During the COVID-19 pandemic many people faced homelessness, hunger, and loss as a result of the coronavirus and related shut-downs. But one newly opened restaurant outside Sacramento, California was able not only to survive the pandemic, but thrive and help others survive in the midst of it.
UrbanFaith sat down with Chef Q who is the Executive Chef & Owner of Q1227 restaurant outside of Sacramento as he shared his recipe not only to survive, but thrive as an restauranteur, person of faith, and community catalyst in the midst of the pandemic. His restaurant was able to feed over 40,000 homeless and in need families in 2020 and he has made his restaurant one of the most impactful and successful institutions in his community. The full interview is above.
This story is from a partnership that includes NPR, KQED and KHN.
For months, journalists, politicians and health officials — including New York Gov. Andrew Cuomo and Dr. Anthony Fauci — have invoked the infamous Tuskegee syphilis study to explain why Black Americans are more hesitant than white Americans to get the coronavirus vaccine.
“It’s ‘Oh, Tuskegee, Tuskegee, Tuskegee,’ and it’s mentioned every single time,” said Karen Lincoln, a professor of social work at the University of Southern California and founder of Advocates for African American Elders. “We make these assumptions that it’s Tuskegee. We don’t ask people.”
When she asks Black seniors in Los Angeles about the vaccine, Tuskegee rarely comes up. People in the community talk about contemporary racism and barriers to health care, she said, while it seems to be mainly academics and officials who are preoccupied with the history of Tuskegee.
“It’s a scapegoat,” Lincoln said. “It’s an excuse. If you continue to use it as a way of explaining why many African Americans are hesitant, it almost absolves you of having to learn more, do more, involve other people — admit that racism is actually a thing today.”
It’s the health inequities of today that Maxine Toler, 72, hears about when she asks her friends and neighbors in Los Angeles what they think about the vaccine. As president of her city’s senior advocacy council and her neighborhood block club, Toler said she and most of the other Black seniors she talks with want the vaccine but are having trouble getting it. And that alone sows mistrust, she said.
Toler said the Black people she knows who don’t want the vaccine have very modern reasons for not wanting it. They talk about religious beliefs, safety concerns or a distrust of former U.S. President Donald Trump and his contentious relationship with science. Only a handful mention Tuskegee, she said, and when they do, they’re fuzzy on the details of what happened during the 40-year study.
“If you ask them ‘What was it about?’ and ‘Why do you feel like it would impact your receiving the vaccine?’ they can’t even tell you,” she said.
Toler knows the details, but she said that history is a distraction from today’s effort to get people vaccinated against the coronavirus.
“It’s almost the opposite of Tuskegee,” she said. “Because they were being denied treatment. And this is like, we’re pushing people forward: Go and get this vaccine. We want everybody to be protected from covid.”
Questioning the Modern Uses of the Tuskegee Legacy
The “Tuskegee Study of Untreated Syphilis in the Negro Male” was a government-sponsored, taxpayer-funded study that began in 1932. Some people believe that researchers injected the men with syphilis, but that’s not true. Rather, the scientists recruited 399 Black men from Alabama who already had the disease.
Researchers told the men they had come to Tuskegee to cure “bad blood,” but never told them they had syphilis. And, the government doctors never intended to cure the men. Even when an effective treatment for syphilis — penicillin — became widely available in the 1940s, the researchers withheld it from the infected men and continued the study for decades, determined to track the disease to its endpoint: autopsy.
By the time the study was exposed and shut down in 1972, 128 of the men involved had died from syphilis or related complications, and 40 of their wives and 19 children had become infected.
Given this horrific history, many scientists assumed Black people would want nothing to do with the medical establishment again, particularly clinical research. Over the next three decades, various books, articles and films repeated this assumption until it became gospel.
“That was a false assumption,” said Dr. Rueben Warren, director of the National Center for Bioethics in Research and Health Care at Tuskegee University in Alabama, and former associate director of minority health at the Centers for Disease Control and Prevention from 1988 to 1997.
A few researchers began to question this assumption at a 1994 bioethics conference, where almost all the speakers seemed to accept it as a given. The doubters asked, what kind of scientific evidence is there to support the notion that Black people would refuse to participate in research because of Tuskegee?
When those researchers did a comprehensive search of the existing literature, they found nothing.
“It was apparently a ‘fact’ known more in the gut than in the head,” wrote lead doubter Dr. Ralph Katz, an epidemiologist at the New York University College of Dentistry.
So Katz formed a research team to look for this evidence. They completed a series of studies over the next 14 years, focused mainly on surveying thousands of people across seven cities, from Baltimore to San Antonio to Tuskegee.
The conclusions were definitive: While Black people were twice as “wary” of participating in research, compared with white people, they were equally willing to participate when asked. And there was no association between knowledge of Tuskegee and willingness to participate.
“The hesitancy is there, but the refusal is not. And that’s an important difference,” said Warren, who later joined Katz in editing a book about the research. “Hesitant, yes. But not refusal.”
Tuskegee was not the deal breaker everyone thought it was.
These results did not go over well within academic and government research circles, Warren said, as they “indicted and contradicted” the common belief that low minority enrollment in research was the result of Tuskegee.
“That was the excuse that they used,” Warren said. “If I don’t want to go to the extra energy, resources to include the population, I can simply say they were not interested. They refused.”
If you say Tuskegee, then you don’t have to acknowledge things like pharmacy deserts, things like poverty and unemployment,
Now researchers had to confront the shortcomings of their own recruitment methods. Many of them never invited Black people to participate in their studies in the first place. When they did, they often did not try very hard. For example, two studies of cardiovascular disease offered enrollment to more than 2,000 white people, compared with no more than 30 people from minority groups.
“We have a tendency to use Tuskegee as a scapegoat, for us, as researchers, not doing what we need to do to ensure that people are well educated about the benefits of participating in a clinical trial,” said B. Lee Green, vice president of diversity at Moffitt Cancer Center in Florida, who worked on the early research debunking the assumptions about Tuskegee’s legacy.
“There may be individuals in the community who absolutely remember Tuskegee, and we should not discount that,” he said. But hesitancy “is more related to individuals’ lived experiences, what people live each and every day.”
‘It’s What Happened to Me Yesterday’
Some of the same presumptions that were made about clinical research are resurfacing today around the coronavirus vaccine. A lot of hesitancy is being confused for refusal, Warren said. And so many of the entrenched structural barriers that limit access to the vaccine in Black communities are not sufficiently addressed.
Tuskegee is once again being used as a scapegoat, said Lincoln, the USC sociologist.
“If you say ‘Tuskegee,’ then you don’t have to acknowledge things like pharmacy deserts, things like poverty and unemployment,” she said. “You can just say, ‘That happened then … and there’s nothing we can do about it.’”
She said the contemporary failures of the health care system are more pressing and causing more mistrust than the events of the past.
“It’s what happened to me yesterday,” she said. “Not what happened in the ’50s or ’60s, when Tuskegee was actually active.”
The seniors she works with complain to her all the time about doctors dismissing their concerns or talking down to them, and nurses answering the hospital call buttons for their white roommates more often than for them.
As a prime example of the unequal treatment Black people receive, they point to the recent Facebook Live video of Dr. Susan Moore. When Moore, a geriatrician and family medicine physician from Indiana, got covid-19, she filmed herself from her hospital bed, an oxygen tube in her nose. She told the camera that she had to beg her physician to continue her course of remdesivir, the drug that speeds recovery from the disease.
“He said, ‘Ah, you don’t need it. You’re not even short of breath.’ I said ‘Yes, I am,’” Moore said into the camera. “I put forward and I maintain, if I was white, I wouldn’t have to go through that.”
Moore died two weeks later.
“She knew what kind of treatment she should be getting and she wasn’t getting it,” said Toler of L.A., contrasting Moore’s treatment with the care Trump received.
“We saw it up close and personal with the president, that he got the best of everything. They cured him in a couple of days, and our people are dying like flies.”
Toler and her neighbors said that the same inequity is playing out with the vaccine. Three months into the vaccine rollout, Black people made up about 3% of Californians who had received the vaccination, even though they account for 6.2% of the state’s covid deaths.
The first mass-vaccination sites set up in the Los Angeles area — at Dodger Stadium and at Disneyland — are difficult to get to from Black neighborhoods without a car. And you practically needed a computer science degree to get an early dose, as snagging an online appointment required navigating a confusing interface or constantly refreshing the portal.
It’s stories like these, of unequal treatment and barriers to care, that stoke mistrust, Lincoln said. “And the word travels fast when people have negative experiences. They share it.”
To address this mistrust will require a paradigm shift, said Warren of Tuskegee University. If you want Black people to trust doctors and trust the vaccine, don’t blame them for their distrust, he said. The obligation is on health institutions to first show they are trustworthy: to listen, take responsibility, show accountability and stop making excuses. That, he added, means providing information about the vaccine without being paternalistic and making the vaccine easy to access in Black communities.
“Prove yourself trustworthy and trust will follow,” he said.
This story is from a partnership that includes NPR, KQED and KHN.
For the past 15 years my family tradition is to travel from Washington, D.C., along with both grandparents, to sunny Florida to celebrate Thanksgiving with cousins. This year we decided to skip the travel and will have fall and winter celebrations at home.
We are not canceling the holidays, but to keep ourselves and others safe, we are keeping plans small and flexible and remembering that the health of those we love is most important as we enter the season of gratitude.
Before you gather
First, it is important that everyone who will be attending any holiday celebration is on the same page about how to take precautions before getting together. The idea is to lower infection risk in the weeks leading up to the holidays and then test to confirm.
In conjunction with quarantining, testing is the second strategy.
Research has consistently shown that people are most contagious a day or two before they show symptoms, so everyone plans to get tested with an RT-PCR test within 72 hours of Thanksgiving, while still being able to get results in hand before we gather.
No matter how careful you and your family are, there is some risk that someone will be infected. With that in mind, the goal is to reduce the conditions that lead to viral spread. The biggest risks are indoor spaces with poor ventilation, large groups and close contact. So we are planning the opposite: a short outdoor Thanksgiving with a small group and plenty of space between everyone.
To reduce the risk of infection from flying and to keep the gathering small, the only people coming to Thanksgiving at my family’s home in D.C. are my mother, my aunt and my uncle – all of whom live within driving distance. This is in addition to myself, my husband and our kids. When deciding how many people will come to the holidays, keep it small and consider the amount of space you have to maintain social distancing.
If the weather cooperates, we plan to be outside for trivia games and the turkey meal. Rather than eat around one table, we will have individual tables and place settings spaced far apart and space heaters around. I’ve got a mini care package planned for each guest so that everyone will have their own blanket, hand sanitizer, utensils and a festive mask. My mother won’t be helping out in the kitchen this year and, unfortunately, that goes for cleanup too. We won’t take a group picture but I will be sure to capture some of the special moments.
If the weather doesn’t cooperate, Plan B is to be inside in the large family room with as many windows open as possible and with everyone spaced as far apart as possible. Being outside is safer, but if you must be indoors, improve ventilation by opening doors and windows. Consider turning on exhaust fans and using an air purifier.
Everyone who lives in the household will be in one section while my mom will have her own individual area, as will my aunt and uncle. Even though we won’t hold hands before sharing the meal, we will still recite that we are “thankful for family, friends and food.”
Whether outside or inside, everyone will wear masks when they aren’t eating, maintain 6 feet of distance and use the hand sanitizer that I will place throughout the house.
It is also important to be mindful of alcohol consumption, as a pandemic is not the time for lowered inhibitions and bad judgment.
After the event
I hope everyone enjoys the meal and quality time spent with one another in this melancholy year, but the work is not done once the dishes are clean and everyone is home safely.
Everyone is planning to get another COVID–19 test one week after the meal. Additionally, Thanksgiving is our family’s trial run for Christmas, so a few days after, I plan to call everyone and discuss what worked well and what didn’t. If all goes well, I hope to repeat this quarantine, test and gather process for Christmas.
The ending of 2020 deserves to be celebrated, given this difficult year. This Thanksgiving will be different from those of other years, and my kids understand they need to manage their expectations. But we still plan to uphold our tradition of writing all that we are thankful for and reading our messages aloud to one another. We will still share love, some laughs and a good meal while everyone does their part to protect one another.
Two emergency room doctors, Dr. Tsion Firew in New York and Dr. Cedric Dark in Houston, discuss their cities’ coronavirus outbreaks — and responses. (Columbia University Irving Medical Center; Baylor College of Medicine)
Health workers across the country looked on in horror when New York became the global epicenter of the coronavirus. Now, as physicians in cities such as Houston, Phoenix and Miami face their own COVID-19 crises, they are looking to New York, where the caseload has since abated, for guidance.
The Guardian sat in on a conversation with two emergency room physicians — one in New York and the other in Houston — about what happened when COVID-19 arrived at their hospitals.
Dr. Cedric Dark, Houston: When did you start worrying about how COVID-19 would impact New York?
Dr. Tsion Firew, New York: Back in February, I traveled to Sweden and Ethiopia for work. There was some sort of screening for COVID-19 in both places. On Feb. 22, I came to New York City, and nothing — no screening. At that point, I thought, “I don’t think this country’s going to handle this well.”
Dark: On Feb. 26, at a department meeting, one of my colleagues put coronavirus on the agenda. I thought to myself, “Why do we even need to bother with this here in Houston? This is in China; maybe it’s in Europe?”
Firew: On March 1, we had our first case in New York City, which was at my hospital. Fast-forward 15 days and I get a call saying, “Hey, you were exposed to COVID-positive patients.” I was told to stay home.
Dark: My anxiety grew as I saw what was happening in Italy, a country I’ve visited several times. I remember seeing images of people dying in their homes and mass graves. I started to wonder, “Is this what we’ll see over here? Are my colleagues going to be dying? Is this something that’s going to get me or my wife, who’s also an ER doctor? Are we going to bring it home to our son?”
In March, we repurposed our urgent care pod, which has eight beds, into our coronavirus unit. And for a while, that was enough.
Firew: In late March, health workers without symptoms were told to come back to work. It felt like a tsunami hit. I’ve practiced in very low-resource settings and even in a war zone, and I couldn’t believe what I was witnessing in New York.
The emergency department was silent — there were no visitors, and patients were very sick. Many were on ventilators or getting oxygen. The usual human interactions were gone. Everybody was wearing a mask and gowns and there were so many people who came to help from different places that you didn’t know who was who. I spent a lot more time on the phone talking to family members about end-of-life care decisions, conversations you’d normally have face-to-face.
In New York, the severity of the crisis really depended on what hospital you were at. Columbia has two hospitals — one at 168th and one at 224th — and the difference was night and day. The one on 224th is smaller and just across the bridge from the Bronx, which was hit hard by the virus.
There, people were dying in ambulances while waiting for care. The emergency department was overwhelmed with patients who needed oxygen. Its hallways were crowded with patients on portable oxygen tanks. We ran out of monitors and oxygen for the portable tanks. Staff members succumbed to COVID-19, exacerbating shortages of nurses and doctors.
My friends who work in Lower Manhattan couldn’t believe some of the things we saw.
Dark: I went to medical school at NYU and have a lot of friends in New York I was checking in with at the time. I thought that in Houston, a city that’s almost as big, we had the conditions for a similar crisis: It’s a large city with an international airport, it attracts a lot of business travelers, and thousands of people come here each March for the rodeo.
In late March, a guy about my age came into the hospital. It was the first day we got coronavirus tests. A few days later, a nurse texted me that the patient had tested positive. He hadn’t traveled anywhere — it was proof to me that we had community transmission in Houston before any officials admitted it.
You became infected, right?
Firew: In early April, I became sick, along with my husband. I never imagined that in 2020 I would be writing out a living will detailing my life insurance policy to my family. Walking from my bed to the kitchen would make my heart race; I often wondered: Is this when I drop dead like my patient the other day?
A few days before I got sick, the president had said that anybody who wanted a test could get one. But then I was on the phone with my workplace and with the department of health begging for a test.
It was also around that time that a brown-skinned physician who was about my age died from COVID-19. So I knew being in my mid-30s wouldn’t protect me. I was even more worried when my husband became ill because, as a Black man, his chances of dying from this disease were much higher than mine. We both recovered, but I still have some fatigue and shortness of breath.
When did cases pick up in Houston?
Dark: We saw a gradual increase in cases throughout April, but it stayed relatively calm because the city was shut down. The hospital was kind of a ghost town because no one was having elective procedures. Things were quiet until Texas reopened in May.
I remember when I lost my first COVID patient. He started to crash right in front of me. We started CPR and I ran the algorithms through my mind trying to think how we could bring him back, but kept ending up at the same conclusion: This is COVID and there’s nothing I can do.
It’s like serving on the front lines of a war. We initially struggled to find our own personal protective equipment while the hospitals worked to secure the supply chain. Although that situation has stabilized, a lot of patients who come in for non-COVID reasons wind up testing positive. COVID is everywhere.
Our patient population is heavily Latino and Black and, for a time, our hospital had some of the highest numbers of COVID cases among the nearly two dozen hospitals in the Texas Medical Center network. It’s revealed the fault lines of a preexisting issue in terms of inequities in health care.
As area hospitals fill up, they reallocate additional floors to COVID patients. Who knows, if we don’t get this under control, maybe one day the whole hospital will be COVID.
Firew: Now I’m just chronically angry. The negligence came from the top all the way down. Our leaders do not lead with evidence — we knew what was going to happen when states reopened so quickly.
Dark: Yeah, this was completely avoidable, had the governor [Texas Gov. Greg Abbott] decided not to open up the economy too fast.
How are things in New York now?
Firew: There have been several days where I’ve seen zero COVID cases. If I do see a case, it’s usually someone who has traveled from abroad or other states.
People are coming in for non-COVID reasons. Recently, a woman in her early 40s came in with a massive lesion on her breast. She’d started experiencing some pain three months ago, during the peak of the pandemic, and was too frightened to come to the hospital. To make matters worse, she didn’t have insurance and couldn’t afford the telehealth that many had access to.
By the time she made it to our hospital, the mass had metastasized to her spine and lungs. Even with aggressive treatment, she likely only has a few months to live. This is one of the many cases we’re seeing now that we are back to “normal” — complications of chronic illnesses and delayed diagnoses of cancer. The burden of the pandemic layered with a broken health care system.
Dr. Tsion Firew is an assistant professor of emergency medicine at Columbia University and special adviser to the minister of health of Ethiopia.
Dr. Cedric Dark is an assistant professor of emergency medicine at Baylor College of Medicine and a board member for Doctors for America.
This conversation was condensed and edited by Danielle Renwick.
George Floyd’s senseless death has set my soul on fire.
I like to think that I am an objective, rational person. I never hitch rides on bandwagons, and I always want to know both sides of an issue before forming an opinion, and then I usually only share it with close friends and family.
But the death of George Floyd was so disgusting and incomprehensible to me that I feel compelled to use my voice, since his has been extinguished. His senseless death has set my soul on fire.
I am a Black educator, and I know that brutality against Black people by the police and the world at large is nothing new. In 1850, Congress passed the Fugitive Slave Act, which made the federal government accountable for locating, returning, and trying slaves that had successfully escaped. We may have been “free” since 1865, but we are still being hunted by bigots who feel obligated to return us to our “rightful” state of bondage or death.
It does not matter the perceived offense. Whether we are walking through a neighborhood where we live, selling cigarettes, watching birds, jogging, sleeping, playing with a toy gun, partying, getting a traffic ticket, lawfully carrying a weapon, shopping, reading, decorating for a party, relaxing at home, asking for help after being in a car accident, holding a cell phone, playing loud music, going to church, riding in a car, or breathing, our existence spurs the hate-mongers into action. It’s troubling and just plain sad.
There has never been a time in my life that I have not been aware of the color of my skin. During my freshman year at Broad Ripple High School, I was waiting outside — ironically, under the flag — for my stepfather to pick me up after ballet rehearsal. A car sped down the avenue, and a man screamed, “Go home, n—!” I graduated high school exactly 24 years ago, and I still recall that incident vividly.
Even today, as someone with several degrees, I am never quite certain if I am viewed as credible by white counterparts. I recently declined a position at a primarily white and affluent school to avoid dealing with racist attitudes. I understood that I would be challenged more than my white colleagues on pedagogical style and content knowledge, and I did not wish to fight that battle daily.
I have to fight as a parent, too. I have two sons, ages 21 and 10, and I have explicitly taught them how to interact with law enforcement. My older son knows to always remain calm, keep quiet unless addressed, and to be compliant. The objective for him is to leave any encounter with the police alive.
When my older son initially received his driver’s license, he did not come to a complete halt at a stop sign and received a hefty ticket. When I reviewed the ticket, I noticed it had him listed as white. I couldn’t help but wonder if that mistake had spared him harm. This is why we discuss high-profile murders and systemic racism: so that they both may understand the severity of what they are facing as Black men in America.
Each death highlights the urgency of my message. That doesn’t mean I teach that all police officers are dangerous. One of our neighbors, a white male police officer, is friendly and kind. But my sons cannot count on such treatment in America.
My daily response to this violence is to tie social justice into every facet of my high school English curriculum. My students have read about the murder of Emmett Till, responding in disbelief when I displayed the photograph of his grotesque corpse for a stream-of-consciousness writing session. We have read the story of Amadou Diallo, watched William Bonilla perform his poem “41 Shots,” and listened to the Springsteen song “American Skin.” We have read articles and watched “Fruitvale Station” to process the life and untimely demise of Oscar Grant. We used the New York Times’ 1619 Project as a prelude to reading “Kindred.” We have also combed through Brent Staples’ profound personal essay, “Just Walk On By,” which outlines his brushes with racism and how he has chosen to cope.
As an educator, I simply cannot ignore my civic duty to address current events relevant to my students. My Black students have to be taught how to “read” the world in order to navigate its mainly hostile terrain. They need to know who they are historically and culturally. And my students have truly appreciated my willingness to set aside “traditional” topics and tackle ones that matter to them and their futures.
Not having an opportunity for a face-to-face discussion with my students now, because of the coronavirus, is painful. No matter how school takes place in the fall, whether it be in the traditional setting, online, or a hybrid, this will be a first priority.
As we move forward, it would be wise to remember the words of the Holocaust and writer Elie Wiesel, who said, “We must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. The opposite of love is not hate; it’s indifference.”
Sometimes we ignore what is taking place in our society no matter how vile and overt it is merely because it is uncomfortable to take action, and we “have no skin in the game.” My two precious Black sons, my Black family members and friends, and all the Black students that I teach are my skin in the game. And there is no denying that our skin, Black skin, is simply the most dangerous skin in the game.
But we all have skin in the game as Americans, and this is a fight that Black people cannot win alone. We need all our white allies to stand alongside us. White friends and colleagues, I challenge you to speak up. Use any platform you have, whether it be posting on social media, writing letters to the editor, contacting your members of Congress, participating in peaceful protests, organizing protests, informing yourself on the issues at hand, creating petitions, or talking with your children.
Enough is enough. It’s time to refuse to be silent in the face of injustice.
Nikia D. Garland is an English teacher and an adjunct professor who resides in Indianapolis.
Chalkbeat is a nonprofit news site covering educational change in public schools.