By Dr. Richard Stevens
Coronaviruses are a group of deadly RNA viruses that can jump back and forth from different species. Severe acute respiratory syndrome coronavirus (SARS-CoV) was the first identified family member that preferentially infected humans. Its death rate in 2002 was ~10%.
SARS-CoV2/Covid-19 (Covid) appeared in China in 2019. At the genome level, the two coronaviruses are 86% identical. While Covid is less lethal than SARS-CoV, it’s more infectious. That’s why there is no place in the world today that is Covid-free.
Covid’s small genome encodes just twenty-nine proteins, one of which is its spike protein. Covid uses this cell surface protein to infect human epithelial cells. Its receptor is the human protein ‘angiotensin converting enzyme-2 (ACE-2)’. Once the virus attaches to the surface of its susceptible ACE2+ human cell, another cell-surface human membrane protease activates the virus’s spike protein, thereby allowing the pathogen to enter and replicate in its host cells.
Covid’s disease symptoms vary considerably. Many infected people (especially those younger than 25) have no symptoms, whereas others become so sick they need to be on an oxygen ventilator to survive. As of today, Covid has killed >1.1 million Americans. That’s more Americans than in any war. From 2020 to 2022, Covid was the third leading cause of death in the United States, just behind heart disease and cancer. Even with the development of effective vaccines in early 2021, Covid is still killing ~500 Americans every day.
Age is the primary risk factor determining whether an infected human will likely succumb to Covid. Before the development of effective vaccines, the Covid-induced death rate was >1,000-fold higher in infected Americans older than 50 relative to infected teenagers. Certain preexisting health problems (e.g., chronic obstructive pulmonary disease, asthma, and lung cancer) also impact one’s ability to survive a Covid infection.
Another risk factor was found to be one’s genetic and racial background. In the first two years of the pandemic, infected Blacks, Hispanics, and Native Americans died at a rate approximately twice that of infected Whites and three times that of infected Asians.
Three hypotheses emerged to explain the virus’s ability to preferentially infect the latter three minorities shortly after the virus appeared in the United States. The first was genetics. The second was one’s environment and lifestyle decisions. The third was the health inequalities in America.
In support of the first possibility, the human ACE2 gene was sequenced in different ethnic groups. While all examined humans contained a functional ACE2 gene, its nucleotide sequence differed somewhat in each group. Nevertheless, it has not been shown that one of these genetic differences is a significant risk factor in Covid-dependent death.
Regarding the second hypothesis, no evidence was obtained for an ethnic, dietary-dependent risk factor in Covid susceptibility. When it was discovered that the spread of the infection occurred primarily by an aerosol route, it quickly became apparent that close contact with an infected person was a significant risk factor in spreading the virus. In that regard, many Blacks and Hispanics who died in the initial wave of the infection in the Northeast tended to live in New York City. Although it became apparent that those minorities who lived in crowded cities were at increased risk of infection and death, that initial finding did not explain the increased death rate of those minorities who lived in rural settings once the coronavirus reached the less crowded areas of America.
Just one year after Covid appeared in the United States, Pfizer-BioNTech and Moderna developed similar mRNA vaccines that were highly effective in their clinical trials. In that regard, the federal government spent more than $30 billion to date on these vaccines. That included incentivizing their development, guaranteeing a market, and ensuring that the vaccines would be provided free of charge to America’s citizens.
In both instances, the Pfizer-BioNTech and Moderna vaccines targeted the virus’s spike protein. In early 2021, these vaccines became available to healthcare workers, first responders, and those Americans who were 60 years or older. Shortly thereafter, they became available to every adult. Unfortunately, due to the politicization of the vaccines and misinformation posted on various social media sites, a higher percentage of Blacks and Hispanics than Whites initially refused to be vaccinated.
There is some confusion as to how vaccines work. They don’t prevent one from becoming infected. Instead, they minimize the chances of developing severe pathology by inducing the generation of spike protein-specific antibodies that block the virus’s attachment to human cells. These vaccine-induced antibodies also facilitate the destruction of circulating viral particles by a complement-dependent pathway.
A year after the Modera and Pfizer/BioNTech vaccines became available, it was discovered that >95% of the Covid-infected Americans who entered our hospital ICUs hadn’t been vaccinated. Thus, in 2021 and 2022, the high Covid-induced death rate in the United States was primarily due to the unvaccinated.
Before the vaccine rollout, there already was great distrust of the government’s health programs in the Black and Hispanic communities due to the ‘Tuskegee Syphilis Study’ and other unethical health matters. Nevertheless, blatant misinformation on various social media sites (e.g., the false claim that the vaccines caused infertility) was the primary reason why so many Blacks and Hispanics initially refused these vaccines. Despite those concerns, the Modera and Pfizer/BioNTech vaccines saved the lives of at least 25 million Americans the first year they became available. That fact eventually led to a greater willingness of the minority community to get vaccinated.
I currently live in Florida. Every child who enters the first grade in this State’s public schools must be vaccinated against polio and six other infectious organisms. In Connecticut, the required vaccines for its school children depend on the child’s grade. Nevertheless, some of the required vaccines are those directed against influenza, diphtheria, tetanus, acellular pertussis, chickenpox, hepatitis A and B, polio, measles, mumps, and rubella. Like Florida, it’s not mandatory in Connecticut that our children be vaccinated against Covid before they enter school.
It’s inexplicable why so many in Connecticut, Florida, and other States refuse to get vaccinated against Covid to this day yet have no problem getting themselves and their children immunized against less deadly pathogens.
It’s inexplicable why so many in Connecticut, Florida, and other States refuse to get vaccinated against Covid to this day yet have no problem getting themselves and their children immunized against less deadly pathogens.
While polio killed ~3,000 Americans in its worst year (namely 1952), Covid killed >3,000 Americans on many days in the past two years. Covid deaths/day peaked at 4,400 on 12 Jan. 2021. Even today, two years after the effective vaccines became available and tested worldwide, >100 million Americans are still not ‘fully’ (two shots) vaccinated against Covid.
Unfortunately, the effectiveness of the Pfizer-BioNTech and Moderna vaccines wane after a year. Because Covid also mutates at a higher rate than the smallpox virus, the initially created vaccines also turned out to be less effective against some of the newer Covid variants that appeared this year. As a result, the ‘bivalent’ booster vaccine was developed to deal with virus mutation.
The third explanation why Covid preferentially killed a higher percentage of Blacks, Hispanics, and Native Americans than Whites in the early stages of the pandemic was a consequence of the health inequalities in the United States.
The average cost of a complex Covid hospitalization in which the infected patient ends up in an ICU varies in each state. In Connecticut, such a hospital stay averaged $239,250 last year (see https://www.beckershospitalreview.com/finance/average-charge-for-covid-19-hospitalization-by-state.html). For those minorities in the lower economic strata who didn’t have adequate health coverage, they weren’t able to cover the enormous hospital bill if they ended up in an ICU. Thus, decreased hospital availability partly explained why more infected minorities died in the early stages of the pandemic.
Regrettably, racial-, political-, and financially-motivated vaccine corruption cases also were a contributing factor that led to the preferential death of Covid-infected minorities during the early days of the pandemic when there weren’t enough vaccines for everyone.
To deal with the vaccine supply problem, the government created a priority list for those who were initially eligible to receive a Covid vaccine. One of the more famous Covid vaccine scandals occurred in Florida’s Mantatee County. In this instance, the Florida Ethics Commission concluded that Manatee County Republican Commission Chairwoman Vanessa Baugh broke the State ethics laws. Her crime was that she illegally organized a Covid vaccine pop-up site so that a financially well-off, predominantly White Republican community could get the Covid vaccines they were not yet entitled. In a plea deal, Baugh acknowledged her unethical (if not criminal) actions. Once that occurred, she received a public censure and an $8,000 fine.
What occurred in the Baugh vaccine abuse case documents that racially motivated health inequalities exist in America, even though it’s sometimes hard to identify them. Blacks, Hispanics, and other minorities in America, therefore, must be constantly vigilant to prevent them from happening. When unethical behavior, abuse, or even corruption is identified that preferentially affects the health of America’s minorities, loss of employment and possibly prison time for the guilty party is a mechanism that can be used to minimize those illegal activities from happening in the future.
Dr. Stevens is an internationally recognized scientist who also is an ally of America’s minorities. For nearly four decades, he was a member of the faculty of Harvard Medical School and Brigham and Women’s Hospital (Boston, MA). He was the first Ph.D. at those institutions to achieve the rank of Full Professor in their Departments of Medicine. For over four decades, his biomedical research was funded by numerous government agencies and private foundations worldwide. Dr. Stevens is presently the owner of the consulting company Stevens Scientific Services.
