Ep 6: We All Count: Civil Rights & Coronavirus

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“The nation is confronting this kind of social distancing and quarantine for the first time in the modern era, and it isn’t clear to me that the laws in place are going to be sufficient. We haven’t had enough protections. We don’t have paid sick leave, a lot of companies are not giving time off to low wage workers in a way that makes them feel secure…And so this is a problem because not all communities are equally protected right now.” – Vanita Gupta

In today’s episode, co-hosts Dr. Celine Gounder and Ron Klain talk with Vanita Gupta, one of the nation’s leading civil rights lawyers. Gupta is the President and CEO of the Leadership Conference on Civil Rights and is on lists to be a future Supreme Court appointee. Previously, she was the Principal Deputy Assistant Attorney General and head of the Civil Right Division at the U.S. Department of Justice, as well as Deputy Legal Director of the American Civil Liberties Union. Gupta discusses the responsibility the media has in reinforcing anti-Chinese xenophobia, as well as the lack of sick leave and other protections that need to be in place for American workers. Finally, our hosts answer listener questions- including the role of wearing a home-made mask.

They also speak with Michael Macagnone, a policy reporter with Congressional Quarterly Roll Call, who has been covering the 2020 census. They discuss the huge challenge that coronavirus poses to the census, and how it may exacerbate the undercount of minorities, young children, people in rural areas, and Native Americans on reservations.

This podcast was created by Just Human Productions. We’re powered and distributed by Simplecast. We’re supported, in part, by listeners like you.

Celine Gounder: I’m Dr. Celine Gounder,

Ron Klain: and I’m Ron Klain,

Celine Gounder :and this is Epidemic.

Today is Friday, March 27th. In this episode, we’re going to speak with Michael McCone, who’s a policy reporter with congressional quarterly roll call.

Ron Klain: And we’re also going to be speaking with, they need a Gupta, one of the nation’s leading civil rights lawyers. She’ll talk about your rights during the time of coronavirus and also how this crisis is impacting one of the most important things we do as a country.

The U S census required by our constitution every 10 years. This is not only a pandemic year, but it’s a census year in the United States.

Celine Gounder: Today, we are joined by Michael McInerney, a policy reporter at congressional quarterly roll call. Michael, you recently published a piece titled Corona virus crisis complicates in-person census outreach.

I’m curious, what did you learn from your reporting.

Michael Macagnone: Well, uh, I’ve been reporting on the census for almost a year now. And the thing that stuck out the most from the very beginning has been how much the census process relies on person to person contact. Because people are distrustful of the government, of opening their doors to strangers of, of responding to official mail, things like that.

Outreach organizations from the national level to local neighborhood groups. We’re counting on being able to talk to people face to face to convince them to respond to the census and they’ve really can’t now. And they kind of have to fall back on social media, on, um, traditional advertising on, you know, hoping that somebody picks up a leaflet and a doctor’s office.

Cause that’s the only thing that’s open these days. And they really don’t know whether that’s going to be enough right now to get people to respond to the census.

Celine Gounder: Who are these people who are distrustful of the government? Because I don’t think that’s necessarily about one political party. Right? So how might you skew the results if only people who really trust the government are responding here?

Michael Macagnone: Well, it would be a worse version of what the results have been in past censuses. So in pretty much every census that they’ve had measurements for, there’s been some sort of undercount, uh, particularly of minorities, young children, people in rural areas, worst under count in the last census was actually native Americans on reservations.

And it’s not just that they don’t trust the census process, but also that they’re harder to count. They may be a recent immigrant, so they don’t understand the process and they need somebody to explain it to them. And there’s also a corresponding over count of people who own homes, Caucasian Americans.

Uh, it might be a college student who’s counted both at the college campus or at home, or somebody who’s counted at both the home that they live most of the time. And then maybe a second home, like a summer home.

Celine Gounder: Is there any reason to believe that these hardest to count people might be the very people who are the most vulnerable for COBIT 19

Michael Macagnone: Alana, the people who are hard to count also.

Um. Because part of the reason they’re hard to count is because they don’t have access to the same sort of infrastructure that a lot of other people in the country do. So, for instance, they may not have a mailing address or a permanent residence, or, um, they may live in a, uh, unconventional living arrangement or a complicated family.

Um, that would make it. More difficult for them to, uh, respond to the census. And also may be more difficult to get access to health resources or be able to kind of weather out the virus and work from home. They may have to risk exposure just to keep food on the table. But in general, across the board response rates to surveys of all kinds, government and otherwise have fallen in recent years.

And it just seems like people don’t want to participate. And that’s really a problem for something as fundamental as the census.

Ron Klain: Yeah. You know, Michael, I think it’s important for people to understand that the senses, it’s not just a academic exercise to find some interesting data. So much of our lives are shaped by its outcome.

Right. Where funding goes for schools and social services. Obviously, how much power our neighborhoods getting Congress in the state legislature and all kinds of aspects of our lives are touched by this count. But I think the point of your piece is. The dose groups that are always under counted, people of color, immigrants, the very young and some cases the very old and and certainly people in rural areas.

Those people who are always under counted are going to be, especially under counted by this census proceeding the way it is at a time of coronavirus.

Michael Macagnone: Yes. And also the a aspect that has come up a lot in recent days because the process is supposed to start soon for this is what’s called group quarters counting.

So people who live on college campuses, uh, in dorms who live in prisons, who live in nursing homes, and the like, that process has been delayed and disrupted by the pandemic. And this is going a little bit further ahead of the piece. So a little bit of a preview of coming recording, um, that just, just about every aspect of the census so far, aside from the things that can proceed online or proceed over the airwaves has been disrupted in some way by the pandemic.

Even to the point that the new hires for jobs that aren’t going to start until may, can actually get onboarded because they can’t go to a fingerprinting center to get fingerprinted because it’s closed right now.

Ron Klain: Talk to me about the timeline here. If the census winds up really not getting its feet on the ground til August or September, what are the consequences of

Michael Macagnone: that?

Well, we haven’t really had a census that missed its deadline. And right now the census Bureau has said that it intends to still meet, it’s December 31st deadline, but a lot of the other things before that are up in the air. And right now the census Bureau is relying on online phone and mail self response.

But. Even in its planning documents, they estimated that they would get about 60% of the households in the country to respond on their own, and they were going to have to make up the 40% through knocking on doors through coming through administrative records through all of that. And the biggest portion of that was the door knocking process where they hire 500,000 people to go door to door, and it’s going to be really difficult to do that under these current conditions.

Ron Klain: Yeah. So let’s, let’s take a step back. And for people who are not census aficionados, I’m sure they may be listening and saying, Hey, you know, they postpone the Olympics. You know, why do we have to do a census in 2020 why not just do like the Olympics do and say, we’ll move it to 2021.

Michael Macagnone: Well, uh, for, for one thing, it’s the law that the census occurs this year.

And that’s a little bit of easy answer, but this census was planned for more than a decade, and just changing the year for one thing would cost billions of dollars and for another would maybe run into constitutional issues because the constitution specifies account every 10 years. But. In order to delay the census.

My understanding is that it would require a change in law and Congress hasn’t taken that step yet. The census Bureau hasn’t asked for that yet. So, at least for right now, everybody is operating under the assumption that we’re going to try and make the census work this year and it’s going to be tough.

And I have talked to a couple of people who have studied the history of the census, and there’s not a really ready analogy for this. The flu pandemic. I’m talking about 1918 flu pandemic was in a very different public health sphere and it was over and done before the 1920 census, and it is very hard to say that they faced a challenge like this before.

Even the census Bureau themselves said that this was something out of their nightmares. It’s really hard to say. No, they’re not going to be able to do it, but they do have a whole lot of challenges that they are struggling to deal with and I don’t think anybody could have really prepared for it.

Ron Klain: All the way back to the very earliest days of our country in the 18th century.

We’ve completed the census every 10 years through Wars and disasters and all kinds of other challenges. So the question is, has the constitution met its match and the coronavirus we’re going to find out. So Michael, thank you very much for joining us on the podcast. Thank you for your reporting and thank you for your insights on this really important issue.

Michael Macagnone: Thank you. Thank you for having me on.

Ron Klain: Pleased to be joined today on the epidemic podcast by Vanita Gupta is one of the nation’s leading civil rights experts. She’s on some lists to be a future Supreme court appointee. Right now she’s the president and CEO of the leadership conference on civil rights, and we’re delighted to be joined by Vanita today, and let’s start here.

We’re already seeing throughout the country, instances of discrimination, of bullying, of other kinds of actions against Chinese Americans, Asians, Americans, because the disease did begin in China. There’s an association with that. What do you think about this? What are you seeing out there already?

Vanita Gupta: Well, first of all, thank you so much for having me on this podcast.

It’s so incredibly important that it exists out in the world in a time of so much untruth and disinformation, but there’s no question, Ron, that there are really serious civil rights implications for covert 19 on this country and in the world right now on the discrimination front. We have seen a whole host of ways in which the Asian American community around the country has been targeted, especially young kids in, for example, in San Fernando, California, 16 year old Asian-American boy was physically attack that school because he was accused of having the coronavirus.

Uh, in New York, a woman was wearing a face mask and was believed to be Asian, and she was physically and verbally assaulted in a subway station. And then kind of more broadly, there’s been an economic impact. Asian-American businesses, we’re seeing a significant decline and customers before there was active social distancing.

And so these are some of the ways in which we have seen, uh, you know, the impact, kind of the discriminatory impact as a result of this disease. And the step of dynamic.

Ron Klain: Well, you know, one thing we like to say on this podcast is, of course the disease strikes humans not in any particular racial or ethnic group.

There’s no reason to discriminate against anyone. It’s against the law, and it’s also not based on science. If people see an incident like the ones you’re describing bullying or some other kind of incident, what should they do about it?

Vanita Gupta: Well. Um, these kinds of acts are against the law and, um, they’re also just so kind of counter to what we stand for in the United States of America.

That if you are a witness or a bystander to this kind of incident, you should speak up. We need people to stand up in schools. For instance, if. Students and parents should be reporting it to their schools. Schools have an obligation under federal law to ensure that all students are able to attend school a fear free from harassment and discrimination.

If there’s an actual hate crime and physical attack, uh, people should be calling the police or reporting it to the FBI. There should be no tolerance for this kind of. Uh, discrimination. And I think all of us have our responsibility to do what we can. We’ve got robust federal and state laws in place to protect vulnerable communities.

In this instance.

Celine Gounder: I’ve really been struck by some of the media coverage and even really places I really respect, like the New York times had a piece maybe a week or two ago now, and they were reporting on the healthcare worker who was returning from Iran to New York city, and the picture that accompanied the story actually had nothing to do with that case.

It was a picture of one of the best dim sum places in Chinatown. But it was really reinforcing that anti-Chinese xenophobia that we’re already seeing. You know, what are you supposed to do if you’re a business who is suffering from the way this is being covered in the media? Well,

Vanita Gupta: I think the media has an enormous responsibility and that kind of incident, um, it should not happen.

There’s all kinds of ways in which people get implicit and explicit messages that can reinforce stigmatization of particular communities. And I think the economic impact at this time right now is being fell across communities and frankly, across, uh, you know, national economies. Maybe the irony will be that in the social distancing phase of this, we will understand our common humanity and a common kind of, um, uh, vulnerabilities that we face, not only as individuals and communities, but frankly across nations right now.

Celine Gounder: Vanita, what’s been the history of this kind of scapegoating and xenophobia? You know, how has this behavior played out with prior infectious disease outbreaks?

Vanita Gupta: I mean, we’ve seen the cycle of, um, racism, ignorance, fear, kind of causing scapegoating of particular communities during these kinds of outbreaks.

Historically. You know, even just recently, we’ve, we’ve been hearing from workers in retail, hospitality and healthcare sectors that are, um, confront hearing from customers and patients saying that they don’t want to be treated by. Asian-American staff. We’ve heard that historically in these contexts, in the Ebola virus at time, and Ron obviously knows that better than anyone.

There was an effort by the federal government across the agencies to message out the importance of, um, fighting any discrimination, uh, against people from African nations. Um, and. The role of the, of the federal government, of local and elected officials as faith leaders in messaging out both during Spanish flu during Ebola.

And today is really important to kind of stand up against this kind of scapegoating. I think one of the things that is really difficult right now is many of us feel that the federal government and the administration are not doing what they should be in response to this virus. And then it is that much more incumbent on all of us to be out there pushing out the importance of fighting against discrimination and targeting of any community at this time.

Celine Gounder: We’ve seen civil rights protections change over time in response to infectious disease outbreaks?

Vanita Gupta: Well, I think over time there’s been a much greater understanding of how, uh, civil rights protections actually include protections against. Um, discrimination for people who either have infectious diseases or may be prone to infectious diseases, but certainly protections and include these category of problems that schools and hospitals and healthcare workers and restaurant owners are facing.

But in the end, the laws on the books are only as powerful and meaningful as the kind of people, uh, are to enforce them and to norm them in their everyday lives. And that is a really important thing. So the work to kind of make sure that communities and individuals are protected against discrimination at this time requires kind of all of us.

Being mindful and standing up and speaking out against discrimination when we see it. Um, and, and calling upon our leaders to kind of really double down and reinforce that message.

Ron Klain: So Vatina this is the one time every 20 years where we both conduct a presidential election and have a census. And so I’d like to ask you briefly about both of those events.

Let’s start with the census. How will the Corona virus affect the ability to complete the census in an accurate and complete way?

Vanita Gupta: So this is having a major civil rights impact, but the good news with the census is that there, right now is an opportunity since March 11th to fill out the census from the comfort of your home.

And so right now you don’t have to leave. You can practice social distancing and you have three ways of actually completing the census. And I would urge all of your listeners to do it. And then to spread the word, one is to go and to fill it out online. Another is to call +1 844-330-2020 and to fill it out by phone.

And the third option is to fill out a paper form and mail it. If you’ve received the paper form at home, it just takes a few minutes. If people fill that out, we won’t need organizers to knock on your doors and to try to get them completed in the weeks and months after. The best thing we can do right now is for all of us to fill it out using one of those three mechanisms and to get everyone else that we know to do exactly the same.

So that’s my hope, given everything that’s at stake with the sunset for the next 10 years for this country, I hope everyone will complete it.

Ron Klain: So Vinita as we’re heading into this kind of shutdown economy phase where people are really being urged to stay home, if they can and whatnot. What’s your thought on workers’ rights to decline, to come to work and to try to hang onto their job?

If someone feels like they’re particularly vulnerable, perhaps, uh, maybe over 60, uh, maybe have some kind of particular immunodeficiency disease. Do they have rights under a federal anti-discrimination laws or the Americans with disabilities act to ask for some kind of accommodation, not to have to come to work.

Vanita Gupta: You know, the nation is confronting this kind of social distancing and quarantine for the first time in the modern era. And it isn’t clear to me that the laws in place are going to be sufficient. We haven’t had enough protections. We don’t have paid sick leave. A lot of companies are not giving time off to low wage workers in a way that makes them feel secure and have economic and jobs security should they do what public health officials are saying they should do, which is to engage in social distancing.

And so this is a problem because not all communities are equally protected right now. And this is something that we need to figure out in short order.

Ron Klain: Eventually businesses will start to reopen. And I imagine some employers will perhaps ask workers who they suspect had Cova 19 to go get tested or prove their negative, maybe even some old terminate workers who they believe had coven 19 what rights do workers have in this situation to deal with those kinds of either terminations or just requests or demands from their employers?

Vanita Gupta: You know, there are legal protections that have evolved as a result of our experiences and history through this. So right now, I think there’s a lot of legal services and legal aid offices that are working to really think about how to create and provide guidance to lower wage workers who won’t have the access that you and I may have to understand the legal system and what our rights are right now.

We need to make sure that we are pushing out the kind of know your rights for workers at all parts of the economy, but also ensuring that there is legal support for those who confront discrimination. We are certain to see it and we have to be ready to deal with that.

Ron Klain: Benita, thank you so much for joining us on the epidemic podcast.

We appreciate your wisdom and your views.

Celine Gounder: Thank you.

Vanita Gupta: Thank you so much for having me.

Ron Klain: Vinita mentioned that you can fill out your census form online and we certainly encourage everyone to do that. You can go to my 2020 census.gov that’s my 2020 census.gov and complete the census a safely and securely from your own home.

So every week we also answer a couple of listener questions. You can send us your question by recording an audio file on your phone with that question and email it to us@helloatjusthumanproductions.org that’s hello@justhumanproductions.org so our first list of question today comes from Brianna, who works in a grocery store.

Celine Gounder: ‘m an employee of

Ron Klain: a grocery store that helps over a thousand people per day. It is impossible to keep a six foot distance at all times. Many of us are experiencing high levels of stress and anxiety. We fear it is not a matter of if, but when we will be infected. Because the CDC doesn’t recommend masks for anyone, but healthcare providers, we aren’t allowed to wear them.

We feel expendable. I understand that surgical and  95 masks must go to healthcare workers who are saving lives but are unprotected level of exposure is certainly feeling the spread of this virus. Given this high level of exposure. Many of my coworkers are wondering if we should be allowed to wear homemade cloth masks.

Online tutorials, show double layer cotton masks with home air filters. Cut his inserts and soft metal wire for accurate fitting. My question is for retail workers, but a homemade cloth mask like this be better than nothing at all.

Celine Gounder: Thank you. That’s a really difficult situation to be in because you are in a sense, one of those essential personnel.

You are a frontline worker in the midst of this pandemic and you are right to be concerned that you are at risk for infection. Working in a grocery store with lots of people coming in and out. I think the kind of the kind of cloth masker describing making it home would make a lot of sense. You could even just use a scarf or a bandana for the purpose of preventing transmission from yourself to other people, but if everybody does that, we will be protecting ourselves as a group.

It’s just important to remember that these masks are not going to protect you from infection against others. It’s really about you protecting others against infection from you. Yeah. I think the best we can be doing in that situation, given the tremendous shortage of masks, both for healthcare workers as well as for really anybody else, is for all of us to be covering our nose and mouth when we’re out in public.

And if we all do that, we should be able to protect all of us as a group from transmitting infection.

Ron Klain: Brianna. Also, I’d add that I have a piece that came out recently in the Washington post where I talk about the fact that at a time of mass closures of businesses, we need to remember that a lot of people like you are at work and making it possible for other people to stay home.

So first of all, thank you and all the unheralded heroes who are out there to every day doing the work we need to do to keep society functioning, even as we try to. Get as many people, uh, to not be out there in society functioning. That wouldn’t be possible if people like you. I also think it’s really incumbent on policy makers to start to think about how we protect our workers who are working now and who will eventually go back to work before.

We have a complete solution to coronavirus. And what kinds of gears should they get? Uh, what kinds of protections should we have for those workers? Of course, the medical gear first has to go to the health care workers. They need it most urgently on the front lines. But as we ramp up production of some of these things, as we start to really, uh, get more and more.

Protections out there. We need to be thinking about this. There’s a lot of conversation about putting the country back to work, but not enough conversation, but how to keep workers safe. That should be the big public policy conversation we’re having right now. So thank you. So our next question is from Jason Holder.

Michael Macagnone: Hi, this is Jason from South Jersey.

Ron Klain: I have a question on how we’re not testing anybody unless they’re

Michael Macagnone:  high risk. Now I know that’s what’s happening here and New Jersey and what’s happening in New York state, New York.

Ron Klain: Um, how does that mess with, um, the data that we’re collecting on. Um, the virus this year, and what kind of effects will that have on the, the death rate, uh, for the virus and then how it’s represented in the media, uh, say maybe in the fall.

Thank you.

Celine Gounder: So Jason, unfortunately, we really do have a scarce supply of testing available for coronavirus right now. And so we’re really having to target that resource to the situations where it’s going to change what we as healthcare providers do for our patients. And I’ll give you an example of this.

I saw a patient in the hospital who had a chronic. A lung infection, something that’s been longstanding for which he takes three antibiotics has been doing so for months. It’s something that’s a distantly related to tuberculosis, and unfortunately he’s had issues with getting his insurance to cover one of those three antibiotics just over the last few months.

And so he’s been on and off that third antibiotic. He’s gotten worse clinically as a result of that was actually in the hospital about a month ago for that. And then he comes into the hospital again. And then the question is, is he more short of breath now because he’s been on and off that third antibiotic?

Or is he more short of breath? Because he now also has COBIT 19 so that’s a situation in which knowing if he tests positive or negative really does change what we’re going to do for the patient. So that’s the kind of situation in which we’re trying to focus our testing right now. I do agree with you that it is going to impair our ability to collect and analyze data and and draw scientific conclusions about that when we are not sure that all the people who are clinically diagnosed as having COBIT 19 truly had it.

So that may well create some. Biases and other problems with the data that we’re collecting, but ultimately we have to focus on the clinical care and public health issues first and try to address some of these data collection issues, um, as a high priority, but a little bit less urgent, relatively speaking.

Ron Klain: And look, I think on the media issues, I think it’s very important for us to hold the media accountable for how it represents the disease and its course. I think by and large, the reporting on coronavirus has been much more responsible and accurate than it was certainly at the peak. Fears about Ebola back in 2014.

But I think that we have to be mindful of false information in the media and we have to be really insistent that they continue to focus on getting it right. That’s really something we try very hard to do on this podcast, and if you ever feel like we’ve gotten it wrong, I’ll be sure to reach out to us and let us know that we haven’t gotten

Celine Gounder: Epidemic is brought to you by just human production. Today’s episode was produced by Zach dire and me. Our music is by the blue dot sessions. If you enjoy the show, please tell a friend about it today. And if you haven’t already done so, leave us a review on Apple podcasts. It helps more people find out about the show.

You can learn more about this podcast, how to engage with us on social media, and how to support the podcast at epidemic dot. F. M that’s epidemic dot F M just human productions is a five Oh one C3 nonprofit organization. So your donations to support our podcasts are tax deductible. Go to epidemic.fm to make a donation.

We release epidemic twice a week. On Tuesdays and Fridays, but producing a podcast costs money. We’ve got to pay Zack, so please make a donation to help us keep this going. Also, check out our sister podcast, American diagnosis. You can find it wherever you listen to podcasts or an American diagnosis. Dot. F M on American diagnosis, we cover some of the biggest public health challenges affecting the nation today.

In season one, we covered youth and mental health in season two. The opioid overdose crisis and in season three, gun violence in America. I’m dr Celine

Ron Klain: and I’m Ron claim.

Celine Gounder: Thanks for listening to epidemic.

 

Guests
Michael Macagnone Michael Macagnone
Vanita Gupta Vanita Gupta
Hosts
Dr. Celine Gounder Dr. Celine Gounder
Ron Klain Ron Klain