COVID-19 Vaccine Administration Preparedness

On September 16, the CDC released the COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations. This document lays out some fairly realistic expectations of jurisdictions (mostly states) in their distribution, administration, and tracking of COVID-19 vaccinations. That said, even though there continue to be many unknowns about the vaccines to be utilized, dosages, timetable of availability, and how and where vaccines will be delivered to states, there are reasonable assumptions that could be made and high probability strategies identified, which the CDC failed to do. Instead, as is a hallmark of many poor managers, they provided a punch list of considerably detailed demands but not the very essential information and parameters needed to support good planning. Information is everything.

Garbage in/garbage out is a pretty simple concept of utilizing poor or lacking information to inform a process, which will result in similar outputs. After reviewing New York State’s COVID-19 Vaccination Plan, that concept is fully demonstrated. Most sections of New York State’s plan are vague at best, saying what they will do but not how they will do it. They do identify some roles and responsibilities, but without delineating the boundaries between functionaries. For example: they will utilize pharmacies, local health departments, and state-fun facilities, among others, to accomplish public vaccination. This is a solid and expected strategy, but the responsibilities for each are poorly defined for their own operations, much less how they will or won’t work together. Many concepts in the plan are vague at best, and even lacking more defined federal guidance, should have better detail. A big component of vaccination will be community delivery through local health departments, yet this is barely acknowledged. I would have expected this plan to provide guidance and outline preparedness requirements for local health departments, even if they were communicated separately. I acknowledge this is intended to be a strategic level plan, but it doesn’t seem to even consistently provide that measure of detail. I’m left with a lot of questions. And while it may be petty, the document itself is poorly written and published – I expect better from state government.

I’ve not looked at the plans of other states, but if this is indicative of the general state of things, the term ‘shit show’ is the phrase that comes to mind. While we will no doubt improve, there is a long way to go and I think jurisdictions will find themselves in a bind, being poorly prepared when they receive notice of an imminent delivery of vaccines with no detailed plan or assigned resources to get the job done. If anything, we have had plenty of time to prepare for vaccination efforts. There are clearly failures at all levels. While communication between and among federal, state, and local jurisdictions has certainly taken place beyond these documents, the standards and measures need to be more apparent.

We need to do better and be better. Reflecting a bit on the piece I wrote yesterday, we need to be thorough and imaginative in our preparedness efforts without excluding possibilities. Local jurisdictions must be prepared to support vaccinations in their communities. As I’ve written before, most health departments simply don’t have the capacity to do this. Jurisdictions need to engage with their health departments for the best guidance possible and work from that. An 80% solution now is better than a 20% solution later. As with any disaster, local communities are the first stakeholder and the last.

What are you seeing from your states? What do you think is missing in our overall efforts?

© 2020 Timothy Riecker, CEDP

Emergency Preparedness Solutions, LLC®

How BC is Acing the Pandemic Test (Guest Post)

I’m excited and honored to promote a new blog being written by Alison Poste. Alison has led major disaster response and recovery efforts in Alberta, Canada, including the 2013 floods and the Fort McMurray wildfires, and currently works as a consultant specializing in business continuity, emergency management, and crisis communications. Her new blog, The Afterburn – Emergency Management Lessons from Off the Shelf, takes a critical look at lessons learned and how they are applied.

I’ve pasted her first post below, but also be sure to click the link above to follow her blog. I’m really excited about the insight Alison will be providing!

– TR

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The pandemic has upended how those in the emergency management field have seen traditional response frameworks. Lessons learned from the pandemic response will be useful to governments and the private sector alike in the coming years.

The ICS framework for emergency response is well equipped to address the unique needs of any disaster, including a global pandemic. The rapid scalability of the structure allows the response to move faster than the speed of government. It provides the framework for standardized emergency response in British Columbia (B.C.).

The B.C. provincial government response to the coronavirus pandemic, led by Dr. Bonnie Henry, the Provincial Health Officer (PHO) has received international acclaim. It is useful therefore to learn from the best practises instituted early on in the pandemic to inform future events. 

In February 2020, the Province of B.C. published a comprehensive update to the British Columbia Pandemic Provincial Coordination Plan outlining the provincial strategy for cross-ministry coordination, communications and business continuity measures in place to address the pandemic. Based on ICS, the B.C. emergency response framework facilitates effective coordination by ensuring the information shared is consistent and effective. The Province of B.C. has provided a daily briefing by Dr. Henry and Adrian Dix, the B.C. Minister of Health as a way to ensure B.C. residents receive up to date information from an authoritative source.

While we may consider the COVID-19 pandemic to be a unique event, a number of studies have provided guidance to emergency response practitioners of today. The decisive action taken by the B.C. PHO on COVID-19, has focused on the twin pillars of containment and contact tracing. Early studies regarding the effect of contract tracing on transmission rates have seen promising results, however the tracing remains a logistical burden. As studies indicate, these logistical challenges have the potential to overwhelm the healthcare system should travel restrictions be relaxed, leading to the possible ‘importation’ of new infections. 

B.C. has instituted robust contract tracing mechanisms to reduce the spread of COVID-19 in alignment with best practises in other jurisdictions. When instituted methodically, contact tracing, consistent communication, and Dr. Henry’s mantra to “Be calm. Be kind. Be safe.” remain critical tools to ensure limited spread, a well-informed and socially cohesive population.

How has your organization helped to slow the spread of COVID-19?  As always, I welcome your feedback and suggestions for how to improve the blog.