“Our messengers travel many, many miles. Our doctors and our staff travel miles,” said Susan Jarvis, president and CEO of Sanford Health in northern Minnesota.
In Bemidji, Minnesota, the last leg of the vaccine journey for several of these communities begins when it is unloaded from its ultra-cold storage and packaged in refrigerators like those you can see on a barbecue – except that they have essential data recorders attached.
“They are under scrutiny with regard to freezer temperature, refrigeration temperature storage requirements and only work for five days after being removed from the deep-frozen freezer,” said Matt Webb, director of pharmacy at Sanford Saúde.
“So that data logger is a device that monitors the temperature during transport until it reaches the hospital’s refrigerator.”
Once the doses are guaranteed and ready for use, the next step is simply to get into the minivan – and drive. A vaccine delivery trip that CNN followed began in Bemidji and ended in a town of 9,000 inhabitants called Thief River Falls, just over 145 kilometers to the northwest.
“I don’t think there is any concern about catching it,” said Carla Szklarski, an infection preventive (among many other jobs), at Sanford Health Thief River Falls. “It was more the logistics of how it was going to happen.”
President Biden said he expects the United States to be able to vaccinate 1.5 million people a day “for the next three weeks or more”, but in many parts of rural America the barrier to being part of these vaccinations is simply reduced at a distance.
“It’s good to play in attack, for a change,” said Webb. “Ensuring that we can vaccinate people as close to home as possible is very important.”
Sanford has only five sites that are capable of meeting the ultra-cold storage requirements for the Pfizer / BioNtech vaccine in a coverage area of more than 200,000 square miles in North Dakota, South Dakota and parts of Nebraska, Iowa and Minnesota.
The state of Minnesota determined that the vaccine should be distributed only to hospitals – as long as they have the necessary storage capacity.
Sanford couriers search these five locations and depart.
“It was really a process that already existed and that we were able to take advantage of and expand so that we can use it for the delivery and distribution of vaccination,” said Jarvis.
But that does not mean that there are no obstacles.
In Bagley, a town about 30 miles from Bemidji, some of Sanford’s laboratory results had to be postponed because of conditions on winter roads. “Mail routes were canceled because they were blizzard conditions,” said Stephanie McKnight, administrator of the hospital and clinics in Bagley.
“I can’t think of a time when we don’t completely have what we needed. There were times when we got too close.”
“Distance, obviously, in northern Minnesota plays a big role in the ability to obtain vaccines efficiently. It can also prevent someone’s decision to get a vaccine if we make it difficult to receive,” said Alyssa Carlson, pharmacy manager at the Hospital Bemidji and Bagley centers.
Sanford Health told CNN that, in late January, in northern Minnesota, he managed to obtain two doses of the vaccine for more than 1,000 employees as part of group 1a and at least the first dose for hundreds of patients aged 65 and over as part of the next distribution phase. The system says it is now sharing storage resources with the local public health department in Bemidji as part of getting vaccines as soon as possible.
‘Everyone knows everyone’
“In a rural community, we tend to know who our patients are before they become patients,” said Dr. Colleen Swank, vice president of clinics at Sanford Health in northern Minnesota.
“It’s not the 75-year-old man in bed with Covid, it’s Mr. Smith, my neighbor’s father.”
Thief River Falls, about 70 miles from the Canadian border, initially thought he had prevented the pandemic – until he found out he hadn’t. The health team told CNN that at one point, most of their inpatients were Covid-19 patients in a city where “everyone knows each other”.
“I went home and cried that first night and I had to tell someone that they couldn’t come and visit,” said Szklarski.
“We always think that, you know, nobody dies alone. The family is a big part of your care, your emotional and physical well-being, and so not being able to have them here was the most difficult thing.”
She described these patients as being members of her own family, which made the pain of the pandemic much more difficult, “go to practically a family member and tell them, I’m sorry that you can’t come in and see your mother.”
Szklarski, like so many others, looks at this vaccine as a source of hope, especially because of his double family, the one that includes his relatives – and the one that includes his patients.
“I think it’s something that we really took for granted in the past, you know? Enter the hospital and visit our loved ones. And we can’t do that anymore, ”she said.