Flattening Epidemic Curves and COVID-19: Policy Rationales, Inequality, and Racism.

ABSTRACT

This commentary first provides lists of rationales for and against intervening to flatten an epidemic curve instead of letting the natural spike occur. The context is the U.S. COVID-19 experience, but the analyses apply to any communicable disease epidemic. After briefly exploring various reasons for flatter instead of spiked curves, it explores in detail the observation that flattened curves increase risks to essential workers and low-income and minority populations. Racism is the specific form of inequality highlighted, because discussions of race currently dominate civic discourse and have generated important new literature. Three forms of racism/inequality are distinguished simple, systemic or institutional, and structural. Structural racism is distinct from the other forms by lacking intentionality, rendering praise or blame inappropriate. The commentary concludes that flattening exacerbates structural inequality. Nonetheless, societies should mitigate and compensate victims of inequality due to prolonging an epidemic.