It’s generally bad when West Virginia makes headlines. The state has a long and sad history of extreme poverty, health problems, political corruption and natural and man-made disasters.
But in mid-January, some very good news started to come in from West Virginia: Mountain State was somehow making 81% of its vaccines available on its citizens’ biceps, while larger states struggled to distribute up to half of their vaccines. vaccines available.
While the national media went down to the state to find out why, much of the report focused on the state’s decision to distribute vaccines through local pharmacies, contrary to the federal plan to use the national CVS and Walgreens networks.
That is not the whole story of the vaccine’s triumph in West Virginia, however. The state’s path to success began long before there was such a thing as Covid-19, let alone a vaccine to combat it, and it was based on the state’s unique response to a series of tragic disasters. One that can be difficult to replicate.
In March 2020, as Covid-19 cases increased, West Virginia Governor Jim Justice established a “joint interagency task force” to oversee the state’s response to the pandemic.
It’s a simple idea borrowed from the world of military strategy: bringing everyone involved in an operation to the same table, so that everyone can share information and coordinate their efforts. This specific task force would be comprised of federal, state and local government agencies, the West Virginia National Guard and groups representing hospitals, pharmacies and nursing homes.
“We took the construction of what the military does in operations, mission planning and applied it to our public health partners. We operate a public health emergency, ”said Major-General James Hoyer, who serves as director of Covid’s task force.
Hoyer, who recently retired from the armed forces after 40 years in uniform, participated in several joint interagency task forces during that time, because West Virginia has suffered an extraordinary series of bad luck over the past decade.
In June 2012, a violent windstorm hit the state, cutting electricity to more than 680,000 residents – almost a third of the state’s population – and killing three people. In October of the same year, a cold Arctic front collided with the remnants of Hurricane Sandy, pouring feet of wet, heavy snow into West Virginia, again turning off the power of thousands of residents and killing seven West Virginia residents.
In 2014, a leak at a chemical storage facility in the capital, Charleston, contaminated the water supply and left nearly 300,000 people without water for five days.
In 2016, the state suffered a 100-year flood, which destroyed thousands of homes, businesses and schools and killed 23 people.
Although each of these tragedies presented unique challenges, the state approached them in the same way: with a task force with all the necessary actors, from the Federal Emergency Management Agency (Fema) to local voluntary organizations.
It was natural to set one up for West Virginia’s Covid-19 response.
Hoyer said the strategy appears to work especially well in West Virginia. “We are small enough to know everyone,” he said.
That is why Dr. Clay Marsh, director of health at West Virginia University and czar at Covid State, suspects that the task force approach may not work in large states with larger populations and many municipalities.
“Working together, not having too many egos in the room, not having too many problems with who’s controlling what … I feel like we work as a single team,” he said. “It’s Trumanism: ‘It’s amazing what can happen when you don’t care who gets the credit.’”
As soon as Covid’s task force was created and on the move, members began daily meetings at the West Virginia National Guard Arsenal in Charleston. Even though everything from birthday parties to award shows has gone virtual, members of the task force have continued to meet in person – with lots of masks, plexiglass and social distance, of course.
Hoyer, who remained as director of the task force after retiring from the national guard in January, says that face-to-face connection is essential. It allows task force members to communicate quickly and effectively. It allows everyone to stay up to date with the latest data on the state’s Covid cases, hospitalization rates and vaccination numbers – information that is constantly updated on the screens of projectors and TVs that dot the arsenal’s drilling floor.
Seeing each other in person allows the task force to act quickly and decisively and allows members to resolve the Covid blocks, school closings, mask orders and other preventive measures that West Virginia used last year. It is also how, in December 2020, the state was able to quickly set up its own vaccine distribution plan.
“We analyzed the data with the governor and understood that 77.5% of our deaths occurred among people aged 70 and over,” said Hoyer. “And we also knew that at the height of the event, around December, more than 50% of our deaths were from asylum residents.”
With these data in hand, the task force appointed two of its members – Dr. Krista Capehart, professor of pharmacy at West Virginia University and a member of the West Virginia Board of Pharmacy, and Marty Wright, CEO of the West Virginia Health Care Association, who represents nursing homes – to propose the most efficient way to immunize nursing home residents in the state.
Capehart and Wright realized that, of more than 200 pharmacies in West Virginia, half are locally owned. Many of these pharmacies had existing relationships with nursing homes in their communities. They compared this to the federal vaccine distribution plan and its reliance on CVS and Walgreens stores, which do not exist in many rural West Virginia counties.
It was clear to Capehart and Wright that his state would need to go its own way. The rest of the task force agreed and took the plan to the governor.
“I remember him looking me in the eye and saying, ‘Is that what you believe is the best way to do this?'” Said Hoyer. “And as a group, we all said, ‘That’s it’.”
Pharmacies started operating when West Virginia received its first batch of vaccines on December 15. By the end of January, the state had finished vaccinating all residents and staff of the nursing home, as well as a significant number of other health professionals, emergency personnel and teachers. With that concluded, West Virginia began the next phase of vaccine distribution, aimed at citizens aged 65 and over.
As West Virginia enters this phase of vaccine distribution, the state’s inter-agency task force is launching its next innovation – vaccine clinics in all 55 counties. Each county will establish its own task force with the local health department, emergency services, community health centers, hospitals, pharmacies and other essential actors.
Dr. Deborah Koester, who serves on the state task force as a liaison for local health departments, says that the creation of these local groups will be just as essential for vaccine distribution as the state task force has been. “Each of the 55 counties is so unique, it’s going to be a little bit different, and that’s okay. They know their communities better, ”she said.
The only major obstacle that West Virginia faced in implementing the vaccine is a lack of supply. The state receives 23,600 initial doses of the Moderna and Pfizer vaccines each week. Hoyer says the state could easily distribute 125,000 vaccines a week, which would make everyone in the state over 65 years old vaccinate in a matter of weeks.
Hoyer said that, just as previous disasters prepared West Virginia to respond to the Covid-19 pandemic, he hopes that this pandemic will serve as a learning experience for future events.
“I think, unfortunately, we will have something like that in my life,” he said. “The better prepared we are, the less the impact on our people will be.”
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Zack Harold is a freelance writer and radio producer in Charleston, West Virginia. He is a regular contributor to West Virginia Public Broadcasting’s Inside Appalachians and previously served as entertainment editor for Charleston Daily Mail and administrative editor for WV Living, Wonderful West Virginia and WV Focus magazines.