The wait for a COVID-19 vaccine is over, and as much of the general public anxiously awaits the opportunity to get the vaccine, hospitals and healthcare facilities across the country are continuing to ramp up efforts to safely receive, secure and administer the vaccines during the first phase of the rollout.
While the monstrous and ever-evolving task of executing a vaccine rollout has required cooperation and dedication from nearly all hospital employees, security departments have played an integral role in ensuring it runs as smoothly as possible with minimal threats.
As with any public health crisis, natural disaster or other emergency, it is essential that hospitals constantly review security plans already in place to ensure the continued safety of patients, employees and assets. ASIS Int’l, a professional organization for security professionals, recommends facilities review their processes for coordinating with local law enforcement partners and other healthcare facilities to “stay abreast of any potential risks, such as civil disturbances, protests or other security issues” that may arise during the rollout.
Civil disturbances were of significant concern before vaccine distribution began due to many reports of conspiracy theorists looking to disprove the existence of or steal or sabotage the vaccine in order to halt its distribution for a multitude of reasons.
Ben Scaglione, director of security at White Plains (N.Y.) Hospital, is part of a small group of ASIS members who continue to have weekly meetings to discuss the challenges that have come with securing the vaccines, share their experiences and make necessary improvements. While there have been instances of vaccine naysayers attempting to intervene in different parts of the country, overall, it has not been a significant issue, he told SSI sister publication Campus Safety. So far, no other members of the 14-person group have reported these types of incidents.
“Security directors … we’re kind of paid to be paranoid,” Scaglione says, highlighting the importance of preparing for the worst-case scenario. “We’re always looking at those possibilities and trying to reduce that risk.”
One advantage hospitals have in keeping potential civil disobedience at bay is the fact that many remain on some level of lockdown, where only personnel and patients are allowed entry in order to reduce the potential spread of the coronavirus. These protocols have been in place for months in some capacity at most hospitals, providing time to iron out the details of keeping out unwanted or unapproved individuals.
Hospitals Must Share Resources, Knowledge
As anyone working in healthcare knows, emergency plans can significantly vary from hospital to hospital, often due to available resources and past experiences. Some hospitals have secured important assets in the past, giving those facilities a solid jumping-off point when it comes to reviewing processes that would lend themselves to securing the coronavirus vaccine.
For instance, throughout his long-standing career in hospital security, Jeff Hauk, director of public safety and police authority services at Memorial Healthcare in Owosso, Mich., has established a decade-long relationship with the pharmaceutical manufacturer that was responsible for the anthrax vaccine.
“I brought a lot of those things into play when we were reviewing our security plans,” he says. “Our security program is based on that predicate on a daily basis, so officers have already been taught these things and deploy them regularly. I think it was a lot easier for us because we’re prepared — whether it’s a vaccine, a special event or a VIP. Our program really lends itself to being prepared for these kinds of things.”
Hauk also recognizes that his hospital is at an advantage since its security team is completely in-house, allowing them to fully control and manage emergency plans.
“I think there are a number of different hospitals, particularly in our area and similarly sized to ours, that just don’t have the resources,” he says. “It’s maybe one or two people that are doing the security and they contract the frontline staff out. And then that frontline staff has also been stretched very thin, just as it is here with all of the COVID pandemic requirements that we’ve assisted with. One of those that comes to mind is entrance screening. I know a number of other hospitals I speak to don’t have the staff in the security realm or public safety to be able to do those things; either other staff members are doing them or they’re contracted out.”
Vaccine Shipping and Receiving Must Be Protected
For many hospitals, the physical involvement of the security department with the vaccine rollout begins with shipping and receiving. A predetermined, secure route from the receiving dock to the storage location should be coordinated with the help of shipping and receiving, pharmacy and security personnel. When possible, many experts recommend security personnel provide escorts during the transport from shipping and receiving to other locations within the hospital and during any other subsequent movements of the vaccine.
For many hospitals, as previously mentioned, this capability is dependent on available resources. At Memorial Healthcare, this was not a significant logistical challenge as the facility already has an armed presence of professionalized officers.
“When they transport the vaccine from a secured environment to the locations for our distribution, that’s escorted from start to finish,” says Hauk. “We also provide an armed officer at the site during the duration of the distribution of the vaccine.”
At other hospitals with fewer resources, this has not been the norm. In these instances, Scaglione strongly recommends that security teams develop close relationships with pharmacy directors and shipping and receiving personnel, so they are always aware of any evolving security needs.
Both Scaglione and Hauk also emphasized to their respective teams the importance of avoiding the public dissemination of details surrounding the dates and locations of vaccine transportation and storage. This requirement should also be communicated with shipping and receiving and pharmacy personnel.
For many hospitals, a significant hardship regarding the shipping and receiving of the vaccine has been the constant changing of delivery times due to both known and unknown factors.
“We have no idea when we’re going to get these shipments, and we have these meetings on an almost daily basis, and so we’re kind of kept in the dark until the last minute,” Hauk says. “Last-minute planning and preparation are certainly difficult to maneuver around and to do it successfully. I think for us, it’s been the challenge of always having to be ready to flip that switch and be capable of receiving the vaccine shipment, and then also being able to provide the appropriate level of security from the point of taking the vaccine and shipment to its distribution.”
Hauk recalls being told four different times that the hospital’s first shipment was about to come in before it actually arrived.
“We’re constantly having to get ready and then it doesn’t happen, and then we get ready again, and then it doesn’t happen,” he says. “You can get complacent doing that, especially in the security world, so that’s certainly been a challenge.”
Monitor Points of Dispensing with Cameras
Once the vaccine is safely transferred from shipping and receiving to its point of dispensing (POD), there are many more considerations for ensuring the vaccine remains secure. At a minimum, it is recommended by ASIS that PODs have a camera in the immediate area, allowing a view of persons in the hallway leading to the POD and at the entry point.
It is also recommended that hospitals set up video surveillance monitoring of storage refrigerators and to areas where the vaccine is being handled. High-resolution cameras should be pointed at both sides of the ingress/egress point, and a downward-facing camera in any area where the drug is handled should also be considered.
While some hospitals do have cameras inside PODs for additional security, this is not the case for all. For this reason, among others, most pharmacies have a double system that requires two people be in the room to ensure there isn’t theft or inappropriate waste when handling controlled substances.
“When it comes to pharmacy practices, at least in hospitals, there’s a lot of checks and balances,” says Scaglione. “So it was relatively easy to put this process in place for the coronavirus vaccine and to make sure we were doing all the right things.”
Security experts also recommend carrying over this system into other steps within the vaccine distribution process, such as having two people signing off on and being present during any movement of the product.
Whether it was due to lack of cameras, lack of continued surveillance, or lack of a two-person system, a recent incident in Wisconsin, where a pharmacist deliberately sabotaged hundreds of coronavirus vaccines by removing them from refrigeration and leaving them out long enough to be rendered ineffective, is a perfect example of why these processes should be in place to limit the insider threat. Drug diversion has always been an issue for hospitals — especially in recent years — and the currently thriving black market for the vaccine is even more reason to ensure proper security measures are in place.
To avoid incidents like the one in Wisconsin, many hospitals set up 24-hour remote alarm monitoring to refrigerators, added more locks, mounted them to the floor and walls, and continuously monitor both video surveillance feeds and access control. Many have also ensured a daily inventory of the vaccine is conducted and extra security rounding is completed and documented. Hospitals are even checking to ensure that existing walls prevent ceiling penetration to the PODs.
Access Control and Backup Generators Needed Too
While video surveillance can be essential in ensuring insider threats are kept to a minimum, implemented access control measures leading up to the POD are just as crucial, if not more. Electronic access control should be established, allowing for the ability to conduct periodic audits as to who is entering the area. Prior to this, a review of who has access to these secure areas should be conducted and limited where possible.
It is also important for hospitals responsible for storing and distributing the vaccine to consider contingency plans for natural disasters or other emergencies that may cause power outages. While the acquisition of backup generators isn’t always handled by the security department per se, some security directors double as emergency managers. Hauk says this step was included in his department’s checklist when preparing for the vaccine’s arrival.
This Is Just the Beginning
Not surprisingly, in the weeks since the vaccine rollout, pharmacies have been short-staffed, particularly those in areas experiencing high rates of infection. That is why each security measure being put in place is essential to ensuring the quick yet safe distribution of the vaccine, so that we can begin to return to some sense of normalcy.
For hospitals, the duty of securing the COVID-19 vaccine has only just begun. While the enormous task of vaccinating healthcare workers and other at-risk populations is currently underway, vaccinating the general public isn’t expected to start for at least several months.
Scaglione predicts the next potential threat or vulnerability will come when hospitals start offering vaccinations to the general public or are tasked with supporting non-healthcare facilities that will help with administering the vaccine to the public. Hauk says his hospital has already received a surprisingly large volume of calls from people in the surrounding community looking to set up vaccination appointments.
By constantly reviewing security plans and making subsequent changes, keeping open communication lines with all involved, and continuing to monitor video surveillance and access control, hospitals will be a wonderful resource and model for community clinics that will continue to pop up around us in the coming months.
This article first appeared in SSI sister publication Campus Safety.
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