Hospital scrambles to prioritize first workers on COVID shots | State News

This story continued NBC News..maybe It was reissued for free.

If there is something like a fateful date, it is on Dr. Taesombelle’s calendar.

At noon on Tuesday, emergency physician Bell will be one of the first health care workers at the University of Virginia Health System to roll up his sleeves to ward off the coronavirus.

“This is the first time in a while,” said Bell, 37, who applied for a hospital email last week. “The story of this crisis is that every week feels like a year. It’s really the first time I have real hope that I can turn the corner.”

So far, that hope is limited to the selected minority. Bell provides direct care to some of the most ill COVID-19 patients at UVA Health Hospital in Charlottesville, Virginia. However, he is one of about 12,000 “patient-friendly” workers in his hospital and is eligible for about 3,000 early vaccinations, said Dr. Costi Sifri, director of hospital epidemiology.

“We are trying to come up with the highest risk categories that spend a considerable amount of time caring for patients,” says Sifri. “It doesn’t explain everyone.”

Even if the Federal Food and Drug Administration had intense deliberations prior to the approval of Pfizer and BioNTech’s COVID vaccine on Friday, hospitals across the country had their first vaccine a few days before the first 6.4 million doses were released. I have been working on the distribution method of. A rare shot.

The Centers for Disease Control and Prevention’s advisory board recommends placing top priorities on long-term care facilities and front-line healthcare professionals, but early allocations are always far below necessity and selective screening Among the important hospital workers who were always expected to be needed.

Colin Milligan, a spokesman for the American Hospital Association, sent an email to advise hospitals to target the most risky employees, but determine exactly who they are. Said that it was left to the facility itself.

“It was clear that in the first few weeks the hospital would not receive enough to vaccinate all of its staff, so we had to make a decision,” Milligan wrote.

At Intermountain Healthcare in Salt Lake City, the first shot is directed at staff who “have the highest risk of contact with COVID-positive patients or their waste,” said Christine, director of infection prevention and employee health care. Dr. Duscom said. Within that group, the manager decides which caregivers are in line first.

UW Medicine in Seattle, including the Harbor View Medical Center, said one of its early plans was to randomly select high-risk staff to receive the first dose, Shireesha Dhanireddy, medical director of the infectious disease clinic. The doctor says. However, the University of Washington hospital system expects to receive enough doses to vaccinate all its high-risk individuals within two weeks, so no randomization is needed — for now. ..

“We allow people to schedule themselves,” said Dhanireddy, encouraging staff to be vaccinated near the end of the week in case they react to a new vaccine. ..

According to test results, shots often cause side effects and are not debilitating, but can cause symptoms such as fever, muscle aches, and malaise and can be at home for a day or two.

“We want to make sure that not everyone is vaccinated on the same day, so if there are any side effects, we won’t run out of staff,” said Sifri of UVA Health. According to the guidelines, more than 25% of units are vaccinated at one time.

At UVA Health, after the first 3,000 doses are distributed, the hospital will rely on what Sifri describes as a “very strong code of ethics” to allow staff to decide where to line up. is. They are required to consider professional factors such as the type of work and personal risks such as age and underlying illnesses such as diabetes.

“Use the Code of Ethics to encourage team members to determine the risk of COVID and whether they need to accelerate vaccine enrollment time or delay vaccine enrollment time. I’ll ask, “he said. ..

The plan was chosen after medical staff categorically rejected other options. Few people supported the proposal to allocate doses via the lottery, for example, the chaotic birthday-based system depicted in the 2011 pandemic horror movie Contagion. “That was the biggest loser,” he said.

Hospital officials also have a distribution plan that ensures that the vaccine is distributed fairly among healthcare workers, including social, racial and ethnic groups that have been disproportionately damaged by COVID-19 infection. He emphasized that he was trying to devise. To do that, we need to think beyond the front lines of doctors and nurses.

For example, in UVA Health, one of the first groups invited to take shots is 17 workers whose job is to clean the room of a special pathogen unit where severe COVID cases are treated. ..

“We admit that everyone is at risk for COVID. Everyone deserves a vaccine,” Sifri said.

In many cases it is clear who should go first. For example, Dhanireddy, an infectious disease doctor who consults about cases of COVID, is willing to wait for vaccination. “I didn’t mean to put myself in the first group,” she said. “I think we really need to protect the staff there most of the day. It’s not me.”

However, hospitals must remain vigilant about relying on workers to prioritize their access, Dhanireddy warned. “Sometimes self-selection works more for self-defense,” she said. “It’s great to say that some people leave it to others, but in reality it may not.”

For some healthcare professionals, not being in the first line of vaccination is fine. Initially, the vaccine is only allowed for emergency use, so hospitals do not need to inoculate employees as part of this first round. According to an internal survey, 70% to 75% of UVA Health and Intermountain Health healthcare staff accept the COVID vaccine. The rest is uncertain — or unwilling.

“Some people are ready to accept it, others want to follow up,” says Dascomb.

Still, hospital officials say they are confident that those who want the vaccine don’t have to wait long. Sufficient doses should be available by early January for approximately 21 million healthcare professionals, according to CDC officials.

Emergency physician Bell said he was grateful that both parents, especially those living in Boston, were first vaccinated after being infected with COVID-19. He posted on Twitter about his upcoming appointment, stating that he and the other health care workers in the first row should be publicized about the process.

“It serves as an example of how this is a safe and effective vaccine,” he said. “We put it in our body. You should make it yours too.”