To Reduce Anxiety, Vaccine Program Should Have Had Central Booking

The psychological impacts of how one is required to obtain  a COVID-19 vaccination in Massachusetts could have been foreseen, but, understandably, they were not: our state has never before attempted to vaccinate more than four million citizens in a compressed timeframe during a global pandemic.

Today, most Massachusetts citizens who want to get a shot for COVID-19 -- unlike their counterparts, say, in New Jersey or Florida or New Mexico -- have to get on a new state website and hunt for their own appointment at the same time that hundreds of thousand of other folks are hunting too. With demand for shots far exceeding supply, the large majority of vaccine seekers have not succeeded in securing these coveted appointments.  

People are spending long periods on computers filling out the required form, only to be told at the expected culmination of the process that there are no available appointments and they'll have to try again later.  When they sign off, all the information they have provided vanishes, meaning they'll have to fill out the form again (and again) until one day they get lucky. 

If the Governor Baker administration had, instead, incorporated a central registration feature into its electronic sign-ups, as some other states have done, persons would have filled out the form only once and subsequently been notified when appointments in their areas became available.

No system designed in a hurry to deal with an unprecedented national medical emergency would ever have been perfect, and I'm sure there are some drawbacks and downsides to a system built around central registration; however, one of the beauties of central registration is that it provides users with an instant feeling of accomplishment or progress.  People feel: "I'm in the system.  They know me. It's a just matter of time before I get my shot."

By contrast, in Massachusetts, way too many folks who are doing what they are instructed to do, and failing repeatedly to secure an appointment, have become frustrated and obsessed about when, or even whether, they'll be able to get a shot.  They feel:  "I've put hours into this and gotten nowhere.  Next week, I'll have to do it again -- and probably strike out again.  I'm on the outs.  And no one cares."  

Mass frustration with the COVID-19 vaccine finder website is overshadowing the actual good results of this program.

As of last Wednesday, Feb. 24, 1,084,888 persons had received at least one dose of a vaccine, and 433,593 persons had received both doses.  Also, 77% of vaccine doses shipped here by the federal government had been administered.

Massachusetts is best in the nation for first doses administered per capita among states with five million or more citizens, and ranks second in the nation for percentage of Black residents who have gotten at least one shot.  

Also, Massachusetts has administered more than three times the doses per capita as the European Union and more than five times per capita as Canada.

State Senator Diane DiZoglio, D-Methuen, has filed a bill that would require the Executive Office of Health and Human Services to institute a central registration system for COVID-19 vaccinations.  If I were the governor, I'd pre-empt that by ordering EOHHS to implement such a system as soon as possible.  Right away people would feel better about the program.  And maybe they'd start thinking about the good things the administration has done in fighting the pandemic.

HEAD-SPINNING NUMBERS: During a virtual hearing this past Thursday of the legislature's Joint Committee on COVID-19 and Emergency Preparedness, Charlie Baker was asked for the numbers on federal pandemic aid to the Commonwealth.  His answer made me sit up and take notice.  Seventy-one billion dollars has come to Massachusetts one way or another through four major federal relief programs, Baker said, adding that $20 billion-plus of that went to unemployment insurance, $27 billion to Payroll Protection Program benefits for businesses, and $8 billion to stimulus checks for individuals and families.  It's hard to imagine how badly we'd be doing now without that help from Washington.

UPDATE, 3-11-21: Gov. Baker announced yesterday that the Commonwealth will be implementing this Friday a new pre-registration system for residents seeking a COVID-19 vaccination. They will be able to fill out a form online or by phone, which will put them in a virtual queue for appointments.  On a first-registered, first-serve basis, registrants will then be notified when an appointment is available at one of the seven large, regional vaccination sites near them.

Oh Happy Day When COVID Ends...but a Bigger Test Is Coming

The COVID-19 pandemic is not the biggest test of our nation's strength and character.  That will come after, when we decide what we will do (or not) about the inequities revealed by the pandemic.

Based on how the U.S. responded to similar inequities after the last pandemic, the Spanish Flu of 1918-20, there's reason to expect we will fail the post-COVID-19 test, with terrible consequences for our country.

A great deal has been written and said about how some population groups have been hurt more deeply than others during the current pandemic; no single post could summarize all the evidence of such impacts. Here are just two examples:

• Last summer, the COVID-19 Health Equity Advisory Group of the Massachusetts Department of Public Health reported that Black non-Hispanic residents and Hispanic residents in our Commonwealth have a three-times higher positive coronavirus case rate than white, non-Hispanic residents, and that Black and Hispanic residents also have higher rates of hospitalizations and deaths compared to white or Asian residents.
• In the Fall 2020 edition of "Harvard Public Health," the magazine of the Harvard T.H. Chan School of Public Health, Madeline Drexler wrote, "Today's coronavirus pandemic is the only public health crisis in the last hundred years as profoundly disruptive to society as the 1918 flu.  And like the 1918 pandemic, it has unmasked persistent racial injustice.  According to the COVID Racial Data Tracker, one of the most reliable sources of data on racial disparities in today's catastrophe, as of September 1, 2020, COVID-19 had killed at least 36,320 Black people in the U.S.  A collaboration between the COVID Tracking Project and the Boston University Center for Antiracist Research, the Racial Data Tracker also found that while Black people make up 13 percent of the U.S. population, they account for 22 percent of deaths in which race is known.  Black Americans are dying from COVID-19 at 2.4 times the rate of white people."

The Spanish Flu killed somewhere between 50 million and 100 million around the world, including up to 850,000 in the U.S., about .81% of our population at the time.  Those deaths were a collective shock to the nation unlike anything else in history.  Yet, within a few years, the shock effects had worn off and Americans were reveling in the prosperity of the Roaring 20s.  

Long ago, I read somewhere that one reason we seemed to move on quickly from those 850,000 deaths was that immigrants, desperate for a new start in America, quickly replaced those who had been taken by the flu.

Today, the COVID-19 death toll in the US stands at around 489,000.  We don't know how much worse it will get.  Let's be hopeful, optimistic; let's say U.S. deaths will top off at 525,000.    

The U.S. could admit that number of immigrants in 2022, if it wanted to. (Maybe we should for reasons totally unrelated to COVID-19.)  And if we happened to do that, let us hope that, when 2023 rolls around, the U.S. is seriously addressing racial and economic injustices rather than mindlessly enjoying prosperity's rebirth.    

I'll end with an excerpt from a recent report by the Center for Employment Equity at the University of Massachusetts Amherst. Written by Donald Tomaskovic-Devey, Rodrigo Dominguez-Villegas and Eric Hoyt, the report was titled, "The COVID-19 Recession: An Opportunity to Reform Our Low Wage Economy?"

"If the recovery from the COVID-19 recession follows the path of the 2007-2009 Great Recession, it will generate mainly low-wage, low quality jobs, and we as a nation will have embraced our past failings yet again.  The ability of the U.S. to respond to crises of any sort depends on the resiliency of its people and institutions.  If we do not make access to health care, sick and family leave, and living wages a social right before the next economic crisis -- whether it is financial, viral , or some new surprise -- we will have failed again to learn the shameful lessons of our own history.  If we do not disrupt the power dynamics that leave most workers exposed to insecurity and poverty level employment, we will leave our country vulnerable to economic and social collapse, perhaps now, certainly in future crises -- whether economic or political."