This morning New South Wales announced their worst day yet of the latest Covid-19 (Delta strain) outbreak. There were 319 new cases acquired locally, with 345 people in hospital, 56 in intensive care and 5 new deaths in the past 24hrs bringing the state’s total to 84.
Many parts of Sydney and parts of regional NSW are in lockdown, as well as the state of Victoria and parts QLD). The goal of these lockdowns is to restrict movement and break chains of transmission. This relies heavily on the general public obeying the public health orders to stay at home. The infections continue to grow in NSW, indicating that the current approach is failing.
As the days and weeks have rolled on, the NSW Premier Gladys Berejiklian and Minister for Health, Brad Hazzard and Chief Health Officer, Dr Kerry Chant have seemingly become accepting of the fact that we’re not going to reach the goal of reducing the daily transmission figures to zero. Instead, the policy seems to be focused entirely on vaccinating the population to at least 80% before contact tracers, hospitals and ICU beds are overwhelmed and more people die.
This is absolutely a race.
While many debate if even harsher restrictions like curfews should be applied or non-essential retail like Bunnings should be closed, the reality is, it seems the politicians have made up their mind, this is as severe as NSW restrictions get.
So given the mission of getting everyone vaccinated, before they let Covid-19 run through the community, let’s consider how best to achieve that.
In the past 18 months, Australia has become great at drive-through tests, with tens of thousands conducted every single day. What isn’t being leveraged is drive-through vaccinations and given their successful use internationally, it’s hard to understand why.
- The UK was the first in the world to deploy drive-through vaccinations back in December 2020.
- India started their drive-through vaccinations back in May this year, as did Canada.
- The Centers for Disease Control and Prevention (CDC) have a detailed page on considerations for planning curbside/drive-through vaccination clinics.
- Melbourne’s own Vaccine Education Centre also provides a plan to implement drive-through immunisation clinics.
While there are beginning to be mass-vaccination walk-in clinics, these are slow, far too slow to get the millions of vaccinations in people’s arms in the next month or two.
At our current rate, we’re unlikely to reach full vaccination (double dose) of 80% of each state and territory, before the end of 2021. Given the Delta strain is impacting children if we were to include them, the 80% target grows considerably, requiring millions of more jabs and likely move the end date well into 2022.
As someone who is 39, I was faced with a choice of waiting months for Pfizer, or seeing my GP before getting my first shot of AstraZeneca. I wanted it sooner rather than later, so opted for AZ (zero side effects). Between the discussion with my Doctor and the shot itself, it was basically a 45-minute process, much slower than the potential rapid delivery with a drive-through system.
How would this work?
The process should really be quite simple. The Government would find suitable locations like football fields, or large caparks (maybe Bunnings can be useful). There would need to be multiple lanes of traffic which are processed through multiple vaccination stations. Those stations need to have supply of vaccines available and refrigeration considerations need to be met, meaning this needs to be a powered site, likely with generator backups in the event of a power outage.
As drivers (and passengers from the same household) enter the drive-through vaccination center, there could be express lanes for those that have pre-completed the vaccination information and confirmed they have no pre-existing conditions that would really require a consultation with their doctor.
For those who haven’t registered, there could be signs with QR codes to scan, taking participants (up to 4 per car, 1 per window) to a web page to register and be informed about potential side effects.
With that information completed, the participant could receive a QR code to display to the nurse as they proceed to the vaccination station. The resulting QR code could be scanned by the administering nurse and the patient details could be transferred to their system, to trace who is receiving the dose, which could, in turn, be uploaded to their MyHealth digital record.
The actual vaccination would be as simple as rolling up your sleeve, rolling down your window and getting the jab. Something that could be done as rapidly as a couple of minutes for up to 4 people per car.
Post-vaccination, the car would then proceed to a parking bay for 15 minutes to ensure there are no side effects and the appropriate emergency services would need to be on hand in the event there was. The vast majority would then complete their time and return home without issue.
The Massachusetts Medical Society has a great diagram of how this could work.
The numbers
I imagine a setup where as many as 20 lanes could be set up, so we could potentially get a throughput of 80 people vaccinated every couple of minutes. Even at 5 minutes per car, we could see 12 batches of 20 lanes processed every hour, or 960 vaccinations per hour.
Imagine we have a serious vaccination campaign, where we leverage celebrities like movie and music stars (pay them if we have to), while also leveraging every business in the country to encourage employees and really ramp up vaccinations to 24 hours per day.
At a rate of 960 per hour, that’s 23,040 vaccinations per day.. or 161,280 per week and that’s just at a single site.
With a location and urgency like what we have in Sydney, we could easily see 10x of these drive-though vaccination hubs, stood up to help vaccinate the city of around 5.3 million people and more than 8.1 million across the state.
In the best-case scenario, we could be vaccinating a massive 1.61 Million per week (assuming supply is available).
Of course not every car would have 4 people in it, so imagine this new drive-through approach delivers a more conservative 1 Million extra doses, on top of existing efforts. Even at those levels, we really would have a chance at having all of NSW at a vaccination rate of more than 80% not by Christmas or New Years, but potentially by the end of September (accommodating for both doses).
Takeaway
What I want to express with this post, is that we shouldn’t give up, we shouldn’t accept that numbers will simply continue to rise and things are not out of our control. There are still plenty of options available to us and it’s time our politicians and health leaders pulled every lever available to them.
We can’t let Covid-19 run in our community or many, many people will die. We need to stop the spread and prevent severe illness by getting as many people vaccinated as fast as possible and our current approach is far too slow. Let’s put the foot on the accelerator, spend whatever it takes to get this done and we can say goodbye to lockdowns and return to something approaching normal once again.
