Shaheen told COVID-19 vaccines likely to require subzero storage

BERLIN - The two leading vaccines being developed for COVID-19 require being kept at subzero temperatures and local health-care providers told U.S. Sen. Jeanne Shaheen they expect cold storage equipment will be the next challenge for the supply chain.

At a virtual meeting with Shaheen last Friday, Androscoggin Valley Hospital President Michael Peterson said the two pharmaceutical frontrunners in the race to develop a vaccine are Pfizer and Moderna and both are working on vaccines that will require being distributed and stored at temperatures around 94 degrees below zero.

"Those freezers are going to be a hot commodity and just the distribution mechanisms are going to be a challenge for all of us," Peterson said. "We don't want to be in the same boat, when the vaccine is out and we can't get it out and we can’t store it effectively."

Shaheen asked if the hospital has any capacity now to store a vaccine at those temperatures. Brian O’Hearn, chief of nursing and vice president of patient care services at AVH, said the hospital would need to obtain equipment.

"But, I'm certain that if it was available, we would find a way to get that very quickly," he said.

Shaheen said she has not heard the issue of cold storage addressed in the planning underway and said she anticipates there will similar challenges as there were with personal protection equipment.

"So that’s a really good question that we should ask," she said.

Shaheen said she has worked hard to get interest rates reduced on the Medicaid Advanced Payment Program loans made to hospitals to allow them to survive being shut down for COVID-19.

She said some of the changes passed and she will take another shot at it in December when the continuing resolution comes up for a vote again.

Peterson thanked Shaheen for her work and said the entire state Congressional delegation has been helpful. He said the funds allowed AVH to remain solvent and to avoid any layoffs. AVH hopes to repay the advancements before the interest kicks in. He said it would better if some of the loan payments could be converted to grants.

COVID-19 has had a major impact on the hospital. Peterson said gross revenue for the just completed fiscal year was $12 million below target projections because the hospital largely closed down for three months and stopped all elective surgery. He said it took time for patients to return once the hospital re-opened. He said people really started to return in July and August and September were reasonably good months.

"So, we really realistically turned the corner toward late summer and started to see a more normal set of volumes," Peterson said.

He said the hospital is still struggling with the availability of turnaround testing for pre-operative patients but said AVH has a great relationship with Dartmouth, which has helped with testing. Peterson said right now they are in good shape with personal protective equipment but said he hopes the second wave that is hitting the country doesn’t lead to shortages of supplies like last spring.

Citing the outbreak at the federal prison, Shaheen asked if the hospital is working with the medical staff there to provide treatment. Eight inmates in the minimum security camp and two staff members tested positive.

O’Hearn said the prison is capable of handling any medical issue within their facility but the hospital is there for backup.

Peterson said local providers and officials were quickly informed of the outbreak because of an ongoing COVID-19 community call. He explained that early in the pandemic, Coos County Family Health Services CEO Ken Gordon set up an ongoing community call that includes representatives from all health-care providers, both nursing homes, municipal officials, the two school districts, both prisons, the chamber of commerce and emergency medical services.

O’Hearn said the call, which is currently held weekly, allows the sharing of information and has provided a structure for collaboration. He said the parties have fully utilized the opportunity to share information.

"I think it’s a testimony to how collaborative people in the North Country can be," Peterson agreed.

O’Hearn said he also wanted to recognize the job done by North Country nursing homes, which he called "just phenomenal." Not only have there been no major outbreaks of the virus, he said they have also drastically reduced respiratory infections. At one point, a few months ago, he said there were no respiratory infections.

Peterson asked Shaheen to continue to support social distancing, hand hygiene and mask wearing. He said he supports a federal mandate for mask wearing, saying they have proven at AVH that it works.

The senator asked if the region is seeing an increase in substance use disorders because of the pandemic. O’Hearn said it is a growing problem and AVH is educating staff on protocols to follow and how to assist individuals in getting help. He said the mental health centers have done a good job with telehealth and reaching out in new ways.

Shaheen said the recognition of how effective telehealth can be is one of the few good things to come out of the pandemic.