海角大神

Back in early March, shortly after Mardi Gras had raged in New Orleans and Florida welcomed spring breakers, Savannah Mayor Van Johnson made an unpopular decision. He canceled the second largest St. Patrick鈥檚 Day parade in the country.

It fit with the Democratic mayor鈥檚 early response to the COVID-19 pandemic, which was as aggressive as that of any civic leader in the South at the time.

He issued his city鈥檚 stay-at-home order on March 19 鈥� more than two weeks before the statewide order in early April. He closed non-essential businesses, including barber shops and beauty salons, cracking down on 30 businesses that refused to close. He ordered police drones to disperse street parties. And he even broke up a fight at a local Walmart, which he said had become a version of 鈥渢he club鈥� 鈥� a replacement for the loss of evening revelries.

Editor鈥檚 note: As a public service,聽all our coronavirus coverage聽is free. No paywall.

Residents bristled at the early shutdown, calling the mayor a tyrant and sending him about 2,000 mostly critical messages.

But Mr. Johnson had a different perspective. Back when he first issued his stay-at-home order, in the country鈥檚 coronavirus cases were just gaining attention. Now, they are in stark relief. Black residents make up less than a third of Georgia鈥檚 population but account for more than half its COVID-19 fatalities 鈥� a trend seen nationwide.

Patrik Jonsson/海角大神

Mayor Van Johnson of Savannah, seen here on April 20 in his office at Savannah City Hall, has been a relentless enforcer of social distancing rules in Savannah, Georgia, after after three members of his own family in New York contracted the virus. "We keep the faith and follow the science," he says.

Some causes are seen as particular to this pandemic, with a number of black leaders noting, anecdotally, that members of the community weren鈥檛 taking the virus seriously early on. But the deeper problems are chronic, with the coronavirus merely amplifying long-standing inequities, from a lack of access to care to the related dearth of trust in the health system.

鈥淲hat this [virus] did was it exploited every weakness we鈥檝e had in our socioeconomic system, every single one,鈥� says Mr. Johnson. 鈥淚t exploited what we already knew: If you were poor, if you were darker, if you were less educated, if you did not have a home, you were going to be disproportionately affected by this. The national figures bear that out.鈥澛�

That was why he acted the way he did.

鈥淎 lot of people are just, like, 鈥榃hy we got to talk about race?鈥欌�� he adds. 鈥淲e have to talk about race. The problem is that we haven鈥檛 been talking about race. All of those things become very, very real to us.鈥�

Indeed, at least part of Mayor Johnson鈥檚 actions sprang from the experience of his own family. His father, sister, and brother-in-law, who live in New York City, had each contracted the virus. A deacon at his church had died.

The view from Savannah

Now, Mr. Johnson鈥檚 approach is coming into conflict with his governor鈥檚. Georgia Gov. Brian Kemp, a Republican, announced the state 鈥� among the last to issue a stay-at-home order 鈥� would begin to restart its economy last week. Gyms, bowling alleys, tattoo parlors, as well as hair salons and barbershops, were allowed to reopen on April 24 with strict social-distancing rules 颅鈥� a move the Savannah mayor called 鈥渞eckless, premature, and dangerous.鈥�

Savannah, which is 54% black, has seen its cases stabilize. Its numbers have also been more evenly distributed across racial groups. That has helped change the attitudes of many of Savannah鈥檚 black residents. Early resistance has shifted to solid support 鈥� and kinder messages, the mayor says.聽

鈥淭his virus ain鈥檛 racist,鈥� says Bobby Lewis, pitmaster at Randy鈥檚 BBQ, a popular local haunt that has stayed open for delivery and pickup. 鈥淣o one is immune. Everybody has to step up.鈥�

As a community, 鈥渨e鈥檙e trying to get from where we鈥檝e been to where we need to be,鈥� he adds. 鈥淰an Johnson鈥檚 attitude has been a big part of that. Not everybody likes it. But I do. I think it鈥檚 working.鈥�

That blunt message was needed, some say.

鈥淲hen COVID first came out, there really was a sense that this is not a black people鈥檚 disease because it started in China and went to Europe,鈥� says Sandra Elizabeth Ford, head of the DeKalb and Fulton County health departments in Georgia.聽

That perception has changed. Since March, a number of national polls have indicated that black and Hispanic Americans have been more concerned about the virus than white Americans. The聽 that 43% of Hispanics and 31% of black adults said they were very concerned about contracting COVID-19, compared with 18% of white adults.聽

鈥淭here are so many dimensions that matter for African Americans with this pandemic,鈥� says Alford Young, a sociologist at the University of Michigan in Ann Arbor. 鈥淓very social and health-related and structural factor in their lives exacerbates their exposure to the virus.鈥�

鈥淎frican Americans live in smaller spaces and in more densely populated communities,鈥� Dr. Young continues. What鈥檚 more, 鈥渢he extended family for the black community is about as intimate as the immediate family for a lot of other Americans. When African Americans check in on their family, they鈥檙e thinking cousins, uncles, my aunts, grandparents 鈥� not just siblings and parents at home.鈥�

The deeper challenges

The racial disparities seen in the COVID-19 pandemic are nothing new and stem from structural inequities woven into American society for decades, if not centuries, scholars say.聽

For example, the deliberate 鈥渞edlining鈥� of black neighborhoods to exclude them from federal programs to purchase homes has chronically depressed black wealth. With education funding based on local property taxes, that has contributed to underresourced schools.

These economic stresses have made it hard for hospitals and health clinics to survive, too. Few residents have health insurance, and Medicare and Medicaid simply can鈥檛 pay the bills.

All these factors contribute to the greater vulnerability of minority populations in general, and during a pandemic in particular. 聽聽

鈥淲e have an economy where you鈥檙e going to see people of color disproportionately working low-paying service jobs where they are essential workers, but they may not be getting the right聽protective equipment,鈥� says Andra Gillespie, a political scientist at Emory University in Atlanta. 鈥淏ut then there is, 鈥極K, if you鈥檙e going to ignore congregation bans and go to a party 鈥� that鈥檚 not race-specific, but just individual dumb behavior.鈥欌��

鈥淲hat can we empower people to do, to be their own best advocate and their own defense against contracting this disease against so many聽systemic odds?鈥� she asks.

One answer is to help build trust in the health care system among black Americans.聽聽

鈥淭here鈥檚 a level of distrust that鈥檚 rooted in history and in lived experiences that makes it more difficult for life-saving messages to get through to these communities,鈥� says Jamila Michener, professor of government at Cornell University in Ithaca, New York.

Giving care, building relationships

That is a big reason why Lisa Price Stevens became a doctor in the first place. She鈥檚 wanted to be a doctor ever since, at age 7, she saw her mother save another family member with the Heimlich maneuver.

鈥淎s physicians, we are innately concerned about the health care disparities and racial disparities we鈥檙e seeing, and particularly as an African American physician, this is a passion of mine,鈥� says Dr. Stevens, chief medical officer at JenCare Senior Medical Center in Norfolk, Virginia.

Her patients are among those most vulnerable: lower-income, Medicare-eligible seniors, over half of whom are people of color.聽So treatment includes more than just medical care.

鈥淲e work in care teams where we address the social determinants of our patient鈥檚 health, with social workers and case managers so that we not only address the holistic caring of the mind, body, and soul, we鈥檙e looking at, Where do you live? Housing is health. How do you obtain your nutrition? So I can manage your diabetes,鈥� Dr. Stevens says.

鈥淭hose relationships do everything when you talk about health,鈥� she adds.聽

It鈥檚 one of the reasons Mayor Johnson has turned things around in Savannah.聽

鈥淚 don鈥檛 live in a spirit of fear. I鈥檓 not going to be intimidated,鈥� he continues. 鈥淭he vast majority of people recognize that these are extraordinary times that require extraordinary measures, and we have extraordinary tools to keep our citizens safe.鈥�

Editor鈥檚 note: As a public service,聽all our coronavirus coverage聽is free. No paywall.