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Staff shortage may slow vaccine rollout

Hope in the form of a vaccine came in December. Nurse Michaele Dobson, right, administers the Pfizer coronavirus vaccine to nurse Laura Hooker, of Wilmington, at the Adirondack Medical Center in Saranac Lake on Dec. 23. (News photo — Elizabeth Izzo)

As the number of people eligible for vaccination against the coronavirus grows, staff shortages could be a significant hurdle for the North Country region to overcome in its distribution efforts.

Dr. Wouter Rietsema, vice president of population health and information services at Champlain Valley Physicians Hospital in Plattsburgh, told reporters during a press conference Tuesday, Jan. 5 that a lack of qualified staff will be the “number-one rate limiter” for the North Country region as more people become eligible for vaccinations.

With more people expected to become eligible to get vaccinated in the coming weeks, county health departments will be stepping in to help vaccinate that expanded eligible part of the population. But these departments have faced budget cuts for years, Rietsema said, and taking on vaccine distribution will force many of them to divert staff from things like contact tracing to make it happen.

“Vaccination takes people,” Rietsema said. “(Staffing is) the single most limiting fact, I think. I think we’ll probably get to a point where our supply will no longer be a rate limiter, and staff will be a rate limiter.”

The Essex County Health Department, for example, has eight staff members. A state contact tracing team will be taking on more of the county’s contact tracing duties — though the health department will continue to work directly with county residents who test positive for COVID-19 — as the department prepares to stage mobile, drive-thru vaccine clinics throughout the county, according to Essex County Public Health Director Linda Beers.

The Medical Reserve Corps, a national network of volunteers, is also recruiting volunteers to supplement local vaccine distribution efforts.

Retired nurses, doctors and other health care professionals who may be able to help with vaccinations are encouraged to contact their respective county health departments to learn more about how to help. Rietsema said the work of vaccinating others is “very rewarding.”

“Every morning, before I do anything else, I walk through the vaccination clinic (at CVPH),” he said. “I see happy people, and happy people receiving the vaccine.

“If you’re aware, you have skills and you can help with vaccinations … you will be needed.”

Broader distribution network

Hospitals and county health departments aren’t the only organizations that have applied to be vaccine distributors.

Gov. Andrew Cuomo on Tuesday said a total of 3,762 organizations statewide have enrolled to be vaccination provider sites — including health departments, hospitals, federally qualified health centers, private doctor networks, pharmacies and urgent care centers. Only 636 of those have been “activated” so far with vaccine deliveries, according to Cuomo. In the North Country region, 25 of 150 that have applied have been activated.

Cuomo also noted that the state plans to authorize “special efforts” — meaning some agencies, like police departments, fire departments and unions, will be allowed to organize their own vaccine distribution systems to take some of the pressure off of main distribution hubs.

“They have their own employees that can do the vaccines,” Cuomo said.

The state also plans to work with churches, community centers and other organizations on vaccine distribution in an effort to make the process more equitable.

New York state has received shipments of about 300,000 vaccines per week in the last few weeks, according to Cuomo. The governor said he has asked the federal government to increase New York’s allotment of vaccines.

At least 2.1 million New Yorkers are eligible for vaccines in phase one of the state’s vaccine rollout. The state broadened the categories of people eligible to be vaccinated on Monday, to include all those administering COVID-19 vaccines, including health department staff, ambulatory centers staff, home health care workers and hospice workers, and “congregate setting” staff and residents. Health care workers, first responders, nursing home residents and staff are also eligible to be vaccinated in the first phase of the state’s vaccine rollout. Those unsure of whether or not they’re eligible to be vaccinated can visit online at https://am-i-eligible.covid19vaccine.health.ny.gov.

On average, New York hospitals have distributed about 46% of the vaccines delivered to them, Cuomo said Monday. Adirondack Medical Center in Saranac Lake is among the swiftest, administering 87% of its allotted vaccine doses as of Monday, according to the governor’s office.

Cuomo announced on Monday that hospitals that don’t use up their existing vaccine stock by the end of this week could face fines of up to $100,000. Of the more than 774,000 COVID-19 vaccines distributed in New York, 237,000 of them had been administered as of Monday, according to the U.S. Centers for Disease Control and Prevention.

Adirondack Medical Center

No one will say how many vials of the Pfizer and Moderna vaccines have been delivered to AMC or its parent organization, the Saranac Lake-based Adirondack Health. As part of New York’s distribution plan, the state required health care facilities to sign a memorandum of understanding that restricts representatives of those facilities from disclosing many pieces of information to the public, including how many vials of the vaccine they have on hand.

Adirondack Health spokesman Matt Scollin attributed the hospital’s success in quickly distributing the vaccines, in part, to its community ties and proactive approach.

Both the Moderna and Pfizer coronavirus vaccines have to be used within a certain time frame from when they arrive at the hospital. When a vial of the Moderna vaccine is opened, for example, all of the doses in that vial have to be administered relatively quickly. There are typically 10 doses per vial, although Cuomo has said many vials hold enough liquid for 11 doses.

To keep the vaccine rollout moving, the hospital has been keeping in contact with organizations outside of the hospital that employ people who are also eligible for vaccinations under the state guidelines, such as first responders and behavioral health professionals, according to Scollin. On days when there were doses of the vaccine available for outside organizations but those scheduled to receive it aren’t able to come in, Adirondack Health contacts the outside organizations and asks if any other people are available to get vaccinated that day.

“There’s no requirement that we do that; we just did it,” Scollin said. “I think that’s certainly helped us achieve this high percentage.”

Scollin also credited the hospital’s success to the work of staff at the hospital’s in-house vaccine clinic, some of whom have been working 12-hour days.

“Our staff doing the vaccinations deserve all of the credit,” he said.

COVID variant is here

Public health experts say the state’s vaccine rollout has to speed up before hospitals become overwhelmed again — or before a new variant of the virus spreads in New York, the New York Times reported on Friday, Jan. 1. Cases of the new variant of the coronavirus — which is more contagious than the virus that has infected millions in this country — have been found in Colorado and California, and on Monday, New York announced its first confirmed case of the variant, in Saratoga Springs.

“We are in a footrace right now between vaccine implementation versus the infection rate and hospital capacity,” Cuomo said on Tuesday. “This UK strain changes the whole footrace.”