The Covid-19 vaccines are getting closer and closer to the American public as the virus continues to infect people and send them to the hospital.

Claire Hannan, executive director of the Association of Immunization Managers, said Tuesday that states have not been given a date to expect shipments of coronavirus vaccines, but they’re preparing to receive them as early as December 11.

“The CDC is telling us, ‘You need to be ready,'” Hannan said.

To prepare, states are testing their vaccine data systems — submitting files that are then received by a US Centers for Disease Control and Prevention clearinghouse.

“All the states are going through testing,” said Hannan, whose association is helping states with their immunization plans. “Everybody’s got to pass that test to make sure that they can transmit data, that their providers are enrolled successfully, that they can transmit orders and receive communication in the data system.”

As Americans wait for the vaccine, Covid-19 has been spreading quickly. The month of November set records 20 times for the number of coronavirus hospitalizations, the most recent Monday with 96,039, according to the Covid Tracking Project. Johns Hopkins University data reports the United States has reached more than 13.6 million total cases and 269,667 deaths. And the impacts of Thanksgiving get-togethers still won’t be felt for weeks, health experts say.

Upcoming holiday gatherings around Christmas and Hanukkah could further spread infections to loved ones.

As officials concern themselves with rising case numbers, they are preparing for the first wave of vaccine distributions.

Vaccine candidates from Pfizer and Moderna are awaiting emergency use authorizations (EUA). States have until Friday to request the number of doses for Pfizer’s vaccine, Claire Hannan, the executive director of the Association of Immunization Managers, told CNN on Monday.

Stephen Hoge, the president of Moderna, told NBC that they are “quite optimistic” when it comes to authorization of their Covid-19 vaccine candidate.

Once the US Food and Drug Administration grants EUAs and the CDC makes recommendations on which groups will get the vaccines first, they will be ready to be shipped out, Dr. Moncef Slaoui, Operation Warp Speed chief scientific adviser, said Monday. And that very day or the next, the first immunizations can be administered, he said.

Panel debates who gets vaccines first

Two Covid-19 vaccines are expected to be ready soon, and already one thing is clear: There won’t be enough vaccines to go around.

Although federal officials expect to have 40 million doses of coronavirus vaccine available by the end of December, those doses will not all be available at once, CDC vaccine advisers were told Tuesday. CDC’s Dr. Sara Oliver told the Advisory Committee on Immunization Practices that the CDC expects between 5 million and 10 million doses to become available each week for the first few months as vaccine makers ramp up manufacturing.

The decision on who gets the vaccines first was made by the committee, a panel of independent advisers to the CDC. They decided Tuesday afternoon to put both health care workers and residents of long-term care facilities at the front of the line.

Vaccinations are expected to begin in mid- to late December, depending on other approvals. The panel is set Tuesday to vote on whether the first group to be vaccinated should be health care workers and residents of nursing homes.

If those two groups are first — or “Phase 1a” in CDC parlance — then other high priority groups will have to wait, including people with underlying medical conditions, essential workers such as police officers and firefighters, and elderly people who are not in nursing homes.

ACIP chair Dr. Jose Romero said to expect frontline health care workers to get the first wave of vaccines.

“It seems pretty clear that the top group of individuals will be health care providers,” Romero told CNN’s “New Day.”

Each state will then decide who within that group of providers will get the vaccine first.

“Anybody that works within a health care institution that could have contact with an individual who has Covid should receive vaccination,” Romero added. “That includes individuals such as the persons delivering food, those persons in housekeeping who rapidly turn over rooms in the emergency room or who perform cleaning in the patient’s rooms. Those individuals will be included.”

Florida surpasses 1 million cases

But even after vaccines start to be distributed in December, there won’t be enough for the wider public to be immunized until April or May of 2021, Dr. Anthony Fauci, the nation’s top infectious disease doctor, said. Until then, the US is still contending with an unprecedented spike.

Florida became the third state to surpass 1 million cumulative Covid-19 cases on Tuesday, following behind Texas and California, according to the Florida State Department of Health.

In Minnesota, more than a third of counties are 10 times over what would be considered a high-risk threshold for infection rate growth as the state is in “the worst spot we’ve been in since March,” Minnesota Department of Health Commissioner Jan Malcolm said Monday.

“When there’s this great increase in the number of Minnesotans needing hospitalization for Covid, that can have some really serious implications for the availability of hospital care for other critical issues as well,” Malcolm said. “And the number of people being admitted for Covid is far overshadowing what we saw back in May.”

At least 35 hospitals in Minnesota are reporting over 95% of their staffed ICU beds are in use, according to the state’s dashboard.

To manage the risk of reopening, New Mexico Gov. Michelle Lujan Grisham announced a new “Red to Green” system that tiers counties by their risk of spread. The data will be updated biweekly, and if a county fails to meet the metrics, it will begin operating at the most restrictive level within 48 hours.

Nationally, Monday marked the 28th consecutive day that the US reported more than 100,000 new cases — a number that far exceeds the records set in the spring and summer surges which both stayed below 60,000.

Hospitals under stress

As cases increase over the holiday season, so have hospitalizations — putting health care systems under stress.

California Gov. Gavin Newsom on Monday told reporters that the intensive care unit bed capacity in the state might reach 112% by Christmas Eve, if the trend of surging coronavirus cases continues.

In Rhode Island, officials have prepared to use field hospitals after telling residents their systems were already at capacity.

In New York, where some hospitals saw room capacity taxed in March, Gov. Andrew Cuomo said this time medical systems need to take steps to move patients to other facilities that have space.

“No patient wants to be in an overwhelmed hospital, because you’re getting less care, the staff is stretched thin, it’s in the patient’s best interest, distribute the patient load over the system,” Cuomo said Monday. “We’re not going to live through the nightmare of overwhelmed hospitals again.”

Health care systems might be even more strained this time around because researchers are now seeing people affected by the virus even after they no longer show symptoms, Fauci said.

Some, called “long haulers,” experience lingering symptoms for months. Others see residual and perhaps indefinite organ system dysfunction, he said.

“The idea that you get infected, you either get no symptoms or you die, and if you don’t die, you’re OK — I think that’s really a misperception,” he added.

Medical staffers Christopher Peter (R) and Paul Truna check on the comfort of a patient wearing a helmet-based ventilator in the COVID-19 intensive care unit (ICU) at the United Memorial Medical Center on November 29, 2020 in Houston, Texas. Texas reports more than 1.2 million positive cases of Covid-19, and more than 21,800 deaths. (Photo by Go Nakamura/Getty Images)

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