If Colorado officials are serious about saving as many lives as possible from COVID-19, they should continue to design their own vaccine distribution course, rather than doggedly following the latest advice from the Centers for Disease Control.
At the end of December, almost 80% of all deaths from the virus in Colorado were people aged 70 and over. Play on those over 60% and it’s 90%.
This breakdown is similar in most states.
If you have a limited supply vaccine, give priority to those most likely to die from the disease. Wasn’t that the mantra of public health officials and politicians in the past 10 months? That they were imposing extraordinary restrictions to save lives?
Most likely to die are the elderly, not younger teachers, postal workers, correctional officers, traffic officials or firefighters. Unless these workers have an underlying health problem, in which case they also deserve a high priority, their chances of dying from COVID-19 are arguably very small.
Unfortunately, the CDC advisory panel recommended that the next groups to be vaccinated after frontline health workers and nursing homes, who are already receiving the vaccine, should include people aged 75 and over (so far so good) , as well as certain groups of essential workers of all ages. This is a sloppy political approach to a crisis during which we are warned every day that we must follow science.
Compare the report by the CDC advisory committee with the one released this month by a similar council on immunization in Britain. This group came up with a wonderfully concise and logical list of targets for the vaccine.
First, “residents of a retirement home” and their caregivers. Then, in the following order, “2) all those aged 80 and over and frontline social and health workers; 3) all those aged 75 or over; 4) all those aged 70 and over and clinically extremely vulnerable individuals; 5) all over 65 years of age; 6) all individuals aged between 16 and 64 years with underlying health problems that put them at greater risk of serious illness and mortality; 7) all those over 60; 8) all over 55 years old; 9) all those 50 years of age or older. “
Now that’s putting the priority on saving lives.
Since the risk of mortality “increases exponentially with age,” explained the panel, “it is estimated that, together, these groups account for about 99% of avoidable COVID-19 mortality.”
The CDC’s proposal will achieve nothing like this percentage with speed or efficiency.
Colorado’s priorities for the vaccine, as outlined on the state’s website, begin with the most at-risk health workers and staff and residents of long-term care facilities. Which makes perfect sense.
The next priority for vaccines this winter, “Phase 1B”, are “health professionals and health professionals at moderate risk”. You could argue with some of the categories of workers mentioned, especially if they are under 60, but many come into direct contact with COVID-19 patients and, therefore, understandably, feel under pressure.
What is problematic is how the state project waits until “Phase 2” in the spring to finally mention anyone “65 or older”, cannot distinguish between the very old and merely old, and then lists in the same Phase 2 a series of large groups such as “people who interact directly with the public at work” and “workers who serve people who live in high density environments”.
Why aren’t people aged 80 and over getting vaccinated in the first wave of winter – at least in Phase 1B? Their age group in Colorado comprises more than half of all deaths from the virus.
Why aren’t people aged 70 to 80 listed right behind them or at least as a separate top priority for the next wave of vaccination?
Nationally, some health officials have argued that we need to stop the spread of the virus in groups where transmission of COVID-19 is more prevalent to suppress the pandemic. Some complained that the elderly are disproportionately white and that society should give preference to categories of non-elderly that include more minorities.
These arguments fail to explain the moral imperative to save as many lives as possible. Each dose of vaccine diverted to an essential but not elderly worker, while the vaccine is in short supply, is literally delaying the protection of the most vulnerable.
And because the death rate is often higher for older adults, you actually save more lives for people of all ethnic groups by choosing the elderly.
According to Colorado Sun, a research article published in September, whose authors included academics from the University of Colorado, reinforces this principle. “Of course, the recommendation should be that the most vulnerable people be vaccinated first,” said Professor Daniel Larremore of UC.
To his credit, state officials have revised his plan since its initial launch in October, increasing the emphasis on vaccinating the elderly. Now, they need to make sure that Phase 2, whenever it arrives, does not become a MMA, where low-risk individuals in designated groups delay delivery for those who are really at greatest risk of dying.
Contact Vincent Carroll at [email protected].
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