I had planned to write this month’s column on managing traffic flow; highlighting stoplight-induced congestion at major intersections, the speechless frustration of non-connecting parking lots, the unholy juxtaposition of pedestrian and vehicular traffic on our shoulder-less, busy thoroughfares, etc.
But a looming awareness of the cluster that is our state vaccine distribution system trumps the latter.
Being of an age and having survived two different episodes featuring massive pulmonary embolisms (each of which I was told would have killed me in a couple of days, had I not gotten to a hospital when I did. And which reduced my overall lung capacity by 30%) it is incumbent upon me to avoid the current COVID-19 contagion.
People in my position face a likelihood of dying — or at least a life of suffering on becoming infected.
Thus the availability of vaccines to obviate this threat is most welcome. And while the effort to develop vaccines happened in record time, the distribution of the same is appalling.
Wild rumors are circulating on where the vaccine is available.
Waiting lists for where shots will be given out are “booked up,” presumably because the numbers of registrants far exceeds the projected availability of supplies.
Yet a friend secured her shot of the Pfizer vaccine — listed as totally unavailable in this area for the near future — by simply wandering the halls of a nearby hospital (names withheld in the interest of stampede avoidance) and happening upon a vaccination site, whereupon she got in line and got her shot.
The lack of federal coordination of vaccine distributions as they come online seems to have resulted in a free-for-all among the states as they compete for supplies and try to affect their own distribution systems.
Some states, like North Dakota and West Virginia, appear to have figured it out, inoculating almost their entire population (or at least enough to flatten the curve) with Pfizer or Moderna vaccines.
Of course these states have small, relatively homogeneous populations so availability is not as budget-busting as a large state like Georgia. This largest of the states east of the Mississippi has experienced closure of 128 rural hospitals since 2010, and thus access to both vaccination nodes and care for the infected is both rare and expensive.
In a system straining to handle the third COVID wave personnel scarcity also factors in.
There’s that.
And the laissez-faire approach to the seriousness of the pandemic by elected state officials, allowing restaurants, bars and hair salons to operate openly in the early days of its onset is another factor.
As are the myriad messages coming down from federal entities (NIH, the CDC, Homeland Security, etc.).
Supplies of the vaccines are limited as production ramps up, supply lines rife with choke points and overly ambitious scheduling also figure in the mix.
That said, and recognizing the obstacles the powers that be are confronting as they attempt to make this happen, I nevertheless feel compelled to point out some obvious flaws in the overall scheme:
Givens:
a) Not enough vaccines currently available to meet the need.
b) Weary personnel, from delivery people to medical staff, operating in an underfunded, overworked environment limits effectiveness.
c) Not all who qualify will seek vaccination.
d) Rural vax centers are few and far between and likewise congested in the few available sites by people who must travel many miles to access them.
e) Politics has roiled the picture, with voting accuracy disputes occupying large swaths of politicians’ time, distracting their efforts to cope with the pandemic.
Probable (eventual) remedies:
1) Supplies will become adequate given the massive production underway.
2) More personnel are being hired, borrowed from other states and assigned to areas of acute need.
3) As to the never vaxers, all that can be done is to publicize vaccine effectiveness and potential consequences and hope for the best.
4) Some facilities are being repurposed in hard-to-reach areas and mobile clinics can help address this need.
5) Despite an armed insurrection, a new administration is taking hold and is focusing on some of the inconsistencies.
But why is it so hard to coordinate actual injections?
Why are most of the websites devoted to COVID, concerned with explaining what it is, how to quarantine, symptoms and social distancing rules, etc., with links to inoculation sites obscured?
And upon reviewing the above, one wishes to say “OK, when and where can I be vaccinated?”
One is presented with a list of sites on which to register, along with a short quiz to determine eligibility, and invited to register at the nearest one. Upon which a message “overbooked” prevents even registering to get in line.
Setting aside for a moment the CDC guidelines on who gets the first shot at the shots — medical personnel, nursing home residents, seniors over 65, etc. — the remainder falls into a massive political/ethical category that is way open to interpretation.
*Should obese people, more inclined to suffer serious complications upon testing positive, or youth, more disposed to congregate and because they are less likely to become disabled by infection, become themselves super-spreader vectors for the rest of us — which of these gets first crack?
*Should laborers in close quarters(chicken processors, meat packers, etc.,) supersede teachers where crowded classrooms make separation and masking difficult?
*Where does the pregnant housewife, the immigrant fruit picker figure in the mix?
*And what about prisons and jails? Many inmates have yet to be tried but cannot make bail, and overcrowded jails are premier super-spreader events.
I suggest a centrally coordinated effort, perhaps with regional commissions composed of medical personnel, scientists, social workers, law enforcement and private citizens to decide these priorities. Nothing they decide will be without controversy, but the buck has to stop somewhere.
Registration would be universal, with no confusing ‘overbooked’ site designations, because a team of dispatchers monitors and assigns people based on their place on the list as designated by the commission.
This team notifies the shotees using a phone bank — perhaps paid, or volunteers or both — to determine their availability and register them and if necessary arrange transportation using the buses currently available to residents of retirement centers and nursing home.
I don’t think those residents will object to the use of their buses for such an acute emergency. But if they did well, this is a certified emergency.
This type of operation has been done in the past (smallpox in Boston, polio and measles nationwide) and requires a political will to make it happen.
The longer it’s delayed, the more serious the results and hopes of "flattening the curve" recede into the distance.
Jeff MacKenzie, the Design Consumer, examines issues of design — be they objects or systems — all are designed and all are products the citizen consumer uses. He may be reached at dnccninput@gmail.com.
