Dr. Claude Brunson, executive director of the Mississippi State Medical Association (left), and Dr. Timothy Quinn (right) listen as State Health Officer Dr. Thomas Dobbs describes receiving the Pfizer-BioNtech covid vaccination. Credit: Vickie D. King/Mississippi Today

Exactly one year ago today, Mississippi confirmed its first case of COVID-19. In that time the virus has infected 299,124 people across the state and killed 6,864. 

COVID-19 has killed more Mississippians than diabetes, Alzheimer’s, chronic liver disease, influenza, accidents, suicide and homicide killed — combined — in 2019.

And the virus is not done with us yet. In January, Mississippi set new single-day records for new COVID-19 cases and deaths and a monthly record of 1,240 deaths. 

But as many reflect on the year filled with loss and fear, some say there is room for optimism. The number of COVID-19 cases, deaths, and COVID-related hospital admissions in Mississippi have been trending sharply downward since the January spike. The caseload for the first week of March was more than 83% lower than the January peak, and nearly 75% lower for hospitalizations.

“We’re not done with the COVID pandemic. COVID is real. And we’re really winning,” State Health Officer Dr. Thomas Dobbs said during a Monday press conference. 

Still, MSDH officials acknowledge that any ground Mississippi has gained in combating the virus is fragile and at the mercy of how the public behaves going forward. 

January’s peak was attributed to holiday travel and gatherings, and the upcoming Spring Break is a prime candidate for causing another such spike.

That vulnerability will also be tested in the coming weeks as we see the impact of Gov. Tate Reeves’ removal of all state-imposed mask mandates and most COVID-related restrictions on business operations. Dobbs has warned people against responding to decreasing infection numbers by abandoning the preventative measures that limit virus spread.

“If you’re up a run or two in the sixth or seventh inning, you don’t just lay down and let the other team just go at it on offense,” Dobbs said. 

Dobbs said that he’s seen most people wearing masks in public, but that is not an experience shared by many Mississippians. One of them is Carol Lang, a 33-year-old grocery store employee in DeSoto County. Though she’s had to deal with plenty of unmasked customers over the past year, that number ballooned as soon as the mask mandate was removed.

“It felt like we were opening the floodgates a little bit,” Lang said. “Believe me, I understand the COVID-fatigue, but it’s not much to ask of someone.”

Though federal guidelines classify certain retail employees like Lang as essential workers, she is still not eligible for a COVID-19 in vaccine in Mississippi. Now she’s just waiting for her turn and praying she doesn’t bring the virus home in the meantime. 

While reflecting on the entirety of the COVID-19 pandemic earlier this week, Dobbs held up a keepsake, the vial that once contained the first vaccine doses given in Mississippi. On Dec. 14, he and other health officials received their shots on camera to show its safety as the state’s first shipment was distributed.

Since those first shots were given, a total of 517,156 Mississippians — just over 17% of the state population — have received at least one dose of a COVID-19 vaccine. More than half of Mississippians over the age of 75 and about half of those over the age of 65 are vaccinated.

MAP: Where Mississippians can get the COVID-19 vaccine

More than 1,000,000 vaccine doses have been distributed statewide, and they’re being administered as fast as the state can get them. For the most part, MSDH’s drive-thru vaccination sites run like clockwork thanks to local health departments and the Mississippi National Guard. 

Over 132,000 shots were given last week, several thousand more than the state received in the same period. This is due in part to eligibility requirements that are broader than most states and currently include a massive chunk of the population.

Mississippi joined most other states in abandoning the Centers for Disease Control and Prevention guidelines regarding which groups to include in phases of the vaccine rollout following healthcare workers and residents of long-term-care facilities. Last week, Mississippi also became the first state to open up vaccine eligibility to people ages 50 and up

Currently, people 16 to 49 years old are also eligible for a vaccine if they have one of 12 chronic health conditions. Mississippi is one of at least 16 states that doesn’t require proof of a qualifying health condition, meaning anyone in that age group who wants a vaccine can get one if they’re willing to lie about it.

Getting shots in arms isn’t a problem, but making that process equitable has been difficult for MSDH. 

“We are always trying to fine tune availability with eligibility,” Dobbs said. 

Barriers to vaccine access are varied in who they affect and how difficult they are to remedy. Older, more vulnerable populations might be less tech savvy than younger people typically are, unable to book an appointment for themselves online without help. MSDH reserves a percentage of its drive-thru appointments for scheduling through their phone line for this reason. 

Rural counties receive fewer doses and have fewer vaccine providers in their area, necessitating lengthy commutes for those lucky enough to secure appointments. MSDH has tried to mitigate this challenge by placing several of its 23 drive-thru locations in each of the state’s nine public health districts.

Addressing the racial inequities of the state’s immunization efforts has been especially difficult. The access problem is also combined with a trust problem for many Black Mississippians due the racism and abuse Black people have been subjugated to by U.S. governments and healthcare systems. While accounting for 38% of the state’s population, Black Mississippians were accounting for only 15% of the vaccines given in the state early in the distribution effort. That share has grown to 26%, and the gap is closing.

Dobbs credited this improvement to the work of Black community leaders in churches and healthcare settings, who continue advocating for vaccination. 

“I’m proud of Mississippi. I’m proud of what we’re doing,” Dobbs said. “Let’s keep our foot on the accelerator, pushing COVID down so that we can get back to full normal before too long.”

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Will Stribling covered healthcare and breaking news for Mississippi Today.