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Getting consent for long-term care facility patients will slow COVID-19 vaccine distribution

Delivering shots to most at-risk patience will be ‘logistic nightmare’

ORANGE COUNTY, Fla. – Florida’s first doses of the Pfizer vaccines were already being given to frontline health care workers Monday as phase one to inoculate the state against the deadly COVID-19 virus began but the next stage, vaccinating long-term care facilities and other most at-risk residents, will require more logistics and planning.

On Monday evening, the day before Orange County receives its first 20,000 shots, the county’s top doctor with the Florida Department of Health, Dr. Raul Pino, asked for community resolve because the work has just begun.

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“I want to ask for your patience and understanding, as we are going to engage in a logistic nightmare to try to deliver those vaccines to assisted living facilities, and other places that need it urgently,” Pino said.

AdventHealth is set to receive the region’s first doses Tuesday morning via FedEx.

Orange County has more than 9,000 individuals and employees in long-term care facilities. Gov. Ron DeSantis has challenged the Department of Health to have all those individuals vaccinated with the first dose in four weeks. That’s a challenge for several reasons, Pino said.

Some facilities have as few as four residents while others have hundreds.

Next, not all residents have the ability to legally consent to receive the COVID-19 vaccine. Some include memory care facilities with individuals sufferings from dementia.

“Before we administered the vaccine, we have to have consent from each of the individuals,” Pino said. “So many people in these facilities ... the next of kin is another individual that it may not even be in the county that may release information, sometimes it’s the facility has the power of attorney for health. So it’s complicated from that point of view.”

Once vaccinators have consent, giving the actual shots will not be a problem, even on a large scale, Pino said.

He said the local DOH is ready and willing to start inoculating patients at long-term care facilities but has not been tapped by the state to start just yet.

Orange County’s health department applied to be part of a pilot program to inoculate long-term care residents. Broward and Hillsborough counties are already part of the program. Orange has not heard back from state officials yet whether it can take part.

“Together with the county we have expressed to the state of Florida, that this county is ready if we are called to engage in distributing and administering vaccines to long-term care facilities, when they become available to do so,” Pino said.

When it’s go time to administer shots to long-term centers, Pino said personnel will have to vaccinate more than 500 people a day for seven days a week for four weeks.

If the county DOH gets the go ahead, it has begun training emergency medical service employees to be vaccinators. The DOH is also seeking any licensed medical professionals to help.

In order to meet the need, some services normally administered by the county DOH may be impacted to make sure it’s all hands on deck to inoculate as many people as possible.

“Some of our services will be either reduced, or in some cases, closed for a period of time, so that we have enough vaccinators, in case that we are called to spring into action, which we have expressed our readiness to do so and we have engaged intensively since last Friday in planning process even further than we had originally planned to do so because we may be called into action earlier than expected,” Pino said.

Orange County alone has 1.4 million residents. Mayor Jerry Demings said it will take awhile for 75-80% of the population to be vaccinated to help build immunity to the virus. In the meantime, everyone is asked to continue keeping their distance, wearing masks and washing their hands.

DeSantis estimated the vaccine may be in mass distribution to the general population by February 2021.