As the novel coronavirus disease 2019 (COVID-19) pandemic sweeps across the world, troubling associations between race and disease have gone viral.
On social media, theories of black people’s immunity to COVID-19 spread rapidly and widely, with the initially small number of cases in Africa often cited as evidence. Since then, the virus has spread to the continent and will surely exacerbate already compromised health systems.
The virus was also erroneously labelled as the “Kung Fu Flu” and the “China Virus,” among other epithets, by members of the Trump administration—including the President himself. While these labels may have the air of jest, white supremacists have sought to use the novel coronavirus for bioterrorism, targeting racial minorities.
Claims of immunity falsely suggest that black people cannot contract the disease. Meanwhile, labels that construct the disease as Chinese obscure the vital pathways the contagion has taken irrespective of racial categories. These claims are more than just racist and xenophobic—they are dangerous to everyone’s health.
It is times like these, amid existential fear and anxiety, when we must be most attuned to the ways in which race is deployed, to the historical origins from which these ideas emerge, and to how these ideas undergird social fear and political inaction.
Race has no biological basis. Rather, it is historically, politically, culturally, and affectively produced not only by systems and structures, but by moments. The embedded effects of oppression, marginalization, and racism have very real biological consequences. We must consistently ask ourselves: What does the racialization of disease reveal and what does it occlude? What meanings do we attach to a condition and create in these processes of racialization? How do these meanings impact people’s day-to-day lives?
COVID-19 is an infectious disease caused by the novel coronavirus, SARS-CoV-2. The disease causes respiratory illness with symptoms such as cough, fever, and in more severe cases, difficulty breathing. This virus disproportionately impacts the elderly and people with certain preexisting conditions. We know that 50 to 129 million non-elderly Americans have such conditions. This figure increases substantially when you consider individuals over the age of 55. Black, brown, and Indigenous communities bear a disparate burden of these conditions. We know that COVID-19 will disproportionately impact communities of color. The racialized experience of COVID-19 will be further exacerbated at the intersections of class, gender, and age.
Assertions of black immunity to COVID-19 represent the persistent afterlife of slavery and the pervasive power of white supremacist thought. As historian Rana Hogarth argues, these theories emerged in the era of enslavement, as the system itself made such observations of racial difference possible in the Atlantic world. According to Hogarth, “Slavery apologists would, of course, eventually use this claim to suggest that Black people’s peculiarities were a sign of their fitness for servitude.”
While a pandemic of this size and scope is unprecedented in our generation, the world bore witness to major outbreaks of the past. Black immunity theories emerged, perhaps most prominently, in Philadelphia in the late eighteenth century in the face of successive Yellow Fever outbreaks.
Prominent Declaration of Independence signatory and abolitionist, Dr. Benjamin Rush, ardently believed that African Americans were immune to the disease as a result of their purportedly acclimatized bodies. In Philadelphia, Rush worked with African Methodist Episcopal ministers Absalom Jones and Richard Allen to recruit the city’s free black community to care for dying white citizens. When African Americans themselves succumbed to disease, their suffering was ultimately erased, unexplained by immunity.
Even today medical students are taught to quickly associate disease with racial and ethnic identity. Sickle Cell Anemia is associated with African Americans, Cystic Fibrosis with European descendants, and Tay-Sachs disease with Ashkenazi Jews. While these shorthand associations facilitate consultation speed and efficiency, they are dangerous and sometimes fatal.
A classic case of the consequences of associating race and disease has been shared widely by legal scholar and critical race theorist, Dorothy Roberts. Roberts recounts a Pediatrics journal article on the misuses of racialized diagnosis when a young Black girl repeatedly returned to the emergency room for pneumonia or respiratory concerns over a six year period. At a subsequent ER visit, the 8-year-old’s x-rays were examined by a radiologist, who exclaimed, “Who’s the kid with cystic fibrosis?” Her medical records illuminate a narrative of racialized assumptions that rendered her invisible to the myriad clinicians who treated her over the years.
Diseases without clear etiologies—like ALS, which has been dubbed a “white” disease—often accrue false, racialized narratives as well. Scholars have discovered that Western medicine’s beliefs that particular races cannot contract certain disease does not just impact patient diagnosis or misdiagnosis but impacts the entire care system.
While some scientists and physicians rely heavily on associations between race and disease, less attention is devoted to serious analysis of the social determinants of health, i.e. the structural forces that often lead to disparate disease burden in racial minorities. A preliminary paper by a group of epidemiologists in Wuhan, China drew on myths about minority immunity based on blood type, claiming, “#COVID19 deaths likely higher in Europe but less so in Asia/India (more B) or Latin Americans (more O).” Yet, who was the first person to die of COVID-19 in Brazil? A Black female domestic worker. The first person to die of COVID-19 in St. Louis County was an older Black woman who worked as a nurse.
Those who are the most invisible, most marginalized, and who lead the most precarious lives will be the ones most affected by COVID-19. They certainly are not always the first individuals diagnosed, but they are usually the first to die.
COVID-19 spread globally for two chief reasons: a particularly high R0, the “reproduction number” indicating how contagious an infectious disease is, and individuals who had access to resources which allowed them to travel. Thus, in locations like St. Louis, the first case of COVID-19 emerged in a white-majority county suburb—a white student was infected in Italy before returning to St. Louis. Early on, it was easy to joke that the virus was a “white disease.” And then a black woman succumbed first.
When we consider the afterlife of slavery, ongoing medical racism, global histories of medical mutilation and experimentation, and black invisibility within white supremacist medical systems—asking why black people would joke about our own susceptibility is warranted. Theories of black immunity sound like the perfect reward for generations of racialized violence, amid a dystopian global nightmare. The reality is, regardless of diagnosis, we are particularly susceptible and arguably among the most vulnerable.
In an effort to find control in chaos, racialized claims like black immunity ultimately represent a scrambling for power and a desire to make sense of uncertainty. We deploy these ideas which ultimately play into our own oppression and the oppression of others, however. Although the history of race and the cultural innovations created in response to oppression, do give communities of color resilience in the time of great anxiety, racialized rhetoric about diseases can be dangerous for your health. This language is as dangerous when black people co-opt it.
COVID-19 has no demonstrated biological association with any racial or ethnic group–viruses do not discriminate. In fact, the virus has the ability to infect us all, and will inevitably indirectly touch each and every human life in the world. Its most severe impact will be on those who are most socially vulnerable—the incarcerated, the unemployed, the unhoused, the uninsured—groups in which black and brown individuals are disproportionally represented.
Racializing disease on those grounds alone has no impact other than to promulgate dangerous assumptions. Seemingly banal claims of “black immunity” may bring some semblance of humorous communal bonding, but they are not funny.
Chelsey Carter is a doctoral candidate in Anthropology and Master’s in Public Health candidate at Washington University in St. Louis.
Ezelle Sanford III is a postdoctoral Fellow in the Program on Race, Science, and Society and project manager for the "Penn Medicine and the Afterlives of Slavery Project" in the Center for Africana Studies at The University of Pennsylvania.
Edited for length and reprinted with permission from with the African-American Intellectual History Society’s award-winning blog, Black Perspectives, https://www.aaihs.org/racializeddiseaseandpandemic/.