Annc: This Studio Sacramento episode is supported by UC Davis Health where doctors, nurses, and researchers share a passion for advancing health.

Learn more about their latest medical innovations at health.ucdavis.edu.

♪♪ ♪♪ Scott: Within days of being sworn in as Government Operations Agency Secretary, Yolanda Richardson was tasked with responding to the COVID-19 pandemic.

Almost a year later, Secretary Richardson joins us to talk about the current status of the vaccination process and the Newsom administration's plans for returning California to normal.

Madam Secretary, where does the state stand today in its progress in vaccinating, all Californians?

Yolanda: Scott, I'm so happy, first of all, to be here and to share that we are just shy of 11 million doses that have been administered to Californians, which is, we all know is so important for us to,uh, be able to make that progress so that we can all get back to doing all of the things that we love so much.

Scott: Okay.

At this rate, how long do you think it'll take for the state to be fully vaccinated?

Yolanda: Right now, we are listening very attentively to the White House and to the Biden administration on supply.

My charge is to make sure that there is no barrier to Californians getting vaccinated other than the pace at which the supply comes into California.

Up to now, it has not been ideal.

We hav-- we still need more, but we are listening very attentively and understand that hopefully by the end of May there will be more in the state and we want to be ready to receive it and get vacc-- and get Californians vaccinated.

Scott: Interesting that you mentioned about the learnings along the way.

The Governor in a State of the State Address has said, quote, "I know our progress hasn't always felt fast enough and look, we've made mistakes.

I've made mistakes, but we own them, we learn from them, and we never stop trying."

What mistakes was the Governor referring to in the State of the State message?

Yolanda: You know, Scott for... for all of us, I think we wish we have had started a lot of these conversations back in the fall.

Doesn't mean that a lot of work hasn't been done in those early months, but, you know, definitely we felt a real sense of urgency in January when I joined the team.

And so, now we're working, you know, with our partners across the... the state, our county partners, our legislators, um, and all of the many people who care so very deeply about this important, um, work, in making sure that we get those vaccinated.

So, I do appreciate that the Governor noticed that in January and really, you know, uh, got us all together to think about how we could expedite, um, vaccinations.

And we've done that.

Um, definitely a far cry from where we were in January.

Scott: Mhmm.

And just, how is that the Governor Newsom involved on a day-to-day basis in the management and decision-making regarding the deployment of vaccines in California?

Yolanda: You know, to answer that question, I'll share a story with you.

Um, when he asked me to join the team in January, he brought together, um, a group.

He had a meeting and he brought together healthcare executives, um, uh... uh... he brought together labor leaders, uh, advocates, state leaders, county, uh... uh, everyone from the county in all kinds of leadership.

And he talked to all of us together about vaccines and what was at stake and how important this was for all of us to be involved.

And then he gave us kind of a call to action.

And he said, "All hands on deck."

He meant him too.

Um, he is extremely involved, and he encourages all of us across the state to be involved in bringing our thoughts and ideas to the table.

Um, one of the good example of that is the recent rollout of our equity approach.

Definitely many active conversations across the state and the administration about how we were going to make sure that we reach the most vulnerable comm-- communities.

We weren't always on the same page.

Many people had many different ideas, but it was rich, and it was expansive in terms of all of us bringing our background and our unique perspectives to the table.

And then the Governor took that bold move to say, not only are we going to build a network across the State of California, but we're going to back up that network with allocating doses to those most vulnerable communities.

It was a bold step, and it's one that we really appreciate his leadership in doing and we're looking forward to making sure that this vaccine is going to make a difference for everyone.

Scott: It's interesting you mentioned that because in the State of the State as well, he referenced that with regards to equity, that there was a normal prior to the pandemic and that that normal, and I'm paraphrasing here, was not acceptable.

And so, um, at the end of this, the state would not be going back to normal, it wants to be better than normal.

What was behind that?

Yolanda: Well, one of the things-- there's lots of things about that.

We want to be a better California.

I think this is a real opportunity for us to take all of the lessons that we've learned through this horrible pandemic and certainly enhance.

But for me, this is really about those populations who are-- we conti-- consistently talked about being underserved.

Um, I had the opportunity of being on a panel with some very passionate doctors from Kedren Clinic in... in South LA, who just talked about the vaccination process and talked about hesitancy, and some of the things that we're hearing in our communities of color, especially.

And they talked about how we need to get the word out about what's available and the benefits to these communities.

As we all know so many people, um, in these, um, underserved communities suffered as a result of the pandemic.

And the Governor has been very clear about being bold about making the decisions that we need to make to make sure that doesn't continue.

And so, having an equity strategy that's based on making sure that 40% of the supply goes to those populations, making sure that we're working with trusted advisors in the neighborhoods, making sure that we have lots of strategies, whether it's mobile or it's going into the homes and vaccinating people, um, doing all of those things is not going back to normal, but making sure that we do everything we can to make sure that we get rid of this disease.

Scott: It sounds like that there have been a lot of learnings along the way and so, it raises a question and I'd like you to go back to the beginning of this process.

What led to so many, at least the perception is fits and starts, in getting the program rolling in the first place?

Yolanda: You know, one of the things that I try to always do is look at the data, um, because the data is an opportunity for you to make the decisions and know what you need to do.

We had some problems with data in the beginning.

And so, we have really had a concerted effort across the state to work with our county partners and... and our providers to make sure that we have accurate data.

Now, is it perfect?

No, but we're going to continue to work on that data and make sure that it's transparent and that everybody has access to it, whether it's where the doses are, who's getting the doses.

And we can use that to make sure, like for all operations, that we can make plans, execute, evaluate, and make sure that we can make the adjustments that we need to, to reach our statewide goals.

Scott: As you know, uh, currently there are many critics of the Governor that have been very, very vocal and among them, the most loud charge is that they, the Governor's critics, uh, charge that he is surrounded by policy wonks, and, uh, that has led him into paralysis analysis and not enough focus on implementation execution.

And that's everything from PPE in the beginning of the pandemic to, uh, the vaccine process.

How do you respond to those critics?

Yolanda: Well, I respond with what we've accomplished since January.

I've been in this role a little over nine weeks, and I will tell you that going from where we were with the vaccine administration to where we are now, based on the Governor's charge, his leadership and his mandate to make sure that we accelerate the administration of doses, that we improve the data that we expand the network.

We are well-positioned to be able to have in the State of California, by the end of March, the capacity to provide 3 million doses.

And we are in that same position to increase that to 4 million doses by the end of April.

That isn't because we've been sitting around, that is because we have been driving, quite quickly I would add, to make sure that we have the capacity and the infrastructure, uh, to do exactly what the Governor said he wanted to do, which is make sure that every Californian that wants to be vaccinated can.

Scott: When... when you talk about infrastructure, one of, uh, the recent developments has been, uh, a new relationship or an expanded relationship with Blue Shield of California.

Can you tell us more about that relationship and what it's going to mean for vaccine distribution?

Yolanda: Absolutely.

So, we-- with everything that's been going on, um, it is important for us to just really be mindful of how do we stay focused on the things that we need to do.

So, in the middle of the surge, it became quite clear that we wanted to bring on a partner that could help us make sure that we had the focus that we needed to take on the delivery of vaccine.

And so, I'm very excited about partnering with Blue Shield.

Blue Shield is a California based nonprofit health plan that covers all 58 counties in California.

It's the only health plan on Covered California that has a PPO network covering every residential zip code in the state.

And with their experience on the testing task force, working with the Governor in this COVID environment, they're uniquely qualified to help us track every single dose, which is critical to our collective goal of getting back to doing exactly what we want to do.

Scott: You mentioned Covered California and, um, my understanding is that you were among the first employees for Covered California when it first got stood up.

And that, that process after the passage of healthcare reform was a pretty intense-focused process on being able to get that platform up and running.

What lessons from that experience did you bring with you to this effort?

Yolanda: Wow, um, Covered California, is one of my most cherished memories in my career.

Uh, definitely a lot of similarities, compress timetables, intense pressure, long days and nights, and definitely, uh, working with a vast, uh, number of stakeholders and definitely wanting to do something to change the lives of Californians.

Coming from that I recognize the... the spirit of collaboration for me really has been valuable.

Really taking in a lot of ideas and working together to do what in many instances was impossible to do.

Very, very short timetables at California and we stood, uh, for Covered California-- and we stood up that program and what people thought was impossible.

And it was one of the most successful health exchanges in the country and still is today.

And we were able to deliver over a million, um, benefits to a million people, which, uh, definitely was a very high metric, and we have brought that same spirit and intensity to this project as well.

Scott: And... and likewise, does the administration have a timetable that it is set out as a goal for itself on ensuring that all Californians are fully vaccinated?

Yolanda: You know, I-- the Governor desperately wants one.

I think he wants to... to set that once we understand the supply, um, that has been the thing that we just don't have an idea about.

Right now, the way that the process works is we find out each week what the supply is going to be, and then that gets distributed.

But as we get more predictable and the supply becomes more steady, we'll be able to, be able to provide the data that will tell us exactly what it would look like in terms of getting everyone that wants to get vaccinated, vaccinated.

Scott: You... you talked about the Blue Shield relationship.

Beyond Blue Shield, how is the administration working with healthcare providers and systems in private industry to-- and also the safety net providers to aid you all in deployment?

Yolanda: Well, just today, Blue Shield announced that in the statewide vaccine network, we have over 1,200 providers.

They include, um, major hospitals, they include federally qualified health centers, they include large health systems.

And of course, our county partners have always been there right alongside of us.

Um, now there has been some frustration about this and I would like to think that it's because this is so critical and so important.

Everyone understands what we're trying to do here.

But we've been very excited about working together to build the infrastructure, to build the capacity, because this is going to be about access, for everyone.

And so, having everyone working together, again, the clinics, the hospitals, the community doctors, and all the providers working together to provide that access, I think is where it-—where we need to be in order for us to reach that goal.

Scott: When you talk about that there's been frustration along the way, what exactly are you referencing there?

Yolanda: You know, when we brought on-- when we brought on the third-party administrator, Blue Shield, um, I think there were a lot of concerns about change.

Um, we were starting to see a lot of the vaccines taking place and people were building that their own structure.

And so, there was a lot of confusion and there was a lot of concern about change.

And so, we wanted to make it extremely clear that what the state wants to do is build on all of the great work that all of the providers have been doing.

We want to scale up and we want to do that with speed and with equity and partnering with everyone.

So, this was a real opportunity to kind of, you know, as that frustration was... was brought to our attention to really make sure that, um, people understood what it was that we were trying to achieve.

Scott: One of the things that puzzles many Californians is we really don't understand the relationship between the Federal Government's actions, the manufacturers of the vaccines that are available actions, and the state's actions.

And so, can you help us understand where it is that you're relying on external entities, like the Federal Government and the manufacturers and how their actions have impacted, uh, the state's ability to roll out its vaccine program?

Yolanda: Sure, Scott.

You're talking about supply chain 101.

So, the Federal Government, um... um, is responsible for the manufacturing of vaccines.

We have two that we have been using, Moderna and Pfizer, and most recently it was introduced too, Johnson & Johnson one-dose vaccine that will be coming into the state very shortly.

What happens is, the-- because the supply has been so limited, the Federal Government has allocated whatever supply it has across the nation with the State of California receiving just a percentage of that.

It wasn't nearly enough for us to support the magnitude of... of... of our population, but it was some.

Once it comes into the state, of course, you know, then the State of California had... had the charge along with our health partners, um, at the county level to distribute the vaccine.

And certainly, you heard and you continue to hear that we just don't have enough to do all that we need to do.

And so, we continue to distribute that vaccine based on the amount that we get.

And that's why we're so encouraged by what we're hearing coming out of the Biden administration, that they're doing everything that they can to increase the manufacturing of the ... of vaccines, and then that means we can have more come into the State of California.

And... and at the same time, while Blue Shield is building the capacity, those meeting in the middle means more access for more Californians.

Scott: Right.

Another issue that tends to confuse, uh, many of us is the prioritization, uh, seems to be ever changing and even sometimes random.

Uh, how much of that is perception and how much of that is reality?

Yolanda: Well, you know, I-- one of the things about me is, you know, I am definitely in my operations lane, that's... that's what I've been asked to do.

But I know that my colleagues at the California Department of Health, and Health and Human Services is constantly working with their committees and their experts and their doctors and their scientists to make sure that the policies that need to support our operations are definitely being thought of very carefully.

Listen, um, it has, again, going back to the frustration, it really has been about the supply.

But we didn't want that to limit making sure that whatever we got, we were getting into the-- to the right arms.

And I think everything that has been done, it's been about making sure that we got whatever we have in, um, getting it to the people that needed it the most.

So, that's the reason why they rolled out, um, healthcare workers first, wanting to protect, um, the health community who was helping all of us and protecting all of us.

Scott: Hmm.

Well, aside from availability, what's been the most difficult part of this process in having a fully functioning supply chain from manufacturer to patient injection for the state?

Yolanda: Well, to-- it's a good point.

I-- you know, I think that it is just, um, just the magnitude and... and... and... and how hard this is to know that there are so many Californians who have lost their lives and knowing what we're doing can change that for the future.

And so, I think for my colleagues, just watching just everyone working day and night, seven days a week, um, we always say every day is Monday for us at the state.

But definitely it's just, it weighs heavy on our hearts and that has been tremendously hard to be thoughtful and wanting to do the right things but knowing that what you do is so desperately needed by so many.

Scott: Hmm.

When is it that we're going to get some optionality as Californians on which vaccine, uh, that we choose?

Right now, there's been an emerging concern, particularly around the J & J vaccine, uh, on religious grounds by some, and there is a growing question as to do I get a choice, when would I get a choice?

Anything you can share with us on those?

Yolanda: Well, you know, um, again, I leave this to the doctors, but I will tell you what the doctors say.

The doctors say that all three of the vaccines will protect you against illness and ultimately death.

And they recommend that people get the vaccine that is available.

And so, I think it's going to be really important as we go forward, not in addition-- not only just having the infrastructure and the capacity and the thing that I've been talking about, but really getting those trusted advisors out into the community to talk more about the value of the three vaccine options that we have and what this can mean for so many people.

So, I really appreciated some of the things that I've been hearing around how the testing worked and how they just had so many people involved in the trials and how safe it is and the efficacy of all of the different vaccine options.

And I think people need to make sure that they are just knowledgeable and aware and listening to the experts who have so much great information about what they have available to them and the benefits for them.

And I think that will help them when they show up to the doctor to get their vaccine feel comfortable about that experiment.

Scott: W-- uh, a bit earlier, you and I were talking, uh, a bit about equity, and I'm curious, how has the state rectify-- rectifying the low level of vaccination for particular groups like Latino citizens, who according to the Department of Health Services' own data make up 40% of the population, but, um, currently have only received about 17% of the doses.

Yolanda: So, that's... that's a lot about what this whole bold step that we're taking on equity, which is looking across the state and looking at those zip codes that we-- what are we calling our Healthy Places Index.

But we're looking at it by actual zip codes, communities of people who have been underserved or most impacted by this vaccine, which by the COVID-19, um, disease, which unfortunately is a lot of people of color.

And what we've done is not only Blue Shield is making sure that we have a network that provides services to those communities, or we have providers in those communities.

But we're layering more vaccine on top of that to make sure that they have enough vaccine in those communities to get everyone vaccinated.

In addition to that, we're also partnering those providers with county-based organizations that are trusted, understand those communities and... and how their... their languages and... and... and supporting them in all the different ways that they have been for so many things.

And then on top of that, we're making sure that we're laying that with data so we can continue to track.

Look, we know very clearly we're not anywhere where we need to be, especially in our African American and Latino communities, but because we have that data, we can hold ourselves accountable for all of the various things that we're doing and continue to look at it and make changes and... and... and work with our county partners to make sure we have the right strategies and the right focus in those communities to make sure that we get more of those people vaccinated as quickly as possible.

Scott: Incidentally, related to the data, according to the most recent data that I was able to obtain, it showed that the greatest level of penetration in the state was for mixed-race residents who far out distanced any other category.

Is that accurate or is there potentially a blip in the data?

Yolanda: Well, you know, we had the same situation at Covered California.

Um, I think when it comes to self-reported race data, um, there can be a hesitancy to report.

I mean, we did everything we possibly could to explain to people and reassure them that it was okay to tell us their actual race, but we know that there are people who are uncomfortable with that.

But what we know that the numbers aren't perfect, but I think it's fair for us to infer from them what we're seeing is not where we need to be.

And so, it is our North Star to make sure that we double down on those strategies in those communities that we know have been most hardest hit.

Scott: Okay.

And, um, uh, there's a lot of pressure across not only the state, but the country to open up.

What is the relationship between the percentage of population in any given county and being totally vaccinated and the... the full reopening of those regions in terms of going through the levels?

Yolanda: Now, I leave all that reopening stuff to my wonderful and amazing colleague, Dr. Mark Ghaly.

I'll tell you what my part of it is though, is back to our equity goal.

We have the first milestone that we need to reach is to vaccinate 2 million people in those hardest hit, um, communities.

And that's what I'm focused on, is working with our county partners and our healthcare partners across the state to make sure we're getting to those people.

And once we do what we need to do, Dr. Ghaly and the California Department of Health, um, colleagues will take care of the rest and that's going to support all of the things that you've been hearing about the Governor in terms of reopening California.

Scott: Uh, along those lines, is there any efforts by, uh, the... the work that you're leading or that of the rest of the administration, including Dr. Ghaly, on tracking adverse outcomes related to the vaccines?

Given that they were developed and deployed so quickly, um, there are some who say that, uh, we don't really know what we don't know about potential adverse outcomes and their impact on Californians.

Yolanda: Yes.

I mean, the... the... the scientists and the doctors at the California Department of Health are always looking at, um, reactions, they're studying the vaccines and they're putting out lots of information.

But what I'm hearing from the providers who are actually getting those doses into people's arms, doing this work every day is that these vaccines are safe and that people with-- even in my own circle or community are just experiencing very, uh, low, uh, reactions, sore arms.

Uh, I think Dr. Fauci talked about maybe feeling a little flu-ish, but for the most part, people are saying that this is just an amazing experience that they're having, and they're just encouraging everyone to get vaccinated so that we can open back California.

Scott: And in our final moments, just wanted to ask you what statistic should we the public be using to hold, uh, this administration and the state accountable for its progress in getting us all vaccinated?

Yolanda: You know, one of-- we are looking at a community of eligibles based on those over 16.

Right now, that's over 25 million people in the State of California.

I think you're going to hear over the course of weeks, the Governor talk about access for those Californians.

And that is not only access in terms of going to a mega site, but also how we're meeting them where they're at.

It's also going to be about how are we making sure that anyone who wants to get a vaccine can do it in the way that's most comfortable for them, whether it's making an appointment on a computer or going to get an appointment at a church or working with their clinic or working with a community-based organization and having access.

You're going to hear about, um, ways that we're putting out information in multiple languages.

You're going to hear about trusted advisors in the community talking to Californians about the vaccine options and what the vaccine benefits are.

And so, I think to hold us accountable is just making sure that every Californian who wants to get vaccinated can.

And all of the many ways that we're going to be rolling out across the state over the next couple of weeks.

Scott: And I think that we will leave it there.

Thank you, Madam Secretary.

Yolanda: Thank you, Scott.

Scott: And good luck.

And that's our show.

Thanks to our guest and thanks to you for watching Studio Sacramento.

I'm Scott Syphax.

See you next time right here on KVIE.

♪♪ ♪♪ Scott Syphax: All episodes of Studio Sacramento, along with other KVIE programs, are available to watch online at kvie.org/video.

Annc: This Studio Sacramento episode is supported by UC Davis Health where doctors, nurses, and researchers share a passion for advancing health.

Learn more about their latest medical innovations at health.ucdavis.edu.