Two communities living different pandemics

By Mahlon Meyer
Northwest Asian Weekly

Helen Lam, chief vaccinator for ICHS, stands outside the student union at Green River College hoping people will come. (Photo by Mahlon Meyer)

The long, wide, resounding student union was empty. Inside, several nurses, a check-in attendant sitting beside a table, and a college representative were all waiting. But so far, only a handful of people have shown up to get a vaccine.

“I’m so disappointed,” said Helen Lam, the chief vaccinator for the International Community Health Services (ICHS). Lam had led her team to Green River College in Auburn, in South King County, last month for the first of a possible three pop-up clinics.

“If we get enough people, we’ll be back,” she said.

But by early afternoon, as the sun began to slant across the cold, empty floors of the hall, the prospects were not looking good.

The lack of response, after the school and ICHS had publicized the day-long event, was an indication of one of the key challenges facing health care workers during the pandemic. Vaccination rates, particularly for Asian Americans, while high in urban areas, are lower in rural parts of the state.

And yet one community presents a stark contrast.

For Native Hawaiians and other Pacific Islanders (NH/PI), case rates, hospitalizations, and deaths are constant across the region. They are the highest of any marginalized group.

Minseok Shin, a student from South Korea, is vaccinated at the ICHS/Green River College clinic. (Photo by Mahlon Meyer)

“We have been experiencing a different pandemic,” said Joseph Seia, executive director and founder of Pacific Islander Community Association. “Every single one of us knows at least one person who has died of Covid.”

But the successes each group has found in protecting itself from the coronavirus have come from a parallel history.

Although leaders from both communities emphasize the importance of disaggregating data for the two groups in the pandemic, their approaches to preserving themselves have been similar, said Dr. Lakshmi Deepa Yerram, interim chief medical officer at ICHS.

Marginalized groups, because they were not part of the mainstream, were forced to develop their own organizations that have proven valuable to promote vaccination, she said.

Besides formal organizations promoting inoculation, such as ICHS, vaccination drives among Asians and Asian Americans have been successful when paired with cultural meccas. Pop-up clinics held in Uwajimaya or Viet-Wah, for instance, have been huge successes, said Lam.

“When we hold our clinics in the city or the suburbs, we can also go in advance to farmers markets, restaurants, and other places and spread the word,” she said. “Out here, there’s no place for us to go.”

Seia faced a different challenge. It was the start of the pandemic and elders in his community were dying faster than in any other group.

Even today, after a mass vaccination campaign that resulted in the highest rates of vaccination among any community, the statistics of the disease and people dying are still astonishing.

A vaccine clinic put on by the Pacific Islander Community Association (PICA-WA). (Photo courtesy of PICA-WA)

The average death rate per 100,000 for NH/PI, adjusted for age, is 403.7—nearly double that for Latinos, which is 230.9, and Blacks, which is 214.1, according to a Sep. 9 report by the Washington State Department of Health (DOH).

Seia’s organization had started out as a support group for families that were victims of police violence. But when he began to organize to confront the pandemic, he found the very glue that held the community together presented difficulties for his efforts.

There are 64,000 NH/PI in the state, the third-highest population after Hawaii and California. Many of the elders were bound together through their churches. And mainstream discussions pitting the Bible against science were worrying elders.

“Scripture can be weaponized,” said Seia. But he encouraged the churches to return to their cultural values, which involve caring for the group as a whole. He and church leaders found scriptural passages to support this concept—and encourage vaccination.

In January of last year, they joined with Swedish for a pop-up clinic, one of several.

Another challenge was language. There are only two Pacific Islander doctors in the state, said Seia. He arranged clinics equipped with outreach workers that spoke 12 of the NH/PI languages. Those include native Hawaiian, Marshallese, Chuukese, Fijian, Kosraean, Samoan, Chamorro, and others. He also worked with the DOH to translate materials into those languages. His group grew from one staff member—himself—last year, to 28 members this year.

Now, over 90% of NH/PI are vaccinated, he said. But hospitalizations and deaths still remain high. The number of comorbidities, a result of centuries of neglect by the mainstream health care system, still remains higher than any other group, he said.

“We are 11 times more likely to be hospitalized and five times more likely to die than the rest of the population taken together.”
More recently, Seia’s organization entered into an ongoing relationship with Harborview for clinics to be held several times a month.

“We didn’t want to have to keep begging health care providers for help,” he said.

Back in the ICHS clinic at Green River College, Lam was talking about another time when practically no one showed up. That time, however, the challenge was entirely different, underscoring how complex the roadblocks are for marginalized groups to achieve safety.

In Federal Way, she and her team had arranged for a clinic for Native Americans through a local organization that supports them. They brought 100 vaccines. No one showed up.

“However, it was probably because of the heat, since it was 115 degrees that day, so people probably just wanted to find cool spots,” she said.

But then a seeming miracle occurred—and her worries evaporated.

An Asian student walked in the door. He was tall and lanky and slid down in a chair as the ICHS vaccinator finally had an arm into which to stick a needle. A few moments later, another Asian student sidled in. He also sat down without a word and accepted the shot.

It turned out the two were students, both from South Korea, and had been living on campus for several months. They could not be vaccinated in their home country and had just received an email from the school.

“There were no vaccines for young people when I left,” said Minseok Shin, 22.

Both were from Seoul, and they had enrolled in the college for two years to study subjects like engineering and aeronautics.

In many ways, they were exceptions to the phenomenon occurring in the state—as international students, they had come from a densely populated urban area to a rural countryside. The school is surrounded by pines and firs and, beyond that, farmland.
But for Lam, it meant she had reached her quota. She could come back for another clinic in three weeks.

Mahlon can be contacted at info@nwaweekly.com.

This health series is made possible by funding from the Washington Department of Health, which has no editorial input or oversight of this content.