US law enforcement crowd control tactics at anti-racism protests: a public health threat
Authors: Adam W Gaffney, Danny McCormick, Steffie Woolhandler, David U Himmelstein
Journal: The Lancet (2020)

George Floyd's murder by Minneapolis police on May 25, 2020, the latest of many such extrajudicial killings of African Americans and Native Americans, triggered protests throughout the USA and beyond. Many law enforcement agencies have responded with excessive force, raising serious health and human rights concerns. Numerous videos document law enforcement officers' indiscriminate use of chemical irritants and kinetic impact projectiles (KIPs); striking peaceful protesters, and even journalists, with batons, fists, and vehicles; and corralling crowds in confined areas, making physical distancing impossible. Chemical irritants, including tear gas and pepper spray, have been lobbed at protests nationwide. In one well publicised incident, officers used chemical irritants to chase peaceful protesters from a square near the White House to clear a path for President Trump to attend a photo opportunity. Such weapons, which are banned in warfare, carry substantial risks. A systematic review1Haar RJ Iacopino V Ranadive N Weiser SD Dandu M Health impacts of chemical irritants used for crowd control: a systematic review of the injuries and deaths caused by tear gas and pepper spray.BMC Public Health. 2017; 17: 831Crossref PubMed Scopus (53) Google Scholar of 31 studies found that among 9261 injuries from chemical irritants, 8·7% were severe, two were lethal, and 58 caused permanent disabilities. Because chemical irritants provoke coughing and sneezing, their use during the COVID-19 pandemic raises particular concern about viral spread. The use of KIPs such as rubber bullets and bean bag rounds, sometimes shot from standard firearms, raises even more serious health concerns. A 2017 review2Haar RJ Iacopino V Ranadive N Dandu M Weiser SD Death, injury and disability from kinetic impact projectiles in crowd-control settings: a systematic review.BMJ Open. 2017; 7e018154Crossref PubMed Scopus (58) Google Scholar of 26 studies involving 1984 individuals wounded by KIPs showed that 3% died and 15·5% suffered permanent disabilities, including vision loss and surgical abdominal injuries. In the last 3 days of May, 2020, alone, at least twelve protesters incurred grave injuries from KIPs according to media reports (appendix); several required intensive care, and five suffered severe ocular trauma resulting in partial or complete loss of vision. Mass arrests of protesters, often for curfew violations, raise additional concerns. The USA incarcerates more people than any other nation, and its overcrowded jails have functioned as incubators for COVID-19. As many as 15% of COVID-19 cases in Illinois may be attributable to the cycling of community members into and out of jails.3Reinhart E Chen D Incarceration and its disseminations: COVID-19 pandemic lessons from Chicago's Cook County Jail.Health Affairs. 2020; (published online June 4.)DOI:10.1377/hlthaff.2020.00652Crossref Scopus (117) Google Scholar Mass arrests, particularly combined with indiscriminate use of chemical irritants, risk accelerating the pandemic's spread. The medical profession must join in demanding an end to human rights abuses by law enforcement. Police murders of people of colour and assaults on peaceful protesters must stop. A moratorium on the use of tear gas is needed.4American Thoracic SocietyTear gas use during COVID-19 pandemic irresponsible; moratorium needed, says American Thoracic Society.https://www.thoracic.org/about/newsroom/press-releases/journal/2020/tear-gas-use-during-covid-19-pandemic-irresponsible-moratorium-needed,-says-american-thoracic-society.phpDate: June 11, 2020Date accessed: June 17, 2020Google Scholar KIP use should be banned. Some of the US$115 billion spent annually on law enforcement in the USA5Urban InstitutePolice and corrections expenditures.https://www.urban.org/policy-centers/cross-center-initiatives/state-and-local-finance-initiative/state-and-local-backgrounders/police-and-corrections-expendituresDate: Oct 20, 2017Date accessed: June 7, 2020Google Scholar would be better spent on alternatives to policing, such as health, educational, and social programmes. All authors declare serving as leaders in Physicians for a National Health Program, a non-profit organisation that favours coverage expansion through a single-payer programme. AWG is reimbursed for some travel on behalf of the organisation; all other authors receive no compensation from the organisation. Download .pdf (.14 MB) Help with pdf files Supplementary appendix