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Ideas
June 8, 2020 9:43 AM EDT
Brooke Cunningham is a general internist, a sociologist, and an assistant professor in the Department of Family Medicine and Community Health at University of Minnesota. Her research focuses on developing strategies for health care providers to address racism as a health risk factor.

As thousands of people march in the streets to protest police brutality, many worry about the risk of COVID-19 transmission. Protesters do not always social distance or wear masks. It is difficult to maintain six feet of separation when the streets fill quickly; it can be tough to call out for change behind a mask; and silent protests feel inadequate when the goal is to finally have one’s voice heard. Because of mass gatherings, COVID-19 cases are projected to rise. This is particularly frightening for people living in places, like Minneapolis, where daily hospitalizations and deaths from COVID-19 are on the rise or flatlining. Unfortunately, the struggle for racial justice has always required people to put their bodies on the line. Protesters are essential workers in a pandemic of police brutality and global racism.

Racist societies—whose norms, social policies, and institutions systematically disadvantage people of color relative to white people—are by definition violent. The World Health Organization defines violence as “the intentional use of physical force or power [my emphasis], threatened or actual, against oneself, another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation.” Police in the U.S. have always used violence (or the omnipresent threat of violence) to maintain the racial order. Many of the country’s police departments trace their roots back to the slave patrols that curtailed black freedom by returning runaway slaves to involuntary servitude. In addition, interlocking social systems work in concert to (re)produce racial inequities, thwart potential, and frustrate self-actualization (e.g., consider the effects of residential segregation on wealth accumulation and in turn school quality). Finally, Black people are paradoxically hyper-visible and invisible to individual Whites, who aim to discipline their behavior and also misrecognize them as stereotypes

Oppressed people will resist the “knee on their neck;” they will fight to breathe; and they will find allies. Today’s protesters are working across historical divisions to create an inclusive, equitable, democratic society in which we are all valued, in which risk and opportunity are not disproportionately distributed by race, in which police do not kill black people with impunity. Protesting is critical, urgent, and, unfortunately, risky. Because protesters take risks for our collective wellbeing, the question then is not, “Should people be protesting in a pandemic?” Rather, it remains, “How can we best protect our essential workers?”

Protecting essential workers requires providing them with information and tangible resources to mitigate their risk. In addition to ongoing broad educational campaigns about the symptoms of COVID-19 and ways to limit exposure (e.g., masks, hand washing, disinfecting surfaces), public health departments could further educate protesters about strategies routinely employed by other essential workers. Those strategies include:

  1. wearing eye protection
  2. changing clothes ideally before entering the home
  3. isolating items—such as bags and shoes—that cannot be laundered
  4. washing hands, or better yet showering, prior to interacting with others
  5. if symptoms develop, getting tested and self-quarantining

Protesters should consider informing close contacts (e.g., household members) of their possible exposure to COVID-19 through protest work, particularly if those contacts are elderly adults, immunocompromised, or have lung disease (e.g., asthma) or other chronic medical conditions.

While many employers rely on essential workers to use their health insurance to cover testing, certainly there are protesters and other essential workers who are uninsured or underinsured. Given that protesters work on the public’s behalf, local public health departments should provide COVID-19 testing for asymptomatic protesters (and other essential workers) who, by definition, would not need any additional medical care. Those who test positive would simply be advised to self-quarantine for 10 days and monitor for symptoms. This could be logistically challenging as public health clinics may not have “negative pressure rooms” to control the spread of the virus. Local public health departments could partner with hospitals and clinics that have these rooms or test protesters outside. This could incentivize protesters to be tested because they would not incur additional charges associated with a physician office visit. Health departments should also address legitimate concerns that identifiable information gathered from testing and contact tracing could be handed over to the police in the name of public safety.

In addition, the police need to halt behaviors that will lead to greater virus spread, such as the use of tear gas, which causes coughing, which in turn widely disperses virus-laden droplets. Police should also limit arrests. When protesters are arrested, police often de-mask them and place them in crowded conditions, as in police vans and jail cells. And even more fundamentally, police leadership needs to address the reality that their personnel have been injuring protesters daily, and to immediately strengthen policies designed to curb excessive use of force.

The protests may go on indefinitely. After the police killed Michael Brown in 2014, there were daily protests in Ferguson, MO, for over a year. Certain places in Minneapolis—like the corner where George Floyd died, the state capital, and police precincts—may become semi-permanent protest sites. There is no reason that a protest site cannot also be a mobile health site. Such sites could—and should—provide COVID-19 testing, emergency first aid, and masks, as well as information about COVID-19; mental health services, with a focus on coping with the trauma from repeatedly witnessing black men being killed by the police; and ways to access food, medical care, and housing—all of which are needed for optimal health and may be more difficult to access in communities that will need to rebuild due to property damage.

Some protesters will become patients. Their medical care teams will learn that they were at the protests because, as part of routine COVID-19 screening, they will be asked about protest participation. Some health care workers may have less empathy for people who they deem irresponsible. Rather than seeing protesters as doing the essential work of democracy, some health care workers are certain to judge protesters negatively, as reckless, even as troublemakers. Health care organizations should take steps to counter those narratives and to monitor for disparities in care by exposure route.

We would never blame any other type of essential worker for contracting COVID-19. Let’s not start blaming protesters.

Contact us at letters@time.com.

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