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States Prepare For COVID-19 Vaccine Distribution

STEVE INSKEEP, HOST:

OK. Now, once a vaccine is approved and states begin getting their supplies, hospitals, along with other health care providers, will have the job of actually vaccinating people. So how are they preparing? One of the first providers scheduled to receive the vaccine is Deaconess Health System, which runs eight Indiana hospitals, along with hospitals elsewhere. Dr. James Porter is the president, and he's on the line. Good morning, sir.

JAMES PORTER: Good morning, Steve.

INSKEEP: Are you ready?

PORTER: We are getting ready, and we will be.

INSKEEP: The Pfizer vaccine, as Pien Huang noted, has to be stored at supercold temperatures, I guess minus 60 to minus 80 degrees Celsius. Is that as challenging as it sounds?

PORTER: Well, we have the freezers available to be able to handle the stock that we're going to receive. I have heard that after it became known more widely that that was necessary that it got a little tougher to get those freezers. But fortunately, we had ours in plenty of time.

INSKEEP: Oh, so there's a bit of a run on freezers. How many doses do you expect to get initially?

PORTER: We're not entirely sure. We were just on a call with the Indiana State Department of Health last evening, and that's still a little bit of a moving target. It is sounding more optimistic, though, that perhaps we're going to get more doses than we were most recently thinking. We still don't know for sure exactly what that number is going to be. We do believe, though, that between Pfizer and Moderna, assuming that they both get their emergency use authorizations, that we'll be able to immunize several hundred thousand people in Indiana in the month of December.

INSKEEP: Whoa, several hundred thousand in the month of December only in the state of Indiana in the month that we are in now. That's impressive.

PORTER: That's what we're hoping for.

INSKEEP: So this is getting beyond just giving health care workers immunizations, I would suppose. This is beginning to get to other members of the public.

PORTER: Yes, it would. Stage 1-A in Indiana is going to be one week where we focus very specifically on health care workers and even more specifically at the very first on the employees of the organizations that are getting the first rounds of vaccines. But that moves very quickly then into other stages that does open it up more widely.

INSKEEP: Then we start talking about people who are older, people with underlying conditions, people in nursing homes, that sort of thing, right?

PORTER: Yes. People in nursing homes are actually part of that very first initial round as well because they're at such high risk and they are representing such a large portion of patients who are hospitalized and get particularly ill.

INSKEEP: How widespread is skepticism of the vaccine?

PORTER: You know, I think that remains to be seen. As you know, there are always sort of that anti-vaxxer group that are out there, you know, opposed to any vaccination. I think there is a little bit more concern about these just because they have been produced so quickly. But I can tell you, in the health care and scientific world, we're very encouraged about the data that's been produced so far, and we believe there'll be more of that data once the EAUs (ph) are submitted. And we also feel really good about the process that is a well-established process of how those vaccines are manufactured and produced. So we feel really good about them.

INSKEEP: Are you saying that as a doctor this is a transparent process? If you have questions, you can go find answers and everything looks good to you.

PORTER: Yes. The FDA is very thorough and definitely - I do believe that safety is their top priority. And I don't believe that they're going to be rushed or delayed based on any kinds of external pressures.

INSKEEP: Now, let's talk about the other side of this story. We're at this dramatic moment where you're saying hundreds of thousands of people could be vaccinated just in the state of Indiana in this very month. And yet we're hearing about hospitals that are filled with patients. How are your hospitals doing right now?

PORTER: We're very busy, and we have been for some time. Our numbers have been climbing again since back in October. And we've been working closely with our local government to, you know, try and get the message out and do what we can to try and mitigate the spread without the kinds of devastating impacts on the economy that we saw with the original shutdowns. So numbers have been climbing. Our workforce is tired and stressed. We're definitely having to do things differently than we have in the past to be able to accommodate the numbers of patients that we're seeing. But so far, we're being able to manage it, and, you know, we really haven't had to make any of the kinds of tough decisions that we've put contingencies in place should we get even more overwhelmed.

INSKEEP: We've heard reference to California's Governor Newsom focusing on the percentage of ICU beds that are full and 85% is the point where he sees a serious problem. Occasionally, we hear about a state or a hospital where it's well over 100% capacity. What is the capacity where you're at and how close are you to the limit?

PORTER: We're always running pretty close. You know, the thing that causes me to cringe a little about hearing those percent capacity numbers is managing the census of a hospital and a health system is a minute-to-minute, hour-to-hour activity. That's always true for us. We have significant logistics systems established to be able to manage that, but on any given day, the number of patients that we're going to be able to receive has a lot to do with the number of patients that we move into a different care setting or discharge. So it's a fluid number, but we're running close. It's true that any time a health system is over 85% to 87% occupied, things start getting more complicated. And we have been running in the 90s, especially for ICU capacity recently.

INSKEEP: Over 90%. Are you having to be more discriminating about who you admit or more aggressive about who you let out the door to make sure you don't fill up entirely?

PORTER: No, I wouldn't say we've been more discriminating about who we admit. We have become, I think, more involved in using alternative resources but doing that in a very safe way. So, for example, some people that we might have put in the hospital just to be on the cautious side, we're utilizing home health care and technology to be able to monitor them at home and perhaps even provide them with some oxygen. So that's a little different than what we would typically do if we had more than enough beds. But in some ways, I think some of those changes are good and are part of the change that really we see needing to happen in health care.

INSKEEP: You know, we talk about the availability of beds. What about the availability of qualified staff? Is it hard to have enough people and hard to have enough healthy people on hand day by day?

PORTER: It is challenging at times, and, you know, that's what I say. Our intensive care nurses, our intensive care doctors are some of the ones that we are concerned about the most. But we have been able - folks are pulling together and helping. Our anesthesiologists are helping out with ventilator management in our ICUs. Our hospitals have changed the way they work to help our intensivists. So people are pulling together and we're figuring out ways to get it done.

INSKEEP: Just in 10 seconds or so, could we be in a different world just one month from now or could you be?

PORTER: We certainly hope so. The monoclonal antibodies that we're now using, we hope, are avoiding some hospitalizations. And we believe that the immunizations have the opportunity to make a big difference.

INSKEEP: Dr. Porter, thanks for your time and your insights, really appreciate it.

PORTER: Thank you. It's my pleasure.

INSKEEP: Dr. James Porter, president of Deaconess Health Systems, which operates hospitals in Indiana, as well as Kentucky and Illinois. Transcript provided by NPR, Copyright NPR.