Signs of the Times -Safeway

[Goose]

Do you think the state has a working data base set up yet to keep track of the massive volumes of residents who will be vaccinated?  Won’t they need all sorts of interfaces with lots of EMRs and provisions for manual tracking?

My guess is probably not. Even if they do, do all the people giving immunizations know what they have to do in order to update it properly? This actually isn't all that hard to do. If it were a company, it would be simple, although there would be "roll-out" issues that should have been solved in November. It is not as if the State didn't know this would be required way back in the summer.

I could be (gasp!) wrong, but for some reason I doubt the IT group that couldn't count COVID-19 tests correctly is going to roll out a de novo vaccine tracking system without serious glitches. It may be they are relying on all individual's medical records being updated by their primary care doctor/provider. That actually might work if all vaccines were given that way, but since they mostly will not be in this case I expect that approach isn't viable. In addition, such records are not in general available to the State. Who knows what the plan is? If anybody here does, speak up please!

[akiddoc]

Some more clarification on Alameda County Health System. They have given 2000 of there 7,000 vaccine doses. They are currently giving 260 doses a day. Only 130 will be newly vaccinated as they get into booster doses. The person running the program is in over her head and has no idea what resources are available to her to get the vaccine out faster. There is a bunch of paperwork mandated by the feds every time they give a dose and they only have three people trained to do that. I got permission from my boss to email her directly today to propose a way to immunize every person working in my clinic in one Friday afternoon. We have about 125 employees in our facility. The Pediatric department gives as many as 120 vaccines a day in the normal course of a clinical day. We could easily mobilize our department to do this in 4-5 hours. I expect my proposal to be rejected. It makes too much sense. I even volunteered to run the entire effort. I normally do not work on Friday afternoons.

[Goose]

Some more clarification on Alameda County Health System. They have given 2000 of there 7,000 vaccine doses. They are currently giving 260 doses a day. Only 130 will be newly vaccinated as they get into booster doses. The person running the program is in over her head and has no idea what resources are available to her to get the vaccine out faster. There is a bunch of paperwork mandated by the feds every time they give a dose and they only have three people trained to do that. I got permission from my boss to email her directly today to propose a way to immunize every person working in my clinic in one Friday afternoon. We have about 125 employees in our facility. The Pediatric department gives as many as 120 vaccines a day in the normal course of a clinical day. We could easily mobilize our department to do this in 4-5 hours. I expect my proposal to be rejected. It makes too much sense. I even volunteered to run the entire effort. I normally do not work on Friday afternoons.

Sad, but this is what we get when there are no "dry runs" done in advance to demonstrate the problems of the "plan". One can argue that in this case it could be foreseen that 260 immunizations a day wouldn't cut it. However, it was not foreseen. A dry run would have disclosed it, hopefully back in November when the problem could have been more easily addressed. It is also an indictment of our local news media for not being all over this story and of the Board of Supervisors for not recognizing and addressing the issue quickly.

That said, Akiddoc is demonstrating the eternal truth that no matter how good or bad the plan is, the battle is won or lost by the troops, not the generals. Hopefully he will be allowed to lead his "company strength" detachment to their objective of being immunized without the "headquarters REMFs" getting in his way.

[M T]

Do you think the state has a working data base set up yet to keep track of the massive volumes of residents who will be vaccinated?  Won’t they need all sorts of interfaces with lots of EMRs and provisions for manual tracking?

My guess is probably not.

The CDC's Tiberius system is the software to keep track.  What I haven't heard is whether that has every individual's name/id in it already, or whether the states are responsible for getting the names in there.  My guess is that SSN is being used to distinguish one James Kirk from the next one.   I rather doubt it is tied to the latest census because that wasn't finished and probably isn't cleaned up yet.

Edit: Another article on Tiberius. OWS indicated they sent IT people to the various jurisdictions (states, mostly) to help with getting everything working.

One thing is for sure (I hope, anyway), is that the database doesn't know whether I should be in group 1A, 1B, 1C, or 2, especially with states making the final say on prioritization.  So it can't be the driver for any master prioritization list.  (Indeed, while one may have major disagreements with where teachers are in the prioritization, I think it is a failure that there was no way to create a prioritization list once they put "frontline-whatever" into the priority criteria. They created a criteria for which there was no way for the people responsible for allocating shots could say where Adam (for every Adam) is in the priority scheme.)

I'm not saying they were stupid and should have prioritized in a different way (well, I'm not saying it here).  But that this is a problem.  I think we're seeing the fallout of this problem in the delay in getting shots into arms.

I believe Teejers is the one suggesting a birthday lottery.  Just using that for an example, if SCC knew that about 5,000 16+year-olds were born on a particular day and would be coming in for their vaccinations  when they announced that day, they might have enough sites set up to administer shots.

Suppose the whole of the US (people, counties, states) said "We're committed to getting shots in arms in 6 months".  For a 2M-population county like SCC, that's roughly 10K shots a day.   SCC is doing 20K tests per day (about half by the County Health Care System itself).  It can be done.  Line 'em up in the fairgrounds.

But it isn't going to get done with situations like aKidDoc is in, or with the issues that Stanford is having.   While the guys at my place of employment are pretty good, I can't expect them to be better than the similar people at those two health care providers.   What about Joe's Auto Shop?

And, if we continue with the priority system (which I think we will), you can't get SCC to use the fairgrounds to administer shots because they are not in a position to know whether the person wanting a vaccine is a frontline healthcare worker or the greeter at Walmart.  They sure won't know if he/she is diabetic or are immuno-compromised.

[chrisk]

They did mass vaccinations 65 years ago with little technology, albeit only for kids.


The limiting factor should be the vaccine production not the distribution system.

Warpspeed is paying the producers and front end distributors enough to make them interested in doing things quickly. Apparently, the people responsible p for the last mile are not being paid enough to “motivate” them.

[Leftcoast]

A friend (who will remain nameless) is a pharmacist in the UCSF system and received her vaccine a week ago.  She occasionally consults with patients but most interaction is remote.  She was surprised to be called so early but was told UCSF is in good shape for vaccine supply.  She also works with the homeless population in Oakland outside of her "official" duties so she was happy to receive it.


I expect there will be anomalies while the distribution glitches are worked out.  Best way to resolve this is to flood health care systems and LTCF with supply so the anomalies are 1 or 2 day discrepancies rather than months-long issues.

==========================

I still find this board a good source for info on vaccine approvals, distribution, comparative statistics, etc.  I'm also surprised the mods believe its time has passed.  Perhaps, policing the occassional political rabbit holes has worn out our volunteer mods? 

[Goose]

Do you think the state has a working data base set up yet to keep track of the massive volumes of residents who will be vaccinated?  Won’t they need all sorts of interfaces with lots of EMRs and provisions for manual tracking?

My guess is probably not.

The CDC's Tiberius system is the software to keep track.  What I haven't heard is whether that has every individual's name/id in it already, or whether the states are responsible for getting the names in there.  My guess is that SSN is being used to distinguish one James Kirk from the next one.   I rather doubt it is tied to the latest census because that wasn't finished and probably isn't cleaned up yet.



Edit: Another article on Tiberius.  OWS indicated they sent IT people to the various jurisdictions (states, mostly) to help with getting everything working.

To keep track of what?

Tiberius integrates the data related to manufacturing, supply chain, allocation, state and territory planning, delivery and administration of both vaccine products and kits containing needles, syringes and other supplies needed to administer the vaccine.



With information from both federal and local sources, Tiberius can provide a zip code-by-zip code view of priority populations, including frontline workers and nursing home residents. 



Tiberius provides planning tools for states to optimize their allocation and distribution plans. Based on priority recommendations, Tiberius provides decision support to leaders around the country, drawing from the data which includes planning information provided by jurisdictions.

Unclear to me that it records anything about individuals at all, at least based on the link above. It doesn't appear to know "James Kirk xxx-xx-xxxx got Moderna on ... Supposedly, there is no identifying data involved. While this may be a useful piece of software, it is unclear what if any relationship it may have to AKidDoc's issues.

Suppose the whole of the US (people, counties, states) said "We're committed to getting shots in arms in 6 months".  For a 2M-population county like SCC, that's roughly 10K shots a day.   SCC is doing 20K tests per day (about half by the County Health Care System itself).  It can be done.  Line 'em up in the fairgrounds.

Yes it can, but we aren't doing it that way. Instead we are worrying about who should get it first without worrying about getting it distributed at all. Recipe for failure IMHO. It would appear the counties have totally underestimated what is going to be required of them. Hopefully CVS and Walgreen's will do better. Equally crazy that Stanford hasn't delivered all their vaccine's yet.



M T, I do have a question for you. When you say "by the County Health Care System itself" do you mean they are actually running the PCR operations themselves or do you mean they are collecting the samples and sending them out for the PCR processing and reading? The answer doesn't change your point, I am just curious about this issue.

[teejers1]

I believe Teejers is the one suggesting a birthday lottery.  Just using that for an example, if SCC knew that about 5,000 16+year-olds were born on a particular day and would be coming in for their vaccinations  when they announced that day, they might have enough sites set up to administer shots.

Somebody else.  Someone who used KISS acronym, which is not one I would use, particularly here (maybe KIS, though).

[BostonCard]

A friend (who will remain nameless) is a pharmacist in the UCSF system and received her vaccine a week ago.  She occasionally consults with patients but most interaction is remote.  She was surprised to be called so early but was told UCSF is in good shape for vaccine supply.  She also works with the homeless population in Oakland outside of her "official" duties so she was happy to receive it.


I expect there will be anomalies while the distribution glitches are worked out.  Best way to resolve this is to flood health care systems and LTCF with supply so the anomalies are 1 or 2 day discrepancies rather than months-long issues.

==========================

I still find this board a good source for info on vaccine approvals, distribution, comparative statistics, etc.  I'm also surprised the mods believe its time has passed.  Perhaps, policing the occassional political rabbit holes has worn out our volunteer mods? 

UCSF has injected 6300 doses of vaccine, and they are anticipating being able to do 10,000 people a week.  They anticipate being done with all 19,000 high-risk workers (both doses) by mid-February.

BC

[akiddoc]

As expected my email was ignored. 

Got to wear my space suit today while seeing infected families.

[BostonCard]

I believe Teejers is the one suggesting a birthday lottery.  Just using that for an example, if SCC knew that about 5,000 16+year-olds were born on a particular day and would be coming in for their vaccinations  when they announced that day, they might have enough sites set up to administer shots.

Somebody else.  Someone who used KISS acronym, which is not one I would use, particularly here (maybe KIS, though).

It was GR.

BC