Local long-term care facilities eagerly await vaccines | SteamboatToday.com

Local long-term care facilities eagerly await vaccines

STEAMBOAT SPRINGS — In terms of risk of death, there are perhaps no Routt County residents more vulnerable than those living at Casey’s Pond in Steamboat Springs and The Haven in Hayden.

Of the 18 deaths attributed to COVID-19 in the county, 72% have occurred among residents at the two long-term care facilities — 11 at Casey’s Pond and two at The Haven.

Long-term care facility deaths make up close to half of all COVID-19 deaths in Colorado. Across the nation, as of Thursday, they account for approximately 38% of COVID-19 deaths in the U.S., although less than 1% of the population lives in these facilities.

Casey’s Pond remains on outbreak status per the Colorado Department of Public Health and Environment’s definition, which lasts 28 days after the onset of symptoms of the last case. The most recent case was a staff member who tested positive Thursday.

The two facilities in Routt County are scheduled to begin vaccinations Dec. 28 — possibly sooner.

The highest priority vaccination 1A group, according to the state, includes first, people who have direct contact with COVID-19 patients for 15 minutes or more over a 24-hour period and second, long-term care facility staff and residents.

The federal government set up an entirely separate mechanism for vaccinations in long-term care facilities through a nationwide contract with Walgreens and CVS pharmacies.

Adrienne Isdal, director of The Haven, said it has been frustrating not to have more information to tell her residents, staff and families about when they will get vaccines or why they are nearly two weeks behind the first batch of vaccines administered in the community.

Isdal said she requested vaccines sooner than Dec. 28.

She is especially eager to get staff members vaccinated, Isdal said, especially given the fact that most live in Moffat County, which has seen a recent spike in cases and now has as many deaths as Routt County.

But Isdal emphasizes that “there is nobody to blame,” and both Isdal and Brad Boatright, executive director of Casey’s Pond, said the county’s public health officials have been strong partners throughout the pandemic.

While the first batch of 580 Pfizer vaccines went to UCHealth Yampa Valley Medical Center last week, vaccinations are expected to begin this week at other locations employing those 1A health care workers.

The Routt County Public Health Department is anticipating a direct shipment of 100 Moderna vaccines this week, according to Routt County Public Health Director Roberta Smith.

“We have been working on how to prioritize that minimal amount of vaccine, but our first doses will go to our medical partners that have been testing for COVID-19 and those that are involved on the frontlines of COVID-19 response and potentially to cover some gaps in our long-term care facilities,” Smith said in an emailed interview.

The public health department also is anticipating potential surplus vaccines from the hospital, Smith said.

“We have requested that extra doses be transferred to public health and are awaiting that information,” Smith said.

As of midday Monday, more than 415 staff and providers at the Yampa Valley Medical Center had received their Pfizer/BioNTech vaccines, with more scheduled for the afternoon, according to UCHealth communications specialist Lindsey Reznicek.

“The state has asked all organizations that receive vaccines to have a plan to administer the vaccines allocated to them as quickly as possible — the quicker we administer, the more protection for everyone in the community,“ Reznicek said.

The hospital is scheduled to receive 200 doses of the Moderna vaccine this week and potentially as early as Tuesday, pending any weather or shipping delays.

“We recognized last week that most vials have contained enough for six doses, not five, and because it is a priority for us to not waste a single dose, we contacted Pfizer and received permission to provide this extra dose for our health care workers,” Reznicek said in an emailed interview. “The Colorado Department of Public Health and Environment also gave their approval to using the overage. This is allowing us to vaccinate more people with the limited vaccine shipments we originally received.”

With the additional 116 doses in addition to the CDPHE-allocated 580 Pfizer doses, the total received in the first shipment was actually 696 doses.

“As the community’s hospital, UCHealth Yampa Valley Medical Center is glad to transfer the balance of the vaccine to Routt County Public Health as soon as we complete our Tier 1A vaccine administration,” said Eli Nykamp, director of operations and COVID-19 incident commander at the medical center. “We know there are Tier 1A individuals in our community who haven’t yet received their first dose of a COVID-19 vaccine, so hopefully, this will allow them to receive it soon.”

The Walgreens initial allotment may not be enough for the two long-term care facilities, according to Smith.

There are 13 residents at The Haven and 16 staff members, and Casey’s Pond has approximately 80 residents and 120 staff members.

“Based on information from Walgreens contacts and leadership at Casey’s Pond, public health has noted that the doses allotted for Casey’s Pond is not enough to cover their whole population,” Smith continued. “Public Health is working to fill this gap with any vaccine we can transfer from UCHealth, or if we can’t get doses that way, we will use our initial shipment this week to cover the gap. Additionally, we will see if there are any gaps with The Haven. As we understand it, the doses through the pharmacy program cannot be transferred within the county to other entities such as public health.”

Reznicek said everyone vaccinated at the hospital with the first shipment of doses falls into the state’s 1A category, though staff was broken into two tiers for prioritization — a high-risk group and a moderate-risk group.

“All of these employees spend more than 15 minutes in a 24-hour period with patients whose COVID-19 status is positive or unknown,” she said. “We were fortunate at YVMC to receive enough vaccines for all of our state-tiered 1A employees, whereas at other UCHealth facilities that was not the case, hence the internal tiers. Simply put, our internal 1A and 1B are all state 1As.”

What the vaccines will mean for the residents and staff at Casey’s Pond and The Haven is hard to overstate. Of course, some will choose not to get the vaccine, although Boatright said he doesn’t know of any residents yet who will decline the vaccine, based on an informal poll.

Among staff, he said it “shakes out about like the national average, with 60% to 65% saying ’yes,’ and about 15% on the fence, saying they’d like more information.”

As to what the vaccine means to Casey’s Pond, Boatright said he wish he knew how to express it in words.

“The shining hope that this provides at a time when recently we didn’t have this to look forward to and we didn’t know what the future would hold,” Boatright said. “This changes everything — absolutely everything.”

But while it is a huge milestone, Isdal and Boatright acknowledge the restrictions and policies at the facilities are going to take time to change. They are still dependent on the disease prevalence of the larger community.

It has been a hard year, Boatright said, exhausting and “an emotional roller coaster.” They have suffered great loss but also celebrated many recoveries.

Boatright noted being among the first to get the vaccine means his residents and staff who choose to do so will make history.

“They are taking a leap of faith,” he said.

Isdal said 100% of her residents are eager to get the vaccine and close to that for staff.

“Our residents are so resilient,” Isdal said. “We have an old population. They’ve lived through a lot. But they do say this is the hardest experience they’ve ever had. At this end stage of their life, this is the last thing they want to be dealing with. They want to be with family and having meaningful interactions.”

Boatright and Isdal also cannot say enough about the resiliency and dedication of their staff.

“Our staff has been through a lot,” Isdal said, “and still show up every day with a smile on their face and love in their heart — and provide the same level of care they would provide for their own loved ones.”

Next up for vaccination is 1B group, which includes health care workers with less direct contact with COVID-19 patients, workers in home health/hospice and dental settings, EMS, firefighters, police, correctional workers, dispatchers, funeral services, other first responders and COVID-19 response personnel.

“We expect that vaccine will begin flowing into the county on a regular basis,” Smith said.

She said based on a survey distributed to 1B populations, there are about 600 people that will need vaccines in Routt County.

“For this first phase, public health will schedule with the clinics and will come to them to administer the vaccines,” Smith said. “For the larger phases, we will have more partners giving vaccines and will host community clinics for those that qualify.”

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