Learned on the road
How life traveling with Twisted Sister prepared the man running Baltimore County’s COVID-19 vaccine sites
Rock concerts and COVID vaccine clinics aren’t all that different, if you ask Terry Sapp. The man running the show at Baltimore County’s vaccine sites has spent decades training and coordinating emergency preparedness at the state and local levels. But he credits much of his skill to his years on tour with Twisted Sister across 20 countries from 2004 to 2016, working his way from blogger to production assistant, and as a stage manager for local 1980s cover band The Reagan Years.
“Running something like this, running a large-scale music event or even a concert — the similarities are all there,” says Sapp, who is the public health emergency coordinator for Baltimore County’s health department.
Instead of road cases full of instruments, now the cases are filled with medical supplies. Gaff tape, it turns out, marks out traffic cone locations as well as it secures amp cables — guiding patients to vaccinators within the Cow Palace at the Maryland state fairgrounds in Timonium. And it’s important to know how to get the crowd moving.
It’s more logistical than clinical, he says: A small team of health department employees and county firefighters takes a page from public safety response — with a squad of commanders delegating tasks to roughly 150 government workers running the site.
On Wednesday morning, police security driving golf carts ferried older patients from the parking lot to the Cow Palace. Nurses, Maryland National Guard members and county employees checked them in on iPads.
Finally, workers pointed patients to one of nine short queues to await their shots.
The preparation seems to be paying off. Maryland’s third-most populous jurisdiction has outpaced the rest of the state getting shots in arms, with more than 66,500 people having gotten their second dose in Baltimore County as of Thursday.
The Timonium site is inoculating around 2,800 people daily, with “close to zero waste,” Sapp said. Any leftover doses go to those helping run the site. The county also operates a Randallstown clinic and opened another Friday in Essex. Sapp splits his time among
all three.
Coordinators said 1,400 doses had already been administered between 9 a.m. and 10:30 a.m. Wednesday.
There are parallels between propping up a makeshift clinic and setting the stage for Dee Snider to sing about fighting “the powers that be,” Sapp points out. As he circles the 158,400-square-foot Cow Palace, a tattoo of a “Mad Max”-style Armadillo — his nickname as a roadie — peeks out from beneath his left arm sleeve.
The geometric Twisted Sister logo, inked on his left arm, is generally hidden.
Whether organizing a clinic or a concert, everyone fills their niche. Backstage, the guitar tech is focused on tuning the string instruments. The light tech chooses which gels to filter the most suitable onstage lighting.
Like roadies, Sapp says, county clinic staff each have just one job, facilitating a more streamlined process. It’s a departure from some other mass vaccination sites, he says, where nurses may be asked to screen, fill out patient records, prepare vaccines and administer shots.
Sapp has been a leader in building the system and coordinating between the fire and health departments, said Fire Department Lt. Howard Simons, a member of the clinic’s vaccination command staff.
“We know how to run a fire ground,” Simons said. But effectively running a vaccine clinic was learned on the job with Sapp’s guidance.
It’s a balancing act. Patients can’t be screened and processed too quickly or lanes leading to vaccination stations become overcrowded. Moving too slowly means some could be left waiting outside or in their cars. The goal is to keep things moving.
The county’s pandemic planning began long before the coronavirus outbreak. Shortly after Sapp joined the county health department in 2008, he had a different virus outbreak to contend with as the H1N1 flu began spreading rapidly.
The county’s H1N1 vaccine operation — among the largest clinics in the state — was essentially expanded and tweaked to suit the coronavirus response. Since then, Sapp has helped coordinate seven vaccination sites during the county’s Super Saturday flu vaccine events.
“It allowed us to build that muscle memory,” he said.
Girl Scout cookies also played a part. Looking for low-cost ways to test the efficiency of the county’s system to dispense mass medical countermeasures — often antibiotics, spurred by widespread anthrax attacks in 2001 just after Sept. 11 — Sapp struck a partnership between the county and the Girl Scouts of Central Maryland.
The cookie boxes are identical to the weight and dimensions of a case of antibiotics from the federal cache, Sapp said. Girl Scout troops — simulating local organizations that would dispense the antibiotics — lined up in cars to receive the cookie boxes in a drive-thru.
That training, which began in 2009, provided a template for the county to deliver personal protective equipment to around 300 county nursing homes at the outset of the pandemic.
“It’s just like cookies, guys,” Sapp told health department operations personnel last year. “It’s gonna be OK.”
Martin Wolff and his wife, Libby, are both over 80 years old and struggled to navigate at least six different websites looking for appointments to no avail. Their niece finally secured them one through Baltimore County’s registration portal.
Compared with that, the process at the fairgrounds “was a piece of cake,” said Martin Wolff, a retired Anne Arundel County Circuit Court judge as he sat with his wife in a sectioned-off area of the makeshift clinic after receiving their first doses.
Baltimore County is currently vaccinating those prioritized in phases 1A and 1B — frontline workers, nursing home residents and staff, those 75 and older, educators and those with developmental disabilities.
As of Wednesday, there were 250,000 on the county’s vaccine waiting list, county spokesman Sean Naron said.
The process took half an hour, Martin Wolff said. Their second doses are scheduled for Libby’s birthday.
The health department has gotten “dozens of letters” thanking clinic nurses, Sapp said. He wants to tape them to a wall in the Cow Palace. That kind of testimony makes the 12-hour days rewarding.
Knowing a patient has had an experience as compassionate as it was efficient — “that’s music to my ears,” he said.
Sapp expects the operation to continue throughout the summer. That timeline could depend on how quickly pharmacies and primary care physicians will be able to provide more vaccinations.
“We’ll keep going until we don’t have to,” he said.