As school begins, state sees uptick in coronavirus cases and Pfizer vaccine is approved by FDA

The first day of school looked vastly different last year. Masks were required at NR-S, students received daily screenings upon entry, and class sizes were reduced to minimize spread of the novel coronavirus. Secondary students entered school through a different door than the elementary students.

On Tuesday, Aug. 24, students went back to school with mostly pre-pandemic protocols, as only one active case of COVID-19 had been reported in Eddy County since June 1. Elsewhere in the state, however, case numbers have risen 237% since Aug. 1, from 448 to 1,508.

On Monday, the New Rockford-Sheyenne School posted the following notice, "We are all watching the escalating COVID-19 numbers and school districts around the country taking steps to mitigate the effects. We will continue to utilize a robust cleaning process through the building. We also respect and welcome each student/families [sic] individual choice to wear masks or seek out vaccinations. However, we recognize that this is a personal choice. Our community, staff and student body stepped to the plate last year when needed, in support of protocols that were recommended, and hopefully resulted in the mitigation of disease in our school. If needed, we are confident that they will support us in the future. In the meantime, we will respond to the data, and currently, we do not have any data that suggests we need to take additional steps to create a safe environment. It is really important that our staff and students are in school, in person, every day... Please support us by keeping your students home when they are ill, communicating your needs and practicing good hand hygiene: wash your hands, cover your cough and keep your hands off of your face. Simple things, it all helps. Thank you!"

As students and staff prepared for their first day of classes, there was big news on the vaccine front. The Food and Drug Administration (FDA) gave full approval to the Pfizer-BioNTech COVID-19 vaccine on Monday, Aug. 23. The approval is effective for use in individuals age 16 and older.

More than 92 million people have been fully vaccinated with Pfizer's vaccine since it was granted emergency authorization from the FDA on Dec. 11, 2020. The approval was granted at lightning speed, with the FDA announcing its action 97 days after Pfizer reportedly submitted hundreds of thousands of documents regarding its safety and effectiveness.

The approval was expected to set off a series of vaccine mandates across the country. Earlier this month, President Biden and Secretary of Defense Lloyd Austin said they would mandate the COVID-19 vaccine for all military personnel by September 15 or upon FDA approval, whichever came sooner. On Monday, the Department of Defense announced that it would speed up the mandate for all 1.3 million of its active-duty troops in light of the approval, according to Pentagon press secretary John Kirby.

New York, New Jersey, California and Hawaii have instituted mandates that require all teachers to either be vaccinated or submit to regular testing. Health systems across the country have also issued mandates to their employees.

The first known local company to issue a vaccine mandate was Carrington Medical Center. Mariann Doeling, Market President at CHI St. Alexius Health - Carrington, told the Transcript Tuesday that all staff at Carrington Medical Center are required to be vaccinated or have an approved religious or medical exemption by November 1, 2021.

The mandate came about two weeks ago, Doeling said, when the California legislature mandated that all healthcare workers have 55 days to be fully vaccinated. Carrington is part of CommonSpirt Health, and its larger hospitals are located in California. Therefore, the mandated vaccine is required of all CommonSpirit entities. So far, Carrington Medical Center has not lost staff due to the vaccine mandate; however, some are concerned that their request for a religious or medical exemption will not be accepted. Should that happen, staff may decide to end their employment.

"It's a difficult decision when most other healthcare entities are requiring staff to be fully vaccinated as well," Doeling said. "Staff are important to us, and so is our obligation to protect our patients. It is a difficult time right now with COVID-19 on the increase in states."

Case numbers throughout North Dakota today are nearly the same as they were one year ago, prior to the deadly fall peak. On Aug. 23, 2020, the state had 1,462 active cases. On Monday (Aug. 23), the state reported 1,508 active cases.

Eddy County had one active case as of Monday, compared to five active cases on Aug. 23 last year. By Wednesday, however, there were four active cases in the county.

Due to the rise in COVID-19 cases in North Dakota, Jamestown Regional Medical Center has put restrictions on visitation as of August 25. All in-person events are transitioning to virtual, and masks are required for employees, patients, and guests.  

The Centers for Medicare and Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), is developing an emergency regulation requiring staff vaccinations within the nation's more than 15,000 Medicare and Medicaid-participating nursing homes.

CMS strongly encourages nursing home residents and staff members to get vaccinated as the agency undergoes the necessary steps in the rule-making process over the course of the next several weeks. CMS expects nursing home operators to act in the best interest of residents and their staff by complying with these new rules, which the agency expects to issue in September.

Shelly Peterson, President of N.D. Long Term Care Association, has said that while they support the vaccine, her agency is not supportive of a government mandate.

While on average, two-thirds of the state's long term care workforce is vaccinated, Peterson said facilities are at risk of losing staff if vaccines are required.

The national standard is 75% staff vaccination, which only 24% of North Dakota nursing homes had met early this month, according to AARP.

North Dakota ranks high nationally for resident vaccinations, and in the mid-range for staff, when compared with other states, Peterson told the Minot Daily News.

Here in Eddy County, Lutheran Home of the Good Shepherd has not required its staff to get vaccinated.

"I have not taken a stance either way," Jensrud said Tuesday in regards to vaccine mandates.

Jensrud noted that should CMS issue directives that tie funding to vaccination requirements, LHGS will be in a tough position, as payments for over 50% of its residents are covered by Medicare or Medicaid.

While funding is necessary for LHGS to remain viable, so is maintaining adequate staffing levels. "With us being so rural, we can't afford to lose one employee," Jensrud said. "I don't want the staff to feel that I'm pushing them in anyway. I got vaccinated to protect others."

Eddy County Public Health continues to make vaccines available to the public, recently offering pop-up vaccination clinics at local events. They also held a back-to-school immunization clinic one evening earlier this month to administer a variety of vaccines to residents, including the COVID-19.

As shown in the chart, vaccination rates in Eddy County are above 75% for senior citizens (adults 65 and older), but lag under 50% for adults and below 20% for eligible youth ages 12-17.

"We have given far more Moderna vaccine, as it was the most available vaccine early on," Eddy County Public Health Nurse Danette Schmid said Tuesday. All three vaccines - Moderna, Pfizer and Janssen (Johnson and Johnson) - are available at public health. To date, Eddy County Public Health has administered 1,044 doses of Moderna, 376 doses of Pfizer and 37 doses of Johnson and Johnson.

"In the past couple of months, we have given [the] Pfizer vaccine twice as often as Moderna," Schmid added, due in part to the fact that Pfizer vials contain fewer doses. That way there is less waste should they not have enough patients to use a full vial before it expires.

Nearby on the Spirit Lake Reservation, health officials have administered more than 4,000 doses of COVID-19 vaccines with nearly 2,000 people fully vaccinated.

A recent uptick in cases has put Spirit Lake on alert. An individual tested positive for COVID-19 after attending a funeral service in St. Michael on Monday, Aug. 16. One week later, the number of active positive cases had grown to seven.

"There are fully vaccinated individuals testing positive, who can transmit the virus to others," reported Layne Miller, COVID-19 Incident Commander for the Spirit Lake Tribe.

Since Aug. 10, workers and visitors to all Spirit Lake tribal facilities and businesses have been required to wear masks, regardless of vaccination status.

"It is very critical we do our part and ensure the safety of the community. Please limit large gatherings and physical distance," Miller said.