COVID-19大流行锚定战略工作组成员, left to right: Nicole McCann, Tina Tolson, Sherita Golden, Panagis Galiatsatos, Alicia Wilson. (Photo: Keith Weller)
Peering at his computer screen, Panagis Galiatsatos 评估巴尔的摩教堂的新座位安排. 他很高兴看到会众之间的距离将超过6英尺, 这是为了防止导致COVID-19的冠状病毒的传播.
自今年3月以来，这位肺病和重症监护医生以及 Medicine for the Greater Good has been participating in frequent telephone and video conversations with leaders of local churches, synagogues and mosques. In the early days of the pandemic, 他们讨论了如何将COVID-19信息添加到虚拟布道中. 现在的重点是安全地重新开放保护区.
“前线的人不是医生和护士，”加利亚萨托斯说. “We are the last line. The community is the front line. 人们越能传播正确的信息，而不是传播病毒, 我们就能更好地结束这一流行病.”
Better Health for All
The conversations are part of a multipronged push by Johns Hopkins Medicine and The Johns Hopkins University to tackle a particularly troubling aspect of the COVID-19 pandemic: the disproportionate harm it is causing to already disadvantaged communities, 尤其是非洲裔美国人和拉丁裔美国人.
The effort, 称为COVID-19大流行锚战略, 为巴尔的摩的社区带来信息和测试, 为讲西班牙语的推荐十大正规网赌平台提供额外的双语支持, distributes food, 并打开了与社区居民和领导人沟通的关键渠道.
“You can give people medicine, 但如果你没有满足他们的基本需求，你就没有真正对待整个人,” says Sherita Hill Golden, vice president and chief diversity officer at Johns Hopkins Medicine and a member of the Pandemic Anchor Strategy group.
Disparities Didn’t Start with COVID-19
The COVID Tracking Project, 哪个记录了各州的种族和民族差异, shows that African Americans and Latinx people are at greater risk of COVID-19 harm compared to whites in Maryland.
African Americans, at 29% of the state’s population, 占COVID-19死亡人数的41%和病例的36%. 占人口10%的拉丁裔占死亡人数的11%，患推荐十大正规网赌平台数的31%.
占人口51%的白人，占死亡人数的43%，占患推荐十大正规网赌平台数的26%. 在全国范围内受到严重打击的印第安人的死亡率不到 .占该州人口的0.05%——太少了，无法显示在跟踪项目的数据中.
The factors contributing to these health disparities were entrenched long before COVID-19, says Golden.
因为系统性的种族主义影响了医疗系统和社会政策, she says, people of color are disproportionately distrustful of health care institutions and more likely to live in neighborhoods with poor access to green spaces, healthy food, and safe and affordable housing. For those reasons, 他们更有可能患上哮喘等疾病, diabetes and cardiovascular disease, which can worsen COVID-19’s toll.
The same people are at particular risk of infection from the coronavirus because they more often have low-paying jobs that don’t allow the luxury of working from home or taking time off. They are also more likely to live in densely populated neighborhoods and in close quarters with extended family, 让身体保持距离成为挑战.
Latinx patients and families may also experience language barriers that hinder appropriate education, testing or care.
大流行使卫生保健机构的沟通更加困难. With face masks and noisy powered air-purifying respirators, speech is harder to understand. Also, visiting restrictions mean family members can’t be there to comfort their loved ones.
The Pandemic Anchor Strategy
In March, as The Johns Hopkins Hospital began treating its first patients who had COVID-19, Alicia Wilson, vice president for economic development at The Johns Hopkins University and Johns Hopkins Heath System, was thinking about how to take the hospital’s response to the pandemic beyond its walls.
在约翰霍普金斯大学校长的支持下 Ronald J. Daniels 约翰霍普金斯医疗系统主席 Kevin W. Sowers, she brought together health system and university leaders to form the COVID-19 Anchor Strategy Work Group.
The group identifies, 与巴尔的摩学校系统协调制定和部署干预措施, the city and state health departments, 和其他机构和组织带来教育, testing and other resources to Baltimore communities that are particularly hard hit by the pandemic.
The efforts so far include:
· Connection and Education. Johns Hopkins experts have led phone and video conversations and town halls with clergy members, parents, students and older adults on topics such as how to entertain children during the summer, and legal rights in case of eviction. Virtual movie nights, TikTok competitions and trivia games, offered in English and Spanish, 提供更多与年轻人建立联系的机会. 用英语和西班牙语分发的传单提供了有关保持身体距离的信息, 佩戴口罩等安全措施.
· Culturally Appropriate Care. A new program called Juntos seeks to reduce cultural and language isolation for Latinx patients and their families by connecting them with bilingual clinicians. “有人直接用推荐十大正规网赌平台的母语与他们交谈是令人欣慰的,” says Tina Tolson, 约翰霍普金斯医学语言获取服务的高级运营总监. Tolson created Juntos with Kathleen Page, associate professor of medicine; Centro SOL (Center for Salud/Health & Opportunities for Latinos) and the 多样性、包容性和健康公平办公室.
这项服务不能取代医疗口译, Tolson says, 但为这一弱势群体提供了额外的支持. “The Juntos providers are often able to ascertain more information directly from the patient to promote healing and ensure understanding of a complex clinical situation,” she says.
Talia Robledo-Gil, 内科-城市卫生居民, 是一打与推荐十大正规网赌平台和家属交谈的Juntos志愿者之一吗, 有时回答问题，有时只是缓解他们的孤立和恐惧. “With really critically ill patients, 这可能意味着向他们所爱的人解释为什么他们需要插管, 尽管他们昨天还好好的,” says Robledo-Gil, who grew up in a bilingual, 他在迈阿密拥有两种文化，父母出生在秘鲁.
· COVID-19 Testing and Follow-Up. 约翰霍普金斯大学的临床医生正在前往无家可归者收容所, sober living facilities and neighborhoods deemed COVID-19 hot spots to provide on-site testing.
They set up temporary testing sites, 其中一个就在琼斯瀑布高速公路下面, in response to requests from the city or from organizations like Health Care for the Homeless or the Helping Up Mission.
The testing teams notify people of their test results and help them get appropriate care if needed.
One option as a place to live for people with mild or asymptomatic COVID-19 — and for health care workers — is the Lord Baltimore Hotel. 通过约翰霍普金斯大学的合作, 马里兰大学医疗系统和护理第一, the hotel is providing rooms to people who are homeless or living in crowded conditions that make physical distancing difficult.
· Food. Grab-and-go meals and food pantries are available for employees at The Johns Hopkins Hospital, 约翰霍普金斯湾景医疗中心和西布里纪念医院. Wilson notes that employees may be living in households with reduced incomes because of pandemic shutdowns, 他们可能会担心去杂货店的安全问题. Johns Hopkins also works with the Maryland Food Bank to provide meals to thousands of low income adults in East Baltimore.
· Advocacy. “We are working with our government and community affairs team to brief state lawmakers about COVID and disparities,” says Golden. 还计划建议旨在减少健康差距的立法, she says, but they are still in the early stage. “We are able to have our pulse on a lot of these issues because we are talking and listening to residents,” says Wilson.
The programs all build on the recognition that health care does not begin and end at the hospital door. 有时，它会采取与青少年进行虚拟课程的形式.
加利亚萨托斯曾是Maree G的客座教师. Farring Elementary/Middle School in Baltimore, returned recently to give lessons about COVID-19. 他讨论了消毒剂的化学成分，并解释了口罩的重要性. 一名学生透露，她的母亲可能感染了COVID-19, 加利亚萨托斯为她安排了检查和所需的护理.
“My school has a very diverse population of learners,” says Olivia Veira, a teacher at Maree G. Farring. “他们的很多信息来自表情包和社交媒体. 他们想知道病毒从哪里来，什么时候能结束.
“Dr. 加利亚萨托斯用学生容易理解的术语来回答问题, 同时也强调了戴口罩和保持身体距离的重要性. 他给了他们真正的科学信息.”
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