Florida to send 'strike teams' to long-term care facilities for COVID vaccines

Dec. 11--Florida Gov. Ron DeSantis on Thursday offered new details on the state's plan to allocate an initial 179,400 doses of likely-to-be-approved Pfizer COVID-19 vaccine, saying the health department will send strike teams into long-term care facilities to vaccinate those at greatest risk of contracting the disease.

The Florida Department of Health will send 21,450 doses of vaccine, using teams from the department as well as the Division of Emergency Management and National Guard, to areas with a "high concentration of [long-term care] facilities," DeSantis said. He added that those vaccination efforts will "supplement" those of CVS and Walgreens, which are partners in the federal government's Operation Warp Speed and are set to receive 60,450 of Florida's Pfizer vaccine doses in the first round, which will also be used for long-term care facilities.

"Our top priority is residents of long-term care facilities," DeSantis said in the video message. "They are at the greatest risk and this vaccine could have a positive impact on them, not just protecting them from COVID, but allowing them to return to a more normal life."

It remained unclear Thursday which long-term care facilities would get the vaccine next week.

The remaining 97,500 doses will go to five hospitals -- two of them in South Florida -- that will receive about 20,000 doses each to vaccinate healthcare workers, once the vaccine receives a full emergency approval from the U.S. Food and Drug Administration, according to Jared Moskowitz, the director of Division of Emergency Management.

The five hospitals, which include Jackson Health System in Miami-Dade County and Memorial Healthcare System in Broward County, have already identified their employees who are eligible and willing to receive a vaccine, Moskowitz said.

Commenting on both the Pfizer and the Moderna vaccines at the end of November, DeSantis had previously said "Florida's share would be at least a million, maybe as much as 2 million" doses of vaccine.

Hospitals prepare to vaccinate

The five Florida hospitals in the Pfizer rollout have also each identified about 25 other hospitals that would receive the doses after their own employees have been vaccinated, according to Moskowitz. Jackson Health System, Miami's public hospital network, has already identified nearly 3,000 employees who want the vaccine in the first phase. An official at Jackson said the hospital system expects to share its doses with other area hospitals in the following week to 10 days after it receives them.

Moskowitz said many of the logistical details will be kept secret due to security concerns about the precious cargo -- deep-frozen vials of a potentially pandemic-ending technology.

"I can't tell you where it's landing, where it's going, or when it's arriving," Moskowitz said on Thursday.

Though Moskowitz is in charge of the logistics of getting the doses to the hospitals, what happens after they get there is largely up to the healthcare systems themselves, who will be following federal guidance.

It's still not entirely clear how all five Florida hospitals determined eligibility for their employees to receive a vaccine in Phase 1 of the Pfizer rollout, though Moskowitz said federal guidelines define eligibility as those who come in high contact with COVID patients or patient areas.

Venessa Goodnow, chief pharmacy officer at Jackson Health, described the public hospital network's process of identifying those eligible last week, saying the hospital starts in the COVID wards and works its way out to employees who frequently visit them, anyone from transportation to environmental service or dietary workers.

"There are a truly large number of employees that are potentially exposed to the front line with those COVID patients, so when you look at the healthcare teams, there are many members that would qualify for the first phase," Goodnow said.

On Thursday morning, Goodnow said the health system had already identified nearly 3,000 such employees and was still in contact with others. That would still leave about 17,000 doses to be distributed to the 24 other hospitals, many of which would be presumably smaller than Jackson, the largest public hospital in the southeastern U.S.

"When we do receive the vaccine, we're prepared to start vaccination as soon as possible," Goodnow said on Thursday.

A question of ethics

Some public health professionals have criticized the potentially wide application of eligibility for healthcare workers in Phase 1 of the Pfizer rollout.

Howard Forman, a public health professor at Yale University and frequent critic of the federal government's pandemic response, recently bashed a vaccine distribution plan that is similar to Florida's -- in Massachusetts -- because it groups healthcare workers and long-term care residents together in the first phase, but makes high-risk individuals outside of long-term care settings wait until the second phase.

"We should be protecting TRUE front-line health workers (not just any health care worker) & then most vulnerable, first & foremost," Forman wrote on Twitter. "As it stands, young low-risk/low exposure healthcare workers will be protected before 80 year-olds."

Yonatan Grad, an immunology and infectious disease professor at the Harvard T.H. Chan School of Public Health, told the Miami Herald on Thursday that he can see persuasive arguments for both priorities.

The argument for vaccinating those on the front line is obvious, Grad said, but there are less obvious reasons for inoculating more people in a given healthcare system if the goal is to insulate it from a future surge of COVID patients.

For instance, Grad said that social interactions between healthcare workers in a given hospital stretch across professions, and that by vaccinating more broadly, you can insure against outbreaks.

"There are ways to argue this on both sides," he said. "I do not know that there is really an absolutely right answer here."

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