Dear Brandon,
The other day when I was criticizing the fact that 30 year old firefighters and nurses who don't work with covid patients were getting the vaccine before 65 year olds with diabetes you said, "It makes sense to me, it's like a how in war you have to protect your medics". Now while this may seem perfectly reasonable at first glance specifics matter. Let's say you have an army with 5000 medics and only 500 people who are actually going into territory where they get shot at. Would it still make sense to give all your limited body armor, helmets and protective gear to the medics first? Obviously not. We should not simply assume that giving healthcare workers (which is super broadly defined) the vaccine first even if it seems reasonable at first glance. Specifics matter.
Now before you think I am unreasonable just know that I think giving the vaccine to healthcare workers who work directly with covid patients is reasonable. But if our goal is stop covid deaths and we plan to vaccinate broadly defined "healthcare workers" first (regardless of their personal risk of covid death or if they work directly with covid patients) the following factors are relevant.
About how many people are at EXTREME risk of dying if they don't get the vaccine? (About 11 Million)
About how many people are at high risk of dying if they don't get the vaccine? (About 30-40 Million)
How many healthcare workers/First responders are there in the US? (About 20-25 Million)
How many high risk people will die each day this winter. (About 2-3K per day)
How many vaccines we can distribute per day? (About 1 Million)
How long will it take to vaccinate our healthcare workers? (About 1 Month)
How many people have died due to a lack of available healthcare workers during this pandemic? (no data)
I hope that immediately you can see the issue. If we have 11M people at extreme risk from covid about 20-25M healthcare workers/first responders why would we spend a 3-5 weeks vaccinating healthcare workers while letting high risk people die when we could simply vaccinate the highest risk people during the same time period and save the lives of all those at extreme risk?
Well, some might argue that it is because healthcare workers interact with a lot of high risk people. But if there are less people at extreme risk than there are healthcare workers, why wouldn't we vaccinate those at extreme risk first? Also how many deaths have been caused by firefighters and special ed teachers spreading it? Is there any data to suggest that healthcare workers themselves are the cause of covid spread that is leading to death? With the exception of senior care facilities, all the data seems to suggest that nearly all covid spread and the resulting death comes from prolonged interactions with relatives or in public gathering places where people are in close proximity without protective measures in place like they have in medical facilities.
We actually have very good data on who dies from Covid. The two main factors are pre-existing conditions and age. Only about 1-2% of the roughly 400,000 who have died had no pre-existing conditions. So if you have no pre-existing conditions your chances of dying (even if you are older) are very low!
And per the CDC only about 4% of covid deaths have been people under 50. So why would we give a 30 year old firefighter or a 35 year old special ed teacher the vaccine before a 68 year old with a heart condition and diabetes?
This is no small matter. If you take 4 weeks (28 days) to vaccinate the healthcare workers. We can extrapolate that 50,000-80,000 high risk people will die while waiting for the vaccine. If we were able to vaccinate 50% of the highest risk individuals during this time its perfectly plausible that we would save 20,000- 40,000 peoples lives.
So why are they putting healthcare workers first? From what I can tell it has to do with the models they used which explicitly don't just focus on death, but put significant emphasis on theories about spread minimization. But who really cares if the spread does not result in death? I would much rather have 20 extra people get covid and be fine a few weeks later rather than watching someone die who did not have to. I also have to question the fact that all the policy recommendations that are made by HEALTHCARE bureaucrats. It would not be surprising if these policies were made by Wal Mart employees that they might be bias toward protecting grocery workers.
In the end this is no joke. I am a leader in my church and currently we have 5-10 people in our congregation who are vaccinated. We probably have 10-20 people who are at high risk from covid. None of them have the vaccine and one of them is in the ICU. I don't blame people who are getting the vaccine now. They normally have to take it per the policies of their employer. My issue is with the policy makers who are using models and theories rather than the hard available data to make decisions. Even after examining the broader data and listening to the arguments I can see no reason why the 5-10 people in my congregation who are vaccinated, are not the most at risk from the virus. Data > Theory.