U.S. Surgeon General Jerome Adams on COVID-19's disproportionate impact on black America
The following is an exclusive interview from BET.com, a part of ViacomCBS.
The novel coronavirus has infected more than 400,000 Americans and killed almost 15,000 in the nation. U.S. Surgeon General Dr. Jerome Adams is on the front lines of efforts trying to convey a message to the nation to continue social distancing and proper hygiene to "flatten the curve."
President Donald Trump nominated Adams, who previously served as Indiana's state health commissioner under then-governor Mike Pence, for surgeon general in 2017. He is the fourth African American to hold the position.
And now Adams, 45, is facing perhaps the biggest challenge of his career as the novel coronavirus continues to spread throughout the country and reveals itself to be a particular threat to African Americans.
Reports from Chicago show that black people account for more than 70% of all COVID-19-related deaths and more than 50% of total cases in the city, while making up only 32% of the population. Louisiana reports a similar figure, while only 32% of the state's residents are black. In Milwaukee, where blacks comprise only 26% of residents, the numbers mirror Chicago's data.
As a result of these findings, many, including Representative Ayanna Pressley of Massachusetts, are calling for national tracking of virus infection rates and deaths by race.
Without the proper demographic data "…it will be impossible for practitioners and policy makers to address disparities in health outcomes and inequities in access to testing and treatment as they emerge," she and Senator Elizabeth Warren wrote in a letter to Health and Human Services Secretary Alex Azar on March 30.
In the face of the data and calls for a federal response, Adams acknowledges that African Americans are much more vulnerable to COVID-19 due to health disparities and historic racism around housing, education and employment. Adams says he is now focusing on formulating a federal response to address the problem.
Adams spoke with BET exclusively about the impact of race on the pandemic's spread, what communities of color can do to protect themselves and why even he's concerned about his own children wearing masks in public.
Here is an excerpt from our interview with U.S. Surgeon General Jerome Adams. This interview has been edited for length and clarity.
BET.com: In light of the disproportionate impact of the virus in the black community why has it taken so long to create a national federal response and will there be specific outreach drafted to address?
Dr. Jerome Adams: COVID-19 affects people who have chronic disease, heart disease, lung disease, diabetes, disproportionately. I want people to understand that African Americans [and] communities of color are at higher risk for COVID-19 than the average population out there for a couple of reasons.
Number one, unfortunately in this country we know that being black means that you are likely...to be of a lower socioeconomic status and the things we're telling people to do to protect themselves — social distancing, staying home from work — are not options for people who are part of the gig economy or who were relying on a job which may or may not have health insurance to keep them safe.
And when they do go home, in many cases, they aren't as able to be as far apart from others as someone would if they're living in a nice big house in the suburbs. So that's one reason why communities of color are at higher risk. We also know the communities of color unfortunately have a higher incidence of diabetes, of heart disease, of lung disease. And so that puts them at higher risk also.
So what are we doing from a federal perspective? We're working with the CDC to make sure we're collecting the data about all populations, but in particular looking at breaking it down by race and by age, by gender, by location, so that we can tell communities specifically what they need to know to keep themselves safe.
What are those conversations sounding like right now among all the various agencies, like the Department of Health and Human Services, the CDC and your office? What are some of the conclusions you're finding?
This virus has been incredibly humbling to everyone. We're learning more about it each and every day. One of the things that we may talk about in a bit is the fact that we now know a lot of this is being transmitted asymptomatically whereas we originally thought that most of the transmission was by people who we knew were sick or who had a positive test. And so these conversations are really about always following the data.
Our recommendations have changed in some cases and they will continue to change because we are always looking at the data each and every day, including breakdowns by race, ethnicity, and other potential risk factors. And we're always adapting what we tell people to do based on the newest data and most recent research.
Do you think clear messaging about social distancing reached the black community in time?
Well, I think that messaging about social distancing has been difficult in all communities. We still see that nine states have not issued stay-at-home orders for their citizens. And so, it's a challenge, and we have to balance these things.
I think that's part of the reason why it's been hard to get that message out about social distancing and in addition to the fact that quite frankly, a lot of communities just didn't take this seriously enough early on. The good news is now the country is getting the message and acting on that by staying at home as much as possible.
A lot of black and brown people can't social distance because of their living arrangements or employment situations. How can they stay safe?
Well, you can't always maintain six feet from the nearest person at all times, but we can take pains while we're at work to say, 'Look, I'm going to do everything I can if I'm at work or I'm in public to keep that six feet distance between me and the next person.'
If you are talking to someone, or near someone, try to turn to the side, try to not be in that direct line of fire. Always wash your hands frequently. Everything your mother told you, it's true. That's really what this comes down to, trying to practice good hygiene and stay away from folks.
Is your office monitoring this spread throughout the prison system right now, or are you still developing that outreach?
To my knowledge, there aren't numbers overall, but the individual prisons are all carefully tracking their numbers and the CDC stands ready. And the United States Public Health Service Commission Corps stands ready if there's ever an outbreak in need of response. We're also working to look at prisons that are particularly overcrowded and looking at sending additional support and officers to those prisons so that we can help them maintain good infection control practices.
There was an inmate in a federal prison fairly recently, who reportedly died from the COVID-19 virus. Is your office working with the federal prisons to mitigate and prevent further infections?
My brother, and many people have heard me share this story, has been incarcerated for crimes he committed to support his heroin addiction, and I'm passionate about lifting up his story so that people understand addiction can happen to anyone. But I also very much know from personal experiences the difficulties people face when they become subject to the criminal justice system.
Our job is to protect, promote and advance the health and safety of our nation and a large number of our officers work in federal prisons. They are doctors, nurses, pharmacists in federal prisons, put there to keep people safe. And so we're in constant contact talking about ways we can promote good hygiene in those situations, making sure we're recognizing symptoms, making sure we're trying to do things to help people be safe.
The most honest answer I can give you is it's difficult. It's difficult when you have people in close quarters tightly packed together. We are very aware of this personally and professionally. I'm invested in making sure we're trying to keep those individuals safe.
Some in the African-American community have concerns about wearing masks outside and being targeted by law enforcement. What's your response?
I hear you. I have to have talks with my two boys about the whole Trayvon Martin situation and that people will look at you and think you're up to no good because you're covering your face in some way, shape or form.
It's something that we're addressing. It's something that I constantly talk about. The good news is that now everyone is wearing masks or facial coverings. So while we're addressing the social inequities that have occurred and that can cause poor health in our society, we are also trying to give people the tools to keep themselves safe from COVID-19.
Related: Some black Americans do not feel safe wearing a face mask in public
Church in the black community isn't just an institution, it's a way of life. Have you been communicating with black clergy about the importance of social distancing and moving towards online worship?
Absolutely. I've been talking to faith leaders constantly. At least once a week I have a meeting with various faith leaders from across the country. Evangelicals, Catholics, black faith leaders in particular, helping them understand that social distancing doesn't mean social isolation.
When people isolate they actually are at higher risk for health complications, as we discussed earlier. People need church, they need community now more than ever. The good thing is we have Skype, we have FaceTime, we have different opportunities to be able to use technology to stay connected.
On the other side of this pandemic, we're still going to be left with the fact that healthcare disparities exist in our community. What is your office, HHS and all the other agencies doing to create a strategy to target minority communities for support?
I think it starts with collecting the data. And I'm going to do what I can from my office to collect the data and make sure it's collected. We need people in the black community to talk to their state health departments, and their local health departments, their city and county health departments to make sure their leaders are collecting that data so we understand the true toll and impact this has on communities of color first and foremost.
We need to come up with a plan to mitigate that harm during and after this [pandemic]. And so I promise you that this is at the top of my mind. Professionally, I've always tried to put a focus on health equity and addressing health disparities.
What can black people do to advocate for themselves to get through this challenging time?
We need people to focus on eating healthy during this time because the healthier you are, the more you can fight off COVID-19. We need people to think about how you can exercise. Being at home and being inside doesn't mean that you still can't exercise. If it's appropriate, go out and take a walk, just maintain six feet of social distance.
While I'll never be upset or offended if anyone contacts me or the federal government, most of public health actually happens at the state and the local level. It's just as important, and in many ways more important, that you're talking to your governor and your state department of health and your mayors and county commissioners and your local departments of health.
A few days ago, you said that this week would probably be one of the "hardest and saddest" moments of our lives. You called it a possible "Pearl Harbor" for a lot of people. Should the country be in a national lock down right now?
Well, I was referring to the fact that we've had many times in our history where there's been tremendous sorrow and after each of those times the country came together and that's what we need to do right now. As far as a national lock down is concerned, there are real concerns if [the country goes] to a police state, particularly for the African-American community.
That's not what we want in our communities. We want people to do the right things on their own, and they're doing it. Over 90% of people out there are doing the right thing. So, there's a lot of focus on the people that aren't, but there's not enough focus on the people who are and for those people, I want to say thank you because you're protecting yourself, you're protecting me, you're protecting our community.
Is there an overall message that you want to leave with black America about the COVID-19 pandemic?
The overall message is that mitigation, meaning social distancing, staying at home, good hand hygiene is working. We know it's working because of Washington and California. We know it's working because New York and New Jersey are starting to see their cases go down, but it only works if everyone cooperates.
This virus spreads person to person and the way we fight it is by each and every person out there doing their part to maintain proper social distancing, to maintain good hygiene. If we continue to do this, we will get through to the other side more quickly and with fewer deaths.