More than 100 vaccines have been administered to Johnson County long-term healthcare workers and residents, frontline healthcare workers in hospitals and first responders and more are planned for the coming weeks as the COVID-19 pandemic continues to affect the county, with confirmed, active cases holding steady throughout the past week in our community.

“It’s overwhelming and it’s not something that we’ve had to deal with before — none of us have had to do any kind of

vaccinating or contact tracing on this scale. It’s just a huge undertaking, all of this is,” said Julie Bush, Public Health Director at the Johnson County Health Department. “What we’re seeing right now is an increase in cases, we’re seeing a surge and at the same time, we’re trying to vaccinate people because now there’s a vaccine available. It’s a lot. Public health nurses, right now, directors, everybody that’s working COVID is probably very tired and overwhelmed right now.”

Bush said that doing a large amount of work with little resources was standard fair for people in the public health line of work — but that the amount of overtime and weekend work that has been happening since the pandemic begin has worn the workers thin.

“We’re working nights and weekends, and COVID doesn’t know that it’s Saturday or Sunday, and if we don’t work the weekend, then we come in on Monday to three times the work with new cases laying on the fax machine,” Bush said. “It’s constant. There’s never a free minute, really.”

Adding to that fatigue, Bush said, was the uncertainty that comes with trying to tackle the pandemic as it comes.

“Things are so uncertain, right, because they set a rule and this is how you’re going to do it, and then, ‘Oh, well, this is not working so let’s do it a different way that, maybe, works better,’” Bush said. “Some of the epidemiologists at the state like to say we’re building the plane as we’re flying it, and that’s really what we’re doing. We’re trying to figure it out as we go. Bottom line is, we just don’t have a lot of answers. We have a lot of questions and not a lot of answers, unfortunately. Information comes in quickly and it changes almost daily.”

Bush said that, in her work on social media, trying to update the community directly, she wants to help communicate in a way that everyone can understand that the pandemic is real and it is affecting Johnson County residents.

“We’ve got a little bit of that on our Facebook page, you know, I do the social media too, (Mary Beth Castle) and another lady helps me, but that’s mostly me giving those answers and that information. It’s very hard for me to put it into the right words that people understand … we’re working very hard day in and day out because there are actual cases, actual people that have it and they’re sick. How you could still continue to think it’s not real is beyond me, I don’t even know,” Bush said, although she said that disbelief in the virus and its seriousness has waned. “I do think we’re at the point now to where we’ve had so many cases and so many families have been affected, that most everybody knows somebody who’s had it or been in quarantine because of it.”

It is difficult, Bush said, to even trace the overall impact when considering the number of people that have now either been positive or were placed into quarantine after an exposure.

“On our end, we see and we deal with the ones that are sick, and in the hospital and on the ventilator, we can’t talk to them on the vent, but we talk to an (intensive care unit) nurse or a spouse or a child and we see how sick people can get from it,” Bush said. “We see how sick people can get from it, it’s not just the elderly, it’s 30-year-olds, 40-year-olds, little kids. It’s everybody, if you’re immune-compromised, it could be a really bad outcome. We’ve had 19 deaths in Johnson County, it’s a small town and, to me, that’s significant.”

Bush said that with the high incidence of smokers and vapers and other people that have pre-existing or underlying lung issues, regardless of age, in our area — it’s unpredictable how one might react to the virus.

“A lot of people around here are smokers, still, the rates are better than they used to be and with the vaping, that affects the lungs too, some people are just prone to pneumonia, that affects them, too,” Bush said. “The scary thing is, we’ve seen them turn on a dime. They could be fine one day, we call to check on them the next day and they’re at the emergency room. It’s very unpredictable and that’s very scary for us because we don’t know what we’re going to get when we call them again and it’s people we know, it’s our families, it’s our friends, it’s people in the community that we know. It’s a small town and everybody knows everybody, we know these people. That makes it even harder when you know they’re sick and you worry about the outcome.”

Bush said that vaccines had already been administered and the vaccine schedule is much in flux as new information and guidance arrives from either the state level or the Centers for Disease control.

“People think we have a ton of vaccine and we’re just going to get everybody knocked out and that’s just not the way it is,” Bush said. “The vaccine is so limited right now, that’s why we have to do the schedule like we’re doing, we have to do the priority people first, and those were long-term care, those were number one priority and assisted living facilities.”

There was some confusion, due to changes in the CDC’s recommendations for vaccine scheduling, as to when first responders would be vaccinated, but, Bush said, at the Kentucky state level, those vaccinations are already being administered in spite of the fact that the CDC has now rescheduled first responders to be in the 1B group of priority to receive the vaccine.

“We’ve tried to follow what the Kentucky Department of Public Health puts out, as much as we can, unless there’s not specific guidance from them, in which case we follow the CDC’s guidance,” Bush said. “We were all working towards vaccinating first responders, that’s what health departments were doing – then, the CDC says first responders are in 1B, so then, we’ve had calls off and on with Dr. Steven Stack, through this whole thing, because we need guidance, and he’s been very available to us. So we said to him, ‘You know, we’ve all made plans to do first responders, do we need to switch gears, move them to 1B and just focus on healthcare,’ … the guidance was, if you’ve planned to do first responders, just stick with that and go ahead and do them … we had already made those plans and already had those agreements, that was our plan initially and that’s what we continued with, but at the same time, we’ve also been doing health care workers.”

Bush said the health department has only received two shipments of vaccines thus far, totaling 200 vaccines to be administered, with the second shipment being opened up for ordering last week as opposed to the prior system in which the state pushed as many vaccines as deemed necessary to each county.

According to Bush, the first round of vaccines were administered on Dec. 28, and the second shipment arrived Monday, Jan. 11, and represented the second 100 doses and that the health department is now working to finish up all of the county’s first responders and working on administering the vaccine to as many healthcare workers as possible.

“I think we’re going to have enough vaccine to finish up all of the first responders, plus all of the healthcare workers that have reached out to us thus far,” Bush said. “But it’s so uncertain as to when the vaccine is going to be available … so we have to make these plans tentative.”

Bush said that there have not been any reactions observed in those who have received the vaccine thus far outside of the normal and expected scope of vaccine reactions, including soreness at the site of injection and other reactions such as mild fevers and not feeling well for a day or so.

“We’ve vaccinated 120 people so far, and, mostly, the only reaction that we’ve heard was just soreness at the site,” Bush said. “Some of the other things, we’ve heard somebody ran a fever, we’ve heard somebody didn’t feel good – those are things we’d expect from any vaccine … I’d say if you have a reaction like that, which is a normal reaction to a vaccine, that just means it’s starting to work and you’re starting to form an immune response.”

Bush asked the community for patience moving forward, knowing that the plans are ever-shifting and when shipments will arrive is uncertain.

“A vaccine is really the only way we have out of this thing, we don’t have any other options. We’ve got the mask mandate in place, we’re pushing social distancing, we’re pushing hand-washing, and we’re still seeing a surge,” Bush said. “Literally, the vaccine is the only option and it’s going to take more people taking it to see more of an effect in a community. One thing I would ask is for people to just be patient with us, our phones are ringing off the hook and I understand, everybody knows it’s available, they’re seeing stuff on television about the CDC and the guidelines … we’re giving them the best information that we can when they call and just asking them to be patient with us.”

Bush said there was an additional challenge in handling the vaccine, as each vial contains ten doses, and, due to the temperature-based storage requirements mean those ten doses must be used within six hours of puncturing each vial, scheduling vaccines has been made difficult.

“I don’t think we realized when we went into this what a challenge the scheduling and the logistics of it were going to be, as far as taking it out of the freezer and thawing it, and there’s a process to how you handle the vaccine,” Bush said. “Once you puncture that vial and give that first shot, you only have six hours to use up that whole vial and give all ten shots. You have to make sure you have ten people lined up to schedule and make sure they all show up and if they don’t, you have to have a backup plan. We don’t want to inconvenience people on when we need them here, but we also don’t want to waste any either. It’s too precious of a commodity to mishandle. We’re trying to be very thoughtful with how we do it and just plan accordingly.”

The JCHD confirmed 29 new cases on Jan. 11, bringing Johnson County to a total of approximately 1484 cumulative cases since the pandemic began, according to a statement from the JCHD  with 230 currently active cases, 13 people currently hospitalized due to the disease and 19 total deaths attributed to the virus, as of the evening of Jan. 11.

Symptoms of COVID-19 include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting or diarrhea.

According to the U.S. Centers for Disease Control and Prevention, people with COVID-19 have had a wide range of the reported symptoms, ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus.

Anyone of any age can contract the virus. However, older adults and people who are immunocompromised or who have severe underlying medical conditions — including cancer, heart disease, lung disease, diabetes, COPD, obesity, asthma, hypertension or high blood pressure, sickle cell disease, chronic kidney disease and liver disease — have a higher risk of developing more serious complications from COVID-19.

According to the CDC, the primary ways to protect against contracting or spreading the virus is to do frequent hand washing, maintain social distancing (keeping six feet apart from others) and wearing a face mask or facial covering when around others.

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