Opinion | "Vaccination Hubs" are not enough; we need full-service COVID outpatient "One Stop Centers"

"If you build it, they will come" is a catch phrase made famous by the film "Field of Dreams." As we roll into 2021, invention is born of necessity, not dreams. Customer-focused health care for all would answer a need, and would go a long way to restoring credibility to a health care system in which underserved communities have lost faith.

According to a December 23rd story in the Bronx Times, Bronx Borough President Ruben Diaz Jr. recently hosted a panel of experts to discuss the vaccine roll-out. While it's fabulous that Mr. Diaz hosted that panel, it was reportedly said that the new mRNA vaccines represent an "advancement from earlier treatments, such as the antibody cocktail Regeneron." That's misleading, as prevention and antibody treatment are not the same thing; they are two legs of a stool on which an effective response to the COVID pandemic depends. What they have in common is that both involve needles going into arms, and neither requires hospitalization. Though they are being distributed through hospitals, vaccines and supplemental antibodies are both outpatient drugs. Which to take comes down to whether the recipient is COVID positive on the day of administration, and the way to know that is to get a COVID test on the way in. That's the logic of having a single, one-stop facility.

It's important to listen. This writer has heard people being told that they 'should' get vaccinated. This 'messaging' leaves people feeling preached at, in some cases by people who have not delivered for marginalized communities in the past. While the message is basically right and commendable, it puts the shoe on the wrong foot. Our health care delivery system DOES have something to prove. If McDonald's can offer burgers AND fries, outpatient walk-in centers can offer testing, vaccine, AND early therapeutic treatment.

It's no longer the case that there's only enough REGN-COV2 and Bamlanivimab for members of the Trump Administration and residents of the wealthiest retirement communities. Hospitals have it; it's being distributed to them through state health departments. Northwell, a private health care system that serves Long Island and parts of Queens and Manhattan, has set up a hotline so their providers can schedule time at infusion centers for patients to receive Bamlanivimab. Montefiore, a private health care system that serves The Bronx, has not, and neither has NYC Health & Hospitals, the City of New York's department that runs Jacobi Hospital, among others. Our community's medical school, Einstein, enjoys ties to both Montefiore and Jacobi.

My proposal: erect a high-end fabric shelter, 200' x 100', in the Einstein College of Medicine parking lot. It should be for outpatient COVID testing, vaccination, and treatment only, initiated walk-in or drive-thru, and should not replace any other hospital function. It should have (self-contained, modular) negative-pressure infusion rooms, provision for easy and frequent bathroom cleaning and disinfection, and a raised, perforated floor throughout. In winter hot air can be supplied beneath the floor and vented out the peak of the roof, providing a continual updraft throughout the building. In summer this can be reversed, drawing air out through the floor in the manner of manufacturing "clean rooms." Both service and waiting areas can be partitioned with clear Plexiglas, so everyone can be seen, and nobody is lost in the shuffle. Customer experience, satisfaction, and safety are watchwords.