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Stanford apologizes after vaccine allocation leaves out medical residents

270 points by potench 6y ago

cultus 6y ago
Seems like very typical behavior for university and hospital administrators.
mmastrac 6y ago
The great thing about an algorithm is that when it gives you results that benefit you, you can accept them and then pass the buck on to it when people get outraged: "According to an email sent by a chief resident to other residents, Stanford's leaders explained that an algorithm was used to assign its first allotment of the vaccine. The algorithm was said to have prioritized those health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents apparently did not have an assigned location, and along with their typically young age, they were dropped low on the priority list."
- craftinator 6y ago
  Welp, apparently Stanford is shit at algorithmic design
- 1-6 6y ago
  An algorithm is clearly a virtual scapegoat. They’ll need to interview those who were involved in coding it. Dig deeper to find out why.
  - SpicyLemonZest 6y ago
    The quoted explanation sounds pretty complete to me. They used "assigned location" to determine who was working with COVID patients, but residents don't have an "assigned location", so they were incorrectly passed over even though they do in practice work with COVID patients. Maybe that doesn't completely exonerate the administrators from blame, because someone should have sanity checked the plan, but it also seems like a very understandable error to make when you're rushing.
    - jrumbut 6y ago
      It's an understandable error only if residents and their safety isn't at the front of your mind. Perhaps if a resident had been closely involved they would have been able to tell the developers that they don't have anything in the location field. It's not like Stanford didn't know a limited supply vaccine was coming several months ago, there was time to figure this stuff out. And it would have been, if it had been a high enough priority.
      - SpicyLemonZest 6y ago
        Not everything can be high priority. Stanford administrators several months ago would have been working on securing adequate supplies and staffing for the expected fall surge; that's a much more important problem, both to the system as a whole and to the residents, than who gets vaccinated today vs. next week.
        tannedNerd 6y ago
        The article says they realized the error Tuesday and did nothing about it till the residents staged a protest. It very much seems like they were hopping it would blow over.
        renewiltord 6y ago
        I've got to be honest with you: this thing can totally be solved with a human pass. In fact, give me the list, your employment rolls, and I'll fix this for you for free in a couple of hours at max. Government workers are particularly vulnerable to this sort of failure mode: assuming everything is hard. This is not that hard. It's pretty easy. But big company workers are also usually susceptible to this. They don't get things done very fast so they're used to things taking a long time to do and assume that even trivialities must take a couple of days. But that's why companies like Tesla and SpaceX succeed to these peoples' surprise. They look at these companies and say "They can't do that. This is hard. It takes maybe a half century of engineering." Turns out lots of things, even if they're hard, can be done pretty fast. But not by those who've been damaged by their own slowness not being punished.
  - chaostheory 6y ago
    The people “coding it” are probably following requirements usually set by HR and upper management. Not sure about Stanford hospitals, but in most orgs HR is usually the lead department when it comes to COVID-19 protocols.
- tmotwu 6y ago
  The whole mess has demonstrated why ethical AI research is important. It's so easy for people to disregard why and how biases exist in their systems when it doesn't affect them personally.
  - xiphias2 6y ago
    What happened had nothing to do with ethical AI research. People in power put themselves first. This has happened before computers as well.
  - 1-6 6y ago
    If Stanford truly used ML to generate the algorithm, there’s really no back-tracing to find where the decision went wrong besides looking through datasets. There’s your perfect scapegoat.
  - josefx 6y ago
    What would be important are criminal charges for gross negligence while distributing vaccines to medical professionals in the middle of a fucking pandemic. In the best case prioritizing the administration was unintentional, which means nobody ran even basic sanity checks on the output until the staff noticed that they got almost nothing. Add in a murder charge for anyone in the area dying of COVID until the case is over.
  - deleted 6y ago
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- ssivark 6y ago
  I hope they can be pushed to publish the algorithms so we can understand exactly how this happened.
- jtbayly 6y ago
  Are you saying that the algorithm shouldn’t consider age and other risk factors? What in the world do you want them to do, give it to babies because they are cute?
  - xiphias2 6y ago
    If those babies work with thousands of potentially COVID patients and your father gets sick and get to a hospital, you will understand it.
- cambalache 6y ago
  Exactly. There can be a cottage industry using evolutionary algorithms in which the fitness to optimize is the benefit of the interested part. "This new algorithm indicates that the best way to improve the economy is to increase 3X the compensation of Senators".
jerry80 6y ago
Why is Stanford in a position to choose allocations in the first place? I thought the government was going to handle allocations.
- lambda_obrien 6y ago
  They have a huge hospital and medical program.
- jrochkind1 6y ago
  The federal government has allocated to states, and pretty much left it up to the states how to allocate internally. With some vague sort of guidelines. Most states seem to be deciding to prioritize healthcare workers (especially those taking care of covid patients) either entirely or among other groups. So the way you do that is delivering to hospitals makes sense. CA presumably allocated a certain amount to Stanford Medicine, as a large hospital system. I don't know how CA decided what hospitals to give to in what amounts, but it certainly wouldn't shock me if political influence were part of it, why wouldn't it be, what sort of guidelines or transparency is there to stop it? There is not really any written procedure for how to decide which hospitals to get how much in most states, it's just... happening. Then Stanford was clearly left entirely on their own to decide how to allocate internally. This is far too important and too politically fraught (political in terms of POWER, in terms of distributing a resource for which demand far exceeds supply for something that can literally be life-and-death) -- to have left it up for everyone to just make up their own prioritization rules and medical ethics determinations on the fly, in a hetereogenous way. It means people will make terrible mistakes, and the powerful will take advantage to have their needs prioritized. It is ridiculous there aren't much more clear/specific guidelines, and in some cases enforceable policies/regulations, from the federal government. It's like nobody's driving the bus here
  - davidf560 6y ago
    > It is ridiculous there aren't much more clear/specific guidelines, and in some cases enforceable policies/regulations, from the federal government. It's like nobody's driving the bus here. Why is this not California's fault? States were each permitted to establish their own procedures, which somewhat makes sense given the challenging distribution requirements of the Pfizer vaccine. Montana has significantly different challenges than Rhode Island in that sense. Most states that I know of have established clear guidelines saying who gets it and when - I assume California is the same. Seems like California is the governmental entity that failed to exercise proper oversight and/or requirements specification here.
JoeAltmaier 6y ago
My Resident daughter-in-law was scheduled to be vaccinated. Was sick on the day. Turns out, she had the virus! So no vaccination needed any more. One way to resolve it.
jgeada 6y ago
Lets see: first they give themselves what they want. Only after, and only if there is any outcry, then they apologize without any consequences. Yeah, I think management learnt something /s. We're always going to keep getting more of this behavior unless and until we start holding management fully accountable for this type of insider dealing. And accountable means being immediately fired, no golden handcuffs, and a full clawback of any issued bonuses and stock options.
- tsycho 6y ago
  What if management is the judge, jury and executive? Who will bell the cat?
  - jgeada 6y ago
    Well, if all the people that actually produce the value (that is the workers) walk out on strike until the cat is belled, things would move. Of course, that requires that strikes be legal. In the USA, that is frequently not the case.
jtbayly 6y ago
Why should residents who are young and very low risk be a high priority? The answer is simple. They shouldn’t. This is absurd to complain about. Lots of other people should be higher priority. Edit: I’m not surprised at the downvotes, but I’m just laughing. It’s like everybody’s brain has turned to mush! How on earth do you expect them to prioritize these vaccines if not based on age and other risk factors?
- koeng 6y ago
  “ Residents are doctors in training, who have graduated from medical school.” It’s because you didn’t read the article. Residents are doctors in training, not just people living there - and they are interacting with sick people.
  - jtbayly 6y ago
    I’m fully aware of what a resident is, which is why I assumed that nearly all of them are young. Mostly they are under 30 because they just finished medical school.
- lern_too_spel 6y ago
  > How on earth do you expect them to prioritize these vaccines if not based on age and other risk factors? On their required interactions with many infected people, causing them to be risky for spreading the disease and causing labor shortages in the hospital if they are found to be infected. It makes no more sense to administer the vaccine to an elderly hospital administrator working from home than it does to give it to an elderly professional of any other kind working from home. They should get the vaccine eventually, but they should not be among the first when vaccines are rationed.
- davidf560 6y ago
  > Why should residents who are young and very low risk be a high priority? Maybe they shouldn't be top priority, but if they're dealing directly with covid patients they sure as heck should have higher priority than a VP or administrator that's been working from home this whole time.
- 6y ago
amb23 6y ago
The labor of medical residents is something hospital systems exploit during normal times, but that exploitation has severely deepened during the pandemic. At the hospital my partner works at, respiratory therapists and nurses got a $10k bonus for working during COVID; the residents got nothing despite working insane hours in ICU, routinely working more than the legally mandated 90 hours per week. Just because doctors earn more later in their careers does not excuse the level of labor exploitation they are subject to during residency. Stanford is not the only hospital system to restrict access to the vaccine from frontline residents. I can name 3 other local hospital systems in my city that have vaccinated administrative & C-suite/VP level staff before doctors, nurses, and other frontline employees. If vaccine allocation is getting messed up this early on within these closed systems, I can't help but think the next 2-3 phases will go awry as well--what checks are in place to ensure these vaccines get distributed to grocery store workers before people who are willing to pay more to get it early?
- davidf560 6y ago
  > I can name 3 other local hospital systems in my city that have vaccinated administrative & C-suite/VP level staff I don't understand why society is putting up with this. Right now if you're not in a daily COVID-facing role (i.e. an actual front line medical worker) or in a nursing home you should not be getting the shot. This makes my blood boil. There should have been laws passed regarding ordering of the distribution with criminal penalties for line jumpers like this. There's an article in our local paper with a happy picture of one of our state's congressional representatives (a healthy 34-year-old!) getting the shot. Like WTF? There's doctors and nurses who are treating covid patients who can't get it yet. Why the heck does Congress get priority over them? Not only do these people have no shame, half of them even have the nerve to brag about it to the rest of us plebes who will have to wait months or more to get it.
  - edoceo 6y ago
    And all is plebs do is comment on their actions. If they have no consequences why would they stop screwing us?
jrochkind1 6y ago
> "[A]lgorithms are made by people and the results ... were reviewed multiple times by people," You got that right. The way they talk about "an algorithm did it" makes it seem as as if they think that somehow explains it, like there was only one algorithm possible handed down from god or something. We'll be seeing more and more of this of course. "We can't be blamed, it was an algorithm! We can't be blamed for trusting in the algorithm, because everyone knows algorithms are objective, right?" I'm not sure "laypeople" realize that, especially in this particular case, "algorithm" is just a fancy word for "formula". Right, you MADE the formula, and it was wrong.
- fairity 6y ago
  I think most people are misunderstanding the likely root cause. > An algorithm was used to assign its first allotment of the vaccine. The algorithm prioritized health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents did not have an assigned location, and along with their typically young age, they were dropped low on the priority list. Whoever coded up the algorithm for personal COVID-risk probably forgot to take care of null-states for the location input. Residents had their location set to null, and were therefore prioritized lower than they should've been. It's possible that the admins purposefully created this null-state bug so as to have a reasonable fallback story in the case they got caught, but per Occam's Razor, I think it's much more likely it was a dumb, honest mistake.
  - jrochkind1 6y ago
    I don't think I was assuming anything in particular about the intents. it's a rather important thing not to check on actual data, including residents in the sample, isn't it? they just never bothered to test the algorithm, didn't even review the results it spit out, before delivering the results as a plan? (it is quite possible indeed they didn't, I'm not saying that is a coverup for some other motive, I'm saying that is incompetent). What was the QA process like? Who was involved in it? From the article, apparently not any department heads or medical staff in general. That's not a competent design process for something so important, is it? That they never bothered to see how "the algorithm" treated residents demonstrates that they didn't give a shit about residents, not necessarily that they were intentionally screwing them. The administration doesn't say much about how the algorithm was designed, they just say "oh, it was an algorithm." I think many people believe that "algorithms are objective" and they are trying to play that.
fairity 6y ago
> According to an email sent by a chief resident to other residents, Stanford's leaders explained that an algorithm was used to assign its first allotment of the vaccine. The algorithm was said to have prioritized those health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents apparently did not have an assigned location, and along with their typically young age, they were dropped low on the priority list. So, basically, whoever coded up the algorithm for personal COVID-risk forgot to take care of null-states for the location input. So much for all the outrage over selfish intent. Sure, it's possible that the admins purposefully created this glitch so as to have a reasonable fallback story in the case they got caught, but per Occam's Razor, I think it's much more likely it was a dumb, honest mistake.
- root_axis 6y ago
  The outrage stems from the fact that they doubled down on it after the problem was pointed out, this is what caused things to escalate to the level it did, which became a PR nightmare and resulted in them reversing their position. Heads should roll over this, not because there was a mistake in the algorithm, but because the leadership cannot be trusted to make correct decisions in the face of obvious errors.
  - fairity 6y ago
    > The outrage stems from the fact that they doubled down on it after the problem was pointed out This might be the reason you're outraged, but most outraged people here don't even know the administration doubled down on their position. They're outraged due to assumed selfish intent. I think this assumption is wrong.
    - function_seven 6y ago
      Had they not doubled-down, and instead corrected the allocation error, we wouldn't even be reading about this. So, I'm not sure that it makes a difference if some people—hearing about their screw-up—are angry for the wrong reason. To be clear, I'm with you that this probably wasn't a mustache-twirling attempt to divert vaccinations from the frontline staff. But I don't think that it matters much, given the medical expertise we would expect from an organization like this.
ArtDev 6y ago
Residency requirements are nothing more than a form of hazing. The doctors are half-asleep while making important decisions. How can this be not be outrageously unacceptable?
Dumblydorr 6y ago
Gross oversight: Veterinarians are not in the first wave of vaccinations, despite being both essential and healthcare workers. The mega corps that own most Vet clinics don't care about them, they have continued operating apace. Meanwhile, corona could be all over the dogs and cats brought in, very few owners sanitize their indoor pets before Vet visits.
- wang_li 6y ago
  Neither are farm workers, grocery store workers, utility workers, and many other people whose work and service are used by the vast majority of the country every single day. Medical workers do not make up large percentage of COVID-19 deaths, less than 1% in the US. I don't know what the numbers are for other types of essential workers, but I doubt it's a lot different, since the majority of deaths fall largely on people 55+ years old. Another factor that should be accounted for, but I've not seen in any official policy, is the people who've contracted the virus and recovered. While there is research showing that the human immune response to SARS-COV-2 may persist for years[0], even if that's not true we do know that it lasts for 6+ months as shown by the small amount of confirmed reinfections[1]. So put those people at the end of the line. We really should write down the objective and then work out the way to achieve that objective. If the objective is to preserve the maximum amount of life years, then the criteria should heavily bias toward people older 55+ and people with comorbidities. Being a front line health care worker is very honorable and should carry a lot of respect, but it may not be the truly relevant criteria for maximizing the preservation of life. 0. https://bgr.com/2020/11/18/coronavirus-immunity-years-antibodies-b-t-cells-la-jolla/ https://bgr.com/2020/11/18/coronavirus-immunity-years-antibo... 1. https://www.forbes.com/sites/joshuacohen/2020/11/16/though-rare-the-number-of-reinfections-with-covid-19-is-growing/ https://www.forbes.com/sites/joshuacohen/2020/11/16/though-r...
at_a_remove 6y ago
Washington University in St. Louis is currently under fire for the exact same "oversight."
1-6 6y ago
I’ve been tracking the news and the priority of administering the vaccine has been a debate in itself. If ML can truly find out the obvious and identify key areas to target, we can avoid a bunch of unnecessary finger pointing. What may seem obvious to humans may be totally wrong.
Rebelgecko 6y ago
Another messed up thing I've heard is that many hospitals are prioritizing vaccines for WFH Administrators over staff that are actually working at hospitals.. Its a weird system, I asked someone I know who is doing her residency how many times she's been COVID tested this year... just once. Apparently as long as you're not working on the COVID floor there isn't really a requirement at her hospital.
throwaway9870 6y ago
I can't really get upset until I understand who got it instead of the resident.
- edoceo 6y ago
  C-Suite and WFH admins - the low risk, safe group. The system forgot front-line infantry (again)
  - systemvoltage 6y ago
    Not “The system”, but the people in charge forgot them.
    - edoceo 6y ago
      "The system" IS the people in charge
  - leg100 6y ago
    Source? The article irritatingly doesn't say.
    - edoceo 6y ago
      SfGate and NYT articles mentioned execs and admins. I can't find direct links on mobile
- doctoring 6y ago
  The residents who didn't get it: those working 80+ hrs/week in the emergency room, in the ICU, intubating patients, operating on patients, etc etc etc Some people I know of who got it instead: Radiologists who primarily work from home. Administrative roles with relatively low (or no) patient interaction. Not saying those people shouldn't get vaccinated -- just that if you were asked to come up with a priority list, it wouldn't be this. Disclosure: am a physician at Stanford.
  - 6y ago
chromatin 6y ago
Evidence like this suggest that medical leadership for the most part care very little about house officers (residents), and that is pretty universal. Our institution built a new billion dollar hospital and did not include call rooms. Great job.
- neilv 6y ago
  I found this opinion interesting: https://www.kevinmd.com/blog/2015/09/how-call-rooms-reflect-the-personality-of-residency-programs.html https://www.kevinmd.com/blog/2015/09/how-call-rooms-reflect-...
  - js2 6y ago
    If you visit this page with an ad blocker enabled, nothing renders. If you disable your ad blocker on the page, well, god help you: https://ibb.co/PskWz4d https://ibb.co/PskWz4d A couple alternative links for reading: - https://outline.com/udkxSE https://outline.com/udkxSE - https://pastebin.com/5MQE91k3 https://pastebin.com/5MQE91k3
    - afterburner 6y ago
      Seemed fine with uBlock Origin
      - js2 6y ago
        I'm using AdGuard on iOS/macOS with an aggressive set of content blockers. Not sure which rule is blanking the entire page, but there's so many ads and other crap on that page I don't care to debug it. When I load with content blockers disabled, Safari reports 17 (!) trackers prevented.
  - renewiltord 6y ago
    Short summary for people who don't want to read it: author says that call rooms were for functionality and that they believe that call room quality and medical learning quality are non-correlated. Author does not discuss absence of call rooms. Only adding that summary because I assumed, given context of GP, that absence of call rooms would have been discussed. If you're like me, hope I've saved you the time.
cs702 6y ago
In all likelihood, this was an innocent mistake (i.e., not done with malice)... but it's hard not be cynical about it, especially when we consider the context. Medical residents: 1) are at high risk, overworked, stressed out, and underpaid; 2) are regularly being called "heroes" in slick posters and PR campaigns; and 3) have just been left out of the initial vaccine allocation. The combination of 1), 2), and 3) seems almost "engineered" to induce psychological and emotional breakdown in the very people who least deserve it. Horrible.
- deathanatos 6y ago
  > In all likelihood, this was an innocent mistake From the article, > While leadership is pointing to an error in an algorithm meant to ensure equity and justice, our understanding is this error was identified on Tuesday and a decision was made not to revise the vaccine allocation scheme before its release today," they wrote. The residents' point here is that it ceases to be an innocent mistake when it is pointed out to you, and you deliberately decide to do nothing about it.
  - cs702 6y ago
    Do you actually think this was done with malice? I doubt it. Per Hanlon's razor, we should never attribute to malice that which is adequately explained by (bureaucratic) stupidity.[a] [a] https://en.wikipedia.org/wiki/Hanlon's_razor https://en.wikipedia.org/wiki/Hanlon's_razor
nextweek2 6y ago
Medical professionals should not be in the early rounds of vaccines. If the vaccines have a delayed negative effect you cripple health care. Vaccines are great once they've had years of testing, but risk management would tell you to play it safe with critical staff. If the vaccine disabled 20% of medical professionals in January how many people would die as a consequence?
- taylortbb 6y ago
  That's why we run trials. Over 20,000 people got this vaccine months ago, and have been carefully followed since. If it was going to wipe out 20% of people one month after injection we'd know already.
- joshz404 6y ago
  This is not how any of this works...
- hannob 6y ago
  The possibility that a vaccine that has not shown any serious sideeffects until now will disable 20% of people getting it is extremely low. And you make the typical mistake of forgetting to weight vaccine risks against the risks of not vaccinating. Is this possible that a yet completely unknown sideeffect that hasn't shown up until now will suddenly appear? Yes. Is it likely? No, absolutely not. Is it possible that a mutated strain of Covid-19 will disable 20% of medical personel? Yes. Is it likely? No. But still: It's much more likely than a vaccine that has not shown any serious adverse events until now doing this.
- iends 6y ago
  Are you confusing medical trials with the vaccine rollout? The first vaccine was given March 16th.
deleted 6y ago
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andi999 6y ago
Most likely residents are young, arent they? So if they prioritized people most like getting affected by the disease and only have 5000 shots, I am not suprised that no resident made it to the list.
- magneticnorth 6y ago
  The problem is that the doctors who are doing their job completely remotely are getting the vaccine ahead of the people who have to work 90 hours a week in overcrowded hospitals. While age does matter, ability to control exposure and risk of spreading the disease within the hospital should be at least as important, in my opinion.
craz8 6y ago
Since this algorithm is obviously flawed this way, is it likely to be flawed with respect to the timing of the second dose? Every report I’ve seen from experiment subjects (who may have received the placebo) indicates that the second dose sucked for 2-3 days, and was much worse than the first. If you give all your, for example, ICU staff the second dose at the same time, and then they can’t work for 2 days, how do you staff that? Did you plan for this, or will it be a surprise that “The Algorithm” missed?
- emcq 6y ago
  This is easy to resolve by staggering doses which I know at least other hospitals are doing.
  - craz8 6y ago
    It is, but are they actually planning to do this? The key is that you need to stagger them now - maybe over a 10 day period to be safe (plan for 2 days off, so 20% out of action with 10 days, try to use “weekend” time for this) But in the middle of a pandemic, even 20% is a lot of lost capacity And then some people need to be in the day 8, 9 and 10 groups so won’t “get the vaccine first” So it’s actually not quite as simple as just spreading them out over a few days and hope for the best.
knolan 6y ago
Algorithm? They probably mean a HR spreadsheet.
courtf 6y ago
There is incredible pressure to give out vaccine to those with the tallest soapbox from which they can harass decision makers. And of course, said decision makers aren't exactly known for their backbone when handling conflict, so we get situations like this. Administrators often don't even know who in the hospitals spends the most time around sick patients. Entire front-line departments are forgotten, primarily because they don't have any political power or representation. To see such a highly regarded institution fail this very simple test is another example of how the human creature needs more time to evolve. It's not just a mistake, this is a pattern playing out all over. Anyone who spends time in these environs would not be much surprised, but when the best hospitals still can't take care of their most vulnerable staff because of pernicious political maneuvering, the contrast between perception and reality is all the more stark.
1024core 6y ago
> that resulted in an outcome we did not anticipate," they wrote. I bet the "outcome" they're talking about is the _protest_, not the allocation.
renewiltord 6y ago
It should be no surprise that, when confronted with this error (if it is one, POSIWID, etc. etc.), admin staff insisted on preserving the erroneous state. Should America ever find herself with single-payer healthcare during shortages, she will find herself encountering this same situation once again. She will then react with outrage and surprise, learning not that centralization sets these incentives, but falsely doubling down in the belief that this repeated failure of centralization is evidence that the wrong kind of people were at the centre: not very different from communists who argue that "it just wasn't done right by the right people".
cosmiccatnap 6y ago
But they didn't correct it... Apologies shouldn't be accepted for actions that clearly show no remorse or concept of having done wrong.
flowersjeff 6y ago
This sounds way too convenient - basically the modern day equivalent of the "dog did it". So we're to believe that a rogue computer code screwed up?.. i.e.: nobody in charge mess'ed up? Why again do those with the largest paychecks, given the largest slack?
bpodgursky 6y ago
Nobody is catching that residents are almost universally 25-35 years old, which puts them in an extremely low risk category for serious illness. Which sucks, but is 100% the most efficient way to prevent deaths. Giving the vaccines to older workers first is correct.
- sxg 6y ago
  The 25–35 age group is not "extremely low risk" for a serious COVID-19 infection. The risk is lower than older age groups, but it's also substantially increased due to their higher degree of direct patient interaction compared to Stanford's executives and remote employees who did receive the vaccine. Also due to residents' high degree of patient interaction, they are at high risk of spreading COVID-19 to other patients and healthcare workers. Your opinion is poorly thought out.
deleted 6y ago
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Pfhreak 6y ago
This is going to be how it goes broadly, at a national and international level. I guarantee you that you'll see access for the wealthy much sooner than you'll see access for the folks at highest risk. I don't know how to help with this, but I'd much rather see farm workers, grocery store clerks, the homeless, bus drivers, etc. get access after we take care of the medical staff (who are exposed to patients) and the elderly (and others in extremely risky environments.) Yet I'm sure that's not how this will go. How long before testing and vaccination becomes an employment perk at a FAANG company?
Dowwie 6y ago
I don't see how free will has anything to do with this. The algorithm is clearly calling the shots. (pun intended)
curiousllama 6y ago
I have one question: was the "algorithm" an excel scorecard? I bet it was
WalterBright 6y ago
Under a capitalist system, resources are allocated to those most willing to pay for it. Under a socialist system, resources are allocated to those with the most political power. Under an anarchist system, resources are allocated to those with the most firepower. The vaccine is being distributed under a socialist system. Nobody should be surprised at the results.
- asddubs 6y ago
  didn't know stanford was located in a socialist country, or does it have an anti-capitalism force field around it?
  - WalterBright 6y ago
    The distribution of vaccines is under the control of the government. There are none for sale, and in fact those in charge have adamantly said they wouldn't be selling vaccines. https://www.latimes.com/california/story/2020-12-18/wealthy-patients-scramble-covid-19-vaccine https://www.latimes.com/california/story/2020-12-18/wealthy-... So yeah, socialism :-)
  - chaostheory 6y ago
    While Stanford is a private entity, it acts and is structured like a public one. Even its full time employees aren’t at will like the private sector at large. We can argue about whether or not Stanford is “socialist”, but I don’t feel he’s wrong that Stanford allocated vaccines according to political power. He also doesn’t judge any system. He’s just giving an observation
    - WalterBright 6y ago
      The newspapers are full of reports of special interest groups jockeying for priority. It's a test of how much political pull each has, rather than their need. (Of course, each will frame it in terms of their need.) Powerful politicians are already getting vaccinated. It's a virtual certainty that those offering $25,000 for a dose are going to find someone in the distribution system providing it and pocketing the money.
almost_usual 6y ago
If this pandemic has shown anything it’s that the poor and front line is throwaway. Inequality in the US is getting more and more extreme. This shit will not be tolerated much longer, riots will get worse, people will get angrier.
- anonytrary 6y ago
  Trying times accentuate dividing lines...
JohnGB 6y ago
No, Stanford is sorry that they were called out, but not sorry for what they did - or they wouldn't have done it in the first place.
TruthHurts44 6y ago
I wonder isn't it better to run a lottery who gets the vaccine when...
raadore 6y ago
Here’s another algorithm screwup: https://www.who.int/news/item/14-12-2020-who-information-notice-for-ivd-users https://www.who.int/news/item/14-12-2020-who-information-not... Oh, wait, no more need for false PCR tests, we have vaccines now. Forget testing, they’re wrong anyway, everyone get in line for a dose of nothing. The good news appearing in media recently are the high percentage of people all over the world against being vaccinated, it means the human reason algorithm is still top notch.

270 points by potench 6y ago

Seems like very typical behavior for university and hospital administrators.

The great thing about an algorithm is that when it gives you results that benefit you, you can accept them and then pass the buck on to it when people get outraged: "According to an email sent by a chief resident to other residents, Stanford's leaders explained that an algorithm was used to assign its first allotment of the vaccine. The algorithm was said to have prioritized those health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents apparently did not have an assigned location, and along with their typically young age, they were dropped low on the priority list."

craftinator 6y ago
Welp, apparently Stanford is shit at algorithmic design
1-6 6y ago
An algorithm is clearly a virtual scapegoat. They’ll need to interview those who were involved in coding it. Dig deeper to find out why.
- SpicyLemonZest 6y ago
  The quoted explanation sounds pretty complete to me. They used "assigned location" to determine who was working with COVID patients, but residents don't have an "assigned location", so they were incorrectly passed over even though they do in practice work with COVID patients. Maybe that doesn't completely exonerate the administrators from blame, because someone should have sanity checked the plan, but it also seems like a very understandable error to make when you're rushing.
  - jrumbut 6y ago
    It's an understandable error only if residents and their safety isn't at the front of your mind. Perhaps if a resident had been closely involved they would have been able to tell the developers that they don't have anything in the location field. It's not like Stanford didn't know a limited supply vaccine was coming several months ago, there was time to figure this stuff out. And it would have been, if it had been a high enough priority.
    - SpicyLemonZest 6y ago
      Not everything can be high priority. Stanford administrators several months ago would have been working on securing adequate supplies and staffing for the expected fall surge; that's a much more important problem, both to the system as a whole and to the residents, than who gets vaccinated today vs. next week.
      - tannedNerd 6y ago
        The article says they realized the error Tuesday and did nothing about it till the residents staged a protest. It very much seems like they were hopping it would blow over.
      - renewiltord 6y ago
        I've got to be honest with you: this thing can totally be solved with a human pass. In fact, give me the list, your employment rolls, and I'll fix this for you for free in a couple of hours at max. Government workers are particularly vulnerable to this sort of failure mode: assuming everything is hard. This is not that hard. It's pretty easy. But big company workers are also usually susceptible to this. They don't get things done very fast so they're used to things taking a long time to do and assume that even trivialities must take a couple of days. But that's why companies like Tesla and SpaceX succeed to these peoples' surprise. They look at these companies and say "They can't do that. This is hard. It takes maybe a half century of engineering." Turns out lots of things, even if they're hard, can be done pretty fast. But not by those who've been damaged by their own slowness not being punished.
- chaostheory 6y ago
  The people “coding it” are probably following requirements usually set by HR and upper management. Not sure about Stanford hospitals, but in most orgs HR is usually the lead department when it comes to COVID-19 protocols.
tmotwu 6y ago
The whole mess has demonstrated why ethical AI research is important. It's so easy for people to disregard why and how biases exist in their systems when it doesn't affect them personally.
- xiphias2 6y ago
  What happened had nothing to do with ethical AI research. People in power put themselves first. This has happened before computers as well.
- 1-6 6y ago
  If Stanford truly used ML to generate the algorithm, there’s really no back-tracing to find where the decision went wrong besides looking through datasets. There’s your perfect scapegoat.
- josefx 6y ago
  What would be important are criminal charges for gross negligence while distributing vaccines to medical professionals in the middle of a fucking pandemic. In the best case prioritizing the administration was unintentional, which means nobody ran even basic sanity checks on the output until the staff noticed that they got almost nothing. Add in a murder charge for anyone in the area dying of COVID until the case is over.
- deleted 6y ago
  [deleted]
- deleted 6y ago
  [deleted]
ssivark 6y ago
I hope they can be pushed to publish the algorithms so we can understand exactly how this happened.
jtbayly 6y ago
Are you saying that the algorithm shouldn’t consider age and other risk factors? What in the world do you want them to do, give it to babies because they are cute?
- xiphias2 6y ago
  If those babies work with thousands of potentially COVID patients and your father gets sick and get to a hospital, you will understand it.
cambalache 6y ago
Exactly. There can be a cottage industry using evolutionary algorithms in which the fitness to optimize is the benefit of the interested part. "This new algorithm indicates that the best way to improve the economy is to increase 3X the compensation of Senators".

jerry80 6y ago

Why is Stanford in a position to choose allocations in the first place? I thought the government was going to handle allocations.

lambda_obrien 6y ago
They have a huge hospital and medical program.
jrochkind1 6y ago
The federal government has allocated to states, and pretty much left it up to the states how to allocate internally. With some vague sort of guidelines. Most states seem to be deciding to prioritize healthcare workers (especially those taking care of covid patients) either entirely or among other groups. So the way you do that is delivering to hospitals makes sense. CA presumably allocated a certain amount to Stanford Medicine, as a large hospital system. I don't know how CA decided what hospitals to give to in what amounts, but it certainly wouldn't shock me if political influence were part of it, why wouldn't it be, what sort of guidelines or transparency is there to stop it? There is not really any written procedure for how to decide which hospitals to get how much in most states, it's just... happening. Then Stanford was clearly left entirely on their own to decide how to allocate internally. This is far too important and too politically fraught (political in terms of POWER, in terms of distributing a resource for which demand far exceeds supply for something that can literally be life-and-death) -- to have left it up for everyone to just make up their own prioritization rules and medical ethics determinations on the fly, in a hetereogenous way. It means people will make terrible mistakes, and the powerful will take advantage to have their needs prioritized. It is ridiculous there aren't much more clear/specific guidelines, and in some cases enforceable policies/regulations, from the federal government. It's like nobody's driving the bus here
- davidf560 6y ago
  > It is ridiculous there aren't much more clear/specific guidelines, and in some cases enforceable policies/regulations, from the federal government. It's like nobody's driving the bus here. Why is this not California's fault? States were each permitted to establish their own procedures, which somewhat makes sense given the challenging distribution requirements of the Pfizer vaccine. Montana has significantly different challenges than Rhode Island in that sense. Most states that I know of have established clear guidelines saying who gets it and when - I assume California is the same. Seems like California is the governmental entity that failed to exercise proper oversight and/or requirements specification here.

JoeAltmaier 6y ago

My Resident daughter-in-law was scheduled to be vaccinated. Was sick on the day. Turns out, she had the virus! So no vaccination needed any more. One way to resolve it.

jgeada 6y ago

Lets see: first they give themselves what they want. Only after, and only if there is any outcry, then they apologize without any consequences. Yeah, I think management learnt something /s. We're always going to keep getting more of this behavior unless and until we start holding management fully accountable for this type of insider dealing. And accountable means being immediately fired, no golden handcuffs, and a full clawback of any issued bonuses and stock options.

tsycho 6y ago
What if management is the judge, jury and executive? Who will bell the cat?
- jgeada 6y ago
  Well, if all the people that actually produce the value (that is the workers) walk out on strike until the cat is belled, things would move. Of course, that requires that strikes be legal. In the USA, that is frequently not the case.

jtbayly 6y ago

Why should residents who are young and very low risk be a high priority? The answer is simple. They shouldn’t. This is absurd to complain about. Lots of other people should be higher priority. Edit: I’m not surprised at the downvotes, but I’m just laughing. It’s like everybody’s brain has turned to mush! How on earth do you expect them to prioritize these vaccines if not based on age and other risk factors?

koeng 6y ago
“ Residents are doctors in training, who have graduated from medical school.” It’s because you didn’t read the article. Residents are doctors in training, not just people living there - and they are interacting with sick people.
- jtbayly 6y ago
  I’m fully aware of what a resident is, which is why I assumed that nearly all of them are young. Mostly they are under 30 because they just finished medical school.
lern_too_spel 6y ago
> How on earth do you expect them to prioritize these vaccines if not based on age and other risk factors? On their required interactions with many infected people, causing them to be risky for spreading the disease and causing labor shortages in the hospital if they are found to be infected. It makes no more sense to administer the vaccine to an elderly hospital administrator working from home than it does to give it to an elderly professional of any other kind working from home. They should get the vaccine eventually, but they should not be among the first when vaccines are rationed.
davidf560 6y ago
> Why should residents who are young and very low risk be a high priority? Maybe they shouldn't be top priority, but if they're dealing directly with covid patients they sure as heck should have higher priority than a VP or administrator that's been working from home this whole time.
6y ago

amb23 6y ago

The labor of medical residents is something hospital systems exploit during normal times, but that exploitation has severely deepened during the pandemic. At the hospital my partner works at, respiratory therapists and nurses got a $10k bonus for working during COVID; the residents got nothing despite working insane hours in ICU, routinely working more than the legally mandated 90 hours per week. Just because doctors earn more later in their careers does not excuse the level of labor exploitation they are subject to during residency. Stanford is not the only hospital system to restrict access to the vaccine from frontline residents. I can name 3 other local hospital systems in my city that have vaccinated administrative & C-suite/VP level staff before doctors, nurses, and other frontline employees. If vaccine allocation is getting messed up this early on within these closed systems, I can't help but think the next 2-3 phases will go awry as well--what checks are in place to ensure these vaccines get distributed to grocery store workers before people who are willing to pay more to get it early?

davidf560 6y ago
> I can name 3 other local hospital systems in my city that have vaccinated administrative & C-suite/VP level staff I don't understand why society is putting up with this. Right now if you're not in a daily COVID-facing role (i.e. an actual front line medical worker) or in a nursing home you should not be getting the shot. This makes my blood boil. There should have been laws passed regarding ordering of the distribution with criminal penalties for line jumpers like this. There's an article in our local paper with a happy picture of one of our state's congressional representatives (a healthy 34-year-old!) getting the shot. Like WTF? There's doctors and nurses who are treating covid patients who can't get it yet. Why the heck does Congress get priority over them? Not only do these people have no shame, half of them even have the nerve to brag about it to the rest of us plebes who will have to wait months or more to get it.
- edoceo 6y ago
  And all is plebs do is comment on their actions. If they have no consequences why would they stop screwing us?

jrochkind1 6y ago

> "[A]lgorithms are made by people and the results ... were reviewed multiple times by people," You got that right. The way they talk about "an algorithm did it" makes it seem as as if they think that somehow explains it, like there was only one algorithm possible handed down from god or something. We'll be seeing more and more of this of course. "We can't be blamed, it was an algorithm! We can't be blamed for trusting in the algorithm, because everyone knows algorithms are objective, right?" I'm not sure "laypeople" realize that, especially in this particular case, "algorithm" is just a fancy word for "formula". Right, you MADE the formula, and it was wrong.

fairity 6y ago
I think most people are misunderstanding the likely root cause. > An algorithm was used to assign its first allotment of the vaccine. The algorithm prioritized health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents did not have an assigned location, and along with their typically young age, they were dropped low on the priority list. Whoever coded up the algorithm for personal COVID-risk probably forgot to take care of null-states for the location input. Residents had their location set to null, and were therefore prioritized lower than they should've been. It's possible that the admins purposefully created this null-state bug so as to have a reasonable fallback story in the case they got caught, but per Occam's Razor, I think it's much more likely it was a dumb, honest mistake.
- jrochkind1 6y ago
  I don't think I was assuming anything in particular about the intents. it's a rather important thing not to check on actual data, including residents in the sample, isn't it? they just never bothered to test the algorithm, didn't even review the results it spit out, before delivering the results as a plan? (it is quite possible indeed they didn't, I'm not saying that is a coverup for some other motive, I'm saying that is incompetent). What was the QA process like? Who was involved in it? From the article, apparently not any department heads or medical staff in general. That's not a competent design process for something so important, is it? That they never bothered to see how "the algorithm" treated residents demonstrates that they didn't give a shit about residents, not necessarily that they were intentionally screwing them. The administration doesn't say much about how the algorithm was designed, they just say "oh, it was an algorithm." I think many people believe that "algorithms are objective" and they are trying to play that.

fairity 6y ago

> According to an email sent by a chief resident to other residents, Stanford's leaders explained that an algorithm was used to assign its first allotment of the vaccine. The algorithm was said to have prioritized those health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents apparently did not have an assigned location, and along with their typically young age, they were dropped low on the priority list. So, basically, whoever coded up the algorithm for personal COVID-risk forgot to take care of null-states for the location input. So much for all the outrage over selfish intent. Sure, it's possible that the admins purposefully created this glitch so as to have a reasonable fallback story in the case they got caught, but per Occam's Razor, I think it's much more likely it was a dumb, honest mistake.

root_axis 6y ago
The outrage stems from the fact that they doubled down on it after the problem was pointed out, this is what caused things to escalate to the level it did, which became a PR nightmare and resulted in them reversing their position. Heads should roll over this, not because there was a mistake in the algorithm, but because the leadership cannot be trusted to make correct decisions in the face of obvious errors.
- fairity 6y ago
  > The outrage stems from the fact that they doubled down on it after the problem was pointed out This might be the reason you're outraged, but most outraged people here don't even know the administration doubled down on their position. They're outraged due to assumed selfish intent. I think this assumption is wrong.
  - function_seven 6y ago
    Had they not doubled-down, and instead corrected the allocation error, we wouldn't even be reading about this. So, I'm not sure that it makes a difference if some people—hearing about their screw-up—are angry for the wrong reason. To be clear, I'm with you that this probably wasn't a mustache-twirling attempt to divert vaccinations from the frontline staff. But I don't think that it matters much, given the medical expertise we would expect from an organization like this.

ArtDev 6y ago

Residency requirements are nothing more than a form of hazing. The doctors are half-asleep while making important decisions. How can this be not be outrageously unacceptable?

Dumblydorr 6y ago

Gross oversight: Veterinarians are not in the first wave of vaccinations, despite being both essential and healthcare workers. The mega corps that own most Vet clinics don't care about them, they have continued operating apace. Meanwhile, corona could be all over the dogs and cats brought in, very few owners sanitize their indoor pets before Vet visits.

wang_li 6y ago
Neither are farm workers, grocery store workers, utility workers, and many other people whose work and service are used by the vast majority of the country every single day. Medical workers do not make up large percentage of COVID-19 deaths, less than 1% in the US. I don't know what the numbers are for other types of essential workers, but I doubt it's a lot different, since the majority of deaths fall largely on people 55+ years old. Another factor that should be accounted for, but I've not seen in any official policy, is the people who've contracted the virus and recovered. While there is research showing that the human immune response to SARS-COV-2 may persist for years[0], even if that's not true we do know that it lasts for 6+ months as shown by the small amount of confirmed reinfections[1]. So put those people at the end of the line. We really should write down the objective and then work out the way to achieve that objective. If the objective is to preserve the maximum amount of life years, then the criteria should heavily bias toward people older 55+ and people with comorbidities. Being a front line health care worker is very honorable and should carry a lot of respect, but it may not be the truly relevant criteria for maximizing the preservation of life. 0. https://bgr.com/2020/11/18/coronavirus-immunity-years-antibodies-b-t-cells-la-jolla/ https://bgr.com/2020/11/18/coronavirus-immunity-years-antibo... 1. https://www.forbes.com/sites/joshuacohen/2020/11/16/though-rare-the-number-of-reinfections-with-covid-19-is-growing/ https://www.forbes.com/sites/joshuacohen/2020/11/16/though-r...

at_a_remove 6y ago

Washington University in St. Louis is currently under fire for the exact same "oversight."

1-6 6y ago

I’ve been tracking the news and the priority of administering the vaccine has been a debate in itself. If ML can truly find out the obvious and identify key areas to target, we can avoid a bunch of unnecessary finger pointing. What may seem obvious to humans may be totally wrong.

Rebelgecko 6y ago

Another messed up thing I've heard is that many hospitals are prioritizing vaccines for WFH Administrators over staff that are actually working at hospitals.. Its a weird system, I asked someone I know who is doing her residency how many times she's been COVID tested this year... just once. Apparently as long as you're not working on the COVID floor there isn't really a requirement at her hospital.

throwaway9870 6y ago

I can't really get upset until I understand who got it instead of the resident.

edoceo 6y ago
C-Suite and WFH admins - the low risk, safe group. The system forgot front-line infantry (again)
- systemvoltage 6y ago
  Not “The system”, but the people in charge forgot them.
  - edoceo 6y ago
    "The system" IS the people in charge
- leg100 6y ago
  Source? The article irritatingly doesn't say.
  - edoceo 6y ago
    SfGate and NYT articles mentioned execs and admins. I can't find direct links on mobile
doctoring 6y ago
The residents who didn't get it: those working 80+ hrs/week in the emergency room, in the ICU, intubating patients, operating on patients, etc etc etc Some people I know of who got it instead: Radiologists who primarily work from home. Administrative roles with relatively low (or no) patient interaction. Not saying those people shouldn't get vaccinated -- just that if you were asked to come up with a priority list, it wouldn't be this. Disclosure: am a physician at Stanford.
- 6y ago

chromatin 6y ago

Evidence like this suggest that medical leadership for the most part care very little about house officers (residents), and that is pretty universal. Our institution built a new billion dollar hospital and did not include call rooms. Great job.

neilv 6y ago
I found this opinion interesting: https://www.kevinmd.com/blog/2015/09/how-call-rooms-reflect-the-personality-of-residency-programs.html https://www.kevinmd.com/blog/2015/09/how-call-rooms-reflect-...
- js2 6y ago
  If you visit this page with an ad blocker enabled, nothing renders. If you disable your ad blocker on the page, well, god help you: https://ibb.co/PskWz4d https://ibb.co/PskWz4d A couple alternative links for reading: - https://outline.com/udkxSE https://outline.com/udkxSE - https://pastebin.com/5MQE91k3 https://pastebin.com/5MQE91k3
  - afterburner 6y ago
    Seemed fine with uBlock Origin
    - js2 6y ago
      I'm using AdGuard on iOS/macOS with an aggressive set of content blockers. Not sure which rule is blanking the entire page, but there's so many ads and other crap on that page I don't care to debug it. When I load with content blockers disabled, Safari reports 17 (!) trackers prevented.
- renewiltord 6y ago
  Short summary for people who don't want to read it: author says that call rooms were for functionality and that they believe that call room quality and medical learning quality are non-correlated. Author does not discuss absence of call rooms. Only adding that summary because I assumed, given context of GP, that absence of call rooms would have been discussed. If you're like me, hope I've saved you the time.

cs702 6y ago

In all likelihood, this was an innocent mistake (i.e., not done with malice)... but it's hard not be cynical about it, especially when we consider the context. Medical residents: 1) are at high risk, overworked, stressed out, and underpaid; 2) are regularly being called "heroes" in slick posters and PR campaigns; and 3) have just been left out of the initial vaccine allocation. The combination of 1), 2), and 3) seems almost "engineered" to induce psychological and emotional breakdown in the very people who least deserve it. Horrible.

deathanatos 6y ago
> In all likelihood, this was an innocent mistake From the article, > While leadership is pointing to an error in an algorithm meant to ensure equity and justice, our understanding is this error was identified on Tuesday and a decision was made not to revise the vaccine allocation scheme before its release today," they wrote. The residents' point here is that it ceases to be an innocent mistake when it is pointed out to you, and you deliberately decide to do nothing about it.
- cs702 6y ago
  Do you actually think this was done with malice? I doubt it. Per Hanlon's razor, we should never attribute to malice that which is adequately explained by (bureaucratic) stupidity.[a] [a] https://en.wikipedia.org/wiki/Hanlon's_razor https://en.wikipedia.org/wiki/Hanlon's_razor

nextweek2 6y ago

Medical professionals should not be in the early rounds of vaccines. If the vaccines have a delayed negative effect you cripple health care. Vaccines are great once they've had years of testing, but risk management would tell you to play it safe with critical staff. If the vaccine disabled 20% of medical professionals in January how many people would die as a consequence?

taylortbb 6y ago
That's why we run trials. Over 20,000 people got this vaccine months ago, and have been carefully followed since. If it was going to wipe out 20% of people one month after injection we'd know already.
joshz404 6y ago
This is not how any of this works...
hannob 6y ago
The possibility that a vaccine that has not shown any serious sideeffects until now will disable 20% of people getting it is extremely low. And you make the typical mistake of forgetting to weight vaccine risks against the risks of not vaccinating. Is this possible that a yet completely unknown sideeffect that hasn't shown up until now will suddenly appear? Yes. Is it likely? No, absolutely not. Is it possible that a mutated strain of Covid-19 will disable 20% of medical personel? Yes. Is it likely? No. But still: It's much more likely than a vaccine that has not shown any serious adverse events until now doing this.
iends 6y ago
Are you confusing medical trials with the vaccine rollout? The first vaccine was given March 16th.

deleted 6y ago

[deleted]

andi999 6y ago

Most likely residents are young, arent they? So if they prioritized people most like getting affected by the disease and only have 5000 shots, I am not suprised that no resident made it to the list.

magneticnorth 6y ago
The problem is that the doctors who are doing their job completely remotely are getting the vaccine ahead of the people who have to work 90 hours a week in overcrowded hospitals. While age does matter, ability to control exposure and risk of spreading the disease within the hospital should be at least as important, in my opinion.

craz8 6y ago

Since this algorithm is obviously flawed this way, is it likely to be flawed with respect to the timing of the second dose? Every report I’ve seen from experiment subjects (who may have received the placebo) indicates that the second dose sucked for 2-3 days, and was much worse than the first. If you give all your, for example, ICU staff the second dose at the same time, and then they can’t work for 2 days, how do you staff that? Did you plan for this, or will it be a surprise that “The Algorithm” missed?

emcq 6y ago
This is easy to resolve by staggering doses which I know at least other hospitals are doing.
- craz8 6y ago
  It is, but are they actually planning to do this? The key is that you need to stagger them now - maybe over a 10 day period to be safe (plan for 2 days off, so 20% out of action with 10 days, try to use “weekend” time for this) But in the middle of a pandemic, even 20% is a lot of lost capacity And then some people need to be in the day 8, 9 and 10 groups so won’t “get the vaccine first” So it’s actually not quite as simple as just spreading them out over a few days and hope for the best.

knolan 6y ago

Algorithm? They probably mean a HR spreadsheet.

courtf 6y ago

There is incredible pressure to give out vaccine to those with the tallest soapbox from which they can harass decision makers. And of course, said decision makers aren't exactly known for their backbone when handling conflict, so we get situations like this. Administrators often don't even know who in the hospitals spends the most time around sick patients. Entire front-line departments are forgotten, primarily because they don't have any political power or representation. To see such a highly regarded institution fail this very simple test is another example of how the human creature needs more time to evolve. It's not just a mistake, this is a pattern playing out all over. Anyone who spends time in these environs would not be much surprised, but when the best hospitals still can't take care of their most vulnerable staff because of pernicious political maneuvering, the contrast between perception and reality is all the more stark.

1024core 6y ago

> that resulted in an outcome we did not anticipate," they wrote. I bet the "outcome" they're talking about is the _protest_, not the allocation.

renewiltord 6y ago

It should be no surprise that, when confronted with this error (if it is one, POSIWID, etc. etc.), admin staff insisted on preserving the erroneous state. Should America ever find herself with single-payer healthcare during shortages, she will find herself encountering this same situation once again. She will then react with outrage and surprise, learning not that centralization sets these incentives, but falsely doubling down in the belief that this repeated failure of centralization is evidence that the wrong kind of people were at the centre: not very different from communists who argue that "it just wasn't done right by the right people".

cosmiccatnap 6y ago

But they didn't correct it... Apologies shouldn't be accepted for actions that clearly show no remorse or concept of having done wrong.

flowersjeff 6y ago

This sounds way too convenient - basically the modern day equivalent of the "dog did it". So we're to believe that a rogue computer code screwed up?.. i.e.: nobody in charge mess'ed up? Why again do those with the largest paychecks, given the largest slack?

bpodgursky 6y ago

Nobody is catching that residents are almost universally 25-35 years old, which puts them in an extremely low risk category for serious illness. Which sucks, but is 100% the most efficient way to prevent deaths. Giving the vaccines to older workers first is correct.

sxg 6y ago
The 25–35 age group is not "extremely low risk" for a serious COVID-19 infection. The risk is lower than older age groups, but it's also substantially increased due to their higher degree of direct patient interaction compared to Stanford's executives and remote employees who did receive the vaccine. Also due to residents' high degree of patient interaction, they are at high risk of spreading COVID-19 to other patients and healthcare workers. Your opinion is poorly thought out.

deleted 6y ago

[deleted]

Pfhreak 6y ago

This is going to be how it goes broadly, at a national and international level. I guarantee you that you'll see access for the wealthy much sooner than you'll see access for the folks at highest risk. I don't know how to help with this, but I'd much rather see farm workers, grocery store clerks, the homeless, bus drivers, etc. get access after we take care of the medical staff (who are exposed to patients) and the elderly (and others in extremely risky environments.) Yet I'm sure that's not how this will go. How long before testing and vaccination becomes an employment perk at a FAANG company?

Dowwie 6y ago

I don't see how free will has anything to do with this. The algorithm is clearly calling the shots. (pun intended)

curiousllama 6y ago

I have one question: was the "algorithm" an excel scorecard? I bet it was

WalterBright 6y ago

Under a capitalist system, resources are allocated to those most willing to pay for it. Under a socialist system, resources are allocated to those with the most political power. Under an anarchist system, resources are allocated to those with the most firepower. The vaccine is being distributed under a socialist system. Nobody should be surprised at the results.

asddubs 6y ago
didn't know stanford was located in a socialist country, or does it have an anti-capitalism force field around it?
- WalterBright 6y ago
  The distribution of vaccines is under the control of the government. There are none for sale, and in fact those in charge have adamantly said they wouldn't be selling vaccines. https://www.latimes.com/california/story/2020-12-18/wealthy-patients-scramble-covid-19-vaccine https://www.latimes.com/california/story/2020-12-18/wealthy-... So yeah, socialism :-)
- chaostheory 6y ago
  While Stanford is a private entity, it acts and is structured like a public one. Even its full time employees aren’t at will like the private sector at large. We can argue about whether or not Stanford is “socialist”, but I don’t feel he’s wrong that Stanford allocated vaccines according to political power. He also doesn’t judge any system. He’s just giving an observation
  - WalterBright 6y ago
    The newspapers are full of reports of special interest groups jockeying for priority. It's a test of how much political pull each has, rather than their need. (Of course, each will frame it in terms of their need.) Powerful politicians are already getting vaccinated. It's a virtual certainty that those offering $25,000 for a dose are going to find someone in the distribution system providing it and pocketing the money.

almost_usual 6y ago

If this pandemic has shown anything it’s that the poor and front line is throwaway. Inequality in the US is getting more and more extreme. This shit will not be tolerated much longer, riots will get worse, people will get angrier.

anonytrary 6y ago
Trying times accentuate dividing lines...

JohnGB 6y ago

No, Stanford is sorry that they were called out, but not sorry for what they did - or they wouldn't have done it in the first place.

TruthHurts44 6y ago

I wonder isn't it better to run a lottery who gets the vaccine when...

raadore 6y ago

Here’s another algorithm screwup: https://www.who.int/news/item/14-12-2020-who-information-notice-for-ivd-users https://www.who.int/news/item/14-12-2020-who-information-not... Oh, wait, no more need for false PCR tests, we have vaccines now. Forget testing, they’re wrong anyway, everyone get in line for a dose of nothing. The good news appearing in media recently are the high percentage of people all over the world against being vaccinated, it means the human reason algorithm is still top notch.