COVID 19: We’re in the Second Inning – According to Noted Epidemiologist Dr. Michael Osterholm

Dr. Marjory Innocent

[ Music ]
Moderator: Welcome to Conversations on Health Care with Mark Masselli
and Margaret Flinter, a show where we speak to the top
thought leaders in health innovation, health policy, care
delivery, and the great minds who are shaping the hea lthca re
of t he future.

This week, Mark and Margaret speak with Dr. Marjorie
Innocent, Director of Health Programs at the NAACP in the
wake of the dramatic uprising across the country and around
the world to the killing of George Floyd by police officers. She
talks ab out the 100 plus years of work being done by the
NAACP to address entrenched racism and the need to take
immediate action to curtail police brutality, health disparities
and economic inequities that are affecting minorities in this
country.

Lori Robertson also checks in, Managing Editor of
FactCheck.org looks at misstatements spoken about health
policy in the public domain, separating the fake from the facts.
We end with a bright idea that ’ s improving health and
wellbeing in everyday lives.

If you have co mments, please e - mail us at [email protected]
or find us on Facebook, Twitter, or wherever you listen to
podcast. You can also hear us by asking Alexa to play the
program.

Now stay tuned for our interview with Dr. Marjorie Innocent
here on Conversations on Health Care.

[Music]
Mark Masselli: We ’ re speaking today with Dr. Marjorie Innocent, Senior
Director of Health Programs at the NAACP, the National
Association for the Advancement of Colored People. Dr.
Innocent h elped launch the NAACP’s health department as a
resource for influencing health policy, aimed at addressing
health disparities for people of color.

Margaret Flinter: Dr. Innocent served as Vice President of Research and
Programs for the Congressional Black Caucus Foundation, and
she was the Director of the Maryland School Based Health
Center Initiative at the governor ’ s office for children, youth
and families. She earned her PhD in Health Policy
Management at the Johns Hopkins Bloomberg School of Public
Hea lth, and Dr. Innocent, we welcome you to Conversations
on Health Care.

Dr. Marjory Innocent

Dr. Marjorie Innocent: Thank you so much.

Mark Masselli: Oh, that ’ s great. I think our viewers know that the NAACP is
the nation ’ s oldest and largest civil rights organization . You
m ay not know it was founded back in 1909 to address the
cultur al violence against black people in America. Now here
we are 111 years out 2 , 200 chapters later, violence is still not
abated , and it seems that systemic raci sm is alive and well in
America. I n spi te of so much hard work by so many people to
address in mitigated, and as the country and really the entire
world has been ignited by the death of George Floyd, at the
hands of police brutality, what messages are the NAACP
wanting Americans to hear right n ow .

Dr. Marjorie Innocent: Well, thank you so much for that question , and for your
remarks, your very timely remarks . This time has been coming,
unfortunately for a long time , and really, now ’ s the time to
make some really long overdue changes to the frame work
through which we really operate in our country and the
framework through which we really define our policies. While
it ’ s been incredibly disheartening to see yet another case of
police brutality, and one leading to the demise of a human
being, it ’ s be en very heartening to see the level of energy, the
level of rebuke, really , and desire to make change happen, and
to speak out for change that ’ s been emanating from across the
country, and to see it happen, certainly, through the efforts of
young people an d young people across all racial ethnic groups,
all backgrounds, and really around the world , it ’ s been really,
really terrific. We really encourage this, this continued energy
and ultimately a focus on changing our policies.

Margaret Flinter: Well, Dr. In nocent , to get at the root of so many of these
hardships that are entrenched in our communities of color.
We want to look at the broad er context . We have a policing
system that is particularly harsh on minority communities.
Certainly , we see this in the le vels of incarceration among
people of color . But we also know that housing and economic
and food insecurity are huge factors in health disparities
leading to higher incidences of chronic disease and poor
health outcomes , and as if we didn ’ t know that alrea dy,
certainly, we see this amplified every day by the COVID - 19
p andemic, kind of recognizing it and now really seeing in the
data, in terms of the disparities of how hard hit communities
of color are . How is the NAACP addressing these social
determinants o f health as drivers of these really tragic
statistics?

Dr. Marjorie Innocent: So the NAACP is really uniquely positioned to address the

Dr. Marjory Innocent

social factors that affect health by virtue of our large
membership base and certainly our large base of state and
local leaders . But it ’ s also a function of the issue areas that we
cover. Our work is really centered around seven areas that we
view as really critical for advancing health and opportunity for
African Americans, and they include health, education,
economic opp ortunity, public safety and criminal justice,
environmental and climate justice, advancing youth and young
adult engagement, and voting rights and political
representation , and those for us are really foundational.

Over the past several months in particul ar, we really have
doubled down on our efforts to really examine the policy
recommendations that have been proposed to address the
pandemic across our issue areas and really to learn from each
other and really build on each other ’ s work. And a lot of that is
also involved, really bringing to bear the voice of our local
leaders and their engagement with their constituents as well
to really lift up their voices. So we really recognize that the
COVID - 19 pandemic was something we certainly were not
expecting bu t really helped to lift up the need to really, really
have a very engaged group of people , really at all levels of
government and all levels of society, if you will, to really be
able to effectuate change , and so that ’ s definitely very much
such a core to who we are and really part of what we ’ re doing
right now.

Mark Masselli: Well, that ’ s wonderful. And you know, the NAACP has a great
president Derrick Johnson , he held a powerful Town Hall this
week , featuring some really key participants are Senator Cory
Booker and Congresswoman Val Demings who certainly I think
everybody knows Cory, but Val Demings , Former Orlando
Police Chief and one of the names being mentioned as a
potential running mate for Vice President Biden and Senator
Booker, Former Mayor of New Work, who lived in his own
cities, tenements, to experience really the experience that so
many people live in who live in poverty. Congresswoman
Demings , who was the Orlando ’ s first black female police
chief, you know, both speak truth to power, and what d id they
share about the specific actions the nation needs to take to
really address systemic racism across the cou ntry in this
particular moment?

Dr. Marjorie Innocent: Absolutely. We really were grateful for the participation of
Representative Demings and Senator Booker in the Town Hall,
and they certainly shared our outrage at what happened with
George Floyd and the symbol of what really does need to
change and is incredibly problematic with law enforcement

Dr. Marjory Innocent

and policing really in our country. They really echoed a lot of
what we ’ re focusing on at the NAACP. So for us, we ’ re really
calling for sweeping police reform at this point in time. It must
include federal legislation that really requires a zero tolerance
approach in penalizing and prosecuting police o fficers, who
take it upon themselves to kill our non - violent , non - resisting
individuals that they ’ re arresting. We also are callin g for the
Department of Justice to reinstitute consent decrees on police
departments and municipal governments that have
demon strated real pat tern of racism discrimination and
mis trea tment to our people of color.

One of the items that we also call for and we ’ re very, very
happy to see that Minnesota Governor Tim Walz has named
the State ’ s Attorney General Keith Ellison, as a spe cial
prosecutor for this case . We thought that that was really
something that was necessary and definitely a step in the right
direction.

Margaret Flinter: Dr. Innocent, I wonder if I could go back and do a little more of
a dive into the work that you ’ ve b een doing as the Senior
Director of Health Programs, and before that as the VP for the
Black Congressional Caucus Foundation . This issue of health
disparities just weighs on our mind all the time , and your goal
is to promote policies that will get at the c auses of inequalities
and health disparities. But these are, as you so well know, very
complex issues to tackle. Our country is made up of vastly
different communities from coast to coast. Maybe you could
share with us the policy work that you ’ re doing at the national
level with the NAACP that leverages the might of these
thousands of local chapters and this best membership that you
have to try and effectuate real change at the local levels,
where people as we like to say live, work, play and pray.

Dr. Marj orie Innocent: Absolutely. Historically , we really have focused on a number of
issues that impact the health of African Americans,
disproportionately . But over the course of the next several
years, we really are going to bear down and focus more of our
adv ocacy efforts on some of the more central challenges to
the healthcare system that we believe impact African
American health and the ability for African Americans and
others to be able to get access to quality and timely health.
That’s really focusing on e xpanding community based home
health care and really ensuring healthcare coverage for
everyone. The latter, in particular, as you well know, has been
a major topic of conversation that we ’ ve been able to make
some progress but we definitely are not where w e need to be.

Dr. Marjory Innocent

From our perspective, really efforts to expand healthcare to
where people live and really close to home is something that
seems to be losing steam, quite frankly, and that ’ s something
that we absolutely recognize as really primordial to not just
being able to access health, but really being able to ensure
that people are able to have a medical home, to be able to
have a medical home that ’ s close to where they are, that
certainly makes good use of assets such as community health
workers, certa inly, that ’ s getting the financial support that it
needs as well. Within the kind of an intersection, if you will, of
the issue of making sure that community health centers and
other sources of local healthcare have the resources that they
need and really expanding healthcare coverage.

We definitely are going to be focusing qu ite a bit on Medicaid
expansion but also looking at the reimbursement rates really
that are being offered to those that really deliver care to
Medicaid recipients. Within the univ erse of expanding
community - based health care , we definitely include school
based health centers, which we see as being very, very
important for students to be able to ensure that they ’ ve got
care in a comfortable setting , a familiar setting, that ’ s right
wher e they are for a good chunk of the day . That quite frankly
winds up being a big advantage for families r ight , for their
parents and caregivers, but also that doesn ’ t require them to
potentially have to break - off from work to be able to get their
young pers on to care, especially for underserved populations
might mean having to miss work and having to miss pay ,
literally not being able to get paid as a result, especially, for
those who don ’ t have paid leave yet.

Mark Masselli: We ’ re speaking today with Dr. Ma rjorie Innocent, Senior
Director of Health Programs at the NAACP. Dr. Innocent
previously served as Vice President of Research and Programs
for the Congressional Black Caucus Foundation, and was
Director of the Maryland School Based Health Center Initiativ e .
Well, first of all, you ’ re preaching to the choir about school
based health centers. They are one of our favorite programs
that we run here, but we also have been working with a School
Based Health Alliance, the National Association. I think part of
thi s was about racism and health inequalities, really just trying
to get at how we engage everyone . As you think about the
NAACP’s very clear strategic game plan , tell us how you want
people to be engaged with the NAACP and engaged in their
local community. S o much of the change happens at local
levels. So maybe some of your thoughts on what you see
participation levels looking like how do you think they ’ ll be
organized.

Dr. Marjory Innocent

Dr. Marjorie Innocent: I think it ’ s increasingly important for people to really
understand the importance of their role in participating in our
political process and in shaping policies. More importantly,
quite frankly, I think , at the state local levels, because
ultimately what resources actually come to communities are
ultimately really shape d by what ’ s happening within their local
and state landscape . From the standpoint of really recognizing
the importance of voting, that ’ s got to be something that
people recognize is a must , point blank, really . The folks who
really get elected ultimately t o key positions really helped to
shape , really what it is that folks get , what it is that they don ’ t.
It’s important for people to remain civically engaged and really
remain connected to the process throughout. In terms of
looking at, ultimately how – what appropriations are being
made, how policies are really being implemented, where they
are, that ’ s also very muc h part of what they need to do.

I think it ’ s also really important for them to share information
that they are learning and to seek out informat ion also . I think
about what the challenges are in their communities, the
solutions that are being proposed, and really to help bring
more people into the process. I think without that we ’ re going
to continue t o see some folks who continue to succeed and
o thers who don ’ t.

Margaret Flinter: Well, Dr. Innocent, as Mark noted, you ’ re preaching to the
choir when he talked about school based health centers a few
minutes ago. We think this is possibly the most important
upstream prevention work that we do. We hav e over 100
school based health centers, nurse practitioners, behavioral
health therapists, dental hygienists, who visit on a regular
basis, right there where the kids are and maintain the thread
over the summer and now Telehealth , which we ’ ve embraced
duri ng this pandemic. It ’ s really made us think about what we
can stay in close connection with these kids, even as they
change schools, and even as they leave school as young adults.
It ’ s such an effective way to teach kids how to use the
healthcare system th emselves. But we would love to give you
a chance to opine on your work with school based health
centers and your focus on expanding access to school based
clinics as part of the solution where does that fit in the
National Health Policy landscape? And real ly ties back to that
question we asked earlier about the local level, because if
there ’ s one thing every community has, it ’ s a school.

Dr. Marjorie Innocent: That ’ s exactly right. First and foremost, we absolutely believe
in advancing community based healt h care, as I mentioned
before, to really bring needed care to people where they live.

Dr. Marjory Innocent

We certainly believe that building our infrastructure to
strengthen primary preventive health care is for all people ,
right , in the United States is really critical to ad dress the health
disparities that we have to really help to bring about a more
health equity center lens to the services that are available to
the care that ’ s available broadly and really help us to be able
to close the gaps that have been persisting in ou r country for
entirely too long.

So advocating for policies and resources that will really help to
expand properly equipped centers is certainly part of what
we ’ re looking at. As I mentioned befor e also, we certainly see
school - based health centers as par t of that universe . We have
some very important work that we do around education that
really looks at the educational system and the resources that
are available to kids. From the health lens, we also recognize
that the importance of really looking at how to ensure the
health of kids to be able to advance their ability to learn
successfully to be successful students and certainly to be able
to keep them in school as much as possible, which, again, is
really beneficial to their families, ultimately, is defin itely a
very, very viable model that we need to be looking at .

So the school based health center work obviously is a
particular passion of mine. But as we ’ re going to be really
working to advance the work that we do, to look at effective
models for expand ing care within communities, the work of
school based health centers, and the role of school based
health centers will definitely continue to be part of that. I
should say increasingly, so especially within the NAACP.

Margaret Flinter: Great.

Mark Masselli : That ’ s great. That ’ s great. So, NAACP , tell us more about how
the organization is working in terms of how people might be
engaged in the NAACP, you ’ re 2 , 200 chapters around, but it ’ s
so important to have a strong vital organization and I know all
organiz ations go through reinventing themselves in ways that
are important to the population that they serve. Tell people
about where you are now as an organization, how people
might be engaged in that , join the members of the NAACP , tell
us what you can about th e structure and the engagement.

Dr. Marjorie Innocent: Absolutely. As you ’ ve mentioned, the NAACP is a well
established civil rights and social justice organization that
focuses on advancing wellbeing and opportunities for African
Americans in particular, but what we recognize is that doing so
really advance s the nation as a whole and what that means is
that we are absolutely committed to having anyone who is

Dr. Marjory Innocent

interested in advancing the narrower agenda, if you will,
toward the goal of advancing the larger a genda is welcome to
be part of the association. There are a lot of assumptio ns that
people have which one can certainly understand that only
African Americans are welcome as members. That ’ s in fact not
the case. We’ve got a diversity of people really, who are
members of the association and we definitely continue to
expand the diversity of members througho ut the country and
really well.

So you can certainly visit us at www.naacp.org for more
information about us . We’re also on all the major social media
platforms, Facebook, Instagram, Twitter, and we welcome you
not just as a member, but hopefully, as a member with
appointed role. We really do have a very, very diverse group of
units . Those are local branches that are ge nerally overseen by
a State Conference so those are the state leaders. And then at
the national office, we really bring you know everyone
together . In terms of the opportunities, they have various
roles within the association as chairs for each of our majo r
game changer program areas, to be able to be – really just play
a really active role within the branch and really helping to
define and shape the work of each branch . That’s absolutely
something that we are looking for more and more people to
become invo lved to do and overall to jus t become really active
members. So we really, really call on you to come join us.
Remember the importance of getting involved, staying
involved, and really being a voice for change

Margaret Flinter: We ’ ve been speaking today wi th Dr. Marjorie Innocent , Senior
Director of Health Programs at the NAACP . You can learn more
about her work by going to www.naacp.org , and also follow us
on Twitter at NAACP. Dr. Innocent, we want to thank you for
all that you ’ ve accomplished , thank you for your commitment
to advancing health equity , and thank you for taking the time
to join us today on Conversations on Health Care .

Dr. Marjorie Innocent: Thank yo u so much again to both of you.

Mark Masselli: Thank you .

Margaret Flinter: Wonderful.

Mark Masselli: Continued success. We ’ ll continue to follow your work , and
look forward t o seeing you in person one day.

Margaret Flinter: That ’ s right. We’re members of our local chapter.

Dr. Marjorie Innocent: That’s adorabl e . Thank you so much.

Dr. Marjory Innocent

Margaret Flinter: Stay safe.

Mark Masselli: Take care. Bye, bye .

Dr. Marjorie Innocent: Take care. You too, you too.

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Mark Masselli: At Conversations on Health Care, we want our audience to be
truly in the know when it comes to the facts about healthcare
reform and policy. Lori Robertson is an award winning
journalist and Managing Editor of FactCheck.org, a
nonpartisan, nonprofit consumer advocate for voters that aim
to reduce the level of deception in U.S. Politics. Lori, what
have you got for us this week?

Lori Robertson: At a White House meeting in May with fellow republicans
President Donald Trump said without evidence that the
Coronavirus “ is going to go away without a vaccine. ” While it's
impossible to predict the future, e xperts say it's unlikely that
the virus will simply go away. Marc Lipsitch, an epidemiologist
at the Harvard T.H Chan School of Public Health said there was
no basis for statement, calling it “ completely fanciful and not
evidence based .” On Fox News Sunday , Tom Inglesby , Director
of the Center for Health Security at the Johns Hopkins
Bloomberg School of Public Health also objected to Trump's
claim . “ No, this virus isn't going to go away ,” he said.
Hopefully, over time, we'll learn to live with it and we'll be able
to reduce the risk of transmission, but it's going to stay as the
background problem in the country and around the world until
we have a vaccine.

Anthony Fauci , Director of the National Institute of Allergy and
Infectious Diseases, and a prominent member of the
Coronavirus Task Force has said that it will take a vaccine to
allow society to le t up on all of its mitigation efforts. In an April
16 TV interview Fauci said, “It's not going to be over to the
point of our being able to not d o any mitigati on until we have
a scientifically sound base and effective vaccine.” Fauci called
the novel Coronavirus extraordinarily efficient in being able to
transmit from one person to another, “those kinds of viruses
don’t just disappear,” he said. The World Health Organization
too has said that while a vaccine is humanit y’s best chance of
getting rid of the virus, even then there’s no guarantee that
the virus will go completely away.

Researchers at Harvard and the University of Minnesota have
a tempted to model ho w the virus will spread under different
assumptions to understand what the possibilities might be.

Dr. Marjory Innocent

That work suggests the virus will be around for the long haul.
The Harvard team found that repeated wintertime outbreaks
will probably occur and even if the virus might appear to go
away, resurgence could occur as late as 2024. That's my fact
check for this week. I'm Lori Robertson , managing editor of
FactCheck .org.

[Music]

Margaret Flinter: FactCheck.org is committed to factual accuracy from the
country's maj or political players and is a project of the
Annenberg Public Policy Center at the University of
Pennsylvania. If you have a fact that you'd like checked, e - mail
us at www.chcradio.com , we'll have FactCheck.org's Lo ri
Robertson check it out for you here on Conversations on
Health Care.

[Music]

Margaret Flinter: Each week Conversations highlights a bright idea about how to
make wellness a part of our communities and everyday lives.
Baltimore, Maryland has one of the h ighest emergency
medical call volumes in the country and it results in a
significant number of patients being taken to the ER for
conditions that could have been treated outside of the ER . The
University of Maryland Medical Center and the Baltimore City
Fi re Department teamed up in the hopes of reducing
unnecessary ambula nce trips and hospitalizations.

Dr. David Marcozzi : How do we all start to address health issues more
comprehensively than simply calling 911 being transpo rted to
an emergency department wh en that is n ot optimal care for
patients n or benefits the system ?

Margaret Flinter: They created a new pilot program which pairs doctors and
nurses at the hospital level with paramedics in the field,
bringing medicine right into the patient's home.

Dr. Dav id Marcozzi : A nurse practitioner or physician is partnered up with a
paramedic, and we monitor the 911 system , and it's
completely synchronized with that system so that 911 low
acuity calls, we augment the Baltimore City EMS system so
that we co - dispatch a paramedic and either nurse practitioner
or doctor to the scene a low acuity calls, have t hem logged in
at scene through E pic , ask the patient whether or not they
could – what they would like to be treated at scene. If they can
sent, we then enroll them i nto our program, register them ,
they are just like a mobile urgent care center. We then treat
them at scene, discharge them with the same exact

Dr. Marjory Innocent

paperwork, we discharge them from the hospital, from the
emergency department, with prescriptions as needed, and
then we follow up with him within 24 hours to mak e sure they
got what they need.

Dr. David Marcozzi : Dr. David Marcozzi of the University of Maryland Medical
Center says that this Mobile Integrated Health Care
Community Paramedicine Program has a two pron g , goal one,
reducing unnecessary trips to the ER by delivering right care at
the scene ; t w o , bringing a coordinated paramedicine team
including doctors and nurses into the homes of patients being
released from the hospital to ensure that their recovery is
supported for better outcomes. The pilot also seeks another
goal to keep vulnerable patients being released from the
hospital healthier with paramedics doing frequent followups
over a 30 - day period to ensure that patients are compliant
with their medicine s are getting enough to eat and thus
greatly reducing the risk of re - hospitalization.

Dr. David Marcozzi : It's eye - opening to o, once you understand the challenges
when we discharge a patient or when patients are seen for low
acuity issues. People stay just at home to navigate this short
industry, the multiple providers the y're supposed to follow up
with, the diagnostic testing that they may have to get an MRI,
then the follow up back to their primary care . The challenges
that individuals face certainly here in Baltimore, and we're
exploring, could we do this for longer? Or is there a better way
once we hopefully empower folks to transition to maybe a
lower resource intensive setting so that we can kind of
transition them to potentially another health support
infrastructure for THS, is a Transitional Health Support the 30 -
day follow program.

Our data demonstrates that the patients who are followed in
our program utilize and are admitted to the hospital
significantly less and utilize their healthcare primary c are
services significantly more , that translate into lower cost to
the system from a physician billings’ construct , from a hospital
construct , and b y the way, from an EMS construct because you
know what happens? Those patients typically c all 911 to get to
the hospital.

Margaret Flinter: Dr. Marcozzi estimates that the two - year pilot will save the
University of Maryland Medical Center, at least $4 million
dollars and the fire department expects to save just under 2
million. But most importantly , he says the patient outcomes
are markedly improved. The mobile integrated healthcare
community paramedicine program , rethinking how

Dr. Marjory Innocent

paramedicine is deployed in the field, reducing unnecessary
emergency room trips , and by the way, making sure that the
emergency respond ers can respond that much more quickly to
the true emergencies. Now , that's a bright idea.

[Music]

Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health.

Margaret Flinter: Conversations on Health Care is recorded at WESU at Wesleyan
University, streaming live at chcradio.com , iTunes, or wherever you
listen to podcasts. If you have comments, please e - mail us at
[email protected] , or find us on Facebook or Twitter. We love
hearing from you. This show is brought to you by the Community
Health Center.

[Music]