Covid-19 vaccines are by far the hottest topic of conversation today as millions (over 7 to be exact) of people want the vaccines in New York State, yet to date we have received statewide about 1.7 million, depending on the source, when it comes to first doses (I shy away from the complicated conversation about second dose as that is a whole other issue).  Regardless the gap is about 5 million people short and therefore we have a COVID-19 hunger games playing out throughout New York State (along with all of the other states).

This past week the Governor announced now that the counties will have discretion in certain areas regarding who to include for vaccination eligibility. This was a step in the right direction by the Executive as the counties have been clamoring for more decision making.  However, this may fall into the category of “be careful for what you ask for” as now the county executives or county legislatures have difficult decisions to make and inevitably there will those who will be happy (who you will not hear from) and those that will not (who you will hear from).

Keep in mind that starting at the federal level and followed at the state level during the months of December and January, the issue quickly became complicated and confusing for many as eligibility pools expanded but the initial populations did not have full access.  At the federal level, the focus was correctly placed on nursing home patients, the staff, and front line health care workers.  To date, some health care workers are still waiting and that was at a pool of over 2 million people.  The next step increased eligibility to those age 75 and above expanded the pool to 4 million people. Subsequently, a few weeks ago, the former President announced an expansion those age 65 and older, and New York State followed suit pushing us over the 7 million mark.  This week, the Governor allowed counties to consider including restaurant workers and Uber/Lyft/Taxi drivers which expands the number, but I have not heard any estimate yet on how many will be included.

I agree that many in the restaurant industry as well as ridesharing drivers are absolutely individuals on the front line and I share those concerns. Helping our small businesses survive has been one of my priorities throughout this pandemic. However, a population that has been sidelined are those who are under 65 and who live with pre-existing conditions.  This population is a large one and as the data and science indicates, these are individuals who are very prone to having more complications to COVID than otherwise healthy individuals.  This I believe is unfair to those who consistently struggle with lifelong illnesses and now it will depend on what county you live in whether or when you move up the list.

I give Dan McCoy, the Albany County Executive, credit for being first out of the box with the tough decision.  He is focusing attention on those with pre-existing conditions which is the appropriate call and is consistent with history of pandemic disease management.  One only needs to look back to H1N1 where the focus was on protecting those who had the greatest risk of harm from the virus, which was children.  Today with COVID, the opposite appears to be true and I give Dan credit for making sure those who are most prone to complications are higher in the priority list. It is a difficult decision and not meant to minimize the concerns that many face. Prioritization is necessary due to a lack of supply and by allowing those who may need more medical care than others or may suffer greater complications, we keep our ICU bed availability numbers higher, which benefits everyone. This is not saying that one group is more important than another or that one deserves it more, it is looking at what we know so far about risk and making an educated decision as to how we control this pandemic so that we all are safer and we control spread. These decisions are triaging the issue of prioritized vaccine distribution that became complicated as decision-makers expanded eligibility pools.