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Pritzker administration defends its vaccine distribution metrics, urges patience

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Illinois

* Heather Cherone at WTTW…

The first doses of a COVID-19 vaccine could be distributed to health care workers in Illinois and Chicago between Dec. 20 and Dec. 26 if federal officials grant an emergency use authorization, as expected, to pharmaceutical company Pfizer, Gov. J.B. Pritzker said Friday.

Illinois expects to get 109,000 doses of the Pfizer vaccine, including 23,000 doses reserved for Chicago, in the first shipment, Pritzker said. However, that depends on federal officials voting to authorize its distribution on Thursday.

But that will only be enough for a fraction of the 654,598 health care workers in Chicago and Illinois, Pritzker said. The first doctors and nurses to be vaccinated will be in the 50 Illinois counties with the highest death rates per capita, officials said.

That includes DuPage, Kane, Will and Lake counties as well as suburban Cook County, officials said.

OK, let’s pause it right there.

First, keep in mind here that this round of vaccines is going to doctors and nurses, not the general public. But the administration is using a general public metric - county death rates - and not a frontline metric, like, perhaps, hospitals with the highest patient loads.

* Here’s the list of counties…

Several of those counties feed their patients into regional medical centers in places like Springfield, Quincy and Peoria. But the three counties with those hubs are not on the list.

Again, perhaps if the metric was “counties where people actually die in the hospital,” it would make more sense. But why should Tazewell County get aid for its workers when COVID-19 patients are being sent to Peoria? If you Google “Tazewell County Hospitals Illinois,” the list is almost purely Peoria facilities. Same for Christian, Shelby, Morgan, etc. and their medical hub in Springfield.

Again, we’re supposed to be helping frontline medical workers with these vaccines. The metric isn’t based on those medical workers. So, a whole bunch of hard-working nurses and doctors are being left out of this round.

* I asked the governor’s office for a response…

Decisions about how best to distribute limited doses of the vaccine are of course wrenching, but using deaths as the determinant was important because death is the ultimate worst outcome that we hope to prevent. Next week, health care workers in places with lower death ratios will begin to receive vaccines. And in the meantime, local health departments should prioritize distribution of the vaccine to facilities where residents of the hardest-hit counties receive their care. Healthcare workers are a part of their community and the healthcare workers who live in communities with the highest rates of death will get the first doses. The state expects regular shipments that will roll out to all healthcare workers soon after the first round.

posted by Rich Miller
Monday, Dec 7, 20 @ 12:48 pm

Comments

Since the regional hub hospitals are where the greatest amount of treatment of Covid patients occurs (as well as deaths) it seems like the governor’s office response is missing the boat. I bet there will be a re-look at this now that reasonable questions are being raised.

Comment by Responsa Monday, Dec 7, 20 @ 12:58 pm
What ability do we have to see back down the supply chain? If we can count on a continuing flow of vaccine then all the 109,000 doses can go out immediately. It will take another 109,000 doses and 6 weeks to have the first group actually protected. That will be less than a fifth of frontline healthcare workers. Even within hospitals distribution must be prioritized.

Comment by Last Bull Moose Monday, Dec 7, 20 @ 1:04 pm
There is no perfect way to make this decision, and I honestly cannot imagine the agony that goes with it, so I’m gonna’ cut the people making this decision some slack.

However, focusing on where the deaths are occurring (and where the subsequent medical service is therefore most needed) seems reasonable for this first round.

Comment by Just Me 2 Monday, Dec 7, 20 @ 1:05 pm
I know a nurse who visits people in their homes.

She’s been told she will get the vaccine this month.

My family doctor has no knowledge when she will get the vaccine.

Two data points.

Comment by Fav Human Monday, Dec 7, 20 @ 1:07 pm
The Eastern Bloc, home of we will not wear a mask, has several communities on the list. Has Bailey and the boys made a statement?

Comment by Only in 2020 Monday, Dec 7, 20 @ 1:11 pm
Put a different way, who are these frontline health care workers that will get priority vaccines in Cass, Pike, Shelby, Morgan, etc?

Nothing against dentists, but is every dentist there going to get vaccinated before a single ICU nurse at the regional medical centers in Champaign, Peoria or Springfield?

Comment by Leigh John-Ella Monday, Dec 7, 20 @ 1:15 pm
The governor’s office response does not make sense, which indicates muddy thinking. This initial round needs to be given to those who actually provide front-line care to covid patients, especially in the ICU where invasive procedures are done and transmission risk is higher. This is far less than 600K people. Some parts of Illinois with high per-capita rates don’t even have ICU beds, as discussed months ago here.

Comment by Jibba Monday, Dec 7, 20 @ 1:15 pm
Jiminy Christmas, can’t you people do anything correctly? You’re going to first distribute the vaccine in counties where actual death numbers are very low overall but the ratio is highest because few people live there? Out of all the possible choices the govs office could have made in this scenario, you choose the dumbest possible option *facepalm*

Comment by Lester Holt’s Mustache Monday, Dec 7, 20 @ 1:15 pm
This is a bias speaking here since my wife works in these facilities but it seems (using even LaSalle as an example) that staff at long-term care facilities is an exposure vector that leads to outbreaks in those facilities.

That would seem to be the place to start, especially facilities that have current active outbreaks.

Again, feely admit, I have a bias.

Comment by OneMan Monday, Dec 7, 20 @ 1:20 pm
People actively caring for COVID patients should be at the front of the line. OHSA’s list of most at risk professions:

Very High Exposure Risk:
Very high exposure risk jobs are those with high potential for exposure to known or suspected sources of COVID-19 during specific medical, postmortem, or laboratory procedures. Workers in this category include:
Healthcare workers (e.g., doctors, nurses, dentists, paramedics, emergency medical technicians) performing aerosol-generating procedures (e.g., intubation, cough induction procedures, bronchoscopies, some dental procedures and exams, or invasive specimen collection) on known or suspected COVID-19 patients.
Healthcare or laboratory personnel collecting or handling specimens from known or suspected COVID-19 patients (e.g., manipulating cultures from known or suspected COVID-19 patients).
Morgue workers performing autopsies, which generally involve aerosol-generating procedures, on the bodies of people who are known to have, or suspected of having, COVID-19 at the time of their death.

Comment by illdoc Monday, Dec 7, 20 @ 1:20 pm
Greene County has a small, community hospital - Boyd Memorial in Carrollton with limited bed space. They feed into Jersey Community in Jerseyville. Not sure of the bed count.

Pike County has Illini Community Hospital, which is facility with just over 50 beds.

Morgan County has Passavant Area Hospital in Jacksonville, which is a part of the Memorial Health System that of course is a part of the Springfield hospital, but it has an 80 bed facility. MHS has been swapping patients based on need of care to each of its hospitals. Cass, Greene, Scott, Pike, Schuyler, Brown, Northern Macoupin and Western Sangamon all feed into Passavant.

Schuyler County has Culbertson Memorial Hospital in Rushville which is similar in size to Boyd, and is completely private. They ultimately ship people on to Macomb and Quincy when necessary.

I think its only fair to include these smaller, regional hospitals in the scope of things, because often they are ones to see COVID patients first before they get moved on to more intensive care down the line that these smaller hospitals can’t ultimately provide or don’t have the space to.

Comment by WLDS News Monday, Dec 7, 20 @ 1:26 pm
Here’s what I am hoping:

The list of those 50 counties with the highest death rates may have been put together by someone who was unaware that it would be based off of the physical location of the death and so the list of those 50 counties is both the right list, but the wrong list for distribution.

Besides Springfield, Peoria, and Quincy, they’ve also missed Carbondale, but have listed just about every county that feeds into Carbondale Memorial which also has a better reputation than the hospitals in Williamson County, so patients often choose to travel their for admission when they’re transporting themselves.

Comment by Candy Dogood Monday, Dec 7, 20 @ 1:29 pm
While I support - OneMan -‘s take, a person who comments here on the subject of Covid 19 I look to for smart and reasoned takes, I also look at the job the Administration has in distribution, and I don’t envy this task.

As this begins, I’m sure there will be more thinking and more tweaking, and I’m counting on both, so I’ll let the Administration do what they think, but hope they take what - OneMan - and Rich bring to the discussion as well.

Good luck.

Comment by Oswego Willy Monday, Dec 7, 20 @ 1:30 pm
I imagine other metrics were considered and compared. I suspect that this initial distribution plan was the plan that had the broadest geographical distribution in order to appear “fair” to all parts of the state.

If they went strictly on number of cases or hub hospital locations or some other metric, the geographic distribution might be focused on metropolitan areas.

Realistically, we are looking at a difference of a few weeks before every county gets an allotment.

(Personally, I would have gone with a plan where the counties that take the virus most seriously get the first allocations. Counties where they publicly refuse to enforce mask mandates, indoor dining restrictions, and other measures should have to wait until everyone else is covered.)

Comment by Pot calling kettle Monday, Dec 7, 20 @ 1:31 pm
WLDS News — Boyd Memorial doesn’t have an ICU, neither do many of the “hospitals” you list.

We’ve got hospitals in Illinois running out of staffed ICU beds because of COVID patients. Shouldn’t they be the priority in the first wave of vaccinations?

Comment by Leigh John-Ella Monday, Dec 7, 20 @ 1:32 pm
Though this kind of distribution is more complicated, they should have prioritized the list by duties instead of geographic location.

ICU nurses, hospitalists, pulmonary specialists, ER Docs, ER Nurses, Triage Nurses, and any other physician that is involved in rounding on COVID-19 positive patients.

It is substantially easier to send out the vaccines with the expectation that someone else make those harder choices down the line.

Comment by Candy Dogood Monday, Dec 7, 20 @ 1:32 pm
To be clear, my suggestion above is not punitive, it simply follows the priorities being set by each county.

Comment by Pot calling kettle Monday, Dec 7, 20 @ 1:34 pm
The JB plan is short-sided. It is also a variation on that old baseball adage “hit it where they ain’t”

Comment by Donnie Elgin Monday, Dec 7, 20 @ 1:36 pm
==Though this kind of distribution is more complicated, they should have prioritized the list by duties instead of geographic location.==

Actually, it should not be that complicated. Distribute the vaccines to hospitals and long-term care facilities on a per-capita, prorated basis. Those facilities are already best able to handle and administer vaccines and they have the target populations.

Comment by Pot calling kettle Monday, Dec 7, 20 @ 1:37 pm
===To be clear, my suggestion above is not punitive, it simply follows the priorities being set by each county. ===

We’ve reached the point where hope of receiving vaccine isn’t enough of a carrot to motivate those corrupt local public officials and law enforcement officers and denying the vaccine isn’t going to motivate them either.

After the dust has settled, there have to be consequences.

Comment by Candy Dogood Monday, Dec 7, 20 @ 1:38 pm
Nothing against dentists (our family has an EXCEPTIONAL one), but I just don’t see them being a “priority one” category. Get 100% of Illinois’s practicing RN/LPN/CNA vaccinated first then move to the dentists…. and the proctologists - can’t forget about them.

Comment by What Do We Do Next Monday, Dec 7, 20 @ 1:58 pm
It would help if state vaccine distribution plans were crafted with the help of CDC. Instead, without any data on effectiveness or any assistance at all, states were required to submit plans.

https://www.bloomberg.com/news/newsletters/2020-10-15/getting-a-vaccine-where-it-needs-to-go

You can view those plans here:

https://www.cdc.gov/vaccines/covid-19/covid19-vaccination-guidance.html

Comment by Precinct Captain Monday, Dec 7, 20 @ 2:05 pm
At least two of the counties on this list, Jasper and Cumberland, do not have hospitals. Their residents often use the hospital in Effingham County, which is not on the priority list.

Comment by Don't Bloc Me In Monday, Dec 7, 20 @ 2:08 pm
Tried to search for it but came up short — is there any info about when the next shipment after this initial batch will come and how large it will be? Previous national reports indicated 20 million people being vaccinated by the end of the year, so 40 million doses. I believe it’s being distributed based on state population, which would give Illinois roughly 1.6 million doses. 109,000 is a long way away from that number.

Comment by harp5339 Monday, Dec 7, 20 @ 2:18 pm
A no-win situation. Even if everyone at a small facility could get a vaccine, it might not be wise to do so. What if everyone received the same vaccine brand, and most developed side effects? Also, there are 7+ vaccines in various stages of development, incl the three in the news. Three have completed enough testing to get final approval (Pfizer, Moderna / Dolly, and AstraZeneca), two are in final phases of testing, and two expected to begin testing soon. More will come, so hang in there.

Comment by Ares Monday, Dec 7, 20 @ 2:20 pm
===Previous national reports indicated===

You need better Google skills.

Comment by Rich Miller Monday, Dec 7, 20 @ 2:29 pm
Cass County is another county without a hospital. Patients here go to other counties.

Comment by Bruce( no not him) Monday, Dec 7, 20 @ 2:43 pm
In small counties vaccinate the workers at care homes (helps stop the spread of COVID to most at risk)

In larger counties vaccinate the front line med care workers. (helps keep those healthy who need to keep the rest of us healthy)

Comment by Cool Papa Bell Monday, Dec 7, 20 @ 3:03 pm
Just because healthcare workers live/work in an area represented by Eastern Block goofs doesn’t mean that healthcare worker should’ve be able to get vaccinated as soon as possible. Sheesh.

Comment by Occasionally Moderated Monday, Dec 7, 20 @ 3:04 pm
Just because there isn’t a major hospital, doesn’t mean there aren’t paramedics, nursing home nurses, home care nurses, hospice nurses and such dealing with high case counts in these places. I have a hunch one could critique any methodology used. I suspect the big hospitals have better options for safety than rural volunteer ambulances and small, rural nursing facilities.

Comment by Shemp Monday, Dec 7, 20 @ 3:27 pm
Shemp, long term care facilities are in a direct distribution program with the feds that’s being administered by CVS/Walgreens. They’re not part of this first wave rollout from the Pritzker admin.

https://www.hhs.gov/about/news/2020/10/16/trump-aministration-partners-cvs-walgreens-provide-covid-19-vaccine-protect-vulnerable-americans-long-term-care-facilities-nationwide.html

Comment by Leigh John-Ella Monday, Dec 7, 20 @ 3:45 pm
This is a case of damned if JB does and damned if he doesn’t.

No plan is going to satisfy or make sense to everyone. At least he has a starting point.

Comment by Huh? Monday, Dec 7, 20 @ 3:48 pm
I see Chicago Public Health Dept is distributing the
vaccine to hospitals in Chicago–what metric are they using ?

Comment by ANON Monday, Dec 7, 20 @ 4:03 pm
I wonder how many nursing home residents have declared a no-vaccine decree in their end of life petition.

Comment by Blue Dog Dem Monday, Dec 7, 20 @ 4:12 pm
= Just because healthcare workers live/work in an area represented by Eastern Block goofs doesn’t mean that healthcare worker should’ve be able to get vaccinated as soon as possible. Sheesh.=

My comment wasn’t about the healthcare workers. It was about Bailey running around that region implying Covid is a hoax and we should open up the state. How can he now deny that it just like the flu when many communities in the Bloc have high death rates and are the first to qualify of the vaccine? Every healthcare worker deserves access.

Comment by Only in 2020 Monday, Dec 7, 20 @ 7:05 pm
The focus should be on long term care facilities.

Comment by Chicagonk Tuesday, Dec 8, 20 @ 7:18 am