A TALE OF TWO STATES

As everyone has seen, the rollout of the COVID-19 vaccine has been fraught with problems. The apt description that comes to mind is “FUBAR.” For those of you who are not familiar with the acronym it stands for “Fouled up beyond all recognition.” (For those of you who favor more colorful language feel free to substitute another word for “fouled.”)

From what I can discern based on various news reports the success or failure of the rollout has varied from state to state depending on the adequacy of that state’s planning, organization and leadership. Every state has had to cope with a shortfall of supply to some extent, but some have dealt with the problem better than others. One common theme is that politicians at all levels – federal, state, county and local – have been doing what they do best: blame someone else. It’s so typical and expected, but no less annoying.

Rather than trying to analyze the experiences of all 50 states, with apologies to Charles Dickens I will compare the experiences of two states – New York and Florida.

NYS’s rollout has been problematic from the start. For instance:

  1. Apparently, Governor Cuomo is unaware of or has forgotten that old adage, “an ounce of prevention is worth a pound of cure.” NY has proven to be as ill prepared for the rollout as it was last summer for the pandemic, itself. As a result, it has been scrambling to catch up. NYS State Senator Phil Boyle opined that the state should have had a distribution plan in place and ready to go prior to the arrival of the vaccines. Dr. Wafaa El-Sadr professor of epidemiology and medicine at Columbia University echoed that sentiment. “We had the the time to engage the [local] communities, engage the leaders, [and] educate them. We lost that opportunity.” I agree. It’s not as if we were taken by surprise. Everyone knew months ago that the vaccines would be ready eventually, and that when they arrived time would be of the essence.
  2. In my view, NY has been one of the many states guilty of “micromanaging.” NY officials from the governor on down have been trying to exert too much control at the state level instead of delegating the rollout to local authorities who, obviously, are more cognizant of the needs of their communities. When asked to comment on this issue Nassau County Chief Executive Laura Curran tried to be diplomatic, but her frustration came through anyway. “We communicated to them [the state]….that we were ready to be helpful. ….”I think the state is now seeing how valuable we can be on the local level.” The cruelest irony of all, as pointed out by Alex Azar, HHS Secretary, is that while many people were unable to arrange appointments thousands of doses were lying in warehouses undistributed. There were reports of some that had to be destroyed.
  3. The vendors have been unable to deliver sufficient supplies of the vaccine. There are various reasons for this. All states have had to figure out how to deal with this issue.
  4. In addition, there have been reports of shortages of necessary supplies such as needles, vials and swabs
  5. Some states have coped better than others. Florida is one of the states that has been able to adapt; NY, not so much.
  6. Cuomo has been complaining that the Feds have “shorted” NY by tens of thousands of doses. Cuomo spokesman, Jack Sterne, tried to deflect responsibility stating that “every state had trouble in the beginning due to a lack of support and planning from an incompetent federal administration.” Yes, but as I said, some states have handled it and adapted to it better than others. Like I said, every state is being forced to deal with the same issue. I say, Andy, put on your “big boy pants” and deal with it. Take responsibility. Show some initiative and some leadership. Instead of griping, find a solution.
  7. NYS failed to delineate clearly the order of priority of different groups of people. For example, the second group to receive the vaccine was “essential” workers and people over 75, but before all of them could be inoculated the next group was authorized to and began to receive the vaccine. Thus, in one fell swoop the state tripled the number of persons eligible to receive the vaccine. Millions of persons were vying for appointments at the same time, which overwhelmed an already taxed system. Also, some people in the third category have been vaccinated ahead of those in groups 1 and 2.
  8. Making appointments has been plagued by computer glitches. Predictably the system has malfunctioned and “crashed” on multiple occasions. It became routine to spend hours on line trying, in vain, to get an appointment. Often, people would continually get error messages. Try to imagine the frustration and stress of an 80 year old person trying to navigate through such a situation. Also, many people don’t have access to a computer, or are homebound. What do they do? How is a nursing home patient, who is likely immobile, supposed to get to an inoculation site? The worst situation occurred with respect to the facility at Stonybrook. Some 20,000 persons had their appointments voided. Melissa DeRosa, a senior aide to Governor Cuomo ascribed that to that old standby excuse, a computer “hack.” But, Perry Halkitis, dean of the Rutgers School of Pubic Health, has ascribed the malfunctioning computer system to a “lack of preparation.” I believe that is the more likely explanation.
  9. Trying to get an appointment by telephone has been no better. If one were lucky enough to get through it was common to wait on hold for long periods and then either get cut off or be told their were no appointments available.
  10. According to Newsday NYS’s rigidity as to who was eligible to be vaccinated has contributed to the problem. Governor Cuomo’s defense was that he was merely following CDC guidelines.
  11. Newsday reported that additional sites have been needed to cope with the demand, and some are scheduled to open up over the next few weeks. Fine, better late than never, but the state will be playing catch-up. It will also have to resolve the other abovementioned issues.
  12. Even these new sites have proven to be inadequate. For example, last week a new site opened at Jones Beach. There were 55,200 slots available. They were filled within two days, and the dates were months away. How many more people will die before they can get their vaccines.
  13. On the other hand, Florida appears to have been better prepared and better organized. It should be noted that FL’s population has a higher risk profile than that of NY in terms of COVID. According to the latest US Census Bureau figures available it is the third largest state in terms of population with 21.9 million and ranks second in percentage of residents in the high risk category of 65 and over (20.5%). Do you know which state is first? See answer below. It will surprise you. By comparison, NY is the fourth largest state with 19.4 million and ranks 26th in percent of elderly (16%).
  14. FL’s Governor Ron DeSantis has affirmed that the elderly and healthcare workers and patients have been and will continue to receive top priority.
  15. FL has been utilizing the local infrastructure of its individual counties. Vaccines have already been shipped to all 67 FL counties for distribution. People I know who live in FL have had a much easier getting vaccinated than New Yorkers. FL appears to be well ahead of NY in distributing the vaccine to those who need it.
  16. According to Florida Health Carlos Montoya, president and CEO of Jackson Health System, praised Governor DeSantis for his “planning ahead” and exhibiting “tremendous leadership in getting the vaccine out into our community quickly.” FH noted that from the very outset DeSantis ensured that those at the greatest risk were given top priority. He “prioritized frontline healthcare workers as well as residents and staff of long-term care facilities.”
  17. According to Business Insider since FL is not requiring proof of residency many “snowbirds” have been flying down there to be vaccinated. Many of them stay for a while and enjoy a mini-vacation while they wait for the booster shot. DeSantis called the practice “vaccine tourism.” According to the Wall Street Journal FL health official explained this policy thusly: “If [people] are spending time in our community….they can be spreaders.” In addition, people have come from as far away as Argentina.

CONCLUSION

NY is continuing to be plagued by a resurgence in COVID cases, hospitalizations and fatalities. According to various news sources total hospitalizations have exceeded 8,800 for several days running, a total not seen since last May. At the same time, as discussed above thousands of elderly and immunocompromised persons have been unable to get vaccinated.

This is a chance for president-elect Biden to show some leadership. He made COVID the central issue of his campaign. He has said he will direct the feds to establish mass inoculation sites and mobile clinics, provide billions of dollars in additional funding, and pressure the manufacturers to step up production not only of the vaccine but also of related supplies such as vials, needles and swabs. Talk is cheap. Let’s see if he can pull it off. I, for one, will remain skeptical until and unless he does so.

Quiz answer: Maine (20.6%).

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