This is what the frontline of the fight against COVID disparity looks like
Meet three healthcare pros leading the effort to bring Miami’s Black community access to COVID testing, information and vaccines.
Get Dr. Cheryl Holder talking about COVID-19 and you’ll quickly realize she’s not one to be easily surprised. Or intimidated. Or daunted by the task of providing medical care to the most vulnerable in the face of a global health crisis. She says with a chuckle: “I always tell people—Hashtag, Not My First Pandemic!”
Holder is Interim Associate Dean for Diversity, Equity, Inclusivity and Community Initiatives at Florida International University’s Herbert Wertheim College of Medicine, president of the James Wilson Bridges MD Medical Society, the local chapter of the country’s oldest Black medical society, and a doctor of internal medicine firmly planted at the frontlines of the fight against AIDS. These days, however, her focus is squarely on the coronavirus pandemic, specifically its disproportionate impact on the most vulnerable in Miami’s Black community, where there are higher death and hospitalization rates than in white communities but where the vaccine has lagged and reached far fewer.
A recipient of one of various Health Foundation of South Florida grants made last year to address racial and ethnic disparities unleashed by the virus, Holder along with two other healthcare leaders in their own rite—Phyllis Rhymes Johnson and Patrise Tyson, both officers of the Black Nurses Association Miami chapter—joined forces to orchestrate an effort to reach Black Miamians with COVID resources and information using a unique approach.
STEEPED IN HISTORY & FAITH
Their project, called Keeping The Faith, set out to bring COVID education, protective supplies like masks and hand sanitizers, testing and vaccine information to the Black community through faith-based institutions and houses of worship. While it’s been lauded as innovative, Holder says their idea is actually deeply rooted in history. “The evidence has long shown that any public health effort requires trusted messengers,” she said. “And if you’re looking for a trusted messenger in the Black community, you have to start by going to where the community has gone for hundreds of years in search of refuge: church.”
Holder, Rhymes Johnson and Tyson launched the program in September 2020 and have since worked with more than 20 Miami-Dade faith-based institutions, held 11 pop-up testing events and provided tests to more than 1,200 residents. They have also hosted countless community Zoom meetings, produced YouTube videos and hit the local radio airwaves, all part of a mission to debunk myths and misinformation about the pandemic and the vaccine, arming people with facts and science instead.
In addition, each house of worship they work with is paired with a healthcare team consisting of a nurse, a community health worker and a medical student. Those teams not only helped the churches implement safe reopening plans in late 2020, but they continue to provide direct support to parishioners, securing doctor appointments, medications, food and anything else they need. In a community where people too often don’t have access to basic primary care, having assistance just a phone call away has proven to be a game-changer—and a lifesaver.
One of the keys to their success, all three say, is having coalesced their respective organizations along with a number of other groups around the cause, including the Haitian American Nursing Association, the Haitian American Faith Based Network, the Haitian American Coalition and the local chapter of the Student National Medical Association.
DR. CHERYL HOLDER
Born in Jamaica, Holder grew up in New York City and moved to Miami-Dade to begin her career in 1987 as a National Health Service Corp Scholar working with the region’s medically underserved communities. A specialist in HIV and an undisputed leader in the battle against AIDS, more recently she has focused her attention on the connection between health and climate change and is the co-chair of Florida Clinicians for Climate Action.She is also President of the James Wilson Bridges MD Medical Society’s Miami chapter and serves as project lead for Keeping The Faith.
INSPIRATION & CHALLENGES
Still, the effort has been marked by moments of inspiration as well as frustrating challenges. Tyson recalls the hard day when a case brought both: a patient they had seen at one of the pop-up events had tested positive. As a matter of process, anyone who tested positive and contacted the Keeping The Faith team was assigned to a nurse, who would check in on a regular basis. Several days after testing positive, when the assigned nurse called the patient, she “heard him over the phone and immediately could tell an ambulance needed to be called—and she did just that,” Tyson said.
The patient arrived at the hospital and was placed in ICU, on a ventilator. The good news, Tyson explained, is “we were able to intervene on behalf of that person and get them the care they needed.” The sad, disturbingly familiar part? “The patient couldn’t be weened off the ventilator,” she said, her voice trailing. “He didn’t make it.”
Another challenge has been simply convincing people to be tested even if they present no symptoms. “We definitely learned that we have a lot more work to do in the way of education,” Tyson said. “All these months in, we still see that many people don’t understand the concept of asymptomatic spread of the virus.”
PHYLLIS RHYMES JOHNSON
Rhymes Johnson is a South Florida native in every sense: she is a graduate of Miami Jackson High School, Miami Dade College, University of Miami, Barry University and NOVA Southeastern, where she earned her Doctorate in Health Science. An advanced registered nurse practitioner, she worked in various capacities for Jackson Health System for more than 30 years, specializing in cardiac care and cardiac devices, and taught nursing at Keiser University. Now retired, she is the principal caregiver for her 88-year-old mom at home, serves as Parliamentarian for the Miami Chapter of the Black Nurses Association, and coordinates and organizes all Keeping The Faith events.
LESSONS ALONG THE WAY
For as much experience as Holder, Rhymes Johnson and Tyson collectively bring to the table, Keeping The Faith never stopped surprising them.
Rhymes Johnson says that while technology played a key role in disseminating messages, delivering test results and making testing or vaccine appointments, it also failed to help entire swaths of the population. “I remember a 79-year-old female calling me, desperately trying to schedule a vaccination. She didn’t know how to go online, so she called 311 and they scheduled an appointment. It turns out the appointment was in…Tallahassee!” Rhymes Johnson said. “Some people came to take tests, gave phone numbers so that they could be called with the result. They didn’t realize it was supposed to be a cell phone number and that the results were going to be texted. When you think of older people, this whole system just left them out. And so many just gave up.”
Another lesson along the way: initially, Keeping The Faith had put together a series of Zoom calls and invited various churches in Little Haiti to attend. Though they had people who spoke Creole on hand, many attendees found it impossible to join because they didn’t have data plans or wi-fi that would allow them to be on a call for an hour. “Some people just dialed in on a phone, but then they couldn’t see the slides,” Holder recalled. “We quickly learned from that and pivoted. We started creating YouTube videos and made them short. And we also brought on Haitian nurses to start canvassing by phone. But at the beginning, we just didn’t realize how big the digital divide really is.”
An Indiana transplant, Tyson holds a Master of Science in Nursing from Florida International University. A research nurse working as a sub–investigator on phase one clinical trials for Syneos Health Solutions, a biopharmaceutical company, she is President of the Miami chapter of the Black Nurses Association. For Keeping The Faith, she supervises data collection and progress reports, and oversees the initiative’s registered nurses and community health care workers.
HOPE & HEALING
And yet, one of the most moving moments for Holder happened during a virtual community call that featured Pastor Richard Dunn from Miami’s Faith Community Baptist Church, who had just been vaccinated. On the call, Pastor Dunn “admitted he had been afraid. He shared that he ultimately understood the risks, and that he was more afraid of getting the virus itself. I thought it was so important that he acknowledged that fear and validated it. Because the fear people feel is understandable and we have to empathize with it.”
Now, Keeping The Faith is gearing up to work on more vaccine outreach while still reinforcing the importance of continuing to get tested. Of the individuals who have received at least one dose of the vaccine in Miami-Dade County, only 6 percent are Black — a number they hope to increase significantly. Their ongoing effort will address not just equitable distribution issues, but also seek to overcome vaccine hesitancy and move toward vaccine confidence. As with all they have done so far, Holder said their approach will be tailored to the moment and to the community.
Most critical, she said, is showing “respect, compassion and empathy. Supporting the person in their decisions and respecting their autonomy. We explain to them that the benefits of the vaccine far outweigh the risks, but we still respect the pain and fear that exists. As people go through this process, we’re there, standing by and ready to help.”