Breaking barriers to COVID-19 care
UC Davis casts wide safety net for people with decreased access to medical services
When Pastor Mark Meeks of City Church of Sacramento told his city councilman, Jay Schenirer, that he wanted to make sure people in Oak Park would have access to the COVID-19 vaccine, Schenirer introduced Meeks to UC Davis Health CEO David Lubarsky. Thanks to that connection, in February, an old section of the church sanctuary was quickly converted into a full-fledged vaccine clinic.
Meeting people where they are to administer COVID-19 vaccines has been a hurdle to jump for UC Davis physicians, medical staff, faculty and students. Near the end of winter when a steadier supply of vaccines began to arrive across the Sacramento area, UC Davis leaders worried about whether medically underserved populations would have access to the shot. Statistics exposed alarming rates of infections in poorer neighborhoods.
In addition, some ethnic and racial groups showed wide health disparities in the pandemic — although Latinos comprise 40% of California’s population, they had nearly 56% of the state’s COVID infections and 46.5% of COVID deaths.
Thus, clinics such as the one at City Church, a community-minded congregation that serves the Oak Park neighborhood and is adjacent to the UC Davis Health campus filled a glaring need. As Meeks put it, the vaccine clinic in the church sanctuary “(Is) not a broad broadcast, but a very targeted, hand-to-hand, person-by-person encounter to let folks know that COVID vaccinations are being offered in the Oak Park community.”
To modernize the space, UC Davis Health installed high-capacity infrastructure that included routing ethernet cable to the patient registration area and brought in a low-temperature fridge for vaccine storage. Meanwhile, the church sent its members on a special mission to reach the community by canvassing door-to-door.
The effort, what Meeks likes to call “low-tech, high-touch,” quickly registered 100 people for the first clinic on March 12.
City Church chaplain Tracee Lewis knocked on doors, trying to convince
residents that the COVID vaccine “will open up the world to them, their family to them a little bit.” She added that she was eager to be involved in this outreach “as part of not just the African American community but the Oak Park community, which is very diverse.”
On the clinic’s opening day, a smiling Lewis greeted those she had signed up. She watched as community members worked their way through an efficient operation staffed by UC Davis employees — from the registration desk, to the vaccination table, to the monitoring area.
UC Davis Health has since partnered with numerous community organizations in a robust effort that has resulted in the immunization of tens of thousands of people, many of them from communities with limited access to health care. The initiative includes undergraduate and medical students volunteering at community vaccine clinics, partner organizations providing shots to farmworkers in outlying areas and physicians inoculating people experiencing homelessness.
Providing vaccines under the freeway
“The goal of this is to meet people where they really are,” said Mary Kathryn Orsulak, an associate physician in the Department of Family and Community Medicine. “Offering this vaccine is just the right and equitable thing to do.”
One team worked the streets under the freeway near the local fire station, while the other group started around Alhambra Boulevard. They worked toward each other in the corridor known as WX, the area between W and X streets.
“Good morning,” Orsulak
announced, outside the closed door of a trailer on 24th Street. “I’m sorry to wake you up. I’m with the outreach team, I just want to see if you’re interested in receiving your COVID vaccination.” Nobody answered the door, and she continued on.
A few feet away, Sara Cummins prepped a man’s arm for an injection while Angela Jarman asked medical history questions from a script.
Jarman, an emergency medicine physician, said the experience was meaningful.
“This is something we all do on our day off because it makes us feel like we’re making a real difference in terms of preventing what we see in the emergency department,” Jarman said. “Especially with local patients who don’t have good access to care, this is something that has a measurable impact.”
Orsulak said the vaccine will provide safety to those living under the freeway and acknowledged more needs to be done. “This is one step to decrease barriers to care,” she said.
Or in a mosque
Unlike other vaccination sites in the region, the Shifa Community Clinic is working out of the basement of a mosque in downtown Sacramento and managed by UC Davis students. Over just seven weekends from February through April, the clinic administered 7,600 vaccine doses.
Shifa’s vaccine clinic started because students were dismayed that essential workers, including those employed in health care, were unable to get the vaccine. The students arranged to purchase refrigerators, tapped dozens of volunteers and made connections with Sacramento County Public
Health for vaccine supply.
During “street outreach” to a highly vulnerable population, six physicians from the School of Medicine and UC Davis Medical Center spent a March morning offering the vaccine to people experiencing homelessness under Interstate 80 Business/Highway 50 in Sacramento.
The doctors, lugging a temperature-controlled storage box, approached tents and rickety recreational vehicles to ask if anyone wanted a dose of the Johnson & Johnson shot. Dozens agreed.
The clinic provides culturally respectful care. At the far-left corner, next to a cart holding dozens of rolledup prayer rugs, is a section partitioned from the rest of the basement — the space is reserved for women who choose to get their injection in private. “In our cultures,” explained Sirjan Mor, a clinic student leader, “not everyone is comfortable taking off a piece of clothing in front of everyone.”
Concurrently, it’s been tougher for students to get hands-on clinical experience during the pandemic due to patient limits at student-run clinics. But dozens of undergraduates from the Davis campus and the School of Medicine are finding another way to stay engaged — by volunteering to vaccinate patients.
“I never walked into medical school thinking I would get involved in a project of this scale and pull it off,” said Khadija Soufi, a firstyear medical student who helps oversee the clinic. “I feel like it empowers us to realize that even though we’re students, we have a voice, and we can have an impact.”