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It’s usually bad when West Virginia makes the headlines. The state has a long and sad history of extreme poverty, health problems, political corruption, and natural and man-made disasters.
But in mid-January, some really good news started to come from West Virginia: Somehow, the Mountain State was putting 81% of its available vaccines into the biceps of its citizens while larger states struggled to distribute even half of their available vaccines.
While national media have taken to the state to understand why, much of the reporting has focused on the state’s decision to distribute vaccines through local pharmacies, contradicting the federal plan to use the national chains CVS and Walgreens.
However, that is not the whole story of the vaccine triumph in West Virginia. The state’s path to success began long before there was something called Covid-19, let alone a vaccine to combat it, and hinged on the state’s unique response to a series of tragic disasters. One that can be difficult to reproduce.
In March 2020, as cases of Covid-19 increased, West Virginia Governor Jim Justice created a “joint interagency task force” to oversee the state’s response to the pandemic.
It’s a simple idea borrowed from the world of military strategy: to bring everyone involved in an operation to the same table, so that everyone can share information and coordinate their efforts. This particular task force would be made up of federal, state and local government agencies, the West Virginia National Guard, and groups representing hospitals, pharmacies, and nursing homes.
“We’ve taken the construction of what the military does in operations, mission planning, and we’ve applied it with our public health partners. We have operationalized a public health emergency, ”said Gen. From division James Hoyer, who is director of the Covid task force.
Hoyer, who recently retired from the military after 40 years in uniform, participated in several interagency task forces during this period as West Virginia suffered a series of extraordinary bad luck during the last decade.
In June 2012, a violent windstorm ravaged the state, cutting off power to more than 680,000 residents – nearly a third of the state’s population – and killing three people. In October of the same year, an arctic cold front collided with remnants of Hurricane Sandy, dumping feet of heavy, wet snow over West Virginia, again cutting power to thousands of residents and killing seven Western Virginians.
In 2014, a leak at a chemical storage facility in the capital, Charleston, contaminated the water supply and left nearly 300,000 people without water for five days.
In 2016, the state suffered a century-old flood, which destroyed thousands of homes, businesses and schools and killed 23 people.
While each of these tragedies presented unique challenges, the state approached them all in the same way: with a working group of all the necessary actors, from the Federal Emergency Management Agency (Fema) to local voluntary organizations.
It was natural to create one for West Virginia’s Covid-19 response.
Hoyer said the strategy appears to be working particularly well in West Virginia. “We’re just small enough that we know everyone,” he says.
This is why Dr Clay Marsh, director of health at the University of West Virginia and state czar Covid, suspects that the task force’s approach may not work in large states with a larger population. important and many municipalities.
“Working together, not having a lot of egos in the room, not having a lot of issues with who controls what… I feel like we worked as one team,” he says. “It’s Trumanism: ‘It’s amazing what can happen when you don’t care who gets the credit.'”
Once the Covid Task Force was up and running, members began daily meetings at the West Virginia National Guard Armory in Charleston. Even though everything from birthday parties to awards shows went virtual, the members of the task force continued to meet in person – with lots of masks, plexiglass and social distancing, of course.
Hoyer, who remained director of the task force after retiring from the National Guard in January, says this face-to-face connection is essential. It allows working group members to communicate quickly and effectively. It keeps everyone up to date with the latest data on Covid cases, hospitalization rates and state vaccination numbers – constantly updated information on projection screens and televisions dotted around. the arsenal drilling ground.
Seeing each other in person allows the task force to act quickly and decisively, and has enabled members to address lockdowns, school closures, mask warrants and other Covid prevention measures used by West Virginia in over the past year. This is also how in December 2020, the State was able to quickly set up its own vaccine distribution plan.
“We went through the data with the governor and understood that 77.5% of our deaths were in people aged 70 and over,” Hoyer said. “And we also knew that at the height of the event, around December, more than 50% of our deaths had occurred in nursing homes.”
With that data in hand, the task force appointed two of its members – Dr. Krista Capehart, professor of pharmacy at the University of West Virginia and member of the West Virginia Board of Pharmacy, and Marty Wright, CEO of the West Virginia Health Care Association, which represents nursing. nursing homes – to find the most effective way to immunize residents of state nursing homes.
Capehart and Wright realized that of over 200 pharmacies in West Virginia, half are locally owned. Many of these pharmacies had relationships with nursing homes in their communities. They compared it to the federal vaccine distribution plan and its reliance on CVS and Walgreens stores, which don’t exist in many rural West Virginia counties.
It was clear to Capehart and Wright that their state should go its own way. The rest of the task force agreed and presented the plan to the governor.
“I remember him looking me in the eye and saying, ‘Is that what you think is the best way to do this? Hoyer said. “And as a group we all said, ‘This is it.’
Pharmacies began operating when West Virginia received its first batch of vaccines on December 15. By the end of January, the state had completed vaccinating all residents and staff of nursing homes, as well as a significant number of other healthcare workers, emergency personnel and teachers. Once this was completed, West Virginia began the next phase of vaccine distribution, focused on citizens aged 65 and over.
As West Virginia enters this phase of vaccine distribution, the state’s joint interagency task force is rolling out its next innovation – vaccination clinics in all 55 counties. Each county will set up its own working group with the local health department, emergency services, community health centers, hospitals, pharmacies and other key players.
Dr Deborah Koester, who sits on the state task force as a liaison for local health services, says the creation of these local groups will be as essential to vaccine distribution as the state task force. ‘State has been. “Each of the 55 counties is so unique, it will be a little different, and that’s OK. They know their communities best, ”she said.
The only major hurdle West Virginia has faced in its vaccine rollout is a lack of supplies. The state receives 23,600 initial doses of Moderna and Pfizer vaccine each week. Hoyer said the state could easily distribute 125,000 vaccines per week, which would allow everyone in the state over 65 to be vaccinated within weeks.
Hoyer said in the same way that previous disasters had prepared West Virginia to respond to the Covid-19 pandemic, he hopes this pandemic will serve as a learning experience for future events.
“I think, unfortunately, we’re going to have something else like this in my life,” he said. “The better prepared we are, the less impact it has on our employees.”
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Zack Harold is a freelance writer and radio producer in Charleston, West Virginia. He is a regular contributor to West Virginia Public Broadcasting Inside the Appalachians and previously was entertainment editor for the Charleston Daily Mail and editor of WV Living, Wonderful West Virginia and WV Focus magazines.
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