ON THE WAY
Landmark readies for vaccine distribution
WOONSOCKET – Landmark Medical Center expects to begin administering the COVID-19 vaccine to hundreds of healthcare staffers early next week, while municipal firefighters and EMS workers from all of Northern Rhode Island will get it shortly after Christmas at a regional clinic at Smithfield High School, officials say.
Dr. Glenn Fort, Landmark’s chief medical officer and infectious disease clinician, said the hospital is due to receive 975 doses of the vaccine beginning Thursday and commence the vaccinations of doctors, nurses, lab technicians and service workers who clean the rooms of patients with COVID-19 beginning the following Monday, Dec. 21.
“The arrival of the vaccine is going to be a game changer,” said Dr. Fort. “We’re finally seeing some light at the end of the tunnel.”
The hospital is to receive enough vaccine to dose just about all workers who have contact with patients at Landmark, which employs roughly 1,000 people. But Dr. Fort is predicting much of the staff won’t immediately get the vaccine after the hospital makes it available to them.
“Some cannot wait and they’re very excited about it, and we have some that have a more wait-and-see attitude,” said Dr. Fort. “At least half of them will actually want a vaccine in the early stages and others will want to wait.”
There are multiple COVID-19 vaccines in various phases of clinical trial and production, but the Pfizer, Inc., product that’s presently being distributed throughout the nation this week was the first to be approved – just four days ago – by the Food and Drug Administration. The clinical trials and the regulatory process were completed so quickly that many Americans are still worried about possible
long-term side effects and allergic reactions, but Gov. Gina Raimondo’s administration has embarked on an all-out campaign to convince citizens that the vaccine is safe.
Moderna, Inc., appears to be positioned for second place in the race to the vaccine finish line with the FDA scheduled to consider approval of its version of the corona shield later this week. Both require two shots a few weeks apart and are said to be about 95 percent effective, far better than the average flu vaccine.
“I personally remain incredibly optimistic about vaccines, specifically the COVID vaccine,” said Dr. Phillip Chan, a Rhode Island Department of Health epidemiologist, in a Facebook event on Friday.
It could be months before enough vaccine trickles into the state to supply the two-tier shot to everyone who wants it, but the state has established a four-phase protocol for who gets it first. The first doses are on their way now to hospital workers, staff members of long-term care facilities and first responders like EMS workers and other municipal firefighters.
Those groups are in a December-February time slot that also includes, just behind them, people with two or more underlying conditions, or comorbidities, and older adults living in congregate care or overcrowded group-living situations.
Woonsocket Fire Chief Paul Shatraw says the Woonsocket Fire Department is on track to receive 107 doses – enough for the entire staff. The medications will be administered to firefighters from a centralized, regional clinic at Smithfield High School due to commence roughly between Dec. 26 and Jan. 1.
“I think generally speaking everybody is certainly eager for anything that can assist in putting closure to the pandemic,” Shatraw said.
Like the hospital, there will be no municipal mandate for WFD workers to receive the vaccine, Shatraw said.
Smithfield EMA Director Todd Manni said plans have been in place to use the town’s high school as a staging ground for a possible pandemic immunization program for years, so his team is ready to hit the ground running. The location is favored for its centralized location as part of the state’s long-range emergency planning.
“I have a high degree of confidence in the system we have in place,” Manni said. “Some of these plans have been in place since we had H1N1, about ten years ago. We always knew there was a threat of something like this happening and it’s arrived on our doorstep.”
Manni expects to have some 2,000 doses of the vaccine available to inoculate the priority first responders from Woonsocket, Burrillville, Cumberland, Foster, Glocester, Johnston, Lincoln, North Smithfield and Scituate. In addition to firefighters and EMS workers, Manni said the regional center will administer the vaccine to home healthcare workers.
There will be no pecking order for the targeted first responders based on municipality. Once the vaccine is available, Manni said, anyone in the designated Smithfield service region will be able to register for an appointment.
The most important rule, said Manni, is that the clinic won’t see more than 40 percent of a single department’s staff in one fell swoop. Based on the clinical trials, Manni said, about 40 percent of people who get the vaccine experience some type of side effect – headache, body aches and an elevated temperature are the most common.
The rule is designed to prevent essential firefighting staffs from becoming briefly depleted by having too many workers call in sick with symptoms that result from receiving the vaccine all at the same time.
“So we’re going with a strategy of leaving plenty of room between vaccinations,” he said.
Back at Landmark, Dr. Fort said the hospital has already selected the first patient who will receive the vaccine. For now, he can’t release the individual’s name, but he identified what’s shaping up as Woonsocket’s first recipient of the COVID vaccine as a veteran intensive care nurse.
On Friday, said Dr. Fort, Prime Healthcare Services, Landmark’s owner, is expected to deliver an ultra-cold freezer for the Pfizer vaccine, which must be stored at minus 80-degrees Celsius to preserve its effectiveness.
Like other hospitals, Landmark has been treating COVID-19 patients for the duration of the pandemic, and a number of staffers have been stricken with the virus as well.
But Dr. Fort said Landmark has never had to use its COVID-19 surge unit. Most patients are treated in a special COVID-19 unit, the ICU or a “step-down progressive unit.”
Landmark’s early challenges with securing sufficient protective gear like masks and gowns are pretty much a thing of the past. And while the hospital is seeing more patients now than at the first peak in late spring, they’re coming to the hospital sooner and aren’t as sick when they arrive.
“We’re also more prepared,” he said, adding that several therapeutic treatments, including convalescent plasma, the antiviral drug Remdesivir and anti-inflammatory steroid Decadron, are now among the hospital’s arsenal against coronavirus.
The vaccine is a giant step forward, but Dr. Fort said it’s imperative to continue vaccinating more people, starting with the most highrisk, as the state’s plan envisions.
Phase Two of distributions, according to RIDOH, is slotted for the February to April time frame and includes K-12 teachers, school staffers, child care workers, “critical workers” in high-risk settings and people with moderate underlying conditions.
This phase also includes people in homeless shelters, prison inmates and all older adults.
Phase Three is zoned for April to June and includes young adults and children, and Phase Four, which begins after that, includes everyone else.
Ironically, the vaccine is on track to arrive just as healthcare experts envision the darkest days of the pandemic, with a national surge in infections. On Monday, for example, the Rhode Island Department of Health reported 1,422 new coronavirus case since Friday, with a test positivity rate averaging 8.9 percent for the past week.
There were also 552 new cases in the last 24 hours, plus 20 additional deaths, bringing the total number of infections since the onset of the pandemic to more than 74,000, with 1,555 fatalities. There were also over 430 people in various hospitals, many of them in intensive care units.
Some 70 percent of those who’ve died were residents of nursing homes and other congregate care settings.
“I’m very excited about the ability to finally have a vaccine that will help prevent infection,” said Dr. Fort. “Nursing homes and group homes, those are the groups we need to target quickly, too.”