Va.’s frontline is set to receive first doses
Health care workers will receive COVID-19 vaccine this week
The state expects to receive 480,000 doses of coronavirus vaccines in the next few days, the first strike against a pandemic that has killed at least 4,000 Virginians since March.
Virginia opted to put frontline health care workers, followed by long-term care residents, in the top priority group for immunization, based on federal recommendations. It’s not known when shots will be available for the rest of the population, but public health officials believe it will happen in the new year.
The decision means doctors and nurses who have cared for infected patients and watched
many succumb to the disease will be among the first to receive the protection against COVID-19. As of last week, more than 15,350 health care workers have been diagnosed with the coronavirus statewide, 40 of whom have died.
“The nurses and doctors are literally exhausted,” Gov. Ralph Northam said at a news conference Thursday. “They’ve been working around the clock for months. Even worse, many of them are now dealing with COVID at home. They live with someone who gets it, or they get it themselves. That takes them out of the work rotation, and it makes the pressure on others even worse.”
But putting health care workers ahead also means they will be part of an experiment, the first to try a new medical product before it reaches the masses. Northam, a pediatric neurologist, described the fight against COVID-19 as “the biggest class project we’ve ever participated in.”
Public health officials have tried to prepare people for the imminent vaccine campaign by emphasizing that it will not give them the virus but spur their immune systems to make the antibodies required to stop it.
Though health professionals are more likely to know that than the lay population, recent studies have shown hesitance even in the medical community about getting a COVID-19 vaccine. Perceptions of political influence and corner-cutting for rapid development have contributed to the wariness.
The vaccines won’t be mandatory for anyone, and it’s hard to tell how many will volunteer to get the federally funded shots. Only 63% of health care workers polled in recent months said they would get them, according to a U.S. Centers for Disease Control and Prevention poll.
Hospital employees in Hampton Roads might have similar concerns. Riverside Health did a survey in early October and found that just under 30% were ready to take a vaccine, 35% didn’t want it and the remainder were unsure, said Cindy Williams, the health system’s chief pharmacy officer.
Since the poll, the public has learned a lot more about the vaccines. Clinical trials have shown they’re 95% effective against coronavirus infections, with few reported side effects.
That information has likely helped ease some minds. Riverside did a follow-up survey that closed last week and found a little less than 60% of respondents were ready to get immunized.
“In essence, we’ve moved a great number of those who were in the unsure category,” Williams said.
On Friday, Hampton Roads hospital systems waited for the U.S. Food and Drug Administration to give drug manufacturer Pfizer’s vaccine the nod and allow people to be inoculated immediately. Updates were coming in the form of text messages and emails, with different dates being bandied about for when immunizations would begin. Most were planning for their internal clinics to start Tuesday. “Our goal is to get the vaccine into our team members’ arms as soon as it’s available,” Williams said.
At 9:40 p.m. Friday, the FDA announced it had issued an emergency use authorization to Pfizer for it to begin distribution.
Moderna, another pharmaceutical company, has a vaccine following closely behind Pfizer’s. Its first batch is expected to go through the same process about a week later.
The state is directing the first Pfizer-BioNTech shipment, about 72,150 shots, to hospital systems, and the Moderna shipment, an estimated 146,400 shots, to nursing homes and assisted living facilities. A federal pharmacy partnership with Walgreens and CVS will dispense most of the vaccines for nursing homes.
The subsequent shipments will be divided equally between health care workers and long-term care residents. State officials say the exact amount of vaccine Virginia receives is a moving target and depends on when and how quickly doses are made. The Virginia Department of Health will decide all future prioritization plans with federal guidance.
In a parallel program, the U.S. Department of Defense will receive 43,875 doses. Those vaccines, separate from Virginia’s allotment, will go to medical personnel, essential national security and deploying forces. People considered to be at the highest risk for severe illness are also in the priority group. The Portsmouth Naval Medical Center will be among the first sites to get the shots.
The vaccines will come as confirmed cases mount over 238,000, and a winter surge pushes 10.8% of standard nasal swab tests to come back positive for the virus statewide.
The Virginia Disaster Medical Advisory Committee voted this month on the initial vaccine plan. Health care workers were defined as paid and unpaid staff working in medical settings where they could come in direct or indirect contact with COVID-19 patients or infectious materials. Long-term care facility residents were considered adults who reside in facilities that provide services for people unable to live independently.
The decision to send Pfizer’s doses to health care workers had much to do with the nature of its vaccine. It must be stored at extremely cold temperatures — about 50 degrees below a household freezer — and after being defrosted, can be kept in a refrigerator for only five days.
The doses also have to be diluted before they are administered. Once people are given the first shot, they have to return for a second about three weeks later.
Hospital systems in the region started working this fall to find ultra-cold storage big enough for trays holding 975 vaccines each. Sentara Healthcare plans to use special freezers at Norfolk General Hospital that came from Eastern Virginia Medical School. Staff will have to pack the vaccines on dry ice to transport them to other hospitals within the system.
Riverside bought new freezers at about $20,000 apiece for its allotment of vaccines. The system also plans to provide storage for the initial doses for Chesapeake Regional Medical Center’s employees.
The Moderna vaccine, on the other hand, can be stored at a standard freezer temperature, and kept in a refrigerator for about a month after defrosting. It can sit at room temperature for 12 hours, versus Pfizer’s six. The second shot in the series also comes a little bit later, after four weeks instead of three.
About 300 skilled nursing and 1,000 assisted living facilities have enrolled throughout the state and are expected to get their doses before the end of December. National pharmacy chains will handle the storing, administering and reporting of vaccinations through a federal program.
“It is an intense process that most long-term care facilities are not equipped to do,” said Christy Gray, co-chairwoman of Virginia’s Vaccine Advisory Workgroup.
Virginia’s hospital systems face the daunting challenge of preparing their staff to give and get a vaccine for which they’ve had little time to train.
Sentara, which owns 17% of the state’s hospital beds, anticipates it will receive 12,000 doses of the Pfizer vaccine, though it has perhaps 15,000 workers who could qualify.
Mary Morin, head of Sentara’s COVID-19 Vaccine Taskforce, said workers in the emergency rooms, intensive care units, coronavirus patient wards and respiratory units will be eligible in the first phase. So will food service, cleaning crews and other employees who interact with patients.
The company intends to let workers schedule their shots around or during their shifts. No incentives are being offered for employees to get vaccinated.
Morin thinks seeing successful reports from the United Kingdom could give health care workers the confidence they need to roll up their sleeves. England began administering the Pfizer vaccine on Tuesday. Only two health care workers who got the shots have had allergic reactions, according to England’s National Health Service.
“There are a lot of staff interested,” Morin said.
“I think they’re just glad it’s going to be available.”
Figure 2: When these very small blood vessels become diseased, they begin to shrivel up and the nerves
begin to degenerate.
As you can see in as the blood vessels that surround the nerves become diseased they shrivel up which causes the nerves to not get the nutrients needed to survive. When these nerves begin to “die” they cause you to have balance problems, pain, numbness, tingling, burning, and many additional symptoms.
The main problem is that your doctor has told you to just live with the problem or try the drugs which you don’t like taking because they make you feel uncomfortable.
There are now facilities right here in your area that offer you hope without taking those endless drugs with serious side effects. (see the special neuropathy severity examination at the end of this article)
In order to effectively treat your neuropathy three factors must be determined.
1) What is the underlying cause? 2) How much nerve damage has been sustained?
Once you have sustained 85% nerve loss, there is nothing that we can do for you.
3) How much treatment will your condition require?
The treatment that is provided at Chronic Conditions Center has three main goals:
1) Increase blood flow
2) Stimulate small fiber nerves 3) Decrease brain-based pain
One treatment used to increase blood flow utilizes a specialized low-level light therapy (not to be confused with laser therapy) using light emitting diode technology. This technology was originally developed by NASA to assist in increasing blood flow.
The low level light therapy is like watering a plant. The light therapy will allow the blood vessels to grow
Figure 3: The blood vessels will grow back around the nerves much like a plant’s roots grow
when watered.
The amount of treatment needed to allow the nerves to fully recover varies from person to person and can only be determined after a detailed neurological and vascular evaluation. As long as you have not sustained 85% nerve damage then your condition can be treated.