S04 E07: Unmasking Reopening

Episode Transcript

Vanessa: Welcome to “Pod for the Cause,” the official podcast of the Leadership Conference on Civil and Human Rights and the Leadership Conference Education Fund, where we expand the conversation on the critical, civil and human rights issues of our day. I’m your host, Vanessa Gonzalez, coming to you from a sunny and beautiful Washington, D.C. And like we set off every show, we’ve got the Pod Squad, where we discuss pop culture, social justice and everything in between. We have got some amazing folks on the Pod Squad today, Sherod Haynes, MD, PhD candidate at Emory University. Hey, Sherod.

Sherod: Hey, how’s it going?

Vanessa:Hangin’ in the there. And also, we have Melvin Wilson, senior policy advisor for social justice and human rights at the National Association of Social Workers. Hi, Melvin.

Melvin: Hey, Vanessa, how you doing?

Vanessa:Good. Social worker’s one of my favorites.

Melvin: All right.

Vanessa:On this episode of “Pod for the Cause,” we want to reimagine our society, instead of returning to the status quo, to create a reopening strategy that takes account of the effect this year has had on all of our mental and physical health. The pandemic’s devastating effect on black, brown and low income communities is an indictment of our failure to rid American institutions of long-standing institutional racism and systemic inequality. Students who are low income, black, brown, Asian-American, Native-American, or have a disability who have faced educational inequities for decades, will be left even further behind when schools reopen, unless there is an aggressive and focused action to ensure educational opportunity for children and support their families.

Working people should not have to choose between their health and safety and their livelihood. Everyone in America needs the relief that our government must provide in times of crisis, but everyone’s needs are not the same. Wealthy people and corporations are better situated to ride out the pandemic. The average working person, student, healthcare worker, first responder and small businesses, particularly minority and women-owned businesses in America is not, remember, normal wasn’t always good for everyone.

Before we jump in, I want to set the stage with some quick stats. The numbers of people with moderate to severe symptoms of depression and anxiety has continued to increase throughout 2020 and remains higher than rates prior to COVID-19. Nine point seven percent of youth in the U.S. have severe major depression, compared to 9.2% last year. That rate is even higher among youth who identify as more than one race at 12.4%. While rates of anxiety, depression and suicidal ideation are increasing for people of all races and ethnicities, Black or African-American communities have had the highest average percent change over time for anxiety and depression, while Native-American or American-Indian communities have had the highest average percent change over time for suicidal ideation. People who identify as Asian or Pacific-Islander are searching for mental health resources more in 2020 than ever before.

Black communities have also experienced some of the worst losses since the onset of the virus. As of July 22, 2020, the Centers for Disease Control reported that nearly a quarter of COVID-19 deaths have been black, despite the black population making up only 13% of the United State’s population. LGBTQ+ people of color are 44% more likely and transgender people are 125% more likely than the general population to have had a reduction in work hours since some states initiated reopening policies. So, now that you have the stats, let’s get into it.

I want to start off by talking about vaccine equity. We are already dealing with inequities of vaccine distribution and access, in part because of the historical inequities we have discussed in about every episode here. And let’s be clear. It is not hesitancy, it’s caution. Black and brown bodies have been abused by the medical community for generations, and so there is an understandable pause. But overall, we still find that a majority of people of color, while taking that caution, are still planning to get the vaccine when available to them.

I want to turn it over to Sherod. Can you talk to us a little bit about how can we ensure that the vaccine does not create yet another social dichotomy where it’s providing more advantage to the populations who already have more access and higher levels of disadvantage in judgment really on the most vulnerable populations. How are we gonna stop that or break that cycle?

Sherod: That’s a very good question and that’s one that us and the science and the public health realms spend a lot of time thinking about. What we do know is that, and a little bit about my background, I’m a neuroscientist who studies essentially the neurobiology of emotion. And so, when we’re talking about this vaccine conversation, it’s very important that we ground ourselves in the fact that this is not only just a scientific discussion, but this is one that’s rooted in emotions. And so, fear being a prominent one.

I love how you frame that, Vanessa, the discussion of vaccine hesitancy versus vaccine caution. And so, as we root ourselves in this conversation, it’s important to recognize that fear is essential emotion and it’s the central premise beyond which people are actually making their decisions. And so, yes, we can throw statistics. We have amazing vaccine options, unprecedented levels of efficacy from first shot out the box, particularly with the mRNA vaccines. But, we know that that’s not enough. We can talk stats all day until we’re blue in the face, but essentially, what people are looking for is to be met in the space of fear where they are.

And it’s important to note that these fears, they far outstretch our lived experience. We know from a biological perspective that a lot of this anxiety that we have, particularly black and brown communities, this is something that’s passed down to us, not only just in folklore and stories and experiences that we’ve endured vicariously through our loved ones, but also in our genetic material through the epigenome. And so, we have a true visceral response at the thought of getting a vaccine. And so, in terms of ways in which that we can talk about it, it can be first acknowledging where someone is in their fear, and I think a lot of times because from the start of the entire pandemic, things have been politicized that everyone sort of has their boiler plate talking points.

And so, one of the first things I would recommend is to leave that aside. This is a human in front of you. This is a human who has goals and aspirations for their future. And I think a lot of times, we are not also rooted in grief. All of us have lost something over this past year, and that I think we’re not having enough discussions about that concept, that we’re all in a position that none of us thought in a million years we’d be in, where we’re being forced to take either a red or blue pill, and I understand that a lot of people, particularly black and brown communities, they hope to do what’s called a shielding effect, or benefit from a shielding effect which is essentially allow those who are more willing to take the vaccine, while others benefit from the herd immunity. So, that’s called immune shielding, whereas I don’t have to really take the risk of getting vaccinated, but I get the benefits of the virus rates driving down in my community because of others who’ve been vaccinated.

Vanessa:That’s really fascinating. I wanna make sure that we are grounded in something what you said and make sure people understand, they have permission to feel fear and grief. That is expected. That is what you should be feeling. And the idea that you’re gonna have to reintegrate into a world and you don’t know who’s vaccinated, you don’t know somebody’s situation, you don’t know if someone lost someone and you have to deal with all these incoming changes. It’s understandable that people would also have heightened anxiety. One of the things I really wanna get to, I wanna make sure that we don’t lose that historical tie. You know, let’s be honest. We know that the medical community for, again, generations, experimented without permission on black and brown bodies. Horrific experiments. And we even know of the study just a few years ago, where it was found physicians didn’t think that black bodies felt the same amount of pain. I mean, so when we are telling people who are leading this industry, people who are leading these campaigns, “Hey, there is a difference when you’re talking to black and brown folks about this,” it’s not because we’re trying to shield and make it seem like we don’t understand, right? There are very valid reasons for people to have caution, and to ignore those will continue to perpetuate this fear and this mistrust.

I mean, in the Latino community, we still can’t get translators, you know, for basic visits, and that is just a core best practice. And so, now, we’re asking people to show up for something that they’re already terrified of doing. Can you talk a little bit more about how we’re seeing that historical perspective, because again, you know, we saw it during the AIDS crisis and we saw how that rollout was extremely detrimental to black communities and transgender communities in particular. So, how are we seeing that repeating again or, I’m just throwing all these big questions at you because you’re gonna get your PhD, so how are we seeing that play out again, what can we do right now, like, what can we tell the people leading these campaigns to stop doing so that we don’t have repeated history?

Sherod: Great questions again. I’ll answer them actually in reverse order. So, the first thing I’d say to that is that the messenger is just as important as the message. And I think that in order to tackle that, that’s gonna lead to maybe for another time, a broader discussion on what does our workforce look like. How many black and brown individuals are in a position, you know, that I’m grateful to be in, where I have these degrees and have this advanced training to be able to have validity behind what I’m saying. And so, first thing we should think about is who are we sending forward to present the message and are there biases within their training that they may not have addressed fully before they go before the public to spread information.

Because what we do know is that as there has been a history of distrust and mistrust, what we don’t talk about is that, for example, in the Tuskegee Experiment, those were also black and brown nurses that were administering syphilis. And so, there is also this idea that’s very much still in the zeitgeist, particularly in the black community, that it’s called my color, but not my kind. So, it’s the idea that, yes, we know with COINTELPRO, so many other examples that individuals and entities will use the identity politics, the nature of you know what? They will listen to you because you guys have a perceived shared history, to then advance agendas that are very harmful to black people. And so, it’s very important that I’m not going to go before a person, say, “You know, yes, I have this MD and this PhD training and da, da, da, da, da,” listing all these degrees. That’s not the important in the landscape of, as you said, fear and grief. It’s no, “I’m from the south side of Chicago. I’m human. I have the same fears. I got vaccinated for example, but I was scared all the way up until the needle was in my arm.” So, sharing from that very humanistic perspective is going to be what advances the message and allows the message and messenger to align and gain rapport.

And as far as your second question about the stigma, absolutely. We see that happening now because what we do know is that, again, I just have to go back to the idea, this is not vaccine hesitancy that we’re seeing, because there was a latest Pew study that show by and largely, black and brown people, 70% to almost 80% said that they will get the vaccine literally within six months of it being available. Only a small percentage said, “Absolutely not.” And so, what we know, and this is stats I can speak on from New York City, only about 7%, these are those that reached the criteria at that time, only 7% actually got the vaccines despite wanting it. And these are in black, brown, Asian, Latinx, indigenous communities across the board. And so, what we’re seeing now in New York City, they have released what’s called Excelsior Card, which essentially, you can upload a negative test result, you can upload your vaccine certified card, and then that will gain you access if private vendors decide to use it, which they’re being heavily incentivized to use it, to gain interest into bars, into different venues. And so, we’re starting to see a segregation and because of the racial breakdown on who is getting vaccinated, this is already creating a social separation.

Vanessa: Wow.

Sherod: Not to mention along with that is going to be a stigma, because we’ve seen since the beginning of this pandemic, the narrative is that, if you have had hesitancy, if you don’t wanna get vaccinated, you are a threat to society. And it may not be said as directly as that, but implicitly, some people are ashamed to state their fears at this point. And the idea is that with public health and behavioral public health specifically, there’s a thin line between encouraging people to do things, and sometimes within that toolkit is aspects of fear, and it can be quite successful just in the short-term period. However, that is not a long-term strategy. It is not one that’s going to be helpful for many disenfranchised groups.

And so, I do think what will need to be done is to call attention what’s happening, call attention to there is grace and compassion there for people who are not yet ready. I think we like to binarize, either this person doesn’t want the vaccine or they do want it, and there is a hefty middle ground where individuals are just saying, “Simply not right now.” And we’re seeing, you know, things are happening with the Johnson & Johnson vaccine, where there was this temporary pause, which it has now been resumed, but these are moments in time where those who are in that middle ground say, “See. This is why I didn’t want to. I wanted to see what happens.” And so, as we undergo this process of continuing to get vaccinated and if there are hiccups in the road, it’s to continue to remember those in that middle ground, and to know that it’s a very highly dynamic process. So, a no today has no bearing on a yes tomorrow.

Vanessa: Mm-hmm. Everyone in America needs the relief, right? We know that. But, not everyone’s needs are the same, as we say to the average working person, especially someone with shift work, who has really had to juggle, students, healthcare workers, parents, they are facing a very different crisis apart from each other, from other folks who might have the luxury to work from home, still have childcare, right? So, Mel, you know, we talked about the stigma when it comes to mental health. We’ve talked about the importance of speaking out. But, the false sense of security that social media might give us that people are posting. So, can you tell us a little bit about what you are seeing, what you expect to see get worse? How can we start kind of shielding ourselves and getting ourselves ready?

Melvin: What I’m seeing, Vanessa, is that there is a kind of binary, a two-crisis situation. Obviously, the virus itself, and the pandemic and the physical parts of it, but also and equally important, is the economic impact, specifically the population that you talk about. That we talk about major depression level job losses earlier in the pandemic and still going on, that’s a total disruption economically in families. And you don’t have it happen to you unless you experience a high degree of anxiety and depression.

And one the examples that we look at, and when I say, we, at NASW and some of the things we write, is around the whole issue for instance, of housing. And that, throughout this crisis, there’s been an eviction crisis that has happened, because of the economic impact. And that’s literal. So, eviction obviously leads to being thrown out of your home, but then it leads to homelessness. Now, you have another disruption. So, there’s going to be significant depression and if it isn’t discussed, if the individual who’s going through the experience doesn’t feel the power to talk to someone professional about it, or even reaching out to other family members and other community members just to talk about the fact what they’re feeling.

And your point about folks not wanting to do that and looking at from a cultural standpoint, from black and Hispanic standpoint, there’s a tendency to not really embrace notions of mental illness, or see it as something that, “Well, you can get over that.” I think that the vaccine is going to be successful. It’s going to be successful. But, the economic impact is generational potentially. And so, that’s something that me being from a provider community, from social workers, we need to recognize that there are going to be generations that will see from a mental health standpoint, and also from a job welfare support. This is something that should not be taken lightly. Professionals, everyone should pay maximum attention to what that emotional impact and that is a long-term impact.

Vanessa: I think you’re right that we haven’t really dived in yet, into the generational impact of what this has done. I think that some of us, myself included, I find myself falling into this idea that when the outside opens, we’re gonna be okay. That is from a point of privilege, I will wholly admit. I was not always at a point of privilege in my life, believe me. And so, every now and then, I take a step back and I think, “Man, those days that I was living, you know, in Section 8 housing, where you couldn’t even nail anything to the walls because everything was bricks.” You had to get real creative to make your house cute. You know, if I had gotten sick, if I’d lost my job, even in Section 8 with my certificate, I would have been out. We’re gonna have millions of people like that in that situation, and I think that when we think about mental health in this country, we still think of it as a luxury, right? I think because you see on TV, people get to stay on the couch, they get to have this nice conversation. What are some strategies that you would recommend or free resources, in particular for black and brown folks, that you could recommend to really take mental stock and take care of themselves, even in what seems like the hardest parts of their life right now?

Melvin: I think the first step is public health step of educating and letting folks know, through public service announcements and everything, that not only the potential, even almost the likelihood that you are gonna go through some experience of at least depression and anxiety, and that something that you don’t take lightly. So, that public health outreach is really critical. Then, the resources in communities, that’s not barren. You know, some communities are resource-rich in terms of community mental health centers, being able to get into systems, and some resources in rural areas may not have access.

One of the things again, I bring up social workers in rural areas, there’s not necessarily [inaudible 00:20:05] a social worker available who may be able to do it. So, even it’s a manpower issue. So, this brings together that whole notion, it’s the individual, of course, that has to at least get to a point where they recognize that they need to address some feelings that may be hampering their progression. But, it certainly is the society, the community and the government working together around resources. It’s the professionals, folks that certainly are going to be available, churches, all these support systems need to be able to talk very freely. We’re not being condescending about what they’re feeling. It’s not something that you are lacking. It’s an experience that you’re going through and that it is transitory. It’s not going to be forever and ever and ever, but you need to deal with it right now. But that, to me, is a big public health plan that needs to be in place. I think we all need to be together on that.

Vanessa:That’s fantastic. I would love to see something coming together as a larger public health campaign. We still kind of silo it out, and that’s not gonna be as helpful or impactful as it could be. I wanna talk to both of you as we’re trying to provide real, clear examples of what folks could do. So, Sherod, as people are prepping to go back to work, some of this stuff is, like Mel spoke about, is in their control, talk to your friends, talk to family, talk to folks who get you, and if you can afford it, talk to some professionals, if your insurance covers it, great. But, on the other end, some of the stuff we can’t control is what our employers do and how they set up our offices and how they do that. So, for those people who are the bosses out there that might be listening, what are some things that folks who have this power should take into account on reopening?

Sherod: I think the biggest thing in terms of reopening, really two major principles. The way that the virus that causes COVID-19 spreads is really in close spaces, spaces where there is high density and unventilated spaces. And normally, that goes hand-in-hand. The other thing that we’re starting to appreciate more, and it may be intuitive, but now more data are coming out to suggest that the “6-feet social distance,” I’m putting in air quotes, does not confer anything really about safety. And in fact, an MIT study just came out this week that showed that if we were to ascribe a distance to when a person would be safe, it would be something more on the order of 60 feet. And it’s because the virus, which we now know and CDC has come forward with very clear messaging on this, that by and largely, most of the spread is through aerosol or airborne. So, it’s gonna be in air particles that can stay and last in the air for a long time, depending on relative humidity and as I said, the ventilation system.

And also, at the same time I should mention there is a deemphasis on contact transmission, meaning surfaces, by and largely the data suggests that occurrences where a person has gotten COVID, let’s say from a door knob or something like that, are just infinitesimally low. And so, soap and water in terms of personal hygiene seems to be a good thing, so I would absolutely stock the office space with plenty of that, making sure that all of that from a hygiene perspective, of course, is done.

But, in terms of the way individuals are positioned, I’ve seen a lot of designs where there are glass partitions and plastic partitions. As I said, because of the airborne nature of the way that the virus is spread, it’s not that that would be necessarily effective. And so, what I would emphasize more is a heavy investment on air filtration. And I think you can always do a great deal in the way of preventing transmission by way of testing. We now know that the FDA has authorized a number of tests, which can be, I’ve actually seen some at the local Walgreens. And there’s two tests for $7.99 at the one that I saw, encouraging testing, particularly for those who are not yet ready to be vaccinated. And then, of course, staggering schedules, and it never hurts to decrease the density. But, I think people should know that any kind of prolonged indoor contact, even with masks, there is a risk there.

Vanessa: I wanna get to that point, you mentioned cleaning, the hand-washing. Can we just take a moment and not to make fun of this, but I think when this all started, I remember seeing on social media, of course, a bunch of jokes about how people were so upset they had to wash their hands so much. And folks like me, I was like, “Were you not doing this before? You should be doing this at all times, global pandemic or not.” And so, you know, hope that’s something we stick with, Clorox everywhere.

Sherod: Absolutely.

Vanessa: Let’s keep it all nice and clean for other reasons. Thanks so much for that, Sherod. Mel, when we talk about the physical space, that’s one thing and I think Sherod is right. We know that a lot of companies are trying to think about staggered schedules or shifting desks around. What are some things that folks who are bosses really need to be taking into consideration when it comes to mental health?

Melvin: That’s something that’s really, really important. Again, it’s over a year now. Most of us have not been working directly in our offices, so there’s a retransition back into the office, and that is going to be adjustments to being back in the office. There are going to be folks who are part of your staff that may have had death in the family. They have themselves been sick from COVID or struggled just to maintain day-to-day. So, there has to be that flexibility and accommodation. And if you were the boss, you have supervisors, there’s gotta be training that has to happen and preparation for that reentry of folks coming in.

The other thing I think is going to happen, this is societal, is how much of this will change from where it is now, meaning that will everybody come back and work in the office, or is it going to be continue much more of a work from home kind of distant theme? We still learned something that, you know, Zoom’s kind of worked in the circumstances. I know on our, at NASW, that’s being considered, you know, it’s optional when you choose to come back. When it opens up, folks will have the ability to come back. But, if someone says, “Well, I really want to continue to work from home,” there’s gonna be some flexibility, my understanding is, around allowing that to happen. So, building in that flexibility. So, the bosses have to be really informed. They have to make sure that they are informed and not doing kinda knee-jerk decision-making, because we, as Americans, have gone through something that just came out of the blue.

Vanessa:Yeah, I appreciate you framing that as both the individual and the social, right? We are all a community, even if you don’t like everybody, you’re still community, we’re in this together. And so, I appreciate that there has to be awareness of both of those tensions and what that can look like. I wanna just also make sure that people understand, when we’re having this conversation, it’s not only to say, you know, “Here’s what people should be doing. Here’s XYZ.” We’re not trying to do that. But, we do wanna make sure that people understand that you need to look for valid and reliable resources when it comes to your vaccine information, so you can make the choice that is right for you. If you have the option to return to work, again, make sure that you’re looking at valid and reliable resources about what that can look like, what that means. Ask all those questions. And whether it’s the CDC, state health departments, or the Leadership Conference on Civil and Human Rights, because we are actually partners in the Made to Save campaign, which also aims to provide accurate information so that people can make their own decisions. So, check that website out at Made to Save as well as Leadership Conference or National Association of Social Workers website for additional information, as well as resources that you can find for your mental health, whether it’s taking that walk outside every day, whether it’s making sure that, once the kids are in bed, if you just need that 10 minutes alone. I know locking yourself in the bathroom sometimes doesn’t even work. If you have toddlers, they’re still going to find you.

Sherod: Thank you.

Vanessa: But, I you can find those 10 minutes of the day to restore yourself, please try your best to do it. So, I wanna say thank you again to our fantastic experts and our panelists for today. Again, thank you so much to Sherod Haynes, MD, PhD candidate at Emory University, can’t wait to call you Doctor. And to the amazing Melvin Wilson, again, senior policy advisor, social justice and human rights at the National Association of Social Workers, which I have a very soft spot for as an MSW myself. Miss that work in the field every day, but so grateful for the experience that I had. Thank you again to both of our panelists and thank you to everybody for joining us for “Pod for the Cause.”

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Thank you to listening to “Pod for the Cause,” the official podcast of the Leadership Conference on Civil and Human Rights and the Leadership Conference Education Fund. For more information, please visit civilrights.org and to connect with us, hit us up on Instagram and Twitter @PodForTheCause. You can also text us. Text civil rights, that’s two words, civil rights to 40649 to keep up with our latest updates. Be sure to subscribe to our show on your favorite podcast app and leave a five-star review. Until next time, I’m Vanessa Gonzalez. Thanks for listening to “Pod for the Cause.”

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