Why Do We Ignore Systems?
It is very easy to play armchair problem-solver, especially in retrospect, but… I’m going to play armchair problem-solver because we have a current problem—vaccine rollout—that could have used a known system—grassroots organizing—and unfolded differently.
If you want, let’s say, a group of people to vote, you don’t throw up a website, tell people to register themselves, and hope for the best.
You organize at the hyperlocal level. Get all people in this neighbourhood registered. Do not trust that they will register themselves. Make it as easy as possible to get them into the system. The team leader of that neighbourhood effort is looped into a town leadership team, who is looped into a county leadership team, who is looped into a district leadership team, who is looped into a state leadership team. Hyperlocal ripples outward, encompassing a larger and larger area until everyone is included. We know this works because we use this system over and over and over again.
We had about nine months to prepare for the vaccine rollout. Since that was always the plan—build a vaccine—we could have assumed that it would happen and started building that grassroots system of getting people signed up for the vaccine before we ever had a vaccine. Last March, we could have been figuring out the leadership at all levels, and that leadership could have been people who were already in leadership positions. For instance, our county council could have been a great starting point for leading the county-wide leadership, and they would have had to get volunteers or employees (hey! There are a lot of people out of work who could have done this work) for the neighbourhood and town levels. Again, not difficult because we already have systems in place. Time-consuming or costly, perhaps. But not difficult.
Yet that’s not what happened. At all.
Our county rollout is a goat rodeo, and it’s not clear if/when they will ever get to my group. Or what I’m supposed to do once they get to my group. We have eight separate places to check for appointments.
There have been plenty of times when I’ve been confounded during the pandemic. People dead set against wearing masks—why? People ignoring the advice of experts—why? People going on vacation because they feel so stressed—having COVID-19 or knowing that you participated in a chain of events that harmed another person seems a lot more stressful. But the vaccine rollout has topped the list as the most confounding part of the pandemic.
5 comments
YES. And why are we continuing with the “system” that clearly isn’t working? Fix it! My parents got their first shot because the hospital affiliated with their primary care docs got shots and organized themselves – they contacted those eligible and set up appointments. My in-laws are on lists everywhere. One was contacted because his primary care doctor’s hospital has shots but the other doesn’t have a PCP so she’s just waiting. Meanwhile my husband and I just hope they get to us one day. And my kids…it’s hard to stay optimistic when I think about it too hard.
Goat rodeo is a very accurate depiction.
I agree with you that the way the vaccine roll-out is being done is neither the most effective nor efficient way to accomplish the goal of getting as many doses to as many people in the designated priority groups as quickly as possible. My mother-in-law, who lives in one of many “55+ communities” in our metro area questioned why they wouldn’t just have mobile events in these communities, where most of the residents are 75+ or at least 65+, and the only explanation we could come up with was lack of resources and planning.
IMO, the problem with the vaccine roll-out has two main sources: lack of leadership and inadequate funding. State and local health departments are being asked to handle most of the nuts and bolts of this effort, even though they have been understaffed and underfunded for years in most areas of the country. The one thing that the prior administration did correctly was getting the vaccine through R&D more quickly than ever before, but it appears that they made no plans for its distribution.
Goat rodeo is a good description.
Who could possibly have predicted that a lack of planning would have this effect? :/
I have access for myself through work – I’m half vaccinated now and will be fully done in 2 weeks. My employer is trying to open up to family members too, and I’ve taken advantage of that for the 1 person eligible. But you shouldn’t have to know someone to get vaccinated when you’re 97 years old or Category 1a. I hope that the next relief package will alleviate some of this, but in the meantime, we have lots of people trying to get things organized from the outside.
Yes! I have been told repeatedly to advocate for myself. I don’t know what that means! and when should I start that.
How bad is my asthma? Should I wait till my age group? Should I be advocating for my parents who live in another state? My husbands parents spent days on the phone trying to get an appointment.
I never thought I was a systems kind of person. Especially when I worked in an engineering firm with about 1200 engineers, scientists and architects! I was definitely the flaky arts degree outsider. But I discovered there the true value in good systems. And I am continually amazed at the number of times we find systems let us down – poor planning, poor communication, etc etc. Especially in health care. (I used to rant about this during my – even then generally good – experiences during my ectopics!) Unfortunately, over the last year, systems failures has become even more of a life and death issue.
I hope this is sorted out for you sooner rather than later.