I’m on the faculty at a research center in Boston that, among other things, examines the costs and benefits of different strategies to improve health. Tests, treatments, vaccines, you name it — even social distancing and other public health interventions.
We held a meeting this week (virtually, of course) to discuss the killing of George Floyd and how we as a group might offer a useful response. There were somewhat predictable conversations about trying to be more inclusive and diverse in our hiring practices. This sounds nice in the abstract but is much more difficult in practice; the numbers of health economists and health services researchers of color are infinitesimal, for all the reasons you might imagine — systemic and institutional effects on educational opportunities, differences in consideration of grant applications, lack of mentorship and support.
A few of us took a different tack on the Zoom call. We know that black and brown patients fare poorly relative to their white peers in the U.S. health system, and the COVID-19 pandemic is no exception.
Black Americans are more likely to be infected with the virus and over twice as likely to die from it.
Why not take all of our modeling expertise and make a business case for prioritizing an eventual vaccine to be given to people of color and other vulnerable communities first?
Gov. Baker has been appropriately letting available data and evidence guide policy around our flattening of the curve. In fact, state guidelines have already been put in place regarding ICU and ventilator care (although not without controversy), so why not add a prioritization model for vaccines to the mix? The call ended, but I continued to ruminate on this possibility. Then it all became clear.
We don’t need a damn model.
Just do it, Gov. Baker. Just come out and say that, when a vaccine becomes available, communities of color will be at the head of the line. They get it before anyone else. Yes, there certainly are other vulnerable populations — frontline health workers, the elderly, as the administration recently mentioned in their planned rollout strategy — but their vulnerability is to some extent chosen or the product of survival to a given point. They didn’t have factors that make one especially susceptible to an infectious and lethal disease, like crowded housing conditions and lack of access to healthy food or preventive healthcare services, foisted on them as communities of color have.
Some clinical experts will scoff at this idea, I’m sure. They may say that those who stand to gain the most from a vaccine should be first in line, that individuals who are too sick may not be able to muster enough of an immune response.
No. The prevalence of a complex cluster of diseases, the sickest of the sick, is higher in communities of color. And in oh so many ways, we as a community, as a state, as a nation — caused that prevalence to be higher. And maybe in one small way, we can make one part of this mess a bit better.
You don’t need a model, Gov. Baker. You don’t need a fancy set of analyses or a scoring system. White people like me can wait in line for a change. You need to do the right thing.
Dan Ollendorf
Lexington
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June 21, 2020 at 12:07PM
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Who is first in line for a coronavirus vaccine? Do the right thing, Gov. Baker - Lowell Sun
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