COVID-19: The American Apartheid Hotspot Detector

Although infectious diseases are biological in form, they invariably take place in a social context. Hence, the best way to understand epidemics and outbreaks is to understand the social context in which they take place. Before discussing the social context of the novel coronavirus, it is useful to review how social arrangements and power dynamics played a role with epidemics of the past.

The Social Context of Previous Epidemics

Throughout the history of widespread epidemics and global pandemics, deadly pathogens have often been unleashed alongside projects of imperialism, colonization, and racialized apartheid. As British, French, and Spanish colonizers spread across Indigenous people’s land in North America and prosecuted wars against Native populations from the 1500s through the 1800s, the simultaneous exposure to viruses such as influenza, measles, and smallpox amplified the devastation of European and American imperialism, settler occupation, land dispossession, and treaty violations. This all contributed to the Great Dying, the loss of millions of Native Americans in the land that would become the United States.

Starting in the 1870s, Belgium’s King Leopold II, brutally exploited the Congolese, aided by European colonizers and the Force Publique. By the 1920s, the land known then as the Belgian Congo was unknowingly experiencing the spread of the human immunodeficiency virus or HIV. King Leopold II’s avarice helped ignite the spread of the HIV pandemic. The 2014 Ebola outbreak in West Africa followed the American, British, and French colonization of Liberia, Sierra Leone, and Guinea, respectively, during the late 1800s. The fractions caused by decades of colonial rule led to deadly civil wars in the 1980s through the early 2000s which helped weaken public health infrastructure. These social contexts help explain the outbreaks of influenza, measles, and smallpox from 1500 onward, the emergence of HIV in the 1920s, and the Ebola epidemic in 2014.

In other words, historical trauma and deadly diseases go hand in hand. The legacies of imperialism, colonization, and apartheid are intricately linked to spread of deadly viruses and pathogens. Widespread epidemics and global pandemics reveal the power dynamics in societies. People who have been colonized and marginalized bear a greater burden of disease than the people who belong to the group that engaged in colonizing, enslaving, and occupying.

Pathogens often arrive with conquistadors and colonizers. In other instances, the activity of colonization contributes to the zoonotic transmission and the spread of virus (as was the case with HIV). Once unleashed, as pathogens spread throughout societies, they eventually find their way to populations at the bottom of social hierarchies where they spread more rapidly and wreak more damage. The prevalence of disease and the fatality rate of pathogens always has a more devastating effect on vulnerable populations.

COVID-19 in America

This brings us to the current moment where the United States of America is in the midst of a rolling crisis in the form of the COVID-19 pandemic. While other developed counties have either flattened the curve or kept their prevalence low, the USA has struggled to end the first wave of the outbreak. By April 2020, COVID-19 had swept across America in three waves:

· Nursing homes in the Seattle area and then California

· Large metropolitan areas especially hard-hit areas like New York and Detroit

· Rural areas, Native American reservations, and the Black Belt in the Deep South

The second and third waves of COVID-19 exploded in the very places and spaces scarred by spatial systems designed to relegate Native Americans into reservations and segregate Black, Brown, and other marginalized people into redlined areas. Many of the large urban areas that emerged as hotspots are linked to a legacy of racial hypersegregation.

The spatial character of America’s racial segregation can be described by using the analogy of hurricane categories. Using a hurricane-like scale is a way to illuminate the intensity of racial segregation in metropolitan areas. Category 1 is a city with a low level of racial segregation. Category 2 is a moderately segregated city while Category 3 is a highly segregated city. Categories 4 and 5 are classified as hypersegregated — the most devastating and intense forms of racial segregation in America.

Examining COVID-19 Hotspot Data

According to the Brookings Institution, any county with at least 100 cases per 100,000 is considered to have a high prevalence of COVID-19. When examining the confirmed number of COVID-19 cases per 100,000 in the table below (during April and May), the association between hotspot cities/counties and racial hypersegregation is clear.* Chicago, Detroit, and Flint are currently classified as Category 5 hypersegregated cities. New York City and Philadelphia are currently classified as Category 4 hypersegregated cities. New Orleans, Washington DC, and Indianapolis are currently categorized as Category 3 highly segregated cities, however, all three were once hypersegregated. Denver and Albany, GA are currently classified as Category 2 moderately segregated cities, but both were once hypersegregated cities as well.

Some counties that contain Native American communities also emerged as COVID-19 hotspots. Three such counties are shown in the table below. In Arizona, Navajo Nation and the White Mountain Apache are being adversely impacted by the virus in Navajo County and Apache County. Navajo, Hopi, and Zuni tribes are also deeply impacted by COVID-19 in McKinley County, New Mexico.

In addition to the legacies of hypersegregation and reservations, America is a nation of mass incarceration. Mass incarceration is a form of spatial concentration and COVID-19 is a virus that spreads easily among humans in close proximity. Hence, some counties with correctional facilities experienced devastating outbreaks due to COVID-19. In each instance, Black people are incarcerated at a higher rate than the percentage of Black people that live in the state.

COVID-19 also inflicted tremendous harm in the Deep South, particularly in Black Belt counties. This is what is shown in the U.S. COVID Atlas from the University of Chicago below (image from June 1, 2020). States such as Louisiana, Mississippi, Alabama, and Georgia were aflame with COVID-19. It is no mistake that these are the same states that have a long legacy of slavery, lynchings, and a racial caste system often described as Jim and Jane Crow.

America’s Spatial Legacies

Global pandemics and structural oppression are often intertwined. In the United States, the current spread of the pathogen COVID-19 is deeply enmeshed with the ongoing legacy of European colonization and American Apartheid. Before, during, and after the Civil War in the United States, White settlers pushed west from the Atlantic to the Pacific, colonizing and confiscating Native lands and territory. White settlers displaced Indigenous peoples and uprooted them from their lands, forcing them to live on reservations.

While the Civil War was raging, orator and human rights champion Frederick Douglass outlined the two paths that the nation could take emerging from the military, social, and economic crisis. He argued that abolishing slavery was the mission of the war:

In a grand Crisis like this, we should all prefer to look facts sternly in the face, and to accept their verdict whether it bless or blast us. I look for no miraculous destruction of Slavery. The war looms before me simply as a great national opportunity, which may be improved to national salvation, or neglected to national ruin.

With the abolition of slavery, Douglass argued, America could achieve national salvation. With the maintenance of slavery, America would fall to national ruin. After the war, America abolished slavery, but with a crucial caveat. The nation only partially abolished slavery with the Thirteenth Amendment, allowing it to continue for people who were incarcerated and convicted of felonies.

After the Civil War, American Apartheid was established and enforced via reservations, tribal policies, sundown towns, racial zoning, racially restrictive covenants, and segregated public housing. Chinese Americans were often confined to Chinatowns in urban areas, while Japanese Americans were uprooted and forced to live in internment camps during World War II. In the 1930s, the federal government and city governments worked together to draw Residential Security Maps with communities colored red, yellow, blue, or green.

In cities like Baltimore in Maryland, Jewish residents were barred from living in greenlined communities and many lower income European immigrants were pushed into yellowlined communities. Meanwhile, many urban Black and Native Americans were relegated to redlined communities where they were denied access to public and private capital. Here is the Residential Security Map for Baltimore, Maryland.

Stopping COVID-19 in America

These are the spatial legacies that explain why certain geographic hotspots emerged within months of the outset of the COVID-19 pandemic in America. Hypersegregated cities became COVID-19 hotspots precisely because redlining results in segrenomics and the hyper-deprivation of resources in Black neighborhoods. Native American reservations in Arizona and New Mexico became COVID-19 hotspots because colonization involved economic deprivation and tribal land dispossession. Prisons became COVID-19 hotspots because mass incarceration concentrates disproportionately lower income and Black people into highly dense and unhealthy spaces of confinement. The Black Belt in the Deep South became a COVID hotspot because of the lethal legacies of slave trading, slavery, lynchings, and the discriminatory allocation of public goods.

Halting the spread of COVID-19, therefore, requires linking COVID-19 data with America’s spatial legacies of colonization, hypersegregation, and mass incarceration. COVID-19’s lethal march across the nation can only be halted by acknowledging ongoing historical trauma and allocating deep resources to communities and people who have been deeply under-resourced. These resources should include guaranteed income, free medical care, an expansive community health worker program, and halting all foreclosures and evictions (for at least a year or until the pandemic is over). COVID-19 has shown the nation exactly where these and other resources should be committed, because the novel coronavirus is the American Apartheid hotspot detector.

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*The city data shown in parenthesis are derived from each of the home counties of the listed cities. All COVID-19 case data are derived from the U.S. COVID-19 Atlas.

Lawrence Brown, PhD, MPA is a Visiting Associate Professor in the Department of Population Health Sciences, University of Wisconsin Population Health Institute