24 | February | 2021 | The Homa Files

Archive for February 24th, 2021

Connecticut is “de-complicating” and adopting West Virginia’s vaccination model…

February 24, 2021

“Essentiality” and “equity” are hard to administer, get gamed and clog the system.
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Earlier in the month, we asked:

So, why is West Virginia kicking other states butts?
And, why aren’t other states imitating WV’s approach?

The essence of West Virginia’s successful strategy:

Be prepared … anticipate a vaccine sooner rather than later
Set clear objectives … save lives, grow the herd
Own the problem … act instead of complaining
Keep It Simple … prioritize by age; minimize IT dependence
Make bold decisions … be contrarian when necessary

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The WSJ reports that Connecticut is adopting the essence of the West Virginia model.

Concluding that complexity is the enemy of speed, Gov. Ned Lamont declared “We’re going to focus on the old business motto, KISS: Keep it simple, stupid.”

Specifically, Lamont recognized that the more states prioritize work “essentiality” and social “equity,” the more complicated and inequitable vaccine distribution becomes.

So, Connecticut is starting to base Covid-19 vaccine eligibility strictly on age.

See WSJ: Start sequencing vaccinations from oldest to youngest … period!

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Connecticut had planned to vaccinate “essential workers”, younger people with underlying health conditions like diabetes and minorities.

Immediately, definitional creep exploded.

For example, the CDC said grocery and food service workers should get priority.

“So, we started getting calls: What about convenience stores and box stores? They sell food.”

The CDC said that obesity should be a priority.

“So, people started wondering: Should I bulk up on doughnuts to meet the public-health definition of obesity?”

Lamont concluded: “A lot of complications result from trying to finely slice the salami and it got very complicated to administer.”

People of all races develop more health conditions as they age, and their immune systems weaken.

But, decisions about who is or isn’t an “essential worker” are completely arbitrary.

And, while minorities have significantly higher Covid death rates than whites, outcomes differ far more by age than race or underlying conditions.

A 58-year-old black retiree is 10 times more likely to die from the virus than a 40-year-old black worker.

The simple solution: Prioritize by age and set up more inoculation sites in low-income communities to improve vaccine access.

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The WSJ concludes: “Bravo to Mr. Lamont for thinking of the larger public good, and understanding that simple can be smart.”

Now, maybe more “smart” states will concede that they got outsmarted and start following West Virginia’s lead. mitigating the current vaccine-chase folly: constantly changing eligibility rules, persistent web-checking, link sharing, remote venue access, fake IDs, etc.

It’s not too late and it might happen, but I’m betting the under ….

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VAX: So, why is West Virginia kicking other states butts?

February 24, 2021

And, why aren’t other states imitating WV’s approach?
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Originally posted Oct. 10, 2021

Based on all key outcome & efficiency metrics – e.g. percentage of population vaccinated and utilization of available supply — WV’s performance has been stellar – in absolute terms and relative to other richer and self-proclaimed “smarter” states.

See States’ Performance Ranks

Why is that?

First, let’s stipulate that being a small state has had its advantages:

> Per capita vaccine allocations (from the Feds) have tended to be higher for smaller states – probably a function of logistical rules (think: minimum shipping quantities and critical mass required to “seed” a vaccinator network).

> Smaller states are more accommodative to centralized management. The “sight lines” from the state capitals to the borders are shorter than in large states … i.e. it’s easier to see what’s going on without relying on filtered reports from layers of self-interested politicos and bureaucrats.

> There is less dependency on grandiose scheduling & information systems. Much of business can be transacted via personal relationships using very basic (often manual) legacy processes.

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OK, so the degree of difficulty for WV’s dive is lower than the dive in, say, New York, California or Maryland.

But, based on my analyses, those structural advantages don’t come close to explaining WV’s success.

Urban elites may shudder at the thought, but their states were outcoached and outplayed by a team of rural ragamuffins. (Note: I say that out of respect, not disdain!)

So, how did West Virginia do it?

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