NC officials provide update on vaccine distribution
State health and safety officials provide a Jan. 26, 2021, update on the coronavirus outbreak in North Carolina and the state's response to it.
an emergency management director Mike Spray Berry, Brian Tipton and Monica McGhee are are American sign language interpreters and Jackie Matav, Yer and Erica Kugler are are Spanish interpreters, starting with the numbers. As of this morning, there were 3978 new cases reported today, 3368 people are currently hospitalized right now across North Carolina, and sadly, there have been 8776 deaths. North Carolina vaccine providers have worked tirelessly tirelessly to ramp up and vaccinate people under difficult circumstances are vaccine providers are the very same people that have been on the front lines of this pandemic? For close to a year, these women and men have been working overtime, day in and day out to slow the spread of cove in 19 and save lives. They have cared for the thousands of North Carolinians that have needed to be hospitalized, created a testing infrastructure that has completed more than 8.5 million tests. They've conducted contact tracing for a virus that has now infected more than 723,000 North Carolinians. They've educated their communities about the three W's and so much more they born await. That would break many. Yet not only have they stood firm, they have continued to rise to the occasion. I'm happy to report, As of midnight, 95% of all first doses of co vid vaccine have been administered in the state. That's right, 95%. That leaves less than 5% of first dose is still to be administered today before our next federal shipment arrives tomorrow. North Carolina vaccine providers have given more than 810,000 doses. 630,000 people have gotten there. First doses of Covad, 19 vaccines from North Carolina providers and 260,000 of those first doses were just given in this past week alone, after the federal government put all states on notice that future vaccine allocations would be based on how much supply our state had on hand, we charged are vaccine providers with exhausting North Carolina's supply of first doses, and our partners stepped up. Hospitals, local health department and other vaccine providers worked as one team team vaccine on the shared goal. Together, they got 95% of first doses into the arms of North Carolinians across the state, an incredible achievement that demonstrates to the federal government that North Carolina is ready to take on more vaccine. And we need those additional vaccines now. Now the providers have cleared the backlog. This coming week is going to feel like a big change. First, the state on Lee gets 120,000 new first doses from the federal government each week. That's much less than the nearly 260001st doses they just gave in the past week and this coming week. A large number of doses are committed to large scale events plan several weeks back when we were addressing that backlog in vaccines. So this week is going to feel particularly tight, with many providers getting small or no allocations. But we know that our providers need as much stability as we can give them in what is a very unstable environment. We've communicated with all vaccine providers, outlining a process for allocations for the coming weeks to ensure more transparency and certainty. Now that the state has largely exhausted the backlog of that vaccine supply, there are some things we cannot control first there is very limited supply of vaccine coming into our state. Second, we have very little advanced notice. The federal government allocates and ships vaccine to North Carolina on a weekly basis, without advanced certainty of supply. Third providers are given a 48 hour window on when even vaccine supplies air going to arrive, making it hard to plan clinics and schedule events. But here's what we can control. Starting with this week's allocation, North Carolina will reserve 84,000 doses of our weekly 120,000 allocation of first doses from the federal government for our local vaccine providers. Providers will be given a baseline amount of first doses that they can expect for the next three weeks. Vaccines will be allocated to each county based on population and then divided among the county's providers based on their vaccine capacity. The remaining 36,000 doses will go towards balancing vaccine distribution across our counties after our big push To clear that backlog, we'll also work with local partners to increase access for historically marginalized populations, with a focus on achieving racial and ethnic equitable access to this vaccine. Third, we're going to strategically onboard a few new providers to expand access in certain locations. We continue to expect vaccine providers to use all first doses each week or transfer them to a provider who can. We will always have supply of second doses on hand that are going to mirror those first dose allocations to ensure everyone gets both shots at the right time. But those first doses need to be off the shelves and given to people each and every week. We're also asking providers to prioritize equity. The percentage of vaccines administered to historically marginalized populations should meet or exceed the population estimates of their communities in their county and region. The state is aiding these local efforts by offering support with data entry event planning, coordination amongst community players, pairing volunteer work force such as vaccinators and registration assistance, helping to answer phones and materials to inform people about the vaccine well, this has been hard on providers. We know that it's also very hard on North Carolinians. Demand for vaccines vastly exceeds our supply. Limited supply may result in wait times and sometimes delayed appointments, but everyone will have a chance when it's their priority group is eligible and vaccine supplies increase. We're working to build a better way for people to get information. Yesterday, we launched a new online tool to help North Carolinians know when they will be eligible to get their vaccine. Find my vaccine walks through users The A Siris of questions to determine which vaccine group there in people can then sign up to be notified when their group can get vaccinated. Find my vaccine group is available in English and Spanish. Go to your spot your shot dot n c dot gov to try it out. We also added, are are about to add some new data to the vaccine dashboard. You can now see how many doses the federal government has promised to North Carolina and how many the state has actually received. You'll also be able to see the percent of doses that have been administered. The dashboard provides information for both North Carolina vaccine providers and the federal long term care program. All right, that was a lot. So to Recap one, vaccine providers in North Carolina have exhausted 95% of the state supply of first doses. Next, the vaccine supply is incredibly limited. We're asking providers to continue to use all first doses each week before the next shipment arrives. We've shared a plan for the next three weeks to give providers as much stability as possible. We have a tool for North Carolinians to find out which vaccine group there in and the dashboard has new data. With all the attention we've been putting on vaccines, we cannot lose sight of the fact that this pandemic is still spreading disease across our state. This past weekend, we reported the first known case of co vid 19 variant called B 117 which was first detected in the United Kingdom. Early data suggest that this variant maybe mawr contagious, and that's very worrisome. My directive remains in place. Please stay home on Lee. Leave home for essential activities like work school or to meet health care needs. If you must leave home or be with people who you don't live with, where a mask all the time, stay at least 6 ft apart and wash your hands often keep doing those three W's and staying home so we can slow this virus down while we get everyone a spot to get their shot. And with that, I'll turn it over to director Spray Berry. Thank you, Secretary Cohen, and thank you for your continued outstanding leadership. Good afternoon, everyone. Today is day 3 23 of the state emergency response team activation for the Covad response, along with our many partners, emergency management is continuing to support the cove in response. Across the state with a variety of resource is the state emergency Response team has Civil Air Patrol members, state public health employees and the community care of North Carolina employees working on the vaccination effort. It's all hands on deck this week. There are also 18 National Guard vaccination strike teams and 18 National Guard vaccination administrative support teams on scene supporting counties with vaccination events. There is a total of 256 National Guard members currently supporting vaccination efforts across the state. We should note that other National Guard members are also continuing to provide vital support to food banks and surged to Kelvin testing sites across the state. We're also continuing to coordinate volunteers who can support vaccination sites. If you would like to register as a volunteer, both medical and non medical toe help at the vaccination site or at medical facilities. The website to visit is terms dot N. C e m dot org's That's t e r M s dot n. C e m dot org. You'll go into a pool of volunteers to be screened, and if approved, you could be called on to assist the vaccination site or a medical facility in your area. Part of the new federal administration strategy to Combat Cove. It includes additional support available through FEMA to the states, particularly around vaccinations. We're working closely with our local partners and FEMA toe. Identify specific needs for North Carolina related to vaccination, support, timing of availability and the necessary wraparound services to begin plans to get him on the ground in order to augment and support the incredible vaccination work being accomplished in our local communities. Let's also remember there's still a great need for personal protective equipment. As part of our prevention strategy, work is continuing to provide counties with all forms of PPE and related supplies. DHHS and NCM Logistic teams ship PPE to over 40 counties yesterday. A special thanks go out to our local partners, emergency management and emergency services, health departments and health care organizations and all the others for your tireless work in every facet of the cove. In response to predict all North Carolinians here it the Stadio See, We continue to enjoy the great success stories about your vaccination events. And, yes, we value your shared input as to how we can put a better operational product out on the field. You continue to make a difference. We've had bumps along the way. But if we stay together and maintain solid lines of communications will achieve success. Just reflect on your amazing body of work over the last year. Incredible. I want to encourage everyone to get the vaccine. When your turn comes, it's safe and it's free. I'm 66 I was able to get my first shot last weekend, and I'm looking forward to getting the follow up shot in a few weeks. A special thank goes to Kobe Sawyer, who jumped my truck when I came out of the clinic. You have a shot, so take your shot. With viral spread at critical levels, it's more important now than ever to observe the three W's just like madam secretary told us where a cloth face covering Wait at least 6 ft apart and wash your hands often. Stay home where waiting wash and is always. Don't forget to look out for your family, friends and neighbors and to call your loved ones daily. They will appreciate it. What kindness and cooperation we will all get through this together is one team, one mission and one family. Thank you very much. And thank you, Madam Secretary. Well, thank you, Director. Glad to hear about your vaccination. I'm certainly looking forward to mind when it is my spot, um, to take my shot. So we're excited about how Maney vaccines have gotten out across the state. And with that, we will open to your questions. The first question today is from Richard straddling with the news and observer. Okay. Hi, Dr Cohen. Thanks for taking my question. Um, looking at the numbers of doses allocated through last week, the allocations per capita very pretty widely from county to county. Now, the Wake County has received one dose per 27 residents, while other counties have received one dose for eight residents or even fewer in some cases. How does that happen? How how are you deciding how to allocate the vaccine among the counties and which factors are more important than others. Richard, Thanks for that question. Um, and again, I think we have had different moments in time. Already. In just these few short weeks, we've been doing our vaccination efforts. When we first allocated vaccine, we very much did it population base, where every county was getting the same number of doses per population. But as we needed to move to this posture of speed, Um, and make sure that we could clear our backlog because we saw that we did have vaccine building building up here in North Carolina. And we wanted to demonstrate to the federal government that we are ready to take on more vaccine. And we want that vaccine here. We shifted our posture 2 to 1 of speed, and we certainly asked all of our partners all across the state to ramp up. And that wasn't necessarily, um, in unequal way in every single county. Um and so we committed to multiple strategies to doing that. Some, um, were additional partners were added like our federally qualified health centers. Others when we were asking for higher throughput sites like here in Wake County, others were we committed to what I'd call a mega site like we did at Charlotte Motor Speedway, and we'll do a Panther Stadium. So using that mix of strategies is how we really cleared our backlog. I think what we're articulating today is what is our go forward strategy? As we now have cleared the backlog, How do we think about, um, that allocation first? What we're saying is that 84,000 of our 121st doses that we get every week 84,000 of them are going to be distributed to our county's based on population. However, Richard, you rightly point out that because of that big effort, we just did to clear the backlog, that there are some counties who have gotten less doses than others. And so we want to use that reserve that extra 36,000 to do exactly that to re balance after we've done that, that push to get rid of our backlog. So that's what you will see as we move forward. And doing allocations this week is to make sure that we're readjusting uh, now to make sure we're getting doses, um uh, in an equitable way. Not just for geography, I wanna point out, but also that we're reaching our historically marginalized populations as well. I will say we will continue to reassess this as we learn, Um, and I think will be a different moments in time. Aziz, we get different information from the federal government in terms of supply. But at this moment, we're making that shift from that push to get rid of the backlog to this more steady state where we can give our partners some certainty. We do that allocation by population across county and then use some of a reserve state reserve supply to do that re balancing, um, that we may need to do either for geographic equity, um, or for racial and ethnic equity. Thank you. You have a follow up from Richard Straddling. Thanks for that s I want to ask how Why did the state choose Durham County for a mass vaccination event? What went into that decision? So, Richard, I think we've had we have Max fascination events everywhere in the state. So I don't know what I could say about Durham versus others. I think we're doing that in so many places. Um I couldn't even list them all at this point. So we're really appreciative that all of our partners have ramped up their capacity. That's happening in Greenville, in Greensboro and in Durham in Nashville. So in the Charlotte area, So it's happening all over our state. And so we're grateful to the partnership with emergency management with the National Guard, um, to be able Thio, ramp up some of the additional capacity. Um, the governor and I just visited um, What I what I would consider a high throughput vaccination site at the Friday Center in Orange County. So these air happening across the state and as I mentioned, we do need multiple strategies to make sure we can get this vaccine out quickly. We need to continue to demonstrate to the federal government week over week that we're getting that vaccine out quickly so that we are at the front of the line to be the one to say, Give us more vaccine. That's what we want here in North Carolina, because we know the supply is limited. So anything that we can dio to get more vaccine into our state is what we want to dio. Thanks. The next question is from Tina Terry wsoc TV Charlotte Good afternoon. This a sanitary with wsoc? Thank you for taking my question. I know there has been an emphasis on these larger high throughput site. You just talked about that. But that has left some county health directors with little or no vaccine at all this week. Um, and there is concern Turn about people who live in these, uh, smaller counties in rural areas about those people being able to get to these larger sites. What are you all doing to ensure that specifically elder elderly people in these rural counties are able to get to the vaccine? Dina, thanks for that question. Um, I think we need a mix of strategies to make sure that people are getting vaccinated as quickly and as equitably as possible. I think large scale vaccination events are one part of that, but not the only part. And so that's why you see us doing a range of strategies. Some of them are going to be these bigger events. But that is why we are giving all of our partners across North Carolina the certainty of the vaccine they will get Now the supply is incredibly limited. So they are going to see less doses, um, in in the coming weeks just because of our limited supply. And we are expecting them to get out all of the vaccine they have before a next shipment comes from the federal government. But we know that we have to work to get folks to those vaccine sites. So last week we announced $2.5 million in transportation money that is going to our local transportation providers to help with transportation to and from vaccine events. And we're also working with the many, many local partners who have really stepped up to provide, um, transportation. So there many community partners, um, I want I want to commend Duke in particular, who's working with quite a number of counties thio aid and transportation to and from their vaccine events. We're seeing that across the state. I think this is also about locating vaccine events in the communities that we want to serve. I want to call out no Avants in particular, who's done quite a number of events in their communities at churches, uh, to make sure that these are not just accessible points but trusted points as well. So that is what we are hoping to continue to see our partners do as we move through this and, um, from the state, that is our expectation. We in our provider guidance that we're putting out to all of our vaccine providers today we go through a lot of operational details and suggestions and best practices on ways that they can make sure that they're getting equitable distribution of this vaccine as we go forward. Thank you. We have a follow up from Tina Terry to be associate. Obviously there's been attained in administration. What have you heard from the federal government about plans to ramp up and provide MAWR vaccine since that seems to be kind of the root of the problem here or part of it, at least thanks for that. Yes, we know supplies are incredibly limited right now, and we are certainly advocating with the federal government that we need mawr vaccine and we want to be at the front of the line to show that we have used nearly all of our first doses in the state. So as of midnight, we're at 95%. I expect us to be nearly at 100% by the end of today, meaning before our next shipment comes tomorrow, Um, that we have used up all of our first doses. So I think we're making our strongest statement to the federal government that we can take on more vaccine and we need more vaccine. We have heard good news on this front. I think we're starting to hear that there may be some additional vaccine in our future. We have not gotten that definitively yet. I don't think it's going to be for this week, but we hope in the coming weeks there may be the opportunity more for more vaccine. That's why I want all of our providers to be at the ready to turn turn that capacity back up. Um, if we are to get mawr vaccine again, that's why we're gonna need multiple strategies here, um, to deploy pretty quickly because we get that short notice of Hey, we might just be told at the last minute you're going to get an extra, um you know, even 2000 doses, we need to make sure we're ready to take those doses and get them out as quickly as possible to the people of North Carolina. I think that's the partnership, that we're working with all of our local partners, emergency management and others s so that we can be ready to be good partners with the federal government. Um, if more vaccine becomes available, Our next question is from Jason to Bruins, this North Carolina Public Radio. W N C Hi. Thanks for the call or the question rather, um, so I know that it's d to justice mandate to local health departments in hospitals that you really should not waste any doses at all. And I think that makes a lot of sense. It seems like there's less guidance in terms of the strategies that hospitals and Health Department should use to making sure that at the end of the day, they don't waste any, Uh, maybe two part question. Have you given any guidance? What? What what sort of guidance have you given to, uh, clinics for them to, you know, sort of get rid of those last few doses? Um, and do you have a sense off what they are doing? Like are you doing ah, survey of some kind to understand the different strategies across the state that clinics were implementing Jason. Thanks for that question. And so we are providing. And we're we will post today the guidance that we gave to our vaccine providers, both on how we're going to do the allocation, our expectations of speed and equity and then some operational guidance. I think first is us all getting on the same page about the timing and the cadence off when allocations air known when shipments come. And what is that pace that we need to keep up right? That certainty, I think, is foundational for us. Thio work with our partners to get that vaccine out right? So part of this is is hard because we're working on a Wednesday toe Tuesday cycle. Most shipments come on Wednesday, but sometimes it comes Tuesday and sometimes it comes Thursday, and that's really hard for our providers to really plan clinics. So I think part of our guidance really is about getting on this operational cadence or timing so that we know in a shipment comes. They plan their their first dose vaccine clinics to get those out as quickly as possible, and then it means likely. Sunday Monday, Tuesday as we wait for the next shipment. They're probably not doing first doses. They're doing maybe second doses for folks at that time. So I think it's first an operational tempo and pace that we're working on with folks that helped them get that out. We have surveyed all of our partners to understand their capacity. They'll have a certain max capacity, right, because last week we got out 260,000 doses, so we know we have that capacity. But that was heroic kinds of capacity. And I'm so grateful for for that incredible push last week. But we are going to be at a lower rate of vaccinations. Um, as we go forward here with a limited supply, even if we get a 10% or 20% bump up from the federal government, that's gonna be nowhere near 261st, 260001st doses in a week s. So we we are going to see folks be below their ultimate capacity when we give them their allocation this week. But that's why we want them to be at the ready. I want a big sure that we are going to be ready to say to the federal government, Yes, we can take this right now today and we can get it out quickly. Um, so I think we're working through all of those details and again trying to give folks as much operational guidance and best practices. And we're all learning this together as we go and then we're learning the best practices directly from our providers that are working through this on the ground. I think it's been incredibly collaborative process I do. The last thing I'll mention is about the fact that if folks can't use it, there is a process to transfer vaccines. And we've seen a lot of that in the last week. And I wanna thank folks for being such collaborative partners that if you can't ramp up for this week, let's get it to a provider who can. We've had transfers of more than 100,000 vaccines from one provider to another in order to get it out within that same week, and that is always going to be ah, Part of the strategy is to make sure we can match vaccine with the partners who can get it out in that that quick, um, and Equitable manner. Thanks so much. A follow up from Jason de Bruin at the U. N. C. Uh, thanks for that. That was a lot of really good information. Um, I appreciate that. And, um, I appreciate also the thoughts on timing I our understanding, that is, um, sort of impacting how providers were able to get the vaccine out. So my question, I guess my follow up question is going to be about at the end of the day, right? It's It's difficult to get those last doses out, and it sounds like it least some providers are basically just calling friends and family and saying, you know, whoever is able to get down here the quickest if you're able to, you'll get a shot. I think clearly everyone would agree that's better than wasting the dose. Uh, but I think this has the potential for line cutting, and you probably don't wanna happen too often. Uh, have you thought about how much of that kind of, uh, usage, so to speak you're willing to tolerate in the system before you look at clinics and say, Hey, you know, we really want you getting the vast majority of these doses to the people that are, you know, in the proper groups. Uh, right now, thanks, Jason are very clear. Guidance is that folks should be prioritizing the categories that are open right now. That means those who are 65 up and all health care workers. That is a very clear guidance. We encourage folks to keep a wait list on hand off folks who fall into that category so they don't need to be calling friends and family at the last minute. That should be a last resort again. I do not want a single dose of this vaccine wasted, so we understand that that may happen some of the time, but it should be exceptionally rare. I think there are easy operational ways for folks to keep wait lists. Um, for the people who are in that priority group for folks to be able to to use up doses if they see no shows, they have extra doses at the end of the vaccine clinic. Um, I think there are strategies to do that. And so we hope that the the not the actions off pulling in that first arm that you see is very, very rare, and we are sticking to the priority groups as much as possible. But again, never, never waste and make sure we get that vaccine into into an arm. Thanks. The next question is from test Barge uber with Fox eight. Wghp Thank you Test Bar Harbor Fox eight. I just had a quick question from Guilford County County leaders here and city leaders here yesterday and made it pretty clear that they have the capacity to administer Ah, lot more vaccine than what they received this past week. Understanding, of course, that there is a limited toe why county leaders were wondering if there might be a mega site created here. Are there any plans in the works right now to creating a mega site? And if so, when could that be happening? Thanks Tests. You know, we're hearing that from a lot of leaders, and I'm so appreciative, right? It shows in our numbers, right. We were able to ramp to a capacity of 260001st doses, and now we're going to be in a steady state of 120,000, so we know there is more capacity out there than there is supply. And I'm so grateful for that. And so we know that this is a bit of an adjustment. Then again, we're going to be looking to see Are there places in the state that have less doses per population? And can we give them some additional doses to balance those out? I haven't looked at the data, um, for for Guilford to know if there there there is an imbalance there that we need thio address. But certainly we'll look at that. I know that they have already set up a high throughput site, I believe at Greensboro Coliseum. Uh, there. And so again, capacity is there, That is that is terrific. Um, and that is where that conversation with our teams about how we can support them. Um, and their efforts, um, as as a whole, right. We want all the partners to come together to say, How are we going to get the vaccine that is allocated to our county or to our region out in a quick and equitable way? And we just wanna work with partners to facilitate those those, um, activities as they go forward. So appreciative of of everyone recognize that they ramped up to and can take on more capacity. We do have limited supply here, but stand at the ready. Like I said, I am hopeful that we're gonna Seymour vaccine from the federal government and that we will be able to go well, e shouldn't say well beyond beyond the baseline that that we will see again, supplies are limited on. That's that's That's the unfortunate place where we are right now. Thanks. I'm gonna follow up from test part number Fox eight. Thank you for that. I had a two part follow up question. I was wondering what if any changes were being made for a C. V. M s understanding that some providers were having challenges with this system and they were calling it burdensome. So what changes would be made to the management system? I was also wondering if the state is tracking no shows for appointments. I know you said that. You know, we're really looking to make sure that everybody's making it to those appointments. Um, but are you tracking people that do not show up for appointments and has not been a problem across the state? Thanks. Test first on our overall I t system that we're calling our C VMS system, which everyone logs the vaccines debate they've been given. We know, obviously, it is a system that is working because we've been able to log over 800,000 vaccinations. But we are always trying to improve that system and make it mawr efficient as we go forward. So there's a number of ways when we've done that, and we've continued to do updates on that system nearly every week. Um, so first, we wanted to unlock, um, some some features of the system so that local vaccine providers could go in and edit some or of the data that they put into to speed up the process. Second, we wanted to make sure we're moving towards integrating that system with our Elektronik health records through the system. So we are working on a process using our health exchange, our health information exchange. To do that, that integration eso that is gonna be something we work on over the course of February. But in the meantime, we have actually opened up opportunities for folks to use different kinds of, um of computer bots to help with with filling in information and getting it in quicker is like the my my my lay version of understanding on to to really reduce that burden on our providers of getting the data in. So I think we have a number of strategies in which we're trying to improve that that system overall for folks. Um and then you ask about no shows. That is not something we're tracking at the state level. But is it? It is exactly why. You know, we want to make sure that folks have a wait list on hand from that priority group. So if they do have no shows and they do have extra vaccine appointments at the end of the end of the day, we don't want them wasting. We want them to call folks in and get get folks in and vaccinated it as quickly as possible. Thanks. A next question is from Daniel Bio toe with Telemundo. Charlotte. Thank you, Secretary. Going for my question. Some counties like Gaston didn't receive any doses all at all this week, with about 600 appointments already, Boog. According to the Gaston Health Department, they were able to receive doses from Integra for this week our counties like Asa receiving any doses next week on. Are you concerned that this situation could compromise the goal off one million vaccines for July 4? So, Daniel, couple of things to tease apart there. So we recognize that this coming week that we were particularly tight on our allocation because we were moving from that high capacity to the to the to the lower amount that we have in first doses. And we committed to a large vaccination event at Panther Stadium this coming weekend, so that constrained our allocation even more. But going forward, we have committed that every, uh, every county is going to get vaccine going forward, and we're going to allocate that based on population. And then we will distribute that that county allocation amongst the providers. So that will be the go forward. And then we're going to try to correct on top of that to make sure we're getting, um, as equitable distribution of doses per county as well as looking at equity. Um, for our African American Hispanic Latin X community as well. And use those doses above the 84,000. Um, to make that possible. Thanks. You have a follow up from Daniel by Oto. Telemundo? Yes, my follow up was about Hispanic community. But I think you answered the question already. So, um, I do concern that this situation could compromise the goal off one million vaccines for July 4th. Well, thanks for that s o I, I I will say that we are going to, of course, be limited by the number of vaccines coming into our state for the federal government. So we want to get that vaccine out as quickly as possible. And I hope to be, um, at a point of vaccinating. Um, you know, folks as that vaccine, I think it depends mawr on how much vaccine is coming into our state than in any sort of the allocation procedures. I am hopeful if we get another vaccine approved. I think that will be a really important boost to our supply as well as seeing if they're going to ramp up manufacturing capability. I think those mawr of are the limiting steps on can that I believe it was. The Charlotte area said they wanted to vaccinate a million folks in in the Mecklenburg area. Um, certainly we want to get to those kinds of goals. But I think our limiting factor is how much vaccine is coming to our state. Thanks. My final question today will be from envy. A Blandford with ABC 11. Hi, Dr Cohen. Thanks for taking my question, Aziz. You know the North Carolina Healthcare Association President Steve Lawler sending that letter to Governor Cooper yesterday, listening to several concerns with the rollout among them, he talked about communication issues. He says that hospitals and health systems that are giving the shot have been largely left out of the conversation about how to design the rollout and said, Just receiving directives from the state. Do you agree with that? And if so, what is your plan for including these providers from the beginning, especially before you move to the next days Vaccinations. Thanks for that, Andrea. And I wanna, um, really appreciate all of our vaccine providers who have been working incredibly hard. Um, we we take their feedback, Um, and and definitely I think you see our plan going forward incorporates their feedback in in the planning we're doing specifically with hospital. We have a number of ways in which we touch base with them. I talk often about the fact that I talked to, um, the CEOs of them of our of all of our large hospital systems and some of our smaller each and every week. Um, we also have now a separate sub group of folks who are just focused on vaccine operations. We secondarily have another workgroup that's just focused on those I t. Data integration, um, platforms. So of course we want to move as quickly as possible, and we want to be a collaborative of possible. So I'm really appreciative of everyone coming together giving us that feedback. I think we've incorporated that into the work going forward. Um, and you know, im again, appreciative of all of the work partners have been doing to respond to this pandemic for a year and then to go above and beyond this past week to get out 95% of our first doses. It's incredible. And I'm I'm I'm very grateful for everyone's hard work. What from India? Blandford. If you see 11. Thank you. Just one more question for you, Dr Cohen. You know, people are coming into North Carolina from other states such as Virginia to get vaccinated here in our state reports that that have been coming out in recent days. You said earlier that you are trying to demonstrate to the feds that North Carolina is moving vaccine quickly. So does it matter who is getting the VAX seen in North Carolinians or people from Madison State? And if that's not supposed to be happening, what is the state's plan for preventing it? Do you see a requirement soon to show I d before getting a vaccine? Thank you. It's Andrea. Obviously, our priority is to vaccinate North Carolinians. We get an allocation based on our North Carolina population. That being said, it is clear in our agreement with the federal government that we cannot limit by borders by jurisdiction. And so we're certainly doing our communications and operations toe lean towards prioritizing North Carolinians. But we cannot, um, by our agreement with the federal government, because remember, these are assets that the federal government has paid for and our shipping to us. Our agreement is that we are not blocking folks from a jurisdictional perspective. Um, again, I think there are ways in which we're using our communications tools and our operational tools to make sure that we are prioritizing North Carolinians, but we both ask for folks not to do to make sure that they're They're they're being open, um, across county borders and and others, um, to make sure that, um, folks who are in the eligibility category are able to get vaccinated. And again, we're vaccinating all health care workers and those who are ages 65 up right now. So that's it's been a long briefing with a lot of detailed information. I hope you get a chance to look at our new dashboard with all of this information. I also think you should take a look at the provider letter that outlines a lot of these details. I went through a lot. Um, today, Um, I want to thank our part. I know I've done a lot of thank you, but they so deserve it to our Our local partners are local health departments. Our hospitals are F Q HCS and others are emergency management partners have just been incredible. And they've been incredible for a year. Um, it is. It has been a long year, and the fact that we can we can take these steps forward on top of a hard year has been incredible. So we're gonna keep that up for the people of North Carolina, because that's what what is needed, um, for us to beat this pandemic. And we will do that together. One team, one mission, one family stay. Well, everyone.