- Welcome to "American Black Journal."

I'm Stephen Henderson.

You know, it was five years ago this month when the World Health Organization declared COVID-19 a global pandemic.

Of course, the virus is still around and it continues to have lingering health, social, and economic effects.

That's especially true in the African-American community.

Joining me now to talk about COVID's impact is Dr. Nancy Fleischer.

She's an associate professor of epidemiology at the University of Michigan School of Public Health.

Welcome to "American Black Journal."

- Thank you so much.

- Yeah.

So it's hard to believe, five years ago this month, basically the world shut down.

We all went home and had to stay away from each other for a long time.

And we started to really understand the consequences of the pandemic and the illness.

From your chair, where are we five years later, of course, the virus is still here.

Things are very different than they were in '20.

- Absolutely, the world looks much different than it did five years ago when we all went home.

I think for a large part of society, people have sort of moved on and are kind of continuing with their lives, but there's certainly been long lasting impacts of the virus and the pandemic.

- Yeah.

Let's start with what's happening now.

We still have COVID with us.

My mother was recently diagnosed with COVID, very different circumstances than five years ago.

She's 82 years old.

Someone who's got other health challenges.

That would've been a real red alert five years ago.

Now she's taking a little medicine and staying home.

And she'll be fine.

I mean the progress is one of the things I think we have to acknowledge.

- Yes, absolutely.

I think getting the vaccine out very quickly was a huge success from the pandemic.

And developing treatments that have been effective and all of our additional measures in public health have really made a big impact so that the virus now is not causing as much severe illness or as much death as it was then.

- Yeah, but the lingering consequences from the pandemic itself and the effect that it had on different communities is still something that we're grappling with.

Let's talk about what those differences are, and especially with the African-American community.

- Yeah, absolutely.

So we saw at the beginning of the pandemic that the African-American community was affected very deeply.

They had very high rates of illness and very high rates of death.

And that was due in part to kind of the circumstances of many people being able to go home and work from home or not.

But many African-Americans and other people of color work in jobs where that's just not possible.

And they were in essential industries that kind of kept going.

So I run a study at the University of Michigan called the Michigan COVID-19 Recovery Surveillance Study.

And the study is in partnership with the Michigan Department of Health and Human Services.

And so from the beginning of the pandemic, we started interviewing people to try to understand the impact of the illness, but also the pandemic on people's lives.

And so absolutely we've seen this disproportionate impact on the African-American community.

So for example, we saw that Black adults had a harder time paying important bills.

They also lived in households that were more likely to be laid off or have reduction in work hours.

In terms of the illness itself, during that sort of acute phase, they had more severe illness and had higher rates of hospitalization than people from other racial and ethnic backgrounds.

But then we also see lingering effects.

So we've continued to follow up with people over time, and we just finished interviewing people about three years after their illness.

And we see that African-American adults have the highest rates of long COVID, so these lingering impacts on their health.

- Let's talk about what long COVID is.

I think we hear that term a lot, and people are not sure what that actually means.

What is long COVID?

- Yeah, so it's taken a while to kind of come to a definition of long COVID, but now the consensus is that if people have new or ongoing symptoms for 90 days or more, that that's considered long COVID.

And so some of the symptoms that are kind of the most prominent among people with long COVID include things like fatigue, brain fog, muscle weakness, loss of sense of taste and smell.

But there's a whole host of symptoms that affect different parts of the body.

- And what's the reason, I guess, what's the connection between this long COVID and the African-American community, why are more African-Americans suffering?

- Yeah, I mean I think that we don't totally understand that yet.

But we do see that disproportionate impact.

- Put this in the kind of more the broader public health picture.

Of course, pick the disease, pick the health condition, African-Americans suffer at higher rates than other parts of the population, largely because of other kinds of circumstances that make our lives different.

Is COVID similar or identical to those patterns?

Or is there something particularly pernicious about the COVID-19 virus that makes it different from what we would generally see in those disparities?

- Yeah, I mean, I think COVID-19 is interesting because we see both kind of this acute viral illness.

But then we also see these longer term impacts.

And we see that kind of together.

And so I think it's just been very pronounced, the disproportionate impact in the African-American community.

- Yeah, yeah.

In the research that you're doing, obviously the hope is to learn more about what happened to deal with it differently in the future.

Are there some things you could pull out that are obvious changes we should be making or things we ought to be addressing?

- In public health kind of as a whole?

Yeah.

I mean, I think one important thing is that our public health infrastructure needs to be continuously invested in.

So that means investing in systems and people at the Centers for Disease Control and Prevention, at our state health departments, at our local health departments.

And we can't just give funds during emergencies.

We have to be adequately funding that to have the infrastructure to deal with these public health emergencies.

- Yeah, well, and at universities as well, where a lot of the research takes place.

Of course, what we're seeing now is kind of the opposite.

I mean, there's a real pullback in federal spending across the board, but also in terms of research and research at the University of Michigan.

Do you worry that we won't be able to do the things we need to do if we don't make that investment?

- Yeah, absolutely.

I mean, these are very hard times for people in public health and for people in academic research worried about having the resources to be able to continue the work.

- Well, Dr. Fleischer, it was really great to have you here with us.

Thanks for joining us on "American Black Journal."