The Dose

While rich countries are doling out booster shots of the COVID-19 vaccine, many poor countries have vaccinated less than five percent of their population. And, while many leaders agree that vaccinating the world is the only way out of the pandemic, vaccines are still not moving around the globe in a rapid and equitable manner. This is because "we live in a hierarchy of health," says Priti Krishtel, a health justice lawyer and cofounder of I-MAK, a nonprofit focused on building a more just and equitable medicines system. On the latest episode of The Dose, Krishtel argues that unequal access to vaccines is rooted in a long-standing system of incentives that governs drug development and allocation. She says rethinking the drug patent regime and other incentives — and working together to ensure every country gets a fair allocation of vaccines — is the way to end this and future pandemics.

Even as the Delta variant rages through the U.S., many Americans have not received a COVID-19 vaccine. The reasons are complex, but for Black and Latinx communities, a long history of poor access to health care has been a tall barrier. On the first episode of our brand-new season of The Dose podcast, host Shanoor Seervai talks to Rhea Boyd, M.D., a pediatrician and public health advocate, about what it takes to dismantle the historic racism that has long prevented people of color from getting the health care they need. Black and Latinx health care professionals like Dr. Boyd are answering questions about the COVID-19 vaccine online and in person. If we make it a national priority, she says, we can ensure Black and Latinx people get credible information about the vaccines and easy access to them.

The Dose is the Commonwealth Fund's podcast that asks, What can the U.S. do differently when it comes to health care? Join host Shanoor Seervai every other Friday for conversations with leading and emerging experts. This season we're focusing on new ideas that could strengthen and improve health care for everyone. Get the Dose in your inbox: https://thedose.show/signup Music by Blue Dot Sessions.

Many Americans have started to behave as if the pandemic is over, but large numbers of people remain unvaccinated. At the same time, other parts of the world are experiencing their worst COVID-19 surges yet. On the season finale of The Dose, Sandro Galea, physician, epidemiologist, and dean of the Boston University School of Public Health, talks about what it will take to vaccinate the entire world and how we can protect ourselves from future pandemics. He explains that while vaccines may mitigate the crisis in the short run, they cannot be a substitute for long-term investments in the social services that keep people healthy. Please take a minute to fill out our survey and tell us what you think about the podcast: https://www.surveymonkey.com/r/themicrodose.

When the pandemic hit last March, the U.S. was still facing another major public health crisis —the opioid epidemic. Between COVID-19 lockdowns and economic devastation, overdose deaths soared. Experts estimate that around 90,000 people died of a drug overdose in 2020. That's the highest number of overdose deaths ever, and it represents the largest one-year increase. On the latest episode of The Dose, we explore why drug deaths are rising and how policymakers can help fix the problem with guests Brendan Saloner, professor of health policy at the Johns Hopkins School of Public Health, and Jesse Baumgartner, a research associate at the Commonwealth Fund.

Many of us can recall a time we felt nervous about seeing a doctor. Maybe it was because we were wary about how much the visit would cost, or what a diagnosis would mean for our health. Now, imagine how much more stress you would feel if you had experienced trauma — from domestic violence or human trafficking, for example. Trauma survivors are the people family medicine physician Anita Ravi, M.D., cares for. On the latest episode of The Dose, Ravi and Keisha Walcott, one of her former patients, talk about how to design health systems for women and girls who have experienced gender-based violence. Ravi and Walcott explain how health, poverty, and trauma are interlinked and why providers must address all three.

Migrants are crossing the southern border in record numbers this year, many of them unaccompanied children. What happens to them once they make it into the U.S., or if they've been here for a long time, when they need health care? On the latest episode of The Dose podcast, Carrie Byington, executive vice president of University of California Health explains, drawing on her expertise as a pediatrician and infectious disease specialist, and personal experience treating immigrants and their families. Byington, a member of the Commonwealth Fund's Board of Directors, describes how the pandemic has illustrated the urgent public health need for immigrants to have health care, because "people may choose to forgo testing, or choose to postpone vaccination if they're afraid to sign up for a vaccine."

The Biden-Harris administration has taken several measures in its first three months to strengthen the nation's social safety net. Many of these policies will have an outsized impact on women — particularly women of color, who often struggle to access health care and now are bearing the brunt of the COVID-induced economic crisis. From mandating paid sick leave and shoring up childcare to addressing the maternal health crisis, the new administration clearly recognizes the ways health and economic security are intertwined and how this impacts women. On the latest episode of The Dose, Debra Ness, president of the National Partnership for Women and Families, makes the case that the pandemic has exposed inequities too difficult to ignore. And she believes women will emerge "smarter and stronger" from this crisis.

Hate crimes against Asians in the United States more than doubled from 2019 to 2020. Last month, in one of the most conspicuous acts of violence against Asians in recent history, six Asian American women were shot dead in Georgia. Racism against people of Asian descent is not a new problem, but it has been exacerbated of late by politicians using racist rhetoric to describe the coronavirus. Asians in America are now facing a dual pandemic: a heightened fear of racist abuse, from verbal slurs to physical assault, on top of all the anxiety of living through COVID-19. In this episode, Vivian Shaw and Susanna Park of the AAPI COVID-19 project talk about the deep roots of anti-Asian bias, as well as their research into how the pandemic is affecting the lives of Asians in the U.S.

If you're an optimist, then every piece of good news about vaccine approvals and shots in arms has put the end of the pandemic in sight. If you're a pessimist, then all the new variants with names sounding like computer-generated passwords signal the apocalypse. Will hope win, or will dread? On the latest episode of The Dose podcast, Eric Schneider, M.D., talks about the high-stakes race between the quick-spreading variants of COVID-19 and the effective vaccines that more Americans receive each day. Schneider brings us up to speed on the state of the pandemic and the challenges ahead. Drawing on his expertise in public health, he explains how we can "break the back of the virus" and ultimately win the race. Share your stories of pandemic optimism or pessimism—send an email to thedose@commonwealthfund.org.