This is important and we need to parse Dr Fauci’s statements carefully.
New data shows African Americans are dying of coronavirus at higher rates. What can you tell us?
Yeah, unfortunately that’s not surprising and the reason is there is a health disparity as we call it, that African Americans disproportionately suffer from diseases diabetes, hypertension, heart disease, and even some cancers like prostate cancer in African American men. One of the problems is that many of these conditions are the underlying conditions, which no matter what your race or ethnicity gives you a greater chance of getting a complication with coronavirus disease. So if you are a white person like me and you have hypertension, you’re at high risk, but the chances of my having hypertension or diabetes is much less than the general African American population. And that’s the reason why they’re suffering disproportionately. They have the underlying conditions that seem to make coronavirus worse. In addition, often their access to good healthcare is not as good as the general population.’
Posted: Tue 10:51 PM, Apr 07, 2020
“I see a similarity here because health disparities have always existed for the African American community,” Fauci said.
‘“As Dr. Birx said correctly, it’s not that they are getting infected more often, it’s that when they do get infected their underlying medical conditions — the diabetes, hypertension, the obesity, the asthma — those are the kind of things that wind them up in the ICU and ultimately give him a higher death rate.”
Fauci said, “when all this is over and, as we said, it will end, we will get over coronavirus, but there will still be health disparities which we really do need to address in the African American community.”
‘Dr. Anthnony Fauci, who sits on President Donald Trump’s coronavirus task force, said the COVID-19 outbreak is “shining a bright light” on how “unacceptable” the health disparities between blacks and whites are. “Yet again, when you have a situation like the coronavirus, they are suffering disproportionately,” Fauci said of minorities.’
Let us start with ‘health disparities have always existed for the African American community’. What does always mean? This phrase gives the impression that the disparity has nothing to do with anything we are doing today. ‘Always’ suggests that the disparities are ‘natural’ like the weather. One might think this is a harsh reading but look closer. In Quote A he mentions the disparities and then says: ‘ In addition, often their access to good healthcare is not as good as the general population’. So the access to good healthcare is ‘in addition’ and obviously not the cause!!!! So according to Dr Fauci the health disparity exists separately from the access to healthcare. This itself is a sensational statement. He is saying that African Americans given the same or better healthcare than Whites would still have health disparities. This is something for which there is NO evidence.
Dr Fauci is making a statement about the environment and social conditions that is totally at odds with all evidence. For example the median height of Japanese people has risen in 20th Century.
‘In 50 years, according to statistics kept by the Ministry of Education, the average height of Japanese 11-year-olds has increased by more than 5 1/2 inches. The height of girls, who grow faster at that age, meanwhile, has increased even more.’
In fact all epidemiology will start with the assumption that similar causes will generate similar effects. So we return to his use of the word ‘always’? Is he referring to the time of slavery and reconstruction? Is he suggesting that well off African Americans with stable social and economic environment will show no distinct difference in health disparity? Lets be clear: the incidence and susceptibilities of a hereditary disease will not be affected by present economic circumstances. Yet if we look at the food that poorer people eat in US and the housing environment we know that these affect the health outcomes. We also know that joblessness and stress affect health and life outcomes. There are studies showing that different post codes in London have seriously different health profiles to the extent that a few miles apart can bring a difference of 8 years to life expectancy.
Back to Dr Fauci. When asked about the disparity his first response in Quote A is ‘Yeah, unfortunately that’s not surprising ‘. What does this mean? Not surprising to whom? This phrase ‘not surprising’ suggests that this is not something to be worried about, that it was ‘inevitable’. It is not surprising that it snows in Winter or that Arican Americans have poorer health outcomes. This attempt to ‘normalise’ the disparity is quite outrageous.
Another comment of Dr Fauci is absurd. He says that African Americans suffer more from Covid-19 because of underlying comorbidities. This a polite form of words. It actually meaningless. It says that African American suffer from Covid-19 because they suffer from Covid-19. The definition of comorbidities is simply the same thing. It is a formally circular statement and worthless as an explanation.
Let us be technical for a minute. A research paper reveals that the terms is formally opaque:
‘Comorbidity is associated with worse health outcomes, more complex clinical management, and increased health care costs. There is no agreement, however, on the meaning of the term, and related constructs, such as multimorbidity, morbidity burden, and patient complexity, are not well conceptualized’
Then again comorbidity is widespread in US population.
‘In the United States, about 80% of Medicare spending is devoted to patients with 4 or more chronic conditions, with costs increasing exponentially as the number of chronic conditions increases.2 This realization is responsible for a growing interest on the part of practitioners and researchers in the impact of comorbidity on a range of outcomes, such as mortality, health-related quality of life, functioning, and quality of health care.’
This study concluded:
‘From an epidemiological and public health perspective, the key issue is the genesis of concurrent diseases.’
‘Defining Comorbity; by Jose Valderas et al.’
It can be seen that Dr Fauci is even ignoring the most pressing use of the term for ‘epidemiological and public health’ purposes. To put the matter bluntly: what makes a person more susceptible to disease A may be the same thing that makes them more susceptible to disease B rather than disease A either causing the disease B or increased mortality from disease B.
The question is and remains : why the relevant comorbidity differences? What is generating the concurrent diseases?
What are we to make of the comparison with AIDS sufferers? Dr Fauci talks of stigma as if the situation of Africa Americans is mere stigma not an economic and social oppression. Such oppression may generate stigma but stigma is not the cause. People with leprosy had a stigma but the core issue was not to remove the stigma but address the underlying matter by curing and preventing leprosy
But there is worse to come:
Dr Fauci states’ “when all this is over …. there will still be health disparities which we really do need to address in the African American community’.
This present disparity in mortality is not, according to Dr Fauci, something that requires immediate action. The disparity of death in cities such as New York causes national focus and immediate diversion of fiscal resources, but the disparity in deaths between ethnic groups doesn’t require any immediate action. Dr Fauci’s phrase ‘when all this is over..’ means let us push this into the future when the political rumpus has died out and the matter can be ignored. Does anyone else hear ‘with all deliberate speed’? Can you imagine any suggesting ‘When all this is over’ we should look into why New York is suffered more mortalities and what can be done about it?
Further Dr Faucci says that the health disparities ‘in the African American community’ as if they were apart from the rest of the America. This is outrageous. Now in the UK, the Jewish Haredi community suffers from Covdi-19 disproportionately but there is a clear and present explanation in the way the community socialises. In terms of social exclusion there is no such evidence . To suggest that the health disparities arise ‘in the African American community’ is to suggest that the answer lies in the African American community. No external resources are required.
As Valderas explicitly states: ‘A number of different factors determine the overall health of populations and individuals, ranging from genetic and biologic characteristics of the individual to the political and policy context.’
Let us put this together in plain English. What Dr Fauci is saying to the African American community is:
WE DON’T CARE!