Though a fraction of the doses typically given out at large mass vaccination sites, the event was a success, say organizers — a coalition of health care providers and elected officials. Held outdoors, it allowed for a physically distant, communal atmosphere that many have missed over the past year.

“People would get their shot, and then say, ‘I’m going to get my wife or my daughter,’” said Dr. , a Tupelo internal medicine physician and coalition member.

The group has held two more events and administered a total of 110 doses, Rayford said. More pop-ups are scheduled.

Mississippi had already narrowed an outsize gap in covid-19 incidence and mortality rates for its Black residents, leveraging community partnerships to promote masks and physical distancing while dispelling rumors. Now health advocates hope to stretch those partnerships to help ensure vaccines reach all Mississippians equally.

It appears to be working. Vaccine rates are neck and neck among Black and white residents, with available state data showing a slightly higher rate for whites and Centers for Disease Control and Prevention data showing the opposite. Mississippi is one of the few states where the Black rate isn’t lagging significantly behind the rate for whites.

And as of mid-May, African Americans, who make up 38% of the state’s population, are getting 40% of the doses given each week, said state epidemiologist Dr. .

“We continue to reach parity with our doses,” Byers said during a May press conference.

This is the latest phase of Mississippi’s dramatic turnaround on covid among its Black residents.

In the first four months of the pandemic, the incidence of covid was almost three times higher for African Americans than whites — 1,131 cases per 100,000 for Black Mississippians compared with 403 cases per 100,000 for whites. Mortality in those first months was almost twice as high for African Americans — 46.2 per 100,000 compared with 24.6 per 100,000 for whites, based on an analysis of weekly covid reports published by the Mississippi State Department of Health.

“Covid revealed what many already knew in the public health community: that the inequities in Black and brown communities have existed for a long time,” said , who directs the state health department’s preventive health and health equity division.

That disproportionate toll on Black Mississippians started to wane, though, as covid cases began a rapid climb in the state and the rest of the country in the fall. Public health officials saw per capita rates of infection and deaths for African Americans drop below the rates of the white population. Through the peak of the holiday covid wave in mid-January, the infections and deaths rose for both groups, but the rates for African Americans remained lower than for whites.

State health department officials pointed to outreach through churches, historically black colleges and universities and community organizations that reinforced the importance of masking and physical distancing among African Americans. Efforts were also underway to reach other underserved groups, including Hispanics across the state, Native Americans in eastern Mississippi and Vietnamese communities on the Gulf Coast.

While Mississippi was , the groups hit hardest by the pandemic were more open to masking and physical distancing than the overall population, health officials said.

“It didn’t get political in the African American community,” Rayford said.

In Tupelo, the Temple of Compassion and Deliverance’s Bishop Clarence Parks was among the Mississippi clergy who used his pulpit both in his church and on . He lost his 91-year-old mother to covid on April 9, 2020. Hers was among the first cases diagnosed in Tupelo.

“It did give me a sense of urgency,” Parks said. “I saw what covid was doing.”

In addition to moving church services online and into the parking lot, Parks made a point to talk to his congregation about how to protect themselves, their parents and grandparents from covid. As small groups came back inside the church, masks were required. He talked to other pastors about safeguarding their flocks. Parks, 61, posted on Facebook when he got his covid vaccine.

In his congregation of 400, Parks estimates about 15 became infected with covid.

“My mom is the only one in our church who passed from covid,” Parks said.

Mississippi Valley State University, a historically Black school in Itta Bena, a town in the Mississippi Delta, hosted drives to distribute masks and information on protective measures, plus hosted Zoom community meetings to reach beyond its campus boundaries.

“We’re trying to focus on the Delta,” said , chief of staff and legislative liaison for the Mississippi Valley president.

Parity on vaccines, though, got off to a slow start. When supply was limited and appointments were snapped up in minutes in February, African Americans were receiving about 15% of the vaccines distributed through the state health department. As more vaccine became available, the department started sending thousands of doses to community health centers and clinics serving large minority populations, said State Health Officer Dr. .

“We want to make sure we‘re addressing trust and access issues,” Dobbs said during a February press conference.

In southwestern Mississippi, Alcorn State University, a historically Black school, organized a vaccine clinic in partnership with the state health department and local county emergency management agency. Located in a rural county with the closest hospitals about 45 minutes away by car, the university has attracted between 160 and 200 Mississippians to each drive-in clinic session. The organizers even made walk-up appointments available to reach students and staff members on campus.

“We’re drawing a wide range of ages and races,” said Jennifer Riley Collins, Alcorn State’s covid response coordinator.

In recent weeks, the state health department has increased efforts to partner with community groups on smaller vaccination events and to reach the homebound. They are also working to direct the public to pharmacies and clinics offering the vaccine.

Health advocates remain concerned that more Mississippians of all races and ethnicities need to be vaccinated or the state risks another wave of infections that could overwhelm health care resources.

In results released in mid-May, the Mississippi State Health Department, which polled 11,000 state residents across all 82 counties between December and March, found that 73% were likely to take the vaccine, but as of Thursday only 33.7% of the state’s residents had rolled up their sleeves for at least one dose, according to CDC data. Nationwide, the rate was 49.9%.

Among African Americans, the survey found 56% intended to get vaccinated, compared with 80% of white Mississippians.

“We’re still at risk,” Dobbs said. “We still have a large part of the population that is still vulnerable.”

Even as racial equity in vaccine distribution has improved, closing the gap among the still hesitant and skeptical remains a significant challenge to achieving widespread immunity.

Health care workers, ranked as top vaccine influencers in the health department survey, will need to switch out of their traditional role of giving monologues and engage instead in a dialogue to understand what is preventing the unvaccinated from getting the shots, said Dr. , chief medical officer for Tupelo-based North Mississippi Health Services.

“We need to listen more effectively,” Blanchard said.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

The 55-year-old man, who moved to Tupelo from Georgia to take care of his dying father nearly four years ago, found manufacturing work that came with health insurance. But last month, he joined 26 million other Americans who have lost their jobs because of COVID-19 in the past five weeks.

With the job went Delbert’s health coverage — and the money to pay for medications to control his diabetes and cholesterol. Insulin alone would cost him $600 a vial. Delbert said he would be sunk without the free clinic, which opens twice a month to provide health care at no charge to anyone without insurance.

“My medications are so expensive,” Delbert said. Because of the medication assistance, he added, “I can keep my head above water.”

Typically, three rows of benches outside the clinic are filled hours before it opens. Forty volunteers coordinate paperwork, eye screenings and prescriptions. A dental clinic performs extractions based on referrals from the clinic. Through the eight hours it is open each month, the Tree of Life provides basic medical care for 175 patients, fills around 700 prescriptions and provides dental services for 30 patients.

But at the beginning of March, Dr. Joe Bailey, the clinic’s founder, consulted with local infectious disease specialists and pulmonologists to figure out how the clinic could continue to safely care for its patients as COVID-19 spread.

“They advised us to close, but I didn’t have the heart to do that,” Bailey said. “We came up with a workable compromise.”

Now, though the Tree of Life continues to open twice each month, its operations are far from routine. Patients wait in cars for the volunteer physicians to review their charts and pull together prescription refills. Volunteer medical staff cannot do physical checkups. The dental clinic is closed because the state health department ordered all elective dental care to be deferred.

The same 10 volunteers handle each session to minimize exposure for others. Six of them are over 50, with Bailey and retired cardiologist Dr. Mike Boland both 73. They’ve tried to get coveted N95 masks but do not have any personal protective equipment, known as PPE, beyond gloves and two boxes of basic disposable masks.

Across the country, other free and charity clinics are facing similar challenges as the need for them will only grow larger as more people lose their job-based insurance and struggle to pay their bills.

To adapt, the clinics are turning their delivery models on a dime, said Nicole Lamoureux, president and CEO of the , which represents 1,400 organizations. Some clinics are like the Tree of Life, focusing on medication refills. Some screen patients for fever before they come in for appointments. Others are trying to establish telemedicine options, even as such clinics have been left out of federal relief packages thus far.

“It doesn’t matter if they have a $1 million budget or $95,500,” Lamoureux said. “There’s no federal funding and no access to PPE.”

Still, charity clinics are finding ways to continue their free care.

“Our role is to help people stay as healthy as they can during a scary time,” Lamoureux added. “Without that service, they would be going to the ER, no question.”

Surge Of Need Looming

The Tree of Life operates out of a West Main Street building provided rent-free by neighboring Calvary Baptist Church in this city of 38,000 in northeastern Mississippi. It sees anyone without public or private insurance, regardless of residency, work requirements or immigration status, drawing patients from around the region. In 10 years, the clinic has recorded more than 22,000 patient visits.

“It has exceeded our wildest expectations,” said Bailey, a retired gastroenterologist. “The need is greater than I anticipated.”

Yet on April 18, the clinic handled just 224 prescriptions, including 74 bottles of insulin. Bailey worried people are going without at a time when it’s most important for people with diabetes and hypertension to stay healthy.

“Ordinarily, we have 25 to 30 new patients each time,” Bailey said. “We had two or three.”

The clinic can take new patients who need help getting refills to keep their chronic conditions stable if Bailey feels he can safely prescribe to them. But the volunteers are limited in what else they can do, given the lack of protective equipment.

“We can’t do complete physicals or blood tests,” Bailey said. “We try to provide what they need. It’s not ideal.”

Charity clinics are bracing for a tsunami of new patients, though, because so many people have lost health insurance and income, Lamoureux said. The influx could come as donors and foundations are forced to scale back clinic funding because of the economic downturn.

“They see a wave coming,” she said.

Although economists can track layoffs via new unemployment claims, tracking the uninsured in real time is trickier, as each worker can carry insurance for multiple family members, and some are able to shift to other sources of coverage. An analysis by the Economic Policy Institute estimated that of losing their health insurance coverage.

The Coverage Gap

Before COVID-19, Mississippi had a high rate of uninsured: 18% for adults ages 19-64 compared with 12% nationally, according to the . The state did not expand Medicaid eligibility under the Affordable Care Act and very few able-bodied adults can qualify under the state’s requirements.

“We anticipate we will see a lot more people falling into the coverage gap,” said , executive director of the Mississippi Health Advocacy Program, a nonprofit that operates a help line for consumers with Medicaid, ACA and private health insurance issues. “It will only get worse.”

He does not see how the state can continue to avoid expanding Medicaid eligibility on ideological grounds as the long-term effects of the pandemic and economic disruption hit Mississippi families and rural hospitals.

“Right now, the state needs every tool to fight coronavirus and stay safe,” Mitchell said.

Jacqueline Vance was trapped in the coverage gap even before the COVID-19 pandemic. The 37-year-old Pontotoc, Mississippi, resident has acute asthma, sarcoidosis, fibromyalgia and coronary artery disease.

“I make $100 too much for Medicaid,” Vance, who works as a school bus monitor, said as she waited at the Tree of Life clinic.

With her weak lungs, she needs to stay as healthy as possible. The ER is the last place she needs to be.

“This is really scary for me,” Vance said.

Delbert, the man who joined the uninsured after losing his manufacturing job last month, said that he hopes he will soon be back at work but that he is deeply grateful for the Tree of Life.

“They were here for me when I couldn’t help myself,” Delbert said. “This is a really big help to the community.”

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .