key: cord-027472-pr037x2t
authors: Gaffney, Adam W; McCormick, Danny; Woolhandler, Steffie; Himmelstein, David U
title: US law enforcement crowd control tactics at anti-racism protests: a public health threat
date: 2020-06-19
journal: Lancet
DOI: 10.1016/s0140-6736(20)31421-5
sha: 
doc_id: 27472
cord_uid: pr037x2t

nan

Numerous videos document law enforcement officers' indiscriminate use of chemical irritants and kinetic impact projectiles (KIPs); striking peaceful protesters, and even jour nalists, 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 review 1 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 COVID19 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 review 2 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 COVID19. As many as 15% of COVID19 cases in Illinois may be attributable to the cycling of community members into and out of jails. 3 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. 4 KIP use should be banned. Some of the US$115 billion spent annually on law enforcement in the USA 5 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 nonprofit organisation that favours coverage expansion through a singlepayer programme. AWG is reimbursed for some travel on behalf of the organisation; all other authors receive no compensation from the organisation.

Health impacts of chemical irritants used for crowd control: a systematic review of the injuries and deaths caused by tear gas and pepper spray

Death, injury and disability from kinetic impact projectiles in crowdcontrol settings: a systematic review

Incarceration and its disseminations: COVID19 pandemic lessons from Chicago's Cook County Jail

Tear gas use during COVID19 pandemic irresponsible; moratorium needed, says

Police and corrections expenditures

See Online for appendix