COVID-19 VACCINATION IN MANITOBA WEEKLY TASK FORCE BRIEFING - February 3, 2021 - Province of Manitoba
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COVID-19 VACCINATION IN MANITOBA
WEEKLY TASK FORCE BRIEFING
February 3, 2021
DELIVERING 1.5 MILLION DOSES Ramping up for the 2nd quarter
SECOND To administer 1.5 million doses in Q2,
Manitoba will be ready to deliver 20,000 doses per day
QUARTER
EXPANSION • Manitoba will be ready - if vaccine • To achieve this: projecting a daily
Building from Manitoba's supplies are available maximum capacity of 20,000
small, deliberate and safe doses
starting point to deliver the • We have invested time in
largest immunization developing models that can be • At the same time, we will not
campaign in provincial scaled up sacrifice safety for speed
history
• We can shift from delivering
100,000 doses in Q1 to 1.5 million
in Q2
3
PLANNING
PRINCIPLES • Use the right model, at the right • Inject what you get: Planning
time: From supersites and FIT's and models must reduce wastage
The Vaccine Implementation to the distributed model with and maximize every resource at
Task Force works from these four doctors and pharmacists, our disposal – vaccines, people,
operational planning principles. Manitoba needs a variety of facilities and supplies.
approaches, deployed at the right
time and context. • Be ready to pivot: Every plan
must have a contingency plan to
• Minimize the drain on the adapt in order to meet the
healthcare system: The existing vaccination needs of Manitobans
health care system is the
backbone and starting line-up for
the vaccination program, but must
be returned to front-line
healthcare as the vaccination
program grows.
4
PLANNING ‘BELOW THE SURFACE’
Focused Immunization Teams
Supersites First Nations partnership
Pop-up clinics Weekly vaccination statistics
Supersite operations manual
Logistics & security Geographical & population Clinical planning
analysis
Distributed channel model
Managing appointments Inter-jurisdictional Stakeholder
IT infrastructure Recruitment & collaboration consultations
training
Securing freezers and
Complex forecasting and Risk register &
5
critical supplies
responding to vaccine quality assurance
delivery schedulesSECOND QUARTER EXPANSION
SUPERSITES • Two supersites will be ready to launch
in Interlake-Eastern and Southern
Centralized and efficient Health-Santé Sud as early as Mar. 1.
vaccine delivery, easily scaled • Actual opening day will depend on
in response to vaccine supply vaccine supply.
• Winnipeg supersite will expand
Act as a home base & point capacity by March 1 and a second
of distribution for FITs and "warm" site can be activated with a
pop-up clinics day's notice.
• Supersites in Brandon, Thompson and
EST. 70% OF the Thompson Vaxport
are activated, based on vaccine
DAILY DOSES supply.
IN Q2
6SECOND QUARTER EXPANSION
Supersite Location RHA Status Launch Date
SUPERSITES RBC Convention Centre
Back-up Site, Winnipeg
Winnipeg
Winnipeg
WRHA
WRHA
Launched
Launched
Jan-04
Jan-04
Centralized and efficient
Keystone Centre Brandon PMH Launched Jan-18
vaccine delivery, easily scaled
Thompson Supersite Thompson NRHA Launched Feb-01
in response to vaccine supply
Thompson Vaxport Thompson NRHA Planned Feb-08
Act as a home base & point IERHA 1 TBD IERHA Planned Mar-01
of distribution for FITs and SH 1 TBD SH Planned Mar-01
pop-up clinics WRHA 3 TBD WRHA Planned Mar-01
IERHA 2 TBD IERHA Planned April
EST. 70% OF SH 2 TBD SH Planned April
DAILY DOSES PMH 2
NRHA 3
TBD
TBD
PMH
NRHA
Planned
Planned
April
April
IN Q2
WRHA 4 TBD WRHA Planned April
7SECOND QUARTER EXPANSION
DISTRIBUTED • Manitoba announced partnership with
doctors and pharmacists yesterday.
MODEL • This work will create broader vaccine
access in more communities, in a
Building on established familiar setting.
partnerships with doctors and • Builds on expertise in delivering other
pharmacists vaccines like the annual influenza
vaccine
EST. 25% OF • Will use an application-based process to
identify qualifying medical clinics and
DAILY DOSES pharmacies.
IN Q2
• Suitable COVID-19 vaccines for this
model not yet approved, will require
additional work & systems to administer.
8SECOND QUARTER EXPANSION
POP-UP • First clinics launching in Flin Flon and
The Pas on Feb. 8
CLINICS • In coming weeks, pop-up sites will
also be used in Churchill, Gillam, Lynn
Short-term sites for targeted Lake, Leaf Rapids, Grand Rapids.
immunization • Model can be expanded in Q2 based
on vaccine supply.
• "Heat mapping" shows demand based
on prioritized population.
• These sites are not as efficient as
EST.SECOND QUARTER EXPANSION
FOCUSED • Manitoba has completed a
vulnerability assessment of future FIT
IMMUNIZATION populations, based on:
• age
TEAMS • health status
• ability to follow public health
Taking the vaccine directly to
the most vulnerable guidance
Manitobans • income
• Beginning this week: patients in
hospital waiting for PCH
EST.SECOND • Moving forward, we Site / Approach
Daily Maximum
Capacity
QUARTER will begin reporting our
Supersites (RBC,
Daily Maximum Capacity
EXPANSION Backup Site, Keystone,
Thompson)
6,097
Building from Manitoba's • This shows how many doses
Distributed Channel
small, deliberate and safe could be delivered on any 0
Model
starting point to deliver the given day in Manitoba, if we
largest immunization had adequate supply. Focused Immunization
campaign in provincial Teams 500
history
• This figure will be added to
Pop-up Clinics 500
the public dashboard,
and will be updated as Current Daily
Maximum Capacity 7,097
new facilities and staff are
added to increase capacity. Target Daily Maximum
Capacity in Q2 20,000
11SECOND QUARTER EXPANSION
APPOINTMENTS • Centralized system currently used for
supersites and pop-up sites
AND BOOKING • Bilingual, flexible, scalable to meet
demands – including outbound calls
Connecting Manitobans with • Available call lines have increased 10x
vaccine by phone & online from December
• 260 trained agents
• Call-back option introduced to reduce
AVG TALK TIME: wait times for callers
• Improvements planned for Q2:
13 MIN. adapting to multiple vaccines,
AVG WAIT TIME: locations, self-serve online booking
1 MIN.
12SECOND QUARTER EXPANSION
MORE • Cannot substitute one vaccine for
another in 2nd dose
VACCINES = • Need to ensure 2nd dose is available,
at same location, in the recommended
MORE timeframe (ie: 21 or 28 days)
• Complicated by growth in distribution
COMPLEXITY points in Q2: pop-up clinics, mobile
sites, FITs, doctors' offices,
pharmacies, supersites
• More complex work plans are needed
to support quality assurance, patient
experience and patient safety
13COVID-19 VACCINATION IN MANITOBA
OPERATIONAL UPDATESFOCUSED ON FULL PROTECTION: THE NATIONAL PICTURE
• Manitoba currently ranks People Fully Immunized / 100k Population
2nd in the country for total Prince Edward Island 1,608
population fully immunized. Manitoba 759
• This reflects the success of New Brunswick 571
Ontario 489
our plan.
Saskatchewan 415
• We only book 1st dose Alberta 388
appointment when there is Newfoundland and Labrador 333
enough in-stock or an Nova Scotia 302
expected shipment for the Northwest Territories 277
2nd dose to be injected British Columbia 99
Yukon N/A
within recommended
Nunavut N/A
timeframes Quebec N/A
- 200 400 600 800 1,000 1,200 1,400 1,600 1,800
15 Data as of February 3, 2021 7:10amWORKFORCE RECRUITMENT
DAILY OPERATIONAL SCHEDULE As of January 29
RBC CONVENTION CENTRE KEYSTONE CENTRE FIT TEAM - Winnipeg
859 Doses 136 Doses 688 Doses
62 14 15
TOTAL STAFF (FTE) TOTAL STAFF (FTE) TOTAL STAFF (FTE)
25 Immunizers (FTE) 4 Immunizers (FTE) 15 Immunizers (FTE)
CURRENT WORKFORCE
2,292 285
•
•
1,345 immunizers
8 clinic managers
STAFF (FTE) • 364 clinical leads
As of Jan. 29 this week • 352 navigators
• 223 observers
16PROCUREMENT,
STORAGE & • Procuring all supplies to immunize • Providing security for vaccine in
Manitobans - like freezers, transport and in storage in
LOGISTICS needles and swabs - when
everyone around the world is
Manitoba
A look at how Manitoba
trying to do the same thing. • Confirming and supporting clinics
coordinates vaccines and all
in handling and tracking vaccine
necessary immunization supplies
• Delivering these supplies to sites and supplies received
located across the province, at the
right time.
• Tracking and monitoring vaccine
shipments to Manitoba, following
federal and manufacturer
requirements for each product
17VACCINE DELIVERY MODEL UPDATES
Winnipeg Brandon Thompson
SUPERSITES 481 120
In larger centres, supersites 5,732
allow for rapid and large-scale DOSES ADMINISTERED DOSES ADMINISTERED DOSES ADMINISTERED
IN LAST WEEK
vaccination for increased IN LAST WEEK IN LAST WEEK
speed and efficiency.
23,803 1,965 120
TOTAL DOSES TOTAL DOSES TOTAL DOSES
ADMINISTERED ADMINISTERED ADMINISTERED
820 151 --
AVG. DAILY DOSES AVG. DAILY DOSES AVG. DAILY DOSES
62 14 12
18 EST. DAILY STAFF (FTE) EST. DAILY STAFF (FTE) EST. DAILY STAFF (FTE)CONTINUOUS IMPROVEMENT: RBC SUPERSITE
Total processing time:
• 28-47 minutes
Non-productive time:
• 2-38 minutes
Total turnaround time:
• 30- 85 minutes
Average time client spent waiting for immunization:
• High Volume of Clients (Jan 5/6): 22 minutes
• Low Volume of Clients (Jan 13): 8 minutes
OBSERVATION # IMMUNIZERS # APPTS
Average time to vaccinate client: DATE ON SITE SCHEDULED
• 4.5 minutes Jan 5, 2021 19 1170
Jan 6, 2021 14 871
Average time to reconstitute and pre-draw (6 doses):
• 8.1 minutes Jan 13, 2021 14 ~650
19VACCINE DELIVERY MODEL UPDATES
• All eligible residents in Manitoba's licensed personal
FOCUSED care homes were immunized in three weeks – one
week ahead of schedule.
3,924
IMMUNIZATION • Second doses to be delivered to all PCHs before end
of February WEEKLY DOSES
TEAMS (FITs) • Teams comprised of FIT members and site staff,
where available
ADMINISTERED
FITs visit facilities to deliver
vaccines where people live or
congregate.
8,255
Phase 1: Personal Care TOTAL DOSES
Homes ADMINISTERED (EST.)
Phase 2: Congregate living
sites with vulnerable
populations
20CONTINUOUS IMPROVEMENT: FITs
Total processing time:
• 19-49 minutes
Non-productive time:
• 2-6 minutes
Total turnaround time:
• 23- 54 minutes
Average time to vaccinate client:
• 4 minutes
Average time to reconstitute (6 doses):
• 8.7 minutes OBSERVATION # IMMUNIZERS # APPTS
DATE ON SITE SCHEDULED
Jan 14, 2021 5 197
21UNRELIABLE
SUPPLY CHAIN • Significant uncertainty for future
Pfizer and Moderna vaccine
• A team of analysts maintain
complex data sets that link
Supply uncertainty means we deliveries vaccine deliveries with inventory
must plan, be ready, and wait to • No confirmed timelines for "fridge levels and known appointments
see what arrives stable" vaccines, such as Astra • This allows Manitoba to react to
Zeneca supply disruptions on a real-time
• Lack of clarity on possible effects basis
of export restrictions in the • The result of Manitoba's careful
European Union, where 100% planning: Successfully
vaccines expected in Canada in weathering supply disruptions with
the coming months are all second-dose appointments to
manufactured occur within recommended
timelines
22SUPERSITE
Closing Stock Balance - Supersites
8,000 10,000
INVENTORY 7,000
9,000
8,000
MANAGEMENT
6,000
7,000
5,000
6,000
4,000 5,000
Projected for the next 30 days
4,000
3,000
3,000
2,000
2,000
1,000
1,000
0 -
2021-01-31
2021-02-01
2021-02-02
2021-02-03
2021-02-04
2021-02-05
2021-02-06
2021-02-07
2021-02-08
2021-02-09
2021-02-10
2021-02-11
2021-02-12
2021-02-13
2021-02-14
2021-02-15
2021-02-16
2021-02-17
2021-02-18
2021-02-19
2021-02-20
2021-02-21
2021-02-22
2021-02-23
2021-02-24
2021-02-25
2021-02-26
2021-02-27
2021-02-28
RBC Supersite Keystone Supersite Thompson Supersite Total
Projections as of February 02, 2021. Each rise in doses represents a scheduled delivery.
NOTE: Manitoba follows the guidance of the National Advisory Committee on Immunization (NACI) and vaccine
manufacturers to provide first and second doses on the clinically-advised schedule.
23VACCINE PRIORITIZATION – LOW SUPPLY SCENARIO • Based on 70% vaccine uptake. • Only includes Pfizer and Moderna vaccines. • Timeline depends on vaccine supplies provided by the federal government, and is based on projections as of Jan. 27. • Updated to show the prioritization of First Nations 24
VACCINE PRIORITIZATION – HIGH SUPPLY SCENARIO • Based on 70% vaccine uptake. • Includes 700,000 doses of currently unapproved product to arrive in Q3. • Timeline depends on vaccine supplies provided by the federal government, and is based on projections as of Jan. 22. • Updated to show the prioritization of First Nations 25
RISK
MANAGEMENT • Manitoba has a workstream
dedicated to identifying,
• Examples of risks being managed
include:
Identifying, assessing and registering and tracking risks,
responding to risks to the which is continually updated to • Breaking the cold chain
immunization campaign reduce or respond to those risks • Use of unsuitable syringes
• Timely delivery of supplies
• Focuses on risks to personnel, the (including re-allocated
public, the vaccine, security, vaccine trays)
infrastructure, scheduling and • Ensuring proper post-
workforce availability immunization observation
protocols
• Ensuring adequate social
distancing at supersites
• Adverse weather events
• Inadequate security
26DOSE ADMINISTRATION PROJECTION
• Based on current Daily Doses Administered - Projection
Does not include doses allocated to First Nations
supply projections, 2,500 80,000
we estimate an 2,000
60,000
average of 1,183
1,500
injections per day in 40,000
February, subject to 1,000
20,000
current vaccine 500
supply forecasts. - -
2/1/2021
2/2/2021
2/3/2021
2/4/2021
2/5/2021
2/6/2021
2/7/2021
2/8/2021
2/9/2021
1/31/2021
2/10/2021
2/11/2021
2/12/2021
2/13/2021
2/14/2021
2/15/2021
2/16/2021
2/17/2021
2/18/2021
2/19/2021
2/20/2021
2/21/2021
2/22/2021
2/23/2021
2/24/2021
2/25/2021
2/26/2021
2/27/2021
2/28/2021
Supersites FIT (Pfizer for WRHA, Moderna for other RHAs) Total Cumulative
Projected as of February 02 and reflects supply reductions announced by
27 Pfizer on January 15 and 19COVID-19 VACCINATION IN MANITOBA
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