In a recent Town Hall meeting organized by the Dean of the School of Public health at Georgia State (@PHGSU) to discuss racial equity in response to the pandemic of racism, following the murder of George Floyd, I gave examples of how to understand the pandemic of racism that tend to remain unaddressed, even when racism is acknowledged. The silence surrounding how to unpack racism continues to accumulate untold burden on Blacks in general and Black men in particular. I live and work in Atlanta, Georgia and my wife lives and work in central Pennsylvania. Heeding the early warnings of @Laurie_Garrett to decide and get to the place where one would prefer to be locked down if one had a choice, I left Atlanta in March to stay in Pennsylvania with my wife, as the devastation of COVID-19 became imminent. Three months later, I began to plan my return to Atlanta. I needed to retrieve some critical books and materials from my office now that I had accepted to chair our School of Public Health Task Force on Racial Equity and Inclusion. As the protests against racism continued on the streets of this and other countries, the ravages of COVID-19 also continued, resulting in a double pandemic that has mounted unparalleled devastation on Black and Brown bodies. At the Town Hall, I emphasized the urgency for action. It was clear to me as I shared with my colleagues, that we could not go back to business as usual.

Some nights earlier, Lester Holt on NBC news reported about traveling during COVID-19. Based on recommendations from infectious disease experts, Lester cautioned, driving was relatively safer than flying when it comes to risk mitigation for COVID-19. The scientific basis of the traveling recommendation is not in question when focused solely on COVID-19 risk mitigation where social distancing is far more difficult to achieve when flying than when driving. Notwithstanding, I had the urge to immediately get up from my seat to draw Lester’s attention to the fact that this information was important but incomplete for me.  It only dealt with one of the pandemics – COVID-19 and not with the second pandemic of racism that I must face. For me to travel, as a Black man, I had to consider as well the silent risk calculus for racism in policing. I had already mapped the route I would take if I were to drive the 12 hours from Central Pennsylvania to Atlanta, Georgia. The driving distance was not the primary concern for me, but the institutional racism enshrined in police brutality on the Black body. For my journey to Atlanta, not only would I have to worry about social distancing to prevent COVID-19, but I would also have to worry about police distancing as a form of prevention from the 400 years of violence and death visited on the Black male body by police and law enforcement. For this pandemic of racism, I would need to prevent the risk of a potential racist encounter that may become fatal particularly since I will be alone with no guarantee that anyone would be around to record such an event, were it to occur. The drive from Central Pennsylvania to Atlanta would see me through several States and counties, that each had their own history of racism in policing. The core of the stressful conversation I had with myself was how can I be sure I will drive 12 hours without being stopped by a police officer in any of the states; Maryland, Virginia, the Carolinas and indeed Georgia. Moreover, even though I have driven such a distance without stopping in the past, what if I were tired and wanted to stop. Would I become a victim of not only driving while Black, but also of sleeping in the car while Black…

I am now back in Atlanta and would need to make a return trip to Pennsylvania but first must undergo the same agony of dual risk analyses once more. The most revealing part of my experience, upon my arrival in Atlanta, was the sense of relief expressed by friends and colleagues who cared but missed the burden of racism inscribed in my story. The story of the pandemic of racism that led to my ‘stressful burden of racism analysis’ was not about the decision I ended up making about driving or flying, but about how racism caused me to agonize over my travel decision in ways that a non-Black in general and a non-Black male in particular may not.  I am thankful to have friends and colleagues who cared, but I also realized that they too have not fully understood the risk calculus of the pandemic of racism on Black males. The negative health outcome of racism on my Black body, in this case, is not the safe arrival at my destination, but rather the undue stress and burden of calculating my obvious yet invisible risks for what options I have for the journey. It is not the decision I made in my travel but the stress of having to layer risk permutations and analyses of potential encounter with a police officer over the obvious risk analysis of COVID-19.

Racism has long been a public health problem and indeed crisis as evident in how we have addressed drug addiction which remains at the intersection of public health, policing and the carceral/prison systems. We can draw lessons and evidence from how Black bodies and communities were criminalized as individual and cultural failures during the crack cocaine epidemic of the 80s and 90s. First, different punishments for cocaine use were crafted into policy that resulted in higher prison sentences for Blacks for the same amount of crack cocaine compared to powder cocaine for Whites. Before COVID-19, opioid addiction that disproportionately affects White individuals and their communities has been widely acknowledged, and rightly so, as failure of the system and the state rather than criminality of the users’ (mostly Whites) bodies. Yet, systemic racism denied Blacks the same institutional consensus that the system and the state are to blame for crack cocaine, such that intervention would have been focused on addiction treatment rather the expansion of the carceral/prison systems and the increased militarization of policing against the Black and Brown bodies.

In the midst of two pandemics, we should not face one and ignore the other. Epidemiologists measuring risks may capture the burden of COVID-19 in the higher case numbers in Black and Brown populations, but often fail to capture the invisible racism burden that leads to increased rates of hypertension, diabetes, asthma, and other non-communicable diseases that have persisted in these populations. We know more about how to measure negative outcomes in diseases than we do about understanding the structural and systemic processes that create and maintain these outcomes. These outcomes may show us, for example, consequences of trauma revealed in relatively shorter telomere for Blacks in some studies, but not so much the invisible tiring times devoted to processing the consequences of racism. For a double pandemic, deeper analyses are needed, if we are to achieve social justice and racial equity, to unpack what Fannie Lou Hamer meant when she said: “I am sick and tired of being sick and tired”.  As I coupled the intersecting burdens of the two pandemics, I too was sick and tired of being sick and tired … of racism, of the invisible burden of diseases. We have much to learn from our history. There are many experiences from 1619 to COVID-19 that offer lessons for our present double pandemics. The 400 years between 1619 and 2019 share a common link: racism. The year 1619 was the year the first group of Africans arrived to Virginia following their kidnap from Africa to be brought into slavery in the Western world. Also, 2019, as we know, was when COVID-19 was first known, culminating in what today for Blacks is a double pandemic of racism and COVID-19. This is a reality we must face.

James Baldwin has long reminded us that “not everything that is faced can be changed, but nothing can be changed until it is faced”. We will overcome COVID-19 sooner or later as a pandemic. The question is, how do we overcome the pandemic of racism enshrined in structural and systemic racism against Blacks?

Collins O. Airhihenbuwa