Gov. Jim Justice advocates for “age, age, age” when it comes to arguing who should be among the first in line for Covid-19 vaccinations in the state. And, as is his habit, he makes the obvious point. Public health statistics show the elderly, especially those in congregate settings such as long-term assisted care facilities, are among the most vulnerable to the devastating effects of the disease.
But the lines that the governor draws, and there are many in his vaccination program, cannot be so hard and fast or totally obedient to age that essential workers, some of whom are those hardest hit by the pandemic, are left standing in back of the line. Next to our health care workers, these are people who by dint of their work are among the most exposed to the transmission of the disease. Right now, grocery store workers – by way of example – are not singled out in the governor’s plan.
And while that is a problem – it is also eminently fixable.
We know that nursing homes in West Virginia have accounted for about 40 percent of the state’s 1,253 Covid deaths. So, yes, by all means, the statistical profile makes the logical case that people in such congregate settings, along with the people who care for them inside the facilities, should be the first to be offered vaccinations.
So, too, with those health care professionals who work inside hospitals – nurses, doctors, specialists, their many assistants and administrative staffers.
And that is the fire, as the governor is fond of saying, that the National Guard is running to with the first batch of two different vaccines – one by Pfizer, one by Moderna.
The plan, as Justice has broadly outlined, offers vaccines – based first on availability – within six weeks to all individuals identified in four categories. In addition to assisted living residents and staffers and hospital employees, people in community infrastructure such as ambulance drivers, first responders, emergency responders and the National Guard are on the list. It extends its reach as far as home health providers and covers those in education, both higher ed and K-12, and utility and transportation workers.
Nowhere, however, does the governor’s plan account for the likes of the neighborhood grocery store worker or those with jobs in restaurants or construction or the retail shop downtown or out at the mall.
Not only does it make sense to include these people from a public health policy standpoint, but from an interest, too, in support of our economy. Seems like we would do well to protect those who serve so many.
Low-wage workers have suffered the brunt of the economic pain of the pandemic. Social distancing measures have resulted in huge job losses among lower-wage workers. Leisure-hospitality and retail, which offer lower wages than most, took the hardest hits, according to a Brookings Institute analysis. In April, retail posted a 17.1 percent unemployment rate across the United States, totaling 3.2 million people. In leisure-hospitality, the unemployment rate was a staggering 39.3 percent, totaling 4.8 million people.
The coincidence to be leveraged, here, is that these essential workers, who are low wage and represent a larger proportion of people of color than other priority brackets within the governor’s plan, are the very people who are getting hit especially hard by this disease. Black, Latino and Native American have death rates that are close to three times as high as they are for white and Asian people. Low-wage workers and people of color shoulder some of the most severe financial and health burdens associated with the coronavirus. If they could move closer to the front of the vaccination line, transmission of the disease could be – would be – strangled in communities where it is most prevalent and doing the most damage. That would be both a public health and an economic policy win.
It would also help correct an overreliance on age, age, age calculations.
Consider this: The average age of death from Covid for a white person across the country is 81, but for a Latinx person it is 67, and for a Black person it is 72. Many of the people in these groups don’t even reach 75. And if an age bracket for vaccination begins at 75, whom are we helping? Whom are we not?
We are not certain as to what the right age brackets are, but we should think about how to make it equitable and data-driven, and the most effective at stopping the disease where it is rampaging. We need to understand that the virus has spread along social inequality fault lines, not just those of age. Vaccines and medical interventions will protect the most vulnerable only if we take careful and considered aim.
It comes down to leaders like Justice who will be responsible at day’s end for pushing these vaccines out in weighted numbers so high-risk areas get more vaccines first, so that clusters of infection are attacked, so that we protect those people who often have no choice but to show up for work – often to feed their families and keep the lights on – in high-risk, public-facing settings.
They do that for us. What are we doing for them?