WILMINGTON—Wielding a track record of making healthcare in the region more accessible, the Cape Fear Clinic — which operates in a three-building campus under the shadow of New Hanover Regional Medical Center in Wilmington’s medical district — will likely be involved in a high-profile mission in the near future: administering the Covid-19 Moderna vaccine to the clinic’s clientele.
“We’ve submitted all the paperwork, and we’re waiting on the final approval from the state,” said Dr. M. Kent Locklear, chief medical officer for the clinic.
The Cape Fear Clinic operates with a staff of 18 and a robust volunteer network to serve people who are uninsured, as well as people with incomes of less than double the federal poverty level and those with Medicaid coverage — patients from New Hanover, Brunswick, Pender and Columbus counties. After originating 30 years ago as a one-night-a-week operation run out of St. Mary Catholic Church, Cape Fear Clinic has since evolved into one of the region’s premier charitable medical facilities.
The clinic collaborates with homeless shelters, food banks and other institutions to provide accessible coverage, and has an in-house pharmacy to fill prescriptions. Last year, Cape Fear Clinic served more than 2,000 patients and provided over 33,000 prescriptions.
As part of Operation Warp Speed, federal health officials are collaborating with state-level counterparts to initiate bulk vaccine shipments into the hands of all states, Locklear said. State authorities have brought the N.C. Association of Free and Charitable Clinics — of which the Cape Fear Clinic is a member institution — into the conversation.
The North Carolina Department of Health and Human Services will spearhead the allocation of N.C.’s doses to the counties of the state.
Locklear said the final Food and Drug Administration review of the Moderna vaccine will likely occur within two weeks, and in preparation of an approval, preemptive distribution of the vaccine at the federal-to-state level has already begun.
“Our understanding is they have distributed it to the states and the states are holding it in some central location,” he said. “Or they may still be in the process of doing that, so when the approval day comes — assuming that it is approved — it will be more of a local effort.”
The N.C. Legislature allocated $5 million to the NCAFCC in a Covid-19 relief package signed by Gov. Roy Cooper in early May, then increased the number to $7.425 million in a bill Cooper signed July 1.
“The state does not want the underserved to be left out of this process, and that’s why they came to the free and charitable clinic association,” he said. “Once the approval occurs, we are being told in a matter of days to weeks they will be delivering the first shipments to the vaccinating facilities.”
He expects the clinic to administer doses by late December or early January, which would be in the midst of the state’s first phase of vaccinations. The clinic is expecting the delivery of a new freezer in the coming days.
Phase 1a, as it’s called in N.C.’s current plan, involves vaccinating medical professionals working in areas at highest risk of Covid-19 exposure, focusing on those who will be heavily relied on throughout the vaccination process; long-term care staff are in this group, too, which the state estimates could amount to between 140,000 and 160,000 people. Phase 1b will include long-term care residents, adults 65-or-older in congregate living, and people with two-or-more chronic conditions that indicate a high risk for Covid-19 complications.
The bulk of Cape Fear Clinic’s patient base would align with the state’s Phase 2 plan, which includes marginalized populations, uninsured and low-income individuals, adults younger than 65 suffering from one chronic condition, and adults older than 65 with zero or one chronic conditions.
During the first phase, the clinic hopes to vaccinate its own staff, according to Locklear, which would allow the reintroduction of many volunteers who had to be sidelined in recent months due to a high risk for Covid-19 complications. Last year, more than 150 volunteers worked at the clinic, and the number has declined to about 100 this year, according to figures maintained by the clinic. Volunteers include retired medical professionals like doctors and nurses, and college interns.
“I do think there’s going to be sort of a mad dash, a mad scramble for these vaccines once they come available,” Locklear said. “Lots of organizations are going to want to try to get their hands on it. So we’re making sure that all our ducks are in a row, and we have all the required storage facilities.”
The Moderna vaccine better suits the clinic’s infrastructure because the required storage temperature is less cold than that of its Pfizer counterpart, which must be kept at colder than minus-80 degrees Fahrenheit. Shipments of the Moderna vaccine will be sent out in groups of a few hundred or fewer doses, while the Pfizer vaccine will be shipped out in bulk quantities of more than 1,000 in some cases, Locklear said.
“None of this is new for us,” he said. “It’s a new disease and it’s a new vaccine, and we’ll have to learn the specifics of it. We’ll have to learn what we need to tell folks about it and what to expect. But in terms of the process, this is nothing new.”
The clinic routinely handles adult immunizations, administers flu shots each year and has a network of practitioners well-versed in treating different illnesses.
In a written statement attributed to New Hanover County Public Health, a spokesperson said Cape Fear Clinic serving as a provider of the Covid-19 vaccine “is a natural fit.”
“Cape Fear Clinic is a valuable resource, and has served for years as an assurance service provider to our community in offering free quality healthcare to those in need,” according to the statement. “Their role is similar to most any other healthcare primary care provider, but free and charitable clinics are a critical part of the health care safety net system.”
Dr. Jennifer Buxton, the chief pharmacy officer, said many people often assume that since the clinic’s services are discounted or free, the care must be of a lesser quality than that of traditional medical practices.
“That’s simply not the case,” Buxton said. “Most, if not all of what we do, is funded by grants and donations, and our grant funders and our donors won’t fund us if we’re not providing a certain quality of service.”
Cape Fear Clinic, she said, not only provides grassroots healthcare to those who lack other options, but it also alleviates burdens from other facilities like emergency rooms.
“Free clinics serve different roles in different communities depending on how that community is structured,” she said. “Here in the cape fear region, Cape Fear Clinic is truly the bottom of the safety net. So patients that can’t afford to get care anywhere else can come to us.”
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