The speed and spread of the coronavirus has been stunning. Roughly three months ago this virus was unheard of, yet it has resulted in more than 720,000 known cases and more than 34,000 deaths around the world. In my home of King County, Wash., which includes Seattle and was the initial hot spot for the U.S. outbreak, as of Sunday there were an estimated 2,159 confirmed cases and 141 deaths.
The spread of the coronavirus and its associated disease, COVID-19, will highlight and likely exacerbate social inequities in our cities and counties, disproportionately impacting low-income communities of color as well as indigenous, immigrant and refugee populations. These inequities are the result of historic and systemic racism, and it is imperative that we prioritize equity in our response.
In times of crisis, decisions must be made quickly, often sacrificing typical governmental processes, considerations and public engagement. However, in King County, social equity has been an important tenet of many of our decisions for responding to this pandemic. Although it may not seem like every decision was made through an equity lens, a concerted effort has been made to center equity in our work by considering who each decision impacts and how to ameliorate the impacts of difficult decisions.
As other local governments and states prepare for the pandemic, the following response elements have equity implications that should be considered:
Community mitigation: There are steps that every jurisdiction must take to curb the spread of the virus, from promoting hand washing and social distancing to mandating the closing of facilities. Our mitigation strategy has equity considerations built into decision-making for the community institutions with which we are working: small businesses, community- and faith-based organizations, behavioral health providers, housing providers and services for seniors, as well as other governments. These teams are focusing on sectors with the fewest resources and the greatest vulnerabilities, and are working with these communities' leaders to ensure that messaging is customized for their specific needs.
Public communications and social stigma: King County is quite diverse, so we have been working to ensure that essential communications are delivered in a variety of languages, which is challenging due to rapidly changing technical guidance. We also have assembled resources to combat social stigma, which has initially impacted the Asian and Pacific Island community, and embedding anti-social-stigma messaging remains a priority.
Equity management structures: Equity needs to be built into the structure of the command and response system. King County's incident command structure includes an equity team and a briefing by an equity officer in the daily command meeting. In addition, the county created a Pandemic Community Advisory Group to gather input, advice and reactions on an ongoing basis; this group also will play a key role in helping to determine criteria for distribution of donations.
Facilities and siting: During this pandemic, facilities to allow for isolation and quarantine (I&Q) of suspected and confirmed cases are urgently needed. Locating an I&Q facility is not an easy task, especially with high community concern and lack of time for a thorough community siting process due to urgent public health needs. King County placed its first I&Q facilities quickly in areas with large minority populations, with very little process or communication, which resulted in claims of inequitable treatment. Over time, the use of other sites, including county-owned buildings and properties, may reduce the impression that this was an unfair process.
Policy decisions: Closing schools and restricting public gatherings has disproportionate impacts on communities of color and those without shelter, jobs or other resources. Impacts on those employed by the service sector, in the gig economy, or with small businesses must be carefully considered. There are also proactive policies to consider, such as anti-eviction ordinances, better sick-leave policies, expanding health-care coverage, and providing grants to small businesses regardless of an owner's citizenship status.
Despite the need for quick decision-making in a time of crisis, and the resulting imperfect participation in those decisions, leaders across all sectors should be conscious about applying social equity considerations. Social equity isn't an add-on or optional step; by systematically considering equity implications in our work, we make better decisions for all and help create a more equitable future.
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