1 00:00:03,279 --> 00:00:08,959 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day three forty 2 00:00:09,160 --> 00:00:14,320 Speaker 1: since coronavirus was declared a global pandemic. Today's main story. 3 00:00:15,320 --> 00:00:19,919 Speaker 1: As vaccines roll out across the US, logistics and supply 4 00:00:20,400 --> 00:00:23,960 Speaker 1: are just some of the challenges in making sure everyone 5 00:00:24,360 --> 00:00:29,720 Speaker 1: has equal access to the vaccine. One Boston health system 6 00:00:29,840 --> 00:00:35,280 Speaker 1: is also confronting another major problem in vaccine distribution, a 7 00:00:35,440 --> 00:00:41,640 Speaker 1: long history of racial inequity in the US healthcare system. 8 00:00:41,640 --> 00:00:59,760 Speaker 1: But first, here's what happened in Virus News today. Knew 9 00:00:59,840 --> 00:01:02,200 Speaker 1: you York City may have to hold back as many 10 00:01:02,280 --> 00:01:07,840 Speaker 1: as thirty five thousand vaccine appointments after severe winter storms 11 00:01:07,840 --> 00:01:12,640 Speaker 1: across the nation delayed deliveries. That's according to Mayor Build 12 00:01:12,680 --> 00:01:17,560 Speaker 1: a Blasio. The city currently has fewer than thirty thousand 13 00:01:17,560 --> 00:01:20,760 Speaker 1: first doses on hand and could run out by the 14 00:01:20,840 --> 00:01:26,520 Speaker 1: end of the day. On Wednesday, South Africa will begin 15 00:01:26,560 --> 00:01:31,280 Speaker 1: administering Johnson and Johnson's vaccine to health workers following the 16 00:01:31,400 --> 00:01:34,840 Speaker 1: arrival of a first consignment of the shots on Tuesday night. 17 00:01:36,000 --> 00:01:40,160 Speaker 1: The country has offered its supply of the Astrasennica Oxford 18 00:01:40,240 --> 00:01:43,800 Speaker 1: vaccine to the African Union after it was found to 19 00:01:43,840 --> 00:01:47,760 Speaker 1: have little effect on the variant first identified in the country. 20 00:01:47,880 --> 00:01:53,360 Speaker 1: Late South Africa has recorded more than one point four 21 00:01:53,560 --> 00:02:00,600 Speaker 1: nine million coronavirus cases, the most in Africa and finally 22 00:02:01,080 --> 00:02:05,280 Speaker 1: in New Zealand. Auckland's three day lockdown will end after 23 00:02:05,320 --> 00:02:10,200 Speaker 1: authorities expressed confidence that the latest community outbreak is contained. 24 00:02:11,320 --> 00:02:15,079 Speaker 1: Auckland moved to alert level too at midnight on Wednesday, 25 00:02:15,520 --> 00:02:19,760 Speaker 1: allowing schools and businesses to reopen. The remainder of New 26 00:02:19,800 --> 00:02:23,120 Speaker 1: Zealand has moved to Level one, meaning people no longer 27 00:02:23,240 --> 00:02:27,920 Speaker 1: have to observe social distancing or limit the size of gatherings. 28 00:02:34,320 --> 00:02:39,040 Speaker 1: And now for today's main story, Distributing the coronavirus vaccine 29 00:02:39,080 --> 00:02:42,480 Speaker 1: is one of the largest logistical tasks in the world today. 30 00:02:43,400 --> 00:02:46,640 Speaker 1: To guarantee that vaccines reach communities that are most in 31 00:02:46,760 --> 00:02:52,239 Speaker 1: danger from the coronavirus, authorities must overcome not only daunting logistics, 32 00:02:52,520 --> 00:02:56,160 Speaker 1: but also deep fissures that trace back to an enduring 33 00:02:56,280 --> 00:03:00,920 Speaker 1: history of racism and segregation. In the US, one of 34 00:03:00,919 --> 00:03:04,360 Speaker 1: the largest health systems in the Boston area, Mass General 35 00:03:04,360 --> 00:03:09,160 Speaker 1: Brigham decided to take action to narrow the health inequity gap. 36 00:03:10,240 --> 00:03:14,000 Speaker 1: I spoke with reporter Angelica Levito, who reports on how 37 00:03:14,040 --> 00:03:17,600 Speaker 1: the problems n G be encountered in distributing the vaccine 38 00:03:17,639 --> 00:03:21,679 Speaker 1: to its own employees showcases how much work it will 39 00:03:21,720 --> 00:03:27,120 Speaker 1: take to ensure vaccines are administered equitably on a national level. 40 00:03:37,040 --> 00:03:40,680 Speaker 1: As vaccine distribution continues across the US, there have been 41 00:03:40,960 --> 00:03:45,960 Speaker 1: increasing reports about inequality along racial lines in terms of 42 00:03:45,960 --> 00:03:49,320 Speaker 1: who's been able to get vaccinated. Now, you looked at 43 00:03:49,320 --> 00:03:53,480 Speaker 1: the situation with regard to one particular system of teaching 44 00:03:53,520 --> 00:03:57,360 Speaker 1: hospitals and physician networks in Boston and how they approached 45 00:03:57,520 --> 00:04:02,640 Speaker 1: their employees regarding vaccine education and access. Tell us a 46 00:04:02,720 --> 00:04:07,560 Speaker 1: bit about what you found. At Mass General Brigham Health 47 00:04:07,600 --> 00:04:11,800 Speaker 1: System in Boston. They spent a lot of energy trying 48 00:04:11,840 --> 00:04:17,280 Speaker 1: to ensure that vaccines were administered equitably across the health system, 49 00:04:17,320 --> 00:04:20,839 Speaker 1: and the executives there looked at the data in the fall, 50 00:04:21,400 --> 00:04:25,279 Speaker 1: the survey data that showed a large gap among racial 51 00:04:25,360 --> 00:04:28,800 Speaker 1: lines and who was willing to get vaccinated. They saw 52 00:04:28,839 --> 00:04:32,400 Speaker 1: the data and their team that's focused on equity knew 53 00:04:32,440 --> 00:04:34,800 Speaker 1: that there would be an issue here that they had 54 00:04:34,839 --> 00:04:39,840 Speaker 1: to overcome a lot of mistrust, a lot of misinformation 55 00:04:40,560 --> 00:04:45,440 Speaker 1: and try to reach the most vulnerable people. Because in Boston, 56 00:04:46,000 --> 00:04:49,760 Speaker 1: like many places across the US, the impacts of the 57 00:04:49,760 --> 00:04:53,839 Speaker 1: coronavirus have not been equal. Communities of color have been 58 00:04:54,000 --> 00:04:57,080 Speaker 1: hit the hardest, and for a city like Boston that 59 00:04:57,320 --> 00:05:02,679 Speaker 1: his complex history of aracial strife and distrust, that actually 60 00:05:02,680 --> 00:05:08,040 Speaker 1: equated to most cases being concentrated to a few zip codes. 61 00:05:08,640 --> 00:05:11,480 Speaker 1: And so early on they thought about ways that they 62 00:05:11,520 --> 00:05:15,960 Speaker 1: could educate their workers across all of the different departments 63 00:05:16,520 --> 00:05:20,040 Speaker 1: from different racial backgrounds, how they could educate them about 64 00:05:20,120 --> 00:05:24,000 Speaker 1: back seeds, and so they decided to find what they 65 00:05:24,040 --> 00:05:29,200 Speaker 1: called trusted messengers throughout the hospital. They found doctors, particularly 66 00:05:29,200 --> 00:05:33,080 Speaker 1: people of color, who could show that they were vaccinated 67 00:05:33,120 --> 00:05:38,120 Speaker 1: and go and answer questions. Early on, they hosted twenty 68 00:05:38,200 --> 00:05:43,240 Speaker 1: eight educational sessions in seven different languages, and they even 69 00:05:43,279 --> 00:05:46,119 Speaker 1: sent people to different departments to go and help people 70 00:05:46,200 --> 00:05:51,239 Speaker 1: schedule appointments, particularly people who were not comfortable with English 71 00:05:51,240 --> 00:05:55,320 Speaker 1: as their first language, so that they were not impacted 72 00:05:55,320 --> 00:05:58,520 Speaker 1: by any of the barriers in terms of scheduling appointments 73 00:05:58,560 --> 00:06:04,440 Speaker 1: and getting the accurate information. And so, during the rollout 74 00:06:04,480 --> 00:06:08,880 Speaker 1: of vaccines at Mass General Brigham, when they looked at 75 00:06:09,000 --> 00:06:14,040 Speaker 1: who actually was getting vaccinated, I mean, how did that data, 76 00:06:14,320 --> 00:06:16,520 Speaker 1: what did it show in terms of the demographics and 77 00:06:16,640 --> 00:06:19,320 Speaker 1: racial breakdown as far as the hospital workers who had 78 00:06:19,360 --> 00:06:22,960 Speaker 1: received the vaccine, so one thing that they invested in 79 00:06:23,000 --> 00:06:27,120 Speaker 1: heavily was measuring the results. They knew that in order 80 00:06:27,160 --> 00:06:31,480 Speaker 1: to hold themselves accountable, they would need accurate data, and 81 00:06:31,480 --> 00:06:35,719 Speaker 1: they used this data throughout to monitor their progress, and 82 00:06:35,880 --> 00:06:40,680 Speaker 1: early on they noticed really large disparities. And now six 83 00:06:40,720 --> 00:06:44,440 Speaker 1: weeks in, it's getting better, but the numbers are still 84 00:06:44,839 --> 00:06:49,080 Speaker 1: pretty stark. About seventy of the health systems eighty thou 85 00:06:49,320 --> 00:06:55,080 Speaker 1: workers have been immunized, and along racial lines of white, 86 00:06:55,440 --> 00:06:59,880 Speaker 1: seventy six percent of Asian employees, fifty percent of Hispanic 87 00:07:00,040 --> 00:07:05,000 Speaker 1: and of Black employees have received shots. And then among 88 00:07:05,080 --> 00:07:08,080 Speaker 1: people who speak a language other than English, the rate 89 00:07:08,160 --> 00:07:12,320 Speaker 1: is fifty So you can see that despite all this work, 90 00:07:12,440 --> 00:07:17,240 Speaker 1: there's still a pretty wide gap along racial lines. Now 91 00:07:17,400 --> 00:07:21,720 Speaker 1: I want to touch on this question of language because 92 00:07:22,040 --> 00:07:24,240 Speaker 1: I want to unpack a little bit how that might 93 00:07:24,320 --> 00:07:29,520 Speaker 1: affect someone's ability to either receive information about the vaccine 94 00:07:29,840 --> 00:07:34,680 Speaker 1: or perhaps even a willingness to be vaccinated. So I 95 00:07:34,760 --> 00:07:38,280 Speaker 1: think it's really important to note that people of all 96 00:07:38,400 --> 00:07:43,680 Speaker 1: colors and all backgrounds naturally are skeptical of a vaccine 97 00:07:44,120 --> 00:07:47,520 Speaker 1: that was developed in less than a year, and we 98 00:07:47,600 --> 00:07:50,920 Speaker 1: know that the science did not emerge overnight. It had 99 00:07:50,960 --> 00:07:54,960 Speaker 1: been decades in the making. And unfortunately, there's so much 100 00:07:55,160 --> 00:07:59,880 Speaker 1: misinformation spreading. More so, if you're a non English speaker 101 00:08:00,080 --> 00:08:03,080 Speaker 1: in the US, you might not, you know, be able 102 00:08:03,120 --> 00:08:06,240 Speaker 1: to understand all of the public health messages that are 103 00:08:06,240 --> 00:08:10,360 Speaker 1: coming out, and you might be even more isolated and 104 00:08:10,800 --> 00:08:14,720 Speaker 1: disconnected from the health system. And so that's why the 105 00:08:14,880 --> 00:08:18,800 Speaker 1: team over at Mass General Brigham decided to really focus 106 00:08:18,880 --> 00:08:24,400 Speaker 1: on bringing trusted information to people across the workforce in 107 00:08:25,080 --> 00:08:28,560 Speaker 1: many different languages. Um So for one, in one example, 108 00:08:28,960 --> 00:08:32,560 Speaker 1: I spoke to a doctor who she volunteered to be 109 00:08:32,600 --> 00:08:37,400 Speaker 1: a trusted messenger and teach people about the vaccines in Mandarin, 110 00:08:37,559 --> 00:08:40,520 Speaker 1: and she only had one person show up to her session, 111 00:08:40,679 --> 00:08:42,679 Speaker 1: but you know, she was able to have a one 112 00:08:42,679 --> 00:08:46,400 Speaker 1: on one conversation and reach someone and answer their questions 113 00:08:46,440 --> 00:08:49,600 Speaker 1: because a lot of people have questions. At this point. 114 00:08:49,600 --> 00:08:52,800 Speaker 1: In the US, the vaccination campaign really has been sort 115 00:08:52,840 --> 00:08:55,560 Speaker 1: of a competition to see who can get an appointment 116 00:08:55,600 --> 00:08:59,120 Speaker 1: the fastest, and how can you find the information and 117 00:08:59,160 --> 00:09:02,600 Speaker 1: find the appointment, And if you don't speak English, a 118 00:09:02,679 --> 00:09:06,640 Speaker 1: lot of these websites might miss you. As part of 119 00:09:06,679 --> 00:09:10,240 Speaker 1: your reporting, you spoke to a number of different employees 120 00:09:10,480 --> 00:09:13,760 Speaker 1: at mass General Brigham and in a number of different departments. 121 00:09:14,040 --> 00:09:16,600 Speaker 1: What did you hear about some of the reasons that 122 00:09:16,720 --> 00:09:21,439 Speaker 1: employees either had not yet been vaccinated or say, reasons 123 00:09:21,480 --> 00:09:26,000 Speaker 1: you heard about perhaps problems accessing the vaccine. I spoke 124 00:09:26,040 --> 00:09:31,280 Speaker 1: to one environmental services manager named Ivan, and Ivan told 125 00:09:31,280 --> 00:09:34,760 Speaker 1: me that when he surveyed his employees in the fall 126 00:09:35,360 --> 00:09:38,400 Speaker 1: about whether they wanted to get a vaccine, none of 127 00:09:38,440 --> 00:09:41,600 Speaker 1: his twenty seven employees wanted to get it. And of 128 00:09:41,640 --> 00:09:45,640 Speaker 1: course that's problematic many of his workers don't speak English, 129 00:09:46,000 --> 00:09:48,720 Speaker 1: because we know these are the communities that are the 130 00:09:48,800 --> 00:09:52,840 Speaker 1: most vulnerable to the virus. He had said that a 131 00:09:52,920 --> 00:09:55,680 Speaker 1: lot of what he was hearing was just misinformation, and 132 00:09:55,720 --> 00:09:58,079 Speaker 1: as he puts it, you know, people spent a lot 133 00:09:58,120 --> 00:10:00,760 Speaker 1: of time on Facebook, a lot of time on in Stagram, 134 00:10:00,800 --> 00:10:03,240 Speaker 1: and when that's all you're seeing and you're not connected 135 00:10:03,360 --> 00:10:06,560 Speaker 1: to the health system and the accurate information, it's really 136 00:10:06,600 --> 00:10:11,000 Speaker 1: easy to get caught up. And so fortunately, after all 137 00:10:11,040 --> 00:10:16,120 Speaker 1: of these different educational sessions and his own advocacy among 138 00:10:16,200 --> 00:10:20,040 Speaker 1: his employees, almost all of them out of seven are 139 00:10:20,040 --> 00:10:25,000 Speaker 1: now vaccinated UM, one other employee has an appointment, and 140 00:10:25,240 --> 00:10:29,120 Speaker 1: one is still refusing. And I think that the reasons 141 00:10:29,120 --> 00:10:32,800 Speaker 1: are complex. Not everybody is not everyone will change their 142 00:10:32,800 --> 00:10:35,400 Speaker 1: minds immediately. I think a lot of it too that's 143 00:10:35,400 --> 00:10:40,080 Speaker 1: important to remember is that mistrust among particularly Black Americans 144 00:10:40,720 --> 00:10:45,920 Speaker 1: Hispanic people. It's been built up over centuries. You know, 145 00:10:46,280 --> 00:10:50,120 Speaker 1: all kinds of issues, whether it's um you know, history 146 00:10:50,160 --> 00:10:53,720 Speaker 1: of being experimented on, or just being ignored by the 147 00:10:53,760 --> 00:10:56,959 Speaker 1: medical system. These are not going to be solved overnight, 148 00:10:57,280 --> 00:10:59,880 Speaker 1: but it's important to recognize them and to try and 149 00:11:00,040 --> 00:11:03,479 Speaker 1: take steps early on so that they can be addressed 150 00:11:03,520 --> 00:11:08,120 Speaker 1: and not just forgotten. That REases like a really important point. 151 00:11:08,160 --> 00:11:12,080 Speaker 1: I think it also touches on the larger context of 152 00:11:12,200 --> 00:11:15,480 Speaker 1: the city. So for example, you know Mass General Brigham 153 00:11:15,520 --> 00:11:20,200 Speaker 1: located in Boston. You know, how does the history of 154 00:11:20,520 --> 00:11:24,520 Speaker 1: segregation or racism in that particular city. How do you 155 00:11:24,520 --> 00:11:28,439 Speaker 1: think that has affected, for example, what you've seen at 156 00:11:28,520 --> 00:11:33,760 Speaker 1: Mass General. So Boston has a complex history. The city 157 00:11:33,800 --> 00:11:37,800 Speaker 1: gained international attention during the nineteen seventies when it's public 158 00:11:37,840 --> 00:11:41,480 Speaker 1: schools were under court order to desegregate through bussing. It 159 00:11:41,559 --> 00:11:44,960 Speaker 1: led to white flight to the suburbs and protests and riots, 160 00:11:45,760 --> 00:11:49,679 Speaker 1: and it's something that, unfortunately, something that we've seen across 161 00:11:49,720 --> 00:11:52,959 Speaker 1: other cities in America too. But one thing it's important 162 00:11:53,000 --> 00:11:57,280 Speaker 1: to remember about the impacts of this segregation is that 163 00:11:57,720 --> 00:12:01,000 Speaker 1: it often has left communities of color out. And so 164 00:12:01,240 --> 00:12:04,280 Speaker 1: one of the executives who is leading the equity work 165 00:12:04,320 --> 00:12:08,560 Speaker 1: at Mass General, Tom Sequist, as he put it, for years, 166 00:12:09,480 --> 00:12:13,440 Speaker 1: the health system has has not catered to communities of colors. 167 00:12:13,520 --> 00:12:17,360 Speaker 1: The facilities, the hospitals, the doctor's offices, they've been in 168 00:12:17,400 --> 00:12:20,520 Speaker 1: the other side of town, and they've felt disconnected from people, 169 00:12:20,559 --> 00:12:23,920 Speaker 1: and they haven't really gone to the communities that are 170 00:12:23,960 --> 00:12:27,240 Speaker 1: most vulnerable and catered to people there. It's been you 171 00:12:27,280 --> 00:12:30,280 Speaker 1: need to come to us, and unfortunately, if you already 172 00:12:30,320 --> 00:12:33,440 Speaker 1: feel uncomfortable, you're not going to go there. And so 173 00:12:33,880 --> 00:12:38,280 Speaker 1: the system has really left people out, and you're seeing 174 00:12:38,320 --> 00:12:42,080 Speaker 1: that play out in Boston and other places around the country. 175 00:12:43,000 --> 00:12:46,439 Speaker 1: You know, what are the parallels then, about the situation 176 00:12:46,480 --> 00:12:50,079 Speaker 1: you're seeing at Mass General Brigham in terms of what's 177 00:12:50,120 --> 00:12:53,080 Speaker 1: going on at a national level with the vaccine rollout. 178 00:12:53,480 --> 00:12:57,359 Speaker 1: At this point, Unfortunately, it's really hard to know exactly 179 00:12:57,400 --> 00:13:02,720 Speaker 1: how the demographic divide is playing out across the US 180 00:13:02,760 --> 00:13:07,160 Speaker 1: because we have only about half of states reporting demographic 181 00:13:07,240 --> 00:13:10,480 Speaker 1: data at least publicly. So here at Bloomberg, we started 182 00:13:10,559 --> 00:13:16,240 Speaker 1: a vaccine demographic data project and we're tracking the publicly 183 00:13:16,280 --> 00:13:21,440 Speaker 1: available demographic data across states, and so far, even though 184 00:13:21,520 --> 00:13:25,760 Speaker 1: the data are incomplete, you're seeing a very large divide 185 00:13:26,240 --> 00:13:31,200 Speaker 1: among white people, Asian people, Black people, and Hispanic people. 186 00:13:31,960 --> 00:13:35,439 Speaker 1: Most people getting vaccinated in the US are white, and 187 00:13:35,960 --> 00:13:40,040 Speaker 1: we are seeing more Asian people getting vaccinated, but black 188 00:13:40,080 --> 00:13:43,560 Speaker 1: and Hispanic are falling well behind. It's hard to say 189 00:13:44,080 --> 00:13:48,640 Speaker 1: whether that's because of mistrust or access, and I don't 190 00:13:48,640 --> 00:13:52,240 Speaker 1: think it's any one reason, but we are seeing this gap. 191 00:13:52,280 --> 00:13:55,400 Speaker 1: And again, given what we know about the virus and 192 00:13:55,440 --> 00:13:59,920 Speaker 1: how it's disproportionately affecting communities of color, everyone I speak 193 00:14:00,040 --> 00:14:03,079 Speaker 1: he says that if we really want to end this pandemic, 194 00:14:03,280 --> 00:14:06,240 Speaker 1: these are the people we need to be reaching, and so, 195 00:14:06,360 --> 00:14:09,280 Speaker 1: regardless of what the reason is, if we had this gap, 196 00:14:09,800 --> 00:14:20,240 Speaker 1: it'll be really hard to end the pandemic. That was 197 00:14:20,280 --> 00:14:23,640 Speaker 1: Angelica Levito and that's it for our show today. For 198 00:14:23,720 --> 00:14:26,480 Speaker 1: coverage of the outbreak from one and twenty bureaus around 199 00:14:26,480 --> 00:14:31,920 Speaker 1: the world. Visit Bloomberg dot com, slash Coronavirus, and if 200 00:14:31,960 --> 00:14:34,160 Speaker 1: you like the show, please leave us a review and 201 00:14:34,200 --> 00:14:38,000 Speaker 1: a rating on Apple Podcasts or Spotify. It's the best 202 00:14:38,000 --> 00:14:42,400 Speaker 1: way to help more listeners find our global reporting. The 203 00:14:42,440 --> 00:14:46,720 Speaker 1: Prognosis Daily edition is produced by Topha Foreheads, Magnus Hendrickson 204 00:14:46,880 --> 00:14:51,280 Speaker 1: and me Laura Carlson. Today's main story was reported by 205 00:14:51,320 --> 00:14:56,520 Speaker 1: Angelica Levito. Original music by Leo Citrin. Our editors are 206 00:14:56,640 --> 00:15:01,120 Speaker 1: Rick Shine and Francesca Levi. Francesco Levi is Bloomberg's out 207 00:15:01,120 --> 00:15:03,400 Speaker 1: of podcasts. Thanks for listening.