By Lilly Adams, independent consultant on nuclear weapons policy and outreach
The COVID-19 pandemic is forcing us to confront the vast inequities in our society that have made this virus more deadly in some communities than others. This is also true in the world of nuclear weapons policy: US nuclear weapons activities have, and continue to, hurt communities through harmful and sometimes deadly radiation exposure. Now, the survivors of this radiation exposure are also at greater risk from COVID-19. Effective COVID-19 response requires that those who need care can receive it. It also means recognizing who is at greatest risk, and addressing their needs. As we gear up for another stimulus package, UCS and more than 100 other organizations across the country are calling for Congress to include funding for health care access for communities directly harmed by US nuclear activities.
Nuclear Frontline Communities
Our race for nuclear dominance during WWII and the Cold War left many casualties in its wake: workers in the uranium industry, workers and those downwind of nuclear production sites, soldiers and civilians exposed to above-ground nuclear testing, those who attempt to clean-up and dispose of nuclear waste, and those unlucky enough to live near that waste. These people were exposed to radiation and other toxic chemicals, in many cases causing severe health problems, while never being told by their government or their employers about the risks. To add insult to injury, these exposed populations are disproportionately from Indigenous communities, communities of color, low-income, or rural communities, and often face significant barriers to receiving adequate health care even in the best of times.
Today, the injustice of their exposure stings a little sharper because they have an added fear of contracting COVID-19. Many factors may increase their risk: age, radioactive and toxic chemical exposures, air, soil, and water pollution, existing health conditions such as cancer, poverty, institutionalized racism, etc. These factors can also all contribute to a suppressed immune system.
The Radiation Exposure Compensation Act
Some of the individuals in these communities are able to apply for compensation from the US government through a program called the Radiation Exposure Compensation Act (RECA). RECA is meant to offset what are often debilitating health care costs, though the funds can be hugely insufficient. The program is set to expire in 2022, and many exposed communities are still not covered by RECA. This includes those downwind of the 1945 Trinity Test in New Mexico, downwinders of the Nevada Test Site in states and counties originally excluded from RECA, residents of Guam, veterans who cleaned up radioactive waste in the Marshall Islands, uranium workers past 1971, and civilians downwind of nuclear production sites.
The deficiencies of RECA, and the threat of it disappearing entirely, are already a huge disservice to these communities. But in the face of an international pandemic, those already struggling to manage extreme health consequences from radiation exposure must now also face the spectre of COVID-19.
One of the most common illnesses suffered by those exposed to radiation is cancer. Recent studies show that those with cancers are up to three times as likely to die of COVID-19 than those without cancer – especially blood and lung malignancies, two common cancers that are eligible for RECA compensation.
Tina Cordova, a downwinder of the Trinity Test and co-founder of Tularosa Basin Downwinders Consortium adds: “Many of us live in fear of the virus now not only because it is highly infectious and deadly to most but because we also know we are highly susceptible to getting the virus and dying from it due to our underlying health issues as a result of being exposed to radiation. Once you’ve been diagnosed with cancer and been through the radiation and chemotherapy necessary to save your life you know your immune system has been compromised.”
While flawed, RECA is a crucial program. It can mean the difference between care and no care, financial stability or bankruptcy, losing or keeping your house, and even life or death.
These communities must not be left without health care. The good news is that there is a solution. The Radiation Exposure Compensation Act Amendments Act of 2019 – HR 3783 and S. 947 – would extend RECA to 2045 and expand access to many of the communities currently excluded. Many members of Congress have already been championing the effort to pass this bipartisan legislation, including Congressman Lujan (D-NM), Senator Crapo (R-ID), and Senator Udall (D-NM).
Given the urgency of health care access for these communities today, Union of Concerned Scientists is calling on Congress to include the provisions of the RECA Amendments Act in upcoming stimulus packages.
Photo: Advocates from different communities impacted by nuclear weapons activities gather in Springdale, AR on March 1, 2020 for Nuclear Remembrance Day, the anniversary of the Castle Bravo nuclear test in the Marshall Islands. (L-R): Sosylina Maddison (KBE Annex Arkansas); David Anitok (COFA Alliance National Network-WA); Ken Brownell (Enewetak Atomic Cleanup Veterans); Holly Barker (Republic of the Marshall Islands National Nuclear Commission), Lilly Adams (author); and John Baenan (Enewetak Atomic Cleanup Veterans).
Medicaid for COFA Communities
The Marshall Islands is one of three countries under the Compacts of Free Association (COFA), which allows citizens of these countries to live and work in the US in exchange for the US military’s exclusive use of and access to these nation’s lands, airspace, and waters. COFA was also supposed to give these communities access to federal benefits, including Medicaid. But in 1996, Medicaid was stripped from COFA communities in what has been called an “oversight.”
In the face of an international pandemic, this “oversight” is made all the more severe. Even before the pandemic, studies are showing that in COFA communities, higher death rates are associated with the loss of Medicaid after 1996. Today, data shows that Pacific Islanders in the US, including the Marshallese, are contracting COVID-19 at rates two to three times higher than other Americans.
On the importance of addressing this issue in the stimulus now, David Anitok, Project Coordinator at COFA Alliance National Network of WA (CANN-WA) said, “Timing is highly crucial and far too many people are dying that could’ve been prevented had everyone had health equity access and resources.”
There is also a simple solution for this oversight: bills have been introduced in Congress to restore Medicaid to COFA communities – HR 4821 and S.2218. Already, nearly 300 organizations across the country have supported this effort. In light of the pandemic, there is no time to wait. Congress should include the provisions to reinstate Medicaid for COFA Residents in a future stimulus package.
I am constantly inspired by the advocates in these communities. Even before the pandemic, they stared death in the face every day. Those who have survived are fighters, working tirelessly for the care they deserve, battling illness after illness, yet miraculously maintaining their compassion, community, and resilience. They attend too many funerals; they wonder if their government is simply waiting for them all to die. Now facing a pandemic, there is no more time to wait. It’s time for Congress to act.
Originally published in the Union of Concerned Scientis blog All Things Nuclear. Lilly Adams, the author, was previously awarded a grant with the Ploughshares Fund Women’s Initiative for a project to build connections with nuclear frontline communities and amplify issues of nuclear justice. New long subtitle from Lilly Adams added as awell as a link to Union of Concerned Scientists.
Photo (top): Mount Taylor uranium mine, New Mexico. Wikimedia / Eve Andree Laramee (cc)