From Spanish Flu to COVID-19 Race, Class and Reopening St. Louis
BY EZELLE SANFORD III AND CHELSEY CARTER
A
s the novel coronavirus and its associated disease COVID-19 burst onto the global stage, its seemingly indiscriminate rate of infection caused some to label it the “great equalizer.” While the virus has the potential to infect anyone, alarming new demographic data demonstrates that while the virus itself may spread indiscriminately, it exacerbates existing social disparities.
African Americans bear a significant burden of the disease and resulting fatalities. As CNN contributor Van Jones put it, “It’s an epidemic jumping on top of a bunch of other epidemics already in the black community.” St. Louis city illustrates this very conundrum. Like COVID-19 today, the Spanish flu pandemic occurred at a pivotal moment in St. Louis history, not only in terms of public health policy, but also in terms of municipal race relations. While St. Louis led the nation in implementing “social distancing” policy in 1918, it contributed to a retrenchment of racial policy fueling the implementation of racial segregation. This century-long history, between 1918 and 2020, has contributed to COVID-19 hitting those traditionally marginalized communities extra hard. he Spanish flu pandemic, of unknown national origin, was similarly seen as a “great equalizer” and remains the prominent comparison point for the contemporary COVID-19 outbreak more than a century later. That early-twentieth-century crisis impacted tens of millions around the world, as the “Great War” came to a close. Among major cities in the United States, St. Louis was the most effective at reducing the flu s fatalities. This was due, in large part, to Health Commissioner Dr. Max Starkloff, who worked with city administrators and special interests to implement a policy of social distancing. Schools and businesses were shuttered. Police enforced distancing. And when cases surged after social distancing was lifted, Starkloff re-implemented the policy, avoiding more fatalities in the pandemic’s sec-
18
RIVERFRONT TIMES
ond wave. While this historical case demonstrates that social distancing works, even today’s coverage neglects the impact of that policy on African Americans. Medical historians, like George Washington University Professor Vanessa Gamble, have noted that African Americans did not succumb to the flu at the same rate as other Americans. But the Spanish flu had a long lasting social impact on African Americans in St. Louis and across the nation. In the years before the Spanish flu hit, African Americans had begun to leave the South in large numbers, making their way to other regions of the country. St. Louis saw its African-American population rise significantly. Between 1910 and 1920, St. Louis’ nonwhite population rose by 59 percent according to U.S. Census data. And in terms of health care access, the city was far from prepared for the influ . Municipal facilities and infrastructure were overwhelmed — including the city’s public hospital. Black St. Louisans obtained hospital care in the colored wards of City Hospital No. 1 or in the private People’s Hospital, if they were hospitalized at all. Frustrated with the lack of access to health care, black elites and health professionals began in 1914 to argue for a negro hospital. Industries depended on healthy laborers, yet many white St. Louisans feared that germs knew no color line. In 1916, St. Louisans voted to support racial segregation ordinances as backlash
MAY 13-19, 2020
riverfronttimes.com
fatalities. In St. Louis, the city’s first four deaths were African-American women. In the St. Louis American, city Health Director Dr. Fredrick Echols announced that the first twelve VID-19 deaths in the city were African Americans. Since then, the mortality rates among the black community in both St. Louis and St. Louis County have continued to rise. Considering these data, COVID-19 is in fact not a “great equalizer.” Although St. Louis is today a mid-sized city, situated far from many coastal virus epicenters, the stakes of its COVID-19 response are exceptionally high. St. Louis’ unfortunate and fraught history of socioeconomic and racial inequities has negatively affected poor and African-American communities. This history, in part, can be traced back to the early twentieth century. Generations of African Americans, particularly in north St. Louis, have and continue to experience undue oppression through social policy. These policies and their ultimate consequences include voter suppression, environmental discrimination, medical racism and experimentation, the racial wealth gap often tied to homeownership, and housing segregation, a consequence of redlining and race-restrictive covenants. How local, state and federal leadership tackle these social inequities will deDr. Max Starkloff. | COURTESY MISSOURI HISTORICAL SOCIETY termine how successfully St. Louis flattens the curve. It was not until April 2 that ffinia ealthcare opened the facilities at the tail end of the flu s testing center in second wave. St. Louis City Hospi- first tal No. 1 was later renamed Max north St. Louis. Suburban and C. Starkloff Memorial Hospital in rural metropolitan clinics imple1942, shortly after the pioneering mented COVID-19 testing as early public health official passed away. as mid-March. A second north St. Amid the COVID-19 pandemic, Louis site opened at Care STL on recent studies have shown that April 6, just two blocks from the frican mericans bear a signifi- historic Homer G. Phillips Hospicant burden of the disease and tal, now Homer G. Phillips Senior are overly represented among its Residential Center. But neither against African Americans rose all across the region. (The United States Supreme Court later deemed ordinances like St. Louis’ unenforceable.) The 1917 East St. Louis race “riot” subjected hundreds to racial violence. The pandemic fueled racial segregation policies, the effects of which have led to African Americans’ disproportionate experience of COVID-19 more than a century later. It is no coincidence that the precursor to Homer G . Phillips Hospital, City Hospital No. 2, opened in 1919 — expanding African Americans’ access to segregated hospital
