Pandemics don’t spread evenly. The spread depends on environmental conditions such as temperature and airflow, population density and size, and, as it turns out, privilege. Brutal capitalism has driven the disproportionate impact of COVID on marginalized communities, and it is now driving inequities in vaccine distribution.
Not surprisingly, the contours of COVID’s impacts have reflected pre-existing societal disparities — which are often shaped along gender, race and class lines. These disparities determine not only how a virus spreads, but also the impacts that the virus has on the individual communities that are exposed. It has been widely reported that Black communities have been impacted disproportionately by COVID, experiencing higher rates of hospitalization, infections and mortality; these trends have continued on into the third wave of COVID, and have inspired hundreds of cities and counties, as well as the Centers for Disease Control, to declare racism to be a public health threat. Black, Indigenous and Latinx communities have less access to health care and testing, access to information, economic stability and work conditions, all of which contributes to the virus’s disparate impact.
In addition to race, another significant social determinant of health is class. Essential workers and those who do not have the privilege of working from home are disproportionately impacted by COVID, as they are much more likely to be exposed to the virus. Black workers and most of the low-waged frontline workers have less access to sick leave and are less likely to have health insurance coverage, contributing to the disproportionate impacts of COVID.
“People in lower income neighborhoods are more likely to have COVID-19 and are at greater risk of COVID-19 deaths as compared to people in higher income neighborhoods,” Gregorio Millett, former scientist at the Centers for Disease Control and Prevention and author of the paper “Assessing differential impacts of COVID-19 on black communities,” told Truthout.
Lisa Dubay, co-author of the Urban Institute research report titled, “How Risk of Exposure to the Coronavirus at Work Varies by Race and Ethnicity and How to Protect the Health and Well-Being of Workers and Their Families,” noted, “We thought it was really important to look at the intersection of race and exposure, because what we know is that the U.S. has a long history of structural racism and interpersonal racism…. That has resulted in long-standing occupational segregation that privileges whites and people with higher education.” Dubay noted that the lack of sick leave, living wages and health insurance drove COVID’s spread among low-wage workers, disproportionately workers of color.
Another population that has been disproportionately impacted by COVID is incarcerated people. According to research reported in the Journal of the American Medical Association, incarcerated people are infected by the coronavirus at a rate more than five times higher than the country’s overall rate. And as of April 16, more than 661,000 incarcerated people and staff have been infected. Amber Casey of the Washington State Department of Public Health told Truthout, “When those folks go back into their communities, which are often heavily policed communities, Black and Brown communities — the same communities that are heavily affected by COVID due to other factors — those communities are more likely to be exposed and it does really keep a reservoir of COVID circulating.”
Casey also works closely with folks experiencing homelessness and people who are using drugs — both of which are populations that have been impacted disproportionately by COVID. She points to how a sharp increase in drug overdoses has accompanied the pandemic in these communities. Casey and her department are currently trying to get as many vaccines as possible out to people experiencing homelessness and who are currently using drugs.
Indeed, now that the vaccine is quickly rolling out, an opportunity has emerged to remedy the inequities cemented by COVID — but instead, vaccine distribution has proven to be yet another area where disparities are made plain. The Biden administration has been fairly successful at making vaccine shots available — however, when it comes to equitable distribution, it’s a different story.
Research has shown that Black and Brown communities in the U.S., for example, are less likely to get access to vaccines for a number of reasons, including internet access for appointments, proximity to vaccine centers or clinics, and informational barriers.
As Truthout has covered in depth, similar patterns in vaccine equity also exist on the global scale. According to Krishna Udayakumar, the founding director of the Duke Global Health Innovation Center, just four regions — the U.S., China, India and Europe — account for 70 percent of all vaccinated people in the world. And this is not an issue of supply — it’s actually projected that by this summer, the U.S. will have an enormous oversupply of the vaccine. The issue is equitable distribution.
“High-income countries like Australia, Japan, the U.S. and Europe, for example, pre-purchased a lot of the vaccine before it was even manufactured,” Merith Basey of Free the Vaccine told Truthout. “That purchasing power has led to this concept of hoarding, which has left a lot of poorer countries — or even middle-income countries — behind.”
Free the Vaccine is a collective of volunteers from 29 countries campaigning for equitable global access to COVID vaccines. Without affordable access for everyone, they believe that the vaccine cannot do its intended job, and that since taxpayers have largely funded the development of these vaccines, they should be available for free to everyone.
According to Basey, one of the largest problems is that high-income countries are not sharing the intellectual property around the vaccines.
“There are [a lot of] countries around the world [that] could manufacture the vaccine locally and work to treat their own populations,” Basey said. “But because of the sort of capitalist frame of the current biomedical R&D system, it means that sharing isn’t happening.”
The United States has fully vaccinated roughly 25 percent of its population, but poorer countries like Brazil and Mexico, for example — which have some of the highest rates of COVID cases and deaths, have both vaccinated less than 10 percent of their populations.
“The world has a scarcity mindset right now,” Basey said. “But we have the recipe, we just need to share it — there’s more than enough to go around. The idea is to have a much more people-centered system rather than a profit-centered system.”
Countries like South Africa and India have led efforts to temporarily suspend patents on COVID vaccines, but these efforts have been blocked by the United States and other wealthy nations at the World Trade Organization. This comes as India is experiencing a massive wave of COVID cases and deaths, recording 315,000 new cases in just a single day, the highest daily toll since the start of the pandemic.
As wealthy nations like the United States continue to prioritize shareholder profit over people’s lives, we’re also seeing how global politics and imperialism has penetrated the rollout of COVID vaccines. For example, it has been reported that the pharmaceutical company Pfizer made demands to Latin American countries to put up sovereign assets, such as embassy buildings and military bases, as a guarantee against the cost of future legal cases as part of their COVID-19 vaccine negotiations.
Groups like Free the Vaccine are doing important work to ensure global equity and access, but they are up against a corporate, global system that is unwilling and unlikely to make any substantial changes to a profit-focused agenda.
As we continue to see the stark disparities in how COVID impacts marginalized communities here in the U.S., as well as inequities in response to COVID globally, it’s become increasingly clear that our current global capitalist economic system is not prepared to deal with major crises adequately.
Moments of acute crisis such as this, as devastating as they are, can make space for new conversations and open up opportunities for change. As COVID lays bare the major structural problems in our current social, political and economic systems, we are seeing communities across the country and across the globe rise up to demand substantial reforms, and in many cases, a complete overhaul of entire structures. With the very real possibility of another pandemic on the horizon, it’s important that we fully understand the root causes that drive the inequities in our society so that we can avoid replicating these harmful and deadly patterns in the future.