- [Announcer] Funding for this program was made possible by the POISE Foundation, The Pittsburgh Foundation, Hillman Family Foundations, and Giant Eagle, produced in collaboration with the Black Equity Coalition.

Thank you.

(gentle pensive music) - We were at the forefront of diagnosing COVID-19 here in Allegheny County.

- It is important for everyone to remember that this is really a very rapidly changing situation.

- It's gonna be decades before we understand and are able to really make sense of what we are going through now.

- They equate what we're experiencing now or have experienced to the 1918 Spanish Flu.

- We are making, and made, some of the same mistakes in 2020, '21, 2022, as we made in 1918.

- [Rachel] 33 Pennsylvanians who have tested positive for COVID-19.

- Failure to adopt rapid guidelines in terms of closings.

We were slow to adopt mass testing.

- We need to get to the root of the problem as to why there is a disparate condition in Black and Brown people and people of lower socioeconomic in terms of their overall healthcare.

- The last, I would say, two years or three years in which we have been experiencing a global pandemic has been tremendous and immense.

- We know that COVID-19 has disrupted all of our lives.

- The pandemic created a flashpoint on the inadequacies of healthcare.

- There was a reluctance on the part of significant percentage of our population to accept vaccination.

- It would be shallow of us as the healthcare providers of the country to just say the pandemic is over.

Let's go back to normal.

(dramatic music) - March 16th, 2020, I was just in my office, and two of our patients called me saying they were having these symptoms of respiratory problems.

(soft dramatic music) They were actually the first two positive patients in the county.

They were African American.

They were in their mid-50s.

There was reports of people dying, people getting seriously sick.

At that point, there was no real readily known treatment.

So we had them evaluated at the emergency room.

We had chest X-rays done, and we treated them at home with supportive care.

And fortunately they both got through it just fine.

- You know, you're scared.

You don't wanna die, you know?

♪ Great, great, great, great ♪ - We lost three people to COVID, and one of them was a lead band director.

Great are you, Lord.

The last text I got from the young man that passed away, and he was a young man, and he did not have underlying health conditions.

Let me say that.

His last text to me was, "This is no joke.

Tell the people."

- One person I did the test on Thursday was a elderly couple in Homewood.

He was a retired pastor.

He came in Thursday.

We tested him, turned out positive.

And Saturday morning, the wife called me, saying he was having trouble breathing.

And we got him in the hospital and into the ICU at Shadyside, and, unfortunately, he passed.

He died by Sunday evening.

- And I've known people personally who've lost moms and dads and aunts and uncles, and, you know, any type of loss hurts.

So just imagine that if you're just losing someone to a basic illness, but then this illness is suffering.

- This isn't the flu, and half a million people don't die of the flu every year.

In my family, we've already lost three.

So, you know, these people that say it's not real, and they're dying of something else, no they're not.

No they're not.

They're dying of COVID.

- The vaccine that was developed, the actual science behind it and the approach to the development of vaccines for COVID have been in development for decades and so, the science and what we knew from that work was only being adjusted and implemented for our current context and pandemic.

(pensive music) - I think that the reason why people have a lot of distrust over this vaccine is just the speed at which it has become available.

And if I have to admit the truth, I also was a little bit skeptical from the beginning because in our minds, we think of vaccines taking anywhere from 18 months to a year to be developed.

All they really did when this new virus came through was lay that new information on developed technology.

And so that's why they were able to bring these out so rapidly.

- The vaccines don't prevent you from actually getting COVID.

What it does prevent is serious illness as well as hospitalizations and death.

And that's the goal for us, is to not have the death and the serious illness associated with COVID.

- It's not 100% foolproof, nor is any vaccine, but these vaccines are, by and large, even better than the average vaccine at doing their job.

- For me, this vaccine is a way for us to turn the corner on this pandemic.

- I was quite happy to be vaccinated, quite willing to be vaccinated.

(gentle pensive music) Unfortunately in other communities, like, for example, the African American community, there has been for quite a long time, and for very good reason, a suspicion of the health system.

- When the pandemic started, we knew that there would be inequities as it related to race and income.

We are a country that does not provide support for all populations to have health and wellbeing.

- So many of these things that make Black and Brown populations more vulnerable, like preexisting medical conditions, we heard about folks who needed to have a relationship, a trusting relationship, with a medical professional, folks who could afford to social distance and stay home from work.

- Part of the reason why the Black and Brown community was affected poorly is the system.

We're not treated as valuable.

We might not have the insurance that other communities have just because of our socioeconomic status.

Then we begin to fall through the cracks.

- We've had negative experience within the healthcare industry, whether it's what we felt was racism, whether it was just what seemed to be a lack of care.

And we wondered whether it was based on our race, and that's just currently.

Then we also are aware of the the atrocities of the past, (somber string music) whether it's Tuskegee and others, that I think that there is a legitimate concern within our communities of whether the vaccine and the whole medical community is a safe place for us.

- We also knew that there would be inequities with respect to job status and employment.

Because of both historical and contemporary oppression, people who are more likely to be Black and low income are working in jobs in which they are more likely to be exposed.

(melancholic music) - Pittsburgh is one of the poorest working-class Black communities in the entire country.

And so what that means oftentimes is we make up these frontline workers.

- Who's driving the bus?

Who's driving the taxis and the Ubers?

Who's serving the groceries?

Who's serving the meals?

Who's doing the laundry at the hospital?

You know, these are disproportionately Black and Brown low-income folks.

And so those folks, because they were deemed essential, or they didn't have the finances to work from home, they were exposed at a much higher level.

- They were not provided the protections early on, no masks, and not having any social distance or space and also, you know, no information about whether or not if someone were to become sick, what supports would be provided to them.

- It just made it so much more worse for Black and Brown folks, and the numbers bear that out.

Even when exposed at the same level, worse outcomes.

Hospitalization rates, death rates were much higher.

- There are so many things that are just impediments for people to trust the medical institutions.

So we've had a lot to overcome.

And plus, you know, we're living in an age of disinformation.

- Social media is a big information source for our younger generation.

This vaccine does not implant chips.

- You can go onto social media, you can turn on your television, you can talk to your neighbor and hear the most unbelievable story about what happens to you if you get vaccinated.

- This vaccine causes people to become infertile, and that is a myth.

It has nothing to do with infertility.

There are some thoughts that this vaccine actually changes your DNA.

This vaccine does not alter your DNA in any way.

- And then what happens to you if you don't get vaccinated?

- What do you feel about the incentives and the rollout behind the vaccine?

- So when the vaccine came out, it was like really scary for me because, one, I'm not a scientist.

Two, you know, what is this that I didn't make it?

(laughs) So I can't say what really went into it.

- So really getting down to the basic sources of what's true and what's false and making my own decision from there.

- It's so important to know that research that was done in the past did not have the regulations that current research does now.

And there were not people of color involved in the past, where they are now.

- Cholera was a 19th-century epidemic.

Polio was a 20th-century epidemic.

But COVID, in particular, is a fascinating one because it's contemporary.

We had so many ways to reduce the number of deaths and sicknesses, and then we had a vaccine within a year, and it still didn't do its full job.

(poignant music) As far as specifically as the 1918 Spanish Flu pandemic is concerned, it did not originate in Spain.

Best as people can tell, the Spanish Influenza started some time in the late winter or spring of 1918.

And because of the movement of troops to Europe in the winter and spring of 1918, many people who were sick were on the troop ships, ended up in France, ended up in England.

And as a result, because the influenza was so communicative, so easily spread from one person to another, it was unclear from the beginning what exactly was the cause.

I'd been a women's health physician for nearly 35 years.

Several years ago, because I've always had a love of history, I decided to formally train as a historian.

One of the interests for me is looking at comparisons between the 1918 Spanish Flu pandemic and this COVID pandemic.

(suspenseful music) What killed people, and as we know, there were perhaps 30 million deaths worldwide between 1918 and 1919, what actually killed people was the secondary pneumonia.

The initial phase attacked older people.

Then in the second wave, which was in the winter of 1918 and into 1919, younger people, healthier people, were also affected at that point.

The state health department was very aggressive about ordering closures of bars, of entertainment facilities, and, ultimately, even of schools.

The problem was, and this will sound familiar to many people, is that local authorities, particularly in the city of Pittsburgh, were very hesitant to accept the orders of the state.

(gentle upbeat music) Even 100 years later, people are much better educated in how to prevent the spread of infectious pandemics.

And yet despite that knowledge, despite that information, as we know, there have been tremendous objection politically and otherwise to the wearing of masks, to the social-distancing rules, to the closing of facilities, schools.

We have a World Health Organization.

We have a Center for Disease Control, which our people are everywhere in the world working with other countries.

It could have been much different if the international community had come together as they have done in the past.

- Early in the pandemic, probably February of 2020, it clicked in my head that so many of these things that make folks especially vulnerable really were gonna hit Black people hard.

(melancholic music) I'd made a video and put it on YouTube and Facebook on my on my page and said, "Hey, ring the alarm.

This is a warning sign."

- [Narrator] When COVID hit our area.

- The Forbes Fund at Pitt School of Public Health, at the Heinz Endowments, some of these folks said, "Hey, you're right.

What do we need to do?

Let's assemble to talk about how we can make it happen."

- We know that COVID-19 has disrupted all of our lives.

- Many of us here in the region in Pittsburgh, leaders who were in the public health space and outside of the public health space, said, "We need to come together and figure this out," and that's how the Black Equity Coalition was developed.

It was actually the Black Equity COVID Coalition.

We were coming together out of a pandemic and a global emergency, right?

But the work that we do has long-term implications.

- We thought about who needs to be on this team, where do we need to have... We need to have people who have relationships in the communities, you know, and so that meant leaders of some of the neighborhood organizations.

You know, we needed to have medical doctors who were Black and Brown.

It was important to get the federally qualified health systems involved.

- The beauty of community health centers is that people trust us.

We have relationships, and we're real, you know?

Our providers pray with our patients.

Our providers treat our patients like human beings.

We treat everyone with dignity and respect.

The reason that's important, because when the virus became obvious, and it became necessary that we needed the vaccine, people wanted to talk to people they trusted.

- There's some wonderful people here.

(doctor laughs) They say we could have a lunch in here or whatever you want.

- We're here in the community.

People could walk.

people could take a bus.

We're right here in East Liberty, kind of the hub of the East End, so we were accessible.

(somber guitar music) - People in the Latinx community, they were hesitating a lot because at the beginning of the pandemic, they didn't have information in Spanish regarding the vaccine and COVID.

So we started working on giving that information out to our community.

Let's try it out and see if that...(laughs) (Claudia speaks in Spanish) - The Latino community in Southwestern Pennsylvania is a large and growing community.

We're in the ballpark of 45,000 Latinos in Southwestern Pennsylvania.

I think a large segment of the population is getting the vaccine.

I think if there is a problem with getting vaccinated, some barriers, right now, a lot of people are working really hard, so they have to go to employment.

So if we could get the vaccines to the place where they are working, that would be ideal.

- Shortly after the pandemic hit, we started to look at numbers and figures about how many people in the African American community were not getting vaccinated.

Along with our partners from the Black Equity Coalition and the POISE Foundation, we decided that we needed to launch an initiative that would try to get awareness out there and try to gently, respectfully encourage people to get the vaccine.

And the best way to do that was not preaching at them or yelling at them about how dangerous this was.

- Vaccines are a manipulation of the immune system.

- [Minette] I think the outreach helps, but I think what helps more than anything else is seeing people that look like us, seeing doctors and experts and scientists and just other people in your community saying, "I got it.

You can too.

I'm okay."

- What prompted you to get a vaccine?

- I'm going back to school, and the teachers feel like everyone who's going back should be vaccinated.

- I got it because I have underlying conditions.

I have lupus.

It was important for me to make sure my family and myself was safe, and it would be nice for the younger people to listen to someone like you to know that it's a good thing to do because you wanna have your family protected.

- It makes me feel safer around my grandma because my grandma has both of hers, so.

- Pittsburgh started to do like these town halls, and there were no Black people on the town halls.

1Hood got with UrbanKind Institute and Dr. Jamil Bey.

We did our own town hall, and it was called "What Black Pittsburgh Needs to Know about COVID-19," and it got such a response from our community that we started to do that every week.

Then we started "Ask a Black Doctor About COVID-19," because by this time, we saw COVID was disproportionately affecting the Black community.

We started to look at our Facebook page like a channel and started programming our Facebook page around how can we get information to our community around COVID.

- We set up a COVID-19 vaccine clinic to help support the area and the community of need for COVID-19 vaccinations.

So making sure that everyone has access to those vaccinations is a priority of UPMC.

We're able to provide all vaccines for patients, their first dose, their second dose, their booster dose.

- So what else is new for you guys?

- What has been so important about this effort with UPMC is the strong partnerships that they afford, certainly with the Neighborhood Resilience Project and other community partners, of working together to find these trusted messengers, these, what we call, community health deputies, to go through the community, who already have relationships that can be leveraged to increase that trust.

- Doors.

- That's unbelievable.

- Over the last two years, as we've struggled with this pandemic, we've found that it has affected everybody differently, whether they live in Wexford, or whether they live downtown, and kind of where they are in life.

So we, in terms of the folks that we take care of in the Hill, wanted to try to meet them right where they were.

- I serve on the UPMC underserved vaccine effort.

We're the advisory council who reaches out to communities to do vaccine workshops and clinics.

When you start looking at underserved and through racial lines, we do see discrepancies, especially in our younger populations.

And so in our 20s and teens, there's a difference between white patients and Black patients with regards to vaccination rates.

- We have done a lot of work to make the vaccines accessible to everyone.

Now you can get the vaccine at any one of our 200 locations by just walking up to the pharmacy counter and requesting the vaccine.

We have done some larger-scale clinics in many of our operating areas.

That has helped to increase the access to the vaccine as well.

(gentle pensive music) - What really surprised me, and I think many people, was how politicized a medical issue became.

This has never happened before in the history of medicine.

- Now the former president did not take the pandemic seriously.

There's no country in the world that's handled it as poorly as the United States, and it came from the top.

- Well over 30% of our population in the United States has refused to be vaccinated.

Somehow it became an issue of Republicans and Democrats, political, failure to believe the science, failure to believe what the public health authorities were telling us.

- And when we don't own that, acknowledge that, let's not ignore history.

- The other thing that I think was very surprising in this particular situation, the lack of international cooperation.

I mean, the presumption is, whether by intent or accident, COVID arose in China.

Now, there were months, at least weeks, if not months of delay, not only on the Chinese side, but on our side too in terms of trying to figure out what had happened.

Had there been a better international response, it is very likely that the spread of this particular virus would have been minimized.

- When we think about the long-term impacts of not just the health impacts, the medical impacts, (poignant music) the changes to the way that we interact, the two years, 2 1/2 years of high school that a lot of kids, it was disrupted, college, jobs, all of these things, the way that we work.

There's gonna be a boom in sociologists trying to make sense of what happened and how we move forward.

- Will we turn our D?

The most difficult part of it was that the experiences that they're losing out of childhood, so much of that was taken away from kids all over of just being able to go out and play it tag or baseball in the field.

Those things are memories, and they also mold you a little bit as the person you become.

- Right now, the demand for mental health services has never been higher, never been more intense.

We're still under the gun, meaning many of us are still trying to keep ourselves safe, adapt each day, find ways of not getting ill.

If we or our family members become ill, we're trying to manage their care and make sure they're okay.

(somber string music) Unfortunately, some of us have had people in our lives who've passed away, so we're managing the grief and the sadness about that.

- People are tired, and I get it.

I'm tired.

We're all tired.

But I think there are things that are still critical that we continue to do and be mindful of.

This is something we will be dealing with for quite some time.

If we do not make the steps to ensure that we are protecting our population in the short term and long term, we are gonna continue to see death.

We are going to continue to see morbidity and severe illness.

- As far as the next pandemic, I don't think anyone knows either when it will happen or what it will be.

- Lots of people are reevaluating their life and trying to do things that increase meaning and purpose and make their lives feel more useful.

- COVID didn't cripple us.

It didn't make us feel as though we didn't matter, you know, because we couldn't get out the house, or we couldn't interact.

- And that's why the Black Equity Coalition has come together, so that we can partner with other entities.

- It was one of the first times we actually started to have a national conversation about what, like, medical racism looks like and how does it show up.

- Double masking, like staying at home.

When I have to look at why our population is at risk, it's due to systemic, you know, issues like, you know, the food that we eat isn't healthy.

You know, we're overstressed, overworked.

We live in toxic environments.

- It made it very obvious, and I'll use this word, too, that social determinants of health has been a huge barrier to not only healthcare, but to addressing the pandemic.

- Whether or not we're better prepared, again, that's not a question that I can answer.

One would hope that humanity has learned.

- Well, there was so much we did not know.

- The world has changed, and our role and place in it has to change.

(gentle upbeat music) (somber string music)