Tennessee hospitals are largely suspending their efforts to vaccinate patients in their systems against COVID-19. But they say it’s not because of a new state rule that they have to offer doses to the wider community.

Instead, they’re citing a new policy from the state that they say makes it impossible to keep vaccination clinics open. Regardless, the decision represents a dramatic shift in how Tennesseans will be vaccinated against the coronavirus.

First, the Tennessee Department of Health told hospitals in a letter dated Jan. 4 to get the vaccine out to their existing patients 75 and over. But then last week, the state changed course and said they have to offer the vaccine to the wider public, not just those that they have a previous relationship with.

At the same time, hospitals were warned that they’ll be getting far fewer doses because supplies from the federal government haven’t ramped up as expected.

“The majority of hospitals view it as part of their responsibility to the community to be a part of the vaccination effort and want to be,” says Dr. Wendy Long, president of the Tennessee Hospital Association. “But they also are just looking for some clear direction, and we thought we had it.”

Long is referring to hospitals’ prior role at the forefront of vaccine distribution. She says they would be happy to continue running  vaccination sites — if they could get a steady supply of vaccine.

“The reason they’ve backed off is because of a lack of vaccine and not that they haven’t been willing to play by a new set of rules,” she says, specifically citing an announcement by Ballad Health to close down community vaccination sites in northeast Tennessee.

More: Tennessee Orders Hospitals To Stop Restricting COVID Vaccine To Their Own Patients

“Recently, the Tennessee Department of Health has made a policy decision to shift distribution away from hospitals, and thus, the supply of vaccines being provided to Ballad Health from the Tennessee Department of Health has been reduced substantially,” the health system said in a statement.

The state health department confirms it is prioritizing health departments who are providing vaccination “without regard to a patient’s insurance status or established relationship with a health system.”

Dr. Lisa Piercey, the state’s health commissioner, tells WPLN News it may be just as well, for now, that hospitals pitch in with the local health department sites, because vaccine supplies have not ramped up as expected. She also says that some Tennesseans may not feel comfortable stepping foot inside a hospital.

“There could be some substantial barriers for community members going to a hospital, if they think they’re going to get charged, or if they have an outstanding balance there,” she says.

Piercey says hospitals may take on a larger role once local health departments are receiving more vaccine than they can handle. But the new guidelines will remain in effect.

“Going forward,” she says, “if you want to continue being a site that gets vaccine, you’re going to have to step up for the community.”

Tennessee hospitals have been vaccinating seniors, but only those who are existing patients. Now state health officials say hospitals won’t get any more doses unless they’re made available to the wider community.

Tens of thousands of Tennessee seniors 75 and over are trying to find the quickest way to get the life-saving COVID-19 vaccine. Peggy Burgess of Nashville is among them. The 82-year-old widow heard a few neighbors who are patients of Ascension Saint Thomas were able to get a shot through their doctor’s office. But when she called her physician in a Saint Thomas complex, she found out she didn’t qualify.

“Even though their offices are there at the medical office building, that doesn’t mean they are Saint Thomas doctors,” she says she was told.

Instead, Burgess has been left to wait for a call from the Metro Public Health Department, which is vaccinating 1,200 seniors each weekend.

But the dead end she hit with her doctor has become a point of contention between public health officials and hospital systems.

Last month, hospitals received considerably more vaccine than they needed for their staff members. So with the state’s blessing, they started giving it to people over 75, but only to patients already in their systems.

That means a senior in Middle Tennessee without a doctor at Saint Thomas, TriStar or Vanderbilt Health didn’t have as much access, putting many like Burgess at a disadvantage.

“You’re not going to see me walking down the street, saying ‘who got my vaccine?’ I am not angry. I just want it to be fair to everyone, including me,” she says.

More: Nashville Launches ‘Standby List’ For Unused COVID Vaccine

The state finds this practice unfair too, especially since “equity” is one of the stated priorities of Dr. Lisa Piercey, the state’s health commissioner.

She tells WPLN News she’s informed hospitals that now they will have to make the vaccine available to everyone, whether they have insurance, and preferably at a convenient site that’s away from the hospital with easy access to public transportation.

“If they contact their own patients who are 75 plus, great, fine, let them do that,” she says. “But going forward, we want hospitals to be an open access point for everybody if they’re going to vaccinate.”

Some health systems have already bowed out, though Ballad Health, in Northeast Tennessee, says it’s shutting down its community vaccination sites solely because the state is cutting back on how many doses it’s providing hospitals.

“Ballad Health remains poised to continue working with local health departments and health districts to assist as requested,” the health system says in a statement.

Saint Thomas, TriStar and Vanderbilt all confirmed to WPLN News they are currently limiting vaccinations to seniors already in their systems. They have not said how they’ll proceed under the state’s new rules.

Other states have taken an even harder line. Louisiana’s health chief threatened hospitals with financial penalties if they were caught giving preference to their own patients.

Update: This story has been updated with more information on hospitals’ decision to wind down vaccine distribution.

Tennessee is tweaking its vaccine distribution strategy again, releasing an updated plan Friday that moves the families of medically fragile children into the state’s 1c phase, along with patients who have poor health themselves.

Dr. Lisa Piercey, the state’s health commissioner, says these additions include residents of households with children on ventilators, or those who require the use of wheel chairs or other technology.

“When you talk about them, they can’t receive the vaccine,” she says. “But undoubtedly, if they were to get infected, they would have very severe and life-threatening consequences.”

No counties in Tennessee has yet moved to 1c recipients, though some smaller counties are already on 1b, which includes teachers and childcare workers.

The state has also elevated guards at prisons and jails to be vaccinated immediately. Piercey says they’re more important to vaccinate than the inmates because they go in and out of facilities and would be more likely to catch COVID in the community and bring it back in.

As risk-based vaccinations have proceeded, county health departments have been vaccinating seniors over 75. Next, instead of moving to 65 and up, the state announced Friday it will move to 70 and older, since COVID-19 has been so much more deadly at the higher end of that age bracket. Now the 65-and-older group is slated to start in March, though it depends on the county.

The highly contagious coronavirus strain is here

A lab at the Centers for Disease Control and Prevention has confirmed that the new, more contagious strain of COVID-19 first identified in Britain is present in Tennessee — and has been for weeks.

State health officials say they’re not overly concerned, because it doesn’t seem the strain is more deadly. But there haven’t been studies determining whether the existing vaccines will still be effective against it.

The mutated virus does pass more easily, making it more important than ever for people to wear masks and keep their distance, Piercey says. She expects it will be the dominant strain of COVID in Tennessee by March.

The country’s largest hospital chain is getting into the manufacturing business. Nashville-based HCA says it’s entered into a new joint venture with a health care products manufacturer to make masks, gloves and gowns in North Carolina.

HCA is responding to the global shortage of personal protective equipment that rose to crisis levels early in the pandemic and have persisted. Most of the country’s PPE came from China, which had its own COVID-related needs.

“The recent surge in demand for PPE due to the pandemic has underscored how dependent we have been on supplies from overseas and the importance of working to diversify our supply chain,” chief medical officer Dr. Jonathan Perlin says in a statement.

Compared to the prior year, HCA says it spent nearly $200 million more in 2020 to acquire protective gear for its 187 hospitals.

The company is working with A Plus International to make the products in Asheville, where HCA recently purchased the Mission Health system. In fact, the money for the project comes from a fund set up as part of acquiring the nonprofit, which is meant to invest in the local community. And the manufacturing site will be located on one of Mission Health’s campuses.

The protective gear will be available to other hospital systems as well, distributed by HCA subsidiary HealthTrust, which supplies roughly a quarter of all the hospitals in the U.S.

After just eight games, the Vanderbilt women’s basketball season is over.

A statement from the university says the remainder of the season will be cancelled due to a combination of COVID-19 related circumstances, opt-outs and injuries.

Vanderbilt says students led the decision making.

“Their health, safety and well-being have always been, and will continue to be, a top priority,” athletic director Candice Lee says in a statement. “We know that this was a tough call for them, in a year full of tough calls, and a disappointing outcome for the student-athletes and the program.”

The Commodores already had to reschedule games because of quarantine protocols. They have gone 4-4 but had no wins against Southeastern Conference opponents. South Carolina beat Vanderbilt 106-43 last week.

Nashville students won’t be returning to school buildings after Martin Luther King Day next week.

The district began the spring semester with students in all grades attending classes online. It says it still doesn’t know when it’ll begin phasing back in-person instructions, but that it won’t happen until the city has a decrease in positive COVID-19 cases.

Students who need tech support can continue visiting select high schools for virtual learning assistance. Families with students in grades K-5 are encouraged to contact the Nashville YMCA for child care options.

Starting next week, Nashville will change the hours of the COVID-19 community testing centers to 10:00 a.m. to 3:00 p.m. during the winter months.

Although the Office of Emergency Management installed heaters at the testing sites, the drive-thru facilities are completely outdoors and staff can’t wear warm layers while wearing protective equipment. On days when the wind chill is below 35 degrees only Nissan Stadium will open, while testing at Meharry Medical College and the former Kmart on Murfreesboro Pike will close.

“I would welcome anyone to take a minute to realize for 40 weeks Meharry has been out there in the heat [and] also in the cold weather,” Nashville Fire Department Chief William Swann says.

Metro will do hourly weather analysis to ensure staffers are safe. If the temperature drops unexpectedly, testing centers could close.

On days testing is up and running as planned, residents can continue to get tested for free at all three testing sites.

All of the city’s COVID-19 testing centers will be closed Monday for Martin Luther King Jr Day.

 

Nashville has launched a “standby list” to make sure no COVID-19 vaccine goes to waste. It’s open to anyone who can make it to the Five Points area of East Nashville in 30 minutes.

The state’s health commissioner has called these rapid response lists a “best practice” after the city of Jackson, Tenn., started a similar program to deal with leftover vaccine at the end of the day. As they widen the vaccine distribution to seniors, health departments around the country are struggling to make sure they thaw the right amount to use every dose, since they can’t be saved for the next day.

At most, Nashville says it will have four doses a day, given the number of doses per vial. The Metro Public Health Department is requiring people to sign up every day to make sure people are available. They’re asked to email [email protected] and include a phone number, with instructions to answer any call from an unknown number around 2:30.

It’s at that time public health nurses will determine whether there will be extra doses and randomly draw names to summon for their shot. Recipients do not have to qualify by age or occupation, and they will be notified how to get their second dose a few weeks later.

Tuesday will be the first day of operation for the standby list, but it won’t be live every day since the vaccination schedule is constantly in flux.

Statewide, most counties are vaccinating people 75 and older, but some have even moved on to vaccinating the 1b group which includes teachers. Tennessee has created a centralized website for checking vaccine availability and distribution phase, but it’s not as up-to-date as information coming directly from local health departments primarily on social media.

Tennessee Congressman Chuck Fleischmann has tested positive for COVID-19.

The Chattanooga-area Republican received his result Sunday, noting he had contact with his infected roommate in Washington, D.C., a Florida representative.

He’d already been isolating since learning that his roommate tested positive on Wednesday. That’s the same day rioters stormed the capitol, causing a lockdown that doctors say may have exposed many lawmakers to the virus.

Today, I learned that I have tested positive for COVID-19. I have been in quarantine since Wednesday night. I will continue to work for my constituents while self-isolating. I currently feel okay and remain in contact with the Attending Physician.https://t.co/BsGj9RS272 pic.twitter.com/zconzlLkfi

— Chuck Fleischmann (@RepChuck) January 10, 2021

Fleischmann says he is feeling OK, planning to work remotely, and urging mask wearing.

“I again, want to urge all Americans to continue to wear masks, practice proper hygiene, and follow CDC guidance as we work to combat COVID-19,” he wrote in a statement.

As Tennessee widens the eligibility for who can get a COVID-19 vaccine, many health officials statewide are mostly taking people’s word that they qualify.

Almost every county opened vaccination to people 75 and up this week. So Frank Bargatze of Murfreesboro got an appointment for his father and went ahead and put his own name in, though he’s 63.

“He’s 88,” Bargatze says, pointing to his father in the passenger seat after they received their vaccination. “I jumped on his bandwagon. I’m going to blame it on him.”

Bargatze says he does work a few days a week with people in recovery from addiction, so in a way, he might qualify as a health care worker.

Overwhelmed health departments aren’t doing much vetting, says Dr. Lorraine MacDonald, Rutherford County’s medical examiner. She’s been working at the county’s vaccination site this week.

“That’s a difficult one,” MacDonald says of people near the age cutoff joining family members in getting the vaccine. “It’s pretty much the honor system.”

More: Nashville Seniors To Start Getting COVID Vaccines This Weekend

People getting vaccinated in Williamson and Rutherford counties this week say they did not have to show ID or proof of qualifying employment. Health departments are generally erring on the side of giving the shot. The state has told them people do not have to be a resident or be in the country legally to get the vaccine.

MacDonald says if people seeking the vaccine make it through the signup process online and show up for their appointment, health officials are not going to ask any more questions — as long as they’re on the list from the online signup.

Still, she acknowledges that some people under 75 need the vaccine more than those over that line.

Gayle Boyd of Murfreesboro is 74 and in remission from lung cancer. She says she was so eager to get the vaccine, she joined her slightly older husband.

“Nobody’s really challenged me on it,” she says, noting that she made sure to tell them her risk factors. “Everybody’s been exceptionally nice.”

Technically, in the state’s current vaccine plan, having a risk factor like lung cancer doesn’t lift anyone into the current phase.

Public health officials admit the cutoff is imperfect. But ultimately, the point is getting vaccine to the people who need it most — first.

“We try to be responsible,” says Gina Kay Reid of Eagleville, who says she chose not to slip in as she brought her husband and mother to get vaccinated on Wednesday. “If you take one and don’t necessarily need it, you’re knocking out somebody else that is in that higher risk group.”