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Louisiana Hospitals Broaden Vaccination Effort As COVID-19 Hospitalizations Rise

Paula Burch
Tulane University

Louisiana hospitals are scrambling to immunize an ever-broadening pool of Louisianans eligible for COVID-19 vaccines, even as they struggle to keep up with the rising tide of COVID-19 patients.

On Wednesday, administrators across the state’s hospital systems laid out their immunization plans. This follows a directive issued by the Louisiana Department of Health on Tuesday urging the state’s hospitals to begin administering their excess doses of the Pfizer vaccine to 640,000 Louisianans in the Phase 1B, Tier 1 priority group. This group includes people age 70 and older, providers of dialysis treatments and their patients, people who receive and provide home healthcare services, and other outpatient healthcare service providers.

The effort comes as the state surpassed two grave milestones related to the pandemic. On Wednesday, the Louisiana Department of Health (LDH) reported a record-high 6,882 new cases in a single day and 1,993 hospitalizations, surpassing a record set in the chaotic early days of the pandemic.

Dr. Joseph Kanter, State Health Officer and coordinator of Louisiana’s coronavirus response, said the state is taking great pains to avoid wasting any vaccine doses. So far, 146 doses have spoiled, including 120 doses of the Pfizer vaccine that were lost over the weekend when a Baton Rouge healthcare provider suffered a power outage during inclement weather.

Louisiana has received more than 210,000 vaccine doses over the past four weeks. As of Tuesday, only 56,000 doses had been administered. Louisiana expects to receive an additional 56,000 doses from Pfizer and Moderna in next week’s shipments.

State public health officials said the number of people who have received their first of two required doses is likely much higher than what they are currently reporting — there is a significant delay between someone receiving the vaccine and the healthcare provider reporting that vaccination electronically to the state.

But even with the reporting lag time, state and public health officials acknowledge that vaccine rollout has been slower than they anticipated, especially as vaccine providers attempt to reach a broader subset of the population.

When asked if the 107 pharmacies that received vaccines this week would receive another shipment next week, Kanter replied "Not necessarily."

"Our first goal is to make sure distribution is equitable from a geographic and racial, ethnic standpoint," Kanter said. Twelve of the state’s 64 parishes received no vaccines this week for pharmacy distribution.

Each Monday the LDH will update the list of pharmacies that will receive a portion of the following week’s shipment of Moderna vaccines. Edwards promised that all 64 parishes would have a vaccine distribution location next week.

Nearly all of the state’s allocation of Pfizer vaccine doses — more than half of the state's total allocation of vaccine doses — have been sent to hospitals, which have the equipment needed to store the vaccine at “ultra-cold” temperatures it requires.

Administrators across the state’s hospital systems say they are seeing overwhelming demand for the COVID-19 vaccine from people age 70 and older.

In a virtual press conference on Wednesday, Ochsner Health President and CEO Warner Thomas said the hospital system expects to administer the first of the two Pfizer shots required for immunization to roughly 16,000 patients in the Phase 1B, Tier 1 group, with a focus on the elderly. Ochsner is hoping to expand that number to 25,000 next week.

In Baton Rouge, Our Lady of the Lake Hospital is in the beginning stages of offering the vaccine to qualified patients within its healthcare network, but as of Wednesday none had received doses.

Most of the hospitals within the LCMC Health system in New Orleans have begun making appointments with elderly patients and with patients on dialysis.

Ochsner Health President and CEO Warner Thomas said that just below 50 percent of the health system’s staff have received the first of two shots of the Pfizer vaccine. LCMC Medical Director of Emergency Management Dr. Jeffrey Elder said more than 6,500 employees, roughly 55 percent of its staff, have received the initial injection. Health systems began administering the second doses to staff this week. Both hospital systems continue to vaccinate staff members who want the COVID-19 shot.

Dr. Catherine O’Neal, an infectious disease specialist for Our Lady of the Lake, said many frontline healthcare workers eligible in the first phase of vaccine distribution were hesitant to get vaccinated and waited to see if their colleagues experienced negative side effects before rolling up their sleeves and getting it themselves.

Gov. John Bel Edwards said the “vaccine hesitancy” witnessed among healthcare workers was frustrating, especially with so many willing recipients in the latest phase of the rollout. But he stood by the decision to include those workers in the first priority group, as advised by the CDC’s Advisory Committee on Immunization Practices.

"There's nothing easy about this process, but working in priority groups is absolutely essential because we're trying to preserve hospital capacity and save lives,” Edwards said.

Elder said that LCMC anticipated a 50 to 60 percent initial uptake of the vaccine among staff.

“There's going to be people who are the early adopters who really want this vaccine right away,” Elder said. “ … And we have people that have questions, and maybe, you know, need to, you know, have a little bit more information, to feel comfortable to be vaccinated.”

Elder said that he noticed a sense of relief among staff members who received the vaccine.

“As these vaccines roll out, you can see these health care workers that have really worked just constantly for the past 10 months start to see that light at the end of the tunnel and just feel a little bit more protected,” Elder said.

This time infections appear to be spread out more evenly throughout the state compared to last spring when the virus was concentrated in New Orleans, Baton Rouge and other urban centers.

In a virtual press conference on Wednesday, Chief Medical Officer of Ochsner Health Dr. Robert Hart said 640 COVID-19 patients were hospitalized in the health system’s facilities. Hart said the medical organization has seen an increase of 200 COVD-19 patients across the state in the last two weeks.

“And this is not even the Christmas spike yet,” Hart said. “We've basically doubled our COVID volumes across the system in a month. This is all of the pre-Christmas holiday parties that we know were going on. And so we still have Christmas and New Year’s ahead of us and frankly, that's what has us concerned.”

O’Neal noted that Wednesday, 50 members of the Our Lady of the Lake staff were on leave because they had either tested positive for or been exposed to the virus — effectively wiping out the staffing gains they made by hiring traveling nurses.

Edwards’ current coronavirus restrictions will not expire until Jan. 13, at which point Edwards could tighten those restrictions. But Edwards said he is hesitant to require additional mitigation measures when so few people comply with those that are already in place.

“What are we going to do, start locking people up if they insist on not wearing a mask when they’re supposed to?” an exasperated Edwards asked at his Tuesday press briefing.

“We are not going to enforce our way out of this people. We’re either going to do the right thing or not, and if we don’t do better we’re going to watch a lot more of our Louisiana brothers and sisters die.”

Republican members of the state House of Representatives have attempted to nullify Edwards’ declaration of a public health emergency and strip all of the coronavirus restrictions that accompany it.

Edwards and Republican Attorney General Jeff Landry, who is representing the House of Representatives, are locked in a protracted legal battle over that effort.

Edwards’ orders remain in effect, but the conflict has undermined public buy-in for the restrictions.

“Quite frankly, they’re not that damn onerous,” Edwards said of his restrictions. “Put a mask on. You owe it to the community, you owe it to those healthcare workers, even if you’re not concerned about yourself.”

Tegan Wendland contributed to this report.