Wednesday, March 3, 2021

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The vaccine rollout shows that expanding internet access is a matter of life or death

The pandemic has highlighted the digital divide, especially among children across the U.S. forced to learn remotely — and the vaccine rollout is putting an even brighter spotlight on the number of Americans without internet access.

Many elderly, low-income people and communities of color aren’t getting appointments because cities require them to register online, according to Nicol Turner Lee, director of the Center for Technology Innovation at the Brookings Institution.

“What we're seeing in the vaccination rollout is similar to what we saw with the breakdowns of providing remote learning to school-aged students,” she said, “where we as a country are just not fully prepared to migrate our government services to an all digital platform.”

It’s not a small problem. According to Gigi Sohn, distinguished fellow at Georgetown Law Institute for Technology Law & Policy, tens of millions of Americans don’t have broadband access because they can’t afford it.

“And then, of course, people in rural areas don't even have access to broadband infrastructure so even if they could afford it, there's no network to connect to,” she added. “So it's a huge issue.”

So how do we get people vaccinated if they don’t have internet access? While the FCC recently approved emergency $50 per month broadband discounts for certain Americans, others in rural areas may be out of luck, at least in the short-term.

“I think, in the interim, if we're going to be reliant upon digital platforms to enroll people in vaccination scheduling, that it's important that we meet people where they're at. And that means either meeting them with a computer or meeting them with a syringe,” Lee said.

The digital divide is clearer than ever

It’s difficult to know exactly how many Americans lack internet access. Acting FCC Chairwoman Jessica Rosenworcel has written that the FCC often underestimates the number of Americans with broadband. While the FCC has said it’s just 18 million, she believes the number of Americans without high-speed internet could be closer to 100 million.

According to Dr. Kim Rhoads, associate professor of epidemiology and biostatistics at the University of California San Francisco’s School of Medicine, people who lack internet access could miss out on receiving vaccines.

“It's going to be the people who don't have access to technology, don't have access to Wi-Fi, and who have to do it by phone, where maybe you're going to be on hold forever, those are the people who we're going to see not getting vaccinations...disproportionately,” Rhoads said.

That, she said, tracks with the same kind of disparity in areas like San Francisco’s poorer neighborhoods, where despite being the tech capital of the world, tens of thousands of residents don’t have access to affordable, reliable high-speed internet.

According to CDC data available Wednesday, 65% of the 51.7 million Americans who have received at least one of their COVID vaccine shots were white. Only 8.5% were Hispanic/ Latino, while Black and Asian Americans made up just 6.7% and 4.8% of those vaccinated, respectively. According to a Pew Research Center report from 2019, while 79% of whites have access to broadband internet, just 66% of Black and 61% of Hispanic respondents said they had such access.

Available internet access doesn’t explain the totality of that disparity, but with vaccine appointments largely available online, it’s certainly not helping.

So why does the government make appointments available only online if it creates a disparity? In part, because the internet helps get as many people vaccinated as quickly as possible. But that inevitably leaves behind those who don’t have readily available internet access or can’t afford it.

That is especially dangerous for communities of color, which have been disproportionately impacted by the pandemic and its fallout.

While the new subsidy will help those with available internet access, individuals in rural locations will have to wait some time still before they can get online because services providers need to build out their networks. By the time those networks are built out, hopefully, the pandemic could already be over.

Confusion and canceled appointments

The lack of internet access isn’t the only technical problem getting in the way of people finding vaccine appointments — glitches have plagued the rollouts across various states, and there’s often a confusing array of websites.

In New Jersey, software offered by Microsoft (MSFT), which was contracted to help with vaccine appointments, was blamed for double-booking or canceling appointments, and system crashes that took entire vaccine sites offline. Even those who called in to make appointments faced difficulties, as phone lines also went down. Microsoft has said it’s been addressing the issues.

In New York, my own friends and family have been unable to navigate the array of different websites set up to help residents book their appointments including those provided by the state, city, and local pharmacies. And while state and city sites provide a means for multiple groups to receive vaccines, including those with preexisting conditions, pharmacy websites run by the likes of Walgreens limit availability to individuals 65 and older.

While I qualify to receive a vaccine now, I couldn’t find an appointment using New York’s system. Every day for a week, I checked for appointments but never had any luck — and using the internet is my full-time job! A physician I know finally took my personal information and booked the appointment for me. She’d become familiar with New York’s tricky appointment system and gets a little rush every time she’s able to nab one for somebody who needs it.

Not everybody is so lucky. Many people with jobs that don’t require them to sit in front of a computer simply don’t have an opportunity to hit “refresh” every few minutes until they find an appointment. According to Rhoads, one solution to the problem could be better communication between health departments and low-income residents. If, for example, they have a window explaining when new appointments become free, that would eliminate the need to stay online waiting for a web page to refresh with available slots.

In the end, though, we may just need more health workers out in the field, meeting those who are the most vulnerable to COVID where they live. That would help get more of those Americans with limited broadband access vaccinated faster.

And when the crisis is over, the task of ensuring those without connectivity can access it should become the government’s next top priority. It’s clear now that the internet has become not just a utility but also a human right that could mean the difference between life or death.

By Daniel Howley, tech editor. Follow him at @DanielHowley