By Jack P. Shonkoff and David R. Williams, Center on the Developing Child, April 27, 2020

The COVID-19 virus is ruthlessly contagious and, at the same time, highly selective. Its capacity to infect is universal, but the consequences of becoming infected are not. While there are exceptions, children are less likely to show symptoms, older adults and those with pre-existing medical conditions are the most susceptible, and communities of color in the United States are experiencing dramatically higher rates of hospitalization and death. As we all come together around the world to halt the spread of this brutal pandemic, it’s critical to understand why some of us are more likely to be affected than others, and what all of us can do about it. Every person’s health is intertwined with the health of everyone else—especially when dealing with such a highly infectious virus.

Because COVID-19 is a new disease, scientists are just beginning to learn about its distinctive features. We know that its greatest harm is inflicted on the respiratory system, so people with impaired lung function or a compromised immune system are at greatest risk for more severe illness. Certain pre-existing medical conditions are also associated with increased risk, with hypertension, obesity, heart disease, and diabetes (conditions that are more prevalent among African Americans) among the most worrisome. And while the continuing inadequacy of current COVID-19 testing and tracking data in the U.S. makes definitive conclusions particularly challenging at this point in time, it’s likely that people of color are being tested at lower rates, thereby undercounting the already disproportionate numbers of those most affected.

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