Connect to End COVID-19: Why Complacency is not an Option Jen Norton, PhD, MSW, Connect to End COVID

Connect to End COVID-19: Why Complacency is not an Option

Jen Norton, PhD, MSW, Connect to End COVID-19 Ambassador

Isn’t the Pandemic Over?

We are now into the fifth year of a pandemic that most of us never could have imagined, or wanted to imagine. And for many, the COVID fatigue is real. We are ready to move on with our lives. We are ready to attend parties, events, gatherings without fear of entering someone’s breathing zone and wondering what invisible particles we’ll pick up. For those of us with children, we never want to hear the words “flexible instruction day” ever again. Sure, some people are still getting COVID. But those aren’t people we know, right? Or they are, but it’s just like getting a cold or a typical flu. They’ll be home for a few days, drink plenty of fluids, rest, and they’ll be back to their normal health in a week.

For many families, this narrative doesn’t hold true. As of April 2024, nearly 1.2 million people in the US have died due to COVID-19; most were unvaccinated, even though vaccines were widely available. That figure includes over 55,000 Pennsylvania residents. In January 2024, weekly death at the national level peaked at 2,553; in Pennsylvania, the peak was 139 (COVID Data Tracker - Deaths). For those who haven’t been directly impacted by a COVID loss, that figure might not be as meaningful. Some might point to these numbers as evidence that COVID is not a prevalent issue anymore. Take a moment, though, to think about these numbers. Imagine a room full of 139 acquaintances, clients, and loved ones. Now imagine the room is empty. Until the weekly death rate reaches zero, we have work to do.

Why I Care

When the pandemic began in March of 2020, I was the director of an online MSW program in Pennsylvania, serving approximately 800 students across the country and internationally. Naively, I imagined COVID would have little impact on our classes, as we were already structured as both online and asynchronous. It took a couple of weeks for me to realize how ridiculous my assumption was. I stayed in my position until March 2022, and in the two years at the helm of our program, I bore witness to every possible type of loss among our students. I’m still not sure how, but we did not lose a single online student or faculty member during that time.

For the students, though, the levels of loss were tremendous. Students were going through the death of multiple family members, friends, clients, acquaintances. Spread across the country, many students were located in some of the worst hot spots for hospitalizations and deaths. If they weren’t experiencing losses directly, they were overwhelmingly impacted by the increased reliance on essential workers, the loss of income, added caregiver burdens, and on and on. It was an absolute miracle that so many students were able to handle their additional trauma and stress with grace, let alone attend to their coursework and field internships. I have never been so impressed with the fortitude and resiliency of humans as I was by what I witnessed from our students during those two years.

Truthfully, aside from the vicarious trauma stemming from supporting students and faculty as best I could in my program director role, I was and am incredibly privileged when it comes to the direct impact of COVID on myself and my family. My wife and I were able to work from home with relatively little difficulty. Our child was just under two years old at the start of the pandemic, and we hadn’t been reliant on daycare thanks to flexibility in our work schedules. Neither of us lost any immediate family members or had any family members hospitalized for an extended period of time. Yes, we lived in fear just like most other people, but our fears weren’t realized in any direct way. I recognize how unique and lucky we were in our experience, though, particularly through the lens of knowing what my students were going through. I also recognize that more than zero deaths per week when we have effective vaccines means that I will do whatever it takes to keep my loved ones and your loved ones safe. None of us, nor our clients, are guaranteed to make it through the pandemic--whatever that looks like--unscathed.

The COVID Landscape

Vaccines are safe and highly effective. Being up to date on vaccinations is the best way to prevent severe illness, yet fewer than 22% of Americans have received the current booster dose. Vaccine uptake is significantly lower in special populations that are at risk of severe illness and death, such as BIPOC, the uninsured, and pregnant people.

As social workers in Pennsylvania, where do we need to focus our attention? The data shows us that age continues to be the strongest risk factor for serious COVID-19 outcomes, and that risk increases with age. When looking at deaths by age group, 40-49 year-olds make up less than 5% of total deaths due to COVID, while those 75 and over comprise more than 55%. Indeed, “compared with ages 18-29 years, the risk of death is 25 times higher in those ages 50-64 years, 60 times higher in those ages 65-74 years, 140 times higher in those ages 75-84 years, and 340 times higher in those ages 85+ years” (COVID Data Tracker - Underlying Medical Conditions).

Considering how the risks for older adults compare with data on vaccination of nursing home residents and staff, we have a clear issue. In PA, approximately 47.0% of nursing home residents are up to date with COVID-19 vaccinations. Among staff, the percentage drops to less than 10% (COVID Data Tracker - Nursing Home COVID-19 Vaccination). Those of us who are involved in nursing home and assisted living facilities can target this gap, educating colleagues on the importance of keeping our clients safe.

Underlying medical conditions put people of any age at greater risk for more serious COVID-19 outcomes. In Pennsylvania, only 7 of our 67 counties have less than 40% prevalence for any of five underlying chronic medical conditions found to increase the risk of illness associated with COVID-19: heart disease, chronic kidney disease, obesity, diagnosed diabetes, and chronic obstructive pulmonary disease (COPD). Four counties have over 50% prevalence (COVID Data Tracker - Underlying Medical Conditions). Pennsylvania is geographically diverse, with a high rural population contrasted with major urban and metropolitan areas. Counties closer to Pittsburgh, State College, and Philadelphia tend to have lower prevalence percentages than those in the northern, western, and south central areas of the state. Social workers in geographic areas where chronic medical conditions are more prevalent--or social workers in agencies where clients are more likely to have one of the conditions listed above--can also educate their colleagues and clients on the importance of vaccination in protecting each other.

The Connect to End COVID-19 Initiative

I keep bringing up education, but where can we go for guidance? The NASW encourages all social workers to follow vaccination guidelines from the CDC, and promote vaccine uptake by family members, clients, and others in the community. To advance these goals, the NASW is partnering with UT/Austin in a CDC-funded initiative through September 2024, Connect to End COVID-19. In addition to providing accurate vaccine information tailored to social workers, they are providing complimentary virtual training, with complimentary CEUs, to equip social workers to support their clients in making informed decisions regarding becoming vaccinated. The aim is to enable social workers in a broad range of settings to meet clients wherever they are in their vaccination journey. They are not--nor am I--instructing social workers to coerce clients to become vaccinated. Instead, the program shows how we can put our distinctive professional expertise to effectively work with clients around their vaccine decision-making.

Clinical evidence and outcome data for millions of people demonstrate that the COVID-19 vaccines are safe and highly effective for people aged 6 months and over. The benefits of being vaccinated far outweigh the risks of severe illness, hospitalization, death, Long COVID, and other negative outcomes. Unvaccinated people are up to seven times more likely to die of COVID-19 infection than vaccinated people. Although people who are up to date on vaccinations can experience a breakthrough infection, they are much less likely to become severely ill or die of it. Social workers might desire more understanding about the safety profile of COVID-19 vaccines as they decide whether to get vaccinated. NASW’s initiative provides opportunities for social workers to gain a greater understanding on these topics.

Summary

As social workers, we are committed to the well-being of all people and we have the unique position of being trusted messengers in our communities. Vaccines are free and widely accessible across the nation. Unfortunately, disinformation campaigns and misinformation continue to pose significant barriers to the public fully understanding the severe risks posed by COVID-19, including among those who are at greatest risk of severe illness and death. Vaccine and booster uptake must be pervasive to be effective. Though uptake has increased over time, the rates are still low in certain subpopulations and geographic areas, such as among those who are uninsured, living below the poverty level, or living in a rural area. We have the opportunity to make a difference in the lives of our clients and loved ones. Please join me in spreading this message and visit the NASW’s Connect to End COVID-19 resource center.

This project and article are supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $3.3 million with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.

Additional Resources

Centers for Disease Control and Prevention and National Center for Immunization and Respiratory Diseases. (2021, November 3). How to address COVID-19 misinformation. Click here to address COVID-19 misinformation

National Association of Social Workers. (n.d.). Connect to end COVID-19. https://bit.ly/3kkJTAa

References

Centers for Disease Control and Prevention. (2023, May 30). Risk for COVID-19 infection, hospitalization, and death by age group. https://archive.cdc.gov/#/details?url=https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html

Centers for Disease Control and Prevention. (2024, April 4). COVID data tracker. https://covid.cdc.gov/covid-data-tracker/#datatracker-home