Four Pandemic Americas: Infinite Choices, Few Choices, Pseudo-Choice, and No Choices at All

My mother is a Black woman. But when I had to place her in nursing home care in 2016, I intentionally chose a home in a largely white community.

Why? Because she was more likely to survive there. Let me explain.

After President Trump’s recent Covid-19 hospitalization, people said there were two Americas — one where people like him top shelf medical care and drugs, while the rest of us don’t.

But the impact of the pandemic on communities of color has demonstrated at least four different Americas: one with infinite choices, one with few choices, one with only pseudo-choice, and one with no choices at all.

I see the America of Michael Hickson, a 46-year old Black man, who died on June 11 in an Austin hospital from Covid-19. His medical treatment and tube feedings were withdrawn because his doctor thought Hickson, who was quadriplegic, “didn’t have any quality of life.”

Hickson lived in the America without choices. Life and death decisions were made for him, regardless of what he or his family wanted.

I see the America of Rana Zoe Mungin, a 30-year-old Black woman. She died on April 27 from Covid-19 after being turned away from hospitals twice, despite having a fever and shortness of breath.

Mungin, a well-educated Black woman with a bright future, lived in the America of pseudo-choice. Despite her education, full time job, and benefits, she was denied care.

I see my friend Anne’s America. She struggles to pay for life-saving medication for her pre-existing autoimmune disease, despite working and having insurance. Anne, a woman of color, worries about losing access to health care if the Trump administration dismantles the Affordable Care Act.

She lives in the America that wavers precariously between few choices and no choices. Today, she lives with few choices. Tomorrow she may have none.

Finally, I see the America of Donald Trump, who received oxygen at home and proprietary experimental treatments. He was flown to a first-class medical facility and stayed in a suite more spacious than my apartment.

Trump lives in the America of choice and privilege. He is cavalier with his Covid-19 diagnosis and in exposing others because he will always get top-shelf care.

Covid-19 has hit Black and brown Americans especially hard due to racial health inequities that can have a domino effect across a lifetime.

Limited access to quality healthcare means Black and brown people experience higher levels of disability and are more likely to need long-term care. Yet insufficient community-based services in our neighborhoods cause us to be placed in nursing homes, where we’re more likely to contract and die from Covid-19.

I knew this firsthand, because I stayed in nursing homes several times while recovering from flares of multiple sclerosis. That’s why I made a different choice for my mom, and it was the right one: During Covid-19, none of the residents where my mother lives have contracted the disease, compared to multiple outbreaks and several deaths at every nursing home where I had stayed.

Nursing homes need to be held accountable — after all, the public health issues that plague nursing homes didn’t start with Covid-19. But we also need to ask ourselves why nursing homes are the only choice for so many families, including my own. Universal long term supports and services, with an emphasis on home and community-based care, is a much better option.

There should only be one America: one where we all get the best care and the widest range of choices, no matter the color of our skin, our level of ability, or how much money and power we have.

Voting for candidates who support strong care policies up and down the ballot is the first step towards building an America that cares for us all equally.

Elaine Shelly is a freelance writer and public policy volunteer. She lives in Oakland, California.