Atul Nakhasi couldn’t stop thinking about Dodger Stadium.
The storied ballpark-turned-coronavirus-vaccination-site just 10 minutes from his apartment in downtown Los Angeles had been briefly shut down by anti-vaccine protesters, and Nakhasi, a doctor, was horrified. To him, the nearly hour-long delay amounted to an act of “public harm” and served as a chilling example of how far people who oppose vaccines are willing to go to make their point. He had to do something to respond, but what?
The question weighed heavily on Nakhasi’s mind as he drove to a south L.A. hospital to begin his 12th straight day of caring for patients, some severely ill with covid-19. It was still on his mind as he spoke to the family of a young man in his 20s, whose lungs were so damaged by covid that he could no longer breathe on his own. A vaccine might have changed this young man’s life, Nakhasi thought, as he told the father that his son would probably need a permanent breathing tube.
So when Nakhasi got home that evening, despite feeling as though he could collapse into bed and not wake until the next morning, he instead grabbed his phone and opened Twitter.
“As a frontline doctor who lives near Dodger Stadium this is outrageous, treacherous, & an act of harm to the public,” he typed, retweeting another doctor who was upset by the anti-vaccine protesters. “Every eight minutes,” he wrote, an Angeleno dies of the disease.
It was 6:20 p.m., and Nakhasi had worked nine grueling hours. But his day wasn’t over.
“You wrap up your day, and you’re hoping the fight ends,” said Nakhasi, 33. “You’re fighting for lives that whole day … keeping people here to the next morning. And then you get home and you feel like the fight never stopped. It just changed turf. The landscape just changed.”
As a frontline doctor who lives near Dodger Stadium this is outrageous, treacherous, & an act of harm to the public. Every eight minutes we lose an Angeleino. #ThisIsOurShot to save lives.@DrPanMD @AlexMMTri @CMAdocs @AntiVaxWatchOrg @VaccinateCal @Ready2Vaccinate @DrLindaMD https://t.co/prM3MVbCmj— Atul Nakhasi (@Nakhasi_MD) February 1, 2021
‘The information war’
Nakhasi is one of countless health-care workers who have found themselves combating the coronavirus on two fronts during a global pandemic that is now stretching into its 12th month. Beyond spending their working hours in hospitals and clinics, many doctors and nurses have also voluntarily entrenched themselves in “the information war,” as Nakhasi calls it.
It’s a fight Nakhasi and other medical professionals say feels overwhelming. Baseless claims often spread faster than facts, and purveyors of misinformation are quick to retaliate with vitriol and threats. And yet, health-care workers, many of whom are already experiencing burnout and the emotional toll of witnessing covid ravage their patients, haven’t backed down.
“It’s never-ending,” Nakhasi said. “There’s not a moment where I don’t feel some level of duty or responsibility” to take action.
A family medicine doctor in rural Kansas, who is also her county’s health officer, responds to a daily flood of pandemic-related texts and social media messages while running her clinic and taking emergency room shifts. A pregnant nurse in California opens up online about her decision to get vaccinated, hoping that her personal story might persuade others to do the same. A pulmonary and critical care physician in Baltimore, who’s done more than 170 virtual town halls, gives out his personal email address to anyone with questions or concerns.
“The misinformation that’s out there is, like, one of our worst enemies,” said Jennifer Bacani McKenney, who has been practicing family medicine for more than 10 years in Fredonia, Kan., a community of roughly 2,500 people about 100 miles south of Topeka. “It’s almost worse than the virus itself.
“At least we have some science to deal with the virus,” McKenney, 41, continued. “We have strategies to deal with the virus. There’s not a great strategy to deal with the random memes, or the stuff that’s presented as data that’s not actual data, or the bogus YouTube videos or whatever that look like they’re scientific and there’s no basis. It’s amazing the people that believe it and share it, and there’s not a strategy against that.”
In non-pandemic times, Nakhasi barely used social media. Now, he’s the co-founder of #ThisIsOurShot, a digital campaign to promote positive messaging about the coronavirus vaccines through a network of more than 25,000 health-care workers. He also checks Twitter, Instagram, Facebook and LinkedIn multiple times a day — scrolling through feeds in the morning as he’s scarfing down a bowl of cereal and waiting for his coffee to brew, taking a quick glance on his way to the bathroom at work and signing on again in the evenings at home. These days, he can hardly find time to make himself dinner, instead subsisting on a rotation of peanut butter and jelly sandwiches, Chipotle and Subway.
“Almost every waking second, minute and hour outside of work right now is being spent on digital engagement to build vaccine trust in our communities,” said Nakhasi, a primary care doctor who usually works at a clinic in Compton but has been deployed to nearby hospitals to help with staffing shortages. When it comes to combating misinformation online, he said, “we are flying the plane and building it at the same time.”
This moment is dedicated to the 317,801 souls who've left us for the Heavens above. Who didn't live to see this moment. To have this chance. To get this miraculous shot. To my patients, to all people everywhere & anywhere, today there is hope. And it is here. #ThisIsOurShot pic.twitter.com/6JBTUWaalh— Atul Nakhasi (@Nakhasi_MD) December 21, 2020
To that end, Asha Shajahan, a doctor in Detroit and one of the leaders of the #ThisIsOurShot campaign, is working an extra 40 hours a week trying to come up with a curriculum for physicians on how to handle social media misinformation.
“In general, physicians kind of tend to be siloed and do their own thing because they’re so busy,” she said. But during the pandemic, Shajahan noted, many have come to realize the importance of “collective impact.”
Health-care professionals in Illinois launched a volunteer-based organization called Impact, which aims to use social media to amplify science and educate the public. Meanwhile, others have coordinated messaging through less formal group chats or are teaming up for virtual talks. For instance, a group of Black doctors have started using Clubhouse, a trendy, invite-only, audio social media app, to host sessions on covid.
“We’ve just been kind of joining forces,” said Bernard Ashby, 40, a vascular cardiologist who practices in South Florida and is part of the Black doctor group. After members of the group were vaccinated, Ashby said they went on Clubhouse and “basically said, ‘Hey, we’re alive, we’re fine. These were our experiences.’ ”
Given the low rates of vaccination in some of our most vulnerable communities, I’ve been working with @MiamiDadeCounty to set up more vaccination sites and engage the community to help close the gap. This PSA is part of that work. Check it out! pic.twitter.com/Kw0tpC0PdB— Bernard Ashby (@BAshbyMD) February 1, 2021
‘We need to humanize the pandemic’
In a time when facts are frequently questioned and undermined, front-line health-care workers have found powerful weapons in their own stories. Early on, emotional videos and lengthy social media posts provided glimpses into hospitals overrun with sick and dying covid patients as doctors and nurses struggling with shortages of protective gear begged people to stay home. More recently, social media sites have been flooded with vaccine selfies, which are often accompanied by detailed captions explaining the decision-making process to get vaccinated, side effects and the science behind how the shots work.
“We need to humanize the pandemic,” Nakhasi said. “What we’ve realized is when you put a face to it, when you put a story to it, people can empathize with it. It builds an empathetic bridge to the public.”
That’s what Mawata Kamara, an intensive care unit and emergency room nurse in Alameda County, Calif., hoped to do when she chose to share her experience getting vaccinated. As a Black woman who at the time was 29 weeks pregnant, Kamara, 36, knew she could relate to two groups of people who have been especially concerned about the vaccines.
“People want to get information from people they can trust or people they believe are going through the same thing they are,” said Kamara, a board member of California Nurses Association/National Nurses Organizing Committee.
Initially, Kamara also had reservations about the shots. The clinical trials didn’t include people who were pregnant, and both vaccines being distributed to the public had been developed in record time.
“I wanted to admit that I was afraid, even though I’m a nurse,” she said. “I didn’t want people to feel like I had all the answers, I didn’t.”
Instead, she explained in a Facebook post that she had only arrived at her decision after doing her own research, which included talking to other medical professionals who advised her that “the risk was definitely worth taking.” Kamara had seen pregnant people in the ICU infected with covid who “never made it to see their babies.” And, she wrote, she has another young daughter who needs her.
“I wanted to let people know that it’s okay to take the vaccine from my point of view,” she said in an interview, noting that her post-vaccine prenatal checkups have gone well.
But as health-care workers have continued to share their personal stories, their openness has come at a cost. “One of the challenges of being messengers in a polarized moment is the vulnerability to be attacked and to be criticized,” Nakhasi said.
Even before the pandemic, medical professionals have been frequently targeted online, particularly if they are doing advocacy work or promoting vaccines, said Vineet Arora, a doctor and medical researcher at the University of Chicago who studies social media. Women, Arora noted, have traditionally faced more intense harassment, including sexual comments and threats.
“We have studied social media attacks and harassment on Twitter, and it’s terrible,” she said.
McKenney, the Kansas doctor, has weathered attacks on social media and in person. People she considered friends and good acquaintances have accused her of not caring about the community she grew up in. Others have called for her to be fired.
At one point during the summer, McKenney couldn’t take it anymore.
“I very intentionally waited for everybody to leave my clinic, go home for the night, and I just kind of sat in my office,” she said. “And once I knew everyone was gone, I just laid my head on my desk and just started crying.”
In recent weeks, Nicole Baldwin, a pediatrician in the Cincinnati suburbs who is a vocal advocate for vaccines, has blocked more than 100 accounts across Twitter, Instagram and Facebook. She regularly deletes negative comments on her posts.
“I’ve been called an effing psychopath,” said Baldwin, 43, who has also gotten comments from people telling her to kill herself. “Someone called me a female version of Hitler.”
If you're an antivaxxer who shares my content, says nasty things about me and invites your community to attack me...don't act so surprised when I block you.— Nicole Baldwin, MD, FAAP (@NicoleB_MD) February 5, 2021
Not really sure what you thought would happen 🤷♀️#VaccinesSaveLives #EndCyberbullying pic.twitter.com/JhZzHpGZjf
But she also recognizes that the responses mean her message is getting out there. “I don’t think they would be coming after me or attacking me if I wasn’t making an impact.”
Adam Karpman has a similarly optimistic view. “It inspires me to do more because I still think we have work to do to change their minds,” said Karpman, 39, a cardiologist in Tulsa, who started a covid-focused Facebook blog. “I’m not necessarily thinking that these people are negative or hateful. I think it’s more of a need for more education and to inspire them to do the right things for our country.”
Still, deciding how or whether to respond to people online has presented a challenge.
“Some people ask legitimate questions that I really want to answer, and then other people ask these, like, leading questions,” Baldwin said. “It’s almost like they’re an anti-vaxxer in disguise, that they’re trying to pretend that they’re very nice.”
Nakhasi said he tries to assess the motives behind people’s messages before engaging with them. “What is the tone? What is the intent? … I think that’s just a judgment call.”
When Panagis Galiatsatos, a pulmonary and critical care doctor with Johns Hopkins Medicine in Baltimore, encounters pushback during any of the dozens of virtual town halls he’s done during the pandemic, he has a simple approach to de-escalation.
“Here’s my personal email,” Galiatsatos, 36, tells them. “Email me.”
Those people often do reach out, and Galiatsatos said he makes sure to take his time with each response.
“I know this might sound like the world’s most tedious thing,” he said. But, that one person may have the ability to reach others. “If you can convince them, you may be convincing one other person, two dozen people.”
‘If not us, then who?’
The walls of McKenney’s office are a contrast to the vitriol and criticism she faces online. They’re covered with dozens of letters and cards from people thanking her for her work. Some are from residents in her community, like the note from her former librarian’s husband, while other messages of appreciation have arrived from as far as California and New York.
“Small towns need brave people like you,” one person wrote.
“When people are mean, there’s a part of you that starts to question yourself, like, am I doing the right thing?” McKenney said. “These cards literally say, ‘Thank you for what you’re doing. You’re doing the right thing.’ … It gives you that motivation to keep going and to stay strong and tells you people are listening to you.”
Karpman’s Facebook posts have been similarly inundated with positive comments.
“Great information as always and learning a lot,” a user wrote. “I was very hesitant to take the vaccine until your blog. So thank you!!”
It’s a privileged position, Nakhasi says, that he and other medical professionals are in — to be able to spread information and messages that can literally save lives. But that privilege is also a responsibility.
“We realized that if not us, then who?” he said. “And if not now, then when?”
A photo caption in an earlier version of this report gave the incorrect name for the medical facility at which Atul Nakhasi was reviewing patient results. It is Martin Luther King Jr. Outpatient Center, not Martin Luther King Jr. Community Hospital. This version has been corrected.
Photo editing by Monique Woo. Design by Emily Sabens.