Covfefe-19 The 12th Part: The Only Thing Worse Than This New Board Is TrumpVirus2020

[St. Clown]

My wife just sent me a text that her employer (private school) is trying to organize vaccinations for their faculty and staff.

[MichVandal]

Don't we leave flu vaccinations up to the states?

Not according to the CDC- https://www.cdc.gov/flu/prevent/vaxsupply.htm

It's privately coordinated with general oversight from the CDC.

Given that existing structure, it makes no sense at all to let the states do the work. It's just not something they are skilled at. But given the "leadership" from the CDC's overall boss, it's no shock at all that a brand new way to distribute something that we do every single year in a different form be tried.

As wT pointed out, flu vaccines are rolled out at almost 20M per week nationwide with the current structure. And I've never seen a line at the pharmacies who administer it. 20M/week would cover the US in just over 16 weeks, and that's not a strain on any distribution system.

[rufus]

Don't we leave flu vaccinations up to the states?

If the flu was killing 350,000 people/year we wouldn't be.

[leswp1]

I think many states are over-thinking distribution. They are too worried that someone "more deserving" might get vaccinated after someone "less deserving" that they overly complicate the prioritization and end up delaying the vaccination of the vulnerable even more than if they just did something super simple that was primarily based on age. Basically what the UK did was prioritize healthcare workers and elderly.


I've been told by someone involved in the vaccination program administration in a hospital that the Feds don't want them holding onto doses. Use all the doses you get, don't hold half in a freezer for the second dose.

THis is true with the local hospital. They are getting rolling shipments. This is the reason all of the doses weren't sent out at once.

[SJHovey]

Well that is fine for WV (and he is 100% correct) but that is easier to do there than say...California, TX or NY wouldn't you say? There is some rather obvious differences.

Again, if actual people with knowledge of this stuff were in charge on the federal level things would be better off. Make the decisions at the highest level and get things going. Take the decision making out of the hands from the people who are apparently overthinking everything. Not to mention it will offset the "it isnt real" rhetoric if it comes from the people they trust. (i.e. Trump and Trumpers)

Sure there is going to be a difference between the states. But wouldn't you agree that the states that should be most equipped to handle this without federal hand-holding should be states like NY and California?

[rufus]

Sure there is going to be a difference between the states. But wouldn't you agree that the states that should be most equipped to handle this without federal hand-holding should be states like NY and California?

Depends.

How strapped has this pandemic already made them, with no help coming from the feds to offset?

[SJHovey]

Depends.

How strapped has this pandemic already made them, with no help coming from the feds to offset?

California is the 5th largest economy in the world. If they're too poor to do this, we need to just call it a day.

[dxmnkd316]

If the flu was killing 350,000 people/year we wouldn't be.

If anything was killing 350,000 people/year, we have a MASSIVE infrastructure in place trying to prevent it (or monetize it). Top causes of death in the US per the CDC:

• Heart disease: 655,381
• Cancer: 599,274
• Accidents (unintentional injuries): 167,127
• Chronic lower respiratory diseases: 159,486
• Stroke (cerebrovascular diseases): 147,810
• Alzheimer’s disease: 122,019
• Diabetes: 84,946
• Influenza and Pneumonia: 59,120
• Nephritis, nephrotic syndrome and nephrosis: 51,386
• Intentional self-harm (suicide): 48,344

Only stroke and nephritis are ones I can't recall any "awareness month," NFL week, ribbon, or national drive to "end ______". And both of those combined are about 60% that of covid. The idea that we're dealing with something in the noise among causes of death is enraging. And we still have three months to go losing 1,500 - 2,000 people a day. This is going to kill more people than all cancers combined over the same period.




Also, I see Cuomo doing his usual Try-To-Fix-Something-But-End-Up-Making-It-Worse routine...
Covid vaccine: NY Gov. Cuomo to propose law making it a crime to skip line (cnbc.com)

Again, this is dumb. If someone is lucky enough to be at the "vaccine counter" when they're going to have to throw some away if they don't get it in an arm, so be it. Spend less time worrying about that, more time worrying about organizing this initial push. If you find someone jumping because they paid money or used their status or fame, fine, prosecute them. But if Joe Blow happens to get it because a pharmacist or nurse is going to have to discard it, that's not a crime.

[rufus]

California is the 5th largest economy in the world. If they're too poor to do this, we need to just call it a day.

As you've often let us know, they've also been hit hard by this pandemic that you think is no big deal.

But you keep on being a self-righteous doosh. You're real good at it.

[dxmnkd316]

If the federal government had a competent response, yeah, you might have a point.

[MichVandal]

Sure there is going to be a difference between the states. But wouldn't you agree that the states that should be most equipped to handle this without federal hand-holding should be states like NY and California?

No state is equipped to distribute vaccines. none of them have ever done it before, so why would one state be better than another just because of the size of the economy? Makes no sense.

Whereas the CDC does at least coordinate with the private sector to distribute the flu vaccine ever single year.

Based on experience, the CDC is light years ahead of the individual states. Helping annual flu >>> zero.

Alas, the CDC got their knees knocked early on to actually help.

[SJHovey]

Also, I see Cuomo doing his usual Try-To-Fix-Something-But-End-Up-Making-It-Worse routine...
Covid vaccine: NY Gov. Cuomo to propose law making it a crime to skip line (cnbc.com)

Again, this is dumb. If someone is lucky enough to be at the "vaccine counter" when they're going to have to throw some away if they don't get it in an arm, so be it. Spend less time worrying about that, more time worrying about organizing this initial push. If you find someone jumping because they paid money or used their status or fame, fine, prosecute them. But if Joe Blow happens to get it because a pharmacist or nurse is going to have to discard it, that's not a crime.

What's beautiful is that he's also threatening to fine hospitals $100,000 for not vaccinating people fast enough.

[leswp1]

Not according to the CDC- https://www.cdc.gov/flu/prevent/vaxsupply.htm

It's privately coordinated with general oversight from the CDC.

Given that existing structure, it makes no sense at all to let the states do the work. It's just not something they are skilled at. But given the "leadership" from the CDC's overall boss, it's no shock at all that a brand new way to distribute something that we do every single year in a different form be tried.

As wT pointed out, flu vaccines are rolled out at almost 20M per week nationwide with the current structure. And I've never seen a line at the pharmacies who administer it. 20M/week would cover the US in just over 16 weeks, and that's not a strain on any distribution system.

Flu vaccine is a whole different animal in multiple ways-
-in general there is no shortage-
-there are different formulations- injection and nasal mist with only one does required.
-the orders and coordination for ordering happen months in advance- you have options of where to obtain and have predictable, scheduled deliveries
-it is distributed in multiple settings- private offices, clinics, pharmacies, various town/county 'clinics', in-patient settings, residential settings
-all settings have protocols set up to encourage people to get the vaccine and most start promoting this months in advance- our practice sent out messages to everyone on the portal.
-storage is pretty basic- regular fridge- in some of the pop up places they put it in a cooler but it is gone so fast it doesn't spoil.

Even when we had H1N1 where they had to work on the fly, we had excellent communication re the supply of vaccine, when it was coming, and who should get it first.

Current vaccine is completely different-
-more than one type- not interchangeable.
-2 doses needed and they have to be the same kind
-limited supply. Usual system of ordering, coordinating what/when/how much is not in control of the people who are attempting to coordinate.
-there was no ramp up preparing people for what would happen creating confusion for everyone at every level. They didn't make recommendations until it was approved and there was all sorts of debate in attempt to predict what the recommendations would be.
- supply chain is not clear/not predictable. It's not delivering as promised which makes planning a cf- you need to give vaccine while rationing what is available hope delivery happens for dose 2
- Most places are getting both types but what and how much is is a roll of the dice. exacerbating planning issues.
- guidance has been given but no real leadership- it is like the wild wild west with different States doing different stuff.
- you need to observe the pt after it is given for at least 15 minutes so you can't just do drive thru- you need to put them somewhere- NH is doing drive thru and holding in parking lot.
- Not available to many of the places who would usually give flu vaccine- private practices, small clinics, pharmacies, various small facilities- the distribution lots are too large and they don't have volume or storage. Storage is an issue for most of the places that pop up to distribute the flu vax.

[Slap Shot]

Large Numbers Of Health Care And Frontline Workers Are Refusing Covid-19 Vaccine

Great.

[leswp1]

Sure there is going to be a difference between the states. But wouldn't you agree that the states that should be most equipped to handle this without federal hand-holding should be states like NY and California?

No one is equipped to handle this until the Feds can work out the supply chain. It is not a question of hand holding. It is a question of giving very clear guidance and developing protocols that are evidence based. Medicine does not work well using a business model or libertarian model where everyone gets to pick what works for them like you are choosing a color of paint. Protocols should have decision trees that take into consideration the different situations each state is in*.

*a lot of the fly over States and southern States have minimal Public Health infrastructure. This has been true since I was in grad school in the mid 80s. No matter what the protocols say, they are incapable of implementing without a whole lot of help- esp in the rural areas decimated from yrs of underfunding and no State support.