Smokers in New Jersey can get COVID-19 vaccine before teachers, general public

Originally published at: https://boingboing.net/2021/01/14/smokers-in-new-jersey-can-get-covid-19-vaccine-before-teachers-general-public.html

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Good.
It should be based on risk, not punitive. Smokers and prisoners, get in line!

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This would make a good TNG episode

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It seems like this fine parsing of eligibility is mostly just acting to confuse and slow vaccine distribution. I’d like to see a model where they completely open it up coupled with aggressive outreach and assistance to vulnerable and marginalized communities. The current approach seems like a bureaucratic and logistical nightmare.

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Here is the CDC list of all the underlying conditions that may get you in line ahead of teachers and just about everyone else:

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Mmmm - so… assuming the actual health risk of dying is a significant increase in smokers, I guess they should be ahead of others who are at less risk. Even if they “did it to themselves”. You can say that about many if not most ailments people have.

In unrelated news, teachers in New Jersey take to smoking in unprecedented numbers.

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Risk is hard to qualify objectively and allowing smokers to get the vaccine before anyone else incentivizes bad behavior.

In the very least it puts doctors in a position where they may have to decide which patients are telling the truth about being smokers and which are just claiming to be smokers so they can cut in line for the vaccine.

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Well, thing is, the supply is super limited. If it’s just opened up first come first served, then a bunch of rich fuckwads will just buy up all the doses.

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Smokers made bad life choices. I hope every one of them quits, even if it takes them a thousand attempts. But they don’t deserve to die (even if they statistically are likely to die sooner than a non-smoker).

We should prioritize vaccines for people who are most likely to end up in a hospital if they get sick. Asthma, Emphysema, COPD, and many other conditions are very high risk for complications around COVID-19. And it should be no big surprise that smokers are the biggest group with respiratory illness.

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It should be distributed by health departments cost-free. I don’t see any reason to allow private individuals to purchase doses.

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I’m getting used to thinking of alcoholism or heroin addiction as a ‘disease’ rather than ‘bad behavior’. Given that nicotine is as addictive (or more addictive) than those other two, we probably need to stop thinking of smokers as self-harming idiots and treat smoking like the public health issue that it is.

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And that is why this decision makes sense. If the moralists got their own way we would end up with full hospitals turning away people, unless they want to introduce death panels or something.

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There are two types of risk being weighed here: risk of death and risk of infection. Smokers fall into the former, teachers fall into the latter. If you’re at high risk of complications (a smoker) but otherwise at low risk for contacting the disease in the first place I don’t believe priority access makes sense.

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The problem is this is a serial event. They can’t fly airplanes over population to “gas” them with Vaccine. It hasto ge done armby arm.

So somebody has to be first, and every interest group is lobbying to be early.

This isn’t just about smokers, look at the list.

Everytime a group is proposed to get on the list early, there is good reason, and yet a case can be made for other groups to be more important.

The most important thing is to ensure the vaccine flows fast enlug, and the process of getting it into arms is rapid.

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The problem with distributing the vaccine based on risk is that once you get beyond a few easily verified criteria like “are you a registered healthcare worker” or “do you live in an assisted living facility” or “are you over age X” then it starts to get messy really fast, leading to situations where distribution gets slowed down by the process of figuring out who qualifies and who doesn’t.

For example, do we count a person who just took up occasional smoking the same way we count a lifelong smoker who has lung disease? What about former smokers? What about people who claim to be smokers just to cut in line? Who ends up being the person making these judgments, and how do they do it without introducing further bureaucracy and delay into the system?

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Agreed. It really isn’t enough of a cultural meme how means-testing can reach a point of diminishing returns and become costly and destructive at a certain point (I mean, Conservatives know, and weaponize accordingly…). We need some kind of catchy “A stitch in time” rhyme or folksy “boy who cried wolf” fable to get this into the collective psyche. I mean, “provide services to all, then recoup the cost from those with sufficient means via taxation” is accurate but insufficiently catchy…

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Or we can prioritize them for people who are most likely to be infected due to the essential job they selflessly continue to perform. I think health care workers and teachers that are required to work in person with students should be vaccinated ahead of smokers.

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That’s not really the right way to go about it. Now health care works, due to their high exposure levels and large numbers of healthcare workers exposed, are frequently ending up in the hospital. That’s an argument they should get a vaccine first (and they have).

It’s not clear that otherwise healthy teachers are likely to experience a high level of exposure that a healthcare worker does. Being in a room with children is not the same as washing a patient.

But admittedly there isn’t a lot of data one way or the other. It would be prudent to include teachers on a second or third wave of vaccines. In line after the elderly and chronically ill (for reasons I stated previously). Second or third wave is depending on supply and logistics of delivery.

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I’m not telling you what should happen. I’m telling you what would absolutely happen if you just made the vaccibe generally available to anyone who can afford.

Just to clarify: public school teachers are exposed to large groups of children, all day, indoors. Children are known to be frequent asymptomatic carriers of the Corona virus. For that reason many public schools this year started keeping children inside during recess & lunch, rather than letting them interact on the playground. The teachers who supervise those lunches are exposed to large groups of maskless children eating, talking, laughing & shouting, indoors, often in badly-ventilated rooms, in winter with windows closed. Arts, P.E., & other specialty teachers, who used to rotate from classroom to classroom, are now assigned to one room with multiple groups of children rotating through it, including for their recess & break times. Teachers may not be in as much danger as first responders are but they are definitely at high risk, to the extent that many teachers quit rather than put themselves & their families in jeopardy. If we want schools to re-open & stay open we need to protect teachers first.

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