STATES SLUGGISH with covid shots.

Scarcities of funds, equipment, personnel all playing role in lag

TALLAHASSEE, Fla. — Overworked, underfunded state public health departments are scrambling to patch together plans for administering covid-19 vaccines.

Counties and hospitals have taken different approaches, leading to long lines, confusion, frustration and jammed phone lines. A multitude of logistical concerns have complicated the process of trying to beat back the scourge that has killed over 340,000 Americans.

Florida Gov. Ron DeSantis is asking for patience, noting the vaccine supply is limited.

“It may not be today for everyone, may not be next week. But over the next many weeks, as long as we continue getting the supply, you’re going to have the opportunity to get this,” he said Wednesday.

Florida has placed a priority on residents 65 and over to receive the vaccine once medical workers and long- term care residents and staff get the shots. The decision bucks a suggestion from the Centers for Disease Control and Prevention to place a priority on people 75 and older and essential workers such as teachers and first responders.

Dr. Ashish Jha, a health policy researcher and dean of the Brown University School of Public Health, said the main problem is that states are not getting adequate financial or technical support from the federal government. Jha said the Trump administration, principally the Department of Health and Human Services, has set states up to fail.

Lags in reporting vaccination numbers explain in part why many states aren’t meeting their year-end goals, but officials blame logistical and financial hurdles for the slow pace.

Many states lack the money to hire personnel, pay for overtime or reach out to the public. The equipment required to keep the vaccines cold complicates their distribution. Also, providers need to track vaccinations so they have enough to dispense the required second doses 21 days after the first.

Dr. James McCarthy, chief physician executive at Memorial Hermann in Houston, said the hospital system has administered about half of the roughly 30,000 doses that it has received since Dec. 15.

The system had to create a plan from scratch. Among other things, administrators had to ensure that everyone in the vaccination areas could socially distance, and they had to build in a 15-minute observation period for each patient so that recipients could be watched for any side effects.

“We can’t just hand it out like candy,” McCarthy said.

Pasadena, Calif., is vaccinating its firefighters in groups of 50 after their two-day shifts are over so they can recuperate during their four days off. “We don’t want the majority of our workforce — if they do experience side effects — to be out all at the same time,” city spokeswoman Lisa Derderian said.

In South Carolina, state lawmakers are questioning why the state has administered just 35,158 of the 112,125 Pfizer doses it had received by Wednesday. State Sen. Marlon Kimpson said officials told him that some frontline health care workers are declining to be vaccinated, while others are on vacation.

Meanwhile, California on Thursday surpassed 25,000 coronavirus deaths since the start of the pandemic, the third state to do so after New York and Texas, health officials said.

The grim milestone comes as the nation’s most populated state faces a surge of covid-19 infections that has hospitals stretched to capacity and forced nurses and doctors to treat more patients than usual. California also confirmed the second reported U.S. case of a mutant variant of the coronavirus that appears to be more contagious.

The state Department of Public Health says hospitals in Southern California and the agricultural San Joaquin Valley, which together account for a large majority of the state’s 40 million residents, have no capacity left in intensive care units to treat covid-19 patients.

Hospitals are housing patients in hallways, conference rooms, a cafeteria and gift shops. Makeshift hospitals are being set up in tents, arenas and schools.

In Georgia, covid-19 cases are swamping hospitals, testing them in ways that were previously unimaginable. Hospitals say that they are not rationing the most important care — yet. But, caregivers are already making decisions about who gets which scarce resources. The only question is how grave those decisions will become, with projections showing that hospitalizations will continue to surge in the weeks ahead.

Gov. Brian Kemp said his focus is on making sure that the state has enough hospital beds for everyone who needs one. The state is racing to reopen the Georgia World Congress Center as an emergency field hospital for a third time. It will take overflow patients from other Georgia hospitals who need a hospital bed but not intensive care.

But Kemp acknowledged the challenge is more than just buildings and beds — it’s the limited availability of trained medical workers.

Information for this article was contributed by Bobby Caina Calvan, Michael Kunzelman, John Raby, Stefanie Dazio, Adriana Gomez Licon, Sean Murphy, Lauran Neergaard, Marion Renault, Michael Schneider, Desiree Mathurin, Michelle Liu and Don Thompson of The Associated Press; and by Ariel Hart, J. Scott Trubey and Helena Oliviero of The Atlanta Journal-Constitution.