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- How will Memphis get vaccines to the people who are hardest to reach?

Tonight, on Behind the Headlines.

[intense orchestral music] I'm Eric Barnes with The Daily Memphian, and thanks for joining us.

I am joined tonight by Melanie Keller, President and CEO of Meritan, a nonprofit that among other things works with homebound senior citizens.

Melanie, thanks for being here.

- Thanks for having me.

- The Reverend Keith Norman is the Vice President of Baptist Memorial Healthcare and Senior Pastor at First Baptist Broad Church.

Reverend Norman, thanks for being here as well.

- Thank you.

Thank you for having me.

- And along with Bill Dries, reporter with The Daily Memphian.

We'll, we'll talk today about, you know, a variety of of issues around vaccines as as we begin to get as a country, but you know, specifically here in Memphis and Shelby County, more and more vaccine and and getting to more people is getting harder.

And so I wanted to talk to you both about how we as a community are going to reach some of the hardest to reach people.

We'll also get into vaccine hesitancy, vaccine resistance and some of the data that's come out on that.

But I'll start with, I think I'll start with you, Melanie.

You all do a lot of different work with seniors and and other other people in need in the community, but talk about what it takes to get to say, homebound seniors and reach them and get shots to them.

It's no small thing.

I mean, we're talking about a big population who can't make it to Pipkin, right?

Who doesn't have those resources, doesn't have the help to do that.

How are you and others helping in that circumstance?

- Well, for us, one of the services we offer is field home care.

So we're used to going house to house and reaching those that are unable to get out to the position that, that have acute care needs in the home.

So this is really a good fit for us.

I think one of the biggest challenges is identifying the population that needs a vaccine and are unable to reach like you said, the Pipkin Building or unable to get out to pharmacies and so forth.

So the first is identifying them.

And so what we've done is we've created an email address, a phone number, and as we identify the people that truly have that, that homebound need, and can't get out then we're putting them on a schedule and going, basically door to door.

I recognize that it's not the most efficient way, you know with a the mass pods you could vaccinate several thousand in a day, where you know, our, our max capacity is usually about 30.

But it's definitely a need, not, not everyone can, can get out.

And so we're trying to reach those that without us going to their home would otherwise not be able to get vaccinated - Well, and you have some sense of how many people that is?

- You know, it's, it's kind of difficult to ascertain right now.

The more the word gets out that we're doing this of course, the larger volume we're seeing.

We started the home bound vaccinations on March 16th, and thus far we've vaccinated about 200 people.

And the emails continue to come in, the calls continue to come in.

And so, maybe about a thousand but it's really hard to tell right now.

- For we'll, we'll give some more sort of resource information as we go along, but I wanted to bring you in Reverend Norman.

I mean, you know, obviously Baptist, you wear a couple of hats today, we'll talk about the, the hospital side maybe first, Baptist has been in the heart of this, you know, fight against COVID and treating people.

And now administering vaccines, obviously at the hospitals and various places, but what, what all are you doing?

I mean, what are your thoughts on how we reach people whether they're homebound, or maybe not even homebound but you know, not everyone has a cell phone by any stretch.

Not everyone has a landline, not everyone has the wherewithal for whatever reason to sign up online or call in and make an appointment.

And again, now that we've gotten to a point where the big vaccine, there's enough availability, that there's plenty to go around it seems now.

We've lowered, you know, as a community that the age limit down to what 18 and above, a lot of appointments are going unfilled at some of the big vaccine sites.

So again, with all that in the backdrop, how how are you all, whether it's through Baptist or it's through your church, and maybe you want to say both reaching these people that are hardest to reach?

- Well, thank you for the question, Eric and what you really speak to are problems that have existed prior to COVID.

How do you deliver health care, much needed health care, to people who are in areas of poverty where there's poor transportation, lack of broadband services to reach those communities.

Baptist has been overcoming and working to overcome many of those issues prior to the COVID pandemic by strategically placing ourselves in those communities.

We operate a homeless van that actually goes to people who may not have an address at all through our community health partners and churches that we partner with for health fairs and other pop-up type events, we're in those communities.

And we build those relationships.

So what you're really speaking to is something that has existed in largely impoverished communities for quite some time.

Even our home health network is a part of what we do.

We'll go into the home and deliver care.

So we have that system in place already.

And I think what we have to do now is we have to ramp it up.

We're working with partners.

We partner with the Shelby County task force with the city and county where we will operate a pod that Chief McGowan will designate from week to week.

We go to community churches right now there is a station at the church where I serve as pastor and we're vaccinating every day in that location.

But no matter what you do, there's always more to do.

We'll get into vaccine hesitancy later on, but a part of that when you couple it with poverty, lack of broadband, poor transportation, it's a, it's always a work in progress.

It's always something to do to overcome.

- And you mentioned before I go to Bill, I'll say that we chief of staff, or excuse me, chief operating officer for the city, Doug McGowan, who is co-leading the city/county effort to get vaccine out there with Gina Sweat the fire chief, they will be on the show next week.

So we'll talk about some of those, what they're doing on that side next week, but let me go to Bill.

- Keith, talk about what you're seeing in terms of how this specific population has fared in the last very strange and very disorienting year with the pandemic that we've seen.

How are these people who are hardest to reach, how are they bearing up under the strain of these very unusual circumstances?

- In a surprising way, amazingly well, because they are resilient people.

And they have learned how to navigate when there are when there's a lack of resources.

And when there seems to be transportation issues, however there will always need to be assistance that comes from the larger faith-based community corporate community, philanthropic communities and government to support these groups.

So what we're saying is, first of all a pandemic come into our city, our community and really ravage through the people whom are most vulnerable, people whom are essential workers at the lowest scale.

And in many cases people who did not fully understand the ramifications of the pandemic and getting education to that population and also delivering services.

We saw unemployment rise during this particular period of time but we continued to see people fight back and they were very resilient.

We've seen food lines reduce and that over a year but there were many, many places where we had to supply needs and meet the needs of a community.

So we've seen a very resilient response, but it has been with the aid and assistance of hospitals, corporations and many other community partners.

- Melanie, to Keith's point on this.

What have you seen overall in terms of how this population has reacted to this?

And, and do you have people who have been new to this kind of isolation as was mentioned because of unemployment, because of of just general fear of the virus?

- Our services predominantly that the people that we talked and we reached this as an ongoing challenge for them the homebound situation because of health and so forth.

So for us, especially early on in the pandemic it wasn't just a matter of the typical access.

It was a matter of not being able to get cleaning resources, not being able to get toilet paper, some of those basic necessities that that we take for granted when it's difficult enough to to get out and get to the grocery store and get essentials, and that's compounded by a pandemic and also by fear.

And then what we've also seen unfortunately is the limited network that some people have was even further diminished by the pandemic.

People not going to not being able to see their loved ones, not being able to check in on them for fear of exposing them.

So it's really amplified in many situations, the isolation and challenges that they already had.

So it's been a great opportunity to reach out to the people in our community and to meet their needs not only from a healthcare standpoint but also from a general day to day resource.

- Is there a tendency for people to say some people to say I'm just going to ride this out as long as I'm isolated, who recognize that they're isolated and, and who maybe say I'm just going to stay where I am and ride this out without getting the vaccine?

- We have not seen that, even though they are home bound, they, they still want to have the interaction with the family members and members of the community that can come and see them.

And they've not been able to do that without a vaccine.

So I haven't seen that particular issue where people don't want to be vaccinated because they think, well I'm homebound, I'm not going anywhere anyway.

They still want to have the opportunities for people to come and to see them.

And so that's why it's important that this population is vaccinated as well.

- Keith, from your perspective, what's the case because I think what we've all learned in this last year is just how much we really value human contact.

- Yeah.

Well, there are a couple of things and I think we could, I could segue into the church side of this on the human contact but when we talk, first of all, about the vaccine the resistance to being vaccinated there's a small population that we understood from the very beginning that just rested in the category of I will not get a vaccination.

That's not just with the coronavirus vaccine.

- That's with the flu vaccine that's with every vaccine out there.

So there's a part of the population that you never ever convince that vaccines are good.

So I think you have to concentrate on the other populations of those whom have made up their mind to receive the vaccination and those who are in that middle category of when will I get the vaccination and how can I move them to going forward expeditiously.

What we've seen is the vaccination that came online rather quickly.

And with all of the information that we've seen in the news people are Googling more now and researching more on their own.

So what we see is there's a little hesitancy but eventually when information is disseminated and people have an opportunity to get information through forums and through other places they do move to that category.

So they will participate.

If I could briefly segue, One of the things that happened in the African-American community specifically has been the disbanding, somewhat of gathering in churches where people receive so much inspiration and information.

We typically over the pulpit share with people, our, our personal information and experiences which help them to make a decision.

We don't make a decision for them, but we do help give good information that causes people to make prayerful well-informed decisions.

- Well, Melanie let's segue into the hesitancy which we've been touching about and resistance to getting vaccine.

And we, we had done a survey in Memphis a week or so ago that you know, of those who haven't got a shot yet.

It was something around 51% say those who are remaining definitely want a shot just as a matter of getting it, 12% were probably of that group.

It was 61% were who would are white Memphians, 49% were black.

Men were 60, women were 45%.

So there's, you know, some variations.

And then the people who said they would not get a vaccine, 36, I mean a third of them said, you know, it's just not safe.

And to some degree to I think maybe what Reverend Norman just touched on 23% just said, hey, we don't, I don't get vaccines.

I don't do this.

So I would assume for you prior to the pandemic you've had challenges with some families in some situations of getting vaccines and certain medicines to people where if even if the homebound senior was not resistant the family member or the caretaker was.

How do you all approach, specifically COVID vaccine resistance?

But again, I imagine to some degree that's an issue you've dealt with forever.

- Well, I think the key is, is education and explain it to people at a level that they understand.

You hear people with vaccine hesitancy, especially the first two, ModeRNA and Pfizer.

I don't want my DNA to be altered, and some people and I've heard that even in my own home with my, my adult children I don't want something that's going to change my DNA.

So now that they've both been more willing and are getting the Johnson and Johnson vaccine because they had those concerns.

But it's educating people that no, while this seems that it's happened very quickly, the science and the technology has, has been around for awhile.

And as I explained to my own child and to some of our employees here if you have the opportunity to protect yourself from a disease, regardless of that disease, you know why not do that?

What is your rationale for not wanting to protect yourself?

And I take it all the way back to, you know, the measles vaccine, the chickenpox vaccine there, you know, so it's really meeting people where they are and explaining it to them at a level that they understand and that the science is legitimate.

And this isn't something that was just created overnight and making sure that they understand the importance of it for themselves and also for the people that they're in contact with.

- And, and how much does, I'm bouncing around a little bit, but I'll stay with you, Melanie, you mentioned the Johnson and Johnson vaccine.

It's a one-shot vaccine.

The city has gotten like a couple of rounds of doses now.

And I think they've earmarked most of what's going to the city/county they want to use for seniors and other people where getting the homeless people where giving one shot is going to make things much, much simpler.

I mean, is that, so I assume that's welcome news to you all that you're just, you're talking about doing 30 a day sometimes.

I mean, the hard work of getting to people, then you got to do it all again with a second shot.

So I assume J and J has changed everything for y'all?

- J and J was a game changer for us when we started working on this project a couple of months ago, and looking at the logistics and so forth.

And we initially planned on starting with ModeRNA.

And as you mentioned, that that's a two-shot series.

And so the logistics were quite honestly a little overwhelming when we thought about having to go back out and do that second round.

So just before we launched our program, Johnson and Johnson became available and the opportunity to be one and done is really helping with our efficiency.

So it was an absolute game changer for us, especially with the homebound.

And I'm sure also with the homeless population when it's difficult enough to get that first vaccine in let alone having to worry about the second.

So absolutely the one-dose vaccine has been a game changer for what we do.

- Keith do, are we going to, you know, you see from where we were some months ago, where there was one site, you know where you could get a vaccine and a pretty limited number of people, then, you know, that number has been growing.

And now, you know, it, it is again with the age restrictions essentially lifted and the availability of vaccine there's, I hesitate to say plenty to go around, but it seems like there is plenty to go around in terms of supply but reaching people again, that challenge of reaching people, whether they are not mobile, whether they're for whatever reason, not aware of where they can go or they're resistant.

I mean, will it get down to doing pop-up tents in the parking lot of your church, or I'm, you know I live in Crosstown and there's a plaza and people come through, I mean, is it going to come down to almost block by block location by location setting up opportunities for people to get vaccine if we're going to get to what we need, which is what sixty to eighty percent of the population?

- So taking the vaccine to where people are located that's going to be essential.

I think you're going to see workplaces get in the game pretty soon so that they can begin to bring their workforce back.

They're going to make the vaccine available at the work site per shift, if you will.

That would be a great way to capture a number of people, family events, where people are planning outdoor events and large scale events.

There will be unique approaches and innovative approaches which the task force is really already using right now.

But I think it's going to be essential to do that if we are going to achieve community immunity.

I like to use that phrase better than herd immunity, simply because we're trying to vaccinate our entire community.

We need to get to 60 to 80% or 70 to 80% of the community in order for this to really be effective.

- And we are just for people who don't obsess over these numbers, the way I imagine we do.

And we do certainly in the newsroom, you know we're a little over 215,000 people have gotten at least one dose.

And, you know, depending on how you count it we've got to get, there's 900,000 people in Shelby County.

I'm looking at these numbers, I have next to me.

So we've got another 200 to 400,000 depending if you count the children in there and you know kind of how you do it, but we're, we're making great progress.

But it is telling before I go to Bill that the task force is reporting, you know, twenty percent, sometimes as much as fifty percent of available appointments are unused.

So, but let me go to Bill as a, with a few minutes left here.

- I think we've had this part of the discussion on every show that we've done on COVID since the beginning of this crisis.

And it's, that there is a side to this that has allowed us to see with the greater urgency a better way of doing things.

Keith, what changes in that regard and reaching these populations once this virus is dealt with can we apply this to other problems persistent problems that have been with us for quite a while?

- Yes, by all means we can.

Yesterday, or recently I should say, we've seen an infrastructure bill that has been released from the White House which suggests that we really need to go back and rebuild the community and the infrastructure based on not what was yesterday's greatest need but what is the greatest need of the future.

Communication, access to broadband, improved access in transportation, relocation of services, and making sure that all communities have access to great health care and to the services that are needed so that when things like this happen, we don't have to go and research how to reach those communities.

We already know, because there are established sites and relationships in those communities.

Often one of the things that we know about COVID and this pandemic is that we've always known where the food deserts were in Memphis.

We've always known where the underserved communities were.

What had we done to overcome those things prior to now would determine how well and how quickly we can get services and information and partnership in and to those communities.

So, yeah, we've learned a lot from it and we should not go back.

I'm thinking re-imagining as we re-engage is a very important thing that we have to do moving forward.

- Melanie, is Meritin a different organization once this is over?

- I don't think so.

This really fits into what we do on a day-to-day basis reaching those in the community, reaching people where they are.

I think the only thing that's really going to change within our organization is truly just administratively and having people continue to work remotely that can, but no, overall, I think we're going to continue to do what we're doing which is meeting people where they are and taking care of the most vulnerable out in the community.

So for us, the pandemic and the outreach whether it was the testing and now the vaccination fits well within our mission and our services.

I do see us making, possibly expanding and doing more, but I don't feel like overall, it's going to change.

- All right, I'll stay with you, Melanie, just before I forget for people who want to know more about what you all do who maybe have a family member, friend, senior who might you know, need the services you all provide, what what should they do?

- Oh, they can absolutely go to our website at meritan.org.

So that's in meritan.org.

On our website there is a link where people can fill out an online form to request a homebound vaccination.

Our phone number for vaccines is on there at 901-612-2122.

And so that phone number actually goes directly to an email that an RN answers within two to three days but all the information is right there available on our website, or they can call our main number at 901-766-0600 and we will help whoever we can help.

- Same question to you before I forget, Keith, how maybe I don't know if you're going to represent the task force the church or the Baptist or the Baptist Memorial Healthcare system, but what should people do who have questions whether it's seniors, or it's maybe someone with some physical disabilities that they just don't know how to get this done?

- Sure.

It all starts with Baptist.

If you are a person in our system, of course reach out to your personal healthcare provider your primary care provider, but then there are also there's also our website that you could go on to.

You could also dial 227-TEST if you're looking to get the vaccine and and really schedule that appointment.

If you're on my chart, you can reach out by doing scheduling appointment on my chart that will give you available appointments.

And then you can just simply click the button.

But then for that individual who needs to call just call and we'll make sure that we get you in.

We have stations and outposts where we will be working with the city and, and in other spaces.

And so we'll be available.

- The last question for you.

I mean, the faith, you mentioned that your church but I mean, all of the churches, synagogues, you know, mosques around town have been either completely or very shut down.

What is your sense of when you will be back to normal as a place of faith and worship?

- You know, I think the way we've operated we may not be back to normal.

And that may be something that we need to think about for the future.

We're going through a process right now of re-imagining everything in our sanctuary from contactless worship, you know the whole idea of contactless giving and how we have to greet people by and large the church has always been a place of wonderful fellowship.

We are noted for loving and hugging and kissing and handshaking.

So a lot of that has to change.

And so we're re-imagining those processes right now but we're looking at opening sometime in the summer.

- I got you.

Well, thank you.

And thank you both.

And thank you for the work you do.

That is all the time we have this week.

Again, next week, we've got Doug McGowan and Gina Sweat who are the co-leaders of the task force.

If you miss any of the show you can get it at wkno.org or download the full podcast of the show from The Daily Memphian site or wherever you get your podcasts.

Thanks, and we'll see you next week.

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