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Opening Mass COVID Vaccine Sites Would Pose Huge Challenges

Opening a mass vaccination site, such as at a sports venue or convention center, would require consideration of a host of factors. Among them would be parking to handle the rush of patients, as well as staff.

by Robert Higgs, cleveland.com / March 4, 2021
TNS
(TNS) - President Joe Biden announced last month that he intends to provide enough COVID-19 vaccine to immunize all 300 million Americans by the end of July.
 
But getting that accomplished poses a mammoth logistical challenge, that of establishing and staffing mass vaccination sites across the nation - and quickly. Can it be done?
 
For an answer, cleveland.com and The Plain Dealer gathered information from Gov. Mike DeWine’s office, three large hospitals, the Center for Health Affairs in Northeast Ohio and a medial professor.
 
And the answer is: It is doable.
 
What will it take?
 
Opening a mass vaccination site, such as at a sports venue or convention center, would require a host of factors be considered. Among them:
 
Parking to handle the rush of patients seeking vaccinations. 
 
And staff on hand to check in and direct patients, to administer the shots and to observe patients after they get injections.
 
“It’s not just about giving a shot,” said Dr. Robert Bonamo, a professor at Case Western Reserve University’s School of Medicine. “It would require thinking, but it’s not impossible.”
 
“It’s not just about giving a shot,” said Dr. Robert Bonamo, a professor at Case Western Reserve University’s School of Medicine. “It would require thinking, but it’s not impossible.”
 
That may be put to the test soon.
 
A third vaccine — from Johnson & Johnson — was approved this week and Biden announced that the U.S. expects to take delivery of enough coronavirus vaccines for all adult Americans by the end of May.
 
Where do mass vaccination efforts stand now?
 
Health officials say their planning is already underway. The major hospitals in Cleveland said recently they’re ready to expand their operations.
 
The state has acknowledged the Cleveland Browns, Indians and Cavaliers, as well as the Cincinnati Bengals, have offered use of their homes as mass vaccination sites.
 
“This is something the Department of Health prepares for every year, pandemic or not,” Dan Tierney, a spokesman for Gov. Mike DeWine, said. “The identification of sites is always an ongoing process.”
 
So far, however, mass vaccination efforts have not been possible because of a lack of available vaccine doses.
 
Leaders from the Cleveland Clinic and University Hospitals told a Cleveland City Council panel they could each handle about 40,000 patients a week, but at the time they were getting as little as 400 doses of vaccine to administer.
 
A spokeswoman from MetroHealth System said that system, too, would be able to handle large numbers of patients.
 
But allocations from the federal government have been increasing. The state received nearly 220,000 first doses for patients last week and expecting about 310,000 this week.
 
How many people would need to be inoculated each week?
 
The U.S. Census estimates the state’s population at 11.7 million, including roughly 9 million adults.
 
As of Wednesday, more than 1.7 million Ohioans had got their first injection of the Moderna vaccine.
 
So about 1.5 million adults would need to get their vaccinations each month for all to have at least their first shot by the end of July. That’s about 375,000 per week across the state.
 
The demand might not be quite that high, though, said Beth Gatlin, the director of emergency preparedness for the Center for Health Affairs in Northeast Ohio, an association of hospitals.
 
Many people may decide not to get vaccinated, particularly among younger adults, Gatlin said.
 
What logistics are involved in setting up a mass vaccination site?
 
The first step is to find a large site that can be broken up into 40 or 50 injection stations, Bonamo said. That sight needs to be easily accessible, either for people to drive to or ride to via mass transit.
 
The site would need staff to do intake when patients arrive, people to run each injection station and others to monitor patients after they’ve received an injection to be sure no complications arise, Bonomo said.
 
Ideally, patients would be scheduled on a staggered basis to allow them to flow through the process more easily, Bonomo said.
 
From arrival to departure, the process likely would take about half an hour, Bonomo said.
 
Where would the staff come from?
 
Bonomo said he expects mass vaccination sites would require use of doctors, physician assistants, nurses, paramedics and others with medical backgrounds.
 
But he expects the public would step up.
 
“People will volunteer,” Bonomo said. “I have faith in our community.”
 
If workers are brought in from out of town, lodging might have to be worked out, Tierney said.
 
How would appointments be handled?
 
Last month, DeWine announced the state is developing a centralized online scheduling system that would allow users to type in their ZIP code and access a list of providers within 20 miles of their homes.
 
Tierney said Wednesday it was always the intention of the Ohio Department of Health to use that site to help schedule patients for mass injection sites.
 
What about large medical institutions?
 
While the DeWine administration has acknowledged receiving offers of use of stadiums and arenas around the state, Tierney noted that sites did not necessarily need to be sports venues.
 
Bonomo suggested a place such as the International Exposition Center adjacent to Cleveland Hopkins International Airport. It has highway access and ample parking.
 
Another option might be drive-through sites, as some other states have tried.
 
Cleveland’s large hospital complexes have also been planning to handle mass vaccinations.
 
The Clinic, UH, MetroHealth and others have been on daily conference calls regularly coordinating efforts.
 
“We all have been partnering for more than a year,” Dr. Alice Kim of the Cleveland Clinic recently told Cleveland City Council. “We’ve put down our rivalries … we are all coordinating efforts.”
 
Are there other efforts?
 
Yes.
 
Locally, the Cleveland Department of Public Health and the Cuyahoga County Board of Health have been providing vaccinations.
 
In Cleveland, interim Health Director Brian Kimball has said the department might be able to handle as many as 8,000 shots a week.
 
The city has been using Public Auditorium as a distribution site and and administering shots at recreation centers.
 
On a larger scale, the Federal Emergency Management Administration and the National Guard have been used to open community vaccination sites around the country.
 
One such FEMA site opened this week in Philadelphia with the expectation that it could administer 6,000 shots a day.
 
Last month the Ohio National Guard began assisting with vaccine distribution.
 
Will Ohioans still be able to get the vaccine at their pharmacies?
 
Yes.
 
If mass vaccination sites were set up, they would be in addition to the infrastructure already in place, Tierney said.
 
Bonomo added that keeping the local sites is important, particularly to assist people who would find it difficult to travel to a mass site. Seniors, for example, may be more comfortable going to their local pharmacy.
 
The DeWine administration made a point of spreading out distribution across the state to ensure that vaccines would be available in rural areas. Hundreds of pharmacies and community sites are involved.
 
“We have tried to emphasize convenience by making it close to home,” Tierney said.
 
Most importantly, Tierney said, is the need to get doses into patients’ arms.
 
“The overarching goal is to save as many lives as possible.,” he said.
 
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(c)2021 The Plain Dealer, Cleveland
 
Visit The Plain Dealer, Cleveland at www.cleveland.com
 
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