Dear Friend of the Foundation,
The most significant developments related to the COVID-19 pandemic are the expected surge related to the Christmas/New Year’s holidays, the detection of the UK variant B117 in the United States and the rollout of the Pfizer/ Moderna vaccines. CDC forecasts project a sustained high level of 1.2 to 2 million new cases per week in the U.S. National models continue to project an increasing number of hospitalizations due to COVID-19. State level models demonstrate a continued high level of new cases in Florida (75,000 new cases per week) over the next 4 weeks. Unfortunately, we are experiencing the impact of this trend on our urgent care centers, emergency department and our inpatient wards/ICU, as demonstrated by the JMC metrics below.
The second important item is the detection of the UK variant in the US. The B117 variant is believed to be 40-70% more transmissible than other strains, meaning that more persons are likely to be infected when they come in contact with an infected individual. Projections show that the retransmission rate (Rt) may be increased by 0.4 to 0.7 by the new strain. It is not yet known whether the new strain produces more severe disease. Scientists are currently evaluating the susceptibility of the variant strain to the current vaccines. At the present time, it is believed that the Pfizer and Moderna vaccines will be effective against the new strain.
Statewide Metrics
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There were 91,109 new cases during the week ending December 27th·
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There were 7,245 patients hospitalized on January 3rd·
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The percent positive rate averaged 12.4% for the week ending December 27th·
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The retransmission rate (Rt) is 1.15
Palm Beach County Metrics
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There were 796 new cases on January 4th and 5,088 new cases for the week ending December 27th.
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The positivity rate was 9.85% for the week ending December 27th.
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COVID-like illness cases have increased to 617 new cases per week (ending December 27th).
Jupiter Medical Center Metrics
- There are 29 COVID positive patients admitted at JMC.
- 6 of these patients are in the ICU (two patients requiring mechanical ventilation, one requiring BIPAP support).
- The number of patients being tested daily in the ED for COVID illness has jumped to over 50 per day.
- We are testing over 1,000 patients per week in our urgent care centers for COVID.
Vaccines
While the development of the Pfizer and Moderna vaccines in record time has been a boon, distribution of the vaccines has proven to be a significant logistical challenge around the globe and our nation.
In Florida, the state has received nearly 965,000 doses of vaccines for Covid-19, of which 533,000 doses have been provided to hospitals and approximately 250,000 of those vaccines have been administered. The vast majority of the doses arrived between 12/22/20 and 12/29/20, hampering rollout due to the holiday break.
On December 23, 2020, Governor Ron DeSantis signed an Executive Order prioritizing vaccine administration to healthcare workers, long-term care facility residents and those over age 65. Unfortunately, the current supply of vaccine is not enough to meet the demand even for the priority categories, and it will require months to successfully vaccinate these individuals. Hospital staff and long-term care residents/staff in Florida constitute at least 750,000 individuals and there are more than 4.5 million individuals 65 and older. Compounding this challenge is the fact that the current vaccines require administration of a second dose to these recipients within 3-4 weeks of the first one.
The first week of Covid-19 vaccine deployment in Florida began with the distribution of Pfizer vaccine to five pilot sites, for the purpose of vaccinating healthcare workers and long-term care residents. Week two marked shipment of the Moderna vaccine to hospitals across the state for healthcare workers, along with vaccination of long-term care residents by CVS/Walgreens. In week three, all 67 county health departments received the vaccine to begin community vaccinations.
As we enter week four, Governor DeSantis has directed the Florida Division of Emergency Management to work with the Florida Department of Health to identify state-run COVID-19 testing sites that can be converted into vaccine sites. He has also directed the Florida Division of Emergency Management to identify places of worship and other locations in underserved communities where the vaccine may be administered. Florida has already begun a pilot program in Escambia County, where over 500 seniors have received their vaccine and have been scheduled for their booster shot, which they will receive at the same location. The governor has directed the Florida Division of Emergency Management to hire 1,000 contract nurses to support vaccination efforts and these nurses will be deployed throughout the entire state to help run vaccination sites. Governor DeSantis is also directing the Florida Division of Emergency Management to assume additional responsibilities regarding the administration of vaccines in Florida’s over 3,000 assisted living facilities, supplementing and accelerating the efforts being undertaken by CVS and Walgreens, pursuant to their agreement with the federal government. At this time, vaccines for those over 65 will be available from the county health department and hospitals.
At Jupiter Medical Center, we are proud that we were able to start vaccinating healthcare workers (team members and medical staff) within 2 hours of receiving our first vaccine allocation on December 23rd. Additionally, we administered the vaccine on Christmas eve as well as Saturday and Sunday of the holiday weekend to increase access for medical staff providers unable to participate during the week due to patient care responsibilities.
We have exhausted our first allocation of the vaccine focusing on healthcare workers and have submitted a plan to the Agency for Healthcare Administration (AHCA) requesting a significant increase in future allotments. This would allow us to vaccinate thousands of community members weekly, prioritizing those over 65 years of age, while continuing to vaccinate healthcare workers. We have offered to conduct community vaccination clinics on JMC campus, our Urgent Care Center locations and in the community, seven days a week.
While we don’t yet know the exact timing or quantity of our next shipment of vaccine from the state, we anticipate receiving it as early as next week. Much of the uncertainty stems from a national vaccine supply chain process which is still under development. Currently, the states receive a varying allotment of vaccine on a weekly basis from federal authorities and subsequently allocate it to hospitals and county health departments. In our discussions with state health agency officials, they have assured us that significant efforts are underway to streamline this process and improve predictability of vaccine allotment in the upcoming weeks and months.
JMC leadership continues to advocate with state and local leadership/legislators for increased vaccine allocation for our community. As mentioned above, we have a plan in place to administer community vaccinations, which we are ready to operationalize as soon as we receive notice of our next vaccine allocation. Once we receive notification, we will send out detailed communication regarding the appointment scheduling process, locations, etc.
While we are all glad to put 2020 behind us, we face significant challenges for the first few months of 2021. COVID-19 cases are on the rise and are projected to increase over the next 4-6 weeks as a result of holiday travel. Although vaccines will provide much needed protection against future spread of the virus, the current demand far outpaces supply.
Please know that through these trying times, the entire JMC team is here to serve. Whether it is to diagnose those presenting with COVID-19 symptoms at our urgent care centers/emergency department, or to provide the latest treatments for those requiring admission to the hospital, we are here. While the vaccine rollout presents significant challenges, we are advocating vigorously to obtain as many doses as possible for community vaccinations and re-purposing personnel throughout the organization to operationalize vaccine clinics as soon as we receive more vaccine.
We will get through these trying times together.
Best wishes for a safe and healthy new year.
Amit Rastogi, MD, MHCM
President & Chief Executive Officer
Jupiter Medical Center
