Inside the PPE Underworld; Spotting Racism in Medicine

  • As the U.S. continues to break records for coronavirus cases and deaths, hospitals are once again facing PPE shortages. Doug Bock Clark explores the dark underworld of the PPE supply chain and the federal government’s inadequate response ~ Inside the Chaotic, Cutthroat Gray Market for N95 Masks (The New York Times)
  • “Each tube, about the size of a pinkie finger, contains a few precious droplets of frozen coronavirus vaccine,” which can provide one shot of protection to five people, writes Carolyn Y. Johnson, of the delicate and time sensitive process of getting a vaccine to patients ~ A vial, a vaccine and hopes for slowing a pandemic — how a shot comes to be (The Washington Post)
  • Emily A. Wang, MD, MAS, and colleagues discuss the ways in which U.S. prisons and COVID are “deeply entangled,” creating a perfect breeding ground to spread the virus ~ A Report From the National Academy of Sciences, Engineering, and Medicine ~ COVID-19, Decarceration, and the Role of Clinicians, Health Systems, and Payers (JAMA)
  • Growing up, Betial Asmerom watched doctors treat her family with disrespect but it wasn’t until she took a course on health disparities that she realized how often communities of color had similar experiences. Elizabeth Lawrence explores the fundamental changes medical school curricula must undergo to address health disparities and racism in medicine ~ What Doctors Aren’t Always Taught: How to Spot Racism in Health Care (Kaiser Health News)
  • When Kevin M. Simon, MD, fields questions from parents, colleagues and friends about how to talk about racial tensions, he combines evidence with the lived experiences of black men. As a black man and a physician, Simon has found “caring for Black boys and their families is one of the most rewarding and emotionally challenging endeavors I face” ~ Them and Me — The Care and Treatment of Black Boys in America (New England Journal of Medicine)
  • Arif H. Kamal, MD, MBA, MHS, and colleagues discuss the essential role palliative care can play when patients and their families face life-threatening conditions ~ The Role of Palliative Care During the COVID-19 Pandemic (Mayo Clinic Proceedings)
  • “With mounting death tolls, increasing case burdens, and public confusion, we face an enormous task,” write Moncef Slaoui, PhD, and colleagues, regarding the need to develop effective therapeutics against COVID while the nation waits for safe and effective vaccines ~ Bridging the Gap at Warp Speed — Delivering Options for Preventing and Treating Covid-19 (New England Journal of Medicine)

Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what’s going on in the world of primary care medicine. Pelzman’s Picks is a compilation of links to blogs, articles, tweets, journal studies, opinion pieces, and news briefs related to primary care that caught his eye.

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The long shadow of racism in medicine leaves Black Americans wary of a COVID-19 vaccine




a close up of a sign


© Yahoo News



As the coronavirus pandemic has progressed, and the need for a vaccine has become more urgent and apparent, the number of Americans who say they would take such a vaccine keeps falling. In particular, Black Americans — who have been among those hit hardest by the pandemic — are resistant to the idea. A new Yahoo News/YouGov poll found that only 27 percent of Black Americans and 46 percent of white Americans plan to get a coronavirus vaccine if and when one becomes available.  

The perceived politicization of the vaccine process and unprecedented pace of Operation Warp Speed has led to doubts nationwide. Until very recently, President Trump was predicting that a vaccine could arrive ahead of Election Day, Nov. 3, contradicting members of his own coronavirus task force, who have repeatedly given less optimistic time frames that have turned out to be more realistic. 

But whether a vaccine is ready next month or next year, many Americans may not trust it, even after it is approved by the Food and Drug Administration. A Kaiser Family Foundation survey published in September found that 62 percent of Americans worry that political pressure from the Trump administration will lead the FDA to rush to approve a coronavirus vaccine without making sure it’s safe and effective. Whether that will change if a new administration is in office after Jan. 20 remains to be seen.

Dr. Peter Marks, director of the Center for Biologics Evaluation and Research at the FDA and self-proclaimed “FDA point person on COVID-19 vaccines,” wrote an op-ed Tuesday in USA Today attempting to alleviate those concerns.

“We hope to ensure public confidence in COVID-19 vaccines by being transparent about FDA’s decision-making process,” he wrote. “Whether a vaccine is made available through an EUA [emergency use authorization] or through a traditional approval, FDA will ensure that it is safe and effective.

“Trust means everything.”

Trust, experts say, is crucial to Americans’ willingness to accept a COVID-19 vaccine. But for many Black Americans, that trust will be difficult to earn after a long history of exploitation and abuse by the health care system has led them to be wary of the U.S. medical establishment. 



Bill Clinton wearing a suit and tie: Herman Shaw speaks during ceremonies at the White House on May 16, 1997, in which President Bill Clinton apologized to the survivors and families of the victims of the Tuskegee Syphilis Study. (Paul J. Richards/AFP via Getty Images)


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Herman Shaw speaks during ceremonies at the White House on May 16, 1997, in which President Bill Clinton apologized to the survivors and families of the victims of the Tuskegee Syphilis Study. (Paul J. Richards/AFP via Getty Images)

The Tuskegee Syphilis Study is the most famous example. Sponsored by the U.S. Public Health Service, the project enrolled uneducated Black men in the South without informing them of the purpose of the experiment, which was to study the natural progression of the disease. Participants went untreated for years after an effective cure had been discovered. A 1972 Associated Press story on the experiments, observing that “human beings with syphilis” had been “induced to serve as guinea pigs,” caused public outcry and finally brought the study to an end after 40

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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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How Modern Medicine Has Been Fueled by Racism

There’s a dark side to medicine that involves the literal use of Black people.

Medical advances save lives and improve quality of life, but many of them have come at a high cost. There’s a dark side to medical advances — one that includes the literal use of Black people.

This dark history has reduced Black people to test subjects: bodies void of humanity.

Not only has racism fueled many modern medical advances, it continues to play a role in preventing Black people from seeking and receiving appropriate medical attention.

J. Marion Sims, credited for the invention of the vaginal speculum and repair of vesico-vaginal fistula, is referred to as the “father of gynecology.”

Starting in 1845, Sims experimented on Black women who were enslaved, performing surgical techniques without the use of anesthesia.

The women, considered the property of enslavers, were not permitted to give consent. Further, it was believed that Black people did not feel pain, and this myth continues to restrict Black people’s access to proper medical treatment.

The names of the Black women we know of who endured torturous experimentation at the hands of Sims are Lucy, Anarcha, and Betsey. They were taken to Sims by enslavers who were focused on increasing their production yields.

This included the reproduction of enslaved people.

Anarcha was 17 years old and had gone through a difficult 3-day labor and stillbirth. After 30 surgeries with nothing but opium to ease her pain, Sims perfected his gynecological technique.

Anarcha Speaks: A History in Poems,” a poetry collection by Denver poet Dominique Christina, speaks from the perspectives of both Anarcha and Sims.

An etymologist, Christina was researching the origin of “anarchy” and came across Anarcha’s name with an asterisk.

Upon further research, Christina found that Anarcha was used in terrible experiments to aid in Sims’ scientific discoveries. While statues honor his legacy, Anarcha is a footnote.

“No Magic, No How” — Dominique Christina

right there

right there

when Massa-Doctor look

right past the

way i hurt

to say

she a tough ole gal,

can take a mighty lickin’

Healthline

The Tuskegee Study of Untreated Syphilis in the Negro Male, commonly referred to as The Tuskegee Syphilis Study, is a fairly well-known experiment conducted by the United States Public Health Service over a 40-year period starting in 1932.

It involved about 600 Black men from Alabama who were between ages 25 and 60 and experiencing poverty.

The study included 400 Black men with untreated syphilis and around 200 who didn’t have the disease to act as a control group.

They were all told they were being treated for “bad blood” for 6 months. The study involved X-rays, blood tests, and painful spinal taps.

When participation waned, the researchers started providing transportation and hot meals, exploiting the participants’ lack of resources.

In 1947, penicillin was shown to be effective in the treatment of syphilis, but it wasn’t administered to the men in the study. Instead, researchers were studying the progression of syphilis, allowing

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