H5N1

Europe is living a COVID19 flashback, plus a backlash

Via Politico.eu: Europe is living a coronavirus flashback, plus a backlash. Excerpt:

Lockdowns are back, but there's a big difference this time.  

As countries across Europe adopt stricter measures to slow the pace of the second wave of the coronavirus epidemic, Europeans are experiencing a sense of flashback to the spring. But besides the change in season, there is something else: a growing backlash against the restrictions. 

“This time we are dealing with two enemies: the coronavirus itself and a corona fatigue,” European Commission President Ursula von der Leyen said last week.  

As contagion curves veer upwards across Europe, with critical care units risking or reaching overload in many countries, governments are adopting more measures, including new lockdowns in Belgium, France, Germany and the U.K., and tough restrictions in Spain, Italy, Greece, Portugal and Austria. But this time they’re not as well received, as people struggle with economic hardship, and many see the current situation as avoidable — a sign of government inefficiency. 

Italy is the most blatant example. The country was the first and among the hardest hit in the spring, and enjoyed a summer hiatus during which most activities resumed. But a spike in cases forced the government to adopt strict new measures, including closing bars and restaurants at 6 p.m.  

Over the past week demonstrations broke out in the city of Naples, following the announcement of a regional lockdown, later retracted by the regional governor. In Rome, a group affiliated with Forza Nuova, a neo-fascist party, clashed with police as it protested a nighttime curfew and the "sanitary dictatorship." Scores were arrested in Milan at a protest against new restrictions, including the early closure of bars and restaurants. 

Prime Minister Giuseppe Conte said he understood the new restrictions “provoke rage and frustrations,” but warned against the risk of “infiltration” of protests by “antagonistic groups who try to fuel clashes.”  

While a majority of Italians support the new measures adopted Sunday, or even stricter ones, a quarter of Italians think they’re excessive, according to a poll by SWG. 

The protests are feeding on a growing sense of illegitimacy among those bearing the brunt of the economic costs of the pandemic, according to Clifford Stott, a professor of social psychology at Keele University and a member of SAGE, a body advising the British government on the pandemic.  

The economic ills are “hitting society unequally and this is creating a context of increasing disenfranchisement from those who are suffering the greatest harm,” including the poor and the young, Stott said. “The realization that this is going to get worse is creating a context where conflicts become more likely.”  

Italy’s not alone in facing social unrest. In Spain, protests against coronavirus restrictions turned violent in several cities for a second night on Saturday. Dozens of people were arrested and about 30 officers injured in Saturday's altercations, media reported, after clashes erupted in Madrid, Barcelona and other cities.  

In Brussels, police dispersed an unauthorized anti-lockdown protest on October 25. Belgium, which now has the highest number of infections per capita in Europe, announced a second lockdown on Friday. 

In Berlin, police reported an arson attack on October 25 on the Robert Koch Institute, the federal agency advising the government on the pandemic, suspecting a political motive. The same day a few thousand protesters marched against coronavirus restrictions in the German capital — a heterogeneous crowd that’s been gathering since the summer, including both far-right extremists, vaccine skeptics, and people believing in conspiracy theories crediting 5G technology with spreading the virus.

COVID-19 surge in Northwest Syria as cases multiply by 14 times in one month

Via ReliefWeb, a World Vision report: COVID-19 surge in Northwest Syria as cases multiply by 14 times in one month. Excerpt:

Saturday, 3 October 2020 - COVID-19 case increases in Northwest Syria have reached alarming levels, almost 100 new cases are being reported every single day as 2.7 million people remain displaced in the area. Child focused aid agency World Vision warns that unless the already weakened health system receives immediate international support, the situation will become dramatically worse very quickly. 

“The number of cases have increased by 14 times since last month with over 1,000 positive cases recorded. Children on the move are at a higher risk than ever before. The health system in North West Syria is not capable of dealing with this crisis. We desperately need support to improve testing capacity, preventive equipment and surveillance systems. Without increased international aid Syrian children and their families, who have been forced from their homes and have endured almost ten years of conflict, will suffer even more,” said Johan Mooij, Syria Response Director at World Vision.  

This year alone, 218 children have been killed and another 800 civilians died. Covid-19 is a crisis within a crisis in Northwest Syria. Many health workers, who are already under huge pressure to do their job in a weak health system, are now reportedly testing positive for COVID-19 – putting effective containment and response to the virus at even greater risk.  

“The number of Syrian people infected with this virus began to increase slowly at the beginning of July, but now we are seeing a dramatic surge in positive cases,” said Mr. Mooij. “We are seriously concerned about the dreadful impact this will have on displaced people in the northern part of the country. These people have been displaced for years on end. Profound economic deterioration in Syria makes their situation even more difficult and now the threat of COVID-19 is causing more stress, fear and dependency on external aid,” he added. 

Due to the severe lack of testing capacities in the area and perceived underreporting, aid agencies on the ground fear that the actual number of positive cases is actually much higher. UN reports have stated that people with COVID symptoms have not been seeking treatment, either due to fear of stigmatisation or of catching the virus in the medical facilities. 

“Although they are increasing at an alarming rate, the current official figures do not show the true picture of the severity of this pandemic in Northwest Syria. We believe that the number of confirmed cases will dramatically increase if testing becomes more readily available,” said Mr. Mooji.

Anthony Fauci says he has received death threats over his COVID-19 work

Via The Guardian: Anthony Fauci says he has received death threats over his coronavirus work. Excerpt:

Anthony Fauci, the top infectious disease expert in the US, has had to hire security to protect himself and his family after receiving death threats in response to his work to stop the spread of coronavirus. 

Fauci, a member of the White House coronavirus taskforce, told CNN that the pandemic has brought out “the best of people and the worst of people and you know getting death threats for me and my family and harassing my daughters to the point where I have to get security, it’s amazing”.  

Donald Trump’s administration has consistently downplayed the public health threat of coronavirus, but Fauci has just as consistently rejected those efforts. Since the early days of the pandemic, Fauci has provided blunt assessments of the crisis in media appearances and in remarks at the White House, which have been less frequent in recent months.  

“I wouldn’t have imagined in my wildest dreams that people who object to things that are pure public health principles are so set against it and don’t like what you and I say, namely in the world of science, that they actually threaten you,” said Fauci.  

The US has recorded more than 158,000 Covid-19 related deaths and more than 4.8m coronavirus cases, according to Johns Hopkins University, far more than any other country in the world. 

In an interview with Politico’s Pulse Check podcast released on Thursday, Fauci was more specific about the threats against his family and said he had worked to ignore the conspiracy theories about him online.  

“There’s one thing about that nonsense that I do object to, and that is the effect that it has on my family,” the doctor added. “Because when you get death threats that require you having security protection all the time, and when they start hassling your children on the phone and at their job and interfering with their lives, that pisses me off. I must say.”  

In July, Trump officials and advisers publicly undermined Fauci and attempted to discredit his expertise. The White House trade adviser, Peter Navarro, went as far as to attack Fauci in an op-ed in the USA Today newspaper, where he said he treats the doctor’s advice with “skepticism and caution”.

Haiti: Cité Soleil and the coronavirus--July 19, 2020

Dr. John Carroll is an old Haiti hand, a veteran of the cholera outbreak, a superb photographer, and much more. Via Facebook, he writes: Cite Soleil and the Coronavirus--July 19, 2020. His complete post:

We entered Cité Soleil this morning from Route 9 and travelled towards Bwa Neuf. I was with Fr. Tom Hagan of Hands Together. I have known Father Tom for years and Father baptized Luke in Haiti in 2006 when Maria and I were in the middle of Luke’s adoption. 

There were some pedestrians on this main highway but not near as many as usual and there were no other cars at all. We soon crossed the water canal that bisects Route 9. As usual it this canal was full of garbage and black sludge as it trickles towards the ocean. 

The people of Soleil are currently caught in the middle of yet another war between local gangs. Intense shooting between the gangs was as recent as yesterday. I can't definitively say why certain gangs are involved or who finances them but I can confirm it is a vicious situation which has paralyzed the population of Soleil and shut down the clinic where I normally work.  

As we moved down Route 9 towards the main intersection in Soleil, there were occasional road blocks made up of garbage, rocks, and large debris. However, they were moved for us so we could inch through the opening under the watchful eyes of armed gang soldiers in the adjacent neighborhood.  

However, as we approached the abandoned police station in Soleil, another barricade of debris was strewn across the road and this was impossible to quickly clear. So we turned right and coursed through a water engulfed and very muddy neighborhood before we turned right on the main Soleil drag going towards the ocean. 

My main goal in coming to Soleil this morning was to ask the locals what their experiences were with coronavirus. We stopped near Soleil 17 and I talked to various people inside a "Covid-closed" school which is scheduled to reopen on August 10. 

The same story was told to me by almost everyone I talked to this morning-- 

They were all aware of many people in Soleil who had fever and headache. When I asked if people with fever and headache were going to the doctor, they said “no” because the state run St. Catherine’s Hospital in Soleil is not functional and is empty. 

They also said that along with having nowhere to obtain medical care, people are very afraid of being attacked if there is the possibility that they have Covid-19. So almost every sick person elects to stay inside and drink home made tea. (Tea is made using lila leaves which are boiled in water and a pinch of sugar and salt are added.) 

I was also told that no one in the slum was getting tested for coronavirus because there is nowhere in the slum that offers testing and many would not want to be tested due to the associated stigma. 

And when I asked if they are aware of anyone dying of the “fever” in Soleil, they said no, but cautioned that their views may be constricted and that there was no “proof” what the sick people really have. 

After doing my “random interviews,” since it was Sunday and Fr. Tom was going to say Mass at St. Anne's Church in the back part of Soleil, I walked over to the church and sat in the back. There were several hundred people in attendance--mainly women and children. Gazing up, I could see the linear bullet holes in the corrugated metal roof of the church from fifteen years earlier when the the UN soldiers (MINUSTAH) were fighting gangs in Soleil leaving many dead. 

This morning there was shooting outside of church during the entire Mass. It was interesting to see the many people in front of me reflexively lowered their heads with each gun shot. Even though they are used to this mayhem in the slum, they still duck as all life is precious. 

Conclusion-- 

Cite Soleil is the worst I have seen it in 40 years. My written words above do this dire situation little justice. The gangs and the virus have decimated a broken place and its innocent people. 

I would say that the level of coronavirus infections in Soleil is very high with essentially no confirmed cases because of a lack of testing. The case fatality rate from Covid-19 is not known here and never will be known. Optimistically, maybe it is lower than in the United States or Italy due to the young median age in Soleil. 

The number of sick people in Soleil is directly correlated with the violence and poverty in the slum and the dysfunction of the Haitian government, which long ago abandoned this population.

Colombian cartels killing those who don't obey their COVID-19 lockdowns

Via The Guardian: Colombian cartels killing those who don't obey their Covid-19 lockdowns. Excerpt:

Drug cartels and rebel groups are imposing their own bloody coronavirus lockdowns across Colombia – and killing those who do not obey, according to a new report by Human Rights Watch (HRW). 

At least eight civilians have been murdered by the armed groups, some of them holdovers from Colombia’s half-century civil war, which are using Whatsapp chats and pamphlets to warn citizens of the lockdowns in the rural areas where they operate.

In Tumaco, an impoverished and violent port city on the Pacific coast, residents are banned by gangs from fishing, limiting their ability to earn money and food. A 5pm curfew – far stricter than the measures imposed by the government – is also forcing street vendors inside. 

Across the country, violent gangs are stopping people from leaving their homes at all, even when sick, according to humanitarian workers cited in the report. In two provinces, Cauca and Guaviare, armed groups have torched the motorcycles of those of those who ignored their restrictions.  

“They have shut down transport between villages, and when someone is suspected to have Covid-19 they are told to leave the region or they will be killed,” one community leader in Colombia’s southern Putumayo province told the Guardian, on condition of anonymity for fear of reprisal. “And people have no choice but to obey because they never see the government here.” Advertisement 

On 8 June, Edison León Pérez, a community leader and activist, was murdered in the Putumayo town of San Miguel by La Mafia, a drug trafficking gang with ties to rightwing paramilitarism, days after he called on local authorities to address the gang’s lockdown orders. 

Like much of South America, Colombia is bracing for the worst of the coronavirus pandemic. Since the first case of Covid-19 was confirmed on 6 March, medical authorities have confirmed 159,898 cases, with 5,625 deaths. Cases regularly climb by over 5000 a day. 

The government has imposed lockdowns, both nationwide and locally, but they have never been as strict as those decreed by armed groups, and the consequences for breaking them nowhere near as grave.

COVID-19: Belgrade protesters storm Serb parliament over curfew

Via BBC News: Coronavirus: Belgrade protesters storm Serb parliament over curfew. Excerpt:

Dozens of police and protesters have been hurt in riots that broke out outside the National Assembly in the Serbian capital Belgrade.  

The protests began peacefully on Tuesday evening and included students and families, angered by a move to re-impose a weekend curfew because of a rise in coronavirus infections. 

Protesters broke into the assembly, prompting police to intervene. 

Clashes erupted and police fired tear gas to disperse the protesters. 

Far-right nationalists have been blamed for stirring up the unrest and storming the assembly building. Serbian media said they included an MP who has pushed anti-vaccine and anti-5G conspiracy theories. 

Serbian President Alexander Vucic on Wednesday condemned what he described as the most brutal political violence for years and appealed for the protests to end, citing the risk of increased infection. 

On Wednesday evening police again clashed with protesters, firing teargas as bottles, stones and flares were thrown from the crowd.

Why the protests began 

Serbia saw its deadliest day so far in the pandemic on Tuesday. President Vucic announced in a televised address that there had been 13 further deaths and 120 people were on ventilators, with 4,000 people being treated in hospital. 

The situation was most alarming in Belgrade, he said, before imposing a ban on gatherings of more than five people from Wednesday, with a curfew in force from 18:00 local time (16:00 GMT) on Friday until 05:00 on Monday morning.  

Mr Vucic said on Tuesday the curfew would apply only to the capital, but he was keen for it to be extended nationally.  

However, in a sign that situation was being reassessed on Wednesday, Serbia's chief epidemiologist, Predrag Kon, said later that Belgrade was improving and a lockdown in the city was "unlikely".  

In a further TV address on Wednesday, President Vucic said a curfew would probably not be imposed on the capital, but stricter measures would be announced. A decision will now be taken by the Covid-19 crisis response team on Thursday.

Serbia has seen a dramatic rise in cases and authorities have announced a state of emergency in several towns and cities. 

Opponents accuse the president of lifting the lockdown far too early, in May, allowing football matches with spectators and few limitations on movement ahead of elections on 21 June that Mr Vucic's party won by a landslide. 

Critics also accuse the government of not giving the true number of deaths during the initial weeks of the pandemic. Serbian authorities say there have been 341 deaths and 17,076 cases. Some 300 new infections are being reported daily.

WHO: Countries complaining about contact tracing are 'lame'

Via an AP report in The New York Times, Dr. Tedros shows that even teddy bears have sharp teeth: WHO: Countries Complaining About Contact Tracing Are 'Lame'. Excerpt:

LONDON — The head of the World Health Organization on Monday dismissed complaints from countries complaining that contact tracing is too difficult to implement as a control strategy for the coronavirus pandemic as “lame.” 

The U.N. health agency has repeatedly advised countries that shutting down their COVID-19 outbreaks requires having a strong contact tracing program in place, a labor-intensive process of tracking down contacts of people with coronavirus to ensure those at risk isolate themselves.  

In recent months, countries with large outbreaks of COVID-19, including Britain and the U.S., have said there are simply too many contacts to trace for an effective system to be put into place.  

Britain had vowed to have a “world-class” contact tracing system in place earlier this month. But the U.K. ultimately ditched the digital app it developed for that purpose and politicians have acknowledged the program is not yet running at full strength despite recruiting thousands of workers. In recent weeks, British health officials have said their contact tracers are failing to reach about one quarter of people with the virus — leaving thousands of people free to pass on COVID-19.  

At a media briefing on Monday, WHO Director-General Tedros Adhanom Ghebreyesus pointed to his emergencies director Dr. Michael Ryan as an example of someone willing to go to extraordinary lengths to conduct contact tracing, citing Ryan’s work — while wearing a bulletproof helmet and vest — during an Ebola outbreak in a part of Congo where armed groups had attacked and killed health workers.  

“He believed he had to do everything to stop Ebola and to show that saving lives actually requires that level of commitment,” Tedros said. 

Tedros said it wasn't acceptable that some countries claimed there were too many contacts to trace and that the process itself was too difficult. He has previously lauded the contact tracing programs adopted by countries like South Korea, Singapore and China, which involved teams of health workers tracing tens of thousands of people and ensuring that those exposed to the virus were isolated. 

Tedros said that well-resourced countries that aren't fighting wars have little excuse for not carrying out good contact tracing.  

“If contact tracing helps you to win the fight, you do it, even (when) risking your life," he said. “If any country is saying contact tracing is difficult, it is a lame excuse.”

Mondragone and COVID-19: Clashes in the night, the army asked by De Luca arrives

Via Corriere della Sera: Mondragone and Covid: clashes in the night, the army asked by De Luca arrives. Mondragone is a town near Naples, which suggests the pandemic may have migrated south from Lombardy. A lightly edited Google translation:

"If we were to have 100 positives after 3/4 thousand screening swabs, all Mondragone will be closed. Have I been clear? I am used to speaking clearly," said Vincenzo De Luca, president of the Region, last night at the microphones of TGR Campania. 

“We have quarantined all the buildings. Now everyone must stay at home, the rules must be respected: for 15 days no one must enter or leave those buildings. This Mondragone situation has existed for years and years. But among interior ministers, prefects and mayors, nobody has noticed. I am used to speaking clearly and I asked for strict 24-hour checks of the army, police and carabinieri to start," he added. 

In the evening, the Minister of the Interior Luciana Lamorgese sent a contingent of 50 soldiers. 

Still tension in the night in the area of ​​the former Cirio buildings, which since Monday has been a red zone due to about fifty coronavirus infections, widespread in particular in the Bulgarian community that lives there. Around 2 o'clock the firefighters intervened for the fire of a van in Viale Margherita, near the buildings. The vehicle was owned by a Bulgarian man. From the first investigations it seems that the cause is painful and that an incendiary bottle was used. 

 After the tensions, 730 swabs were taken to contain the infection of the people of the former Cirio buildings: the staff of the ASL of Caserta moved to Piazza Crocelle and Piazza Falcone to offer tests to citizens on a voluntary basis. 

In Piazza Falcone, near the town of the town at the center of controversy for the new outbreak, a hundred people are ready to undergo the test. "Our daughter has to give birth," says an elderly man, "so we decided to swab for safety."

COVID-19: Amid threats and political pushback, public health officials are leaving their posts

This is appalling. Via The Washington Post: Amid threats and political pushback, public health officials are leaving their posts. Excerpt:

For Lauri Jones, the trouble began in early May. The director of a small public health department in western Washington State was working with a family under quarantine because of coronavirus exposure. When she heard one family member had been out in the community, Jones decided to check in.  

The routine phone call launched a nightmare.  

“Someone posted on social media that we had violated their civil liberties [and] named me by name,” Jones recalled. “They said, ‘Let’s post her address . . . Let’s start shooting.’ ” 

People from across the country began calling her personal phone with similar threats.  

“We’ve been doing the same thing in public health on a daily basis forever. But we are now the villains,” said Jones, 64, who called the police and set up surveillance cameras at her home. 

Public health workers, already underfunded and understaffed, are confronting waves of protest at their homes and offices in addition to pressure from politicians who favor a faster reopening. Lori Tremmel Freeman, chief executive of the National Association of County and City Health Officials, said more than 20 health officials have been fired, resigned or have retired in recent weeks “due to conditions related to having to enforce and stand up for strong public health tactics during this pandemic.”  

Although shutdown measures are broadly popular, a vocal minority opposes them vociferously. There have been attacks on officials’ race, gender, sexual orientation and appearance. Freeman said some of the criticisms “seem to be harsher for women.”  

Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, said attacks on health officials have been particularly awful in California, Colorado, Georgia, Ohio and Pennsylvania.  

This month in California, Nichole Quick, Orange County’s chief health officer, stepped down after she faced threats and protests at her home for requiring face coverings in many businesses as cases rose. The mandate, issued May 23, was softened to a recommendation a week later.  

Andrew Noymer, a professor of public health at the University of California at Irvine who is part of a county task force, said it was not the first time Quick had been undermined.  

On March 17, Quick issued a strict lockdown order; a day later it was amended to add exceptions.  

“It was couched as a clarification, but it was a walk back,” Noymer said, because of pressure from business leaders.  

Quick’s departure is part of an exodus of public health officials across the country who have been blamed by both citizens and politicians for the disruptions caused by the coronavirus pandemic.  

“I don’t think I’ve ever seen anybody resign for the kinds of reasons we’ve seen recently,” Plescia said. “We are very concerned that if it continues to get worse it’s going to have major implications for who will be willing to have these jobs.”  

Ohio’s public health director, Amy Acton, shifted to an advisory role after enduring months of anger against the state’s preventive measures, including armed protesters at her home bearing messages including anti-Semitic and sexist slurs. One Republican lawmaker linked Acton, who is Jewish, to Nazi Germany; another called her a dictator.  

Georgia’s public health director said last month that she receives threats daily and now has an armed escort. 

Pennsylvania’s secretary of health, who is transgender, has come under fire for the state’s handling of the pandemic, including from a county official who resigned after saying at a recent meeting that he was “tired of listening to a guy dressed up as a woman.” 

Four public health officials in Colorado have left their jobs recently.  

A day after telling political leaders in Weld County, Colo. that their insistence on a speedy reopening despite a high case rate and widespread transmission was giving him “serious heartburn,” Public Health Director Mark Wallace got a 7:30 p.m. email: He had until 9 a.m., it said, to weigh in on guidelines for reopening businesses — “churches, salons, restaurants, etc.” They would go public an hour later.  

Wallace, who declined to comment for this article, retired soon after. 

Theresa Anselmo, executive director of the Colorado Association of Local Public Health Officials, said 80 percent of members had reported being threatened and more than that were at risk of termination or lost funding.

Racism, the public health crisis we can no longer ignore

Correspondence in The Lancet: Racism, the public health crisis we can no longer ignore.

Extraordinary times call for extraordinary measures. We are facing a global pandemic, a climate catastrophe, an imminent recession, and possibly depression. The health of the most vulnerable and all of humanity is at stake. Yet there is nothing new, extraordinary, or unprecedented about racism, xenophobia, and discrimination. The killing of Mr George Floyd, on the back of numerous other deaths of Black Americans at the hands of the police, and the two–four times increased mortality risk from COVID-19 for minority ethnic groups have brought to light social and structural injustices that have existed for centuries and are derived from the same intersecting systems of oppression. 

When a single act of violence is captured and amplified on social media, much like the televised US civil rights protests of the 1960s, it brings police brutality into the consciousness of people across the world. It elicits a visceral response, and humanity joins together in condemning racism.  

However, police homicides are a daily occurrence in parts of the world, and the people who die are usually poor, young men from othered groups. When it comes to violence, race and gender intersect. This means that Black and minoritised women are at higher risk of sexual and intimate partner violence, and Black trans women are over-represented in hate crime murders. Society is built on racial hierarchies, established through colonisation, that pervade structures, histories, politics, and, ultimately, minds. Overt acts of violence are surface-level symptoms of structural and cultural forms of racism that extend far deeper. Under this lies a pyramid of abuse, marginalisation, and injustice that exists in every society. 

The forms of discrimination and the targets might vary: in some societies they are based on race or ethnicity; in others, colour, caste, religious beliefs, Indigeneity or someone's migratory status. However, the underlying oppression that caused these injustices to occur are largely similar. Racism and xenophobia are about division and control, and ultimately power. Together they constitute a structural form of violence that results, at the extreme, in innocent people being murdered. 

The COVID-19 outbreak has uncovered a crisis in our social and political fabric extending beyond the outbreak itself: an uncomfortable propensity towards racism, xenophobia, and intolerance exacerbated by transnational health challenges and national politics. Internationally, we have witnessed the vilification of particular nationalities, with overt forms of sinophobia. Politically, xenophobia has been weaponised to enforce border controls against particular nationalities and undermine migrant rights. In the UK, minoritised ethnic groups are more likely to contract a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and, subsequently, face a higher risk of a severe form of illness. 

Why is this? People from minoritised ethnic groups are more likely to work as key workers in frontline jobs that expose them to SARS-CoV-2, and are more likely to live in overcrowded accommodation, meaning social distancing is not an option. They are then more likely to have barriers to accessing health services, meaning that they present late in a worse condition, and with a higher probability of underlying illnesses that put them at greater risk of death. In some cases, the existence of these comorbidities lowers the chances for intubation and ventilation, resulting in a double burden of being more prone to be severely unwell and less likely to receive intensive care.

Beyond these proximal causes of ill health lie racism and structural forms of discrimination. Marginalised groups are disadvantaged in all the social determinants of health. However, racism is more than this, it is a fundamental cause of ill health. At all socioeconomic levels, people of colour have poorer health outcomes. Racism cumulates over the lifecourse, leading to activation of stress responses and hormonal adaptations, increasing the risk of non-communicable diseases and biological ageing. This trauma is also transmitted intergenerationally and affects the offspring of those initially affected through complex biopsychosocial pathways. The root of these so-called biological causes is racism, not race itself. 

Society is unwell. The symptoms—racialised violence, and excess morbidity and mortality in minority ethnic populations—reflect the cause: an unjust and unequal society. Scientists and doctors, by remaining technocratic and apolitical, are complicit in perpetuating discrimination. As a health community, we must do more than simply describing inequities in silos, we must act to dismantle systems that perpetuate the multiple intersecting and compounding systems of oppression that give rise to such inequities and injustices. 

To this end, we are producing a series of academic papers to centre the complex challenges of racism and xenophobia in the health discourse. We are working with a diverse team of academics and activists globally to highlight injustices, identify solutions, and enact change. Alongside this, we are launching the Race & Health movement, a multi-disciplinary community of practice that will continue beyond the social media. 

Our vision is to provide a catalyst in tackling the adverse health effects of racism, xenophobia, and discrimination. Academic outputs on their own are irrelevant. We must use the evidence to advocate for change and improvements in health. In this spirit, we are launching a global consultation, asking: what should we do, and how should we do it? 

Racism kills, and this is a public health crisis we can no longer ignore. As a health community, where were we? As the hashtags disappear and we start to emerge from the pandemic, even in ordinary times, we need extraordinary measures.