Transcript: ‘Watch a Man’s Feet’ (Half Vaxxed)

NINA FELDMAN, HOST: For the first few weeks after the Philly Fighting COVID fiasco, it was all anyone could talk about in Philadelphia. It dominated the news cycle. Posters even went up around Andrei Doroshin’s neighborhood warning people they had a neighbor who was trying to profit off the pandemic.

But soon, as vaccine doses started to flow into the city in greater numbers, the scandal faded into the background. And it seemed, perhaps, for good reason: People were getting vaccinated. Maybe this had just been a one-off disaster, something to put behind us.

In fact, when she was recently asked about the long term impact of the Philly Fighting COVID fiasco on the city, the interim health commissioner said that rehashing all this was just “a distraction.”

But for longtime activists in the Black and Latino neighborhoods hit hardest by the virus, the Philly Fighting COVID scandal isn’t just some fluke. It’s a part of a pattern…

[music]

… An illustration of the neglect and structural racism that has long been baked into the way public health, and governments in general, operate.

CLIP, DR. ALA STANFORD: For many people of color, it’s not the first time. It won’t be the last. Because you’ve experienced it your whole life.

NF: And each misstep like the Philly Fighting COVID scandal fuels a cycle of mistrust. People become wary of what the government or the health care system has to offer. They wonder, will it really help them?

CLIP, MICHAEL BROWN: There’s no convincing people to trust the city. Why don’t you trust — ‘cause it’s the city.

NF: As a result, many of the people who would benefit most from what the government has to offer, like public safety or public health efforts, are less likely to get them.

CLIP, SIRIA RIVERA: The more barriers and the more obstacles, the less likely someone who’s already distrusting or uncomfortable is going to go through all that work.

NF: And that widens the gap in health outcomes for people of color.

[theme music]

So these activists say, no — the Philly Fighting COVID scandal wasn’t just a distraction. It can’t be swept under the rug on the grounds that the vaccine rollout carried on and most adults in Philadelphia are vaccinated now. They say if we don’t learn from this disaster, we’re doomed to repeat the same pattern.

From WHYY, this is Half Vaxxed. I’m Nina Feldman.

While Andrei Doroshin was printing 3D face shields, Dr. Ala Stanford was hatching a plan of her own.

AS: I was home in March like everyone else, staying home in my pajamas and watching TV all day thinking, “This is kind of fun.” When the reports came out the first week of April saying, particularly in Philadelphia, that Black people were contracting the disease and dying at a rate greater than everyone else, it just hit me, like, what is going on?

NF: Stanford is a pediatric surgeon, but the shutdowns meant her procedures had been canceled. So she gathered a bunch of other people who weren’t doing their normal jobs in the medical field, rented a van, and started offering COVID tests wherever people needed them — on street corners or in church parking lots.

[ambient sound at clinic: “Have you been around anyone that tested positive that you know of?”]

Word spread that a group of Black doctors was offering free testing in Black neighborhoods. Stanford’s sites brought in hundreds of people a day and evolved into an enormous operation, which she called the Black Doctors COVID-19 Consortium. I visited one site last fall and talked to some people there.

MAN BEING TESTED: I wanted to get tested and I wanted to make sure that the people testing me were, like, Black, you know what I mean?

NF TO MAN: And why did you want to make sure the people testing you were Black?

MAN TO NF: I’m a historian, an Africana studies major at college. And so to be truthful, when like new diseases drop? I’m a little weird about, like, the mainstream testing me or stickin’ anything in me. I’m gonna be truthful. So I found out about her and what was going on here and I was down for it.

NF: Like Andrei, Stanford started out fronting all the money for testing herself. But some members of Philadelphia’s City Council weren’t satisfied with that. It was clear that Black people were getting COVID and dying at higher rates than any other racial group in Philadelphia. Here was Stanford offering them testing on a large scale. She had the trust of the Black community. The mayor and the health commissioner loved to point to the great work her group was doing. So, why not pay for it?

They pressed Philadelphia Health Commissioner Dr. Tom Farley about this at a budget hearing. He said he appreciated the work the group was doing, but he didn’t think of them as unique.

DR. TOM FARLEY AT HEARING: It wasn’t like they’re the only organization out there offering testing to African-American populations in the city.

NF: That hearing was just a couple days after George Floyd was murdered by a police officer. The next day, protests erupted across the city and the world.

[music]

A few weeks later, Farley had changed his tune, and made a big show of awarding the Black Doctors the city’s first testing contract.

TF AT PRESS CONFERENCE: So I’m really pleased to establish that relationship. I want to thank Dr. Stanford personally, and her wonderful team…

AS AT PRESS CONFERENCE: That’s right, our team! [applause]

NF: And Farley said the city would rely on this group long into the future.

TF: When we have the vaccine, we’re also going to turn to this organization and say, “We need help to get everybody vaccinated.”

NF: In the months that followed, Andrei hustled the health department and members of City Council, inching closer and closer to a deal. Stanford asked the city about vaccines, too. But she was told to wait. That there would be a formal application for funding.

AS: I remember asking and being told by the health department that the earliest we would be able to do anything was February. And so I was just kind of like, “OK, well, I’ll write it up, but I’ll wait till you give the green light.” But then once these guys came on the scene, I thought, “Well how are they on the scene?”

NF: Stanford found out about Philly’s first mass vaccination effort on the news — just like everybody else.

NEWS CLIP: “A mass vaccination site is now up and running in Center City Philadelphia for health care workers. The site at the Convention Center opened this morning…”

AS: And I remember thinking, “How is that happening? Like, I’ve been on the Vaccine Advisory Committee. I hadn’t heard anything about mass vaccination.”

NF: For Stanford, this wasn’t just about being recognized by the city. It was about who could save the most lives. The way she saw it, Black people were the most likely to get serious cases of COVID, so it made most sense to focus there first. The faster that group was vaccinated, the slower the virus would spread, and the sooner everyone could start getting back to normal. She knew from her work testing in the Black community that this might not be as straightforward as health officials imagined.

AS: We know it’s going to take more time because of the lack of trust. We know it’s going to take more time because folks got to go to work and they need time off and hours that are open.

NF: In mid-January, while she was still waiting for word from the city about how to get vaccines, Stanford got an email that surprised her. Someone from the health department asked if she wanted to partner with Philly Fighting COVID to run a vaccination clinic on Martin Luther King Day.

AS: And it was under the guise of “so we can reach the underserved.” They were bringing the vaccine, but we were the trusted messenger. And so by putting us with them, people were going to say, “Oh my gosh, Black Doctors COVID-19 Consortium is doing vaccines now. Let’s go.” Only the vaccines would have been allocated to Philly Fighting COVID.

NF: Stanford turned down the offer to partner. And she was mad. She couldn’t help but feel like the city had put Philly Fighting COVID on the fast track.

AS: People are dying to the left of me, to the right of me, but I trust you to give me the vaccine — like, we earned that trust. I mean, I’m very proud of that. We worked hard for that since March and April of 2020. And they just walked right into it. They didn’t have to sort of beat the pavement, if you will, for people to come out. They didn’t have to do anything.

NF: Stanford watched from afar as the clinic at the convention center imploded. When it did, she had the same question as everyone else: Why had the city picked Philly Fighting COVID?

AS: You can’t look at their track record ‘cause they didn’t have one. You can’t look at their years in medicine, in public service, ‘cause they didn’t have that. You can’t even say, “Well, he’s born and bred in Philadelphia. This is his home.” So you can’t say that…

NF: So, what can you say? For Stanford, it comes back to bias. The instincts people tend to fall back on when they’re not prepared.

AS: I think some of it was just comfort, you know? And I don’t know that people will openly admit or say that, but some people are just more comfortable working with white men. He was familiar, he looked like someone’s son, he looked like someone’s nephew, and, you know, that’s why.

NF: Philadelphia passed over an experienced group led by an accomplished Black woman doctor, who had the trust of the community the city said it most wanted to help. Instead, they chose a startup run by a young white man that had turned its back on Black and Latino communities who were counting on them for tests.

What happened to the promise Farley made to Stanford when he awarded her that testing contract, that he’d rely on her for vaccines when the time came? Or what about the pledge from day one that this rollout would be equitable?

AS: I think uniformly everyone would agree is if we had focused on the most vulnerable from the beginning, then we would not have lost so many lives.

NF: This type of neglect, the kind that’s not necessarily malicious on its face, it adds up.

MB: It’s always just a little worse on our side. Our numbers are always lower. Our death rates are always higher. We never get — whether it’s access to the same education, the same medicine.

NF: That’s Michael Brown again. His collective in Northwest Philly had been planning a big testing event with Philly Fighting COVID, but at the last minute, Andrei told him they weren’t doing tests any more, only vaccines.

MB: You tell us that you love us, but you continue to show us opposite. And so, I’m always taught to watch a man’s feet. Don’t listen to his words. See what he actually does.

NF: Michael lays out a hypothetical. What if his group had agreed to switch to vaccines and been the first to get shots from Philly Fighting COVID. And then, what if Philly Fighting COVID had sold patient data like their generic privacy policy allowed them to?

MB: Those would have been our names that he was selling. Those would have been our arms that he was profiting off of.

NF: Again, there’s no evidence that Philly Fighting COVID ever did this. But they could have. And Andrei told many of his staffers he wanted to make lots of money off of vaccines. Michael does not have a hard time imagining the lengths Andrei would have gone to do that.

MB: So he had a profit to gain on every level and it was going to start with us. Why, ‘cause we, oh, we don’t ask questions, this is what we’re used to, we’re grateful, we’re just happy to be getting help? We’re not going to do that.

[music]

NF: Michael says it’s one thing for Andrei and Philly Fighting COVID to turn out to be bad news. But watching the city put faith in a guy who bailed on testing and could have turned around and sold patient data — that makes him question the city. And he says this dynamic explains why so many Black people are distrustful of the government and the health care system in the first place. How can you trust a system that’s wronged you in the past?

MB: The last boyfriend was horrible, but the new boyfriend could be the greatest person in the world. But because of your past experiences, it’s informing you that I can’t trust you. I’m questioning you, you know, even though you’re doing the right thing. But I can’t trust you. I’m giving you everything I should’ve gave the last person. And now I’m going to lose something good because I simply can’t trust.

NF: The way Michael sees it, this cycle of mistrust is a matter of life and death.

MB: And then you look at us and say, “Well, why is there only 37, 35% of the Black community vaccinated?” We don’t trust you. And you keep showing us why we don’t trust you and there’s nothing that Michael Brown or anybody can say to that. There’s no convincing people to trust the city. Why don’t you trust — ‘cause it’s the city. Look at what’s happened over the years.

NF: Michael and I talked a few months ago. Now, about 56% of Black Philly residents have gotten their first shot. But his point stands. And he’s right — this is far from the first time something like this has happened. City officials have done plenty over the years to weaken that trust.

And in fact, one of those city officials is Philadelphia’s Health Commissioner Dr. Tom Farley. Here is where you start to see the pattern.

[music]

Back in 1985, the city of Philadelphia dropped explosives on the compound of a radical Black liberation group called MOVE. It killed six adults and five children. More than 60 homes were destroyed. An entire neighborhood was left in ruin.

NEWS CLIP: Let’s take a careful look at this. 5:27 p.m. State police helicopter drops — [explosion] — There’s the explosion…

NF: The incident is a permanent stain on the city’s history — an extreme instance of police brutality and a stark example of the way a government can turn on its citizens.

Fast forward 32 years. It turned out that the Philadelphia’s Medical Examiner’s Office still had some of the remains of victims killed in the MOVE bombing. When he learned that, Farley ordered the remains destroyed without notifying the family. He’d said he was just following standard procedure. News broke of Farley’s actions in May. This time, Mayor Jim Kenney couldn’t defend his health commissioner.

NEWS CLIP: A bombshell from the Philadelphia Health Department. Health Commissioner Dr. Thomas Farley has resigned and it was not his choice…

NF: We tried to reach Farley a number of ways for this podcast, but never heard back from him.
For Michael, Farley’s handling of Philly Fighting COVID and his desecration of the MOVE remains are just variations on a theme.

MB: It’s ironic that the same person who makes that decision to, you know, say, “Hey, let’s give this guy a chance with vaccines and the public health, give him a chance,” is also the same guy who makes the decision to put the remains of people in boxes instead of turning them back over to they family.

NF: Just for the record, Farley didn’t decide to store the remains in boxes. It was his call to have them destroyed once they were found.

And Stanford says, yes, there is a certain bias or set of assumptions that you could see as a common thread between those two incidents. But she says, this pattern extends way beyond Farley.

AS: What I hope, you know, we learn is people don’t say that what happened with Philly Fighting COVID was just sort of by chance and it happened to do with the one person who was ultimately terminated, right? But that this was more a systemic problem that was allowed to happen and it went by a lot of people’s noses. It passed the sniff test for a lot of people. Like, nobody said, “Are you sure we should be going on with these 20-year-old, non-medical people to run our vaccination clinic?”

NF: And she’s right. Everyone who screwed up is gone now. Farley’s not here to answer our questions, or to keep running the health department, or to regain the public’s trust over the city’s handling of vaccines.

[light music]

Andrei stayed in Philly, but has laid low. Drexel University confirmed he’s not a grad student there anymore.

Andrei’s dad and brother stayed in the vaccine game. They repackaged Andrei’s idea of perfecting the model for a vaccine clinic and selling it like a franchise. They’ve started a new company called StudentVax where they offer to stand up vaccine clinics for school districts in Georgia and Texas. We asked them about it and they didn’t respond. We also asked around among the pharmacies they planned to partner with. No one had ever heard of the group.

There is one person who’s still here: Mayor Jim Kenney. He could answer for these mistakes. Explain how the city plans to keep them from happening again. But he won’t. At least, not to us. He declined our interview request for this podcast.

And that leaves everyone who relied on Philly Fighting COVID to shoulder the burden of repairing the damage. They’re still here. Michael Brown and Siria Rivera — they’re the ones whose reputations were on the line. They’re the ones picking up the pieces.

SR: They used my community, our logo, basically, our name, and the relationship we built with their community to say, “Yeah, we did that,” But they didn’t do anything.

NF: That’s Siria. She’s the one who runs the community center in a mostly Puerto Rican neighborhood and was also ghosted by Philly Fighting COVID.

SR: You’re creating a lack of trust between my agency and the community, because it’s our face and our name that’s on this effort. It’s who they recognized. And so when we’re advertising, “come Tuesdays, come Wednesdays,” and people were showing up or calling and we’re like, “Sorry, they didn’t show up,” I literally had no other explanation other than, “I’m sorry, they didn’t come .” And even though I’m saying “they,” it doesn’t matter, right? Could you imagine saying, “Hey, we have free food for you” and then you show up and it’s like, “Oh, sorry, we didn’t get our delivery because, you know, every other week this happens.” No, that’s horrible. They got that opportunity on the backs of the people of these communities.

[theme music]

NF: After the break, how to rebuild that trust and what happens if we don’t.

[MIDROLL BREAK]

NF: This is Half Vaxxedf. I’m your host, Nina Feldman.

I want to tell you a story about Dr. Ala Stanford that I think says something about the kind of leader she is. A consistent one. One who leads by example.

When the conversations about vaccines were getting started. Stanford wasn’t planning to get vaccinated herself. She’d had COVID, knew she had antibodies, and wasn’t sure she needed the vaccine. Plus, she was just slightly wary of the whole thing in general. She felt like it had been rushed. I talked to her about it last fall, before the vaccines were out.

AS: I don’t mind being part of a task force to help distribute, to make sure those who are vulnerable receive it, but it will just be planning. I won’t be administering anything until I see the data and I’m able to read it.

NF: But by the time the vaccine arrived, she realized she’d become a public figure. People were looking to her for guidance.

AS: So many people said, “Doc, when you say it’s OK, I’ll get it and I’ll roll up my sleeve.” And the only way to show them I really believed it was safe was to get vaccinated.

NF: I was there the day Stanford and the rest of her team got their first doses. It was the middle of December during a huge snowstorm. Up until the moment she got the shot, she was nervous.

AS AT VACCINATION: I feel a little scared, but I keep saying I’ve read everything, I know the facts. And, it’s heavy, but I prayed on it, I’ve already cried enough. Now, I’m just ready.

Afterwards, Stanford gave a speech to her team. A lot of them had been hesitant, too. But after she went for it, many of them followed suit.

AS SPEECH: For so many African Americans, I understand that this is a hard choice. I understand an untrustworthy health care system. I understand racial bias. I understand the criminal justice system not being on our side. And I’m not asking anyone to forget that. But don’t allow it to impede you when there is something that can stop the disease, stop the transmission, stop the death. Don’t shy away from it because it’s here.

[music]

NF: After that, Stanford started to walk the walk. And it paid off. Once she announced she would start vaccinating, people came in droves. Stanford didn’t see any of the vaccine hesitancy from Black people that everyone was talking about on the news. Not at first. Instead, she saw lines of people, wrapping around the block multiple times, waiting for shots in the freezing cold. There was so much demand, the consortium held a 24-hour clinic so people who work different shifts could come whenever they had the time.
Stanford used her own trepidation about the vaccine to inform the way she talked to people. She was empathetic and kind. People even started coming to her vaccine clinic for other medical concerns.

AS: They wait in line. Time for the vaccine. “Oh, I already got vaccinated.” “Oh OK, then how can we help you?” “Well, I’ve got this lump on my neck. Can you tell me…?” Or, “I got these labs back from my doctor. Do they look OK?” Or, you know, “My doc thinks I need to get surgery. What do you think?” And you’re like, “Oh, well, there’s all these people waiting to get vaccinated…”

NF: But she says she does her best to follow up with them. For some, it’s the first time they’ve been to a doctor in years. She doesn’t want to lose her chance to get them the care they need.

Just by showing up, she’s demonstrated to people who might otherwise not seek out a doctor that there’s someone they can trust. And she’s trying to harness that. She’s planning to turn her vaccine operation into a larger medical clinic that will offer other vaccinations, too — plus lab work, and even primary care — all at the same church in North Philadelphia where they’ve been doing the COVID shots. I visited her there one day over the summer.

The lines were much shorter, but people were still trickling in all day long. She took a break from vaccinating to talk to me in her office, tucked away in the back of the church. Off to one side of her desk, strewn with papers, was a white board. It had a few Philadelphia maps tacked to it, showing the zip codes with the highest rates of COVID and the lowest rates of vaccinations. And above that, written in looping green script, was a question. It said, “How many times will organizations make the same mistakes over and over and ask us to clean up the errors?”

Stanford says, once Philly Fighting COVID was out of the picture, the city did start giving her more resources.

AS: So there was no, “We totally screwed up with these kids. Tell me what you need.” But I felt like that was part of it. And they saw that we were doing the work, so they gave us the support we needed.

NF: And she says she’s grateful for that. She just wishes they had listened to her earlier. When she said they needed to focus on the people being hit the hardest, first.

AS: It’s the afterthought. It’s the, “Oh, dammit, we’re not meeting our goal. Why not? Oh, it’s these zip codes. Oh, wait, these are the same zip codes where it was positive a year ago! Maybe we should have had a really hard focus here from the beginning.”

[music]

NF: Stanford’s approach may not have resonated with the city in the way she wanted. But others were paying attention.

After his falling out with Andrei, former Philly Fighting COVID medical director, Dr. Jose Torradas finally helped start his own group. He admits he lifted the strategy directly from Stanford. It’s called Unidos Contra COVID or United Against COVID and the goal is to get Philly’s Latino population vaccinated. Not through mass clinics, but through smaller, more intimate events.

DR. JOSE TORRADAS: Talking about undocumented folks. You’re talking about people who are in the shadows, but also using the tactics that we’re talking about now of like, how do you decrease barriers? How do you increase vaccine confidence? How do you really reach those folks? And it requires a different formula than the “come to us, we can put through 5,000 people in a day” type model because that did work for the first few months, but it’s not the play now.

NF: Over the summer, the rate of vaccinations for Latinos in Philly skyrocketed. A greater percentage of Latinos are now vaccinated here than white residents.

Stanford says, it’s results like these the city should be working towards.
AS: The Mission statement of the Department of Public Health is to promote health, prevent disease, and to support and provide a safety net for our most vulnerable citizens. If that’s all we did, it would be fine. I think the laws as they are, the mission statements bylaws that are written in the Department of Health Bible, if you will, are good. We just need to follow them.

NF: Because if we don’t, it just fuels that cycle of eroding trust. And the entire premise of our social fabric hinges on that trust being there. The government offers services to people, and people take advantage of them. Drinking water. Schools. Public safety. Public health. But if the government keeps screwing up and doesn’t deliver the services promised, people lose faith.

[music]

They stop using those services, even when they’re perfectly good. The entire system breaks down.

MB: That’s the negative impact. It’s just one more reason that I got to watch the hand that’s feeding me instead of just accepting what’s being fed to me.

NF: So, how do you interrupt this cycle? One way is to teach government leaders to challenge their assumptions, so they’re more likely to do what they said they’re going to do. Here’s public health researcher Alison Buttenheim.

ALISON BUTTENHEIM: So every decision that Andre was making that the vaccine advisory committee was making, that Dr. Johnson was making, you know, all were operating from a whole bunch of assumptions stated and unstated.

NF: But all that unlearning is labor intensive. There’s no time for confirmation bias training in the middle of a public health crisis. That goes back to Alison’s point from the last episode about consistent funding for public health — so our leaders can work on all this before a crisis hits.

AB: We have to practice public health emergencies and our responses to them or we’ll be slow and we’ll be biased in the response.

SR: My concern is that all of our lessons learned would be, you know, swept under the rug like a lot of things that happen in this country, right? We see things. They get exposed. They rise to the surface and you can’t ignore it. But then people move on. Things get back to normal.

NF: That’s Siria Rivera again. She says it’s great that the city has finally turned to grassroots groups as a way to help get people vaccinated, but she worries they’ll just skip over that step again next time around.

SR: So the best thing that could happen from that lesson learned is that those funding opportunities start coming up not in crisis mode, but in preventative ways.

NF: Because that’s the other way to interrupt the cycle: Give responsibility and money to groups that the people you want to help already trust.

Lately, Michael’s been shifting a lot of his focus to another public health crisis facing Philadelphia — the city’s gun violence epidemic. Michael says he finds a lot of the strategies that worked when talking to people about the vaccine also work when talking to young people about violence prevention.

MB: People say, “Well, you know, Mr. Mike, Mr. Brown, why were you so effective with these kids?” I was consistent. I showed up every day. I did what I said I was going to do and that was it. Like, consistency, it’s no secret. Show up. Be there. Let them know that you’re somebody that can be trusted because you show up and you take care, you take time, you’re a man of your word. The worst F word that you can ever be is fraud.

NF: Michael says, if he loses their trust, he has no chance of reaching young people. It’s his only hope. Without it, the door is closed.

The trust of the Black community is the one thing that Dr. Ala Stanford has had all along. Because she’s been consistent. She’s said she wants to prioritize the most vulnerable and she has. Over and over again, she’s called city leaders out for failing to do the same. For paying lip service.

Now, she’s ready to be done hounding the people in charge. After Farley resigned, Stanford threw her name in the hat to replace him as Philadelphia’s Health Commissioner. That search is ongoing.

Stanford says if she gets picked, she is going to try her best to lead by example. She knows that becoming a public servant isn’t some sort of silver bullet for solving the city’s health problems or dismantling the systemic racism that props them up. She’d be entering into a whole new mess of complications in this role.

AS: I worry about, will my hands be tied? Do I have more autonomy and freedom to make changes as an independent sort of private citizen? So that does cross my mind.

NF: But the way she sees it, at least this way, no one can tell her to wait her turn.

[theme music]

If she gets passed over, she hopes it’s for someone who’ll share her vision, whose ear she’ll have. But she’s not getting her hopes up. She knows better than that.

Half Vaxxed is reported by me, Nina Feldman, along with Alan Yu and Max Marin. Our producer is Buffy Gorrilla. Our engineer for this episode was Diana Martinez. Mixing and sound design by Charlie Kaier. Original music by Max Marin. Our editor for this podcast is Katie Colaneri. Our editors for our original reporting were Danya Henninger and Joanne McLaughlin, and we can’t thank them enough for their guidance. Special thanks to John Sheehan, Maiken Scott, Dan Gorenstein, Ann Marie Baldonado, and Alex Stern. WHYY’s News Director is Melony Roy. Our Vice President of Digital Strategies and Services is Gabe Coan. Our Vice President for News and Civic Dialogue is Sandra Clark. This podcast is a production of WHYY and Billy Penn.