Financially Challenged But Fierce, Griffin Hospital Innovates Its Way Through Pandemic

When nursing homes in North Carolina realized that the coronavirus pandemic had arrived within the state, facility managers and staff began enacting measures to prevent the spread of the virus amongst their residents. Adapting existing infection control and prevention plans, many were able to ensure a robust supply of PPE and reinforce their staffing numbers, which has paid off as most of the facilities have avoided outbreaks.

E25Bio created a rapid COVID-19 test soon after the pandemic began and had an existing factory that could be repurposed to quickly manufacture tests. The prototypes, priced under $10 each, attracted major donors and would have made at-home antigen tests that identified around 80% of contagious cases available from the pandemic’s early days. Instead, an unclear FDA review process that prioritized higher detection rates over inexpensive ways people could test often, as well as resistance from medical device regulators, prevented the company from producing the tests for the public early in the pandemic.

Political cooperation and an infrastructure of existing relationships and trust built by NGOs and community leaders during Hurricane Maria and a devastating 2019 earthquake allowed for a quick public health response to COVID-19 focused on prevention and vaccination. All trusted public figures, across political backgrounds, advocated wearing masks and getting vaccinated. As a result, Puerto Rico achieved the highest COVID-19 vaccination rate among all other U.S. state or territory. It also had among the lowest Covid-19 death rates since the start of the pandemic.

Dare County, a relatively isolated and rural coastal county in North Carolina, has the highest vaccination rate in the southern U.S. The successful vaccination campaign is due in part to an existing communication infrastructure that local governments and healthcare systems use to coordinate during hurricane emergencies. Existing communication channels and relationships made it easier to publicize mass vaccination sites and get people to register online. Officials also went to great lengths to get more vaccines, petitioning the state for extra doses and even driving to other counties to pick up surpluses.

Grassroots volunteer groups are helping people across the country make COVID-19 vaccine appointments. Get Out the Shot: Los Angeles has 100 vetted volunteers who have booked 300 appointments through the group’s system and thousands more on their own. Residents leave a message or fill out a Google form with their information and a volunteer picks up their case, books an appointment, and calls them to confirm. These volunteer organizations fill important assistance gaps in local government services that are stretched thin. Some groups focus on getting appointments for people from underserved communities.

Milan’s tampone sospeso or “suspended test” initiative provides rapid COVID-19 tests to stop the spread of the virus. The initiative sets up in highly visible public areas of Milan and is based on a model of mutual support where everyone pays what they can. It is run with the help of over 50 volunteers and Medicina Solidale, a group of medical professionals who provide free medical advice to those who can’t afford to access care. The project has raised 24,000 euros from 436 donors, which has enabled them to administer rapid antigenic swabs to more than 3000 people.

In the race to vaccinate hundreds of millions of people, innovators in certain places have excelled at getting shots into arms, including in hard-to-reach or vaccine-reluctant populations. West Virginia broke from the herd using national pharmacy chains, working instead with local shops that had a head start in nursing homes. Alaska's Yukon Kuskokwim Health Corporation, serving indigenous and remote villages, got creative in how it shipped vaccine to roadless outposts. And UK's private and public teams worked closely with immigrant faith communities to overcome vaccine resistance.

Most states in the U.S. are struggling to effectively and efficiently distribute the COVID-19 vaccine, while "West Virginia became the first state to finish round one of the two-dose vaccine series in nursing homes." The key to the state's success included preemptively preparing a vaccination dissemination plan and partnering with independent and chain pharmacies.

Hundreds of thousands of indigenous people in remote regions of the Amazon have been vaccinated for COVID-19 in part thanks to programs that send indigenous vaccinators with non-mRNA vaccines to remote villages. There, they meet with community leaders and work to gain the community’s trust before vaccinating those who are willing. Non-mRNA vaccines are used due to the refrigeration needed for mRNA doses, but they also make it easier to address misconceptions associated with the new and unfamiliar mRNA technology.

One rural hospital in Indiana vaccinated hundreds of immigrants from Central America by working with trusted community leaders and setting up a Hispanic Health Task Force. Health officials held vaccine clinics alongside trusted community members at locations that were familiar to residents, like a local Catholic church that offers Spanish-language services. The hospital and task force initially established community connections to distribute information about COVID-19, so they were able to utilize the connections to increase vaccination rates once the vaccine rolled out.