NC apologizes, promises change after hospitals, counties balk at vaccine distribution

Frustrations boil over for hospitals, health departments; Cohen apologizes and promises more certainty for next three weeks.

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Travis Fain, WRAL statehouse reporter,
Joe Fisher, WRAL multimedia journalist
RALEIGH, N.C. — North Carolina's secretary of the Department of Health and Human Services apologized Monday afternoon on a call with hospitals and county health departments for changes to the coronavirus vaccine distribution calculus that saw some struggling to balance a decrease in supply with an increase in demand.

Dr. Mandy Cohen proposed that, instead of a week-to-week allocation to the counties that leaves them unable to plan far ahead, the state would guarantee some minimum baseline allocation each week for the next three weeks.

“Three weeks is what we feel comfortable with certainty," Cohen said.

The call came after local hospitals and health departments were forced to cancel or delay thousands of vaccination appointments across the state after a lower-than-expected allocation.

Some of the supply the counties and hospitals expected to have on hand in the coming weeks will instead be diverted to at least one massive vaccination event that the state hopes will speed up the process of getting shots in arms.

That event, Friday through Sunday in Charlotte at Bank of America Stadium, could reach up to 20,000 people.

But that comes with a cost: pulling supply from hospitals and health departments the state had just told to speed up their own vaccination efforts.

Cohen said vaccination operations faced a double whammy this week. The state asked hospitals and health departments in recent weeks to speed up and burn through a backlog of doses so the federal government wouldn't punish the state by reducing future shipments. But the new pace didn't mean the state would receive more than the roughly 120,000 first doses it has been getting each week.

"I apologize for not being more clear," Cohen said on the afternoon call. "I own that, and I apologize. It has put you all in a difficult, difficult position."

The state reaches out with allocation numbers at the end of each week, and by the weekend, it was clear hospitals and health departments would get less vaccine than they'd scheduled shots. Cone Health alone, which serves the Greensboro area, said it would cancel 10,400 first-dose appointments.
Second-dose appointments won't be affected, the system said.

Local health department managers wrote Cohen Sunday, saying they'd be forced to call an unknown number of people, most of them over 65, to cancel appointments.

"This after (local health departments) did exactly what was directed of them: Schedule appointments, commit to individuals and get them into future slots," the heads of the North Carolina Association of Local Health Directors said in their letter.

"Because doses were diverted, grandmothers and grandfathers who had appointments in rural NC now wait," the letter states. "Health care workers who had appointments where they serve patients now wait."

The state hospital association expressed similar frustrations, saying in its own letter to Gov. Roy Cooper that the state needs a better distribution plan and that hospitals need more input with fewer surprises.

"Hospitals have also repeatedly pivoted on short notice to accommodate various urgent directives and orders from state and federal leaders, typically with no prior consultation for input or clear measures of success," the letter states. "We can, and do, adapt on the fly, but it is time for the state to now take steps to coordinate a better plan and way forward on vaccine deployment."

State officials acknowledged the frustrations and said they're trying to speed up the process, but supply remains limited. Cohen and other top officials in the state's vaccine effort spent about an hour on Monday's conference call, laying out the new plan, asking for feedback and promising better communication.

Kody Kinsley, a deputy secretary at DHHS focused on pandemic response, said local providers could expect basics Tuesday on how much vaccine to expect over the next three weeks. Cohen said the state will take 84,000 doses from the state's expected weekly allotments and divide it among the counties by population, then divide that among providers in each county.

"That means not every provider is going to be able to get vaccine," she said. "The numbers don’t work for everyone."

The remaining 36,000 doses the state gets each week will be used to "plus up" organizations that can help reach marginalized communities, including rural and minority communities that are typically underserved, Cohen said.

Once local operations get their shipments, they'll have five to six days to get all those doses into arms, Cohen said. Demand will continue to far outstrip supply, she said.

"We're not going to have enough vaccine, I don't believe, for a while," she said. “But we will get there. We will work through it together. I apologize again.”


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