Public health officials warn new cases of COVID-19 probably will emerge after mass gatherings fueled by the death of George Floyd in Minneapolis and racial unrest in cities across America.
Health experts fear carriers of coronavirus, which causes the disease, with no symptoms could unwittingly infect others at protests where social distancing is simply not taking place. The merits of the protesters' cause "doesn’t prevent them from getting the virus,” said Bradley Pollock, chairman of the Department of Public Health Sciences at the University of California, Davis.
At least one protester in Tampa, Florida, is known to have COVID-19. Tampa Police Chief Brian Dugan, who expressed dismay last week about Floyd's death, tweeted Monday that five of his officers were exposed to the protester, whom he did not identify.
Protesting – especially without a mask – can put people at higher risk for infection, said Dr. Michael Mina, an assistant professor of epidemiology at Harvard T. H. Chan School of Public Health.
"There's no doubt in my mind that these can become breeding grounds for this virus," he said during a Monday media availability. "I would not be surprised to see in the next couple of weeks that we see increases that may be linked to protests."
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As businesses re-open, it will be difficult to figure out whether someone caught the virus at a protest or in some other encounter, Mina said.
Hopefully, the fact that protests are taking place out of doors, will dilute the virus and reduce disease transmission, he said. Wearing a mask will help reduce infections, though it won't completely eliminate risk.
"If there's a floridly positive person who is coughing and spending a whole day around a lot of other people, that person might very well get other people sick despite having a mask on," Mina added, but "there's a good chance that even homemade masks will actually do quite a bit to help people not get infected and not transmit."
There is historical precedent to suggest that viruses can be spread by large public gatherings.
In September 1918, people in Philadelphia held a parade to celebrate the return of soldiers from World War I. The gathering of 200,000 people, crammed shoulder to shoulder, reignited a deadly flu epidemic, leading to massive closures and thousands of deaths, records show.
Yet, there's a public health cost to not protesting the status quo, said Dr. Hillary Babcock, an infectious disease specialist at the Washington University School of Medicine in St. Louis, and immediate past president of the Society for Healthcare Epidemiology of America.
"Systemic racism also causes large public health impacts and public health risks for large portions of our population," Babcock said.
She disagreed with calls for protesters to stay home to avoid fueling the outbreak.
"I don't think using public health as a reason to discourage protests after these events is really appropriate," Babcock said. "It's a little disingenuous to say that the health risk from protesting is somehow bigger than the health risk at Lake of Ozarks (where people gathered for fun over Memorial Day weekend) or the practices that brought us to this point in the first place."
At least one reveler at the lake party tested positive for COVID-19, according to the Camden County Health Department. Others were advised to monitor for symptoms.
Babcock said it is possible to minimize the risks of protesting, with masks, social distancing and asking sick people to stay home. Arresting people and putting them into close contact with others increases risk, Babcock said, as does spraying protesters with pepper spray, which causes violent coughing and can potentially spread the virus.
Timeline: George Floyd protests: How did we get here?
Dr. Leana Wen, an emergency room physician and former Baltimore health commissioner, said there is risk of longer-term effects in communities disproportionately affected by COVID-19.
Wen was Baltimore's health commissioner when protests erupted following the 2015 death of Freddie Gray. The death triggered civil unrest in communities already burdened with deep-seated inequities, she said.
"When over a dozen pharmacies burned down and closed and stores were looted, it was community members themselves who were affected the most," Wen said.
While protests over the past week following Floyd's death have highlighted police-community relations, demonstrators are also calling attention to social justice issues, including health disparities.
"The same communities that are already the most affected are potentially going to have an increase in the number of cases as a result of people gathering," Wen said.
Melanie Campbell, president of the National Coalition on Black Civic Participation, said anger in the black community has been building for years. Floyd's death spurred them to take to the streets, even as the coronavirus has taken a disproportionate toll on African Americans.
"Black people are risking their lives protesting in the middle of a pandemic that’s killing black folks. That’s real," she said. "There is no convenient time to fight back."
Meanwhile, state and local public health agencies plan to monitor for new COVID-19 cases.
Any large gathering during a pandemic is a concern, said John C. Welch, director of partnerships and operations for the Massachusetts Covid Response project.
Partners in Health, a Boston-based nonprofit, handles Massachusetts’ contact tracing of individuals infected with or exposed to the virus. Following such a large gathering, potential cases need to be monitored over two weeks, the virus’s incubation period.
“The epidemic curve should guide the response and the phased reopening of society," Welch said. "Until the epidemic is declared over, social distancing and wearing masks should remain the new normal."
Peter Pitts, president and co-founder of the Center for Medicine in the Public Interest, a nonpartisan research and educational organization, said he worries COVID-19 will take advantage of people gathering to protest police violence.
"Social distancing and social conflict are a very potent negative combination when it comes to spreading a virus," he said. "The timing is highly unfortunate."
Public health concerns, which are usually complicated, can easily be drowned out by other "sexier" stories, he said, citing the recent SpaceX launch. But the virus "doesn't cease to be a real threat because of other threats happening simultaneously," he said. "That means we have to twice as smart and twice as dedicated and twice as focused."
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