WASHINGTON – President Biden has repeatedly stated that racial equity will be at the heart of his response to the coronavirus. Dr. Marcella Nunez-Smith is responsible for making this happen.
A Yale epidemiologist who grew up in the U.S. Virgin Islands, Dr. Nunez-Smith is the chair of Mr. Biden’s Coronavirus Equity Task Force, tasked with advising the president on how to allocate resources and ” reach underserved populations to fight a pandemic that has had a devastating impact on people of color. Blacks and Latinos are almost twice as likely as whites to die from Covid-19.
“Make no mistake – beating this pandemic is hard work,” Dr Nunez-Smith told reporters on Wednesday, after the White House appointed members of the task force. “And defeating this pandemic while ensuring that everyone in every community has a fair chance to stay safe or recover their health, well, that’s hard work and good work.”
Dr Nunez-Smith spoke to the New York Times about the challenges ahead. This interview is edited and condensed for clarity.
Q. You have only been in office for a few weeks. What have you learned?
A. What is great is to be facing the audience. I hear Americans everyday, every day. People write all the time with their own experiences.
What do they say?
People might write and say it’s great that you get the elderly vaccinated, but one person wrote – they were Hispanic – and said, “Culturally we keep the older members of our family at home, and it is a multigenerational household. Or: “I am an 82 year old person living in place X and I do not know how to register for my vaccine”. “
So what do you do when you receive this kind of letter?
A. We are going to set up a system to respond formally, but during this transition period, I would simply respond to them and simply say, “Thank you”. And we were trying to connect people with their local resources. And people write out of gratitude, even though I haven’t done anything for them yet.
What do they say when they write out of gratitude?
A lot of people say they are really happy that there is a commitment to fairness. This is by far the dominant message that I receive. I did not expect that.
Obviously, you can’t address racial disparities in health care overnight, so what are you aiming for, at least in the short term? And then in the long term.
We are charged with making recommendations for early intervention and then paving the way for equity in the recovery. We talk a lot about vaccines. But we cannot forget everything else. We are thinking of essential frontline workers and others who still struggle to have inadequate protection in the workplace. Access to testing is also uneven. It’s exciting to see new technologies emerge, but we also need to make sure that everyone can benefit from all scientific discoveries.
The Centers for Disease Control and Prevention recently released a report showing that they have data on race and ethnicity for only 52% of those vaccinated. Were you surprised by this?
I can’t say I was surprised. It’s a big part of my academic reality.
Is tackling the data problem the most immediate thing you can do to get the biggest impact in the shortest time?
It is fundamental for us. We cannot follow or intervene on what we cannot see. The absence of data is in itself a reflection on the choices we make. In a march for fairness, you must have data to guide that work. This is only a first principle.
What are you going to do then to improve it?
I often say, “Race and location matter a lot to health outcomes in our country.” So we think of things like postal codes, areas with socially vulnerable geographic markers, and the integration of our rural communities as well. The idea is that we can have a toolbox of different metrics that we can use and track. We’re never going to hang our hat entirely on a data point.
I am optimistic that we will get to a place where we will be able to run in a data driven manner. I am very optimistic and confident about this.
Gov. Andrew Cuomo said that in New York City, among hospital workers, the reluctance to vaccinate African Americans they see is through the roof. What are you doing about it? I know it must be on your mind.
This worries me a lot. And, you know, the governor is right about that observation, and it’s playing out across the country, both in hospitals and in long-term care facilities. We’re seeing about 38 percent participation among long-term care workers who identify as black and brown.
But there are no transport barriers, as the vaccine is given at work.
There are structural barriers. I have heard many stories that invitations to register for vaccination were sent by email, and they never even activated their email account because they were working in environmental services or they worked in dietetic services. So they didn’t even know they were invited.
Or there were others who said after the second hit you might want to take a day off or something, but maybe they didn’t have any sick days. And they didn’t want to feel bad after being vaccinated. So I think in every conversation about reluctance or confidence in vaccines, we are forced to think a little deeper.
I have family members who write to me and say they think it causes infertility.
Members of your own family?
Oh sure! On the Internet, it’s bad. The misinformation is out there and travels fast, so we’re going to be really intentional about it. At the end of the day, you need to know who people trust. My cousin did not write to me because I have a role in administration. She was just, like, you’re my cousin and you’re in health care. I’ve had a lot of these incoming texts.
How often do you see the president and what is his message to you?
We regularly inform the president, the Covid-19 response team. Its message is clear and consistent: we must lead with fairness at work. It is a clear call from the president and vice president. I appreciate how often they want to hear from us directly.
Is there a special reward for you being a black woman and working for an administration that made history by putting the first black woman in the vice president’s office?
It’s phenomenal. I am a parent. I have three young biracial children and they were thrilled when we had our first biracial president. And now to see her make history this way, it’s amazing.
So for now, are you dividing your time between Yale and Washington? What’s your plan?
This is the plan. I am honored to chair the task force and am trying to get out of this role.