Bottleneck

Reuters reports that there’s a bottleneck in the inoculation of people with the newly-approved COVID-19 vaccines. It’s just a week until the end of December and it’s estimated that about a million shots have been administered to date. Nearly 10 million doses have been delivered by Pfizer and Moderna. Where’s the bottleneck?

Margaret Mary Health, a 25-bed rural hospital in Indiana, built a drive-thru vaccination clinic at a local fire station and one at a local recreation center to vaccinate healthcare workers in the surrounding counties, according to Chief Executive Officer Tim Putnam.

Putnam, who has done traffic control at the clinic’s drive-thru, said they have used about 400 of 1,100 doses received.

“We’re asking for volunteers from our staff, volunteers from the local community college to step in and build this process from the ground up,” he said.

Some of the largest U.S. hospitals inoculated more than 1,000 people per day, having done dry runs of the vaccine delivery and rollout.

Vermont, Delaware and Idaho were among states that confirmed their states had given only thousands of doses – a fraction of those available to them – during the first week.

Jason Schwartz, assistant professor of health policy at Yale School of Public Health, described the initial tally as “discouraging” and said “the challenges of getting vaccines out as quickly as we’re able to manufacture them will only grow.”

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Dr. Saul Weingart, the chief medical officer of Tufts Medical Center in Boston, said the hospital had given about 750 doses of the around 3,000 available as of Friday. It started with 100 shots per day and worked up to about 450, he said.

He said experts at the hospital modeled that giving Pfizer’s COVID-19 vaccine would take 10 minutes, about two to three times as long as a flu shot, due to the procedures needed because the vaccine is stored in a deep freeze. Patients need to socially distance before and after being given the vaccine and be monitored for allergic reactions.

The United States gives 170 million flu vaccinations each year within a few months, but for the COVID-19 pandemic, the United States must give about three times that number of shots – the Pfizer and Moderna shots are two doses – to reach most Americans by July. At its current pace, the U.S. appears to have the capacity to administer less than a third of the shots that are shipped in a given week, underscoring the gap.

A spokesperson for Houston Methodist, a hospital in Houston, Texas, said it had given 8,300 employees the vaccine as of Monday with about 7,000 doses left from the first shipment.

The University of Southern California’s Keck Medicine medical school has vaccinated over 3,000 employees and said it will take six weeks for everyone, similar to its flu vaccination schedule.

It may just be that there’s a lag between inoculations and reporting. Or it may be there’s actually a bottleneck in inoculating people.

Early on in the pandemic I predicted that staffing would be a significant bottleneck. That’s beginning to look right. For mass distribution you need mass production rather than the artisanal approach we take towards health care.

We just need to accept some bumps in the process. Nothing like this has ever been attempted anywhere before.