COVID-19 X BLACK LIVES MATTER SPECIAL ISSUE by Yale Global Health Review

A SPECIAL ISSUE FEATURING

R x TE T -19 A ID S M OV VE T C LI OC 20 K 20 AC BL

Research-based articles Illustrations Poems & Personal anecdotes

THAT EXPLORE THE TRIALS & TRIBULATIONS OF THE COVID-19 PANDEMIC & BLACK LIVES MATTER MOVEMENT, WITH SUBMISSIONS FROM ALL AROUND THE WORLD

SPONSORED BY

Yale Global Health Review Yale Scientific Magazine Yale Journal of Medicine & Law

CONTENTS

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Black by Popular Demand Catching up in Crisis Echo of Oppression Selling Out Black-Enchained The Day I Was Made Black Stay in the Streets When! Our Rubikâ&#x20AC;&#x2122;s Cube of Race Racism in Medicine Restart the Simulation

CREATOR

EJ Jarvis Rebecca Amonor Samantha Trimboli Ella Attell Omar Almasri Daniel Cardoso Laura Bao Megan Ruoro Madi Lommen Celia Cacho & Ngozi Okoli Chika Ogbejesi

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CREATOR

Rising COVID Cases and the Case for Decarceration Nityshri Baskaran Re: Resourcefulness When Confronting Invisible Enemies Eric Chen Under Fire Cassandra Chu Is the Show Really Paused? Allen Lu a place of separation & running water Jacob Kaufman-Shalett Our Bodies Were Never Meant to Lie So Still Jude Okonkwo The Dangers of Biological Metaphor Gwendolyn Wallace

Short Story

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BLACK BY POPULAR DEMAND By EJ Jarvis

reaking news: An eighteen-year-old, African-American male has just been shot and killed by a police officer. It is believed that the suspect was unarmed at the time. Officials say that the police officer who fired the shots has been placed on administrative leave. Many of you have heard this story. Many of you have cried over this story. But what if I told you this story isn’t real? What if I told you that the eighteen-year-old, unarmed, African-American male was me? What if I told you that my death sparked riots across America; my face printed on thousands of t-shirts saying one phrase: Black Lives Matter. What if you saw images of my body, lying still in the street, three bullet wounds: two in my back, one fatal shot in my head. You see me bleed out, handcuffs pressing against my wrist. I take my last breath and close my eyes. That isn’t who I am. I am not dead. I am right here. I am alive. I am not just another hashtag. I am EJ Jarvis. I am a son, an older brother. I am loved by both my mother and my father, equally. I have dozens of positive role models who are not just present but involved. I am an exceptional student and graphic designer; and I love to play basketball. I am not just another eighteen-year-old, unarmed, African-American male. I am a unique individual. I am me. As I grow older, I begin to understand that my skin color comes with a price. Many want to observe it, some desire to kill it, and few are bold enough to replicate it, market it, and profit from it.

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People who don’t look like me or you will dance like us, talk like us, and even try and look like us. They want to be Black but keep their white privilege. They simply want to be us, that is until things get serious. When innocent people are killed, when drugs destroy neighborhoods and families, when fathers go to jail, when siblings are split apart. When an eighteen-year-old, AfricanAmerican male is pulled over for no good reason, except for the fact that he looks suspicious. Except for the fact he is Black. Outsiders will adore our culture but ignore our struggle. They will love our features but dehumanize the people who own them. They want to be just like us, but make fun of us when we “act Black.” We are no longer looked at as people. But as statistics and data. My skin color is what is in style. Our culture is the new trend. We are Black by popular demand. ■

EJ JARVIS is an undergraduate student from Washington, DC, USA, currently studying at Yale University.

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Personal Anecdote

CATCHING UP IN CRISIS A GHANAIAN-AMERICAN PERSPECTIVE ON THE BLACK LIVES MATTER MOVEMENT

By Rebecca Amonor

“S

hould Africans be concerned about social justice?” This was the headline of a flyer that my church sent out about a Zoom panel they were hosting on Sunday, June 28, 2020. Two thoughts immediately jumped to my mind: why is this even a question, and further, why are we just now having these conversations? Even in my own home, I have seen my family talk about racial injustice in a way that I have never witnessed before. The mass revival of the Black Lives Matter movement, sparked by the murder of George Floyd, has not only opened the eyes of non-Black people in America to racial injustice, but it has opened the eyes of my community of African immigrants in Columbus, Ohio. In this time of COVID-19 and racial injustice protests, my community has finally realized that the ir ethnic differences do not exclude them from the racial injustice that threatens every Black American.

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Personal Anecdote

To understand the position of Africans immigrants in the context of racial injustice, one must first understand the ethnic background of my local church community. The church I attend is predominantly Ghanaian, and the members consist of Ghanaian immigrants and their children—people like me who were born and raised in the U.S. or those who attended a significant portion of school in the U.S. One key difference between people like myself and the older generation in the church is that we do not understand our Blackness in the same way. The older generation of Ghanaians distanced themselves from the African-American community and identity, while the younger generation drew closer and thus see us as more similar rather than different from African Americans. Growing up in my Ghanaian community, the older generations always reinforced in their words and actions that we were not African Americans. Ghanaians in my community ate their jollof rice, listened to their hiplife music, wore their kente cloth, practiced their special funeral customs, and spoke their native language—Twi. While African Americans ate their cornbread and collard greens, listened to their R&B, wore their stylish clothes, practiced their funeral customs, and spoke their slang, or Black English. Ghanaian immigrants had African accents; African Americans did not. And in addition to the differences in culture and lifestyle, Ghanaians in my community unfortunately associated crime with African Americans and allowed the negative media to really shape their perception of the African-American community. In America, the older Ghanaians in my community adopted the reality that African American is equivalent to Black, and thus never identified as Black—except legally. Since Ghanaians in my community did not perceive themselves as African American, growing up I never heard conversations about racial injustice or oppressions because Ghanaians saw that to be an African-American issue. Ghanaians in my community saw themselves as separate from African Americans, even though as Black Americans they were still oppressed by the same racist systems and structures in America as African Americans. Due to the separation between African and African American that my community enforced, as a child I faced internal tension about my Black identity in America, for I grew up in a Ghanaian household and was socialized into African-American culture by my peers. I did not eat jollof or corn bread, but both. I listened to both Ghanaian music (not as much by choice), and AfricanAmerican music (I love the sound of R&B). I wore kente cloth to church and dressed in the typical trend at school. I understood

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Twi, yet also spoke in Black slang at school. Despite the feeling that these two Black identities were mutually exclusive, I was, am and will always be Black in both ways—African and African American. Therefore, although at home I never had conversations about racial injustice, I experienced it outside and actively discussed it with my Black friends; as a child of African immigrants, racial injustice is not new to me. However, for the older generation of Ghanaian immigrants in my community, the recent resurgence of the Black Lives Matter movement has sparked a light in them: the realization that the African-American struggle is their struggle too. In my own home, I have heard my dad make comments about his difficulty as a Black man in American—something I have never heard him vocalize before. I have even seen my own sister, who like me grew up in both African and African-American culture, express pain and passion towards racial injustice, something I have never seen her do before. Also, in my church youth group chats I have seen my leader—a Ghanaian man, a Black man—express his pain and anger towards the senseless killings of Black people in America. I believe that the senseless murders of George Floyd, Breonna Taylor, Ahmaud Arbery and so many others has not only helped Africans understand that they should care about social injustice, but come to the realization that they have been and are the victims of racial violence and injustice in America too. It is unfortunate that it has taken a global pandemic and mass protests for Africans to finally see that racial injustice plagues every Black person in America, Africans included. But although a little late to the field in the fight for racial justice, I am thankful Africans are joining. I hope that African immigrants’ support of the Black Lives Matter movement does not fade with the momentum, but that Africans stand together with African Americans in Black solidarity. My dream is that one day Black people from all over the African diaspora will stand together with and for each other, celebrating our differences that enrich the diversity of the Black community, rather than function as points of dissension between groups. Because at the end of the day, Africans and African Americans are all Black, and I hope we come to understand that we can be unified without being uniform. ■

REBECCA AMONOR is an undergraduate student from Columbus, Ohio, USA, currently studying English and AfricanAmerican Studies at Yale University (’21).

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Illustration

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Illustration

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ECHO OF OPRESSION

aking quotes from the overwhelming media, this piece is a visual representattion of the undeniable oppression being brought to light in the United States. Words of anger, disappointment, and painful empathy surround a black woman who is just trying to protect herself in the face of America. This piece is not only a symbol but an exhortation to listen to and understand the emotions and experiences of the Black community. â&#x2013; SAMANTHA TRIMBOLI is an undergraduate student from Staten Island, New York, USA, currently studying at Yale University (â&#x20AC;&#x2DC;23).

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Personal Anecdote

SELLING OUT By Ella Attell

ates Mills, Ohio, is not the kind of place where political feathers are ruffled. Multi-generational homes sprawl across green acreage with the righteousness of money that is no longer earned but inherited. It’s idyllic in aesthetic: maintained but not cookie-cutter, sophisticated yet rural. It’s not uncommon to see equestrians take their horses out for morning trots alongside BMWs and vintage convertibles. Ninety-three percent of the village is white, one percent of residents are Black, and nearly no one falls below the poverty line. When George Floyd gasped for air, he wasn’t breathing the air that residents of Gates Mills breathe. And even when Cleveland residents took up signs and chants, the tear gas stained air I encountered felt like it had never touched the shuttered stables and rose gardens only thirty minutes away. I have to think that when some protesters started throwing bricks at court house windows, they imagined raging against the iron gates that have kept so many people out of places like Gates Mills. And yet, while glass shattered downtown, not a blade of grass was askew in one of the many communities in my state that effectively voted Donald Trump into office. I thought for a moment that our efforts as protesters would be better spent marching through the tree-lined streets of a community that treats tax law like a suggestion and voter suppression as folklore.

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BLACK LIVES MATTER

When I passed through Gates Mills days after the protest, I couldn’t help but become unhinged at the sight of a lawn jockey in blackface. My first impulse was to return to the village at night and smash or steal the statue to spite the homeowners. And yet, I found myself persuaded by better angels to take a different approach. So, I penned a placating letter:

they cracked open Audre Lorde or W.E.B. DuBois, and they likely still belong to the local country club in which the guests are white and the employees Black. Should I be content that they made a conscious alteration even if a can of white paint means virtually nothing to anybody but the involved parties? I think the answer lies somewhere between yes and no.

In front of your lovely home, there is a lawn jockey dressed in red. As you will see in the second document, the lawn jockey has a complicated history. Often depicted as a caricature of the African-American male (large lips and dark skin), lawn jockeys are ornaments of servitude. In short, they present the African-American man as in service of his white homeowners for whom he lights the path and decorates the lawn he serves.

I have to think that their display of Black servitude had fostered some kind of internalized legitimacy of racial superiority. The objects we surround ourselves with are the subtle forces that move us, and the spaces those objects inhabit determine how we move. One should reckon with that statue in a museum or on the cover of Paul Beatty’s Sellout, not pass it mindlessly on the way to work.

It is important to note that the lawn jockey may have been used as a tool during the Underground Railroad to signal freedom to enslaved peoples. If you display your lawn jockey to celebrate this particular history, I understand your doing so and would perhaps suggest tying a green ribbon around the statue’s wrist as a more explicit celebration of the positive history of the lawn jockey. If you display your statue for its kitsch, however, I urge you to contemplate how such a decoration perpetuates the narrative of Black folks being less than their white counterparts. It is this particular idea of racial hierarchy that contributes to disproportionate rates of police brutality and the mass incarceration of Black Americans. Please consider the history of the lawn jockey as well as your personal ability to counter the stories our country should no longer tell.

Then there’s the lie of the letter, perhaps the very reason they acted. I’m not their neighbor. I don’t belong to the Homeowners Association or sit on local boards. The owners of this statue and I, unbeknownst to them, are completely anonymous to one another. And yet, I suspect that these particular homeowners will hold themselves differently at the next neighborhood cocktail party, believing that someone in this crowd thinks them tactlessly racist. Is it wrong that I had to make myself one with the oppressor to elicit change? Maybe so, especially when it seems like people of great privilege are always the ones being met halfway. Taking or destroying the statue would have given the homeowners a closer sense of what it is to not be rich and white. For a second, they might have known what it’s like to feel as if your property doesn’t belong to you, but likely their anger would just have affirmed anything they’ve ever wrongfully believed about anti-racist efforts. I wish that weren’t so.

I left the letter, along with some reading about the history of the lawn jockey, without expectation of removal. To my surprise, just days later the statue’s face was repainted in white. Was this victory? I’m not so sure.

I suppose, in some sense, I am their neighbor. If we let collective humanity be the only zip code that matters, then Tamir Rice, who was murdered just a few exits from Gates Mills in 2014, was their neighbor too. I wonder what the world would be like if people of privilege started referring to the too many Black deaths in our country as “my neighbor was murdered.” With perspective, our world, no matter how siloed we have designed it to feel, isn’t big. We are all neighbors, stewards of the same earth. We just happen to forget it more frequently than we remember. ■

I chose a moderate approach and, in turn, got a moderate result. The homeowners didn’t remove the statue nor did they, to my knowledge, make donations to bail funds or boycott corporations that use incarcerated labor. I doubt

ELLA ATTELL is an undergraduate student from Cleveland, Ohio, USA, currently studying at Yale University (’23).

Signed, Your neighbor

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Poem

BLACK-ENCHAINED By Omar Almasri

ILLUSTRATION COURTESY OF KITTY KAN

Black The color of excellence, inventiveness, eloquence and poise, heroism and valor, athleticism and intelligence, historic feats and immeasurable impact MLK, Ali, Shabazz, the OG Baldwin, Huey/Fred, Harriet, Sojourner, Rosa, Shirley, Angela/Assata, Stevie, Ray, Louis, Marvin, Prince, James, Tupac/Biggie, Aretha, Billie, Ella, Marian, Whitney, Lauryn, MJ-B, Beyonce Kareem, Satchel, Hank, Arthur, MJ-squared, Serena, Althea, Flo-Jo, Lisa, Debi, Simone, Jackies 42 and 88 Never enough They’re still: marginalized, crippled, sneered at, vilified, demonized, and criminalized by the system, the establishment, hierarchy designed and built to weigh them down, to make them feel less than, and force them to push, stand up, wrestle for parity and equal opportunity for their: basic rights, equality and dignity, liberation and emancipation, affirmation at the expense of their adolescence, adulthood, and life expectancy Breonna Taylor, Eric/a Garner, Trayvon Martin, Sandra Bland, George Floyd, Emmett Till lives taken and robbed, gunned down, strangled, and disfigured by the system, white-empowered and Black-enchained, that continues its ruthlessness and pitilessness unabated But the streets, from all corners and angles, continental or pocket-sized, never forget, relent, nor yield to change the tables, the imbalance, disproportion, discrimination, racism, and marginalization in the face of hails of bullets, tear gas, and beatdowns They’ve done it once, twice, thrice, countless and incalculable amount of times And they’ll do it again, hopefully for the final time ■

OMAR ALMASRI is a master’s student from Amman, Jordan, currently studying at Arkansas State University.

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Personal Anecdote

BLACK LIVES MATTER

THE DAY I WAS MADE BLACK By Daniel Cardoso

ILLUSTRATION COURTESY OF JOYCE TSUI

My “Bl a ckn e ss” wa s giv en to m e b y s oc i e t y. I remember the day I was made Black. In third grade, I was filling out a form for what I believe was the Connecticut Mastery Test. My parents, to their credit, never defined me by race. So, when given the option to select “Race,” I chose “Other.” After all, based on my knowledge of crayons, my skin was neither black nor white. When I had to choose “Ethnicity,” I also chose “Other.” Based on everything I was taught up to that moment, I was an American. That was the only way I thought to define myself. But, this was not an option. My teacher was checking to see if everyone was done filling out the form. When she saw mine, she said that I had filled it out wrong. She told me to select “Black” for “Race” and “African American” for “Ethnicity” I was very confused because these were not the ways that I thought of myself. But, I did not argue because my parents taught me to respect my teachers, and I didn’t think it was a big deal either way.

That was the day I was made Black. It is almost thirty years later, and I have had a lot of time to learn what it means to be Black in this country. One of the consequences is that people still feel the need to remind me of my Blackness with their questions and their jokes. So, forgive me if I am Black and I am angry. Because after all, society chose this role for me. I would have been happy with just being an American. ■

DANIEL CARDOSO is a community member from New Haven, Connecticut, USA, and a graduate of Southern Connecticut State University. https://bit.ly/covidxblm

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Illustration

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STAY IN THE STREETS T

o encourage all the young people standing up in the streets, using their voices to force change—keep on going! Thank you for what you are doing and for giving hope to the generations coming up behind you. ■ LAURA BAO is a designer from Los Angeles, California, USA.

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Poem

“WHEN!” By Megan Ruoro

I am so tired. Weighed down By the constant throbbing beneath my dark brow. The close pang that I must put on numb in order to function. In order to survive. Everyday I feel the cackle of metal chains Pounding against my bones, Gifting me with an endless brokenness that I am required to fill. So I mend myself With amendments to myself, Molding into something More or less like a self. Drowning out the throbbing of my brow With discussions. Disregarding the sweat in my eyes With understanding. Ignoring the pain of the color of my skin With forgiveness. But I am so tired. Tired of the “have you heard?”’s and the stories and the numbers and the rants and the retweets and the likes and the statements and the videos that were once my brothers and sisters. When? When? When!

MEGAN RUORO is an undergraduate student from Harrisburg, Pennsylvania, USA, who will matriculate at Yale University (‘24).

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OUR RUBIK’S CUBE OF RACE IN HONOR OF GEORGE FLOYD ON JUNE 2, 2020

By Madi Lommen

want to learn the colors and to solve the Rubik’s cube at the same time. That is what it feels like to process the death of George Floyd by a white police officer on the streets where I grew up and all of the events that have unfolded since. My heart wants to cry, my head wants to know how to “fix” it, and my feet want to realize that solution—as if there is a solution to crime against humanity. As if there could ever be a solution that would bring George Floyd back to life.

I did not know George Floyd. I am not mourning his death like his family is. I am mourning how deeply ingrained racism is within the American justice system, still. What does that actually mean? It means that in the South, where confederate flags still cling to the doorsteps of rural homes, a Black person is eleven times more likely to end up on death row than a white person if the victim is white—twenty-two times more likely if the person is Black and the defendant is Black, too (Stevenson, 2012). It means that although Minnesota has the second highest graduation rate of public schools in the United States (Table 228, 2006), it also has a high achievement gap between

white and non-white students.1 It means that I can live my life as a white person without knowing the statistics, but my Black friends cannot. Growing up, I shifted between “white suburbia” and “urban city kid” with relative ease. The loss of my parents’ business and an ugly divorce set my family back financially, but for the first memorable decade of my life, I lived without having to confront, at least in any chronic fashion, unwarranted prejudice. Instead of adding to the racial inequity that my friends of color faced, setbacks created a commonality between me and other kids at

65% of White students in grades four and eight achieved ‘proficiency’ on the reading and math MCAs (Minnesota Comprehensive Assessments, the standardized test all public school students take across Minnesota) respectively, while only 31% and 29% of Black, 31% and 25% of Native and 32% and 35% of Hispanic students did, respectively (Grunewald and Nath, 2019). 1

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Personal Anecdote

school who were on scholarship or came from single-parent households, many of whom were also Black. I often sat at the “Black lunch table,” the only one my college preparatory school tolerated. We got along, those classmates and I. None of us could keep up with the lives of our classmates, especially when it came to birthdays and vacations.

When Jaila and I settled on our mere existence as our thencondition, we testified to a single polarizing fact: that we existed—the most basic of truths that George Floyd and too many others can no longer claim. Our existence now gives us the opportunity to be witnesses. It also gives us the opportunity to be more than witnesses; it grants us the opportunity to act.

I distinctly remember one of those vacation periods at home, spring break of eighth grade. I was crafting a banner that would decorate our school entrance for a special campaign that a friend, Jaila, and I were planning for the day we all returned to class. Jaila was African American, later my co-captain of the volleyball team, Homecoming Queen, and my best friend. She and I had planned a project to fight bullying. We were calling it REACH: Raising Expectations And Changing Hearts. We wrote a proposal, pitched in to the dean, and convinced teachers to cancel an entire day of class for students to engage in “team-building” exercises that would build relationships without ever mentioning the word “bullying.” We even made t-shirts, complete with an emblem of a water droplet falling into a pool to reflect that our campaign would inspire a “ripple effect” of kindness.

Medaria Arradondo, the Chief of Minneapolis Police, responded to questioning on the pending punishment of the three police officers present alongside Derek Chauvin, the white police officer responsible for George Floyd’s death, in an interview last week by saying that those who are complicit in injustice take the side of the oppressor (“Floyd’s Family Asks Police,” 2020). Knowingly or unknowingly, he was quoting the cleric and activist, Desmond Tutu: “If you are neutral in situations of injustice, you have chosen the side of the oppressor.”

That was nine years ago. Today, I live nine thousand miles away in Singapore under strict lockdown measures to contain the spread of coronavirus, whittling away at a book project that involves deciphering a twentieth-century scroll of Chinese calligraphy. Jaila works at a sports entertainment agency in Charlotte, soon to be Atlanta. I called Jaila on the fourth day of protesting in Minneapolis. We both treaded lightly: how are you? It was a simple question, but we both knew the answer was loaded with emotions words could not describe. “I am…I am—” “You are.” “I am.” In Just Mercy, a book about the injustices of the American criminal justice system, defense attorney Bryan Stevenson draws upon the European leader Vaclav Havel for inspiration on his especially tough days in prison: “When we were in Eastern Europe,” he quotes Havel saying, “we were dealing with all kinds of things, but mostly what we needed then was hope, an orientation of the spirit, a willingness to sometimes be in hopeless places and be a witness” (Stevenson, 2015).

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I agree. Still, my fingers hesitate to shift the Rubik’s cube. Just because I see some colors, wouldn’t it be better to learn them all first? At what point in uncertainty, in other words, do we act? I am struggling with this particularly in the context of social media. While I recognize that posting stories can build awareness, I also question whom those stories reach. Take it from the Bible or just common sense: “If you love those who love you, what credit is that to you?” (Luke 6:32, New International Version). It is harder to love those with whom you disagree. Social media enables us to feign activism by advocating our beliefs to like-minded followers without confronting those who hold opposing beliefs. Would not that uncomfortable conversation with your white, veteran uncle who occasionally makes racist comments be more effective than double taps on Instagram from people who already like you? This is not to say we should not speak up when injustice prevails. Rather, I have settled on three thoughts to consider as a starting point when doing so. First, the medium through which we choose to voice our opinions itself is an implicit statement about how we want people to engage and what types of responses we wish to receive. Are we—am I—willing to risk a family feud by talking politics at our next gathering? I still believe that a face-to-face conversation can be the most intense, but also the most powerful, method of productive change. Second, when we do post digital stories on our social media, let them truly be that: stories. Seeing the destruction

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Personal Anecdote

of my home city this week, I cannot help but think of the lives of people impacted by fires caused intentionally or not during the riots. In part, this is because I joined the American Red Cross in 2016 as a responder on the Minneapolis Disaster Action Team (DAT). My main responsibility in the four years since has been to guide families displaced by house fires through immediate next-steps after their house has burned down. I am often the first point of contact after firefighters and see firsthand how devastated some families are, sometimes losing pets. I have even met people at the hospital, although thank God, no lives have been lost on any of my cases thus far. When fires broke out at the protests last week, the flames displaced thirty residents in an affordable housing complex, many of whom were struggling within the same fallible systems rioters set out to expose. How do these residents feel? Hearing their stories may shed light bright enough to change our perspective on how and when protesting becomes counterproductive. Third, we have a choice whether or not we compound polarization. When we use rhetoric like, “we have no leadership” and “shoot the white folk” (heard at a rally in Minneapolis on Thursday, May 28, 2020), we blanket complex situations that exacerbate (or excuse) political polarization (Carlson, 2020). Indeed, some of the loudest voices with the widest audience (e.g., Trump, Limbaugh) have done more to separate than to unite our country (“Rush Limbaugh Denies White Privilege,” 2020). At the same time, however, there are leaders, many of whom are local, who have demonstrated tenacity and compassion: Tim Walz, the governor of Minnesota (whatever your views on his coronavirus policies, he condemned looting as a distraction from real racial problems with little-disputed clairvoyance) (“Governor Tim Walz”, 2020); Phil Hansen, CEO of the American Red Cross Minnesotan Region; Justin Simmons, free safety for the Colorado Broncos; Frederique Schmidt and Mauri Friestleben of Minneapolis schools... I am grateful to these people for their “Vaclav Havel” type hope during this time. Jaila and I disagreed on something when we talked about the riots. “If they would just do what we asked and convict the four policemen,” she said on the phone, using “we” to invoke either all protestors or all Black Americans, I wasn’t sure which, “then there wouldn’t need to be any more riots. No justice, no peace.” I thought otherwise. This is bigger now than the charges of four policemen. People have usurped the peaceful protests with

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other agendas, however well-intentioned, that undermine the real reason people ought to protest: an innocent Black man died at the hands of the very body that was supposed to protect him. I said as much, but my mind ventured further: “No justice, no peace.” Last night, I got on my knees, and I asked to hear God through the noise. His answer shook me: there is no “justice” for a life wrongly taken. George Floyd’s family will decide for themselves what they need to heal. For me, another’s punishment does not assuage the pain of losing a loved one, at least not completely. I am not saying that the officers should not be punished; they should be. What I am saying is that punishment alone will not solve the Rubik’s cube that is our puzzle of interconnected sociopolitics. “Many seek an audience with a ruler, but it is from the Lord that one gets justice” (Proverbs 29:26, New International Version). Besides, who am I to judge? Christianity tells me that my sin murdered an innocent man named Jesus. And how did he repay me? He granted me eternal life. It is my responsibility to realize justice only insofar as I vote for representatives who ensure a legal system neither favors nor discriminates. The rest is up to local authorities, and spiritually, up to God, if you choose to believe. It is my responsibility whole-heartedly, however, to build a society in which people of all colors can have life, liberty, and the pursuit of happiness. It is my responsibility to learn the Rubik’s cube. And it is my responsibility to turn and to twist to see all its colors, even if I make mistakes in the process. When Jaila and I were about to hang up, she told me about the end of a saga in Finland, her transition to North Carolina, how Mom and Grandma were. “I love you,” she said. “I love you, too.” Those three words were enough to give me the courage I will need for all the mistakes I will make in twisting and turning our Rubik’s cube. ■

MADI LOMMEN is an undergraduate student from Minneapolis, Minnesota, USA, now studying at Yale-NUS College (‘20) in Singapore.

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Research-Based Article / Personal Anecdote

RACISM IN MEDICINE

RETHINKING THE WAY WE TRAIN FUTURE DOCTORS

By Celia Cacho & Ngozi Okoli

he Black Lives Matter movement and events surrounding it have brought to light how ingrained racism, specifically anti-Blackness, is within American society. Although systemic racism manifests itself in many forms, it is particularly rooted in the damage of Black bodies and the deaths of Black people. The term “medical racism” is the embodiment of this destruction and encompasses the ways in which Black people have been exploited, overlooked in terms of their scholarship and contributions to the medical field, and altogether disregarded. This historical abuse, coupled with recent protests, prompted several pre-health students to write an open letter and create a resource document to guide future health professionals in addressing the problematic origins of medicine that continue to affect Black, Indigenous, and people of color (BIPOC) patients today. The use of Black people for experimentation has existed since the early days of slavery. John Brown, an enslaved man, endured several experiments at the hands of a white doctor (Washington, 2008). He was exposed to extreme temperatures—sometimes using fire—as the doctor attempted to find remedies for sunstroke (Mithcell, 1997). Anarcha, Betsey, and Lucy, three of twelve enslaved women, underwent various painful operations carried out by James Marion Sims (Washington, 2008). His procedures became the foundation for modern gynecology. Though slavery ended before the turn of

the 20th century, the experiments and exploitation did not. From 1932 to 1972, six hundred black sharecroppers from Macon County, Alabama were enrolled in the US Public Health Service’s Tuskegee syphilis study (“Tuskegee Study”, 2020). The men endured unnecessary procedures, and those with syphilis were never formally diagnosed nor treated, resulting in blindness, dementia, and death (“Tuskegee Study”, 2020). Undoubtedly, the need for medical “innovation” has consistently been used as an excuse for white doctors and researchers to justify harm done to Black people.

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Beyond the experimentation and exploitation endured by Black people, the contributions of Black physicians and researchers within the field of medicine continue to be underappreciated. Dr. Charles R. Drew developed techniques for blood preservation, saving the lives of millions of patients in need of blood transfusions today (“Charles R. Drew, MD”, n.d.; “Celebrating 10”, 2019). Dr. Marilyn H. Gaston’s 1968 study on oral penicillin in children with sickle cell anemia led to the development of a national sickle cell anemia screening program, which has become a staple of newborn

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Research-Based Article / Personal Anecdote screenings in the US (“Celebrating 10”, 2019). Dr. Patricia E. Bath founded the discipline of community ophthalmology, a community health-based approach to vision care, to address the inequities she observed during her residency (“Celebrating 10”, 2019). Although the groundbreaking work of these Black doctors has positively contributed to the health outcomes of patients across the country, few people can associate these scholars with their work. Today, medical racism manifests itself in the disproportionately high rates of mortality and morbidity experienced by Black patients in America. Black people are less likely to receive pain medication when compared to their white counterparts (Goyal et al., 2015; Meghani et al., 2012). Among Black women, roughly forty per one hundred thousand live births result in pregnancy-related deaths, over three times the rate among white women (Petersen, 2019; Hoyert & Miniño, 2020). What is worse is that many of the deaths are preventable, mainly attributable to systemic issues including lack of access to quality treatment and physician bias (Petersen, 2019; Hoyert & Miniño, 2020). The recent pandemic has failed to break the cycle. As of June 2020, Black people have made up twenty-three percent of COVID-19 deaths despite making up less than thirteen percent of the US population (“COVID-19 Provisional”, 2020). Thus, healthcare facilities are more often than not a line between life and death for the Black community. Medical racism also involves the perpetuation of harm done to Black bodies within medical education. Most often cited is a 2016 study that surveyed first- and secondyear medical students. Forty percent of these students believed that “Black people’s skin is thicker than white people’s,”(Hoffman et al., 2016) and with this belief comes the assumption that Black patients feel less pain and are biologically different from their white counterparts. Students like those in the study eventually become doctors, allowing their biases and false beliefs to permeate the healthcare system—causing even more harm to Black patients. Unfortunately, this issue is not isolated to the Black community but extends to the BIPOC community at large.

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In 2018, 56.2 percent of active physicians were white, 17.1 percent were Asian, and only 11.1 percent were under-represented minorities (URMs) (“Figure 18”, 2019). This lack of diversity among physicians compounds the damage done by inadequate medical school curricula, leading to increased distrust between BIPOC patients and their physicians. As stated in the open letter, “[H] istory always manifests itself in the present,” and as the medical system stands now, this pattern of bias and misinformation paired with distrust is guaranteed to continue. So how do we fix this? How can we make things better for patients of color? Part of the solution is to increase the number of URMs in medicine. Although increased minority representation in the medical field should not be viewed as the cure-all-end-all solution to this problem, URMs often share lived experiences that are very useful in combating physician biases. However, with this goal realistically being achieved far in the future, it is important to set and achieve smaller goals that more immediately improve the quality of care for minority patients. One option is to educate all pre-medical and pre-health students on topics ranging from the history of racism in medicine to inequities in access and quality of healthcare to BIPOC patients. Such education would compel doctors to face their implicit biases, including those they may not even realize exist. Because doctors are entrusted with the lives of others, they must have a profound understanding of how the history of medicine and race impacts their patients’ access to and ability to receive care. Medical school prerequisites are excellent at ensuring that medical students are competent in the sciences but do very little to ensure that doctors, with all of their scientific knowledge, can properly care for their patients. Though many schools recommend that students take a social science course (typically introductory psychology or sociology), choosing which courses satisfy this requirement are largely left up to the applicant. Additionally, these introductory courses rarely, if ever, adequately cover a topic like medical racism.

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Consequently, many medical school students matriculate without ever having learned about the disparities of medicine and why they exist. These doctors will continue to put the lives of BIPOC at risk by belittling their pain and not comprehending how such patients’ experiences outside of the doctor’s office directly impact their state of health. Hence, without knowledge of these disparities and this history, doctors are doomed to perpetuate them. Medical racism exists two-fold, within the prejudices that doctors hold and within the structural biases that make healthcare disparities an institutional problem that will ultimately require institutional support to fix. As aspiring doctors, we have learned about these disparities. And as black women in America, we have experienced the results of continued racism within healthcare. We know that as wellintentioned as we are, certain systems—as they stand today—will continue to deter us and others from finally bridging the gaps in the quality of medical care between white patients and BIPOC patients. Checking biases is, at the very least, a very productive place to start doing the necessary work. The open letter is intended to raise awareness about medical racism and provide resources for education against it, but it is just a small start to the anti-racist work that needs to be done at medical institutions. Medical schools should follow suit and require pre-med students to take courses on racism in medicine and health disparities among BIPOC patients. This revised premed curriculum would reflect the value of understanding both patients and science within the practice of medicine. Both are inextricably important to cultivating properly trained doctors. ■ Link to the open letter: https://bit.ly/33FtXxV

CELIA CACHO from Bronx, New York, USA, and NGOZI OKOLI from Glenview, Illinois, USA, are both undergraduate students currently studying at Yale University.

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BLACK LIVES MATTER

Poem

RESTART THE SIMULATION Part 1 What am I supposed to think right now? My knees hurt. Thoughts and prayers are too weak to be tinder. The hashtags kindle no more than performance. Nothing is working. I may not be violent, But I’m angry And I’m not alone Even if my anger burns with a different hue. His anger burned so bright it took down buildings with it. Her anger scorched statues and roasted strangers. My anger blackened the streets and said enough is enough. And now they say we are too angry. They don’t know the heat in my core That’s boiling me from within, Filling my lungs with smoke until I can’t breathe. I feel so powerless. Like the world is resting on my neck, Holding me back While I lay on my chest. I burn through my bank account, donating here and now there, but I still feel hidden in the shadow. What shall I do instead? I can read, I can write, I can share the word, donate more— But what can I do, in the here and now that will mean something? God, I hope this is a simulation because this was a failed attempt.

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Poem

BLACK LIVES MATTER

By Chika Ogbejesi Part 2 Shall I give up on this world? Be done with it? Let the sun’s rays do as it will As I watch and burn as well. Shall I stay, but not fight? Be in the world, but not of it Because charred flesh doesn’t smell as good now as it did when it was the flesh of a Black body? Can I still love these people? Even the ones that make me lose hope, Make me want to see this world smolder And all of the peace ablaze with it. Because it doesn’t deserve to be safe and privileged and secure While so many fear for their bodies every day, Fearing the boys in blue and the boys in ICE. Fearful because they have names cauterized into their minds, Names others have forgotten. We are in the season of upgrade Tasked with creating Something new From something broken. But how will we do it better? What glitch will we fix in the simulation So that when we face trial and tribulation We aren’t forced to restart? ■

CHIKA OGBEJESI is an undergraduate student at Yale University (‘21) from Madison, Connecticut, USA.

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Research-Based Article

RISING COVID CASES AND THE CASE FOR DECARCERATION By Nithyashri Baskaran

ld age. Preexisting health conditions. Crowded quarters. Each is a risk factor for contracting COVID-19.

Compared to 1993, state prisons today hold four times more people older than fifty-five, half of whom have at least one chronic condition, and all of whom are endangered from close confinement (Hawks, Woolhandler, & McCormick, 2020). Disparities in social determinants of health resulting from centuries of racial discrimination have left Black communities particularly vulnerable to the coronavirusâ&#x20AC;&#x2122;s debilitating effects over the past months. At the same time, Black Americans have been disproportionately harmed

by prison and police systems. The growing strength of the Black Lives Matter movement during a worldshaking pandemic is no coincidence; in the United States, the dual crises of COVID-19 and of the criminal justice system cannot be divorced from one another. In no place is this more evident than in jails and prisons, where urgent changes must be implemented to prevent further fatalities. Published in April 2020, data from an epidemiological model constructed by the American Civil Liberties Union (ACLU) in

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partnership with researchers from Washington State University, University of Pennsylvania, and University of Tennessee projected nearly one hundred thousand more COVID-19 fatalities over the next six months than estimated by current models that omit jails (ACLU, 2020). This means that total fatalities would be double the number of current projections. The model was built upon a COVID19-specific SEIR compartmental model which placed individuals into one of four compartments: Susceptible, Exposed, Infected, or

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Research-Based Article

Recovered. It was then tailored for jail population, total population, daily jail admit and release rates, and jail officer population using updated datasets for 1,242 counties (representing around ninety percent of the total US population). The model assumes that the probability of effective contact for COVID19 transmission is three times higher in jails and six times higher in processing, taking into account their crowded conditions relative to the community. It also adjusts for a burn-in period, during which the virus spreads for a custom number of days in each county before shelterin-place would be implemented. Of the five scenarios the model tested, “Shelter-in-place, with Jails” and “Shelter-in-place, with Jails, ninety-five percent arrest reduction & two-times release acceleration” were the most relevant to the researchers’ conclusions. The former represented communities that sheltered in place while jails continued to operate as usual; the latter was interpreted both as a policy alternative as well as a baseline for other public models that omit jails. The difference in fatalities between the two scenarios—one hundred thousand—yielded the undercount of deaths by public models, and the number of deaths that could be prevented should counties implement strong decarceration reforms (ACLU, 2020). Given that the model accounts for neither prisons nor medical shortages, it is likely that even more lives are at stake. Two months have passed since these data were published. In the wake of limited reform across states, its predictions are already becoming

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reality. From mid-May to mid-June, prison deaths due to COVID19 have risen by seventy-three percent, and the five largest known coronavirus clusters in the US today are inside correctional institutions (Williams, Seline, & Griesbach, 2020). Racial discrimination

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The growing strength of the Black Lives Matter movement during a worldshaking pandemic is no coincidence; in the United States, the dual crises of COVID-19 and of the criminal justice system cannot be divorced from one another.

underlies every aspect of the US criminal justice system, from one’s arrest to trial to sentencing to post-prison experiences; thus, Black communities are hurt disproportionately by this toll (Sentencing Project, 2018). Even if those who are incarcerated were provided with ample personal protective equipment, testing, access to treatment, waived co-payments, and expedient care—a scenario far from the status quo—measures like social distancing, quarantine, and

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isolation for infected individuals are extremely difficult to implement in overpopulated prisons and jails. Due to continuous movement between these institutions and the community, viral spread due to staff and a churning jail population will continue to exacerbate the COVID19 crisis. The most effective way to avoid future outbreaks is to significantly reduce populations of jails and prisons. Already, local efforts have resulted in reduced admissions and expedited release from many jails. However, state prisons have been slow to address overcrowding (Prison Policy Initiative, 2020). Criminology data affirms that releasing those at high risk due to age or underlying conditions, those convicted of a nonviolent crime, or those with little time remaining in their sentences would save lives while posing little risk to public safety (Hawks, Woolhandler, & McCormick, 2020). Referring those who are released from incarceration to telehealth visits, housing, and safety net programs would further protect their health and that of their communities. The Black Lives Matter movement calls for the replacement of systems that fundamentally disregard human life with those that safeguard it. To this end, decarceration amidst the COVID19 pandemic is a crucial step. ■

NITHYASHRI BASKARAN is an undergraduate student from Santa Clara, CA, USA, currently studying at Yale University.

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Personal Anecdote

RE: RESOURCEFULNESS WHEN CONFRONTING

INVISIBLE ENEMIES By Eric Chen

Dear Family, I hope everyone’s staying safe in the cities you’re living in. It turns out invisible enemies have the ability both to unite and to divide a society. But there’s a lesson that I think we can learn about how to continue to protect each other and to show empathy for others. One invisible enemy we’re all familiar with now is SARSCoV-2. Our first instinct was to learn more about the virus, specifically how it affected other countries and how it might affect us if we don’t contain its spread. A stream of COVID-19 resources flowed between our family members. YouTube videos and website links explained the symptoms of the disease and introduced ways to go safely about our daily routine, for example, encouraging social distancing and the use of masks. We could even monitor the increase in daily cases in our very counties. Although the threat was new, we took concrete actions to make the best of the situation by protecting ourselves and those around us—especially the most vulnerable populations. With a specific problem to address, it’s pretty straightforward to act upon solutions together. Of course, there were people who rejected the wearing of masks—people who thought that masks were in no way a benefit to them, let alone a benefit to others. At best, they may have had their doubts in the way the media portrayed the severity of the pandemic and were grappling with the discordance between their beliefs and the appropriate actions that a minority (e.g., doctors, public health professionals,

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epidemiologists) of the population was advocating for. But at worst, they outrightly ignored and distrusted the science. “Why should we be so concerned about the health and well-being of a complete stranger?” they would say. In the case of COVID19, I’d respond, “Because we can do something as easy as putting on a mask. Plus, that same stranger would do the same for us.” This bidirectional consideration is an example of the contract on which our society has functioned: the golden rule that is practiced and encouraged in our family. Like a growing number of Americans, we have and will continue to practice safe measures to prevent the spread for as long as it takes society to adapt to and to adopt some of these measures into our daily routine. Maybe washing our hands frequently for at least twenty seconds at a time was the right way all along. But here’s a question we should then ask ourselves: if our empathy towards that stranger comes primarily from our own fear of getting sick, would we act differently if we were immune? For example, would you never wash your hands? No, but you might be tempted to wash your hands less. But wait, you can still be a vector! If you touch the same door handle as a

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Personal Anecdote

sick person did and then touch another communal surface that a healthy, susceptible person then touches, you can still spread contamination: you just don’t suffer the consequences. Your immunity doesn’t change your capacity for empathy. It merely gives you the opportunity to ignore it. And that’s why what I’m going to address next may be difficult to hear. What if I said that there’s been another invisible enemy—a “disease”—that people we know suffer from? Although we may have been ignoring it in some way, I also think we have the capacity to acknowledge the problem and can begin to empathize with those who are most susceptible to it.

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... racism, a virus that has infected the consciousness of humanity since before America’s founding

The problem didn’t arrive recently—it’s been here since before we called America home, and may still be around when we aren’t here anymore. Some scholars call it systemic inequality or systemic racism, and it has many symptoms: racial inequality, implicit bias, police brutality, mass incarceration, and the list goes on. In other words, observing or experiencing these behaviors would collectively point to the overarching disease of systemic inequality caused by racism, a virus that has infected the consciousness of humanity since before America’s founding. If you’re surprised, it may be because this virus is virtually invisible today—disguising itself, mutating, and adapting. For us to even begin to understand how it behaves, we have to first ask the doctors—the professors, lawyers, civil rights activists, sociologists, and more—who’ve dedicated their lives to studying the different aspects of the disease the virus causes. What exactly are its roots? Is there a vaccine? How can we stop its spread? Today, we are lucky that we have access to the resources that they compile and distribute to inform the general public. But those who’ve studied this disease know it isn’t so straightforward to eradicate, in part because many Americans see the same symptoms as indicative of a different, less severe disease. As a result, they can unknowingly propagate it. However, what is generally ascribed to another disease may just be another symptom. Furthermore, the solutions to fixing the problem— just like the virus—aren’t so tangible or concrete. But we can start somewhere. With the resources that the professionals recommend, we’ll be able to understand which aspects of our daily routine, many that we take for granted, have been spreading the disease. Those of us who are immune each have a question to ask ourselves. Will I choose to help stop the spread?

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Here’s what I know: we are resourceful. We are willing to learn and to share videos and articles about what guidelines to follow for disease prevention. We are willing to do what is right for the betterment of the community. We may even already know who around us is more susceptible to the disease and signs of how prevalent it is. Will we sometimes falter and not wash our hands long enough? Yes, but let’s make a commitment to start believing that our fellow citizens deserve as much empathy as members of our own family—for as long as it takes society to adopt, to adapt, and to become as just and equitable as we intend it to be.

Love, Eric P.S. Here are some resources I’d like to leave you with: “We need to talk about an injustice.” A TED Talk by Bryan Stevenson, a civil rights activist and lawyer: https://bit.ly/34wAj32 “How we can make racism a solvable problem—and improve policing.” A TED Talk by Phillip Goff, a psychologist: https://bit.ly/31ufzHm 13th, a 2016 documentary by filmmaker Ava DuVernay, initially released on Netflix: https://bit.ly/32vhwlU “How to deconstruct racism, one headline at a time.” A TED talk by Baratunde Thurston, a comedian and author: https://bit.ly/3lmrkas “Let’s get to the root of racial injustice.” A TEDx Talk by Megan Ming Francis, an associate professor in political science: https://bit.ly/2QqYNCs “Police Killings of Blacks: Here is What the Data Say.” A New York Times article written by Sendhil Mullainathan, a professor in computation and behavioral science: https://nyti.ms/31rq1zb ■

ERIC CHEN is a graduate of the University of Delaware (PhD ‘18) and Columbia University (BS ‘13) and is currently a postdoc in the Department of Electrical, Computer, and Energy Engineering at Arizona State University.

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Illustration

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UNDER FIRE

his is to my fellow healthcare workers, African Americans, and LGBTQ+ community members, the warriors of 2020 who, despite their struggles, continue to thrive. â&#x2013; CASSANDRA CHU is an undergraduate student from Atlanta, Georgia, USA, currently studying at the Georgia Institute of Technology.

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Research-Based Article

IS THE SHOW REALLY PAUSED? COVID-19, BLACK LIVES MATTER, AND HOW MUSIC PLAYS A VITAL ROLE IN BOTH

By Allen Lu

n March 12th, 2020, Broadway, the heart of musical theatre, abruptly paused all its current and upcoming shows from running as the SARS-CoV-2 virus spread across the globe (The Associated Press, 2020). Elsewhere in the music world, arenas, concert halls, and underground clubs closed overnight to stem this virus’s spread. Big-name artists like Alicia Keys and Lady Gaga were forced to push their album releases to indefinite dates, popular festivals like SXSW and Coachella have been cancelled or postponed for the year, and stars like Billie Ellish are grappling with cancelled tours (Hissong, 2020). Large musical gatherings as we know them remain unlikely to happen until COVID-19 cases are reduced or a vaccine is produced and distributed. Such a massive shutdown is particularly concerning when considering that humans have historically relied on music to connect. As a primary means of communication and expression, music has shaped human civilization for more than thirty-five thousand years (Suttie, 2015). Even when humans had to spend their days devoted to hunting and gathering, music’s ability to enhance social cohesion made it evolutionarily advantageous to perform music together. After all, “endorphins [that are created during singing] are the main mechanism for social bonding in primates,” said Robin Dunhar, Professor of Evolutionary Psychology at the University of Oxford

(Murray, 2020). So, when thousands of shows are suddenly cancelled for months, we lose an essential element of humanity. However, modern-day humanity has something that early humans did not: digital technology. Aided by the internet, music has unexpectedly thrived during this pandemic. Live streaming, the act of broadcasting real-time footage and audio, has risen as a viable alternative to live concerts, aided by live streaming startups (Millman, 2020) and big streaming platforms like YouTube and Twitch, with the latter targeting video gamers (Grant, 2020). By allowing users to view the same content and

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communicate in real time, these live streams allow for humans to connect, even through a virtual platform. Although musicians like Indian artist Nirali Kartik find it harder to feel the crowd’s energy in live streams, being able to connect to fans in real-time and to see them commenting, liking, and reacting to their music is nonetheless “surreal” and exciting (Mittra, 2020). Digital technology has also allowed both skilled musicians and ordinary citizens to gather and perform pieces. University A Cappella groups, such as the Vanderbilt Melodores and the University of Pennsylvania Pennchants, https://bit.ly/covidxblm

Research-Based Article and high school and community choirs across the country have moved singing, a form of music that is particularly risky given its potential to spread SARS-CoV-2 viral particles, to a virtual environment (Carrillo, 2020). Most orchestras, such as the Toronto Symphony Orchestra and the Rotterdam Philharmonic Orchestra, are too large to allow for adequate social distancing and have also moved online. UK nurses, an overburdened and stressed group, have used virtual ensembles to “boost their wellbeing and connect with others.” Like Indian artist Nirali Kartik, Anna Lapwood, who created a National Health Service (NHS) virtual choir, noted that virtual platforms such as the NHS virtual choirs are “a little bit disconcerting ... but what’s lovely is people can comment along in real-time, ... and it does almost feel like a real choir practice” (Murray, 2020). Despite the distance the COVID-19 pandemic created, music yet again has proven its ability to transcend barriers and connect individuals. Then, on May 25th, 2020, George Floyd’s death forced music to look within and address how it has ironically done the opposite: stifle human connectivity. George Floyd’s death laid bare America’s daunting problem with racism and how it is entrenched not only within the criminal justice system, but within urban design, education, public health, and a myriad of other institutions. But people argue that, unlike those institutions, music is universal and breaks down barriers. In reality, music is political, messy, and full of the same injustices, as is anything that involves human interaction. Particularly, Black musicians struggle to achieve the same success compared to white musicians, especially in the hip hop, R&B, soul, and jazz genres, even though these genres are traditionally Black and were born from the struggles of Black people. R&B and hip hop emerged as methods of expression for Black youth who had resources stripped from their neighbourhoods and diverted to affluent white suburban areas (Puryear, https://bit.ly/covidxblm

2016; Milliman, 2019). Soul and jazz share similar beginnings, as Black jazz musicians like Billy Strayhorn were unwelcome in predominantly white Classical music settings (Chaffee, 2019), and Black soul musicians were not welcomed in white churches (“History of Soul Music”, n.d.). Modern-day white musicians like Sam Smith, Adele, and Ariana Grande draw influences from genres rooted in Black struggles while achieving much greater success in their craft than Black artists. White musicians are aided by record labels who became reluctant to sign on Black musicians, as these labels slowly saw white musicians gain greater recognition—and commercial viability—in Black genres (Kornhaber, 2019; McQuaid, 2015). In response to George Floyd’s death and the glaring problem of white appropriation of Black music, Atlantic Records executives Brianna Agyemang and Jamila Thomas started #TheShowMustBePaused, a campaign to urge the music industry to reflect on its issues with systemic racism. Its creators noted, “the music industry is a multi-billion dollar industry ... that has profited predominantly from ... the efforts, struggles, and successes of Black people,” thus making it necessary to hold the industry accountable for their actions (Kaufman, 2020). In response, major music labels like Warner Music Group, Sony/ATV, and Dirty Hit reposted the #BlackoutTuesday message and committed to observing the day, taking a small, but important first step to authentically celebrating Black music. This movement has also extended beyond pop music to classical music, where classical musicians, concert halls and opera houses joined forces to observe the day as well (Asprou, 2020). However, even with the show paused, it has still gone on. At the same time as #TheShowMustBePaused, peaceful Black Lives Matter protests, many with music as the unifying force, spawned across the United States. One of the most prominent videos from those Black Lives Matter protests showcases people dancing to the beat of a drum in Newark,

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New Jersey. A couple of weeks later, when the death of young violinist Elijah McClain was brought to light, protesters in both Aurora, Colorado (Clasen, 2020), and Cincinnati, Ohio (Nelson, 2020) rallied to host violin vigils to honour his life. As the rich, yet mellow, sound of violins vibrated through the air, observers witnessed the raw collective of grieving souls, coming together to mourn the loss of a valued human being. No virus nor hate crime stood in the way of humans coming together—safely—through music. From our earliest daysas nomadic beings to the present, music has been both nonpolitical and extremely political. It is nonpolitical in the sense that it can unite individuals and whole countries together, like when UK nurses banded together to create an NHS virtual choir, Italians came together on their balconies to thank health workers by singing at the top of their lungs, or a single nurse in Chile played the violin to COVID-19 patients to comfort them. It is political for the same reason it is nonpolitical—it can be used to tell stories of pain, grief, and injustice, as seen with Elijah McClain’s violin vigil or Billie Holiday’s “Strange Fruit,” a 1939 song that addressed the lynching of Black people across the United States. There is beauty in this duality of music in society—while music is intertwined with politics, it also can erase labels and strip humans down to their core emotions. It is when this duality is harnessed that music’s strengths really shine through. So, is the show really paused? Not at all, as it certainly hasn’t stopped people from continuing to use music for what it has been used for historically—a universal unifier as well as a tool to fight injustices in society. ■

ALLEN LU is an undergraduate student from Toronto, Ontario, Canada, who will matriculate at University of Waterloo (‘24) to pursue a Bachelor of Knowledge Integration.

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Poem

a place of separation & running water By Jacob Kaufman-Shalett

This piece is written in response to numerous recent events in my hometown, Chappaqua, NY, where I have been quarantined since March after returning home from my first year of college. The water in this town tastes like it has forgotten my lips. Taps in other places fill my void now. It took months to unlearn this flavor, forget its filtered ease, its scintillating, fluoridated flow, to squeak teeth clean to smile for every camera. But the natural reservoir rushes over ancient soil. Colonial disregard poisons distant waters, yet seeps into our well as well. We are not immune to our own toxic. We must stop blaming bad apples, start blaming the bloodsoil of trees that line our suburban lanes. They say Black lives matter, and sweep controversy under the rug, the N-word from the bathroom mirror, from their TikTok feed and Snapchat memories. Numb the symptoms of our true colors, heinous complacency by telling us we’re cured. Between venti chais and self-congratulations, it’s easy to laugh when words face no consequence, when being caught racist is just as tasteless as juuling. Suspend them for two days’ time to learn their lesson to reflect on what they did in their bedrooms with their Xboxes. On Fortnite there may be meritocracy, but not at school, administrative hypocrisy. They hide behind inaction and fester complicity through the teeth of their apologies.

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Poem

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Why tarnish a reputation, so eerily white and clean. Hurt standings, Hurt image, Hurt silenced bodies. To reckon with mishandling and mistakes our dual liberalism and privilege is to wake to the fact that we break rules and take risks to hug estranged friends, but when it’s time to march and protest, laws of quarantine won’t bend. Obliterate social distance to pose in cute bikinis on a crowded beach. Wait for permission from the Instapolice To okay your frivolousness, To absolve you from ignoring Pandemic and plight. The ongoing fight set a woman alight. She burns in Wisconsin while we extinguish our sin before the flames upset the neighbors. They lit fireworks above their drive-in graduation under scorched stars. We spark new fires to distract from the old, taint communal introspection with nocturnal nostalgia, drink to forget our broken world on public fields where cops won’t catch us. At not-so-social-distance, these tender flowers are tangled in their own mangled roots. The paradox of our inclusive bubble is we always drink the running water and remind ourselves that’s why we live here: the public school that sets us apart and the good tap water, Yet in Chappaqua we don’t learn about Algonquins erased; Our namesake lost in translation: Shapequa “A place of separation” and of “Running water.” ■

ILLUSTRATION COURTESY OF ANYA PERTEL

JACOB KAUFMAN-SHALETT is an undergraduate student from Chappaqua, New York, USA, currently studying at Yale University (‘23).

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Poem

OUR BODIES WERE NEVER MEANT TO LIE SO STILL By Jude Okonkwo

Our bodies were never meant to lie so still in these bare city streets gone now is the music of vendors calling and the percussion of rubber tires scraping up against the pavement once again cities are rocked by fiery breathing and the crash of human bodies and desperate calls for unity and for mercy young men play as sirens rush through the city on this beach I’ve found women hugging the sea the orbs of seawater streaking down their backs scores of crushed soda cans lying in the grass the fragility of our lives like moisture on the skin the closeness of these souls, a haunting the music, a reminder that touch can become a substitute for poison. In this our world, planes drive empty like castles floating across the sky newscasters mourn as the markets crash mothers try to translate their love over facetime believers reach up to God for comfort In a small apartment room in this our city the man attempts to swallow waiting for the woman who heaves in the iron chamber the one who taught him that change was like moving sandcastles away from the shore like rising again. ■

JUDE OKONKWO (Harvard, ‘21) is a pre-med student from Dix Hills, New York, USA, currently studying English and biology. His work has previously appeared in Pleiades, the Journal of the American Medical Association, and Flash Fiction Magazine among other publications.

COVID-19 X Black Lives Matter Special Issue

ILLUSTRATION COURTESY OF ELLIE GABRIEL

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Research-Based Article

THE DANGERS OF BIOLOGICAL METAPHOR

COVID-19 X BLM

By Gwendolyn Wallace

s members of the media seek to address both the coronavirus pandemic and the protests against policing, it has become increasingly common to write that Black people are fighting two pandemics. Framing racism as a pandemic fits into a long legacy of medicalizing social issues, replacing the language of systems for words like “disease,” “epidemic,” or “pandemic.” At a time when it is strikingly clear how the prison and medical industrial complexes work together to kill Black people, it is more important than ever to understand the work that the language of medicalization does. When Western biomedicine and ruling class media speak about racism, colonialism, and other systems in biological metaphor, it only serves white supremacy by obscuring the true nature of these structures. In her essay “Medical Violence Against People of Color and The Medicalization of Domestic Violence,” Ana Clarissa Rojas Durazo writes, “medicalization represents a deep threat to the movement, because it uproots the conceptualization of domestic violence as a social problem. Instead, it replaces the ideology and structures of social movements with the ideology and structures of (Western) medicine, subsuming grassroots to state and capital interests” (Durazo, 2016). The medicalization of racism functions in this same way, framing racism, and thus the mass death of Black people, as unavoidable or natural. The truth is that anti-Blackness is not a pandemic temporarily sweeping the world; it is the foundation of global systems.

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Biological metaphor is especially dangerous when the values of Western biomedicine and the medical-industrial complex run in contradiction to the well-being of all Black people. Though medical institutions portray themselves as benevolent and objective, the structural reality is that biomedicine was forged in the political and social terrain of colonialism. Ultimately, Black “health” is an impossibility in a system built and sustained by anti-black violence and logics through exploitative research, medical discrimination, and eugenic principles. Further entangling the language of racism and the language of medicine only perpetuates the idea engrained in Western medicine that race is natural and distinct from racism. Instead of calling for systemic changes and the abolition of anti-Black structures, medicalization instead searches for a cure. When Paul Ehrlich discovered Salvarsan as a treatment for syphilis in 1909, he called it a “magic bullet.” This brought in a new era of “magic bullet” medicine, with scientists and the rest of civil society desiring ideal medicines that target diseases with no negative side effects (Tan & Grimes, 2010). Comparing racism to a pandemic harkens back to this era, but racism has no “cure” and certainly no “magic bullet.” It is not for lack of a cure that Black people are dying at the hands of the state. It is the presence of policing and its structural foundation of anti-Blackness. From any angle, freedom for Black people does not exist within the boundaries of biomedical language.

Language that is meant to be revolutionary cannot reinforce the same systems it is attempting to dismantle. In her essay, “Problems of Language in a Democratic State,” June Jordan remarks on how the ruling class media uses the passive voice to transfer responsibility from the state onto the people. Jordan writes, “Should we really just relax into the literally nondescript, the irresponsible language of the passive voice? Will the passive voice lead us safely out of the action? Will the action and actors behind it leave us alone so long as we do not call them by their real names?” (Jordan, 2003). The same could be asked of biological metaphor. The language of current systems will never create a radically different world. Instead, fissures need to be created in vocabulary that create the room to call the actions and actors of racism by their real names. Abolition is always a positive project. Once the old systems are destroyed, then comes the task of world-building, of imagining a matrix of alternative systems and resources. The movement to end policing cannot pander to “health-care” systems that rely on medical violence against Black people to function. Rather, this current moment requires language that is demanding, accurate, and healing. ■

GWENDOLYN WALLACE is a rising senior at Yale College from Danbury, Connecticut majoring in the History of Science and Medicine.

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CONTENTS

COVID-19

CREATOR

Distance Learning Denise Abercrombie The Sprint to a COVID-19 Vaccine Kelly Farley In Memory Sonia Lai A Germaphobeâ&#x20AC;&#x2122;s Guide to the Global Pandemic Sydney Gray The COVID-19 Pandemic Necessitates the Sarah Tran Asian-American Physician-Activist Waiting for Camellias Sophia Zhao What can we learn from COVID-19 in Europe? AnMei Little Our Saturday Nights Anasthasia Shilov Isolation Sonia Lai How Democracy Can Retain Its Legitimacy in Ning Yiran the Time of COVID-19 Consumption Denise Abercrombie nightshade Donald Gray COVID-19 Information Richard Jo & Huanyan Huang The Last Moment Houyee Chow COVID-19 and the Nervous System Maria Fernanda Pacheco Davids Distancing Maxine Tanjutco The epidemiology of Racism Genevieve Ding Protect against COVID-19 Sophia Zhao The rise and fall of hydroxychloroquine Beatriz Horta

Poem

COVID-19

DISTANCE LEARNING By Denise Abercrombie

One hawk, then another, swoop into the meadow, and perch on fence posts. We walk a new path on Horsebarn Hill as a couple passes with their teenage daughter. A parent, who once called the principal to complain about my politics, greets us and jokes, Let’s keep our distance. I suppose we share a deep love of this place since we meet so many nights on the slope. A father and his sons fly kites: a rainbow and a stained-glass bat tangle in midair. Back home, a friend invites us to a virtual party for her camera-shy husband. So many faces fill the screen, his birthday song’s staccato. Still she displays, then cuts his homemade cake covered with fifty-some-odd candles. Our older son studies slave manifests from the Colonial era and calls to say he’s growing cabbages in his Madison apartment. Soon he’ll forage for fiddleheads and morels. An estranged buddy calls about his daughter’s fourth grade teacher just to hear the sound of my husband’s voice. A colleague who ignores me at work texts me at home: Just wanted to touch base and see how you’re doing. For years we’ve been cliquey and buried beneath stacks of uncorrected papers. One morning, three kits come out from hiding under the barn floor to wrestle in the grass. As we struggle to take good pictures through our dirty kitchen window, our younger— recently evacuated from college—observes how they blend in with the fallen leaves. At night, he builds a fire in the front yard pit and invites us in. We step away from our online lives. Witness the blaze. Sit as close as we possibly can to him. ■

DENISE ABERCROMBIE (Wesleyan, ‘95) is a featured poet and the director of Fine Arts at E.O. Smith High School in Storrs, Connecticut, USA. In addition to performing and directing works with Stage Left Ensemble, she helps coordinate Curbstone Foundation’s Poetry in the Julia de Burgos Park series in Willimantic, Connecticut, USA.

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COVID-19 X Black Lives Matter Special Issue

COVID-19 Research-Based Article

THE SPRINT TO A COVID-19 VACCINE WHAT HAS BEEN DONE AND WHAT IS YET TO COME

By Kelly Farley

ur return to normality is contingent upon a widely available vaccine. Its accelerated development promises a vaccine within months instead of years, overcoming hurdles of design, testing, production, distribution, and implementation faster than ever before. Why do we need a vaccine?

Design

Your body does all it can to block invaders. But, sometimes, an invader sneaks past barriers. Inflammation kicks inâ&#x20AC;&#x201D;blood and cells rush to the area. As days pass, the immune system rises to the challenge, training specialized cells specific to the invader. B cells produce antibodies that neutralize invaders in the bloodstream, and T cells attack infected cells. After the invader is gone, antibodies and memory cells remain, ready for another pathogenic attack.

More than a hundred groups are joining the effort to bring a COVID-19 vaccine to market, a process that usually takes ten to fifteen years and billions of dollars (Burns, 2020). The goal is at least one vaccine that prevents infection, limits severity, or shortens recovery time. Different vaccines may be useful for different demographics. For instance, the injectable high-dose flu vaccine is recommended for adults older than sixty-five years, while the nasal spray is recommended for those ages two through forty-nine (Nania, 2020).

A vaccine triggers this response. Since a modified invader is injected, a vaccine does not produce the severe symptoms of the normal invader but still produces the same antibodies and memory cells (Nania, 2020). The most effective vaccine we have is for measles, which is ninety-seven to ninety-eight percent effective (Cohen, 2020). In contrast, the annual flu vaccine ranges between thirty and fifty percent (Chen, 2020). The COVID-19 vaccine must be at least fifty percent for FDA approval (Smith, 2020).

The vaccine may be a weakened or inactivated version of the virus. Or it may be a piece of its genetic material (Chen, 2020). We have produced vaccines based on modified forms of a virus for decades. Weakened viruses lead to lifelong immunity (but can be dangerous for immunocompromised individuals), while inactivated viruses usually require booster shorts (Burns, 2020). Both require work with a potentially infective virus, and there are very few manufacturing facilities with the proper protective equipment to manufacture enough doses (Khamsi, 2020).

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As a result, companies have turned to RNAand DNA based-vaccines that instruct our cells to make COVID-19 proteins. While their production is simpler and faster, no vaccine of this type has been previously approved (Rosenbaum, 2020). Testing Though hundreds of vaccine candidates will start testing in animals, less than six percent will make it through the three rounds of human testing (Smith, 2020). Phase I trials establish safety: does the vaccine cause dangerous, immediate side effects? Phase II trials establish efficacy: does the vaccine provide a protective immune response? Phase III trials expand upon previous results, testing thousands of people over a longer period of time (Kommenda & Hulley-Jones, 2020). As of July 2020, 140 COVID-19 vaccine candidates were in preclinical testing, nineteen were in Phase I, eleven were in Phase II, and three were in Phase III (Kommenda & Hulley-Jones, 2020). Phase I and Phase II trials are being accelerated once safety is indicated, but Phase III trials are limited by scientific restraints on length and breadth https://bit.ly/covidxblm

Research-Based Article (“This is why,” 2020). Phase III trials also must be broad enough to reveal any rare side effects (Nania, 2020). Although technically legal, it would be unethical to vaccinate participants then expose them to COVID-19 without an approved treatment (Chen, 2020). Instead, participants are vaccinated with the drug or a placebo, then live their everyday lives, and researchers record whether participants become ill (Palca, 2020). Even if they vaccinate thousands, only a few may actually become exposed to COVID-19. Phase III trials must last long enough that enough people in the unvaccinated group become infected that it can be determined that the vaccinated group performs better. Production We do not yet know if we will need to grow cells, synthesize RNA or DNA, or even grow plants to mass-produce the vaccine (Khamsi, 2020). To account for this uncertainty, the Trump administration has allocated ten billion dollars towards a project called“Operation Warp Speed” that will boost manufacturing of facilities that may never be used (Weise & Weintraub, 2020). The administration has selected five companies (Moderna, Oxford University and AstraZeneca, Johnson & Johnson, Merck, and Pfizer) to receive additional funding and assistance (Weiland & Sanger, 2020). Moderna’s mRNA-based vaccine has been a front-runner from the start. Its design was developed in forty-eight hours following the sequencing of the COVID-19 genome, injected into volunteers in March, and tested in Phase II trials beginning in May (Rosenbaum, 2020). Though Moderna expected to begin Phase III trials in July, its start date has been delayed over trial protocol conflicts with the FDA (Garde, 2020). Another leader in the field is Oxford and AstraZeneca’s vaccine. It is composed of a harmless virus genetically engineered to express the same surface proteins as COVID19 (Kommenda & Hulley-Jones, 2020). This vaccine candidate entered Phase III trials on July 1 (Smith, 2020) and has an estimated eighty percent chance of success (Baker, 2020). Ideally, once a strong candidate is https://bit.ly/covidxblm

identified, manufacturing would be able to begin immediately in the pre-built facilities. Distribution At least eight billion doses will be needed to protect everyone on the planet. These doses will not be available at once, so decisions must be made about who receives vaccination first. Healthcare and essential workers are likely high priority, along with those at risk of severe complications if infected, such as the elderly and people with pre-existing conditions (Nania, 2020). COVID-19 knows no borders but its vaccine may. Many countries allow the government to force manufacturers to sell domestically before exporting abroad. In the 2009 H1NI influenza pandemic, Australia shared the vaccine with its citizens before allowing exportation (Khamsi, 2020). Even if the vaccine is available for purchase by all countries, not all countries will have the resources to procure enough dosages. In the United States, where COVID19 infection and mortality have disproportionately affected Black and brown communities, experts worry about equitable distribution. In all age groups, the death rates among Black and Hispanic/Latinx populations exceed those of white populations (“COVID-19 in Racial and Ethnic Minority Groups”, 2020). In New York City, the death rate of Black and Latino populations is twice that of the general population; in Los Angeles, the death rate of those in low-income neighborhoods is three times that of those in wealthier areas ( Jauhar, 2020). Though these disparities are not yet fully unpacked, it is suspected that poor access to health care, lack of health insurance, and unstable housing, as well as essential jobs that require work outside of the home, have made these populations vulnerable not only to COVID-19 but also to preexisting conditions that worsen its effects ( Jauhar, 2020). It is essential that the vaccine is made available to these communities, with special attention to distribution site locations.

COVID-19

Implementation Even if a vaccine becomes widely available, the possibility remains that not everyone would accept vaccination. Recent polls indicate only half of Americans plan to become vaccinated, with a quarter wavering on the matter (Cornwall, 2020). Some may be unable to be vaccinated through no fault of their own, such as children, those with weak immune systems, and autoimmune and cancer patients. To protect these vulnerable populations, seventy percent of the population must acquire immunity to prevent the disease from easily spreading (Cornwall, 2020). Next Steps Even with vaccine development progressing faster than ever before, there is still much to learn. We are not sure how long immunity to COVID-19 remains after infection (Chen, 2020). A vaccine may need to be given repeatedly, with the first dose priming the immune system and the second dose strengthening the response (Ellis, 2020). Even those previously infected may need booster shots (Chen, 2020). Luckily, it is not likely that a new vaccine will be needed every year, like the flu vaccine, as COVID-19 does not appear to mutate rapidly (Chen, 2020). The road to a vaccine has many obstacles, from design to testing to production to distribution to implementation. It has been half a year since the first outbreak of COVID-19, and experts estimate that we are about one-third of the way towards a widely available vaccine (Weise & Weintraub, 2020). We will have to face the remaining roadblocks together, with government officials, pharmaceutical companies, public health experts, manufacturers, and the general population collaborating with one another. The road to a vaccine is one that must be walked—or, in this case, sprinted—together. ■

KELLY FARLEY is an undergraduate student from Chicago, Illinois, USA, currently studying at Yale University (‘22).

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COVID-19 Illustration

COVID-19 X Black Lives Matter Special Issue

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Illustration

COVID-19

IN MEMORY D

rawn in memory of the healthcare workers who have passed away during the fight against the COVID-19 pandemic. As a healthcare worker myself, it has been particularly hard to deal with the losses within the healthcare community. â&#x2013; SONIA LAI is a community member from San Francisco, California, USA.

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COVID-19 X Black Lives Matter Special Issue

COVID-19 Personal Anecdote

A GERMAPHOBE’S GUIDE TO THE GLOBAL PANDEMIC By Sydney Gray

am no stranger to the Dance of the Public Restroom. It begins as I balance on my left leg and my right foot brushes past my left knee through développé. My right leg now positioned parallel to the floor, I plié and flick the knob of the toilet with my right foot to flush. Depending on the restroom, I usually have half of an eight-count to shimmy out of the stall before the water in the bowl swirls fast enough to generate an invisible plume of peril that might spew pathogens into the cubicle. Next comes the hand jive at the sink, as I swipe my palms beneath the soap dispenser and the faucet, waiting for something, anything, to come out. For the finale of this Ode de Germaphobe, I strike the button on the hand dryer with my elbow and wait for the gust of lukewarm air. I read once in a University of Connecticut study that a hot-air hand dryer takes in microbes from the bathroom air and expels them back out through its cacophonous mouth (though these particles are usually harmless, there is the occasional exception of Staphylococcus aureus bacteria). So, with my arms outstretched, I keep my shoulders back, my neck elongated, and my chin cocked over my right shoulder to avoid inhaling any infectious aerosols. It is in this position that I resemble a ballet dancer standing in the wings, waiting for her cue to join the show.

COVID-19 X Black Lives Matter Special Issue

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Personal Anecdote

COVID-19

With the emergence of COVID-19, the entire world seemed to have turned into one giant public restroom. This is to say, things went to sh*t.

parents? As with any newfound freedom, there came an increase in responsibilities, the most prominent of which was the responsibility to make safe decisions.

By March in the United States, “college dorms,” “office spaces,” and “neighborhood parks” all became synonyms to “petri dish.” The lines outside the local Costco on a Tuesday grew longer than a queue of groupies waiting in 2018 to see Billie Eilish perform live. Headlines like “coronavirus cases spike” became as commonplace on the nightly news as the logos of the broadcast stations themselves. As I watched businesses, schools, and daycares close—as I watched the world retreat—Rod Serling’s voice echoed eerily in the back of my mind: “you just crossed over… into the Twilight Zone.”

Yesterday, I decided to walk my dog. Equipped with Purell in my pocket and a face mask looped around my ears, I set out to explore a different neighborhood for a change of scenery. As I turned a corner, a man, not wearing a mask, approached me and started shouting.

Yet I had no idea that the beginning of quarantine would be the easiest part of the pandemic for me. I could heed the pleas of hospital staff and first responders: “I stayed at work for you, you stay at home for us.” The instructions from public health officials were more or less clear. Avoid leaving the house unless you are an essential worker, wear a mask in public, and maintain a physical distance of six feet from those who are not a part of your household unit. It was a tangible checklist that I could recite when the future looked grim and fatalities continued to climb.

I was appalled. Nauseous. Numb. He walked away laughing as I sat down on the hot asphalt of the street and ripped off my mask. What just happened? All of those hours I spent frantically cleaning and a stranger walked up just to cough in my face?

Then our sleep-deprived teen of a nation slowly rolled out of bed and into restaurants, summer camps, and shopping malls. My hometown in California made it to “Phase 3” of reopening; nail salons, tattoo parlors, and other non-essential businesses began to open their doors. Though the government’s guidelines called for a gradual reopening, I watched on social media as people I knew immediately flouted physical distancing guidelines, partied in large groups, and burned masks at beach bonfires to show that they were “over this whole pandemic thing.” But we are not “over this whole pandemic thing.” As I write this, The Washington Post just reported that seven states had their highest rates of coronavirus hospitalizations since March. So my movements began to more closely mimic those I had grown accustomed to in the ladies’ room. I started meticulously scrubbing my groceries with a sanitized toothbrush. My can of Lysol spray became my most valuable possession as I followed perhaps the worst “treasure” map of all—a trail of germs that I imagined glowing green on every doorknob, handle, and counter in my house. I compulsively scrubbed my hands with the strongest dish detergent I could find until my fingers were numb, the skin on my palms became raw, and my nail beds cracked or bled. With reopening came constant and encumbering questions. What is an acceptable risk for me to take in a global pandemic? What is my obligation to others? Will I make a mistake that will harm my immunocompromised, elderly

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“Enough with the masks already. What are you afraid of, huh? What would happen if I got closer? What would happen if I…?” He lunged forward, close enough so that I could smell the sandalwood scent of his cologne, and coughed in my face.

I traced my fingers over the stitches on the mask, searching the threads for answers. Then, another strange feeling, almost an empathy for the man, emerged. Though we reacted on two extreme sides of the spectrum to this pandemic, we were both fearful because we felt powerless. With every breath I took underneath my mask, the stale, sticky air pulsing against my face was a reminder of my constant danger. For the stranger, it was terrifying to look at a world where the smiles of other humans were covered—where what could have been a pleasant interaction between neighbors was now a possibly life-threatening exchange. However, there is a middle ground between my histrionics when it comes to germs and the stranger’s blatant disregard for safety. Public health guidelines still serve as a checklist for minimizing risks even as the economy reopens. Though these rules vary by state, I can use them to calmly contemplate the pandemic rather than constantly catastrophize it. The first step is to put down my toothbrush and to stop suffocating myself with Lysol spray. Meanwhile, the stranger can actively consider the issue of coronavirus rather than operate in denial. The first step for him is to put on a mask. Most of all, we can both use those guidelines to recognize that we are not powerless in this pandemic. Every family gathering we sacrifice, every party we forgo, and every hug we save for later mark a little victory toward a larger cause. We can act, not out of a fear of dying, but out of the courage to help save lives. ■

SYDNEY GRAY is an undergraduate student from San Diego, California, USA, currently studying at Yale University (‘23). She is also a staff reporter for the Science & Technology Desk at the Yale Daily News.

COVID-19 X Black Lives Matter Special Issue

COVID-19 Research-Based Article

THE COVID-19 PANDEMIC NECESSITATES THE ASIAN AMERICAN PHYSICIAN-ACTIVIST Sarah Tran

any Asian Americans are entering the medical field. According to the Association of American Medical Colleges, in 2018, 17.1 percent of all active physicians were Asian American (Association of American Medical Colleges, 2019). By comparison, the US Census Bureau estimates that in 2018, the US population was about six percent Asian, Native Hawaiian, and/or Pacific Islander (United States Census Bureau, 2019). Of course, data disaggregation proves that “Asian American” is too broad of a term and that there are many Asian American subgroups underrepresented in the physician profession. In spite of this, both sociocultural perceptions and racial demographic data suggest that Asian American community and identity are often associated with some involvement in the medical field. Becoming a physician ties closely with the “model minority” myth: achieving financial success for one’s immigrant parents and using the supposed meritocracy to increase one’s social standing. These are all narratives largely prevalent in Asian American history. However, the arrival of the coronavirus disease (COVID-19) pandemic complicates this vision. Not only are physicians working long shifts in which they are risking their lives (often without adequate personal protective equipment), but many Asian American physicians are facing discrimination from patients who snarl at being treated by someone they

suspect might carry COVID-19. For many East Asian Americans in general, COVID19 has brought them their first personal experiences with racial discrimination, cementing the idea of Asian Americans as perpetual foreigners. However, it is insufficient to simply lead awareness campaigns of anti-Asian racism. It is also insufficient to uphold a healthcare system that proves itself unstable and harmful specifically to marginalized communities. Asian American physicians, who hold a large space in the physician community compared to other racial minorities, must look beyond their immediate work and finally connect

COVID-19 X Black Lives Matter Special Issue

their pain and struggle to those of other marginalized individuals in the United States. It is time for the widespread rise of the Asian American physician-activist. Lawyer and activist Betty Hung describes movement lawyering as a pathway for lawyers to advance social change by considering the “intersectional humanity of the whole person and entire communities in order to build movements together” (2017). She calls upon movement lawyers “to practice courage and be willing to relinquish our privileges in order to act and stand up for https://bit.ly/covidxblm

Research-Based Article justice.” Much like lawyers, physicians also hold high status and privilege due to their profession, and a conscious effort must be made to advance social change. The COVID-19 pandemic only highlights how many interlocking systems impact health. Tying healthcare to employment becomes a problem when hundreds of thousands of individuals are unemployed due to the pandemic. Although statistics remain incomplete, analyses show that Black and Latinx Americans—especially Black Americans—have disproportionately high rates of mortality from COVID19 (Centers for Disease Control and Prevention, 2020). This is due to systemic marginalization that increases the likelihood for Black and Latinx Americans to work on the frontlines, lack access to health insurance, and live in low-income neighborhoods that lack resources. It was always the case, but in 2020 especially, healthcare has been inextricably linked to sociopolitical systems that unambiguously impact society’s most vulnerable. Physicians must advocate for the welfare and long-term health of the patients they serve. “Helping people” encompasses everything from working with patients on a treatment plan that takes their intersectional experiences into account, to advocating for better governmental healthcare policies. According to Hung (2017), advancing social change also involves risk and relinquishing privileges. Such risk-taking could involve supporting healthcare policies that might lower physician benefits but increase healthcare access, such as universal healthcare proposals or applying pressure to hospitals that participate in discriminatory practices against patients or staff. Relinquishing privileges includes stepping aside to let Black and Latinx physicians lead. After all, “by centering the leadership of those directly impacted… and having the courage to do what is just and necessary even when we are fearful and may suffer, we can model the world that we seek and does not yet exist” (Hung, 2017). One of the most important actions that a physician can do in a position of power is uplift the voices of those who are most vulnerable. https://bit.ly/covidxblm

Becoming a physician-activist is relevant to any physician, but what does it mean for Asian American physicians in particular? The Asian American community as a whole navigates a tenuous relationship with race, struggling with both white adjacency and a history of discrimination often shared with Black and Brown communities. Asian Americans, occupying a “racial middle,” as lawyer and activist Mari Matsuda (1996) calls it, are called upon to evaluate their allegiances. “The [racial] middle can dismantle white supremacy if it refuses to be the middle, if it refuses to buy into racial hierarchy, and if it refuses to abandon communities of Black and Brown people, choosing instead to forge alliances with them,” Matsuda argues (1996). It should not take Asian Americans experiencing racism themselves for them to feel sympathetic to the lifelong struggles of Black and Brown individuals. The aggressions that the Asian American community faces during the COVID19 pandemic represent only a fraction of the racism and oppression that has devastated Black, Brown, and Indigenous communities throughout America’s history. The Black Lives Matter movement exposes the violence and anti-Blackness that the United States is built upon. This anti-Blackness permeates all systems, including the healthcare system. Thus, it is the responsibility of the Asian American physician to build interracial coalitions and to actively reject white supremacy in all its forms. As Black and Brown individuals disproportionately suffer from COVID19, the Asian American physician must treat them with care adapted to their backgrounds, as well as advocate for policies and movements that will increase health access, safe homes, and just lives. In addition, the Asian American physician must learn how to call out racism, classism, sexism, homophobia, and other oppressions whenever they occur. Social justice is central to a physician’s duties, and Grace Lee Boggs (2011) provides a beautiful vision of social change in her book The Next American Revolution: Sustainable Activism for the 21st Century. One of the book’s most prominent theses is that despite overwhelming, oppressive structures

COVID-19

such as racism and classism, one of the most powerful forms of activism involves building meaningful relationships on a personal and local level. “Dramatic and systemic change always begins with critical connections,” Boggs writes (2011). In addition, “struggle doesn’t always have to be confrontational but can take the form of reaching out to find common ground with the many ‘others’ in our society” (Boggs, 2011). This thought is extremely relevant to physicians because the one-on-one, personal physicianpatient relationship lies at the center of a physician’s responsibilities. Successful physicians connect with their patients, gain their patients’ trust, and provide personalized care and treatment. Thus, the physician-patient relationship is a crucial site for social change and leading “the next American revolution.” As a recent college graduate hoping to enter medical school in the future, I am aware that if I do not actively lead efforts for social justice, I am simply participating in a hierarchical system that preys on the socioeconomically disadvantaged. I pursue this career path because I believe that physicians can be valuable and powerful activists. As the COVID-19 pandemic continues to disrupt communities around the world, revealing vast social injustices and political shortcomings, becoming a “movement physician” is unavoidable if one wishes to truly help others. The COVID-19 pandemic presents a crucial turning point for Asian American physicians. I hope it is a chance for Asian Americans to de-emphasize individual desire for money and power, to unite against injustices, and to ally with marginalized groups. Activists in the United States have fought for rights based on their visions for a more just, equal, and loving future. As we dream of a better, post-COVID world, it is up to us to continue that activist legacy. ■

SARAH TRAN is a recent graduate of Pomona College (’20), with a major in Neuroscience and a minor in Asian American Studies. She currently lives in southern California, USA.

COVID-19 X Black Lives Matter Special Issue

COVID-19 Illustration

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Illustration

COVID-19

WAITING FOR CAMELLIAS T

his watercolor piece navigates the mood changes and mental health shifts that accompany a self-isolated life. Waiting for Camellias alludes to the (currentlyforecasted) months during which the pandemic will continue to keep us inside. â&#x2013; SOPHIA ZHAO is an undergraduate student from Newark, Delaware, USA, currently studying at Yale University (â&#x20AC;&#x2DC;23).

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COVID-19 Research-Based Article

WHAT CAN WE LEARN FROM COVID-19 IN EUROPE? By AnMei Little

â&#x20AC;&#x153;

Because of the non-pharmaceutical interventions (NPIs) implemented in Europe, researchers estimate more than three million lives were saved.

n December 2019, no one could have foreseen the rapid political, social, and health changes the world would undergo as a response to COVID-19. Six months later, the virus has spread from Wuhan, China, to all corners of the globe. The rapid course of the spread forced country leaders to quickly enact policies that they believed could best control the situation. These high-pressure decisions may determine the fate of the community, both economically and socially. Apart from research and vaccine mobilization, many policymakers throughout the world enacted various non-pharmaceutical interventions (NPIs) to reduce the public transmission of the virus. These unprecedented interventions range from enforcing social distancing to closing non-essential businesses and schools. Europe has recently seen a significant decrease in COVID-19 cases, and many countries have plans to reopen their borders to a select number of countries that have managed to contain the virus (Stewart 2020). Keeping an eye on case numbers, these countries are

slowly returning to normal. Across the Atlantic in the U.S., on the other hand, cases have begun to increase (New York Times database). What did the U.S. do wrong? And what can we learn from Europe on how to effectively stop the spread of COVID-19? Responses to COVID-19 across the United States varied widely from state to state. Some states imposed strict stay-athome orders and closures for nonessential businesses, while other states remained mostly open, even as case numbers began to rise. Many argued that the economic consequences of implementing NPIs outweighed the benefits; however, the World Bank reports that early implementation results in improved economic and health outcomes as compared to delayed and reactionary policies (Demirguc-Kunt 2020). This strongly-endorsed preventive approach, which includes more proactive tracing, testing, and isolating of cases, was more commonly adopted in Europe than in the United States. A thorough analysis of public health interventions in Europe could help better inform policymakers of the practical strategies for overcoming a pandemic.

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The Imperial College COVID-19 Response Team, assembled to advise COVID-19 policies in the United Kingdom, aimed to do just that. They created a microsimulation to model and predict the effects of various NPIs in the UK and the US. They concluded that only enacting one NPI is fairly ineffective. Rather, the combination of multiple NPIs substantially lowers infection rates (Ferguson 2020). Additionally, they distinguished between two types of policies: mitigation and suppression. Mitigation policies aim at mitigating the spread of the virus, whereas suppression policies seek to stop the spread completely. They found that even the best mitigation strategy resulted in â&#x20AC;&#x153;hundreds of thousands of deaths and health care systems being overwhelmed many times overâ&#x20AC;? (Ferguson 2020). On the other hand, the best suppression policies, which included universal social distancing, home quarantining of potential carriers, and possible school and university closures, seemed to drastically reduce death numbers. The downside of these policies, however, is that they would have to be maintained until an effective https://bit.ly/covidxblm

Research-Based Article

COVID-19

ILLUSTRATION COURTESY OF ANMEI LITTLE

vaccine is released to prevent another peak of cases (Ferguson 2020). According to the model in which no NPIs are enacted, eighty-one percent of the population becomes infected, leading to at least 510,000 deaths in the U.K. and 2.2 million in the U.S. within a couple of months (Ferguson 2020). But, because of the NPIs implemented in Europe, researchers estimate more than three million lives were saved. The reproductive number, Rt, of the infection has also decreased. This value represents the average number of people to whom an infected individual spreads the virus. To efficiently suppress virus transmission, the Rt has to remain less than one. Data has shown that, since NPIs have been put in place, the Rt has been reduced by eightytwo percent in Europe, with a current and promising value of 0.66 (Flaxman 2020). These values help us understand the importance of NPI policy, even though we cannot physically see it. But there are limitations to modeling such a novel and variable situation. https://bit.ly/covidxblm

Since many NPIs were implemented at once, it is almost possible to attribute changes to any one NPI. Furthermore, it is difficult to take into account the two-to-three week lag of hospital case results that emerge following a new NPI (Demirguc-Kunt 2020). There is also uncertainty in true case numbers, as many cases are asymptomatic and/or unconfirmed. Additionally, results can vary based on region and population, and community compliance is equally important as the NPIs themselves. As we learn more about COVID-19, the figures presented in this article may begin to shift and new conclusions may be drawn. Beyond the scientific community, all eyes are on Europe, as many European countries are cautiously opening businesses and borders. Some of these countries have banned entry of travelers from specific highrisk countries, such as the US, while other countries require travelers to quarantine for two weeks immediately upon arrival. Some countries are even establishing travel bubbles, where a group of countries,

usually neighboring, selectively open their borders to each other (McClanahan, 2020). According to Manuel Muñiz, the Secretary of State for Global Spain, the success of these so-called exit strategies are contingent on the countries’ ability to meet four criteria: “Track the virus’s spread; test anyone with symptoms; trace the contacts of those who test positive; and treat those who fall ill” (McClanahan, 2020). These rules establish clear guidelines for current and future policies, but just as we could not have predicted the global effects of a spreading virus in Wuhan back in December, we cannot truly predict what the next six months will look like. But with collaborative effort from all aspects of society, from governments, to the scientific community, to citizens, we can begin to combat the virus that has taken over the world. ■

ANMEI LITTLE is an undergraduate student from Nashville, Tennessee, USA, currently studying at Yale University (‘22).

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COVID-19 Illustration

OUR SATURDAY NIGHTS

e have known each other online longer than we have in person. Some of us spend days alone, others in full households. None of us ever thought that a Zoom call would be the most stable part of our week. I am grateful for my friends, our conversations, and Saturday nights. ■

ANASTHASIA SHILOV is an undergraduate student from Hinsdale, Illinois, USA, currently studying at Yale University (‘23). 16

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ISOLATION

Illustration

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his illustration was drawn as a reflection of my thoughts and feelings as a healthcare worker and primary care provider during the COVID-19 pandemic. â&#x2013;

SONIA LAI is a community member from San Francisco, California, USA.

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COVID-19 Research-Based Article

HOW DEMOCRACY CAN RETAIN ITS LEGITIMACY IN THE TIME OF COVID-19 By Ning Yiran

hen then-US President Barack Obama was awarded the Nobel Peace Prize in 2009, he recognised the controversy surrounding his award,1 emphasising in his speech: “We can acknowledge that oppression will always be with us, and still strive for justice…. Clear-eyed, we can understand that there will be war, and still strive for peace. We can do that—for that is the story of human progress; that is the hope of all the world” (The Nobel Prize, 2009). In a complex world where ideals often conflict with reality, he called for the courage to persevere in the pursuit of our ideals, while accepting and dealing with events as they really are. Today, as world leaders attempt to lead their countries out of the pandemic, a conflict has emerged between the widely recognised ideal of promoting and protecting the values of democracy, and the reality of a public health crisis that requires a level of efficiency that democracies struggle to offer. Governments worldwide recognised the need for decisive measures to prevent the spread of the highly contagious coronavirus disease; by the first week of April, more than half of all humanity—more than 3.9 billion people—were placed on some form of lockdown or curfew by their governments

(Sandford, 2020). To quickly track and isolate suspected and confirmed patients of COVID-19, governments began developing and experimenting with technologies that would scale up contacttracing, prompting widespread concerns regarding the trade-off between privacy and public safety (Marr, 2020). These developments invited much discussion and criticism of democratic governments, which have had to give up some of the democratic values that they should have been upholding (Dunst, 2020), such as the freedom of assembly and the human right to privacy (United Nations, n.d.).

As it becomes clear that governments that quickly implemented such measures have outperformed those unwilling or unable to do the same (Bremmer, 2020; Buchanan, 2020), many have understandably started to question if democracy should continue to be promoted universally as the ideal form of government (Commission on Human Rights, 2002; Goncharenko, 2020). However, it would be premature to conclude that the success of authoritarian measures has undermined the legitimacy of democracy. Although heavy-handed approaches may be effective during

The controversy was that even though the prize was awarded to those who have done the most to promote world peace, Obama was, in his own words, “the Commanderin-Chief of the military of a nation in the midst of two wars” (The Nobel Prize, 2009). 1

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Research-Based Article the crisis, they are not sustainable for democratic governments if other democratic values are not protected. When democratic governments use authoritarian measures as a short-term solution, they are tapping into the reserve of public trust built up over the years (Diamond, 2020). This trust greatly determines the effectiveness of policies during a public health crisis (Giuliano & Rasul, 2020)—a trend that was also seen during the Spanish Flu of 1918–1920, the last time humanity battled a pandemic (Siegreist & Zingg, 2014). Measures such as lockdowns and widespread contact tracing require the sacrifice of individual freedoms and the right to privacy. However, to prevent the reserve of public trust from depleting, governments must preserve as much as possible other aspects of democracy. They can do so by, for example, maintaining transparency and accountability, doing their best to protect human dignity, and accessing power in accordance with the rule of law (United Nations, n.d.). Failure to do so could quickly erode public trust and support in the government. In the US, the pandemic hit as public trust in the federal government was at a historic low of just 17%. The Vietnam War, Watergate scandal, and 2008 financial crisis contributed to decades of increasing political polarisation, and an erosion of confidence in the federal government on both sides of the political spectrum (Pew Research Center, 2020; Tavernise, 2020). This polarisation has contributed to a highly bipartisan divide in the public’s response to the pandemic. According to Pew Research Centre (2020), only 44% of Republicans believe that their actions affect the spread of the virus “a great deal,” compared to 73% of Democrats. As a result, greatly inconsistent measures and behaviours between the two groups have contributed to the ongoing difficulty of getting the virus under control. In Singapore, public trust in the government has always been relatively high—in 2019, 67% of the people surveyed said that they trusted the government to do what is right (Edelman, 2019). However, during the pandemic, the government faced repeated

episodes of public uproar—two significant ones being caused by the perceived lack of transparency and accountability regarding the outbreak in migrant worker dorms (Vadaketh, 2020), and privacy and transparency concerns regarding the TraceTogether token2 (Chew, 2020). These episodes contributed greatly to an unusually high level of distrust and dissatisfaction toward the government, which contributed substantially to a ten-point drop in votes for the incumbent People’s Action Party in the nationwide elections of July 10, 2020, as compared to the previous elections five years ago (Beech, 2020). Instead of losing their legitimacy when authoritarian measures like lockdowns are used, a government that is able to uphold other democratic values while making the necessary trade-offs can earn the respect and support of its citizens. For example, while New Zealanders were one of the first to go into strict lockdown, Prime Minister Jacinda Ardern’s leadership, which prioritised compassion, authenticity and transparency (Luscombe, 2020), resulted in 88% of New Zealanders trusting in their government’s future decision-making based on their response to the pandemic (Manhire, 2020). In South Korea, a high level of social trust allowed the successful implementation of measures that were relatively more intrusive on privacy, such as publicising through mobile apps the hour-by-hour, and sometimes even minute-by-minute, movements of infected people (Fisher & Choe, 2020). Without relying on threats of harsh punishment, such as those seen in China (Greitens & Gewirtz, 2020) and the Philippines (The Economist, 2020), governments that protect democratic values can tap on the trust that they have built to convince their citizens to make the necessary short-term sacrifices during the crisis. The challenge of trying to reconcile the legitimacy of democracy with the perceived need for a more centralised and efficient approach during a crisis is not new. In ancient democratic Rome, the Senate

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could convene to appoint a dictator for no more than six months, if the republic is facing an immediate and unexpected threat (Silverstein, 2020). In recent decades, democratic theorists have been discussing a provision for expanded powers for modern democracies: Clinton Rossiter, an American historian and political scientist, introduced the idea of a “Constitutional Dictatorship”—a legitimate constitutional provision that would provide the head of state with expanded power to resolve an emergency (Genovese, 1979). To safeguard the provision from abuse, there should be specific provisions that even a temporary dictator cannot override—for instance, the length of rule allowed before the government or its citizens must convene again to vote on the next course of action. The Constitutional Dictator should also be held accountable by law for the consequences of their decisions once the emergency has ended. These discussions invite the possibility of a democracy tapping on authoritarian measures during a crisis while retaining its legitimacy. It is not naïve to continue to hope and to fight for the values of democracy in times of crisis. Instead, we must remain steadfast in our beliefs while being realistic about the challenges that we face and the adaptations that we need to make. As Obama emphasised in his speech, the constraints of reality should not deter us from striving to achieve our ideals. Even in this pandemic, leaders have the choice to maintain transparency and accountability, and continue to be a champion for human rights and dignity. In this sense, this pandemic has provided democratic governments worldwide with an opportunity to renew our hopes in the pursuit of a more just and peaceful humanity. ■

NING YIRAN is a rising sophomore from Yale-NUS College in Singapore. She hopes to pursue a major in Global Affairs and is interested in issues related to international conflicts and human rights.

The TraceTogether token is a small wearable device that works like the app, exchanging information with other apps and devices for the purpose of contact-tracing. As clarified by the government, it does not track locations (Chew, 2020). 2

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COVID-19 Poem

CONSUMPTION By Denise Abercrombie

The recluse up the road purchases a Winnebago and a 4-wheel drive truck. Like us, he’s afraid of ticks, falling trees—now this. Someone I don’t remember friends me. Our neighbor, a pharmacist, stands in the road to wish us good morning and to share survival tips. He pauses, then warns: Mail-order drugs invite theft. Three homemade surgical masks arrive in the mail—one black-eyed Susan, one dotted with moose, one navy blue. Another kind neighbor—her mom’s business card tucked inside. Fishing season opens early: mid-April and the Fenton’s empty of trout. When fishermen trespass on our land, we let them. A red fox risks a run from the river up the Turnpike in broad daylight. In its mouth, something dead. We imagine her den in the woods. I close doors on my family to attend virtual meetings in our living room. An irate colleague is asked to mute himself. Like everyone, I think about the spread and pay attention to the soap disappearing from its dish. After a trip to the grocery store, my friend breaks down: People’s faces—they look at me and look away. She confesses she has too many clothes—vows she’ll never shop again. My husband orders pullets and seeds online. He grows a flat of cold-weather greens on a windowsill. I join an organic wine club in California, a vineyard at the headwaters of the Russian River in the Red River Valley. We buy one son a new laptop, the other a home gym. At night, watch the news, eat cheddar bunnies, chocolate pudding, and stream every Scorsese film we can find. A FedEx package—too large to carry alone—arrives at the end of our driveway, addressed to someone we don’t know. We plan to deliver the box from Cacaoholics.com to our mystery neighbor across the river. Who knew we shared a passion? On the drive over, I fantasize about gourmet chocolate—dark, ganache-filled truffles, bittersweet bark, raw cocoa-dusted confections—and consider, for a moment, keeping the goods. ■

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Poem

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nightshade By Donald T. Gray

there is nightshade in the air and my people are dying it is soft and fragrant on the vine but now some burn it in the night it seeps through doors and pores killing us a bit by morning much like hate once charred it cannot be stopped from its killing spree I have no more sacred stones to soothe me so I count small porcelain dogs first the little spaniel from Jamaica all the way to the mastiff from the mountains in Tibet they are so very cold and still but for small comfort are adequate for a night that’s waning when the scent of deadly nightshade fills the air. ■

ILLUSTRATION COURTESY OF ZIHAO LIN

DONALD T. GRAY (Yale University ’70) is a community member from Del Mar, California, USA, and was previously a Carnegie Teaching Fellow at Yale University.

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COVID-19 Comic

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Comic

COVID-19

n this informative science comic, Neko and Dumble introduce the reader to the details surrounding the COVID-19 pandemic. Together, the two bring light to issues associated with the disease. ■

HUANG HUANYAN and RICHARD SHIM JO are undergraduate students currently studying at Yale-NUS College (‘23 and ‘22, respectively). https://bit.ly/covidxblm

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COVID-19 Personal Anecdote

THE LAST MOMENT By Houyee Chow

oday we say our goodbyes to the ones we once knew. No longer being able to see their physical form, you desperately try to remember the last time you saw them. The last moment they were at your sight, if you knew what you know now, you would have held on tighter during your last embrace. You would look them in the eyes and say you lived your life right and that it was an honor to have them in your life. Their lives were taken too soon. The news said that high risk folks were the ones sixty and up, so why was it that the ones that lost their battle were barely reaching the peak of their life. Never to see their kids grow up, never again to see the light of day. People laugh and gawk at the idea of wearing a mask, yelling, “It’s a hoax, don’t be a sheep!” Funny how they also thought this in the beginning, yet it’s sickening that they paid with their lives for not believing. It’s a privilege to learn of these stories through papers instead of through phone calls, and even worse to have to relay this information to your other family.

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Family. It was a family affair. The eldest daughter, a firstgrade teacher, was exposed during a brief hospital visit and soon found she had tested positive. Across town, her brother embraced his son of seven years who unknowingly exposed him, and soon the brother exposed his mother who then exposed the father. As fast as it came, it ferociously attacked, knocking them all down. The battle centered in their lungs;

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Personal Anecdote

everyone was desperate for oxygen tanks, but there weren’t enough to go around. Unable to move or speak, the daughter and brother’s lungs were both in trouble, bedridden in different hospitals without the knowledge that they both were at war for their lives. Access to ventilators were waitlisted and his lungs were extremely low in oxygen. He left behind his son of seven years; they never got the ventilator to him. The middle child then sacrificed her life and home with her two children and husband and went to live with her parents. She knew they were weak, knew they needed help, knew that she too would meet the virus face to face. One week later, overcome with sadness and sickness, the father’s heart gives, and he meets his son. The prayers of loved ones filled the air. The eldest daughter in critical condition had tubes inserted into her body in hopes that it would keep her alive; she didn’t know that her brother and father had passed, didn’t know her mom was sick, didn’t know the sacrifice her sister had made. The mother and middle daughter embraced in fear. They felt helpless and angry, for death was near their doors, but desperately hopeful that the remaining would survive. Two weeks later. . . she dies, the daughter in the hospital fighting so courageously for almost two months felt her heart give out. As she gasped for her last bits of air, she thought of her children and husband that were waiting for her to come home. She knew she would be with them in their hearts as she joined in the arms of her father and brother. The sun rises the next day without her, and the song of mourning joins in unison, for a family was torn apart by the virus. The mother cries and screams that the virus nearly ended her family. She questions in anger why she was the lone survivor, why was she chosen to live when those she loves died. She embraces her only child left, together knowing they must spend the rest of their lives caring for the children left behind. It takes one day. One day for the hospitals to cremate and to deliver the ashes to you. One day for you to see a small container arrive at your door. One day to hold onto a cold, small, quiet container. Today you say hello to the ones you once knew. No longer being able to see their physical form, you desperately try to remember the last time you saw them. The last moment they were in your sights, if you knew what you know now, you would have held on tighter during your last embrace. You would look them in the eyes and say you lived your life right and that it was an honor to have them in your life.

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COVID-19

In Memory of: Breshnev Pérez Jiménez 1981- 2020 Rodolfo Pérez de la O 1946- 2020 Ana Karenina Pérez Jiménez 1975- 2020 “Death doesn’t discriminate Between the sinners and the saints It takes and it takes and it takes And we keep living anyway. We rise and we fall and we break And we make our mistakes. And if there’s a reason I’m still alive When everyone who loves me has died” Wait for it. Booklet. Hamilton. Atlantic Records, 2015 ■

HOUYEE CHOW is a community member from San Jose, California, USA.

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COVID-19 Research-Based Article

COVID-19 AND THE NERVOUS SYSTEM DISSECTING UNEXPECTED CONNECTIONS

By Maria Fernanda Pacheco

magine waking up to a throbbing migraine. You try to get up but can barely stand without losing your balance. Even though it takes you longer than usual, you eventually manage to stagger towards the bathroom. As you try to brush your teeth, the peppermint scent of your toothpaste wafts up your nostrils, but this time you can’t smell a thing. You look through your window and see a lion walking inside your neighbor’s apartment—or at least you think you do. “That’s weird,” you think to yourself. Maybe something isn’t right. Headaches. Dizziness. Loss of sense of smell. Hallucinations. While these manifestations are common to a host of neurological diseases, they have also been reported among patients infected by the coronavirus (Reinberg, 2020). The similarity in symptoms, however, represents more than mere coincidence. Under the light of a growing body of evidence, they seem to demonstrate that SARS-CoV-2, the virus that causes COVID-19, affects the nervous system in more ways than initially assumed (Molteni, 2020). Despite the first description of COVID19 as a pneumonia-like disease (Sun & Berger, 2020), it has become increasingly clear to scientists and physicians that thinking of it as a multi-system condition might be more appropriate. As it turns

out, it seems that the coronavirus can assail not only the lungs but also different organs, including the heart, the gut and the brain (Wadman et. al, 2020). Because of that, efforts to understand the long-term ramifications of the virus, be it on the neurological front or in other bodily systems, has become a priority for scientists all over the world.

in the disease, after a median time of one to two days. Similarly, according to the Washington Post, a study conducted in France and published in June also found that eighty-four percent of COVID-19 patients requiring intensive care exhibited neurological symptoms, while one-third of them demonstrated some level of disorientation upon discharge (Cha, 2020).

The first report of neurologic manifestations among hospitalized COVID-19 patients was posted on the preprint server medRxiv in late February. Among the cohort of 214 patients examined in Wuhan, the disease’s first epicenter, 36.4% of patients presented with neurologic symptoms affecting either the brain, the spinal cord, the peripheral nerves or the skeletal muscles (Mao et al., 2020). As described in the paper, the onset of these symptoms often struck early

While scientists do not have a concrete answer for why these COVID-related neurological phenomena happen, they have known that the coronavirus invades human cells using the spike proteins that give it a crown-like shape. These spike proteins help the virus latch onto ACE2 receptors, which in turn act as a molecular entrypoint for viral infiltration into the host. Building upon that knowledge, researchers have explored the distribution of these ACE2 receptors in tissues

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Research-Based Article

within the brain in the pursuit of a better understanding of how the virus affects the nervous system (Chen et al., 2020). Using transcriptome databases, which contain information about the genetic material found in biological samples, a group of researchers produced a spatial distribution analysis that mapped out brain regions expressing ACE2 receptors. Among multiple observations, the group found that the choroid plexus, which produces cerebrospinal fluid (CSF), seems to be a site of high ACE2 expression—an important realization considering how immune cells often travel via CSF (Chen et al., 2020). A case study published by physicians in Japan in May reported the development of meningitis and encephalitis, or brain inflammation, associated with SARSCoV-2 infection in a twenty-four-year-old man (Moriguchi et al., 2020). Curiously, the virus’s genetic material was not identified in the patient’s deep nose swab. After performing a head computed tomography (CT) that demonstrated swelling and detecting viral RNA in a sample of his CSF, however, it seemed clear that not only had the patient contracted COVID-19, but the coronavirus had also trespassed into his nervous system (Molteni, 2020). When it comes to immune responses to the coronavirus, many scientists speak of “cytokine storms”—unfettered immunological reactions promoted by small proteins called cytokines that mediate immune responses and, when in excess, can kindle the inflammation of tissues (George, 2020). If these cytokines travel up towards the brain through the CSF, it is possible that they cause localised swelling, which could trigger symptoms including seizures. Whether the coronavirus induces damage to the brain by infiltrating nerve cells or by provoking the firing of cytokines remains unclear (Moyer, 2020). There is a lot about COVID-19 that still puzzles scientists, but not knowing for sure why some patients develop neurologic

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complications when they are infected while others only experience symptoms after recovery or, in some cases, never at all, seems to foment curiosity. One of the most puzzling yet common symptoms associated with the coronavirus is the loss of the sense of smell, which seems to have a neurologic motivation. The initially inscrutable nature of this phenomenon intrigued many researchers and elicited multiple hypotheses. Could it be due to the structures inside the nose? Or are the roots of the symptom concealed deep within the folds of the brain? Some scientists have been looking into whether it is possible for the olfactory nerve to serve as a viral gateway into the brain. Others have even hypothesized that patients’ inability to smell suggests that the virus makes its way towards the brain by going up the nose and through the olfactory bulbs, which is found on the bottom of the cerebral hemispheres (Wadman et. al, 2020). While substantial evidence has been published to suggest that the coronavirus provokes inflammation, there are still discrepancies surrounding whether this is true. Dr. Mary Fowkes, a pathologist at Mount Sinai Health, for example, told the Washington Post that she did not find a lot of inflammation or viral presence in the brains of COVID19 patients that she looked at (Cha, 2020). Similarly, neuropathologist Isaac Solomon, who examined the brains of eighteen deceased patients who had been infected by the coronavirus, wrote a letter published in the New England Journal of Medicine reporting that while he did not see evidence of inflammation, he did observe neuronal death in the cerebral cortex and other areas, indicating oxygen deprivation (Solomon et al., 2020). Along those lines, a related concern surrounds the possibility of deadly ischemic strokes in patients infected with the coronavirus. This type of stroke occurs when blood clots occlude vessels carrying

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blood to the brain, inducing the death of brain cells. But while studies have linked the coronavirus with coagulopathies (Iba et al., 2020), which make the blood more prone to clotting, others, including researchers at Weill Cornell Medicine, have suggested that the risk of strokes associated to COVID-19 is not significantly higher than for other viral respiratory infections (Merkler et al., 2020). One of the many lessons that the coronavirus has taught us, however, is that some things are not what they seem. As an example, Jennifer Frontera, a neurocritical care specialist at New York University’s Langone Medical Center, spoke to Science Magazine about how she wonders whether it could be possible for the coronavirus to affect the brain stem reflex that detects when you are being starved of oxygen, which could help rationalize how some patients have not been experiencing difficulty breathing even though their oxygen saturation levels, which measure how much oxygen is in your blood, are low (Wadman et. al, 2020). When it comes to the nervous system, arguably the most complex system in the body, the enigmatic effects of the coronavirus intensify the challenge of understanding its neurological impacts. But if we think about how far we have come in terms of dissecting the elusive layers that surround coronavirus mysteries, there is reason to remain hopeful. When COVID-19 first emerged, there was not a lot about it that we understood, but now that it has been around for some time, we are beginning to unpack its treacherous mechanisms, to learn more about longterm effects, and to inch closer to finding answers to even our most vexing questions..

MARIA FERNANDA PACHECO is an undergraduate student at Yale University (‘23) and alumni of The British School of Rio de Janeiro (‘18) and is from Rio de Janeiro, Brazil.

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COVID-19 Illustration

COVID-19 X Black Lives Matter Special Issue

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Illustration

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DAVIDS DISTANCING

n illustration of two David statues practicing physical distancing. With the distance created, the nature around them has started to bloom. â&#x2013; MAXINE TANJUTCO is a community member from Muntinlupa, Metro Manila, Philippines.

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COVID-19 Research-Based Article

THE EPIDEMIOLOGY OF RACISM YELLOW PESTILENCE IN THE AGE OF COVID-19

By Genevieve Ding Yarou

“The body is a biopolitical reality; medicine is a biopolitical strategy” –Foucault, The Birth of Social Medicine (1974)

n the midst of a global pandemic, waves of protests against racialized police violence has indicted the uncanny sense of ordinariness that has long veiled rampage violence against coloured communities in America and around the world. The assertion of “Black Lives Matter” articulates the precarity and disposability of Black and coloured lives in America and condemns intersecting powers of nationalism, xenophobia, and capitalism. These powers produce and perpetuate the discursive and systemic discrimination of ethnic minorities on the domestic and global level. The global turn to the right—in India, Philippines, Britain, Hungary, Brazil, France, and many other countries— and recent political events surrounding repressive and racialised regimes worldwide demand our attention to the continuities of history and humanity, through which conditions

of neglect, precarity, and lethality subject coloured bodies to bare forms of social existence between life and death (Agamben, 1998; Mbembe & Meintjes, 2003). The racial disparity in COVID19 infection and mortality rates has brought to the forefront the differential exposure of ethnic minorities to health and social risks, and their subordinate position in the neoliberal economy. Through this position, ethnic minorities are subject to a specific form of racial biopolitics that is reconfigured globally— ethno-nationalist governance that simultaneously demands for the unceasing flow of capital from the labour extraction of coloured bodies and their parallel social ostracization through fortified borders and racial exclusivity (McIntyre & Nast, 2011; Melamed, 2015). As strategies of

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racial vilification and scapegoating (re)deploy and (re)produce the racial marginalisation of ethnic minorities to define the threshold of citizenry, the focus of sovereign and penal power has shifted from social morality and integration to immobilisation and expulsion from the polity. Such a shift traps coloured bodies in a carceral continuum between immigration detention and mass incarceration, thus making clear the fragility of rights, identity, and membership in contemporary society (Bosworth et al., 2018; Wacquant, 2001). The racial and identity politics of the pandemic is felt acutely by the Asian diaspora, whose bodies are ontologically pathologized to be of pestilence and, therefore, risk contaminating the sanctified public space. Trump’s xenophobic diagnosis of COVID-19 as “Kung Flu” and a

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Research-Based Article

“Chinese virus” is an example of the binding of pathology to race, deployed in the service of political expediency. Since the outbreak of COVID-19 in Wuhan, China in January 2020, globally, people of Asian descent have overwhelmingly been the target of discrimination and social exclusion (Human Rights Watch, 2020). From verbal abuse to violent attacks on the street, on public transport, in grocery aisles, and on school campuses, the fear of Eastern contamination has latched onto the social imagination of the public and has normalised anti-Asian sentiments in America and abroad. The stigmatisation of the Chinese as an abstraction of disease, deviance, and degeneracy in public discourse is not new to the current pandemic. In 19th century San Francisco, following a virulent outbreak of smallpox, epidemiological investigations of infectious diseases in Chinatown seized upon the unsanitary space as evidence of the deviant and diseased nature of the Chinese immigrant community. An investigative report of the sanitary conditions of Chinatown conducted by the mayor, a microbiologist, and a city health official in 1880 denounced the Chinese—“this infamous race”—for the “diabolical disregard of our sanitary laws” and condemned Chinatown as a “nuisance” (Workingmen’s Party of California, 1880, p. 6, emphasis added). The American government construed the impoverished Chinese community as malicious in their intentional disregard of the city’s welfare, and pathologized the site of Chinatown as a diseased and demoralised space that incubates epidemics and breeds vices such as opium smoking, gambling, and prostitution— all of which could lead to the physical and moral destruction of young, white Americans (Craddock, 2008). By 1885, in a government sponsored public health survey of Chinatown, the racist sentiment that the Chinese

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lived in depravation by cultural and genetic proclivity rather than by economic necessity concretised an order of differences between Chinese and white Americans as biological and preordained. The 1885 public health investigation report explained the exceptionalism of Chinatown beyond the general categorisation of slums: Here it may be truly said that human beings exist under conditions (as regards their mode of life and the air they breathe) scarcely one degree above those which the rats of our water-front and other vermin live, breathe and have their being. And this order of things seems inseparable from the very nature of the Chinese race. (Farwell, 1885, p. 33) The report emphasised the indifference of the Chinese to human comforts and compared the impoverished living conditions of the Chinese to those of pests. This comparison not only dehumanised the Chinese as ontologically inferior but insinuated that the Chinese has an instinct for crowded, dilapidated, and filthy environments that destine the race to diseases and degeneracy. In the racial imagination of the white government officials, disease was conceived as organic to the Chinese living space and symptomatic of the ontological defect of the Chinese. Essentially, the spatial hygiene of Chinatown became a metonym for the social hygiene of the Chinese. Departing from a prejudiced position that pathologized the Chinese as a contagion within the contaminated Chinatown, anti-Chinese policies started prioritizing the segregation of spatial and social bodies of the Chinese and white community. The ideologically neutral epidemiological guise of sanitation reforms sanitised the racially discriminatory impulse to contain the

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Chinese within a spatial boundary and to control contact between Chinese and white Americans (Shah, 1995). Two centuries later, in 2020, the pathologisation of the Chinese—and other coloured bodies who, racially profiled, share their physiognomy— as contagious carriers of COVID-19 who contracted the virus through their cultural proclivities reveals that stigmas of disease, deviancy, and depravity continue to locate Chinese bodies as the site of infectious emanation. Burdened by images of shame, disease, and depravity, the bodies and spaces of the Asian diaspora and ethnic minorities have long been inscribed with the ideological rendering of discursive regimes. The racial health disparity of ethnic minorities in the current climate of COVID-19 reveals that racial logic, colonialism, and health sciences are interlocking systems of power that have justified and have continued to perpetuate exploitative institutions through ideas of biological racial differences and metonymic representation of coloured bodies as diseased and deviant. The biopolitical violence against coloured bodies unsurfaced in the midst of COVID-19 and the Black Lives Matter movement emphasises that it is the pathogens of segregation, neglect, and institutional discrimination that plague ethnic minority communities and create systemic challenges that increase their risk of infliction and mortality. In the face of an epidemiological pandemic of disease and a moral pandemic of racism, we need to confront the current hierarchy of human-ness that justifies the uneven distribution of life and death, and to question who is ‘human’ and deserving of ‘rights’ in society? ■

GENEVIEVE DING YAROU is an undergraduate student from Singapore, currently studying at Yale-NUS College.

COVID-19 X Black Lives Matter Special Issue

COVID-19 Illustration

COVID-19 X Black Lives Matter Special Issue

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Illustration

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PROTECT AGAINST COVID-19 T

his illustration highlights our healthcare heroes and their incessant efforts to fight against and protect us from the COVID-19 pandemic. ■ SOPHIA ZHAO is an undergraduate student from Newark, Delaware, USA, currently studying at Yale University (‘23).

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COVID-19 X Black Lives Matter Special Issue

COVID-19 Research-Based Article

THE RISE AND FALL OF HYDROXYCHLOROQUINE By Beatriz Horta

n early April, doctors in Wuhan, China, reported that mildly ill coronavirus patients treated with the anti-malaria drug hydroxychloroquine saw symptoms disappear faster than most patients (Chen et al, 2020). What followed was a whirlwind of media coverage, a few questionable scientific studies, and considerable political lobbying, all of which tried to answer the question: have we found a cure for the coronavirus? Most likely not, it seems. Despite the initial reticence of the Chinese doctors and most media outlets, widely emphasizing that “more research was needed,” scientists had stirred up hope that a quick and effective treatment for the virus that was ravaging the country had been found (Grady 2020). The Wuhan study was posted in medRxiv, a preprint server for research results that are awaiting or undergoing peer review, before they are formally published. Despite its small sample size (sixty-two patients) and lack of peer review, it became the pillar for research related to the use of the drug for coronavirus treatment. When did it start? Hydroxychloroquine, known commercially as Plaquenil, is a disease-modifying antirheumatic drug (DMARD) (American College of Rheumatology, 2020). It is used to prevent and treat malaria, and to alleviate the symptoms of rheumatoid arthritis, lupus, and other autoimmune diseases. Hydroxychloroquine’s effect on the body is not yet known, however scientists believe it prevents the body from activating an immune response against itself. It also affects production of cytokines, which are signaling chemicals secreted by cells in the immune system

(Sinha, 2020). The drug was first used in the treatment of autoimmune diseases in 1955, and became FDA-approved for large-scale use in 1956 (Lupus.org, n.d.). There are several worrisome side-effects, including irreversible retina damage and heart complications (Sinha, 2020). A French study published at the end of April described the use of hydroxychloroquine as a treatment combined with the antibiotic Azithromycin (AZT), this time in a larger sample of patients (1061 cases). The researchers concluded that the drug combination was “associated with a very

COVID-19 X Black Lives Matter Special Issue

low fatality rate in patients” (Million et. al, 2020). Following these studies, The National Institute of Allergy and Infectious Diseases (NIAID) began a clinical trial on the combined hydroxychloroquine and AZT treatment on adults with mild to moderate COVID19 symptoms (NIH, 2020). Including the placebo group, this study involved over two thousand adults. Early supporters After preliminary scientific evidence became known, many politicians, including U.S. president Donald Trump, https://bit.ly/covidxblm

Research-Based Article pointed to hydroxychloroquine as a saving grace and expressed optimism for its use in treatment. This led to a surge in the stockpiling of hydroxychloroquine, leaving many autoimmune disease patients without their necessary prescriptions (Grady, 2020). There were soon reports of people self-administering the drug as a preventative measure—President Trump himself acknowledged doing so (Hickok, 2020). Other politicians around the world, including Brazilian President Jair Bolsonaro, embraced the supposed cure and encouraged its citizens to selfmedicate (Benke, 2020). In an effort to support Brazil’s failing response to the pandemic, the US government shipped two million doses of hydroxychloroquine in the beginning of June, even as the country’s own health agencies began disputing the scientific evidence supporting the drug’s use (Togoh, 2020). The doubters These moves prompted a swift response from the scientific community, who expressed their concern over the increased, unregulated use of the drug. The Federal Drug Administration “cautioned against the use of hydroxychloroquine … due to risk of heart rhythm problems,” and also revoked the emergency use authorization (EUA) of the drug for treatment of COVID-19 outside of a clinical trial (FDA, 2020). The aforementioned NIH clinical trial was halted at the beginning of June, when not enough patients had signed up to participate and the agency decided that the drug “was unlikely to be effective” (Thomas, 2020). RECOVERY was a large-scale UK clinical trial designed to test the effectiveness of the drug as a treatment for the coronavirus. It published its results on June 5th, announcing that there had been “no clinical benefit from use of hydroxychloroquine in hospitalized patients with COVID-19” (Horby & Landray, 2020). A University of Connecticut study, published in the Annals of Internal Medicine, summarized the results of twenty-three studies, and concluded that the “evidence on the benefits and harms of using https://bit.ly/covidxblm

hydroxychloroquine or chloroquine to treat COVID-19 is very weak and conflicting” (Hernandez et. al, 2020). These negative results led to a growing wariness towards the use of the drug. Despite the evidence against it, there is still relative controversy surrounding the drug. Much like many aspects of the coronavirus prevention, symptom management and treatment, the accelerated timeline and lack of information leads to conflicting reports. A study published by doctors at the Harvard Medical School in The Lancet, one of the world’s most prestigious medical journals, claimed that the use of hydroxychloroquine (or its sister drug chloroquine) led to an increase in in-hospital deaths (Mehdra et. al, 2020). Based on the results of the study, many institutions including the World Health Organization moved to suspend their clinical trials involving hydroxychloroquine. The study was redacted by The Lancet when over 100 scientists and doctors questioned the validity of Surgisphere, the database used as the basis for the study analysis (Rabin, 2020). In an open letter to the journal, the signatories called for a review of the study’s methods, citing many instances where the recorded data seemed unlikely to be true. One example was that the data from Australian hospitals included “more in-hospital deaths than had occurred in the entire country during the study period” (Rabin, 2020). With even more confusion in the field over hydroxychloroquine’s plausible benefits and harms in the treatment of the coronavirus, scientists seem unwilling to give any definitive answers on the subject. Where do we go from here? The short-lived fame of hydroxychloroquine serves as a warning to researchers, the media, and the general population. Many have now started to wonder if rushing to find a cure, speeding up review processes for published articles, and endorsing unproven cures will do more harm than good in the long run. Was it wise to direct funding and resources into

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hydroxychloroquine research? Would it be imprudent, on the other hand, to halt all related studies? Experts in the field seem to have found a possible compromise. The World Health Organization has resumed its study on the use of hydroxychloroquine to treat the coronavirus, but health officials are neither encouraging nor defending the administration of the drug in hospitals or by patients themselves (Park, 2020). Scientists are also cautioning against the drive to speed up the peer-review process in order to produce quick knowledge about the coronavirus, which could lead to misguided data collection methods and an incentive to find results where there may be none. The hydroxychloroquine saga has made plain the scale of the challenge that COVID-19 poses to the scientific apparatus at large—when our understanding of a disease is only inchoate, but when human lives are widely at stake, scientists must plough on with whatever correlations they find, even if the data are only promising and not definitive. It falls onto the lay audience and the media to acknowledge the complexity of such pursuits, instead of jumping to their own conclusions. Experts remain in a race against the clock to find a cure for COVID-19. Many are still disagreeing on key aspects, but one thing they all agree on is: the rush to find a cure without proper information and reliable evidence could end up harming patients more than helping them. The case of hydroxychloroquine shines a light on the importance of separating politics from science, as well as the confounding incentives that drive research in a time of crisis. Ongoing research on hydroxychloroquine can serve as an opportunity to improve the way we test drugs, change the incentives behind research, and teach us how we can provide better healthcare in the future in times of crisis. ■

BEATRIZ HORTA is an undergraduate student from Rio de Janeiro, State of Rio de Janeiro, Brazil, currently studying at Yale University.

COVID-19 X Black Lives Matter Special Issue

STAFF

EDITORS-IN-CHIEF OUTGOING EICS Debbie Dada Tomeka Frieson Marcus Sak Leslie Sim Antalique Tran INCOMING EICS Jenesis Duran Jane Fan Kara Liu Meera Shaw Enrique Vazquez Sophia Zhao

REVIEWERS Debbie Dada Jenesis Duran Kelly Farley Tomeka Frieson James Han Kara Liu Hannah Ro Marcus Sak Meera Shaw Leslie Sim Anna Sun Antalique Tran Oby Uche Enrique Vazquez Katarina Wang Katherine Yao Sophia Zhao

EDITORS Jane Fan Kelly Farley Tomeka Frieson James Han Ayla Jeddy Kara Liu Bryan Mendoza Esther Reichek Hannah Ro Marcus Sak Anna Sun Antalique Tran Sophia Zhao

PRODUCTION & DESIGN Ellie Gabriel AnMei Little Ishani Singh Antalique Tran Katarina Wang Sophia Zhao Julia Zheng

LETTER FROM THE EDITORS Dear Readers,

We write to you during an immensely unique time in history. The year 2020 has brought with it a global coronavirus pandemic infecting tens of millions of people and killing hundreds of thousands globally while simultaneously dramatically transforming the way we interact, learn, and move within the world. Within this year, we also saw the tragic and unjustified deaths of more Black people—George Floyd, Breonna Taylor, and Tony McDade—at the hands of police. This awakened masses to the ever-present reality of police brutality and anti-Black racism and prompted months of demonstrations and protests in solidarity with the #BlackLivesMatter movement all over the world. We have decided to respond to this painful and important moment in history through art and writing. We sent out a call to voices all over the world affected in various ways by the syndemic of racism and COVID-19 and received a striking response. This issue features work from those living in Singapore to Brazil to Jordan to South Korea to the Philippines to right here in New Haven, Connecticut, USA. We hear the personal story of a family stripped of loved ones by a faceless disease, and we encounter the heartbreaking poetry of those bearing the emotional burden of justice deferred. We learn about the nuances of non-routine vaccine development, and we see the beautiful resilience of healthcare workers striving to heal in the face of the unimaginable. We are honored to have the privilege to share with you a piece of history in the making through this special edition COVID-19 x Black Lives Matter publication, sponsored by the Yale Global Health Review, Yale Journal of Medicine and Law, and Yale Scientific Magazine, and in collaboration with Yale Literary Review. We wish you peace and health today and always.

Signed,

Editors-In-Chief ABOUT

Anger, hopelessness, grief, and weariness—but also hope, strength, persistence, and unity. Through these illustrated hands, I hoped to capture the emotions entangled in the Black Lives Matter movement that were beautifully conveyed in the submissions for this special issue. Antalique Tran, BLM Cover Artist

ILLUSTRATORS Ellie Gabriel Kitty Kan Zihao Lin Anya Pertel Joyce Tsui

THE ART

As COVID-19 shook the world off its feet this year, people were suddenly whisked away from their loved ones. The resilience and compassion in this issue will remind us of how we stood apart to stand together in the face of uncertainty and despair. Ellie Gabriel, COVID-19 Cover Artist

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Chaffee, K. (2019, November 30). Music Memories: Billy Strayhorn. LAPL. https://www. lapl.org/collections-resources/blogs/lapl/music-memories-billy-strayhorn Clasen, G. (2020, July 15). Violinist transformed hostility into beauty at vigil for Elijah McClain. Street Roots. https://www.streetroots.org/news/2020/07/14/violinisttransforms-hostility-beauty-vigil-elijah-mcclain Grant, K. (2020, May 19). The Future Of Music Streaming: How COVID-19 Has Amplified Emerging Forms Of Music Consumption. Forbes. https://www.forbes.com/sites/ kristinwestcottgrant/2020/05/16/the-future-of-music-streaming-how-covid-19-hasamplified-emerging-forms-of-music-consumption/ Hissong, S. (2020, April 16). The Week the Music Stopped. Rolling Stone. https://www. rollingstone.com/pro/features/music-crisis-concerts-tours-980968/ History of Soul Music. (n.d.). English Club. https://www.englishclub.com/vocabulary/music-soul.htm Kaufman, G. 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Folk Life. https://folklife.si.edu/talkstory/2016/tell-it-like-it-is-a-history-of-rhythm-and-blues Suttie, J. (2015, January 15). Four Ways Music Strengthens Social Bonds. Greater Good Magazine. https://greatergood.berkeley.edu/article/item/four_ways_music_strengthens_social_bonds C O V I D -19 The Rise and Fall of Hydroxychloroquine - Beatrix Horta Behnke, E. (2020, May 23). Bolsonaro volta a defender uso da cloroquina: ‘não tem outro remédio’ - Saúde. Estadao. https://saude.estadao.com.br/noticias/geral,bolsonaro-voltaa-defender-uso-da-cloroquina-nao-tem-outro-remedio,70003312516 Chen, Z., Hu, J., Zhang, Z., Jiang, S., Han, S., & Yan, D. et al. (2020). Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. medRxiv. https://doi.org/10.1101/2020.03.22.20040758 Facher, L. (2020). Fact-checking Trump’s optimistic hydroxychloroquine claims, the antimalarial drug he’s touting as a coronavirus treatment. 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COVID-19 and the Nervous System - Maria Fernanda Pacheco Cha, A. (2020). Coronavirus autopsies: A story of 38 brains, 87 lungs and 42 hearts. The Washington Post. https://www.washingtonpost.com/health/2020/07/01/coronavirusautopsies-f indings/?utm_campaign=wp_post_most&utm_medium=email&utm_ source=newsletter&wpisrc=nl_most. Chen, R., Wang, K., Yu, J., Howard, D., French, L., Chen, Z., Wen, C., & Xu, Z. (2020). The spatial and cell-type distribution of SARS-CoV-2 receptor ACE2 in human and mouse brain. BioRxiv. https://doi.org/10.1101/2020.04.07.030650 George, A. (2020). Cytokine storm. New Scientist. https://www.newscientist.com/term/cytokine-storm/. Iba, T., Levy, J., Levi, M., Connors, J., & Thachil, J. (2020). Coagulopathy of Coronavirus Disease 2019. Critical Care Medicine, Publish Ahead of Print. https://doi.org/10.1097/ ccm.0000000000004458 Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Li, Y., & Hu, B. (2020). Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurology, 77(6), 683–690. https://doi.org/10.1001/jamaneurol.2020.1127 Merkler, A., Parikh, N., Mir, S., Gupta, A., Kamel, H., Lin, E., Lantos, J., Schenck, E. J., Goyal, P., Bruce, S. S., Kahan, J., Lansdale, K. N., LeMoss, N. M., Murthy, S. B., Stieg, P. E., Fink, M. E., Iadecola, C., Segal, A. Z., Cusick, M., . . . Navi, B. B. (2020). Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2020.2730 Molteni, M. (2020). What Does Covid-19 Do to Your Brain?. Wired. https://www.wired. com/story/what-does-covid-19-do-to-your-brain/. Moriguchi, T., Harii, N., Goto, J., Harada, D., Sugawara, H., Takamino, J., Ueno, M., Sakata, H., Kondo, K., Myose, N., Nakao, A., Takeda, M., Haro, H., Inoue, O., Suzuki-Inoue, K., Kubokawa, K., Ogihara, S., Sasaki, T., Kinouchi, H., . . . Shimada, S. 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The Washington Post. https://www.washingtonpost.com/ world/2020/01/21/what-we-know-about-coronavirus-spreading-china-elsewhere/ Wadman, M., Couzin-Frankel, J., Kaiser, J., & Matacic, C. (2020). How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes. Science | AAAS. https://www.sciencemag.org/news/2020/04/how-does-coronavirus-killclinicians-trace-ferocious-rampage-through-body-brain-toes. How Democracy Can Retain its Legitimacy in the Time of COVID-19 - Ning Yiran Beech, H. (2020, July 10). In Singapore, an Orderly Election and a (Somewhat) Surprising Result. The New York Times. https://www.nytimes.com/2020/07/10/world/asia/ singapore-election-results.html. Bremmer, I. (2020, June 12). The Best Global Responses to COVID-19 Pandemic. Time. https://time.com/5851633/best-global-responses-covid-19/. Buchanan, M. (2020, June 4). Are Covid-19 Lockdowns Slowing Infection Rates? Science Says Yes. Bloomberg.com. https://www.bloomberg.com/opinion/articles/2020-06-04/ are-covid-19-lockdowns-slowing-infection-rates-science-says-yes. Chew, S. (2020, June 13). Are Our Fears About The TraceTogether Token Justified? We Asked A Data Privacy Expert. Rice. https://www.ricemedia.co/current-affairs-featurestracetogether-token-data-privacy-expert-interview/. Diamond, L. (2020, April 16). America’s COVID-19 Disaster Is a Setback for Democracy. The Atlantic. https://www.theatlantic.com/ideas/archive/2020/04/americas-covid-19disaster-setback-democracy/610102/. Dunst, C. (2020, May 1). Western democracy’s problem with authority makes it more vulnerable to Covid-19. Quartz. https://qz.com/1847421/why-most-western-democraciescant-contain-coronavirus/. Edelman. (2019). 2019 Edelman Trust Barometer: Global Report [PDF file]. Edelman. https://www.edelman.com/sites/g/files/aatuss191/files/2019-02/2019_Edelman_Trust_ Barometer_Global_Report_2.pdf. Fisher, M., & Choe, S. (2020, March 23). 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CNET. https://www.cnet.com/how-to/coronavirus-vaccine-are-we-closeto-finding-one-heres-whats-happening/ Sparks, D. (2020, June 30). Herd immunity and COVID-19: What you need to know. Mayo Clinic. https://newsnetwork.mayoclinic.org/discussion/herd-immunity-and-covid-19what-you-need-to-know/ This is why we may not see a coronavirus vaccine for 12-18 months. (2020, May 11). ABC 7. https://abc7.com/nc-coronavius-coronavirus-vaccine-covid-19/6163732/ Weiland, N. & Sanger, D. (2020, July 9). Trump Administration Selects Five Coronavirus Vaccine Candidates as Finalists. The New York Times. https://www.nytimes. com/2020/06/03/us/politics/coronavirus-vaccine-trump-moderna.html Weise, E. & Weintraub, K. (2020, June 30). We’re one-third of the way to a widely available coronavirus vaccine, experts say. USA Today. https://www.usatoday.com/in-depth/news/ health/2020/06/30/covid-vaccine-progress-widely-available-coronavirus-expertpanel/3242395001/ Zimmer, C., Sheikh, K., & Weiland, N. (2020, May 20). A New Entry in the Race for a Coronavirus Vaccine: Hope. The New York Times. https://www.nytimes.com/2020/05/20/ health/coronavirus-vaccines.html

COVID-19 X Black Lives Matter Special Issue

RESOURCES

COVID-19

Facts from the Center for Disease Control https://www.cdc.gov/coronavirus/2019-ncov/your-health/index.html Feeding America https://www.feedingamerica.org/take-action/coronavirus Donate blood to the Red Cross https://www.redcrossblood.org/donate-blood/dlp/coronavirus--covid-19--and-blood-donation.html Give Directly COVID relief fund https://www.givedirectly.org/ Mental Health Resources from NAMI https://nami.org/Support-Education/NAMI-HelpLine/COVID-19-Information-and-Resources/COVID19-Resource-and-Information-Guide

RACIAL JUSTICE

5 ways to address bias in your school https://edmn.me/36FaE7u Connecticut Bail Fund http://www.ctbailfund.org/ Youth Justice Coalition https://youthjusticela.org/

Confronting white nationalism in schools http://edmn.me/3gCQrDV A detailed list of anti-racism resources http://medium.com/wake-up-call/a-detailed-list-of-anti-racism-resources-a34b259a3eea Connecticut Black-owned business guide https://www.shopblackct.com

COVID-19 X BLACK LIVES MATTER SPECIAL ISSUE

Articles inside

Catching up in Crisis

Racism in Medicine

Our Rubik’s Cube of Race

Selling Out

Black-Enchained

Black by Popular Demand