Many public health experts say most of the factors that have slowed the state’s inoculation plan are outside the governor’s control: California’s size and complexity, a fragmented public health care system spread over 58 counties, unsteady federal leadership and the challenges of transporting, storing and administering current COVID-19 vaccines.
The typical blame President Trump, but let me just re-state that California ranks in the bottom third in getting vaccinations from inventory into arms of people. You can't blame that on President Trump. California is in the same situation as the other 49 states. Many of the other complaints just sound like excuses as they would apply to other states (excluding the size complaint), as well.The state’s initial distribution framework, which prioritized Californians by occupation group, underlying medical conditions and housing status, may have slowed the process by creating a system that was difficult to administer and hard for the public to understand.
. . . And last week, the governor announced a simplified eligibility system. Once counties finish vaccinating healthcare workers, next in line will be teachers, childcare workers, agricultural workers and emergency responders, and Californians over the age of 65. After that, counties will move through their populations solely by age.
Here's where an elegantly designed framework hits reality. Sure, if you had plenty of time to plan, it might make sense to prioritize based on occupation, medication condition and housing. At least they decided to simplify the situation. But the state only stuck with that simplified approach for a few weeks as will be discussed a few paragraphs below.
“If you want to vaccinate everybody within a six month time period, assuming you have the supplies and the vaccine, we have to do an excess of 300,000 vaccines a day,” said [Grady Joseph, assistant director for the state’s Covid-19 Logistics Task Force].
So the above article was written on February 2nd and the article mentions that the LA Times estimated the average vaccination doses at a little over 167,000 per day. Looking at the data a couple weeks later, the LA Times now has the daily 7 day average at 163,384. It is slightly lower. I am sure that vaccinations will continue to pick up, but we currently are a far distance from 300,000 doses a day.
. . . And last week, the governor announced a simplified eligibility system. Once counties finish vaccinating healthcare workers, next in line will be teachers, childcare workers, agricultural workers and emergency responders, and Californians over the age of 65. After that, counties will move through their populations solely by age.
Here's where an elegantly designed framework hits reality. Sure, if you had plenty of time to plan, it might make sense to prioritize based on occupation, medication condition and housing. At least they decided to simplify the situation. But the state only stuck with that simplified approach for a few weeks as will be discussed a few paragraphs below.
“If you want to vaccinate everybody within a six month time period, assuming you have the supplies and the vaccine, we have to do an excess of 300,000 vaccines a day,” said [Grady Joseph, assistant director for the state’s Covid-19 Logistics Task Force].
So the above article was written on February 2nd and the article mentions that the LA Times estimated the average vaccination doses at a little over 167,000 per day. Looking at the data a couple weeks later, the LA Times now has the daily 7 day average at 163,384. It is slightly lower. I am sure that vaccinations will continue to pick up, but we currently are a far distance from 300,000 doses a day.
Joseph's statement was made in December. Now I doubt anyone believed that this would be as of day one. So I would think that California's goal was to vaccinate most everyone by the end of July. There is still plenty of time to start ramping up, but I doubt the ramp up will result in California vaccinating more than 300,000 a day to get to an over-all average of over 300,000. Grady Joseph adds that the most the state has tested on a single day is 215,000. This, to me, implies there is a capacity cap in California that might actually be below 300,000.
Let's say you can average 300,000 doses a day for 6 months. That would imply that 54 million doses would be delivered by July or a minimum of 27 million people (if this is just Pfizer / Moderna more with the one shot Johnson & Johnson vaccine). That indicates a target of at least 68% of the population. That seems well below herd immunity of 80%, but I'll assume we're excluding those under the age of 18 and the one dose vaccine would get that percentage up. If California can really only administer 215,000 doses a day, it would take us over 8 months to get to a minimum of 68% of the population (pharmacies are getting involved in vaccinations so I'm thinking the 215,000 dose estimate is too conservative, but at least it gives a lower bound). My guess is that we'll hit the "vaccinate everybody" target sometime between August - October. Now caveats are: no new variants that can by-pass the current vaccines, no supply issues and that there is demand. To me, new variants and demand issues could shift those dates out further into perhaps early 2022.
And then adding to the complexity of an age based approach could cause delays due to confusion. Likely due to political pressure, California has moved away from the simplicity of an age based approach and is now looking to go back to an elegantly designed approach. The LA Times (Feb 12) reports:
California officials said Friday that people ages 16 to 64 who are disabled or at high risk for morbidity and mortality from COVID-19 will be eligible for vaccination beginning next month.
The underlying conditions explicitly stated under the latest guidance include cancer, chronic kidney disease of stage four or above, chronic pulmonary disease, Down syndrome, immunocompromised immune system from solid organ transplant, pregnancy, sickle cell disease, heart failure, coronary artery disease, cardiomyopathies (excluding hypertension), severe obesity, and Type 2 diabetes mellitus.
California officials said Friday that people ages 16 to 64 who are disabled or at high risk for morbidity and mortality from COVID-19 will be eligible for vaccination beginning next month.
The underlying conditions explicitly stated under the latest guidance include cancer, chronic kidney disease of stage four or above, chronic pulmonary disease, Down syndrome, immunocompromised immune system from solid organ transplant, pregnancy, sickle cell disease, heart failure, coronary artery disease, cardiomyopathies (excluding hypertension), severe obesity, and Type 2 diabetes mellitus.
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