While there are no specifics yet on the local plan to vaccinate for COVID-19, the Health Department’s goal is to vaccinate 70% or more of the county’s population within the next year.

“Because of the size of our community and all of the partners working on it, many people will be at the table to deliver vaccine,” Alisa Haushalter, director of the Shelby County Health Department, said at the COVID-19 task force briefing Thursday, Dec. 10.

The first doses of the Pfizer vaccine, which could arrive here in days, will go to the hospitals so they may begin inoculating their front-line workers.

The Health Department will follow suit in vaccinating first responders, in partnership with the city and municipal governments.

Over time, pharmacies and other health care outlets will receive the vaccine before the general public.

Moderna’s vaccine is also slated to be shipped to Shelby County, but when is unclear. Neither has been approved by the FDA, but an advisory committee to it late Thursday recommended emergency-use authorization.

Until there is final approval, few of the final plans can be put in place. The size of vaccine allotments to each region are changing day to day, Haushalter said, which complicates planning.

“This is quite a feat. It takes a lot of coordination and logistics, and there’s a lot of work happening on behalf of Shelby County,” she said. “I applaud all of our partners.”

Locally, partners include schools of nursing and medicine, which are prepared to marshal thousands of student volunteers to the frontlines, both in the vaccine effort and to care for patients in hospitals.

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The City of Memphis and Health Department are planning a variety of ways to hear community concerns about the vaccine, including a phone survey underway now.

“Many partner agencies are doing COVID-specific training so people can make a decision about getting the vaccine or not. It will take all of us to get information out,” she said.

The Health Department and the University of Memphis will jointly conduct online meetings to hear from the public.

“We don’t want to make assumptions trying to respond to the wrong questions,” Haushalter said, as the agency designs public education campaigns. 

The trick is making them informational without being heavy-handed, she said.

“As a health care provider and particularly as a nurse, I really value people having information to make an informed decision. So, our role collectively is to get information that’s accurate and timely to the public so that people can make informed decisions for themselves and their families.”

The early COVID-19 vaccines are the first RNA vaccines to come to market. They have been developed much faster than previous vaccines.

It’s because it is an RNA platform that the process was able to move faster, said Dr. Stephen Threlkeld, co-director of the infectious disease center at Baptist Memorial Hospital-Memphis.

“That platform allows us to skip over completely the processes that can take months or years,” Threlkeld said. “You have to grow up virus. You have to modify the virus to make it non-dangerous, then add genes for spike proteins to regrow the virus.”

He made an analogy to chefs in a kitchen in this new endeavor.

“All we’re doing with an RNA messenger RNA vaccine is we’re sneaking in a side door of the kitchen and handing the chef a recipe for a non-human protein that they have never seen before. The cook essentially looks at it and says, ‘I don’t know what this thing is, but if that’s what the boss wants, that’s what the boss gets,’” he said.

“It makes out these spike proteins from coronavirus, which then — when you produce these proteins through an elaborate and amazingly complex system — alert the immune system that something is going on that is not us,” he said.

Because the immune system is singularly focused on “us,” it is alerted when it sees the new proteins. It mounts its defense to deal with any infection and then remembers the intruder if it sees it again, he said, noting that the messenger RNA is a “terrific thing.”

The worry that it has never been tried before, Threlkeld says, is not true.

“This is technology that has been under development for quite a few years now, and it just happened to be the moment that we were able to utilize it.”

Hospitals

The health care community is doing everything it can to meet staffing and capacity needs in the hospitals. And it is a larger picture than just COVID-19.

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“If the hospitals are backed up, or they’re beyond capacity that means ambulances can offload,” Haushalter said. “If you reduce the number of ambulances in the field, you reduce that ‘magical hour’ of getting a person from either an accident scene or from heart attack into the emergency room.”

And it’s not just being admitted to a hospital but being in the right unit.

“If all the beds in an ICU are taken by individuals who have COVID, it’s very difficult to meet the other needs of our community,” Haushalter said. 

“As we have stressed before, we continue to have opioid overdoses in our community. They’re going up. And we all know we’ve had a record number of homicides this year,” she said. “It’s important that we think about how all of these things are interconnected, particularly as we get toward the end of the year and toward the holiday season.” 

Current surge

There are 3,595 active cases of COVID-19 in the county; another 8,000 are in quarantine. Deaths are averaging five or six a day, a pandemic high. The positivity rate is 12.9%, well above the 10% rate that has been the goal.

“We are at the fall surge,” Haushalter said. “In addition to this being the peak of the pandemic, it is actually the peak of our response locally.”

By mid-January, the outlook is expected to be worse.

Testing

Besides all the other testing, the City of Memphis is hosting surge testing on weekends leading up to Christmas so people can know their status. While it is for everyone, health officials are particularly interested in attracting people younger than 40.

They are the age group most affected by infection, and have been since the beginning of the pandemic.

Enforcement

The Health Department closed nine businesses last weekend, and will be out in larger force this weekend, said Dr. Bruce Randolph, its health officer.

“We have increased our efforts in enforcement and have asked police and sheriff to accompany (Health Department) teams as they inspect,” he said. “We will be following up on complaints we received.”

Randolph said that the agency has received 70 complaints that it will prioritize and investigate.

“It is important we have law enforcement with us,” Randolph said. “We have received threats and racial slurs. It will not be tolerated. We are not out to simply close businesses. We are out to protect the public’s health.”

Inspectors are looking for deviations from the latest Health Directive, including employees or customers not wearing masks, people not socially distanced, whether the bar is open, whether there is smoking and dancing.

“Get a copy of the Health Directive,” he said. “You can obtain a copy to make sure you are compliant. If you have questions, we will provide technical assistance. We have preached and begged. Now, when we take action, I think it is appropriate.”

The inspectors are to provide business owners with a copy of the checklist from their inspections that spells out the violations.

“I just want to let folks know that we trust the integrity of our inspectors,” he said. “There is not much of an appeal process. We have warned you and educated you.

“When found in violation, there is no need to call me, (deputy director) David Sweat or Dr. Haushalter. It is not our intent to close businesses. We want to work with you.”

Current coronavirus statistics

• 53,058 cases, up 695 in a 24-hour period. 
• Averaging about 5-6 deaths a day.
• Currently 3,595 active cases.
• Weekly positivity rate is 12.9%. 
• Reproductive rate is over 1. 
• More than 8,000 people in quarantine.