A Fireside Chat on COVID & Health Equity
By Cindy Sanders
Recently, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to President Joseph Biden, sat down for a virtual fireside chat with James Hildreth, PhD, MD, one of 12 national leaders tapped for the president's new COVID-19 Health Equity Task Force and a member of the Food & Drug Administration's Vaccines and Related Biological Products Advisory Committee.
The two infectious disease leaders compared perspectives on COVID-19, with Fauci delivering his outlook on the worldwide pandemic. "I've been through a lot of infectious disease crises," he said. "I've never been through one that immobilized the world for a year."
They spoke at length about the development and distribution of vaccines, as well as addressing confidence in the vaccine among minorities. "The virus has had the largest impact on our communities of color with underlying health conditions. Without our immediate attention and a national effort to fight this virus, we will be dealing with its impact for years to come," Hildreth said.
Of ongoing concern is a distrust among many in the African American community about the safety of the vaccine. Fauci, who has been actively addressing black churches and organizations, noted this distrust is understandable based on the egregious violations of ethical principles in the past.
"The hesitancy we see in African Americans relates to something we need to deal with. It's an extraordinary, unfortunate history that African Americans were subjected to under federal programs that related to health issues," he said of the infamous Tuskegee experiment. "The horror of that and other experimentation on black populations has been handed down through generations.
"You have to respect that hesitancy. You have to acknowledge what happened was real and isn't something to be simply set aside. However, the next you do is to tell people that since that time, there have been ethical constraints and guidelines put into place that would make something like that impossible to happen today."
Once the historical fear has been addressed, Fauci said the number one reason for reluctance is a feeling that the vaccines were created too quickly, so perhaps corners were cut. He stressed the vaccine candidates have been through exhaustive reviews and are safe and effective. He pointed out the rapid development of COVID-19 vaccines merely reflects the "extraordinary advances in the science of vaccine platform technology."
Hildreth, who is dean of Meharry Medical College in Nashville, one of only four HBCU medical schools in the country, along with other prominent black physicians and community leaders, have helped address many of those fears by publicly receiving vaccines. Speaking honestly and clearly about where the science has led public health practice is a key factor, as well.
Hildreth pointed to a recent award Fauci received from Israel for speaking truth to power while serving on the coronavirus task force during the Trump administration. Fauci said the fact that there was any type of discussion or disagreement over items that should have been purely in the public health realm - masks, congregate settings - was discouraging. He was astounded by reports of overwhelmed ICUs filled with COVID patients who claimed the pandemic was a hoax.
"One lesson to be learned from the past year is to recognize how the politicization of the CDC and FDA affects public health," Fauci said. "Counterproductive is a mild word. We must remain acutely aware that it can happen. Some organizations should be completely free of political influence.
"I believe the Biden administration's move to rejoin the World Health Organization is a significant step forward. Obviously, we have to take care of our own country, but we live in a global community. Even if the pandemic is brought under control in the United States, a failure to help the rest of the world means we will continually be threatened by mutant strains from overseas."
The virtual health summit was the first in a three-part series. The goal is to open a dialogue with stakeholders and health experts nationally to develop a community-centered approach that prioritizes prevention of disease and eliminates COVID-19 healthcare disparities among minority groups.
"These conversations have never been more important," Hildreth said. "COVID-19 has only illuminated the health disparities gulf that exists between majority and minority communities across our country, particularly in rural communities. Over the last year, we have further focused our efforts on addressing these disparities, and this summit will provide our community with the opportunity to engage around how best to make lasting changes that will impact the lives of all people."