The vaccine rollout is a mess. Across 50 states, there are 48 different ways that the vaccine is being distributed.

“It’s a little bit like designating one part of the swimming pool for urination and hoping for the best.”

latest from me and @CShalby latimes.com/california/sto…
Almost every state has made up its own list of who should get early access to the vaccine: police officers, teachers, incarcerated people, psychiatric patients, pregnant woman. There are CDC guidelines, but only three states are still following them. latimes.com/california/sto…
The patchwork has created a frustrating situation in which the place you determines if you can get a vaccine yet. Not only does each state have its own list, but within California, there are as many as 61 more as counties are allowed to do their own thing.
For leaders making those decisions, it is effectively a zero-sum game: giving priority to some means fewer doses for others. And this moment is likely the most contentious phase of the rollout — a collision of relentless demand and constrained supply.
The nation’s vaccine supply may be abundant in a few months, but for now, when there are only so many lifeboats to go around, some people are bound to be harmed by being left onboard.

“I so regret having to think about it as an either-or."

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More from @skarlamangla

23 Feb
Thought I'd collect and share some differing perspectives about the California variant and acknowledge that there's a lot of debate about it! So the UCSF researchers found some stuff that seemed alarming...
Yet the California variant is already dominant here, yet things aren't getting worse -- far from it
the California variant has been around for months, yet it didn't suddenly take over like B117 has, suggesting it is not as worrisome

“It’s not as big a deal as the others,” said Harvard epidemiologist William Hanage, referring to other well-known variants
Read 7 tweets
22 Feb
California is vaccinating around 200,000 people a day, according to Gov. Newsom. Since the Pfizer and Moderna vaccines each require two doses, it would take 13 months to vaccinate everyone in the state at this pace.
Newsom says that the vaccine supply the state is receiving is low and "simply not what we’re capable of administering, meaning we could do exponentially more."
Important note here: The FDA will likely approve the Johnson and Johnson vaccine this week, which is a single-dose vaccine. So that will hopefully rapidly bring our vaccination rate up, since it'll add another vaccine to the mix and also only requires one shot for coverage.
Read 6 tweets
21 Feb
In LA, we’re vaccinating neighborhoods hardest-hit by COVID at the lowest rates — the opposite of how you’d distribute a vaccine if you wanted to prevent the most transmission and deaths. latimes.com/projects/la-co…
These trends also means that we won’t be able to get the pandemic control, because we won’t prevent outbreaks in the neighborhoods most likely to have them. And then they’ll spread to elsewhere.
If a house were on fire, you’d put the most water on that house to stop the fire and prevent it from spreading. Ignoring that house and watering houses a few blocks away makes no sense and allows the fire to keep going, grow in size and destroy other houses.
Read 5 tweets
11 Feb
So the CDC changed its masking guidance yesterday to recommend tighter-fitting masks as well as double masks. But they specifically warned against layering KN95s, which surprised me given how common that combo has become

This is how they explained it when I followed-up:
KN95s and N95s work very well on their own and adding masks on top or underneath could "affect how well they fit the face and decrease their effectiveness" and also make them hard to breathe through and uncomfortable, officials say.
"Masks that are not comfortable may not be worn by people as long as they are needed. It's important for consumers to find a mask that fits well but that also is comfortable enough that they can wear it for prolonged periods, if needed," reads a CDC statement sent to me.
Read 8 tweets
10 Feb
The status of COVID variants in California:

-159 cases of the B117 UK variant
-1,203 cases of West Coast variant
-no cases of P1 variant, believed to have emerged in Brazil
-two cases of the South African B1351 variant -- one in Alameda and one in Santa Clara County
What we know about these variants:

-the B117 variant is believed to be about 50% more infectious. it's prevalence in the US is doubling every week
-research on the B1351 variant suggests it may make some vaccines less effective. it's an issue to keep an eye on
Some more details about B1351 in California:

In the Santa Clara County case, the person infected returned from international travel in mid-January and began experiencing symptoms several days later.
Read 4 tweets
10 Feb
LA County officials say that food and agriculture workers will become eligible for vaccination here in the next two to three weeks.
That sectors breaks down like this. About half a million people in this category in LA County.
LA County officials say that childcare and education workers will become eligible for vaccination within the next two to three weeks. There are nearly 700,000 people who qualify under this category in the county.
Read 5 tweets

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