Early in the coronavirus pandemic, there were countless examples of backlash against people of Asian descent in the United States, presumably because the virus is believed to have originated in China.
But now, new evidence shows that implicit biases also may extend beyond people of Asian descent, with many apparently assuming people of color are more likely to be infected.
According to a recent study published in the American Journal of Preventive Medicine, racial and ethnic minorities in the U.S. have experienced an uptick in COVID-19-associated discrimination, with these individuals also experiencing increased mental distress.
Ashley Rose, a Haitian American and resident of Boston, said she's experienced moments of discrimination in which she believes strangers have assumed she might be at a higher risk for infection.
"I can remember boarding a pretty empty plane," said Rose, who works as a restorative justice specialist at Suffolk University, "and a white male seated many rows up, looking at my son and I take a seat. He then asked to move his seat away from us even though we were already far away. He seemed fine with the new seat, even though it brought him into closer proximity to another white male."
Later, Rose became one of more than 3 million Americans to become infected with COVID-19, and while she was sick, she said she experienced an even deeper stigma. The new AJPM study offers data on perhaps why that was.
The study, which focused on discrimination against people thought to have COVID-19, even if they didn't, examined the subjective experiences of discrimination from 3,665 participants. Additionally, their symptoms of depression and anxiety were assessed during a single two-week period from March into April.
Respondents also were asked whether they had worn a mask or face covering in the past seven days and whether they'd experienced COVID-19 symptoms.
"Cumulatively, about one in four people have experienced at least one incident of discrimination since March. We also saw racial/ethnic disparities persist since March, when we first started tracking people's perceptions and experiences related to COVID-19," said Dr. Ying Liu, the study's lead author and a research scientist at the USC Dornsife Center for Economic and Social Research.
"Asians are the first group to have experienced substantial amounts of discrimination, and their rate remains highest, followed by African Americans and Latinos," Liu added.
According to the study's co-author, Kayla Thomas, a sociologist at USC Dornsife, the increase may be attributable to the rise in media coverage regarding the pandemic's disproportionate impact on African Americans.
As the pandemic worsened, research showed that COVID-19-associated discrimination more than doubled from 4% in March to 10% in April, mostly affecting racial/ethnic minorities, immigrants or those of a younger age. Those who had experienced COVID-related discrimination also showed more symptoms of anxiety and depression.
Although the updated data through June showed a slightly downward trend, the racial/ethnic disparity in America persists, with 13% of Asians and 9% of Blacks and Latinos still experiencing discriminatory encounters, compared with 5% of whites.
The association between perceiving discrimination and mental distress also is persistent, according to the researchers. Such experiences, Liu added, can have a direct impact on public health and COVID-19 transmission.
"Research in the past on the social influence on previous outbreaks, such as SARS and H1N1, indicated that the mental distress experienced by social stigma resulted in individuals being less likely to seek care. This discrimination associated with COVID-19 could potentially undermine current disease control efforts," Liu continued. "Both the CDC and WHO have called to stop COVID-related discrimination since the very beginning of the pandemic, but we still observe a substantial rate, especially among racial/ethnic minorities."
In a more comprehensive study conducted by Liu and colleagues, different aspects of people's lives under COVID-19 are tracked, and people of color were, in fact, the most negatively affected by the pandemic.
Liu said the new research points to a moment of social reckoning both in regard to the pandemic's harsh light shone on social disparities and on longstanding systemic racial injustice issues.
"I also would like to stress, in a broader context of social policies," Liu said, "that the racial/ethnic disparities shown in our study are partly attributable to the long-standing social bias against racial/ethnic minorities in this country."
Ayodola Adigun, M.D, M.S., an attending in pediatric and adult psychiatry at Columbia University Irving Medical Center and a clinical instructor at Yale Child Study Center, is a contributor to the ABC News Medical Unit.