BOZEMAN — Gallatin County reported 160 new COVID-19 cases on Wednesday. The county now has 795 active cases, 6,301 recovered cases, and 7,114 total cases. Currently, there are 34 people hospitalized and 18 deaths.
The Gallatin City-County Health Department will be closed on Nov. 26 (Thanksgiving Day) and Nov. 27 in order to give our staff some much needed and deserved time off. This closure will include the COVID-19 Call Center. If you have COVID-19 related questions during that time, please visit their website for more information.
NOTE: As the number of COVID-19 cases increases in Montana, the disparity between state data from DPHHS and data from county health departments continues to grow. As of Thursday, November 19th, MTN News has decided to use a combination of these sources to deliver more accurate and timely information. County health departments are often alerted to cases/deaths before Montana DPHHS; as those counties share that information with us and/or the public, MTN News believes it should be reflected in our reporting. Using that county-level data means there will be times when MTN News data differs from the state report. Click here for the Montana COVID site.
RESTRICTIONS: Tighter restrictions went into effect on Friday, November 20th, due to the continuing increase in the number of cases and deaths. Masks will be required in all counties regardless of the number of active cases. Capacity at restaurants, bars, and casinos will be reduced to 50%, with a limit of six people per table. Click here to read the full text of the directive.
CONTEXT: Not every person who tests positive actually becomes ill or exhibits symptoms. Many do not; of those who do become sick, some experience mild symptoms and do not require hospitalization. Others, however, do require hospitalization, as noted in the daily update on the number of people hospitalized. However, every person who tests positive for COVID-19 has the potential to spread the virus to other people, including family members and friends, which is why public health officials continue to encourage everyone to wear a mask and maintain at least the recommended six feet of "social distance" when in public. The CDC released data in late August which emphasizes that people with contributing or chronic medical conditions are at much greater risk of dying from COVID-19. Click here to read more.
On Monday, the Montana Department of Public Health & Human Services announced a statewide team that will help answer some questions surrounding COVID vaccines, and released a draft plan for the distribution process. The COVID-19 Vaccination Plan Coordination Team, made up of Montana medical, tribal, government, and community leaders, will also give feedback as the process rolls out.
Montana Immunization Program Manager Bekki Wehner stressed that this is just version one of what she expects to be several iterations of the state’s COVID-19 Vaccination Plan.
With evolving guidance coming from the Centers for Disease Control and Prevention, the Food and Drug Administration, and other agencies and organizations, it’s likely that Montana’s plans to distribute a COVID-19 vaccine will have to adapt to that changing guidance. Even so, the first plan is here, and this is what it says:
There will be three phases of distribution for the vaccine. In Phase One, there will be a limited supply of the vaccine, and it will go to infrastructure workers and people who are at increased risk for severe illness as a result of COVID-19. In Phase Two, which the DPHHS estimates will be about three to six months after the initial vaccines arrive, people who are at increased risk of contracting the virus will be prioritized. Then in Phase Three, when the vaccine is widely available for anyone that wants to get it, healthy adults with limited or no chronic health conditions can get the vaccine, along with anyone who has not yet gotten it. State officials estimate Montana will enter this phase at least six months after the vaccines start being distributed, if not longer.
Click here to read the complete plan (PDF).
So when will the U.S. approve and start distributing these vaccines to states? U.S. Health & Human Services Secretary Alex Azar said on Tuesday that the country could begin distributing COVID-19 vaccines as early as mid-December. In fact, his exact words were “if all goes well, we could be distributing vaccine soon after December 10.”
If that’s the case, Montanans that fall under the categories listed in Phase One could begin receiving these vaccinations as early as a few days after that.
DPHHS says the vaccine will not be mandatory, and that everyone who wants to get it will be able to eventually.
Wehner said that it’s likely the vaccine will need to be administered in two separate doses. Because of that, she estimates that the state will need between 90,000 and 100,000 doses of the vaccine just to vaccinate all frontline healthcare workers in Montana. It’s not known yet how many doses will be included in the first shipments to states.
It’s also not clear which vaccine the FDA will move forward with. Moderna and Pfizer have been the forefront of vaccine development in the United States recently, but the University of Oxford and pharmaceutical company AstraZeneca also recently announced some successful vaccine trials. While each vaccine has its advantages, only two of those, Moderna’s and Pfizer’s need to be stored at sub-freezing temperatures. Oxford-AstraZeneca’s can be stored at normal refrigerator temperatures.
That could have an impact in how facilities prepare to store the vaccine. Wehner says Montana has six or seven ultra-cold storage sites around the state to store vaccines. Despite the differences in storage temperatures, time required between each dose, and other things, Wehner doesn’t think it will have a major impact on when the vaccines can begin being administered in Montana.
“The cold storage units aren’t a critical component of vaccine allocation, they’re just a piece of the puzzle,” she explained. “So, if there are concerns that there are no ultra-cold units in a certain geography of Montana, that won’t preclude there being a vaccine allocation in that area.”
One question that came up a lot back in March when Stay-At-Home orders were being put into place around the country involved the term “essential worker.” Now, some of those same essential workers will be among the first people to receive this vaccine in Montana.
According to the official draft of the COVID-19 Vaccination Plan released by the Montana DPHHS, “Critical Infrastructure Workers”, those that will be receiving the vaccine in Phase One, include the following occupations: healthcare professionals such as pharmacy staff, school nurses, and EMS workers. Phase One also includes workers identified in pages 7 through 23 of this document published by the U.S. Cybersecurity & Infrastructure Agency. According to the information on that document and Montana’s COVID-19 Vaccination plan, a lot of the people were considered essential workers in March will retain that designation as vaccines are given out.
The Montana DPHHS is currently in the process of enrolling hospitals and some other facilities around the state as COVID-19 Vaccine Providers, a process that including a fair bit of training and preparation. According to the Vaccination Plan, “The Immunization Program is obtaining primary contacts and emails for all potential Phase 1 COVID19 vaccine providers identified as having the ability to reach Phase 1 critical populations. The Immunization Program will prioritize processing Phase 1 enrollments initially and progress to providers in other phases as the vaccination effort develops.”
The Montana DPHHS is also utilizing the state’s immunization program to assist with this entire process, from training providers to administer vaccines and teaching them how to store the vaccines to how to report vaccine data to the state.
So what else? Wehner says that with every vaccine order, the distribution facility will also receive a supply kit. That kit will include, among other things, a card that people who receive the vaccine can use for two things. First, it will remind them when they need to go get their second dose (required timing between the first and second dose varies based on which vaccine you are getting). Second, it can be used as proof that they did, in fact, receive the first vaccine.
This won’t be the first time that a vaccine requires more than one injection to take full effect. While the flu shot only needs to be taken once each year, the Human Papillomavirus (HPV) vaccine is actually three doses of a vaccine, which men get between the ages of 19 and 21, and women get between the ages of 19 and 26.
Some vaccines which are merely recommended and not necessarily required for things like enrolling in school or other programs are also multi-dose vaccines. The Hepatitis A vaccine is given in two separate doses, while the Hepatitis B vaccine comes in two doses. (Source: Centers for Disease Control and Prevention & American Academy of Family Physicians)
Wehner also announced during the meeting that the plan is to provide this vaccine free of charge, even to people without health insurance. “The vaccine will be provided by the federal government without cost,” she said. She went on to add that the cost to distribute the vaccine will be covered by your healthcare provider, and that anyone who does not have healthcare should be reimbursed for any cost they might have to pay to receive the vaccine.
One question that was brought up near the end of the meeting: How will the state handle vaccinating active COVID-19 patients? Medical guidance recommends not getting a flu shot if you have a fever, so does the COVID-19 vaccine come with the caveat? Wehner said she did not have the answers to those questions readily available, and more information is needed from the FDA and the ACIP to provide an accurate answer.
Lastly, if you’re looking to get your child vaccinated, that will likely have to wait, though it’s not clear how long. Wehner says that there is currently no data available about the efficacy of any of these vaccines in children. Because of that, the state is currently not recommending that anyone under the age of 18 get any of these vaccines.
Do you have questions about Montana’s COVID-19 vaccine plan? Email them to me at Matt.Holzapfel@krtv.com, and we’ll try to get answers.