Tag Archives for Rhode Island Department of Health

Ramping up COVID-19 Vaccine Plans

Published in RINewsToday.com on January 17, 2021

As state health officials say they are clamoring for more doses of COVID-19 vaccine, just days ago, Health and Human Services Secretary Alex Azar said in an interview with NBC’s Lester Holt there is no “reserve stockpile” of COVID-19 vaccine doses left to release to states, and all vaccine has now been released to fulfill orders by the states. Azar’s comments come after his announcement on January 12th that the states no longer need to hold back a second shot because there is confidence that Pfizer and Moderna, manufacturers of the vaccine, could keep up with the demand.

In the January 12th announcement, Azar noted several steps the states should take immediately, and the federal government was taking:

Expand groups getting vaccinated to include all those over the age of 65 – Vaccinate those 16-64 with co-morbidities – Expand channels to include those more familiar with people to reach them where they are, such as pharmacies – release all supply to order by states.

Azar encouraged states that are holding back “second shots” to not do so, saying, “Every vaccine dose that is sitting in a warehouse means another life lost…”

In response to the rollout of COVID-19 vaccines, Katie Smith Sloan, president and CEO of Washington, DC-based Leading Age and acting President and CEO, of the Visiting Nurse Associations of American, had some thoughts. “With COVID-19 death tolls topping 4,000 a day, it’s chilling to hear that vaccine stockpiles may have been misrepresented, and that older Americans who have been dying in record numbers might suffer as a result,” she said in a Jan. 15 statement.

Making it a Priority of Giving COVID-19 Vaccines to Seniors

“We hope these reports are not true. For weeks, state policy makers, distribution partners and aging services providers have been basing their vaccine allocations and strategies on vaccine stockpile estimates,” Sloan noted.    

“Because more than 265,000 people 65 or over have died of COVID, we have been pleased that many states have made the right decision to prioritize older Americans and their caregivers for immunizations, and that the process is underway in long-term care.  We hope this news is not a setback for those people, as well as others waiting for vaccinations in home health, hospice, PACE programs, adult day or other settings,” says Sloan.  

Rhode Island’s plan not changing

However, Rhode Island has chosen not to prioritize the distribution of it COVID-19 vaccine to older Rhode Islanders. The Rhode Island Department of Health (RIDOH) expects residents age 75 and older who reside in the community to be vaccinated in February or possibility March. Specifics as to vaccinating residents ages 50 to 74 have not been announced. While other states are beginning mass vaccination sites at stadiums, no such plans exist in Rhode Island.

AARP Advocates for those over 50

“Since the start of the pandemic, over 95 percent of the deaths from COVID-19 have been among people 50 and older,” AARP Rhode Island State Director Kathleen Connell and State President Phil Zarlengo said in a Jan. 8 letter to Gov. Gina Raimondo, urging the state’s top official to “ensure that Rhode Islanders age 50 and older are prioritized to receive a vaccine.”  (see Weiss Commentary printed here on January 11). 

AARP is fighting for older Americans to be prioritized in getting COVID-19 vaccines because the science has shown that older people are at higher risk of death.  On Jan. 11, the Washington, DC-based AARP sent a letter to HHS Secretary Alex Azar calling for his agency to take immediate action to address the issues that have slowed down vaccinations across the country.

RIDOH’s plans

On Jan. 15, in a Vaccine Update, Nicole-Alexander Scott, MD, MPH, Director, Rhode Island Department of Health, stated: “There was a lot of news this week about the federal government urging states to vaccinate people who are 65 years of age and older. We want to get vaccine to people older than 65, too. The limiting factor is not federal rules, or our approach in Rhode Island. The limiting factor is the amount of vaccine we are getting. We are getting 14,000 first doses of vaccine a week. There are close to 190,000 people in Rhode Island who are 65 years of age and older. It would not be honest or fair of us to say that all Rhode Islanders older than 65 can get vaccinated tomorrow, because we just don’t have the vaccine.” 

It is unclear if RI is holding “second shot” vaccine doses in storage. There is about a week’s lag from receiving the doses and distributing them. On January 15th, the state said they had administered a total (first and second shots) of 51,220 shots. On January 12th, the most recent report provided, the state says it has received 72,175 doses from the federal government.

Scott added:” We’ve seen the confusion and frustration that has resulted in states that have opened eligibility to groups that they did not have enough vaccine for. In Rhode Island, we are vaccinating older adults incrementally and thoughtfully. That means that when we tell you you can get vaccinated, you know that there is a real, physical vaccine waiting for you – not just that you fall into a broad category that is eligible to get a vaccine when we eventually have one. Please know that if we could, we would make sure that everyone got vaccinated immediately. But we’re just not getting enough vaccine right now, so we’re doing the best we can with what we have.”

Rhode Island’s report

After listening to the state’s reports on plans for getting out the vaccine to the group the Centers for Disease Control and Prevention is recommending, those over 65, and those under 65 with underlying medical conditions, there seems to be an overall lack of urgency in ramping up for this new directive, said Nancy Thomas, Publisher of the RINewsToday.com, who was on the update webinar this week, with other reporters. “There are no plans – or none they are willing to announce – for how people will register, or sign up, for when the 65 and over category is ready to go. Questions about how people will identify themselves at the site also were yet to be determined. When asked about mass vaccination sites, officials said they may consider schools, but had no plans for using McCoy Stadium or other large sites. We’ve seen states all around us opening up stadiums – many of whom are still vaccinating medical workers – but ramping up to do as many as they can until supplies are exhausted for that day. Massachusetts even has swag – pins, wristbands, and banners – to build up the sense of excitement, which also builds compliance. We have asked RIDOH about public education campaigns and they say they have a campaign coming.  

With such a large percentage of seniors in Rhode Island, are we ready to ramp up? Some states are vaccinating 24/7, with appointments at 2am and such. I guess a sense of frustration weighs on me and on others who do not see big plans, forward looking plans in the near future. Meetings with the public focus more on reporting of what has been done and where we’ve been, rather than where we’re going,” Thomas said.

Biden Releases COVID-19 Vaccination Plan

President-elect Joe Biden, speaking a day before he unveiled his COVID-19 Vaccine Plan on Jan. 15 in Wilmington, Del, unveiled a $1.9 trillion “American Rescue Plan” to combat COVID-19 and to shore up a wobbly economy. The emergency vaccination and relief package combine funding to reduce the economic impact of the pandemic (including direct stimulus payments of $1,400 per person, extending unemployment compensation, raising the minimum wage, continuing eviction and foreclosure moratoriums to increasing the Child Tax Credit) with strategies to fight to combat the virus itself.

About $400 billion of Biden’s “American Rescue Plan” is directed to controlling the virus by setting up mass vaccination centers, funding more sophisticated scientific analysis of new strains and creating teams of local health workers to trace the contacts of infected people.

President-elect Joe Biden’s Jan 15 press conference, lasting a little more than 19 minutes, warned that “We remain in a very dark winter. He noted that COVID-19 infection rates are creeping up 34 percent, COVID-19 related hospitalizations are increasing, and 3,000 to 4,000 people are dying every day of COVID-19.  “Things will get worse before they get better,” he said.

When releasing his five step COID-19 Vaccination Plan, Biden stated, “This is the time to set big goals and to pursue them with courage and conviction because the health of the nation is at stake.”  His strategy of getting 100 million Americans vaccinated during his first 100 days in office relies on the following steps: encourage states to vaccine more people age 65 and over including front line workers; creating thousands of community vaccination centers at gyms, sports stadiums and community centers; activating local pharmacies to give vaccines; ramping up supplies of vaccines by triggering the Defense Production Act and distributing vaccines quickly; and regularly updating state and local officials as to how much vaccine they are getting and when to expect the delivery.  Biden promised to give regular updates pertaining to the meeting of his goals, “both the good news and the bad.”

Mask Mandate – Wear that mask

During his first 100 days, Biden will be issuing an executive order to require masks for federal workers, on federal property, and on interstate travel, like trains and planes.  He is also urging governors to require masks in cities and states.

“I know masks have become a partisan issue,” says Biden, stressing “it’s a patriotic act.  Experts say that wearing a mask from now until April will save more than 50,000 lives, he noted.

Biden called on Congress to make his COVID-19 Vaccination Plan happen. “I’m optimistic. I’m convinced the American people are ready to spare no effort and no expense to get this done,” he said, stressing it “will take many months to get where we need to be.”

AARP: Making Seniors a Priority in Getting COVID-19 Vaccines

Published in Pawtucket Times on January 11, 2021

Last month, a statement the Rhode Island Department of Health (RIDOH) announced recommendations from the Rhode Island COVID-19 Vaccine Subcommittee for hospitals that vaccinations would begin for frontline hospital workers against COVID-19. This recommendation was made at an emergency meeting of the Subcommittee. RIDOH has accepted this recommendation and has communicated to hospitals that they may begin vaccinating these workers, as soon as vaccine arrives.

Two doses will be needed for someone to be fully immunized. Second doses will start arriving in Rhode Island in roughly three weeks. Rhode Island expects to receive approximately 10,000 doses of Pfizer vaccine the first week it is available, and approximately 19,000 doses of Moderna vaccine the first week it is available. Vaccine will come to Rhode Island in weekly allotments over the coming months, says RIDOH.

Epidemiologists, primary care providers, pharmacists, pediatricians, long-term care advocates, ethicists, nonprofit leaders, school leaders, faith leaders serve on Rhode Island’s COVID-19 Vaccine Subcommittee.  This group is responsible for performing an independent review of the process for evaluating the safety and efficacy of the vaccine. The Subcommittee is advising RIDOH on how to prioritize distribution of the vaccine to ensure that it is done equitably, and in a way that best protects the State as a whole.

At press time, the U.S. Food and Drug Administration (FDA) has granted an Emergency Use Authorization for a COVID-19 vaccine developed by Pfizer, and a vaccine made Moderna.

Making COVID-19 Vaccine Available Throughout the Ocean State

“After a rigorous scientific review, we know that COVID-19 vaccine is safe. We also know that it is one of the most effective vaccines ever developed,” announced Director of Health Nicole Alexander-Scott, MD, MPH in the Dec. 14 statement. “In the coming weeks and months, as vaccine becomes more available, getting vaccinated will be one of the most powerful things you can do to keep yourself and the people you love safe from COVID-19. We are going to work to ensure that every person in every community in Rhode Island has access to the vaccine, especially those communities hardest hit by this virus,” she said.

Added, Philip Chan, MD, MS, Consultant Medical Director for RIDOH’s Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, “We have never had a vaccine that has been – or will be – more closely monitored than the COVID-19 vaccine.”

“Teams of scientists at the national level have been scrutinizing thousands of pages of technical data for weeks, focusing on vaccine effectiveness, safety, and the manufacturing process, and our own local review has happened here in Rhode Island. I absolutely plan on getting vaccinated when it is my turn.,” said Chan.

According to RIDOH, the national vaccine trials for the COVID-19 vaccine involved tens of thousands of people to make sure they meet safety standards and people of different ages, races, and ethnicities. There were no serious safety concerns. (When vaccinated against COVID-19, people do sometimes develop post-vaccination symptoms such as soreness at the spot of the shot and headaches. This is normal, healthy, and expected. It means your immune system is working to develop protection.) Several systems are in place to do ongoing safety monitoring of the vaccine.

As of January 8, the last update on RIDOH’s COVID-19 Data Tracker, out of the 31,541 does administered, 29,743 have been vaccinated with their first of two doses, only 1,798 people were fully vaccinated with two doses.

Don’t look for the roll out of COVID-19 to take days or weeks, it will take months to complete, warns RIDOH officials. Phase 1 of the vaccination program is expected to run through late March.  At press time, the state is currently working its way through the top three tiers of this phase, including hospital staff, healthcare workers, EMS personnel, home health and hospice workers, nursing home staff and residents, high-risk incarcerated persons, first responders, school nurses, and even hard-hit communities.

Finally, those in the final two tiers of Phase 1 to be vaccinated include outpatient providers (Dentists, primary care), Dialysis Center workers and death care professionals, expected to begin Jan. 25, and adults over 75 years of age, expected to start by February.

Phase 2 is expected to kick-in by late March.  A number of factors are being considered to target the distribution of COVID-19 vaccinations a person’s age, high-risk conditions, occupation and geography.  

Make Older Rhode Islanders a Priority in Receiving Vaccines

AARP Rhode Island, representing 132,000 older Rhode Islanders, calls for Governor Gina Raimondo to make the state’s seniors a priority in its time-line for on distributing COVID-19 vaccines.  The Jan. 8 correspondence, cosigned by Kathleen Connell, State Director of AARP Rhode Island and Phil Zarlengo, the group’s State President, called on Raimondo “to increase COVID vaccination transparency,” as it relates to older Rhode Islanders.

AARP Rhode Island asked the Governor to include the numbers of Rhode Islanders vaccinated by age and other criteria on a daily/weekly basis on RIDOH’s COVID-19 Data Tracker.  Specially, the largest state-wide advocacy group called for the state’s website to include:

·         the numbers and percentages of older Rhode Islanders by race and ethnicity, that have been vaccinated:

·         the number of Rhode Islanders vaccinated and their age demographics on a daily/weekly basis;

·         a clear and easy-to-understand schedule of vaccine administration for all populations; and the process by which individuals may seek and obtain a vaccine;

·          the numbers and percentages of long-term care residents, by facility, that have received their first and second doses of vaccines;

·         the numbers and percentages of long-term care staff, by facility, that have received their first and second doses of vaccines.

While acknowledging the many challenges the state officials must tackle in determining how to equitably, safely and effectively distribute COVID-19 vaccines, Connell and Zarlengo call for Rhode Islanders age 50 and older to be made a priority in receiving a vaccine.

“The data clearly show that the older people are, the higher risk they face if they contract COVID-19.  Given that older individuals are at a greater risk of death from COVID-19, we strongly urge you to ensure that Rhode Islanders age 50 and older are prioritized to receive a vaccine.  These individuals must be given priority access to vaccines, in addition to those individuals receiving care in nursing homes and other long-term care facilities,” say Connell and  Zarlengo.

“For years, the long-term care system has been shifting away from institutional care in nursing homes to home and community-based settings (HCBS). Here in Rhode Island, a significant percentage of long-term services and supports are provided in the home or settings such as assisted living facilities, residential care facilities, veterans homes, and in individuals’ own homes,” says Connell and Zarlengo, stressing that this why the state should prioritize seniors, especially those with underlying conditions, receiving care in these additional settings and the staff providing care, to receive a COVID-19 vaccine.

Finally, AARP Rhode Island’s correspondence urges the Governor to ensure that all providers are fully complying with established state procedures for vaccine distribution and prioritization. “We urge you to investigate and take swift action against anyone who attempts to commit fraud, including by inappropriately selling the vaccine or intentionally providing vaccines to those who do not meet qualifying criteria in an attempt to circumvent the distribution process.”

From AARP’s National

 “We urge public health officials at the state and local level, as they decide on vaccine allocations, to rely on the evidence and make plans backed by science.  As production is ramping up, AARP is advocating hard to ensure every older American who wants to get the vaccine can get it.  It’s also vital that distribution plans for authorized vaccines are smoothly implemented.  There’s no time to waste: it’s time for full-scale mobilization, and any delays or early bottlenecks in distribution systems need to be addressed urgently,” says AARP Executive Vice President and Chief Advocacy & Engagement Officer Nancy A. LeaMond in a Dec. 28 statement.  

 

AARP’s new COVID-19 Dashboard for national/local Nursing Home Data

Published in RINewsToday.com on October 26, 2020

While public health experts are predicting a second spike of the COVID-19 virus, expecting it to hit the nation as early as – now – and reaching its peak in December, AARP releases its Nursing Home COVID-19 Dashboard created to provide four-week snapshots detailing the infiltration of the virus into the nation’s nursing homes and its impact on residents and staff.  AARP’s latest Public Policy Institute analysis is the result of the Washington, DC-based aging advocacy group’s successful efforts to push for the public reporting of nursing home COVID-19 cases and deaths.

Using data collected by the Centers for Medicare & Medicaid Services—which is self-reported by nursing homes—the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the AARP Nursing Home COVID-19 Dashboard to provide four-week snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff. The first release of the dashboard on October 14 reveals that nursing homes in every state reported shortages of PPE, ranging from 8 percent of facilities in the best-performing states, to 60 percent in the lowest-performing state. The dashboard also compared state and national data on COVID-19 cases and deaths, staff cases and staffing shortages.

Key Findings of AARP’s First Dashboard

The AARP Public Policy Institute will analyze data and report on key findings as the dashboard is updated over time.  Here are some observations about AARP’s first Dashboard (using data from August 24 to September 20, in which 95 percent of the nation’s 15,366 nursing homes submitted data for this time period):

According to the database, in every state, nursing homes indicated a shortage of PPE (defined as not having a one-week supply of N95 masks, surgical masks, gowns, gloves and eye protection during the previous four weeks). Nationally, about one quarter (25.5 percent) of nursing homes had a PPE shortage during the Aug. 24 to Sept. 20 reporting period. In the highest performing state, 8 percent of nursing homes had a PPE shortage; in the lowest-performing state, 60 percent did not have a one-week supply.

The researchers note that while considerable attention has been paid to infections among nursing home residents, it is also critically important to consider direct-care staff. In the four weeks ending Sept. 20, one-quarter (24 percent) of nursing homes had at least one confirmed COVID-19 case among residents, and twice as many (50 percent) had at least one confirmed staff case. Per 100 nursing home residents, there were 2.6 COVID-19 resident cases and 2.5 staff cases, corresponding to a total of about 55,000 cases nationally.

Finally, there is considerable variation across states. COVID-19 deaths in the four weeks ending Sept. 20 averaged 0.5 per 100 residents across the nation (about 1 out of every 200 residents). At the state level, the death rate was as high as 1.2 per 100 residents (about 1 out of 80), and several states reported no resident deaths in the past month.

Looking at Rhode Island, AARP’s first dashboard detailed the following: 

·         2.2 COVID cases per 100 residents

·         0.2 COVID deaths per 100 residents

·         1.7 staff cases per 100 residents

·         19.7 percent of nursing homes without a 1-week supply of PPE

·         28.9 percent of nursing homes with staffing shortages

AARP’s dashboard will be updated every four weeks to track trends over time and will evolve to include more categories to follow other measures of interest.

As Others See It – in Rhode Island

“We have been very clear in our messaging: No state has done a good enough job to protect nursing home residents and staff,” said AARP Rhode Island State Director Kathleen Connell. “That said, it is good to see that in the first round of data postings on the AARP Nursing Home COVID Dashboard shows Rhode Island in better-than average shape compared to other states. But to our point, anyone in Rhode Island with a loved one in a nursing home expects – hopes and prays – for more than ‘better than average.”

“As we see daily reports of increased cases and deaths, safety concerns for nursing home residents and staff should be increasing as well. The pandemic is far from over and among many complicated aspects of dealing with it is transparency. The COVD Dashboard provides the public with a benchmark and tracks monthly changes; people need to pay attention and demand action at all levels to make nursing homes safer. These aren’t just numbers. These are lives,” says Connell.

On the other hand, the Rhode Island Department of Health questions the accuracy of AARP Nursing Home COVID-19 Dashboard as it relates to its Rhode Island findings. “The data don’t accurately reflect the Rhode Island reality in part because of how the questions are phrased,” says Joseph Wendelken, RIDOH’s Public Information Officer, specifically related to PPE data. “The question asks about PPE in the nursing homes. Nursing homes receive a weekly supply of PPE from their corporate warehouses. The question asks about one point in time. On occasion, reporting happens shortly before facilities receive their re-supply,” he says.

“RIDOH has taken several steps to protect nursing home residents, says Wendelken, noting that his department has built Congregate Setting Support Teams to conduct targeted to facilities regarding infection control, PPE, testing, and staffing. 

“We have weekly contact with facilities. We’ve worked with facilities to develop creative plans for reopening. We have implemented regular testing of staff every 10 to 14 days. We will take the lessons and experience we’ve gained from these past seven months and apply them to the increase in cases we see today,” adds Wendelken. 

According to Scott Fraser, President/CEO, of the Rhode Island Health Care Association (RIHCA), the AARP analysis shows what his organization has been saying in the last few weeks and months—that COVID-19 cases in nursing homes continue to drop. “Rhode Island is below the national average in all categories measured for this dashboard,” he says, stressing that the number of cases in nursing homes is dropping as is the number of deaths,” notes Fraser.  

The successful efforts to protect nursing home residents and staff can be directly linked to the measures the facilities have taken since the pandemic first hit, notes Fraser. “We are stocking up on PPE. We initially suspended visitation.  We are testing staff regularly and residents when necessary.  We are carefully monitoring visitors and vendors who come into our homes.  We isolate and quarantine anyone who tests positive or any new resident who moves into our facilities,” he says. 

Fraser says that RIHCA continues to advocate for regular testing of vendors who come into the state’s nursing homes, including ambulance drivers, lab technicians, and hospice workers.  RIHCA continues to call on RIDOH to renew the policy of having two negative tests before a hospital patient can be released to a nursing home and to allow those certified nursing assistants who received temporary emergency certifications to obtain their permanent licenses.

A Call to Action

More than 84,000 residents and staff of nursing homes and other long-term care facilities have died from COVID-19, representing 40 percent of all coronavirus fatalities in the U.S., according to Kaiser Family Foundation’s most recent analysis released on Oct. 8. Yet in its statement announcing the release of its Dashboard, AARP charges that federal policymakers have been slow to respond to this crisis, and no state has done a good enough job to stem the loss of life. 

According to AARP, policymakers have taken some action, such as requiring nursing homes to self-report COVID-19 casers and deaths at the federal level, ordering testing, and providing limited PPE and other resources to nursing homes. But more must be done, says the nation’s largest aging advocacy group in its statement urging elected officials “to acknowledge and take action to resolve this national tragedy — and to ensure that public funds provided to nursing homes and other long-term care facilities are used for testing, PPE, staffing, virtual visits and for the health and safety of residents.”

COVID-19 cases across the U.S. are again on the rise, and nursing homes remain a hotbed for the virus, says AARP promising to “continue to shine a light on what’s happening in nursing homes so that families have the information they need to make decisions, and lawmakers can be held accountable.”

AARP has called for the enactment of the following five-point plan to protect nursing home and long-term care facility residents — and save lives — at the federal and state levels:

·         Prioritize regular and ongoing testing and adequate personal protective equipment (PPE) for residents and staff — as well as inspectors and any visitors.

·         Improve transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.

·         Require access to facilitated virtual visitation, and establish timelines, milestones and accountability for facilities to provide in-person visitation.

·         Ensure quality care for residents through adequate staffing, oversight and access to in-person formal advocates, called long-term care ombudsmen.

·         Reject immunity for long-term care facilities related to COVID-19.

To see AARP Nursing Home COVID 19 Dashboard, go to:

www.aarp.org/content/dam/aarp/ppi/pdf/2020/10/rhodeisland-nursing-home-dashboard-october-2020-aarp.pdf