This morning I read a post arguing that the sole reason that blacks in the United States have been more affected by COVID-19 that other racial groups is racism. While I think that racism is a reason that more blacks have died relative to their numbers in the population, I don’t believe it’s the only reason. The reason I’m not linking to the post itself is because of this confident assertion: “This is no genetic basis for the disease”. The truth is that we don’t know whether there is a genetic basis behind who contracts COVID-19 or how severe your case is likely to be should you contract. There’s actually some evidence of a genetic basis for them, e.g. blood type.
Additionally, it’s been suggested that Vitamin D may play a role. Darker skin impedes the endogenous production of Vitamin D and, since the most common exogenous source if from milk and as many as 75% of blacks may be lactose intolerant that could contribute to the matter as well.
My question is how do you disaggregate the various factors? It’s not unimportant—optimization theory suggests that you change the cheapest, easiest thing that will produce the most effect first. Decrying racism may make you feel good but it’s also a heckuva lot harder to correct quickly as the experience of the last couple of centuries should convince you.
“My question is how do you disaggregate the various factors.”
Its probably all but impossible. Even though initially trained as, and a 6-7 yr practicing, engineer – a data driven discipline if there ever was one – I eventually grew up. In my current business, anyway, you become very accustomed to dealing with incomplete and flawed data and are forced to make rather weighty decisions as the world presents them, not necessarily on your terms. The clock ticks; you can’t wait. (and, for example, I can’t imagine that a steve or others here have not similarly become so accustomed – its about the magnitude of the risk; not everyone is up for it) Its all about experience, judgment and risk tolerance. You sleep at night because you do your very best, even though you know you will not put the puck in the net every time. You just won’t.
It would not be surprising at all if blacks had different potential outcomes. After all, they do wrt other disease risks.
More broadly, politicians generally fail miserably at experience/judgment/risk tolerance. Other than political risk judgment born of experience. And that’s not a complement.
The medical and public health establishment suffer from the problem of narrow expertise and their legendary arrogance – narrow experience and judgment – and a risk bias that is not holistic.
You put those last two paragraphs together and you have our disastrous response to covid19.
It seems to me the real analytical question is why so different a policy response and public perception from the Hong Kong flu? I suspect social media crappola, a one-sided agenda driven political media bias, and a total risk aversion (wimpy) culture that has evolved out of political correctness would be the headlines. Maybe add in the slavish employment of “science” (science!!!!) when convenient. Well, science isn’t all its cracked up to be. (And I’m a guy who took 2 major research lab theories and experiments and commercialized them into useful engineering material products). Practitioners are realists; theory converted to the useful. Theorists are useful in pushing the boundaries, but don’t let them within a hundred miles of policy. Be very afraid.
I think a big factor in the inequality of the mortality rate will have to do with population density/population diversity. Something that is needed is to run stats on black/white death ratios in rural areas versus in cities. If there are significant differences between them, then population density is the driver or a big driver.
I’m not sure what the writer meant by “no genetic basis for the disease.” In the sense that the disease is a virus, of course its unlike the genetic error that causes downs syndrome. I don’t know anyone that would suggest otherwise.
There are studies showing that the receptor that the virus targets is controlled by the ACE2 gene, which varies in expression between populations. The study I was able to find suggested the variation is similar to the differences in blood types — American Indians and Africans would be expected to have receptors less susceptible to the virus than those whose ancestors originate from the Eurasian land mass. (That could mean blood type merely correlates with a significant gene variation)
African-Americans on average derive about 80% of their ancestry from Africa 500 years ago, which means its not easy to make broad conclusions. The ACE2 genes for African-Americans might mostly originate from Europeans, or vary enough within the population of African-Americans that the effect is not observable in small slices.
It was a confident statement that the only factor behind the greater prevalence of the disease among blacks was racism—they were not more susceptible due to anything but racism.
In Chicago, almost half of the people tested for the virus are identified as being of “unknown” race/ethnicity, and constitute almost a quarter of those testing positive. I doubt we know as much as we think we know about demographics and infection rates.
@dave, I remember reading a plea a few months ago from an African researcher, perhaps in Nigeria, that Western researchers keep Africans in mind when they work on their vaccines and treatments, because they don’t always work as well on Africans who have a different genetic makeup.
That’s aggravated by there being more genetic variance among the people in sub-Saharan Africa than there is in the entire rest of the world.
Unless someone has done genetic studies we dont know about, I dont know how you confidently claim there is no genetic component to Covid. If Covid sticks around long enough I am pretty sure we will be able to disaggregate the various factors, but in the short term Drew is correct. We have to make our best judgments based on limited data.
BTW, vitamin therapy is a corollary to my theory on diet studies. All vitamin studies done in the last 30 years are probably wrong. If you think it is correct, just wait and it will be found wrong.
Steve