Opinion | As a Black Doctor, Should I Choose My Skin Color or My Health?

As a black emergency medicine physician, concern about the spread of Covid-19 at protests in the wake of the murder of George Floyd is not top of my mind. And yet many continue to seize on this concern. The risk of spread of Covid-19 is clearly elevated at demonstrations: People are yelling, stirring up respiratory droplets and projecting them into the air; people are marching long distances, exerting themselves and taking gulps of air in the process; people are standing and kneeling much less than six feet from one another; and mask use is, over all, abundant but admittedly inconsistent.

And yet — the tension between Covid-19 and the protests did not even occur to me until a journalist asked. And why not? Because as a black physician, I understand that the protests are the necessary medicine for both ills.

It is well established that the weight of Covid-19 mortality falls disproportionately on black communities. Per the Centers for Disease Control and Prevention, non-Hispanic blacks and African-Americans comprise 18 percent of the population but 23 percent of the Covid-19 deaths. In New York City in particular, this virus has ravaged communities of color because of their underlying health conditions, likelihood of being “essential” workers exposed to many people, and the multigenerational homes they’re more likely to live in.

Black communities suffer these inequities in silence. I learned in medical school that black skin was a risk factor for diabetes and hypertension. I should have learned that record levels of incarceration keep black people out of the job market and thus ineligible for health insurance — just one of the many drivers of health care disparities. That black people are disenfranchised from the health care system is a tale as old as America and an injustice wrought by the federal government that we should have been protesting for decades.

Like Covid-19, the murder of George Floyd is but the most recent manifestation of injustice toward black lives in this country. The ugly history of torture in slavery, lynching, mass incarceration and police violence toward black people is crucial to American history. While the widely seen image of a white police officer killing a black man triggered these protests, there are innumerable black victims before him who all deserved their own nationwide protests. Just as an inequitable health care system deals out higher black mortality rates in the wake of Covid-19, so does an inequitable system of law enforcement wantonly end black lives at the hands of mostly white police officers.

Of course I am concerned about the spread of Covid-19. Of course I do not condone a gathering for a concert or sports game or party, because these are unnecessary. They are not rooting out a core injustice baked into health care and law enforcement.

In contrast, these protests are essential to America. They are necessary for the recognition and eradication of injustice. These protests are the first dose of medicine needed to rid the system of metastatic racism. To ask, “What do you think as a black doctor about Covid-19 and the protests?” is to ask me to choose my skin color or my health.

This is precisely the false choice black Americans make all the time, which we should cease to make today. The answer to both is the same: Enact policies that do not systematically disenfranchise and endanger black people.

Voting is also in jeopardy. As with organized protest, if a spike in Covid-19 is the price we pay to vote, we must do so — albeit with as much mitigation as possible. The life of our democracy depends on it. As with the protests, where simple legislative change could satisfy many demands and avoid the further spread of Covid-19, mail-in voting could alleviate risks. But we need to prepare ourselves for Republicans claiming that “if you could protest and risk Covid-19, then you can vote and risk Covid-19.” We shouldn’t have to risk our lives to vote.

To the protesters, I say wear a mask, try to maintain distance, wash your hands, stay home if you feel sick or have a temperature, do not injure yourselves or others, get tested.

But ultimately, the medicine you are dosing will cure both ills. Do not forget that.

Dr. Steven McDonald is an assistant professor of emergency medicine at Columbia University.

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