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Women Leading California’s COVID-19 Response: Surgeon General Nadine Burke Harris

“Probably the biggest part of my job is that I translate science into information that people can use to help keep themselves healthy. That’s probably my favorite part of the job,” she says. 

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Dr. Nadine Burke Harris. Facebook photo

This Women’s History Month, California Black Media is profiling three Black women on the leading edge of California’s response to the COVID-19 pandemic: Here, we focus on Surgeon General Nadine Burke Harris.

Nadine Burke Harris is California’s first Surgeon General, a role that consists of a number of high-level internal governmental obligations as well as a significant amount of public-facing responsibility. In addition to advising the governor on health matters, she is also the state’s “public health spokesperson,” Burke Harris told California Black Media.

 “Probably the biggest part of my job is that I translate science into information that people can use to help keep themselves healthy. That’s probably my favorite part of the job,” she says. 

When asked what her biggest success has been regarding California’s pandemic-related public-health efforts, Burke-Harris focused on the state’s equity measures. 

They include equity metrics within the state’s reopening blueprints for counties as well as an equity strategy within COVID-19 vaccine allocation that reserves 40% of vaccines for socio-economically disadvantaged communities. 

 She also mentioned her role as co-chair of the Community Vaccine Advisory Committee, which is part of the process of determining how California allocates and distributes its vaccines. 

 “I think our reopening blueprint really demonstrates how seriously California is taking the issue of equity because our whole notion is that we recognize that this pandemic is disproportionately hard on Black communities, and we really want to make sure that when we are reopening that we are doing an equitable reopening,” said Burke-Harris.

Prior to becoming California’s Surgeon General, Burke-Harris treated children as a pediatrician. She is the founder of the Center for Youth Wellness in the Bayview Hunters Point neighborhood of San Francisco. In her decade and a half working in the community, Burke-Harris saw how certain equity and accessibility issues would impact her patients’ ability to receive care.

Burke-Harris said, “There are a lot of little things that you realize. For example, I was just on a conversation where we were talking about how close a vaccine site has to be in order to be considered accessible. One of the things that I highlighted is that I live in San Francisco, and I have a car, so for me, something that’s five miles away is perfectly acceptable. But for the patients that I cared for, I had the experience of seeing how hard it is for someone who’s got two or three kids to take three buses across town to get where they have to go. Five miles away may not be accessible. That has certainly informed my role in the state and how I advise the governor.”

In addition to her work on the COVID-19 response, Burke-Harris has also continued her previous work on raising awareness about Adverse Childhood Experiences (ACEs) and how toxic stress affects children. A training initiative, which she began in January 2020, has now educated almost 20,000 doctors about how to identify and improve healthcare outcomes for people who have experienced ACEs.

As for her biggest challenge during the pandemic, she acknowledged a feeling of exhaustion. Such exhaustion, she says, is common among health care providers and others on the frontline of the COVID-19 response and relief efforts, after a full year of the pandemic.

 “It’s been a real sprint. My colleagues in government, and especially in health and human services, have been working around the clock responding to this emergency. It’s a lot, it’s late at night, on the weekends, my family not seeing enough of me. I think that for all of us, just the endurance has been pretty intense,” Burke Harris says.

 To help recover from the daily pressures of work, Burke Harris values self-care and family time. She makes an intentional effort to practice meditation as self-care when life gets hectic. As for family time, she enjoys game nights and snuggles from her children to cultivate joy. Also, her kids are quick to tell her when she seems stressed.

Burke Harris says, “I remember there was one point during the January surge that was really intense. I was having dinner with my family and my 8-year-old said, “Oh no, it looks like Mama lost her giggle.” At that moment, he just held up a mirror for me, and how much the intensity and the pressure of my work were coming into our family life. It just reinforced for me that no matter what I’ve got to keep that sense of playfulness with my kids.”

Activism

ESSAY: Technology and Medicine, a Primary Care Point of View 

The COVID-19 pandemic, for example, restricted millions of people to their homes, which required reliance on the internet for communication and information.  Personal internet searches became essential to understanding information about COVID, human physiology, symptoms, and keeping up with vaccine updates.  However, this increase in independent online research resulted in people accessing more misinformation circulating on the internet. This posed a challenge for medical providers trying to treat patients according to research-based guidelines.  With so much information within reach, it was difficult for providers to help their patients distinguish between legitimate evidence-based sources and opinion, speculation, and fabrication.    

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Dr. Adia Scrubb Photo provided by California Black Media..
Dr. Adia Scrubb Photo provided by California Black Media..

Dr. Adia Scrubb
Special to California Black Media Partners

Technology has enhanced communication between medical professionals and patients; improved patient care management; and eased access to care and information, benefiting both patients and medical clinicians.

However, despite the ease and many conveniences these patient care improvements have ushered in, adequate patient care still includes physician supervision, examinations, and interaction, which present challenges for keeping up with demands on the healthcare system and accurate patient education.

Technology has made more educational resources available at our fingertips, and it has created independence for those who want to know more about their bodies.

The COVID-19 pandemic, for example, restricted millions of people to their homes, which required reliance on the internet for communication and information.  Personal internet searches became essential to understanding information about COVID, human physiology, symptoms, and keeping up with vaccine updates.  However, this increase in independent online research resulted in people accessing more misinformation circulating on the internet. This posed a challenge for medical providers trying to treat patients according to research-based guidelines.  With so much information within reach, it was difficult for providers to help their patients distinguish between legitimate evidence-based sources and opinion, speculation, and fabrication.

Nowadays, patients continuously arm themselves with medical information and challenge clinicians with the research they gather from internet sources to advocate for themselves and their care.  This often leaves medical professionals with the complex task of navigating challenging discussions, pointing patients to validated and verified medical information, and following evidence-based medical guidelines for treatment.

Reviewing information before an appointment can certainly make an office visit much more productive, but it is essential to acknowledge the possible bias and limitations of internet searches.  Consideration of the author, source, and date of the information may help determine its validity.

Furthermore, simply asking medical professionals for their preferred patient information resources will direct patients to safe and validated information that is in line with standards of care practices.  This can help patients better understand the recommendations from their doctors and streamline their internet searches.

Access to individual online medical record information, such as blood tests, MRI reports, and office visit notes, has been a significant expansion of technology in medicine. This digitization of medical information enables and positions patients to take a leading role in managing their care.  What used to be multiple sheets of paper in a large file folder is now a click away at any time.  Despite these benefits, instant access can be overwhelming for both patients and medical providers, especially since patients, in many instances, can receive their test results online before the physician has had the opportunity to review them.

Patients may review the office visit notes or their lab results out of context or misinterpret information, which can lead to anxiety, confusion, and fear.  Clinicians are put in a difficult position when they are not able to suddenly break away from their scheduled office visits to reassure an unscheduled patient about their results and next steps.

Medical providers have tools to assist with identifying sensitive results that need urgent review, and efforts are made to notify anxious patients as soon as possible.  However, a patient can be proactive in scheduling a follow-up visit ahead of time to review results with their provider specifically.  This can help patients avoid the stress of suddenly trying to get a hold of their doctor when dealing with unclear or concerning results.  Normal test results often don’t require explanation, but allowing several days for your provider to work through hundreds of test results before sending messages requesting clarification will help medical professionals prioritize their responses to test results based on medical urgency.

Technological improvements such as online messaging and video/telephone appointments have made access to care much easier both for patients and clinicians.  Telephone and video visits have been especially beneficial for patients who are elderly, disabled, or do not have access to transportation.  However, the increase — and ease of — access has created much higher demand for physician time both during and outside of the office visit.  Test results, patient messages, insurance forms, emails, and medication requests are all pouring in while providers conduct their daily scheduled appointments.  Thus, very little time is left in the day for a clinician to respond to every email, fill out every form, and review every lab result when they are responsible for 1,800 or more patients.

This situation, unfortunately, creates a perceived delay in response in a culture where an instant response is expected from messaging and phone calls.  But the reality is that the medical provider is constantly playing catch up to thousands of inquiries due to the around-the-clock online access patients now have.

Patients can make the most of their experience and their physician’s time by taking the time to learn their physician’s communication preferences.  Despite the multiple modalities of access (telephone, email, video, in-person), a medical provider will have a preferred method of communication with their patients.  Some may ask their patients to make an appointment to explain a complex topic, instead of responding to multiple messages. Others may prefer to communicate via phone call if they have to deliver bad news.

There will likely be more medical providers who prefer to communicate only through email or video appointments as remote work becomes more common. If a patient’s communication preferences align with their physician’s preferences, it will create a stronger patient-doctor relationship and foster more effective and impactful communication.

The expansion of technology in medicine has fostered better collaboration, communication, and education between patients and their medical professionals.  Combining electronic resources with rapport, mutual respect, and trust for providers will help patients navigate this new landscape of healthcare.

About the Author   

Dr. Adia Scrubb, MD, MPP, is a Board-Certified Family Medicine Physician currently practicing in Solano County. 

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Alameda County

After Years of Working Remotely, Oakland Requires All City Employees to Return to Office by April 7

City Administrator Jestin Johnson recently told city unions that he is ending Oakland’s telecommuting program. The new policy will require employees to come to work at least four days a week. These new regulations go into effect on Feb. 18 for non-union department heads, assistant and deputy directors, managers, and supervisors. All other employees must be back at work by April 7.

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Oakland City Hall. File photo.
Oakland City Hall. File photo.

By Post Staff

The City Oakland is requiring all employees to return to the office, thereby ending the telecommuting policy established during the pandemic that has left some City Hall departments understaffed.

City Administrator Jestin Johnson recently told city unions that he is ending Oakland’s telecommuting program. The new policy will require employees to come to work at least four days a week.

These new regulations go into effect on Feb. 18 for non-union department heads, assistant and deputy directors, managers, and supervisors. All other employees must be back at work by April 7.

The administration may still grant the right to work remotely on a case-by-case basis.

In his memo to city unions, Johnson said former President Joe Biden had declared an end to the pandemic in September 2022, and that since then, “We have collectively moved into newer, safer health conditions.”

Johnson said “multiple departments” already have all their staff back in the office or workplace.

The City’s COVID-era policy, enacted in September 2021, was designed to reduce the spread of the debilitating and potentially fatal virus.

Many cities and companies across the country are now ending their pandemic-related remote work policies. Locally, mayoral candidate Loren Taylor in a press conference made the policy a central issue in his campaign for mayor.

City Hall reopened for in-person meetings two years ago, and the city’s decision to end remote work occurred before Taylor’s press conference.

At an endorsement meeting last Saturday of the John George Democratic Club, mayoral candidate Barbara Lee said she agreed that city workers should return to the job.

At the same time, she said, the city should allow employees time to readjust their lives, which were disrupted by the pandemic, and should recognize individual needs, taking care to maintain staff morale.

The John George club endorsed Lee for Mayor and Charlene Wang for City Council representative for District 2. The club also voted to take no position on the sales tax measure that will be on the April 15 ballot.

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Bay Area

Authorities Warn: There’s a COVID Surge in California

According to data estimates by the Centers for Disease Control and Prevention (CDC), the coronavirus in California’s wastewater has spiked for eight consecutive weeks. Hospitalizations and emergency room visits have also increased since the rise of the new subvariants. Over the last month, Los Angeles County experienced an average of 389 hospital patients per day that tested positive for the coronavirus. The FLiRT subvariants such as KP.3.1.1. Made up over 2% of coronavirus samples nationwide, an increase of more than 7% last month.

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Photo provided by California Black Media.
Photo provided by California Black Media.

By Bo Tefu, California Black Media

California is experiencing a COVID-19 surge this summer, experts warn, as numbers of infections increased for the third month this year.

State public health authorities attribute the summer COVID surge to more infectious subvariants that have emerged as the coronavirus evolves.

Dr. Elizabeth Hudson, regional chief of infectious disease at Kaiser Permanente Southern California, stated that subvariants of COVID-19 called FLiRT increased in recent months, particularly one named KP.3.1.1 that has become the most common strain in the country.

Dr. Peter Chin-Hong, an infectious diseases expert at UC San Francisco, said that the subvariant KP.3.1.1 seems most adept at transmission.

“The subvariant is the one that people think will continue to take over, not only in the United States, but … around the world,” Chin-Hong said.

According to data estimates by the Centers for Disease Control and Prevention (CDC), the coronavirus in California’s wastewater has spiked for eight consecutive weeks. Hospitalizations and emergency room visits have also increased since the rise of the new subvariants. Over the last month, Los Angeles County experienced an average of 389 hospital patients per day that tested positive for the coronavirus. The FLiRT subvariants such as KP.3.1.1. Made up over 2% of coronavirus samples nationwide, an increase of more than 7% last month.

The majority of the people who tested positive for COVID-19 complained of a sore throat and a heavy cough. Risk factors that can increase the illness include age, underlying health issues, and vaccine dosage.

Health experts stated that the demand for the COVID-19 vaccine has increased in Northern California. However, people are having a hard time getting the vaccine due to the increasing number of cases.

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