National

‘The truth is, nobody told us what to be ready for’

Roger Desjarlais, manager in Lee County, Fla., on the unanticipated challenges of rolling out the vaccine
Fort Myers, Florida - January 8, 2021: Roger Desjarlais poses for a portrait at the Lee County Emergency Operations Center in Fort Myers, Florida on January 8, 2021. Desjarlais is the County manager for Lee County. (Photo by Eve Edelheit for The Washington Post)

We’re trying to get this vaccine into people’s arms as fast as we can, but everyone seems to have a better solution than the ones we’re using. I’m not very popular right now. I’ve been called incompetent more times in the last month than I have in my whole career.

About this series
Voices from the Pandemic is an oral history of covid-19 and those affected.

Could our vaccinations have been more efficient from the get-go? Absolutely. I could spend all day trying to pass around blame and dodge responsibility, but I’ve been in public service for 40 years, and part of being in a leadership position is knowing how to stand up and take some hits. We’re trying to get better. We’re figuring it out as we go.

I’ll be the first to admit that I didn’t expect for us to be managing this rollout at the county level. For whatever reason, I made the assumption back in the fall that when vaccines became available, it would be handled by some combination of federal and state government. Why I didn’t think beyond that, I can’t tell you. I’m feeling a little stupid right now. Each state was left to figure this out. The state handed the operations piece on to the county. That’s not what I anticipated. I’ve gotten a lot of emails from people saying: “You’ve known for nine months that this was coming, and you should have had a plan in place.” But the truth is, nobody told us what to be ready for. I had no idea this would be our responsibility. I’m sorry, but I just didn’t.

There had been rumors for weeks about vials of vaccine starting to show up in Florida, but we didn’t know where, or which one, or if it would be one dose or two, or who would be eligible to get it. I got a phone call the Saturday after Christmas from our local health department asking for my help, and that was the first time I got involved. The state had given us 12,000 doses of the Moderna vaccine with instructions to administer it as fast as possible to health-care workers and anyone over age 65. There wasn’t a whole lot more information. We asked the higher-ups: “How much more vaccine are we getting? When should we expect to have more?”

Nobody knew. We’ve been given a lot of responsibility when it comes to giving out this vaccine, but not much control. It was basically: “You know as much as we do. Go get shots in arms.”

The best and fastest way we could come up with was to have people line up — first come, first served. You get them in the same place and then it’s “next, next, next, next.” We have 240,000 seniors in this county. Cases are spiking, and we’ve got this new strain to worry about. It’s a race. We have to be fast. I’m lucky that I work for a great county commission, and we have a big team. The sheriff got involved, the department of public safety, emergency management. We opened up community sites, put out a press release and got everything together within about a day.

County Manager Roger Desjarlais is shown in the Lee County Emergency Operations Center in Fort Myers, Fla. (Eve Edelheit for The Washington Post)

We expected to have a big demand, but I don’t think anyone could have anticipated just how much. People started lining up 10, 15 hours before we opened. They camped out overnight, even though we asked them not to. So now you’ve got seniors coming with blankets and medications, and they’re sleeping in chairs in a parking lot. That’s not what anyone really wants. It got a little chilly overnight. The criticism was extreme, and I understand it. I recognize that’s a hardship for some people. We had one gentleman fall down while he was waiting in line, and the ambulance came, and he got his vaccine in the back of the ambulance because he didn’t want to miss out. We had snowbirds, tourists, people caravanning from other parts of the state. If they’re over 65, the federal and state rules prohibit us from turning them away. So now you’re dealing with hard feelings about that. You’re dealing with traffic issues, because you have 2,000 people showing up at a rec center. There’s line-cutting. There’s anxiety. We don’t have a mask mandate in Lee County, so we can’t force people to wear masks, and that’s another issue in line. We asked them to maintain social distance, but a lot of people don’t. A few people complained it was going to be a superspreader event, and I’m not so sure about that, but you certainly don’t want to be doing more harm than good. The police brought a mobile watchtower, and 12 nurses administered vaccines. You had seniors who are breaking down in tears because they’re so grateful and relieved that they can finally start seeing their grandkids again. We were getting through 200 vaccinations an hour, so that’s a very happy crowd. But then you had other people who waited for hours and couldn’t get in, and they’re getting panicky. They’re cursing. They’re trying to call in favors. They’re pleading with you even though there’s no vaccine left on-site.

So it’s this tremendously emotional event, and afterward you look at the numbers, and the math isn’t very forgiving. That first week across all the sites, we administered a total of about 5,000 doses. That’s a tiny percentage of our seniors. Then we still have to do the second dose. Then it’s the rest of our population.

We could trudge along for months and months, and that’s not an option. We have to do more. Last week, we decided to construct a centralized site for vaccinations out at the airport to build our capacity. We hired people to manage traffic flow. We got a big air-conditioned tent from New York. We trained more paramedics to give out the vaccine. We set up a phone reservation system through a vendor so people could call in and get a guaranteed slot.

We had 5,000 slots for appointments spread out over the week, because that’s all we could accommodate until the state gives us more vaccine. The 1-800 number went live Monday at noon. Within the first four minutes, people started to get a busy signal. Thirty minutes in, we’d hit 1.5 million calls. These residents are smart and they’re determined. We looked at the phone records and one woman had called something like 236 times. People would enlist 15 relatives from around the country to keep calling on their behalf. We had situations where 10 seniors would get together in a room, and if one got through to somebody, they’d make their appointment and then say: “Hold on. The guy next to me needs an appointment, too.” The system was flooded. It started to fail. People were getting odd sounding beeps and error messages. Apparently, some calls got intercepted by scammers trying to sell vitamins. Other people were put in a queue to get a reservation time, and they waited on hold for three or four hours and then suddenly got cut off.

I hear about all of it. It’s emails and more emails. Hell, I’d be mad, too. I know the call center can fix the glitches. That part we’ll sort out. But with a lot of these emails lately, they’re asking me questions I still can’t answer: “How many more doses will you give this month?” “I got my first shot. What about my second?” Look, if I knew right now that we had 50,000 doses to give every week, we could set it up on a schedule and really manage this thing. We could scale up. We could do it fast. We could take more control. But I don’t know when we’re getting more vaccines. I can’t create a long-term schedule. I don’t know how many doses will be in the next batch. I don’t know what to tell people about their second shot, because we’re still waiting on that information from above.

The message we keep getting from the state and federal level is it all depends on the supply chain. They say we need to be prepared to roll with the punches as they keep coming.

There’s only one way to satisfy everyone. We got 5,000 more seniors vaccinated last week, and they’re happy. That means we have about 230,000 left to go.

eli.saslow@washpost.com

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