DHHS chief: Many NC hospitals won't get first batch of coronavirus vaccine doses
State health and safety officials provide a Dec. 3, 2020, update on the coronavirus outbreak in North Carolina and the state's response to it.
are American Sign language interpreters and Jasmine Met. Heavier and Ron Vasquez are are Spanish interpreters as faras today's numbers. As of this morning, there were 5637 new cases reported today, 2101 people are currently hospitalized, and sadly, there have been 5410 deaths. Today we hit another devastating milestone, going well beyond 5000 new cases reported in just 24 hours. This number is alarming. Yesterday we saw our highest rate yet of the percent of tests that were positive, hitting 11.4%. Our hospitalization numbers air also setting records with now over 2100 people in the hospital with Cove in 19. I am very worried. I know this is a particularly hard time of year to stay home and away from family and friends. Yet it is the best way we can take personal responsibility and show our care for them as we fight this global pandemic. Earlier this week I shared that in just 11 months, co vid has killed more than three times the number of North Carolinians as the flu did in the past decade. We must keep working together to protect our loved ones, to make sure our hospitals air there for those who need them and to save lives. If you are with someone you don't live with, where a mask and keep your distance. Better yet, limit your social actions as much as possible. We need to stay strong and strong together. You attended a Thanksgiving gathering. Please go get tested. Social gatherings can quickly become virus spreading events, putting those who attended and the larger community at risk. We are so close to having the means to control this virus with a safe and effective vaccine. The Food and Drug Administration and their external advisory committee will refute to vaccines this month. I'm going to take some time today to provide more details about vaccines, both how we got here and what will likely happen in in the coming weeks. Although vaccines were developed quickly over the course of this year, corners were not cut. The vaccines were built upon years of work in developing vaccines for similar viruses such a SARS. In addition, billions of dollars have been invested to allow clinical trials to proceed without delay and ensure manufacturing of those millions of doses of vaccines were happening at the same time. All of this allowed for our scientific community to shorten the time in getting us a safe and effective vaccine. So no corners cut for the Pfizer and Madonna vaccine. More than 70,000 people combined participated in clinical trials to see if the vaccine vaccines are safe and if they can effectively prevent someone from getting Cove in 19. Both companies worked to recruit people from historically marginalized populations to participate in those trials. For the Pfizer trial, 41% of their participants were non white, including 26% who are Hispanic Latin X and 10% who were black. For the Modern, a vaccine, 37% of the participants were nonwhite, including 29% who Hispanic Latin X and 10% who are black. The people who make the decisions about whether or not toe authorize the use of these new vaccines that are are FDA scientists and their career scientists, not political appointees. The data is also reviewed by another independent body. They're called the Vaccine and Related Products Advisory Committee. This committee works with the FDA to determine safety and effectiveness. The process is independent and it's transparent. Looking at the vaccines themselves, it's important for people to understand there is no co vid 19 virus in the vaccine itself. The vaccine imitates the infection so that our bodies think a germ like the virus or cove it is attacking. And this creates the antibody defenses. We need to fight off co vid If and when the rial germ attacks once the vaccine is authorized by use by the FDA, supplies will be very limited. At first. Independent federal and state groups of experts have determined that the best way to fight CO vid is to start vaccinating first, those who are at most risk. Therefore, the initial supply of vaccines will go to a limited number of hospitals to vaccinate healthcare workers at high risk of exposure to Cove in 19, those who are directly caring for or cleaning areas used by patients with Cove in 19. Because of the limited initial vaccine supply, not all hospitals are going to even receive vaccine initially, but as more vaccine becomes available, it will be distributed to Mawr of our states hospitals and then to our local health department to focus on vaccinating high risk health care workers. Long term care staff and residents will also be in the first group to receive the vaccine. Vaccinations at skilled nursing facilities and adult care homes are being managed by the federal government through a partnership with CVS and Walgreens. Vaccines used in our long term care will come from the states allotment of vaccine. The federal government will determine the number of Covic vaccines each state will receive. The amount of vaccine sent to the states will be based on the size of our state's population. The state will then tell the federal government or the C D. C where to send the vaccine, and the federal government works with the manufacturer or the distributor to place the order. Then the manufacturer distributor ships the vaccine directly to the providers. We've been told that if the Pfizer vaccine is authorized this month, we will likely receive a first shipment of about 85,000 doses, possibly as early as mid December. We expect that MAWR vaccines will then be shipped every single week. We hope that by early 2021 that health departments and community health centers will start vaccinating other adults who are at high risk for complications meeting they have to or mawr chronic conditions identified by the CDC and who are at higher risk for exposure. While clinical trials are showing safety and effectiveness for adults, Children will not initially received vaccine as these clinical trials with Children are needed to assure the safety and effectiveness. Okay, I know that was a lot of information, So let me recap a bit. First Cove in 19 vaccines must go through and past clinical trials. Like any other drug or vaccine, Pfizer and Madonna did recruit people from historically marginalized populations to participate in their clinical trials. The vaccine authorization process is independent and transparent. There is no co vid virus in these vaccines. Supplies of the vaccine will be very limited at first. In these initial supplies will go to long term care staff and residents and a limited number of hospitals to vaccinate healthcare workers at high risk of exposure to covert 19 again, those who are caring for or cleaning the areas used by patients with Cove in 19. We have the state have been hard at work preparing for this moment, but this is a big we know there will be bumps in the road administering a vaccination program of this scale. States will need federal support and federal dollars as they undertake such an unprecedented effort. As I said earlier this week, having a safe vaccine within reach is an extraordinary scientific achievement. But it's not a quick fix. It will take several months to have enough supplies that anyone can readily get a vaccine until most people are vaccinated. The three W's remain our best tool to protect our loved ones, to make sure our hospitals air there for those who need them and to save lives where a mask weighed 6 ft apart and wash your hands where weight and wash. Okay with that, I will turn over to your questions. My first question today is from Hannah Critchfield with North Carolina. Help me. Hi, Dr Cohen. Thank you for taking my message or my question. Um, I wanted to ask you about the distribution plan after it goes from health care first responders and into that phase one B when, um, prison staff and some high risk prisoners will start receiving the vaccine. I was wondering if you could talk a little bit about the logic behind the decision. Thio vaccinate all staff and then some high risk prisoners rather than opting toe first, prioritize vaccinating all prisoners, just given the rate of spread on. Then, as a second piece of that, I was wondering if you could talk a little bit about, um, if in that phase one b if they're limited doses to the point where you couldn't vaccinate all steps and all high risk prisoners. Um, how does doses will be prioritized between those two groups? Thank you. Well, thanks for that question. Let me back up and explain the prioritization of how the limited amount of vaccine that will we have at first will go. So, as I mentioned, we expect that that very first week there will be one vaccine available. Um, and that one vaccine we think will likely be the Pfizer vaccine. We think that first week Well, good. About 85,000 doses and we will distribute those 85,000 doses to a number of hospitals. We won't have even enough to get it to every single one of our hospitals. It'll be a limited number of of hospital, so we'll distribute those 85,000 doses, and the hospital will then be vaccinating again healthcare workers who are at higher risk of exposure, meaning they're working directly with co vid patients or cleaning the areas. Um, for for COV patients. Additionally, we will be allocating, likely starting from our second week of vaccine allocation so that first week is just healthcare. By the second week, we anticipate we may have vaccine from as many as two manufacturers, Madonna and Pfizer. At that point, we anticipate being able to both send tomb or hospitals as well as start to do the vaccinations in our long term care settings. We don't have exact numbers of how much vaccine we will have in Week two and beyond yet, but we are learning mawr every day and trying to get that information. So we will be starting to vaccinate our long term care, uh, staff and residents as well. And again we had a number of external advisory bodies who created that prioritization that said we should go with healthcare workers exposed to Cova. 19 go with long term care workers on DSO half first. Those advisory bodies included the National Academy of Medicine um, the advisory board to the, um the Centers for Disease control of the C. D. C. That just met this week and created that prioritization. And here in North Carolina, we also had our own vaccine advisory committee that was convened by the Institute of Medicine. Um, so I want to thank all of those experts for weighing in on these priorities. The reason they came up with those priorities is like, See, we just we have a limited number. Where do we wanna put those? Resource is first and we said, We want to put it for our health care workers who are actually being exposed to co vid as well as in our long term care settings. As you know, that has been a place where we have some of our most medically frail folks, as well as difficulty keeping virus out of those congregate settings. When we move on from health care worker and long term care, we move on to other adults with two or more chronic conditions. Again, these independent advisory committees said you move to that group next is because they are at highest risk for having a bad outcome from Cove in 19. We've talked for many, many months about people who have chronic conditions seeming to have worse impacts from co vid. It's not any chronic conditions. There's a specific set of them things like diabetes or heart disease or underlying lung disease or immunodeficiency problems with your immune system. Those are the kinds of chronic diseases, and we know if you have two or more of them, it puts you at a lot more risk for having a bad outcome from Cove in. So that's the next group we want to get to. So we think about all of those adults across North Carolina that have two or more chronic conditions. We also know that there are certain settings where those adults are that are more risky. And so, as we think about our allocation and the work we need to do to distribute that those vaccines, we want to send them not just to the to target the adults with two or more chronic conditions, but also to those settings. And that's where I think your question comes in to How do we think about congregate settings? Ah, prison is a congregate setting. A homeless shelter could be a congregate setting and others. Um, and we certainly do want to go to those settings. But we are going to target those adults with two or more chronic conditions first, because they are at highest risk off severe disease. So again, we're relying on that expertise from those independent panels to go with healthcare workers, long term care and staff, and then two adults with two or more chronic conditions, while we also target them to settings we know are higher risk. Um, so I know that was a long answer, but really want folks to understand how that prioritization works. The fact that we relied on these independent bodies of experts that really all aligned on how that prioritization should work and we're going to be following their their recommendations. Thank you anything. The next question is from Brian Anderson with The Associated Press. My doctor Cohen, Brian Anderson here with the A P. I have a follow up question for you about vaccine distribution, but I've gotta ask first about co vid. Uh, there's an increase in 82 deaths that were reported yesterday, the most since it started with pandemic cases, and hospitalizations are at all time highs and for the first time ever for first time since they brought, I should say positivity rates above 10% for three consecutive days. And I know you and the governor reduced indoor gathering limits from 25 to 10 ahead of Thanksgiving. And there's some pepper language on math enforcement and additional restrictions could be on the table. But my question is the status. The status quo clearly isn't working. So why they're reluctant to impose additional restrictions at statewide visible Brian, Thanks for that question. Um and you you just elucidated a lot of the things that we're trying to help folks do in order to slow the spread of this virus we knew as we headed. We're heading into the season when things air colder and thus people go inside Mawr. We head into the holidays where people want to gather more. We knew that there is just going to beam or risk of spread, and unfortunately we are seeing that play out in our numbers. We know, though, what to dio. We know what prevents this right? We know the three W's work we know wearing a mask. We know keeping your distance limiting your interactions with other households washing your hands. All of that works. So if we were all to follow the things that are currently in place right now, I don't think we needed to do more. Um, but we know that that is hard. We know that we're asking a lot of folks, and it may be possible that we need to go backwards. Um, the governor said earlier this week, everything is on the table. We are looking at other options. I certainly look at a lot of other states around the country. What are the actions that they're taking? How has that impacted their numbers? And I look around the world, Um, what are other countries doing? How how have restrictions, um, improved or not improve their numbers. And what does that mean for us here in North Carolina? So we're trying to take in all of that information and make good decisions as we always have, um, through this entire time of co vid on dso that those kinds of are the things that go into our our thinking. I am certainly concerned about our numbers. We can all do things right now to slow the spread of this virus. We have thio because, as you said, our hospitalizations were going up and and people are dying. So we need to work hard at this. Thanks way. Have a follow up from Brian Anderson with a P thanks. And we know that the fighter in the dinner plans or do this Friday and next. Can you just share the timetable for the release of that? And I know you said there that there's a limited number of hospitals that will get the first wave of doses uh, North Carolina distributing them to healthcare workers based on specialty or sort of a number of Covad cases per capita. Can you talk through that? Let me let me start, um, with your second part of the question. So we will do a distribution, um, to our hospitals based on their hospital size. Um, And the way the Pfizer vaccine is packaged, you essentially have to ship 1000. It's actually 975 in a unit. So that's a lot we have to package together. So we can't actually break it down into smaller units and get it to even more hospitals. Which is why when we get 85,000 doses. It can only go to so many hospitals. It can't even get to the more than 100 hospitals we have here in our state because again they package it 1000 together. We certainly don't want to be wasting any vaccine. In our early days here, we want to be really, um, efficient with how we get our vaccine out. So it will be to a limited number of hospitals. It will be based on hospital size, a swell as you know, figuring out the population. So that is how the distribution will go again to a limited number of hospitals generally are are larger hospitals. The hospitals themselves will then prioritize vaccination for their, um, for their staff that work directly with co vid patients. So we're asking them to really be thoughtful about prioritizing to people who work on co vid units. Clean co vid units may be part of the environmental staff, um, folks who are in the emergency room who are, um, uh, taking care of patients where they don't know if they have cove it or not, but have a high risk of exposure. Um, and so I know all of our health care teams are going through that work to prioritize that right now, eh? So they will be handling that assed faras. Your other question about the timeline we don't know exactly right, because the FDA is doing its good, thoughtful work on reviewing the data. That data will then go in front of the independent advisory board for the FDA. That meeting is currently scheduled for the 10th of December, so next week, we believe that after that that public advisory meeting that the FDA will be able to wrap up their work, integrate all of that feedback into what will become an emergency use authorization. It will authorize use of the vaccine, and it will tell us for what population it will be authorized for. That will inform who can get vaccinated. There is one more step where the an advisory committee for the C. D. C. It's called the a sip committee has also tell us and give us their recommendations of who is the right population to get that. That is the last step before we are able to take that vaccine and put it into someone's arm. So we think we are estimating the earliest that could happen is probably around December the 15th. That is what we're planning for at this at this point. Could be a few days earlier. A few days later. Um, but that is around when we think we will. We will have both e, uh, emergency use authorization as well as the recommendation from a sip. And then we will be able to proceed forward. Thanks, Brian. Right. Next question. Next question is from Test Bar Goober with Fox eight. News. Good afternoon, Secretary Cohen Test R Jafar Fox eight News We're hearing from some of our local public health departments, particularly in precise county that are needing more contact tracers. And they're saying even if they get these contact tracers, they're getting to the point with their case numbers that they know they won't be able to to make contact with every single person. I was wondering if there were any new statewide initiative to provide mawr, contact tracers or any other prioritization efforts when it comes to contact tracing. Thanks for that question. Yes, with a record number of cases when we put up 5600 new cases like we are in just 24 hours. There's there's only so much our teams can keep up with eso. We are very much aware of both needing. Thio always recruit mawr Contact traces What? What we dio. But we really need toe prioritize uh, the work itself. And so actually our team has been working for a number of weeks with our local health department on ways that we can prioritize that work. We've looked at what other states are doing the guidance that they have been giving out. Um, learn from some of our other public sector partners and we are giving MAWR guidance in order to better target that work. We wanna make sure that we get as much information from that as possible again. It's still really valuable information, but what? What I think is important for folks to understand is that we have wide spread. We have community spread of this virus everywhere in every community in North Carolina. That's why you need to take precautions as if everyone around you has it. You have to be wearing a mask. You have to be waiting 60 department washing your hands. Um, because the traditional tools of of contact tracing really aren't going to be as effective when things are spreading this quickly, we're going to keep doing that work. And our local health departments have been amazing, um, as well as our contact tracers and and, uh, you know, contacting everyone and staying abreast of that. But, um, if there were a lot of cases coming our way and that's why everyone needs toe work hard, um, and and really approach things as if if those around you could have it and for you to take those precautions, take that personal responsibility to say, Look, I gotta wear a mask. I gotta wait 6 ft apart. I'm not going to go to, uh, that event. I'm not gonna take that that risk right now. There's just a lot of virus here in North Carolina. Thanks. We have a follow up from test larger burn. Foxy. You mentioned some guidance for public health departments when it contact tracing. Can you be a little bit more specific about what they what that guidance is and what they're being told? Still under development. And so, um, they're going to be asked to really look at their cases and prioritize some of some of the work. So, um, still still under development as we work with our local health departments. Next question is from Joedy. McCreary with CBS 17. All right, Thank you, Doctor. Coming. I wanted to ask about the percent positive. I've had questions from viewers about the way it's calculated and the specific numbers that go into it not being public. My question is right. How difficult would it be for the state to release those numbers on in terms of public understanding? What benefits might come along with doing that? Well, thanks for that. As you know, our dashboard has received many awards for the level of transparency and the kind of data that is available on our dashboard. We've worked very hard over the course of this pandemic to make more and more data available, allow it to be downloadable. Allow folks to really understand and follow along on the metrics that we use to inform decision making will continue to update, uh, that that information, as as we continue toe evolve our work as far as the percent positive. That again is a metric that helps us understand of the total amount of testing that is being done. How many are actually positive. And it does give us a sense of how how much viral spread is happening across our state. So an important metric to us, the way it is calculated, is based on those labs that are able to report to us Elektronik Lee s. So it is not the whole universe of every single tests were very clear about that on our dashboard about the subset of data that we use it. It is it is nearly all but not all of the testing data. Eso we do have some limitations on that. That total universe of data on then we are able to calculate from a total test that aired on how many of those are our positive. Thanks. I'm our final question today is from Andrew Beller, the Bloomberg News. Hi, Dr Cohen. Thanks for being here and taking this call. Um, I was wondering if you go into the cold storage issue a little bit. Do we have enough? Uh, capacity for shipments were coming down the road I saw in the in the vaccine plan that, uh, that purchasing ultra cold storage units was not recommended this time because dry ice could be used. Could you kind of go into that a little bit for me, please? Yes, Andrew. Great question. So, for one of the two vaccines that are under consideration of the FDA, the Pfizer vaccine in particular, um is one that requires what everyone's been talking about, which is ultra cold storage. Mean it can't be in a normal freezer. It has to be even colder than that. Um, for the initial doses, we we do have a particular sites that can store those over for a longer period of time in ultra cold storage. But you're exactly right, is that, um the Pfizer company has arranged for dry ice to be available in order. Thio, uh, keep it at the appropriate temperatures. So we haven't needed to purchase ultra cold storage facilities or other mechanisms. So Pfizer has taken care of that from a dry ice perspective. Um, and then the Madonna vaccine does just require regular freezer and refrigeration, so it does make it a little bit more mobile and transportable. Thanks for that. I think that was the last question. Uh, Andrew. So thanks so much again. We went through a lot of information today on vaccines. I know it's a lot. Um, I know that this has been a long year. Um, everyone has worked really hard to keep the virus level low. And when we see numbers like 5600 cases in 24 hours, I know it can feel discouraging, but we know what works. And it's the three W's. So keep them up, wash your hands, wait 6 ft apart. And importantly, where that face covering. So whatever your reason, get behind the mask. Thanks so much. Stay well. Ah, yeah.