February 19, 2021
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Dear Neighbors,

As I watch news reports of the suffering taking place in Texas, my heart is with my family and friends in the Lone Star state. It reminds me of how far we have come since the 2012 Derecho when parts of District 16 were without power for days on end.

While we still rank 39th in national rankings of vaccines distributed, this week Maryland made significant progress in our fight against COVID, and there is really good news to report. Since the vaccine became available in mid-December:

  • Our COVID death rates have decreased by 30%.
  • Hospitalizations are down 24% from the state’s peak last month, 
  • The state positivity rate is down to 4.17% from 7.53%

That’s a 39% decrease in positive cases since mid-December!

That’s not all the good news. As frustrating as it has been, we are vaccinating a lot of Marylanders! This week, Maryland has vaccinated 11.3 % of our population. That’s up from 6% three weeks ago. And Montgomery County has nearly closed the gap with the statewide average. A full 11% of our County population has been vaccinated with at least one dose. This, even despite some vaccinators canceling or rescheduling appointments due to weather, and weather-related vaccine shipment delays.
  
How is that? It’s not because we got a mass vaccination site in our county, or because we got a larger shipment of vaccines to reflect our larger number of eligible residents. Unfortunately, despite repeated requests, those things did not happen.
 
In large part, our success is because Montgomery County residents have become somewhat desperate scavengers, searching across the state (and country!) for available vaccine appointments at retail pharmacies and state-run mass vaccination sites. If we can, we will drive for hours, take a whole day off of work, and spend hours on end hitting refresh or waiting on hold in order to get and make appointments for ourselves, our loved ones, and our neighbors. Montgomery County residents are above all else, resourceful and big believers in science. Through the force of sheer will, we are increasing our vaccination numbers. It’s an amazing story of resilience and tenacity. But it shouldn’t be this hard!

GREAT NEWS! MORE VACCINE COMING INTO MARYLAND

  1. Three weeks ago we were getting 72,000 first doses a week for Maryland’s allocation. The allocation increased about 5% a week. Then this week President Biden announced he’s increasing the shipment to states from 11 million a week to 13.5 million a week- a more than 20% increase! That means by next week we are expecting well over 100,000 first doses from the Biden Administration. More doses mean more people can be vaccinated!
  2. On top of that, last week the Feds started sending doses to CVS and Walgreens for the Federal Retail Pharmacy Partnership. These 20,000 additional doses coming into Maryland resulted in lots of appointment availability this week. New appointments open up most days of the week and get snapped up immediately. See my COVID Vaccine Resources list at the end of this email for links. 
  3. Finally, this week President Biden announced he will begin sending additional doses directly to Federally Qualified Health Centers (FQHC), which serve our most vulnerable residents. The Silver Spring based CCI Health & Wellness was the first FQHC chosen in Maryland. Beginning March 1, they will have 300 doses a week for their patients.    
 
EXCITING UPDATE! 

Last week I highlighted the need for communities densely populated with seniors to form partnerships with pharmacies and hospitals. 

The nonprofit Little Falls Village (a senior village) did just that. Volunteer leaders formed a partnership with Giant pharmacy to host a vaccination clinic for seniors in Sumner Village this afternoon. 

I am extremely hopeful that the pharmacies participating in state and federal partnerships and the Montgomery County hospitals will replicate this model across the County. Partnering with volunteer leaders to bring vaccines to people where they live is an extremely efficient way to vaccinate our seniors. The key to success with this model is making it easy for the vaccinator (pharmacy or hospital). If volunteers can coordinate appointments and assure a significant number of eligible people this will help the vaccinators hit their weekly metrics, and fulfill their community service obligations. 

OK, SO WHAT’S THE DARN TIMELINE? 

Here’s where we are at. Two weeks ago, 25% of Montgomery County’s population over 75 had been vaccinated. This week, that number is up to 52%. Now, that's some progress!

You can find all this data and more on the County's new Vaccine Data Dashboard. As you may know, the State is vaccinating 1A, 1B, and 1C (individuals 65 and over), whereas the County is vaccinating only 1A and 1B (individuals 75 and over). 

The Montgomery County Health Department has been guaranteed 18,000 doses over a four-week period. These doses will be used to ensure that people over 75 who cannot find an appointment through other means have access to a vaccine. 

Last week, I drew attention to the 17,000 seniors 85 and older who were on the County waitlist, awaiting a vaccine appointment. I urged the County to prioritize their doses towards this population. In response, the County sent invitations to everyone 100 years old and older for a special clinic this weekend. I have been assured after the centenarians are vaccinated, the County Health Department will move through people in their nineties and eighties. In fact, everyone 75 and over will receive an invitation within the next 2 weeks!

In the next 2-3 weeks as people over 75 find appointments through community clinics, hospitals, pharmacies, state mass vaccination sites, and the County Health Department, our percentage of vaccinated individuals 75 and over will steadily increase. In 2 to 3 weeks, we should be ready to start focusing on the 65-74 age bracket through the County Health Department.

In early April, after about a month focusing on the 91,000 people in the 65-74 bracket the County will likely enter their Phase 1C, Tier 2. That’s the Phase for people with pre-existing conditions. This should be about the same time that the state is entering Phase 2! So, while it’s extremely confusing to have people with pre-existing conditions in different phases with the County and the State, in practice, these should be starting up around the same time. At that point, people with health conditions that make them vulnerable to severe disease will be able to get the vaccine from a state-run mass vax site, pharmacy, hospital, or, if all else fails, the County Health Department. 

BUILDING STATE RUN MASS VACCINATION SITES

This is a Good News/Bad News Story. 

All those extra doses coming from the Federal Government are being sent to new mass vaccination sites being run by the state. There’s one at Six Flags in Bowie (a drive-thru site!), another at the Baltimore Convention Center, and a third opening next week at Raven’s (M&T Bank) Stadium, also in Baltimore, just off of 95. Since opening two weeks ago, they have administered 19,650 first doses, mostly at Six Flags. 

In early March, the state will open three more sites: one in Western Maryland, one in Southern Maryland, and one on the Eastern Shore. In April, it’s possible more sites will be opened in other parts of the state, hopefully including in Montgomery County.

First, the good news:
These sites are administering A LOT of vaccines to Montgomery County residents. Six Flags can give out 2,000 doses a day! Raven’s Stadium will do 1,500 a day. And when more vaccine is available, they may be able to do even more. In addition to expediting our progress through phase 1A, 1B, and 1C we are also building the infrastructure we need for a mass vaccination effort in late spring and summer.  Appointments are available online (https://massvax.maryland.gov/) and via phone (1-855-634-6829) daily. Checking back regularly starting early in the morning is the key to success. 

Now, the bad news:
I’ve heard from many of you about the need for a mass vaccination site in Montgomery County. Yes, we continue to lobby for this! It’s unreal that the state’s largest county does not have a mass vaccination site up and running. I continue to ask, the Montgomery County Delegation has asked, the County Council has asked, County Health officials have asked, and many of you have asked – we know the demand is there, we know there are locations available and yet the Hogan administration continues to resist for reasons that are unclear and unarticulated to date. 

Please keep urging the Hogan Administration to add a location in Montgomery County in the next batch of sites. When we move into Phase 2, we are going to need this even more than we already do.  

YOU KEEP TELLING ME TO MAKE AN APPOINTMENT LIKE THAT’S FEASIBLE. WHEN WILL APPOINTMENTS BE EASIER TO GET?

Believe it or not, it is getting easier. The opening of the mass vaccination sites two weeks ago increased the number of vaccines available to Montgomery County residents significantly. If you can make it to Six Flags, that’s the easiest and most convenient place to get a shot for most people. The opening of the Federal Pharmacy Partnership also opened up a lot of appointments at CVS and Walgreens locations across the state where Montgomery County residents can be vaccinated.

There’s still way more demand than supply. But every week we are chipping away at that demand. Right now, 2.2 million people are eligible for the vaccine in 1A, 1B, and 1C. Only about 50% of eligible people want the vaccine. That’s 1.1 million doses that are in demand (and another 1.1 million that public health leaders hope will be in demand eventually!).

So far, we have administered 651,000 of the 1.1 million doses that are in demand in Phase 1A, 1B, and 1C. That means that after 10 weeks we are almost 60% of the way towards our goal. Don’t fret though! Remember the first 6-8 weeks of vaccine administration were very slow going. Now that we have more vaccine options, we have ramped up our ability to administer vaccines to about 100,000 first doses each week. 

Some simple math indicates that even with (hopefully) demand increasing for the vaccine, we should be able to finish with (state) Phase 1A, 1B, and 1C in the next 6 to 8 weeks. 


If you click on the link above, you will have access to links, information, and where available, phone numbers for all the vaccine providers in Montgomery County, and the state mass vaccinations sites.

WHY WE TARGET HIGHLY IMPACTED ZIP CODES

My (almost) husband runs a health clinic that serves the immigrant community in Montgomery Village. One of his neighbors is a Spanish-language church. The couple that runs the church tragically lost their son to COVID 19 a few weeks ago. Seeing but he's in his early 30s, my heart aches for these parents who lost a son, and for his wife and three young children, who lost their father. I haven’t been able to stop thinking about the enormity of their loss, and how it makes my very real frustrations with isolation and home-schooling feel trivial.  

This week, I dug a little deeper on disparities in Montgomery County and learned some more I’d like to share with you. According to research, two major factors contribute to the disproportionate impact of COVID on communities of color nationally. 

The first is disparities in outcomes- when a Latino or Black person gets COVID, they are more likely to die. And the younger people are, the larger the gap in death rates between Black, Latino, and white people. Higher rates of obesity, diabetes, and other pre-existing conditions that make COVID even more dangerous play a large role in this disparity.

The second factor is an even more significant driver of the numbers. It’s the fact that case rates in communities of color are often much higher. So, individuals who live in these communities are much more likely to get Covid in the first place because of exposure through work or where they live. It’s this fact more than any other that is leading to the tremendous and disproportionate burden being borne by these communities. 

Montgomery County is not immune to these national trends. The zip codes with the highest case rates are also those the zip codes with the most diverse populations. Montgomery County’s Latino population is especially hard hit. Making up less than 20% of our population, this community has more than 30% of our positive COVID cases. 

Montgomery County has the state’s largest Latino population. 50% of our Latino population was born outside of the United States, and 25% do not speak English well. This community faces barriers in access to health care, access to technology, and in access to information about vaccines.  

These deaths are happening to much younger people than you might expect. According to Dr. Kathleen Page from Johns Hopkins Medicine:
 
People Under 65 Years Old Make Up:
10% of deaths in the white Population
30% of deaths in the Black Population
35% of deaths in the in Latino Population


Right now, Montgomery County’s Latino community is facing a huge disparity in vaccinations. Montgomery County’s awesome new Covid Vaccine data dashboard shares information on vaccine administration by race and ethnicity over the last 7 days. 

Vaccinations By Race
(Seven Day Average - Doses Per 10K Population ) 
30 White residents
18 Asian residents
10 Black residents
7 Latino residents

While some of this disparity can be explained by the relative youth of Montgomery County’s Latino and Black populations, it is clear that there is a growing gap in vaccination rates. Closing this gap must become a priority for all vaccinators as we move into County 1C/State Phase 2 (pre-existing conditions) and expanded workforce vaccinations. Remember, we are all in this together. And the only way we are going to get out of this is together. 

Numerous community groups are working together with the State and County in partnerships aimed at closing this gap. Mobile vaccination units are being tested, Spanish and English materials are being developed, churches and other community leaders are being engaged. We should all be asking ourselves what positive role we can play in closing these gaps. 

A FRAME SHIFT IN HOW WE SEE THE COUNTY HEALTH DEPARTMENT

The Health Department is here to protect and serve all of us. However, their main priority is serving the people who otherwise have difficulty accessing health care, and ensuring our vaccine allocations are being distributed equitably. This goal is not just moral, it’s in everyone’s best interest. The vaccination effort won’t work to curb the pandemic unless the people most impacted have access to the vaccine. 

The County Health Department is operating clinics specifically targeting people 75 and older in our most vulnerable zip codes, where COVID is spreading rapidly. If you DON’T live in a targeted zip code (Hint: nowhere in District 16 is a targeted zip code) and an immediate vaccination is important to you, it is in your best interest to seek an appointment from a pharmacy, hospital, or mass vaccination site. These locations combined have about 70% of the doses in Maryland, compared with about 30% for the Health Departments. 

If you are 75 or over and you can’t find an appointment, or you can’t arrange transportation to get to an appointment, the County has assured me they will send you an invitation for an appointment within 2 weeks regardless of your zip code. If you are homebound, the County is setting up a home visit program. Details should be finalized next week.

Please remember, if you CAN seek an appointment from a vaccinator other than the Health Department, this is “a mitzvah”- a good deed. Yes, it’s a giant pain in the neck, and we should absolutely have a better, easier system for doing this. But getting your vaccine at a hospital, pharmacy, or mass vaccination site leaves a vaccine available at the Health Department for another vulnerable community member and speeds up the process for everyone. 

**That said, the County Health Department will make sure everyone over 75 has access to the vaccine within 2-3 weeks before they move on to the younger age group**   

For the 91,000 people in the 65-74 age group, it’s the same plan. If you're in a hurry for a vaccine, first try to find a vaccine at a hospital, pharmacy, or mass vaccination site clinic if you can - people in your age group are eligible now at almost all the vaccination sites. (Click here for my list of vaccine resources.) The County Health Department should be viewed as a vaccinator of last resort. These vaccines are being used for people who are not able to access any of the other sites. Communities with high COVID death rates and high COVID case counts will be prioritized. However, if you can't find a vaccine elsewhere, the Health Department will absolutely vaccinate you before moving into the next phase.    
 
The work the Health Department is doing in vaccinating our highly impacted neighborhoods is not easy work. If you get an invitation (directly) from a County run clinic but you are not in a targeted zip code, and you still need a shot, take that appointment! One way we can help the County Health Department is with our willingness to show up and get vaccinated at County Clinics when we are invited. The more the County focuses (rightly) on equitable access, the harder it becomes for them to fill appointments. So there will be days and weeks when they need to give lots of shots to people not in target zip codes in order to meet their metrics. 

WE’RE ALL IN THIS TOGETHER 

The Maryland Vaccine Hunters (community volunteers helping seniors secure appointments) and the volunteers at Little Falls Village are examples of some of the best work our community can do. Together, we can move mountains. 

I know this is an incredibly stressful time for so many of us. It’s hard to be patient and have faith that a vaccine appointment will be found. It’s hard to imagine we will ever make it through to a brighter time when life returns to something more familiar. It’s exhausting, plain and simple. And it’s disappointing that our government hasn’t done a better job managing the vaccine rollout. The stakes are so high, and failure is not an option. This is a time when we want to be leading the pack, not bringing up the rear. 

I have gone over the state plan in my head over and over, I have identified what I consider the wrong turns. Many constituents smarter than I have shared their analysis on this as well. Some roadblocks are unavoidable. Others are inexcusable (uhhhm, no mass vax site in MoCo?). And there will be a time for reflection on and accountability for everything that went wrong.

But for now, I am trying to focus on a simple thought. It is the guiding principle of the Health and Government Operations Committee, the Committee on which I have served for eleven years. “We are all in this together.” It’s a simple premise that applies well to public health issues. This is not an everyone for themselves situation. 

In a global pandemic, we have to take care of ourselves, and our neighbors.