My intersection of race and privilege with COVID-19


I am a 40-year-old Black, female pediatric psychologist, and I contracted COVID-19.  So did my 95-year-old grandmother.  This virus flourishes within the inequities, bred by historical and current racism, of social determinants of health, having a more negative impact on Black and brown individuals.  Nevertheless, we both survived.  Black Girl Magic persists, and with the privilege of education combined with the grit of advocacy, my grandmother and I became statistics of resilience.

In March, after two years without a sniffle, I awoke to a 101-degree fever with no respiratory symptoms.  As faculty at an academic medical center, I had access to COVID-19 testing.  However, due to a mangled national response, tests were limited and criteria stringent.  I had not traveled, been exposed to a known case, with no shortness of breath or cough, so I was denied a test.  Twice.    After a negative flu test, loss of smell and appetite, headaches, and dehydration from a 10-day fever, with no improvement–I questioned the effectiveness of the testing criteria.  I had no doubt that respiratory symptoms were prominent among the data available, but I doubted that data included Black women.  That is when I knew I had to advocate for my health, so I called again to access a test, and disclosed respiratory symptoms that I did not have.  I was tested and became the second positive case in my entire institution.  After 14 days, I returned to work seeing pediatric obesity medicine patients via telehealth.

My patients and their families, who are primarily persons of color, are at elevated risk from COVID-19 because of severe obesity and its comorbidities. Given how sick I was, my concern for my patients and their families is significant.  I asked about following stay at home orders, and virus anxieties.  I heard about worsening symptoms of depression from isolation from peers and preferred activities, dysregulated sleeping and eating schedules, and increased substance use.  I also heard about patients still working in grocery stores, restaurants, and call centers, as well as hoping to find work.  I was direct, transparent, and firm in providing education about risk, frequently self-disclosing having contracted the virus myself.  I definitely got their attention, although behavior was unchanged.  At the same time, I also knew that some were working to financially support their families, so despite health risk, the immediate need for food and shelter was priority.  I also know that substance use is a common way to self-soothe.  It pains me deeply to watch social determinants play out in lives so young.  But, I continue to do what I did before the pandemic–promote resilience–by using my privilege to provide care and education to, and advocate on behalf of, my patients.

In April, the need for education and advocacy became personal again when I learned my grandmother had contracted the virus in her nursing home several states away.  She was born in the Deep South in 1925, and survived overt racism, poverty, lack of access to education, and scarlet fever.  I was heartbroken that her life might painfully end as a statistic.  When she was infected, I was well into my own recovery and reading the available information to better understand the pathogen enemy.  I learned about convalescent plasma and was aware that options for donation were appearing locally to me.  I realized I could potentially donate my plasma to my grandmother.  I prayed for wisdom and spent the next several days reading federal regulations, Mayo Clinic research protocols, and speaking to blood banks to learn the process and possibilities.  What I never expected was that my research would make me the most knowledgeable person about the process on my grandmother’s treatment team.  I also didn’t expect to navigate through “that’s so sweet, but …” and initially feeling dismissed more than feeling heard.

As a psychologist, I know that in the most stressful scenarios, personal biases about identity characteristics, such as race, gender, age, and perceived social status influence decisions even more than usual.  And the usual is more than most would like to admit.  I also understand how difficult it is to stay on top of rapidly changing treatment information, and the toll that grueling situations can take on personal and professional functioning.  But, as a Black woman, I have lived my life in the skin of societal subordinance, with education as my only privilege, so I have learned to make myself heard.  Once I was heard, and my knowledge respected, my grandmother received two units of locally available plasma, which played a significant role in saving her life.  She was discharged on her 95th birthday and has returned to baseline.  Because she was the first person in her hospital to receive convalescent plasma, the process is now established for other patients.

As I reflect on the miracle of my grandmother’s recovery, I am struck by the disparity between our life experiences.  She was denied a high school education because of her race and gender, despite being intelligent and wanting to enroll.  Two generations later, I am privileged to hold a doctorate degree.  Her resilience built the shoulders that I have stood on to realize a life of her, and our ancestors’, dreams.  This education has privileged me to medical knowledge, access to resources, the luxury to prioritize my health and well-being, and the skill and confidence to advocate, all of which allowed me to recover from the virus myself, and to help save her life.  It is the same privilege that I wield to support my patients. It is what drives me to donate my plasma and participate in research studies to build more representative data.  However, the reason why this education I have is called privilege is because not everyone has the opportunity for it, especially not people who look like my grandmother, my patients, or me.  Though I am proud of, and grateful for, the resilience that my grandmother and I have been blessed with, privilege of any kind should never be the difference between life and death.

Amy R. Beck is a pediatric psychologist. 

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