Vaccine roll-out a long haul for Alamance County
“It’s a marathon not a sprint,” said Alamance County Health Director Tony Lo Giudice talking about the COVID-19 vaccine rollout.
Lo Giudice was candid about the obstacles the Health Department faces in getting close to 170,000 Alamance County residents inoculated against the coronavirus – inoculating the public from unrealistic expectations. Right now the biggest one is the meager 975 doses per week the state is allocating to Alamance County.
“There is still a trickle of vaccine,” said Julie Swann, head of the Industrial Systems Engineering Department at N.C. State and an expert in how health systems operate, “and high expectations.”
North Carolina got 60,450 doses for first shots of vaccine this week, according to the Centers for Disease Control and Prevention, and another 60,450 for second shots. Swann said that’s about proportional to the county’s population, about 1.6% of the state.
“So you’re getting your population’s share,” she said. “It sounds crazy.”
“It sounds like your local health department is going faster than others have.”
The Health Department’s goal is to administer 500 doses per day, depending on staffing, Lo Giudice said. That is 2,500 per week. At that rate, it could still take 68 weeks, almost a year and a half, to vaccinate everyone, so he pins his hopes on the supply increasing as soon as possible.
After starting with medical personnel and first responders, group 1a, the Health Department started vaccinating people 75 and older, group 1b, last week. Demand overwhelmed supply from day one, and the Department went to appointment-only vaccinations Friday. It took an hour and 20 minutes to fill the available slots, Lo Giudice said.
The Department scheduled another 300 injections for Monday, but Lo Giudice didn’t want to schedule much beyond that until the Department got its shipment from the state Tuesday to make sure the county got its full allotment. So far, close to 4,000 people have gotten the first dose in Alamance County.
“We can only give what we have,” Lo Giudice said.
With an estimated 8,000 to 11,000 local people in the 1b group, it could take a couple of months to get to all of them at 975 doses per week.
“That’s a lot of people to get through,” Lo Giudice said.
Those numbers don’t include the separate distribution to long-term-care facilities through CVS and Alpha XR, according to the state. That is a separate supply chain. According to the CDC, more than 4 million doses have been distributed nationwide, and 937,028 people have gotten their first doses through that system as of Monday.
Both the available vaccines require two doses. The Health Department plans to start injecting those doses on Jan. 25, Lo Giudice said. Those who have already gotten their first dose from the department should hear from schedulers in the next week about making an appointment for the second, according to Arlinda Ellison, the department spokesperson. There will be a separate site for second injections, Lo Giudice said, but he could not yet say where it would be.
Operation Warp Speed is holding back large amounts of vaccine for those second shots, Swann said. They are supposed to be 21 days between injections for the Pfizer vaccine and 28 days for the Moderna vaccine. While some public health experts recommend giving as many people as possible the partial protection of the first dose, Swann says that is risky. Too little is known about whether or not the vaccines would be less effective if the shots are four, five or six weeks apart.
The FDA does not support that so far either. President-Elect Joe Biden pledged 100 million doses will be administered in his first 100 days in office – an approach that could depend on there being enough production to replace the reserve doses.
The primary Alamance County injection site will stay at the Career and Technical Education Center on Buckingham Road for the time being, Lo Giudice said, but that will probably change in February, though, again he couldn’t say where yet.
Everything depends on production ramping up, Swann said. When that happens, Lo Giudice said, the Health Department will work toward expanding hours to vaccinate people on evenings and weekends outside standard working hours. That would mean having more staff, he said, which means more money.
North Carolina had administered 211,572 first doses of the 820,825 the CDC has distributed to the state as of Monday, according to CDC. That does not mean there are warehouses full of vials, Swann said, but they are in a complicated supply chain on their way into someone’s arm, and it’s like this in nearly every state.
“Everywhere is struggling,” she said. “The population needs to be patient. ... We’ll be wearing masks for months.”