ICU Doctor Stresses COVID-19 Severity In Communities Of Color, Faults White House

Nov 8, 2020
Originally published on November 8, 2020 9:26 pm

Dr. Taison Bell, the director of the medical intensive care unit at the University of Virginia in Charlottesville, was doing rounds in the COVID-19 ICU, caring for about 20 patients, when he noticed that his unit was full almost entirely of Black and Latinx people, despite the fact that Charlottesville is 70% white.

Bell, who grew up just an hour away from the hospital, says he "just couldn't escape the thought of this virus disproportionately killing people in my community."

As he tells NPR's Michel Martin on All Things Considered, he had to pause rounds and "acknowledge how tough emotionally it was for me just to see what we were seeing."

"I didn't know what to do about it," he says. "I didn't know how to deal with that emotion, but I had to get it out there because if I was feeling that way, I knew that several other of my team members were feeling the same way, too."

The United States has been experiencing a massive surge of COVID-19 cases. Last week the new record was more than 120,000 confirmed cases a day, three days in a row, according to the Johns Hopkins Coronavirus Resource Center.

Bell, who is also an assistant professor of medicine at UVA, notes that those numbers represent real people.

"At the end of the day, we're tracking a lot of numbers because the metrics are important," Bell says. "But we have to remember that behind that number is a story, a story of a life that either may not make it. And even if they do make it, their life may be completely different from now."

It's a pandemic that has infected nearly 10 million people in the country and killed more than 230,000, and it disproportionately affects Black and Latinx people in the U.S. Black Americans are dying of COVID-19 at a rate of nearly twice their share of the population. Latinx people made up a greater share of confirmed cases and deaths than their share of the population as well, according to data analyzed by NPR.

Bell says the Trump administration didn't adequately emphasize the virus's disproportionate impact on minority communities.

"There was an opportunity lost there to communicate the urgency, the necessity and the basic public health measures that we could take and the fact that even if it's not in your community now, it's likely to be in your community later," Bell says, "so we all need to take the same sort of safety measures."

Bell says one of the problems at play was the messaging from the Trump White House, which he says led "large segments of the country" to not take the virus seriously.

"You have to connect it to the top where in the White House, they may have been holding events outside, but very tight," he said. "No mask, no social distancing, not setting an example of how we should be proceeding in society to control the spread of COVID-19."

Bell says the virus has changed the nation dramatically, and that the death toll is almost impossible to fathom.

"In the minority community, it's exposed a lot of issues in our society," he says. "But just to think about the individuals that we're losing and the weddings that are being missed, the barbecues, the hugs, the reunions and all of these opportunities and moments that are going to be lost because of this virus. It's just really hard to think about."

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MICHEL MARTIN, HOST:

The coronavirus pandemic did not take a break for the election this past week. In fact, the U.S. set new records for the number of daily new COVID cases for several days in a row, with more than 126,000 new cases reported on Friday alone - that according to Johns Hopkins University.

And even as the pandemic rages on across the country, there's a sense that at least some Americans don't view it as a problem - at least, not their problem - refusing to wear masks or practice social distancing or pushing back against measures intended to slow down the spread of the virus.

We wanted to talk about that more with someone who's been on the front lines of battling COVID-19, so we called Dr. Taison Bell. He is the director of the medical intensive care unit at the University of Virginia in Charlottesville.

Dr. Bell, thank you so much for making the time to speak with us.

TAISON BELL: Thank you for having me.

MARTIN: First of all, can I just ask you what this past week has been like for you? Are you seeing many new cases where you are?

BELL: So far, we have not seen a large rush of cases in the central Virginia area. But we do expect that along with the rest of the country that we'll soon start to see an increase in cases. So I'm going to be actually in the COVID ICU next week, and we're just getting ready for the influx's coming.

MARTIN: You know, and at some point after this crisis began to unfold in the United States, we began hearing about how communities of color were being particularly hard-hit. For example, in Chicago, I mean, the city's only 30% Black, but Black people are 60% of the COVID fatalities. In Nebraska, Latinos are only 11% of the population, but they're 60% of the coronavirus cases, and they are 1 in 4 deaths. Have you been seeing that where you are?

BELL: So nationwide, the age-adjusted mortality for Blacks and Latinos is three times higher than in white patients. Luckily, at the University of Virginia, we do see a disproportionate number of cases in minority populations. Mortality, however, is around the same. So we have been very proud of that fact - that we do seem to be at least getting people through it at the same rate, although we're seeing a disproportionate number of cases coming in.

MARTIN: Now, I wanted to ask you about the messaging around that. I mean, the fact is that a lot of health advocates started pushing the message out once they realized that this disproportionate impact was occurring because they were concerned that the Trump administration was not communicating the risks of the virus forcefully enough, especially to those most at risk.

And, of course, now we have proof in the president's own words to a journalist, Bob Woodward, that he was, in fact, downplaying the severity of the virus, you know, for his own reasons. But as I said, you know, advocates, people who are particularly close to this issue, started pushing out the fact that there was this disproportionate impact. And now I'm wondering whether that's affected people's attitudes around the country about COVID-19. Could that be part of the reason that other groups don't think this is serious?

BELL: Well, you know, the interesting thing about COVID-19 is that it's contagious, right? So even though COVID-19 is really just a new manifestation of something that we've seen in several diseases that disproportionately affect minority populations, this is one that will eventually make its way to every part of the country. So earlier on in the pandemic, it was mostly focused on highly concentrated, dense urban areas that had higher minority populations. There was a sense that maybe it wouldn't come to other parts of America. And, you know, we've seen that that's certainly not the case at this point.

MARTIN: I understand that. But what I'm trying to understand is, why is it that the message around the severity of this doesn't seem to be penetrating some groups?

BELL: Well, it wasn't just that the messaging was not disseminated. It was actively suppressed. There are large segments of the country that do not believe this is serious because they were told that it's not serious or not emphasized how serious it was. And until you actually see it in your community, that's the only point when you begin to understand how bad this can be.

MARTIN: And before we let you go, without violating anyone's, you know, privacy, are there any stories that particularly stand out to you of circumstances that you think might help people understand the gravity of this if they don't already?

BELL: There was one day I was rounding in our COVID ICU, and we were taking care of around 20-some patients or so. And we have one wing of our ICU that's almost all Hispanic last names and another half of ICU that's almost all Black last names. And I only grew up an hour away from where I'm working, so I actually know a lot of these family names and are familiar with them. And these are people that I know.

And I was trying to get through the day and just try to get through the business of morning rounds. But I just couldn't escape that thought of this virus disproportionately killing people in my community. And I had to pause where I was and just acknowledge how tough emotionally it was for me just to see what we were seeing. And I didn't know what to do about it. I didn't know how to deal with that emotion. But I had to get it out there because if I was feeling that way, I knew that several other of my team members are feeling the same way, too.

You know, at the end of the day, we're tracking a lot of numbers and, you know, because the metrics are important. But we have to remember that behind that number is a story - a story of a life. Just to think about the individuals that we're losing and, you know, the weddings that are being missed, the barbecues, the hugs, the reunions and all of these opportunities and moments that are going to be lost because of this virus - you know, it's just really hard to think about.

MARTIN: That's Dr. Taison Bell. He directs the medical intensive care unit at the University of Virginia.

Dr. Bell, thanks so much for talking with us today.

BELL: Thank you for having me. Transcript provided by NPR, Copyright NPR.