Buncombe County prepares to start vaccinating adults 75 and older

As Buncombe County’s COVID-19 vaccine rollout gets underway, emergency preparedness director Fletcher Tove asked for one thing: Patience. 

County health officials will move into phase 1b of the COVID-19 vaccination process the week of Monday, Jan. 11, announced Stacie Saunders, Buncombe’s health director, at a Jan. 5 briefing to the Buncombe County Board of Commissioners. 

The first group to receive priority in that phase will be individuals age 75 or older, followed in group two by patient-facing direct health care workers and essential frontline workers over the age of 50. Phase 1b’s third group will consist of all other direct health care workers and frontline essential workers, regardless of age. 

But limited vaccine allotments from the state mean it will take a long time — possibly several months — to ensure everyone in phase 1b of the rollout is able to get a shot. The Buncombe County Health Department received 700 doses of the Moderna vaccine the week of Dec. 21, followed by 975 doses of the Pfizer-BioNTech vaccine on both Dec. 28 and Jan. 5. Future allocations are unknown, Saunders explained: The health department only learns of the contents of the next shipment will be a few days before the vaccine’s arrival. 

Those early doses vaccinated health care workers and first responders in direct contact with COVID-19 patients, as well as staff and residents of long-term care facilities, Tove explained, as outlined under North Carolina’s vaccine phase 1a. The federal government is handling vaccinations at the majority of the long-term care facilities through partnerships with CVS and Walgreens; Buncombe health officials are responsible for vaccinating staff and residents at the roughly 90 facilities not covered by the federal effort using the county’s weekly vaccine allotment from the state. 

In Buncombe County, health officials estimate that the phase 1b, group 1 subclassification includes roughly 40,000 adults; another 5,000 are expected to fall in phase 1b, group 2. If the county continues to receive only 1,000 doses of vaccine each week, and some of those doses go to people who qualify under phase 1a, the math “just doesn’t add up,” Tove said. 

“Clearly, we’re not going to get there,” he said. “The mentality we need to see these phases in is not that that phase is dedicated to this specific group, but that the phase is a headstart for that group as the phases advance.” 

Starting next week, the county health department will begin administering vaccines at the A-B Tech Event Center, a space large enough to safely vaccinate 2,000 people each week, if supplies allow. Eventually, officials plan to set up a permanent vaccination site at the old Sears building at the Asheville Mall. 

Instructions to sign up for an appointment will be released late in the day on Wednesday, Jan. 6, said Stacey Wood, health department spokesperson. At this time, pharmacies and primary care practices have yet to be certified as COVID-19 vaccine providers. 

“We know there will be a lot more people demanding the vaccine than we have the capacity for,” Tove said at a Jan. 6 press conference. “In the next phase, there will be tens of thousands of people wanting to get vaccinated. Please understand the constraints that we have.” 

Haywood County residents over the age of 75 can now pre-register for a vaccine appointment, the Haywood County Department of Emergency Management announced on Jan. 5. Henderson County remains in phase 1a; when the county is ready to move into phase 1b, group 1, the health department said it will release detailed information for scheduling an appointment. 

Mission Hospital is “deep in the surge” 

Buncombe County hit 10,000 COVID-19 cases on Jan. 6, a milestone that comes as hospital capacity is stretched thin. 

At the Buncombe County Board of Commissioner’s pre-meeting briefing on Jan. 5, Dr. William Hathaway, Mission Health’s chief medical officer, painted a grim picture. The number of COVID-19 patients at the flagship Asheville hospital jumped from an average of 40 a day in November to 130 on Jan. 5, and staff members expect to see numbers rise to 200 in the coming weeks. 

“I used to say that the surge was lapping at our shores euphemistically,” Hathaway said. “Now we are deep into that surge, and it’s going to get worse.” 

Hospital capacity is calculated via a “sophisticated set of metrics” that look at factors including open beds in the intensive care unit, the percent of patients on a ventilator and the amount of personal protective equipment on hand. Right now, the biggest concern is nursing staff, Hathaway said, who are already working with more patients than they typically do. 

COVID-19 related hospitalizations continue to set new records at the state level, with 3,893 people receiving care on Jan. 5. The number of empty and staffed ICU beds across the state is dwindling, with only 13 open in both the Duke Healthcare Preparedness Coalition and the Capital Region Healthcare Preparedness Coalition. 

When asked if Mission Heath would consider accepting patient transfers from other parts of the state, Hathaway said that while the hospital system would do what it could to care for patients in need, its priority was ensuring capacity remains for patients in Western North Carolina. 

In other news

• Food and Nutrition Services recipients will see their benefits temporarily increase by up to 15%, a measure included in the federal Emergency Coronavirus Relief Act of 2020. FNS recipients can check changes on the ebtEDGE mobile app, by visiting ebtedge.com or calling 1-888-622-7328. The increase in benefits will last through Wednesday, June 30.
• Dr. Mandy Cohen, the state’s secretary of health and human services, issued a secretarial directive outlining immediate actions North Carolinians can do to protect themselves from COVID-19. The full document can be found here.

Updated at 3:15 p.m. on Jan. 6 to include Cohen’s directive.