National & Arizona COVID-19 and Vaccine Update April 15

There were 419 new cases of COVID-19 reported to the Arizona Department of Health Services (ADHS) on Wednesday, April 14, bringing the state total to 851,265 cases overall. There were four new deaths reported, and Arizona is now at 17,109 total deaths due to the virus. 16% of intensive care unit beds are available and 9% of ICU beds are occupied by COVID patients.On Wednesday, 46,744 people received vaccinations in Arizona with 4.3 million doses total administered to Arizonans. The Centers for Disease Control and Prevention (CDC) reports 30% of the state population is now vaccinated and 78% of the 5.4 million delivered doses have been used in the state. Across the county, 194,791, 836 doses have been administered, reflecting 30.5% of the population overall.

These numbers come from the ADHS Data Dashboard and the Bloomberg Vaccine Data Tracker. ADHS also put out a press statement this week celebrating the 4 millionth dose of COVID-19 vaccine. From ADHS Director Dr. Cara Christ:

With vaccine supply approaching demand, we need everyone’s help to keep up this momentum and get to the point where everyone is protected against COVID-19.

ADHS announced a change in confirmed results last week, with the state reporting 1,302 cases last Friday. 625 of the new cases were from before March in three counties from positive tests that were not yet recorded because of incomplete information, KTAR reports.

ADHS also heeded the CDC and Food and Drug Administration (FDA) joint recommendation for a pause in the Johnson & Johnson Janssen (J&J) vaccine distribution, according to an ADHS statement. Of the 6.8 million doses of the J&J vaccine administered across the county, six women between the ages of 18 and 48 experienced blood clotting that warranted a pause in distribution and blunt public announcement of the recommendation. The Advisory Committee on Immunization Practices (ACIP) convened on Wednesday to investigate reports of serious threats from the vaccine. Furthermore, the FDA released a Frequently Asked Questions on Wednesday to address concerns regarding the J&J Janssen vaccine pause.

From Dr. Cara Christ, via ADHS press release:

While the occurrence of this rare blood clot are extremely rare compared to the number of doses of the Johnson & Johnson vaccine administered nationwide, we are following the guidance of the CDC and FDA out of an abundance of caution and we will continue to work with our federal and statewide partners about the status of the vaccine.

The pause could spell a great deal of difficulty for distributing to two high-risk populations: seniors and rural communities. The J&J vaccine’s single dosage and relaxed refrigeration requirement made it the much more accessible choice for people less able to get to vaccination sites. As reported by the Atlantic, rural areas also tend have a much higher rate of vaccine hesitancy, making public announcements like the pause in J&J vaccine distribution much more likely to slow the rate of vaccination.

Seniors in long-term care facilities or who rely on home-based care also are getting the short end of the stick with the J&J pause. According to McKnight’s Long-Term Care News, the J&J pause “essentially halts” distribution to assisted living facilities and nursing homes. From Dr. David Gifford, M.D., MPH, chief medical officer for the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL):

Unfortunately, today’s development essentially halts vaccinations in long-term care, as the federal government was primarily allocating the Johnson & Johnson vaccine to nursing homes and assisted living communities. Without swift action to replace these vaccines, we could see tragic consequences.

KJZZ also reported methods by which Arizona housebound seniors could get the vaccine, including sending people to homes in areas where points-of-distribution are taking place. According to April Rhodes, CEO of Spectrum Healthcare Group, which operates Yavapai county PODS, the J&J vaccine was the primary one used by the program.

This comes just as the nursing home partnership with Walgreens and CVS is coming to an end. While enrolled nursing home residents are highly vaccinated, staff members are falling short. From Christopher Laxton, executive director of AMDA, the Society for Post Acute and Long Term Care Medicine, via KJZZ:

While residents to a very large degree (over 90%), nationally, have been vaccinated, staff are still at the 50 to 60% level.

Employee Burnout

The American Medical Association (AMA) published a blog post this week to guide providers and provider groups on ways for healthcare professionals to deal with burnout and stress heightened by the COVID-19 pandemic. These include things like meeting the basic needs of providers, aligning with leadership structures, creating space for reflection and making help accessible.

We really tried hard to continue to support people, to learn from our experiences and to think about how we can carry that forward.

LISTEN: Federation of American Hospitals podcast, “Surviving Covid: How Physicians are Providing Vital Care and Keeping Practices Open.” Featuring Dr. Susan Bailey, President of the American Medical Association.

Local Updates

The Arizona Health Care Cost Containment System (AHCCCS) formed a partnership with the Crisis Response Network to provide transportation to vaccine appointments for Medicaid members, with a hotline for patients to make the appointment. From Jami Snyder, AHCCCS director, via press release:

With COVID-19 vaccines now widely available, AHCCCS is working to ensure that its 2.1 million enrolled members have the opportunity to schedule and attend a vaccine appointment, and that technology and transportation do not present any barriers to receiving the vaccine.

A $1.2 million contract awarded to Mario E. Diaz & Associates by ADHS is receiving scrutiny following a report on the program’s performance, AZCentral reports. The contract for “marketing and communications to Hispanic populations that have been disproportionately impacted by COVID-19” is expected to grow to $3 million to expand outreach to other areas and was initially awarded as a no-bid contract.

AZ Vaccination Site Updates

• Arizona Emergency Information Network announced a partnership between ADHS and Northern Arizona University for a COVID-19 vaccination site in Flagstaff. Further reading from Governor Ducey’s website.
• The state-run site at Phoenix Municipal Stadium will move indoors to the Desert Financial Arena at Arizona State University’s Tempe Campus, according to 12News.
• Tucson Medical Center is moving its outside clinic from the TMC campus to Morris K. Udall Park, TMC announced in a press release.