The Covid crisis is hitting a peak right now, with dramatic spikes in cases both locally and nationally.
But help is on the way. Vaccines are coming. Antibody treatments are coming.
At a press conference Tuesday morning, UPMC outlined plans for its 92,000 employees to both receive the vaccines and distribute them to those most in need.
“As we speak, hospitals around our network are preparing to receive thousands of the doses of the Pfizer Covid-19 vaccine,” said Graham Snyder, medical director for infection prevention and hospital epidemiology at UPMC. “We also expect the Moderna vaccine to be arriving soon at our skilled nursing facilities. This is only our first allocation, and details of future allocations are forthcoming. Given the robust production of vaccines already underway, we are optimistic we will be able to provide vaccines to our frontline health care workers who wish to receive it before the end of January.”
Don’t expect to get yours anytime soon, however.
“The first allocation of vaccine we receive will not be available to the general public,” says Snyder. “Please do not arrive in our facilities asking for it. As soon as we can make it available to the public, we will do so.”
Vaccines will be voluntary for frontline health workers. Flu vaccines, on the other hand, are mandatory.
“While we’re very excited about the preliminary information we have about how safe the vaccine is and how well it will work, we don’t have any of that other data that we have based our mandatory influenza vaccine policy on,” says Snyder. “So, for now, until we learn more and build our own experience with this vaccine — plus, until we see the uptake of the vaccine in our communities, and have an understanding about the role that vaccination has an ending this pandemic — it’s not the right thing to make it mandatory. It’ll be voluntary.”
Before the first jabs of vaccines go into arms, there are several key steps to take.
“We will await FDA review and issuing of Emergency Use Authorizations,” says Snyder. “Until they do so, we will safely store the vaccines we receive. Our team of virus and vaccine experts are performing an internal evaluation of the clinical trial data available on the vaccine. Until they are satisfied that the vaccine is safe and appropriate for the people we plan to offer it to, we will not be injecting it into anyone’s arms.”
The order to receive the vaccine starts with Phase 1A, which is health care workers. Phase 1B includes other essential workers. Phase 1C is for “other vulnerable people in the community, including people over the age of 65, and people with underlying medical conditions that may predispose them to complications,” said Snyder.
There is also a lot of promise in monoclonal antibody treatments, which UPMC is planning to deploy.
“UPMC just received an allocation of two different antibody treatments from Regeneron and Eli Lilly, which we are giving to certain Covid-19 infected patients,” said Donald Yealy, senior medical director and chair of the Department of Emergency Medicine at UPMC and the University of Pittsburgh.
“We are also developing our own antibodies, Ab1 and Ab8, because we think they have the potential to be much more powerful than the current therapies. Antibodies hold the promise of being curative for those who are Covid-19 positive. And unlike vaccines, which are preventative, they don’t require you to mount any type of response to be effective. We expect to begin our clinical trials soon.”
With Covid exceeding hospitals’ capacity in many places across the country, UPMC is preparing for the expected surge in patients in several ways.
“For example, we have brought in nearly 200 nurses in the past week to provide additional staffing, as we expand hours of care,” said Leslie Davis, senior vice president of UPMC. “And we’ve also expanded the hours of all of our flex-time staff. We have found opportunities to quickly add additional beds across our system. At UPMC Mercy, for example, we accelerated the opening of a new Intensive Care Unit, just a few days ago. And at the same time, we transformed the older ICU unit into a step-down unit, creating a dozen more beds for patients.”
“Fortunately, we’ve gotten smarter about caring for Covid-19 patients, and we are seeing a far lower proportion of critically ill patients needing intensive care and mechanical ventilation, or breathing machines than we did in the spring.”
Davis maintains that UPMC still has the capacity to treat Covid and non-Covid patients.
“Today, we have about 25% of all of the Covid-19 positive patients across UPMC in intensive care beds,” said Davis. “But that means 75% of them are in regular beds. And we have close to 6,000 beds at UPMC. And I think 20% of them are now filled with Covid patients. So again, those broad numbers give you a sense that there is no need to feel nervous or anxious. We are not overwhelmed with this virus.”
Even in the best-case scenario, the vaccines won’t be available to everyone who wants one for months. So it’s essential that the public redoubles efforts to protect themselves from the virus.
“We must continue the basic public health practices that we know protect us, and are needed now, particularly during this holiday season,” said Yealy. “Wear a mask, whenever you’re around anyone who’s not in your household, and wear it properly. It must cover your nose and your mouth, not just one.
“If someone in your household recently tested positive for Covid-19, or if they have symptoms, such as fever, cough, breathing difficulty, headache, smell or taste changes or many of the other Covid-19 symptoms, wear a mask, even inside your own house. Practice safe distancing and avoid gathering with people that you do not live with. We recognize how hard that is during the holiday season. This is a critical time; we need to do it.”