COVID-19, or the corona virus, is the name of the
disease caused by the virus SARS-CoV-2.
The virus initials stand for severe acute respiratory syndrome coronavirus 2;
more on nomenclature here. SARS-CoV-2 is an RNA virus, which means RNA
is on the inside of a membrane sphere spiked with (red) proteins, as shown in Figure 1. The sphere is made up of membrane from the previous host, meaning the
person who sneezed on someone else and gave them the virus. Yup, that’s right. The virus went into the host, multiplied and
broke out again covered in the membrane of the host. Gross, efficient and, in the case of COVID-19,
deadly.
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| Figure 1. SARS-CoV-2 virus particles (from cdc.gov) |
I’ve been following issues in public health in southeast
Michigan, and COVID 19 infections and deaths in this region show troubling
trends. The rate of deaths in Michigan are among the higher rates posted world-wide.
On April 1, the Michigan.gov/coronavirus website published data from which I calculated a crude death rate of 3.6% for April 1 and a death rate of 6.1% for April 12 (Table 1; data from michigan.gov/coronavirus). The world death rate, according the
the World Health Organization and reported in Nature was 3.4% on April 3 (read it here).
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| Table 1. Calculated crude death rates due to coronavirus in Michigan |
This is mirrored by significantly higher infection rates and higher death rates in certain
counties in Southeast Michigan. These counties include Oakland and Macomb counties to the north and and Wayne county immediately south, with the city in Detroit located in Wayne county. In Figure 2, the number of cases per county is shown and you can see a concentration of cases in Wayne, Oakland and Macomb counties (michigan.gov/coronavirus.)
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Figure 2 Total cases by county in Oakland
(Ok), Macomb(Mb)
Washtenaw (Ww) and
Wayne (Wy) counties, modified
from
Michigan.gov/coronavirus, accessed April 12)
|
In Table 2, I've calculated the death
rates for Detroit and four neighboring counties (data from Detroit is given separately; data from michigan.gov/coronavirus).
It is shocking to see that the death rates are higher in
Detroit, Wayne, Macomb and Oakland than in Washtenaw on April 1 and they are much higher by April 12 (Table 2).
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| Table 2: Calculated crude death rates due to coronavirus in 4 counties and the City of Detroit |
What could cause these much higher death rates in Detroit and Wayne, Macomb and Oakland counties?
A recent report by Thebault, Ba Tran and Williams (2020) from the Washington Post states that counties with Black majorities have higher rates of infection and death than counties that have white majorities. In Michigan, according to their analysis, 33% of cases are African Americans and almost 40% of deaths are African Americans, although African Americans make up only 14% of the state’s population (read it here).
What could cause higher death rates among Blacks/African Americans? Brookings Institute scholar, Rashawn Ray, states in a Brookings Institute blog (2020) that pre-existing health conditions and health disparity are the main contributors to the higher death rate among blacks and African Americans (2020). Disparities, he explains, start with redlining minorities into subpar neighborhoods where they have less access to good food and green spaces for exercise, and where they are farther from hospitals and have lower-quality pharmacies. Every health threat leads to more illness and death in these neighborhoods than others (read the article here).
Rashawn Ray goes on to say that occupation is another factor in higher death rates among blacks and African Americans. Blacks and African Americans in
areas with higher death rates are more likely to be considered essential during the pandemic and to work at
jobs with a high degree of public contact. Blacks, he said, make up a significant part of the workforce in occupations like food service worker, bus driver, and cashier. Their dedication to serve others can have deadly consequences
I learned in an article in Metrotimes (Neavling, 2019) that an additional factor leading to high death rates in Detroit is lack of water to wash hands. One of the CDC recommendations to prevent transmission of the virus is to wash hands with soap and water. However, between April and August of 2019, the water was turned off in almost 12,000 homes in Detroit due to lack of
payment. According a report in Mlive (Moore, 2020), on March 28, Governer Whitmer signed an executive order mandating
that all water get turned back on so everyone in Detroit is able to clean their
hands to help prevent spread of the virus in their
homes.
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| Figure 3. PM2.5 emissions in Michigan in 2014 (Michigan Annual Air Quality Report from 2019) |
Finally, there is one more possibility for why Blacks have a higher infection rate and death rate in an unpublished report from Harvard
University’s Chan School of Public Health, as reported in the New York Times (Friedman, 2020). They state there is a correlation between death from coronavirus and PM2.5 air pollution (Particulate Matter 2.5 micron). And, the air in SE Michigan has some issues! The 2018 annual air quality report for
Michigan states, “Particulate trends show that particulate concentrations have
decreased, and the state is in compliance for all particulate NAAQS; however,
Michigan has had past nonattainment issues in Southeast Michigan for TSP, PM10
and PM2.5. (p. 38; read it here ) The data on PM2.5 pollution in Michigan can be found in Figure 3 and the data on number of cases is in Figure 2. If you compare the two maps, you can see the geographic correlation between where the highest PM2.5 air pollution is and where the highest number of cases are,. Furthermore, we'd expect more deaths where there are more cases.
The news about higher rates of infection and higher death
rates in Blacks/African Americans in Michigan spurred Governor Whitmer on April 9 to create the
Michigan Coronavirus Task Force on Racial Disparities to study the problem in Michigan (read the announcement on michigan.gov here).
Interestingly, there is a report by Healy in the LA Times (2020) that there is another group that seems to have a higher death rate. The report is that males might be both more susceptible to infection and more likely to die than females. This trend is under current study and you can read about it here.
Interestingly, there is a report by Healy in the LA Times (2020) that there is another group that seems to have a higher death rate. The report is that males might be both more susceptible to infection and more likely to die than females. This trend is under current study and you can read about it here.
We desperately need to fix inequalities in the structure of
our society, especially in Southeast Michigan.
Everyone needs have access to clean water and air, good food, excellent health care, high-quality education, environmentally-friendly transportation, and a good
standard of living. I’m not sure how to fix these disparities, but we must
stop institutionalized racism, sexism, ageism, and other isms that
separate us, preventing us from living and working together and, importantly these days, fighting coronavirus together.
This blogpost was written for the benefit of the learning community at Washtenaw Community College and beyond as part of my sabbatical activities for Winter 2020. I am solely responsible for the content and hold the copyright for the work. Feel free to use the information in this blog; just credit me with a link back to my blog! -Emily Thompson, Ph.D.
