He’s making a list

Fluid might be best right now

The state of Arkansas says there will be three phases of the vaccine rollout. No matter what you think, or may read. There are only three phases. Even if the first one comes in three parts.

Phase 1-A started this week. Shots for the covid-19 vaccine (thank you, Pfizer) are being given to healthcare workers, bless them each one. Working in a hospital is tough work in normal times; these people should be first in line. Also in this earliest of the early phase, long-term care residents — those living in nursing homes — and employees of such will get the vaccine, too. Phase 1-B: Essential workers. Phase 1-C: At-risk folks, older people and “people who reside in congregate settings,” which we assume means prisons.

Phase 2 will begin when the general population gets in line, down the road.

Phase 3 will begin when everything is close to normal and covid-19 vaccinations are routine.

The governor of Arkansas and his people say the plan is “fluid,” and it needs to be. No point in tying somebody’s hands because a sub-paragraph didn’t include some occupation specifically. Fluid is best. Fluid is necessary. Fluid is life-saving.

And Arkansas seems more than a bit lucky when it comes to officials looking over our health-care plans and practices. Already, one top state official — Dr. Nate Smith — has been called up to the majors. He’s now a deputy director at the Centers for Disease Control. The physician who replaced him — Dr. Jose Romero — is chairman of the CDC’s Advisory Committee for Immunization Practices, and appears in national news stories frequently. And the division chief of internal medicine at UAMS — Dr. Robert Hopkins — is chairman of the National Vaccine Advisory Committee. It is apparent that Arkansas is punching above its weight class in health care, and Gov. Asa Hutchinson has some of the best minds at his disposal.

But — you knew there’d be a but — we do wonder about a couple of things:

“Essential worker” is a broad category. Some news articles estimate that a third of all American workers could be considered essential by government definitions. Teachers are essential. Workers processing chicken and beef, and the grocers that sell meat by the pound, are essential. Truck drivers are essential. The guy who tests your natural gas line is essential. The government worker who inspects that work is essential. There could be 100 million people in this country that meet that definition. So why are they ahead in the line before the elderly, which we know are the most at-risk among the demographics?

We also know that prisons are problem areas among the incarcerated and the staff, and have been since March. And people with chronic health conditions are said to be most at-risk, with the elderly, for serious complications due to covid-19, including death. And both groups are included in phase 1-C. It seems that they should be moved up in line.

Given the health-care expertise in Arkansas state government, we have to assume there are good answers to these questions. We just haven’t heard them yet, or may not understand them. That, Gentle Reader, is always a possibility.

There is another reason for optimism, and it was a paragraph included in a fact sheet posted by the state Health Department earlier this week. Yes, an assurance found in an updated fact sheet from a government agency. Mainly it assured because one has to assume a lot of people signed off on the message:

“There are no definite dates for transition between phases, or even within the separate portions of a phase, as the transition depends on vaccine supply and whether those in the current phase have been sufficiently vaccinated.”

So, again, everything is fluid, including the phases. In this matter, fluid is best. Fluid is necessary. Fluid is life-saving.