HIGH COUNTRY — The High Country and the rest of the world have spent months grappling with the still ongoing COVID-19 pandemic. Lockdowns, masks and quarantines have been put into effect to slow the spread, which have been done with the hope of a vaccine, which is reportedly on the horizon.
November has seen pharmaceutical companies Pfizer, biotechnology company Moderna and others announce preliminary data showing vaccines they are working on were at least 90 percent effective, according to the Associated Press. Vaccines will have to go through the U.S. Food and Drug Administration before seeing emergency use in America.
As the wait for the vaccines continues, so does the spread of the virus. According to the North Carolina Department of Health and Human Services, North Carolina has seen no less than 336,775 total confirmed cases, with at least 5,034 deaths as of noon on Monday, Nov. 23. Since the start of the outbreak, the United States has had 58.79 million total confirmed cases and 256,803 deaths according to Johns Hopkins University as of Nov. 24.
Due to the uncertainty surrounding the potential vaccines, and others in development around the world, there is yet to be a definite timetable for mass use, but health officials are already planning for the eventual delivery.
“Vaccines play a critical role in preventing certain diseases and infections, and while there are still some unknowns about the COVID-19 vaccine timeline and distribution, we do know that the vaccine will be available for priority populations first with healthcare workers as the likely first group to receive the vaccine,” AppHealthCare Health Director Jennifer Greene said. “The news we are hearing now about the effectiveness of the vaccine is very promising and gives us hope that the vaccine will be an important tool to lessen the impact of this virus in our community.”
AppHealthCare noted in a statement that a vaccine likely won’t be available to the general public until spring, and in the meantime the health department will be working with emergency management and other healthcare partners in the effort.
App Regional Healthcare System offered its current plans concerning impending vaccines. The system began participating in statewide conference calls a few weeks ago with N.C. DHHS to discuss vaccines, according to Rob Hudspeth, senior vice president for system advancement at the ARHS. During this conference call, Hudspeth said that the hospital system was made aware that it could possibly be allocated 1,000 doses to be used for health care workers who work directly with patients.
According to the North Carolina Interim COVID-19 Vaccination plan — created by the Vaccination Planning Team and released on Oct. 16 — the state is taking a phased approach to who receives vaccinations. The four-phase plan breaks phase 1 into two parts: phase 1A allows the vaccine dissemination to include healthcare workers and medical first responders who are at high risk of exposure based on work duties or who are vital to the initial COVID-19 vaccine distribution; 1B will include vaccine dissemination to residents in long-term care settings such as nursing homes and adult care homes.
Phase 2 of vaccine dissemination will include people in congregate living settings (migrant farm camps, prison/jails and homeless shelters) who are younger than 65 or have one or no chronic conditions; frontline workers at high or moderate risk of exposure who have one or no chronic conditions; healthcare workers not included in phase 1; adults with one chronic condition identified by CDC/ACIP as increased risk of COVID-19 disease severity; and people who are 65 or older with one or no chronic conditions.
Phase 3 includes remaining frontline workers and workers in industries critical to societal functioning who are at higher risk of exposure and who have not been vaccinated as well as K-12 and college students. Phase 4 includes the remaining population of North Carolina, according to the North Carolina Interim COVID-19 Vaccination plan.
Logistics for how the vaccine is rolled out by ARHS depends on logistics such as which vaccine is approved by the FDA, how the vaccine needs to be stored, if the vaccine requires a follow up dosage and how many doses the hospital system is given, Hudspeth said. Hudspeth explained that Operation Warp Speed — a collaboration of several U.S. federal government departments — has selected three vaccine candidates to fund for Phase 3 trials: Moderna’s mRNA-1273, University of Oxford and AstraZeneca’s AZD1222, and Pfizer and BioNTech’s BNT162. Each potential vaccine requires different forms of storage. To prepare for one that requires storage at ultra low temperatures, ARHS has purchased a low-temperature freezer for the dosages.
ARHS is continuing to work with the CDC and N.C. DHHS to create plans for the administration of vaccines. For more information on the N.C. Vaccination Plan, visit tinyurl.com/NCVaccinationPlan.
Another healthcare partner will be Ashe Memorial Hospital, with CEO Brian Yates saying the hospital is working toward being ready for the vaccine’s arrival.
“While we await a safe and effective vaccine approval, we continue to work diligently to ensure we have processes in place to begin vaccinations when they are made available to us. Ashe Memorial Hospital has completed enrollment in the CDC COVID-19 Vaccination Program in North Carolina and looks forward to the launch of the NCDHHS COVID-19 Vaccine Management System,” Yates said.
Yates called the news of the vaccines’ development “encouraging,” but also noted that they will not be available to the public for some time. He said it was important to continue with efforts to slow the spread of the virus by wearing a mask in public, practicing social distancing and using hand sanitizer.
“Although many may be fatigued and overwhelmed by this virus, we must maintain our vigilance to prevent the continued spread of COVID-19 to protect our loved ones, friends and colleagues,” Yates added.
Drug stores will also play a role concerning a vaccine and are beginning to consider plans now.
Corey Furman, company president of Boone Drug Inc., said his agency is partnering with the CDC, AppHealthCare and N.C. DHHS on the roll out of vaccine administration, as those agencies are serving as liaisons for pharmacies. Furman said when the vaccine is made available, it may at first only be given to front line health care workers and patients with specific diagnoses that necessitate having the vaccine.
Furman was unsure if Boone Drug would be given the vaccine to administer to those groups, or only after it’s available to the public. Once the pharmacy has the vaccine and given the go-ahead to administer it, Furman said Boone Drug will likely enlist the help of its seasonal flu vaccine staff.
Boone Drug staff have had conversations of how it would handle the COVID-19 vaccination rollout. Would the pharmacy administer the vaccine in all of its stores and allow the public to walk in to receive the vaccine? Would staff allow community members to make appointments to get the vaccine, or would staff offer a system similar to its COVID-19 testing site at Horn in the West and offer a mobile vaccination site?
“Until we get a little bit closer and we find out the logistics of how the government is going to do it, we just can’t make a final decision yet,” Furman said. “We’ve run through seven or eight ‘what ifs.’ We’re ready for whatever the government throws at us. I can’t say definitively what it’s going to be until the government tells us exactly what to expect.”
Boone Drug Corporate Pharmacy Manager Spencer Hodges said the agency wants to instill in the community a confidence that Boone Drug will be prepared and ready to serve the public when the time comes to administer the vaccine.
“We’ve got a lot of folks putting in a lot of time, effort and resources into planning and preparing for that,” Hodges said.
Avery County government and the Toe River Health District have been coordinating a countywide immunization effort once a vaccine is approved for use among the general public. While there are still plenty of unknowns to consider and the county continues to await for guidance from the state health department, the county’s contingency plan is already in place.
“The good news is with the CARES Act money, we did buy two mobile crisis units that can go out into the community. It’s like a clinic on wheels, so we hope to have those in in time to help with this vaccination effort. They’re planning in Raleigh on how they’re going to roll this stuff out. We’re just waiting for guidance,” Avery County Manager Phillip Barrier said.
The crisis trucks are able to be hauled out into the community and serve the general public in a similar vein to how mobile blood donation units operate. Barrier said that based on what county health officials currently know about the immunization effort from the state, the first vaccine will be administered in a two-phased approach. After receiving the first dose, recipients will need to wait 30 days, wear a mask and quarantine before receiving the second dose.
“We’re going to be ready,” Barrier said.