We Have Been Here Before
Terry McGovern, Chair, HDPFH, Dazon Dixon Diallo, Sisterlove
As we watch the mostly white male leaders and scientists soak up the airwaves, leading the response to COVID-19, we experience a kind of PTSD. The COVID 19 response is deeply flawed. Why are leaders saying so little about the specific, intersecting impacts of COVID-19 pandemic and the needs of people with disabilities, women, adolescents, communities of color, and immigrants?
We both started organizations in the 1980s to help those people, mostly women of color, who were overlooked in the early response to the HIV epidemic. As we watched women die of HIV-related diseases which were not recognized as AIDS, we joined activists to demand that the federal government address women’s risk for HIV. We ended up successfully suing the federal government (S.P. v. Sullivan, class action 1990) to require the Social Security Administration to provide disability benefits to women dying of AIDS.
The CDC had not thought enough about converging epidemics or biology in its early response to HIV; instead they mostly studied white men. Of course, many white men were facing vicious discrimination and dying, but so were many women and men of color. The disease looked different in different people; for example, women were having gynecological manifestations, which was different from the disease progression identified in gay men. We had to fight to get women included in clinical trials because of old rules barring women of childbearing potential participating, due to possible thalidomide exposure. Changes in these policies were made only after HIV positive women and activists forced change.
This pattern is being repeated yet again as we face the COVID-19 pandemic. We are hearing very little about the possible impact on and considerations for pregnant women with respiratory illness or those who are breastfeeding. We hear little about gender-based violence, even though we know that in Hubei Province in China domestic violence tripled in February during quarantine.[1] The impacts on women of this pandemic are, and will be, profound yet barely mentioned.
Women disproportionately hold jobs in industries without paid family and sick leave, and Latinx and Black workers are less likely than white workers to have access to any paid leave for family or medical reasons.[2] Paid-leave policies serve to reduce existing racial disparities and improve infant health, with the largest benefits accruing to low-income Black and unmarried mothers.[3] Of the 44 million restaurant workers in the United States who rely on tips to earn minimum wage, two-thirds are women, more than half (55%) of whom do not have paid sick leave.[4] [5] Female health care professionals make up the majority of their workforces, including nursing (92%) and health care support work (87%). [6] In the US, women are ten times more likely to stay home to care for sick children than men.[7] Women are also fifteen times more likely to be single mothers than fathers. Single motherhood is particularly prevalent among black (56%) and Latina mothers (26%).[8]
The Government must address these realities. Instead, Republicans delayed legislation requiring paid sick leave while they attempted to add abortion restrictions. They were afraid that funds might go to a private lab to work on COVID-19 that might be using fetal tissue for other research.[9] Why not devote more energy to assisting women and helping states acquire the equipment they need?
The current administration has done everything in its power to undermine access to healthcare for the most vulnerable: weakening the Affordable Care Act, legalizing discrimination against LGBTQI people and gutting Title X Clinics, often the main point of contact for rural folks, due to the administration’s obsession with abortion. The Public Charge rule means that if an immigrant uses Medicaid, they may lose their legal status. It must not go unnoticed that, while Americans are hoarding medicines and groceries, newcomers and immigrant neighbors are working day and night to stock the shelves so that we can be safe and satiated with our snacks and sanitizer.
At least 38.8 million U.S. public school students are now home from pre-k to 8th grade due to closures related to COVID-19.[10] Who is collecting the data needed to follow the well-being of these children, especially when inevitable financial hardship and even domestic violence leads to trauma and behavioral health issues? What kinds of prevention support and comprehensive sexual health education will be afforded the out of school youth? Are we preparing for the unforeseen circumstances of an extended period during which sexually transmitted infections, including HIV, as well as unintended pregnancies will rise substantially? The women who care for the sexual and reproductive health and wellbeing of our young people most certainly are thinking of these consequences, even if our leaders are not.
Yes, we have been here before. What is new is the consciousness of intersectionality. What we did not have before, in the first decade of the AIDS crisis, was the framework of sexual and reproductive justice. Intersectionality awareness and reproductive justice were advanced and led by Black women, and adopted for collective movement building by other women of color and reproductive health and rights proponents. Their work has changed the face and the frame of the movement for gender equity, health justice and human rights.
Now, as in the past, we can count on women, especially women of color, to respond — how about letting them lead?
Terry McGovern is Chair, Heilbrunn Department of Population and Family Health at the Columbia University Mailman School of Public Health and Founder HIV Law Project
Dazon Dixon Diallo is the Founder of SisterLove
[1] Allen-Ebrahimian, B. (2020, March 7). China’s coronavirus quarantines raise domestic violence fears. Retrieved from https://www.axios.com/china-domestic-violence-coronavirus-quarantine-7b00c3ba-35bc-4d16-afdd-b76ecfb28882.html
[2] U.S. Bureau of Labor Statistics. (2019, January 1). Racial and ethnic disparities in access to and use of paid family and medical leave: evidence from four nationally representative datasets : Monthly Labor Review. Retrieved from https://www.bls.gov/opub/mlr/2019/article/racial-and-ethnic-disparities-in-access-to-and-use-of-paid-family-and-medical-leave.htm#_edn5
[3] Jenna Stearns, “The effects of paid maternity leave: evidence from Temporary Disability Insurance,” Journal of Health Economics, vol. 43, 2015, pp. 85–102.
[4] Semuels, A., & Burnley, M. (2019, August 22). How a Booming Economy Left American Service Workers Behind. Retrieved from https://time.com/5658442/tipped-restaurant-workers-american-economy/
[5] Gould, E. (n.d.). Amid COVID-19 outbreak, the workers who need paid sick days the most have the least. Retrieved from https://www.epi.org/blog/amid-covid-19-outbreak-the-workers-who-need-paid-sick-days-the-most-have-the-least/
[6] Bureau of Labor Statistics. (2020, January 22). Employed persons by detailed occupation, sex, race, and Hispanic or Latino ethnicity. Retrieved from https://www.bls.gov/cps/cpsaat11.htm
[7] Ranji, U., & Salganicoff, A. (2019, June 19). Balancing on Shaky Ground: Women, Work and Family Health. Retrieved from https://www.kff.org/womens-health-policy/issue-brief/data-note-balancing-on-shaky-ground-women-work-and-family-health/
[8] Geiger, A. W., Livingston, G., & Bialik, K. (2019, May 8). 6 facts about U.S. moms. Retrieved from https://www.pewresearch.org/fact-tank/2019/05/08/facts-about-u-s-mothers/
[9] : https://www.independent.co.uk/voices/coronavirus-usa-trump-ebola-cdc-us-healthcare-a9365646.html
[10] Map: Coronavirus and School Closures. (2020, March 17). Retrieved from https://www.edweek.org/ew/section/multimedia/map-coronavirus-and-school-closures.html?override=web
