Flyer for The Tuskegee Study of Untreated Syphilis in the Negro Male (1932-1972)
George Floyd had the new coronavirus.
Floyd’s killing by a police officer in Minneapolis on May 25 sparked national and global protests against systemic racism and police brutality. An autopsy of Floyd, a black man who stopped for cigarettes at a corner shop that was open on a national holiday, revealed that he had been infected with the virus that causes COVID-19.
This should be no surprise. What may be a shock outside the black community is the reluctance within the community to get a vaccine for the disease, if one becomes available.
Black Americans are hit disproportionately hard by COVID-19. Different experts give different reasons for the disparity, including pre-existing medical conditions and working outside their homes during quarantines. However, William Spriggs, Chief Economist of the AFL-CIO, said that the data points to the latter:
“Despite what everyone has been saying, that African Americans seem to be prone because of pre-existing health conditions, that’s not the case in the data,” said Spriggs, chair of the Economics Department at Howard University in a National Public Radio interview on June 5.
“The case is that African Americans are far more likely to catch the disease, and it’s precisely because they have forward-looking occupations. When you look at the age of people who get COVID and end up being hospitalized in the black and brown communities, that’s working-age people. For whites, it’s those who are in long-term care facilities. So 64 percent of whites who are in long-term -- who are in hospital -- for COVID are over 65.
“It’s the opposite for black and brown people.”
The death rate of African Americans from COVID-19 is even more staggering. Black Americans comprise 24 percent of deaths, but they make up only 13 percent of the population. Therefore, they are dying at a rate two times higher than their population share. As of June 11, 23,769 blacks had lost their lives, according to the COVID Racial Data Tracker, a collaboration of the COVID Tracking Project, launched by The Atlantic, and the Antiracist Research & Policy Center.
Yet, Black Americans (25 percent) are less likely than Hispanics (37 percent) and Whites (56 percent) to say that they would plan to get the vaccine, according to the Associated Press-NORC Center for Public Research at the University of Chicago, which polled 1,056 adults.
In the same poll, only 49 percent of Americans plan to get vaccinated, and 20 percent said that they would not. Another 31 percent said they were not sure in the survey taken between May 14 and May 18, one week before then-police officer Derek Chauvin kept his knee on the neck of a handcuffed Floyd, lying on his stomach, for 8 minutes and 46 seconds.
Based on early estimates of the virus’ infectiousness, at least 70 percent of the population would have to be immune, either by getting a protective vaccine or getting infected, to stop the spread of COVID-19, according to the Johns Hopkins Bloomberg School of Public Health article “What Is Herd Immunity and How Can We Achieve It With COVID-19” on April 10.
If there is going to be adequate take-up of a vaccine in a country that had the most deaths and confirmed cases in the world as of May 27, it is incumbent upon health officials to listen to the concerns of the populace and address them.
There is a distrust of Black Americans for health professionals, largely, because of past experiences.
In the 19th century, for example, James Marion Sims, known as the father of modern gynecology, developed a surgical technique for the repair of vesicovaginal fistula, an abnormal tract between the bladder and vagina, on 12 enslaved women who he said were” willing” patients. One woman, he bought “expressly for the purpose of experimentation when her master resisted Sims’ solicitations,” according to Terri Kapsalis in Public Privates: Performing Gynecology from Both Ends of the Speculum.
In the 20th century, Henrietta Lack (1920-1951) was an African American woman whose cancer cells are the source of the HeLa cell line, the first immortalized human cell line, which reproduces indefinitely, according to Nature on March 10, 2010. The HeLa cell line has led to a number of medical breakthroughs, including Jonas Salk’s polio vaccine. Scientists have grown as much as 50 million metric tons of her cells for research into cancer, AIDS, gene mapping and many other scientific pursuits. There are almost 11,000 patents involving HeLa cells.
Lacks, a tobacco farmer in Virginia before moving to Maryland, had no idea. As was then the practice, no consent was obtained to culture her cells, nor were she or her family compensated for their extraction or use, according to the Johns Hopkins School of Medicine. Lack, mother of five, had been treated for cervical cancer at Johns Hopkins Hospital, which was one of only a few hospitals that treated African Americans.
Earl Ofari Hutchinson, who hosts the live Los Angeles radio call-in program, The Hutchinson Report, carried out an informal Facebook poll of whether people would get a COVID-19 vaccine. The overwhelming majority of respondents, who were mostly African American, said no, according to the Los Angeles Wave on April 23.
“The one word that repeatedly was tossed out by the respondents was Tuskegee,” said Hutchinson, who is the author of 17 books on U.S. politics and racial issues. “That’s the infamous Tuskegee experiment in which black males suffering from syphilis were deliberately allowed to suffer and die for four decades, with the knowing consent of the U.S. Public Health Service, without any treatment.”
Syphilis is a bacterial infection, usually spread by sexual contact, said the Mayo Clinic. The disease often presents, at first, with a painless sore—typically on the genitals, rectum or mouth.
The Tuskegee Study of Untreated Syphilis in the Negro Male was a clinical study conducted between 1932 and 1972 by the U.S. Public Health Service, according to Tuskegee University, then Tuskegee Institute, which collaborated with the federal agency. It is not clear how much the health workers and educators at the historically black institution knew about the deception of the study. The subjects, poor and illiterate sharecroppers from Macon County, Alabama, were told that they would be treated for “bad blood”, a local colloquial term to describe conditions including but not limited to anemia, fatigue and syphilis. Researchers assured the men that they would receive free health care, rides to and from the clinics, meals on examination days and guarantees that provisions would be made after their deaths in terms of burial stipends paid to their survivors.
Of the 600 participants, 399 had latent syphilis while the control group of 201were not infected. The men who had syphilis were never informed of the diagnosis, despite the risk of infecting others and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.
Whereas there was no treatment for syphilis when the study began in 1932, by 1947, penicillin had become standard treatment. None of the infected men were treated with penicillin. They were given mildly effective, highly toxic treatments, including the arsenical compound, Salvarsen 606, mercurial ointments and bismuth, to quell participants’ suspicions. Also, spinal taps and placebos were administered to some.
By the end of the study in 1972, of the 399 men, 28 had died of syphilis, 100 died of related complications, 40 of their wives had been infected, and 19 of their children were born with congenital syphilis. Only 74 of the men were still alive.
What was the purpose of the Tuskegee Study? U.S. Public Health Service researchers believed that the effects of syphilis depended on the patient’s race. They figured that they could use a Norwegian study for comparison. From 1891 to 1910, about 2,000 patients with syphilis were admitted to the Department of Dermatology at Oslo University Hospital in Norway. The department head, Caesar Boeck (1845-1917) believed in allowing the disease to run its course and withheld treatment. Boeck kept detailed notes of his patients. His two successors carried on Boeck’s work and philosophy. Their research was important for the Tuskegee Study, according to Untreated Syphilis – From Oslo to Tuskegee (December 20, 2016) in the National Library of Medicine publication.
Some administrators of the Tuskegee Study also were involved in the Terra Haute, Indiana prison experiments (241 male inmates from1943-1944) and the Guatemalan experiments (1,308 sex workers, prisoners, soldiers and mental health patients from 1946-1948), whose goal was to find a more suitable prophylaxis for syphilis and other sexually transmitted diseases than the injection of a silver proteinate into the penis. In these experiments, people were, actually, injected with syphilis and gonorrhea.
Back in the United States, Peter Buxton, a Public Health Service venereal-disease doctor in San Francisco, alerted an Associated Press reporter about the unethical Tuskegee Study. The story broke first in the Washington Star on July 25, 1972. The New York Times ran it on the front page the following day.
Senator Edward Kennedy called Congressional hearings. A panel determined that the study was medically unjustified and ordered its termination.
In a settlement of a class-action lawsuit filed by the National Association for the Advancement of Colored People (NAACP) on behalf of participants and their descendants, the U.S. government paid $10 million and agreed to provide free medical treatment to those infected as a consequence of the study.
In addition, Congress created a commission to write regulations to deter such abuses. Now, medical studies require informed consent, communication of diagnosis, accurate reporting of test results, and institutional review boards, according to the U.S. Department of Health and Human Services.
In 1997, President Bill Clinton formally apologized and held a ceremony at the White House for surviving Tuskegee study participants, and five of the eight attended. Clinton said:
“What was done cannot be undone. But we can end the silence. We can stop turning our heads away. We can look at you in the eye and, finally, say on behalf of the American people: what the United States government did was shameful, and I am sorry. . . . To our African American citizens, I am sorry that your federal government orchestrated a study so clearly racist.”
Dr. Garth Graham, vice president of community health and impact at CVS Health, said that the resistance to vaccines is unwarranted. Graham, who is black, headed the Department of Health and Human Services’ Office of Minority Health under Presidents George W. Bush and Barack Obama.
“The history of Tuskegee notwithstanding, you should not assume resistance to vaccines because it could be a lack of appropriate outreach,” Graham said in USA Today on April 20. “Are we designing and pushing the campaign enough so we’re reaching all communities?”
As an investigator and chief of health services research at the University of Florida, he said that he did not encounter much opposition when he explained the risks and benefits.
Hutchinson, of the Hutchinson Report, called for U.S. health officials “to act with all available resources” against “an infection that is feared and deadly to all, irrespective of race or class”.
“It is in part self-interest and self-protection and, in greater part, the rude awakening that this is not 1940 or 1950, when the world was a much smaller place,” said Hutchinson.
“The ease and accessibility of global travel, the non-stop mobility of travelers and immigrants, and the quantum leap in interpersonal contacts between peoples across all ethnic lines in America have radically changed the social, cultural and health picture for Americans and, indeed, the world. Fear of a coronavirus vaccine in the making may be understandable but, given the monumental health risks of doing nothing, it is not excusable.”