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On Having an Action Plan for COVID-19: An Interview with Dr. Valda Crowder

This week’s BlackHer Shero is Dr. Valda Crowder, an emergency physician and violence prevention expert with 30 years of experience providing medical care, including during pandemics, mass shootings, and natural disasters. Dr. Crowder provides health policy advice to leaders in business and government. She has treated COVID-19 patients and gives free weekly webinars to keep families, communities, and workplaces informed and safe during the pandemic.

Thank you so much for agreeing to talk to BlackHer, Dr. Crowder. During your webinars, you say that people need to have a COVID-19 action plan. Can you explain what that is and why Black women need one?

Everyone needs one! You identify the places that could allow you to come into contact with this infection and make a plan to minimize your risk. For example, doorknobs, gas pumps, the pin pad at the grocery store…all of these put you at risk for exposure. People can do things to prepare, like keeping gloves and cleaners in the car to avoid coming into contact with surfaces that can be contaminated and wearing a mask in public. These small changes can make a big difference. 

In a recent op-ed, you said, “Now is the time to address the weaknesses in our healthcare safety net.” How do we do this?

A lot of hospitals are closing in Black and Brown communities. We must advocate for our communities to have access to the facilities, clinics, and doctors we need so we don’t have medical deserts and go without health care for decades. This is one of the reasons our communities struggle with conditions like high blood pressure, diabetes, etc. We have to demand that these services are brought to and stay in our communities.

Before the pandemic, I met with City Council members in Washington, DC (where I live) and Congresswoman Eleanor Holmes Norton about the fact that Ward 8 (the poorest ward in the city) has no hospital at all. 

As a result of COVID -19, many more hospitals will close. COVID-19 is financially devastating to hospitals that are already struggling. If a hospital leaves, what replaces it? Usually nothing. At a minimum, there needs to be at least a free-standing emergency department that provides critical care services. 

Medical illnesses like heart attacks, strokes, and gunshot wounds are time-sensitive medical events. People can’t drive across town to get care. The increased transport time to get to a hospital can make the difference between life and death. I’ve worked with Moms Demand Action on this issue because it is directly related to gun violence. While Congress is passing stimulus legislation, why not include 30 million dollars for a free-standing clinic in DC Wards 7 and 8?

Legislators often say that these facilities have been gone for so long in certain communities that if we put them there, people won’t go. That is not true. I have never seen that. In fact, the opposite is true. When people became insured under the Affordable Care Act, they accessed services. Similarly, in vulnerable communities experiencing health disparities, services are very much used, and health indicators improve.

Throughout this pandemic, we’ve been hearing there is a shortage of staff in hospitals. Why is that the case?

There has been a shortage of medical staff in the United States for a long time. To put it in context, Italy has about 4.8 doctors per 1,000 people. We have about 2.6 per 1,000. Physicians are in demand in the U.S. and can practice in places where the reimbursement is good versus where there is the most need. In the past, the federal government used to provide student loan forgiveness to physicians to work in underserved areas. This was a way to incentivize physicians to work in communities where they are most needed. Now, a lot of that funding has been cut. This is what happens when you have a market-driven versus a care-driven system. We have to decide whether our focus is on profitability or health outcomes.

Why did you start doing weekly webinars about COVID-19?

It was actually very personal. I come from a big family —  some live in rural Mississippi, others in rural New York State. I was concerned about the quality and accuracy of the information they were getting about the virus because so much of the coverage has focused on patients in New York City, even though the virus is everywhere. I felt like this was giving my family and other people a false sense of security, i.e., the virus is only in New York. 

I work in rural Virginia, on the North Carolina border and half of the emergency room has been filled with COVID-19 patients. I wanted to get my family online and have them develop an action plan to do things differently in order to protect themselves. And they got on! They started sending the invite for the webinar to other people and I saw people changing their behavior en masse –wearing masks and gloves, getting groceries delivered, avoiding funerals and birthday celebrations, etc.. To date, over 400 people have attended at least one call and I am proud of them all.  They are taking the message to their communities and workplaces.

I’ve treated people in four pandemics, worked the emergency room after a postal shooting, and worked through Hurricanes Irma and Maria. I’ve treated patients with malaria and tuberculosis in Africa, and treated patients with HIV, when that infection did not even have a name. This disease is by far the worst I’ve seen. I’ve never had to work in a hazmat suit for 12 hours. I’m telling folks, this disease is not something to play with. We need to stay safe until there is a vaccine or treatment. Wearing a mask is the most patriotic thing you can do at this time for our county.

How long do you think this will last?

I am preparing for the fact that this will last most of this year. Over 50,000 U.S. soldiers died in Vietnam, a war that lasted 15 years. This will be far worse and there are already more deaths but instead of 15 years, it will be over the next 15 months. And Black, Brown, and indigenous communities will be hit the hardest. 

We have to be prepared for what happens when this virus peaks. A peak doesn’t mean that things immediately decline. For example, Washington, DC Mayor, Muriel Bowser, has estimated that our peak will be in July. But a peak can last a month or longer. Even when shelter-in-place orders end, we need better testing to identify the hot spots, determine who is transmitting the virus and asymptomatic, and know how to respond appropriately. A lot of planning will need to take place and it’s not going to happen overnight. Our public health system has not been adequately funded for decades.  We are rebuilding the roof while it is raining.  

(Editor’s note: Since this interview, coronavirus deaths in the US have reached more than 88,000).

Let me ask you the miracle question. You go to sleep tomorrow and wake up and it’s May 2021 and a miracle has occurred for Black women. What happened?

We have the health care we need and don’t have an increased incidence of preventable diseases. Black women are not dying at a disproportionate rate from childbirth, cancer, or heart disease. 

To hear more from Dr. V and learn how to protect yourself and your loved ones from COVID-19, sign up for her webinars at www.askdrv.us

 

 

 

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