Week XLIV: Demand drastically exceeds COVID-19 vaccine supply, patience urged

The federal government made several shifts in COVID policy this week: Requiring international travelers to test negative before flying to the United States, changing the guidance for vaccine eligibility, and releasing doses originally held back.

ALBANY COUNTY — Patience was advised this week on both the state and local levels as residents clamored for COVID-19 vaccines while the supply remained limited.

“It’s gonna take time, people. You have to be patient,” said Albany County Executive Daniel McCoy at his Tuesday morning press briefing.

In its 44th week of battling the virus, Albany County broke records for hospitalizations — with 163 announced on Thursday — and for new cases, with 351 announced on Tuesday, topping the Jan. 1 record of 346.

And the death toll continued to grow, reaching 259 on Wednesday after three more county residents succumbed to the virus.

Throughout the week, the Capital Region continued to have the worst rate, among the state’s 10 regions, for available intensive-care-unit beds and among the worst rates for available hospital beds.

The federal government made several shifts in COVID policy on Tuesday: Requiring international travelers to test negative before flying to the United States, changing the guidance for vaccine eligibility, and releasing doses originally held back.

 

Releasing doses

As COVID-19 deaths are soaring nationwide, the federal administration announced it would no longer withhold the second doses it had been saving for residents who had gotten a first dose — both approved vaccines require two separate doses to be fully effective.

On Friday, Governor Andrew Cuomo had written a letter to Alex Azar, secretary of Health and Human Services, signed by eight other Democratic governors, urging quicker distribution of vaccines to the states.

“According to publicly reported information, the federal government currently has upwards of 50% of currently produced vaccines held back by the administration for reasons unknown. While some of these life-saving vaccines are sitting in Pfizer freezers, our nation is losing 2,661 Americans each day, according to the latest seven-day average,” said the letter signed by Cuomo and the governors of California, Illinois, Michigan, Kansas, Minnesota, Oregon, Washington, and Wisconsin.

“The failure to distribute these doses to states who request them is unconscionable and unacceptable. We demand that the federal government begin distributing these reserved doses to states immediately,” the letter said.

As of Wednesday night, according to the Centers for Disease Control and Prevention website, New York State has received 1,796,850 doses and given a first vaccination to 632,473 people, which is 3,251 per 100,000 residents.

The 35 percent of vaccines administered so far in New York State is roughly the national average.

 

“Loaves and fishes”

Before Tuesday, New York State had been following the earlier guidance from the CDC and had started vaccinating people in two tiers:

— 1a for public-facing health-care workers, and for nursing home residents and workers; and

— 1b for essential workers like teachers, police, and firefighters, and for people 75 and older.

But then, the federal government expanded eligibility to people age 65 and older as well as people who have compromised immune systems.

Cuomo, in a call with reporters on Tuesday afternoon, called it a “loaves and fishes situation.”

New York State gets 300,000 doses a week and now 7 million New Yorkers are eligible for the vaccine, Cuomo said. Tier 1a has about 2.1 million New Yorkers; tier 1b, for whom vaccinations started on Monday, has about 3.2 million.

“You just added 1.8,” he said of the 1.8 million New Yorkers who are 65 and older, which does not include New Yorkers who are immunocompromised.

“Immunocompromised is a category that can be defined a number of ways,” said Cuomo. “Obviously it’s people with cancer, chronic kidney disease, COPD, Down syndrome, heart conditions; obesity can be considered immunocompromised, pregnancy, sickle cell, smoking can classify a person as immunocompromised, type 2 diabetes is immunocompromised, asthma — so that has to be defined.”

He also noted that many nurses and doctors, in the first tier, had still not been vaccinated, which he considers essential both to control spread of COVID-19 and also to care for those ill with the virus.

On Tuesday morning, before the federal directive was widely publicized, McCoy said counties were already overwhelmed with requests for vaccinations.

Since eligibility for tier 1b opened Monday, he said, the county is trying to identify residents 75 and older. He urged them to sign up on the state’s website and not to call the county’s health department, which is busy investigating a record number of COVID-19 cases as well as giving vaccinations.

On Wednesday, the county gave 500 vaccinations, McCoy said.

“We want the 75-year-olds. We want the Black and brown communities. We want to give the shots to the most vulnerable people here in Albany County first and foremost,” he said.

According to Albany Medical Center, which is the hub for the eight-county Capital Region, residents age 75 and over will primarily be vaccinated at pharmacies and other sites that are part of the governor’s “retail network.”

Public employees — such as firefighters, police, and public school teachers — will primarily be vaccinated through their groups’ relevant health programs or as organized by their unions.

Health-care workers who are part of the first tier, 1a, will continue to be vaccinated at hospitals and other clinical settings.

On Wednesday night, the Albany Med website reported that 40,005 vaccines have been given; the goal for the Capital Region is 1 million.

McCoy’s own office was overwhelmed with calls. “Last night was the first time in 10 months I shut my phone off,” he said as people he knew from his childhood were calling asking for shots for their elderly parents.

People were calling from New York City, saying they would drive three hours to Albany to get a shot, McCoy said. “Our call volume went through the roof.”

He stressed, “The state is handling it.”

On his call with reporters, Cuomo said, “The county health departments should focus on the essential workers, police, fire, et cetera. That’s who they deal with. City health departments and pharmacies, the general public because they’re best equipped to handle the general public.”

On Wednesday, McCoy announced that a 2-1-1 hotline has been set up by United Way of the Greater Capital Region to help with questions related to vaccine eligibility and distribution site locations.

On Friday, the state will open a vaccination site at the uptown campus of the University at Albany, one of a handful across New York. Vaccinations are by appointment only.

 New Yorkers can use the state’s Am I Eligible app or call the state’s vaccination hotline at 1-833-NYS-4VAX (1-833-697-4829). Appointments to receive the second dose at these sites are scheduled in-person after receiving the first dose.

Currently, all of the slots, running through March, on the Am I Eligible site are filled. Cuomo’s office has advised eligible New Yorkers should be prepared to receive an appointment date as far as 14 weeks or further in the future.

 

NY now has 15 B.1.1.7 cases

Cuomo on Tuesday, during his call with reporters, surmised that the federal government changed its guidance because of the highly transmissible strain of the virus from the United Kingdom spreading in the United States.

“That is what’s panicking the federal officials with good reason because this is a much higher rate of infection,” he said.

Cuomo has long called for COVID-19 testing for airline passengers. On Tuesday, the federal government announced that, effective Jan. 26, international travelers coming to the United States will have to have a negative test for COVID-19 within three days of their flight.

On Tuesday, Cuomo announced a total of eight more cases of the U.K. strain, known as B.1.1.7, bringing New York’s total to 12.

On Wednesday, he announced another three cases, for a total of 15 in the state.

The three newest cases of B.1.1.7 additional were identified in Warren County, which is grouped with seven other countries as part of the Capital Region, adjacent to the North Country.

Four cases in Saratoga County and two cases in Warren County have been identified as part of the cluster connected to a jewelry store in Saratoga Springs, where the first case was found a week ago, through testing at the Wadsworth laboratory in Albany.

Three additional cases in Warren County are under investigation for their link to this cluster, but have yet to be confirmed, said a Wednesday release from Cuoo’s office.

A second cluster has also been identified and includes two cases in Suffolk County, two cases from Nassau County and one from Queens. The final case was identified in Manhattan and is not connected to either cluster.

According to the CDC website, as of Wednesday night, just four cases were listed for New York State with 76 nationwide. California had the most with 32 followed by Florida with 22.

The B.1.1.7 strain is not thought to produce worse symptoms or to be more deadly but is considered highly transmissible, leading to concerns about hospital capacity.

 

“The real thing”

Last Thursday, Albany County administered its first vaccinations. A POD was set up at the Times Union Center in Albany where vaccinations were given to 375 health-care workers, all of whom are part of the first tier, 1a, of those eligible for the shots.

Shot recipients were screened beforehand and were monitored for 15 minutes after getting the vaccinations, Albany County Health Commissioner Elizabeth Whalen said; no one suffered adverse effects, she said.

All of the vaccines were made by Moderna, which are easier to use than the vaccine made by Pfizer-BioNTech. The Pizer vaccine, which needs ultra-cold storage is generally administered in hospitals, Whalen said.

Whalen praised her staff, particularly Tricia Bulatao, RDN, the director of Public Health Emergency Preparedness, who managed the POD.

“This was the real thing and we were so thrilled to get to this day ...,” she said. “We got a lot of positive feedback that people were in and out quickly.”

Most of Whalen’s staff is busy investigating the surging number of COVID-19 cases but some were on hand at the POD to supervise the volunteers in the county’s Medical Reserve Corps who gave the shots.

The county health department will be ramping up to give a thousand or thousands of shots a day, depending on supply, Whalen said. Her department will look at different models, such as a drive-through, and look at ways to accommodate elderly people who are less mobile.

Many of the eligible shot recipients in the 1a tier were reached through a link that was sent out from the county’s health department, and pushed by the hub to various associations like those for dentists or home care as well as emergency medical services and urgent-care providers, Whalen said.

“We need to uncover every stone and vaccinate every person that is eligible” she said.

Of the next tier, Whalen said, “With 1b, it’s likely those links will be public.” People will sign on with an attestation that they will be penalized if they misrepresent what they do for a living.

“We’re working daily with the regional hub on this,” said Whalen of Albany Medical Center. She went on, “Everyone shares a common mission to get vaccines out and into arms as quickly as we possibly can.”

Although other counties have complained about being left out of the process, Whalen has repeatedly said the state’s approach of having a regional hub coordinating with county health departments has worked well in the Capital Region.

Whalen stressed, “This vaccine is safe and effective. We do need widespread uptake of the vaccine to get to the end of this pandemic.”

She also cautioned that masks still need to be worn. Two shots of vaccine are required. 

“If you have the two shots … you will have 95 percent reduced likelihood of being sick from COVID,” said Whalen.

But, since transmissibility wasn’t as actively studied in clinical trials for the vaccine, she said, “We urge people to continue to wear masks … because they may be able to transmit it without becoming ill themselves.”

 

Schools

Whalen said on Friday that she has been working closely with schools in the county that are preparing to do COVID-19 testing in order to remain open for in-person classes. Cuomo had said last Monday that schools in counties with an infection rate over 9 percent will have to do random tests of students and staff in order to stay open. 

The state’s COVID-19 dashboard on Wednesday night reported that, as of Jan. 12, Albany County had a daily positivity rate of 8.8 percent, a seven-day rolling average of 8.7 percent, and a 14-day rolling average of 9.5 percent.

This week, the schools have been trained on using the database for recording test results, Whalen said.

The Guilderland schools, which hope to remain open for in-person learning, have surveyed staff and families of students and found 75 percent would be willing to undergo the random testing.

On Wednesday evening, Marie Wiles, superintendent of Guilderland schools, sent an email saying that the district will begin COVID-19 testing at Guilderland Elementary School on Jan. 15. Testing will continue in all seven Guilderland schools starting Wednesday, Jan. 20, through Monday, Feb. 1.

“Our district is not currently in a state-designated microcluster zone that requires COVID-19 testing in schools, but being aware of the positivity rate in our schools provides us with the data we need to keep our community safe and our schools safely open,” Wiles wrote. “Last week, the Albany County Department of Health informed K-12 schools in the county that they can begin on-site COVID-19 surveillance testing of asymptomatic students and staff.”

Guilderland plans to test about 20 percent of students and staff, selected randomly from those who gave consent.

“Our school nurses will administer a BinaxNow rapid test, which is a minimally invasive shallow swab test involving a swab (similar to a Q-tip) going in the front of the nose,” Wiles wrote. “If you provided consent to have your child tested, you will receive an email notification indicating that your child might be chosen to be tested for COVID-19 in school during this testing period.”

According to the state’s COVID-19 School Report Card, Guilderland has had 107 cases since the start of the school year: 59 at the high school, 19 at the middle school, eight at Westmere Elementary, seven each at Altamont and Lynnwood elementary schools, four at Pine Bush, and three at Guilderland Elementary School.

 

Newest numbers

On Wednesday morning, McCoy reported three more deaths of county residents from COVID-19: a man in his seventies, a woman in her eighties, and a woman over 100 years old.

As of Wednesday morning, Albany County has had 14,761 confirmed cases of COVID-19, including 217 cases since Tuesday.

Of the new cases, 162 did not have a clear source of infection identified, 31 had close contact with someone infected with the disease, and 22 are health-care workers or residents of congregate settings.

The five-day average for new daily positives has decreased to 266.2 from 279. There are now 1,987 active cases in the county, up from 1,948 on Tuesday.

The number of county residents under quarantine increased to 3,343 from 3,154. So far, 44,357 residents have completed quarantine. Of those, 12,774 had tested positive and recovered. That is an increase of 158 recoveries since Tuesday.

There were 15 new hospitalizations overnight, and there are 151 county residents currently hospitalized from the virus — a net decrease of four. There are still eight patients in intensive-care units, unchanged from Tuesday.

As of Wednesday morning, the Capital Region has 525 residents hospitalized with COVID-19, which is 0.05 percent of the region’s population and leaves 24 percent of its hospital beds available.  The region is tied with two others for the worst rate: Central New York and the Mohawk Valley each also have 24 percent of beds available.

Statewide, 0.05 percent of New Yorkers are hospitalized with the virus, leaving 32 percent of hospital beds available.

The Capital Region continues to have the worst rate for available ICU beds at 20 percent, although it is an improvement for a low of 16 percent. Currently, 210 of the region’s 267 ICU beds are in use.

Statewide, 27 percent of ICU beds are available.

The Capital Region’s infection rate, based on a seven-day average, is 8.67 percent. Three other regions have a higher rate: the Mohawk Valley at 9.24 percent, Long Island at 8.90 percent, and the Finger Lakes at 8.72 percent.

Statewide, the positivity rate is 7.08 percent.

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