Addressing racial disparities in the U.S. coronavirus crisis cannot be an afterthought, a top adviser to President-elect Joe Biden on the COVID-19 pandemic response said Tuesday.

That means when testing and vaccination programs are designed and implemented, for example, they must consider fairness and equity along with efficiency in order to be truly effective, said Dr. Marcella Nunez-Smith, an expert on health care inequality at Yale University, in an interview with The Associated Press.

“We cannot get this pandemic under control if we do not address head-on the issues of inequity in our country," she said. "There is no other way.”

Nunez-Smith, associate dean for health equity research at Yale’s medical school, co-chairs Biden’s advisory board on the coronavirus pandemic with former Surgeon General Dr. Vivek Murthy and former Food and Drug Administration Commissioner David Kessler.

Biden’s choice of Nunez-Smith to help lead his pandemic task force signaled his intention to address the pandemic’s unequal toll on minorities, who disproportionally have jobs on the front lines, medical conditions associated with severe disease, higher rates of poverty and poor access to health care.

For Blacks, Hispanics and Native Americans in the U.S., the rates of hospitalization and death from COVID-19 are two to four times higher than for whites, according to the Centers for Disease Control and Prevention.

“It means that almost 50 percent of people of color in this country know someone who has died from COVID-19,” she said. “And quite frankly, it’s getting harder to find anyone in this country who doesn’t know someone who has been affected by COVID-19 or themselves has been affected.”

She emphasized she is not the only one on the Biden team advocating for more attention to the unequal burden of the disease on racial minorities.

“This is a unified voice across the entire transition," she said.

The virus in the U.S. has killed more than 268,000 and caused more than 13.5 million confirmed infections. The country on average is seeing more than 160,000 new cases per day and over 1,400 deaths — a toll on par with what the nation witnessed in mid-May, when New York City was the epicenter.

“We’re in surge everywhere,” Nunez-Smith said, calling on Americans to wear masks in public, keep their distance from others and “to fight the fatigue for another day out of respect for our health care workers who we often call heroes.”

Nunez-Smith said the Biden transition is working on getting a clearer picture of the status of the nation's pandemic response and still has “many questions” about basic information such as vaccine supply.

Gathering that information became easier last week when the federal government recognized Biden as the winner of the Nov. 3 election, she said.

She said the Biden team is grateful for the work of career government officials who are managing the logistics of vaccine allocation to states ahead of a decision by the Food and Drug Administration on what appear to be very promising vaccine candidates.

Americans can expect more unified and coordinated federal guidance under Biden's administration, efforts to rebuild trust in scientific data and an acknowledgement of the unequal access to resources in hard-hit communities, she said.

“The pandemic, very sadly and unfortunately, laid bare what were preexisting structural and social realities that really predisposed particular communities to be hardest hit by this pandemic," she said. “Hardest hit from a health perspective and hardest hit from an economic perspective.”

She said it’s important to “acknowledge a shameful history in our country of medical experimentation on black and brown bodies in particular,” which has fueled distrust among Blacks. In polls, Blacks have expressed more hesitancy about getting a vaccine than other groups, so it will be important to get accurate information to them about vaccine safety, efficacy and cost, she said.

“We’ve had a collective witnessing as a country here in 2020 around the pervasive, deep-seated challenge of racial injustice,” she said, “and COVID-19 exploited that reality.”

She said there are both “moral and pragmatic” reasons to address inequality. “We can’t pretend that COVID-19 has been an equal opportunity offender,” she said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.