Flagler County Health Department Chief Bob Snyder is an optimist by nature, often finding a silver lining in the grimmest numbers as the coronavirus pandemic has unfolded. Today he was flat-out giddy. He described for the first time how the covid-19 vaccine will be available in Flagler this spring, and how it will be rolled out across the county in three phases, at no charge to recipients.
Between those getting the vaccines and those who already have antibodies from contracting the disease, the goal is to have 65 to 70 percent immunity, so that by this time next year, society may well have returned to normal, celebrating Thanksgiving with no fear of hugs, jam-packed travel or or crowded and poorly-ventilated dining rooms.
Snyder had another dose of better news today as well: the much-touted, endlessly awaited rapid tests for Covid-19 are finally in the county. The health department took delivery of 1,000 Abbott Binax Now tests on Monday. They will be used primarily to test students and school staff–where some rapid tests have already been in use–then to complement community testing sites. The nasal-swab test produces results in 20 minutes. If it’s positive, the individual is immediately re-tested with the more customary, non-rapid test, which almost always confirms the first diagnosis, and quarantined.
State and county health officials have been working on the roll-out plan since mid-October. Two companies this month announced that their vaccines are 95 percent effective: Pfizer and Moderna. The Food and Drug Administration has yet to approve either. But approval is expected.
There’s no way to know which of the two vaccines will be made available in Flagler, though one of them–Pfizer’s–requires ultra-cold freezing when it is stored. “We do not have the capabilities to do that. If we are sent the Pfizer, then I know we’ll be getting a freezer along with it,” Snyder said.
The vaccine must be administered in two doses, 28 days apart, to be effective. (By 95 percent effective, it means that out of the thousands of volunteers who took part in Moderna’s trial, and the 95 who contracted the coronavirus, 90 had been given the placebo. Only five who contracted the virus had received the vaccine.)
The vaccination system will closely follow the method used for covid-19 testing in the early days of the pandemic, when first responders and the like had priority. So they will again with vaccines. The first to be inoculated will be health care workers, public health workers, firefighters, cops, and personnel and residents in nursing homes and assisted living facilities, where the disease proportionately has taken its heaviest toll.
That done, Phase 2 will extend to residents at large through what are now Covid-19 testing sites, urgent care facilities and the county health department in what Snyder describes as “mass vaccination clinics.” He expects a large number of doses to be available for that phase.
“We’ll have vaccination distribution sites scattered throughout the community with our team of nurses and staff,” Snyder said. “I can envision this being a drive-through opportunity so that social distancing will continue to take place as we administer the vaccine.” As with testing, the Flagler County Emergency Management department is expected to be closely involved. Snyder was speaking with Emergency Management’s Jonathan Lord today, he said.
It’s no small task. To reach 70 percent immunity, it means that 80,000 Flagler County residents will have to be inoculated or would have had to have contracted the virus and survived. So far, Flagler County has 2,447 confirmed cases of Covid-19, barely 2 percent of the population. Even assuming that 10 times as many people have actually contracted it but don’t know it (the virus is asymptomatic in up to 50 percent of carriers, according to the Centers for Disease Control), that still leaves 56,000 people requiring 112,000 doses, each one of which is the equivalent of an appointment and a shot that must be rigorously documented through Florida Shots.
That’s assuming the vaccine will make it to Flagler in massive numbers by spring. Pfizer and Moderna are estimating that they will have 45 million doses by January, with hundreds of millions of doses available by spring, though some challenges of scale remain. Operation Warp Speed, the federal government’s Manhattan project-like investment toward rapid vaccine development, had set a goal of 300 million doses by the end of 2020. Pfizer had projected making 100 million doses by the end of 2020, but fell short. Pfizer’s vaccine was developed jointly with BioNTech. The two companies will be paid $1.95 billion by the federal government once the FDA approves the vaccine and the first 100 million doses are delivered.
The third phase would resemble times of testing troth when demand falls because most will have gotten inoculated, but supplies remain. Part of the roll-out in Phase 2 may take place in schools, Snyder said, again raising the question of whether the school board will facilitate or hamper vaccination efforts. The Flagler County School Board has been of two minds in the matter, not objecting to certain vaccines being offered at school while objecting to others–namely, the HPV vaccine.
When it comes to the Covid vaccine, Snyder says it should be a different story. “I believe this would be welcomed because bottom line this is life saving,” he said. “I cannot imagine a government or school board member leader dismissing the broad distribution of Covid-19 vaccines. To me that would be reprehensible, and it would be dangerous.”
The vaccine is effective immediately. There is still some question about how long immunity lasts, though new data released just this week suggests that immunity could last for several years, possibly decades. But the findings are based on research that has not yet been peer-reviewed.
Asked if, once individuals have received their vaccine, they can doff their masks, burn them and abandon social distancing, Snyder was cautious. “We’re going to require that they adhere to public health measures until at least their second shot is given.”
Other caveats: first, both state and local health departments touted the rapid test for months, promising it would be available “soon” month after month, and it never was until just now. Similar complications in the logistics of the vaccine roll-out could delay it past spring, the way earlier, sunny Pfizer projections proved unworkable. No company and no nation have ever undertaken a roll-out of this magnitude in history–a rollout that must be coordinated with the health departments of 50 different states, and in turn with the health departments of thousands of counties within those states.
Second, the pandemic is still raging, its third wave on an upswing across the country, in Florida and in Flagler, where–in Flagler–it had its highest seven-day number of infections since summer. Cases have risen significantly in schools in the last 10 days, with 18 cases between students and school staff last week, and 19 in just the first four days of this week. Four cases were announced just today. Ten of the cases this week have been at Flagler Palm Coast High School–six students and four staffers, including Principal Tom Russell and Assistant Principal Tousiant Roberson.
Palm Coast government is seeing its highest number of employees affected in one way or another by the pandemic currently: 29. The number includes those who have the virus, those caring for someone who has it, those who are suspected of having it, and those out sick.
There were two small spikes at assisted living facilities again, including four staff members at Tuscan Gardens, but “everyone jumped on it immediately, including Tuscan Gardens,” Snyder said. “These employees are isolated, quarantined, safe, as are the remaining residents and staff.”
Otherwise, he said, “It is community spread and it is everywhere.” And difficult months, possibly the grimmest of the pandemic, are ahead before the salve of a vaccine.