A COVID-19 testing center in D.C. Credit: Darrow Montgomery

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One year ago this week, the World Health Organization declared the coronavirus outbreak a pandemic and Mayor Muriel Bowser issued a public health emergency. 

In early April, Bowser and her team projected 93,600 people would contract COVID-19 over the course of the pandemic. That’s 1 in 7 D.C. residents. They also expected to hit 1,000 fatalities in November. “We pray it’s wrong,” said Bowser at the April 3 press conference. She spoke at DC Armory, a location her team considered building a hospital at in the event that the health care system became overwhelmed.   

“D.C. residents blunted the curve. They did by their actions. They sacrificed a lot,” said Bowser last week. “When we started that [April 3] press conference, that was our charge, how do we blunt this curve so our hospitals can be prepared … Now, it is our charge to crush it. It’s in sight, so don’t give up yet.” 

The Bowser administration never set up a hospital in the armory, nor did officials ever have to use the one in the Walter E. Washington Convention Center. Now, the convention center is a vaccine site. Over 1,000 residents have died of COVID-19, although D.C. hit that devastating marker in February of this year, not November 2020. As of March 11, 1,038 residents have died of COVID-19 and 42,282 residents have tested positive for the coronavirus disease. 

The devastation has been unequal. While Black people make up 46 percent of D.C.’s total population, they make up 75 percent of COVID-19 deaths. And the city’s less affluent wards—5, 7, and 8—have seen the largest percentages of deaths. Health inequities and systematic racism help to explain this trend.     

A year in, and Bowser is considering lifting some more restrictions, as cases have slowed since the holiday surge and hospitalizations related to COVID-19 have decreased. She expects to make an announcement on Monday. While it used to be that the District would enter a new phase of reopening, triggering the ease of numerous restrictions, officials now have a more targeted approach. The District first entered Phase 2 on June 22. Bowser eventually rolled back activities as cases surged in the autumn and winter months, so expect her to ease Phase 2 restrictions, not just enter into Phase 3 of recovery so venues like clubs can reopen and more people can gather. 

The District is still seeing more cases now than in the summer months. For the city to be out of the red zone, which signifies substantial community spread, DC Health would have to report under 15 cases per 100,000 people. DC Health has not continuously done this since early November. Note that a backlog in testing means DC Health has reported an uptick in cases this week.

Vaccination, which started in mid-December, is well underway. As of March 6, 11.2 percent of residents have received at least their first shot of the COVID-19 vaccine. That is more than 78,700 residents. The District has also been vaccinating people who do not live here but work here. When health providers first started vaccinating the public, most shots went to non-residents. Three fourths of D.C.’s 85,000 health care workers live in Maryland and Virginia, and they were the first group to be eligible. Nowadays, the District vaccinates more of its residents than not because the health department prioritizes seniors and people with qualifying medical conditions who are at higher risk of serious illness from COVID-19. Between Dec, 23 and March 8, only 225 doses have been wasted. A majority of those doses were wasted during the first month when providers were still learning.

The District’s vaccine rollout has not been without challenges. Because District officials first relied on a health care system concentrated in Northwest and a first come, first served portal, communities hit hardest were slow to get vaccinated. When providers started vaccinating seniors in mid-January, Ward 3 residents over 65 got vaccinated at higher rates. “The department of health didn’t create these disparities, but the disparities already existed and they did not account for them,” Ambrose Lane Jr., co-founder of the Black Coalition Against COVID-19, told City Paper last month

DC Health has made deliberate efforts to address disparities. As of March 4, 550 have been vaccinated at mobile sites set up in Baptist churches in Wards 5 and 7; over 1,000 people have been vaccinated at sites set up in public housing buildings; and officials have booked appointments for over 500 seniors through door knocking in hard-hit communities. 

However, some experts take issue with the District reserving second doses. “I don’t think we’ll ever get to a point where we are above 80 percent [of total doses administered], especially as we are confirming everybody who’s had a first dose has a second dose waiting for them,” said DC Health’s vaccine lead Dr. Ankoor Shah.  

“I think that getting first doses into people is going to decrease spread and decrease morbidity, mortality faster,” says Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “And then just get the second doses to kind of mop up, is how I would look at it.”

“In general, I would just say that the standard this far into the roll out has to be to not leave vaccine on the shelf,” he adds.  

A number of jurisdictions and providers seem to be holding back doses for second shots, even though federal officials advise they shouldn’t. The Centers for Disease Control and Prevention also says the Pfizer and Moderna vaccine can be administered up to six weeks after the first shot if a delay is unavoidable. 

The District is administering just over 80 percent of its first doses. As of March 6, 125,294 of the 151,000 doses that were delivered and designated for the first shot were administered. “If it’s a first dose, it should be 100 percent,” says Adalja. “If you look at places like West Virginia, they were very aggressive.” West Virginia’s administration rate exceeds 100 percent. Adalja says D.C.’s vaccine rollout is comparable to other states, and things could get better with the introduction of the one-shot vaccine developed by Johnson & Johnson.  This week, the executive launched its new pre-registration system. Overall, the system proves to be a lot better than the previous system of having to rush to vaccinate.dc.gov and the call center on Thursdays and Fridays to book an appointment. DC Health is sending out 13,550 invitations on Friday so people can book an appointment. They’ll have 48 hours to reserve a spot.

— Amanda Michelle Gomez (tips? agomez@washingtoncitypaper.com)

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