Part The First.
Back in January of this year our retired firefighter page posts a call asking retired FF’s to volunteer to give Covid injections. It was to be done under the local city public health agency. I had not done much to contribute to society since my retirement over 3 years ago. And I thought if I volunteered, maybe I could get my vaccine sooner. So I sent the email to sign up.
For the next month, — nothing.
So when the local grocery chain started giving shots, we jumped at it. We had signed up at every health agency and hospital and mass clinic in a 3 county area, and nothing. We got messages like you place on the list is 14,751 out of 45,000. No way was this going to happen. The pharmacy in the grocery store listed each location statewide and how many appointment slots were available. Really a much simpler method than any of the agencies or hospitals had. But still scarce. Mrs. Manoffire and I both got appointments for Feb 11th. Except hers was in a larger city 1 ½ hours away and mine was in a border town 5 hours away. But we went. Two cars, caravan. After lunch, she went home and I kept on going. I had to stay overnight. I got home the next day to frozen citrus trees.
Still nothing on the volunteer thing.
When March 11 is coming up, things have changed. Now we get emails inviting us to get shots. We decide to cancel the trips out of town and go just 2 counties away, 50 minutes, to get shots #2. But now they don’t want to give us a shot because we didn’t get the first with them. They invited us. We filled in the part about this being a 2nd shot and told them where we got them. We had confirmed appointments for the 2nd shot. After some discussion, which included the terms “medical ethics violations” and “breach of contract”, this hospital caved and gave us the shots. In a football stadium drive through. 25 minutes in and out. We are elated. We have lost a cousin in Brazil to a heart attack during a Covid infection. We know others that have died or family of friends. Many, many.
So now Mrs. Manoffire and I are good to go. I sent more email to volunteer. By the last week of March I go down for my first day volunteering at a drive through clinic. About 16 days after my 2nd shot. The only thing is, except for myself, I have never given a shot to anybody in my life. But my EMT certification is still good. That was enough qualification for the agency that was desperately seeking shot givers, experienced volunteers or not. There are lots of volunteers. Many retired nurses and doctors. I love nurses. They have saved my life at least 3 to 5 times. They are great.
So for training, the nurse shows me once how to do it and I practice once. She says good to go. I am assigned a station and no, I did not tell my first client that this was the first shot I ever gave. That day I gave 67 shots. All Moderna.
I volunteered full time 40 hrs. for 2 weeks. There were some emails about a criminal background check. Could it be that they were willing to start paying me? Wife says you just can’t volunteer on a full time basis forever. I finally agree and cut back to 2 days a week. Two more weeks. I am giving from 57 to 80 shots a day. The cars take more time for moving things around than the walk in clinics.
There were at this time 5 clinics in this system. Each one had 20 to 32 vaccinators. Each vaccinator has a client rep to do the computer work. Then there are all the people to deal with every aspect of the clinic. The responsible doctor has a rep., paperwork, traffic or foot traffic and parking, people filling syringes, safety, security, nursing supervisors, interpreters, logistics, human resources, timekeeping, etc. Some of the people there are contract labor, some are volunteer, some are city or county full time or temp employees. For those 32 people putting fluid in arms (me), there are about 150 total people in the operation. As you can see, the hourly cost of this x 5 clinics is pushing $15,000 to $25,000 an hour. This is one system in one county. There are several other entities giving shots in this county. We are doing 2000 to 4300 shots a day per clinic. A very rough guess has this costing $22 dollars a shot just for labor. More likely approaching $30. Not counting administration, cost of the vaccine, transport, storage, etc.,etc.,etc.
Part The Second
After a month of this, I am now getting paid! On the temp payroll of the city where I was a firefighter/EMT. But now I have to go through orientation for all the employee and computer stuff. And I start getting more medical shot giving training. I am making under $250 a day, no benefits. (But I already have GREAT retirement benefits.) Four 10 hour days a week. In the walk in clinics, things can go faster. One day I gave 105 shots and another day 107. So far averaging about 75 — 80 a day. Every one is enthusiastic, competent, and trying to get it done. A very diverse workforce. A tremendous team effort. I see an old fire buddy and we talk a lot. I also see quite a few still active duty fire cohorts working overtime. They are mostly filling syringes. This is tedious. Frozen vials thawed in your hand. 10 shots per vial. No air in the syringes, exact amount, it takes quite a bit of time to fill 3000 syringes a day. And DO NOT JAB YOURSELF!!! Or the person working next to you.
So then come the clients. We ask no questions about citizenship or immigration status. No ID needed at all. We did appointment only for the first 3 months, since this all started in mid January.
This is really a human story. The people that come in. Happy. Elated. Scared to death. Afraid of needles. Rich and poor. (But we ask about income levels, and unfortunately it seems to me that a lot more rich come in, especially at the drive through.)
There are HIPA laws. No photography in the clinic. Lots of people want a selfie of them getting a shot, but no go Joe.
One client comes in. Has not left the house but 3 times in the last 15 months. Once for an unavoidable dental emergency, once to vote, (against the former guy), and now to get the jab. This person is very very scared. Mask, gloves, the whole bit. And very nervous. But once I pull the empty syringe out of the arm, visible relief. Client leaves much less tense. Another client born in 1923. 98 years old. Ask if the client is ready for the shot and the client yells, “Bring it on!” But about half are really scared, and half are really happy. Some are terribly afraid of needles, about 20%. This is where the Patient Reps are at their best. They start talking to the client, and before they even know it the shot is in and out and a bandage slapped over it. I get about 3 or 4 people a day that bleed a drop or two, some more than that. About 30% don’t even feel the needle, not because I am good but because the needle gauge is so small. Many complement me on my shot giving skill and experience, but it is the needle. A 1 inch needle, long and scary looking, but a very narrow gauge, that makes it go in so easy. One lady was giddy and way talkative. She was nervous about the needle and asked me to sing her a song. I did. (I Never Get Enough of You, by Jon Hendricks, RIP). I ask one client the required question, if they ever had bad reactions to injections. The reply was, I don’t believe in any of this, I have never had a shot in my life. An anti-vaxxer. But this person came in for this shot. One convert. Maybe. Or just too scared to risk it. 90% thank us for doing a great job and admire the level of organization.
People are scared. Some a lot more than others. A diverse group of clients. My clinic that I am now working at is a basketball arena owned by the school district. A very diverse group is showing up. White, Hispanic, Black. The zip codes in town with the highest percentage of shots received are neighborhoods that are traditionally Hispanic, Black, and Asian. They are going in percentages larger that from whiter zip codes. But LOTS of people with ethnic heritage from a part of the world that sweeps from Morroco to Vietnam. Middle Eastern, and South Asian. Also from China, Korea, and the Philippines. This cohort of clients are generally the most earnest. Most seem to be US citizens, many seem to be 2nd and 3rd generation. But almost all of them have the same concern. Their relatives are in trouble. They are very very worried about family and friends. They are very relieved to be getting the jab, as are all the clients. But the worry here about family and the old lands is palpable. So more rich white people are getting shots, but higher percentages of POC. Very fortunately two of those people were my son and his ex-GF. His roommates could not or would not come. The next day his recently ex-girlfriend came and I gave her the vaccine. This gave me a chance to have dinner with her and commiserate.
I am now up to about 1188 shots given. We will come back to this factoid in a bit.
Then we have the interpreters. I speak Spanish fairly well. I lived in South America for 2 years. I also went to Mexico often during my fire career to volunteer working with firefighters there. There are always Spanish interpreters here and they do a tremendous job. If the client speaks another language, there is a bank of IPads that link to about a hundred of the most common languages, and bingo, you have a live interpreter on line. I will do the job in Spanish, but when the interpreter is at my table, I switch back to English and let them do their job. They are great.
This is a human story, and people move from anxiety and fear about things to de stressed and relaxed in the 3 seconds it takes to jab them. Some look away. I say that I will do the looking for them. Some faint. We have cots. But all the work that goes into the moment of that needle piercing their skin takes a community and a nation. With a President that actually cares enough to demand that the jab gets done. Many countries have done a better job than the US dealing with this. Some are in deep urgent crisis. I have been invited to go to an Andean country to teach some fire classes. It should be a two week trip. But the country is requiring a 10 day hotel quarantine upon arrival, fully vaccinated or not. That might stop the trip for now. We are trying to catch up with the world and we are trying to move down the list of most per capita deaths.. Will it be enough? Look at Part the Third.
Part the Third
Here in the US, the divide is bad. The other day, I walk up to the parts counter at the local auto dealer. The experienced white guy parts expert with the gray beard asks if he can help me. I have to say no and I wait for the trainee and his boss. Why? The experienced guy has anti-vax statements, memes, cartoons, etc. all over his counter and sneeze shield. The most prominent one says: I believe in God, not in Dr. Fauci. I want to ask him if he has considered that maybe God sent Dr. Fauci to save us from ourselves. The rest of the things he had posted there were soaking in bad logic and falsehoods. Sorry but I was not going to deal with him at all. He is not going to go get a shot and millions that think like him will not.
This county has, as of last week, 47% coverage of the first dose, and 28% of the second. Nearly the best of the big counties in this state. But no where near what it will take for the so called herd immunity, and that is where the story takes a really bad turn.
Last week the number of shots I gave went from 107 on Tuesday, with about 2200 appointments for the day and then walk ins. We are now giving no appointment walk ins. On Wednesday down to about 85. Thursday way 40ish because the walk-ins take a lot longer for the paperwork. Friday was around 35 that I gave with only 1100 appointments.
Then this week everything crashed. The numbers kept falling. Tuesday I worked a full day. Wed., I got sent out an hour early. Thurs, 2 hours, and Friday I only worked 5:15 hours of 8 hours that we were open. Thursday there were 220 appointments and on Friday 310. At rush hour on Thursday 2 clients came as walk ins. Just 2 weeks before they were still out the door when we were scheduled to close. All that personnel and money and too few are coming in now. We only manned 24 of the 32 vaccinator spots on Thursday. By 6:00 we were down to a ten vaccinators. The rest had been sent home for the day. We started with 28 on Friday. Contract labor is starting to get laid off. I think I will be lucky to make it to the end of the May. Thursday I gave 25 shots and sat there for hours. Friday I gave 13. 13 shots in 5 hours. But like I said there are other clinics. This clinic will close by the end of May and the city might move to a model of clinics in neighborhoods and churches.
People have stopped coming in. People have stopped getting shots at a rate that will save the country. Are the Anti-Vaxxers, the propagandists, and the Trumpists winning? I hope not but I worry about this. A lot.
We are nowhere near herd immunity anywhere in the USA. But this process is collapsing. The county next door 2 weeks ago closed all the public health clinics and sent all their vaccines to the pharmacies and doctor’s offices. That might be good, it has better distribution and maybe better access. I don’t know. But they can’t do the volume that the Public Health Clinics were doing at the peak. But with this crash in numbers, the cost of running the big clinics is just not sustainable.
Please go get your shots. Ask your family and friends to go. Tell people at work play and at church to go get a shot. Maybe God is trying to save us from ourselves, but a lot of people that try to listen to that stuff are seemingly deaf to this. I fear I will be laid off for lack of clients before I can give 2000 jabs. I wont get there in May at this rate.
I am really really happy that I have had this opportunity to give shots, I probably helped in saving more lives than I ever did as a firefighter. Take a family member and a friend. Go get your shots.