Irwin Redlener on COVID, Politics, and Social Vulnerability
Data Dives are conversations with Columbia Climate School researchers to learn more about their work and explore trending topics through the lens of data science and visualization.
Dr. Irwin Redlener, a pediatrician, is a recognized national leader in disaster preparedness and response and is director of the Pandemic Resource and Response Initiative. He is a go-to resource for various media outlets, including digital, print, and broadcast news sources, providing insights about how institutions can best prepare for and respond to crises, evaluating our nation’s resiliency and readiness, and promoting best practices on managing recovery after a disaster.
Sean Hansen is a staff associate at the National Center for Disaster Preparedness, where he supports research activities related to COVID-19, children in crisis, climate change, and broader societal resilience. In this capacity, he works closely with Dr. Redlener and the Pandemic Response and Resource Initiative through research on the epidemiology and public health policies in the U.S., and globally.
In the map, almost 52% of all counties considered to have high COVID-19 mortality rates also have high social vulnerability scores. These counties, shown in dark purple, are concentrated in the southern U.S. How can social vulnerability influence negative health outcomes in communities?
Social vulnerability is inherently tied to public health. We’ve seen elements of this for decades with factors such as socioeconomic status, educational access, or community housing linked to the health outcomes of underserved communities. Think HIV/AIDs, tuberculosis, or hypertension. Each is significantly more common in racial minorities than in white Americans due to a number of socioeconomic factors stemming from the environment where one lives—be it access to housing, education, healthy foods, or clean air and water. These social determinants of health are a huge part of the picture. High social vulnerability can mean that a community has limited access to healthcare, insurance, or quality education, or high rates of food insecurity and poverty. Each of these dynamics exacerbates negative health outcomes in the context of a highly contagious virus like COVID.
Children tend not to get as sick as adults from COVID, but the virus can still have negative impacts on their health. How are children’s health outcomes complicated by COVID, and especially children from disadvantaged families?
Much like the ties between public health and social vulnerability, children also face significant inequities from COVID, despite experiencing less severe cases of the disease. Multisystem inflammatory syndrome in children is a serious condition linked to COVID that can cause inflammation in various organs, and in some cases, death. That’s a significant condition for children, which are typically resilient and healthy with robust immune systems. But in fact, COVID is a top-10 leading cause of death among children—just after Influenza and pneumonia—according to the CDC’s Epidemiology of COVID in Children Aged 5–11 Years.
As long as there are areas with significant pockets of people unvaccinated, the virus will continue to mutate and potentially grow deadlier.
Yet the most wide-reaching effect the pandemic has had on children is in education and development. Remote learning, while it can be effective, has been shown to be deeply inequitable and stacked against disadvantaged families who may struggle with poverty, chronic health issues, housing security, or a host of other factors. If a household cannot afford to ensure that a parent is home with their child and assist with online learning, or depends on the education system for daily meals, or doesn’t have high speed internet access, ensuring equal outcomes in the learning environment becomes impossible.
The Midwest and Mountain West have areas with higher COVID deaths than social vulnerability scores, while many counties in the West show the opposite trends. Are there any data or demographics you think might help explain such regional differences?
Analyzing COVID mortality rates across the country has highlighted the deep political divides of our nation. With states reporting individual statewide data, it’s possible—and fairly easy—to analyze a states’ response to the pandemic emergency with its health outcome. And the data here supports it. COVID mortality rates have been significantly higher in states and counties that Trump won, while Biden counties have on average significantly lower death rates. The politicization of mask-wearing and vaccinations has distorted the health outcomes tremendously, contributing to the higher death rates throughout parts of the Midwest and Mountain West that opposed mask mandates and have consistently lower vaccination rates than parts of the West and Northeast.
COVID Deaths and Trump Vote Percent, U.S. Counties
Native American lands in the Southwest, the Dakotas, and Montana (shown by yellow borders on the map) also suffer from both high COVID mortality and social vulnerability. Can you speak to some of the specific challenges faced by Indigenous populations?
Extricating the country from this morass of politics and ignorance may be a challenge we cannot soon meet.
COVID has certainly had a disproportionate impact on Indigenous peoples here in the U.S. While much of the U.S. was unprepared for the pandemic, Native American reservations rely heavily on the federal government and the Indian Health Service for health care. Yet with a delayed and inept early response, native populations were left vulnerable to early outbreaks, which often claimed the lives of at-risk elders that are critical to tribal communities. Other preconditions made native reservations a tinder box for outbreaks. Underdeveloped infrastructure means that access to clean water and adequate wastewater and sanitation facilities are less common—some 13% of Native American homes lack potable water or wastewater facilities. That means that hand-washing—which was a key recommendation of the CDC early on in the pandemic to prevent transmission of the virus—was less effective than in other parts of the U.S. High rates of poverty and housing issues, including overcrowded intergenerational dwellings, further exacerbated the rapid spread of the virus through indigenous communities.
What has the U.S. gotten right, and what has it gotten wrong, in the national response to COVID?
Let’s answer this as directly as possible. Former President Donald J. Trump deserves credit for accelerating development of COVID vaccines under his “Operation Warp Speed” initiative which, while it was based on pre-existing research conducted over a number of years, allowed the U.S. to get a jump start on protecting the country from the devastating virus. From that point, President Joe Biden launched a very extensive vaccine distribution system under the direction of a highly capable team of experts.
Otherwise, the U.S. has been doing poorly with the highest rate of per capita COVID deaths and lowest completed vaccination rate among high income nations. This is in part due to the reckless politicization of COVID response by the former president and his followers. The other part of the equation is the explosion of vaccine misinformation on the internet and all forms of social media. Extricating the country from this morass of politics and ignorance may be a challenge we cannot soon meet.
Infections from the Omicron variant are currently spiking across the globe. What are researchers and policymakers doing to better understand Omicron and mitigate the impact of future variants? What more could be done?
As Omicron continues to spread like wildfire across the globe, the best we can do is continue to urge for mask-wearing and vaccinations. The current vaccines available are less effective in preventing the spread of the virus, but significantly effective in preventing severe illness and hospitalizations, which at this point may be the best metric for researchers to continue to monitor. With regards to future variants, scientists around the globe will continue to monitor mutations in the virus and alert us to potential deadly variants. But we need to do better as a global community in sharing vaccinations and even vaccine patents with lower income nations. As long as there are areas with significant pockets of people unvaccinated, the virus will continue to mutate and potentially grow deadlier. We need to ensure universal access to vaccines and adequate masks, not just with the American public but with friendly and unfriendly nations, because we’ve seen how rapidly these variants can spread.
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