Coronavirus vaccine takes a long, cold trip to rural America



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“Our couriers cover very many kilometers. Our doctors and staff travel for miles, ”said Susan Jarvis, President and CEO of Sanford Health of Northern Minnesota.

In Bemidji, Minnesota, the final leg of the vaccine’s journey to a number of these communities begins when it’s unloaded from its ultra-cold warehouse and packaged in coolers like the ones you might see at a barbecue – except that these have crucial data loggers attached.

“They go through a lot of scrutiny when it comes to their storage needs for freezer temperature, refrigeration temperature and they’re only good for five days after we take them out of that ultra-cold freezer,” he said. said Matt Webb, director of pharmacy at Sanford. Health.

A Sanford Health minivan transporter travels 90 miles to deliver the much-needed vaccine.

“So this data logger is a piece of equipment that monitors the temperature during transport until they get to their hospital refrigerator.”

Once the doses are secure and ready to go, the next step is to simply get into a van and drive. A vaccine delivery trip that CNN followed began from Bemidji and ended in a town of 9,000 people called Thief River Falls, just over 90 miles northwest.

Data loggers are used to closely monitor the temperature of the fragile vaccine during transport.

“I didn’t think there was a hassle in getting it,” said Carla Szklarski, an infection controler (among a number of other jobs), at Sanford Health Thief River Falls. “It was more the logistics of how it was going to be.”

The arrival of the vaccine in rural communities – for many a light at the end of a very long pandemic tunnel – involves a major logistical feat covering huge swathes of a sparsely populated country.
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President Biden said he expected the United States to be able to immunize 1.5 million people per day “in the next three weeks or so,” but in many parts of rural America, the barrier to being part of these vaccinations is simply the distance.

“It’s good to play offense for a change,” said Webb. “Making sure we can immunize people as close to their homes as possible is really important.”

Sanford has only five sites capable of meeting the ultra-cold storage requirements for Pfizer / BioNtech vaccine in a coverage area of ​​over 200,000 square miles through North Dakota, South Dakota and parts of Nebraska, Iowa, and Minnesota.

The state of Minnesota has allowed the vaccine to be distributed only to hospitals – because they have the required storage capacity.

The Sanford couriers pick up from these five places and leave.

“It was really a process in place that we were able to leverage and expand so that we could use it for vaccine administration and distribution,” Jarvis said.

But that doesn’t mean there aren’t roadblocks.

Doses of the vaccine are placed in a refrigerator in Thief River Falls, Minnesota.

In Bagley, a town about 30 miles from Bemidji, some of Sanford’s lab results analysis had to be delayed due to winter road conditions. “Courier routes have been canceled due to blizzard conditions,” said Stephanie McKnight, administrator of Bagley Hospital and Clinics.

“I can’t think of a time when we didn’t have completely what we needed. There were times when we cut it really close.”

Across the country, rural Americans live, on average, more than 10 miles from the nearest hospital. The region that includes this part of Minnesota has a longer average travel time to a hospital than any other part of the country, according to the Pew Research Center.

“The distance, obviously, in northern Minnesota plays a huge role in the ability to get vaccines effectively, it can also prevent someone from deciding to get the shot if we make it difficult to receive it,” he said. said Alyssa Carlson, pharmacy manager at Bemidji and Bagley medical centers.

Sanford Health told CNN that by the end of January in its northern Minnesota area it was able to get two doses of the vaccine to more than 1,000 staff as part of Group 1a and at least the first dose for hundreds of patients 65 years of age and over. as part of the next phase of distribution. The system says it is now sharing storage resources with the local county public health department in Bemidji as part of getting the shots fired as quickly as possible.

‘Everyone knows everyone’

“In a rural community, we tend to know who our patients are before they become patients,” said Dr. Colleen Swank, vice president of clinics for Sanford Health in northern Minnesota.

“It’s not the 75-year-old in bed with Covid, it’s Mr. Smith, my neighbor’s father.”

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Thief River Falls, about 70 miles from the Canadian border, initially thought she had avoided the pandemic – until she found out she hadn’t. Health care workers told CNN that at one point most of their hospital patients were Covid-19 patients in a city where “everyone knows everyone”.

“I came home and cried the first night I had to tell someone they couldn’t come and visit,” Szklarski said.

“We’ve always thought that, you know, no one dies alone. Family is a big part of their care, of their emotional and physical well-being, and then not being able to have them here was the most difficult thing. “

Doses of the Pfizer vaccine arrive in Thief River Falls after a long drive.

She described these patients as being members of her own family, which made the pain of the pandemic much more difficult, “to go to practically a family member and tell them, I’m sorry you couldn’t come. see your mother. “

Szklarski, like so many others, sees this vaccine as a source of hope, especially because of his dual family, the one who includes those close to him – and the one who understands his patients.

“I think it’s something in the past that we really took for granted, you know? Going into the hospital and visiting our loved ones. And we can’t do that anymore,” she said.

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