Gov. Roy Cooper has mobilized the state’s National Guard to help with North Carolina’s vaccine effort that is showing delays and logistical challenges just a few weeks into the distribution.
“Ensuring COVID-19 vaccines are administered quickly is our top priority right now. We will use all resources and personnel needed,” Cooper wrote in a tweet Tuesday.
The N.C. National Guard has started to form six-member “immunization strike teams” that will travel the state to work at COVID-19 vaccine sites “to help North Carolina get needles into arms,” Brig. Gen. Jeff Copeland said Tuesday.
The Governor’s Office didn’t provide additional details, and the National Guard didn’t say how many members would be activated. Cooper’s office referred questions to the National Guard spokesperson Lt. Col. Matt DeVivo.
DeVivo said details are still being worked out but that the Guard is working with the N.C. Department of Public Safety and Department of Health and Human Services on “how to best deploy Guard personnel and resources that are mobilizing.”
Cooper’s National Guard activation comes as data from the Centers for Disease Control and Prevention shows that North Carolinians are receiving their first dose of vaccine at a slower rate than much of the rest of the country. The state’s rate of 966 vaccinations per 100,000 people, as of 9 a.m. Monday, was the sixth lowest in the country.
Dr. Mandy Cohen, the state DHHS secretary, told The News & Observer that some of the state’s health departments and hospitals have used all of their vaccine allocation, while others are grappling with issues ranging from data entry to information technology issues to not having enough staff to actually administer vaccine.
“We’re two-and-a-half weeks into this, and I know folks are working hard, so I do expect us to really speed up over the next number of weeks,” said Cohen in an interview Tuesday afternoon. “And from the state perspective, our job is to support our local partners in their efforts to do this hard work, and I think that’s what we’re going to do.”
As of 8:30 a.m. Tuesday, 109,799 North Carolinians have received the first dose of a COVID-19 vaccine, according to data released by the N.C. Department of Health and Human Services. Both Pfizer and Moderna vaccines that have received Food and Drug Administration emergency use authorization require two shots to be fully effective, and 461 people statewide have been given both shots.
DHHS cautions that the data is preliminary and reporting can lag by as much as 72 hours. The state only reports updated vaccination data on Tuesdays.
An additional 13,338 people who live or work at long-term care facilities had received first doses from CVS or Walgreens through a partnership with the federal government. The pharmacies have received 165,990 doses of North Carolina’s total allocation.
Cohen said it’s possible that more people have actually received vaccine, since some health departments are struggling with data entry. Vaccines administered through CVS and Walgreens also isn’t included in the state’s vaccine dashboard.
“Another place where we’re trying to work to understand really what is happening on the ground is, is the vaccine really administered and it’s just not in the system?” Cohen said.
Initially, DHHS distributed vaccine based on the population of the recipient county, how many acute care and intensive care beds the county had and whether facilities had freezers that could reach the ultra-cold temperatures required for the Pfizer vaccine.
Beginning next week, though, DHHS will also consider how many doses a health department or hospital reports has recorded as given in the state’s vaccine management system.
“We will allocate our vaccination supply to those facilities who are in need because they are effectively administering vaccines. Further, this data may be considered by the CDC in determining how to allocate constrained supply to the states. So, any location’s failure to provide accurate and complete data can impact the vaccine supply to the entire state,” wrote Amanda Fuller Moore, a pharmacist in the state’s public health department.
By the end of this week, 583,850 “first” doses of vaccine, as well as 85,800 “second doses” of the Pfizer-BioNTech vaccine will be allocated to North Carolina.
The CDC released Tuesday the allocations for the week of Jan. 11, which include 61,425 first doses and 61,425 second doses of the Pfizer vaccine, as well as 60,800 first doses and 175,900 second doses of the Moderna vaccine.
NATIONAL GUARD ROLE
This is the fourth week of a national distribution of vaccines, and states across the country have reported logistical challenges in ensuring the vaccine is available to those who should get it next.
The rollout is happening as the pandemic is rapidly accelerating, both statewide and beyond, with record numbers of people in the hospital for COVID-19.
Last week, North Carolina officials announced an update to the state’s vaccination plan. Anyone who is at least 75 years old will be in the first group of the state’s updated Phase 1b, The News & Observer reported. Next eligible for vaccine will be people who are at least 50 years old and working as either health care providers or frontline essential workers.
The National Guard teams are expected to work at least into April, working down the list of groups as they become eligible, Copeland said.
Copeland said the teams will work in urban areas with large medical facilities as well as in underserved rural areas. He provided details Tuesday afternoon, after Cooper’s announcement, during a live town hall event on Facebook with a panel of NCNG leaders.
Teams will consist of two combat medics and four administrative support members, Copeland said, with the medics administering the shots and the support staff entering patient information into computers and managing logistics.
The National Guard will give the two-step Moderna vaccine, which unlike the Pfizer vaccine, doesn’t require deep-cold storage, from supplies acquired by the U.S. Department of Defense. Vaccinations will be prioritized using the systems established by DoD and the state Department of Health and Human Services, Copeland said.
National Guard soldiers and airmen who have been summoned to duty for the COVID-19 response will able to get vaccinated first, along with Guard members who are actively working in health care, other essential Guard personnel and some senior leaders. Copeland said vaccinations are expected to begin on Thursday.
Guard members are not required to get vaccinated, panel members said, because the vaccine was authorized under emergency use provisions. That could later change.
LOGISTICAL CHALLENGES
Some counties are expected to start rolling out vaccine this week to people in the 1b phase, starting with anyone who is at least 75 years old. But Gaston and Mecklenburg counties have reported that vaccine registration hotlines have faced difficulties, The Charlotte Observer reports.
In Mecklenburg, county officials warned that some people haven’t been able to get through because of the high number of calls and told people to book online if they can’t get through. Gaston officials told residents not to leave more than one voicemail trying to make an appointment.
The Lee County Health Department announced Tuesday morning that it would start vaccinations for all groups in Phase 1b at 9 a.m. Those interested could call one of two phone numbers. By 5 p.m., though, the county had curbed the vaccination to just Group 1 of Phase 1b — people who are 75 years or older.
“The department expected a significant interest in the community for the COVID-19 vaccine, but our staff has been overwhelmed by the volume of calls today,” said Heath Cain, the Lee County health director, in a statement. “As such, we knew we had to adjust our plans to better serve the community.”
Other counties don’t anticipate moving into Phase 1b until next week at the earliest.
“Some places are ready raring to go and are starting to vaccinate 75 and up, that’s great,” Cohen said. “Others are still working on their healthcare workers and are not quite ready to move into 1b yet. That’s OK. So there is going to be a little bit of difference on the ground as we go.”
People who are at least 75 years old should call their local health department or hospital to see if vaccine is available where they live, Cohen said. Even if they are not taking vaccine appointments just yet, they likely will be over the next couple of weeks.
DHHS plans to launch a hotline this week that people can call to learn about the vaccine and to better understand where they can seek out a shot. The DHHS hotline will not be used to book appointments, Cohen said.
Wake County officials have warned that the large number of healthcare workers in the county means it will likely take them longer to move through Phase 1a than many other places in the state. Phase 1a includes vaccinating frontline healthcare professionals and those who work with COVID-19 patients as well as people who live in long-term care facilities and nursing homes.
Wake County has not yet decided how people will be able to sign up for vaccination slots, but hopes to finalize the process this week, Leah Holdren, a Wake County spokeswoman, wrote in an email to The News & Observer Monday.
“We can’t stress enough how little vaccine there is for the population of Wake County,” Holdren said. “Right now, there is not enough vaccine to move to Phase 1b just yet.”
North Carolina legislative leaders, asked to comment on the National Guard’s new role in the vaccine distribution, said the state’s plan would be discussed Jan. 12 at the N.C. General Assembly’s Joint Legislative Oversight Committee on Medicaid and N.C. Health Choice.
Speaker Tim Moore’s office said in a statement that his office is “working with health committee leaders to ensure this oversight meeting addresses concerns with the distribution expressed by state lawmakers and stakeholders.”
Sen. Joyce Krawiec, a Winston-Salem Republican, added in a statement: “There are a number of questions about vaccine distribution planning and execution, and we hope that some oversight will result in improvements and advance everyone’s shared goal of vaccinating all who want it as soon as possible.”
There are 435,000 people who qualify for vaccine in the first group of Phase 1b, according to a DHHS memo, meaning they are at least 75 years old.
The state health department also estimates that there are another 875,000 people who are eligible to receive the COVID-19 vaccine in groups two and three of Phase 1b. Those include an estimated 583,000 frontline essential workers and another 292,000 healthcare employees who work directly with patients.
“For future phases, supplies are very limited and will likely continue to be for the next several months. States are informed about their allocations weekly, so we cannot predict the timeline for each phase,” Catie Armstrong, a DHHS spokeswoman, wrote in a prepared statement.
TRIANGLE PREPARATIONS
Orange County is trying this week to wrap up Phase 1a and hopes to enter Phase 1b early next week, said Todd McGee, a county spokesman.
But many details of what that entails have not been explained.
North Carolina has launched a COVID-19 Vaccine Management System that can be used to determine eligibility, but McGee said questions remain about whether recipients are supposed to register with it or only providers.
Orange County’s plan includes reaching out to people at least 75 years old who are eligible under Phase 1b, but McGee said he doesn’t know how the county would develop that list.
Health departments and hospitals likely will provide the next phase of vaccine in Orange County, but McGee warned that public health workers across the country will need help with the vaccine effort.
“The expectation that county health departments can manage that is ambitious,” McGee said. “The more people we have who can give the vaccine should also help us pick up the pace.”
McGee pointed to the federal government’s lack of involvement in vaccine distribution to explain the lack of details, which has resulted in a state-by-state and county-by-county effort.
“It just seems like it would have been much better off if there were a lot more thought given to this months ago to set this up months ago,” McGee said.
Copeland noted that the N.C. National Guard has been involved in the response to COVID-19 since the pandemic hit, helping out with the distribution of PPE, making food bank deliveries and running testing sites. That’s in addition to the Guard’s normal training and duties.
Guard members who work as civilians in the medical field will not be called up and assigned to the strike teams, Copeland said, because they are needed in their community hospitals and medical centers.
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