Black folks managing COVID; What’s next?

Dr Brian J Dixon
5 min readJul 25, 2020


“Nature abhors a vacuum.”

In the laws of physics, unfilled spaces are “unnatural” and so any matter surrounding the empty space tends to fill it.

Communication about the COVID pandemic is no different. I’ve been absolutely floored, angered, and deeply ashamed at how inconsistent communication has been from the government (federal, state, & local) and (worse) the medical establishment. We have a national informational vacuum and no one’s stepping up to fill it. [ABIM, instead of having barbers give medical advice, how about we support Black physician entrepreneurs with business capital to start direct primary care practices throughout the country?]

Black people, your society is (once again) failing you. It’s up to us to save ourselves.

Most doctors are reticent to speak up without knowing a full plan; saying “I don’t know” is a skill we’re just now emphasizing in medical student and resident training. Fortunately, as a psychiatrist, I’m used to creating treatment plans with incomplete data. The secret: keep it simple and when you get new information, adjust your plan.

Our medicolegal disclaimer: this is a free Medium article and does not constitute medical advice nor should it supercede the advice you get from YOUR medical professional. And yes, you should have one: 10 Ideas to Actually Save Black Lives.

By now, you’ve either been diagnosed with COVID19 or know someone who has. Regardless of your situation, we’re missing crucial foundational messaging that should be repeated over social media, dropped from airplanes, popups on the internet, and mailed to your homes. If I were in charge, I’d recommend a national marketing & awareness campaign called Mask:Wash:Air

Brief science lesson: viruses are proteins that can make you sick. Proteins aren’t imaginary; they can be seen and they can be changed when exposed to certain substances (soap, UV light, heat, etc). The more concentrated the virus proteins, the more risk of illness.

Mask: The mask limits your virus from going out into the world while also limiting you to others’ viruses. Wear your mask anytime you go out of your house and if you’ve tested positive, wear your mask in the house. Remember: the more viral particles you can catch and dispose of, the better. For cloth masks, wash them in soap and water. For disposables, throw them away and wear a new one often (daily if possible.) And I know it’s tough but try not to touch your mask; this increases the risk of you transferring viral particles from the mask to the wet parts of your face (a big no-no!) Yes, we’ll likely need to wear masks until at least December 2020 so buy some with style and personality.

Wash: Soap “denatures” the virus protein. Think of the virus like dry pasta: strong and crunchy. Expose pasta to boiling water and it becomes soft. Viruses (cold, flu, and COVID19) do something similar when you expose them to good old soap and water; they tend to fall apart. The same is true for viral particles in your cloth mask (hence wash them frequently.) Remember, the strategy is to decrease the total amount of virus in the environment. Schools and workplaces will use industrial grade cleaners but you can do your part to limit the amount being transferred into public areas by washing them away with soapy water. And no, do not ingest soap or cleaners.

Air: For most viruses, the higher the concentration of virus proteins, the higher the risk of infection. As a small business owner, I am sympathetic to getting our economy going again and this balancing act will be tough. And as a communal creature, I miss dancing at the club or joining in on “Happy Birthday” at any restaurant. But science is clear with it comes to air: more clean fresh air is better. Thus, if you plan to eat out, only patronize those places that have spaced their tables (i.e. less virus in the air), have to-go options (i.e. less people putting virus in the air) or even better: have outdoor seating. The beauty of outdoor seating is that you get to see and interact with humans while letting nature do the hard work of dissipating the virus. And tip your server 20–50%. There aren’t definite recommendations about air purifiers but if you choose one, make sure it has a HEPA filter. And ask your gym if they can open the windows/doors to keep the air moving.

To recap for my Black peeps:

DO: Actively practice Mask:Wash:Air
(as always, if you’re actively sick, stay home!!!)

DON’T: Overdo the cleaning. Fear drives us to buy “antimicrobial” soaps and to use really strong bleach/chemicals. Resist this temptation. If your bleach solution is too strong, it can cause irritation to your lungs and worsen your respiratory illness. PLEASE DON’T MIX BLEACH AND AMMONIA! Some soaps can strip your skin of its natural defenses and lead to other health risks. Focus instead on consistency in cleaning rather than “deep cleaning”. And if you don’t have soap and water handy, use hand sanitizer with 60% or higher alcohol content.

DO: Find a primary care physician. Medical schools are actively recruiting and supporting Black students who go on to become Black physicians. The pipeline is a minimum of 7 years. Fortunately, we have great physician allies (like Silverdale Peds) across the country who work diligently and compassionately no matter what color, culture, or creed you are. Direct primary care practices are popping up all over the country so if you have one near, sign up! They’re cheaper than the commercial health insurance you can’t afford and can’t use.

DON’T: Feel ashamed. Y’all, the virus doesn’t care who you are, where you’re from, or what you did. It doesn’t care about your politics or personality. Shaming those who have it is pointless. Vice versa, feeling ashamed that you have it can be incredibly damaging to your mental health. Getting sick is not a personal moral failing: you’re still a good person. We’ll sort out the politics and corrections later (and make sure to vote Tuesday, November 3.) For now, concentrate on getting well and limiting the viral spread.

DO: Hold your elected officials accountable. They’ve paid vaccine companies billions of dollars to speed up production and for Black folks, we’re super cautious of what this means for us (re: Tuskegee experiment.) Now’s the time to do your homework. Call your representatives now and ask them:
“How will you ensure this vaccine is safe?”
“What guarantees will you provide People of Color?”
“What legal recourse do we have from the government if someone sustains a vaccine injury?”
“What are you doing to address health and wealth inequities for Black folks?”

It’s up to Black folks to save ourselves.

Let me know how I can help.