When Dr. Nana Afoh-Manin watched Covid explode in Los Angeles, she wasn’t at all surprised to see who was bearing the brunt.
Low-income communities. People of color. “Those who are not insured or underinsured, don’t have regular access to a doctor,” Dr. Afoh-Manin recalled.
In other words, people who are most likely to struggle with health and health care access already. With a pandemic added onto those conditions, “you’re going to see people dying and the mortality explode, and that’s exactly what we saw with Covid.”
Dr. Afoh-Manin – an emergency room physician and advocate for patients and health care workers alike – working with two colleagues, began offering Covid-19 testing at pop-up sites, first in Los Angeles, then in cities around the U.S., through a new task force they call myCovidMD.
It’s a way to get testing to people who might not otherwise get it, often because they lack access to a health care provider, or are uninsured or underinsured.
Although there’s scant evidence on the subject, it’s likely that testing, like health care more generally, isn’t equally accessible, and that people of color are underserved.
Testing sites aren’t always located in places that people can easily access, which is why myCovidMD offers testing in lower-income, largely Black and brown neighborhoods. For people who don’t have a car, drive-through testing won’t work. An organization’s testing hours may not be convenient for someone working a public-facing job.
Even if myCovidMD just offered Covid-19 testing services, it would be a boon to the community that the task force serves.
But Dr. Afoh-Manin sees tremendous potential in the one-time connection between a concerned patient wanting a test and the health care worker in the volunteer lineup.
That one-time encounter presents an opportunity – to connect people to the health services they most urgently need, whether it’s reliable prenatal care or treatment for a mental health concern that the long-running pandemic has only worsened.
“We have to actively engage to break down those barriers for people who are more disenfranchised,” Dr. Afoh-Manin said.
Pop-up events are done in what Dr. Afoh-Manin describes as “kind of a block party style,” with a video jockey and giveaways: a pair of high-end tennis shoes, a vegan jambalaya meal. People who show up can receive fruit and vegetables free of charge.
Free Covid-19 testing is available, but so are telehealth services – a volunteer can instantly put an attendee on the phone with a doctor or mental health provider, who can conduct an assessment and help connect the patient to services.
But in addition, each person who receives a test is assigned to a “community health partner,” who will follow up with them on their test results and also help coordinate access to health care, whether that’s connecting the person with a local health center or referring them to a nearby asthma clinic.
And mental health needs are significant, said Dr. Tichianaa Armah, a psychiatrist who oversees the community health partners, and who has played an active role in finding mental health practitioners “who are committed to and want to do something to improve the status of the people who are the most underserved, the most vulnerable of our population.”
Like Dr. Afoh-Manin, Dr. Armah sees the opportunity that Covid-19 presents. The testing itself is a valuable opportunity to connect with people dealing with what she calls “bread-and-butter anxiety and depression.”
While many underserved people see mental health care as stigmatized, she said, the fact that the pandemic has been so difficult – on everyone – has made them more willing to seek care.
“This is the time when so many people who saw it as a weakness, saw it as some kind of a character flaw, can open their minds,” she said.
The mental health providers who volunteer with the program don’t just treat patients.
“Both the people who are getting tested and also providers on the frontlines are going through a huge amount of stress right now,” Dr. Armah said. Psychiatrists and other mental health providers are also supporting the people doing testing and other frontline health services.
When it came to finding volunteers for myCovidMD, Dr. Afoh-Manin had a ready pool.
She and her fellow myCovidMD founders had already created the larger initiative Shared Harvest, which helps people entering the health care workforce – many of them from low-income backgrounds – with the often staggering student debt they’ve accumulated.
“We knew that we were going to lose those voices if we could not deal with the mental and financial aspects of what they were dealing with,” she recalled. Shared Harvest was an attempt “to solve a deep problem that I don’t think society even cared about.”
When she began looking for health care workers to act as volunteers for myCovidMD, “it just exploded,” thanks to the network that Shared Harvest had built up over time. “They understood our mission,” Dr. Afoh-Manin said.
Direct Relief has been supplying myCovidMD volunteers with PPE to allow them to continue frontline testing and health services.
For Dr. Afoh-Manin, Covid-19 isn’t just an opportunity to increase access to health care for those who show up for testing. It’s an opportunity to have a much larger conversation about health care access.
“There are actual ideas [about increasing health care access] that have never been implemented because we can’t get past the funding,” she said. “Then we hit Covid, and we realize we’re a lot more connected than we want to be.”
Dr. Afoh-Manin is hopeful that people see that interconnectedness as the pandemic spreads through and among communities – and that they’re willing to act on it.
“I’m also in that opportunistic mode because I’m like, ‘Oh, we have your ear now,’” she said. “Let me do Covid and prenatal care for young single moms,” along with a host of other widespread, inadequately addressed health care
But she doesn’t discount the small-scale impact, either. When it comes to connecting patients with the doctors and programs they need, “we’re literally like the little engine that could,” she said.