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Rainbow PUSH
Coalition, National Medical Association, and National Bar
Association Joint Statement on the Response to the
Coronavirus/COVID-19 Pandemic: A Public Health
Manifesto
Just as the sun rises in
the East and sets in the West, COVID-19 has emerged as a
global threat. In the United States the effects of the
disease have disproportionately impacted African Americans
and other communities of color. According to state data
currently available (and that includes demographic
information), rates of infection and death amongst the
African-American population far exceeds the representation
of African Americans in the overall population (in some
instances by a multiple of more than five).
This global pandemic has
amplified the effects of pre-existing health disparities,
structural impediments, and the ongoing harm done by
inadequate strategies to address the dangers of COVID-19 in
the African American community specifically, and communities
of color overall.
This joint public health
strategy proposed by the Rainbow PUSH Coalition and the
National Medical Association addresses these concerns, and
proposes viable, actionable steps that can be immediately
implemented to reduce the possibility of irreparable harm
due to COVID-19 on these at-risk communities.
THE JOINT PUBLIC HEALTH
STRATEGY:
PREVENTION: Shelter-in-Place
(at home) and Worship-in-Place (at home). Houses of worship
and community organizations are encouraged to employ
alternative, safe strategies for socialization and worship.
As human interaction is essential for overall health, we
encourage everyone to practice physical distancing (i.e.,
stay at least six feet from other people, avoid mass
gatherings, wear cloth facial covering in public, and do not
host gatherings at home; people of color, especially
African-American males, should consider selecting a white or
lighter colored facial covering to help offset implicit
bias. Cloth face coverings should not be placed on young
children under age 2, anyone who has trouble breathing, or
is unconscious, incapacitated or otherwise unable to remove
the mask without assistance.) Engage in virtual
internet meetings/gatherings, use phone/email/text
capabilities for communicating, and ensure that regular
handwashing and surface cleaning are employed. Additionally,
prevention messages and up-to-date information about the
status of the pandemic must be communicated in culturally
relevant and effective ways, consistent with the
communication practices and languages of African American
and other racial/ethnic communities.
2. DATA: State and local
health departments and Centers for Disease Control and
Prevention (CDC) must be required to collect and publicly
report COVID-19 testing, emergency department visits,
hospitalizations, and outcomes data, stratified by
demographics (including race, ethnicity, gender, and 9-digit
ZIP codes).
3. SCREENING:
When screening questions are used to determine who will
undergo diagnostic testing, high-risk groups including
persons who are African American, Latinx, American
Indian/Alaskan Native should be assigned a high priority
risk score to enable testing.
4. ACCESS: To date, less than
one percent (one percent) of the population has been tested
for COVID-19, and the numbers are skewed based on race and
socioeconomic status (SES). Access to testing must be
expanded, to ensure timely access to COVID-19 testing
stations, and by prioritize testing in medically underserved
areas, and with populations and neighborhoods impacted by
limited/restricted access to public transportation. The
expanded use of mobile testing units and providing for
“walk-up” testing at drive-up testing stations must be
immediately employed to help ensure equitable access to
testing for underserved populations. The walk-up
capabilities must meet the following requirements:
a. Testing stations should
be no more than 1/4th mile (five-minute walk) from nearest
operating bus stop, train, or subway station.
b. Information concerning
walk-up and drive-up testing stations must be widely
disseminated, and must include multilingual, culturally
sensitive, public service announcements within African
American, Latinx, and American Indian/Alaskan Native
communities.
Consider the use of public
health emergency dollars received by Federally Qualified
Health Centers (FQHCs) as a funding source for this
community outreach. However, if these dollars are utilized
for COVID-19 outreach, the expenditures must be immediately
reimbursed to the FQHC to ensure ongoing liquidity for
ongoing and future public health emergencies.
5. PROTECTION FOR CARE
PROVIDERS:
Require Personal Protective Equipment (PPE) for people at
risk for COVID-19 that are performing duties in support of
hospitals and nursing homes including (but not limited to)
patient transport, environmental services, food service and
maintenance staff, patient care assistants, nurses’ aides,
and pharmacy technicians. Provide cloth facial coverings,
handwashing soap and water or hand sanitizer for persons in
homeless shelters and staff.
6. DO NOT RESUSCITATE
(DNR) ORDERS:
Do Not Resuscitate (DNR) orders enable patients to
pre-determine care decisions concerning the use of life
sustaining/life maintaining therapies. Public health
emergency provisions allow for involuntary DNR protocols
whereby a clinician or staff member (without prior consent
of patient, family, or health advocate) makes the decision
to withhold Basic Life Support (BLS), Advanced Cardiac Life
Support (ACLS) or other extraordinary measures for acute,
life-threatening, or deteriorating health. When a public
health emergency has been declared, it is to be required
that state and local health departments collect and report
all involuntary DNR orders, including data according to
race, ethnicity, gender, and age. This data will be
monitored by an appointed Community Advisory Board, the
responsibility of which will include evaluation for any
trends in the data, especially related to race or ethnicity.
7. PROTECTION OF
VULNERABLE POPULATIONS:
Immediately halt inclusion of persons who are a)
incarcerated, b) reside in a mental institution, or c)
institutionalized with intellectual or physical disabilities
as human subjects for clinical trials and experiments
involving off-label use of medications and vaccines.
8. PROTECTION OF
INCARCERATED PERSONS:
Due to the emerging and ongoing challenge of rising numbers
of confirmed cases of COVID-19 in jails and prisons, and a
recently confirmed death of at least one inmate from
COVID-19, every effort to depopulate jails and prisons of
non-violent detainees and persons convicted of nonviolent
offences must be employed to eliminate close contact, and to
ensure the ability to quarantine persons requiring
separation from other inmate populations. This includes the
use of personal recognizance, appropriate home monitoring,
community release, and enhanced follow-up with offices of
parole and probation to the maximum extent possible.
Additionally, all inmates and staff should be provided cloth
facial coverings, handwashing soap and water or hand
sanitizer.
9. CARE COSTS:
Ensure full implementation of the provisions of the CARES
Act, to include no cost for screening and treatment for
COVID-19 and related conditions. This should include medical
follow-up for related worsening or unmasking of underlying
disease, and aftercare (i.e. skilled nursing facility).
10. AFFIRMATIVE ACTION:
Rescind, effective immediately, the U.S. Department of Labor
suspension of certain Affirmative Action guidelines, as
provided for in the March 17, 2020 memorandum from the
director of the Office of Federal Contract Compliance
Programs. By carving out exceptions to essential equal
opportunity policies as related to federal contracting
during the COVID-19 response, some will be denied
opportunities at the very time when everyone should be
allowed to fully engage in addressing the current public
health emergency. There can be no “whole of America”
response if ALL of America cannot equally participate in the
response.
11. AID TO AFRICAN
COUNTRIES FOR COVID-19 RESPONSE:
An aggressive deployment of essential medical resources, to
include testing kits, PPE, ventilators, and the like be
activated to mitigate further global spread and deaths in
African countries due to novel coronavirus, as well as the
potential for re-emergence in African immigrant communities
in the United States where persons may return to their homes
of origin, and then return to the United States. This
includes needed CDC resources and consultation, additional
budget appropriation for funding support for public health
infrastructure and nongovernmental organizations (NGOs),
including reinstatement of World Health Organization (WHO)
funding, in order to mitigate impact of COVID-19 on
indigenous populations on the African continent.
12. ADDRESSING THE
CRITICAL SHORTAGE OF AFRICAN AMERICAN MEDICAL PROFESSIONALS: The effects of the
COVID-19 pandemic in the United States has revealed a severe
shortage of highly trained, culturally competent medical
professionals in communities of color and rural communities
across the country. There must be funding, and resources
made available to support the recruitment, training, and
deployment of African American medical professionals in the
United States. This includes partnering and supporting
African American schools of medicine, nursing, and health
sciences, reducing the debt burden on students of color
attending medical/nursing schools, and beginning earlier in
the K-12 educational process to expose students of color to
the medical profession, and the opportunities available
within the profession.
The Rainbow PUSH Coalition
is a multi-racial, multi-issue, progressive, international
membership organization fighting to protect human and civil
rights, in the United States and around the world. The
National Medical Association is the largest and oldest
national organization representing 45,000 African American
physicians and their patients in the United States. 3
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