In his first public remarks after taking leadership of the region’s newly announced COVID-19 pandemic task force, Dr. Alex Garza said that a surge is coming in the next two weeks. Then the surge began. On Tuesday, April 7, St. Louis County reported the most COVID-19 deaths (10) and the most new cases (188) in one day in the county or in any other jurisdiction in the region since the onset of the pandemic.
Public officials have been reporting very little information relative to these cases, citing patient confidentiality. However, when St. Louis County and city began to provide maps for incidence of COVID-19 by Zip codes, it became obvious that the racial disparities typical of the region are true of the pandemic as well. The largest raw number of cases (reported by the city) and largest proportion of cases per capita (more helpfully reported by the county) tend to be concentrated in the north of the region, which also, under St. Louis’ de facto apartheid, has the largest concentration of black residents. This was consistent with data from other regions. In Chicago, for example, black people represent just 30 percent of the population but 72 percent of deaths from COVID-19.
Dr. Will Ross and community advocates Kayla Reed and Brittany Farrell foresaw this crisis in these pages last week and called for immediate action. Dr. Ross’ call for testing sites in North City was answered almost immediately, though that was only at the end of the second week that Mayor Krewson’s Stay at Home order had been in place. Reed and Farrell also called for more testing sites and more aggressive outreach in black communities, while framing the problem more broadly. “The pending catastrophe that black communities face,” they wrote, “is due to the failure of decision makers to act and intervene in a growing gap in health disparities that has existed for decades.”
We are reminded of the landmark 2013 report “For the Sake of All,” reported by a team of black researchers at Washington University and St. Louis University led by Jason Q. Purnell – who has been tabbed by St. Louis County Executive Sam Page to consult on racial equity in pandemic response. (Page, himself a medical professional, has shown the most proactive crisis leadership in the region.) We previously have called “For the Sake of All” the canary in the coal mine of the Ferguson unrest that followed a year in its wake. Even more obviously, it was the canary in the COVID-19 coal mine. The “growing gap in health disparities” that Reed and Farrell mentioned was documented definitely in that report seven years ago.
“Differences in social and economic factors by race play a significant role in explaining the differences in health,” Purnell and his colleagues introduced their report in 2013. “There are very real ways in which these differences in health and life outcomes affect everyone in the St. Louis region. Of course, the most important and immediate impact is the loss of our neighbors, co-workers, family, friends — our fellow St. Louisans — to deaths that could have been prevented.” After discussing the negative economic consequences – for all – in these racial disparities in health outcomes, they implored, “We cannot afford to continue like this. Something has to change in order for everyone in the St. Louis region to be able to thrive and contribute to its growth and vitality.”
The premise of the report title, “For the Sake of All,” is more dramatically relevant during this pandemic than ever. The premise is that a less healthy and weaker Black St. Louis is a less healthy and weaker St. Louis region, and conversely a healthier and empowered Black St. Louis would be a healthier and empowered St. Louis region. Long before the publication of “For the Sake of All” in 2013, that was our value proposition to regional leadership in advocating for our community. Don’t do the right thing for our sake; do it for your sake. Do it for our sake. This was never truer than in a pandemic. As long as COVID-19 spreads in any part of the St. Louis region, every part of the St. Louis region is in danger and will suffer, physically, socially and economically.
We cannot afford to continue like this. Something has to change.