‘A balancing act’: As marches continue, spread of virus remains a concern

Many epidemiologists see the need for the protests, saying racism is a huge public health issue. But they worry about too many people gathering in close quarters.

Many protesters have been keeping their faces covered.Erin Clark/Globe Staff

After more than two months of lockdowns and social distancing to avoid spreading the coronavirus, the sight of thousands of protesters crowding Boston’s streets and parks may have been jarring to some.

But to many in the Black community and their supporters, the threat of spreading COVID-19 didn’t compare to their need to demonstrate against the systemic racism and police brutality faced by Black people. The protests erupted following the killing of George Floyd.

“We went from being in quarantine and not being outside to this movement where people are saying, ‘There’s no way I’m not going out, there’s no way I’m not going to fight for Black liberation,’ ” said Daunasia Yancey, founder of Black Lives Matter Boston. “There’s a worldwide revolution happening and we get to be a part of it and it’s beautiful.”

Epidemiologists say they expect virus infections to rise in light of the protests, where people are packed together and chanting or shouting, which can spread more viral droplets. But many said that the protests are vital because of their social justice cause, and that the risks of transmission are reduced because many participants are wearing masks and the crowds are outdoors.

“I’d be very surprised if we don’t see some spikes,” said Helen Jenkins, an epidemiologist at Boston University. But, she added, “Systemic racism is a public health crisis, one which has been going on for decades, centuries. It’s unfortunate we’re having to fight two public health crises at the same time.”

To Black epidemiologists, the pandemic shouldn’t be used to push aside the chance at making historic, needed change on racism, said Shawnita Sealy-Jefferson, an Ohio State University epidemiologist and professor.

“We have been left with no other choice but to resist,” Sealy-Jefferson said. “Yes, there is a risk of the coronavirus being spread at these protests, but that risk is smaller than the risk of us doing nothing and taking the status quo and taking state-sanctioned murder. The status quo has been responsible for anti-Black racism and killing people for 400 years."

While Floyd’s death prompted the protests in dozens of cities, demonstrators also are venting outrage over decades of killings by law enforcement and other manifestations of structural racism — such as the disproportionately high rates among Black Americans for COVID infections, hospitalizations, and deaths.

In Boston, Black residents account for 38 percent of coronavirus cases for which racial data is known, though they make up only 25 percent of the city’s population. As the death rate increased across the state in early April, it surged nearly 40 percent higher in cities and towns with the largest concentrations of people of color compared to those with the least, the Globe reported.

The protests coincide with Massachusetts’ reopening of the economy in phases, which could complicate efforts to determine the cause of any potential surge in new cases, said Jenkins, the BU epidemiologist. And she hoped people wouldn’t stop taking seriously warnings about large gatherings, which she said can become super-spreader events.

On Thursday, the Centers for Disease Control and Prevention director acknowledged the protests could prompt waves of infections and urged protesters to get tested, echoing the words of officials in Atlanta and New York. It can take a few days after exposure to the virus for someone to test positive for COVID-19, and up to 14 days to give rise to symptoms.

Police use of tear gas or other chemicals that prompt people to cough could further increase risks of transmission, Jenkins said. And arrests could increase the disease spread because people indoors share air, she added.

Because many protesters are relatively young, they face lower risks of severe complications from COVID, Jenkins said. But they could carry it to others who are older or have underlying medical conditions, so it’s important for them to take precautions.

It may be hard for protesters to keep their masks on and try to remain apart from others due to emotions running high, said Dr. Zandra Kelley, chief medical officer of the Greater Lawrence Family Health Center, one of the state’s largest community health centers.

“I would imagine that in protest situations, that it would be more likely for people to not be thinking about their masks or their social distancing," Kelley said. "That’s certainly a major concern to have these two very unfortunate horrible things going on at the same time.”

Boston Mayor Martin J. Walsh said the Boston Public Health Commission has provided thousands of face coverings and health resources at the rallies, which he called inspiring.

“Here in Boston, Mr. Floyd’s murder has caused real pain,” Walsh said. “It has brought out real pain that has existed in this city for a long, long time. . . . Change is necessary, but it’s never easy.”

Governor Charlie Baker said he appreciates the protesters who are wearing masks, using hand sanitizer, and trying to keep their distance.

“This is a balancing act," Baker said, "between giving people the right to speak up about what they believe and at the same time recognizing and understanding that we are still in the midst of a terribly dangerous and wildly contagious virus.”

Dr. Ashish Jha, director of the Harvard Global Health Institute, said he sympathized with the protesters’ cause, but urged caution. When the protests have turned into looting and violence, he said, that causes more arrests, which can be higher risk situations for COVID-19 in jails and police vans.

“So really, lots of good reasons why we need to have more peaceful protests," Jha said.

Erin Bromage, a biology professor who studies infectious diseases at the University of Massachusetts Dartmouth, said he has no doubt that the protests are likely to increase the spread of the virus.

“There are too many people, too close, with many of them vocalizing,” he said. “At the time, we still have a high-degree of community spread.”

Some have criticized epidemiologists and other public health officials for not urging people to avoid mass protests, as they have clearly advised the public to distance themselves from other people as much as possible in recent months.

"I’m very aware that people are saying public health professionals are hypocritical for not condemning these protests,” said Julia Marcus, an epidemiologist who studies infectious diseases at Harvard Medical School. “But it’s very complicated. Systemic racism is one of the biggest drivers of poor health in this country. If we make progress on reducing systemic racism, public health risks will decline.”

But she acknowledged the potential dangers.

“I think the risks need to be communicated,” she said. “I would be surprised if we don’t see some number of new cases from the protests.”

With thousands of people thronging to Wednesday’s protest on Boston Common, several supporters decided to hand out masks. Two young men spent $90 on 150 surgical masks to give to demonstrators.

Milly Young, 25, of Medford, hand-sewed 100 masks and brought them to the rally.

She was aware that the risks from the virus remained grave, with hundreds of people still being infected every day in Massachusetts.

“I want people to be able to protest safely," she said.

Andrew Ryan and Kay Lazar of the Globe staff contributed to this report.