When we talk about preexisting conditions and the risks that are conveyed with those conditions, we don’t look backwards. It can be easy to say people have made bad choices and that’s why they are living with diabetes or hypertension. But prevention begins with access to high-quality health care. We don’t think about the environment: Is there access to healthy food, safe outdoor space for exercise? We don’t talk about the environmental toxins that contribute to asthma or other conditions. We don’t talk about the over-representation of Black and brown people in frontline jobs that we have deemed essential—or people who have to go out to sustain their livelihoods. It’s important to put those factors on the radar. Otherwise, it can seem like race is a biological phenomenon—which it is not—and it puts the onus on the individual to do better without understanding the broader picture.

We have surpassed a number of deaths that seemed inconceivable when the pandemic began, with more than 250,000 people dead from COVID-19. And yet, people continue to behave in ways that put themselves and others at risk. Do you think that this is persisting because of a degree of racism in the way that people are processing those deaths?

From my perspective, it is troubling how slowly the reality has been sinking in. This is all anecdotal, but I have heard that some people, in more affluent communities early on, said things like, “This is a disease that affects people of color.” It became this othering that allowed people to say, “I’m not part of that group, I don’t need to curtail my behavior or socially distance or use face coverings.”

But the sad reality is that it’s getting harder and harder to find a person of any background who doesn’t know someone who has been significantly affected by COVID. So much of how we experience information and how we experience truth is through our tight social networks. There might be, for many, an understanding now that they didn’t have in March.

According to a PEW Research Center survey from September, the number of people who say they would get a vaccine is fairly low and has been declining over the course of 2020. [This was before the Pfizer and Moderna announcements in recent days.] Reluctance is particularly high among Black Americans, who have cited racist medical interventions of the past in their reasoning. How do you counter this kind of thinking and help people become comfortable with the vaccine?