Inaccessibility, anti-vax co-workers, and learning on the fly: What it’s like working at one of Los Angeles’s biggest Covid testing and vaccine non-profits

Filed Under: Costs, Patients

- photo by John Cameron on Unsplash

As the Covid vaccine rollout continues, many people have had interesting roles and experiences. We spoke with one — we’ll call her C. — who is helping with the rollout in Los Angeles. I caught up with her for a conversation about her experiences. Here is our conversation, lightly edited for clarity and brevity.

Phoebe

So what exactly is your job? Can you describe it?

C.

I work at Sean Penn’s nonprofit, C.O.R.E. — Community Organized Relief Effort is what it stands for. They originally just did testing. They did all of Los Angeles’s free Covid testing, pretty much, and then they switched the major testing site to a vaccine site and hired a bunch of people. They originally just had volunteers, and when they switched over, C.O.R.E. said, “you want to get paid?” And people were like, “sure!”

C.O.R.E. partnered up with the city of L.A. — the fire department, the mayor’s office, all those good fellows — and they were like, we’ll vaccinate all of L.A., we’ll be like, the lead organization. Great press. I hadn’t ever heard of them before, but they definitely seemed to be like, trying to make a lot of money off of this disaster, as nonprofits like to do. But it was cool because, you know, a bunch of people, myself included, were out of work, and they were offering paying jobs.

I saw they were going to open up Dodger Stadium as a major vaccine site, and it said they needed people to work there. I literally found this job through Google, and I applied through a website; it was a pretty easy process. They told us it was $20 an hour, and most people were like, “ok, sounds great!”

The major sites of vaccination in Los Angeles, like Dodger Stadium, needed like, over 500 personnel to work, pretty much, in each site. We would manage the traffic, document patients and intake them. It took so many people working there because there would be a couple thousand people getting vaccinated a day. And, you know, it’s a very logistically difficult vaccine because you’ve got to keep it in the vials, then you’ve got to thaw it, then you’ve got to draw it. That all takes a while.

Everyone was driving to Dodger Stadium, expecting the customer service of like, a really energetic cheesecake factory where they get to yell at you. So that was pretty much that job.

Change in strategy

And then C.O.R.E. was like, okay, the major vaccine sites aren’t efficiently vaccinating everyone. Even people with appointments were still waiting there for up to four hours. That’s a lot! And not everyone has four hours of their day to just give.

They realized it is way more efficient to have multiple mobile pop-up sites. So, they closed down the main site, and then transferred me to the dependent, homebound population.

The Department of Disability had a list of like, 72,000 people whose phone numbers they didn’t have. All those folks are in a health situation where they can’t get into a car and drive to a doctor’s office or go get vaccinated. So, C.O.R.E. started a service where we went into the houses of these homebound people and gave them vaccines.

I would go along on the house calls as a medical documenter. That was, I think, the weirdest part of the job, when I would physically go inside people’s houses. It’s a truly intimate experience to go inside a stranger’s home and write down their intimate, HIPAA-protected medical information that they’d tell the nurses.

We also did a lot of canvassing, because we need people’s phone numbers to contact them to set up an appointment. I did a lot of canvassing. I had never done political canvassing before and this was kind of intense since obviously the vaccine is now a pretty political issue.

“Weird vibes”

Phoebe

Did you have any weird experiences or reactions from people during canvassing?

C.

Well, the nature of canvassing is pretty weird, like going up to people’s houses. You get weird vibes from people, like, “who is it?” You know, “who’s at my door? Who’s knocking without calling first?”

We got the worst situation with anti-vax people in the valley, in Council District 6, Nury Martinez’s Council District. There was a special canvassing situation setup there, where we would basically cold-call every house, instead of just the list of potentially homebound people, like we did in other places.

Other outreach programs

We went to that Council District because Nury Martinez thought this was a great program and wanted to vaccinate her Council District because it had a really low rate of vaccination. There were a few other outreach programs that we saw there as well while we were canvassing, like Vaccinate All 58, and Kaiser Permanente, who had their own at-home vaccine program.

They had way better flyers than us. Our flyers were not great. We never got them translated to Spanish, and they were very tiny texts in very long, ongoing paragraphs that didn’t get to the point. They were so inaccessible.

I got so frustrated I went on my computer and tried to make a better, Spanish and English version with our QR codes. But they never got the approval to print them and use them. Like, oh my God, our fliers were so bad.

In Council District 6, we just had to go to every house, and ring the doorbell and say, “Hey, we’re here with Nury Martinez to see if you guys have gotten your Covid vaccine yet or want to get it.”

There’s that vibe of like, “Oh, why are you here?” And it’s like, “Oh, I’m here to convince you to do this.” So it got way more political.

Council District 6 projects were where I think we had the most political resistance and a lot of “oh, now the government is here to make us get the vaccine.”

Followed by an unmarked van

There was one time where an unmarked van followed us. My fellow employees got told some crazy stuff like, “you guys are not welcome here” and sometimes people would get up in your face like, aggressively.

We’ve had other incidents too. It didn’t happen to me, but there was a gun violence incident. We had to have like, a whole situational awareness training, which was very amusing because whoever they hired to do that was not an expert at all. They flew her in all the way from Tennessee! She obviously didn’t know anything about Los Angeles neighborhoods.

No one’s gotten hurt, or anything, mostly just rude people. And you’ll get rude people over the phone. You’ll get rude people in the drive-thru. It takes a lot of “Customer Service Face.”

When we were doing that canvassing of everyone, not just the dependent, homebound population, I’d say about 70% of the people whose houses we were going to had already gotten vaccinated. A small percentage, no matter what area you were in, would be like, “Oh, no, thank you, I don’t want it.” Or like, “how dare you? I don’t want it.” There’s also a small margin of people who were like, “oh, yeah, I don’t know yet.” But it wasn’t really our job to convince people to get it because like, we aren’t doctors. We didn’t have training in how to convince people or anything like that.

Not our job to argue

We were repeatedly told by the firefighters we worked with like, if people are unsure or they don’t want it, it’s not our job to argue with people or convince them. That is any other nonprofit outreach campaign. Sometimes you can have the right message, but you really aren’t the right messenger. Like, I might not be the figure that is universally trustworthy in every single Los Angeles neighborhood. There are more targeted outreach campaigns to help spread accurate information, and that wasn’t really our job.

Mostly what I’ve been doing recently is just scheduling people who are referred or who call our hotline after they read our flyers. Most of our referrals come from the County Department of Public Health, though. If you call 211, and you say, “I’m disabled and I need a vaccine,” they can schedule that for you.

Only a small portion of referrals come from our fliers. Not a lot, though, because, like I said, the fliers suck and they’re hard to read! Another small portion will come from other referrals, or word of mouth. But otherwise, there’s no other advertisement campaign. Like, we don’t have any T.V. ads. We don’t have any Facebook targeting, social media ads…we don’t have any of that. I tell a lot of people about this program and no one’s heard of it.

Accessibility issues

Phoebe

It sounds like there were some real accessibility issues!

C.

There are absolutely accessibility issues with using our services. The biggest accessibility issue I found was like, if you’re disabled, you often also have to go to work, and you still have things to do. And if you’re busy during the day, it’s really hard to use our service.

To use our home visit service, you have to be home all day, from 9 a.m. to 4 p.m. That can work out for people who aren’t leaving the house anyway, but if you’re like, going to work? A lot of people are like, “Oh, I work that day, or I have to send my kids to school, or whatever. What time will you be there?” I have to assess their situation on the fly and find a way to accommodate them by either like, literally Googling and looking up a clinic in their area, or trying to schedule a home visit with us.

People with disabilities

If the people have the literal physical ability to leave the house, I can find them a nearby location to get vaccinated. A lot of times people will want a certain vaccine, which can be tough. For example, a lot of places don’t carry Johnson. Like CVS doesn’t do Johnson, Walgreens doesn’t. So for people who want something specific like that, we kind of have to look.

If you need a home visit, like I said, you have to be home and available from 9 a.m. till 4 p.m. Our window used to be 9 a.m. to 3 p.m., but then they cut down on the staff and added another hour that you have to be available.

We don’t have nurses going anymore to administer the vaccines, it’s firefighters now, which may also be a thing that weirds people out. A lot of people say, ‘oh, it’s not nurses?’ Like, ‘are firefighters qualified?’

And I have to explain like, yeah, they’re emergency medical personnel. They can revive you and stuff. They can put needles in your arm.

Shrinking teams

Phoebe

Why did they stop having nurses?

C.

I think funding issues. There are two other health companies that partnered with C.O.R.E.: Curative and Carbon Health, and they were supplying us some nurses. About like, middle of last month, C.O.R.E. told us we’re not going to have any nurses go out on these calls anymore, just firefighters.

I don’t really know the reason but I think it was either because we had no more funding, or I think the nurses were going back into the hospitals, like either their regular hospital jobs or maybe the Covid units opened back up.

We have teams of a firefighter, a nurse (when we had them), and a documenter, and each team will do about 10 house calls a day. Each day the computer will spit out what the best route is for each group to do 10 addresses within a certain part of the greater Los Angeles area. That already kind of ties up our scheduling a lot. Overall, there’ll be like, 30 appointments a day that the organization can do. 30 to 50 I’d say, on a big day.

But we don’t know how long appointments or driving will take, so we can’t give the patients a specific time that we’ll come. We basically get the list that morning, and we call each patient 20 minutes before we arrive at their house to be like, “Hey, get ready soon.”

It’s kind of like a cable repairman or the plumber: you call to schedule them for a specific day, and they come show up whenever. You have to be available for them all day. That’s already kind of weird, and I have to explain that every single time when making an appointment with someone who needs our service.

Scheduling issues

Waiting all day for us to show up is pretty inaccessible! A lot of people need appointments in the morning, or appointments in the afternoon. Even if they don’t leave the house for various reasons, like maybe they’re not awake, or maybe they have something else going on. For folks in the dependent and homebound population, our scheduling is a huge issue.

In general, the biggest barriers I think would be lack of information and accessibility. Like, if it’s not in your area, if it’s not the most convenient thing for you ever, then it’s probably not going to be an accessible service.

We also haven’t done much incentivizing. Like, I usually get my flu shot because it’s incentivized with a little “$5 off of $20” shopping coupon, which they still do. Shoutout to CVS. For people who are not opposed to the vaccine altogether, incentivizing can really work.

The role of misinformation

Phoebe

Did you get the sense that there’s a lot of misinformation amongst the patients or the people that you were speaking with?

C.

Yeah, absolutely. There’s even misinformation amongst the employees and amongst the people who were supposed to be educating us. Unless you stay on top of every single scientific paper that’s released, there’s no way to get totally accurate information about Covid and the vaccines, because what we know is constantly being updated, and it’s constantly changing. When the facts are constantly being tested and renewed and changing, I think that’s a like, peak environment to have the rumor mill and misinformation going.

I guess an example of that would be the firefighter who was giving us one of our trainings. They told us that you cannot, under any circumstances, mix the vaccines. At the point that they were telling us this, there was already literature out there that was saying that’s not necessarily true. Mixing vaccines was already getting approved by various pharmacists at major sites because of supply chain issues, or because someone was due for their other shot and they didn’t have that type of vaccine that day.

I read a study where people were saying they believe there’s more immunity against the variants when you mix the vaccines, which I think people have also seen with other diseases. How about that! But I’m no doctor…

I consulted with the pharmacist about it and they’re like, “Yeah, you mix them, but we have to spread certain information because of liability.” When it comes down to it, it’s each individual nurse’s license on the line for whatever calls they make with experimental treatments and vaccines.

“Learning as we go”

Another thing we’ve learned about and changed is the 30-minute waiting period after you get the vaccine. We did that for a time at the major vaccine sites. That’s one of the reasons why there would always be super-long waiting periods at the drive-through vaccine sites, because we would have people wait the full 30 minutes in their car.

That’s not too possible when we do the dependent home-bound population, but it’s also not so much a concern anymore. Now they say you only have to wait five minutes. Like, if you’re going to have an allergic, anaphylactic reaction, it will happen within the first five minutes. But we didn’t know that back then. We know that now.

We also had some bad reactions, like instances of people passing out after getting vaccinated. I was told later by the paramedic nurses that most of the emergencies that happened with us were because people were fainting because the vaccine was too cold!

When it was injected, it would give them a vasovagal reaction and they’d faint. It was honestly a bit embarrassing when people figured it out. They started warming the vaccine up in their hands right before they injected it, and that solved the problem. We have really just been learning as we go.

Hesitant co-workers

Phoebe

How do your co-workers feel about the vaccine?

C.

Some of my co-workers were hesitant about getting the vaccine themselves at first, or like, didn’t want it. There were even some folks doing canvassing who did not have their vaccine. They were going to people’s houses with masks on. The only reason they got it was because the company changed their policy to be like, yeah, this is mandatory now.

I don’t believe [these co-workers] were anti-vax, I think they were just vaccine hesitant for their own personal bodies. There were protests by like, right-wing type people at the vaccine sites, and I don’t think anyone who is employed at C.O.R.E. holds beliefs like that, that I could tell. Besides the firefighters, of course! A lot of the firefighters were anti-vaccine.

Anti-vax firefighters

Phoebe

The firefighters who are administering vaccines in home visits?

C.

Yes, I think that was the most shocking! The firefighter unions were trying to fight and say you can’t mandate a vaccine, but I think they lost in the end because of the federal mandate. And now I know the police unions are experiencing a similar situation, like, they’re trying to fight it. But it’s reassuring that, since the firefighter union lost that fight, hopefully the police and the nurses unions lose that fight as well and will require vaccines.

Phoebe

You’re stopping work soon, right?

C.

Yes, that is my last week actually. I’ve worked here since the very beginning of January, so it’s not quite been a year, but it’s really gotten me to a very stable position, financially, that I’m happy with. Or, at least, more stable than unemployment, and it pays more than when I was working before.

There have been some nice people here that I’ve vibed with, and we agree it has helped us realize our worth as employees. But our jobs don’t exist anymore! C.O.R.E. is going to cut home visits, as well as the canvassing and the outreach.

A new phase

Phoebe

So they’re just doing pop-up sites now?

C.

There are going to be only a few pop-up sites left, like a handful. Maybe three.

Phoebe

Why did they cut back so hard?

C.

I don’t know. They didn’t make it clear to us. But it’s really surprising to me that they’re doing this now, because people are starting to say we have to do boosters now.

These last two weeks, people were calling me being like, “the C.D.C. just approved boosters. Biden just said I can get my booster, give me my booster.” And I’d have to say, “I really want to, but we can’t unless you’re immunocompromised,” and then I list off the five different conditions of immunocompromise. If they don’t have any of those conditions, I can’t give it to them or else we lose our funding.

But I think we lost it anyway, maybe that’s why so much has been cut. I don’t know. It doesn’t make much sense and there’s definitely more work to be done with getting people vaccinated, so I’m disappointed to say the least.