Health department warns vaccine may be limited initially
By CHRISTIE MASTRIC
Journal Staff Writer
MARQUETTE — The Marquette County Health Department on Thursday cautioned there will not be enough COVID-19 vaccine doses to be distributed initially after they are approved.
“We are all waiting for safe and effective COVID vaccines and based on the current evidence, they are really close,” MCHD said in a statement.
With the projected shortage, the county health department said an allocation plan is being finalized by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, which will be followed nationwide.
MCHD noted that when devising and approving the plan, ACIP will follow the general ethical principles of maximizing benefits and minimizing harm, mitigating health inequities, justice and transparency.
A phased approach has been recommended, with the first phase resembling this scenario:
≤ Phase 1A: health care personnel, paid or unpaid, including EMS, first responders, long-term care personnel and long-term care facility residents;
≤ Phase 1B: essential workers such those in as the education sector, the food and agriculture industries, utilities, police, firefighters, corrections officers and the transportation industry; and
≤ Phase 1C: adults with high-risk medical conditions, and adults age 65 and older.
“It is currently thought the initial allocation through the nation, possible later in December or early January, will not be sufficient for the proposed 1A ‘jumpstart phase’ consisting of health care personnel and long-term facility residents,” the MCHD said in a news release. “Therefore, additional rationing will be needed initially. The logistics of this is currently being planned and finalized by the CDC, which will be followed by the states and then locally.”
Officials noted that large populations will compete for limited doses of the first vaccines to reach the market, with a substantial overlap in groups in phases 1A, 1B and 1C. CDC staff estimates 21 million people would fall into the health care personnel category and 87 million people would be in the essential workers group. More than 100 million adults in the United States, such as those with diabetes and cancers, would fall into the high-risk medical conditions group, while 53 million people would be in the group of age 65 or older.
The MCHD said that if all goes as expected, Pfizer and Moderna vaccines will be approved by the Food and Drug Administration and later by the ACIP, by the middle of this month. The ACIP will outline information needed for the county health department’s medical teams to start the vaccination process.
It is expected other vaccines will be reviewed and approved in 2021 as well.
The county health department said Moderna expects to have about 20 million doses of its vaccine available in the United States by the end of the year, and is on track to manufacture 500 million to 1 billion doses globally in 2021. Pfizer and BioNTech expect to produce globally up to 50 million doses this year, of which 20 million doses will be available in the country, and up 1.3 billion doses by the end of 2021.
Department of Health and Human Services Agency Secretary Alex Azar, the health department noted, said on Nov. 18 that the federal government expects to have about 40 million doses of these two vaccines by the end of this month –enough to provide the two-dose regimen for about 20 million people.
In a telephone interview with The Mining Journal, Dr. Bob Lorinser, medical director for the MCHD, said there many unknowns about the situation, including the long-term effectiveness of the vaccine. The data about long-term effectiveness probably won’t be known until the summer, he said.
However, Lorinser said the FDA, among other entities, will track people to determine the vaccine’s effectiveness. He noted whether the vaccine could be administered annually like influenza shot, or on a shorter or longer time course, is unknown.
“A lot of people are calling it the cure or the panacea,” Lorinser said. “It’s not.”
He noted data shows the vaccine prevents serious illness and death, but no one knows if it prevents infectivity.
“Infectivity means you still got the virus,” Lorinser said. “You can spread the virus, but you don’t get sick from the virus.”
He stressed mitigation efforts to combat the spread of COVID-19 will remain until the infectivity factor is determined in regard to those who are vaccinated. People still must wear masks, follow social distancing protocols and practice good hand hygiene.
MCHD said the health departments in the Upper Peninsula, working with the Michigan Department of Health and Human Services as well as local medical providers and facilities, are outlining the logistics of vaccine distribution, which is “no small task” given the expected initial limited supplies.
MCHD said combined efforts of private and public medical care providers, with assistance from local public health experts and many others in the community, will make this “enormous” project a success.
“It is expected enough vaccine will (eventually) be available for all, but this will take time,” MCHD officials said.
Officials said it is estimated low-risk adults can receive the vaccines beginning in April through June, followed by the pediatric population sometime afterward.
Vaccine link available
Michigan has an online link dedicated to vaccines for COVID-19.
The link, found at www.michigan.gov/COVIDvaccine, has vaccine resources regarding immunizations for COVID-19, facts from the CDC, and provider guidance and education.
“The COVID-19 pandemic demonstrates how diseases without vaccines can devastate economic and public health,” the site reads. “Vaccines have reduced and, in some cases, eliminated many diseases.”
Included on the website is the initial draft of the Michigan COVID-19 vaccination plan, which includes information on vaccine administration capacity, second-dose reminders, vaccine safety monitoring and other topics. The draft will be updated in the coming months.
LMAS Health Department releases update on quarantine guidelines
The Luce-Mackinac-Alger-Schoolcraft District Health Department on Thursday issued an update on quarantine guidelines.
Since Wednesday when the CDC presented scientific findings describing options to reduce the required number of quarantine days for individuals with known exposure to a confirmed COVID-19 positive individual, the Michigan Department of Health and Human Services has been evaluating the information to develop guidance for contact tracing and recommendations for state residents.
The existing 14-day recommendation was based on early data that estimated the COVID-19 incubation period. At the national level, estimations of the incubation period were refined based on a review of case data for hundreds of thousands of cases.
While a 14-day quarantine period is still standard, under certain conditions, the CDC has presented an option for reducing the quarantine period for exposed individuals to 10 days after exposure.
Based on the evaluation of the CDC information, MDHHS has updated guidance to specify that the post-COVID-19 exposure quarantine period for Michigan residents can be modified in specific situations.
While the standard 14-day quarantine period remains, individuals have an opportunity to reduce that to 10 days, but only if an individual does not develop any symptoms or clinical evidence of COVID-19 infection during daily symptom monitoring for the 10 days after the last exposure, and daily symptom monitoring continues through day 14 after the last exposure.
Based on individual assessment, the LMAS District Health Department may continue to require individuals to quarantine for the full 14 days per existing CDC recommendations, officials said. It said the 14-day option most greatly mitigates the possibility of post-quarantine transmission and continues to be the strategy with the most evidence for reducing risk to others at present.
With consideration for existing — and potential — limitations on the availability of testing resources, testing modality and concerns of increased turnaround time for lab results, MDHHS is currently reviewing options for further reduction of quarantine periods based on diagnostic testing results. MDHHS guidance might be updated at a later date based on that review. At this time, there is not an option for reduced time in quarantine based on a negative test.
Michigan National Guard use extended
The use of Michigan National Guard forces for COVID-19 response has now been secured through March 31, according to a press release from Gov. Gretchen Whitmer’s office. Title 32 authority, which allows guard members to receive federal pay and benefits, was previously set to expire on December 31, due to a deadline set by the Trump administration.
“The Michigan National Guard continues to be a crucial part of our fight against the COVID-19 pandemic. I want to thank our men and women in uniform for their dedication and round-the-clock work to protect the people of our state by expanding testing in our communities and ensuring they have what they need to get through this crisis. I implore the president once again to listen to public health experts and work with Mitch McConnell and Nancy Pelosi on a bipartisan recovery package that protects American families, frontline workers, and small business owners,” Whitmer said in the release. “COVID-19 cases and hospitalizations are skyrocketing in Michigan and across the country, and if we’re going to get through this winter, we need the federal government to step up and provide this crucial support.”
In anticipation of rapid vaccine approvals from the Food and Drug Administration, Michigan will look to the Michigan National Guard to provide logistical support and transportation support to help distribute the vaccines, officials said.
COVID report on racial
Gov. Gretchen Whitmer and the Michigan COVID-19 Task Force on Racial Disparities, chaired by Lt. Gov. Garlin Gilchrist II, on Thursday released an interim report detailing the progress Michigan has made in protecting communities of color from the spread of COVID-19.
“From the beginning, our administration has listened to medical experts and taken a fact-based approach to eliminating COVID-19 in our most vulnerable communities, and we have seen significant progress,” Whitmer said in a statement. “Lt. Gov. Gilchrist and the leaders on the task force have been crucial in helping us dramatically reduce the number of cases, hospitalizations and deaths in communities of color by expanding testing and providing crucial support to community organizations.
“Our work is far from over, and cases and hospitalizations are still rising statewide, but this team remains dedicated to working with medical experts and protecting our communities, frontline workers and small businesses.”
The immediate focus, Whitmer said, is holding the progress, flattening the infection curve and remaining vigilant with mask wearing and social distancing.
“The coronavirus pandemic has shined a light on the health, economic and educational challenges that communities of color face daily,” Gilchrist said in a statement.
As of Nov. 16, more than 24,000 tests have been administered in previously underserved communities across 21 neighborhood testing sites, according to the governor’s office. These state-operated sites provide COVID-19 testing on a consistent schedule, several days per week. All sites offer free testing, and a prescription is not required for someone to be tested, nor is any form of ID required.
From March and April to September and October, the average cases per million per day for Black Michiganders dropped from 176 to 59. In the same period, the number of probable deaths per million per day among Black Michiganders dropped significantly — from 21.7 to 1.
“Our work on the task force is far from over, but the data is clear — we have taken swift, meaningful action to protect Michigan’s most vulnerable communities and save lives, and we will continue to do so until this fight is over,” said M. Roy Wilson, task force member and president of Wayne State University, in a statement.
The task force has identified a number of areas to focus on heading into the holiday season and the cold winter months, including:
≤ Closing the digital divide in telehealth and virtual learning to ensure equitable access for all Michiganders;
≤ Increasing enrollment in health insurance plans by making it easy for Michiganders to find out about their options for affordable care, such as Medicaid and federal marketplace plans;
≤ Building mobile testing infrastructure that can also be extended for other health services such as vaccine administration; and
≤ Raising awareness of racial and ethnic disparities in medical care to ensure that every Michigander, no matter their race, can get safe and quality care in Michigan.
The Michigan Department of Labor and Economic Opportunity and the Unemployment Insurance Agency have submitted to Whitmer a report prepared by Deloitte & Touche LLP documenting the chronology of the state’s efforts to identify and respond to fraud risks regarding unemployment claims during the COVID-19 pandemic, according to a Michigan.gov news release.
The report identified areas where UIA’s policy, technological and organizational changes increased the agency’s potential exposure to fraud, and documented steps UIA already has taken to enhance its fraud risk management capabilities to address vulnerabilities.
“Our work isn’t done, and the UIA will continue to review our operations and organization to prevent criminals from accessing the unemployment benefits our hardworking families deserve,” said Liza Estlund, UIA acting director, in the release.
Since March 15, over $26 billion in benefits have been paid to over 2.2 million workers, or about 97% of potentially eligible claimants. The UIA has increased capacity, improved workflow and other internal systems, and reduced red tape to meet the high level of claims that have been filed since the pandemic began, the release said.
Before the pandemic, the UIA had around 650 customer-facing staff, and now nearly 3,000 UIA team members are helping claimants. This includes answering phones through the call center, making proactive calls, answering questions online, solving technical issues and adjudicating claims.
Christie Mastric can be reached at 906-228-2500 ext. 250. Her email is email@example.com.