More than half a million people have signed up for a new service Dr. B in an effort to get a COVID-19 vaccine – and reduce the number of doses that can end up in the bin. Led by Cyrus Massoumi, founder of ZocDoc, Dr. B a website that aims to function as a kind of emergency alarm system for thawed coronavirus vaccines, which usually needs to be injected within six hours of being thawed.
“This vaccine is now the scarcest resource on earth,” says Massoumi. “We were concerned about the fact that a lot of the vaccine was shuffling at the last minute at the end of the day.”
Prolonged relaxation of conventional healthcare, missed appointments has become an extremely important issue for the coronavirus vaccine. Massoumi estimates that as much as 20-30 percent of the vaccine appointments are missed, leaving a thawed vaccination dose that needs to be used within six hours or lost permanently. State reports indicate that few of the doses may lapse. Vaccination sites rather distribute it to employees or whoever is outside. But this confusion has led to chaotic lines and a haphazard approach to priority lists – something Massoumi delicately describes as ‘suboptimal’.
Dr. B is designed to serve as a kind of assistance list for those situations, providing providers with an easy way to call in willing patients within hours. More than half a million people in the US have signed up to be on the waiting list. They each give their zip code and fill out a complete version of the questionnaire of their state. (Each state has a slightly different list of who is eligible for vaccines. In New York, the first level, 1a, are people older than 65 or with co-morbidities. The next level, 1b, contains employees of grocery stores and other essential workers, and so on.)
When a service provider ends up with thawed doses, Dr B sends out texts to the participants of nearby postal codes, and prioritizes them according to the list of the State Health Department. Once an SMS has been sent, a participant has fifteen minutes to confirm that they can go to the provider, then two hours to reach the venue and get a chance. If you say you can not do it, you’re at the back of the line (within your priority group).
The system is counting on providers to schedule a follow-up admission, which still requires both the Moderna and Pfizer / BioNTech vaccinations, but the hope is that it is merely a significant improvement to get patients at the door for their first dose.
This is not the first project aimed at compiling a support list for coronavirus vaccines, but it is fast becoming the largest, absorb the smaller vaccination assistance project in February. What is most impressive is how fast the effort has grown. Dr. B’s waiting list is still limited to America and currently has more than half a million people, compared to 300,000 just two weeks ago.
Providers are coming on board more slowly, as each needs to be checked to make sure it is legal, but there are already two sites that provide photos through the system – in Little Rock, Arkansas and Queens, New York. The company will not say how many doses were dispensed by the sites, but it does say that warnings were sent every day that the two test areas were open, indicating that at least a handful were administered through the system. More than 200 other providers are currently in the pipeline, spanning 30 states.
Massoumi says reporting suppliers is still the biggest bottleneck, but it’s an impressive record for what is still mostly volunteer work. There is no plan to earn the system, and many of the hosting and other back-end services have been donated by companies like Amazon, Twilio and others. Some staff members are loaned to the project through their usual work; others are paid out of Massoumi’s pocket. There is no clear sign of what will happen to the project after COVID-19 is defeated.
“We’re trying to get it going as quickly as possible,” Massoumi said. “We have patients and provider sites that want to use it, and we just want to make sure it’s ready for the first time.”
As with any vaccination issue, there are concerns about who will gain access and who will not. Black and Latino communities lagged behind in vaccination rates, a reminder long-standing patterns of discrimination in US health care. The new standby list runs the risk of exacerbating the inequalities: the nature of the project means that it will only work for patients with phones that can be dropped immediately and go to a vaccination site.
The problem is not lost on medical ethicists. Gabriel Lázaro-Muñoz, a professor at Baylor’s Center for Medical Ethics and Health Policy, said The edge he put the effort behind Dr. B applauded, but he is concerned that the project could exacerbate inequality in the distribution of vaccines.
‘As dr. B sending out a text is most people who are able to give up what they do and get the vaccine, people who have access to emergency care, people with cars, people who are likely to get jobs easier than most populations who are under service, ”said Lázaro-Muñoz. “They are therefore trying to address the problem, but it is also exacerbating the stock issue.”
Many of the solutions the team has tried address only parts of the broader problem. The project has already launched a Spanish version of the website and is in talks with Uber and Lyft to offer free rides in connection with the shots – an attempt that will help the transport problem significantly.
But Massoumi believes that dr. B’s rope system will be fundamentally fairer than most states do, especially as more levels open up. Most state systems have focused on giving seniors and the vulnerable first access to the vaccine – but as more people become eligible for the opportunity, vulnerable patients will find themselves in a larger and larger pool of potential recipients. Under the current system, a first-degree patient who has been waiting for their chance will have no advantage over anyone else in an open-ended setting. Massoumi compares it to a plane boarding call, when a Group 1 passenger arriving late arrives in the same queue as all the other groups. But because dr. B contains information on the level of each person, the system can automatically send the most vulnerable patients to the front of the standby line – a kind of expression lane for late arrivals.
Behind it all, there is the steady rise of vaccinations. More than 20 percent of the U.S. population has received at least one dose of the vaccine at this time, and President Biden said he expects the government to provide enough doses for every adult in America by the end of May. Even small rates or spreads could lag behind in the coming months.
Dr. B’s plans are still limited by the suppliers’ willingness to use the system, which has limited them to the US implementation and locations where the scheduling system fails. But like any startup founder, Massoumi is not afraid to dream big, noting that the system they build does not prevent anything from being applied to doses that have not been thawed, or in other countries where the rollout is slower .
“It’s not just this country. The whole world will only be vaccinated in 2023, ”says Massoumi. “This is a global problem, both the pandemic and the scheduling problem, and what we are creating is a global solution.”