What Happens to Community Care When the Government Decides It’s ‘Every Person for Themselves’ in the Face of COVID-19?
There's no denying that the world looks a bit different a year and a half after she penned the piece: Airlines have lifted mask mandates and COVID-19 testing requirements for international and domestic flights, and almost every state in the country has relaxed its pandemic restrictions. But as the United States continues racing to conditions of pre-pandemic life—even as the number of infections continues to grow—the definition of community care remains the same, and the way in which folks practice it is perhaps more important than ever. In a time when it feels that the government has more or less wiped its hands of COVID-19 as a public health issue, the honor and burden of community care falls back on individuals—meaning, you, me, each one of us. But, how?
- Isaac Dapkins, MD, Isaac Dapkins, MD, is the Chief Medical Officer at the Family Health Centers at NYU Langone.
The two factions of community care: government-led and citizen-led
Community-oriented care comes in many forms. While the idea and practice is prevalent across the world, the concept of public health—the American government's answer to community care—started in the early 1900s. Since the idea found its way to American soil, the average American lifespan has increased 30 years—25 of which are attributed to public-health advancements including vaccinations, safer workplaces, family planning, and cleaner drinking water.
Of course, community care has also stemmed from local, grassroots movements: The Hispanic Federation assembled after Hurricane Maria devastated Puerto Rico. Food banks have played a crucial role in feeding millions in the last few years. And, more recently, Well+Good Changemaker and Liberate Abortion leader Sharmin Hossain is leading an abortion caravan through Jackson, Mississippi, to teach people how to self-manage abortions in a time when Roe v. Wade is likely to be overturned. Such efforts are less quantifiable than those enacted by the government; nevertheless, they are and will continue to be vital—especially as we navigate what community care looks like as it pertains to COVID-19.
How to practice community care right now, amid COVID-19 conditions
That is, how do we practice community care in a time when public health is politically divisive; when only 67 percent of the population has been fully vaccinated against COVID-19 (and vaccination acceptance overall is on the decline)? And when—despite the fact that one million Americans have now died of COVID-19 and others live with long COVID—getting folks to take the virus seriously remains a challenge?
I asked Isaac P. Dapkins, MD, chief medical officer at the Family Health Centers at NYU Langone, who has worked at the intersection of medicine and community care for about six years, for his thoughts. Since the start of the pandemic, he says that he and his team have spoken a lot about how doctors can orient their work toward community care—and one strategy in particular has stood out to him.
When New York City became the epicenter of the pandemic in March of 2020, Dr. Dapkins saw the impact COVID-19 had on the community where he practices: Sunset Park, Brooklyn. "When we had the highest rate of infection, I think the worst part was that, if you got COVID, it really meant that you were putting your family at risk. Whether it was your older parents or your children," he says.
Folks who lived in multi-generational households—specifically Black people, Hispanic people, and people of Asian descent—stood the greatest chance of passing a COVID-19 infection onto one or several loved ones. This risk came to define how Dr. Dapkins spoke to people about community care.
"For example, I had a woman who was in her early fifties, who was adamantly against vaccination, and she had issues that would make her at risk. I was able to connect with her about getting a vaccine by talking to her about how she would protect her mother—whom she was really worried would get sick," says Dr. Dapkins. Ultimately, he was able to convince the woman to get the vaccine for the health and safety of her family.
"The way to communicate with people is to find common ground, things that people share value-wise." — Isaac P. Dapkins, MD, chief medical officer at the Family Health Centers, NYU Langone
Although not all of us are doctors, Dr. Dapkins believes that the future of community care will hinge on getting really good at talking to those we love about how their actions inform the health of their closest communities. "Doctors are really focused on communicating with individual people about their risk [for COVID-19], and I don't believe that's a very effective way to change people's minds. The way to communicate with people is to find common ground, things that people share value-wise," he says.
I know what you're thinking: Finding common ground is a difficult ask. Try as we might to use our power, privilege, and resources to connect with those who have decided the pandemic is over, and these conversations can feel like banging your hands against a brick wall. But if we stop trying, what then?
"If you're out on the street, and there's a little kid who looks like they're going to run out into the road, most people are going to stop the kid. I think there's some nugget of opportunity in that community-care conversation," says Dr. Dapkins. "Would you let a little kid run out into the street and get hit by a car? When you start to frame it in an emotional way for people that's real and doesn't have to do with sort of dry numbers and risk, it at least facilitates the conversation."
Besides having these difficult conversations, another way to practice community care right now is leading by example. If you're someone who, for instance, is fully vaccinated but still prefers to wear a mask in public spaces, wear your mask on the plane. Make it clear that you want to social distance at the supermarket. Require people to show proof of vaccination at your wedding.
The reverse is also true: Your respect and adherence to your family and friends' preferred COVID-19 safety measures is a form of community care. "Again, it's really about trying to encourage people to accept what others want to do about reducing their risk rather than focusing on what your perceived risk is," says Dr. Dapkins.
Infection rates and COVID-19-related deaths stats are important—there's no arguing that. But when it comes to community care, human empathy may be the key to showing up for your people—especially when the government has decided to move on.
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