North Carolina revamps COVID vaccine plan, days after Charlotte hospital controversy
North Carolina is updating its COVID-19 vaccine distribution plan, moving long-term care facility residents and staff and many essential workers to an earlier spot in line for the coronavirus shot, state Department of Health and Human Services Secretary Dr. Mandy Cohen said Wednesday.
The change comes nearly a week after Atrium Health in Charlotte drew sharp scrutiny for scheduling vaccination appointments for employees who do not work directly with COVID-19 patients.
In the last coronavirus briefing of 2020, Cohen and Gov. Roy Cooper emphasized hospitals must follow the new guidelines as supplies of the Pfizer and Moderna COVID-19 vaccines remain extremely limited. Otherwise, hospitals could be disciplined.
“I asked Atrium to follow our guidance, and we had a very productive conversation,” Cohen told reporters. “I know they changed some of the internal work they were doing going forward.”
Atrium officials told the Observer last Thursday as many as 97 employees would have their vaccination appointments canceled as priority groups shifted under new state guidance. But by Monday, Atrium spokesman Chris Berger said the figure had decreased, with some teammates redeployed as the hospital activates its surge capacity plans.
Also on Monday, Atrium released a new tiered distribution plan that appears to allow corporate employees and other personnel working remotely to get vaccinated within Phase 1b. While the state’s new plan includes vaccinating all health-care workers — and other frontline essential workers — in Phase 1a and 1b, it’s unclear whether all corporate hospital personnel and other non-patient-facing employees would fall into that phase.
“We’re continuing to work with the state as additional details become available,” a spokesman told the Observer on Wednesday in an email.
Novant Health has not publicly released a similar tiered approach, though the system has said it hopes to immunize 1,000 people a day.
“I can assure you that the only people who have received vaccines by Atrium Health were categorized by (Phase) 1a ...,” Dr. Scott Rissmiller, Atrium’s executive vice president and chief physician executive, told the Observer last week. “The key is to get those most at risk and those who are on the front lines risking their lives for the community. We get the vaccine to them so they can care for those who need it as others are waiting.”
Cooper and Cohen said they have been in discussion with medical and nursing licensing boards to discuss potential ramifications for hospitals or doctors who don’t follow the phased vaccination plan.
“We can’t have folks jumping the line,” Cohen said.
Cohen also urged hospitals with extra doses to reallocate vaccines to community-based providers and local health departments. This type of collaboration is already happening across North Carolina, she said.
“We don’t want vaccines to sit on the shelf,” she said. “We want to make sure the appropriate folks are getting vaccinated.”
Cooper on Wednesday also said he would extend the state’s eviction moratorium through Jan. 31, 2021.
“Too many families are living on the edge, trying to do the right thing, but left with impossible choices,” Cooper said at the press briefing. “This will help them stay in their homes, which is essential to slow the spread.”
The governor did not announce any new coronavirus restrictions on Wednesday. North Carolina’s modified stay-at-home order, including a 10 p.m. curfew, is slated to expire Jan. 8.
New phased vaccine plan
Cohen said COVID-19 vaccine supplies are limited, so the state must make doses available in phases.
The state had first prioritized health-care workers, especially people working directly with COVID-19 patients, for initial access to the vaccine. Under the new plan, Phase 1a also includes long-term care staff and residents.
Vaccinating those staff and residents began Monday, through partnerships with Walgreens and CVS, Cohen said.
Under the state’s updated vaccination plan, Phase 1b will include anyone age 75 or older, health-care workers and front-line essential workers. There aren’t enough shots to vaccinate everyone in Phase 1b at once, so those people will be further split into groups, Cohen said.
Cohen said the state expects to move into Phase 1b in early January. The state’s full plan is available online at yourspotyourshot.nc.gov.
Up to 2 million people could be in just the first group in Phase 1b, so it will take time to get the vaccine to everyone, Cohen said.
As of Monday night, 63,571 people have received a COVID-19 vaccination, according numbers from the state Department of Health and Human Services.
In the state’s revised guidelines, a wide swath of essential workers are now bumped up into Phase 2, not Phase 3.
Phase 2 of the state’s new plan includes four groups due to the scarcity of vaccines. It includes anyone ages 65-74; anyone ages 16-64 with high-risk medical conditions; anyone who is incarcerated or living in close group living settings, and any essential workers who are not yet vaccinated.
Phases 3 and 4 are not broken into sub-categories.
Phase 3 includes college and university students, as well as K-12 students who are ages 16 and older. The COVID-19 vaccines have not been approved for younger children yet. The final phase, encompassing most of the general public, may not start until “well into the spring,” Cohen said.
Hospitalizations surge
The state’s announcement comes ahead of a potential increase in COVID-19 cases and hospitalizations expected due to Christmas and New Year’s gatherings. Cooper urged the public to avoid gatherings and stay vigilant with coronavirus safeguards, including wearing a mask and practicing social distancing.
Health officials expect to see the full effect of holiday gatherings reflected in the coronavirus trends two weeks later.
Even ahead of that expected surge, COVID-19 cases and hospitalizations in the Charlotte-area have far-outpaced Mecklenburg County’s first COVID-19 peak.
The county surpassed 60,000 confirmed cases over the weekend, DHHS reported. In December so far, Mecklenburg has logged more than 18,000 infections.
On average, the county is adding about 600 cases each day, compared with 220 cases two months ago, according to a Charlotte Observer analysis of public health data.
The number of people hospitalized with COVID-19 in Mecklenburg County has increased at an alarming pace in recent months — nearly doubling in the month of December alone.
As of Sunday, Mecklenburg reported an average of 407 people with COVID-19 hospitalized over the span of a week.
By comparison, an average of 214 people were hospitalized with COVID-19 in the last week of November. At the time, that was a county record.
And health officials warn more cases may be coming as the full effects of Christmas gatherings show up in local coronavirus trends.
It’s unclear when Mecklenburg may hit its coronavirus peak, reflecting the greatest pressure on hospital resources. But one analysis suggests intensive care units in the Charlotte region could be overwhelmed as soon as next week, according to projections from the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill and the Margolis Center for Health Policy at Duke University. Asheville and the Triad area have the same forecast, though the Triangle might not be inundated for weeks.
Leaders from Atrium Health and Novant Health say their key concern is ensuring sufficient staffing levels to accommodate the surge of infections. Already, Atrium officials say employees are being redeployed from their typical jobs to help the strained pandemic response.
This story was originally published December 30, 2020 at 2:29 PM.
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