5 ms·

The Story of VaccinateCA (2022)

37 points by wglb 2y ago

Eumenes 2y ago
> Works in Progress is a magazine of new and underrated ideas to improve the world. > Works in Progress is part of Stripe. Stripe is in the business of producing content? Strange. The UI gives me psuedo-intellectual vibes you'd see from The New Yorker or The Atlantic. Like a web equivalent of a coffee table book you'd see at some product designer's loft in Dumbo who works at Etsy.
- mtlynch 2y ago
  Stripe publishes books that are surprisingly good: https://press.stripe.com/ https://press.stripe.com/ When I purchased The Making of Prince of Persia and saw "Stripe" as the publisher, I assumed it was a totally different company with a coincidentally matching name. I looked it up and was surprised that it was Stripe the payment company.
- dghlsakjg 2y ago
  Stripe has a strong culture of encouraging writing, and runs its own press. I think its a good thing. We always ask how we get back to companies doing things indirect to their industry, but broadly good, like Bell Labs. Well...
briandear 2y ago
[flagged]
- maxerickson 2y ago
  Pulling a product when there are safer alternatives doesn't really get you all the way to unsafe, it just means that the risk-benefit calculation changed.
  - DaSHacka 2y ago
    And yet when we were in the heat of the pandemic, we were explicitly told they were completely "safe and effective" and we had no reason to not get it, regardless of age or risk demographic (unless you were one of those 'problematic' antivaxxers) It's only now, after the fact, that we see revisionist claims about how they were never claimed to be completely safe or effective in the first place, as though we didn't live through 2020. I think this is the crux of the frustration many of us have; its not even that we were lied to in the sake of political and economic convenience, but that no one was, nor ever will be, held accountable and they continue to deny it ever even happened. I hope I live long enough to see what kids a couple generations from now are taught about the event. I wonder, will it be represented as an unavoidable global inconvenience solved by obedience, or an instance of disregard for preestablished checks and procedures in a flurry of artificial panic? Perhaps a bit of both, I suppose only time will tell.
    - maxerickson 2y ago
      The vaccines were safe.amd effective. It's not the fault of public health officials that people interpret that statement in a stupid way.
- deleted 2y ago
  [deleted]
maxerickson 2y ago
I get that the idea is to marginally increase utilization across millions of doses, but I struggle to understand how much of this was just tilting at windmills. With the limited roll out, it wouldn't take much capacity for individual sites to schedule their available doses. And for example, in my smaller town, there were 4 sites, comprised of public health, the hospital and 2 pharmacies. People looking are gonna start at those places.
- striking 2y ago
  > The recipients of the vials in many cases had limited organizational ability to communicate to potential patients that they actually had them available. > Patients then asked the federal government, states, counties, healthcare providers and community groups, ‘Do you have the vaccine?’ And in most cases the only answer available to the person who picked up the phone was ‘I don’t have it. I don’t know if we have it. Plausibly someone has it. Maybe you should call someone else.’ Technologists will see the analogy to a distributed denial of service incident, and as if the overwhelming demand was not enough of a problem, the rerouting of calls between institutions amplified the burden on the healthcare system. Vaccine seekers were routinely making dozens of calls. San Francisco, for example, has a lot of places where vaccines can be administered and a whole lot of people that wanted them. Difficulty scaled with population density.
  - crote 2y ago
    > Difficulty scaled with population density. How much of that was due to government dysfunction, though? I live in a quite dense urban area. For me, getting the vaccine was a walk in the park. There was a single nation-wide website to register your vaccination slot, and it was administered in a factory-like workflow. The government literally hired out a large event space and turned it into a single smooth operation, calling up whatever med student, military doctor, and retired nurse they could find. There was a single plan from the national level, and it was implemented by the pre-existing government structure which normally handles childrens' vaccines and the medical part of disaster response. It seems the US did basically the opposite thing, with dozens of government entities all delegating responsibility downwards, and relying on ad-hoc implementation by commercial entities. That might work fine in a normal situation, but it's not exactly a surprise that it breaks down during a disaster. Stuff like this is literally what the government is for!
roenxi 2y ago
> In some cases, healthcare providers adopted policies to prohibit end-of-day shots because their lawyers told them that if they violated the tier list then the state would revoke the pharmacy’s permission to do business at all. He does touch on this, but the article is long - I would invite a moment of reflection that a key contributing factor to patio11's success here is that he didn't have a license to revoke or compliance lawyers in his ear from the start of the process. I imagine both of those things were significant factors in deadening the natural impulse of the medical professionals in organising themselves. Bureaucracies don't punish people for mistakes. People get punished for non-compliance. That makes any novel scheme risky.
- patio11 2y ago
  Bureaucracies don't punish people for mistakes. People get punished for non-compliance. It is a bit remarkable that nobody in California will take either a career or political hit for instituting a policy of redlining [0] in the provision of medical care, in the clear light of day, despite that being very obviously illegal, but that we actually literally prosecuted people for end-of-day shots. It calls to mind that mind that Joker quote: "Nobody panics if everything is going according to plan, even if the plan is horrifying." The health equity experts and medical ethicists were enthusiastically onboard with redlining. And so we redlined. [0] Access to medical care early was conditioned on living in the correct zip code, and there was a list of priority zip codes adopted by the state as a result of a coalition of county health offices pooling their resources to create that authoritative list. That list was designed, and I am using that word very deliberately, to proxy for race of residents of those zip codes.
wannacboatmovie 2y ago
Anyone else click this thinking it was a story about securing Certificate Authorities?
stefantalpalaru 2y ago
[dead]

37 points by wglb 2y ago

> Works in Progress is a magazine of new and underrated ideas to improve the world. > Works in Progress is part of Stripe. Stripe is in the business of producing content? Strange. The UI gives me psuedo-intellectual vibes you'd see from The New Yorker or The Atlantic. Like a web equivalent of a coffee table book you'd see at some product designer's loft in Dumbo who works at Etsy.

mtlynch 2y ago
Stripe publishes books that are surprisingly good: https://press.stripe.com/ https://press.stripe.com/ When I purchased The Making of Prince of Persia and saw "Stripe" as the publisher, I assumed it was a totally different company with a coincidentally matching name. I looked it up and was surprised that it was Stripe the payment company.
dghlsakjg 2y ago
Stripe has a strong culture of encouraging writing, and runs its own press. I think its a good thing. We always ask how we get back to companies doing things indirect to their industry, but broadly good, like Bell Labs. Well...

briandear 2y ago

[flagged]

maxerickson 2y ago
Pulling a product when there are safer alternatives doesn't really get you all the way to unsafe, it just means that the risk-benefit calculation changed.
- DaSHacka 2y ago
  And yet when we were in the heat of the pandemic, we were explicitly told they were completely "safe and effective" and we had no reason to not get it, regardless of age or risk demographic (unless you were one of those 'problematic' antivaxxers) It's only now, after the fact, that we see revisionist claims about how they were never claimed to be completely safe or effective in the first place, as though we didn't live through 2020. I think this is the crux of the frustration many of us have; its not even that we were lied to in the sake of political and economic convenience, but that no one was, nor ever will be, held accountable and they continue to deny it ever even happened. I hope I live long enough to see what kids a couple generations from now are taught about the event. I wonder, will it be represented as an unavoidable global inconvenience solved by obedience, or an instance of disregard for preestablished checks and procedures in a flurry of artificial panic? Perhaps a bit of both, I suppose only time will tell.
  - maxerickson 2y ago
    The vaccines were safe.amd effective. It's not the fault of public health officials that people interpret that statement in a stupid way.
deleted 2y ago
[deleted]

maxerickson 2y ago

I get that the idea is to marginally increase utilization across millions of doses, but I struggle to understand how much of this was just tilting at windmills. With the limited roll out, it wouldn't take much capacity for individual sites to schedule their available doses. And for example, in my smaller town, there were 4 sites, comprised of public health, the hospital and 2 pharmacies. People looking are gonna start at those places.

striking 2y ago
> The recipients of the vials in many cases had limited organizational ability to communicate to potential patients that they actually had them available. > Patients then asked the federal government, states, counties, healthcare providers and community groups, ‘Do you have the vaccine?’ And in most cases the only answer available to the person who picked up the phone was ‘I don’t have it. I don’t know if we have it. Plausibly someone has it. Maybe you should call someone else.’ Technologists will see the analogy to a distributed denial of service incident, and as if the overwhelming demand was not enough of a problem, the rerouting of calls between institutions amplified the burden on the healthcare system. Vaccine seekers were routinely making dozens of calls. San Francisco, for example, has a lot of places where vaccines can be administered and a whole lot of people that wanted them. Difficulty scaled with population density.
- crote 2y ago
  > Difficulty scaled with population density. How much of that was due to government dysfunction, though? I live in a quite dense urban area. For me, getting the vaccine was a walk in the park. There was a single nation-wide website to register your vaccination slot, and it was administered in a factory-like workflow. The government literally hired out a large event space and turned it into a single smooth operation, calling up whatever med student, military doctor, and retired nurse they could find. There was a single plan from the national level, and it was implemented by the pre-existing government structure which normally handles childrens' vaccines and the medical part of disaster response. It seems the US did basically the opposite thing, with dozens of government entities all delegating responsibility downwards, and relying on ad-hoc implementation by commercial entities. That might work fine in a normal situation, but it's not exactly a surprise that it breaks down during a disaster. Stuff like this is literally what the government is for!

roenxi 2y ago

> In some cases, healthcare providers adopted policies to prohibit end-of-day shots because their lawyers told them that if they violated the tier list then the state would revoke the pharmacy’s permission to do business at all. He does touch on this, but the article is long - I would invite a moment of reflection that a key contributing factor to patio11's success here is that he didn't have a license to revoke or compliance lawyers in his ear from the start of the process. I imagine both of those things were significant factors in deadening the natural impulse of the medical professionals in organising themselves. Bureaucracies don't punish people for mistakes. People get punished for non-compliance. That makes any novel scheme risky.

patio11 2y ago
Bureaucracies don't punish people for mistakes. People get punished for non-compliance. It is a bit remarkable that nobody in California will take either a career or political hit for instituting a policy of redlining [0] in the provision of medical care, in the clear light of day, despite that being very obviously illegal, but that we actually literally prosecuted people for end-of-day shots. It calls to mind that mind that Joker quote: "Nobody panics if everything is going according to plan, even if the plan is horrifying." The health equity experts and medical ethicists were enthusiastically onboard with redlining. And so we redlined. [0] Access to medical care early was conditioned on living in the correct zip code, and there was a list of priority zip codes adopted by the state as a result of a coalition of county health offices pooling their resources to create that authoritative list. That list was designed, and I am using that word very deliberately, to proxy for race of residents of those zip codes.

wannacboatmovie 2y ago

Anyone else click this thinking it was a story about securing Certificate Authorities?

stefantalpalaru 2y ago

[dead]