There’s a real-time experiment in medical ethics and triage playing out right now between us and our sister state to the south, Oregon.
At its core is an uncomfortable question that nobody wants to fall on the wrong side of: Who really is essential in a society?
So who’s up next?
When deciding who’s next in line for the coronavirus vaccines, Washington state, as you probably could have guessed, is like Dr. Science. The people prioritized here for the next round of shots, seniors age 65 and over, are the ones who are mathematically the most at risk of death. So Washington state is following pretty much the broad guidelines as laid out by medical ethicists for the federal government.
Oregon went more with its gut. Oregon’s governor, Kate Brown, decided to put K-12 teachers ahead of 65-and-over seniors in the queue — and also ahead of most other essential workers, such as grocery clerks or farmworkers.
The reason, she said, is that the learning loss from closed schools is crippling a generation of students, especially the ones who were already behind, which makes getting teachers vaccinated of paramount societal importance. She tearfully cited “families where 12- and 13-year-olds are attempting suicide” due to social isolation.
“If we were to vaccinate every Oregon senior first, the unfortunate and harsh reality is that many of our educators would not get vaccinated this school year and Oregon kids would continue to suffer,” she said after coming under withering attack last week. “If we flip that, and prioritize the needs of Oregon kids, it puts a two-week delay on beginning vaccinations for seniors who live independently.”
Medical ethicists are slamming Oregon for this, arguing, bluntly, that it will kill people. About 80% of COVID-19’s 425,000 U.S. deaths were among people 65 and older.
Also not thrilled: some of the state’s seniors.
“The thing that is so upsetting to me is that seniors don’t matter, the elderly don’t matter,” one 75-year-old in Hood River told The Associated Press. “It’s painful to hear that implication.”
Our governor, Jay Inslee, echoed that on Tuesday, when he emphatically rejected moving teachers up the line here in Washington.
“I just do not believe that 25-year-old teachers think they should get in line ahead of their 80-year-old grandparents,” Inslee said. “I think if you ask teachers, they’ll tell you they agree.”
It’s an intense debate, with one governor tearing up and another pounding his points. But who, if either, is right?
Inslee’s definitely got the life and death statistics on his side. The problem is that Washington is currently set to receive only about 116,000 doses of the vaccines per week. There are 1.7 million people ahead of teachers in the line, Inslee said. So that comes out to 15 weeks of vaccinating, just for the first shots of the people ahead of teachers in the line.
If that rate holds, it means we won’t get around to teachers until school is gone for the year.
Oregon argues that teachers are a pretty small group, comparatively, even as they are vital to a million kids. In Washington state, we have 55,000 public K-12 teachers, with about 150,000 school employees total (including bus drivers, custodians, cafeteria staff and the rest). So we could theoretically give all the teachers their first shots in only a couple of days, and cover all the school employees in about a week and half.
That’s what Oregon aims to do, and then it plans to reopen its schools in about a month.
The debate is complicated by the conflicting findings around the danger of coronavirus in schools. Example: In America, the Centers for Disease Control and Prevention just came out with a study finding there is relatively little coronavirus spread in schools, if precautions are in place. While in Europe, scientists have begun finding the opposite, and schools have been forced to shutter again in the U.K., Germany, Austria and elsewhere, the Wall Street Journal reported.
Bottom line: Conflicts like what happened in Bellevue schools this past week, with some schools reopening but teachers balking and even walking out, are going to happen again in other districts. Plus that was just for grades K-2; we also need to get the other 10 grades open, too. It would sure be nice to have the vaccine in the mix to try to help save a lost school year.
When I wrote about this in December, I suggested we hold a “teacher vaccination day,” but I hadn’t thought of the line-cutting problem. I was surprised how many seniors wrote in not to protest, but to say they’d gladly give up their spots in line, especially if it’s only for a week or two.
“They are front line workers and need to be protected,” wrote one. “I am 71 and haven’t had a proper hug in a very long time, but would definitely step aside for teachers to get vaccinated!”
So maybe that’s a possible answer to this medical triage dilemma: Let people donate their vaccinations.
It’d be kind of like giving a kidney. When you register, you could donate your appointment to the schools, or to the farmworkers or to someone else who is a looong way back in line but is nevertheless essential.
That’s a system that would answer the “who’s important” question too. Only it would be more people-powered, and somewhere between Washington’s strict science and Oregon’s going with its gut — which is probably about where we want to be.