Out of the Door and onto the Community’s Doorstep
Access granted: ICHS at the forefront of equity in our communities during the COVID-19 pandemic
When eligibility for COVID-19 vaccines expanded last November to children 5 to 11 years old, Katherine Wong-Velasco immediately began looking for appointments.
“It had been really, really difficult to find an appointment,” said Wong. She’d search online and call medical providers only to find no available appointments and long waitlists.
After weeks of looking, she heard from a friend that a non-profit clinic was hosting a pop-up vaccine clinic with walk-in appointments. She jumped at the opportunity, bringing her daughter Alyf to Highland Middle School to be vaccinated with the International Community Health Services (ICHS).
Ann Mosbacher, International Community Health Services (ICHS) vaccinator, prepares a dose of pediatric Pfizer-BioNtech COVID-19 vaccine for Alyf Velasco at an ICHS pop-up vaccine clinic at Highland Middle School on November 20, 2021.
Setup in a quiet and sunny space in the school, a multilingual cadre of ICHS staff and volunteers checked families in, answered questions from jittery children and parents alike, and gave careful attention to children after vaccinations were finished.
Alyf was the first of more than fifty children to be vaccinated that day. “It’s been very easy, thank you,” said Wong. “Today’s the first time that we learned about ICHS.”
It’s been common for attendees to first hear about ICHS at COVID-19 vaccine clinics says Sharissa Tjok, ICHS community access manager. As an organization founded to assure access to quality health care for those who need it, ICHS has focused on delivering COVID-19 vaccines to underserved communities. “It was never enough to only serve our own patients,” said Tjok.
Reaching the community through pop-up vaccine clinics
ICHS was formed in 1973 as an all-volunteer run clinic by idealistic medical students and community volunteers who recognized that the low-income Asian Pacific Islander elderly and immigrants in Seattle's Chinatown-International District had no access to health services. Language barriers, cost barriers, as well as institutional racism and bias by care providers had left these seniors behind. These volunteers in the early days often had to visit seniors in their own apartments for check-ups or reminders to come in for appointments due to deep-seated feelings of mistrust of medical professionals. Today, ICHS has grown a great deal to serving over 28,000 patients in clinics and service sites across the Seattle region, but ICHS has never stopped its community outreach.
Deeply rooted in the Asian Pacific Islander community, ICHS provides high-quality, culturally and linguistically relevant health services as well as health education, insurance enrollment, and community outreach to immigrant and refugee communities. Nurturing long standing relationships with community partners, from non-profits to places of worship, would all come into play during the COVID-19 pandemic.
ICHS was one of the first health centers in the region to provide COVID-19 testing, COVID-19 vaccines, and more recently COVID-19 therapeutics. Almost of which have been delivered to communities of color that have faced great barriers to accessing life-saving care during the pandemic.
Community health centers like ICHS have been integral nationwide to the Biden Administration’s actions to expand access to COVID-19 vaccines to the hardest-hit and highest-risk communities across the country. Community health centers have provided 19.2 million COVID-19 vaccines nationwide, with over two-in-three shots at a health center administered to people of color.
"We're proud that health centers have met the challenge of the COVID-19 public health emergency," said Ron Yee, MD, Chief Medical Officer at the National Association of Community Health Centers in a February 9, 2022 press release. "They have saved lives and provided a trusted and safe place for families to get vaccinated and learn the facts."
In December 2020, ICHS was one of the area’s first community health centers to receive COVID-19 vaccines directly from the federal government. Following WA state guidelines, ICHS immediately began organizing COVID-19 vaccine distribution first for health care workers and then to eligible seniors.
Dr. Lakshmi Deepa Yerram, ICHS Chief Medical Officer“We met people where they work, live, pray, learn and gather.” says Dr. Lakshmi Deepa Yerram, ICHS Chief Medical Officer. “ICHS has worked hard on fostering community partnerships and we plan to continue to harness those to ensure that those who need vaccinations the most continue being able to access those.”
On February 3, 2021, ICHS held its first pop-up COVID-19 vaccine clinic at the New Central Apartment building in Seattle’s Chinatown-International District (C-ID) with partner, SCIDpda who reached out to eligible seniors by phone or in-person to register them for the event. Staff and translators vaccinated a hundred elderly first-generation Asian immigrants who lived in the C-ID during that first event.
Since then, ICHS has held 130 pop-up vaccine clinics with 40 community partner organizations across King County. This model of actively engaging in the community is rooted in an understanding that many community members experience marginalization from the health care system due to a lack of culturally relevant information, services in their home language, and institutional racism.
“Pop-up vaccination clinics also aim to ensure traditionally underserved communities that have been severely impacted by the virus receive vaccinations,” said Yerram. In 2021, ICHS administered 5,300 COVID-19 vaccines at pop-up vaccine clinics, and 26,000 vaccines overall.
ICHS at the forefront
ICHS has had a long practice to go out into the community rather than expect the community to come to them. “We know there are gaps and barriers in our communities to accessing resources,” said Sherryl Grey, ICHS Director of Community Health Services. That’s why ICHS efforts to contain COVID-19 have been community-wide since the beginning.
Angela Wan, ICHS Community Health Specialist, delivers bundles of cloth masks, info on voter registration, and other free health resources to Helen B. Ratcliff House social services organization on Beacon Hill on November 2, 2020.
In the wake of the first COVID-19 case on January 21, 2020, ICHS and community partners spoke out against bias and xenophobia against Asian American communities. Then in early March, panic struck Seattle’s Chinatown-International District when one positive and two suspected cases of COVID-19 were found among employees at a low-income apartment building.
Responding to the crisis, ICHS, in collaboration with the International District Emergency Center, set up a drive-through COVID-19 testing site in front of ICHS’ International District clinic in March 2020 when testing was scarce.
ICHS would open a COVID-19 testing site at Shoreline a week later, and then in Bellevue College in December 2020. ICHS continued to host free COVID-19 testing until November 1, 2021 administering a total of 61,000 tests last year.
Offering multilingual registration and on-site translation, ICHS COVID-19 testing was a key part of making access to COVID-19 testing equitable to immigrant and refugee communities.
The lingering issue is access
On February 17, 2022, Governor Inslee announced Washington state will soon move into a less restrictive phase of the COVID-19 response.
"The virus has changed significantly over the past two years, and so has our ability to fight it,” said Inslee. “While caution is still needed, we are entering a new phase of the pandemic.”
The announcement comes from declining hospitalization rates, improving COVID-19 vaccination rates, and “broad access to masks and tests.”
Undoubtedly, at-home test kits and N95 masks are more available now then they were a year ago, but ICHS staff recognize that those most at risk of being sickened by COVID-19 — elderly, uninsured or low-income, immigrants and refugees, and racial and ethnic minorities who face barriers accessing health services — don’t have the same access to these life-saving tools, said Braden Hirasawa, ICHS director of clinic operations.
Sieng Douangdala, community engagement manager at Kandelia, a Seattle non-profit serving immigrant and refugee youth, has heard from clients that they’ve found the English websites completely inaccessible, and due to transportation, internet, or language barriers have been unable to find COVID-19 testing during the Omicron surge.
To address these barriers and reach communities in an equitable way, ICHS has partnered with community organizations to distribute test kits widely for underserved communities most impacted by COVID-19.
ICHS was also selected as one of the first community health centers in our region to receive life-saving antiviral medications that previously were rare and nearly impossible to find.
The U.S. FDA has issued an emergency use authorization for Pfizer’s Paxlovid and Merck’s molnupiravir for the treatment of COVID-19 disease on December 22, 2021 and December 23, 2021 respectively. (Photo by ICHS)
COVID-19 Therapeutics
According to the Washington State Department of Health, early intervention with monoclonal antibody therapy can reduce the risk of severe illness and hospitalization for people with COVID-19 who are at high risk of developing more serious illness.
Please speak with your healthcare provider first and get a referral before contacting ICHS to arrange an appointment at our clinic pharmacies. COVID-19 antiviral medications are not available by walk-in and provider’s recommendation is required.
Paxlovid is eligible for individuals 12 years of age and older (with body weight minimums) and Monulpiravir is eligible for individuals 18 years of age and older. There is no cost to anyone for the antivirals themselves and everyone is eligible, no matter their immigrant status.
Language assistance is available at Washington State’s COVID-19 Information Hotline at 1-800-525-0127.