South Florida Sun-Sentinel Palm Beach (Sunday)
Delayed funds, shifting strategy created perfect storm for shot rollout
A shifting strategy, delayed federal help and years of cuts to public health budgets contributed to a rocky rollout of the COVID19 vaccine to the oldest and most vulnerable Floridians, turning the lifesaving arrival of shots into a 65-and-up scramble resembling a Black Friday dash for markeddown televisions.
For months a vaccine has been seen as the endgame for the pandemic, with politicians championing a herculean, all-hands-ondeck push to immunize the masses.
Yet, health officials across the state received little advance notice, and Florida’s only published vaccine plan lacked details on exactly how leaders would handle the onslaught of demand for appointments and information from seniors eager to be immunized.
The hastily designed website in Broward County crashed, leaving users fuming and frustrated.
“They weren’t prepared for the onslaught when Governor [Ron] DeSantis announced it was going to be for seniors,” Broward County Mayor Steve Geller
said. “I don’t think they had plans for that.”
Elsewhere in Florida, Health Departments used Eventbrite, a private online ticketing website, for the public to schedule vaccine appointments. It didn’t take long for fraudsters to make bogus pages exploiting seniors by charging them money for a fake appointment. Attorney General Ashley Moody and prosecutors now say they are cracking down on vaccine-related fraud.
In Palm Beach County, the phone lines crashed. The county’s website instructed seniors they could request an appointment only by email.
Meanwhile, people most at risk of dying of the virus couldn’t get through to get even basic questions answered, despite their leaders having had 10 months to prepare for a vaccine arrival.
“The website is down,” said Eva Axel, an 84-yearold resident of Fort Lauderdale. “I called some number, redialing and redialing, and I can’t get through. I want this vaccine, and I can’t get it. Something stinks. Somebody’s got to fix this. We were the greatest country in the world. Not anymore.”
Elsewhere in the state, hospitals doled out the vaccine on a first-come, first-served basis, leading to seniors waiting overnight in lawn chairs and sleeping in their cars. Aubrey Jewett, a political observer at the University of Central Florida, quipped in an interview with NBC News it reminded him of people lined up to buy tickets for Prince’s “Purple Rain” tour in the pre-internet days.
DeSantis favors limited state role
Gov. Ron DeSantis — who has taken a libertarian approach toward the pandemic — doesn’t favor a heavy-handed state role in vaccine distribution. When pressed by a CNN reporter on why seniors were camped out for the vaccine, DeSantis said Monday the state will not “dictate” how hospitals administer the shot.
“That would be a total disaster,” he said at a news conference in Miami. “These guys are much more competent to deliver health care services than a state government could ever be.”
Building a centralized statewide appointment system wouldn’t have worked, DeSantis said Wednesday, and he preferred people book their appointment directly with the health care provider giving the shot.
That approach, though, has allowed wealthy donors to jump the line or get prioritized access at three South Florida hospital systems — Jackson Health, Mount Sinai Medical Center and Baptist Health, The Miami Herald reported. Some hospitals have reached out to wealthy donors who met the state’s criteria and offered them vaccine, while less-affluent seniors were left to contend with overwhelmed websites and jammed phone lines, the Herald found.
DeSantis attributed some of the issues to Florida’s decision to rush the vaccine out to seniors. DeSantis broke with CDC guidelines, which would have put essential workers like grocery store employees, teachers and postal workers ahead of healthy seniors between the ages of 65-74.
Despite those early issues, seniors living in other states don’t even have a chance to get a shot, DeSantis said. Governors have the discretion on how to administer the vaccine in their states. While many states are following the federal recommendations, seniors 65 years and older are eligible to receive the vaccine in Texas, Ohio and Delaware, according to AARP.
But Geller, Broward’s mayor, said the governor’s Dec. 23 announcement prioritizing seniors caught health officials and county leaders playing a supporting role off guard, and there didn’t appear to be a solid plan.
“He didn’t tell anybody until he made the announcement,” he said. “Once he made the announcement everybody had to scramble.”
The state published a 50-page draft plan on Oct. 16, which didn’t include guidance on how health officials would accept and track appointments. It also was based on the CDC’s guidance that put essential workers ahead of healthy seniors. An updated plan hasn’t been released.
Then there is the issue of extreme demand for the vaccine but a limited supply.
DeSantis should have done more to make it clear there aren’t enough vaccine doses to provide shots to all the seniors who want them, Geller said.
As of Wednesday, Florida had provided the first dose of the vaccine to more than 369,600 people, including more than 148,200 people older than 65, according to the Department of Health.
Based on CDC data as of Tuesday, Florida has been one of the slower states to administer the vaccine, using about 23% of its available doses, according to an USA Today analysis. The worst-performing state was Kansas, which had used 15% of its available doses. South Dakota, the best-performing state, had administered 62% of its available doses.
Meredith Beatrice, a spokeswoman for DeSantis, disagreed with Geller’s assessment. She said DeSantis worked with MiamiDade’s Democratic Mayor Daniella Levine Cava to open a vaccine distribution site at Hard Rock Stadium and collaborated with Publix to launch a pilot vaccine distribution effort in Marion, Citrus and Hernando counties.
“Governor DeSantis is unapologetically putting Florida’s seniors first, in addition to our state’s ongoing efforts to vaccinate frontline health care workers and residents and staff of longterm care facilities,” she said in a prepared statement.
This isn’t the first time state websites have failed Floridians. Crushed by an unprecedented surge in claims, Florida’s unemployment website faltered as the state locked down early in the pandemic. The online voter registration website failed in the hours leading up to the deadline to register to vote in the presidential election.
Ronald Nadel, an 83-yearold snowbird from Massachusetts who winters in West Boca, said the governor needs to do more to lead the vaccination effort and ensure the people he represents get the help they need. Nadel spent an hour on hold with Palm Beach County’s Health Department before getting kicked off.
“The buck stops with the governor,” he said. “He didn’t design the system. But he didn’t hire people who were competent to do it.”
State Rep. Emily Slosberg, a Democrat who represents one of Florida’s oldest districts, said her office has been inundated with calls from angry and frustrated seniors who are confused about how they even go about signing up for the vaccine.
“We have had time to prepare,” said Slosberg, whose district includes sprawling 55- and-up communities near Boca Raton. “We shouldn’t be way behind like this. People should have some idea where to start.”
’This takes people.’
Barry Bloom, a professor of immunology and infectious diseases at the Harvard School of Public Health, said he’s not surprised by what he is seeing in Florida.
“There has not been enough advance planning — not least because there has not been money for the states,” he said. “The CDC budget has been cut every year for the last three years up until this year. The amounts of state budgets that have gone to public health have gone down. This takes people. It takes expertise. It takes informatics and databases.”
Under former Gov. Rick Scott ’s tenure, Florida starved its health departments, leaving them ill equipped to handle one of the worst public health emergencies in modern times. Those cuts came as state government faced revenue shortfalls caused by the Great Recession. Scott’s governing philosophy also favored the private sector over government agencies he considered to be riddled with inefficiencies.
Florida slashed its health departments’ staffing from 12,422 in 2010 to 9,125 in 2019, despite the state’s population growing by 2.4 million, according to a joint investigation by Kaiser Health News and Associated Press. The state’s deputy secretary for county health systems — a key leadership position — is vacant, according to the Department of Health’s website.
The state Health Department no longer has a dedicated communications chief on staff, a position that is important for informing the public about how a mass vaccination effort will be executed.
Federal money is on the way. The COVID-19 relief bill signed by President Donald Trump on Dec. 27 includes $8 billion for vaccine distribution on top of the $340 million sent out to the states last year. But how long it’ll take for the additional money to arrive is unclear.
DeSantis said Florida is recruiting 1,000 contract nurses to help administer the vaccine, which will provide more boots on the ground. He also said he’s directed health departments to assign more people to answer phone calls.
‘A tremendous challenge’
Successfully and safely vaccinating millions of Floridians against COVID19 is a massive undertaking.
Simply transporting and storing the vaccine is a challenge, with the Pfizer shot needing to be kept at minus 94 degrees Fahrenheit.
Patients need to fill out 15 minutes of forms. Personnel need to know how to recognize the signs of an allergic reaction and be able to treat one if it occurs. Public health officials need to be able to record and track doses in case there is a bad batch.
Then there are the logistics of keeping up with thousands of appointments and having the resources available to answer the public’s questions.
Health officials say vaccine is on its way and will become more widely available soon. Carlos A. Migoya, CEO of Jackson Health System, said his network should be able to ramp up in a few weeks to 75,000 doses a week, vaccinating 60% of Miami-Dade’s senior population by early February.
But as of Thursday, many South Florida seniors remained in limbo, wondering when they will be able to rest easier knowing they are protected against the deadly virus.
Mel Cottone, a retired 88-year-old lawyer from Boca Raton on the hunt for the vaccine, recalled a day when business wasn’t conducted all on computer screens.
“In the old days, you’d just make a phone call,” he said.