The Color of Breath

ABSTRACT

[...]the Covid-19 pandemic has generated significant reports of “happy” or “silent” hypoxia the previously little-known phenomenon of people with dangerously low blood oxygen levels who nonetheless function without shortness of breath.1 These cases highlight a central theme emergent from the Life of Breath project that there is often a mismatch between objective and subjective measures of health, also known as symptom discordance. The New England Journal of Medicine recently published a list of race-adjusted algorithms to highlight the growing concerns with their uses given the “mounting evidence that race is not a reliable proxy for genetic difference.” Braun’s Breathing Race into the Machine revealed that the practice of “correcting” for race in spirometry, the study of lung function, promoted scientific acceptance of difference between racial groups, without due concern to the racial categories employed to organize this data in the first place, or to the way that social conditions and living conditions affect lung function.10 McGuire’s Measuring Difference, Numbering Normal developed this analysis by demonstrating the use of variable and inconsistent reference classes in spirometry with regard to women and miners. In Britain, data is disaggregated to reflect racial differences so the extent to which Covid-19 was unduly impacting those categorized as “BAME (black and minority ethnic) populations” became quickly visible.11 The patterns suggested by this data have been implemented in workplace safety questionnaires that ask individuals to calculate their “Covid age” according to their sex, age, ethnicity, and various comorbidities before they return to work.12 Though this data is obviously valuable, such initiatives are based on the premise that risk to health originates in the individual rather than in their ways of living as a member of a particular group—ways of living which might include increased exposure to air pollution, decreased access to quality education, greater levels of poverty and stress, and increased levels of discrimination from health professionals.