[AKN #24] Vaccine distribution is hard and sleep talking turned into poetry
another krappy newsletter #24
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Greetings from the decent state of California. Getting back into the swing of things with work has been a bit of a downer. But it is all good. Unlike the communists, I nod to the fact that I can’t be on vacation forever.
Since I know you are dying to hear, my elimination diet is going strong.
Updates:
Weight loss: I have dropped 7 pounds since Jan 3. This is great! But I will mildly state that the key to getting big numbers like this is to first put 15 pounds on in the previous few months by pounding sweets, IPAs, and goldfish.
Removing caffeine: Headaches are gone. I have a surprising amount of energy. I thought not drinking coffee would really crush me. Ends up no. I am as happy as a clam in shit really. I crush idioms.
Cosmetic/sex appeal: My skin has really looked a lot better. My face is noticeably less puffy than it was. Those sorority girls really were right when they were chatting about inflammation in college. I shouldn’t have made fun of them for that. I should have made fun of them for everything else I made fun of them for.
The way our bodies respond to food is fascinating. But it is definitely making me channel that Right Said Fred energy.
Feeling very motivated about the whole thing right now, but the key is really how do you keep motivation after you lose 10 pounds in the first 2 weeks and now you only lose 0.1 pounds every week from there on out?
I don’t have the answer. That was rhetorical question. So back off.
Anyway. Check out this seamless transition to vaccine distribution.
On to the newsletter!
Table of Contents
Vaccine distribution is hard
Sleep talking in the form of poetry
1. Vaccine distribution is hard
Wow this has been a shit show.
There are a lot of reasons why it has been so painful to get going. The federal government has certainly been to blame for a lot of it. Which is not super shocking at this point.
But in the name of focusing on things we can control, I would like to dive into something that I think is fixable at the state level. Specifically, I want to talk about how bureaucracy is slowing the number of people that we can get vaccinated right now.
Good intentions, Bad results
We should vaccinate old people first. This is all based on good math and science. Theoretically, by injecting the oldest people first, we would minimize deaths. This is the reality of the age stratification of COVID and how it affects these populations in general.
However, what is perhaps counter intuitively a terrible idea is enforcing this ideology with fines and legal ramifications.
Like New York has done:
This type of policy feels good when you make it.
“Yeaaa all these old people about to be hella immune! Gam Gam lives on to give me another Barnes N Noble gift card!”
However, it doesn’t take the distribution and scheduling problems into account. It is hard to get all people (regardless of age) to show up to take the vaccine. It is hard to get older people to sign up digitally for said test. It is hard to deal with vaccines that spoil quickly.
That is how in this same state of New York with all of these fines, you end up with the following result:
Read that thread.
There are 200 available appointments to take the COVID vaccine two days before getting it! These appointments should be booked solid for the next month. Somehow it is harder to get Beanie Babies than it is to get COVID vaccines if you are 75 and live in New York.
Think about how crazy that is. All because of bad user experience on their website and a love of central planning.
Empowering the people doing the work
The problem we are all witnessing in real time is a classic failure of central planning.
In my time working with producing physical goods, I have seen this many many times.
The fundamental issue is that everything in your body wants to give detailed instructions for people to follow. You think it is going to be this very simple algorithm that you are going to give to someone and they will handle execution easily without ever having to break the rules…how naive. What you cannot predict are all the things that are going to happen that make your plan not work.
In the case of vaccines, you aren’t planning for the 75 year old who misses their appointment or the fact that there were a few extra vaccines in the vial at the end of the day. Unfortunately, instead of being able to inject someone new with these new found unused vaccines, you are incentivized to throw them out or let them spoil. After all, you don’t want to get fined $1 million for letting this person jump the line!
So how do you fix this?
Empower the actual people doing the work to make decisions.
The little decisions they can make that are a bit outside of the “rules” will increase efficiency. And efficiency is the only thing that matters when you are trying to reach herd immunity.
This is the exact strategy being utilized by Israel and they have done very very well.
Hell, even if you looked at the absolute scales, it is pretty astonishing how well they have done for such a small country.
So what does this process of empowering the people doing the actual work look like in practice?
They really gave that pizza delivery guy quite the tip! (Get it?)
As mentioned above, Israel utilizes a system called “Organized Chaos” which means “follow the rules until it is hard to follow the rules, in which case do your best to get a vaccine into an arm.” Meanwhile, in the US, we will actively punish people who would attempt a strategy like “Organized Chaos”. We should rethink this approach because it seems pretty obvious that a used vaccine is better than a vaccine that spoils.
If we are trying to minimize the total number of expected deaths towards the end of this pandemic, we should think about how many more people we could save if we were willing to stab the local pizza delivery guy in the arm with our chaos syringe.
Additional good thread on how we may be able to fix this distribution:
2. Sleep talking turned into poems
Part of me knows a lot of these were embellished and did not actually occur, but who cares they are really funny.
Suspension of disbelief is key.
Closing time
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