The Pandemics of Racism and COVID-19: Danger and Opportunity

The convergence of racism and COVID-19 has been framed as a 'twin pandemic,' echoing the disproportionate impact of infectious disease epidemics on racialized communities. This article uses Critical Race Theory (CRT) to analyze how historical, social, and political conditions uniquely affected racialized GBQM during COVID-19 in Canada. While race-based data on COVID-19 infection rates are lacking in Canada, existing research highlights higher infection rates among communities with higher concentrations of Black and low-income residents. The study aims to examine how white supremacist discourses lead to culturally specific discrimination against GBQM of colour, focusing on how COVID-19 affected their experiences of discrimination in their daily lives. The study leverages CRT to understand racism not as an individual act, but as a structural problem embedded in social structures, policies, and institutions.

The literature review explores existing research on the intersection of racism and infectious disease epidemics, particularly the disproportionate impact on racialized communities during the HIV epidemic and the COVID-19 pandemic. Studies in the US have shown higher rates of COVID-19 cases, severe illness, and death among Black, Indigenous, racialized, and immigrant communities due to social inequalities. In Canada, the lack of systematic race-based data on COVID-19 infection rates hinders a complete understanding of the issue. The review highlights the application of CRT as an analytical framework to understand how structural racism shapes health outcomes, exposure to discrimination, and the experiences of marginalized communities. It also examines intersectionality, the concept that multiple social categories (race, gender, sexuality, class) create unique vulnerabilities. The literature reviewed shows how public health studies have largely neglected the intersection of COVID-19 and racism for LGBTQ+ people of color and the lack of attention to how the pandemic has affected the sexual health and experiences of this population. Existing research also highlights the impact of racism on the engagement with HIV care continuum and the historical context of how marginalized communities are often portrayed as vectors of disease during public health crises.

This mixed-methods study employed a qualitative approach using in-depth interviews. The Engage-COVID-19 study, a larger multi-city cohort study examining the impact of COVID-19 on GBQM in Montréal, Toronto, and Vancouver, provided the data. Two rounds of interviews were conducted: the first (November 2020-February 2021) with 42 participants, and the second (June-October 2021) with 51 participants. Maximum variation sampling was used to recruit participants based on age, ethno-racial background, gender, and HIV status, targeting at least 60% BIPOC representation. All interviews were conducted virtually due to COVID-19 restrictions. A semi-structured interview guide covering seven domains, including experiences with discrimination, was used. Inductive thematic analysis was conducted using NVivo software, led by two lead authors (one Black, one East Asian) who drew on their lived experiences of racism. The analysis focused on 59 BIPOC participants and considered how mixed-race participants understood their experiences of discrimination. The study received research ethics approval from several universities' research ethics boards. Participants provided written and verbal informed consent and received a $50 CAD honorarium.

The analysis yielded two main themes: (1) anticipated impacts of COVID-19 on racialized communities and (2) manifestations of racism during COVID-19. Regarding anticipated impacts, participants highlighted the disproportionate effects of COVID-19 on racialized communities experiencing housing instability and living in under-resourced neighborhoods. They noted the blaming of these communities for COVID-19 transmission and anticipated discrimination in healthcare settings due to past experiences of racism. Many expressed fear of receiving less sympathetic treatment from healthcare professionals due to their race. Manifestations of racism during COVID-19 included widespread anti-Asian racism, with East Asian GBQM reporting verbal harassment in public and online, frequently linked to the origin of COVID-19. Black GBQM experienced increased surveillance and harassment while wearing masks. Participants also described how the pandemic impacted their sexual lives, with some fearing discrimination based on their perceived race or ethnicity when seeking partners, highlighting a 'politics of desirability' where whiteness is associated with cleanliness and safety. This led to anxieties about being seen as vectors of COVID-19 transmission, negatively affecting their sexual relationships and online interactions.

The findings underscore the pervasive and multi-scalar impacts of racism during COVID-19, highlighting the need to address structural racism that creates conditions where racialized neighborhoods are underserved and people of color face healthcare barriers. The study demonstrates how subtle forms of everyday racism affect the social and sexual lives of GBQM of color. The intersectional analysis reveals how gender and sexuality play a role in how GBQM of color experience racism, with media portrayals shaping perceptions and vulnerability to harassment. The study highlights the concept of sexual racism, where race informs judgments about sexual desirability and risk. This racialization of COVID-19 affects GBQM of color differently, building on existing stereotypes that link race, sexuality, and disease. The study also discusses the role of mask mandates in exacerbating existing racist biases and increasing surveillance of Black GBQM. Overall the study emphasizes the importance of acknowledging the interplay between pandemic and racism, demonstrating that epidemics amplify existing power structures that facilitate discrimination and exclusion.

The study concludes that racism remains a significant threat to the health and well-being of GBQM of color. The findings emphasize the urgency of addressing racism within public health interventions, acknowledging its impact on healthcare access, mental health, and social connections. Future research should focus on more comprehensive analyses of how COVID-19 and other epidemics affect the sexual and social relationships of marginalized communities, and public health interventions must anticipate the ways in which racialized and minoritized populations are made targets of stigma during epidemics. The study also notes the need for improved data collection to better understand the specific challenges faced by various GBQM of color.

The study acknowledges limitations in its sample size, particularly regarding the representation of Black and Indigenous GBQM. The study's reliance on participant recall, especially for events occurring several months before the interviews, might also affect the accuracy of some accounts. The study's scope also limits its ability to fully explore the experiences of other GBQM of color beyond the groups examined. These limitations should be considered when interpreting the generalizability of the findings.