Women in their 40s and 50s who survive COVID are more likely to suffer from persistent problems: UK studies

The New York Times

Hospital finds vacillation hesitation: ‘I just don’t rush’

NEW YORK – When it was Rev. Al Sharpton’s turn to get vaccinated against COVID-19 last month, he did so in front of the camera at NYC Health + Hospitals / Harlem, a city institution known for providing healthcare to the black community. . Sharpton was trying to send a message to his community: the vaccine is safe and effective. But that message was also directed at the hospital staff. At one point, the facility’s staff had the lowest vaccination rate among hospitals in the city. Even after steady improvement, as of mid-March, the hospital still had a rate well below the average for hospitals in the state. Sign up for the New York Times The Morning newsletter In New York State, African Americans make up about 17% of the adult population, but have only received 10% of their vaccinations. That’s due to difficulties in accessing vaccines, but also persistent reluctance, and that has sounded true at Harlem Hospital, where most of the staff is black, administrators said. The situation at Harlem Hospital underscores how ingrained this mistrust can be: Even workers at a hospital where the vaccine is available are cautious about getting vaccinated. But it also shows how progress can be made in changing attitudes about vaccines, albeit slowly. At Harlem Hospital and nationally, confidence in vaccines has increased among African Americans. Recent polls show that black Americans, although initially more skeptical, are now as likely to want to be vaccinated as white Americans, and that politics, not race, is emerging as a major divide. Republicans are now the group with the highest degree of skepticism: In a CBS News poll from late February, 34% of Republicans said they would not be vaccinated against COVID-19, compared to 10% of Democrats . Brazil Rice, 54, who has worked at Harlem Hospital for 21 years in cleaning and maintenance, was one of those who said they would wait. “It was not properly tested in the field,” he said. “It generally takes years to test a vaccine in the field.” He stressed that his distrust has nothing to do with the hospital, which has made getting vaccinated “quite convenient.” “I have every intention of getting it; I’m just not in a rush, ”he said. And when the hallways are quiet on the night shift, he watches over his friend who has been vaccinated and so far he’s fine, he said. Harlem Hospital’s low vaccination rate did not surprise its leaders. A survey conducted at the institution in late 2020 before the vaccines were approved, showed that only 30% of workers were willing to get vaccinated, said Eboné Carrington, the hospital’s executive director. Black workers cited concern rooted in the legacy of medical injustices such as the Tuskegee experiment, a US government study that withheld syphilis treatment from black men, and general skepticism about a vaccine developed rapidly, under one administration. they didn’t trust. “The staff reflects a population of people who are traditionally reluctant to vaccinate, and not just hesitant, but legitimately fearful that they have been wronged,” he said. The hospital is known as a historic training ground for black medical personnel and for saving the life of the Rev. Dr. Martin Luther King Jr. after a woman suddenly stabbed him in the chest in 1958 at a Harlem department store. Attracted by its prominence, local celebrities have been vaccinated there. Neil deGrasse Tyson, the astrophysicist, posted on Twitter about his recent inoculation at the hospital. “If we can inspire people, as we have done countless times, to protest against certain social ills, I hope we can inspire them to do whatever it takes to have a healthy environment in our community,” Sharpton said in an interview about his vaccination. Keisha Wisdom, a Harlem Hospital chief nurse who spent time in an intensive care unit in 2020 after contracting the coronavirus, also released her vaccine. “I think the history of medical experimentation in black people plays a role in some of the decisions made,” Wisdom said about why about half of his nursing staff remained unvaccinated. “It’s real and it’s something we need to talk about. And then find a way to continue that dialogue. “The first weeks of the vaccine launch saw widespread vacillation among hospital workers across the nation and New York state, with less than half of eligible workers vaccinated early. In the city’s public hospitals, the number was even lower, 31%. That earned the ire of Governor Andrew Cuomo. “This is a management problem for hospitals,” he told a news conference. January 4. While vaccination rates at other hospitals improved, Harlem Hospital was among those that lagged. In late January, Cuomo repeatedly singled out the institution at press conferences for having the lowest rate in the world. city, 37%. The approach angered Carrington, who felt she was being punished for having a black and tan staff whose concerns she was trying to address. Her mother called to express concern. upation when he heard the harsh words of the governor. “Mom, I don’t care,” Carrington told her. Harlem Hospital has been trying to raise the rate with a “reach blitz” that includes advertising, town halls and personal conversations. Its current vaccination rate among staff, 51%, puts it “in the middle” of the 11 hospitals in the city’s public system, the city said, but still well below the average vaccination rate of nearly 80%. for hospitals in upstate New York like everything. Some nurses told their supervisors they didn’t feel an urgent need to get vaccinated because they already had COVID-19, Wisdom said. The hospital was hit hard by the virus, with about 200 patients dying between March and September. The fatality rate was 36.6%, among the highest in the city, according to data that the hospital reported to the state. Now there is no shortage of personal protective equipment, which is why some staff members said they felt safer. “The staff says, ‘I almost died in the first wave, I’m fine,'” Carrington said. “There is this invincibility that is difficult for me to compensate for.” Dr. Mitchell Katz, executive director of the city’s public hospital system, said last month that about 40% of nurses in the city’s public hospitals remained unvaccinated. But instead of expressing alarm, he said he was willing to be patient in the coming months and focus on personal outreach, such as one-on-one conversations, to increase the rate. The additional resources did not flood Harlem Hospital after Cuomo’s criticism, nor did Katz attempt to reprimand Carrington. Katz said he was not tracking vaccination rates by hospital because he believed the rate was not a management issue, but was related to the percentage of black and brown staff at each institution. “To me, there are very understandable reasons why people don’t want to get vaccinated just yet,” he said, mentioning the lack of long-term studies on COVID vaccines and the negative experiences that many black and brown New Yorkers have had with doctors. . “It amazes me that so many people are surprised.” Jasmine Travers, an assistant professor at New York University’s Rory Meyers School of Nursing who studies vaccine hesitancy, said empathizing with staff reluctance was a good start, but not enough. The goal, he said, should be 70% to 80% acceptance and a determined effort on the part of leaders to achieve it. “We should not simply attribute a rejection to that person’s own wishes; we also have to look at ourselves and understand how we are dealing with it, ”he said. “We cannot tiptoe around the subject. It’s one thing to want to be respectful, but we have to ask people how we can best support them. What is the work to do? “Warren Davis, 54, a carrier at Harlem Hospital, was one of those who got over his concerns and made an appointment for a vaccination in late February. Davis believes he had the coronavirus in May, but it was never done. the test. He said he was concerned about the vaccine’s short-term and long-term side effects. He also heard a variety of conspiracy theories, including that the vaccine was designed to harm black people, and for a time, he said, he got caught He then reconsidered. “A lot of people are receptive to the bullshit they’re hearing, the rhetoric that people are telling them,” he said. Sharpton said he had heard that conspiracy theory and many others. He advises leaders to assume those ideas directly, he said, because the vaccine is necessary to keep people safe. “When you see all these white people queuing up to take this vaccine, do you really think they are sacrificing all these people just to Would you kill some of us? “he said. “When are we the ones who don’t have access?” This article originally appeared in The New York Times. © 2021 The New York Times Company

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