Meanwhile, the dying continues. Today, the Centers for Medicare and Medicaid Services (CMS) reported on the impact of COVID-19 on Medicare recipients. They’re calling their report a “Snapshot,” but it contains an extensive survey of over 300,000 cases of Americans diagnosed with COVID-19 symptoms from January 1 to May 16, before the events that took place over Memorial Day weekend when social distancing broke down.[2] Here is what the report reveals.

• • The American Medical Association assigned COVID-19 its own coding designation beginning April 1 (U07.1). Prior to that, medical staff were to code it as B97.29–“Other coronavirus as the cause of diseases.” This means that, until April 1, there was no clear way to classify a patient as having COVID-19.[3] They did not give COVID its own B97.2x designation. They don’t say why that is.
  • Medical professionals coded patients with B97.29 even in early January and those numbers hovered around 550 until late February, when they dropped a bit. In March, the cases rocketed upward.
  • More African Americans had coronavirus and needed hospitalization for it through the whole of the survey—something that we know now but that wasn’t stressed until mid-April.
  • End-stage renal disease (ESRD) patients make up a huge proportion of all Medicare recipients with COVID-19 symptoms. ESRD is one relatively common health outcome of diabetes. This means that diabetics were the ones getting coronavirus and ending up in the hospital. Typically, diabetics come from backgrounds where there is food insecurity or food deserts, so opt for less expensive, processed foods.

I feel like a number of insights jump out from this chart. Some of the most important ones we know well by now: this disease was here sooner than we thought. It is hitting the poor and those who live in neighborhoods without the kinds of food sources that would help them thrive. All of these problems converge in many African American, Native American, and Latinx communities, especially in rural areas from South Carolina to Arizona.[4] No wonder Lowndes County, Alabama is suffering so much.

And it’s another strike against the “epidemics are the great levelers” story. This epidemic disproportionately sickens and kills those that were already getting the short end of the stick. Coronavirus is the great exacerbator.

As if things weren’t bad enough, today the president spread the Steven Miller-fueled white nationalism pain even further. His executive order locks H1-B visa holders out of the country until December.[5] This means that skilled workers from around the world will not be able to get to their jobs, nor will they be able to bring their families. He says this will help America. This will not be the case in the South, however, where all the European and Asian automobile companies have come to take advantage of our “right to work” status and our union busting. The tech giants in the West Coast are equally incensed. They have thousands of positions that no Americans are skilled enough to do.[6]

One of the unexpected consequences of the BLM marches and protests has been the tearing down of the lingering vestiges of the Lost Cause. Many statues, plaques, place names, and other monuments to the Confederacy have come down over just this past month.[7] That momentum has also spread to political and cultural icons who have more complicated legacies, like Woodrow Wilson and Thomas Jefferson. Wilson supported the League of Nations and helped broker the peace in 1918, but he was a virulent bigot who did not oppose the reignition of racial violence. This week, Princeton University is mulling over the removal of Wilson’s name from buildings and centers. Why are they thinking about taking this action now, when Princeton had already wrestled with this in 2015-2016, producing an entire commission to study the problem? Part of it may have to do with the demands of students this time. They’re pushing for much broader curricular changes. Perhaps Princeton rulers regard the name change as sufficient mollification to stave off the larger demands. It seems like tearing down these monuments to a false history are a good start, but we can’t just topple them and go home. We need a larger, more sustained process of recovery and healing to address the larger problem of white supremacy that much of this country carries like a virus in its deepest tissues.

Notes

[1] Letter from Dr. Peter NB Peacock to Margaret Peacock, May 4, 1988.

[2] Centers for Medicare and Medicaid Services, “Preliminary Medicare COVID-19 Data Snapshot, Medicare Claims (1/1-5/16),” accessed June 23, 2020, https://www.cms.gov/files/document/medicare-covid-19-data-snapshot-fact-sheet.pdf.

[3] AAPC Coder, “ICD-10 Code for Coronavirus as the Cause of Diseases Classified Elsewhere- B97.2,” 2020, https://coder.aapc.com/icd-10-codes/B97.2.

[4] Amy Goldstein, “Income Emerges as a Major Predictor of Coronavirus Infections, along with Race,” Washington Post, June 22, 2020, https://www.washingtonpost.com/health/income-emerges-as-a-major-predictor-of-coronavirus-infections-along-with-race/2020/06/22/9276f31e-b4a3-11ea-a510-55bf26485c93_story.html.

[5] Nick Miroff and Tony Romm, “Trump, Citing Pandemic, Orders Limits on Foreign Workers, Extends Immigration Restrictions through December,” Washington Post, June 22, 2020, https://www.washingtonpost.com/immigration/trump-immigration-workers-coronavirus/2020/06/22/3b969e88-b489-11ea-9b0f-c797548c1154_story.html.

[6] Sam Shead, “Google, Apple, Amazon and Tesla Slam Trump’s Immigration Crackdown,” CNBC, June 23, 2020, https://www.cnbc.com/2020/06/23/google-amazon-tesla-trump-immigration.html; Michael D. Shear and Miriam Jordan, “Trump Suspends Visas Allowing Hundreds of Thousands of Foreigners to Work in the U.S.,” The New York Times, June 22, 2020, sec. U.S., https://www.nytimes.com/2020/06/22/us/politics/trump-h1b-work-visas.html.

[7] Hilary Green, “Confederate Monument Removals, 2015-2020,” Google My Maps, accessed July 22, 2020, https://www.google.com/maps/d/viewer?mid=142t5-uHjv2fl293rKwx2R71IL-5kAJ8o.