New confirmed coronavirus cases in Flagler County are raging out of control, with weekly case loads shattering previous records for the past three successive weeks, reaching 338 cases last week alone. There were 20 hospitalizations for Covid-19 at Palm Coast’s hospital this morning, matching a high for the pandemic.
There were more new cases in Flagler last week alone–338–than in the first 18 weeks of the pandemic combined, from March to the beginning of July.
Meanwhile, Flagler County Health Department and county officials were overwhelmed Monday by demand from people seeking the Covid-19, crushing demand that is far outpacing supply, filling vaccination appointment slots minutes after they became available and leaving throngs of people dissatisfied, sometimes angry, though health and county officials are not at fault for the debacle: they don’t control the supply of vaccines. Even state officials have been unable to tell Flagler and other counties when they would get their next shipments, and how much they’ll be getting.
Under 1,000 vaccine doses were available, and only for people 65 and over and health workers–not younger people suffering pre-existing conditions, not front-line workers like teachers, not cops or restaurant workers.
DeSantis was asked again today whether teachers would get vaccines among front-line workers, now that the second semester has begun across Florida. “Not at this time,” he said. The CDC, however, ranks teachers among the nation’s 30 million “frontline essential workers” who should be prioritized for vaccines.
“There’s no triage system anywhere, it’s what the governor’s order says, over the age of 65,” Bob Snyder, who heads Flagler County’s Health Department, stressed. The governor’s order has been controversial both for its generality and its neglect of critical groups of people vulnerable to complications from Covid, as well as for going against Centers for Disease Control recommendations. The CDC’s recommendations are more expansive and call for vaccinating front-line workers and people with underlying conditions. “He did not make a distinction among individuals who have co-morbidity or chronic illnesses or are sicker than others. Over the age of 65. We’ve all been directed to stick to his priority list through his executive order. The only triage we’re able to do is accept people over the age of 65 regardless of their physical conditions or outlook.”
But all 1,000 doses were already snapped up by appointment or were expected to be by late afternoon.
“We have a very small amount of vaccines,” Jonathan Lord, director of Flagler County’s emergency management, said today. “That’s outside of our control or the Health Department’s control. This really is a marathon, not a sprint, so we ask people for patience. We know we’re going to get more vaccines, so try not to get all vaccine appointments all at once.”
Here’s what’s known for Flagler right now: On Monday afternoon at 1 p.m., the county’s Emergency Management division made close to 500 appointment slots available on the web, through the Eventbrite registration system, available here. But no sooner did Emergency Management open the appointments than they were filled. At the same time, the county had phone lines open for people without web access, looking to make appointments by phone (the number is 386-313-4200). Those lines were also overwhelmed to the point where county employees could not make or receive phone calls at various points during the day.
The Flagler County Health Department issued a release at 2 p.m., announcing the new appointment slots. But by then, the slots had long been filled. The department received an additional shipment of 500 doses on Monday, and those would make possible a new batch of vaccine appointments. Lord said those slots would open up later Monday afternoon. But he expected them also to be filled within minutes of being available, just like the first batch.
“The demand is so great but right now the supply is so limited, there’s only so many vaccines to go around here at the beginning of the vaccine administration phase,” Bob Snyder, who heads the Flagler Health Department, said. “But we’re committed to get the vaccines and push them out as soon as we get them.”
Flagler County is not the source of the problem. The problem is a flawed federal rollout that, with a president and his administration all but absent from the scene, failed to meet a series of benchmarks, was ill prepared to supply millions of doses, most of which remain undistributed, and has left all logistical and organizational responsibilities in the hands of already overwhelmed local health departments, counties and cities.
Flagler County’s coordinating system, however, is making do with what it has, ensuring that as many health-care first responders have been vaccinated–as it did Saturday–and standing up the registration system to make vaccine appointments roll with as little a wait as possible, once individuals are able to secure them.
“Bob Snyder is on a mission, he wants as many people vaccinated in our county as possible,” said Dr. Stephen Bickel, the medical director at the Flagler and Volusia health departments. “I’m right there with him.”
But there was no doubt that Snyder, a high-energy optimist who describes himself as the “comforter in chief,” was stretched to new limits on Monday, to the point of having to invite several dissatisfied residents into Health Department offices, sitting them down, calming them, and explaining to them why they could not immediately get appointments for vaccinations. “It’s a little bit crazy,” he said as an understatement, describing the crush of calls, individual dissatisfaction, the uncertainty about future shipments ahead and, on top of it all, the massive surge in local coronavirus cases, which are hugely taxing his department’s ability to conduct contact tracing and case investigations.
“We have to keep a strong complement of staff to do the case investing and to do the contact tracing and to keep the community testing going,” Snyder said. “We knew the month of January was going to be absolutely–just very complex and very much filled with activities, yes, the cases are going up, the numbers are high, so we have to focus on that as well. But we’re so focused on getting people vaccines at the same time.”
The current surge in new cases resulted in a 220 cases the week ending Dec. 19, then 281 cases the following week, then 338 cases last week.
“Totally predictable,” Bickel said of the latest surge which, if the same morbidity ratios apply as they have in the previous 10 months, would add well over a dozen deaths to Flagler’s current tally of 50. “We’ve all been afraid of this. We were hoping it wouldn’t happen, but we were all kind of expecting it.” Bickel said Dr. Anthony Fauci, the nation’s top immunologist, had been warning since September that a combination of Thanksgiving and Christmas travel, plus increasing laxity toward basic precautions, augured a big rise in cases. Since case loads in the United States, including Florida and Flagler, were already high before the holidays, the exponential increase was bound to be very large, as it has been.
Bickel was still skeptical about the new strain of the coronavirus, which is much more transmissible. The strain was detected in Florida last week. “Florida has evidence of the first identified case of the UK Covid-19 variant in Martin County,” the state health department said in a Twitter post Thursday. “The individual is a male in his 20s with no history of travel. The Department is working with the CDC on this investigation. We encourage all to continue practicing Covid-19 mitigation.”
In another tweet, the department added, “Experts anticipate little to no impact on the effectiveness of the Covid-19 vaccine,” the News Service of Florida reported. The announcement came after reports that the strain, or variant, of the coronavirus also had been detected in Colorado and California. The federal Centers for Disease Control and Prevention said on its website that the variant is estimated to have first emerged in the United Kingdom in September.
As of Sunday, 256,000 people in Florida have been vaccinated, including 926 in Flagler County.
Snyder and Gretchen Smith, the spokesperson for the local health department, countered claims that the department was in any way lax or deceptive in the way it allowed people 65 and over to be vaccinated at the County Fairgrounds event on Saturday, though it had previously announced the event as being open only for health workers. “The only thing that was lax was that we didn’t publicize that we were going to let people who are 65 and over, in to get vaccinated,” Smith said. “If we had publicized that, it would have been worse.” In other words, the crush of people at the Fairgrounds would have made it far more difficult to ensure that the very first priority–health care first responders–was served, as it in fact was. But when people 65 and over showed up as well, “They could not be sent away because of the executive order,” Snyder said.
For all the overwhelming response, it’s just for the first shot: the same people who got their vaccines, and will get vaccinated in coming days and weeks, must get their second shot three weeks after their first in order for the vaccine to be as effective as intended. Local officials have not yet taken on that challenge, and are apprehensive about what it will entail, once the second dose becomes due. There’s been discussions at some levels–and enactment, in England–of possibly delaying the second shot for a few weeks, as first-shot logistics are dealt with. But that’s an approach Bickel considers unwise and contradictory of all the vaccine messaging that health officials have been dispensing for months.
Despite the logistical problems of the rollout and the disappointment among many, Bickel said the enthusiasm for vaccination is a bright, silver lining–an indication that the desire for the vaccine is strong and broad, making eventual herd immunity a goal within reach.