What happens when a government, while attempting to address a health inequity in one community, creates an inequity in another? That question has plagued me for several weeks, as I have watched DC officials make a muddled mess of the rollout of the city’s coronavirus vaccine distribution program.
Initially, the process appeared to involve a generalized registration and appointment system. Then came allegations that in effect cast whites as villains who were snatching all or most of the vaccine doses while Black and brown people suffered. Those concerns raised by some DC Council members and advocates gained steam in the press.
Mayor Muriel Bowser and her health director, Dr. LaQuandra Nesbitt, knee-jerked. They shifted from the generalized distribution system that captured all essential health care workers, first responders and seniors over 65 to one that favors certain ZIP codes. That move seems to have resulted in white residents, especially senior citizens — even those with underlying health conditions that make them vulnerable to COVID-19 — essentially being placed on hold; many have sought to understand why they are being treated so poorly by their government.
The controversy surrounding the vaccine distribution portends future racial tensions in the District, as elected officials step up to fulfill their promise of addressing centuries of institutional racism — never mind that at least for the past 40 years African Americans have had their imprimatur on all things DC, managing the local government while setting public policies and funding priorities.
In other words, claims of racial and economic inequity are often more complex and complicated than they appear. As data become available, the same may be true around DC’s vaccine distribution. But few are waiting for all the facts.
“Equality says vaccines will be distributed equally across all wards,” explained Brian McClure, director of the new Council Office of Racial Equity (CORE), which was created through the Racial Equity Achieves Results (REACH) Act unanimously approved last year by the legislature.
“Equality does not take into consideration certain adverse conditions,” continued McClure. “Equity does that assessment.”
As background, the REACH Act was advanced by council Chair Pro Tempore Kenyan McDuffie. The law also mandated the executive branch create a similar entity. Mayor Muriel Bowser announced earlier this week that her administration has begun the search for a chief equity officer, who will be responsible for developing and leading the DC government’s equity team, convening ongoing equity initiatives, and advancing the goal of achieving racial equity.
“As we continue our [coronavirus pandemic] recovery into 2021, we have a unique opportunity to double down on our efforts to put racial equity at the forefront and revitalize systems to ensure a more inclusive and prosperous future for all Washingtonians,” she said in prepared statement.
There have been many questions about how McClure, a former council staffer, became the legislature’s equity czar. During an extensive telephone interview, he told me he worked for McDuffie, and for 2 1/2 years focused on the equity legislation.
Did he have the inside track? McClure said he went through a competitive and national selection process. The DC Council’s secretary, Nyasha Smith, told me via email that 37 applications were received. Along the way, “We re-posted the position with an increased salary and heightened application process which required a two-page writing sample.” She said a selection panel conducted interviews with seven individuals. The top two were invited for a second round. “The panel overwhelmingly recommended Brian; he is qualified, capable, knowledgeable and has a vision,” continued Smith, adding that the other finalist was hired as deputy director.
The combined annual salaries of McClure and three others in the office amount to $405,000, according to Smith. That’s a lot of money in the middle of a pandemic.
McClure was less interested in discussing the mechanics of his job interview. He said he is focused on the work, including my concern that the push for equity in the vaccine distribution may be harming communities in wards 2, 3 and 6.
“Racial equity does not mean we are going to take anything away from other people,” he asserted.
Except that by using the racial lens, some folks in non-prioritized communities have had little or no access to the vaccines. I have received calls from several people who are 70 or older and suffering heart disease and cancer. They are desperate to be inoculated.
It’s true that people of color, particularly Blacks, have been disproportionately impacted by COVID-19 in terms of infection and death rates. I was among the first to report locally on that dynamic. However, the reasons for that situation are myriad and go beyond race, blending with culture and health care attitudes.
For example, Wayne Turnage, deputy mayor for health and human services, told council members earlier this week during a public roundtable that 36% of DC’s Black residents are less likely to seek vaccines than their white counterparts. “I see it in my conversations with my friends. I see it in conversations with my family,” he said. That reluctance is based in part on historical experiences with government-issued vaccines and other medical experiments.
Further, initial reports have portrayed whites as being the dominant population being vaccinated in DC, that may not be accurate. The Bowser administration released data earlier this week indicating 17,000 whites and nearly 10,000 Blacks have been inoculated in DC. However, neither race nor ethnicity information was recorded for 35,000 others. At a press conference, Nesbitt declined to make any “inferences” given the incomplete data.
Then, there is the fact that the lion’s share of the vaccine has been distributed through hospitals, federally approved health clinics and other places where front-line and
essential workers are being vaccinated. Without a full understanding of how those demographics have skewed the totals, it may be too soon to declare massive discrimination.
Nevertheless, the government’s reaction to the claim of racial bias has adversely affected many residents. Ward 3 Council member Mary Cheh wrote a long email to her constituents explaining that the city was trying to give priority to those who are most vulnerable to contracting the virus and dying from it.
“People understood that,” she told me during a recent interview. Still, she offered that the Bowser administration could be “a little bit more sensitive to the fact that vulnerability transcends ZIP codes and race.”
The council’s equity director expressed satisfaction with the executive’s favored ZIP code approach: “There are deep and pervasive disparities, and the common denominator is race,” he told me, before taking me on a tour of racial inequities dating back to 1808 with the first set of Black Codes passed in DC and through local contracting rules that seem to give preference to white-owned, out-of-state companies.
“Our office is here to disrupt the norms that have caused harm,” McClure said. “We are disrupting public policies that will exacerbate inequity.”
He lauded his former boss for raising the equity question. “Then, it wasn’t until those maps and charts were published that people had the visual of the disparity,” referring to the information on COVD-19 deaths and infections available on the District’s coronavirus data webpage.
A picture is worth a thousand words. Sometimes, however, the picture provides an incomplete story — a fact made clear as additional data on vaccinations are being released.
DC’s distribution seems far too arbitrary for me. Though increased supply from manufacturers and the federal government is the ultimate fix, Cheh is right to call for refinements to the current “Hunger Games” system. She has suggested the city consider the approach in New Mexico, where residents are permitted to register and are given a tracking number.
The mayor and Nesbitt have said, however, that they may make a few tweaks but will continue using a system of priority ZIP codes. This week Ward 4 slipped off the list of favorites. Expect a loud and sustained uproar.
We can all find some satisfaction that institutional racism has taken center stage. President Joe Biden has set racial equity as a priority in his administration.
Some critics have said it’s all performative. Locally, they cite as evidence the fact that while McClure’s office will conduct equity assessments of public policy proposals, those evaluations are “non-binding.” Council members can take them or leave them — unlike the compulsory fiscal impact statements. McClure has promised to be comprehensive and “data-driven.”
Will he push for action in the absence of sufficient data, as is being done with vaccine distribution?
Racism, including institutional racism, in this country is a complicated, complex thing. Defining it and parsing its effects can be difficult and messy.
District officials ought to be careful not to create an us-vs.-them environment, especially since most white residents in this city seemingly embrace the goal of dismantling institutional racism. The mayor, the council and other leaders can begin to display their understanding of the complexity of the work to be done by reevaluating the design of the vaccination distribution program, ensuring that residents with underlying health conditions are inoculated soon, regardless of their race or ZIP code.