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How to…
- dispense vaccines as fast as we can make them,
- reduce waste,
- maintain consistent availability over time & across regions,
- give 2nd doses on time without pre-reserving them,
- and ensure that prioritized groups can 𝘢𝘭𝘸𝘢𝘺𝘴 get the #vaccine faster than others https://twitter.com/RELenski/status/1349163401956753409
- dispense vaccines as fast as we can make them,
- reduce waste,
- maintain consistent availability over time & across regions,
- give 2nd doses on time without pre-reserving them,
- and ensure that prioritized groups can 𝘢𝘭𝘸𝘢𝘺𝘴 get the #vaccine faster than others https://twitter.com/RELenski/status/1349163401956753409
A lot of the problems we’re having with vaccine distribution in the USA are extremely foreseeable. 
There are other problems that we haven’t yet had, but which are equally foreseeable — and inevitable without intervention.
There are other problems that we haven’t yet had, but which are equally foreseeable — and inevitable without intervention.
Case #1: NY Gov Cuomo ordered huge penalties for providers dispensing the vaccine to anyone who isn't eligible according to prioritization criteria. https://twitter.com/webdevMason/status/1345519977600716800
This caused tons of vaccine doses to get wasted, and caused the overall rate of vaccination to fall. (Fortunately, he changed course.) https://www.nytimes.com/2021/01/10/nyregion/new-york-vaccine-guidelines.html
This balancing act
strict prioritization
vs.
minimal waste (high utilization) and maximal throughput
… should be pretty obvious to anyone who’s tried to make a factory run more efficiently.
(Operations researchers and industrial engineers, for instance.)
strict prioritization
vs.
minimal waste (high utilization) and maximal throughput
… should be pretty obvious to anyone who’s tried to make a factory run more efficiently.
(Operations researchers and industrial engineers, for instance.)
It’ll take ≥2 yrs to make enough 
for everyone on 
. This analysis (for Israel) projects that vaccinating the oldest 𝟳.𝟱% of people would reduce deaths by 𝟳𝟱%.
So we MUST prioritize dispensation, in order to stanch death rates (disease spread too). https://twitter.com/dwallacewells/status/1340397154683269123
for everyone on . This analysis (for Israel) projects that vaccinating the oldest 𝟳.𝟱% of people would reduce deaths by 𝟳𝟱%.So we MUST prioritize dispensation, in order to stanch death rates (disease spread too). https://twitter.com/dwallacewells/status/1340397154683269123
Case #2: supplies of Pfizer+Moderna are effectively HALVED by attempts to pre-reserve 2nd doses (to ensure their delivery with the optimal 21-28d delay).
Some pub health experts like @ashishkjha advocate dispensing all available vaccine as 1st doses: https://twitter.com/bhrenton/status/1346497425859620864
Some pub health experts like @ashishkjha advocate dispensing all available vaccine as 1st doses: https://twitter.com/bhrenton/status/1346497425859620864
However, virologists like @florian_krammer warn that excessive inter-dose delays could potentially accelerate the emergence of vaccine-resistant strains of SARS-CoV-2 virus.
(Yikes.) https://twitter.com/Dereklowe/status/1346160324240576512
(Yikes.) https://twitter.com/Dereklowe/status/1346160324240576512
Here's a win-win idea…
- DON'T reserve 2nd doses
- DO dispense all available vaccine as first doses, but limit the rate to 50% of the planned delivery rate of FUTURE vaccine shipments.
, queuing theory. (The general problem is very complex. This is a first-order solution.)
- DON'T reserve 2nd doses
- DO dispense all available vaccine as first doses, but limit the rate to 50% of the planned delivery rate of FUTURE vaccine shipments.
, queuing theory. (The general problem is very complex. This is a first-order solution.)
This strategy can ensure sufficient inventory to provide nearly all recipients with their 2nd dose in the ideal time window, and 𝗮𝗹𝘀𝗼 eliminate the need for providers to sit on half of everything they receive.
Half of all doses sitting in freezers, that doesn’t help anyone.
Half of all doses sitting in freezers, that doesn’t help anyone.
Case #3: A problem I haven’t seen reported yet, but which I expect to emerge, is that of temporal and geographical inventory “bubbles.”
Not enough doses delivered here this week, too many next week.
Too many doses available in Colorado
, not enough in Michigan 
.
etc.
Not enough doses delivered here this week, too many next week.
Too many doses available in Colorado
, not enough in Michigan .etc.
Industrial engineers can help with this too. (We call it “line [im]balance” in a semiconductor fab.)
Taming it will require tracking dose inventory levels at the local level, and using that data as feedback to drive efficient+equitable distribution of future vaccine shipments.
Taming it will require tracking dose inventory levels at the local level, and using that data as feedback to drive efficient+equitable distribution of future vaccine shipments.
I could go on… 
Bottom line: USA needs to scale up a complex multi-step process, while minimizing waste of scarce resources, maximizing throughput, 𝘢𝘯𝘥 continuously ensuring prioritization of the most vulnerable recipients.
Experts in these fields should be involved!
Bottom line: USA needs to scale up a complex multi-step process, while minimizing waste of scarce resources, maximizing throughput, 𝘢𝘯𝘥 continuously ensuring prioritization of the most vulnerable recipients.
Experts in these fields should be involved!
Pres-Elect @JoeBiden’s COVID task force will include renowned epidemiologists, physicians, & virologists.
I’m in awe of their expertise, and eager for them to get to work.
I hope he will appoint experts in ops research & industrial engineering as well. https://www.forbes.com/sites/judystone/2020/11/09/president-elect-biden-names-new-covid-19-task-force--whats-the-enthusiasm-about
I’m in awe of their expertise, and eager for them to get to work.
I hope he will appoint experts in ops research & industrial engineering as well. https://www.forbes.com/sites/judystone/2020/11/09/president-elect-biden-names-new-covid-19-task-force--whats-the-enthusiasm-about
Blog post includes a more detailed proposal for dispensing COVID-19 vaccine with low waste, high throughput, and preservation of priority — no matter when a high-risk individual decides to get the vaccine.
Please read it and let me know what you think.
https://telliamedrevisited.wordpress.com/2021/01/12/an-engineering-perspective-on-accelerating-vaccine-distribution/
Please read it and let me know what you think.
https://telliamedrevisited.wordpress.com/2021/01/12/an-engineering-perspective-on-accelerating-vaccine-distribution/
Many many thanks to my father @relenski for the discussions that inspired this (you too, mom!), for encouraging me to write this up, and for giving it a home on his blog.
This is super interesting!
India's vaccine distribution is going to be managed by its national institute for industrial engineering.
Any industrial engineers involved in COVID-19 vaccination here in the USA?
https://timesofindia.indiatimes.com/home/education/news/a-joint-view-of-tata-consultancy-service-tcs-national-institute-of-industrial-engineering-nitie-to-manage-covid-vaccine-distribution-for-india/articleshow/79722661.cms
India's vaccine distribution is going to be managed by its national institute for industrial engineering.
Any industrial engineers involved in COVID-19 vaccination here in the USA?
https://timesofindia.indiatimes.com/home/education/news/a-joint-view-of-tata-consultancy-service-tcs-national-institute-of-industrial-engineering-nitie-to-manage-covid-vaccine-distribution-for-india/articleshow/79722661.cms
