Move toward age groups began Jan. 6

The first inkling in the minds of Gov. Ned Lamont and his top aides that Connecticut might be better off sticking with age groups as the vaccination order, not front-line workers or people with medical conditions, happened in a midafternoon meeting on a very hectic day at the state Capitol in early January.

It was the Core Four: Lamont sat behind his desk on the second floor of the Victorian masterpiece building. Josh Geballe, the chief operating officer, sat in his usual perch, off to the left. Dr. Deidre Gifford, the acting public health commissioner, was on video. Paul Mounds, the chief of staff, was in his office next to the governor’s suite, with CNN on another screen, showing activity in Washington, DC.

Geballe and Gifford presented the first draft of recommendations from the COVID-19 vaccine advisory committee, an unwieldy group of 80 people with about 20 on its all-important allocation subcommittee. Phase 1A, health care workers and nursing homes, was progressing well.

Just about everyone agreed the next round of vaccinations had to include people age 75 and older – the group with the overwhelming

majority of Connecticut’s 7,000 deaths. It made sense to include people living in congregate settings such as prisons and group homes, since they faced immediate danger.

If we add in essential employees in frontline jobs, such as teachers and grocery workers, how many is the total? Gifford answered: 808,000.

No one said it at that moment, but all four realized the number was too large to work in one shot. Lamont asked, “Is there a way that we can do this in bite sizes?”

As they parsed the options, Mounds chimed in with other news: “Hey, it looks like something is happening in DC based on the Electoral College vote.”

It was Jan. 6. The United States Capitol was under siege. That crisis soon took over as Lamont would follow the action, first on a live-streaming feed on CBS. State legislators, as of that day, were back in session and had been sworn in outside the Capitol, with protesters of all kinds shouting from behind barriers.

Everyone had watched Lamont’s prerecorded State-of-the-State speech, an optimistic homily that felt like a campaign speech for a possible 2022 re-election bid. News outlets had just announced results of the U.S. Senate elections on Georgia, giving Democrats control of the whole federal government.

Mounds immediately called James Rovella, commissioner of the state Department of Emergency Services and Public Protection.

And the Core Four kept talking about vaccinations for a little while longer. Lamont had lots of questions, as usual. How, he wondered aloud, can we give people a sense that their turn is coming up without promising too much, too soon?

On Jan. 11, New York State opened up its Phase 1B, with vaccinations to a very large swath of residents. The list included people 75 and older, “corrections officers, teachers and other school staff; in-person college instructors, childcare workers, public facing grocery store workers, transit workers and individuals living and working in homeless shelters,” a press release from Gov. Andrew Cuomo said.

It came wth a warning: Be patient. Appointments would take 14 weeks. And that didn’t even include people with medical conditions, which would come soon enough.

It was already clear that Connecticut was vaccinating people faster than most states, certainly faster than New York, which had all sorts of bottlenecks — much of it around checking who was and who wasn’t eligible.

Three days later, at his regular Thursday news briefing on Jan. 14, Lamont announced that Connecticut’s Phase 1B would be limited to people age 75 and older, and people in congregate housing, a much smaller group. Controversy was muted as no one wanted to see such long waits for one phase, and everyone agreed the 75-plus set needed shots immediately.

Lamont didn’t know it at the time — he was still gathering information as the vaccination system enfolded — but he and his top aides would spend the next five weeks weighing when and whether to open up inoculations to essential workers and people with medical conditions.

At every briefing, every public appearance, news reporters asked the same questions of him and Gifford: When will you decide? What will you decide? People need to know!

The allocation subcommittee of the vaccine advisory group had not yet reached an agreement on exactly which underlying medical conditions Connecticut should use to qualify people, and the U.S. Centers for Disease Control and Prevention was still refining its list of 11 conditions.

As for front-line workers, the bleeding of categories came up at every meeting — the U.S. Postal Service, per the CDC guidelines, but not UPS and FedEx? That means the very people delivering the vaccine were not included.

Transit workers and school bus drivers yes — but what about Uber and Lyft drivers? Does grocery mean convenience stores too? And Walmart? If so, which Walmart workers?

Lamont made the final decision at 10 a.m. Saturday, Feb. 20, on a call with the core group and a couple of others. “I like that one,” he said after the group raised a menu of three options. Connecticut would go with age groups as the order of vaccinations, leaving school employees, mostly teachers, as the only carve-out.

As for racial equity, a discussion at virtually every public and private meeting, the state would demand that health providers delivering the vaccines meet benchmarks by race and in cities.

The decision that set off a firestorm — though still not an organized opposition as we saw with tolls and a broadening of the sales tax — appeared to come suddenly as Lamont announced it on Monday afternoon. In fact, it has been building for weeks, since that first meeting as the U.S. Capitol came under siege by supporters of former President Donald Trump.

On Sunday, Jan. 17, the Core Four met along with Benjamin Bechtolsheim, a young, key operative who joined the state Department of Public Health about a year ago from the blue-chip consultancy, McKinsey. For the next phase, they considered a complex mix of people age 65 to 74, combined with essential workers and people with high-risk medical conditions who were at least 45 years old.

Bechtolsheim and Gifford reported back from the advisory group, which, being large with many factions represented, tended to favor vaccinating more groups, rather than fewer.

But the numbers added up to 1,360,000 — a huge and growing nut, as Lamont noted pointedly. And at the same time, both local political pressure and CDC guidance was starting to lean toward people age 65 to 74.

On Tuesday, Jan. 19, Lamont announced the decision for the next phase: Ages 65 to 74 only, no essential workers, no medical conditions. This time there was more backlash. But the data still showed the vast majority of deaths and severe illnesses happening in older people.

Lamont’s public comments and private questions focused on operations: What can we actually get done, and when? — rather than the ideals. Before he entered politics, he spent two decades as founder and CEO of a company that installed cable TV and internet access at institutions, largely college campuses. That gave him a firm background in the nits and bolts of delivering services.

But by several accounts, Lamont has never said in a meeting, “This is what I learned at Lamont Digital.”

Through January and February, Connecticut remained at the top of the pack of states in percent of its adult population vaccinated — it now stands at just over 20 percent, or more than 600,000 first doses — and in the speed of vaccination from the time doses arrive.

The next phase was crunch time and it would open on March 1, as the number of vaccinations the state is set to receive climbs to 100,000 a week. As Geballe put it, if there was going to be a time when frontline workers and people with medical conditions had priority, this was it.

By Monday, Feb. 15, when the group met, this time with Adelita “Lita” Orefice, the top advisor to Gifford that the commissioner had brought in from Rhode Island to lead nursing home initiaives — to help stanch the tragedy in which 12 percent of all nursing home residents died — and later became chief os staf at DPH.

Lamont had been tracking the performance of other states and it was coming clear: The simpler the better. No one was ready to make a decision and this meeting was less than smooth.

“I want you to look at some different options,” Lamont said to the grup. “Come back to me with the answers.”

The key meeting came Friday, Feb. 19 at 5 p.m. Lamont had publicly promised an answer by Monday.

The governor and Mounds were not on that call but Gifford, Geballe, Bechtolsheim and Michelle Gilman, the point person for the health providers in testing and vaccinations and Geballe’s deputy, met with about ten representatives of the largest providers doing vaccinations.

Dr. Reginald Eadie, Gifford’s co-chairman on the vaccine advisory group, was there in both that capacity and in his role as CEO of Trinity Health New England, the parent of large hospitals in Hartford and Waterbury.