How Joe Biden's team hopes to turn five vaccine doses into six
Low dead-space syringes and the importance of the supply chain
The Biden administration is “working on multiple fronts” to combat the Covid-19 pandemic according to Vivek Murthy, the administration’s designated choice for Surgeon General, including improved testing, investments in genomic surveillance, and of course a multi-pronged effort to improve the pace of vaccination.
In a call with journalists this afternoon, Murthy and Jeffrey Zients, the soon-to-be Covid Czar, talked about a wide range of plans but mentioned one specific idea that seems very promising to me and hasn’t been discussed very much in public.
The basic issue is that, as I first learned from Alex Tabarrok on Thursday, a standard five dose vial of vaccine in some cases actually holds six or even seven doses. The difference turns out to be whether or not you are using a “low dead-space syringe.” With such a syringe, there is less waste and you can stretch your supply by 20 percent or more.
This is quite remarkable. Increasing vaccine supply by 20% by building more factories could cost billions. We should do that, it would be worth it. But in this case, we managed to increase supply by at least 20% use a relatively inexpensive redesign of the syringe. What this indicates is the importance of thinking along the entire supply chain for opportunities for optimization.
The catch? Not all syringes provided by Operation Warp Speed and Pfizer are low dead-volume syringes so not every vaccine distribution site is getting the extra doses. We do need to invest more in the syringe supply chain.
On the call, Zients cited the need to invest in these more efficient syringes and posited that it’s an area where Biden will invoke the Defense Production Act to ensure that America’s production capacity of syringes is deployed to this purpose. It’s a small thing, obviously, and I don’t want to make it sound like it’s the whole Biden strategy for fighting the virus.
Rather, it’s an example of the potentially large gains that can be achieved by looking carefully at the whole playing fields and sweating the details.
Sweating the details is not really the Trump way, but it’s an example of how bringing on a team of competent, experienced, professionals can make a big difference in what is on some level a big logistics problems.
“The current administration has never had a federal or comprehensive strategy,” Zients said, noting that on a lot of these types of questions they simply haven’t received the kind of transition briefings that would let them get full visibility into example what the current situation is. But he says “this is a national emergency and we need to treat it like one. We’re going to throw the full weight and resources of the federal government behind ending the pandemic.”
In the meantime....
I got a robocall last night at 6:30pm from VA-Greater LA that they have the vaccine, for people in Group I (me). The ONLY LOCATION FOR ALL OF LOS ANGELES is the VA hospital in West LA!
The phone line broke down after 2-3 minutes on hold each time I called before I gave up after an hour. I called again at 11pm and spoke to a person. The earliest I could get it is March 8 (for those of you who don't have ready access to a calendar, that is SEVEN WEEKS FROM NOW). I was told I could expect to be there about 90 minutes. That's on top of an hour each way on the world's worst freeway (the 405). I'm a full-time caregiver for a Parkinson's patient who is bedridden while waiting for a hospital bed in the middle of The Worst Medical Crisis In The Country to have her hip replacement repaired. 3.5-4 hours away is just not possible. So maybe in 2-3 weeks the VA location that is 15 minutes away may get the vaccine. So maybe sometime in April, I can get vaccinated.
I just received this warm little note from a good friend in Virginia, also in Group I:
"I called for the first two days once the info was made public. Busy signal (and I called every hour on the hour for 12 hours). Third day, a friend gave me a website. Two days trying it, but with no response when "sending". Fifth day, my email went through and I was placed on an "Emergency" County-wide website-based system that now spits out emails to me daily. Plus, I was allowed to sign-up for a vaccination.
Today's mail (now some 10 days in) said only 40K vaccines were available and I was beyond that initial allocation; so I might have to wait 6-8 weeks.
Meanwhile, on 18 Jan, my wife is eligible as the third group will be 65 and older. She is advised her wait might be to mid-summer.
Lovely. (Oh yes, once we are vaccinated initially, we are to "trust" that the second shot will be available and on time. Are you shitting me!!!!)"
Let's face facts: the US government as currently organized couldn't find its ass with both hands on a clear day with a 12 hour advance notice. And that is not going to change at 12:01
Perhaps the worst aspect of our current hyperpolarization (aside from autocratic violence) is the polarization of the benefit of competence. We are such that not only was the Trump admin grossly incompetent in a way that’s resulted in near WWII level casualties, but that this incompetence isn’t likely have any consequences - electoral or otherwise- because it’s just another one for the partisan slop pile.