Doubt, Bonus: A Surprising Southern Success

I'm talking with Greg Reap. I grew up here. Um so I've been here all my life other than little college time and uh and I got started at a young age. I got a chance to be in the intern, literally in the mayor's office here. Greg is sort of famous in these parts. He started his career writing grants at city hall in the county seat Warren. He worked to get roads paved and sewer systems installed in the

poorer parts of town. In the seventies, at thirty one, he became mayor, a position he held for nearly two decades until he left for a brief career in the Arkansas State Legislature. Bradley is still a dry county, and the most hopping place is Molly's Diner in downtown Warren. Where neighbors catch up over fried bologny sandwiches and grits. It's the kind of place where being mayor means you literally know everyone. We're sitting in Greg's son's downtown art gallery.

Greg can't help but regale me with a little bit of local history. The county, he explains, was named for Captain Hugh Bradley, an early settler of this part of the state, and the town has long been thought to be named for one of bradley slaves. A few years ago, some construction workers at the county courthouse uncovered a letter that appeared to be from Bradley son and confirmed the suspicion. We found that letter where Hugh Bradley Junior fled out,

said it, and it's still at the courthouse. I've been trained to give them the city to get it and you know, make some kind of permanent display in city hall. But I am here in this rural corner of Arkansas to investigate another local mystery. This one has to do with vaccines in Arkansas. We have chosen the path of personal responsibility. The state is wide open. We aren't mandating masks or vaccinations. We know what we must do and for the most part, our Kansans have done the hard work.

The big task before us now is to vaccinate more Arkansas. That's Arkansas Governor Asa Hutchinson talking about the major challenge facing the state. This was in July and the state's vaccination rate had stalled, while the super contagious delta variant was spreading rapidly and hospitals were beginning to reach capacity. Things were starting to look very grim, But there was one bright spot. There is good news and reason for optimism. One single county had met a goal he had set

for vaccination. More than of the population of Bradley County has been fully vaccinated. In the coming weeks. I expect more counties to reach that interim goal than I said, and then we can go up from there. When I heard about this, I googled Bradley County and I was kind of shocked. It's not the sort of place you would expect to be leading anywhere in vaccination rates. Bradley is not only extremely rural, but it has a size will black and Latino population, and a majority of people

there voted for Donald Trump in the last election. Those are all of the demographics we know are most often associated with vaccine hesitancy in America. When Bradley hit the mark in July, other counties in Arkansas had vaccination rates

of half that Bradley County was an outlier. I wanted to know why, and that is what led me here here to a creaky old rocking chair and Rob Reep's art gallery on Main Street in Warren, Arkansas, surrounded by oil paintings of local landscapes and fish and country cottages. It all starts with Greg Reep's wife, Beverly. It's been a tough few months here in the US. We waited for the vaccines, that life could get back to normal, and when the vaccine came, we got a glimpse of

that for only a very brief moment. Now we're in the throes of yet another wave of the virus. Masks are back, concerts are being canceled again. It's all a little too much like the movie Groundhog Day. And one of the biggest things keeping us here in this seemingly never ending pandemic is the number of people who still do not want to get vaccinated. Right now, about a quarter of Americans eligible for the vaccine are still holding out.

That number is not nearly good enough, especially with the ultra contagious Delta variant and an increasing number of cases among vaccinated people. The virus is a powerful invader, and right now they're just aren't enough of us armed to really fight back. One of the most crucial questions right now is how to get those people still holding out to finally get vaccinated. So I went to Bradley County looking for answers. I'm Bloomberg News health reporter Kristin B.

Brown for the Prognosis podcast. This is Doubt, Okay, So now we're back to the story of Greg and Beverly. We both grew up here in Warren, and she was about two years younger than me, but we literally met in school, but we actually kind of got to know each other. And there was a place right down the street down here that's a truck store now, but it was a dairy coming back in those days, and that's where all the school kids hung out. Boy meets girl.

Eventually they get married. Greg went into politics and Beverly became a history teacher at the local high school and middle school. Well, she went through a couple of generations of folks, you know, taught people and then talked her kids and even a few grandkids. I think before she she finally retired, Greg isn't kidding. I talked to several people and Warren who had had Beverly as a teacher themselves,

and then she taught their kids. People have a lot to say about her here, about how she made history fun, and especially about her legendary week long eighth grade trips to Washington, d C. This is how Michelle Weaver, a doctor at the hospital, put it. I think everyone knows Beverly read. She was my teacher. You know, she was my daughter's teacher and my son's teacher, and we all loved her. And she took a group of students to our in DC every year, and you know, really helped

mold people us into a well rounded adults. Beverly was a local icon. Two years ago she retired, and in March, she her husband, her son, and her daughter in law embarked on her dream vacation, a whirlwind five day tour of England and France and Christmas of two thousand eighteen. She sprung it on the whole family had a video there. She'd worked it out for the travel agency in the Little Rock and it's just was narrated telling us where we're all gonna go. We were all she set. They're

kind of astonished she had all arranged, all done. By the time the Reef family was ready to set off on that dream vacation, COVID was in the headlines. It was spreading in China and Italy, but in much of the world it still seemed like a far off threat. The Reefs were a little concerned, but there was no guidance against traveling abroad yet. We even talked to missing medical folks around here and they said, you just wash

your hands, keep everything clean. So in early March, off the Reef family went to London and Normandy and Paris and Versailles. She had a blast, and so did your son and daughter in law. And I'll have to bid Idea too. It was it was just kind of the trip of the last day. Meanwhile, in those early March days, COVID was spreading rapidly across Europe. Cases were starting to take up in the US, to new cases being reported in California, Oregon, Washington State, Rhode Island, and Illinois over

the weekend. The coronavirus has now entered a devastating new phase. The trajectory consider continues to go straight up. It's going straight up. That blue passenger on a flight that was traveling from New York to Florida last night has tested positive for coronavirus. This now makes the first coronavirus death confirmed in the US. The number of affected states cases

and deaths will continue to rise. The family touchdown back home on March twelve, the day after President Trump announced a thirty day travel suspension to most of Europe and the World Health Organization declared the coronavirus outbreak was officially a pandemic. I remember failing a little bit relieve when we got on the plane to you know it out and then didn't turn out some good. Later on, about a week after they returned home, Beverly started to feel sick.

She was also having a little trouble breathing. So with COVID now everywhere in the headlines, they decided to go to the local hospital. Greg says Beverly didn't seem that sick to him, but her illness quickly progressed. It was COVID. She had had open heart surgery. She had to beat this anyway. I mean, she's just struggled a little bit with it. But she was up in Gunman. I mean, it wasn't you know what. She was bedfast or something

like that. But we carried her to the hospital down here and they said, we'd think we'd better go ahead and get you the little walk and which is where are bigger hospitals and all they got her. She went to St. Vincent's up there and she stayed all thirty two days. I think for most of those thirty two days Beverly was on a ventilator. The family was quarantining at home. Greg and his son tested positive for COVID too,

Their daughter in law, Strangely, was completely fine. No one could go and see Beverly and she was too out of it to even talk on the phone. Greg called the hospital every single day for an update. It was the most difficult thing I've ever been through in my life. And what a't evis fault that I couldn't go in and seeing her, But it just was, it was just it was torture not really knowing how bad she was. And eventually the family decided to take her off of

the ventilator. Beverly's lungs weren't really working, and then her kidneys started feeling. She was in a medically induced coma, and doctors told Greg they weren't sure that she would ever wake up. Their family. Physician back and Warren pulled some strings so that Greg and his son could see her one last time. We had to put on space suits and the whole thing, but they did let us go in there and literally see her before she passed away.

You know, I was still, I guess I was praying for a miracle still that when they, you know, took her off a ventilator, maybe she would start, you know, getting better or something. But it she did didn't, And I don't know, I don't know how to explain it. On Saturday, a Beverly passed away at sixty three years old. The Arkansas Times and the Arkansas Democrat Gazette reported the news of Beverly's death, touting the role she played and helping young our Kanson see more of the world outside

of the state. Former students sent messages to the family about how she had touched their lives, and Bill Clinton, who knew the couple from the world of state politics, called Greg with his condolences. Gregg told me that initially he blamed himself for letting the family take that trip, but they couldn't have possibly known what would happen. None of us did. It was so early in the pandemic, back before anyone was wearing face masks or social distancing

or even calling it a pandemic. Beverly was only the thirty six death in Arkansas at the time of her passing. There's still weren't very many cases there at all, especially in the rural parts of the state and urban areas. People spend a lot more time in crowds moving from place to place in city to city, but in areas like Bradley County people are just more isolated. But this tragedy would have a silver lining. The impact of Beverly's death would be far greater than Greg could have ever imagined.

You know, people liked her, loved her, appreciated her, and for her to die, uh and she just retired. I think it really called the attention to a lot of people. This is Dr Kerry Pennington. Like most people here, he has lived in Bradley County almost his whole life. One of his ancestors was actually a founding settler of the county, and for decades now he's been just one of a few physicians in the area. He told me, Beverly's death

shook the whole county. Some people even blamed the rep family for bringing the virus to this part of the state and launched attacks at them online. But as the story of Beverly's battle with COVID spread in Bradley County, the main impact was that people started to take the virus very seriously. They had heard about Beverly's month on a ventilator and how hard it was on the Repe family. This was someone a lot of people here knew and cared about. Her story had an impact before the pandemic

could become so politicized. The people of Bradley County. We're paying attention, you know, people will talk about it, and people would come in shop. And then over the next two or three months, as more people got it and more people to add, it just became more a large awareness that this was serious. Most people know what's going to own and uh, it's not like Little Rock or l A, where you know there may be sixty year seventy people die when that set of down the last week.

But he was talking about Dr Pennington is why I came to Arkansas in the first place. I had read about Bradley County and called him up asking what was going on there. He told me about Beverly and said that he thought her death was a major factor and why people there were getting the shot. And then when the vaccine became available, they were aware and smart enough, I think, to realize that they need to do get it. But Beverly is really just the start of this story.

When I got to Arkansas, it became clear that Dr Pennington was kind of selling his own role short. If you're trying to stop the spread of a deadly virus, there are actually some advantages to being in a rural community like Bradley County. Social distancing, of course, is sort of naturally built into your way of life, but more importantly, everyone knows each other. As we've talked about throughout this series, trust is really a single most important factor in getting

people to vaccinate. Misinformation certainly doesn't help inspire people to get vaccinated, but it often isn't the root cause of someone's hesitancy. Distrust makes that misinformation seem way more believable. The pandemic has made a whole lot of people more mistrustful of what the public health establishment has to say.

But if you went to high school with the local physician or the widower, but COVID victim was a chaperone on your eighth grade trip to d C, we were way more likely to believe them when they say vaccines are good. When the pandemic hit, the public health community in Bradley County immediately understood how crucial the role that they would play here was MC how's it going good? Looking for more answers. I visited the local hospital. It's really small, it only has beds there. I talked to

Michelle Weaver, who we heard from earlier. She's the county public health officer and a doctor at the hospital, and she says, everyone in the medical world and Bradley really joined forces as soon as we found out about COVID. I mean, we knew that it was coming to the US, we knew it was happening. Um we myself and some others we all got together and we made it like a group. And so at first we met I hope to get but before COVID hit here, we all actually

all met one room. And after that first meeting decided that was a bad plan. I didn't think so many people from the community would show up. We kind of invided everyone, but um, the superintendence of both of the schools in this county came, you know, the police officers came, the fireman came, the head of the hospital came. You know. So you know, myself is representing the physicians in the area and UM, our mayor a big part of trying

to make sure we get accurate information. UM and we all met together in a room as a big group to say we're going to come together as as one and support whatever we need to support to keep our county healthy. So that's kind of where it started. Dr Weaver said she and other doctors in the area were constantly texting to make sure everyone was on the same page about everything. They started a Facebook page to update

the community. She would even post videos with helpful tips, like how to handle your teenager who was sick of staying home. They actually can be around their friends, but they should not be in close proximity or in large groups. UM. If they want to have a friend and they go and they keep their distance and they go fishing. UM. Those are kind of things. And when the vaccines rolled out,

there was a concerted push to get people vaccinated. When I visited the hospital, Dr Weaver told me that just that morning she had tried to convince a nurse to get the vaccine for her teen son. She didn't know whether their talk had been successful, but she said her approach is always rooted in empathy and patience, even though it's obviously really frustrating that even colleagues at the hospital

were questioning vaccines. If you get angry with people, you're going to get netwhere like if you go, oh, you're oh, you're a native and that doesn't work, you know. And so I've had arguments, and I don't really call them arguments discussions. I think that two logical adults should be able to sit down and have a discussion, and I should be able to say, you know, here's the facts about vaccine. Dr Pennington and his colleague Dr Joe Wharton sent nurses to vaccinate the football team at the high

school and eventually also the entire eligible student body. The local state legislator, Jeff Wardlaw, invited Dr Pennington to talk to the staff at a center for disabled adults who are highly hesitant. Greg Reep and his family spoke out in the press and the community urging people to get the vaccine, and Tyler Staton, who runs a pharmacy in town,

made it his personal mission to get everyone vaccinated. He says, at first the vaccines apply couldn't match the demand, but when that initial demand waned, he started his own efforts to bring vaccines to the people. I've gone to the nursing homes. UM. I've gone to home visits to help people um that can't get out and can't get a ride to come and get a vaccine. We've gone to manufacturing plants. UM. We have a couple of hardwood flooring

plants here in town. We have um uh one that create manufacturing timbers and stuff like that to their plant, and it did vaccines that go on a monthly basis to some of those places. Tyler says his governing philosophy was to make sure that people had a few excuse says as possible to not get the vaccine. I mean some people may not get off until after we close, it says, you know, and other stores, the big chains may not have availability or they may not be able

to get their shot there. You know. It just I tried to be flexible because I wanted to help the community. And and that's what we've done, and all of our pharmacists have done that to fless and be able to vascinate. And it was a collaborative effort, nurses and pharmacists working together. Um, the doctors were still running their clinics, but they'd send their their nurses to come help vaccinate, and pharmacists from

from the local hospital she came with help me. So you know, it was a collaborative effort between all of us to try and get people have vascinated. Okay, so I'm guessing you're starting to get the picture here. It could almost be the plot of a feel good movie. The death of a beloved small town teacher spurs the community to band together against the a to defeat the evil virus. But how does that have anything to do

with the rest of us? So before I go any further, let me first just say that Bradley County is not perfect. There are still a lot of hesitant people there and the latest surge of the virus has led to rising cases there like everywhere else in the state. But still today it is among the most vaccinated counties in Arkansas.

According to the CDC. So far, more than sixty seven of the population over age twelve has been vaccinated with at least one shot, and its early success in vaccinating did buck the trend of similar regions across the country. If you just looked at the demographics of Bradley, you would expect the vaccination rate to be way lower. It turned out that there were a lot of reasons for why it was doing better. It kind of did everything you were supposed to do to convince people to get

a shot. I think this underscores the power that local leaders at the community level can have in in convincing people to vaccinate. This is Matt Modem, a political scientist at Oklahoma State University. We also heard from him an episode four. Now, the way you don't want that to happen is by people getting sick and potentially dying and

having that be the motivator for people. But it does underscore that when there's a trusted member of the community who lots of folks know, who lots of folks like, that really hits home for people. The very personal nature of this pandemic, these personal appeals talking about the risks that one face and and the the experiences they've had

with the disease can be motivating. Uh. And so when you have that happening at a local level to people that are widely known, to people that are widely trusted, you absolutely have the ability to to get people um out and vaccinating in response. I know this probably seems like common sense. Of course, it makes a difference to have local figure heads out there supporting vaccination and talking to people on a personal level. But the thing is,

this just isn't happening right now in most places. Too often, when people have concerns about vaccines, instead of being taken seriously, those concerns are just brushed aside. People are just expected to be logical and do the right thing, when in fact, if you stop to think about it, there is something totally, just inherently weird about getting an injection with the genetic material of a deadly virus. Too often, the approach is

to find a war of feelings with facts. People wind up feeling ignored and disrespected, like no one cares about how they feel. This can send people on the fence about vaccines right into the arms of the anti vaxers who are working hard to spread rumors and conspiracy theories.

A steady erosion of trust as guidance and policies have flip flopped throughout the pandemic has exacerbated this, and in fact, some leaders have even stoked those concerns in recent months, like the governor of Missouri, who suggested in a tweet that went viral that President Biden's efforts to go door to door to get people vaccinated we're not a welcome in estate. Efforts to get local leaders out there, connecting with the commune city and promoting vaccination are just not

that widespread. Here is where Bradley County offers its most important lesson. Beverly Reap's death touched everyone there. She was beloved, but it was probably what the local leaders and the medical community did after her death that helped get those shots into arms the most. I think the power, especially at the local level, of these personal appeals, finding members of the community who are willing to share their stories

and then and then going public with them. I think that that's potentially a very effective way to do this. That is something every community can replicate. We know what works here, and we just aren't doing it. Tim Callahan, a rule health expert at Texas. A and M says that this has helped fuel an increase in anti vaccine content reas only we aren't necessarily seeing um widespread efforts

to have those trusted messengers developed. We aren't seeing concerted efforts to have those champions out in public, to identify these champions, to fund the champions, give them the resources they need to promote vaccination, and simultaneously, over the past several months, we've seen growing anti vax ratoric as opposed to decreasing anti vax rehdor these lessons are really important

right now. The delta variant is scary and how contagious it is, and that may have moved a lot more people to go and get the job, but there are still a lot of holdouts, and those holdouts will keep the virus circulating for the foreseeable future, leading to more infections among both vaccinated and unvaccinated people alike, as well as potentially new, even scarier variants of the virus. Bradley County was lucky and that all of this happened for

them before COVID became so political. People there were already on board with efforts before anyone was protesting mask mandates or questioning Biden's plan to go door to door to get people vaccinated. More recently, a lot of those protesting voices have begun to change their message after months of promoting conspiracy theories and vaccine misinformation. Tucker Carlson encouraged people

to get vaccinated, so did the governor of Missouri. In Arkansas, Governor Hutchinson has always encouraged people to get the vaccine, but he's been very careful to not sound like he's forcing it. His calls for action have become louder lately, but Tim says, in many places, the damage has already been done. We've fallen behind in our efforts to reach people.

By following the lessons of places like Bradley County, we can definitely get more shots into arms at this point, though a radical change the way we approach vaccine messaging probably isn't enough. I think we need to recognize that a lot of the efforts that can be done from a promotion perspective, from an incentive perspective, have been done. Should promotion efforts continue, absolutely um And I think some of those promotion efforts that need to happen, they need

to be more targeted. They need to be targeted at the groups that are most likely to be vaccine hesitant. Tim thinks that we might be at the point where mandates are necessary to get us to the level of vaccination that we need. Unless there's something that's going to force individuals who are not going to be motivated by promotion campaigns to vaccinate, we're going to have struggles to get to that sort of seventy percent or higher threshold in many states across the country. I asked him whether

he was feeling optimistic about any of this. He said, it's a mixed bag. And the one hand, you know, I'm I'm glad about the progress we've made so far. If you had told me that the start of the pandemic that by this point we would already have vaccinated over the population against the virus, that would have been incredible, right. However, you also have to realize at the same time just how far we have to go and how much harder convincing the rest of the public to vaccinate is going

to be than it was to convince that first. We've in one sense, we've done the easy part. We've got everyone who is easily movable to vaccinate. Now, he faced the hard challenge of convincing the rest of individuals or forcing the rest of individuals to vaccinate. Back in Broadley County, there are still plenty of holdouts. Greg Reap told me that he has been telling everyone who will listen to

go and get their shot. Once the vaccination started being made available, of course, we were urging everybody to get vaccinated, which just it just doesn't make any sense not to you care about yourself and your family. And the months since Beverly passed, Greg's son and daughter in law got pregnant with their first child. Gregg told me he's really heartbroken that Beverly won't get to meet her first grandkid. He really misses her. The past year and a half

has just been unbearably hard. You know. I just want people to do everything they can do to protect themselves, and that starts with the vaccinations, and then they steal especially the things that as they are right Neil right now, need to you know, protect themselves. Where wear the mask? Ok, maybe it maybe I'll help you. But Greg says his one source of comfort is that just maybe Beverly's death had an impact. Maybe their tragedy helped to protect other

people helped them decide to get their shot. Doubt is written and reported by me Kristin V. Brown. Magnus Hendrickson is our senior producer. Our theme was composed and performed by Hannis Brown. Special thanks to Rick Shine, Tim Annette and Top for Foreheads. Francesca Levie is the head of Bloomberg Podcasts. Be sure to subscribe to Prognosis if you haven't already, and if you like our show, please leave us a review. It helps others to find out about the show. Thanks for listening. M