Two additional Flagler County residents have died of Covid-19, the Flagler Department of Health is reporting, raising the county’s total to 52 since April 1 as the coronavirus pandemic continues to infect local residents at a record pace. The positivity rate was close to 15 percent over the past 14 days, with 115 cases confirmed just today and Wednesday.
In a day of rapid developments, Bob Snyder, who heads the state-controlled Flagler County Health Department, said he expects some more doses next week, but he doesn’t know how many, and that second doses will be made available to those who are eligible for them, as a priority.
Meanwhile, State Division of Emergency Management Director Jared Moskowitz, in an appearance before a legislative committee today, said widespread safety measures such as masks and social distancing will be necessary “for probably almost all of this year.” And he painted a bleak picture of the federal vaccine rollout, explaining in detail for the first time that the public could hear why the rollout has appeared so fitful, so short on vaccine, and so equally short on clear information.
Moskowitz blamed the federal government in unusually blunt language for a member of Gov. DeSantis’s administration. DeSantis has almost unfailingly been cheerleader and show or echo of the Trump administration.
“Every state was told to prepare for doses increasing week over week. So of course we prepared,” ordering 5 million syringes, dry ice machines and associated wares in June alone, Moskowitz said, addressing the new House Pandemics and Public Emergencies Committee. He described a range of problems in the federal government’s approach toward Florida that in essence mirror the frustrations felt and described locally in Flagler: restrictions, vague timelines, less supply than expected, no dates of delivery for second doses. “This is the federal system that provided by Operation Warp Speed,” he said. “The problem? The problem is, we can only see six days ahead. Not two weeks, not three weeks, but six days. We find out on a Tuesday what we’re going to get the following Monday. So when people say, where is the long-range planning, the federal government doesn’t tell us. They don’t tell me what I’m getting in two months. They don’t tell me what I’m getting next month. I can’t tell you what I;’m getting in two weeks.”
Though the state got 1 million doses in the first two weeks of delivery, and was told that doses would increase week by week, the federal government cut dose supplies in half by week three and even less in week four. “Providers are now concerned about running out of vaccine,” he said.
“Week five, which we are now in, we received the same amount as week four, 250,000. Let me tell you how that breaks down. We need about 40,000 doses a week for the long-term dare mission. Then, we need 30,000 doses for Publix, 6,000 for church missions. That leaves around 170,000 doses a week for 67 counties. I’ll take our largest county. The smallest counties get about 100 doses a week, based on 65 and older population allocations. But all of Dade County is getting 20,000 doses a week. At that pace, based on the supply controlled by the federal government, it will take 100 weeks to vaccinate the county. This is why it’s a supply issue.”
Dade County has a population of 2.7 million, of whom 453,728 are 65 and over. Flagler County has a population of 115,000, of whom 36,000 are 65 and over. Moskowitz did not provide the number of doses Flagler County will receive. But if the same ratio he disclosed about Dade were applied to Flagler, Flagler’s share next week would be as little as 200 doses.
“I am very confident, based upon a couple of conference calls, that we will be getting an allotment next week. I just don’t know the quantity,” Snyder said. “Our share will be based on population and our share of population 65 and over in our community.” The Flagler Health Department ran out of its allotment of 1,700 doses last week. Four Publix stores began inoculating people this week in Flagler. AdventHealth Palm Coast continues to have its own supply. But all sites could be doing far more, if only they had supply.
Snyder said he confirmed “without question that second dose people, those who got their first dose already, are indeed a priority to get their second dose. Jonathan’s team will take responsibility for calling and letting those second dose folks know the doses are available.” He was referring to Flagler Emergency Management Chief Jonathan Lord. “We will get a shipment next week that will be earmarked for the second dose inventory for those that are ready for the second dose. That would be the people who got initial doses the week of December 28, so 4 weeks later the second doses will be ready for them. That inventory should be shipped out next week. I want to allay people’s concerns and fears about not getting their second dose.”
“1,700 would be what we need for a second dose for those individuals,” Snyder said. “We’ll get a shipment each week that’ll be earmarked for the second dose recipients, and we anticipate then future shipments for additional first dose recipients.”
It remains unclear how, if the number doses heading for Dade is as low as 2,000, Flagler would get anywhere near 1,700 doses in the next or even three weeks, merely to account for people due their second dose–unless that priority than excludes anyone else from getting a first dose.
“Just the sites that we have, the 70 sites that we have, based on supply that we have, we’re doing 23,000 shots there a day,” Moskowitz said. “Those sites can be built to do 552,000 shots a day,” or enough shots to vaccinate every single Floridian in 40 days. That was the sort of scaling up Snyder had described for the Flagler County Fairgrounds, where he Lord were preparing to have an extensive, rolling operation that has yet to see light of day beyond its one significant day in the sun on Jan. 2.
“We can handle 1,000 doses a day with a morning team and an afternoon vaccination team, so we are ready, willing and able once that inventory is here,” Snyder said.
“So it’s not an infrastructure issue. That again goes back to a supply issue,” Moskowitz said.
The same hurdles appeared in the opaque federal contract pledged to inoculate residents and staff in assisted living facilities, with the federal government refusing to inform the state about logistics, leaving 100,000 doses for that program sitting “idle” before it could start, he said. “If we had the supply, we could put the vaccine in 700 Publix [stores] across the state,” he said.
There is also more clarity about people who are not 65 but have underlying health conditions and may be eligible for the vaccine. Rep. Carlos Smith, the Orlando Democrat, asked Moskowitz: “In one of the governor’s executive orders he states that hospital providers may vaccinate persons who they deem to be extremely vulnerable to Covid-19. So the question is, if AdventHealth were to determine that school district employees approaching 65 with co-morbidities, are extremely vulnerable, are those hospitals authorized, ort is AdventHealth authorized, under the executive order, to administer vaccines to these people?”
Moskowitz’s answer was unequivocal: “Yes,” he said. “Under the executive order there is a caveat that you don;t have to be 65 if you have a co-morbidity. While the state government did not define co-morbidities, the governor wanted to give that flexibility up to hospitals to make those medical decisions. So the ultimate answer to your question is yes.”
He said there are no such things as hospitals “sitting on doses. Nobody is sitting on doses. But yes, there are 234,000 doses still in the hospitals that they are moving through the process. But we’re a big state. That’s less than 800 doses a hospital. So there aren’t tens of thousands of doses sitting in any one location, and they’re working through those.”
Moskowitz and Snyder both spoke of the stricter rules applying to “vaccine tourism.” All eligible Floridians may get a vaccine anywhere within the state. So may snowbirds. Otherwise, out-of-state or out-of-country residents may not take a trip to Florida just to get a vaccine. “Snowbirds are fine if they have a residence here,” Snyder said.
“People have asked about the plan. Did we have a plan? Yes we did,” Moskowitz said. “Are we following the plan? Yes we are. So what’s not working? What changed? What has affected the plan? Supply. Allocations. Lack of information. Again, how do you do long-range planning over six days of information? How do you build infrastructure when information changes week to week, when allocations drop, when you have to close sites in the beginning of an operation because you can’t feed them. That is what is happening.”
“At the end of the day,” he continued, “demand exceeds the supply. There are not enough places to go. Too many people are descending on too few locations, crashing websites and call centers. It’s not that we can’t open more locations. It’s that we can’t feed more locations. We know how to do that. We built that infrastructure. We built testing infrastructure. Vaccine infrastructure is almost identical. I have nurses in testing. I have nurses in vaccines. It’s drive-thoughs, it’s walk-ups. Just like we couldn’t feed testing centers in the beginning because there weren’t enough swabs, there weren’t enough tests, it’s the almost identical issue.”
In all, the state has received 1.4 million first doses. Hospitals received 655,000 of those to date, and county health departments received 700,000. In Flagler County, including the hospital and Grand Oaks Rehabilitation, 3,420 doses have been administered, of which 365 are second doses.
“I know we want to get to the end of this nightmare,” Moskowitz said, before cautioning about the still-long road ahead. “People are still going to have to wear masks. We have to be honest with them. We have to tell them they still have to social distance. They have to do the mitigation measures for the foreseeable future, for probably almost all of this year. Dr. [Anthony] Fauci,” the nation’s top immunologist, “has said it’s going to take a year to vaccinate all of the country. I pray it doesn’t take that long.”