Here’s my conversation with Dr. Danny Avula, candidate for Mayor of Richmond VA. This completes the set of all my conversations with Richmond’s prospective Mayors for November 2024. One of these people is going to be leading the city next year. Who it’s going to be is ultimately up to us. I encourage you to compare and contrast them, but here’s a quick takeaway.
All of them like you. All of them are like you. The gas in their engines straddles a leader/servant complex that many don’t relate to personally. I couldn’t imagine anyone without that mission in their veins responding to the call of the office in the first place. The absolutely beautiful thing is, I truly believe their hearts are in the right place. No one here wants to strip you of any rights. All of them want you to be safe, served, and thriving. They don’t all have the exact same plan, but they’re definitely all on the same track. The consistency of sentiment in their goals builds confidence, the same way getting a second and third recurring opinion on car repairs undoes suspicion in your mechanic.
Like choosing a schoolyard basketball team though, you start with your ace. We’ve got a row of aces to pull from up our sleeves this year, but we only get to pick one. If there’s anything I’ve gotten out of this process, it’s the knowledge that we are rich in public servants willing to go to work for us. And if there’s anything they’ve learned, I’d like to think it’s that I will continue to follow up on their promises with hard questions and an expectation for results. Here’s a list for those of you that want to read conversations of me berating people about things that grind our gears:
Andreas Addison LINK
Michelle Mosby LINK
Maurice Neblett LINK
Harrison Roday LINK
…and of course, the subject of this article, Danny Avula.
I have gone out of my way to rile up these cats on subjects that have no easy answers. I’ve tried not to accept deflections, pablum, pandering, and hopefully, where I can give it, maybe provide some insight on Richmond that’ll inform their journeys forward. Most of the time, they would be educating me – as it should be. This is no different today. I’m meeting the man who led the COVID mission in the state of Virginia. I found myself in conversation with a genial, sincere, and cool dude. His boothside manner (we were in a restaurant) was calm, confident, and patient with my ranting.
I was impressed with his magnanimity. He, no lie, actually edified my outlook on a few key issues intrinsic to being a journalist, and moreso, just an empathetic person – which I strive to be. Without further intro, meet the would-be physician for the city’s ills:
Christian Detres: We’re sitting here at Get Tight Lounge and we want to get to the bottom of who Dr. Danny Avula is. What do you want? Why are you taking this race on? What’s up?
DA: Well, who is Danny Avula? Hmmm, I am a husband and a dad. I’m a longtime resident of this city, I’ve been here for 20+ years. I have absolutely fallen in love with Richmond. I moved here back in 2000 to go to medical school at MCV. I was born in India. I grew up in California and then ended up in the DC area late in elementary school.
After graduating high school at 16, I went to UVA for undergrad and taught high school for a year after college – before medical school. I got a taste of Charlottesville, which is so different from the suburban lack of culture, lack of connectivity and experience of growing up in NOVA. When I came to Richmond for medical school. It was a bigger town than Charlottesville, which had its challenges and benefits. It was easy to find pathways to connect with people and to connect with communities. As a medical student, I was leading a bunch of health fairs and working with organizations on public housing. We were mobilizing med students to try to connect with the Richmond community. Towards the end of that time in my life, I just said, “You know what? I love the city. I’d love to be a part of where it’s going.” So we made the decision to stay.
CD: I would ask you what you did with your spare time if I didn’t understand that to be a joke for a med student. There is no spare time. What parts of Richmond’s culture or community felt like home?
DA: My first apartment was in the Fan. It was on the corner of Monument and Meadow. It was a very cool apartment. Living in the midst of the weight of the ‘history’ there while also spending all my time downtown at MCV serving a predominantly lower income African American community was just, jarring. All of this was happening in the same city. So much of my motivation in getting into medicine was wanting to serve communities, and wanting to connect with the patient population. We were leading a lot of health fairs in Chimborazo Park, in Creighton Court. I was living on both ends of the divide in the city. Ultimately, when we decided to stay for my residency, we ended up moving into North Church Hill and have been there since 2004.
My wife and I have raised five kids in the city. Our kids have all attended Richmond public schools. My wife actually teaches kindergarten at Chimborazo Elementary. Our life for the last 20 years has been about the city and about trying to help it move forward. Her through education, me through public health and human services.
I served as the Public Health Director here for a long time. So much of the work of public health is looking at why some communities are thriving and other communities are not. Particularly in the last decade, we’ve seen Richmond on this tremendous development arc. We’ve seen incredible growth in this city. There’s so much cool stuff happening. New housing, new amenities. But my lens as a public health doc was tuned to recognizing health disparities, right? I was having a personal crisis as a resident of the East End, living with lower income neighbors who were having a hard time and, in some cases, getting pushed out of the community. While Richmond was thriving, some communities were suffering. You started with the question, “Why am I doing this?” Yeah, that’s the crux of it. I want to be in a place where I can help shape Richmond’s future. We need to ride the momentum this city is experiencing, continue to drive development. But we need to do it in a way that ensures that the vulnerable and marginalized members of our community get to flourish as well– that everyone gets to benefit from that growth.
CD: That’s an obviously beautiful and noble goal. I think it’s a goal that’s shared by a lot of people, especially with people that are in this same mayoral race. One of the more heartening things I’ve been able to see while covering the Mayoral race is that there’s little divergence in the candidates’ goals. The divergences lie mainly in strategy. All of you see the loopholes and potholes in our system. You all want to fix, or at least challenge the status quo. There’s a common ground to start with.
We have people in this race that lived here their whole life. Michelle Mosby, Maurice Neblett, Garrett Sawyer. They’re trying to serve the people on their childhood neighborhood’s corner. You have a background that pulls in influences and experiences internationally. How old were you when you left India?
DA: Ha, I was one year old. But you know, I mean, growing up in an immigrant family, it’s part of you. India was always a presence in my life of course.
CD: Of course! It should be. I’m sure your California experience is present in you too. I’m sure you frosted your tips at least once.
DA: Hahaha, I was too young to do that and my immigrant parents wouldn’t go for that.
CD: Oh I know. More than you know, sheesh. When you have a partner that is also in a service field, your wife being an elementary school teacher and all, the conversations, ideas, and strategies that must get bandied about over coffee, long drives etc must be fascinating. Do you have any cool ideas that have come from being ensconced in community service at home as well as at work?
DA: I don’t know if “cool” is the word but let me just back up a little and tell you more about how we ended up making the decision to move into the areas we most wanted to heal. When I was at UVA I was a part of a group of friends that would go on this alternative spring break trip. I actually never went on the trip, but my wife did. A bunch of my roommates did too. They’d go down to Jackson, Mississippi, and worked with Dr. John Perkins, a civil rights leader and pastor who had given his life to racial healing work.
He created this intentional community where black and white residents were moving together, living together, doing the work of racial healing together. They were also physically building their community. That exposure was really formative for us. This group of students would come back to UVA, see how segregated the campus was, and choose to try to build bridges. That started to become a part of the DNA of this group of friends. I was here as a medical student trying to do some of that kind of work in the health space, and ultimately we moved into a community where most of my neighbors were lower income African American families and individuals. They became friends, the people that I would hang out with on the front porch. They also became the folks who were telling me how well, or if, I was doing my job.
That came from having deep relationships with those neighbors. Trying to help “Miss Yolanda” navigate the medical system, or try to get on Medicaid, or try to access benefits through social services. All of that shaped the way that I understood the systems that I would eventually come to be in charge of as the city’s Public Health Director, and then later as the state’s Social Services Commissioner. I was changed by their lived experience. My neighbors gave me a lens on how the systems we were subjecting people to were actually being received, and how they were being impacted in the real world.
CD: Hm. This is a pointed question. So right now, to receive Medicaid for a family of two, you can’t make more than $27,000 a year. Essentially, the service is only available if you are literally starving. If you make anything above that, you’re on your own.
For instance, if I make $2,200 a month, my expenses are $1,800 and that other $400 I could maybe put into long term savings. Or maybe I might be able to afford something reasonably cheap, anything that brings joy to my life, like a new outfit or a couple nights’ entertainment. I’d never be able to think about going on a vacation. I’d never be able to think about doing anything to improve or replace essential things at home. That’s not even optional. But with all those limitations, at least I’ll have health care.
So let’s say I get a small raise. Now I make $2500 a month. That puts me over the ability to be able to get healthcare through Medicaid. Now that means I get to spend another $400 or $500 a month to receive anything resembling decent health care. That also comes with a prohibitive deductible. That seems cruel, not to mention counterproductive to the ideal of creating a thriving aspirant class. How does one move up in the world where every step forward is a two-step shuffle backwards?
Is there any power that this office of Mayor would have to at least advocate on making these brackets a little more fair?
DA: No direct control, but certainly the advocacy towards updates on the financial requirements for enrollment. Medicaid was much more restrictive four years ago. We had a pretty momentous thing happen in Virginia when Governor Northam was in office. Between Governor Northam and a Democrat-held house and senate, we were able to expand Medicaid. We went from the $27,000 ceiling you described for a single mom and two kids, to go up to 140% of the federal poverty level. It expanded access to health care for a huge swath of the population, close to around 400k Virginians. That was a huge win. Still not enough. To your point, there are still a large number of families who fall into the gap. They’re not poor enough to qualify for Medicaid coverage, and then they have to go to the marketplace. We do have the ability to keep expanding who qualifies up to 200% of federal poverty.
CD: The cost of living here, which has historically been comparatively inexpensive, now has skyrocketed. We’ve had a population boom. Richmond should be able to incorporate new people and grow without kicking its current residents in the teeth. You can’t ignore the impact that has on existing communities. I feel personally invested in how Richmond potentially grows into an international culture hub and fertile incubator for economic growth. I think culturally our reputation precedes itself. It’s beautiful. People, new and established, love it here. Do you have a perspective on that? A 12-point plan of some sort? Kidding about the 12 point plan, but where does this conundrum take you?
DA: We need to ride the momentum to continue the growth trajectory of the city. We don’t want to shut down development. We want to make development easier. But that has to be done concomitantly with thoughtful investments in our current residents, like advancing affordable housing investments. If we don’t then we’re going to just be a series of gentrified communities. We really need to have a socio-economic, and subsequently a racial, balance baked into the planning that we do. We need to properly incentivize developers to consider a solution to the inevitable displacement their projects could cause. We need to ensure affordable housing is a priority while we grow.
CD: Man, I hear you. Unfortunately for every believable dedication to this exact plan, I have seen (especially in NYC) complicity in City Hall with developers that promise carve-outs for low income or displaced neighborhood residents and jump through whatever available loopholes to avoid their responsibility. The politicians like to take a lot of credit for putting these stipulations in place and then disappear when it comes time to enforce them. If that weren’t the case, we wouldn’t be talking about this. I’ve never seen this issue ever addressed with honesty in its application. It’s maddening.
DA: I think it starts with being clear and unequivocal about what the city’s priorities are. Do we really care about protecting our vulnerable citizens and building a city with a beautiful tapestry of race and socioeconomic status? That’s what a thriving city is. Richmond holds a good deal of the power here. It’s a desirable destination. People want to live in this city. There’s no need to give up as much as we have in previous development deals.
The other side of this is that we need to be realistic. Developers are in it to make money. The city can make the basic functions of City Hall actually work to streamline the permitting process, leaving the developers to rely less on loopholes and stay on target. If we can get really efficient like our neighbors in the counties when working with developers getting their permits, getting the site work done, that’s money saved and everybody wins.
CD: I had this conversation recently with Garrett Sawyer. What is the problem in the permitting office?
DA: It’s operational efficiency, it’s execution.This is what separates me from the other candidates in this race. Trying to improve the delivery of services within the government is a really complex thing to do. There are principles that you can pull from the private sector, but in the public sector, there have to be different goals. The goals and process are different. The degree of transparency and how that impacts procurement are different. The ability to move employees is different. So all of that has to be taken into consideration.
So if we’re really serious about improving the delivery of services, you’ve got to have somebody who’s actually done that. In my career, I’ve spent 12 years leading a local health department and building a culture of improving the delivery of health services. In the last two and a half years, I’ve been running a $2.6 billion agency at the state level, with recognition that we needed to make huge investments in IT infrastructure. I think we forget that what we’re hiring in our next mayor is a CEO of a $1 billion public serving agency that has to deliver services.
CD: This is actually the number one of my biggest pet peeves. Services offered don’t usually match up to the services marketed. So many programs are behind so many locked doors, or broken doors – and down dusty, old dark hallways that lead into who knows where. It’s frustrating, and seems manufactured. Do we have someone watching these service programs? Holding their administrators accountable for their failures? I think the people that I speak to often enough about the subject understand that nobody’s perfect. We understand that there’s trial and error. But we have to have standards. How do you feel that the mayoral office can empower you to create efficiencies and build trust in the turnaround of taxes to services?
DA: Yeah, well, I mean, the reality of any organization is that it starts at the top. Ultimately, it’s an issue of leadership and accountability. And so the mayor, as the CEO of this billion dollar service distributor, needs to be clear about setting the agenda. That agenda has to include specific things like reducing the turnaround time on permitting office by 60%, for example. But then it is about how we ensure that we’re holding that division accountable to actually deliver. One of the things I’ve learned leading local and state agencies is that you do have to set explicit numerical, time bound goals, and hold people to them.
CD: What happens when it doesn’t happen?
DA: Well, when it doesn’t happen, we diagnose why. Sometimes the reason is that we have a really terrible IT system that hasn’t been updated in 20 years, and we have to address that.
CD: Why has that not happened? I’m sorry. I’m not going to get easier. I’ve seen high school students put together websites for fun. I’ve seen startups with not a dime in the bank put together social network style or co-working platforms, whether it’s Slack or something like it. How is it that we’re running a $1B service entity like the City of Richmond on the infrastructure equivalent of an old rusty bicycle? How can it be ignored that they’re riding a janky old bicycle, when it is obvious to everyone else? Just squeaking around with stacks of money falling out of their pockets in their struggle.
How do we fix that? Are there obstacles like contracts with people that we have to fill? What stands in the way of reinventing…
DA: I’m going to push back a little bit (or a lot) on the cost argument, because the reality is that public sector service delivery is held to a different standard than like the high school kids website right? You can’t roll out a crappy system, even though we-
CD: Let me stop you right there for a second though. You shouldn’t be able to roll out a crappy system for sure, I agree. The whole entire problem that we’re discussing is that that is exactly what’s happened and it’s exactly what keeps happening. Crappy systems. The standards are supposed to be higher but they consistently are much lower. You can’t just have someone casually go in and try to revamp the system. That’s fine. I understand that. And yet the people who do casually go in and reinvent systems yield much, much better results than what we’re currently getting through a system that demands higher standards.
So okay, I get what you’re saying. But the results are not – the proof is not in the pudding. So do we need to reevaluate what the standards that we’re expecting from the bidders, the contractors? I don’t mean to dumb it down but there’s clearly some disconnect. Finding that disconnect is important to changing a bad trajectory. Do you have any insight?
DA: I mean, this will feel like a tangent, but it’s not. I will say that one of the things we have not done well in tech delivery historically, especially in the government sector, is actually think about who has to use this on the other end. The rest of the tech world has gotten this because their bottom line depends on this, right? If they don’t make a system that works for the user, then no one’s gonna buy it. That is not true for government.
CD: That is not a higher standard. That is a much lower standard.
DA: It’s really problematic, right? Because it means that we’re going to continue to put out bad systems that aren’t serving the end user and and we’re paying for it. Not only are our tax dollars paying for it, but it also affects the quality of life for the workers we try to hire. We hire kids out of college to come work in our systems. And they’re like, my email works. My iPhone works. And now I have to use this ridiculous thing. I have to do eight different workarounds. Especially in the social services world, when I would go out to local departments, the constant refrain was “this system takes three times as long to do anything in it. And it takes my time away from the human being that I want to be serving.”
One of the things I’ve seen in my time leading in government is these are often super passionate, well meaning people who like public service. But we are not equipping them to be successful in these areas. So I think, again, that comes to leadership. Clear expectations, but also training and support. Do we have things in place so that people can be successful? We’re not going to all of a sudden be able to increase salaries by 20 to 30% to be more competitive with the private sector. It’s a little bit foolish to think that all of a sudden we’re gonna be able to compete better on salary and be able to recruit better talent
CD: Richmond is experiencing a surplus. We have a surplus. We’re talking about prioritizing. What needs to happen to get some app development whiz kid to decide to come to Richmond and work on city infrastructure instead of moving to San Francisco and make five times as much money? We have to get clever on how to do that, or take all this newly found wealth and let the city benefit from the growth that we’ve had. The demand for reinventing systems is strong.
You made the comparison earlier between the private and public sector. Sure, right. Where you’re a private company or you know, companies, they’re gonna be beholden to the public, but they’ll be beholden to their stockholders, shareholders. They don’t get four years. How long do you think they go with the people they have on a failed system before they kick everybody out? This is the conceit. I think that local governments, not just here, but around the country, they’re woefully wrong about that there’s patience embedded into their efforts. There is no patience. There’s none. How do we get the sense of urgency we feel across to city hall?
DA: Absolutely. I mean, that’s part of the role of the Mayor, right? Setting the agenda, bringing urgency. And I think that’s a significant part of solving the problem. Let’s take the permitting office. For years, we’ve been hearing about how slow permitting is. When we elect the CEO of City Hall, we need them to have that kind of business instinct and willingness to bring urgency and bring priority to decisions.
CD: Okay, I mean, I agree with you, you’re not wrong. And I think that’s step one. Of a 12 step process. What is standing in the way? Where’s the gatekeeper? Who’s holding the pocket book?
DA: Who’s got to answer that question is a combination of the Mayor and city hall and city council. Yeah. I think that what we’re seeing at the state level right now is a governor with a business track record who says he wants to improve operations and efficiency. But he cannot get on the same page with the General Assembly to figure out how to make the right investments to substantively and sustainably improve operations.
So the analogue here in City Hall is that the mayor has got to do the work to build relationships with the nine city council members to help them see what’s in it for them and their constituents and to really get on the same page. You know, Andreas and I worked together on a Code for America Initiative. We really were trying to streamline the eligibility process for free clinics’ reentry services. We came up with a pretty quality prototype, but to do that at scale for 230,000 users does take a significant investment. That’s where you got to bring in city council to say “this is gonna be a 50-ish million dollar investment. Are we willing to prioritize it?” And I think we’re in a day and age where the answer is, we have to.
CD: Things are getting more complicated and people are just drowning faster. The city is growing and expanding. It’s providing opportunities, but a lot of opportunities for people who are coming here and not so much for people that have already been here. The neglected are people that provide the infrastructure, that create the culture that gives the city its good reputation.
DA: Can I say one more thing before we move on?
CD: Yes, please.
DA: We’ve talked a lot about talent and leadership and accountability. I think another huge part of the movement of City Hall is culture. The way that we attract a millennial or Gen Z applicant to come to the city is “Hey, this is a great place to work because we’re making the city a better place to live.” Connecting with a mission and a team that is really about doing something positive. People don’t feel like we’re a part of an effective team that’s actually able to solve problems.
CD: I know the solution to this. I think the impression (in context) of Gen Z when we “Olds” think of them is give them a cool place to skateboard around the office and a foosball table, a gym they can go to, and have Friday pizza parties. No. Just pay them. They don’t care about foosball. They don’t care about the culture at the office. They’ll make their own culture there. Yeah. That culture is going to be based on stability. When you pay somebody enough money so they can actually be proactive about their personal life, their stress level is lowered. They can experience safety. Continuity. They can plan a family, buy a house, whatever the case is. Pay. Them. They’ll do the job. It’s not about meeting the highest standard. It’s about avoiding the lowest one. Thank you for your perspective on all that. I appreciate that. Sorry for berating you, haha. I hope my pushback on it is informative.
[EXHALE]
It’s been said that Dr. Fauci is the nation’s Dr. Avula.
DA
Hahaha, I love that.
CD: I wasn’t here during most of the pandemic, but you know, by the time I did get here in mid 2021, Richmond seemed okay. I was coming from New York so yeah, anything’s been better than what it was there. It was a low bar. But, you know, you’re one of the few people in the healthcare world I think, that really got some solid and consistent praise for the way that you handled the epidemic. So thank you. Sincerely.
What aspects of leadership did dealing with the pandemic crystallize for you? What did you get from that experience, besides grief? How did you grow through that situation?
DA: Let me tell you a quick Fauci story and I’ll answer that.
CD: He’s really tiny isn’t he?
DA: Haha, yes, I guess. It’s 2021 and I was walking out of a meeting at a public library. I was getting in my car in the parking lot and this lady was waving me down and walked over to me. I rolled down my window and she points to the roof of my car-
CD: And Dr. Fauci was up there?
DA: Hahah, no. I left my coffee mug on the roof. So she was just alerting me. I thanked her and smiled. I grabbed the coffee mug, but she’s looking at me, like, staring at me. I’m smiling at her. She says, “You look real familiar. Are you Dr. Fauci?” Which was amazing.
CD: That was the last thing I thought you were gonna say.
DA: Dr. Fauci was recently in Richmond for the Richmond Forum. I actually moderated that session, and got to interview him for an hour and a half on stage. I got to the dinner before the meeting and in front of about 400 people, I got to tell that story. He follows me, and opens his remarks with, “Ah, it makes so much sense why everybody was calling me Danny Avula!” He’s a very witty guy.
But to get to the question, what did I learn? First? The power of radical transparency. I think so much of what people appreciated about my presence in the media every day was just that I was super honest about what we knew, what we didn’t know, and how we were trying to make our best decision. That despite our limitations, we would provide the best guidance. People really appreciated that honesty and transparency. Over time, Richmond came to trust me. We’re what, three years removed from COVID now? I’ll still walk down the street and have someone I’ve never met before say “Thanks, doc. Really appreciate what you did!” I mean, it’s so gratifying. I think that response comes from building trust. We’ve got to restore trust in City Hall. We do that with radical transparency, accountability, and the effective delivery of services.
I think the second lesson was learning to come from a place of non judgment. When I transitioned from my local role as health director, really navigating Richmond and Henrico through the pandemic, Governor Northam then pulled me up to the state level to lead the vaccination response. We were trying to convince all kinds of people all over the state with very different perspectives to get vaccinated. While that was a much harder lift in some communities than others, I think the fact that I was willing to listen and try to understand their viewpoints was key. Providing the data for why it makes sense to get vaccinated while respecting their reluctance was impressive for those unsure of what to do. Some people will turn off, but the vast majority of people really appreciated it.
The third thing was connected to what I was saying earlier about the need to set priorities, to set numerical targets, and keep them in front of you. When I got pulled into the role, Virginia was 49th out of 50 states in terms of vaccine coverage. The next week, we dropped to 50th, out of 50.
CD: Ouch.
DA: Right. That was the beginning of January. Every day in the Situation Room in the Governor’s office, we had the numbers up on the screen. We were looking at that number not just because we wanted to be the best, but it was also causing political havoc to be 50th. Virginia shouldn’t be 50th out of 50 in anything. We’re much better than that.
CD: Being 50th out of 50 in this context means people are dying.
DA: Right. There was a sense of urgency that we needed to get better at this, immediately. So, everyday, we had the target on the wall saying “where are we now?” The hard work of partnering with and staying connected to faith communities, getting connected to the right nodes of leadership and marginalized communities, the most at risk of encountering misinformation, was crucial. We had amazing ambassadors, groups of African American pastors met with us, virtually, every week to learn about what they could do to help. By the end of several months of making those relationships strong, they were the ones raising their hand saying hey, “I’ll get vaccinated on camera. Hey, I’ll open up my place of worship to have a vaccination outpost.” And as a result of that partnership with the community and that persistence, we ended up in the top 10 in the nation for vaccination coverage.
CD: Congratulations! Great job. I mean that.
The whole scenario leads to a conundrum in leadership. During the pandemic we were faced with a very misinformed community. You can be informed properly and still have concerns, sure. You were dealing with a population that was deliberately misinformed by a targeted campaign to deceive. How do you bring people around? Whether they arrive at fallacies by faith/trust in an iconoclast, an opposite adamantine distrust in our pharmaceutical industry, the “knowledge” that an essential oil is going to cure cancer, or that a vaccine is somehow going to make children autistic, you have to be able to effectuate change in people’s opinions. How do you face intransigence?
DA: I’ll tease this out a little bit because the disinformation, I would say, was fundamental to all of this. Trust building, right? When I was out in parts of southwest Virginia and Appalachia, what helped me connect with people was actually listening to their stories. There were huge swaths of the community that were devastated by the rubber stamping of Big Pharma that caused the opioid epidemic. Devastated. They’d lived through that for ten to fifteen years.
CD: That is a great point. Yeah, nobody has ever brought that up to me. Wow.
DA: To many of them, this push with the vaccine felt like that all over again. The federal government rubber stamping Big Pharma to bring a “life saving measure” to them.
CD: Were you able to bring that comparison up to them?
DA: Absolutely, man. I think that lowered the barriers to help build trust. That gave me the opportunity to address the disinformation that was circulating in communities. I guess the point I’m trying to make is that by not just beating him over the head with a public health stick, and you know, “the data says this, you got to do this…” Listening to people’s lived experience helped me understand why they might be resistant in the first place. It opened the door to further conversation. We went out of our way to be able to have leaders in communities in southwest Virginia raise their hand and say, “Okay, that makes sense. I’ll host an event here or I’ll do a commercial with you. We had musicians and faith leaders and other influential people join with us in this push. It just takes a certain kind of leadership approach where you’re humble enough to listen to real people tell their real stories.
CD: You’re better than me at that. I spent the entire pandemic, like a lot of people, wondering about the mental capacity of people opposed to Fauci and the push towards vaccination. Disinformation doesn’t solidify into opinions without structures of trust underneath them. I never really considered the fact that trust was eroded into nothing in those areas specifically considering how the opioid travesty affected them. You showed them respect. I was making donkey brain comparisons and I am now sorry about that. It’s not hard to dehumanize people when you make no effort to see things from their perspective. I just learned something. Thank you.
DA: The next era of public health is going to have to figure out how to counter disinformation. To be honest about where that disinformation was coming from. The Center on Countering Digital Hate did a study over a two week period during COVID where they looked at Facebook, Instagram and Twitter. They tracked any COVID related content. They examined the context. They put it into a bucket of true, wrong misinformation, and then disinformation – wrong with intention. They found that 65% of everything that fell into this disinformation category emanated from 12 specific users. So there was this clear group of people who are trying to put this hate into the world. By uncovering that, you get to tell the story about a small, financially motivated, cabal putting this out there.
Fiction spreads a lot quicker than fact. The more that we tell these stories, the more we help equip people on how to consume media. That’s going to be part of tackling disinformation.
CD: That’s a hot upward battle. There are lessons you can pull from that experience into the mayor’s office. The idea of respecting someone’s base of knowledge and understanding that they didn’t come to it without a journey is very mature. I’m sure it translates as respect to people not often on the receiving end of it. Trust.
DA: I’ll give you a Richmond specific example. When I was health director navigating COVID – pre vaccination, I was so focused on addressing access issues. Our low income, black and brown communities had way less access to testing than the more privileged ones. Our health department was being very intentional about doing pop-up testing events in public housing and predominantly Latino communities.
Some of the early social media response to that was “don’t let the health department get you tested. They’re looking for ways to infect you with COVID!” Or “they’re looking for ways to give RHA the ammunition they need to evict you!” – because we were just going through this whole Public Housing Redevelopment fiasco. The Health Department thankfully had years of presence and relationship in these communities. One of the bodies of work that I’m most proud of as health director was that we built a network of clinics in our public housing communities in the previous decade. We placed eight different clinics around the city. We placed a nurse and a nurse practitioner within reach and started to hire residents of those neighborhoods as community health workers. By having a long-standing, sustainable presence in these communities, we had folks on the ground who had so much trust and credibility, we were able to cut through the disinformation like a scalpel.
CD: Dude. High five.
Find more information on Dr. Danny Avula and his campaign HERE
