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Frustration, confusion, and crashing systems as vaccine eligibility expands

a man wearing a mask receives a covid-19 vaccine
C/O Spectrum Health
/

“Extreme call volumes.” Crashing servers. Cancellations. And one county says it’s been completely wiped out of vaccine supply by Monday afternoon. 

The airplane is being built as we fly it here, folks.

That’s the message from hospitals and local health officials around the state Monday, as they started (or in some cases, tried to start) vaccinating people 65 and older, as well as some essential workers.

The surge in demand since Governor Gretchen Whitmer announced on Wednesday the vaccine eligibility expansion from health care workers and those in long term care facilities, has literally been overwhelming: Beaumont Health says its servers crashed over the weekend. Spectrum Health in West Michigan says 45,000 people filled out surveys this weekend saying they were interested in the vaccine.

And Genesee County Health Department said it had run out of vaccines by Monday afternoon, pleading with the public not to add to the “extreme call volumes” from people inquiring about appointments, “which is overwhelming our phone systems.”

Meanwhile, Ingham County health officials say their clinics are now booked through February 24th, with some 12,000 people scheduled to receive their first vaccination.

“People age 70 and older account for most of the newly scheduled appointments, followed by teachers and staff working in pre-kindergarten through high school and child care workers,” an Ingham County spokesperson said in a statement Monday.

“The demand for the vaccine is overwhelming,” said Ingham County Health Officer Linda Vail. “We are working as fast as we can, but the outpouring of people has caused some technical glitches as well as a sizeable backlog of calls and emails.”

Some health systems could vaccinate thousands, if they just had more doses

Over the weekend, Michigan Medicine had to temporarily cancel plans to even begin vaccinating those in the “1B” category after only receiving 4,000 doses for the week.

Safe to say that’s a bit less than the 24,000 the health system requested. The shortage means Michigan Medicine can only handle appointments through Tuesday, as well as second doses for healthcare workers who previously received the first dose.

“Michigan Medicine is ready and staffed to perform as many as 12,000 vaccinations per week, with rapid expansion capability to 24,000 vaccinations per week and additional locations prepared to open when vaccine supply is available,” a spokesperson said in an email Monday.  “We are eager to move into Phase 1B, which includes our patients who are age 65 and older and frontline essential workers, and we are actively working with state officials to partner on solutions for this problem.”

Beaumont Health’s CEO John Fox voiced similar frustrations.

“...We have the capacity to do so much more,”  Fox said in a statement. “Next week, we hope to launch two additional clinics and should have the capacity to do more than 50,000 vaccinations a week. Again, this all depends upon how much vaccine we receive.”

vaccine_open_clinic_03._sign__1_.jpg
Credit C/O Spectrum Health
A line of those waiting to get into a vaccination clinic at Spectrum Health on Monday. The demand for COVID-19 vaccinations has far outstripped the supply of doses on hand in the state, leading to crashing computer systems, overwhelmed phone lines, and frustration.

Beginning Monday, Beaumont said its computer system will use a “randomized process” to select patients with online accounts to schedule a “very limited number of appointments.”

The health system’s servers crashed over the weekend, due to unprecedented demand.

“On a typical day, Beaumont processes approximately 900 new myBeaumontChart accounts,” a spokesperson said in a statement. “On Friday, nearly 9,000 patients activated their accounts, but thousands of others could not access the website. At one point, more than 25,000 users simultaneously attempted to register for myBeaumontChart.”

Lack of centralized intake system makes it harder to meet demand

But for some, capacity is still a major issue - whether it’s handling call volumes or creating a sign-up system - while they’re also still trying to vaccinate health care workers.

“Because we weren't expecting to move forward this quickly, those processes and systems for people to get in the queue and to get signed up, we just weren't quite there yet,” says Washtenaw County Health Department spokesperson Susan Ringer-Cerniglia, who adds the department got more calls “than I’ve seen in my 15 years with the health department” over the weekend.

“Because we're doing one thing at a time. So we were very focused on our healthcare providers, and getting them in.” Actually, the governor’s announcement last week actually pushed some healthcare workers who hadn’t signed up for vaccinations yet to come out of the woodwork, Ringer-Cerniglia said.

“As the news about the next phase got out, it caused another wave of like, ‘Oh, hey, wait, I'm in that first category.’ So we did get a bit of an influx towards the end of the week and over the we ekend of folks that qualified in that 1A category.”

With some 2,000 vaccine doses to distribute this week, about half of those will go to health care workers, with the other half for the first wave of those 65 and older.

vaccine_open_clinic_02._charlie._nancy_walker._73_and_72.jpg
Credit C/O Spectrum Health
Charlie and Nancy Walker hold hands as they receive some of the first COVID vaccinations available to Michiganders 65 and older, as well some frontline essential workers.

“One of the questions we're getting a lot right now is that comorbidity or underlying health condition question. People are emailing and contacting us and saying, ‘Well, I'm 65, but I also have these underlying conditions.’ But right now, according to the guidance [from the state,] those conditions aren't coming into the prioritization. So...that's not something that we're supposed to be looking at, and we haven't been using it. How do we go about figuring out which of these now eligible people do we serve first?”

Limited resources at the county health department means larger hospital systems, which have been receiving the majority of vaccines distributed so far, will be even more crucial in speeding up the rollout.

On Monday, Wayne County’s health department repeatedly urged residents to go right to those health systems directly.

“We are directing our seniors to contact their hospital or health system to request a vaccine time,” Wayne County Chief Health Strategist Dr. Mouhanad Hammami said said in a statement. “Hospitals will vaccinate seniors. Seniors should contact hospitals directly.”

In West Michigan, Spectrum Health said it opened a “high-throughput” vaccination clinic in the Grand Rapids area at 6 a.m. Monday. By noon, the health system said it had vaccinated 575 people in the community, and planned to vaccinate as many as 10,000 by the end of the week.

But that number is still far below the demand for the area.

“Demand is truly astronomical, as you can imagine,” said Dr. Darryl Elmouchi, President of Spectrum Health West Michigan.

Elmouch said more than 45,000 people filled out surveys over the weekend saying they were interested in being vaccinated. An estimated 300,000 to 400,000 residents in the region could qualify for vaccination in the “1B” category, he said.

“That is now expanding exponentially,” Elmouchi said Monday, during an update from the health system.

Even as more than 20 other organizations in West Michigan tried to coordinate vaccine distribution in the region together, there is no one centralized intake process for people trying to schedule appointments. Nor is there a way to know whether someone is trying to double book appointments, in order to get vaccinated sooner.

“If that does happen, the risk we run is we’ll have slots that go unused,” Elmouchi says. “We can end up using that vaccine, I assure you, for the remaining patients, but the more people that miss appointments, the longer it takes to get through the rest of the population. So I’m hopeful, but we have no mechanism to prevent that.”

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