Gov. Andrew Cuomo has cost lives with many of his inexplicable coronavirus decisions. Until just hours ago, he actually believed it was better to discard coronavirus vaccine doses than to vaccinate the undeserving.
Cuomo, whose executive order last week stated that “providers who give the vaccine to individuals outside of the phase protocol will face fines up to $1 million and have all state licenses revoked,” was merely the most draconian and stubborn among many who believed that providers ought to distribute the vaccine strictly according to detailed priority lists created by state governments.
New York expands its COVID-19 vaccine pool by 3.2 million more people, after a lack of eligible candidates forced healthcare workers to throw away spare doses https://t.co/zoQM6AckOX
— Business Insider (@businessinsider) January 11, 2021
It was a central planning, technocratic, fatal conceit, that will literally be fatal, because the result of this overplanning is countless vaccines expiring while countless people are turned away because it isn’t “their turn.” Witness the thread that this tweet begins, about a doctor who tried in vain to get EMTs and others vaccinated, only to have the vaccination staff destroy perfectly good leftover doses.
Just spoke with a close colleague, thought I’d share his story
Have changed minor details to protect him
He’s an ER Doc, working in a hot spot
Few days ago, early evening, vaccine team showed up with a bunch of extra doses of Moderna vaccine
Thread
— Ashish K. Jha, MD, MPH (@ashishkjha) January 11, 2021
Only part of the problem was the overplanning technocratic mindset. Another part of the problem was the punitive sense of “equity” that guides people like Cuomo. They buy into the racial politics of the Left, and they decide the best way to bring about equality is to make sure no bad people (white people, straight people, men, et cetera) get good things. Cuomo made that explicit here and here.
A first-come-first-served protocol for seniors or other populations was blasted by the press, which portrayed long lines as if it were worse than the inability to get a vaccination at all. Connecticut, one state with good success in getting the vaccine out quickly, has succeeded because of a “looser approach,” in the words of Bloomberg News, which reported that Gov. Ned “Lamont said the state wanted to give health systems leeway to make their own decisions.”
There lots of considerations here. West Virginia, with stricter state management and using local independent pharmacies, is doing well. Florida, with a looser, county-by-county, and hospital-led protocol, is in the middle of the pack, with lots of variation by county. But one common error is states, counties, and providers trying to stick strictly to the priority lists and guaranteeing nobody skips in line.
Here’s the thing about priority lists on vaccines: They make sense, but not if sticking to them means fewer people are vaccinated at the end of any given day. The unique thing about a vaccine against a highly contagious disease is that each person who gets vaccinated is also helping each person who hasn’t been vaccinated.
If some graduate student who works at a hospital “skips the line” and gets vaccinated ahead of an at-risk 70-year-old, that’s suboptimal, but guess what? That graduate student isn’t the only one who benefits from getting the vaccine. That’s now one more person who is very unlikely to get sick, which means one fewer person is very, very unlikely to infect anyone else, which means his close contacts are less likely to get sick, and, in turn, their close contacts are less likely to get sick. In other words, vaccinating anybody slows the spread and protects everybody. Also, that means one person who is less likely to take up a hospital bed or the time of contact tracers later on.
That’s not to say there’s no optimal order of vaccination. If vaccines could be given out by simply naming a person and poof, they are vaccinated, then yes, you could create a perfect algorithm weighing likelihood to spread if infected, likelihood to die if infected, likelihood to get infected, cost to society if infected, and so on. But we can’t do that.
So as much as possible, we ought to be blasting the vaccine out as fast as possible — if necessary, to whomever we can.
