Jan 21, 2021
In Episode 2 of Series 6 Attorney Dominique Day, founder and
Executive Director of the Daylight Collective which
seeks to fill the space between the status quo and substantive
justice with creativity, diverse voices, and multi-sector
approaches and understandings talks to Todd about how COVID is
negatively and unequally impacting the lives and human rights of
Black Americans of African descent.
00.00 – 02.20
Todd begins by asking Dominique to comment on the
dis-proportionate impact of the Covid19 pandemic on people of
African descent. She points to significant racial disparities in
terms of:
- Who becomes infected
- Who has access to health care
- Differences in outcomes in terms of severe illness and
death
This is seen as an outcome of policies, which exemplify systemic
racism at a global and local level.
02.20 – 05.30
Todd asks Dominique which factors she sees as playing a key role
in the impact of the Covid19 pandemic.
- Whilst racism is not intentional she sees it as being ingrained
into the presumptions and actions of individual decision
makers
- In emergency departments this translates to medical bias when
doctors are working under stress
- As evidence she points to research
which suggests that medical bias disadvantages people of African
descent (and which she discusses in a related webinar)
- Although the data is widely known her concern is that the issue
of systemic racism is embedded in decision making even at the level
of the individual clinician
05.30 – 12.40
Todd summarises and points out that the reality is that people
of African descent in the USA have a markedly higher mortality
rate, which is linked to a long history of systemic racism.
- Dominque points to “social conditioning” in deciding which
lives matter. By way of example she points to the decision to
withhold the distribution of the Pfizer vaccine on the African
continent and argues that it suggests that this is a decision made
along the lines of race
- In terms of the impact of the pandemic, there are parallels
within the fields of education, the economy and health where
individuals make decisions on the basis of a bias which reflects
systemic racism within society
- She references an
email circulated within NYU hospital in New York where the onus
to make rapid life and death decisions was placed on doctors
working in the emergency department, without supervision and
review. Given the intense stress doctors were under, those
decisions were more likely to be influenced by bias (unwitting or
not)
- Health care providers showed no willingness to discuss the
research data,
-
- predicting the disproportionate impact on black and brown
communities
- identifying systemic racial bias
- individual doctors were prevented from commenting publicly
- Warnings of racial bias were ignored and continue to be
ignored
12.40 – 20.50
Todd moves on to examine differences of outcomes for black and
white communities in relation to encounters with the police and
references
the killing of Michael Brown in Ferguson a suburb of St Louis
in the US in 2014.
- The Ferguson killing follows a common pattern of outcomes for
the black community
- A parallel is suggested with respect to the security
preparations made for the Black Lives Matter protests in 2020 in
Washington
- Comparisons have been made between this protest and the
insurrection staged by pro- Trump militants. Todd argues that any
move to suggest the two events were similar creates a false
equivalence
Dominique points out that:
- In terms of policing there was a higher level of perceived
threat and a heavier response during the Black Lives Matter
protests than for the recent march on the Capitol in
Washington
- Dominique argues that the former was a racialised response
conditioned by acceptance of white supremacy and a long history (in
the USA) rooted in slavery and exploitation.
- She references the origins of racial policing in the USA as
being to protect property from the actions of slaves.
- She identifies a “legacy mindset”, a baseline of white
supremacy, where white people expect to be treated differently
(better) than black people, a mindset which is a major barrier to
progressing racial justice and equality.
20.50 – 23.45
The conversation returns to the pandemic and vaccination
programs in the USA. Dominique has a number of concerns.
- Distribution is a major issue
- More thought needs to be given in terms of prioritising who
gets the vaccine first. The role of essential workers, drivers,
home helpers who have been disproportionately infected needs to be
acknowledged when prioritising vaccination programs.
- There is also a need to talk about racial equity in the
delivery of vaccination programs
23.45 – 26.00
Todd asks why significant numbers of African Americans are
resistant to taking the vaccine.
- In Dominique’s view there is a distrust in black communities
which in part dates back to the infamous
Tuskegee experiment, where black people were exploited in the
name of medical science
- In order to increase the uptake of the vaccine in black
communities their must first be an understanding that there is a
legitimated scepticism based on historical fact
26.00 - end
Todd ends by asking Dominique what she is hoping to see from the
new government administration in terms of the issues she has
discussed in this episode. In terms of the response to the Covid19
pandemic, she would like to see a critical re-evaluation of
responses to the pandemic, and in particular the role of systemic
racism and its impact on African American communities.
Useful links
- Racial Bias in the
time of Covid19, the Time is Now A webinar hosted by Dominique
Day
- Millions of
black people affected by racial bias in healthcare
alogorithms Heidi Ledford in Nature
October 2019
-
NYU Langone tells doctors, “Think more critically” about who gets
ventilators Shalini Ramachandran and Joe Palazollo in Wall
Street Journal 31/03/ 2020
-
40 years of Human Experimentation in America: The Tuskegee
Study Ada McVean, McGill University, January 2019
Additional references
Assessing differential impacts of COVID-19 on black
communities; Gregorio Millet et al, Annals of Epidemiology,
July 2020
Implicit Bias in ED overcrowding, is there a connection? Loner
and Rotolli i EM Resident October 2018
The
effect of race and sex on recommendations for cardiac
catheterization Schulman Berlin et al, New England Journal of
Medicine February 1999
Implicit
racial/ethnic bias among health care professionals and its
influence on health-care
outcomes: a systematic review Chapman et al, Journal of
Public Medicine December 201