Dr. Anthony Fauci hopes that the effort for equitable health care does not end when the coronavirus outbreak ends.
In a conversation with WTOP’s J.J. Green for the podcast “Colors,” the top U.S. infectious disease expert and member of the White House Coronavirus Task Force said the pandemic shined a “very bright light on the fact that we have to do something about these disparities.”
Fauci, the director of the National Institute of Allergy and Infectious Diseases, said African Americans as a demographic group are at a higher risk of actually acquiring infection, and once infected, are more likely to have a severe outcome.
“I call it almost a double whammy, a double disadvantage,” Fauci said.
In addition to not having the easy capability of physically separating because of the jobs they may hold, African Americans have a higher prevalence and incidence of comorbidities.
These diseases that may also be present include diabetes, hypertension, heart disease, lung disease and kidney disease. “The kinds of things that we have in society that are disproportionately and disparately more among African Americans,” Fauci said.
And this happens not just with COVID-19, but with every disease, such as HIV. These social determinants have been ingrained for decades, he said.
Fauci said that there’s “cautious optimism” about a moderately effective COVID-19 vaccine progressing into a trial phase by the end of 2020 or 2021.
However, according to a CNN report, researchers have not recruited sufficient numbers of minorities to join the trials.
Although it won’t necessarily impact the development of a vaccine, Fauci said it would be a gap in understanding.
“When you develop a vaccine, you want to show that it is safe and effective in all elements of society. If we don’t get African Americans and Latinx and Asian Americans and Native Americans, if we don’t get them properly represented in the proportion of those that are in the trial, we will not know for sure — although you can assume it, but you want to prove it — that it is safe and effective in that group,” Fauci said.
He said it is essential to reach out and engage at the community level to minority groups and be transparent about the vaccine.
“So that when the vaccine is shown to be a safe and effective vaccine, you can look the minority community in the eye and say, ‘Hey, we’ve already proven, in a large, really good trial, that this is safe and effective for you,'” Fauci said.
He also said that it’s even more critical for minorities to participate because they are at a higher risk of a severe consequence if they are infected.
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The coordinator of Operation Warp Speed, the government’s effort to develop a coronavirus vaccine, told CNN that several factors explain the challenges of recruiting Black study subjects. These include “historical abuse of Black people in medical experiments like Tuskegee; present racial injustices and health care disparities; and recent social unrest and the financial strain placed on the Black community,” CNN reported.
Until a vaccine is available, Fauci recommends that African Americans protect themselves and vulnerable members of their family — if residing in multi-generational homes — and community to the extent possible, particularly the elderly and those with underlying conditions.
“Abide by the public health issues that we talk about,” he said.
Fauci also said that the minority population should demand testing capability with results that come back quickly.
“So when you get into a group, a location that’s demographically weighed toward minority populations, to make sure they have accessibility to the testing, to the health care,” he said.
Fauci said he hopes the effort toward health equity does not end when the pandemic is over.
“If there’s anything that shines a light on our inadequacies in that, it’s what COVID is doing right now,” Fauci said. “Please let this be a lesson learned. That when we get over this, we don’t lose corporate memory about the importance of being prepared, really well-prepared. But also the corporate memory of what actually happened disproportionately to certain demographic groups. We cannot let that happen again.”
Public health issues and politics
Fauci said it’s a reflection of the intense divisiveness in society where people have essentially put public health issues into a divisive politically charged situation, which he said is “really unfortunate.”
He said that there are those who interpret talking about public health issues as being against the economy or against having people employed, which is not the case.
“We should be using public health measures as a vehicle, a pathway, to opening the country and opening the economy and getting the jobs back,” Fauci said, adding that some people feel that public health officials, such as himself, are harming the public instead of trying to help.
Some people have expressed extreme views in the form of threats against Fauci and his family
“I have never seen this level of divisiveness … hostility … which should not be the case because we are trying to keep people healthy at the same time as we preserve the economy,” Fauci said.
One of the issues that manifest this division is how people will cast their votes: by mail or in person.
“Both of those things can be operational,” Fauci said.
Fauci said that if done safely — as in abiding social distancing guidelines, wearing masks (both voters and polling personnel), avoiding crowds — it can be done in person.
However, for those individuals who feel that they don’t want to take that risk, voting should also be available by mail, he said.
“Mail voting. As well as those who feel if they keep their masks on, they keep their physical distance, and everyone in the polling station wears a mask, uses hand sanitizers, it should be safe person-to-person,” Fauci said. “But there are many people who just can’t do that or they don’t want to do that. And they should be able to vote by mail.”
WTOP’s J.J. Green contributed to this report.