State and local leaders discuss status of COVID vaccine program

The state’s COVID-19 vaccine program — and myriad logistical and supply concerns — dominated today’s regular conference call with state officials and about 180 municipal CEOs convened by the MMA.

Key state officials also addressed favorable changes to federal reimbursement rules and the launch of an ambitious pooled testing program in schools.

Lt. Gov. Karyn Polito gave an update on vaccination sites and shots administered, but pointed out that the state’s ability to vaccinate residents currently exceeds available vaccine supplies.

“Our capacity and shots in the arm are not the same thing,” she said. “It’s the federal government that delivers those doses to the states. … We want to be ahead of it. That’s why we want to have the capacity.”

As of Jan. 23, she said, nearly 440,000 doses of the vaccine have been administered to individuals in Phase 1 of the state’s three-phase program. Those eligible in Phase 1 include COVID-facing health care workers, long-term care facility residents and staff, and emergency first responders.

Phase 2 of the program is due to begin next Monday, Feb. 1, with residents age 75 and older, followed by those age 65 and older (recently bumped up under new guidance from the U.S. Centers for Disease Control and Prevention) and individuals with two or more comorbidities. Next in line will be workers in early education, K-12 education, transit, grocery stores, utilities, food and agriculture, and restaurants and cafes, followed by other specified worker groups.

Jana Ferguson, assistant commissioner at the Department of Public Health, said those who qualify for vaccines in Phase 2 are able to go through their primary care provider or, when making an appointment online, they may fill out a form, under penalties of perjury, attesting that they qualify.

The general public becomes eligible in Phase 3, currently scheduled to start in April.

Polito said residents age 75 and older can begin scheduling vaccine appointments tomorrow. She said the Executive Office of Elder Affairs has provided information to local councils on aging on how to help residents who are uncomfortable making appointments online or are unable to do so. Ferguson said her department is discussing offering assistance via the 2-1-1 non-emergency information line, and that in many cases appointments can be made over the phone.

The state’s web portal, www.mass.gov/covid-19-vaccine, provides the most up-to-date information about the state vaccine plan, when and where residents can get the vaccine, a map of vaccine locations (with links or phone numbers for booking appointments), and answers to frequently asked questions.

By the end of this week, Polito said, Massachusetts will have 103 publicly available vaccination sites and capacity to administer 242,000 shots per week. Capacity is expected to reach 165 sites and 305,000 shots per week by mid-February, including 76,000 per week at seven vaccine “megasites” at locations such as Gillette Stadium and Fenway Park.

The federal allotment to Massachusetts, meanwhile is currently just shy of 190,000 doses per week. Polito said “we are hopeful” that the federal government will quickly ramp up allotments to be more in line with capacity.

Ferguson acknowledged that the DPH has had to notify communities about vaccination supply limits in order to help them plan. The supply shortage creates logistical challenges for the state and puts a premium on ensuring that no doses go to waste, particularly since the vaccines must be stored under exacting conditions.

Pharmacies and community clinics are being added to the website map on a rolling basis as the state seeks to even out availability throughout the state and across different demographic groups. By Feb. 15, Polito said, 71 retail pharmacies are expected to be administering vaccines.

Dr. Larry Madoff, medical director at the Department of Public Health, said individual doctors’ offices that currently offer vaccines will “definitely be part” of the state’s COVID vaccine program going forward. He said the DPH website has “very good guidance” for how providers can enroll to join the vaccine program.

Polito also discussed recent changes related to the state’s four-phase reopening plan. Yesterday, the state lifted the early closure order for certain businesses and a late-night stay-at-home advisory also referred to as a curfew, while leaving in place gathering orders and a capacity limit of 25% for many businesses through at least Feb. 8.

“The good news is the COVID trends continue to move in the right direction,” she said, adding that the positive test rate (4.82%) is the lowest it has been since early December.

She also mentioned the ongoing Small Business Relief Grant Program administered by Massachusetts Growth Capital Corporation, the Community One Stop for Growth portal that she announced last Thursday during the MMA Annual Meeting — and which is the subject of webinars this week for local officials — and the Department of Early Education and Care’s launch yesterday of a pilot testing program in Athol, Billerica, Braintree, Dalton, Franklin, Plymouth, Sturbridge and Westfield for early education workers.

School-based testing
Russell Johnston, senior associate commissioner at the Department of Elementary and Secondary Education, discussed a pilot pooled testing program launching next week for K-12 students and school staff.

Pooled testing involves mixing a number of test samples together — a “pool” — and then processing them together to detect the virus that causes COVID-19. This approach increases the number of individuals that can be tested using the same amount of laboratory resources as a single PCR test.

The nasal swab tests will be performed once per week, and results are delivered within approximately 24 to 48 hours. If a pooled test result is negative, then all individuals within that pool are presumed negative and may remain in school. If a pooled test result is positive, then everyone in the pool is given an individual diagnostic test to determine who is infected. Johnston said the results of these individual tests are available in 15 minutes, so those in a positive pool who are not actually infected do not have to wait unnecessarily before returning to school.

The DESE has thus far stressed common mitigation strategies — particularly distancing, masks and hand-washing — but Johnston said pooled testing “is now more readily available at a scalable level across the state than it ever has been” thanks in part to advances in laboratory testing technology. He added that a new round of federal stimulus funding for schools has also become available to cover program costs.

He said school districts may opt in to a six-week program that is due to start by Feb. 8 and run through late March — paid for by the state using federal dollars — and then may work with a state-vetted provider and use federal stimulus funds to continue the program through the end of the school year. He said the cost is in the range of just $3 to $5 per swab.

In order for the program to be effective, he said, it must test all students and staff, from custodians and bus drivers to superintendents.

“If school districts provide their information to the DESE by this Thursday, they’ll be prioritized for as early a launch as possible,” Johnston said. “We want to get some started as soon as next week.”

Districts that are currently unsure about entering the program will have until early March to decide, he said.

Johnston said it will be a shared responsibility between local boards of health and the DESE to report positive cases to the DPH and ensure that contact tracing is implemented.

He added that rules for the new batch of education-related federal funds — about four times the amount received last fall — are “very flexible,” and the funds likely can be used by districts to address “learning gaps” that have emerged due to remote learning during the pandemic. As for who decides locally how the funds are used, Johnston recommends that superintendents do so with input from the school committee.

Federal funding
Heath Fahle, special director for federal funds at the Executive Office for Administration and Finance, discussed an executive order signed by President Joe Biden last Thursday, effective immediately, instructing the Federal Emergency Management Agency to increase the reimbursement rate for certain emergency response costs from 75% to 100%.

Fahle said his office is awaiting further details and guidance from FEMA, but the news is very good for cities and towns. He said vaccination-related costs, for example, are expected to be 100% reimbursable. He said there are discussions in Washington about whether the order will be made retroactive to the beginning of the emergency.

“Perhaps many of the costs that municipalities have incurred associated with the COVID-19 response will be eligible for full reimbursement,” he said. “There is significant movement underway as the new administration takes over.”

• Audio of Jan. 26 call with administration (39M MP3)