The Chavis Chronicles
Dr. Yolandra Hancock
Season 3 Episode 313 | 26m 14sVideo has Closed Captions
Dr. Yolandra Hancock, discusses racial disparities and the impact of long COVID
Health experts are seeing more people who have had COVID-19 experiencing long-term effects from their infection, known as long COVID. Dr. Yolandra Hancock, a pediatrician and public health expert, weighs in on America’s battle with Covid-19 and how African Americans who suffer from pre-existing conditions such as asthma diabetes and obesity are at particular risk.
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The Chavis Chronicles is presented by your local public television station.
Distributed nationally by American Public Television
The Chavis Chronicles
Dr. Yolandra Hancock
Season 3 Episode 313 | 26m 14sVideo has Closed Captions
Health experts are seeing more people who have had COVID-19 experiencing long-term effects from their infection, known as long COVID. Dr. Yolandra Hancock, a pediatrician and public health expert, weighs in on America’s battle with Covid-19 and how African Americans who suffer from pre-existing conditions such as asthma diabetes and obesity are at particular risk.
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Learn Moreabout PBS online sponsorship♪ ♪ ♪ >> Dr. Yolandra Hancock, outstanding pediatrician, next on "The Chavis Chronicles."
>> Major funding for "The Chavis Chronicles" is provided by the following.
At Wells Fargo, we are committed to diversity and understand our responsibility in supporting and empowering diverse communities.
Diversity and inclusion is integral to the way we work.
Supporting the financial health of our diverse customers and employees is one of the many ways we remain invested in inclusion for all today, tomorrow, and in the future.
American Petroleum Institute -- through the core elements of API's Energy Excellence Program, our members are committed to accelerating safety, environmental and sustainability progress throughout the natural-gas and oil industry in the U.S. and around the world.
You can learn more at api.org/apiEnergyExcellence.
Reynolds American, dedicated to building a better tomorrow for our employees and communities.
Reynolds stands against racism and discrimination in all forms and is committed to building a more diverse and inclusive workplace.
At AARP, we are committed to empowering people to choose how they live as they age.
♪ ♪ >> We're so honored to have a renowned pediatrician, Dr. Yolandra Hancock.
Welcome.
>> Thank you so much for having me, Dr. Chavis.
>> So, a native of Louisiana.
>> Yes.
>> Alright.
Well, what motivated you to become a physician?
>> I decided to become a physician when I was 7 years old.
My Poppa, my great grandfather, was dealing with some health issues.
We had a very small health service center where I live.
And I watched him suffer because he didn't have access to a doctor.
And I remember telling him, "Poppa, I'm going to become a doctor so that I can help take care of you."
>> You made that decision at 7 years old?
>> 7 years old.
And simultaneously, my sophomore year, I lost my 4-year-old cousin, again because of a lack of access to care.
And that was the time at which I committed to becoming a pediatrician.
And I remember in my dorm room talking to my roommate, just bawling my eyes out.
And that's when I made a full commitment to going into pediatrics.
And clearly, as I navigated through my medical career, I was interested in a lot of other areas.
I even thought about becoming a pediatric surgeon.
But I kept being pulled back to pediatrics, and that's -- >> Where'd you go to medical school?
>> UCLA.
I went to UCLA for undergrad and for medical school.
>> Now you're in the nation's capital... >> I am.
>> ...and have started, in fact, your own practice in Maryland.
>> I did.
I did.
I worked for Children's National medical system from 2005, when I finished residency, all the way through until around 2014, when I transitioned out to part time, and then fully in 2018.
And 2020 is when I opened my own practice, in the midst of the pandemic.
>> What advice do you have to all families, but particularly communities of color, about the current status of COVID-19?
>> What I would tell my community specifically is that we're in the middle of a surge, despite the fact that we sort of transitioned away from it -- and rightfully so.
There's so many things happening in the world right now that it's hard to focus on just one of the crises.
But it's important to remain vigilant.
We now know that our numbers continue to increase.
We just yesterday had over 180,000 new cases.
>> Is this because of the new variants?
>> Absolutely.
Absolutely.
So, we're now dealing with variant BA.2.12.1.
I don't know why we haven't created a new name for it, but that's what we know it as now.
This is a subvariant that came out of New York.
And because of this subvariant, we're seeing a continuous increase in terms of our COVID-19 numbers, not where we were back in February with Omicron 1.0, but certainly higher than what is perceived to be.
And although the symptoms associated with this subvariant are less severe, one of the things that we have to be mindful of is particularly long COVID and how that's going to impact us as we continue to see these numbers increase.
>> Let's unpack this term "long COVID."
>> Mm-hmm.
>> Explain.
What is long COVID?
>> Very good question.
So, there's the acute infection that folks have when they have COVID-19, with symptoms lasting about 10 days.
And then most people get better.
Weeks go by, and then, depending on whether or not you're vaccinated, in terms of your risk of it, 10% to 30% of folks -- some folks -- can go on to develop what we call long COVID, also known as "long-haulers syndrome" or "post-COVID syndrome."
There are a lot of different names that we identify it as.
But the basics are symptoms that develop after you have already recovered from COVID that happen a couple of weeks later.
And as my grandmother would say, long COVID can impact you from your rooter to your tooter, from the crown of your head to the soles of your feet.
There is no short COVID.
That's really just the acute infection.
But long COVID are the symptoms that can last months to upwards of a year-plus after having recovered from COVID.
>> What are the mitigating factors that could possibly prevent long COVID?
Does vaccination, does boosters -- does any of that mitigate the chances that one may come down with long COVID?
>> That's an excellent question.
So, recent studies show that if you are not vaccinated, the risk of long COVID is anywhere between 10% to 30%, meaning that if 100 people who are unvaccinated get COVID, between 10 to 30 of those individuals are going to go on to get long COVID symptoms.
>> Unvaccinated.
>> Unvaccinated.
Now, when it comes to vaccinated populations, that's when it gets a little bit tricky.
There's some studies that show that there is a 40% to 50% reduction in risk for long COVID.
There are other studies that show only a 15% reduction in the development of long COVID.
The studies are ongoing so that we're gathering more information.
But with whatever information we read, it shows that there's either a small decrease or a pretty substantial one.
I think for anyone who's considering whether or not to get vaccinated -- The conversation before was about protecting from severe infections, protecting from hospitalizations and death.
Because this particular subvariant is associated with milder symptoms, we still have to remain vigilant about the risk of long COVID.
>> Let's talk about preexisting conditions... >> Mm-hmm.
>> ...like asthma, heart disease, diabetes.
Do these preconditions -- do they also increase one's risk of getting long COVID?
>> That's a very good question.
What we know based on data currently is that these preexisting conditions increase the risk of COVID-19 severity, and by way of that, it increases the risk of developing long COVID symptoms.
We know with long COVID you could have a very mild case or even be asymptomatic and still go on to develop long COVID.
But the highest level of risk is the severity of your infection.
And so if you have a very severe COVID-19 infection, that significantly increases your risk of developing long COVID symptoms.
And part of that risk is in those preexisting conditions that you describe -- heart disease, diabetes, high blood pressure, and obesity.
>> What is the science?
What is the data?
What does your research show about the importance of young people protecting themselves or the parents protecting their children from COVID?
>> I love that you asked that question.
That question doesn't get asked often enough because the view in the United States is that COVID does not impact children or it impacts them very minimally.
You can't compare children to adults.
Children aren't just little adults.
Children are children, right?
And so it's important to compare children with COVID versus children with other infectious diseases like the flu.
We know that influenza disproportionately impacts children year to year.
So, when we look at how children have naviga-- >> Will you explain?
Most people may not know what you just said.
>> Well, it's the truth.
>> About the flu.
>> Absolutely.
>> It disproportionately affects young people?
>> Absolutely.
Absolutely.
So, when you look at flu numbers, those who end up in the hospital and/or dying from influenza are very young and are very elderly, as compared to COVID, where, based on the numbers, the majority of those who lost their lives to COVID were our seniors.
That doesn't mean that children didn't die, but proportionately speaking, less children died due to COVID than seniors died due to COVID.
But when you compare how many children die due to influenza versus how many children die due to COVID, that's where the truth is revealed.
So, when you look at annual deaths related to influenza, at the highest, there were about 180 children at, like, our worst year.
About 180 children died due to influenza.
Within a 12-month -- >> This is a national statistic.
>> This national statistics here in the United States.
Looking at the United States in terms of COVID numbers, by the end of the 12-month period of our COVID pandemic, over 270 children had lost their lives to COVID-19.
And so clearly, more children died due to COVID than they usually do due to the flu.
And that's really one of the pieces of information that I always share with families as they're considering whether or not they're going to get their children vaccinated.
And each variant has also behaved differently.
When we look at what I call O.G.
COVID -- so, the original COVID, alpha, beta, and delta variants -- children weren't as disproportionately impacted as adults.
But when omicron showed up, because Omicron prefers to hang out in the upper part of the airway, in what we call our bronchi, in our bronchioles, our smaller air tubes, that's when children had more disproportionate impact.
And there was a larger number of children hospitalized due to the omicron variant than any of the variants that we have have experienced throughout the two and a half years of this pandemic.
And, again, when perceived risk is low, we start to let our guard down, right?
For instance, if a patient has heart disease, they're still eating the foods that they know they shouldn't until they have a heart attack.
Immediately after the heart attack, they're eating the cleanest they ever have.
And then as time progresses and that risk, that fear, and all of those negative experiences sort of dissipate, we slip back into those basic ways of engaging with -- in terms of nutrition and exercise.
It's the same thing with COVID.
One, the perceived risk, because of how it's communicated both in mainstream media and in just our general conversation -- the risk of it is much less.
Now that we believe Omicron to have less severe symptoms, I've heard conversations where it's no worse than a common cold.
Well, there's no long cold.
There's no long flu.
But there is long COVID.
And if we have more conversations specifically around long COVID, I think it helps people to pay closer attention to why we should still pay attention to our numbers, why we should still mask up if we are in indoor environments where we don't know the status of other individuals, either in terms of whether or not they have COVID or if they have been vaccinated.
And then, of course, to your question about whether or not our children should get vaccinated, we don't clearly know whether or not the vaccine protects against long COVID for our children because it goes, again, to your point about not having sufficient information.
Children always get the short end of the stick -- right?
-- whenever it comes to anything because children don't vote.
Children don't have voice.
It's up to us as adults, particularly in these fields, in media and in science, to put the word out so that families can make an informed decision.
>> So, what do you say to those elected officials in some of these conservative states that are opposed not just to vaccinations for COVID, but are opposed to vaccinations in general, even opposed to polio vaccination?
>> Yeah.
Well, I think my conversation would be directed to the voters.
I have learned in the 20 years that I have been a pediatrician that when you are wedded to your beliefs, there is very little that I can tell you to redirect you.
Like, the science is clear.
We know that without these vaccinations, herd immunity is going to be reduced.
We saw it with measles, mumps, and rubella.
There have been all kinds of measles and mumps outbreaks.
I think because, again, that perceived risk -- we're so far removed from having children experience measles, mumps, and rubella, "I don't see it as risky.
I don't see it as dangerous."
Where there are other countries -- Like, I give an example, Portugal.
Portugal was still experiencing, as a developed nation, some of these diseases like pertussis and tetanus and all of these things up through the '60s.
That's one of the reasons why their vaccination program against COVID was so strong -- because there were adults who still remembered having to deal with a lot of the chronic diseases and infectious diseases that we here in this country have had the privilege of being removed from.
And it isn't until it's in their faces -- right?
-- that we are dealing with children dying from measles because measles has a 10% mortality rate, meaning of 100 children that have measles, 10 of them are likely going to die.
Unfortunately for some people, it will require that painful moment for them to shift away from politics and to put people first.
And it isn't just politics.
It's also power.
We recognize that certain positions and decisions are made to keep me in my office.
It has nothing to do with what's right, but everything to do with political power and positioning.
And I think that there should be a way in which we hold our elected officials accountable to the decisions that they make.
And the way that we do that, really and honestly, Dr. Chavis, is through our vote.
>> Yes.
>> And so I would talk to parents about how they assess viable candidates in terms of how they make those kinds of decisions.
>> How do we overcome getting more universality in the provision of just basic healthcare for all Americans, for all people, regardless of socioeconomic circumstance?
>> That's an excellent question.
One of the challenges in the United States is that health and healthcare is seen as a business and not a right.
If health truly was seen as a right, we would separate insurance from employment status and instead make it a universally accessible resource, which is what it should be.
And I'm a full supporter of universal healthcare.
It should not be dependent on your employment, especially now as we're navigating through this pandemic.
Right now, there are around 33 million individuals in this country that have no health insurance.
And in additional numbers -- >> 33 million.
>> 33 million people without health insurance, which means that the emergency department becomes their health system.
And when that happens, health screenings don't take place, routine vaccinations don't necessarily take place.
The continuity that's necessary to either prevent or treat certain diseases like diabetes and high blood pressure -- they don't exist.
The emergency department was not designed to serve in that capacity.
And luckily we have places like federally qualified health systems that allow individuals to receive care regardless of ability to pay.
But that's limited in terms of number.
We really have to evaluate how we define what healthcare is and how we're able to access it.
As an entrepreneur, there was a period of time where I didn't have health insurance.
I had to navigate through.
And thankfully, because of the Affordable Care Act, I can now afford health insurance outside of it being linked to my employer.
But for some families, they really have to make a decision between groceries and medication, right?
And you have all these intermixings in terms of big pharma being able to influence politics, health systems being able to influence politics.
We really have to take a moment to separate all of that political positioning out and truly treat each person in the way we would want to be treated.
>> Of course.
I'm glad you mentioned the Affordable Care Act.
People refer to it as Obamacare.
I have a sister who's a physician.
She told me that after Obamacare passed, she saw hundreds of people who had come to the doctor for the first time in their whole life.
>> Mm-hmm.
>> So, these public policies, legislation, both at the federal and state level -- it can become a matter of life and death.
>> Absolutely.
It really can.
For some individuals, they may have a blotch on their skin.
They don't have insurance.
They're going to watchfully wait it because they know if they go to see the doctor, that's going to be a $250 expense.
They certainly won't be able to see a dermatologist because, one, it's unaffordable, and, two, you have to have a referral in order to have that take place.
So, now that blotch on the skin now evolves into skin cancer.
That skin cancer now penetrates through all the layers of the skin.
What could have been a simple diagnosis with a quick skin biopsy and pretty much a resolution of it now becomes a life-threatening illness.
The same thing for diabetes.
If we do not screen individuals as part of preventative care, if I don't screen you during your well man checkup, your well, you know, grown-up checkup, and I don't -- >> For those who get checkups.
>> Exactly.
For those who get checkups.
Then I don't get to send you for blood work.
There are a lot of people walking around with diabetes and high blood pressure that don't know it simply because they cannot access a healthcare professional.
And they don't recognize it until they show up with a full-blown stroke, until they are in a full diabetic crisis.
And that's how they're diagnosed with a blood sugar of, like, 1,000, when we could have easily sent them, as part of preventative care, to get a hemoglobin A1C to determine that they're pre-diabetic so that we can prevent them from even transitioning into having some of these disease processes.
>> So, as a pediatrician, do you see the pendulum swinging in the right direction in terms of the provision of healthcare to all these children?
They're gonna be 18 one day, hopefully, if they live that long, will be the new American majority population.
>> Right.
>> But healthcare is going to determine whether or not they make it to become an adult.
>> It's a very interesting question.
When I sort of observe -- Clearly, I'm not -- I don't work in politics.
I do work in health policy, however.
It's interesting to see a shift -- right?
-- as we have what we call a more browning, a majority-minority transition, with the target -- Some estimates say that by 2030, children within this country will be majority-minority.
What we're seeing is policies related to that shift and change -- right?
-- protections of power and position so that when we have an opportunity to vote for something like universal healthcare, the block isn't simply because it doesn't make sense, because financially it does make sense, but instead it's again providing these resources to communities that some would say don't necessarily "deserve" it.
If you work, then you should be insured.
Again, it goes back to rights.
Healthcare and education, safe space to live is -- they are all rights.
And I think if we consider it in that light, then it makes sense for everyone to be able to access healthcare.
We have to have those provisions in place.
We have to address what we call the social determinants of health.
It isn't just access to healthcare, but where a child is born, grows, learns lives, works, plays, prays, and ages that also define what their health outcomes are going to be.
So, when we talk about this shift in terms of people of color being the majority, we have to address all of those things.
What does the educational system look like?
Because that will influence healthcare.
What does the nutritional environment look like, the physical environment look like, so that someone can go out and have a safe space to play?
If we don't have those things in place -- Access to a healthcare provider is only 20% of our health outcomes.
80% of our health outcome is where we live, where we go to school, where we work.
That's really where politics gets involved.
>> You first got the dream of being a physician at the age of 7.
>> Mm-hmm.
>> What would you say to young people today about opportunities to have a career path in medicine?
>> I would say start early.
I would talk to parents first.
Expose your little ones to all that is STEM -- right?
-- science, technology, engineering, math, and arts.
I call it STEAM.
We're gonna call it STEAM because the arts play into a career in science.
Start them out early.
My little one -- we talked about the make-up of food when she was 4 months old.
She could tell you that tomatoes had lycopenes by the time she was 2 years old and knew that they were good for the prostate.
She didn't have a prostate.
She didn't know where the prostate was, but she understood the science behind it.
And now she wants to become an astronaut.
So, start them early.
It's never too early.
And then make sure that they are connected to resources.
I would tell young people in high school, "Don't let anyone tell you what you cannot do.
I don't care what your grades are."
It means apply yourself.
Maybe go to community college first to build up your science grades.
If your science grades are strong enough, apply to a four-year college.
Have a timeline that's flexible.
It took me five years to get out of UCLA, and here I am still with the "M.D."
behind my name.
And when people tell you "no," just recognize that it's a delay and not a denial.
I didn't immediately get into medical school.
I was on the waitlist at four different schools and ended up in a post-bac program.
One week before having to take the MCAT all over again and two days before medical school started, UCLA School of Medicine called me on a Friday to show up for school on a Monday.
That's how close to the rope I was in getting into medical school.
And so don't ever get discouraged.
Even if you are 30- or 40-something years old and medicine has always been in your heart, make a plan.
Connect with people.
You can do it.
>> What is the most important thing that parents need to know in America about raising their children?
>> I would answer that in two ways.
The first is in really thinking through how were you parented because how you were parented can directly influence how you parent your child.
There's something called intergenerational trauma, where if you went through a lot of issues growing up, that can also show up in your parenting.
And it's important to recognize that.
Some of the decisions that we make, some of the ways in which we respond to our children are directly influenced by all of those life circumstances so that we can protect our children against something called adverse childhood experiences.
When we do that, that sets our children up for their best success.
The second, particularly for Black parents -- I think it's important to note that the experience of raising Black children in this country requires different levels of consideration -- right?
-- thinking through, "How do I protect my daughter against bias?
How do I show up for my daughter when I feel like she's being discriminated against and doing it in a way that it provides a learning opportunity for her and, for instance, in the school system in which she exists?"
We know that not every situation is going to be perfect.
We understand that when we send our children out in a hoodie to go get an Arizona iced tea and some Skittles... >> It's risk.
>> ...it's risks involved.
And so it's really having a clear understanding of, "How do I deal with the anxiety that's triggered by raising my Black child in this country?
And how do I set her up for her best success?"
So, it's making sure that -- When my little one was a baby, all the books that I read to her had brown and Black faces in them.
When we would talk through stories, even the old fairy tales, her fairy tales with Cinderella had a little girl with Afro puffs and brown skin because I wanted her to truly and fully appreciate who she was as a little Black girl.
One time I got my hair straightened, the first time I had done it in I don't know how long.
My little one broke down and screamed.
She said, "I don't like shoop-shoop.
I like curly."
I was sad because I was, like, "Oh, I messed up.
This was a mommy slip-up."
And then I was so proud of myself because she took pride in her curly hair.
She didn't say, "Mommy, I want my hair straight."
She was like, "You need to fix yours because something is wrong."
And it let me know that I have built her up to fully appreciate the brilliance and beauty of her as a Black girl, soon-to-be Black woman in about 10 years.
>> Dr. Yolandra Hancock, thank you so much for joining "The Chavis Chronicles."
>> Thank you.
>> For more information about "The Chavis Chronicles" and our guests, please visit our website at TheChavisChronicles.com.
Also, follow us on Facebook, Twitter, LinkedIn, YouTube, Instagram, and TikTok.
Major funding for "The Chavis Chronicles" is provided by the following.
At Wells Fargo, we are committed to diversity and understand our responsibility in supporting and empowering diverse communities.
Diversity and inclusion is integral to the way we work.
Supporting the financial health of our diverse customers and employees is one of the many ways we remain invested in inclusion for all today, tomorrow, and in the future.
American Petroleum Institute -- through the core elements of API's Energy Excellence Program, our members are committed to accelerating safety, environmental and sustainability progress throughout the natural-gas and oil industry in the U.S. and around the world.
You can learn more at api.org/apiEnergyExcellence.
Reynolds American, dedicated to building a better tomorrow for our employees and communities.
Reynolds stands against racism and discrimination in all forms and is committed to building a more diverse and inclusive workplace.
At AARP, we are committed to empowering people to choose how they live as they age.
♪ ♪ ♪ ♪ ♪
The Chavis Chronicles is presented by your local public television station.
Distributed nationally by American Public Television