Thread by @ShriramKMurthi

Shout out to @femaregion1, @RIHEALTH, and others for an amazing experience with COVID vaccination in Providence today, a great illustration that public health is as much a social science as about medicine and biology. A short thread explaining why: ↵

I was accompanying a person who is very, VERY scared of needles. They wanted to get vaccinated, but were also really afraid of doing it. We went to The Dunc [@DunkinDonutsCtr]. Very smooth, quick, efficient. We get to the point where we get assigned a vaccination booth. ↵

The lady senses that this person is really nervous. They can't see the face (mask), but the voice gives it away. They ask, "Are you really nervous about this?" They say yes. I'm expecting the usual, "Oh, don't worry, it's nothing", etc. But no: ↵

"Would you be more comfortable doing it in private?" Yes, they say. How much more private, I wonder, the shots are already administered in booths; but they meant the whole thing, including 15 minute wait. So they give a signal. ↵

We are transferred over to a totally different, completely private region of the place (marked "no entry", and then some separation). There are several private booths set up there. The person who handles the vaccination card leads us there. Shortly after, a FEMA admin. ↵

Soon after, the nurse. Everyone is SUPER calm, soothing, chill. They administer the shot. Then I find a FOURTH person there. I can't figure out her role, but she's chatting with the patient while I help out with the paperwork. ↵

The fourth person is basically like a counselor, who is so calm, so engaged, and so good at keeping a gentle conversation flowing, that the shot is entirely forgotten. The nurse leaves, but the other three stay the full 15 minutes before discharging. ↵

Why does all this matter? Because this person:
1. Is not going to have a traumatic memory.
2. Is ready to come back for a second shot.
3. Is going to tell others "Oh, it really wasn't a big deal".

But I think there's a fourth, even more subtle, effect. ↵

Nervousness is contagious. If you have one person shaking and trembling, or sobbing, or worse (imagine a kid) screaming, everyone else gets worked up. Worse if (think a kid) screams *inside a closed booth*. People freak. Their own experience will feel worse. ↵

This way, they've diverted all these people away, improving the *perceived* experience for both those who need this level of support AND those who •don't•!

Best part: This person said they'd take their second shot in the regular facility. ↵

Overall, the #RhodeIsland setup at the Dunc was just phenomenal. Good directions, good flow, etc. Really cute touches that remind you of attending a game: you can check in at the box office, and when we left we got a printed ticket stub (w/ vaccine printed on it). ↵

I confess, this also made me sad. There are lots of places in the world that just cannot afford anything like this. They can't take 4 people out for 15 minutes just to administer to one patient. ↵

I used to do vaccine and health clinics in India (long story). You'd have babies just screaming away, a doctor doing their best to keep things calm, but not really succeeding, but people had to just keep rolling through. ↵

Parents were so grateful for a vaccine that nobody was looking out for the comfort and relaxation of the patient. (Or, they were looking for it at a lifelong, not momentary, level.) ↵

I will still gladly take an assembly line of jabs over the alternative! But if we can afford to treat people with compassion, imagine how many more people would take better care of themselves and not have to choose! ↵

We love to trash on public services in the US, but this was a shining moment (amongst, no doubt, many others we don't notice). This is certainly not the "Brownie, you're doing a heck of a job!" FEMA. They and everyone else actually did do a heck of a job. •