Latest / The SHEA Podcast / COVID-19 Vaccination Drive-Thru Clinics, 2/18/21

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COVID-19 Vaccination Drive-Thru Clinics, 2/18/21 · The SHEA Podcast

• 0:08
  SPEAKER_00: Welcome to the Rapid Response Podcast brought to you by the Society for Healthcare Epidemiology of America, today, promoting the prevention of healthcare associated infections and antibiotic resistance and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
• 0:24
  SPEAKER_00: I'm Dr.
• 0:25
  SPEAKER_00: Cindy Prince, Clinical Associate Professor of Epidemiology at the University of Florida, and I'll serve as your moderator.
• 0:31
  SPEAKER_00: The discussion on the podcast does not reflect this perspective, but the implementation of multiple perspectives and experiments as we go through the technology time together.
• 0:41
  SPEAKER_00: Today is excited to launch this episode of the podcast and COVID-19 updates of what we know now.
• 0:47
  SPEAKER_00: Today's discussion will focus on COVID-19 vaccination drivers clinics.
• 0:52
  SPEAKER_00: Our speaker today is Dr.
• 0:53
  SPEAKER_00: Richard Zain, Chief of Emergency Medicine and Chief Innovation Officer at UC Health.
• 0:59
  SPEAKER_00: Thank you for joining us today.
• 1:00
  SPEAKER_00: Before we start our discussion, I'd like to turn it over to Dr.
• 1:03
  SPEAKER_00: David Bannick to get us started with a brief news and guidance update for the week.
• 1:08
  SPEAKER_02: Thank you, Dr.
• 1:09
  SPEAKER_02: Prinz.
• 1:10
  SPEAKER_02: So for this week's news update, we'll primarily focus in on several updates from CDC pertaining to different aspects of the COVID-19 response.
• 1:18
  SPEAKER_02: So, first off, there has been a lot of focus on what's known about in terms of school-related transmission.
• 1:24
  SPEAKER_02: And on February 12th, the CDC released an updated brief on this particular topic.
• 1:28
  SPEAKER_02: Essentially, what was described in the CDC brief was that in-person learning has not been associated with substantial community transmission, and that decisions regarding in-person learning should take into account community transmission rates.
• 1:40
  SPEAKER_02: They also describe multiple studies that have shown that transmission within school settings is typically lower than or at least similar to the levels of community transmission when the appropriate mitigation strategies are in place in schools.
• 1:52
  SPEAKER_02: The CDC in this brief also noted that transmission can and actually does occur in schools where these mitigation measures are not implemented or followed, thus highlighting the importance of adhering to the recommended measures.
• 2:03
  SPEAKER_02: And concurrently, the CDC released formal guidance on February 11th regarding schools, which highlighted five key mitigation strategies.
• 2:11
  SPEAKER_02: These include the consistent and correct use of masks, physical distancing, hand washing and respiratory etiquette, cleaning and ventilation, and contact tracing in combination with isolation and quarantine.
• 2:22
  SPEAKER_02: So some news updates on the vaccine front.
• 2:25
  SPEAKER_02: On February 10th, the CDC released an update to its clinical considerations regarding the mRNA vaccines.
• 2:32
  SPEAKER_02: There were several components to this update.
• 2:34
  SPEAKER_02: They included some guidance on how to handle administration errors, including issues relating to timing of the vaccine and other situations that might occur.
• 2:44
  SPEAKER_02: And this was all addressed to a very helpful table included in the guidance updates.
• 2:49
  SPEAKER_02: The CDC also provided some clarification on contraindications and precautions for the mRNA vaccines, including allergies to PEG, polysorbate, and other ingredients in the mRNA vaccines.
• 2:59
  SPEAKER_02: Additionally, the CDC addressed a finding of delayed local injection site reactions.
• 3:04
  SPEAKER_02: This is something that's been reported through VARES to CDC.
• 3:07
  SPEAKER_02: And specifically, what the CDC states is that these localized injection site reactions that may occur several days after the first dose are not a contraindication to receiving the second dose of the vaccine.
• 3:18
  SPEAKER_02: And then the last major update pertains to quarantine recommendations for individuals who have received both doses of the vaccine and then subsequently have a high-risk exposure.
• 3:28
  SPEAKER_02: And this update described that quarantine is not required if the exposed individual is at least two weeks from the second dose of the vaccine and within three months of that dose and remains asymptomatic.
• 3:38
  SPEAKER_02: The CDC guidance also emphasizes that this does not apply to patients in healthcare facilities and residents and long-term care facilities, in which more stringent recommendations are made for quarantine after high-risk exposure.
• 3:49
  SPEAKER_02: The CDC also comments that decisions about return to work in healthcare settings for those employed in healthcare settings can take into account vaccine receipt in order to meet critical staffing needs.
• 4:00
  SPEAKER_02: And lastly, regarding masking, there has been some updates on that front as well.
• 4:05
  SPEAKER_02: So a study that was conducted by Brooks et al.
• 4:08
  SPEAKER_02: and this group at CDC was published on February 10th in the MMWR, which described laboratory experiment, which evaluated two different adaptations to improve the fit of medical procedure masks with the hopes of reducing exposure and transmission to the wearer.
• 4:22
  SPEAKER_02: This included fitting a cloth mask over a procedure mask, as well as a modification, knotting the earloops, and tucking in the sides of the procedure mask.
• 4:29
  SPEAKER_02: And what this study demonstrated was that both strategies improved source control and also decreased the exposure to small respiratory droplets for the wearer when using these different modifications.
• 4:40
  SPEAKER_02: In conjunction, the CDC also provided an update to its infection control guidance for healthcare facilities, further elaborating upon the recommendation to implement universal use of personal protective equipment in regard to expanding the options for source control and patient care activities.
• 4:57
  SPEAKER_02: Essentially, the CDC update included options for source control, consisting of an N95 respirator or equivalent, as well as other options such as a well-fitting face mask, which included selecting a face mask with a nose wire to help the face mask conform to the face, selecting a face mask with ties rather than earloops, as well as the modification of tying the earloops and tucking in the sides as was described in the experiment that was reported that I mentioned earlier.
• 5:25
  SPEAKER_02: And then lastly, the CDC has been collecting ongoing data on the COVID-19 variants that have been identified.
• 5:32
  SPEAKER_02: At this point, the three major variants of focus are the B117 variant from the UK origin, the B1351 variant, which seems to originate from South Africa, and the P1 variant, which originated from Brazil.
• 5:45
  SPEAKER_02: And there's updated tables that reflect how many reported cases have been identified in the US for each of these different variants, as well as the number of states that have been reporting.
• 5:54
  SPEAKER_02: And for some additional information on the variants, there was a great discussion by Dr.
• 5:58
  SPEAKER_02: Barrick from the University of North Carolina on last week's Shea Town Hall.
• 6:01
  SPEAKER_02: And I'd encourage everyone to listen into that discussion and provide a lot of great insight into these variants and what the future may hold.
• 6:08
  SPEAKER_02: That's it for this week's news and guidance update.
• 6:11
  SPEAKER_00: Thank you, Dr.
• 6:12
  SPEAKER_00: Bannock.
• 6:12
  SPEAKER_00: I now want to move into the discussion with our speaker.
• 6:15
  SPEAKER_00: Dr.
• 6:15
  SPEAKER_00: Zayn, thank you so much for joining us today.
• 6:18
  SPEAKER_01: Thank you for having me.
• 6:18
  SPEAKER_01: I'm thrilled to be here.
• 6:20
  SPEAKER_00: During the last week of January, UC Health, under your direction and your leadership, provided one of the country's largest massive COVID-19 vaccination events using a drive-thru clinic, which is incredibly impressive.
• 6:32
  SPEAKER_00: So can you give our listeners some details of that event, please?
• 6:35
  SPEAKER_01: Yes.
• 6:36
  SPEAKER_01: So UC Health is a large healthcare system in Colorado, and we've been partnering with the state of Colorado to distribute COVID-19 vaccine.
• 6:43
  SPEAKER_01: We essentially have three different modalities to administer vaccines.
• 6:48
  SPEAKER_01: We have fixed clinics that are located in our bricks and mortar hospitals or clinics where we can do anywhere between three and 5,000 vaccines per day across 11 different sites.
• 7:00
  SPEAKER_01: We set up pop-up clinics, clinics in areas that have patients that have trouble getting to vaccination sites, typically underserved areas, areas with high vaccine reluctance or trouble getting vaccine, and we partner with local community leaders, and then large mass vaccination sites.
• 7:21
  SPEAKER_01: And this was really the thought of providing a playbook to allow whoever wanted to do a large drive-thru vaccination, essentially the playbook on how to do it.
• 7:32
  SPEAKER_01: And that's really how it started.
• 7:34
  SPEAKER_01: It was the idea of the owner of the Colorado Rockies who said we must do something, and then offered the resources of the Colorado Rockies.
• 7:44
  SPEAKER_01: And we partnered with the Colorado Rockies to do this.
• 7:48
  SPEAKER_00: It's amazing.
• 7:49
  SPEAKER_00: I think when I see those numbers, I feel really envious being in a smaller town where we do these events, but certainly not on that scale.
• 7:56
  SPEAKER_00: Can you describe the process that recipients went through?
• 7:59
  SPEAKER_00: So what was each step and how was each step monitored so that you were maintaining efficiency?
• 8:04
  SPEAKER_00: Because I know that was part of your model to be extremely efficient.
• 8:08
  SPEAKER_01: We were extremely efficient.
• 8:09
  SPEAKER_01: We did that prospectively.
• 8:11
  SPEAKER_01: We set certain guiding principles for this event.
• 8:13
  SPEAKER_01: And these guiding principles really apply to every vaccination event that we do.
• 8:17
  SPEAKER_01: But first and foremost, patients had to be invited and scheduled.
• 8:21
  SPEAKER_01: It was not first come as first served.
• 8:23
  SPEAKER_01: They really had to be scheduled off of registry.
• 8:26
  SPEAKER_01: And we worked with the city and county of Denver and the state of Colorado to identify the patients who were going to be given electronic invitations to schedule, but 100% of the people were scheduled.
• 8:38
  SPEAKER_01: The other was that we wanted to make certain that we conveyed to every single person that if you were scheduled, you were going to get a vaccine.
• 8:48
  SPEAKER_01: So there wasn't an issue of I need to get there early or if I miss out, 100% of the people who were scheduled who made it to the vaccination site were going to get a vaccine.
• 8:56
  SPEAKER_01: And that also applies to vaccine number two because we used the Pfizer vaccine, which as you know is a single dose and then a second dose as well.
• 9:05
  SPEAKER_01: We wanted to make sure that the community was not impacted.
• 9:08
  SPEAKER_01: So we said there would be no traffic jams, there would be no waiting.
• 9:12
  SPEAKER_01: And that's essentially the guiding principles.
• 9:14
  SPEAKER_01: We brought a team together.
• 9:16
  SPEAKER_01: The team was representatives from the University of Colorado Health, the Colorado Rockies, the city and county of Denver, the police, the state of Colorado, and we looked at the site to ideally structure how we would be able to vaccinate 10,000 people in the course of a weekend.
• 9:33
  SPEAKER_01: We did tabletop exercises, we did computer modeling, and then we did a small pilot of a thousand patients in two hours to learn whether one, it was doable, but how we could optimize it.
• 9:46
  SPEAKER_01: And we did continuous time motion studies on every 10th patient that went through.
• 9:52
  SPEAKER_01: So you would enter specifically at 33rd in Blake.
• 9:55
  SPEAKER_01: We had an eight-lane, mile and a half long parking lot, and you would go through different stations of registration, vaccination, and then observation.
• 10:05
  SPEAKER_01: Every 10th card had a placard in the window, and we had computer timestamps and we measured flow, timing, and we really measured everything.
• 10:15
  SPEAKER_01: So we now have this computerized playbook for how to do this down to the second.
• 10:20
  SPEAKER_01: And what we were able to do was understand what made it faster, what made it slower.
• 10:26
  SPEAKER_01: We use a lot of lean modeling, a lot of process implementation and process improvement, and a lot of engineering.
• 10:33
  SPEAKER_01: And at the end of the day, we were able to vaccinate 10,000 people in less than 12 hours, six hours each day, 864 people per hour.
• 10:43
  SPEAKER_01: Each person that was vaccinated spent 22.4 minutes, including the 15 minutes of observation.
• 10:51
  SPEAKER_00: That's just so impressive.
• 10:53
  SPEAKER_00: So tell me, I mean, obviously, once you have the system down pat, you know, you have a lot of players that are part of the system, though, and that need to know their jobs.
• 11:02
  SPEAKER_00: So, how many volunteers or other people did you have?
• 11:05
  SPEAKER_00: Were they strictly healthcare professionals?
• 11:07
  SPEAKER_00: You know, what were the roles they played?
• 11:09
  SPEAKER_00: And are these people who are coming back regularly to do this?
• 11:12
  SPEAKER_00: Or do you have people who sort of, you know, drop in one time to help out and then you're retraining people constantly?
• 11:19
  SPEAKER_01: That's a great question.
• 11:20
  SPEAKER_01: And one of the goals in developing this playbook was really developing a model of efficiency.
• 11:25
  SPEAKER_01: So you could spend unlimited resources and have unlimited numbers of people.
• 11:30
  SPEAKER_01: And eventually, until you achieve sort of economies, you are going to go faster.
• 11:35
  SPEAKER_01: But we wanted it to be the most efficient.
• 11:38
  SPEAKER_01: So we looked at the largest mass vaccination in the country, how many people they used, and we decided we were going to use half those number of people, and we were going to do it in half that amount of time.
• 11:50
  SPEAKER_01: So for those two days, we used approximately 170 people per day.
• 11:55
  SPEAKER_01: And they were volunteers from the Colorado Rockies on traffic mitigation within the site, so flaggers.
• 12:02
  SPEAKER_01: Denver police provided all of the signage outside of the event, including directing people to the event, but not inside the event.
• 12:10
  SPEAKER_01: We used UC Health employees and UC Health employees who were volunteering to do the vaccination.
• 12:16
  SPEAKER_01: And then we had a very large IT infrastructure in partnership with Verizon Wireless, which was just instrumental.
• 12:24
  SPEAKER_01: So we were able to calculate how many people, how much it costs per vaccination, how many vaccines we could do, and then it's extrapolatable, which means that we were limited now only by the amount of vaccine that we can get and the hours of daylight that we have.
• 12:41
  SPEAKER_01: And we believe that we did it on a Saturday and a Sunday and did 5,000 on each day, but with two hours of daylight more, we're convinced we could easily do 10,000 in a day and keep that efficiency to less than 22 minutes per car, including the waiting time.
• 12:56
  SPEAKER_00: So knowing that you're having, you know, 10,000 residents, for example, come through on a weekend, how far in advance did you have to plan with the registration system?
• 13:05
  SPEAKER_00: And you know, when did you know your vaccine availability?
• 13:08
  SPEAKER_00: How do you get around some of this uncertainty of how much vaccine you're going to get and when it may come?
• 13:14
  SPEAKER_01: We partnered with the state of Colorado so that they would guarantee we would have 10,000 doses for the first two days and then 10,000 doses for the second booster dose.
• 13:24
  SPEAKER_01: We would not have done this without that absolute guarantee.
• 13:27
  SPEAKER_01: And it was really a partnership with the state of Colorado because they too wanted a playbook to see how it could be done and if it can be replicated in anticipation of a time when there's much more vaccine.
• 13:39
  SPEAKER_01: So we had a series of go-no-go decisions.
• 13:43
  SPEAKER_01: And one of the go-no-go decisions is do we have a guarantee from the state of Colorado for 10,000 doses of vaccine?
• 13:49
  SPEAKER_01: And when that answer was yes, then we decided to go.
• 13:52
  SPEAKER_01: And when we administer the first dose, we had a guarantee for the second dose as well.
• 13:57
  SPEAKER_01: From the perspective of how we invited people, we have an electronic registry, which I think many places do, and we're able to geolocate.
• 14:05
  SPEAKER_01: And as you know, vaccine equity is incredibly important as we distribute vaccine and as we vaccinate the populace.
• 14:12
  SPEAKER_01: So we were able to geolocate seven specific zip codes around Denver and Aurora and the area where we were trying to vaccinate.
• 14:20
  SPEAKER_01: And we sent out 35,000 invitations over the course of 36 hours to fill 10,000 appointments.
• 14:27
  SPEAKER_01: So we started inviting people on the Tuesday before the Saturday and were filled by Wednesday evening.
• 14:34
  SPEAKER_00: That's amazing.
• 14:35
  SPEAKER_00: Wow.
• 14:35
  SPEAKER_00: So you had mentioned that you had a practice run of administering the thousand vaccines the weekend before.
• 14:42
  SPEAKER_00: So did it lead to any changes for the larger event the following weekend?
• 14:46
  SPEAKER_01: It really did.
• 14:47
  SPEAKER_01: We learned a number of things, mostly around the specifics of how you can quickly vaccinate cars.
• 14:53
  SPEAKER_01: So, for instance, how you register someone, how you confirm registration, what happens if someone shows up who does not have an appointment?
• 15:01
  SPEAKER_01: How do you use, you know, pretty straightforward lean or Toyota processing principles to make sure that things flow forward?
• 15:08
  SPEAKER_01: So we learned that if there's any issue, we call it a SNAFU.
• 15:12
  SPEAKER_01: They either don't have an appointment, the appointment was wrong, there's more than one or two people in a car getting vaccinated, they go in a separate line so that we can keep 95% of the people moving very quickly and flowing forward.
• 15:23
  SPEAKER_01: And then we can put extra resources on the snafu cars, which are cars that just have an issue that need to be dealt with.
• 15:29
  SPEAKER_01: So the cars behind that car do not wait.
• 15:31
  SPEAKER_01: So it's always forward flow, never back, and never stopping.
• 15:36
  SPEAKER_01: The other reaffirmation was that people have to have an appointment and we cannot take walk-ins.
• 15:43
  SPEAKER_01: Walk-ins will really make it impossible to do a large vaccination event.
• 15:48
  SPEAKER_01: It's just impossible.
• 15:49
  SPEAKER_01: We also learned that when someone comes without an appointment, we simply direct them to a different line of traffic and they exit entirely.
• 15:57
  SPEAKER_01: So those were the some of the lessons that we learned.
• 16:00
  SPEAKER_01: We also did three different models of vaccinating all in that day.
• 16:04
  SPEAKER_01: We had something called a pit crew model where everything is done in one spot.
• 16:08
  SPEAKER_01: We have one person registering, one person drawing up vaccine, one person vaccinating.
• 16:13
  SPEAKER_01: And then another area, we had that done in series.
• 16:16
  SPEAKER_01: And it turns out that a combination of those two is the right answer to be most efficient.
• 16:21
  SPEAKER_01: So this Saturday, 80% of the people that will be vaccinated will be done on the pit crew model, and the rest will be done on a series model, and we'll be able to differentially flow to the different streams depending on rate of arrival.
• 16:37
  SPEAKER_00: That is fascinating.
• 16:39
  SPEAKER_00: So you mentioned, you know, we're talking about drive-thru, and obviously this is a mass drive-thru vaccine clinic.
• 16:45
  SPEAKER_00: And, you know, we know there are benefits to being able to vaccinate such a large number of people at one time.
• 16:50
  SPEAKER_00: But tell me about the benefits and drawbacks of this model of vaccination versus a traditional walk-in clinic or the other models that you talked about earlier.
• 17:00
  SPEAKER_01: Well, the benefits are obviously by driving through the issue of access and mobility is much easier.
• 17:07
  SPEAKER_01: So for patients who have mobility issues, it really answered that question.
• 17:12
  SPEAKER_01: In fact, we have people who are specifically asking if they can come to the drive-thru instead of the traditional model because getting in and out of a car is so difficult for them.
• 17:21
  SPEAKER_01: And that also draws the obvious that if you don't have a car, it's hard to go through a drive-thru event.
• 17:26
  SPEAKER_01: So there are pluses and there are minuses.
• 17:28
  SPEAKER_01: And we don't think that every mass vaccination event should be a drive-thru, but the drive-thru model is one of the models that really works.
• 17:36
  SPEAKER_01: So we want a drive-thru model.
• 17:38
  SPEAKER_01: We would like a walk-up traditional clinical model, a pop-up clinic model.
• 17:42
  SPEAKER_01: And ideally, we'd be able to have a model where we have drive-thru on one side of a stadium and walk-up and drop off on the other side of the stadium so that we can accommodate both types of patients.
• 17:53
  SPEAKER_00: So having been to Denver, I'm aware that there's a large Spanish-speaking population there.
• 17:58
  SPEAKER_00: So, how did you work your drive-thru event to make sure that you were accommodating people who are Spanish-speaking exclusively?
• 18:06
  SPEAKER_01: So it starts with the registration process.
• 18:08
  SPEAKER_01: So we have the ability to register patients both online and by phone in both Spanish and English and other languages as well.
• 18:15
  SPEAKER_01: So if you are a UC Health patient and you meet the criteria, which includes the age criteria by the CDC in the state of Colorado, and are in those zip codes, you're automatically sent an invitation in the language that you register.
• 18:28
  SPEAKER_01: If you are not a UC Health patient, you may go to the website and register.
• 18:32
  SPEAKER_01: If you are not able to register, you can call a hotline and give your phone number.
• 18:36
  SPEAKER_01: And you can do that in any number of languages.
• 18:39
  SPEAKER_01: When you call a hotline and you are randomized to receive an invitation, you're selected to get 10 phone calls.
• 18:46
  SPEAKER_01: So you will get 10 phone calls before we go on to the next person.
• 18:49
  SPEAKER_01: And in the first phone call, you pick the language that you would like the phone calls to be in, whether it's English or Spanish or other.
• 18:56
  SPEAKER_01: And we have many languages here in Denver.
• 18:58
  SPEAKER_01: At the site, we have everything in English and in Spanish.
• 19:02
  SPEAKER_01: And for Spanish, because Spanish is the predominant non-English language, we had in-person vaccinators and in-person interpreters for Spanish and English.
• 19:12
  SPEAKER_01: But we also had what look like mobile iPads, which we use in all of our emergency departments, live translation devices that are connected.
• 19:20
  SPEAKER_01: So we put the iPad essentially next to the car between the vaccinator or the registrar and the patient, we push the language and there's simultaneous live translation.
• 19:29
  SPEAKER_01: So we have live people for Spanish and then electronic live translation for the seven other languages we encountered.
• 19:36
  unknown: Wow.
• 19:36
  SPEAKER_00: So having gone through this, you know, you obviously have gained a lot of experience in being able to do this and do it efficiently.
• 19:44
  SPEAKER_00: So what are your words of wisdom for people?
• 19:46
  SPEAKER_00: What are your best practices and lessons for other people who are doing these drive-through sites?
• 19:52
  SPEAKER_01: I think that there's some lessons that are unalterable.
• 19:55
  SPEAKER_01: And unfortunately, the one unalterable lesson that we learned is that first come, first serve, and not having appointments is impossible.
• 20:04
  SPEAKER_01: It's not possible to do that.
• 20:06
  SPEAKER_01: In fact, we looked at the news and looked at what happened in California and Florida to learn that really quickly.
• 20:11
  SPEAKER_01: So it was appointment only.
• 20:13
  SPEAKER_01: And sometimes that's difficult.
• 20:15
  SPEAKER_01: And we had to put in a lot of resources in order for people who can't easily access a smartphone or the internet to get appointments, but we were able to do that, including having people phone called and writing things down and doing it on paper and then converting it to electronic.
• 20:31
  SPEAKER_01: The other is that you can never have enough directionality.
• 20:37
  SPEAKER_01: So communicate often and frequently.
• 20:39
  SPEAKER_01: So leading up to the event, patients were sent messages reminding them the time of the place, where to enter and where to exit and what to plan for.
• 20:48
  SPEAKER_01: In fact, the biggest problem that we had was because mass vaccination events were getting such horrible press across the country.
• 20:55
  SPEAKER_01: And the only thing you would see were 90-year-old people waiting in line for seven hours and then vaccination sites running out of vaccine or protesters blocking it, were that we had mass numbers of people coming hours before their appointment.
• 21:08
  SPEAKER_01: So we sent out invitations again saying you do not have to come early.
• 21:12
  SPEAKER_01: And in fact, when people came early, we accommodated them and we planned for people coming early.
• 21:17
  SPEAKER_01: So the two biggest lessons are no matter what you do, people are going to come early because they're worried.
• 21:21
  SPEAKER_01: And two, you must have appointments.
• 21:23
  SPEAKER_00: Those are, I think, are really critical lessons.
• 21:26
  SPEAKER_00: I know having done some of these here, it really does make it more difficult when you have a lot of people without appointments.
• 21:32
  SPEAKER_00: And you know, certainly as we try to get started, that fast arrival of early birds really complicates things.
• 21:38
  SPEAKER_00: So, how many drive-thru campaigns does UC Health plan to implement from this point?
• 21:43
  SPEAKER_01: So we did the 1,000 patient pilot, then we did the 10,000 two and a half weeks ago.
• 21:48
  SPEAKER_01: We're going to do the second dose of 10,000 this Saturday and Sunday, and then we've made the playbook available to everybody and anybody who would like one, who would like to use it.
• 21:57
  SPEAKER_01: We're going to work with the state of Colorado, and when sufficient vaccine becomes available, we will think about how to do this again.
• 22:04
  SPEAKER_01: But we are not planning on doing another one until there's enough vaccine to make it reasonable.
• 22:09
  SPEAKER_01: We are also very much looking forward to the single dose vaccines, which will make mass vaccination infinitely more practical.
• 22:16
  SPEAKER_00: Yeah, absolutely.
• 22:17
  SPEAKER_00: So for other health systems or organizations who are looking to do their own mass vaccination drive-thru clinic, you know, you mentioned making the playbook available.
• 22:25
  SPEAKER_00: So I'd be interested in where people would be able to access that.org.
• 22:31
  SPEAKER_01: You can go to our COVID-19 tab and you can download the entirety of the playbook.
• 22:35
  SPEAKER_01: It's a living document.
• 22:36
  SPEAKER_01: So every time we update it, you will get an email and we'll show you what we updated it.
• 22:40
  SPEAKER_01: But the entire playbook is open and transparent down to the dollars that we spent per vaccine and how you can optimize it and how you interact with local agencies, et cetera.
• 22:50
  SPEAKER_00: What would you say are the most important considerations for other health systems or organizations to get started in doing their own mass vaccination drive-through clinic?
• 22:58
  SPEAKER_01: First and foremost, do you have enough vaccine to make it worthwhile?
• 23:01
  SPEAKER_01: Because in a fixed clinic, in a small auditorium, we can do almost 2,300 in an eight-hour day.
• 23:09
  SPEAKER_01: So having something in a giant stadium, you want to at least double or triple that and make sure that you have economies.
• 23:16
  SPEAKER_01: The others make sure you have enough vaccine, but you cannot communicate and partner enough with the affiliated institutions, including the state, local municipalities, police, fire, emergency management, and then the owner of the facility and pay attention to directionality, parking, all of the things that maybe we're not so used to doing all the time.
• 23:37
  SPEAKER_00: Dr.
• 23:38
  SPEAKER_00: Zayn, thank you so much for, first of all, for sharing the resource with everyone, but also just for sharing your experiences on our podcast.
• 23:46
  SPEAKER_01: It's my pleasure.
• 23:47
  SPEAKER_01: Let's get this pandemic over with, please.
• 23:50
  SPEAKER_00: Yes, please, absolutely.
• 23:51
  SPEAKER_00: This podcast can be accessed on today's online education center, Learning CE, under the Rapid Response Program.
• 23:58
  SPEAKER_00: You will also find resources such as the recorded webinars, healthcare facility outbreak preparedness, and the today COVID-19 town halls.
• 24:07
  SPEAKER_00: New members can now receive 50% off 2021 today membership by using the coupon code WELCOME2021 until March 31st.
• 24:16
  SPEAKER_00: This concludes this episode of the Rapid Response Podcast.
• 24:20
  SPEAKER_00: Thank you for tuning in.