North Carolina Secretary of Health and Human Services apologized Monday afternoon on a call to county hospitals and health departments for changes in the calculation of distribution of the COVID-19 vaccine, which saw some struggling to balance a decline in supply with an increase in demand.
Dr. Mandy Cohen proposed that instead of a weekly allocation to the counties, which leaves them unable to plan ahead, the state would guarantee some minimum baseline allocation each week for the next 3 weeks.
“Three weeks is what we are comfortable with for sure,” she said.
The call came after local hospitals and health departments were forced to cancel or delay thousands of appointments for COVID-19 vaccines across the state after a less than expected allocation.
Part of the supply that counties and hospitals are expected to have on hand in the coming weeks will be diverted to at least one mass vaccination event that the state hopes will speed up the process of obtaining vaccines.
This event, from Friday to Sunday in Charlotte at Bank of America Stadium, can reach up to 20,000 people.
But it comes at a cost: pulling supplies from hospitals and health departments that the state has just reported to speed up its own vaccination efforts.
Cohen said vaccine operations faced a double blow this week. The state has asked hospitals and health departments in recent weeks to speed up and burn an accumulation of doses so that the federal government does not punish the state by reducing future shipments. But the new pace does not mean that the state would receive more than the approximately 120,000 first doses it has been receiving each week.
“I apologize for not being clearer,” said Cohen on the afternoon call. “I have this and I apologize. It put you all in a difficult, difficult position.”
The state arrives with allocation numbers at the end of each week, and by the weekend it was clear that hospitals and health departments would receive fewer vaccines than scheduled vaccines. Cone Health alone, which serves the Greensboro area, said it would cancel 10,400 appointments for the first dose.
Appointments for the second dose will not be affected, the system said.
Local health department managers wrote to Cohen on Sunday, saying they would be forced to call an unknown number of people, most of them over 65, to cancel the appointments.
“This later (local health departments) did exactly what they were instructed to do: schedule appointments, commit individuals and put them in future positions,” said the heads of the NC Association of Local Health Directors in their letter.
“As the doses were diverted, grandmothers and grandmothers who had consultations in the rural area of NC now wait”, states the letter. “Health professionals who had appointments to care for patients now wait.”
The association of state hospitals has expressed similar frustrations, saying in its own letter to Governor Roy Cooper that the state needs a better distribution plan and that hospitals need more information, with fewer surprises.
“Hospitals have also changed repeatedly in the short term to accommodate various urgent guidelines and orders from state and federal leaders, usually without prior consultation for clear information or measures of success,” the letter said. “We can, and do, adapt quickly, but it is time for the state now to take steps to coordinate a better plan and the way forward for the vaccine implantation.”
State officials acknowledged the frustrations and said they were trying to speed up the process, but the offer remains limited. Cohen and other senior officials in the state’s vaccination effort spent about an hour on Monday’s conference call, exposing the new plan, asking for feedback and promising better communication.
Kody Kinsley, an assistant DHHS secretary focused on the COVID-19 response, said local providers can expect the basics tomorrow about the amount of vaccine to expect in the next three weeks. Cohen said the state will take 84,000 doses of the state’s expected weekly distributions and divide them between counties by population, then divide that between providers in each county.
“This means that not every provider will be able to get the vaccine,” she said. “Numbers don’t work for everyone.”
The remaining 36,000 doses the state receives each week will be used to “augment” organizations that can help reach marginalized communities, including rural and minority communities that are normally under-served, said Cohen.
Once local operations receive their shipments, they will have five to six days to put all doses on the weapons, Cohen said. Demand will continue to outpace supply, she said.
“We will not have enough vaccine, I don’t believe, for now,” said Cohen. “But we will get there. We will work on this together. I apologize again. “