COVID-19 is settling into the cracks of American inequality.
Over the last two months, coronavirus cases have surged in the most marginalized neighborhoods of the poorest states. Latinx people account for 18% of the population but 33% of infections. Black Americans are nearly twice as likely to die and three times more likely to be hospitalized with COVID-19. Prisoners, farmworkers and meatpackers — all of whom are disproportionately likely to be poor and minorities — have the highest infection rates.
For many epidemiologists, this pattern has a tragic precursor: HIV.
Before the development of antiretroviral therapy, the human immunodeficiency virus that causes AIDS was concentrated in cities, ravaging gay men and drug users from a relatively wide range of races and incomes. Since the late 1990s, however, AIDS has become a disease that almost exclusively affects the rural poor and people of color.
As of 2018, people of color accounted for 69% of new HIV infections. Black and Latinx Americans are 550% and 80% more likely, respectively, to die of AIDS than whites. The cities with the highest rates of new HIV infections in 2016 included Baton Rouge, Louisiana; Jackson, Mississippi; and Memphis, Tennessee. In 2018, San Francisco had roughly half as many new HIV infections as New Orleans despite having twice as many residents.
“If you put a map of the HIV epidemic over a map of the worst coronavirus hotspots, they look almost identical,” said Jared Baeten, the vice dean of the University of Washington’s School of Public Health and an HIV epidemiologist for more than a decade. “COVID is becoming just another disease that travels along the fault lines of the disparities in our society.”
America’s policies are almost entirely responsible for HIV falling into these fault lines. As epidemiologists look toward likely scenarios for the future of the coronavirus, they are already seeing the same decisions — and the same outcomes — on the...