It has long been clear that Black Americans have experienced high rates of coronavirus infection, hospitalization and death throughout the pandemic.
But those factors are now leading experts to sound the alarm about what will may come next: a prevalence of long Covid in the Black community and a lack of access to treatment.
Long Covid — with chronic symptoms like fatigue, cognitive problems and others that linger for months after an acute coronavirus infection has cleared up — has perplexed researchers, and many are working hard to find a treatment for people experiencing it. But health experts warn that crucial data is missing: Black Americans have not been sufficiently included in long-Covid trials, treatment programs and registries, according to the authors of a new report released on Tuesday.
“We expect there are going to be greater barriers to access the resources and services available for long Covid,” said one of the authors, Dr. Marcella Nunez-Smith, who is the director of Yale University’s health equity office and a former chair of President Biden’s health equity task force.
“The pandemic isn’t over, it isn’t over for anyone,” Dr. Nunez-Smith said. “But the reality is, it’s certainly not over in Black America.”
The report, called the State of Black America and Covid-19, outlines how disinvestment in health care in Black communities contributed to Black people contracting Covid at higher rates than white people. Black people were then more likely to face serious illness or death as a result.
The Black Coalition Against Covid, the Yale School of Medicine and the Morehouse School of Medicine were authors of the report, which also offers recommendations to policy leaders.
In the first three months of the pandemic, the average weekly case rate per 100,000 Black Americans was 36.2, compared with 12.5 for white Americans, the authors write. The Black hospitalization rate was 12.6 per 100,000 people, compared with 4 per 100,000 for white people, and the death rate was also higher: 3.6 per 100,000 compared with 1.8 per 100,000.
“The severity of Covid-19 among Black Americans was the predictable result of structural and societal realities, not differences in genetic predisposition,” the report says.
Black Americans were overrepresented in essential-worker positions, which increased the risk of exposure to the virus, the authors write. And they were also more likely than white Americans to live in multigenerational homes or crowded spaces, be incarcerated, or live in densely populated areas.
Many Black Americans who contracted the coronavirus experienced serious illness because of pre-existing conditions like obesity, hypertension and chronic kidney disease, which themselves were often the result of “differential access to high-quality care and health promoting resources,” the report says.
The authorization of the first coronavirus vaccines was seen by many experts as a light at the end of the tunnel, but new disparities emerged, driven by both vaccine hesitancy and limited access to the shots.
Though the gap in vaccinations has since narrowed — 80 percent of Black Americans were fully vaccinated as of January, compared with 83 percent of white Americans, the report says — disparities persist.
“We understand that there remains unfinished work yet to do to save and protect our communities from the Covid-19 pandemic,” wrote Dr. Reed Tuckson, who in April 2020 co-founded the Black Coalition Against Covid.
And when it comes to unfinished work, long Covid is top of mind.
“So much of even getting a long Covid diagnosis is tied to having had a positive test right at the beginning,” said Dr. Nunez-Smith, adding that early on in the pandemic, many Black Americans “weren’t able to secure a test and in some cases, were denied testing.”
She emphasized the importance of investing adequate resources into studying long Covid. “Like everything else, without intentionality, we’re not going to get to equity there,” she said.
March 29, 2022
An earlier version of this item described incorrectly the average rate of weekly cases, hospitalizations and deaths from Covid among Black Americans in the first three months of the pandemic. They were rates per 100,000 people, not percentages. An earlier version also included outdated figures provided by the Black Coalition Against Covid that the organization revised after publication.