Q & A: Health Secretary Designate Dr. Tracie C. Collins

Dr. Tracie C. Collins' first week as the state's new health secretary-designate saw the start of front-line health care workers receiving the first COVID-19 vaccine, developed by Pfizer and BioNTech.

According to Matt Nerzig, deputy director of communications and media strategy in Gov. Michelle Lujan Grisham's office, the second Pfizer shipment—12,675— arrived today at Presbyterian Healthcare, University of New Mexico Health and the health department warehouse. In total, 22 hospitals, including Christus, will receive shipments from the DOH Warehouse tomorrow. Initial shipments of the Moderna vaccine—which received emergency authorization from the Food and Drug Administration on Friday— began arriving today, with 31,600 doses anticipated and slated for use on staff and residents at long-term care facilities and nursing homes.

As for the rest of us, Collins tells SFR the health department will be releasing an app soon, possibly this week, to apprise people of their status for vaccination. "People can go to that app and register and it will tell them if they are ready now to go for their vaccine or will circle back to them when they are eligible, so that's something that's coming," she says. The health department website also will be adding regular tracking of its delivery and distribution of vaccines, she says.

Prior to her appointment by Lujan Grisham last month, Collins served as dean of the College of Population Health at the University of New Mexico. A medical doctor and vascular specialist with a clinical practice, Collins also served as chair of Preventive Medicine and Public Health at the University of Kansas prior to her position at UNM.

SFR caught up with Collins mid-morning to hear a little more about her plans for the department and her hopes for seeing New Mexico through the end of the pandemic. This interview has been lightly edited for style and concision.

SFR: Earlier today, doctors and administrators from the major hospitals held a news conference and complimented the state on its help in distributing the vaccine. What can you tell people about the work being done behind the scenes to do that?

Tracie C. Collins: We have a vaccine team led by Dr. Aja Sanzone, who is overseeing getting the shipments into the state and working with her team and myself in distributing it throughout the state. So, there's a lot of activity going on behind the scenes. There are daily check ins to talk about where we are: Did we receive our doses? Are there any concerns? Do we need to reach out to anyone? And then working closely statewide with hospitals and others to make sure they're getting their vaccine distributed.

Can you share some of the discussions about creating tiers for vaccination here?

What I can share is for phase 1, which are health care workers who [have] direct patient contact or exposure to infectious materials: They're first on the list. And we pretty much worked through phase 1a; it's a long list that's going out to providers today to make they understand who's on the list. But succinctly, it's health care personnel, which is not just a doctor or a nurse, it's anyone coming in contact with a COVID patient or infectious material. So, we've got that worked out. What we're turning our attention to now and planning is underway, is to look at the next groups, to make sure we understand what we decide to do. We have guidance from the federal government—they've issued recommendations, I should say—but we, as a state, need to look at our populations and make that decision, incorporating those recommendations, but the decision is ours to make.

Given your experience as a doctor and educator, what do you think a successful public information campaign about the COVID-19 vaccine should look like here?

Communities of color may have issues around distrust, or likely do, so the idea is for us to make sure our messaging really captures the needs of diverse communities and helps them understand the value of this vaccine. When you think about who have been hardest hit [by COVID-19], it's important to for us to target the African American community, Latino community, Native American community, with culturally appropriate messaging so people understand the value of the vaccine to them.

Many of us have come to understand the systemic issues that have made New Mexico so vulnerable during this pandemic, such as our limited hospital capacity, and all the social determinants of health. Do you envision, as you lead this department, these lessons translating to new initiatives to address these systemic problems going forward?  And if so, what would that look like?

I certainly want to. With the pandemic taking up a large proportion of the time, we can't take our eyes off the other ongoing issues. The fact that Hispanics or Latinos, African Americans, Native Americans have been hardest hit by COVID and then the elderly, persons out in rural areas. We need to have initiatives to address things around employment, who has the access to employment…who has the capability to get a good education and what are we doing around education, food deserts, social environments, physical environments—there are a lot of pieces related to the social determinants of heath that we, as a department, need to tackle and move forward, once we can get past this hurdle.

We also have high co-morbidities. I know you’ve worked on diabetes research. Are those also areas you can imagine lessons learned and future work by the medical community?

As a researcher, I have looked at things like smart phone apps for increasing physical activity, but that can also extend to what meds you need to take for your diabetes, your hypertension and ensuring you understand the value of your diet. But you have to have access to nutrient dense foods that can help you change and improve your metabolic profile, so you're less likely to have complications or progress to more severe diabetes.

I know some folks have said they wished we’d had a statewide contact-tracing app during the pandemic, although they don’t seem to have been very successful anywhere. Do you think that would have made a difference?

The best thing that would have made a difference for us is if we could have further contained the virus. We were doing great…and I think people suffered from COVID fatigue and let down their guards. And there are still some that don't want to wear their masks. But I think preventing the spread of this could go a lot farther. Contact tracing is certainly important and we've done a good job with it and we are looking at some technology moving forward, but I think the better message is social distancing, washing your hands and wearing a mask. So please for Christmas don't have a big gathering with people outside your home.

I’ve been following surveys of epidemiologists talking about which activities they are likely to do again and when. Some have said they don’t think they’ll ever shake hands again. Do you think there are ways in which things have been changed permanently?

I think many of us are going to have a little bit of post-traumatic stress disorder from following this, whatever "this" is because it's going to take us some time to get through this pandemic. I do recognize that people will be a little bit shy about shaking hands. But if you're washing them frequently and you're not touching your face, when we've all had the vaccine, I'm hoping that will be less of an issue. You have to recognize in certain cultures, that's the norm for them: They just nod and say hello from a distance, they don't shake hands. So there's that potential in the future. My partner has been concerned about concerts in the future. 'Will we ever get to go to a concert again?' I'm like, 'One day at a time. Let's see how things roll out.'

Do you think the pandemic has changed the medical profession?

I think we've grown from a standpoint of thinking about more innovative ways to take care of our patients. A lot of the components of the things we've done face to face now can be done over phone—you don't have to pull a patient into a clinic to take care of them. It is growing in how we efficiently deliver care.

Have you been surprised by some of the mistrust for science and doctors that has emerged during the pandemic?

I have not been so surprised at the mistrust and the concern. What has really been highlighted for me is that a lot of what people believe…they put weight into what MDs and nurses say, but they also put a lot of weight into what our leaders say. So, when our leaders are good role models, people follow. So, we all have a role to play.

The health department currently has 274 job listings on the state personnel site, far more than any other department. Some, but not all, relate to COVID-19. Can you talk about those staffing needs?

It's a good question and I'm looking at that. We have to evaluate making sure we're taking care of the COVID issue and fulfilling those roles efficiently, but also making sure the various eight divisions, several bureaus in each division…[are] appropriately staffed. Right now the focus is on COVID, but once we get through the next three months, we can begin to look at fulfilling those spots.

You’re a scientist in addition to a doctor and administrator. What questions do you have about COVID-19 and the vaccines that you are keeping an eye on?

What I see as important is making sure people take COVID seriously, that they recognize the value of the vaccines that we have available right now and more to come and they really don't let down their guard. From the scientific perspective in containing this virus, right now we need to make sure people are still adhering to wearing a mask and distancing. The thing I want to keep track of is are there changes in this virus moving forward, are there new risks we need be concerned about and just being aware of what's going on and communicating with the public about what we know.

If you were starting this job and there wasn’t a pandemic, what would your first priority be?

Focusing on understanding the various needs of the state and creating groups to target those needs and clearly understand the determinants of health, by your ZIP code, your area and really working with our colleagues—such as UNM's HEROs program [Health Extension Regional Offices, which links resources to rural and underserved communities], to make a difference in the health of our various diverse communities.  To really get at systemic racism, to be honest with you.

Can we look forward to that after the pandemic?

That's what I'm hoping. Yes.