‘A pandemic within a pandemic’: COVID-19, protests shine a spotlight on inequity

There is a clear picture of injustice, Virginia health and policy leaders say. “We are certainly in this storm together, but we are not in the same boats.”


Amid worldwide protests over systemic racism, a Richmond-area congresswoman, Virginia’s chief diversity, equity and inclusion officer, and the director of the Virginia Commonwealth University Massey Cancer Center hosted a virtual town hall Wednesday to discuss the disproportionate ways that minority communities have been affected by the novel coronavirus.

“Before the protests started and rallies and marches across Virginia and across the country, we were witnessing discussions about equity and justice as it related to who was in our hospitals and who was in our morgues,” said U.S. Rep. Abigail Spanberger. “COVID-19, according to the data, is infecting and killing black Americans at disproportionate rates when compared to other ethnic groups. In Virginia, in particular, African Americans are 23% of the deaths to COVID-19 but represent 13.6% of our population.” 

Spanberger’s office hosted the virtual event. She was joined by Janice Underwood, Ph.D., Virginia’s chief diversity officer, and Robert Winn, M.D., director of Massey Cancer Center. Their discussion centered on the pandemic’s disproportionate impacts on minority communities in central Virginia and across the country.

Underwood said the virus is affecting black communities from a morbidity standpoint but also Hispanic communities, as that group has the highest positive testing rate for the virus in Virginia. To address inequities in its COVID-19 response, the state created the Commonwealth of Virginia COVID-19 Equity Leadership Task Force. The task force is the first of its kind for Virginia and has been a model for similar groups across the country, Underwood said. 

“We know that we are in a pandemic and some of us are in a pandemic within a pandemic,” Underwood said. “And that has never been more clear to me and the administration and the governor in particular. We are certainly in this storm together, but we are not in the same boats.”

The pandemic and the protests in the wake of George Floyd’s death on May 25 are not entirely separate issues, Spanberger, Underwood and Winn said. The three penned a joint op-ed in Tuesday’s Richmond Times-Dispatch titled “America tests positive for our collective disease,” in which they argued that the country has been “in the grips of a disease that has plagued us for more than 400 years.” This disease, they wrote, is structural racism. It is both “insidious and blatant” and can be identified “by inequities of housing, education and employment.”

“Other symptoms include unfair policing, food insecurity and a lack of access to quality health care,” they wrote. “The most toxic of its symptoms, however, is the dehumanization of other human beings, which — like a defective immune system — induces the body to attack itself.”

The solution, they wrote, is treating the root causes, which will be more challenging than creating a vaccine for COVID-19 and require the collective will of the American people.

Winn, during the town hall, said that many of the conversations about the pandemic and the protests seem to center around the idea that these issues are new. But the same issues of poor education, poor housing and structural violence were discussed during the 1918 Spanish flu pandemic. These factors contributed to worse health outcomes for certain populations 100 years ago, the same as they are doing today.

“This pandemic and the protests have brought together an intersectionality of thoughts for me,” Winn said. “I am thinking about where we are going. The truth is in 2020 I remain the only African American cancer center director in the country. We have made some progress, but we certainly have progress to make.” 

However, he is optimistic about confronting the pandemic. When the outbreak started, medical professionals had no idea how to treat patients. Now, clinical trials of several drugs are underway as well as for a vaccine. Winn believes a resurgence of the virus will occur in the fall and winter but will be less severe than what happened in the spring.

“What has kept this virus from getting worse is just individual people,” Winn said. “Individual people being able to do social distancing. Being able to be respectful by wearing masks.”

The panelists said anyone who has joined a protest should be tested for the virus. The federal government has provided funding for free testing.

During the town hall, the panelists were also joined by U.S. Rep. Lauren Underwood, a Democrat from Illinois and no relation to Virginia’s Underwood. She said the pandemic is a unique opportunity to confront the systematic challenges in this country and discuss complex issues that exist within the U.S. and its health care system. 

“COVID-19 is a once-in-a-generation crisis that will change our world forever but it’s also a once-in-a-generation opportunity to catapult us into stronger health systems for everyone,” Lauren Underwood said. 

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