Stanford apologizes after vaccine allocation leaves out medical residents

&gt; &quot;[A]lgorithms are made by people and the results ... were reviewed multiple times by people,&quot;<p>You got that right. The way they talk about &quot;an algorithm did it&quot; makes it seem as as if they think that somehow explains it, like there was only one algorithm possible handed down from god or something.<p>We&#x27;ll be seeing more and more of this of course. &quot;We can&#x27;t be blamed, it was an algorithm! We can&#x27;t be blamed for trusting in the algorithm, because everyone knows algorithms are objective, right?&quot;<p>I&#x27;m not sure &quot;laypeople&quot; realize that, especially in this particular case, &quot;algorithm&quot; is just a fancy word for &quot;formula&quot;. Right, you MADE the formula, and it was wrong.

The labor of medical residents is something hospital systems exploit during normal times, but that exploitation has severely deepened during the pandemic. At the hospital my partner works at, respiratory therapists and nurses got a $10k bonus for working during COVID; the residents got nothing despite working insane hours in ICU, routinely working more than the legally mandated 90 hours per week. Just because doctors earn more later in their careers does not excuse the level of labor exploitation they are subject to during residency.<p>Stanford is not the only hospital system to restrict access to the vaccine from frontline residents. I can name 3 other local hospital systems in my city that have vaccinated administrative &amp; C-suite&#x2F;VP level staff before doctors, nurses, and other frontline employees. If vaccine allocation is getting messed up this early on within these closed systems, I can&#x27;t help but think the next 2-3 phases will go awry as well--what checks are in place to ensure these vaccines get distributed to grocery store workers before people who are willing to pay more to get it early?

Evidence like this suggest that medical leadership for the most part care very little about house officers (residents), and that is pretty universal.<p>Our institution built a new billion dollar hospital and did not include call rooms.<p>Great job.

The great thing about an algorithm is that when it gives you results that benefit you, you can accept them and then pass the buck on to it when people get outraged:<p>&quot;According to an email sent by a chief resident to other residents, Stanford&#x27;s leaders explained that an algorithm was used to assign its first allotment of the vaccine. The algorithm was said to have prioritized those health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents apparently did not have an assigned location, and along with their typically young age, they were dropped low on the priority list.&quot;

Washington University in St. Louis is currently under fire for the exact same &quot;oversight.&quot;

This sounds way too convenient - basically the modern day equivalent of the &quot;dog did it&quot;.<p>So we&#x27;re to believe that a rogue computer code screwed up?.. i.e.: nobody in charge mess&#x27;ed up?<p>Why again do those with the largest paychecks, given the largest slack?

Another messed up thing I&#x27;ve heard is that many hospitals are prioritizing vaccines for WFH Administrators over staff that are actually working at hospitals..<p>Its a weird system, I asked someone I know who is doing her residency how many times she&#x27;s been COVID tested this year... just once. Apparently as long as you&#x27;re not working on the COVID floor there isn&#x27;t really a requirement at her hospital.

Since this algorithm is obviously flawed this way, is it likely to be flawed with respect to the timing of the second dose?<p>Every report I’ve seen from experiment subjects (who may have received the placebo) indicates that the second dose sucked for 2-3 days, and was much worse than the first.<p>If you give all your, for example, ICU staff the second dose at the same time, and then they can’t work for 2 days, how do you staff that?<p>Did you plan for this, or will it be a surprise that “The Algorithm” missed?

Seems like very typical behavior for university and hospital administrators.

&gt; that resulted in an outcome we did not anticipate,&quot; they wrote.<p>I bet the &quot;outcome&quot; they&#x27;re talking about is the _protest_, not the allocation.

I can&#x27;t really get upset until I understand who got it instead of the resident.

This is going to be how it goes broadly, at a national and international level.<p>I guarantee you that you&#x27;ll see access for the wealthy much sooner than you&#x27;ll see access for the folks at highest risk. I don&#x27;t know how to help with this, but I&#x27;d much rather see farm workers, grocery store clerks, the homeless, bus drivers, etc. get access after we take care of the medical staff (who are exposed to patients) and the elderly (and others in extremely risky environments.)<p>Yet I&#x27;m sure that&#x27;s not how this will go.<p>How long before testing and vaccination becomes an employment perk at a FAANG company?

Residency requirements are nothing more than a form of hazing. The doctors are half-asleep while making important decisions. How can this be not be outrageously unacceptable?

No, Stanford is sorry that they were called out, but not sorry for what they did - or they wouldn&#x27;t have done it in the first place.

I have one question: was the &quot;algorithm&quot; an excel scorecard? I bet it was

If this pandemic has shown anything it’s that the poor and front line is throwaway.<p>Inequality in the US is getting more and more extreme. This shit will not be tolerated much longer, riots will get worse, people will get angrier.

Under a capitalist system, resources are allocated to those most willing to pay for it.<p>Under a socialist system, resources are allocated to those with the most political power.<p>Under an anarchist system, resources are allocated to those with the most firepower.<p>The vaccine is being distributed under a socialist system. Nobody should be surprised at the results.

Algorithm? They probably mean a HR spreadsheet.

Here’s another algorithm screwup: <a href="https:&#x2F;&#x2F;www.who.int&#x2F;news&#x2F;item&#x2F;14-12-2020-who-information-notice-for-ivd-users" rel="nofollow">https:&#x2F;&#x2F;www.who.int&#x2F;news&#x2F;item&#x2F;14-12-2020-who-information-not...</a><p>Oh, wait, no more need for false PCR tests, we have vaccines now. Forget testing, they’re wrong anyway, everyone get in line for a dose of nothing.<p>The good news appearing in media recently are the high percentage of people all over the world against being vaccinated, it means the human reason algorithm is still top notch.

Lets see: first they give themselves what they want. Only after, and only if there is any outcry, then they apologize without any consequences.<p>Yeah, I think management learnt something &#x2F;s.<p>We&#x27;re always going to keep getting more of this behavior unless and until we start holding management fully accountable for this type of insider dealing. And accountable means being immediately fired, no golden handcuffs, and a full clawback of any issued bonuses and stock options.

I don&#x27;t see how free will has anything to do with this. The algorithm is clearly calling the shots. (pun intended)

Gross oversight: Veterinarians are not in the first wave of vaccinations, despite being both essential and healthcare workers. The mega corps that own most Vet clinics don&#x27;t care about them, they have continued operating apace. Meanwhile, corona could be all over the dogs and cats brought in, very few owners sanitize their indoor pets before Vet visits.

I’ve been tracking the news and the priority of administering the vaccine has been a debate in itself. If ML can truly find out the obvious and identify key areas to target, we can avoid a bunch of unnecessary finger pointing. What may seem obvious to humans may be totally wrong.

Nobody is catching that residents are almost universally 25-35 years old, which puts them in an extremely low risk category for serious illness.<p>Which sucks, but is 100% the most efficient way to prevent deaths. Giving the vaccines to older workers first is correct.

Why is Stanford in a position to choose allocations in the first place? I thought the government was going to handle allocations.

Most likely residents are young, arent they? So if they prioritized people most like getting affected by the disease and only have 5000 shots, I am not suprised that no resident made it to the list.

My Resident daughter-in-law was scheduled to be vaccinated. Was sick on the day. Turns out, she had the virus! So no vaccination needed any more. One way to resolve it.

In all likelihood, this was an innocent mistake (i.e., not done with malice)... but it&#x27;s hard not be cynical about it, especially when we consider the context.<p>Medical residents:<p>1) are at high risk, overworked, stressed out, and underpaid;<p>2) are regularly being called &quot;heroes&quot; in slick posters and PR campaigns; and<p>3) have just been left out of the initial vaccine allocation.<p>The combination of 1), 2), and 3) seems almost &quot;engineered&quot; to induce psychological and emotional breakdown in the very people who least deserve it. Horrible.

It should be no surprise that, when confronted with this error (if it is one, POSIWID, etc. etc.), admin staff insisted on preserving the erroneous state. Should America ever find herself with single-payer healthcare during shortages, she will find herself encountering this same situation once again. She will then react with outrage and surprise, learning not that centralization sets these incentives, but falsely doubling down in the belief that this repeated failure of centralization is evidence that the wrong kind of people were at the centre: not very different from communists who argue that &quot;it just wasn&#x27;t done right by the right people&quot;.

&gt; According to an email sent by a chief resident to other residents, Stanford&#x27;s leaders explained that an algorithm was used to assign its first allotment of the vaccine. The algorithm was said to have prioritized those health care workers at highest risk for COVID infections, along with factors like age and the location or unit where they work in the hospital. Residents apparently did not have an assigned location, and along with their typically young age, they were dropped low on the priority list.<p>So, basically, whoever coded up the algorithm for personal COVID-risk forgot to take care of null-states for the location input.<p>So much for all the outrage over selfish intent.<p>Sure, it&#x27;s possible that the admins purposefully created this glitch so as to have a reasonable fallback story in the case they got caught, but per Occam&#x27;s Razor, I think it&#x27;s much more likely it was a dumb, honest mistake.

Medical professionals should not be in the early rounds of vaccines.<p>If the vaccines have a delayed negative effect you cripple health care.<p>Vaccines are great once they&#x27;ve had years of testing, but risk management would tell you to play it safe with critical staff. If the vaccine disabled 20% of medical professionals in January how many people would die as a consequence?

There is incredible pressure to give out vaccine to those with the tallest soapbox from which they can harass decision makers. And of course, said decision makers aren&#x27;t exactly known for their backbone when handling conflict, so we get situations like this. Administrators often don&#x27;t even know who in the hospitals spends the most time around sick patients. Entire front-line departments are forgotten, primarily because they don&#x27;t have any political power or representation.<p>To see such a highly regarded institution fail this very simple test is another example of how the human creature needs more time to evolve. It&#x27;s not just a mistake, this is a pattern playing out all over. Anyone who spends time in these environs would not be much surprised, but when the best hospitals still can&#x27;t take care of their most vulnerable staff because of pernicious political maneuvering, the contrast between perception and reality is all the more stark.