By Florby Dorme, Helena Keown
As public health professionals, we hope that what we do protects and improves the health of people in our community. We are intimately connected to our work in a way unlike other professions, knowing the decisions we make can change lives, for better or worse. This is especially true when you work at the intersection of data-driven analysis and people-centered programming, in the face of a pandemic brought on by COVID-19.
When the mobile program started in May of 2020, the pandemic threatened to collapse our healthcare system. As a rapid response initiative, Test & Trace began as a testing program, using data to strategically deploy resources as supplements to brick-and-mortar testing sites. We paid special attention to the communities that were hit the hardest: areas in the city that were black and brown, had difficult access to healthcare infrastructure, and had the worst COVID outcomes. By the end of 2020, our team was deploying 20 mobile units throughout the city each day.
Nearly a year later, we’ve scaled to operate more than 70 units daily including 40 testing units, 25 vaccination units, and six dual purpose test and vaccine units, focusing still on communities where COVID has hit the hardest. We’ve collaborated on some of the largest initiatives in the city, including restaurant week and the opening of Department of Education (DOE) schools, and continue to provide testing and vaccination every day across all five boroughs, having completed more than 155,000 vaccinations and 600,000 testing swabs as of October 2021.
Our mobile program is unique, bringing together just a handful of project managers, a fully equipped provider service team, and a fleet of over 70 vehicles to become one of the most responsive COVID-19 services in the city. We have unique assets that allow us to reach patients in ways other programs cannot. One of those is quite literally bringing vaccines to where people already are.
When we park a vaccine van at a local library, restaurant, or block party, we create an opportunity to connect with those who haven’t yet decided to get vaccinated. Vaccine-hesitant New Yorkers may not be inclined to walk into a regular clinic to get information about the vaccine, but when we make ourselves available in places they normally go, it allows us to start a conversation.
We’ve seen skeptical community members approach clinicians at the vans and ask their questions about the vaccine—and we’ve seen some of the same people come back later after thinking about it, to get their first shot. Testing patients sometimes share that they decided to get tested because they keep seeing the van in their neighborhood every day. Continuity plus connection can pave the way by providing an opportunity for those who are unsure to make a decision on their own, and allows the community to become more comfortable with COVID resources.
Perhaps the most distinct feature of our program is our relationship-centered approach to resource allocation. We understand that partnering with CBOs increases program effectiveness because we look to CBOs as trusted members of communities. Our team seeks out active CBOs, ones that already have established relationships with those in the community, in the hopes of developing long-term partnerships built on trust. Working with CBOs is the primary way we reach communities because it provides the best opportunity to connect with people in a meaningful way.
Our partners know their communities, and are ready to tell us what they need to reach people and reduce barriers to receiving care. Partners articulate community-specific needs ranging from language access, resources to address misinformation, outreach strategies that can help spread the word, and for a consistent presence so that word-of-mouth can do its work.
Communities know best what they need. A cornerstone of our program’s success is the ability to be flexible in how we work with each individual partner, so we can empower those already doing the work and support their platforms to improve health outcomes in the face of this pandemic.
Building strong relationships with our partners has also helped our program grow and thrive. Often, mobile testing partners are connected to the vaccination side, and vice versa. What starts as one pop-up testing site can turn into an ongoing, long-term partnership that offers multiple resources to the community. Existing CBO partners often refer us to new partners too, which is how we’ve come to know many of our partner organizations.
In public health work, we know that an individual’s health can affect that of their community at large, a fact made all the more tangible during a pandemic. To hold the weight of our work to protect and improve the health of our neighbors, which is simultaneously so personal and so communal, we focus on a few takeaways from our program’s success.
Our partner-driven approach works so well because when communities lead, we all gain. Our program isn’t top-down. We have real, strong partnerships with community leaders and organizations, and because of that, we’re able to meet people where they are, increase uptake, and help community members get tested and vaccinated at higher rates.
Our program also works because we’re quick to respond to emerging shifts and needs. Life in a pandemic has acquainted all of us with never-ending change, and naturally, that is reflected in our work. Our team responds at a moment’s notice to shift our schedule, strategy, and protocols according to emergent needs.
Finally, our work is successful because a mobile program design allows room for creative strategy. We’ve made an affirmative effort to make our resources a familiar presence in communities through unique partnerships and approaches and, person-by-person, supported the work of getting New York vaccinated.