Elbert clinic says state punishment over COVID shots was unfair

The Elbert County medical practice at the center of a COVID-19 vaccine controversy says it was shocked at being suspended by the state after giving shots to educators.

“We feel we were used to send a message,’’ said Dr. Jonathan Poon, part of the seven-physician family medicine practice in rural northeast Georgia.

“We were really caught off guard’’ by the six-month suspension of the practice, he said Tuesday. “We truly didn’t feel we weren’t doing anything illegal,’’ but instead were following CDC guidelines.

And Poon said the Medical Center of Elberton received unequal treatment compared to a Rome hospital that went beyond protocols on COVID immunizations. Floyd Medical Center in Rome gave vaccinations to its employees’ families, but so far it has received no sanctions from the state.

Under Georgia’s current priority list, the only people eligible to receive COVID-19 vaccinations are front-line health care workers; residents and staff of long-term care facilities; first responders and police; and people over 65 and their caregivers.

The dispute in Elberton has received national attention as numerous states and municipalities grapple with how to distribute limited supplies of vaccine in the fairest and most effective way.

The Elberton practice had purchased a $7,000 special freezer for the Pfizer vaccine, which requires ultracold storage, and the facility acquired property next door so its doctors could set up a vaccine clinic.

Poon said the Elberton practice had more than 1,000 doses left over in mid-December after vaccinating health workers, EMS crews and residents of an assisted-living facility – people who at the time the time were the only top priority recipients. Back then, Gov. Brian Kemp had not yet approved shot priority for seniors in general, though he has done so since.

“It didn’t make any sense to continue to wait till the next step,’’ Poon said. “The goal was to vaccinate as many as possible. Time was of the essence.’’ Lives were potentially on the line, he added.

So the doctors began vaccinating seniors and essential workers. Poon said 177 educators were given the first dose of the two-step vaccine.

Poon pointed out that the CDC says, “It is not necessary to vaccinate all individuals in one phase before initiating the next phase; phases may overlap. ‘’

“Jurisdictions may consider expanding vaccine availability to priority groups in the next phase in several situations, including, for example when demand in the current phase appears to have been met (e.g., appointments for vaccination are < 80% filled for several days),’’ the guidance says.

Poon said that when shipments of vaccine arrived at the Elberton practice, “there were hardly any instructions.’’

“Nothing in the state guidance told us to stop,’’ he said.  “We thought we were doing well for vaccinating so many.’’

But the Georgia Department of Public Health, in a sharply worded media statement in late December, said in announcing the suspension that “all COVID-19 vaccine providers agree to vaccinate only individuals who fall into the designated priority groups. Again, this is to ensure that the limited supply is going to those who are most at risk. Every Georgian deserves protection from COVID-19, and health care providers around the state are working to make that a reality. Until more vaccine becomes available, it is critical that we protect the most vulnerable.’’

The CEO of Elbert Memorial Hospital, Kerry Trapnell, sent an email to the Kemp administration pleading for it to rescind the suspension.

“The decision made by DPH has to be one of the scariest health care decisions I have ever seen in my 20+ years in health care,’’ said the email, which was obtained by Georgia Health News. “This decision makes it look like the State doesn’t care about vaccinating Elbert County citizens. No solution has been offered on how to get vaccines to the community.’’

The state confiscated the vials of Pfizer vaccine at the Elbert practice, which is by far the biggest primary care practice in the northeast Georgia county. Health officials said there are other vaccine providers in the county.

The Medical Center of Elberton will be allowed to administer second doses to patients to whom it administered the first dose.

State Public Health officials Tuesday emphasized their guidelines were clear on who was in the priority vaccine grouping. Dr. Kathleen Toomey told the Elberton practice that “an official letter from me was sent to all physicians and physician assistants licensed in Georgia identifying these limited populations eligible for vaccination.”

Teachers feel left out

As the Elberton situation played out, vaccination of teachers has become an intense political issue in Georgia.

School superintendents from about a dozen districts sent a letter to Kemp urging him to prioritize teachers for COVID immunizations.

Lisa Morgan, president of the Georgia Association of Educators, told GHN recently that her organization supports vaccinating all educators as soon as possible, from administrators and teachers down to bus drivers and cafeteria workers. Many school districts don’t require students to wear masks, and many classrooms don’t feature proper social distancing, she added

More than 20 states have made some or all teachers eligible for COVID vaccinations.

Kemp has responded that the supply of doses is too limited to allow teachers to get shots currently.

Nationally, the debate over teachers escalated after CDC Director Rochelle Walensky said vaccinating teachers was not a prerequisite for safely reopening schools.

The White House downplayed those remarks, with presidential press secretary Jen Psaki saying that Walensky had been speaking “in her personal capacity” and saying there would be “official guidance” and “final guidance” on the issue, NPR reported.

Double standard?

Floyd Medical Center recently admitted to a TV station that it had opened vaccination to employees’ family members whether or not they were eligible under the state’s list of priority groups.

The hospital’s CEO, Kurt Stuenkel, told WAGA that he thought it was permissible if the hospital had excess vaccine. Stuenkel told the station that his wife was among 766 family members who were vaccinated.

Ethan James, a Georgia Hospital Association vice president, told the AJC that Dr. Gary E. Voccio, health director of the public health district that includes Floyd County, “independently from the state advised [the hospital] that such a practice was allowable and appropriate.”

Floyd issued a statement this week that said “due to our Closed Point of Distribution (POD) vaccine distribution agreement, Floyd does not believe that it has vaccinated any family members of health care workers inappropriately.’’

“However, when the state clarified and indicated that they were insisting on strict adherence to the Tier 1A+ guidelines three weeks ago, we immediately came into compliance with that clarification.’’

Public Health officials said Tuesday that they were still reviewing the Floyd Medical situation.

Colin Smith, a public health expert at Georgia State University, said there has been “no consistent leadership at the top’’ in the vaccine rollout.

He said he has heard of some facilities giving shots to people outside the priority groups once vials have been opened, so doses won’t be wasted. “I see no problem in that,’’ Smith said. Instead of sitting idle in a freezer, vaccine “should be used,’’ he said.

The state’s sanctions against the Medical Center of Elberton “were inappropriate,’’ Smith added. “A slap on the wrist would have been sufficient.’’

Poon said his practice, being a rural provider, didn’t have the same political clout as a giant urban medical center. The doctors’ appeal of the suspension has been denied by state officials.

“We want the state to listen to us,’’ Poon said. “We feel the state isn’t interested in hearing us.’’

The chairman of the board of Elbert Memorial Hospital, Daniel Graves, said the state made the right decision in Rome. “Let’s get the decision right in Elbert County,” he said.

Graves, who says he generally supports Kemp, praised the Medical Center physicians as “Norman Rockwell doctors,” referring to the 20th-century artist whose paintings celebrated the virtues of small-town American life.

“We can’t have our star players, our Tom Brady, on the sideline” during a pandemic, Graves added.

“At worst,” he said of the center’s broadened distribution of vaccine, “it was an innocent mistake.”