Virginia Hospital Center On COVID-19 & Vaccines

As we approach our one-year COVID-19 anniversary, the thing on everyone’s minds in vaccines. Virginia Hospital Center (VHC) has been at the forefront of treatment throughout the pandemic and was recently working on vaccine distribution. LHA’s Executive Director, Ginger Brown, sat down with Adrian Stanton, Vice President of

Business Development & Community Relations at VHC, to discuss everything from vaccine roll out and the toll of COVID-19 on the Hospital to appointment cancellations and what the public can expect in the coming months.

Ginger Brown: Adrian, thank you so much for agreeing to speak with us. I know our community will greatly value hearing what you have to say.
 
Adrian Stanton: It’s absolutely my pleasure Ginger, thanks for inviting me to chat.
 
GB: Let’s get right into it. We all know what a hot topic vaccination is. Where is VHC in the vaccination process and what has that process looked like?
 
AS: In Virginia, vaccine distribution facilities had to submit a request for vaccine doses each week. We felt we could easily distribute 3,000 a week, so that’s what we would request, however we were only receiving about 1,800-2,000 a week. When vaccines started arriving, the most important thing to us was to make sure all our staff on the front lines got the vaccine first. Folks in the hospital not seeing patients came second. In January, Arlington announced that the County was moving from Phase 1a to 1b and we (VHC) were asked to adjust our vaccination process to allow for individuals in 1b to be seen. Every County is different in how they partnered with hospitals, but in  Arlington we agreed to focus on healthcare workers and the way it needs to be stored, individuals aged 75+. To prepare for higher

numbers of vaccinations, we set up clinics at Walter Reed Clinic, the Arlington Free Clinic, and our Arlington primary care physician office. Because of the nature of the Pfizer vaccine and we required individuals to make an appointment. After receiving their shot, those individuals would

stay at the vaccination site for 15 minutes to monitor for any potential side effects (similar to the Flu Shot) and then they were free to go. It was a very efficient and successful process.

GB: Many in the community have likely heard about the cancellations of vaccine appointments that occurred a few weeks ago. What happened? What caused the Hospital to have to make that decision?
 
AS: Early on in the vaccination process, we made the decision to ensure that everyone who got a first dose would get a second dose – this decision has been widely supported by healthcare professionals. But one Wednesday evening in mid-January, we were notified by the Virginia Department of Health that we would not be receiving a shipment of vaccines for the following week. This put us in an incredibly tough bind – we had folks scheduled for appointments through March and we had to cancel about 10,000 appointments. It was awful. But the appointments we cancelled were first doses. Everyone who already had a first dose and was scheduled for their second dose retained their appointments. We wanted to honor that decision we had made all those months ago. Next week will mark the end of those vaccination appointments (second doses). We have, however, shared with the County the list of residents whose appointments were cancelled and they are working through the process of connecting with those individuals and rescheduling their appointments. All future vaccines will go through the County Health Department who will then decide how the vaccines will be distributed based on guidance by the Virginia Department of Health.

GB: How did people react when their appointments were cancelled?

AS: People were understandably upset when their appointments were cancelled. The hospital did not want to cancel the appointments, but we had no choice. We felt strongly that we needed to give second doses to folks who got the first, not just give the first dose to everyone who had an appointment without access to a second. But we were devastated to have to cancel those appointments, it was a gut wrenching thing to have to do. And it wasn’t

just VHC that had to do cancellations – INOVA and Fairfax did as well. It was also heartbreaking for our staff who were involved in the vaccination effort – there was a level of pride they had in doing this. But we understand why the state had to do it.

GB: Why do you think the state stopped providing doses?
 
AS: To my understanding, we stopped receiving doses for two reasons: 1. The Commonwealth had been distributing doses based on how much each vaccination center was asking for and then using. As far as I know, Northern Virginia was using all the doses they received, but other areas of the state were not. 2. I think, because Virginia was not vaccinating as quickly as it wanted to, the state government, for obvious reasons, wanted to make improvements to the rollout plan. Governor Northam moved to increase the number of people who fell in Phases 1a and 1b, which meant more vaccines needed to be distributed across the state to meet this expanded phasing. The state shifted to a new system that would distribute vaccines not based on who’s using it but based on population. Vaccines started to be shipped to County Public Health offices instead of hospitals or other distribution centers. So, instead of places like VHC vaccinating the public, Arlington County is now leading the charge. We do, however, have an agreement with the County and have made sure that they know that if they need our help, we’re ready to jump back in and restart our efforts around vaccination right away.
 
GB: What vaccine was VHC distributing?

AS: Way back when word came out around different types of vaccines, we knew that storage would be a unique challenge – Pfizer requires a high-end refrigerator to hold it at a particular temperature. To the credit of our purchasing folks, they ordered one of those special refrigerators way before everyone else – in fact, there were some hospitals who couldn’t even get access to them. When the vaccines came out, a lot of places couldn’t accept the Pfizer vaccines because they couldn’t store it. So, when the state started looking at the distribution of

Pfizer and Moderna, it rightfully decided to give Moderna to the centers who didn’t have those refrigerators. Because we could store it, most of what we got was Pfizer.

GB: We all know how bad the spike in cases was over the last few months. What is the current status of COVID at the hospital?
 
AS: Right now, things are good. Coming out of the holidays was a different story though. About 2 weeks post-Thanksgiving, numbers started to inflate like crazy. And then we tagged onto that the winter holidays and New Years. We saw an increase in numbers that were very close, if not equal, to the worst part of COVID-19, which, in this area, was last May. The difference this time around, however, was that the hospital is generally much busier in the winter months because of the flu. The “good news” in May was that the hospital had capacity to care for all the patients. What made the recent spike so difficult was how full the hospital already was. The positivity rate - the number of individuals who get COVID tests and test positive - was also incredibly high. If that number gets close 10% on a consistent basis, that starts to concern us. Once we hit summer and early fall, the positivity rate went way down to 2-3%. Then we hit November and Thanksgiving and saw the rate creep up and up and eventually went well above 10%. However, now that we’re past the winter holidays, we’re seeing the number of COVID patients and the positivity rate go down, which is good news. We anticipate a small spike due to Super Bowl gatherings but hope it won’t be too bad. The common thread unfortunately is always people getting together, not adhering to masking or social distancing, not knowing the behavior of the people they’re gathering with – behaviors that might put them at risk. Unfortunately, we see a lot of cases where everyone in the group gets sick. But the good news right now is that numbers and positivity rate continue to go down.

GB: Are you seeing the new strains?

AS: Oh yeah. VHC has not knowingly treated any patients carrying strains, but we know for sure that the UK variant is in Northern Virginia from the reports of the Virginia Health Department.
 
GS: Do you know if that strain is harder to treat?
 

AS: Because I’m not a physician, I don’t really know the answer to that. What we do know is the UK version transmits much faster than the “regular” strain.
 
GB: Back tracking a bit…despite the vaccines being in such high demand, there are still a handful of people who are not yet convinced. Why do you believe the public can and should trust the vaccine?

AS: My sense is that there are people who are concerned about how quickly it came to market. I understand the concern, particularly when you look at the history – a vaccine could take 4 years to get to market and this happened in basically under 12 months. The difference, however, and the reason why I and so many others trust the vaccines is that despite the accelerated time frame, there was extensive testing and safety protocols in place to ensure the vaccines were safe. These vaccines are also incredibly effective. Even if they were only a little bit effective, they would still be worth getting. And now that we see the variant strains, vaccinations are even more important. Much like the flu, I feel very strongly that any opportunity that we have to protect those that we come in contact with, those we love, or ourselves, we owe it to ourselves and our loved ones to do that. And that’s why we have been such strong proponents of the vaccines.
 
GB: I also understand that another reason the vaccines were able to be developed so quickly was because scientists were already studying mRNA (messenger RNA) - the technology used by the Pfizer and Moderna vaccines - for quite some time. Is it true that that already available information helped to shorten the time needed to develop those COVID vaccines?
 
AS: Yes, that is correct.

GB: Well, this all a whole lot of great information!
 
AS: (Laughs) Good!
 
GB: Is there anything else you think our readers should know?

AS: I think I’ll say two things to those who have gotten their second dose: 1. You are not fully fortified until two weeks after your second dose. 2. Being vaccinated does not mean you can let your guard down. You still have to mask up, social distance, and continue taking safety precautions. You may not get sick, but you can still carry the virus and infect others.

GB: Are we ever going to get to a point where that’s not the case?

AS: I think we will. If the question is when that will be, to be honest I have no idea, but we will get there. As good a system as we were able to develop in VHC, we still were not able to vaccinate as many people as the County needed. Even if we had gotten all the vaccines we asked for and could do 3,000-5,000 vaccinations a week, it would take forever to get through the whole Arlington community. From my perspective, you have to dramatically increase the supply and once that happens, move to a much different system of distribution. We need to be taking over a huge stadiums or parking lots, have the national guard help, and have people drive up and stick out an arm. You need that to get mass vaccinations happening every day, otherwise it’ll take years to vaccinate the entire population.
 
GB: Let’s hope we start getting enough vaccines to begin doing something like that!
 
AS: Well, there are signs right now that things will get better. It seems that this new administration’s first order of business is to increase the supply of vaccines quickly and then tackle distribution. It will also be helpful when other vaccine options get approved. Additionally, we’ve seen some states have great success with vaccinations, so we know it’s possible, we just have to follow their lead.
 
GB: Well, this has been wonderful Adrian. Thank you so much! I know this information will be greatly appreciated by our audience.
 
AS: Happy to do it!