Over the course of the pandemic so far, one
trend that has emerged is that the health
impacts of COVID-19 vary widely by race. Although
genetic factors have been considered by some
as an underlying cause, it's clear from the
overwhelming amount of public health data
that something else is at play here. If we
take the U.S. as an example,
Overall, white people still make up the largest
percentage of U.S. deaths from COVID-19, but
white people also make up more than 76% of the total
U.S. population.
About 13% of the country’s population is Black, but Black people make up roughly 22% of the deaths from
COVID and that means that Black people in the
U.S. are dying at a rate that’s roughly
double their population share. 
The disease is having a hugely disproportionate
effect on Latinos and Asians compared to their
population percentage. The Navajo nation
had at one point the highest per capita rate
of COVID-19 in the country.
So, before we get into what exactly is going
on with COVID-19 in particular, we do need to
clear a few things up. There are diseases
that do have a genetic component that make
them more common in certain groups, right,
like sickle cell anemia, for example.
Why is that?
When we think about things like sickle cell,
that's a mutation that's protective against
malaria. And so over time, people living in parts
of the globe where malaria is a real threat
and risk have sort of selected for that mutation in
time.
There is certainly much evidence to show that
ancestry is probably the thing that we're
short-cutting to when we talk about race.
And so where people are from, their ancestors,
there have been many, for example, adaptive
mutations over time that are a response to
the environment.
And there are genetic factors that play a
role in how severely someone may be affected by
COVID-19. That’s not only your genetic lottery
when it comes to underlying conditions that
might make it more difficult for you to handle
or recover from this disease, but also specific
genetic variations in cell surface proteins
that the virus latches onto. But these genetic
variables that I'm talking about here aren’t necessarily classifiable by race.
The conversation around COVID-19 and genetics,
I think is an evolving one. And we will see
what we learn regarding genetics and whether
or not any genetic variance emerge as protective
or as increasing risk. And then another layer
is whether any of those are what we would
refer to as ancestry informative marker associated
variants. So you might see those variants,
but they might be random. They might not actually
be tied to ancestry at all. I think those
are very important and exciting questions
that we just haven't answered yet.
See, alleles are different ‘flavors’ of
a gene, like how much and in what way that
gene is expressed in an individual. 
For example, all humans have genes that code
for hair, but what alleles we express determines
how much, what color, what texture, etc. And this
is an essential concept to grasp, because
according to genetic research of allele makeup, there
is no evidence that the groups we divide into
different races have any kind of distinct
unifying genetic identities. 
Ultimately, there’s so much allelic variation
across and within races that two people of
European descent, for example, may be more
genetically similar to a person of Asian descent
than they are to each other. And many people may
respond to this by saying, so what about skin
color? But the superficial attributes that we
use to classify each other by race, like
skin, eyes, and hair, may only seem like such big
divisions because they are so visible.  But
the genes that code for these characteristics
are only a tiny portion of our genome, and
they evolved independently from most of the
rest of our genome, so they aren’t inherently
linked to other genetic traits. There may be
a few exceptions to rules like this, like melanin
expression in the skin affecting the likelihood
of developing skin cancer, but these are
pretty rare, and ultimately—humans share
99.9% of each other’s DNA.
So, if race doesn’t pre-determine our health
on a genetic level in a vast majority of cases,
then what accounts for the massive racial
health disparities that we see in say, the
U.S.?
Black infant mortality is more than two times
higher than white infant mortality. Pregnancy-related
mortality is 3-4 times higher in Black populations
than in white populations. Black patients
experience significantly higher mortality
rates for all kinds of surgeries and receive
poorer treatment when it comes to pain management. 
Similar trends in treatment disparities stand
out between white populations and other non-white
populations—like Latinos, indigenous communities,
and Asian subgroups. And this is across huge
swathes of medical treatments and patient
outcomes. And all of this is evidence that even
though race is not a genetically or scientifically
valid concept, it’s still a pervasive social
construct that does have real-world impacts on health.
We're having a reckoning now I think as a
country with what has been a really intergenerational
and systemic and structural disinvestment
in communities of color.
And all of that means in terms of denied access
to opportunity and resources and how that
manifests in social conditions that make the
risk of infection higher for many black and
brown individuals and neighborhoods, and then
make the risk of severity that much higher
too. And so, together I think it's important
to state that we are learning a lot about
this virus every day, but we will not discover
at the end of the day that this is about biology
or genetics when we look at the stark racial
ethnic disparities.
The coronavirus pandemic in particular is
the perfect lens through which we see that
health is not so much about the actual bodies
that we live in, but the social constructs
that are imposed on those bodies. 
Health is determined by your access to health
care and education, what language you speak,
how much money you make, whether you can
afford to take time off of work to get seen
by a doctor, whether you live alongside a
lot of people or just a few, whether your
job requires you to interact with a lot of
people, and how your healthcare provider
is going to treat you, literally. And we
can’t just consider these disparities in
retrospect either: there are things we can actively
do as we work toward future solutions to this
pandemic, too.
I think it's important for us to do that work
to make sure that we have a real diversity
in all the things that we're doing around
trials, experimental therapy, access to that,
things like vaccine creation. Representation
matters in this work that we're doing. And
as we seek representation,  we do it with
the full understanding of knowledge that institutionally,
we've earned mistrust from many people of
color. Because of, frankly, our past — but
also some of our present. So, we need to address
that head on.
Now, in this video we’ve focused on statistics
that are unique to the United States, but
similar data from other countries shows that
racial disparities in coronavirus infection
and death rates exist in other places, too
— like in the U.K., where South Asian and
Black populations tend to be the hardest hit.
And all of these investigations are actually
kind of the beginning of the picture, because there
are still numbers and stats missing, both
for accurate case counts and for race of the
affected patient. So wherever you are in the
world, you cannot consider the effects of
any disease without also considering the underlying
societal inequities at play.
Much of our modern world has been built on
a foundation of slavery and colonialism and to see the harmful, lingering echoes of those
racist institutions in today’s society,
like medicine, public health, all
we have to do...is look at the data.
For more topics on COVID-19, check out our playlist here
and if there's an aspect of
the pandemic that you want to see us cover,
let us know in the comments. Make sure you subscribe to Seeker for more and thanks for watching!
