As fall gives way to winter, the sun sets sooner, leaving us in a darker state than months earlier. COVID has also followed suit in creating some dark days not only for our country, but our world and, most importantly, our communities here in N.M. The one flickering ray of light in recent news is that a vaccine is supposedly on its way. Two of them, actually! This is a much-needed victory for a country amid numbers that Friday resulted in one death every 90 seconds. But who shall receive that lifesaving vaccine may soon become a huge point of concern.
First and foremost will be those healthcare workers on the front lines. But even that cross section itself has a cross section. Those that are at higher risk need the vaccine first. So even retired doctors, minority health workers, workers with families can all be taken into account. Native and Hispanic communities in our state are especially at risk, and the lack of health facilities in those communities is of significant concern. The plans for this rollout are still under scrutiny. Calls to the N.M. Department of Health, State Secretary of Indian Affairs and Indian Health Service (IHS) all told me that those plans have yet to be set in stone and that more information will be available in the coming weeks. One tribal health program provided me their email from the state regarding the vaccine. The state has provided each tribe with a short survey regarding some key questions. Do you have refrigeration access below -2 degrees? Do you have a mass vaccination plan? How many health care workers do you have available?
The final and most crucial question was whether health programs would like the vaccine to be administered to the tribe via the Indian Health Service or the State of New Mexico Dept. of Health or a combination plate where you get “mas”—a little NMDOH and a little IHS. When I eat out, I always go combo. N.M. history tells me the relleno plate with a taco on the side is formidable and can’t be beaten. There was also a “d” answer that was basically “None of the above.” If you chose “d,” either you got a whole different plan, or you’re just crazy to not be planning for this yet. In actuality, it said, “To be determined.” Check the box under “Not even, bro.”
I mean, no offense to IHS, but that was a no-brainer vote. Considering the last article I’ve seen about IHS was their attempts to close local tribal facilities during this pandemic. Voting to go with NMDOH is most likely what many tribes will choose. Possibly the #2 Combo, but I figure that tribes right now have a better working relationship with Governor Michelle Lujan Grisham’s office than they do with IHS. Plus IHS is a massive federal ship; it takes a lot to steer, and NMDOH can move much more nimbly. Just to get an official statement from IHS takes them having to call and ask so many gatekeepers at the federal level; they might as well be sending correspondence by Pony Express.
An Oct. 14 article by Harald Schmidt, Lawrence O. Gostin and Michelle A. Williams in the Journal of American Medical Association talks about this issue in far greater detail. It lays out the ethical and legal matters that come with placing minorities and people of low incomes together with those at high risk when considering who gets these medicines first. The World Health Organization itself has released its statement on how vaccines should be distributed. The organization makes clear mention of the disparities that exist for some communities regarding health care and calls explicitly for these disparities to be addressed in the foundation of any vaccination plan. This is great to hear, but we shall see the real results. Not only in N.M. do we have our at-risk tribal folks, but we mustn’t leave out our small Hispanic villages either. They are in the same exact boat, but possibly get overlooked the most. At least the tribes have somewhat of a unified voice.
The legal discussion of this gets into scary territory. Some of the JAMA article discusses how a Supreme Court case might decide on an issue of service being withheld because of someone’s race. It begs the question: If an Anglo man and a minority man walk into a clinic with the same health conditions, but the minority individual was later in the line, will the minority individual receive this care first? Is that legal? It was something I found myself sitting back and pondering for an afternoon. And god forbid it gets to the point where it becomes an issue that the courts must take up.
It brought me to this conclusion—that once again, we can try and divide this situation and make it red or blue and now minority vs. non-minority, but it all comes down to one point. Let’s consider ourselves all people of one communal thing called “Life on Earth” and treat each other with humility and empathy. We might be able to get this vaccination out efficiently—and to people that can gain the most from it. Unfortunately, there are still groups of people who do not have this sense of community and would rather risk others’ health than just comply and do what’s best for everyone.
So I beg you. Vaccine or not. Stay home. Stay masked. Stay safe. Circle “e”—“All of the above.” [ ]