Prince William County COVID-19 Operational Update 2/2/2021

COVID-19 Operational Update Brian Misner Emergency Management Coordinator February 2, 2021

Testing and Hospitalization Data

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Number of Positive Tests vs. Tests Conducted - Cumulative

New Year’s Christmas Thanksgiving

13.5% (1/29) 3

COVID-19 Hospitalizations in NOVA

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COVID-19 Hospitalizations in VA

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Vaccine Dispensing and Registration

Points of Dispensing (POD) in Public Health • “Closed” POD • Set for a specific capacity daily • Requires appointment; no walk-in’s can be accommodated • National planning doctrine did not contemplate including half the general public being eligible

• “Open” POD • Open to the public • Typically, does not require appointments

• Complicating factors for COVID-19 Vaccine • First two vaccine candidates under EUA require post-vaccination monitoring for adverse reactions.

• CDC and VA guidance placed community members in initial priority groups due to their heightened risk.

• Two doses of vaccine complicates recordkeeping; all records must find their way to the Virginia Immunization Information System (VIIS) 7

Current System Limitations - VAMS • VDH required Health Districts to use the Vaccine Administration and Management System (VAMS), developed by Federal CDC. • Deployed the entire Commonwealth as one “institution” in VAMS • Configured Health Districts as “employers” in VAMS. • Until a system upgrade overnight 1/30, there was no difference between first and second dose appointments.

• This resulted in: •

The “closed” POD registration system being “open” to anyone in the Commonwealth who was given access by their health district.

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Many more people uploaded than appointments were available.

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Many people booking in the wrong health district due to limited availability •

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Some people turned away if they did not live/work in that district

Most appointments that were available for booking before 2/1 were taken by people looking for their FIRST dose appointment.

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Second doses started coming due on 1/25 in PW Health District 8

VAMS Limitations – PWHD Actions • On or around January 15th, PWHD and PWC EM staff: • Determined there was a shortage of second dose appointments within the 28-day due-date that our first 1a personnel (EMS workers) needed.

• Assessed that the CDC VAMS system did not (at that time) differentiate between first or second dose appointment slots.

• Took immediate action to turn off GMU Beacon Hall appointment availability beyond 2/15 to preserve “offline” capacity for those who needed their second doses.

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New State System and Interim Actions • January 12th, PWHD: • Was notified by VDH that a new system, PrepMod, would be replacing VAMS. • Was told that training would not begin until January 28th

• January 15th, PWHD asked PWC for help with “manual” booking to accommodate: • Second doses as they became due • First doses from the waitlist as remaining capacity was available.

• January 19th, PWHD: • Was notified that it was in the second wave of PrepMod deployments and that a target “go live” date is February 8th

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VAMS Recovery and Transition Timeline • January 18th the public-facing unified PWHD waitlist form ready for use by the general public.

• January 19th PWC stood up a dedicated scheduling team and app for “offline” scheduling.

• Second Doses • First Doses based on priority

• January 22nd – Implemented a second dose pre-registration form • January 24th the legacy “google sheet” data from PWHD was loaded into the unified waitlist • De-duplicated; highest ID number prevails • Email confirmations sent to all with a valid email address

• January 25th – First day of SECOND doses; implemented a registration tally form to track first vs second dose appointments.

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VAMS Recovery and Transition Timeline • January 27th all 20,000 + contact records uploaded to VAMS by the Health District was aggregated and de-duplicated.

• 1a healthcare workers (unaffiliated) and EMS providers • 1b group 1: police, fire, and HAZMAT workers • 1b group 2: corrections and homeless shelter workers • All records from PWHD Google Sheet before 9:00 AM on January 14th •

Primarily persons aged 75+ but some 65+ or 16-64 with medical conditions were included.

• Result: 17,692 unique records uploaded to VAMS. • January 28th – Follow-up survey was sent to all 17,692 records by email. Of these, 15,833 were delivered successfully.

• January 30th – Survey window closed, 59.91% response rate with 9,487 unique responses.

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VAMS Follow-Up Survey:

VAMS Follow-Up Survey:

VAMS & Google Sheet Recovery: Known Issues • At least 1,890 people from the general public who accessed VAMS share an email address, and a second spouse or partner may need help registering.

• Through 2/15, people needing a second dose slot are booked in a “free for all” appointment slot.

• As of this presentation, second dose appointments beyond 2/6 are not available.

• Actively planning to add capacity through February (more on this in a moment).

• Initial PWHD Google Sheet did not collect phone numbers, because VAMS did not require them.

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All waitlist booking is currently “manual” via phone with the dedicated scheduling team attached to PWHD Call Center.

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All records with a valid email address did receive their waitlist ID number.

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How are appointments being booked today?

• For the week of 2/1: • GMU Beacon Hall •

No change, schedule has been full for several weeks.

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Weather cancellations were given a head-start at rebooking themselves in VAMS.

• Potomac Middle •

Hybrid model – 60% VAMS first dose, 40% VAMS second dose across up to 16 stations, plus 4 stations for “offline” booking.

• Kelly Leadership Center • •

VAMS Only: 80% first dose, 20% second dose across 8 stations.

Allowed PWHD to maximize self-service rebooking for 2/1 and 2/2 weather cancellations.

• Veterans Park – Safeway •

Manual “offline” only from waitlist

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What priority is being used for “offline” booking?

• Second Doses • Will not be contacted until 7 days or less before second dose is due.

• Phase 1a – healthcare workers • Persons aged 75+ based on unified waitlist date • Persons aged 65+ based on unified waitlist date • Phase 1b – frontline essential workers based on group order AND unified waitlist date • Group 1: Police, fire, HAZMAT • Group 2: Corrections and homeless shelter workers • Group 3: Childcare providers / K-12 teachers and staff.

• Persons aged 16-64 with certain medical conditions • Only Moderna available, which requires 18+ 17

PWHD Allocations – Week of 2/1 Provider Type

Week of 2/1

Who is receiving the allocation?

Hospitals

2,925

Novant-UVA (Schools)

Prince William Health District *

5,000

Kelly Leadership Center POD Potomac Middle POD

Medical Practices

800

Arjun Medical Center (200), Bull Run Family Practice (300), Sentara Family Medicine (300) By appointment only to established patients in the current VDH priority groups

Other Community Health Providers

1,300

GPWHC (200), MAP Clinic POD (Private Schools & 1a caregivers– 1,000) Prince William – Manassas ADC (100)

Pharmacies

1,000

Gainesville Pharmacy (200), By appointment for established customers 75+, or Safeway (Veterans Park POD – 800) From PWHD waitlist from the current VDH priority groups

Total Doses

11,025

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*does not include 2,160 doses already on-hand for this week’s Beacon Hall appointments

PWHD: Dedicated Capacity Agreements • K-12 teachers and staff from Manassas, Manassas Park, and PWC School Divisions: • 100% of weekly Pfizer vaccine allocation to Novant-UVA Health • Closed POD’s based on risk level identification • Coordinated directly between school divisions and Novant-UVA

• Private K-12 teachers and staff, certain 1a healthcare sector employees, and certain disability, access, and functional needs caregivers: • GMU Mason and Partners Clinic, operating out of the Manassas Park Community Center.

• Private Pharmacies and Providers: • Required under Commonwealth’s distribution strategy • PWHD is requiring priority be given to 75+ 19

Ongoing Planning and Operational Coordination • January 27th 9:00 PM – PWHD was notified of an extra 5,000 doses to be allocated for week of 2/1.

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Primary use must be the backlog of second doses.

• January 28th – PWHD / PWC / Cities / PWC Schools activated standby plans to add Kelly Leadership Center and Potomac Middle School •

Able to accommodate all 5,000 doses because PWC leaned forward and executed a nursing contract on January 25th.

• Week of 2/1 •

Fill as many appointments in VAMS as possible up to 24 hours before a clinic start time, then switch to “offline” booking.

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Will extend clinics or add days as needed to maximize capacity.

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Key reminder – CDC VAMS system allowed for first vs. second dose appointments as of early AM on 1/31

• Week of 2/8 •

Begin soft-open of large west-end facility for second doses;

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Continue operation of Potomac Middle; unused capacity based on current allocations.

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Kelly Leadership Center and new west-end facility on standby for extra doses.

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Ongoing Planning and Operational Coordination • Week of 2/15 • Balance operation of west-end facility and Potomac Middle School based on vaccine allocation to PWHD. • Kelly Leadership Center remains on standby.

• Operations at GMU Beacon Hall conclude on 2/15.

• Week of 2/22 • Balance operation of west-end facility and Potomac Middle School based on vaccine allocation to PWHD. • Soft-open large capacity east-end facility for second doses.

• Kelly Leadership Center remains on standby.

• Week of 3/1 • Two facilities total, one east, one west, each capable of 30 doses every 10 minutes for a total of 60 stations every 10 minutes.

• Full capacity operation will be dependent on supply 21

Other Known Issues and Uncertainties • VDH “Find out what phase you are eligible for” form • Stopped collecting personal information on or around 1/25

• Statewide centralization of waitlist and registration • Announced by Governor Northam on 1/27 with no additional details available.

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PWHD is expecting an update later this week

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Vaccine Distribution Phases

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Waitlist and Call Center Updates • Waitlist: • Waitlist ID numbers are not your actual spot in line.

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Priority group

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Timestamp of joining list

• Working on a dashboard of data.

• As of 2/1 5:00 PM: 41,443 unique records.

• As of 2/2 12:00 PM: •

1,402 Contacted

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898 Scheduled; balance “awaiting callback,” “bad record,” or “withdrawn”

• Call Center: • Reassigned County staff; working towards minimum staffing of 10 call takers for waitlist questions and 20+ scheduling team members.

• Working on “call back” feature so callers do not have to wait on hold.

• High number of abandoned calls and repeat calls is challenging.

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What can the Community Do? • Vaccine is only one tool in the fight against COVID-19 • It will take months for the current priority groups to be accommodated at the current rate of vaccine supply.

• “Open” POD’s (without an appointment) are not possible until additional vaccine candidates receive Emergency Use Authorization from the U.S. Food and Drug Administration

• Continue to follow mitigation measures: • Wash your hands • Wear a mask • Watch your distance • Avoid large gatherings and crowded places • Telework when able 25

Questions

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