US law enforcement crowd control tactics at anti-racism protests: a public health threat

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 review1 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 review2 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.

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