2021 | Coronavirus

UPDATED: Health officer says ‘accountability,’ ‘effective leadership’ missing from state vaccine rollout

‘Enough is enough,’ Gayles says

share this

Montgomery County Health Officer Dr. Travis Gayles pictured at a press conference on March 12.

File photo

This story was updated at 3:17 p.m. on March 2, 2021, to include information from Gov. Larry Hogan’s press conference and at 9:09 p.m. with County Council comments and a statement from Hogan’s spokesman.

Montgomery County health officer Dr. Travis Gayles on Tuesday criticized the state’s COVID-19 vaccine rollout, saying “enough is enough.”

During a briefing with the County Council on Tuesday, Gayles said “accountability” and “effective leadership” are missing from Maryland’s distribution plan.

“I realize making this comment, I may put my job at risk because I’m a state employee. But quite frankly, enough is enough,” he said. “We should not be afraid to speak out about the policies that are coming from Annapolis for fear that there may be ramifications [because] we might not get a mass [vaccination] site because we’re critical of the governor. Some would argue that that may be what’s happening now, quite frankly.”

Gayles said the state needs to acknowledge problems in the system and that new approaches are needed.

Montgomery County officials have repeatedly pressed the state to set up a mass vaccination clinic in the county, and have suggested an appropriate site.

The state, however, has said it is focusing on at least six other sites first. One in Prince George’s County and two in Baltimore City have been set up and another will open on Thursday at the Regency Furniture Stadium in Charles County.

At a press conference on Tuesday, Gov. Larry Hogan announced the two remaining locations: Wicomico Youth & Civic Center in Salisbury, opening no later than March 18, and Hagerstown Premium Outlets, opening by March 31.

The state has said that a Montgomery County site is possible later, but the possibility won’t be considered until after the first six sites are open. On Tuesday, Hogan said the state is in “active discussions” with counties that have asked for a site.

Asked about Gayles’ criticism of the state, Mike Ricci, a spokesman for Hogan, did not directly comment on the comments in an email on Tuesday afternoon.

“First, I have great respect for Dr. Gayles, and appreciate his work throughout the pandemic,” he wrote in an email. “He’s been on the front lines of this for nearly a year now.”

Council President Tom Hucker noted that Acting Health Secretary Dennis Schrader disclosed on Monday that only 3,558 of the 32,000 vaccine doses administered at the mass vaccination site at Six Flags America in Prince George’s County have gone to Prince George’s residents.

More than 10,000 of the total doses have been administered to Montgomery County residents and 9,000 have been administered to Howard and Anne Arundel counties residents, he said.

Prince George’s County has consistently had the highest number of confirmed cases in the state.

Gayles said the disparity adds to several caused by a system that is not equitable.

“From an equity standpoint, it is insulting to believe — it’s not surprising that the acting secretary made that comment because he also previously said that the response to equity was putting a site in Prince George’s County and Baltimore City,” he said. “What we’re seeing is a lack of understanding of equity, which is a fundamental principle of public health. … If you’ve not done the work to remove disparities, you will continue to see disparate outcomes.”

Gayles said “cosmetic photo-ops” and “surface-level efforts” — instead of creating and investing in resources — do not address the issues at hand. Politics needs to be put aside, he said.

“It is not acceptable to acknowledge the disparities and then shift the blame to local health departments or other entities. It’s time to step up to the plate,” he said.

Council Member Craig Rice said private providers and pharmaceutical companies are “out there doing whatever they want. It’s the wild, wild West in terms of dissemination of vaccine. We’ve seen them pull from vulnerable neighborhoods and take it to more affluent neighborhoods and that is shameful.”

Rice said the state’s distribution has been ineffective and has continued to put people of color at risk by not prioritizing public health departments that have equity distribution plans.

“It’s up to the governor,” Rice said. “Governor Hogan, who I’m sure has aspirations to do a number of things, continues to make sure that when it comes to giving vaccine to public health entities throughout the state that have shown that they are committed to equitable distribution, has decided to take them away from them and give it to folks who don’t have that commitment nor have a plan on how to make that happen.”

The county has implemented an equity plan that sets aside 75% of the vaccines it receives to continue vaccinating residents age 75 and older. Of those vaccines, the county prioritizes “high-impact ZIP codes” to receive vaccines in an effort to target minority and vulnerable communities disproportionately affected by the coronavirus.

Those areas are identified by considering case rates for the past 90 days, death rates for residents not living in nursing homes, and high combinations of cases and death rates for communities of color.

For people within those priority ZIP codes, the county doses are allocated based on case rates and death rates by race and ethnicity.

“We are not trying to discriminate or lock anybody out of the system,” Gayles said, noting that Black residents have a significantly higher fatality rate, while Latinos have a higher case rate.

“We have been able to use epidemiologics and surveillance data to confirm that there are certain qualities and characteristics that have predisposed people to have a higher risk of contracting it, as well as having a severe outcome of the disease,” he said.

Rice said people of color and vulnerable communities can’t be blamed for not signing up for the vaccine list, if they see that the fortunate residents and people with connections are the ones who are getting the vaccine.

“Those that are poor and those that are Black and brown are the ones who continue to be left by the wayside. That is what they’re seeing,” Rice said. “So I cannot blame them for not wanting to register for a system that is working against them.

“Until we fix that, that is one of the stumbling blocks to us making sure we have people of color, people of lower socioeconomic status registering. Why would you register for a system that is stacked against you?”

Asked about the council’s comments, Ricci wrote that he expects the state will continue to make progress and “prove the members of the council wrong.”

“You’ll recall that not too long ago, they were saying that no one in the county would want to drive to Six Flags, and Montgomery County residents account for about out of three appointments,” he wrote. “So we will just keep doing the work, and they can keep doing the opining.”

Council members have publicly said that it would be difficult for some residents to get to Six Flags if they have no transportation or can’t take off from work.

Dr. Earl Stoddard, executive director of the county’s Office of Emergency Management and Homeland Security, said at the briefing on Tuesday that the state is “conflating [vaccine] hesitancy with equity.”

Hesitancy is a real issue and equity is a key factor, he said, but they’re not the same.

“If you treat them as the same thing, it shows a fundamental misunderstanding of the issues,” Stoddard said. “I support the state addressing issues around hesitancy but you can’t use that as a surrogate for actually providing equal access and fair and equitable access to systems, not just sites.”

“Maybe the state should be coming to us and asking us some questions about how we’re doing it effectively,” he said.

Council Member Will Jawando said the county should open up vaccine appointments to more groups of African American and Latino older residents because of health and death disparities.

“It’s the only way we’re going to get the numbers up. If you want to send a message to our Black and Latino community about the need to preregister, open it up to people who are younger by five or 10 years,” he said.

He suggested that appointments be open to Black residents age 65 and older, and Latino residents age 70 and older.

“The legality on this is not 100% clear, but we’re dying and we’re not getting vaccinated. … I think this would be a step we can take, not without risk, but we know there’s a ton of risk in death and cases and everything we’re seeing,” he said. “There is a case to be made about this.”

Dr. Raymond Crowel, director of the county’s Department of Health and Human Services, said attorneys would need to be consulted about the idea.

When the county opens up vaccine appointments to employees of the entertainment and restaurant industries, officials expect to see more young Black and brown residents receive access to the vaccine.

“We will be looking at that, but there are some other factors that will help us as we move forward,” Crowel said.

Staff writer Dan Schere contributed to this story.

Briana Adhikusuma can be reached at briana.adhikusuma@bethesdamagazine.com.