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By Anne Blythe

North Carolina is opening up COVID-19 vaccine eligibility to people who are 65 and older and simplifying its equitable distribution system in an effort to speed up the administration of the limited supplies allotted to the state each week.

Mandy Cohen, secretary of the state Department of Health and Human Services, announced the changes on Thursday during a briefing with reporters.

The adjustments to its multiphase distribution plan come two days after the Centers for Disease Control and Prevention changed its guidance to states.

“Because the supply of the vaccine is limited, we have prioritized getting people who are at the highest risk of being hospitalized or dying and those at highest risk for exposure,” Cohen said. “Starting today to align with the new federal priorities and to facilitate speed of the vaccinations, vaccine providers that are ready to, can expand to now vaccinate all health care workers and anyone who is 65 years and older.”

The state’s plan gives flexibility to local providers such as the hospitals and county health departments to open the vaccination process to the next priority group.

Some health departments might have booked appointments for the weeks ahead for people who are 75 and older and will likely not have enough vaccine doses or slots open to immediately immunize all health care workers and people who are 65 and older.

As of Thursday morning, Cohen said, 326,198 doses of the Moderna or Pfizer vaccine had been administered across the state out of the 358,000 doses of Moderna and 348,075 doses of Pfizer vaccines allocated by the federal government as of Wednesday, but not all yet received by the state.

The state has given 168,000 of those doses to pharmacy giants CVS and Walgreens to administer at the state’s long-term care facilities. A CVS representative told lawmakers earlier in the week that the company planned to have doses administered in nearly half of the 900 nursing homes and long-term care facilities in the program by the end of this week. The remaining long-term care facility residents and staff who accept it should be vaccinated by the end of January, he said.

In developing a vaccine distribution plan, Cohen tapped a North Carolina COVID-19 Vaccine Advisory Commission convened by the North Carolina Institute of Medicine to offer input and recommendations.

In addition to offering the state’s older and most vulnerable residents a first shot at the shots, the commission encouraged the state to ensure vaccine access to communities of color, particularly Black and Latinx residents hit disproportionately hard by COVID-19.

The plan called for getting vaccines distributed to each of the state’s 100 counties with initial allotments coming at the end of the year amid the Christmas and New Year’s Eve holidays.

Some county health department workforces were stretched thin at that time and with the vaccine allotments came the task of figuring out a new data entry system that helps the state track how many shots have been given and where.

“We are hearing that folks are having some data entry issues,” Cohen said.

The underlying system built by the state is working, Cohen argued, and a testament to that is that more than 300,000 doses have been logged.

“We recognize that it takes effort to put the data into the system and that means people and time,” Cohen said. “That’s what we want to be here to help with.”

Where are large vaccine events?

Earlier this week, Cohen faced tough questions from state lawmakers about the bumpy vaccine rollout that North Carolina has experienced just as many other states have.

Cohen and Gov. Roy Cooper have said they want to accelerate the administration of vaccines. They have enlisted the help of the National Guard, as they are already doing at the Forsyth County health department and through Albemarle Regional Health Services, which serves eight northeastern counties.

Cohen told members of the Joint Legislative Committee on Medicaid and NC Health Choice North Carolina planned to begin large testing events across the state with 45,000 doses that will not go out to counties this week that still have supplies.

DHHS supplied a list of events in 21 counties They include:

  • Bertie County at the Bertie County Health Department with assistance from Albemarle Regional Health Services;
  • Buncombe County at the Buncombe County Health Department in partnership with assistance from Western North Carolina Community Health Services and the Western Carolina Medical Society;
  • Cabarrus County at Atrium Health facilities;
  • Camden County at the Camden County Health Department with assistance from Albemarle Regional Health Services;
  • Chatham County at UNC Health facilities;
  • Chowan County at the Chowan County Health Department with assistance from Albemarle Regional Health Services;
  • Currituck County at the Currituck County Health Department with assistance from Albemarle Regional Health Services;
  • Durham County at Duke Health facilities;
  • Forsyth County at the Forsyth County Department of Public Health;
  • Gates County at the Gates County Health Department with assistance from Albemarle Regional Health Services;
  • Guilford County at Cone Health facilities;
  • Henderson County at Blue Ridge Community Health Services, the Henderson County Department of Public Health, the Mountain Area Health Education Center, and Pardee Hospital, a UNC Health affiliate;
  • Hertford County at the Hertford County Health Department  with assistance from Albemarle Regional Health Services;
  • Johnston County at UNC Health facilities;
  • Madison County at the Hot Springs Health Center, Madison County Health Department and Mountain Area Health Education Center;
  • Mecklenburg County at Atrium Health facilities;
  • Orange County at UNC Health facilities;
  • Pasquotank County at the Pasquotank County Health Department with assistance from Albemarle Regional Health Services;
  • Perquimans County at the Perquimans County Health Department with assistance from Albemarle Regional Health Services;
  • Pitt County at Vidant Health facilities;
  • Wake County at UNC REX Healthcare, Duke Raleigh Hospital and WakeMed in partnership with community-based physician practices, Advance Community Health, NeighborHealth and others.

More information about how to set up appointments or reach the facilities where vaccination events will be held is on the state DHHS web site at yourspotyourshot.nc.gov.

Vaccines soon at Charlotte speedway, Panthers stadium

The state also has started to create partnerships with private businesses that have the expertise and space to hold large-scale vaccination events.

One such partnership was announced by Honeywell, Atrium Health, Tepper Sports and Entertainment, and the Charlotte Motor Speedway to set up events at the Carolina Panthers stadium in Charlotte and the speedway in Mecklenburg County with the goal of administering one million vaccines by July 4.

Novant Health announced on Thursday that it would partner with Trane Technologies and work with the Charlotte Hornets to set up large testing events.

Mike Sprayberry, the state director of Emergency Management, said Thursday that his team is beginning to organize volunteers who can help with immunizations in addition to the National Guard and Civil Air Patrol.

“If you would like to register to volunteer to help at vaccination sites or medical facilities, there is a web site set up for that,” Sprayberry said.

People interested should visit terms.ncem.org.

Simplifying the process

As the state moves forward with its distribution plan, further allotments of the weekly shipments coming from the federal government will be sent out based on how quickly each county administers its supplies. Counties that have not used what has been distributed to them might not get a new weekly shipment or as large of one if there are vaccine doses still in their freezers or refrigerators.

“We have offered to folks who are doing these vaccination efforts, if we can help with data entry, we want to do that because we don’t want folks to have their allocation suffer because they can’t get the data into our system,” Cohen said. “But the data in our system is how we need to make decisions about things going forward.”

The initial distribution plan, which largely followed federal guidelines, was difficult for residents and providers to navigate, causing confusion about exactly who fell into which group.

“We are trying to simplify how we’re both talking about it and for operations on the ground,” Cohen said. “We got feedback from our providers to say, ‘Help us with simplicity and how we communicate this.’ So we definitely took that feedback into the simplified way in which we are moving forward.”

The federal government, as it has done for much of the pandemic, has left much of the planning for how to attack COVID-19 to individual states, sowing confusion across the country and setting up different systems from state to state.

On Tuesday at an afternoon briefing with reporters, Cohen and Cooper spoke about how difficult it can be to keep up with the federal government’s shifting guidelines and recommendations and act quickly.

As they were meeting with reporters, Alex Azar, secretary of the U.S. Department of Health and Human Services, was giving an Operation Warp Speed Briefing. He pushed back against states while recommending that they open vaccine eligibility to people 65 and older as well as to younger people with comorbidities that put them at greater risk for severe illness from COVID-19.

“Every vaccine dose that is sitting in a warehouse rather than going into an arm could be one more life lost or one more hospital bed occupied,” Azar said. “We’re expanding the groups getting vaccinated because states’ restrictions on eligibility have obstructed speed and accessibility of administration.”

During the same briefing, Azar said the federal government would release all its supply rather than holding back some for the necessary second doses of the two shots required by Pfizer and Moderna.

Azar added the federal government would be changing its formula for allocating vaccines to states based on how quickly they administered allotments sent to them.

“We’re telling states that they should open eligibility to all of their most vulnerable people,” Azar said. “That is the most effective way to save lives now. Some states heavy-handed micromanagement of this process has stood in the way of this vaccine reaching a broader swath of the population quickly.”

On Thursday, when announcing the changes to North Carolina’s plan, Cohen said her department shifted gears to align with the federal government’s “advice of simplicity and speed.”

“We are making sure that our prioritization is very clear right now,” Cohen said. “Right now, our vaccine providers can move forward to vaccinate anyone who is 65 and older or all of our health care workers.”

‘Remember, supplies are very limited’

Cohen stressed that providers across North Carolina are in different stages because of workflow issues, lack of large spaces to stand up large testing events and other issues, which her team are aware of and working to alleviate.

“We know that providers are in different stages,” Cohen said. “We did not want to hold anyone back at the state level. That’s why we’re trying to give this guidance today, saying if you can and want to run forward with the group that is 65 and older and all health care workers, that’s terrific you can do that.”

That gives county health departments and health care systems flexibility and discretion to determine when they open up eligibility to more people, Cohen added.

“We want to make sure that they aren’t held back by the state and that they can run forward in terms of speed,” Cohen said. “We know that we all share that sense of urgency to get folks vaccinated. So there are some providers we were already hearing from, saying we want to move on to the next group.”

Even with the new simplified phased plan, the state wants to continue with overall priorities stressed in the plan put forward in December. The state will signal to providers when they can move to open up eligibility to essential workers who are not in health care and people younger than 65.

“Please remember that our supplies are very limited,” Cohen said. “Even if we vaccinated everyone today with the vaccine that we have in the state, we would still be at something like 6 percent of our entire population.”

‘Immediate and dangerous situation’

That, Cohen stressed, is why it is important to continue to wear face masks, even if you have been vaccinated, continue to follow social distancing and hand-washing guidelines.

North Carolina reported 9,853 new lab-confirmed cases on Thursday with 3,990 people in hospital and intensive care unit beds suffering from illnesses related to COVID-19. There have been 7,825 deaths caused by the virus.

“Today we face the immediate and dangerous situation of extremely high numbers of people having COVID here in North Carolina and record numbers of people in the hospital,” Cohen said. “The percent of tests that are positive are triple that of where we want to be and there is a new and much more contagious variant of COVID-19 in our country.”

Cohen recently issued a directive to North Carolinians, recommending that they stay home except for work, school and essential trips for food or health care.

“My directive remains in place,” Cohen said. “Stay home.”

Coronavirus by the numbers

According to NCDHHS data, as of Thursday afternoon:

  • 7,825 people total in North Carolina have died of coronavirus.
  • 650,926 have been diagnosed with the disease. Of those, 3,990 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with COVID-19 infections on a given day and does not represent all of the North Carolinians who may have been in the hospital throughout the course of the epidemic.
  • 521,475 people who had COVID-19 are presumed to have recovered. This weekly estimate does not denote how many of the diagnosed cases in the state are still infectious. Nor does it reflect the number of so-called “long-haul” survivors of COVID who continue to feel the effects of the disease beyond the defined “recovery” period.
  • To date, 7,788,507 tests have been completed in North Carolina. As of July 7, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the COVID-19 tests performed in the state.
  • People ages 25-49 make up the largest group of cases (39 percent). While 15 percent of the positive diagnoses were in people ages 65 and older, seniors make up 83 percent of coronavirus deaths in the state.
  • 742 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • There are 3,660 ventilators in hospitals across the state and 1,299 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital. As of Wednesday, 858 COVID-19 patients were in intensive care units across the state.

Anne Blythe

Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.

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