In 1960s and 1970s Latin America, poverty experts often described a “revolution of rising expectations.” This optimistic thinking was initially considered positive: better to anticipate a brighter future for these developing nations than acquiesce in the status quo or worse.
When expectations were dashed (as they too often were, unfortunately), another strain of thinking arose: perhaps it was better, after all, not to have raised expectations in the first place. Just keep up the good work and trumpet successes as they occur.
Perhaps something similar is happening now across this country as the Biden administration rolls out COVID-19 vaccines.
The numbers are massive and daunting: vaccinating over 300 million Americans as quickly as possible in a race against rapidly mutating virus strains. However, devising and executing the rollout (even considering the complications that often arise given our 50-state federal system) should not be that complex. Biden pledges to reach 100 million vaccinations by the end of his first 100 days, but some critics note that even that figure is too small and would, most likely, have been reached under a second Trump administration.
At least where I live (Arlington, Virginia), however, the rollout is turning out to be one of growing frustration: rising expectations dashed by inconsistent or conflicting advice, overlapping jurisdictions and bureaucratic bungling. My hunch is that other Americans may be experiencing similar situations.
On January 15, 2021, I pre-registered with Arlington County and received a 34-character registration number for “Priority Groups 1B/1C.” Since then, I’ve heard nothing from the county.
The Biden folks took over on Jan. 20, 2021. Recently, they announced that one million additional doses of vaccines would be made available to all 50 states. That’s 20,000 doses per state. These doses are now being distributed to various pharmacies such as CVS and Walgreens.
I’ve tried to secure a vaccine appointment through each pharmacy, in addition to trying a nearby Giant Food that also announced that its pharmacy would be giving vaccinations. In each instance, I have to go through a similar, repeat online application process (difficult for many elderly), only to be told at the end that there are no vaccines available. Sometimes the wait is one minute, at other times the wait is 10 minutes or more. The result is the same: no room at the inn.
At least one of these vaccination providers indicates that it will prioritize appointments according to Arlington County’s pre-registration system, but how that will happen has not been explained. Do I have to do anything further? Will the country refer me to a local pharmacy or hospital as vaccines become available? How exactly does the country system mesh with the new vaccination providers?
I’m a lawyer, not a physician, but I did spend a decade in government and have some familiarity with how bureaucracies operate. Here’s what’s missing:
Take a number and get in line.
It’s simple. Most airlines did something like this in the old days when they actually flew airplanes and boarded people according to various seating priorities. Computers did the sorting and the assignments.
The U.S. government knows at this precise moment how many vaccines are being produced, by whom and when they will become available. The U.S. government has also devised a system for prioritizing vaccinations (the 1A/B/C system etc.). Front-line providers, high-risk individuals with pre-existing health conditions and the elderly (in tranches starting at age 65) are supposed to receive their vaccines first.
One of the Virginia pharmacies apparently jumped the gun and signed up anyone for appointments, even people under age 65. It then had to back off to keep from offering vaccines to 20-somethings before those on the earlier priority list. An Arlington County hospital, by the way, performed the same screw-up: I knew people well under age 65 without any pre-existing health conditions who received appointments (actual dates to go and be vaccinated) which then had to be cancelled. To my knowledge, Arlington County has not informed these people what they should do next.
The same computers used to mine cryptocurrencies should be capable of executing what is, fundamentally, a massive state-by-state sorting exercise in which people sign up once for appointments, the appointments are then sorted and prioritized according to the 1A/B/C protocols, these people then get a number, and when it’s their turn, the computer matches them with the nearest provider.
Fortunately, I’m reasonably patient, in excellent health, and have a good sense of humor. So far.
Charles Kolb served as Deputy Assistant to the President for Domestic Policy from 1990-1992 in the George H.W. Bush White House