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Read More News
racial disparities

US Excess Deaths Continued to Rise Even After the COVID-19 Pandemic

Erin Johnston
Global Health

Student Receives 2025 Pulitzer Center Reporting Fellowship

2020: The Great American Trauma.

June 8, 2020
Twitter Facebook
Photo of protesters in Boston by Sophie Park (CAS’20). Photo of Boston skyline at sunrise by Vernon Doucette
Photo of protesters in Boston by Sophie Park (CAS’20). Photo of Boston skyline at sunrise by Vernon Doucette.

This viewpoint originally appeared in BU Today. Viewpoint articles are written by members of the SPH community from a wide diversity of perspectives. The views expressed are solely those of the author and are not intended to represent the views of Boston University or the School of Public Health. We aspire to a culture where all can express views in a context of civility and respect. Our guidance on the values that guide our commitment can be found at Revisiting the Principles of Free and Inclusive Academic Speech.

It has been a hard year. We are living through a global pandemic unlike any since 1918, an economic collapse unlike any since 1933, civil unrest unlike any since 1968, and the greatest unexpected loss of life since 9/11. The entire country is living, collectively, through four events that, each in isolation, would suffice to make the year darkly memorable. That the four events are being experienced together represents nothing short of a remarkable collective traumatic experience, one with immediate, short-term, and long-term consequences for millions of Americans.

And yet it’s important to remember. There was a 1919. A 1934. A 1969. A 2002. There will be sun after the dark of 2020.

In the United States, more than 100,000 people have died as a result of COVID-19, more than 30 million people have filed for unemployment since the pandemic started, and protests have followed the murder of George Floyd at the hands of the police in more than 400 cities, with governors in 23 states calling in the National Guard.

A traumatic event is generally defined as “an experience that causes physical, emotional, psychological distress, or harm. It is an event that is perceived and experienced as a threat to one’s safety or to the stability of one’s world.” The events of 2020 all separately measure up to this measure.

The consequences of traumatic events are pervasive. Traumatic events often result in a sense of a foreshortened future, a loss of hope about what comes next, and a loss of hope that one will have access to life experiences that one otherwise might expect—an education, a fulfilling job. These same traumatic events are associated with a broad range of psychological consequences—including, but not limited to, post-traumatic stress disorder, depression, anxiety, and increased use of substances—and these are in turn associated with a broad range of physical ailments, ranging from heart disease to stroke, from diabetes to cancer. In other words, we are living in a hard moment, one that will have deep and lasting implications for the national psyche and for our national well-being.

Of course, these experiences are not shared equally, and neither are their consequences. The consequences of COVID-19 are distributed unevenly across racial/ethnic and socioeconomic groups. Minorities and the poor are more likely both to get COVID-19, and to die if they do get it. Those who become sick with COVID-19 and the family members of those who die of the disease are clearly much more affected than the rest of us who watch, even as we may be afraid of contracting the virus.

The unemployed—again disproportionately, low-income and persons of color—are much more affected by the moment than those who remain stably employed. And the civil unrest we are experiencing is a direct response to decades, centuries, of racism experienced by people of color and marginalized groups in this country.

So, yes, it is a great national trauma, but one that is—as is often the case with mass traumas—borne unevenly. A trauma that adds the weight of its consequences to groups that are already burdened with disadvantage, and that widens gaps in resources between haves and have-nots across the country.

Compounding this national tragedy has been an unforgiving and unyielding national politics of hate and division, a national response that has cynically exploited the COVID-19 pandemic to score political points with no apparent interest in a rational or reasonable response to stem the epidemic or to mitigate its consequences. This same national politics of division has stoked the fires of the current moment of civil discontent, answering legitimate anger at yet another needless killing of an unarmed black man by threatening more violence. A national politics that has signaled that those who were expressing sorrow over the loss of more lives are the enemy, the other, to be subdued rather than to be heard, further deepening social divisions, further fracturing the fragile national moment.

There is no question that the circumstances of the moment are unremittingly difficult. That many millions are, and will continue, suffering ill-effects from this great national trauma for years to come. That the consequences of the moment include a loss of hope and of trust in our collective capacity to grapple with complex problems and an anxiety and fear that will haunt our dreams for years. There is no question that the moment will further entrench social divides and that these divides themselves will continue to challenge our capacity to see one another as we do ourselves, separating us by widening gulfs of experience, straining our capacity for empathy.

And yet, and yet, we shall, perhaps against all odds, survive even this moment. Why? We know that the country has survived dark moments and has gone on—at least for the privileged some—to thrive. We did survive 1918, 1933, 1968, 2001. We also survived two world wars. Each of these moments seemed to defy hope, to threaten our sense of safety and stability for our world. And yet, there was a year that came after each of these moments that brought better, a dawn after a stormy night.

Each of these moments found some resolution, in some cases vastly imperfect, that allowed the country to move on. We also know, and have seen even in this moment, that the country has stores of fierce determination to survive, to get past the dark. We have seen it in the abundant cases of heroism in the face of COVID-19, in first responders—not only nurses and doctors, but also grocery store clerks and morgue attendants—who continue to do their job, at high personal risk, because it is is the right thing to do, and because it is what is needed to ensure that our society continues to function, that we make it past the moment. We have seen it in the acts of generosity that have sustained so many through the economic hardships of the moment, and in the acts of courage in the face of unimaginable adversity shown by those who are speaking for social justice, facing down entrenched systems of structural racism that are larger than all of us. The past, and the abundant traces of hope offered by the tenuous present, both suggest that we will emerge from this moment. That there shall be sun after the dark of 2020.

The larger question to my mind is: what we do in that sun? Do we emerge into the sun, filled with relief that we are out from the shadows, and set our mind quickly to forgetting what we have just lived through? Or do we ask: how do we build a world that is resilient to the challenges that we just faced, so that we can mitigate the contagion next time? So that we can face the threat of future infectious disease outbreaks with the confidence that they will not threaten our collective safety. Do we set about addressing the forces of structural racism and systemic marginalization that set the conditions for the civil unrest and also set the stage for the racial and socioeconomic patterns of COVID-19 morbidity and mortality?

It is only through a commitment to finding solutions for a better future that we can ultimately redeem the dark of the present. Nothing can make the great national trauma of 2020 worth it. We shall never recover the lives lost to the pandemic, the futures foreshortened by the economic devastation of the year. And we shall never recover the lives lost to racist structures over the past hundreds of years. But if we learn from the moment—if we find within us the compassion to restructure the edifice within which we live—we shall at least redeem the moment, and create the conditions for there to be light in decades to come.

Sandro Galea is the dean of the School of Public Health and Robert A. Knox Professor.

Explore Related Topics:

  • coronavirus
  • covid-19
  • health disparities
  • health equity
  • health inequities
  • healthcare disparities
  • income inequality
  • mental health
  • police shootings
  • racism
  • social justice
  • social movements
  • Trauma
  • traumatic events
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