If you’ve watched the White House briefings about COVID-19, a Black woman physician—Dr. Marcella Nunez-Smith— is sharing insight alongside Dr. Anthony Fauci and fellow national experts.
Nunez-Smith is Senior Advisor to the White House COVID-19 Response Team and serves as Chair of the Presidential COVID-19 Health Equity Task Force. She’s also an Associate Dean, Professor, and Director of the Equity Research and Innovation Center at Yale University.
ESSENCE spoke recently with Dr. Nunez-Smith about what Black communities should know right now about COVID-19, vaccines, the new Delta variant, the rise in cases among younger populations. and more.
This interview has been edited slightly for length and clarity.
ESSENCE: Where do things stand right now in terms of COVID-19 in the U.S.?
DR. NUNEZ-SMITH: So we have, unfortunately, passed the 600,000 mark of lives lost. And it is just staggering. But with the loss and grief, there’s really hopeful news in terms of where we are in terms of the sharp decline in deaths. I think that’s so important to lift up. Initially, the worst outcomes were among the most medically vulnerable, our older family members, those 65 and older. And now, across the country, around 87% of everyone 65 and older has gotten at least one shot, on their way to being fully vaccinated. It’s tremendous.
That’s a large part of why we see the downturn in deaths among the most medically vulnerable. And when we look at Black and brown communities, the death decline is thankfully the same. We’re looking at 80% drops in death.
ESSENCE: That’s considered a sizable decline, correct?
MNS: That’s a huge, huge drop. So that’s incredibly important. But, of course, there’s more work to do. We know that right now we have to focus a lot on connecting with our young people. President Biden set that very ambitious, aspirational goal to see 70% [vaccinated] by the 4th of July. We already are there for 70% of those who are 30 years old and older. So that’s great. But the truth of the story is 18 to 26, really, that [age group] we just have to double down or recommit on connecting with. Now, I’m a practicing internal medicine physician. You know who’s coming into our hospitals now? People who are unvaccinated and younger people.
ESSENCE: Wow. What explains this?
MNS: Yes, it’s hard. And so many of the [young] people come in and they say, `I didn’t think I could get it. I thought it was a disease for older people.’ So there’s still misinformation and disinformation that’s out there. And, the risk is real.
ESSENCE: There’ve been lots of reports about what’s called the Delta variant. Please shed light on that.
MNS: Right now, this Delta variant is of concern. I’m sure you heard Dr. Fauci say this is a threat to the progress that we’ve made and are making with COVID-19. We look across to the U.K., and we see that it’s become the dominant strain there. It’s going to be the dominant strain here. It is on track to become the dominant strain across the globe, quite frankly.
ESSENCE: For the purposes of lay persons, what does a variant mean?
MNS: Of course. It’s a virus’ job to mutate to become better, right? Its agenda is that. So this is very common. It’s what viruses do. They mutate, they change. And so oftentimes when they have their original form of a virus, we call it wild type, and then anything that has mutations after that, we say it’s a variant. It’s like a different version of the virus. Now, some of these different versions are not really important. They don’t really change the consequence, right? But others we say are of clinical significance or concern. And with Delta, what we’re particularly following is that it’s more transmissible, way more transmissible, than that wild type, way more transmissible than, you know, Alpha, which was first sequenced in the U.K. So that in and of itself is concerning because the more people who’ve been infected, of course, the more people we’ll see end up with serious illness. And so that is concerning. Also there’s evidence it has the potential to cause more serious illness in the wild type and some of the other variants.
ESSENCE: I want to make sure we’re clear on that definition of wild type.
MNS: So, wild type is essentially just like the original version, like, the original blueprint. And so when [scientists and physicians] first started talking back in December of 2019, when it was on the national radar that there was what appeared to be a new virus in Wuhan [China] province, that was the wild type. And since then, that wild type has mutated. And every time, every single time a virus spreads, that’s when it gets a chance to mutate. So, you know, there’s just a litany of reasons why we want people to be really careful and cautious – of course, vaccination being a tremendous tool in our tool box to help get people through this.
ESSENCE: Why are vaccines important in your medical opinion?
MNS: Getting vaccinated reduces the likelihood of there being new mutations, reduces the likelihood of people spreading the variants that we do see and, of course, for individuals helps protect them against serious illness, hospitalization and death. It keeps our communities safe and protects those people who can’t get vaccinated for medical reasons. And something I want to make sure is on the reader’s radar is long COVID.
ESSENCE: Yes, I’ve been reading about these cases.
MNS: I think we have to talk about that more because we really have untold numbers. I mean, the estimates are millions of people who are just dealing after infection – and after infection that could have been mild, right? – or even asymptomatic – and deal with these lingering and often debilitating effects. I mean, this is very serious. When we think about the reality that folks in Black and brown communities got COVID at higher rates, we know that the risks then for long COVID in our communities is going to be high. And so I think this is another important part of our conversation, that avoiding long COVID is yet another reason to get vaccinated.
ESSENCE: For some Black Americans, there have been questions raised about the vaccine, due to well-documented historic medical abuse and trauma. That may be coupled with lack of availability or many other reasons.
MNS: You know, there’s so much bad information. There are bad actors targeting our communities with lies about the vaccines. You know, the vaccines work. They are effective in real-world settings. Hundreds of millions of doses safely given in this country. And when we talk about the Delta [variant] we know that the vaccines confer a high degree of protection for Delta, particularly the mRNA vaccines Pfizer and Moderna. And we’re still watching and following and collecting data certainly on Johnson and Johnson.
We’re gathering more data, we’re tracking everything. Should anything change, the Administration will come up with guidance on that. But really, you know, it still remains that vaccination is the best way to protect oneself and one’s family and one community from all the various versions of coronavirus that causes COVID.
ESSENCE: Are Black women largely getting the vaccine or not? What about Black men?
MNS: You know, this is a longer conversation about the kind of work and commitment we need to make as a country to have accurate data to answer those questions. And particularly when you get down to things like Black women and Black men and vaccination uptake. And the truth is a lot of the data systems can’t accurately answer those questions. But what we know is there’s more work to do. We got to meet people where they are every time. You know, the President announced Shots at the Shop, which is about engaging and working with Black-owned barbershops. We want to give information, accurate information, and [share] ways to access the vaccine. We’ve been working from the beginning with lots of coalitions of state leaders, community-based organizations and others. Just understanding a lot of the places other people might go might not be trustworthy for us and thinking about that really critically. But listen, we know, our communities are being devastated. I mean, we’re dealing with the economic consequences, the mental health consequences. Our kids are out of school and [facing] educational losses. The choice before us all is the vaccine or the virus. And, you know, you should not take a gamble with the virus.
ESSENCE: What is the official word at this point with regards to whether one should wear a mask?
MNS: You know, the Centers for Disease Control (CDC) came out earlier and said the evidence really suggests that people who are fully vaccinated are well-protected and don’t need to wear a mask. The CDC hasn’t changed that, and it remains true. What is also true, and the CDC has said, the World Health Organization (WHO) has also said, is that COVID is local – this is a local condition. It’s about your community’s level of virus burden and also their vaccination. And so it’s really always going to be up to local, state leaders to understand what the dynamics are happening in their communities and give guidance, mask requirements, mandates, recommendations. That always happens at the local level. Like the President has said, let us show each other grace in this moment. If people feel more comfortable wearing masks, by all means. I have children who are too young to be vaccinated. So, we often just mask as a family. It really ends up being up to the individual who’s been vaccinated; they have choice. The most important thing is if you’ve been unvaccinated, you need to mask. And it’s to protect people.
ESSENCE: Let’s share final thoughts from one of your recent press White House conferences.
MNS: So when we consider the data that we have on race and ethnicity — and, of course, we have to acknowledge there are still notable data gaps and some caveats remain — the majority of individuals receiving vaccines over the past [few] weeks identified as people of color. Twelve percent of individuals getting their first shot these past two weeks have identified as Black. That’s roughly equivalent in terms of the group’s representation in the general U.S. population.
Latinos make up 17 percent of the total U.S. population, and over these past two weeks have accounted for 34 percent of individuals getting their first shot. So, we do see progress, and particularly so when we look at the federal vaccination channels, and those were set up in the very first few weeks of the Administration. You know, at our community health centers, more than 75 percent of people vaccinated at those locations are people of color. Nearly two-thirds of those vaccinated at dialysis centers are people of color. Over the past two weeks, 58 percent of doses administered at pharmacies have been to people of color. Over 50 percent of vaccines administered at the federally run vaccination centers went to people of color.
Despite this progress, we still have more work to do. And as the President has said…this summer, the work — it’s going to be hyperlocal, person by person to help folks get vaccinated. Each one of us is worth the effort. Every vaccination is a victory.
So we will continue to make vaccination easy and convenient. We’re going to continue to address structural barriers, both to accessing accurate information, as well as accessing vaccination resources, meeting people where they are, especially younger folks. So you’ll see more mobile units in neighborhoods across the country and at summer gatherings. We’ll continue to work with employers on paid time off, and to provide on-site vaccination opportunities. And, of course, we’ll continue to lift up best and promising practices, finding innovative ways to bring vaccinations to people.
And we’re pleased to announce that four of the nation’s largest childcare providers — that’s Bright Horizons, KinderCare, Learning Care Group, and the YMCA — have agreed to continue providing free drop-in childcare for parents and caregivers getting vaccinated through Labor Day, which is September 6th — extended from their initial commitment (July 4).
We’re going to keep partnering with community faith-based organizations all across the country. Those partners are trusted and trustworthy. Whether that’s a house of worship, a barber shop, a medical practice, or a local community center, working together to build vaccine confidence and increase access. Importantly, we have to continue to get the message out to remind everyone vaccination is free; government-issued ID is not required; proof of insurance is not required; and we will always, always commit to maintaining data privacy. And last but certainly not least, we’ll continue to strengthen the data environment to inform equity interventions and commit to prioritizing long-term health equity policies. So, communities are the experts in what they need, all the time. So partnership and collaboration — that’s how we’ll get through this together.