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Crowley County, USA

Photo: Courtesy of Tom Blackout / Unsplash

What in the world is going on in Crowley County? This past week, the worst outbreak in the country has been in a rural Colorado county I had never heard of – Crowley County, where more than 1 in 10 people have been infected with Covid-19.

The county lies out on the Eastern plains in dry land farming country. What could possibly be going on there? It turns out it has a tiny population, only a bit over 6,000 people. About one of every three of those people is, by some reports, an inmate at the Crowley County Correctional Facility, a privately-owned medium security prison for men. Census data show that the county would be close to 90% White and less than 1% Black if the prisoners weren’t counted, but the prison population is nearly 20% Black and nearly 25% Hispanic. According to Wikipedia: “As a percentage of its population, Crowley County has more of its Census population in prison than any other county in the country.”

This prison is owned and run by CoreCivic. The company brags that it is the “nation’s largest owner of partnership correctional, detention, and residential reentry facilities.” It aims to “better the public good”. That includes contracting with ICE and incarcerating undocumented people. It had to rebrand itself recently, leaving behind the name “Corrections Corporation of America” for a bland name that obscures what business it’s actually in: profiting from our country’s commitment to incarcerating more people per capita than any other country on the planet.

We’ve known for months that facilities where vulnerable people are in close quarters are especially likely to have Covid outbreaks. This means nursing facilities, elder care facilities, meatpacking plants and, especially, prisons. Now we have three new promising Covid-19 vaccines in the news. They are likely to get emergency approval from the FDA. Two of the vaccines have 90% or higher efficacy and no serious ‘safety signals’ arising in clinical trials. Already, on radio programs and news sites, we are hearing about who should get the vaccine first, since it will likely be quite a while before there’s enough for all who want it.

The obvious priority is medical personnel. After that, who? First responders? Our elderly in residential facilities or people with certain disabilities? Essential workers? Those who provide essential services are at high risk of contracting the virus because of where they work – places like grocery stores and meatpacking plants. Should we privilege the millions upon millions with health conditions that put them at extra risk? What about prisoners, forced to live in close quarters and suffering from Covid-19 infection at very high rates?

I read an article this summer about what experts and public health officials were thinking. It has already shifted. An expert advisory panel of the Center for Disease Control and Prevention met on Monday and is leaning toward giving health care workers, other essential workers, and those living in long-term care facilities priority over the elderly and those with high-risk medical conditions.

The goal is to bring people of color closer to the head of the line, as they have suffered disproportionately during the pandemic. They are also highly represented among health care workers and other essential workers. There are various obstacles. A September survey conducted by the NAACP and other organizations revealed that fewer than half of Black people and only 2/3 of Latino people said they would definitely or probably take a free vaccine if it were offered to them. And here’s the clincher: only 14% of Black people surveyed said they trust the vaccine will be safe. They also mistrust its efficacy. In short, it’s safe to say they don’t trust the medical establishment.

The official label is “vaccine hesitancy”, and Black Americans certainly don’t have a corner on that market. It’s possible that the perspective has changed since the recent reports on three vaccines in the pipeline. However, there’s the lingering legacy of the Tuskegee experiment – 40 years in the course of the 20th century of physicians and government officials making a highly unethical medical experiment of Black men infected with syphilis. The powers that be pretended to treat their illnesses but instead lied to them and their families all the while. Trying to create conditions of greater equity in medicine is very difficult when trust is deeply damaged or was never established in the first place. Letting Black Americans come near the head of the vaccine line may bring up the old question: Am I being used as a guinea pig for White America?

There’s been a lot of anti-vaccine sentiment in the US in recent years. There’s also the fact that these Covid-19 vaccines are not necessarily a walk in the park. Clinical trial volunteers report temporary but unpleasant side effects. At least one was elated, because he didn’t want the placebo – and when he started to feel bad, he knew he’d hit paydirt.

There’s no sign that anyone will be coerced into getting a vaccine, though the US military hasn’t always allowed its personnel freedom to choose. Civilians are highly likely to have free agency. My hope is that those who feel safe enough and choose to take the vaccine will get the 90% protection the early data suggest, and that this time next year we’ll have moved much closer to herd immunity in many communities around the country. I was more skeptical about all of this just a handful of months ago, but now I am hopeful that the data, the scientific process, and the governmental approval process will be transparent and largely trust-inspiring. Time will tell. I hope the wealthy countries make sure the low-and-middle income countries get their fair share of access to affordable vaccines that are easy to administer in places with limited infrastructure. AstraZeneca and Oxford University deserve praise for creating an inexpensive vaccine that doesn’t require deep freezing and that they plan to offer at cost to poorer countries around the world.

May our cherished freedoms return to us all and may we learn lessons that help us prevent future pandemics worldwide.


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