Lt. Gov. Green Visits Maui as State Prepares for Ramped-Up Vaccine Distribution

By Wendy Osher

Ramping Up Vaccinations; Maui Health Eyes Opening of S and W Maui Distribution Sites as Supplies Increase

Maui Health expects to stand up an additional COVID-19 vaccination clinic in the coming weeks as the state looks to ramp up distribution efforts.

It’s one of the topics discussed by Lieutenant Governor Josh Green during a community Town Hall event hosted online by Maui Health and a press briefing hosted by Maui Mayor Michael Victorino on Thursday afternoon.

“I know it’s not fast enough. You already have sites at capacity to vaccinate people,” said Lt. Gov. Green, noting the reason he accepted the Mayor’s invitation to visit Maui was to see how well the County is doing and to fight for extra vaccinations where they are needed.

Mike Rembis, Maui Health chief executive officer said the hospital is looking to open additional vaccination sites.

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“We are looking at a site now on the south side. We’d like to get something up and running in the next couple weeks, and then extend to the west side as well. It all depends on two things–the availability of vaccine and resources to staff it.”

Mike Rembis, Maui Health CEO

“We want to open up another site. And we’re looking at other sites so that we can have more appointments available,” said Chrissy Miller and Employee Health Nurse Manager with Maui Health but as Lt. Gov. Green mentioned, we’re also waiting for more vaccines. As soon as we can get more vaccines, we are advocating for Maui–then we can open up those other sites,” said Miller.

“The more supply we get, the more resources we have to staff these other sites, then we’re going to be opening up more appointments.”

Where Will the Additional Workforce Come From to Ramp Up Vaccinations?

“There’s a $10.5 million appropriation that already came from the federal government to help us with vaccine rollout. That’s hiring people,” said Lt. Gov. Green. The vaccine itself is free and is covered by insurance or waived for people who are uninsured.

“Beyond that we will use a lot of these monies to support the counties,” said Lt. Gov. Green. “There will be extra hires. I will tell you that the new admin in Washington has proposed a $1.9 trillion CARES Act to follow the $900 billion CARES Act that’s already been approved.”

“A lot of it is going to also go to setting up and paying for staff. We also will see as we get towards Stage 2 of the vaccination process for kind of healthy people/the other half of society that aren’t health care workers or kupuna, you’ll see a lot more vaccinations happening in places like pharmacies. It’ll be more routine… and more like the days when you just go in for your flu shot. By then, also the COVID crisis will have really diminished because our most vulnerable people will be safe,” said Lt. Gov. Green.

150,000 Doses Expected Per Month Once State Hits Its Stride

Lt. Gov Green said that with Pfizer and Moderna vaccines on hand now, the state will begin to vaccinate “large numbers of people” in the coming weeks.

He said, “We’re also expecting two additional vaccinations to be approved in the coming months. That would be AstraZeneca and Johnson and Johnson,” both which require only one dose as opposed to Pfizer and Moderna which require two, taken three and four weeks apart respectively.

“As a state, we expect to receive 150,000 doses per month once we hit our stride,” said Lt. Gov. Green.

“If we add those two companies, it could go up as high as 200,000-300,000 doses per month,” said Lt. Gov. Green.

More than 60,000 Unused Doses: Needed for Patients Coming Up for their Second Shot Next Week

As of Jan. 13, Hawaiʻi received 114,750 doses of the vaccine and there are another 37,900 doses that were due to arrive yesterday and today.

The state has officially administered 40,386, though Jan. 9. (The numbers are updated weekly on Wednesdays). Lt. Gov. Green said that since the numbers are five days old, the amount of vaccine administered statewide is really closer to 48,000 or 50,000 doses to date.

That leaves more than 60,000 unused doses; however those are needed to administer shots to those who are scheduled to get their second dose in the coming week. “Next week will be a very dynamic week for vaccinations across the state,” said Lt. Gov. Green, noting that there will be some additional large vaccination centers on Oʻahu.

“I’m already texting away, asking the director if we have extra, don’t forget the neighbor islands… we know that we on the neighbor islands need the extra vaccine because we have less in the way of hospital capacity, (and) we often have fewer pulmonologists, or specialists that can help us with the condition of COVID,” he said.

Lt. Gov. Green said the there’s at least an extra tray (with 975 doses) that can be secured for Maui. If second doses go as scheduled, that will leave 20,000-30,000 extra doses that state officials say “will be aggressively distributed across the state.”

6,825 Doses Administered to Date in Maui County

Here on Maui, 6,825 vaccine doses have been administered in Maui County as of yesterday. “You can see how well you’ve done. We only started four weeks ago,” said Lt. Gov. Green, noting that there are 8119 individuals identified as 1A including 7,676 on Maui; 304 on Molokaʻi; and 139 individuals on Lānaʻi.

In the 1B category there are more than 27,000 individuals classified in this grouping, including 25,586 on Maui, 1,011 on Molokaʻi, and 464 on Lānaʻi.

In the 1C category for Maui County, there are an estimated 63,000 people who are identified, including 60,127 on Maui, 2,377 on Molokaʻi and 1,089 on Lānaʻi. which includes kupuna ages 65 and older, remaining essential workers and people with chronic disease

While the hospital is accepting appointments for both 1A and 1B registrants, the Department of Health’s Maui District Health Office at the University of Hawaiʻi Maui College drive-in site is not currently open for this wider grouping.

The UHMC site is a “closed” point of distribution site and at last report was still attempting to finish vaccinations for those in the 1A priority grouping (which includes frontline health care workers and long-term care facility residents in congregate settings).

Those getting vaccinated should note that the hospital vaccination clinic is currently offering only the Pfizer vaccine; while the pop-up clinic at the University of Hawaiʻi Maui College, which is run by the state Department of Health, Maui District Health Office, is administering the Moderna vaccine.

“Your first dose, if it’s with Moderna, your second dose needs to be with the same manufacturer, Moderna. If you come here (to the hospital), and your first dose is Pfizer, your second dose also has to be Pfizer,” said Chrissy Miller and Employee Health Nurse Manager with Maui Health.

1,500 People Reqesting Appointments Daily; 11,000 People Awaiting Appointments

Maui Health officials say they’ve been receiving 1,500 requests through the hospital per day from individuals wanting to get a vaccine; for a total of 11,000 people entering the system and are awaiting appointments.

“There should be a way, like other sites, to block out days or time slots that are full. It’s very time consuming,” according to one patient who asked for an explanation on the registration process during a Maui Health Town Hall event Live streamed on Facebook on Thursday afternoon.

“People are on there, scheduling their vaccines as fast as they can. And so, when you go on there, somebody may have already taken it,” said Chrissy Miller and Employee Health Nurse Manager with Maui Health in response to frustrations relating to maneuvering through the scheduling site, which is hosted by the CDC.

Hospital executives say they are vaccinating as many people as possible and are opening up more appointment slots as more vaccine come in.

Individuals meeting the criteria for vaccinations in the current priority grouping, who are having difficulty registering or need assistance can email: [email protected]

March 1 Estimated Date for “Equilibrium” in Demand

Right now the Lt. Gov. has estimated the demand for the vaccine to be “about 3 to 1, or maybe even 5 to 1,” he said. “And that will tip in a better direction for us quickly as we get our vaccine surge , which has been promised to us in the third week of January, where we are headed right now.”

“I think your tipping point is going to be around, if I had to guess, March 1st when all of a sudden it seems to have reached equilibrium where right about the right number of people are asking based on the right number of vaccines. It’s not really that far away,” said Lt. Gov. Green.

What it Will Take to Achieve Herd Immunity in Hawaiʻi

“It’s my job to fight to make sure the neighbor islands get just the same amount of vaccine that they are entitled to based on population as the guys on Oʻahu; and because we have additional considerations of multi-islands; or diminished health care capacity under certain circumstances–sometimes that consideration has to also be calculated and that we should ask for more,” said Lt. Gov. Green.

“You’re doing the right things. Social gatherings have been kept relatively calm. Mask wearing is phenomenal. People are social distancing. And I can tell that there is a strong demand for the vaccine,” said Lt. Gov. Green.

He also asked that the public be patient over the next couple of months. Once people do get their vaccinations, he urged them to still wear their masks and continue with health recommendations until the state reaches herd immunity.

State officials have estimated that Hawaiʻi can get to herd immunity if approximately 75 to 80 percent of the population gets vaccinated. Lt. Gov. Green has said that he anticipates approximately 80 percent of our population ultimately will get the vaccine. With a population of 1.4 million, more than 1 million people would have to be vaccinated.

He said that once vaccinations have occurred, he expects Hawaiʻi won’t have to deal with as much of the Safe Travels program.

“We’re mindful of what the impact could be. We will have over a million people as of tomorrow in three months that have traveled to Hawaiʻi–one third of us returning to our families to be together, the other two-thirds (being) travelers,” he said.

“It means people are able to survive. It means they are able to pay for their rent and to pay for food. One out of five of our families have been hungry during the COVID crisis because they don’t have resources. These are the considerations to balance having an open economy versus worrying about having COVID,” said Lt. Gov. Green.

He said he also hopes the vaccinations will help to lift the burden of the restrictions on inter-island travel as well.

“I will just say that this will be a year that we all remember, and we’ll remember it in an extraordinary way because Hawaiʻi has had far fewer cases, far fewer fatalities and we come together,” said Lt. Gov. Green.

Maui Holiday Surge Discussed

Admittedly, Maui has had a challenging Christmas and New Year’s period, but when compared to other places, out of state and around the world, Lt. Gov. Green said Maui is doing well.

Back on Dec. 1, we had seven day averages of seven daily cases and 1.2 percent positivity rate.

“People were pretty safe over Thanksgiving and we did not see a very large bump, and that was a reflection of the ability to not have large social gatherings; however Christmas time came, and over the Christmas period, we did see a surge in COVID,” according to Lt. Gov. Green.

“On Jan. 14, our seven day average on Maui is 29 new daily cases over the last seven days and 2.8 percent positivity rate. I will tell you that this positivity rate that every other county across the country would relish at the this moment after seeing the incredible surge in COVID all across the mainland where they’re having to close down left and right,”

Lieutenant Governor Josh Green

For December the hospital averages were three a day for COVID, and peaked to 12 at one point. The current COVID-19 hospitalizations stand at eight.

“So we’re seeing that people have taken to heart that we have to be careful about social gatherings. And I don’t mean to dismiss it, but if large groups of people get together and have a drumming party and they’re running around a little bit naked, we’re going to get a lot of spread of COVID,” said Lt. Gov. Green in reference to the drum circle gatherings at Puʻu ōlaʻi “Little Beach” in Mākena that was shut down by the state due to what state officials called “egregious behaviors” including “nudity, alcohol and other illicit substances, coupled with hundreds of mask-less people in close contact with one another.”

According to Lt. Gov. Green, there were an estimated 424 COVID-19 cases to date in January (through Jan. 14) in Maui County compared to an estimated 429 cases in all of December.

“This will be reflected with slightly higher numbers in our hospital, although people are getting better treatment all the time and we’re seeing lower mortality rates,” said Lt. Gov. Green.

Lt. Gov. Gives Accolades to Mayor for Caring Leadership, Maui Masking Rates

Lt. Gov. Green said Maui is doing well relative to other places in large part because people are wearing masks.

“Your masking rate is 95 percent, which is probably the best in the country. This is a reflection of trusting leadership that we sometimes fight,” said Lt. Gov. Green of Maui Mayor Michael Victorino. “I tell you, he is exceptional when he speaks about caring for people and doing the right things–and wearing masks is one of them.”

According to Lt. Gov. Green, cases are projected to come down in part because there’s less reason to gather in January and February.

He did caution against football parties, and advised those who do want to celebrate to do so by themselves or with immediate family.

How are the Priority Groupings Defined:

Phase 1A: December 2020 – January 2021

• Healthcare Workers: Paid and unpaid personnel serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials. (Est. total: 40,000)
• Long-Term Care Facility Residents: Adults who reside in facilities that provide a variety of services, including medical and personal care to individuals unable to live independently. (Est. total: 10,000)

Phase 1B: December 2020 – March 2021

• Hawaiʻi Residents Age 75+: Adults over the age of 75. (Est. total: 109,000)
• Frontline Essential Workers: Workers whose duties must be performed on-site and require being in close proximity to the public or coworkers, are at substantially higher risk of exposure to SARS-CoV-2 and are essential to the functioning of society with special attention to life and safety first. This includes: first responders; corrections officers and staff; emergency services dispatchers; individuals essential for federal, state and local government operations; critical transportation infrastructure workers (harbor and dock workers, public transportation, etc.); critical utilities (energy, water, etc.); teachers and childcare and educational support staff (childcare, preschool, early education, K-12, post-secondary, etc.); US Postal Service employees. (Est. total: 50,000)

Phase 1C: TBD: March – May 2021 (Est. total: 400,000)

• Hawaiʻi Residents Age 65+: Adults ages 65-74 (148,000 individuals)
• Individuals w/Underlying Medical Conditions: Individuals of all authorized vaccine eligible ages with comorbid and underlying conditions that put them at increased risk for severe COVID-19.
• Other Essential Workers: Essential workers not included in Phase 1b

Phase 2 and 3

Vaccination of the general population is projected to begin in early summer 2021 depending on production and federal allocation of doses through “Operation Warp Speed.”