![]() ![]() It may also prioritize those with power and wealth. This strategy clearly prioritizes those who are in-the-know, who have time to sit on hold, or who are willing (in the case of camping out overnight) to put their health at risk. Meanwhile, stories are already circulating about the possibility of the wealthy buying access through concierge doctors. In NYC, there are reports of clinicians rushing to the elevator to be first in line for the vaccine. In Houston, health department call centers have been paralyzed by calls from those desperate to get protected. In some counties in Florida, seniors lined up overnight to get the shot, putting their own health at risk for the chance to avert future infections. Using a list avoids any opportunity to game the system, but it also feels like something that Seinfeld’s Soup Nazi would have done.Ī second, quintessentially American strategy is to treat vaccination like a Black Friday sale: first come, first served – unless you know the right people. This is lovely for those whose last name is “Aguilar,” but what if the person named “Zeal” is actually at higher occupational and physical risk? I have heard from health care workers across the country whose hospitals are offering vaccine slots according to alphabetical order. (Photo by Mario Tama/Getty Images) Mario Tama/Getty Images North America/Getty ImagesĬalifornia ER doctor: Covid is tearing our health care system apart at the seamsĪs a result, the system is open to manipulation and some solutions as to who goes first, versus second, feel a little fairer than others.Ī first distribution option is to treat vaccination like a class list. California has issued a new directive ordering hospitals with space to accept patients from other hospitals which have run out of ICU beds due to the coronavirus pandemic. The hospital is operating at over 200 percent of its normal ICU (Intensive Care Unit) capacity and is currently converting some patient rooms into ICU rooms to treat the increase in COVID-19 patients requiring ICU-level care. ![]() Mary Medical Center amid a surge in COVID-19 patients at the hospital and across Southern California on Januin Apple Valley, California. Further complicating matters, individual states and health care facilities are under no legal obligation to follow ACIP’s recommendations.ĪPPLE VALLEY, CALIFORNIA - JANUARY 06: Clinicians prepare to re-position a COVID-19 patient into the supine position at Providence St. But, even with expanded distribution of the vaccine as outlined by the new plan, someone has to go first, second and last. These guidelines are supported by bioethical principles about the need to balance “priorities of minimizing societal disruption and preventing morbidity and mortality.” Justice and objectivity seem like a no-brainer. Aligning with guidelines advanced by the Centers for Disease Control and Prevention’s Advisory Council on Immunization Practices (ACIP) in December 2020, those at highest risk for getting sick from Covid-19, either because of their job or their underlying health status, should get first dibs. Most of us believe that there should be some element of fairness in the distribution of the Covid-19 vaccines. Meanwhile, many health care workers have yet to be vaccinated. ![]() Well, I – in my personal capacity – have heard about well-connected friends and community members who have managed to get vaccinated against Covid-19, even though they meet no current criteria to join the front of the line. Although I see these plans as a much-needed step in getting first vaccine doses in arms, we must ask whether and how this will affect the speed and equity of vaccine administration. Of equal importance, the announcement also allows for immediate vaccination of individuals 65 and older and provides assistance to states in setting up administration sites. Following an altered distribution protocol that President-elect Joe Biden announced last week, the administration will now release all available doses of the vaccine. ![]()
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