COVID-19 is unique in the scope of its effects on morbidity and mortality. However, the factors contributing to its disparate racial and socioeconomic effects are part of a continuous history of oppressive social policy. This history is characterized by institutionally generated inequalities forged through segregation and neglectful urban planning. In the USA, aspects of COVID-19's manifestation mirror elements of the build-up and response to the Flint crisis, Michigan's racially and class-contoured water crisis that began in 2014. This case shares common macrosocial and spatial characteristics and is instructive in showing how civic trust suffers in the aftermath of public health disasters, becoming especially degenerative among historically and spatially marginalized populations. This article discusses how COVID-19 has both inherited and augmented patterns of spatial inequality. It concludes by outlining particular steps that can be taken to reduce spatial inequalities generated by COVID-19 and restore trust between historically disenfranchised communities and officials.