Amber Ricks From: Lisa Pincey Sent ‘Thursday February 25, 2021 7:36 AM To: Michal Fiscus; Valerie Nagoshiner, Shelley Walker ce Laine Anola Subject: RE:Communicatons w Shelby. Appreciate the documentation. Further, Alisa has personal cell phone numbers an email addresses for both Or. ones land me, and ne attempts were madeto contact ether of us if she was indeed concerned about not being abe to each you. Ukewise,thad a 15-minute call at 12:24pm on February 16 wit Asa, and no mention was made of any expired product. Lisa Piercey, MD, MBA, FAAP| Commissioner ‘Tennessee Department of Health Andrew Johnson Tower, §* Floor 710 James Robertson Parkway Nashville, TN 37243, 615-741-9409 lsapieceyoinen mngownean Connect with TOM on Eacsbock and Tuts @TNDepeotHeath From: Michelle Fiscus Sent: Thursday, February 25,2021 7:26 AM “To Lisa Piercey Lisa Percey tn gov; Valerie Nagoshiner Subject: Communications w Shelby. Incase we'e asked (and fm sure we wil be), below isthe text received from Judy Martin on Saturday, Feb 13 (before the snow, btw) and copies of the ems from Haushaler are attached, This was also during the time when there was contention betwoen the city and SCHD regarding who wae going to bein charge of allocating vaccine doses, laezumed the calls were about that and was tryng not to get inthe middle. In any case, at no time dié they mention expired ‘vaccines or any urgency to this communication. Dr. Haushalter’s comment that she reached out nd my lak of response has no bearing onthe vaccines having been exped or her mismanagement ofthis entire situation. Health Michele. Fscus, MD FAAP Medical Director | Vaccine-Preventate Diseases and immunization Program “730 lames Robertson Pky, 3" Flaor Nashvile, 10372630: 615-741-9477 615.961.0514 From: Michelle Ficus San: Friday, February 19,2021 11:37 AM To: Tim F Jones Subject: Shelby Heres the tox | receive from Judy this weekend bx Ficus De you have ie fo ‘auch phere cal fem De Pevshater and me? ‘Ey the dy at th matte touch Bases wth youtomerron, Tose care of a0 ° © @®0@7Q06 ‘That does not sound urgent to me, especially since she didnot follow-up as she sugested. Follow-up emails attached with “when time permits” and my email back yesterday apologizing for not calling back and ‘Alsa's response that aid not suggest anything of urgency (actually, she didn't address i a al). ‘She did leave a voicemail on Monday 2/15 that also stated she had some things to report and she realized Judy did not ‘connect with me, She sad she wanted me to call her back "ifyou get a chance” Had she orld at any time indicated in any communication that they were concerned about vaccines expiring | would have dropped everything. there wasna indication ofthat and | knew there were ongoing discussions around the Shelby/City of Memphis power struggle, was trying not to get inthe middle ofthis ongoing issue before they had their Joint meeting yesterday (hence setting up the cll fo Friday). There was never any indication they had an urgent onceen about vacenes exping Shelley Bes eatth ‘Michelle D.Fscus, MD FAAP ‘Medical Director | Vaccine-Preventable Diseases and immunization Program 720 James Robertson Pky, 3 Floor Nashville, 7037283 0: 615-741-9477 615-961-0518From: Michelle Fscus| Sent ‘Thursday, February 25,2021 726 AM Te: Lisa Perey; Valerie Nagoshiner, Shelley Walker Subject: Communications w Shelby. [Attachments: TEXTERNAL| Follow-up; [EXTERNAL] Regarding our Meeting; [EXTERNAL] RE: February allocations In case we're asked (and 7m sure we will be), below isthe text | receive from Judy Martin on Saturday, Feb 13 (before ‘the snow, btw) and copies ofthe emails from Haushalter are attached. Tis was also during the time when there was contention between the clty and SCHO regarding who was going tobe in charge of alocaing vaccine doses, | assumed ‘the cals were about that and was trying not to get inthe middle. In any case, atno time dd they mention expired vaccines or any urgency to this communication, Dr. Haushalter's comment that she rzached aut nd my lack of response has no bearing an the vaccines having been expied or her mismanagement ofthis entice situation SSHealth Michelle D.Fscus, MD FAAP “Medical Director | Vaccine-Preventable Diseases and immunization Program 710 James Robertson Pky, 3 Floor Nashville, 1837283 0-615-741-9877 €:615-9610518 From: Michele Fscus ‘Sent: Friday, February 19, 2021 11:37 AMM Tos Tim F, Janes ‘Subject: Sheiby Here's the text | received from Judy this weekend: $0 Bust ys he tin fo 8 yuck phone al fom vatater and me? ‘.Eioy ne dy at he matchite ‘foun bases wth you tomar. Toke core ot ao ° *6©@®006206‘That does not sound urgent to me, especialy since she did not follow-up as she suggested Follow-up emails attached with “when time permits" and my email back yesterday apoogiing for not caling back and Alsa's response that didnot suggest anything of urgency (actualy, she didn’t addres tat al). ‘She did leave avolcemall on Monday 2/15 that aso stated she had somethings to report and she eared Judy did not Connect with me. She sid she wanted me to call her back “you get a enance”. Had she oly at any time indicated in any communication that they were concerned about vacines expiring | would ‘have dropped everything. As there was na indication ofthat and | knew there were ongoing discusions around the Shelby/City of Memphis power strugale, Iwas tying not to get in the middle ofthis ongoing isue before they ha their Joint meeting yesterday (hence setting up the cal fr Friday) There was never any indication they had an urgent concern about vaccines expicing Shelley Michele D.Fscus, MD FAAP “Medical Director | Vaccine Preventable Diseases and Immunization Program 710 James Robertson Pkwy, 3" Floor Nashvile,1N 37243 0: 615-741.9677 615.961.0514Amber Ricks From: Houshoter, Als » SHELBY aa COUNTY GOVERNMENT eae HEART of AMERICAAmber Ricks From: Haushater, Aisa Sent: Friday, Fobruary 19,2021 3:16 AM To: Miele Fiscus ce Jones, Brenda Giliom, Dwan Subject [EXTERNAL] Regarding our Meeting ‘This isan EXTERNAL oma. Please exercise caution, DO NOT open attachments or click inks from unknown ‘senders or unexpected email -STS-Socurity. Dr. Ficus, {Good morning. 1am sending this email related toa few items. While | understand the rationale for adding the City of Memphis to our scheduled call, have a few items to share with you that are SCHD specifi that do no include the ity ‘of Memphis. | wil give youa call this morning regarding those tems. Last, Director Brenda Jones serves as our Director of Homeland Security. She lads the joint meeting regarding allocations. Please include Director Jones onal communications regarding allocations an inelude her inthe meeting invitation Thank-you, Alisa ‘Nisa Haushater, ONP, RN, PHNA-BC Director, Shelby County Health Department, 14 Jefferson Avenue “Memphis, TN 38105 Phone: 901-222-9080 Fax: 901-222-9060, malt: alsa haushalter@shelbycountytngov CONFDENTIALITY NOTE: Theiforatonin ths message confident andmay legaly peed intended soley fer the dtressee,Accsstothsmessgeby anyone ees navthored. Wyouatenet he tehded reap ny dlsue, copying, of dstron {the masage, van atin or amino en by you lane on = rohbtedsndmay be laws Plste Slt thre along ‘mee conta th senda yo ave reaved tha mestagen er SHELBY COUNTY GOVERNMENT HEART «/ AMERICA‘Amber Ricks From: Haushater Alisa Sent: ‘Thursday, February 18,2021 100 PM To: Michele Ficus Subject: [EXTERNAL RE: February allocations Yes, you are correct. ‘Sen athe Samsung Gast Side, a9 ATAT 56 Eolton capable smartphone —— original message From: Michele Fiscus «Michelle Fscus@tngov> Date: 2/18/21 6:34 AM (GMT-06:00) To: "Martin, Judy" Ce: "Haushalter, Alisa” , Subject: RE: February allocations latin, Judy" Judy. Martin@shelbycountytngov> Sore L’t get a chance to call you back yesterday. ‘My understanding is that these allocation requests are coming to me after a joint Thursday meeting with Doug McGowen and the community partners. Am incorrect on that? sF a. Michele. Fiscus, MD FAAP Medical Diector | Vaccine Preventable Diseases and Inmmunization Program 70 James Robertson Pkwy, 3 Floor Nashile, 1N37243, 0: 615-741-9877 615-961-0514 From: Mati, Judy Sent: Thursday, February 18,2021 12:44 AM “To: Micelle Ficus Ce: Haushater, Alisa Alisa Haushalter@shebycountytn gov Judy Martin Subject: [EXTERNAL] FW: February allocations "This is an EXTERNAL email, Please exercise caution. DO NOT open attachments or click links from unknown senders or unexpected email - STS-Securty. ** {Good Evening Dr. FiscusPlease note the attached recommended alocations for Shelby County forthe week of 2-18-24. tincuded he apital request oe Piz and Moora ‘Thank you for your support Best, sudy From: Mati, Judy Sent: Wednesday, February 10, 2021 9:32 PM Tor'Michele Fac’ ; Randolph, Bruce “Bauce Randolphn®selbycountytn go>; Sweat, David : Martin, Judy clus. Martin@®shelbycountytngox> Subject: RE: February allocations {Good Evening Or. Fscus: Please note the attached recommended allocations for Shelby County forthe week of 211-21. receve no direct requests except from Church Heath Center and their request i included. Further, we ae coordinating with Concentea to meet their needs for coverage of thelr Memphis staff ‘Thank you for your suppor. Best, sudy From: Michelle Ficus eich Fiscusitn go> Sent: Sunday, February 7, 2021 710 AM. To: Haushalter, Asa ; Randolph, Bruce Subject: February allocations [ This EMAIL was not sent from a Shelby County Government email adéress. Please use caution. ] Please see attached spreadsheet with three tabs, The firsts forthe allocations you just submitted tobe delivered this coming week. The second tabi the allocation plan for ths week (week of Feb). I need these back by COB Wednesday, Feb 10. These doses willbe delivered the week of Fe 15. The thie abi for panning for doses tobe delivered the week ‘of Feb 22 and Is due to me by COB Wed, Feb 17, ‘couple important things to note: The Feb 4 allocation was higher due toa modest increase in Modema doses andthe reallocation of 11,000 doses reclaimed from Walgreens and CVS that were not gong tobe used forthe LICE partnership. Modern allocation are now predicted tobe level forthe remainder ofthe month. You wil ee an artificial Increase in the allocation onthe Feb 18 tab. This is because Pfizer sofa canging the doses inone tray from 975 10 1,170 to reflect the 6" dose available in most vals. t doesnot result in an increase in Pfizer trays being delivered, t's [st now accounting forthe extra doses you already knew were there. n order to get that 6 dose from as many vials. as possible, be sure to use the cr vanish point syringes included inthe supply kts as they have lss dead space than other syringes and will result in ess waste | wil sti send out hospital requests and an updated list of onboarded entities in your region the week that these allocation plans are due back to me to assist you in determining how best to distribute these doses among the partners In your region.Please lt me know ifyou have questions/concerns. Thanks for allyou'e doing! Shelley Ficus Health Michelle D.Fscus, MO FAAP “Medical Director | Vacine-Preventable Diseases and Immunization rogram 710 Jamer Robertson Phu, 3" Floor Neshvile, 1V37283 0: 615-741-9477 615.961.0514‘Amber Ricks From: Michell Ficus Sent Tuesday, February 23,2021 646 AM To: Lisa Percey Subject: FW: Log and Other Updates ‘Attachments 'SCHD_Pharmacytog. WastedDoses.02-2221.pdf Chicken serateh attached. ‘Ada 700 doses wasted (140 vals} and not accounted fr on that st (wasted because of weather 2/15) 1m trying to come up witha mathematical formula for determining how many doses on hand and have sent an email to the epi that writes the code for allocations. \We have the expectation that a county will use it's weekly allocation within days and the second dose allocation within. MA days of receipt we give them a pas forthe entire week of 2/18, they should have used up any ist doses delivered prior to 2/8 They recelved a shipment of 8,190 on 2/22 that is nt included inthe 50,000 doses we counted on Saturday They received 11,700 on 2/16, 0 we should subtract those fom the 50,000 ‘They eceived 11,700 on 2/15, so we should subtract those from the 50,000 ‘They received a frst dose shipment on 2/10 of 10,725. They should have acminstered haf of those before the snow hit, So subtract 5,360 from the $0,000 ‘They eceiveda second dose shipment on 2/5 of 5850 doses. They should have administered half of those before the snow hit, 50 subtract 2,925 frm the 50,000, Everything else should have been used prior to 2/14. So, by that calculation they should be {8]31S4BEEE behind (essentially 2+ weeks of administration if we disregard ‘anything delivered ater 2/18 ste want to look at ther inventory before the storm, the had 20.967 doses on hand on 2/12 They rceved 10,725 0n 230s subtract 7 ofthat 9192 om the 20367 They received 5850 second doses 25 an shoud Mave weds subrat2925 Everthing ese shoud have Been used, eavng them 880 dosed (essential wekof administration} sof 22 ous = Health Michele Fscus, MD FAAP Medical Director | Vaccine-Preventable Diseases and Immunization Program 710 James Robertson Pkuy, 3 Floor Nash, 1037243 0: 615-741-9477 615.961.0514From: Haushalter, Alsa ‘Sent: Monday, February 22,2021 8.07 AM ‘or Michelle Ficus ‘ce:Paul Petersen ‘Subject: [EXTERNAL] Log and Other Updates ‘"" This is an EXTERNAL email Please exorcise caution, DO NOT opon attachments or click links from unknown, senders or unexpected email -STS-Security. > or Ficus, {Good morning. Attached i the log that retrleved from the pharmazy this morning, There I one tem thats dffcult to View. The date 02-10-21. few other erica updates ‘+The meeting with Regional One i scheduled for 3:30 today 3s we had to schedule after 2:00 since Dr. oopwood ‘needs to attend the meeting, Agenda tems areas we scussed: Regional One ecelvng SCHD vaccine in thelr ‘pharmacy, potentially transferring vaccine and asignng a ferent pharmacist + will work on new computer being putin the lab today ‘+ Totalk with Chie MeGowen short regarding potential transfer of vaccine to Memphis for this week. Lastly, wll be meeting witha small team at noon today. They wile assigned to asist with corrective action plan and implementation. For today and likely tomorrow, both Dr. Bruce ae Dr. Martin willbe Involved Inthe meetings. Thanks, Aliza ‘Alisa Haushalter, ONP, RN, PHNABC Director, Shelby County Health Department ‘14 Jefferson Avenue Memphis, TW 38105, Phone: 901-222-9080 Fax: 901-222-9060 Email: ‘CONFIDENTIALITY NOTE: Theinormtioninthiemeszage scone anda belagaypilges_ intended solely forthe bddresee.Aecesstotisressage by anyone del suraihorced, fyovare note intended recipe on icles, copy, or srbuton ‘the message or any cton or oaton taken by you mehance onyx phd and may beurawi Pease deletes ema and ‘ronal contact the sender you hve reeled eteg@ eo SHELBY COUNTY GOVERNMENT ART of AMERICAPlrer waste Lot EMS /¢- of 13 ra os dese pot E27 Bin yals Het Lbyses oF) ot ELT H BF Viale 165 hos vot BLY Bo jawiale gy Foie vino tae ELT Breads SIT SDA CoF BLAZG4 Hh 14 vals = ——— 70 dose GuAmber Ricks Feo Usa Percey Sent: Tuesday, February 23,2021 652 AM To: Michelle Ficus Subject: RE Log and Other Updates Goodness gracious ~ sorry for making you go through al of those calculations, but THANK YOU! One last queston.the first wastage event (65 doses) was on what dte..feb 2 oF 3? From: Michelle Fscus Sent: Tuesday, February 23,2021 6:46 AM “To: Lisa Piercy Subject: FW: Log and Other Updates Chicken seratch attached, ‘Ade'1 700 doses wasted (140 vals) and not accounted for on that list (wasted because of weather 2/15) rm tying to come up with a mathematica formula for determining how many doses on hand and have sent an emailto ‘the ep that writes the code for allocations. |We have the expectation that 2 county wil use i's weekly allocation within 7 ays and the second dose allocation within 14 days receipt. ifwe give them a pas forthe entice week of 2/28, they should have used up anyfirst doses delivered prior to 2/8. ‘They received 3 shipment of 8,190 on 2/22 that snot included inthe 50,000 doses we counted on Saturday They received 11,700 on 2/16, so we should subtract those fom the $0,000 ‘They received 11,700 on 2/15, so we should subtract those fom the $0,000 ‘They received a fist dose shipment on 2/10 of 10,725. They should have administered haf of those before the snow hit, 50 subtract 5,60 from the $0,000 They received a second dose shipment on 2/5 of 5,850 doses. They should have administered half of those before the ‘snow hit s0 subtract 2,825 fom the $0,000 Everything ese should have been used prior to 2/14 50, by that calculation they should be I8)3HSGBEES behind (essentially 2+ weeks f administration) we disregard anything delivered after 2/18 Ife want to look at their inventory before the storm, they had 20,967 doses on hand on 2/12 ‘They eceived 10,725 on 2/10 so subtract 6/7 ofthat = 9192 from the 20.967 ‘They received 5,850 second doses 2/5 and should have used so subtract 2,925 Everything else should have been use, leaving them ze7N f ealth. BD teatth Michelle Fics, MD FAAP Medial Director | Vaccine Preventable Diseases and immunization Program 710 James Robertson Ply, 3 Floor Nashvie,1037243 0-615-781-9477 615-961-0518 From: Haushalter,Alsa Sent: Monday, February 22,2021 807 AM To: Michelle Fscus Ce: Paul Petersen Subject: [EXTERNAL] Log and Other Updates ‘Thi ie an EXTERNAL oma. Please exerolae caution, DO NOT open attachments or click inks from unknown ‘senders or unexpected email BTS Security. Dr. Ficus, ‘Good morning. Attached isthe log that retrieved from the pharmacy this morning, There fs one item that fifi to View The date fs 021021. A few other ertal updates: ‘+The meeting with Regional One's scheduled for 3:30 today as we had to schedule after 2:00 since Dr. Coopwood needs to attend the meeting. Agenda items areas we discussed: Regional One receiving SCHD vaccine in their pharmacy, potentially transfering vaccine and asigning a differen! pharmacist ‘+ Will work on new computer being putin the lab today ‘+ Totalk with Chie McGowen shortly regarding potential transfer ofvacrne to Memphis fr this week. Lastly, willbe meeting wth small tam at oon today. They willbe assigned to assist with corrective action plan and implementation. For today an ikely tomorrow, both Or. Bruce and Dr. Mrtn will be involved in the meetings. Thanks, Alisa ‘Aliso Haushalter, DNP, RN, PHNA-8C Director, shelby County Health Department ‘14 Jefferson Avenue ‘Memphis, 1 38105 Phone: 901-222-9080 Fax: 901-222-9060 Email: alsa haushalter@shelbycountytngov ‘CONFIDENTIALITY NOTE: Teinfermatoninthsmesiageiconfidertladmay belay prieged. i ttendedsoly forthe esee.Aecesstothismessageby anyone ee unatorand. Foy rena eteedrecpar anyGaclne, copyng, tron afeneanoranyatioyronsten an ymin noha bein dete ea oh Iriel contact the ener you have rains ths mesg tr.Amber Ricks From: Usa Percey ‘Sent: Tuesday, February 23,2021 6:15 AM To: Michele Fiscus ‘Subject: Couple of questions for bifings today Remind me again..recognizing thatthe number varies based on incoming supply, but how many excess days vaccine do "you believe the SIK doses in SCHD inventory represents? ‘Will you send me the chicken seratch ledger, please? Just want to be clear on dates and # dosessa Percay Sunday, February 21,2021 845 AM, Michelle Ficus Paul Petersen RE letter to Coc 2021 Feb 20 temporary assignment of a COC oftcer pat astached From: Michelle Fiscus Sent: Saturday February 20, 2021 6:32 PM. To: Lisa Piercey Ce: Paul Petersen Subject: letter to COC or. Perey, Please soe the attached letter requesting assistance from CDC. | just pu ton generic letterhead, f you culd please sign and return well get it submitted, ‘Thanks, Shelley SUNT BS heath Michelle D.Fscus, MD FAAP ‘Medical Director | Vaccine-Preventable Diseases and Immunization Program 710 James Robertson Pky, 3 Floor Nashville, 1037283 0: 615-741-9477 6159610518DEPARTMENT OF HEALTH “Anew Jaton Tower, Foe "0 ames Roberson Park LISA PIERCEY, MD, MBA, FAAP ‘Governor Nash, Temence 37283 ‘Commisone February 20,2021 Dear Ms. Vele The Tennesse Departnent of Health request the temporary assignment of a CDC officer to provie on the round oversight of vaccine management o prevent vaccine loss atthe Shelby County Health Deparment in Memphis, Tennesse. On February 19,2021, TDH was informed ofthe wastage of CCOVID-19 vaccine doses since at east 232021, wih knowa wastage of 1,315 dose (based on S {ssi SCHD i storing vaccine propel nthe wanspet cles, but management rom thawing scinisraton isnot in compliance with CDC guidelines. As Shelby County i one of th most populous sd disadvantaged ares ofthe sat, iti crite that the administration of vaccines not be ale in tht ‘eanty, SCHD is current in posession of rays of Pizervacine. SCHD isa mateo belth partment hati ot unde the juriditon of TD POC: Michelle Fiscus, MD FAAP, Medical Director, Tennessee Vaccine-Preveniable Diseases tad Immunization Programe State POC Contact Information: ss: ssn 2 615-961-0514, 615-480-8910 Deployment Mision Objective: Training and on-site oversight ofthis process while oer arrangements are made forthe management of fture shipments of vaccines Proposed Deployment Start and End Dates: Febrary 22, 2021 through March 19,2021 Proposed Deployment Type: Field deployment Froposed Deployment Location and Location Type: ‘Shelby County Health Department, 814 Jefferson Ave ‘Memphis, TN 38108 Proposed Number of Deployer Proposed Team Composion: Subject mater expet in COVID-19 vaccine storage, handing and logics ‘TDH will sign one sate-Level staff member to assist with his mission. The State deployed team to investigate the situation at SCHD as soon 8 it was notified ofthe vacine loss. The finding of that ‘vestigation shed light on SCHD's lick f standard operating procedare,trarspareey in operations and sinationalavareness among leadership. We ask that CDC asst with providing oversight and accountability in ede to help SCHD effectively execute their COVID-19 vaccination efor Trunk you for your suport ofthis equ, Pls do ot esate o conte mei you have questions Siconty, An B (an Yoceore Lisa Pity, MD_MBA, FAAP Commissioner ~