WEBVTT - Fixing Vaccine Inequity 0:00:03.279 --> 0:00:08.959 Welcome to Prognosis. I'm Laura Carlson. It's day three forty 0:00:09.160 --> 0:00:14.320 since coronavirus was declared a global pandemic. Today's main story. 0:00:15.320 --> 0:00:19.919 As vaccines roll out across the US, logistics and supply 0:00:20.400 --> 0:00:23.960 are just some of the challenges in making sure everyone 0:00:24.360 --> 0:00:29.720 has equal access to the vaccine. One Boston health system 0:00:29.840 --> 0:00:35.280 is also confronting another major problem in vaccine distribution, a 0:00:35.440 --> 0:00:41.640 long history of racial inequity in the US healthcare system. 0:00:41.640 --> 0:00:59.760 But first, here's what happened in Virus News today. Knew 0:00:59.840 --> 0:01:02.200 you York City may have to hold back as many 0:01:02.280 --> 0:01:07.840 as thirty five thousand vaccine appointments after severe winter storms 0:01:07.840 --> 0:01:12.640 across the nation delayed deliveries. That's according to Mayor Build 0:01:12.680 --> 0:01:17.560 a Blasio. The city currently has fewer than thirty thousand 0:01:17.560 --> 0:01:20.760 first doses on hand and could run out by the 0:01:20.840 --> 0:01:26.520 end of the day. On Wednesday, South Africa will begin 0:01:26.560 --> 0:01:31.280 administering Johnson and Johnson's vaccine to health workers following the 0:01:31.400 --> 0:01:34.840 arrival of a first consignment of the shots on Tuesday night. 0:01:36.000 --> 0:01:40.160 The country has offered its supply of the Astrasennica Oxford 0:01:40.240 --> 0:01:43.800 vaccine to the African Union after it was found to 0:01:43.840 --> 0:01:47.760 have little effect on the variant first identified in the country. 0:01:47.880 --> 0:01:53.360 Late South Africa has recorded more than one point four 0:01:53.560 --> 0:02:00.600 nine million coronavirus cases, the most in Africa and finally 0:02:01.080 --> 0:02:05.280 in New Zealand. Auckland's three day lockdown will end after 0:02:05.320 --> 0:02:10.200 authorities expressed confidence that the latest community outbreak is contained. 0:02:11.320 --> 0:02:15.079 Auckland moved to alert level too at midnight on Wednesday, 0:02:15.520 --> 0:02:19.760 allowing schools and businesses to reopen. The remainder of New 0:02:19.800 --> 0:02:23.120 Zealand has moved to Level one, meaning people no longer 0:02:23.240 --> 0:02:27.920 have to observe social distancing or limit the size of gatherings. 0:02:34.320 --> 0:02:39.040 And now for today's main story, Distributing the coronavirus vaccine 0:02:39.080 --> 0:02:42.480 is one of the largest logistical tasks in the world today. 0:02:43.400 --> 0:02:46.640 To guarantee that vaccines reach communities that are most in 0:02:46.760 --> 0:02:52.239 danger from the coronavirus, authorities must overcome not only daunting logistics, 0:02:52.520 --> 0:02:56.160 but also deep fissures that trace back to an enduring 0:02:56.280 --> 0:03:00.920 history of racism and segregation. In the US, one of 0:03:00.919 --> 0:03:04.360 the largest health systems in the Boston area, Mass General 0:03:04.360 --> 0:03:09.160 Brigham decided to take action to narrow the health inequity gap. 0:03:10.240 --> 0:03:14.000 I spoke with reporter Angelica Levito, who reports on how 0:03:14.040 --> 0:03:17.600 the problems n G be encountered in distributing the vaccine 0:03:17.639 --> 0:03:21.679 to its own employees showcases how much work it will 0:03:21.720 --> 0:03:27.120 take to ensure vaccines are administered equitably on a national level. 0:03:37.040 --> 0:03:40.680 As vaccine distribution continues across the US, there have been 0:03:40.960 --> 0:03:45.960 increasing reports about inequality along racial lines in terms of 0:03:45.960 --> 0:03:49.320 who's been able to get vaccinated. Now, you looked at 0:03:49.320 --> 0:03:53.480 the situation with regard to one particular system of teaching 0:03:53.520 --> 0:03:57.360 hospitals and physician networks in Boston and how they approached 0:03:57.520 --> 0:04:02.640 their employees regarding vaccine education and access. Tell us a 0:04:02.720 --> 0:04:07.560 bit about what you found. At Mass General Brigham Health 0:04:07.600 --> 0:04:11.800 System in Boston. They spent a lot of energy trying 0:04:11.840 --> 0:04:17.280 to ensure that vaccines were administered equitably across the health system, 0:04:17.320 --> 0:04:20.839 and the executives there looked at the data in the fall, 0:04:21.400 --> 0:04:25.279 the survey data that showed a large gap among racial 0:04:25.360 --> 0:04:28.800 lines and who was willing to get vaccinated. They saw 0:04:28.839 --> 0:04:32.400 the data and their team that's focused on equity knew 0:04:32.440 --> 0:04:34.800 that there would be an issue here that they had 0:04:34.839 --> 0:04:39.840 to overcome a lot of mistrust, a lot of misinformation 0:04:40.560 --> 0:04:45.440 and try to reach the most vulnerable people. Because in Boston, 0:04:46.000 --> 0:04:49.760 like many places across the US, the impacts of the 0:04:49.760 --> 0:04:53.839 coronavirus have not been equal. Communities of color have been 0:04:54.000 --> 0:04:57.080 hit the hardest, and for a city like Boston that 0:04:57.320 --> 0:05:02.679 his complex history of aracial strife and distrust, that actually 0:05:02.680 --> 0:05:08.040 equated to most cases being concentrated to a few zip codes. 0:05:08.640 --> 0:05:11.480 And so early on they thought about ways that they 0:05:11.520 --> 0:05:15.960 could educate their workers across all of the different departments 0:05:16.520 --> 0:05:20.040 from different racial backgrounds, how they could educate them about 0:05:20.120 --> 0:05:24.000 back seeds, and so they decided to find what they 0:05:24.040 --> 0:05:29.200 called trusted messengers throughout the hospital. They found doctors, particularly 0:05:29.200 --> 0:05:33.080 people of color, who could show that they were vaccinated 0:05:33.120 --> 0:05:38.120 and go and answer questions. Early on, they hosted twenty 0:05:38.200 --> 0:05:43.240 eight educational sessions in seven different languages, and they even 0:05:43.279 --> 0:05:46.119 sent people to different departments to go and help people 0:05:46.200 --> 0:05:51.239 schedule appointments, particularly people who were not comfortable with English 0:05:51.240 --> 0:05:55.320 as their first language, so that they were not impacted 0:05:55.320 --> 0:05:58.520 by any of the barriers in terms of scheduling appointments 0:05:58.560 --> 0:06:04.440 and getting the accurate information. And so, during the rollout 0:06:04.480 --> 0:06:08.880 of vaccines at Mass General Brigham, when they looked at 0:06:09.000 --> 0:06:14.040 who actually was getting vaccinated, I mean, how did that data, 0:06:14.320 --> 0:06:16.520 what did it show in terms of the demographics and 0:06:16.640 --> 0:06:19.320 racial breakdown as far as the hospital workers who had 0:06:19.360 --> 0:06:22.960 received the vaccine, so one thing that they invested in 0:06:23.000 --> 0:06:27.120 heavily was measuring the results. They knew that in order 0:06:27.160 --> 0:06:31.480 to hold themselves accountable, they would need accurate data, and 0:06:31.480 --> 0:06:35.719 they used this data throughout to monitor their progress, and 0:06:35.880 --> 0:06:40.680 early on they noticed really large disparities. And now six 0:06:40.720 --> 0:06:44.440 weeks in, it's getting better, but the numbers are still 0:06:44.839 --> 0:06:49.080 pretty stark. About seventy of the health systems eighty thou 0:06:49.320 --> 0:06:55.080 workers have been immunized, and along racial lines of white, 0:06:55.440 --> 0:06:59.880 seventy six percent of Asian employees, fifty percent of Hispanic 0:07:00.040 --> 0:07:05.000 and of Black employees have received shots. And then among 0:07:05.080 --> 0:07:08.080 people who speak a language other than English, the rate 0:07:08.160 --> 0:07:12.320 is fifty So you can see that despite all this work, 0:07:12.440 --> 0:07:17.240 there's still a pretty wide gap along racial lines. Now 0:07:17.400 --> 0:07:21.720 I want to touch on this question of language because 0:07:22.040 --> 0:07:24.240 I want to unpack a little bit how that might 0:07:24.320 --> 0:07:29.520 affect someone's ability to either receive information about the vaccine 0:07:29.840 --> 0:07:34.680 or perhaps even a willingness to be vaccinated. So I 0:07:34.760 --> 0:07:38.280 think it's really important to note that people of all 0:07:38.400 --> 0:07:43.680 colors and all backgrounds naturally are skeptical of a vaccine 0:07:44.120 --> 0:07:47.520 that was developed in less than a year, and we 0:07:47.600 --> 0:07:50.920 know that the science did not emerge overnight. It had 0:07:50.960 --> 0:07:54.960 been decades in the making. And unfortunately, there's so much 0:07:55.160 --> 0:07:59.880 misinformation spreading. More so, if you're a non English speaker 0:08:00.080 --> 0:08:03.080 in the US, you might not, you know, be able 0:08:03.120 --> 0:08:06.240 to understand all of the public health messages that are 0:08:06.240 --> 0:08:10.360 coming out, and you might be even more isolated and 0:08:10.800 --> 0:08:14.720 disconnected from the health system. And so that's why the 0:08:14.880 --> 0:08:18.800 team over at Mass General Brigham decided to really focus 0:08:18.880 --> 0:08:24.400 on bringing trusted information to people across the workforce in 0:08:25.080 --> 0:08:28.560 many different languages. Um So for one, in one example, 0:08:28.960 --> 0:08:32.560 I spoke to a doctor who she volunteered to be 0:08:32.600 --> 0:08:37.400 a trusted messenger and teach people about the vaccines in Mandarin, 0:08:37.559 --> 0:08:40.520 and she only had one person show up to her session, 0:08:40.679 --> 0:08:42.679 but you know, she was able to have a one 0:08:42.679 --> 0:08:46.400 on one conversation and reach someone and answer their questions 0:08:46.440 --> 0:08:49.600 because a lot of people have questions. At this point. 0:08:49.600 --> 0:08:52.800 In the US, the vaccination campaign really has been sort 0:08:52.840 --> 0:08:55.560 of a competition to see who can get an appointment 0:08:55.600 --> 0:08:59.120 the fastest, and how can you find the information and 0:08:59.160 --> 0:09:02.600 find the appointment, And if you don't speak English, a 0:09:02.679 --> 0:09:06.640 lot of these websites might miss you. As part of 0:09:06.679 --> 0:09:10.240 your reporting, you spoke to a number of different employees 0:09:10.480 --> 0:09:13.760 at mass General Brigham and in a number of different departments. 0:09:14.040 --> 0:09:16.600 What did you hear about some of the reasons that 0:09:16.720 --> 0:09:21.439 employees either had not yet been vaccinated or say, reasons 0:09:21.480 --> 0:09:26.000 you heard about perhaps problems accessing the vaccine. I spoke 0:09:26.040 --> 0:09:31.280 to one environmental services manager named Ivan, and Ivan told 0:09:31.280 --> 0:09:34.760 me that when he surveyed his employees in the fall 0:09:35.360 --> 0:09:38.400 about whether they wanted to get a vaccine, none of 0:09:38.440 --> 0:09:41.600 his twenty seven employees wanted to get it. And of 0:09:41.640 --> 0:09:45.640 course that's problematic many of his workers don't speak English, 0:09:46.000 --> 0:09:48.720 because we know these are the communities that are the 0:09:48.800 --> 0:09:52.840 most vulnerable to the virus. He had said that a 0:09:52.920 --> 0:09:55.680 lot of what he was hearing was just misinformation, and 0:09:55.720 --> 0:09:58.079 as he puts it, you know, people spent a lot 0:09:58.120 --> 0:10:00.760 of time on Facebook, a lot of time on in Stagram, 0:10:00.800 --> 0:10:03.240 and when that's all you're seeing and you're not connected 0:10:03.360 --> 0:10:06.560 to the health system and the accurate information, it's really 0:10:06.600 --> 0:10:11.000 easy to get caught up. And so fortunately, after all 0:10:11.040 --> 0:10:16.120 of these different educational sessions and his own advocacy among 0:10:16.200 --> 0:10:20.040 his employees, almost all of them out of seven are 0:10:20.040 --> 0:10:25.000 now vaccinated UM, one other employee has an appointment, and 0:10:25.240 --> 0:10:29.120 one is still refusing. And I think that the reasons 0:10:29.120 --> 0:10:32.800 are complex. Not everybody is not everyone will change their 0:10:32.800 --> 0:10:35.400 minds immediately. I think a lot of it too that's 0:10:35.400 --> 0:10:40.080 important to remember is that mistrust among particularly Black Americans 0:10:40.720 --> 0:10:45.920 Hispanic people. It's been built up over centuries. You know, 0:10:46.280 --> 0:10:50.120 all kinds of issues, whether it's um you know, history 0:10:50.160 --> 0:10:53.720 of being experimented on, or just being ignored by the 0:10:53.760 --> 0:10:56.959 medical system. These are not going to be solved overnight, 0:10:57.280 --> 0:10:59.880 but it's important to recognize them and to try and 0:11:00.040 --> 0:11:03.479 take steps early on so that they can be addressed 0:11:03.520 --> 0:11:08.120 and not just forgotten. That REases like a really important point. 0:11:08.160 --> 0:11:12.080 I think it also touches on the larger context of 0:11:12.200 --> 0:11:15.480 the city. So for example, you know Mass General Brigham 0:11:15.520 --> 0:11:20.200 located in Boston. You know, how does the history of 0:11:20.520 --> 0:11:24.520 segregation or racism in that particular city. How do you 0:11:24.520 --> 0:11:28.439 think that has affected, for example, what you've seen at 0:11:28.520 --> 0:11:33.760 Mass General. So Boston has a complex history. The city 0:11:33.800 --> 0:11:37.800 gained international attention during the nineteen seventies when it's public 0:11:37.840 --> 0:11:41.480 schools were under court order to desegregate through bussing. It 0:11:41.559 --> 0:11:44.960 led to white flight to the suburbs and protests and riots, 0:11:45.760 --> 0:11:49.679 and it's something that, unfortunately, something that we've seen across 0:11:49.720 --> 0:11:52.959 other cities in America too. But one thing it's important 0:11:53.000 --> 0:11:57.280 to remember about the impacts of this segregation is that 0:11:57.720 --> 0:12:01.000 it often has left communities of color out. And so 0:12:01.240 --> 0:12:04.280 one of the executives who is leading the equity work 0:12:04.320 --> 0:12:08.560 at Mass General, Tom Sequist, as he put it, for years, 0:12:09.480 --> 0:12:13.440 the health system has has not catered to communities of colors. 0:12:13.520 --> 0:12:17.360 The facilities, the hospitals, the doctor's offices, they've been in 0:12:17.400 --> 0:12:20.520 the other side of town, and they've felt disconnected from people, 0:12:20.559 --> 0:12:23.920 and they haven't really gone to the communities that are 0:12:23.960 --> 0:12:27.240 most vulnerable and catered to people there. It's been you 0:12:27.280 --> 0:12:30.280 need to come to us, and unfortunately, if you already 0:12:30.320 --> 0:12:33.440 feel uncomfortable, you're not going to go there. And so 0:12:33.880 --> 0:12:38.280 the system has really left people out, and you're seeing 0:12:38.320 --> 0:12:42.080 that play out in Boston and other places around the country. 0:12:43.000 --> 0:12:46.439 You know, what are the parallels then, about the situation 0:12:46.480 --> 0:12:50.079 you're seeing at Mass General Brigham in terms of what's 0:12:50.120 --> 0:12:53.080 going on at a national level with the vaccine rollout. 0:12:53.480 --> 0:12:57.359 At this point, Unfortunately, it's really hard to know exactly 0:12:57.400 --> 0:13:02.720 how the demographic divide is playing out across the US 0:13:02.760 --> 0:13:07.160 because we have only about half of states reporting demographic 0:13:07.240 --> 0:13:10.480 data at least publicly. So here at Bloomberg, we started 0:13:10.559 --> 0:13:16.240 a vaccine demographic data project and we're tracking the publicly 0:13:16.280 --> 0:13:21.440 available demographic data across states, and so far, even though 0:13:21.520 --> 0:13:25.760 the data are incomplete, you're seeing a very large divide 0:13:26.240 --> 0:13:31.200 among white people, Asian people, Black people, and Hispanic people. 0:13:31.960 --> 0:13:35.439 Most people getting vaccinated in the US are white, and 0:13:35.960 --> 0:13:40.040 we are seeing more Asian people getting vaccinated, but black 0:13:40.080 --> 0:13:43.560 and Hispanic are falling well behind. It's hard to say 0:13:44.080 --> 0:13:48.640 whether that's because of mistrust or access, and I don't 0:13:48.640 --> 0:13:52.240 think it's any one reason, but we are seeing this gap. 0:13:52.280 --> 0:13:55.400 And again, given what we know about the virus and 0:13:55.440 --> 0:13:59.920 how it's disproportionately affecting communities of color, everyone I speak 0:14:00.040 --> 0:14:03.079 he says that if we really want to end this pandemic, 0:14:03.280 --> 0:14:06.240 these are the people we need to be reaching, and so, 0:14:06.360 --> 0:14:09.280 regardless of what the reason is, if we had this gap, 0:14:09.800 --> 0:14:20.240 it'll be really hard to end the pandemic. That was 0:14:20.280 --> 0:14:23.640 Angelica Levito and that's it for our show today. For 0:14:23.720 --> 0:14:26.480 coverage of the outbreak from one and twenty bureaus around 0:14:26.480 --> 0:14:31.920 the world. Visit Bloomberg dot com, slash Coronavirus, and if 0:14:31.960 --> 0:14:34.160 you like the show, please leave us a review and 0:14:34.200 --> 0:14:38.000 a rating on Apple Podcasts or Spotify. It's the best 0:14:38.000 --> 0:14:42.400 way to help more listeners find our global reporting. The 0:14:42.440 --> 0:14:46.720 Prognosis Daily edition is produced by Topha Foreheads, Magnus Hendrickson 0:14:46.880 --> 0:14:51.280 and me Laura Carlson. Today's main story was reported by 0:14:51.320 --> 0:14:56.520 Angelica Levito. Original music by Leo Citrin. Our editors are 0:14:56.640 --> 0:15:01.120 Rick Shine and Francesca Levi. Francesco Levi is Bloomberg's out 0:15:01.120 --> 0:15:03.400 of podcasts. Thanks for listening.