Wonder why southern California’s COVID-19 vaccination lines aren’t moving faster?
David Aizuss, MD, immediate past president of the California Medical Association, has a good idea. Los Angeles County rules make it difficult if not impossible for many providers to sign up as volunteer vaccinators, he said.
He knows because he’s tried — even calling top county officials he knows from his position as former president of the Los Angeles County Medical Association, such as county health officer Muntu Davis, MD, MPH. He’s complained as recently as late Friday afternoon. He’s hoping his calls will help speed up the process.
Meanwhile, the largest California county is still working through the first priority tier, 1a, amid a mind-boggling surge of cases as providers put themselves at risk.
The first barrier, Aizuss said, is the county health department’s website, which requires seven to 10 clicks before revealing the right place for clinicians to sign up. “It’s so hard to get to; it’s stupidly designed,” he said.
Los Angeles County is looking for licensed professionals in six categories, besides medical and osteopathic physicians, to volunteer: physician assistants, nurse practitioners, registered nurses, licensed vocational nurses, dentists, and pharmacists. Providers are glad to step up for shifts, even without pay.
But the killer requirement is that an LA volunteer must work from 8 a.m. to 6:30 p.m.
“These are all 10-hour shifts, 7 days a week; unfortunately, no part-time shifts are available,” according to the LA County health department.
A check on the LA County vaccination locations website on Sunday afternoon for the week ahead showed that only Saturday shifts had filled up, because that’s when professionals might have that much time off, he noted. Aizuss, an Encino ophthalmologist, is still practicing, giving eye exams and performing surgeries. He can’t be away from his practice for 10.5 hours.
Los Angeles isn’t the only Southern California county where physicians who want to volunteer have been frustrated.
Two former San Diego County Medical Association presidents, Ted Mazer, MD, and Sherry Franklin, MD, said they have been trying to volunteer to inoculate frontline workers for weeks but have been thwarted by a confusing array of steps and processes, 15 pages of forms, and county officials failing to take them up on their offer. Mazer said one county official who finally contacted them was “trying to figure out the very slowly evolving process herself.”
“It’s total insanity,” said Mazer, an otolaryngologist who also is a past president of the California Medical Association. After retiring from his practice last fall, he began his effort to be a vaccinator on Dec. 28. Now, the need is dire, as San Diego County is seeing an unprecedented surge with COVID-19 patients on the verge of maxing out ICU capacity.
Part of the issue is that the county requires clinicians wanting to vaccinate to first go through the state government’s Disaster Healthcare Volunteers website, which isn’t specific to the COVID effort but directs would-be volunteers to their specific counties.
Someone from San Diego County finally got back to him, but said he hadn’t filled out a registration form, a form Mazer said he was never provided, nor could he find. He finally located a paper copy but not a digital version.
Another program to vaccinate health workers in San Diego County is operated by UCSD Medical Center, and Mazer tried there too. “That site says ‘we want you, but we don’t have any way for you to register yet so get back to us when you want to check in.’ Believe it or not, that’s what it says,” Mazer said.
Contacted Thursday, David Bazzo, MD, a UCSD physician and faculty member who posted a photo of himself at a vaccination site Wednesday, said, “UCSD is working on the logistics to get volunteers from outside of our system to be able to sign up. It’s a little bit of a logistical issue but we have to be able to have them sign up, verify credentials and do training modules.” He expected a sign-up system to be up this week.
Franklin, a retired pediatric endocrinologist who now performs post-service reviews for United Healthcare, has been trying for more than a week to join her colleagues along the vaccination lines. Her company even allows her a half-day off to do it.
San Diego County “is still doing 1a. New York is in 1c and Arizona, 1b, giving vaccines to teachers and teacher’s aides. And here we are, supposedly this great state of opportunity,” Franklin said. She echoed Mazer, saying “it’s insane.” She believes the wait times to get through the system have to do with a concern about liability, but “who’s going to sue you? Somebody who says his arm hurt?”
“Put me to work. I can start tonight,” she said.
Franklin said when she heard nothing back, she used her resources as past president of the medical society, and called the top county officials to get through the red tape.
“It shouldn’t be that you have to ‘know someone’ to volunteer.” That top official told her “That’s great, Sherry. We’ll get you. No problem,” and referred her to someone else who told her she’d checked the wrong box and needed to fill out this paper form, with a signature in blue ink, print it out and send it back. She sent in her passport photo, and they verified her license.
“There’s no reason why I should have to jump through all these hoops just to do something good for the community.”
After all that, she was told, she had to go through an online training to verify that she knows how to give an injection, as if someone might sue the vaccination site. A statewide Good Samaritan rule for volunteer vaccinators would solve that, she said.
Franklin realizes those bureaucratic processes and verifications, or “hoops you have to jump through,” might be important “but this isn’t the time. This is a pandemic.” Any physician knows how to give an injection, she said. “It’s ridiculous.”
Aizuss was ready to assign blame to the other side of the country.
“I do feel the difficulties we’re having with distribution of the vaccine are a reflection of the lack of direction on the part of the federal government under the Trump administration,” he said. “I expect we’re going to see great improvement under the Biden administration.”
In time, Aizuss said, he hopes physicians will get vaccines directly in their offices so they can administer them to their patients. “That will make it easier,” he said.
Late Sunday evening, Mazer and Franklin received the slide deck for training to become vaccinators. It took over an hour to complete, and Mazer said they were told “we may be quizzed on it when we arrive for our first assignment.”