Unless we switch to untested 1-dose protocol, we currently have enough doses nationally to vax 40% of over 65s. 40 million doses remaining = 20 million vaccinated. And that’s only if we don’t vax any more under-65 high-exposure folks in health care, education.
If we release all doses from ultra-cold storage right now, it will take careful planning & oversight to ensure we don’t accidentally force the untested 1-dose protocol on a lot of people. I’m not saying it can’t be done, just that caution is warranted.
If more states proceed with opening up access to anyone over 65 (and no one under 65) regardless of exposure/risk, which 40% (or less) of that group *actually* gets fully vaxxed will determine how rapidly we can reduce hospitalizations & deaths.
I understand that well-off retirees w/ ability to stay home desperately want to get vaxxed so they can see the people & do the things they love. No shame in that. But they have means, time & connections to rapidly exhaust our supplies within a matter of weeks if we aren’t careful
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New in @Health_Affairs: “Public Health Emergency Reform Is Coming—These Six Principles Should Guide It.” bit.ly/3rTJQKF Thread 👇
In a legislative session in which some on the far right are seeking to strip executive emergency powers, I’ve crafted a balanced approach to reforming #PublicHealth statutes in light of concerns about overreach without unduly hindering swift responses & nimble adjustments.
Even if you feel public health orders went too far in 2020, there are other infectious disease threats on the horizon that could pose different (e.g., disproportionately killing/injuring children) &/or greater risks (e.g., w/ higher transmissibility or mortality).
This thread re: @ratatousical resonates with some of my thoughts about how in-person education might be even better after our year of connecting online...
I feel like I’m getting to know my students (in smaller classes, at least) *better* than in a typical F2F semester. I’d already noticed that in some of the fully online courses I teach in @AUWCL’s MLS program, but it really stood out to me when my JD courses shifted online.
I can see each of their faces more clearly when they speak. I’m making an intentional effort to create space for us to chat about things other than school & the law, plus I get to meet their pets.
Without high engagement of well-resourced local health depts, privately run, profit-focused health care institutions/mega-pharmacies will do whatever is easiest/most aligned with their financial incentives to quietly get doses out the door. This is going to be the story all year.
Right now many are giving 1a doses to their own nonclinical, low-exposure, low-risk WFH employees (because it’s easiest & helps their bottom line) instead of doing the work to reach unaffiliated front-line clinical workers w/ smaller, more independent & less integrated employers
For phase 1b & beyond, hospitals receiving doses are quietly providing access to “enrolled” patients, leaving patients who lack a regular source of care/receive care from smaller, more independent community providers at the mercy of underfunded county programs
Lots of focus on temporary residents (snowbirds) being permitted access to county-run vax sites in FL. Notably, Oklahoma seems to have adopted an address verification system that’s causing trouble & slowing down it’s vax campaign.
State residency status shouldn’t matter from a public health perspective & denying benefits on that basis might infringe on constitutional right yo interstate travel.
Note: no indication so far that these are “vaccine tourists,” but that could certainly be happening/start happening soon.
Some extended thoughts re: the problems with Operation Warp Speed’s Pharmacy Partnership for Long-Term Care Program & whether WV’s success as the only state to opt out offers a model for future efforts to actively send mobile teams out for on-site vax of high-priority pops.
I can hardly express my disappointment w/ economists, MDs & others calling for elected officials to abandon prioritization. Given that we don’t have enough doses to achieve herd immunity any time in the next 6 months, prioritization is critical to achieving public health goals.
The key question is *how to implement* prioritization. An active approach with mobile teams sent to offer vax on-site at high-risk/high-priority worksites & residential locations is critical to public health success.
This is the predictable result of entrusting the lion’s share of doses to private, profit-focused health care institutions & overseeing them based exclusively on how quickly they burn through doses rather than how well they reach the 1a populations they said they would.
We’ll see a similar dynamic in next phases. Major hospital systems will vax anyone among their “enrolled” patient populations who arguably meets criteria rather than doing the work of reaching folks who don’t have a reg source of care or working w/ community providers/partners.
This will further entrench market concentration, harm smaller, more independent primary care practices, erode equity, & undermine public health goals unless more doses are shifted to community providers & local health departments who partner w/ housing authorities, employers, etc