2021-03-23 00:00:00 - Joint Committee on Covid-19 and Emergency Preparedness and Management
2021-03-23 00:00:00 - Joint Committee on Covid-19 and Emergency Preparedness and Management
(Part 3 of 4)
SHOW NON-ESSENTIAL DIALOGUE
So, Committee, we are going to begin. Um, and, uh, Governor Baker, please let me welcome you back. We're grateful to you for coming to the committee for a second time, and we look forward to this conversation.
GOVERNOR CHARLIE BAKER - Well, thank you very much, Madam Chairwoman and Mr. Chairman, Members of the committee. Um, good afternoon. Since my last appearance before this committee, just over three weeks ago, we reached a major milestone of over one million Massachusetts residents fully vaccinated almost 1.2 million doses of COVID vaccine where ministered to Massachusetts residents during those three weeks, which is enough doses to fully vaccinate the city of Boston. Since I last testified every Massachusetts resident over the age of 16 and when they will become eligible to receive a vaccine and we launched the pre registration system that one million people are using to book appointments, when and where it is convenient for them.
In the last three70 weeks, our administration made all 400,000 educators in Massachusetts eligible launched educator, only vaccination days on weekends across the state, and tens of thousands of educators have gotten vaccinated, are getting vaccinated and we'll get vaccinated. We continue to outperform most other states in our efforts to vaccinate our most vulnerable populations. Those over the age of 75 are black and brown residents and those residing in or working in congregate care settings. Almost 80% of100 residents over the age of 75 more than 70% of those between the ages of 65 and 75 received first doses. Were reaching those who are homebound, and we launched a town by town detailed public report for every dose administered to expand on those efforts.
We, along with many community leaders, are120 implementing a $5 million outreach program, and the 20 communities have been most disproportionately affected by COVID. Were also distributing $27 million in federal funds to community health centers, hard hit133 municipalities and the 20 communities we identified as those that have been hardest hit to expand their vaccination capabilities and support their outreach efforts. I believe Secretary Sudders will speak to more about this when she testifies after me. We also dispersed over $71 million in additional small business support from the largest state run small business relief program in the nation, and we visited one of the many scale manufacturing facilities here in the Commonwealth.
That's producing millions of high quality in 95 mask for our frontline workers, thanks to the work that you and we did to create the MERT program, the States Free COVID vaccination Excuse me Testing Operation, which is one of the largest of its kind in the US, has provided two million tests, and it was upgraded and extended based on conversations with many folks in the community through June. Since the last hearing, the seven day COVID hospitalization censuses dropped by 30%. The daily positive test rate remains at or below 2%. The number of new daily cases has remained relatively flat and our seven-day average COVID death rate has fallen by over 20%. The state also went to phase four of the reopening plan a big deal when you talk about207 how you get back to normal. And of course, we also marked the one year, one-year anniversary of this brutal fight against the virus.
Overall, Massachusetts hospitals, pharmacies, regional collaborative local boards of health, mass vaccination sites and community health centers have delivered over three million vaccine doses to Massachusetts residents, and we lead the nation on almost every key CDC measure among the 24 states with more than five million people to reach herd immunity in Massachusetts, we need to vaccinate about 4.1 million people fully and right now one million are fully vaccinated and done. Another group of just about a million has received one dose, and every single day is getting their second and another million or pre-registered and set to receive an appointment when it's their turn. And there are hundreds of thousands of residents who are currently working through their medical providers, health centers and retail pharmacies, which make up more than half of all the doses that have been administered to set up their appointments and get their vaccinations.
Taken together, Massachusetts has this tremendous goal in its sight, and we just need to follow through in this final stretch. As a result of this work, Massachusetts has made real progress in the fight against the virus, whether measured by public health metrics like COVID hospitalization rates and vulnerable residents getting vaccinated or economic metrics, businesses being able to reopen and workers rehired or simple personal milestones. Grandparents getting and giving hugs, Children returning to a classroom. Massachusetts is making progress, but none of this would be possible without the thousands of healthcare310 workers, first responders, doctors, nurses, public servants and countless others who have been so critical to our efforts. And it wouldn't be possible without a state government that works for the people. And everyone in our administration is deeply grateful for the integral role the Legislature has played since the beginning of this pandemic.
While the fight is far from over, you should all be immensely proud of the work that you've done to make this effort here, work in Massachusetts and beat back the virus. The last hearing were also asked what metrics we use to guide the vaccination program and how we define success. Since the start of the pandemic, we've compared Massachusetts to our peer states and public health metrics, and the same is true for vaccines. Specifically, total doses administered 1st and 2nd doses per capita percentage of the population fully vaccinated, percentage of doses received and administered an average daily administration rate. We also track our progress and vaccinating various eligibility groups like those over 75 over 65 as well as demographics, such as race and ethnicity. In addition, we measured doses administered per capita by county and, of course, doses administered to each channel retail, pharmacies, hospitals, regional collaborative Mass Vacsites and community health centers, for example.
As evidenced here We pay close attention to the394 metrics, and we compare ourselves against the barometer that's most available to us, other states and countries. Our standing as a national leader hasn't gone unnoticed. We should be proud of the fact that the White House senior adviser on COVID recently recognized Massachusetts is one409 of only a handful of states that have reached 25% of the population receiving at least one dose. Again, we know we have more work to do, but thanks to the contributions of many, Massachusetts is getting it done. I do want422 to take a moment to discuss how doses that are ministered because we did learn through various media reports that the committee was particularly interested in the use of mass vaccination sites. I think when we discuss mass vaccination sites and our approach, the vaccine distribution generally, it's important to keep a couple of things in mind.
First, for all the attention that mass vaccination sites have received, they only administer. So far, about 15% of all the vaccines have been administered. Today, hospitals are the number one vaccinated by far at 33% followed by retail pharmacies at 21% and regional, collaborative and local health departments are just behind Mass Vaccination sites at about 11%. Community health centers have distributed about 6% of doses, all in there. About 200 different sites distributing vaccines across the 351 cities and towns in Massachusetts. 85 retail CVS pharmacies alone. The second thing to keep480 in mind is that the approach we've taken is very much in line with the recommendations of the federal government and health experts. I appreciate that some 0.2 plans developed in a pre COVID world and ask why we chose not to follow them. The fact is that COVID and the vaccines developed so far to prevent it present unique challenges that forced us to make adjustments.
The extremely limited supply, the need for cold and hot to cold storage, the prep process, the potential for spoilage and the two dose regimen were all on the ground, realities that required a different playbook than the one we developed and is different than the one we would have used to battle an outbreak using523 a traditional understood or widely available antibiotic or vaccine. Overall, we followed528 the lead of the federal agencies like FEMA and the CDC and modified our approach under both the Trump and Biden administrations. The federal government's distributed vaccines for the same channels were using Mass Vacsites, pharmacies and community health centers. Last fall, the CDC issued a COVID 19 vaccine playbook and ask states to submit their vaccine plans550 in accordance with that playbook, which we did in October, the CDC's playbook asked states to plan for three phases of vaccine distribution.
Phase one with limited doses. Phase two with sufficient doses to be available, demand and phase three with sufficient and perhaps even surplus supply. For all the progress has been made in recent weeks to increase supply. We're very much still in a period of constraints. Apply which means we're still in phase one, according to the CDC's playbook. That playbook says for a scenario with limited vaccine availability quote. Given the challenging storage, handling and administration requirements, early vaccination should should focus on administration sites that can reach prioritized populations, which is much through but as possible. The Biden administration's continued to push for mass vaccination sites, strongly recommending that states run such sites, and it's actively seeking to expand mass vaccination sites across an ancient nation.
In fact, we're working closely with the federal administration and, with the support and advocacy of our congressional delegation, have applied for a FEMA sponsored mass vaccination site here in Massachusetts. The approach is also backed up by medical experts. A recent New England Journal of Medicine piece, written by a group of doctors affiliated with Harvard, Brigham and Women's in Massachusetts. Other institutions, outlines the important role. Mass vacc sites play here in Massachusetts, across the641 US and in other countries to officially in minister vaccine. The authors find these high throughput sites are not only necessary but are the logical651 solution to the challenges of COVID vaccination and are extremely effective in the race against time. Our administration has not been alone in recognising that strategy uses a combination of pharmacies, hospitals, community health centers, mass vaccination sites and regional collaborative is the right approach in the situation of constraining vaccine supply
In fact, the Senate's own vaccine working676 group came to that same conclusion. Last fall, the working group developed a vaccine distribution plan that recommends using hospitals, doctors, offices and pharmacies in a lower medium supply scenario. It states that only in a high supply scenario should the state considered distribution through local community clinics. Here, too, it notes that such an approach would potentially be inefficient and699 that the state might want to quote, limit the number of community vaccination sites available. Close quote. We believe, given the limited vaccine supply we've been dealing with since the beginning, our approach is very consistent with the recommendations in the report before I close, I just715 want to discuss some items that came up during the last hearing. In an effort to dispel misconceptions and to assure the public as the best and most accurate information about the program, many have claimed that the administration cut off local boards729 of health from distributing vaccines.
That's not true. The 13 operational regional collaborative that are already in place are either run by or coordinate with local boards of health and received thousands of doses each week. Four more have been approved and are getting established and anticipating and receiving additional vaccine supply. In fact, these sites have administered more than 300,000 doses in Massachusetts so far, and that statistics755 made available to the public on our website on a weekly basis. In addition, in a February 17th letter sent to local boards of health and to the Legislature, administration asked every local board of health in Massachusetts to partner with the state to vaccinate homebound and other hard to reach populations. As of this week, more than 160 municipalities representing about 40% of the state's population, have stepped up to do this work. The Commonwealth will work with the other communities, representing about 60% of the state's population, to administer vaccines to homebound and hard to reach populations through the state's793 program.
Some have claimed that there are whole regions of the state where there are no vaccination sites available. That's also not true. There is no region of the state that lacks access. In fact, virtually every resident of Commonwealth lives within 30 miles of a mass vaccination site or within 15 miles of a regional site, and that doesn't include the hundreds of pharmacies, health care providers or Community health Center sites that, as I said, before a minister, over half of all the doses that are administered to residents across Massachusetts,825 some have claimed Internet access is required to access doses. That's also not true. The 211 toll free call center has booked appointments834 for more than 50,000 residents, and the aforementioned provider, organizations that make up half of all the doses administered here in Massachusetts are reaching out every day to their patients and their customers in a846 number of different ways and scheduling hundreds of thousands of appointments. Some have claimed the plan didn't prioritize community color.
That's also not true. Over a dozen leading medical and health experts recommended this vaccination plan and made equity a cornerstone. In addition, millions863 of dollars have been and will continue to be invested in our efforts together to serve communities of color. Much has already been done with our 20 hardest hit communities in Mass, and we know that much more needs to be done as we move forward. But I wouldn't want to point out that Massachusetts leads all states except one in the vaccination rate of black residents and ranks among only four states in the nation that vaccinated more than 19% of our black residents. The results are not as high for Latino residents, but Massachusetts has almost double the national average at 11.5%. We would be the first degree that to agree that more work certainly needs to be done here, especially in communities of color, and that will continue to be a905 focus of ours.
The effort to907 vaccinate all of the people in Massachusetts is not and will not be easy. I know we all agree on that, but I also know first time how frustrated many ours. We confront the challenges we've encountered so far. But I do ask, is public officials that we commit to be clear and direct with the people of the Commonwealth, as we possibly can be about the facts that relate to this vaccination effort? There's an abundance of information floating around in the public domain, as you all know about vaccines. Some of it's very helpful and some of it's just plain wrong. And as public officials, it's important for us to take every opportunity to make sure that the information that our constituents have available to them is legitimate confirmed and will help them actually access and use the vaccination program here in the Commonwealth. I want to thank you again for the opportunity present today. And I look forward to the Q and A.
SEN COMERFORD - Yeah, thank you. Government Baker and for both House and Senate members on this call today value as you do factual information. I'm really excited to hear that you have, um, metrics which you are evaluating the work again because it is not to see those metrics.
SHOW NON-ESSENTIAL DIALOGUE
And now I'm going to turn it over to Senator Cindy. Treatment by chair.990 Mhm.
SEN FRIEDMAN - Thank you, Madam Chair. Thank you, Governor, for coming here today and continuing this conversation. Um, I'm a little taken aback by what I've just heard. First of all, as I'm sure your parents and my parents said, comparisons are odious. And when you have 4% of the Latinx community in a larger community for which there are about 75% of the population, that is nothing to be excited about or, um or or even be happy about satisfied in any way. It's just just plain bad. Um, I would also argue that in terms of the local boards of health, while this is a very unique vaccine, I really appreciate that refrigeration, um, you know, the number of doses that all challenging nobody asked them if they could do it. We just seem to have thrown the playbook out and decided on something completely different.
nd in fact, we had that conversation earlier. And many of them were ready, um, to address that issue. Um, if we're getting to the most vulnerable, Um, and that is what we should be focusing on. I would argue that we are now at the point where we were the1076 cohort of people that we have our our1079 people, who cannot get to the mass backs sites or won't get. And we've been talking about this over and over again, and I guess you're understanding of what's going on and my understanding of what's going on are really different because I just keep hearing How are we going to get to those people who you know, work? Who are the dishwashers? Who are the Mrs. Jones who is afraid to leave her house? Who are1108 people who don't have1109 transportation, are people who work during the day and aren't open during the sites.
are the people that we keep hearing from, and I know that we've set up these regional vaccination sites. I understand that. And I'm very happy about it because actually, there's now one in my, um that my town that I live in is part of They haven't gotten any vaccines yet, and that's a decision that we have made. That is a decision1133 that the administration has made. That is the decision that says We're going to keep increasing our doses to the mass site and we're going to wait to give it to the regional sites. Well, these people can't go into the end of the line, and that's what it feels like to make. I also take a little bit of issue with what you said about hearing things from media from media services. We sent you those lists of questions. With all due respect, we did that in a in the effort of collaboration so that we know what we could talk about.
We didn't leak anything to the media. We have been your partners since March. We have done everything we can1179 to be supportive to help you all to be good stewards of this whole pandemic. And I just feel like we've gotten to this point in this vaccine or we have tried very hard, very hard to continue that collaboration. And what we're getting from you is you're all wrong. We're doing great. Please, we don't want to hear it anymore. And I find that really hard to take. I just I just feel like there isn't a give and take here, and and we're We've been trying very hard, so I want to understand, at least to what? To some of the things you said that we're expanding vaccinations. Why are regional Why aren't those regional collaborative getting them? Why are we?
I saw the list that you sent us and percentages that are going to, um, you know to the different cohorts of people that give out this vaccine, and I noticed that there's increasing in mass sites, but there's original sites are still waiting for vaccines. So I got to understand this. These are decisions that you're making and we don't understand them. And we are so worried about the people that are being left behind and they are being left behind. We're not making this up. So I I had another question, but I just I just feel like I had1267 to say something to come back at what? I heard you. The way that you characterize this, I just We're living in two different worlds. I'm sorry, madam1278 Chair. I yield back my time. I not at all what to say. Thank you, Madam. Vice chair.
SHOW NON-ESSENTIAL DIALOGUE
Um, thank you, madam Vice chair. And I think I'll turn now to share your school for a house question.
Thank you. Chair.1294 Coming for it. Can you hear me? Okay.
Yep.1298
REP DRISCOLL - Great. Thank you, Governor, for coming back for the second hearing. Uh, we appreciate it. Um, Governor, since the last hearing, and over the past month, you've been relaxing restrictions and moving the state into phase for of reopening. Um, in that same time, our data has plateau to the high baseline and actually begun rising again recently. It's been said vaccines are great, but vaccinations are what count in terms of getting into people's arms. Um, and we know that the CDC director and Dr. Fauci warned us against relaxing restrictions too soon.
Given the plateau data trends and coupled with the presence of more transmissible variants of concerns. Um, so we've heard a lot of concern from Dr. Fauci or the CDC Director. You recently said in an interview that you've listening to them, but you're also listening to, you know, lots of other, um, experts in this arena. And it begs the question Which public health experts are infectious disease specialists are in favor of relaxing restrictions as the variants rise.
BAKER - Well, let me, first of all, um, say that the we actually talked about this issue today on the on the call with the White House and, um and what was interesting about it was, um, Dr. Fauci was on the call and he talked about the variance. And obviously we're continuing to1389 see variants here in Massachusetts, which is consistent with what people are seeing in other places. But he did say that it's important for states to work their way through their circumstance and their situation based on their information and where they are both in terms of their case counts, um, their hospitalization rates, their vaccination program and all the rest. Um, he made very clear that he thinks it's really important for everybody to maintain what I would describe as kind of the overarching objectives.
Uh, and protocols with respect to distance. and, um and and masks and and rules and guidance, especially around indoor activities. But I think in some ways where we are in Massachusetts, both with respect to the case counts, hospitalizations, positive test rates and all the rest is not the same place that many other states are in. And as a result, we've tried to tailor the decisions we've made to be consistent with that. And, um and we do talk to a lot of folks in the in the public health world and a lot of folks in the in the research world and, um and depending upon the issue, you raise with them and the topic you're trying to sort of drill down on. Um, there are many points of view and and I accept that and I think our approach to this has always been incremental.
And we do make decisions to change in one direction or another based on data. But at this point in time, we continue to see a fairly significant drop in our hospitalizations, which I believe is a function of our vaccination program, Um, and the work that so many have done to get1488 vulnerable populations vaccinated. And I also agree, by the way with Senator Friedman that we have miles to go on the work1497 we do, especially in those 20 most disproportionately hit communities and in communities of college generally. And we would love to work with the Legislature as we go forward on that. But I think in many ways, from the very beginning, everything associated with COVID has been a balancing act. And we've worked to achieve what we consider to be the right balance for Massachusetts.
DRISCOLL - Thank you,1520 Governor. I just want to question if we're looking at the same data around where we are, Um, over since you know, before the last hearing and through the last hearing, we were plateau at a pretty high baseline in terms of daily cases through PCR tests are sewage data indicators, plateau mode. And now we're at a point in the last maybe two weeks or less, where we've actually had an increase in daily cases. Positivity rate. Um, these are the things that we were being warned by the CDC director a month ago as a pretty tough place to be as vaccines were, you know, still hadn't reached herd immunity in in states.
And, you know, if she was specifically asked about Massachusetts, uh, in New York in one interview, uh, national Sunday show. And he cautioned against, uh, making these moves because of the variance in such a time where we don't want to lose our path forward. Um, so right now we're at a baseline or trending upwards. That, um, is as you know, our numbers are in line with November, middle of November, when we were in search, too. So I don't think we can really compare ourselves right now to to where we were last June as we opened back up. I don't think that that I don't think that that's accurate.
BAKER1605 -1605 Yeah,1605 I agree with that, Um, and and if and if we didn't have over 80% of our, um of our folks over the age of 75 and 70% of our folks over the age of 65 vaccinated and a hospitalization rate for COVID that's dropped by about 20% since march 1st, um, we would also be in a different place with respect to how we deal with some of the most vulnerable among us. As we deal with these, uh, these issues associated with, uh, with COVID. Generally, I will say this the two biggest clusters we're dealing with right now, um, one on the cape, which I'm sure Senator Cyr knows a lot about which involved a church community and one of my hometown of Swampscott, which involved a big, giant high school party.
And, um and I want to just make clear to all of you and I1655 make clear every time I talk publicly about this, that this is no time for anybody to let down their guard. Um, but as we have all seen all the way through the last pick a number 456 months of this pandemic, One of the biggest challenges we1674 all face is, um, is doing the right thing when we're in what I call informal settings and informal gatherings. And as the weather gets nice, I think it's going to be really important for all of us. Uh, £2 home, that message to our communities, to our constituents and to everybody else, that, um, just because things seem to be better. However, you wanted to find that, um, we still have a ways to go. And people still need to keep their guard up, which I get is hard.
SHOW NON-ESSENTIAL DIALOGUE
Uh, thank you, Governor. Uh, Senator Cronin, please
Excuse me, Senator. I'll just remind the committee to accept the fact. Uh, Peters are
Can everybody hear me? All right, we can.
SEN CRONIN - Okay, Yeah. Sorry for appearing before the committee today. We spent 20 years after 911, not just developing a plan for mass vaccine distribution, but the plan even executing that plan in 2010 with with H1N1, uh, then we threw the1744 plan out. Uh,1745 and we had a panel this morning of public health experts who testified at the confusion that that created what they had drilled, what they had verified, um, was discarded. And my question is, if constraint of supply has always been the limiting factor for vaccine distribution here in the Commonwealth was trying to reinvent the infrastructure for distribution the right choice.
BAKER - So, um, can you say a little more about H1N1?
CRONIN - Yeah, sure. We had, uh, Sean O'Brien from the Cape this morning talked about how they had set up the infrastructure for an H1N1. But not only that, but drilled this plan in October and had the infrastructure set and ready to go. Uh, and then that was thrown out.
BAKER - So, um H1N1 is.
CRONIN - So there will be more specific.
BAKER - I mean, just crushed. Let me just. H1N1 is a lot different than COVID. Um H1N1 led to the deaths of about 25,000 people in the US Um, COVID's obviously1817 led to the deaths of about 500,000 people, um, hospitalizations on H1N1. I think we're somewhere in the vicinity of 550,000. Throughout the course of the of the time it was, it was surging. And in the US, we're about to pass a million hospitalizations associated with COVID and, um, and in the end, I think nationally about 80 million people got vaccinated one time for H1N1, and we're currently at 127 million shots and three months that have already been given in the U. S. And most people think we need ultimately to vaccinate 300 million people out of a country of about 375,000,000. 600,000,000 million shots. I don't I don't think that's a compatible.
CRONIN - Governor I’m sorry. So my point is that there was a public health infrastructure that existed, Governor, Um, a plan that your administration was responsible for It was last updated in July 2019, and then that model wasn't used. Uh, and so my question is, Was that the right choice to recreate1894 the wheel on the fly?
BAKER - Yeah. Um, for a number of reasons, first of all, for the reason I just started with which is I don't think you can compare what people did around H1N1 from scale or speed or complexity to what people are dealing with with respect to COVID and the COVID vaccination effort. Um, secondly, the as I said in my remarks, the cold storage issues, the two dose regimen, the really severe supply issues and so many of the other handling transport and management issues that came with COVID were a lot different than what people have been expecting or1934 dealt with before. And that's part of the reason why retail pharmacies.
And, um, and hospitals are responsible for more than half of the vaccines that have1946 been delivered in Massachusetts because they are in many ways better suited than almost anybody else and they are the choice, um, the preferred choice for many states, and certainly for the federal government as well. And you know, we1961 created the regional collaborative model because we wanted to make sure we had a mechanism that would work in certain parts of Massachusetts where you weren't going to get enough of an answer from just community health centers, uh, community health centers, retail pharmacies and hospitals. And and we're continuing to build on that. But the Mass Vac sites are a piece of this puzzle.
Remember, 85% of the doses that have been delivered in Massachusetts did not go through a Mass Vac Sites. Mass Vac sites only represent about 15% of all the doses that have been administered here so far. But I think the change we made is also borne out by the fact that we're the number one state in the country across almost every every measure that the CDC keeps track of. For states that have more than four million people. We have a long way to go in a ton of work to do, and I wouldn't begin to say for a minute we don't. But I do believe, given all the issues associated with supply, the nature of the supply, the nature of the rollout, how fast it has to happen and how people needed to manage the product itself. We made the right decision.
CRONIN - Thank you, Governor I’m out of time and Madam Chair I yield back.
SHOW NON-ESSENTIAL DIALOGUE
thank you so much, Senator. Mr. Chair, over to you.2035 Thank you. Chair. I'd like to recognize Rep. Frost for a question.
REP FROST - Thank you. Mr. Chair. Madam Chair. Thank you, Governor. Uh, one second. Sorry about that. Dogs are a, uh, biker going by. Um, thank you again for, for for having this2061 and, uh, governor for participating. And you're sort of looking forward here. So I think that's what's, uh, so most important2070 is, uh is how we are, how we're doing with, uh, vaccines coming in from the federal government. And particularly there was some news stories about, uh, J&J possibly not living up to its commitment or maybe2084 not getting enough uh, manufactured to live up to the, uh, what we were expecting to get.
BAKER - So, um, there was you must be referring to the story in politico yesterday.
FROST - Uh, yeah, Yes, Exactly. Yes.
BAKER - Um, you know, the the whole question of available supply has been, um, a struggle, I think, since the beginning. And, um and it remains one. I will say that that story that you're talking about was the talk of all the governors. Um, last night and this morning. And, you know, the good news was on the call with the White House. They said that No, it won't be 4 to 6 million. Um, next week of J&J doses, which are single shot doses, which I think we all know why that's so important. With respect to, uh, to this effort, um, it's only going to be, um, two million that's going2144 to go to the States, and then a million and a half that are going to go to the, uh, to the pharmacy. So, um, with a pledge that there will be more later.
Um, I think the the great challenge we all face on this and this is just one more example of it is the bumpiness associated with supply projections generally. I the good news is the answer wasn't no, there's not any, which is what that story in Politico implied. But but it's certainly not what were originally expected. We thought we were going to get 4 to 6 million that we could order on Friday for next week or tomorrow for next week. It looks like it's going to be more like two, and the pharmacy is the retail pharmacy chains to get another million and a half, some of which will obviously land here in Massachusetts as well. But that's going to continue to be an2191 issue.
FROST - And I think my last question real quick. Just squeeze in and is, uh, we've had a lot of discussion today. I've seen it in my local media as well here at the central Mass, over where I hear one group of folks who are upset that we don't have a mass vac site in in in in Wister County. But then I hear from other colleagues that mass vaccine, it's not really the direction we should go. We want more regional sites, and I know you know Central Mass has2219 four regional sites and as well as the hospitals and so forth. So so. But aside from that issue, how are we gonna gauge this going forward between the regional versus the mass vac sites? And when can we expect to see the regional sites be available for the pre-registration process so people don't have to go hunting for those?
BAKER - Uh, that's a That's a good question. The, you know, just for your own edification, representative, I think they're about According to my data, there's around 57 sites and Worcester County, Um, some of which are open to the public and are part of those four regional collaborative you were talking about and some of which are, uh, targeted to particular groups. You have a bunch of community health centers. You've got a bunch of hospitals. Um, and you've got, um, some other physician and hospital groups are working on just their patient panels per se. Um, but our goal is to get the, uh is to get the regionals that are coming online going forward, um, onto2289 the onto the pre reg site as they come on. And our goal will be to try to get the other, um, pre read the other regional collaborative that want to go on the pre reg site because it's not clear at this point that they all want to, um, which we should remember. Um, but the ones that want to get on the pre reg site, um, we'll work with them to get them up on their early in April. But but it's not something that all of them. I mean, there are 13 of them now. Um, and four more that we're adding. And we'll probably add some additional ones if we2321 get some more supply. Um, but but it's not clear to us that all of them want to be on the2327 pre read side. We'd be happy to have them all on, but we're going to basically have to work through that with them. But the goal would be to try and get as many up there as we can.
SHOW NON-ESSENTIAL DIALOGUE
Thank you, Representative. Thank you, Governor. Over to Senator Seer.
SEN CYR - Thank you. Chair Comfort and Governor, Thank you for being here with us today. Also thank you for the assistance Administration is providing to medicate. This really illustrates the precarious position that we're2352 in now. Whereas it is spring, it is a nicer weather. We're seeing a drop in cases, but remains remains precarious. And so we appreciate assistance. I want to drill down again and just go back to really understanding your thinking around around local health. And I'm not kind of pushing back on this to be difficult, but I really want to understand this both from from the work. The committee is dead done. And also as someone personally who you know, as you well know, I was a mid level bureaucrat and your administration and fire Governor's administration and there were it was just a playbook.
There were years of tabletop exercises. There was over $60 million between 2003 and 2006. Angle together all 351 local boards of health. Um, into basically 15, uh, collaborative entities, uh, all this effort in time that went into preparing for a2417 whole host challenges. And first it was around concerns around terrorism. And Nan Fracked then was, you know, updated around age and one. Um, and even in the latest plans from DPH, you know, DPH had plans to consider how do you address a novel virus that doesn't have an available vaccine? So I think we really want to understand. And I really want to understand, You know, you're you're thinking here, Um, and why That was the right Why you feel that was the right decision, you know, at the time and what it felt like on the ground.
And I've been I've been deeply involved in this stuff. Um, you know what it felt like I was We were sort of following a plan. We're using that type, his fascinating first responders, which were given 81. And then it just felt like all of a sudden there was a real pivot and a2472 real pivot to the mass vaccination sites, which certainly during February. Um, you know, more than 15% of the distribution was going to those sites. Um, and there was a decision2483 clearly made to prioritize them. Was that from feedback from Trump administration from Biden administration? You know why I mentioned that the hospitals are actually the leading vaccine areas in escape over 30% of vaccinations for their Why are we directing money to the mass vac sites? And I think of my hospital system, which has been bleeding money.
You know, throughout all of this, this is what these are some of the decisions we want to figure out. And we want to know. We heard from local health this morning and this afternoon that that they were really ready to go and and and they really felt like the rug was about from under them that not only a playbook, but, you know, 20 years of, of, of, of emergency management preparedness, Um, was not the decision of where we went. And I think we really want to understand that, Um, and I'll just close and say, you know, the regional collaborative consortium model. I've been deeply involved in this in the Cape, and I really feel like we're reinventing the wheel here. I really feel like we're sort of getting back together. All the folks that were doing this work 20 years ago,2552 Um and it just feels to me on the ground here that we've lost precious time.
And and that that we continue to struggle to reach the most vulnerable. You know, I'm thinking about how we're going to make sure we're going to vaccinate the person who's a dishwasher and a seasonal Kit Kat business, right? How are we going to vaccinate and make sure that the H2BJ1 Visa workers, which fuel our economy here and we're expecting a pretty, pretty busy season? We're really trying to figure out how we vaccinate those most vulnerable people and whether it's homebound or now whether it's essential. Workers here on Cape Cod were coming back to the fact that local health are the people who know where these people are. So I think that's what we're trying to figure out, I think today. And it's really the thrust and the mission of this committee to figure this out.
Yes, so we can continue to have a more equitable vaccine rollout and continue to right the ship here and then also2610 to make sure you know that we have the conditions in our government at the local level and at the state level, you know, to get that done. I think a big part of that is2618 resources. We heard a lot today about the lack of resources at the local level. Certainly I think, um, the lack of resources at the state level, uh, in the recession and then continuing at the Department of Public Health has not helped. Um, you know, But I think this is what we're trying to really figure out. And so, please, if you can further sort of elaborate, you know, from our understanding of it, at the end of January, early February, we all felt that what you had with the state plan with the planning that place was inadequate. Is that correct? And what is that? What? Inform what informs of the pivot there.
BAKER - So first of all, I just want you to see this is the Senate proposal, which I've written over all over for the better part of the past few months. Um, this is a nice piece of work, and the only thing that stuff, the only thing that suffered from Senator was in fact, a lot of the facts on the ground didn't turn out to be the way people originally thought they were going to be. And that wasn't just true. For for you and for the Department of Public Health. It was true, and practically every place in America and the single biggest thing the two big things have changed the number one. You know, these doses came with tons of very important criteria associated with using them. And there was a reason why the first place we sent almost all of them was to hospitals that had ultra deep freeze capability because that's where they were.
That's where they needed to go. The second thing this thing talks about, which was a really interesting idea was how to do long term care. Well, we didn't get to do long term care this way because the federal government made a decision that they were going to do long term care using the CVS is and the Walgreens of the world to get it done. Um, we ended up moving to what I would describe as a mixed model because that mixed model gave us the best opportunity in this race against time to get to the most people as quickly as possible. And I fully expect. Remember, we still have, you know, 13 Regional Collaborative, one of which is yours down on the Cape, which, by the way, is leading the state and percentage of its population that's received the first dose, and I think you're leading in the percentage of the population that's fully vaccinated as well.
Um uh, and we and we and we we're using and working with our colleagues at the local boards of health to do many of the tasks associated with reaching hard to reach populations and their hugely involved in the 20 communities that we, you know, we designated as those that have been hardest hit by the pandemic in the first place. And, um and I think what we've tried to do here is to create models and approaches that were based on the facts as they were available. And, you know, they changed as recently as January. As recently as December, we were being told that it was possible that we would have as many as 14 million doses. Um, by April,2803 I mean, we're gonna have three. And when you get into that kind of a conversation where so many of the things that you thought were going to be true don't turn out to be true, especially with respect to the supply and the product itself.
Um, we made decisions to try to create a program that was a consistent with what the feds were recommending. Both the Biden and Trump administration. And as I said, we're continuing to press the Biden administration with help from the delegation to try to get another big mass vac site here in Massachusetts. Um, and in addition to that was the same guidance and the same approach that was being taken by almost all my colleagues around the country. People didn't go small on this. People went big. And the states that we're having the greatest success. We're the ones that went big and that relied on the pharmacies and their hospital systems and mass vaccination sites and community health centers. The regional collaborative is something that we created that you know, you don't see in a lot of other places, and I think that's fine. I think the worst.
CYR - Governor. Can2867 I just ask the Senate report you're referencing? I'm not familiar with that report. I'm texting with my colleagues. Cindy Friedman really support Joe Comerford is familiar with the sport. Can you tell what this report is? Because I just want2879 to make sure we we know what we're2881 talking about here.
BAKER - This is Yeah, I think it was. I think it was done by a committee. I'm not sure. I think I think Senator Feingold. Senator Feingold. Senator Feingold might have shared this.
COMERFORD - Um, you2900 know, I think we can take this offline.
CYR - Don’t take it offline, I just wanted to ask.
BAKER - Okay.
COMERFORD - You know, I think the plans that we're focusing on today are, you know, from open to the open to the HMCCs to the preparedness coalition. Right? And those are the decades old plans, and we'll we'll figure out what the Senate plan is that you're looking at. Yeah. Thank you, Senator.
CYR - Thank you governor.2931
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Thank you senetor,
you, Senator. I want to move to Rep Taekema next. But before I do,
DRISCOLL - Governor, I just wanted to ask you mentioned, you know, the Cape and Barnstable County and I'm thinking2944 about Barnstable and Berkshire County have been leading in terms of percentage of population vaccinated since before2950 the last hearing, some more than 30 days. Isn't that a2953 ringing endorsement that the local boards of health the regional collaborative czar working? Because these are two counties that don't have, you know, quick driving access to mass sites. And, you know, it's it's not only regional collaborative, but can we only see that number increased if we, you know, send2969 more doses to, um, you know local public health, whether there are stand alone or whether they're collaborating with neighbors.
BAKER - Part of the reason we were interested in creating the regional collaborative, especially in places that lots of geography was. It made more sense to think about doing it that way. And they have been tremendously successful. I I Yeah, I think it's a good model. I think it's worked everywhere. We've put it up so far. We're going to continue to work on. I'm putting them in place as we go forward. Um, but I have to say that if you look at the way the feds are chasing these issues under the Biden administration as well as under the Trump administration, you look at the way most other states are chasing this stuff. Some form of hospital based3018 retail, pharmacy, community house center and mass vaccination sites are absolutely a key element. Not the only element, but a key element in the way people have gone about this and, um, and given especially the supply constraints and the and the difficulty of managing the Pfizer and Moderna vaccines.
Um, I think we chase the strategy here that was consistent with what other people were doing. And more importantly, we have more people vaccinated as a percent of our population than any other big state in the country. And we've been that way now for a couple of weeks, and we're going to continue to be that way because we are in a race against time. And several of you have pointed out with respect to the variants.3055 And if we have a mixed model that actually delivers, um, I think we should continue to put the pedal to the metal and get vaccine in front of and into the arms of as many people as we can, based on supply. And and at the same time, I'm very excited about the fact that we're going to put 30 million3071 bucks plus or minus to work. I'm trying to do some things to enhance and improve our performance and many of those hardest hit communities and communities of color where we have good numbers relative to our peers. But where we all agree, we need to have better numbers.
DRISCOLL - Thank you, Governor.
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Rep Dogma.
REP DYKEMA - Thank you, Mr. Chairman. Madam Chair and Governor always appreciate the time that you spend with us. Um, answering our questions. Um, I think it's I want to underscore a number that you put forward at the very beginning of your remarks. And I think it reminds us all of the challenge ahead of us, which is that we have to get to 4.1 million million people vaccinated twice in order to reach herd immunity.3114 So I have.
BAKER - To get a lot of J&J. They all don't have to get it twice.
DYKEMA - Okay, fully vaccinated. So, um, I have to imagine that a key part of your strategy has to do with getting this very limited supply of vaccine and determining at any given time. What is the most efficient and quickest way to distribute that vaccine and get it into as many arms as possible? And I imagine that's an incredible challenge and has resulted in a lot of hard conversations about prioritization and distribution channels, many of which we're talking about here today. One of the sets of numbers which I've3152 been looking at, um, are the channels that that have been selected for distributing the various percentages of of the vaccine that come in.
And I want to note that since secretary Sudders was here before us two weeks ago.3165 Um, the percentages of those numbers have changed. And to be specific, um, last time we heard that 52% of the vaccine was going to health care institutions. And then you just mentioned recently that that number is now down to 33%. So significantly fewer vaccines going to our hospitals somewhat, slightly more going to mass back sites, essentially the same number going to our regional collaborative. Um, and if I'm doing this math right, it looks like the increase has been seen in going to our local pharmacies. So I'm just curious to hear kind of your, um your perspective on why that might be a key distribution outlet at this point in time.
And then a corollary to kind of highlight some of our colleagues questions about the importance of these local regional collaborative. What strikes me about getting to this herd immunity number if we don't3217 have a vaccine to give to our 163219 and unders, that really increases the pressure on us to reach deep into our3224 communities and get a lot of people vaccinated that are going to be challenging. Um, it's people that are are homebound. Um, it's communities3233 of color, which we keep hearing how essential it is for these regional, collaborative and local health efforts in reaching that public reaching those populations. They have the trust, they know, the people in their communities. So that, to me suggests, uh, not that that should be the only distribution channel by any means.
But I would hope that we would be seeing as we get more vaccine, this balance tilting a little bit more toward for at least an increasing supply or percentage of supply going to our local public health departments. And I guess so I would two questions, really one year perspectives on sending more supply to local pharmacies and then to in the coming months, as we do get more supply. Do you think that roughly 10% going to our local public health departments and regional collaborative will increase? And and if you have a sense of kind of order of magnitude as to how much you think that those local groups will be getting in the months ahead.
BAKER - So, um, the the retail pharmacy, uh, channel is, um, is basically a federal channel. The Biden administration has made a3307 decision to invest heavily in that channel. Um, and they, when we get briefed as governors, um, we the way they brief us is, they tell us this is the amount nationally that's going to states. This is the amount that's going to retail pharmacies, and this is the amount that's going to federally qualified community health centers. They do send doses to federally qualified3331 community health centers directly as well. Um, so the increase, which is right in retail pharmacies, is 100%. The3338 strategy, one of the strategies, is being pursued by the federal government, along with FEMA sponsored mass vaccination sites.
Which they're setting up all over the country, and, uh, and federally qualified community health centers. Um, and I think you're going to continue to see the Fed's focus on the retail pharmacy channel. There are three things I really like about it. The first is it has lots and lots of built in capacity. Um, so it's, you know, it's it's kind of everywhere, right? That's point number one point number two is. Most of them have been in the business of delivering flu vaccines forever, so it's not an uncommon thing for them to be there and to be doing it. And number three, um, they are a national channel. And, uh, for the feds, it's a channel that they, you know, get on and and and treat to some extent as their channel. And I think you're going to continue to see growth and that retail pharmacy channel with respect to the second part of your question,
Um,3404 I'm you know, we're planning to put a big part of the State resources and the federal resources, um, that we are currently investing in those hardest hit communities and in our community health centers to specifically give them support and resources that they can use with face based organizations and community based organizations to find the best and and to work with the best messengers to try to get folks, um, to to come get vaccinated. And if folks can't3436 come get vaccinated, um, to use hopefully more J& J or some other approach to mobile based vaccinations to get to some of the hard to reach and homebound populations. And I think you will see as a result of that effort. Um, if we do it well, you'll see the percent associated with that go up as well because it needs to, and it should. But the pharmacy channel is a Fed channel, and they're driving a lot of vaccine into it.
DYKEMA - Thank you. Thank you, Governor.
COMERFORD - Uh, disappointed Clarity, Stephen at the border of paper that you have in front of you isn't from the Senate as a formal document. We just want to3477 make sure that our companies understand that. Well, I actually have a question for you. Got, uh I want to review the structure for the DH in the preparedness management Were, um we understand this morning that under open their six health medical coalitions or 60 s and that under the HMCC’s 16 public health preparedness step Um, these coalitions of the defending and they're asked regularly concur with plans. Budget in March 9 of these companies are preparing, has confessed coalition. Then what are? Let's not with the Baker Research plans Will do. CDC funding Planning stage. Generally, the state has squandered their procurement, uh, entry and millions of dollars.
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Senator uh, manager. There's nothing wrong with the There's something wrong with the sound. Somebody may have their feud on. Yeah. Okay. Not being muted. Thank you. And I'm sorry for that. Uh, but everyone mute.
Let's see if this works. That's better.
Okay, we'll give it a shot.
Um, thank you. Mine. Okay, that's a good idea.
COMERFORD - And so, uh, so I'm just going to go back. So in in March in mid-March 9 of these PHEP coalition sent what are called letters of non-concurrence with the Baker administration's plans for new CDC funding for emergency planning saying are generally that the state has squandered their preparedness efforts and training and along with it, millions of dollars. So I thought, if this is a pretty striking vote of no confidence3592 by the professionals closest to the ground who know the most about responding3597 to a pandemic Um, Governor, do you know how many cities and towns are represented by the coalitions? That didn't concur?
BAKER - I don't I'm not familiar with the letter either, but take it up with with Secretary Sudders and with Commissioner Barroso.
COMERFORD - Thank you so much. It's a 173 out of 351 municipalities in the Commonwealth. About four million people, which is, you know, as you know, about 59% of the state's residents. So, uh, these coalitions,3626 the ones that chose to reject the plans, had pretty harsh words for the3630 work that the Baker administrations leading. I'm going to share a few quotes, and my question to you is, what’s your response to our local colleagues, some of whom have prepared for decades for a moment such as this and feel ready, are ready through their own work and preparedness and training and actually tens of millions of public dollars.
Um, so I'll just read a couple of passages just so you can get familiar from Hampton County. Uh, quote. Communications from the state have been sporadic and poorly executed. The state does not appear to be following any clear structure. By dismissing the plans and putting additional requirements and quantity restrictions and on vaccines, you have compromised the work done to provide equitable services to vulnerable populations3679 from the Greater Lawrence Public Health Coalition. The non use3682 and dismissal of current plans damaged relationships with our region from Boston.
Which is region foresee. We were not given a chance to implement any of these plans in any strategic coordinated way during the response. And now during the vaccine rollout from the metro region, which is 60 cities and towns. This vote of non concurrence reflects the region's deep concern about the implementation of a COVID 19 vaccination strategy that squanders millions of federal and state dollars and resources along with the associated capabilities that were built with those resources town by town, region by region throughout the commonwealth. So back to you, Governor, what's your response to our colleagues?
BAKER - Well, several of those folks we talked to all the time, so I'm surprised that I didn't hear that before. Um, I guess the second thing I'd say is, um, we believe the facts on the ground, given the nature of the product that was being distributed, the speed with3743 which we had to move. And frankly, the guidance we were getting from federal authorities at the CDC Um, and the White House and from, uh, many of my colleagues in other states was that the program that we established, which was based on3762 hospitals, pharmacies, community health centers, mass3764 vac sites and regional collaborative, was the right way to go. And and I have to say that as unhappy as some people may be with that decision. You know, we are outperforming every other state in the country across most of the CDC’s key performance measures.
And I think that's an important fact with respect to whether or not the choices we made were effective or not. Um, I continue to believe that at some point we will have more vaccine. Um, you know, the message I always got back in the fall was that you'll have more vaccine than you know what to do with. I can't wait to have that problem. Um, and as that, if we end up having that problem, I certainly think we can be in a position where we continue to expand, um, participation. But we have enough capacity right now with the folks who are already engaged to do two x or three X what we're doing now. And I think that speaks to the fact that we've put together a pretty solid way of approaching this and the and the results so far bear that out. I completely agree with all of you, have expressed concerns about the fact that we have work3832 to do.
3833 And many of those communities that are most hardly most hardest hit by by COVID. And we're going to do that. Um, and we're always interested in guidance and support and ideas about how to move that forward. But, you know, I talked to Mayor Walsh almost every day while he was mayor, and I know that Secretary Sudders talked, talked to Marty3852 Martinez is the commissioner of public health in the city of Boston. More than once a day, all the way through this from the very beginning. And, you know, I talked to Dan Rivera all the time when he was the mayor Lawrence, and, um and so some of this comes as a surprise to me only because some of the people you're referencing or people that we've been in regular dialogue with, I understand almost on a daily3874 basis since the beginning of the pandemic.
COMERFORD - I understand we're happy to send over these letters. There was also a3881 as it happens, the Boston Globe story about it. We thought on the committee that these were very significant because these are the people who had been leading for decades training for decades, preparing for decades, and they themselves took the risk of non concurring with your administration to make a statement that we want to take seriously and interrogate. So thank you, Governor. Mr. Chair. Mr. Governor, I think we have exceeded your time. I'm not sure if you have enough.
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If you have time for more questions, so I'll go to a chair. Driscoll do have a What time is it? I have a for 10. Um, okay, how about How about one more? Maybe I'm late for four o'clock. Colin, are you supposed to be talking to some of our folks now anyway? Hey,
DRISCOLL - I want to thank you chair Comerford Thank you, Governor. I just, uh, question When did we wanted the state apply for the FEMA pilot site site?
BAKER - I'll get to the exact date. I don't want to get it wrong. Um, I can probably send you the letter on it. If that would be helpful. Would that be helpful?
DRISCOLL - It would. Thank you.
BAKER - Okay. All right.
DRISCOLL - Thank you for your time, Governor.
COMERFORD - Thank you, Governor.
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