Dr. Uchechukwu Sampson, a hospitalist and internist at Williamson Medical Center, has been on the hospital’s front line, tirelessly fighting to save lives ever since the first case of SARS-CoV-2 appeared in Williamson County in early March 2020.
When the COVID-19 vaccine arrived, he was first in line to get it. He wanted to prove a point.
“We are fighting a war,” Sampson said. “We all have to come together to fight the war. This vaccine gives us an edge in the fight.”
For obvious reasons, Sampson would like to see everyone get vaccinated eventually.
“When we began the rollout, we targeted those on the front line,” he said. “It’s common-sense practices. ... We can’t eliminate the virus. The strategy is to get to the vulnerable population and then go back to fundamentals (vaccinating everyone else). We don’t know how long the vaccine will last, whether it’ll last a lifetime or we’ll need a booster annually. There’s a lot we don’t know.”
Since early March 2020, Williamson County has recorded about 24,300 coronavirus cases. With the county’s population at 243,920 — according to the 2020 census — that means about one in 10 county residents has had the virus.
That rate is slightly lower among the county’s Black population, for which there have been about 840 cases reported among 11,230 Black residents.
While the county has recorded 197 COVID-19 deaths through Feb. 12, a breakdown by ethnicity has not been made available.
There are two vaccines available — one produced by Pfizer/BioNTech and one produced by Moderna — with one from Johnson & Johnson very likely close to approval. While none are 100% effective in preventing COVID-19, each provides the immune system with antibody knowledge to fight the coronavirus if it is contracted, thus preventing serious illness and death.
Data from the Johns Hopkins University School of Medicine and the Centers for Disease Control and Prevention shows that more than 98% of those who contract COVID-19 survive the virus, although some experience extended residual effects.
Sampson said that a risk factor that is getting attention is skin color. Throughout the nation, Black people, as well as Hispanics and Native Americans, have been more apt to contract the disease, experience a more severe case and have a higher death rate because of a combination of socioeconomic conditions and lower levels of vitamin D.
“There’s a larger socioeconomic issue — working conditions and living conditions,” Sampson said. “I see a lot of that, not just in Williamson but in other hospitals.”
Sampson is affiliated with hospitals in Tennessee and Ohio. According to his observations, Black people often have jobs “that expose them to a lot of people” and live in a “confined environment,” two factors that heighten the spread of the disease.
“It’s easier to spread in a tight, confined environment,” he said. “How can you quarantine in small living quarters? It adds severity to already disenfranchised people with co-morbidities straining immune health.”
According to 2019 data from the Bureau of Labor and Statistics, 30% of the nation’s Black population work in education and health services and 10% work in retail. In addition, in urban areas, 34% of the Black population uses public transportation compared with 14% of the white population.
Each category provides higher risks of exposure in a population that already sees higher incidents of underlying health conditions such as hypertension, diabetes, heart disease, asthma and obesity.
Sampson says that Black people have another disadvantage. Vitamin D levels, critical for a healthy immune system, are lower in darker skinned people because their bodies don’t absorb as much vitamin D from the sun as lighter skinned people. Sampson says that insufficient vitamin D lowers immune response, creating unique conditions.
“Ongoing trials are looking into that, and rightfully so,” he added. “But while (vitamin D) is important, the longer issue is the economy and social-economics. At the end of the day, public health can only do the best with what we’ve got.”
Sampson has several suggestions for lowering the risk among the Black population. Among them are to go to the people; give vaccinations at churches, community centers and neighborhood pharmacies and “be open to other unique places.”
“People need to feel safe,” he said. “The venue is important. It (provides) a comfort zone to combat negative views and gets (the vaccine) into communities.”
He added, “What we really need is for the vaccine program to succeed. We must be transparent about what we do know and don’t know — don’t hide anything.”
Sampson is optimistic.
“When this started, it was challenging working with something new,” he said. “It was mentally fatiguing being on high alert all the time. Then it becomes emotional.”
Sampson says that one particularly memorable experience came was when he tried to resuscitate an elderly gentleman.
“He was going fast,” he said, “His wife, also elderly and with COVID, was in the next room and she could hear what was going on.”
The couple were married 50 years and she wanted to see him. Although she couldn’t walk, she made it close enough that she could see her husband.
Somewhat remarkably, he survived.
“That’s the reality,” Sampson said. “It was one of the most emotional experiences in my 25 years of experience.”