County health departments are overworked and understaffed as they attempt to follow the changing protocols and requirements associated with COVID testing and vaccinations. 

“It’s been a disaster, the vaccine (rollout) has — it’s not our fault but we have to deal with it,” said Macon County Commissioner Ronnie Beale during a Jan. 12 meeting. “If the federal government and the state don’t function, we still have to function at the county level.”

Macon commissioners said they were receiving complaints from constituents who have been trying to make a vaccination appointment through the health department. When they call, they either get a busy signal or are put through to voicemail. 

Macon Health Director Kathy McGaha said the health department received over 400 phone calls in one day for testing and had nearly 700 voicemails. 

“Were going to stop taking voice mails because we can’t return all of them,” she said. 

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Even with 15 phone lines and people manning those lines all day, there are still people who can’t get through to make an appointment and are getting frustrated because their phone calls aren’t being returned. 

As of Jan. 12, McGaha said vaccine appointments have been booked out through the end of the month. Meanwhile, counties are at the mercy of the state when it comes to how many vaccines the health department will receive and they can only order 100-200 vaccines at a time. Many residents 75 and older, who have received a vaccine during the first phase of the roll out, will need to be given their second dose in the upcoming weeks — an additional layer to the work needing to be done at the health department. 

“With the numbers, obviously we’ve seen a surge here just like the whole state and nation has seen. As of today, we’ve had 2,100 cases in Macon County. It’s hard to imagine we’d get to this point but we have as a response to the holiday gatherings,” McGaha told commissioners. 

At this point in the process, the health department would like to focus more on vaccinations but after the holidays, the demand for testing has significantly increased and the staff has to split its time between vaccines and testing. McGaha told commissioners they could duplicate their staff in order to test and vaccinate all week and still would probably not meet the demand. However, she’s been advertising to hire more nurses for months and still hasn’t been able to fill the positions. 

“We have a few staff members out each week who are in quarantine because life happens to us too,” she said.

With the post-holiday spike in cases, Beale said it’s easy to understand why there have been so many phone calls and concerns directed to the health department. People — especially elderly populations — are scared and anxious about getting the vaccine as soon as possible. He said the county needed to make it the top priority right now despite confusion and slow implementation from the state. 

“Whatever you need, we’ll support you. We have 300 something employees and there’s nothing more important right now,” he told McGaha. “Let’s make it happen.”

County Manager Derek Roland said he was doing everything he could to offer assistance to health department staff. Emergency Services has been sending EMTs to help with vaccinations a couple days a week. Emergency Services has also assisted with organizing and manning off-site testing spots in the community to help the health department. 

McGaha said she needed the board’s permission to allow her salaried employees to work and get paid overtime hours. She said she’s also hopeful some of the burden on the health department would be lifted in the coming weeks as more private providers and pharmacies in the community go through the process to be able to vaccinate as well. 

Dr. Joseph Willoughby told commissioners his staff was working through the process online, but the process was arduous. 

“As a private practice, we have to register through the website and we’ve run into roadblocks. We’ve been working on it for a week and we can’t find a person to talk to that can tell us how to get to the next step,” he said. 

Once private providers are in the system, they should receive their own shipment of vaccines. McGaha said she hopes that doesn’t cut into the health department’s supply from the state. 

“And from what I understand, the hospitals don’t even have enough vaccines to vaccinate their staff right now,” she added. 

As far as navigating people through the vaccine process, McGaha said the county IT Department was working to set up a way for residents to sign up through the website to avoid more unanswered phone calls. As of Jan 19, that registration form is available at www.maconnc.org.

Commissioners have also received constituent complaints about Macon Health’s recent press release stating that it would no longer be reporting COVID clusters to the public. 

“Convince me why that’s not important to release that information, especially right now,” Beale said. 

McGaha said COVID cases are so rampant in the community that people should just assume it’s everywhere and take necessary precautions or stay home. She added that doing the contact tracing needed to identify clusters was time-consuming and she would have to pull employees away from testing and vaccinating in order to continue to identify and report the clusters. 

“I have to decide what the most pressing issue is so I’m asking the community to do what they need to do because we don’t have the time to investigate everything,” she said. “If we find a cluster, we report to the state, but we can’t call every patient and find out who they were around anymore.”

Because CARES Act funds helped the county cover some salary costs associated with COVID, the county does have funds available in the budget, around $100,000, to help the health department with additional costs. The commissioners authorized the county manager to appropriate additional funds to help them through the COVID crisis. Roland will also help locate someone to serve as a volunteer coordinator to help McGaha manage people willing to volunteer to answer phones or nurses willing to volunteer to do testing or vaccinations. The board will hear an update from McGaha at a Feb. 4 meeting. 

The Swain County Health Department is experiencing similar frustrations regarding the state’s vaccination roll out process. Health Director Alison Cochran told commissioners at a Jan. 14 meeting that the health department had administered 400 doses of the vaccine and that’s all they’ve received from the state. 

“As a county, we’re far behind and it troubles me that there’s been no effort from these rural communities to make sure they’re getting enough doses for their people,” said Commission Chairman Ben Bushyhead. 

Cochran said they were at the mercy of the state and can only receive 100 to 200 doses at a time, which has prevented the county from holding any kind of large-scale vaccination clinic. She said Mountain View Manor nursing home had been vaccinated and that Bryson City Living would be vaccinated the weekend of Jan. 16. Mountain View Manor recently had an outbreak of at least 12 cases, she added. 

Like McGaha, Cochran said she hoped the burden would be lifted as more pharmacies and private providers get registered to vaccinate through the state.

“We have a volunteer list for nursing and we’re using those people, but this week we had four to five people out every day for various reasons,” Cochran said. 

In Haywood County, the health department finished the bulk of those registered in vaccination group 1A, which included doctors, nurses, hospital staff, and doctor and dentist office staff members. Now it is in the process of vaccinating those in the 75 and older group — 1B.

The first mass vaccination clinic was held last week with a goal of vaccinating 500 people. In all, 850 were vaccinated at the one-day event, including Waynesville police officers, and some of the remaining people from the 1A group.

To date, nearly 2,000 people have been vaccinated in Haywood County, through either appointments at Haywood Regional Medical Center or Haywood Health and Human Services or off-site vaccination clinics.

“After overcoming some initial hiccups, the first mass vaccination event, held Wednesday, was very successful. We were able to vaccinate more than 800 people in a single day, the most significant mass vaccination event since the days of polio. A huge thanks to the many Haywood County agencies, staff and volunteers that helped pull off this event,” said Interim Health Director Garron Bradish.

Going forward, Haywood County Health and Human Services is partnering with Haywood Regional Medical Center on a series of weekly vaccine clinics that will continue to expand the county’s capacity for vaccine distribution as we move into the next groups.

These clinics will serve those on the pre-registry list who have been contacted with an appointment time, and will not be open to the public or to walk-ins. Instructions on how to participate will be given when appointment times are scheduled.

Pre-registration is now open for those 65 and older.