The Volokh Conspiracy
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"Why West Virginia and South Dakota Are Beating California at the Vaccine Race"
The San Jose Mercury News (Lisa M. Krieger) has the story, and Bloomberg has the detailed data:
Through the icy hollows of West Virginia, members of the Army National Guard are driving precious doses of COVID-19 vaccines to the state's independent pharmacies. So far six of every 100 residents have received the vaccine, making this poor and rural state the nation's leader at getting shots in arms.
Halfway across the country, South Dakota has taken a very different yet equally effective approach: Divvying up its 66 vast and windswept counties among its major healthcare plans, it tasked each plan with vaccinating every resident in its assigned counties, using well-established courier services.
In contrast, the tech-savvy, populous and economic powerhouse of California has given only 2 doses per 100 residents, even though it has received roughly the same amount of vaccine, per capita, as those other states. The Golden State, with a larger, more fragmented and decentralized healthcare system, is relying on an ambitious but complex tiered priority system. Residents complain of poor messaging and confusion about who is eligible, saying they don't know when, how and where to go for vaccination….
Michigan appears not to have been distributing the vaccines on Christmas weekend (Fri.-Sun.) and New Year's weekend.
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Yup. Places where a lot of healthcare has been socialized for decades—with the federal government picking up the tab for private hospital shortfalls and emergency room visits—are easier to manage than the chaos of the private healthcare system. Who knew?
Yup. Pretty easy to twist the narrative to suit socialism.
In my California county, the HR department at our largest hospital had to sign off on the vaccinations. If you have seventy levels of bureaucrats that each have to demonstrate relevance, it take time.
I could say the same of many on here and deregulated markets.
West Virginia, I understand what you're saying because of very high % medicaid recipients. But SD has very low % of medicaid recipients? And close to average medicare recipients? What socialization are you talking about?
I dunno that %medicaid==socialized medicine, but FWIW in WV 28% of the population is on medicaid, vs. 26% in CA, so not a difference likely to explain the vaccination results.
FWIW, NY is 26% and SD is 14%
Source: KFF
Statistics are just a white patriarchal construct. Socialism is good! Every single event that ever happens proves that socialism is good.
Do you actually have a cite that shows which states have the most socialized medicine systems? Because I would think California would be high up on the list, certainly higher than South Dakota and North Dakota at least.
California has lower medicare than average (presumably because of a younger population) but MUCH higher medicaid. See here https://www.kff.org/other/state-indicator/total-population/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
Remind us how swimmingly things are going under Cuomo's handling of vaccinations in NY.
https://reason.com/2021/01/08/cuomos-new-york-is-just-throwing-away-vaccines-rather-than-distributing-them-competently/
Hmm, no mention of New York and no discussion of how many of New York's "administered" doses were actually thrown out because of Cuomo's bat shit crazy rules.
Failure and success are measured by one's goals. The closer you reach your goal, the better you are and the farther from failure you are.
If your goal is to vaccinate as many people as quickly as possible, then Cuomo has a problem.
If your goal is to continue asserting your control and authority over the populace, he is doing well.
If you click on the Bloomberg link, it shows the shot utilization % per state. New York at 40% is near but slight above average. New York City as a subset of New York is below average. While this doesn’t split out wasted shots from not yet utilized shots, it would appear New York isn’t drastically behind on vaccination based on Cuomo’s missteps.
"If you click on the Bloomberg link, it shows the shot utilization % per state."
Yes, but the vaccines once thawed out don't have much shelf life and it's been reported that clinics and hospitals in New York have been throwing out doses unused because no recipients on the currently allowed priority list are available and Cuomo and NY health officials will not allow them to use those doses for any available willing patient.
I am suspicious that the utilization numbers for NY include doses that were thrown out as expired, rather than being injected.
protocols were followed
I am suspicious that the utilization numbers for NY include doses that were thrown out as expired, rather than being injected.
So you think the numbers are lies and NY is actually in keeping with your narrative, but secretly.
Oy.
So you think the numbers are lies and NY is actually in keeping with your narrative, but secretly.
Or perhaps you could have bothered to read the footnote at the bottom of those numbers, which started with...
"Data gathered from government websites, official statements and Bloomberg interviews."
...which doesn't exactly inspire confidence in the accuracy or consistency of the "data".
I’m guessing it’s relatively low, but even half a dozen is too many.
It just shows Coumo’s megalomania, he thinks he has such tight control, down to every neighborhood clinic in the state, that his totally unrealistic regulations, with dragonian fines, will be unquestionably obeyed.
His threats can freeze people into inaction, but not efficient unquestioned obedience.
"dragonian fines"
Sounds like dwarven mining terminology.
How many doses per 100k were sent to each state?
900k people live in South Dakota in total
54k doses
780k doses in Cali
neither is particularly impressive
It is supposed to be proportional to population.
Doesn't look like it is, if arpiniant's figures are accurate.
That's 6% of ND's population, 2% of CA's.
Where did those figures come from? All of the figures I've found are for doses given, not number of doses vaccine delivered to the state.
sorry that was given not delivered and I just did the math above
So it proves South Dakota and West Virginia are probably more efficient at delivery vaccine to their providers and the providers are more efficient at shooting people in the arm.
I'd imagine in both states the state health officials know many/most of the hospital administrator personally.
What you should be looking at is what percentage of doses the state has received that have been administered. Obviously the can't administer doses they haven't received yet, so absolute numbers don't show how efficient they have been. Texas and Florida are doing the best among large states:
Top 10
Jurisdiction % shots used
West Virginia 72.8
North Dakota 67.5
South Dakota 57.4
Rhode Island 55.5
Connecticut 51.4
Texas 49.3
Montana 49.2
District of Columbia 48.4
Utah 46.9
Florida 45.7
Also rans:
New York 40.7
California 25.9
West Virginia is pretty impressive in a mountainous decentralized state.
What you should be looking at is what percentage of doses the state has received that have been administered.
Sounds right.
I was born in West Virginia. It's a pretty small state and fairly easy to get around.
and fairly easy to get around.
Yes, it is fairly easy to drive around WVA entirely and avoid having to drive through the state. Now, actually getting anywhere in WVA? Hope you got 4wd.
You've obviously never been there.
Texas and Florida included 65+ in the first wave, so there's no hemming and hawing about what to do with a thawed dose.
I mean, it's right there in the article. "In contrast, the tech-savvy, populous and economic powerhouse of California has given only 2 doses per 100 residents, even though it has received roughly the same amount of vaccine, per capita, as those other states. "
Yes - the sense here in NY is that the felt need to be overly prescriptive in how the vaccine gets rolled out is, in fact, slowing its distribution. Cuomo threatened hefty fines for anyone administering the vaccine not in compliance with his prioritization - and hefty fines for anyone not administering the vaccines quickly enough.
There is a point where trying to do the wonky, science-based thing runs up against lived reality. In a perfectly administered world, you'll save more lives by vaccinating people according to the prescribed tiers, rather than serving first-comers and relaxing the tiers. But none of the rollout in NY has been particularly competent, so there's a kind of "broken clock" wisdom in taking a more lenient approach.
One might almost wonder if things might not be going better in NY if Cuomo hadn't spent so many of the past months trying to micromanage which bars and restaurants were allowed to open.
"you’ll save more lives by vaccinating people according to the prescribed tiers, rather than serving first-comers and relaxing the tiers"
I'm not sure that is true if you over complicate the process such that it incurs a great deal of overhead finding and identifying the precise people to treat. If it takes a week longer to inoculate the same number of people have you saved any lives? Getting to Healthcare worked in hospitals is easy, line 'em up and shoot'em up. Same with nursing homes. Once you get to trying to wrangle people out in the wild it gets way more complicated.
"have you saved any lives? "
That is the wrong question. The correct question is have you lowered the level of contagion. ANd you won't knw that until at least 0.1% of covid tests are DNA sequenced to determine if the infection is from the UK strain.
The theoretically optimal solution is often close to worst, if finding it delays your implementing a merely good enough solution.
The real horror in NY is clinics that have vaccine about to expire were giving it to walk-ins, and Cuomo went berserk over it: Better it spoil than be given to somebody outside the plan.
What the should do is when they set up a vaccine location they should administer the vaccine to the targeted priority tiers, then take all comers in the next tier, and so on until all the supply they have on hand is exhausted, even if they have to go out in the parking lot and take passerbys.
Don't make the perfect the enemy of the good.
I mostly agree with this, although it assumes that you're biggest bottleneck is going to continue to be capacity to deliver the vaccine as opposed to vaccine supply. That's definitely the case right now, but I don't know enough about future supply projections or the ability to ramp up delivery to have an opinion on whether it will remain true.
It may make sense to hold back on vaccinating people in much lower tiers if eventually you're going to run out of supply for the people in the higher tiers. But certainly we shouldn't be sticklers about moving to, e.g., Tier 1b when we can't find enough from Tier 1a to use all of our existing capacity.
It's probably reasonable to look at this and say that the states trying to be more proscriptive about process are doing a worse job at this, and that tends to be blue states.
What Cuomo doesn't want to say out loud is that New York is corrupt as shit, and if there are any loopholes, the clinics will set up a system where they give the first dose of every vial to a 75 year old, and the next 9 doses will go to cash customers.
https://www.usatoday.com/story/news/nation/2020/12/22/covid-vaccine-distribution-plan-creates-winners-losers-among-states/3982693001/
Didn't read through all of it but there are some differences in how vaccine is delivered
looking for better source
Which is still utterly irrelevant to the issue of how well states are doing with what they've been allocated. When NY is allowing vaccine doses to expire and throwing them away rather than giving them to people not on Cuomo's approved list it doesn't really matter how those doses were allocated.
I have lived in states with high populations and states with low populations. (low enough I could run into governors and senators at the store) The states with low populations are on the whole much better at delivering services to people. Maybe it's just a coincidence based on where I have lived, or maybe it has something to do with the federalism thing, that some things are best done by a government that is close to people.
When you can yell out your door com git yer vaccine and all 5 people can hear you and do it, that makes it easy
IF you can yell out your door and 50000 people come running, that becomes problematic
Point I am making is that there is not an infinite supply of vaccine being pushed equally into all 50 states at the same time
There are rules and priorities which I am not sure of, so there may be reasons for the differing rates
Or CA may suck
but without a better understanding one cannot know
FWIW, WaPo has a state by state list of 'doses allocated'. It links through to CDC pages that see to define that as:
"This dataset lists the allocations of doses that will be made available for states and jurisdictions to order against. Weekly first-dose allocations are provided to states on Tuesdays; jurisdictions can begin placing orders on Thursdays. After doses are ordered by states, shipments begin the following Monday. The entire order may not arrive in one shipment or on one day, but over the course of the week."
So it sounds like 'doses allocated' might more or less equal dosed shipped with a week lag time.
The USAToday link above in the comments says that the allocations are proportional to the number of adults in the state. I scanned partway through the WaPo list and the state numbers were all in the 7 to 8 per cent range, so it looks like states are getting roughly equal access to the vaccine.
sigh ... 'seeMS to define'
You should compare like to like:
State - Doses Distributed- doses given- %
California 3,435,650 891,489 25.9
Texas 1,984,225 978,042 49.3
New York 1,796,850 732,066 40.7
Florida 1,680,200 768,629. 45.7
California is definitely lagging compared to the other 4 largest states, which also combine large metropolitan areas with a multitude of small and medium size jurisdictions over a large geographical area.
Point I am making is that there is not an infinite supply of vaccine being pushed equally into all 50 states at the same time
There are rules and priorities which I am not sure of, so there may be reasons for the differing rates
Or CA may suck
but without a better understanding one cannot know
And the point you're so feebly attempting to make is still completely irrelevant. The issue is not how many doses are being sent to which states. It's how the states are doing with regard to administering the doses they've received.
Wow, you've suddenly become very agnostic. I guess you couldn't find any evidence to support you, so you resorted to the "Nobody knows for sure. It's complicated" routine.
According to poll numbers only about 50% of people want the vaccine anyhow. Trying to roll it out in tiers is just plain silly when half of the target population won't take it voluntarily. It would be one thing if people were clamoring to take the vaccine, but even in states with high compliance rates there are reports of missed or available appointments with excess vaccine at the end of the day.
If counties just opened up a first come, first serve center and provided transportation options there that would be the best public health policy can do given the numbers.
It would be one thing if people were clamoring to take the vaccine,
Not sure about you, but around here, people are clamoring to take the vaccine.
Lathering the rubes
Lathering the rubes
All right-wingers have left is
Lathering their rubes
What a bore. The same ole crappola, time after time, signifying nothing.
Gov. Newsome should just call up the person in charge of overseeing the count for California and tell him to report a better figure for him, telling him "there’s nothing wrong with saying, you know, that you’ve recalculated."
In the ten days ending yesterday 5024 Californians have died from covid. Maybe he should be applying the gubernatorial boot somewhere.
He can name himself US Senator as soon as Harris resigns.
Dump some politically inspired disinformation to politicize distribution as well, Queenie. It's the only way your mind can process things, as accepting facts and trying to figure out why is too hard.
So sure, everybody in all the other states are simply lying. There can't be anything wrong with California's approach.
Part if the reason that the pandemic has been so bad here is that our political class and media have bent over backwards to politicize it from the beginning. Be nice if at some point it would stop.
Ten months under house arrest and we are still at the roughly 1000 new cases per day in Alameda County
Who would have thought that a state governed entirely by Democrats where the voting population is nearly half mestizo and black would have screwed this up?
Who would have thought a racist could find a way to make vaccines racist
Oh, yeah, racists.....
Actually blacks constitute only 6% of the population of California
So the Pareto Principle is now racist? 80/20 wasn’t enough, now it’s 94/06?
A good reason to recall Newsom.
Michigan seems to always get it the worst.
So what happens in these two states if you refuse the vaccine?
Y’all can have mine. For now it is only available to First Class Citizens here, the ones that wear masks and rush around being important.
The plandemic hysterica continues apace. The conspiracy of ignorance masquerades as common sense.
No different from the flu vaccines or Hep B.
There are many scenarios where you can opt out of the vaccine if you sign a waiver and/or agree to additional PPE.