Penn Pandemic Diary Penn Pandemic Diary, Entry #38: Into the Unknown

Quarantining at home following the closure of campus, I found myself unable to focus on the obscure topics I had previously chosen for my final papers. I, like so many of my peers, have grown accustomed to the comfort of understanding—of being instructed with the tools necessary to consume vast quantities of information, and distill from this what is knowable, while recognizing what remains ill-defined. In an age where information can be called up in seconds, rather than hours, and sorted by tabs on a browser window rather than piles of library books, I think the modern-day university student has grown almost apathetic in the expectation of not having to tolerate any degree of real ambiguity.

For today’s students, there are always means readily available to uncover an answer to a question. This process is so taken for granted that the moment our brains were confronted with such a severe degree of endemic uncertainty, that security blanket of knowability quickly turned to kryptonite—what society has told us is our greatest skill became a handicap, crippling our focus, our drive, our interest in the subjects that previously comprised much of our very identities.  Thus, I—a law student—found myself reading articles on epidemiology and the history of infectious diseases on JSTOR, rather than doing research for my final papers. Even subconsciously, my brain was craving a way to distill any kind of sense, of predictability, of clarity, from such an unprecedented situation.

My solution at first was to “kill two birds with one stone,” changing the topics of several of my final papers to somehow relate to the current pandemic, and the likely challenges the world will face as a result.

For one of my final papers, in a course on human rights law, I decided to ask a question that had been percolating in my mind throughout America’s COVID-19 experience: how does a country’s healthcare system impact that state’s success in confronting a pandemic? To answer this, I compared countries upholding the right to health via their treatment of healthcare access (and related policies, like paid sick leave) to those that do not recognize health as a de facto right. While virtually none of the data examined as of May 2020 can be conclusive, some interesting patterns began to surface. 

The initial hypothesis of the paper, that countries upholding a de facto right to health would exhibit greater success combatting COVID-19, did not entirely bear out. By a notable margin, the states I examined that have fared the best in this pandemic are the states that had experience combatting a similar outbreak in recent history. Specifically, in the years following the SARS and MERS epidemics, states like Taiwan, Singapore, and South Korea crafted national health plans that included prompt and seamless national response measures.

But these countries were able to quickly test, trace and treat in part because of their widely-accessible health care systems. For this reason and others, I found that, while the de facto right to health may not be a sufficient factor in a successful COVID-19 response, it could be a necessary one. (That is to say, while not all states with accessible health care have had relative success combatting the virus, all of the states that have exhibited success do have widely accessible health care systems.)  

Meanwhile, in societies that fail to prioritize access to “basic material needs” like health care, COVID-19 aggravated longstanding inequalities. Such is the case for the United States. For example, in 1995, Special Rapporteur Maurice Glélé-Ahanhanzo authored a UN Economic and Social Council report on the effects of contemporary racism in the United States. His report noted that, at the time, mortality rates arising from cardiovascular disease and heart attacks was 29% higher among black Americans than among white Americans. Black men were 50% more likely to be diagnosed with diabetes than white men, and black women were 100% more likely to be diagnosed than white women. Black Americans were also less likely to work in jobs providing medical insurance.

In the context of COVID, the intersectionality of socioeconomic status, access to health insurance, and likelihood of a comorbidity coalesce in a menacing way in one region in particular: the American South. In an article for The Atlantic, Vann R. Newkirk explains that “about one in 10 deaths in the United States from Covid-19 has occurred in the four-state arc of Louisiana, Mississippi, Alabama, and Georgia.”  Furthermore, younger people in the South are disproportionately likely to suffer from heart disease, cancer, lung disease, or diabetes—all comorbidities that exacerbates COVID-19—when compared to the rest of the United States.  When compared to Glélé-Ahanhanzo’s report, his findings map onto the populations most at risk of dying from COVID to an eerie degree. Excluding Washington D.C., eleven of the fourteen states with the highest percentage black population are Southern states—states whose populations are disproportionately at risk to be hit the hardest by the coronavirus.

As someone who turned to the study and eventual practice of law because it provides a toolset for combatting systemic injustice, this paper helped me go from uncertainty about the disease to certainty about what needs to come after the pandemic: addressing the systematic injustices laid bare by COVID-19. As we’ve seen with the weeks of protests following the tragic murders of George Floyd and Breonna Taylor, American society is yearning for change and poised to take action. I find comfort in believing there will come a time when we can arrive at “normal” again—but more so, recent events give me hope that “normal” itself may be made to look different. There will come a time when society re-opens and all the scabs peeled back will force us to re-examine systems and institutions that have remained static for so long. And at that moment, those of us trolling through epidemiology articles on JSTOR will find purpose again, will rediscover our focus and our drive, and turn to face these challenges waiting to be solved, a world of disparate impacts waiting to be remedied, and we’ll do what we’ve always done: we’ll find answers.  

The views expressed in the Penn Pandemic Diary are solely the author’s and not those of Penn or Perry World House.