When Philadelphia opted to select a start-up run by a 22-year-old without medical credentials as its largest mass vaccination partner, experts explain, something was already wrong.
The city cut ties with that partner, Philly Fighting COVID, after questions from The Inquirer revealed that the organization created a for-profit wing as part of its transition to focusing on vaccination, while a WHYY and Billy Penn investigation revealed that the organization had scrapped its testing efforts and ghosted the community groups it had partnered with.
The scandal has continued to grow and ignite outrage this week, as the press uncovers details. On Thursday morning, the nation and the internet could watch PFC CEO Andrei Doroshin, in an interview with the Today show, “stand by” his decision to take vaccines from the site. But some experts contend that a city government selecting a group with such questionable qualifications causes certain damage to vulnerable communities.
The Philly Fighting COVID imbroglio, health experts say, could motivate Philadelphia residents to navigate their health choices with deeper suspicion, seek treatment solely within community, or not seek treatment at all.
The incident “reinforces” mistrust that already existed among marginalized communities, said Drexel social epidemiologist Sharrelle Barber.
“It’s not just these historical incidents,” said Barber, who has heard some point to events like the Tuskegee experiment recently. “It is contemporary instances like what we’re witnessing that generate the kind of mistrust that we’re seeing in this moment.”
The city Department of Public Health required the start-up to meet CDC vaccination provider requirements, but these requirements do not ask for or stipulate health-care credentials. (As The Inquirer reported, no one asked Doroshin about his medical qualifications when he addressed City Council at an informational meeting in November.)
Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center, said in an email that “the city has a legal and ethical obligation to be good stewards of the COVID-19 vaccine rollout. That includes rigorous vetting of partners in the vaccine program.”
“Episodes like this,” Gostin continued, “sow increased distrust and could be harmful to the overall goal of vaccinating the entire population.”
Kevin Ahmaad Jenkins, a health disparities expert and visiting scholar at the University of Pennsylvania, described the incident as another time where the government had let down marginalized people.
“Instead of just setting it up as a failure issue, my question is: Do you care?” said Jenkins. “Because if you cared, you wouldn’t do that.”
The implications of this, in a city with Philadelphia’s demographics, could be vast, experts agreed. Black Philadelphians make up 44% of the city’s population, but only 12% of the Philadelphians vaccinated so far.
The predicament is even worse, Jenkins said, to be happening at a time like this: “We are in a moment right now where trust is all we have. We don’t even have the element of human touch in this moment.”
That the city didn’t partner with the Black Doctors COVID-19 Consortium, an organization that had built trust with Black communities, makes the matter all the more sour, said Jenkins. (Black Doctors COVID-19 Consortium founder Ala Stanford told Philadelphia Magazine the city suggested it work with Philly Fighting COVID. The consortium has been administering vaccinations without the start-up’s help.) Jenkins also questioned the locations of current vaccination sites, given the data available on which communities have been hardest hit.
“The statistics are telling you these are the places you need to go, right, that’s basically what the stats have been saying from day one, since we first got racial disparities numbers on COVID,” Jenkins said. “We know where the issues are, but yet we don’t place the resources there.”
Adnan Hyder, a global health professor at George Washington University and an expert on public health ethics, said that the position that we’re in nationally, where we have a historic lack of acknowledgement of racial disparities in medicine and urgent needs for a solution to a virus that’s claimed the lives of more than 430,000 Americans, is a situation where science must be diligently followed.
“I have been very careful and concerned about the role of the private sector and the role of industry in influencing policy decisions,” Hyder added, speaking not specifically of Philly, but from his research.
Barber, the Drexel social epidemiologist, said she hopes the fiasco makes public health institutions reevaluate their internal processes.
“I’m going to reiterate: This is a matter of life and death at this point, we’re in the middle of one of the biggest public health crises of a lifetime,” Barber said. “We can’t afford to be making these kinds of mistakes and missteps because our communities, Black communities are going to be the ones who are bearing the burden.”