heavily populated neighborhood.



a group of people standing in front of a mirror posing for the camera: Parishioners stand in Our Lady of Grace Catholic Church in Reserve, LA, during a sermon by Rev. Fr. Christopher Chike Amadi.


© Jasper Colt, USA TODAY
Parishioners stand in Our Lady of Grace Catholic Church in Reserve, LA, during a sermon by Rev. Fr. Christopher Chike Amadi.

As the country cries out for a vaccine and a return to normal, lost in the policy debates is the reality that COVID-19 kills far more people of color than white Americans. This isn’t a matter of coincidence, poor choices or bad luck — it’s by design. 

A team of USA TODAY reporters explored how the policies of the past and present have made Black, Asian, Hispanic and Indigenous Americans prime targets for COVID-19. They found:

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  • America’s education and economic systems are still unequal, disproportionately leaving people of color out of higher-wage jobs. When COVID-19 struck, more people of color were serving as essential workers directly in the path of the virus.

Put simply, America’s history of racism was itself a preexisting condition.

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Of the 10 U.S. counties with the highest death rates from COVID-19, seven have populations where people of color make up the majority, according to data compiled by USA TODAY. Of the top 50 counties with the highest death rates, 31 are populated mostly by people of color. 

“COVID-19 has brought out into the open, with painful clarity, these divisions in our society that have been there for a long time but, for one reason or another, people were able to overlook them,” said Philip Landrigan, director of the Global Public Health Program at Boston College.

With nearly 1,000 people a day dying from the virus and scientists scrambling to grasp exactly how the virus spreads and kills, federal and state data has not provided enough demographic detail to show the full impact on communities of color. The race and ethnicity of people who contract the virus is known in 52% of cases, according to the Centers for Disease Control and Prevention. 

But study after study has shown clear patterns in whom the virus kills.

How systemic racism led to COVID-19’s rapid spread among people of color

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Black people are more than twice as likely to die from the virus than white people, and Hispanics and Native Americans are 1.5 times more likely to die, according to The COVID Tracking Project. 

“You can’t change the fact that America is so segregated and that people of color tend to live in communities where the environmental conditions are worse, and that can increase your risk of heart disease or lung disease and diabetes,” said Richard Besser, former acting director of the CDC and president and CEO of the Robert Wood Johnson Foundation, the nation’s largest

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Obamacare’s Illusion of Preexisting Condition Protections

President Trump’s recent executive order laying out his “America-First Healthcare Plan” makes clear his continued commitment to the long-standing, bipartisan consensus that we should protect people with preexisting conditions. Unfortunately, the previous administration’s attempt to make good on that consensus — Obamacare — has failed to deliver on its promises.

Contrary to the prevailing media narrative, federal health insurance enrollment protections for preexisting conditions long predate Obamacare. Bipartisan legislation passed nearly 25 years ago protects people with preexisting conditions and prior health coverage from having to wait for their condition to be covered when they move to a new job. These protections apply to the 180 million Americans with job-based coverage, who represent roughly 90 percent of everyone with private health coverage.

Obamacare attempted to deliver additional protections for people with preexisting conditions in need of health-insurance coverage. The reality is, however, the law’s prohibitive costs placed coverage outside the reach of everyday Americans, including countless with preexisting conditions.

After premiums doubled and even tripled in some states once Obamacare regulations took effect, individual-market coverage became unaffordable and unusable for millions of middle-class and self-employed Americans earning too much to qualify for subsidies. A 60-year-old couple living in Hannibal, Missouri, who earn $70,000 a year faces a $37,000 annual premium for the lowest-cost silver plan — over half their income — and that’s before a staggering $12,000 deductible. For them, there are no protections if they have a preexisting condition. Sadly, Obamacare has failed to protect them.

It’s time the national debate over Obamacare finally confronts this reality. One can support maintaining formal preexisting protections in the individual market — as President Trump has done repeatedly, and has done again in his recent executive order — while honestly confronting the law’s poor track record in making those protections meaningful for real people.

The data bear this out. From 2016 to 2018, 2.5 million unsubsidized enrollees left the individual market. Census data in turn show that the number of uninsured with incomes greater than 400 percent of the federal poverty line — the cutoff point to qualify for federal tax credits — increased by 1.1 million in 2018.

In short, Obamacare created a new class of uninsured — none of whom, of course, have the slightest protection against their preexisting conditions.

The pandemic has underscored just how unaffordable and unattractive Obamacare remains to most Americans. Over the last six months, millions have lost their jobs and with them their health-care coverage. Each and every one of these individuals who held job-based coverage is eligible for enrollment, and many states opened enrollment to anyone who is uninsured. Still, relatively few have opted for Obamacare thus far.

Americans were promised Obamacare would protect them against discrimination on the basis of preexisting conditions. But when the price of unsubsidized coverage would bankrupt the average middle-class family, the promise of protection rings hollow.

By contrast, no one has done more to protect real people with real preexisting conditions than President Trump. He

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Colorado resident, 20, with ‘mild’ coronavirus case later develops rare condition: officials

A 20-year-old Colorado resident who battled the novel coronavirus later developed a rare but serious condition known as multisystem inflammatory syndrome (MIS-C), according to local health officials in the state. 

The resident, of Boulder County, suffered only mild symptoms of COVID-19 and “appeared to have fully recovered,” said county officials in a news release. But three weeks later, the resident fell ill once more — this time with “severe abdominal pain, watery diarrhea, and fever,” all of which are signs of MIS-C. 

Earlier this month, the Centers for Disease Control and Prevention (CDC) identified the condition among adults, drawing on reports of 27 adult patients to describe a new, similar condition known as multisystem inflammatory syndrome in adults (MIS-A). (iStock)

Earlier this month, the Centers for Disease Control and Prevention (CDC) identified the condition among adults, drawing on reports of 27 adult patients to describe a new, similar condition known as multisystem inflammatory syndrome in adults (MIS-A). (iStock)

Since the pandemic began, there have been various reports of multisystem inflammatory syndrome, but most cases have occurred in children, which is known as MIS-C.

The syndrome is an inflammatory condition that is similar to Kawasaki disease, which causes swelling in arteries throughout the body. Many children with MIS-C — which causes inflammation in the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs —  have either been infected with the novel coronavirus or had been exposed to someone with a COVID-19 infection, health officials have sad. MIS-C can also cause persistent fever, rashes, vomiting and diarrhea, among other symptoms such as a red tongue and eyes.

LOUISIANA CHILD’S POSSIBLE CORONAVIRUS-LINKED MIS-C DEATH THE FIRST IN STATE

However, earlier this month, the Centers for Disease Control and Prevention (CDC) identified the condition among adults, drawing on reports of 27 adult patients to describe a new, similar condition known as multisystem inflammatory syndrome in adults (MIS-A).

“Findings indicate that adult patients of all ages with current or previous SARS-CoV-2 infection can develop a hyperinflammatory syndrome resembling MIS-C,” the authors wrote at the time, adding that measures to limit COVID-19 spread may help prevent MIS-A.

SERIOUS CORONAVIRUS-RELATED INFLAMMATORY CONDITION AMONG CHILDREN NOW REPORTED IN ADULTS: CDC

The Colorado patient required hospitalization and intensive care before they improved and were eventually discharged from the hospital. However, “while most young adults experience mild symptoms from COVID-19,” officials warned, “this case is an example of how the disease can progress and how little is known about the long-term impacts of the illness.”

RARE CORONAVIRUS-LINKED SYNDROME AFFECTS 11 CHILDREN IN WASHINGTON STATE: OFFICIALS

“I hope sharing the information about this patient’s experience will help others to better understand how serious COVID-19 can be, even for young people,” said Dr. Heather Pujet, an infectious disease doctor at Boulder Community Health, in a statement. “The patient became extremely ill very quickly with multi-organ system involvement; they fortunately recovered after a period of severe illness. However, this should serve as a warning for the younger people in the community to please not disregard their own personal risks with COVID-19.”

“Much remains unknown about how this condition develops, but it’s related to the body’s attempts to fight an invader,” added Dr. Sam Dominguez, a pediatric infectious disease specialist at Children’s

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