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California's Covid Vaccine Effort Faces Challenges – The New York Times


Friday: The state’s vaccine rollout is not going smoothly. Here’s why.

People waited in line to receive Covid-19 vaccines on the opening day of the Disneyland vaccination site on Wednesday.
Valerie Macon/Agence France-Presse — Getty Images

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Good morning.

Gov. Gavin Newsom’s announcement on Wednesday seemed sweeping: California would open up eligibility for a coronavirus vaccine to anyone 65 or older, effectively abandoning a rollout plan that was meant to ensure that the most vulnerable would be first in line.

A day later, residents of the vast and varied state were trying to navigate what many described as vaccination chaos.

Some counties shifted gears immediately, like Orange County, which said anyone 65 or older could book an appointment at the vaccination site it opened this week at Disneyland. But the scheduling website was quickly overwhelmed, making scheduling a shot seem like trying to get tickets to a Taylor Swift (or insert your favorite artist here) concert.

[Track coronavirus cases and hospitalizations across California.]

Neighboring Los Angeles County, however, stuck with its strict priority rules, and officials have said that vaccine doses there would continue to be available only to health care workers, regardless of the governor’s announcement.

When health care workers arrive at a vaccination site, like the one the city is set to open at Dodger Stadium on Friday, they’ll have to present either an employee badge with a photo or another form of documentation of their work.

“This is really about expectations,” Mayor Eric Garcetti of Los Angeles said on Thursday. “Politically, it’d be easy to say, open it up to 65-plus.”

But he said that would mean an older person on the city’s wealthier west side, living in a large house, could easily take a spot from a worker who’s younger and living in a crowded home without room to isolate.

[Read about the confusion in the vaccine rollout across the country.]

The dueling approaches illustrate the tension across the country between two competing imperatives: getting as many doses as possible out quickly, and getting those who are at the most risk protected first.

[Read about the future of the coronavirus, which scientists predict will become a common childhood cold.]

About 11.1 million people in the U.S. had received at least one dose of a Covid-19 vaccine, as of Thursday, according to the Centers for Disease Control and Prevention — a figure that is far short of the 20 million the Trump administration had hoped to reach by Dec. 31. Most have received only the first of the two necessary doses so far, but as of Tuesday at least 541,000 have had both doses, according to a New York Times survey of all 50 states.

California, with its decentralized public health system, is a microcosm of the many problems plaguing the national vaccination effort. The state relies on county health departments to administer vaccines, and Dr. David Lubarsky, the chief executive of U.C. Davis Health, said the counties were up against the same problem they faced when trying to ramp up Covid testing: too little manpower.

Dr. Lubarsky suggested that the state should hand more vaccine doses over to health care providers, who already have the ability to reach out to patients selectively. “Almost everyone has a doctor,” he said, including harder-to-reach patients like those with lower incomes or who are undocumented. “We know who’s at risk,” he said.

Jonah Frohlich, a San Francisco-based health care consultant with Manatt Health Strategies, said that a combination of factors had left county public health departments scrambling to cope with a deluge of monumental tasks.

[Find all of The Times’s vaccine coverage here.]

“The same institutions that are trying to manage testing, contact tracing and supports for people,” Mr. Frohlich said, “are the same people who are managing the distribution of the vaccine.”

Worse, he said, they must work with often outdated and overwhelmed information systems, and organize it all on the fly.

“Calling in residents that are part of the tiering system, then tracking them, is on a scale that no health department has ever had to deal with before,” he said. “This is the kind of program and process that should take years to implement.”

The counties are doing the best they can, Mr. Frohlich said, but “there is a real human cost to delaying the rollout of the vaccine.”

(This article is part of the California Today newsletter. Sign up to get it delivered to your inbox.)

Ringo H.W. Chiu/Associated Press

Today, Dodger Stadium, which had for months been one of the largest and most visible coronavirus testing sites in the nation is set to reopen as what Mr. Garcetti said he believed would be the biggest vaccine site in the country, “and will hopefully become a model.”

But administering vaccines takes more people and time than administering tests to drivers who swabbed their own mouths and dropped the sealed samples into what looked like trash bins.

So what will it be like? According to the mayor’s office, here’s how it’ll work:

  • Patients will arrive and be directed to one of three “divisions” where groups of 10 cars at a time will go through the vaccination process, so patients can bring their kids or other family members.

  • First, they’ll have to verify their eligibility for the vaccine and be screened for risk of an adverse reaction to the injection.

  • Then, they’ll be asked to drive forward to park while they’re injected.

  • Finally, they’ll wait in their cars for 15 minutes, where they’ll be observed to make sure they don’t have an allergic reaction.

  • In a day, 194 people will staff the site, including 42 clinicians and 42 “documenters.” Each division is expected to vaccinate about 4,000 people a day, for a total of 12,000 per day, once the site is at full capacity next week.

Ringo Chiu/Agence France-Presse — Getty Images
  • Ahead of President-elect Joe Biden’s inauguration, the F.B.I. has urged police chiefs across the U.S. to be on high alert. The Los Angeles Police Department has ordered all officers to be in uniform every day leading up to the inauguration so they are ready to be deployed at a moment’s notice. [The New York Times]

On Thursday afternoon, the governor announced steps to protect the Capitol and other “critical infrastructure” ahead of the inauguration, including a move to authorize the deployment of 1,000 National Guard troops.

  • An error with, California’s vaccination website, led to hundreds of people showing up at vaccination sites in Santa Clara and Alameda Counties this week, despite not qualifying for the shots. [San Francisco Chronicle]

  • Coming off the success of the 2020 elections, state lawmakers are considering legislation that would extend the state’s universal vote-by-mail provisions for another year. [KQED]

  • Remote work has offered tech workers a chance to flee San Francisco for tropical beach towns, leafy suburbs and states without income taxes like Texas and Florida. They won’t be missed by some longtime Bay Area residents. [The New York Times]

  • The playwright Lauren Gunderson, sequestered in her San Francisco home, based her new play, “The Catastrophist,” on her husband, an expert on pandemics. [The New York Times]

Etienne Laurent/EPA, via Shutterstock

We’ll be off on Monday in observance of Martin Luther King Jr. Day. Even though parades may be canceled this year, here are nine ways to honor his legacy.

We wish you health, safety and peace.

California Today goes live at 6:30 a.m. Pacific time weekdays. Tell us what you want to see: Were you forwarded this email? Sign up for California Today here and read every edition online here.

Jill Cowan grew up in Orange County, graduated from U.C. Berkeley and has reported all over the state, including the Bay Area, Bakersfield and Los Angeles — but she always wants to see more. Follow along here or on Twitter.

California Today is edited by Julie Bloom, who grew up in Los Angeles and graduated from U.C. Berkeley.

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