Black lung is prevalent in Appalachia. Vulnerable coal miners are wary that the rapid spread and the devastating effects of the COVID-19 can easily wipe their community out.

Jimmy Moore, a 74-year old black lung patient in Shelby Gap, Kentucky, does not know when the coronavirus gets to their area. However, if it does, " It's probably just going to wipe us out." he said. Moore worked in the mines for 22 years and retired in 2000. His 51-year-old son also has a more severe case of black lung.

Two workers in Pennsylvania were tested positive for the coronavirus. The population has an increased risk of getting COVID-19 due to those already inflicted with a black lung.

The Black Lung 

Coal Worker's Pneumoconiosis (CWP), commonly known as black lung, is the scarring of the lungs due to years of inhalation of coal dust. Center for Disease Control estimates that at least 1 in ten underground miners has black lungs. 

According to Dr. Leonard Go, a physician and black lung researcher at the University of Illinois at Chicago and Northwestern University, cases of black lung has started resurging in the 1990s, after 20 years of decline. Go, suspects, that changes in mining technology that creates more dust from the rock has caused the increase of black lung incidences. Changes in working habits also contributed to the rise of black lung incidences as a lot more people work overtime, causing them to breathe in more dust.

Appalachia, a cultural region in the Eastern United States, spans from the Southern Tier of New York State to Northern Alabama and Georgia. Other than the black lung, Appalachians have increased risks to cancer, heart disease, and diabetes primarily due to smoking and a sedentary lifestyle. All these diseases increase a person's risk of COVID-19.

In southwestern Virginia, health workers report increased incidences of progressive massive fibrosis, a more severe type of black lung. Teresa Tyson, president, and CEO of Health Wagon said doctors and health workers in the area had spent the past few weeks warning former coal miners and other vulnerable patients to treat COVID-19 seriously. COVID-19, she says, would be a "nail in the coffin." Tyson is a nurse practitioner, and her father also has a black lung.

Suspended Black Lung Evaluations 

In southeastern West Virginia coal country, a breathing clinic that treats black lung and other respiratory problems laid off several employees so as not to expose them to COVID-19. Dr. Dan Doyle plans to monitor housebound patients during the pandemic with lesser employees. Those employees routinely check on black lung patients through telemedicine. Telemedicine allows doctors to use video and other interactive tools to treat patients from afar. It poses a problem, however for black lung patients that neither have the technology and broadband service necessary for telemedicine. 

Go believes that most clinics have suspended black lung evaluation. Although the $2 trillion COVID-19 stimulus bill has allocated some funds to help rural hospitals and clinics, more funds should be allocated to black lung clinics that have had to shut their doors, Go said.  

Business As Usual 

Despite the dangers of the coronavirus pandemic, mines continue to operate with states like West Virginia and Pennsylvania, naming it as an "essential" service. Workers, especially with black lungs, are at risk of contracting the novel coronavirus. 

The National Mining Association, in its statement, said that in light of the recent pandemic, measures such as social distancing increased cleaning schedules and limits on gatherings of groups.

However, in West Virginia, Doyle said it seems like business as usual. People are still walking around town, as usual, possibly spreading the virus. "Until their co-workers start falling ill, I don't think they're going to change. A lot of people here are not convinced they need to do anything."