Stephen B. Thomas, director of the University of Maryland’s Center for Health Equity, considers himself an eternal optimist. Looking back at the devastating pandemic that has raged over the past three years, he believes that more than what the world has lost, it has gained: powerful antivirals, powerful vaccines and, most importantly, unprecedented collaborations. chose to focus on Among clinicians, academics, and his community leaders, he has helped bring life-saving resources to the many who need them most. But Thomas, whose efforts during the pandemic helped transform more than 1,000 black barbershops and salons into his COVID vaccine his clinic, says he expects momentum to begin to wane as he looks to the next few months. , or worse, worrying about it going away. go in reverse.
This week, the Biden administration announced it would allow the COVID-19 public health emergency declaration to expire in May. This transition is expected to push immunizations, treatments, tests, and other types of care out of reach for millions. Americans, especially those without insurance. The move has taken a long time, but for community leaders like Thomas, vaccine outreach and Shots at the Shop, his project relies on emergency funding and White House support, this shift could mean a crisis in the local infrastructure he controlled. And his colleagues have been building for years. It was inevitable, he told me, that community vaccination efforts would eventually run into trouble. “The silver lining of the pandemic has been the realization that hyperlocal strategies work,” he said. “Now we are seeing that erosion.”
I called Thomas this week to find out how the state of emergency declaration has enabled his team to mobilize resources for outreach efforts, and the number of coming years as the country tries to get back to normal. We discussed what happens on the moon.
Our conversation has been edited for clarity and length.
Catherine J. Wu: Tell us about the birth of Shots at the Shop.
Stephen B. Thomas: We started working with barbershops and beauty salons in 2014. It’s called HAIR: Health Advocates In-Reach and Research. Our focus was colorectal cancer screening. We have brought medical professionals such as gastroenterologists into the store.
Now, if I could talk about colonoscopies, I think I could talk about anything. In 2019, we held a national health convention for barbers and stylists. They all came from across the country to discuss different areas of health and chronic diseases. Prostate cancer, breast cancer, etc. We brought everyone together to discuss how we can address health disparities and get more agency and visibility into this new frontline workforce.
When the pandemic hit, all plans put forward at national conferences were put on hold. But we continued our efforts at the barbershop. Zoom Town Hall has started. And I started seeing misinformation and disinformation about the pandemic circulating in stores, but nothing was done about it.
We got coverage in the state media and the support of the White House. And I launched Shots at the Shop. We had 1,000 store signups in less than 90 days.
Wu: What do you think makes Shots at the Shop so successful? What makes this network different from other vaccine advocacy efforts that speak directly to Black and Brown communities?
Thomas: Coming to our clinic didn’t feel like coming to a clinic or a hospital. Felt like you were at a family reunion. A DJ was spinning the music. We catered our meals. There was a festive environment. Some hesitated to show up, while others remained hesitant and got the vaccine. There was no need to change their worldview. But we treated them with dignity and respect. We are not saying that they are stupid and do not understand science.
And the model worked. It worked so well that even the medical professionals were very happy because all they had to do was show up with the vaccine and their arm was ready for the needle.
Barbers and stylists thought they were doing health-related things anyway. They always thought they were doing more than cutting their hair. No self-respecting black barber will say, “I’ll be in and out in 10 minutes.” It doesn’t matter how much hair you have. You will be there for half a day.
Wu: How big a difference do you think your network’s outreach efforts to close the racial gap in COVID-19 vaccination have made?
Thomas: Attribution is always difficult and success has many mothers. So I say this to you: There is no doubt that we have made a huge difference.In a disease like COVID, you can’t afford to leave your pockets unprotected. We were vaccinating people who had otherwise never been vaccinated.
We were also vaccinating homeless people. They were treated with dignity and respect. Court drives and shoe drives were held at some shops. There was also a dentist who provided oral hygiene products such as toothbrush, floss and paste. It made a big difference. When meeting people where they are, all their needs must be met.
Wu: How much difference has the declaration of a state of emergency and the release of resources, tools, and funding made to your team’s outreach efforts?
Thomas: Despite all the work I’ve done in barbershops since 2014, the pandemic got us our first grant from the state. There were resources beyond the usual mechanisms. We have secured thousands of KN95 masks and have been able to distribute them to shops.The same is true for rapid testing. I also sent them a Corsi-Rosenthal box, a DIY filter system to clean the indoor air.
Without the state of emergency we would still be screaming for help in the desert. The state of emergency allowed resources to be obtained through non-traditional channels, doing things other systems (hospital systems and local health departments) couldn’t. We have extended their reach to people who have historically been underserved and mistrusted.
Wu: The public health emergency declaration has not yet expired. What signs of trouble are you seeing now?
Thomas: The bridge between barbershops and clinical sites is closed almost everywhere, including here in Maryland. When I go to the store they tell me T, when is booster coming here? ” Then call the clinical partner who will provide the shot. Some people don’t answer my calls. And when they do, they say. I no longer do community outreach clinics because the grant ran out. The staff we hired during the pandemic, using pandemic funds, are gone. ’ But people are here. they want boosters. And my clinical partner says, “Send me to the pharmacy.” No one wants to go to the pharmacy.
You can’t see me, so you can’t see the smoke still coming out of my ears. We trusted them. Abandoning the community now only reinforces the idea that it doesn’t matter.
Wu: What’s the reaction to this from the community you speak to?
Thomas: It’s like, “I told you, they didn’t care about us. I told you, they leave us with all these other underlying conditions.” And you don’t need a pandemic to build trust. But if you lose it now, it will be very difficult to rebuild.
we built a bridge worked. why dismantle? Because that’s exactly what’s happening right now. The very infrastructure we created to bridge the racial gap in vaccine acceptance is being dismantled. That is totally unacceptable.
Wu: The emergency declaration was always over someday. Was it necessary to play like this?
Thomas: i don’t think so. Talk to hospital administrators and they will tell you the emergency declaration and the money they allowed to add outreach. Even if outreach proves that they can actually do a better job. And the campaign of misinformation and disinformation doesn’t stop. Why go back to what doesn’t work?
Wu: With limited resources, what are your teams planning for the short and long term?
Thomas: As long as Shots at the Shop can connect clinical partners to access vaccines, we will make sure it continues.
No one wants to go back to normal. Many of our barbers and stylists feel like they are alone. I am doing my best to provide them with KN95 masks and expedited testing. Conversations at our bi-weekly Zoom Town Hall Continuing. I started a podcast. We have put out some of our stories in the form of graphic novels. barber shop storybookWe are also launching a national association of barbers and stylists called Barbers and Stylists United for Health.
The pandemic has brought innovation mobilization, awareness of intelligence at the community level, and the need to culturally align strategies. You should keep those relationships intact. This is because it won’t be the last time we see a pandemic, even in our lifetime. Hopefully, people will find reaching out to the Black and Hispanic communities is worth maintaining.
