The details are still coming out, but a COVID-19 vaccination is on the way; and East Shore District Health Department (ESDHD) will be among the distribution coalition that will provide the vaccine to prioritized populations, as part of the state's phased response program. ESDHD serves the towns of Branford, North Branford and East Haven.

"The vaccine is coming, but it is being prioritized," said ESDHD director Mike Pascucilla, speaking with Zip06/The Sound on Dec. 11.

In a case of perfect timing, in about two weeks, a new mobile public health unit, ESDHD's first, will also come online to assist with the department's vaccine distribution effort. As ESDHD works to finalize getting the mobile unit ready for the road, it's also working on other distribution plans to be ready when the vaccine arrives.

"Right now we're in the process of planning to implement the COVID-19 vaccine to our community, and the state has put out the different phases. It's just a matter of waiting for the vaccine to become available," said Pascucilla.

Late on Friday, Dec. 11, the U.S. Food and Drug Administration issued the first emergency use authorization　for the Pfizer-BioNTech COVID-19 vaccine. Anticipated initial distribution of 2.9 million doses is expected to go out nationwide this week.

How much of that first batch will reach this area of the state is still a question, said Pascucilla.

"Right now, there's a supply shortage, so we don't know how much we are going to get," he said. "I think initially it's going to come out in small amounts, but then the production will be ramped up pretty quick."

As soon as the vaccine is received in CT, the state's phased plan for distribution will begin with Phase 1A, inoculating healthcare personnel, long-term care facility residents and medical first responders. Phase 1B (January – May 2021) will follow, for critical workforce such as municipal employees (police, fire, public works); teachers in school systems and others in congregate settings; adults over 65 and high risk individuals under 65. Phase 2 (June – December 2021) will be to vaccinate those under 18 and  remaining people over 18.

Phase 1A will distribute the vaccine through hospitals, local health departments, and pharmacy chains CVS and Walgreens (for distribution to nursing homes), said Pascucilla.

"Local health departments are going to be part of the first rollout of Phase 1A and 1B, and then Phase 2 and even a Phase 3, still to be defined," he said.

While it will take time to get the vaccine thoroughly distributed among most of the population, Pascucilla said the world is on the brink of an historic moment.

"The vaccine is definitely going to end this pandemic," he said. "It's going to take some time; and we have to understand that, realistically, in order to get herd immunity, we're going to need to vaccinate the majority of the population. That's going to more than likely go into spring and early summer. So we still have some time ahead of us, but there's an end in sight; and we're all looking forward to it.'

Staying Vigilant

On that note, Pascucilla said community members need to continue to be vigilant about practicing safety protocols including wearing facial masks, safe social distancing, and avoiding large gatherings, especially holiday gatherings this time of year. And if you're sick, consult your physician and follow any recommended quarantine practices.

"What we're seeing now, not just locally but across the state and the country, is a significant increase in cases, hospitalizations and even fatalities that appear to be from the gatherings that happened over the Thanksgiving break," said Pascucilla. "We really need to remind people we all have to have maybe a different kind of holiday with all of the events coming up. We need everyone to do their part. If not, we're going to see more cases over the next couple of months."

ESDHD provides a COVID-19 dashboard at its website (https://www.esdhd.org/) with the latest New Haven County numbers. Currently, the overall risk is severe, with an average 83.4 cases confirmed for every 100,000 residents and a high infection rate of 1.13 (on average, each person with COVID is infecting 1.13 other people). ICU "headroom" is at an urgent 100 percent (89 ICU beds occupied; 87　ICU beds remaining, with an estimated 114　beds needed by COVID cases, or greater than 100% of available beds).

A Safe Vaccine

Over the coming weeks and months, everyone who has the opportunity to be vaccinated should receive a COVID-19 vaccine and be confident of its safety, said Pascucilla. In addition the approved Pfizer vaccine, other COVID-19 vaccines are in the pipeline (the Moderna vaccine is expected to receive FDA authorization shortly).

"We have to remember vaccines are one of the most essential tools we have to prevent infectious disease," said Pascucilla. "Like other vaccines, this vaccine is safe. It's gone through trials; so you have not just government oversight, but you also have the oversight that's happened within the companies, which have also been working together to get the vaccine out. With the coronavirus, there's been a lot of foundational work that's been done for many years [to where its] developed this particular vaccination for COVID-19. And it's not just the United States -- every country has its own [vaccine] review process, and every country is approving it."

Going Mobile

Within two weeks, ESDHD expects to have the district's first public health mobile clinic unit up and running. The unit, a retrofitted ambulance (minus siren and emergency lights), has been provided by Branford Fire Department (BFD).

One of the unit's first jobs will be to assist ESDHD in mobilizing the COVID-19 vaccination to prioritized populations. ESDHD will also continue to provide outpatient services at its Branford-based facility as well as through temporary satellite clinics, but the upcoming addition of the mobile unit will go even further to "...help us to reduce the barriers" to public health access, said Pascucilla.

While the timing couldn't be better, bringing in a mobile unit has been on the ESDHD wish list for many years, said Pascucilla, who has been leading the department since 2010.

"My staff and I  and our board of directors have discussed having a multi-purpose public health mobile clinic for years; and the opportunity arose because the Branford Fire Department donated an ambulance to us," said Pascucilla.

In October, BFD's Board of Fire Commissioners approved transferring the former Medic 5 ambulance to ESDHD, due in part to the BFD's new ambulance, Medic 2, going into service a couple of months earlier.

Pascucilla also thanked BFD Fire Chief Tom Mahoney for helping to facilitate the transfer, and for repair assistance provided to the unit by BFD. The unit is currently be refitted for use by ESDHD and completing all vehicle permit requirements.

"We're one of the only health districts in the state of Connecticut to have a mobile public health clinic, so we've very excited about that," noted Pascucilla.

Pascucilla is grateful to the board of the Branford Community Foundation (BCF) and the assistance of BCF executive director, Liza Petra, for providing $15,000 in funding from its COVID-19 Response Fund to help outfit and retrofit the mobile unit. He also thanked Branford Counseling & Community Center director Peter Cimino for collaborating with ESDHD to win the grant.

"To stock it and convert it from an ambulance to a public health mobile clinic, there's some costs involved," said Pascucilla. "We worked with Peter Cimino of the Branford Counseling Center, and together we submitted a grant proposal for $15,000 to the Branford Community Foundation, which we were awarded."

The BCF award was one of the last grants to be issued from its community-supported COVID-19 Response Fund, which, as previously reported, raised and distributed over $202,200 between March and November 2020. Petra said providing one of the fund's last grants to help outfit the ESDHD's first public mobile health unit was very fitting.

"As an urgent response to get those resources where they were most needed; the fund started off providing personal protective equipment; and it's ending with retrofitting a mobile vaccine and health unit, [and] once we have the COVID vaccination, that will be another way to distribute it and provide health information," said Petra.

"The tall order here is the COVID-19 vaccine so that's one of the main uses, initially," said Pascucilla of the mobile unit. "But we also serve the vulnerable populations in [the district] so we plan to do different types of health screenings and flu vaccines. And what this opportunity has done for us, is it's going to help us to extend our public health services to the most vulnerable populations, and go to them. We're going to do our best to reduce the access barriers to public health services."