The antidote page for all those chickens

Written By: - Date published: 3:15 pm, August 19th, 2021 - 32 comments
Categories: covid-19, health, Media, Politics, uncategorized - Tags:

COVID-19: Vaccine data

This is the page that I read at least once a week. With a clean brevity it gives me almost all of the strategic summary information about the progress of the vaccinations in NZ. Even the title is clean and clear.

It is the perfect antidote for anyone who has no idea about how real projects get completed and who keeps on wanting to change course mid-stream without any understanding about consequences.

This appears to be many of our chicken little self-assessed opinion makers and ineffectual political political figures. As usual, Mike Hosking comes to mind when looking at the looking at that phrase. But he isn’t unique.

Just to give context about where I’m coming from… In the distant past I was an army medic. After doing a science degrees and working in management, I did a MBA in operations management, ie how to make sure that systems and processes work efficiently. Over decades I have mostly worked with developing long projects, some small and some large, and then delivering them. I’m a computer programmer by profession.

Unlike some journalists, professional opinion makers, and many politicians, I focus on the process and progress towards project delivery. Panic and imitating changing direction without considering the long-term effects on project delivery like some fools have been urging over the last year simply won’t work in a project like our vaccination program. What works is making a plan and putting it up so anyone can see what is happening. That is my favourite New Zealand page for most of this year, I’m only surprised that somebodies made it and kept it updated.

About the only criticism that I can make about this particular page is that the currently what I consider to be the most important and crucial pieces of information about the logistics situation aren’t further towards the top. But that is a personal quibble. I understand that most people don’t even think about that – like some politicians .

As was apparent back in early July the real constraint is the amount of vaccine that we have to inject. This is reflected in the central stock of the vaccine. With the Pfizer vaccine we are using, we need to store it at very low temperatures centrally for any length of time requiring specialised equipment.

This change means that the refrigerated (2°C to 8°C) shelf life of an unopened vial of Comirnaty vaccine is extended from 5 days to 31 days.

Once at 2°C to 8°C, the vial cannot be returned to the freezer and must be disposed of after 31 days or on the vial’s expiration date (whichever happens first).

This change will take effect immediately for any vaccine that DHBs or vaccination clinics have in stock, unless the vial’s expiry date has passed. Vaccine dispatched from Wednesday 2 June will include updated labelling to reflect the new storage conditions.

The vaccine still needs to be kept at ultra-low temperatures (-90°C to -60°C) in the longer term, for up to six months.

Medsafe: Comirnaty (Pfizer COVID-19 vaccine) storage conditions updated

This is reflected in the shipments incoming to NZ and the central stock on hand. This was phased in to ensure that we don’t have vaccines being wasted due to a lack of trained staff or a lack of facilities.

Vaccine available for distribution at week end
Vaccine available for distribution is stock (in doses) held at central warehouses. It does not include stock in transit or available at sites ready for use.

Of course the speed at which the stock can be consumed is directly related to the number of people trained to inject Comirnaty. The other logistic graph is the needlers… What is obvious in this graph is the slow build up of trained staff both to do the initial front-line injections, and then to train the next cohort. This means that there can be shifts and time off – and you don’t have tired people jabbing needles into your arm.

The target here is the current period when the number of people being vaccinated is going to increase rapidly. We have trained staff to go into the number of new sites for a mass vaccination program.

Trained vaccinators and active vaccinators

Trained vaccinators are individuals who have completed the COVID-19 training. Many trained people are only able to offer a small number of hours to the COVID-19 vaccination programme.

Active vaccinators are trained individuals who are actively vaccinating. The number of active vaccinators does not reflect the hours worked vaccinating. For example, one vaccinator may work 40 hours in a week at one DHB and will show as 1 vaccinator in the headcount. In another DHB, 4 vaccinators may work 10 hours each (total 40 hours), but will show as 4 vaccinators in the headcount for that week.

Both counts of trained and active vaccinators are cumulative. The difference between the two is due to a number of factors. This includes: individuals being trained in anticipation of future sites being opened (the largest factor); rostering; leave or non-availability; local health priorities; sites opening and closing.

I like that clear description of what a vaccinator is. It makes it apparent that there is capacity to inject as we get stock in the country. There has been a lot of preparation to make sure that when the vaccine has arrived and the places found to inject, that there will people trained to do the work.

The results are obvious in the summary graph on the page. We’re stocked up with people and vaccines, and teh plan is to have a exponential growth in vaccinations.

Cumulative vaccinations

Production plan figures are the volumes agreed with DHBs and national providers for expected vaccinations. These figures have been matched with expected supply. Detailed plans are available in the Excel file at the bottom of this page.
The Stock received figures are the cumulative supply of doses to date.

Here again you can see how close we were to running out of vaccine stock in early July. That the phased ramp up of vaccinations is proceeding roughly to that what was planned. Ramping up a vaccination plan like this isn’t as easy as some people seem to believe. You don’t have to look too far into history to find examples of just how totally screwed some of the logistics can get. If you compare this graph with the daily count, you can see just how close it was to going off plan due to a shortage of stock. The number of vaccinations stopped increasing as the initial target groups were largely completed and the planned start for the mass vaccinations was waiting on incoming stock.

Vaccinations by day

This chart shows the count of vaccinations administered on a given day from the COVID-19 Immunisation Register. Note some records are entered in the register at a later date than the immunisation was received. This means that the figures for a given date may move for some time after that date.

That ramp up means after stock arrived, that there was a smooth escalation of the capacity.

I could go into the details about targeting, however I’d have to say that also shows pretty good organisation to my eye. I’m sure that organisational simpletons would want all of a one group to be done before the next, but people don’t work that way unless you have a lash, coercion, and guards.

But the effectiveness of using a scarce and hard to obtain resource at the end of the process is measured by a single figure. As at the 25th of July, the estimate of usage is 99.5% with a 0.5% wastage. Bearing in mind that the vaccine we are using requires extraordinary levels of cooling and tight deadlines for use after warming, then this is a very low level of wastage.

I do like this page. Clean summary information with a moderate amount of drill down data, all that I need to see that the vaccination program is planned pretty well and progressing according to the plan.

The sit also provides a spreadsheet of more summary information. It also provides the link to known Adverse events following immunisation (AEFI).

For those who care, you can see the evolution of this page in the Internet Archive.

The detail lacking initial version back in early April rapidly grew into a medium-term plan and a projected ideal model by the end of April. The plan diverged from the model over time as reality bit in. Probably mostly from experience of delivery, with what the DHBs about what they could actually deliver on the ground for sites, and what the delivery schedules were from Pfizer. But the plan isn’t too far off the model back in April. Not a bad effort for such a large program.

All the way through last year and this year we have had idiotic panicked Chicken Littles, who clearly were just incapable of reading a few simple graphs. They kept wanting others (presumably vastly more competent than they were) to do magic. Careful planning and execution to be thrown out and replaced with the wishes of idiots wanting to take the tiller – and running us into the rocks.

Thankfully they were ignored.

32 comments on “The antidote page for all those chickens ”

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  1. Abba Lerner 1
    19 August 2021 at 3:50 pm

    I wonder if spreading out the second dose to 12 weeks instead of 3 weeks would have helped with the roll out and production.

    [Changed user name to previously approved one. Please stick to one user name and e-mail address]

  2. lprent 2
    19 August 2021 at 5:13 pm

    Not much. The stock limitations up to mid-July meant that groups 1 & 2 were the priority. Those where the two groups that needed to have a second dose as early as was feasible – one because of their potential repeated exposure to the virus, and the other because their immune systems needed an early boost because of the relatively weakened immune system.

    The numbers in the other two groups only kicked in from late may and early June – after the majority of groups 1 & 2 had done a first dose and were doing waiting to do their second dose.

    The group 3 & 4 were either in a immune depressed position for things like surgery, or popping in on a ad-hoc basis. And mostly doing their first dose.

    As I say – read the graphs. They answer most questions.

    BTW: The extra response at 8-12 weeks is mainly useful if a good response happens on the first jab – which doesn't happen as much in people with reduced immune responses.

    The response to a second jab is something at 3 weeks is something like 80% of the 12 week response. If you're at a hospital or a MIQ, then getting a smaller but still massive boost from a second jab at 3 weeks is worth more than slightly better response at 12 weeks, That is because you have 9 weeks of a higher probability that the ambiant viral load will infect you.

    That should be pretty obvious just thinking it as a simple risk assessment.

    Basically for the country the most risky places are at our 'border', or shared communities. The effective costs of having people chewing up ICU beds causes real issues because it displaces non-covid patients from those beds. Not to mention that having elderly dying in droves at old folks homes is just not a good thing.

  3. Gypsy 3
    19 August 2021 at 7:11 pm

    Yesterday I found out I was a close contact to two positive Covid cases.

    Today I spent 4 hours queuing at the New Lynn testing centre, only to be told I (along with countless others) would not get tested today. I am hearing of similar events across Auckland, and of people waiting up to 8 hours for a test.

    The MoH have known for months that an outbreak was possible, even likely. And yes I understand there are limited resources, so my beef is not with not getting the test. My complaint is that in all these months the Ministry have not developed any kind of booking or communication system, so that people can get tested without waiting for so long.

    This is the 20th century FFS.

    Edits for links
    https://www.newshub.co.nz/home/new-zealand/2021/08/covid-19-avondale-college-student-turned-back-after-three-hour-wait-to-be-tested-as-aucklanders-brace-for-another-long-day-of-queues.html
    https://www.stuff.co.nz/national/health/coronavirus/300385346/covid19-long-queues-at-aucklands-testing-centres-after-community-cases
    https://www.nzherald.co.nz/nz/covid-19-coronavirus-delta-outbreak-passion-bakery-owner-a-location-of-interest-turned-away-at-northcote-after-waiting-all-day-for-a-test/MZCELSJJENYJTXOC2GUJ5BOJAM/

    • mickysavage 3.1
      19 August 2021 at 8:19 pm

      I received the text, booked and had my first dose within 24 hours. I appreciate the stress. But to catastrophise the system because of an individual experience is not the way to approach it.

      • Andre 3.1.1
        19 August 2021 at 8:24 pm

        Gypsy's point is about testing, not vaccination. The point about there being value in some sort of priority system for known close contacts strikes me as fair.

        • McFlock 3.1.1.1
          19 August 2021 at 11:24 pm

          and a booking system for tests.

          Having people out in public for hours (maybe multiple times) because they're close contacts and need a test that takes only a couple of minutes to confirm ID and administer the swab is a problem.

          • Gypsy 3.1.1.1.1
            20 August 2021 at 10:35 am

            Before arriving at Balmoral this morning, I drove past the St Lukes testing centre. Alongside the long line of cars was a line of people standing waiting. There wasn't a lot of social distancing, although most people were wearing masks. I couldn't help thinking it looked like a petri dish.

    • Treetop 3.2
      19 August 2021 at 10:16 pm

      I would like to know if any modelling was done for testing on the ratio of population to testers?

      The locations of interest some venues are huge, now 3 colleges. Wise to have given Avondale College a 14 day lockdown. I expect the same to occur for Northcote and Lynfield College.

    • Ad 3.3
      20 August 2021 at 9:16 am

      Same experience in my house Gypsy.

      My partner gave up queueing in New Lynn yesterday, and then got up and out of the house at 7 to queue in Henderson, and wait until it opened at 8.30am.

      My brother gets to do 12-hour shifts making steel rebar in New Plymouth and their teams work 24-7; I'm not sure what's stopping 3 teams testing in a pandemic going 24-7 as well.

  4. Matiri 4
    19 August 2021 at 7:13 pm

    Another part of NZ's Covid response 'project' that is really impressive is ESR – the health intelligence that they have been providing on genome sequencing for this latest outbreak is outstanding.
    https://www.esr.cri.nz/our-expertise/covid-19-response/

  5. Patricia Bremner 5
    19 August 2021 at 7:18 pm

    An excellent and informative item Thanks

    Yes going to the vaccine roll out site is very good for the nerves. All the facts and figures without the hype, but your presentation made it even more clear. The sky definitely is not falling. … Love your Chicken Little by the way.

  6. peter sim 6
    19 August 2021 at 7:41 pm

    My first nomination for "chicken little of the year" Would be D Seymour of act fame.

    Caught a clip of him on TV1 news this evening mouthing off how our government was not doing enough vaccination.

    He compared NZ unfavourably with Australia!!!

    Sigh.

  7. Pete 7
    19 August 2021 at 9:57 pm

    We need the gormless like Chris Bishop saying, "We just about ran out of vaccine" as if the world had ended. (There are plenty of gormless in his audience.)

    It's all so, "We won the World Cup Cricket but the other team just about beat us. How terrible."

  8. Treetop 8
    19 August 2021 at 10:06 pm

    Hindsight is a wonderful thing. My strategy would have been targeting Auckland at every age band for vaccination due to the population.

    For every where else I would have done what is being done and made all frontline workers a priority.

  9. georgecom 9
    19 August 2021 at 11:56 pm

    2 names that have cropped up, Chris Bishop and David Seymour. Yup, some 'chicken little' squawks have come out of their mouths in previous months. And on a regular occasion uninformed, ill informed or ignorant statements from arm chair experts how the vaccine roll out is a catastrophe and health leaders are incompetent. It seems incredibly simple in their world to wave some magic wand and change everything. From the day NZ made the decision to go with the Pfizer vaccine the die was cast. We chose to go with what was shown to be the most effective vaccine and had to join the queue once we decided on more than the 1.5 million doses we originally purchased.

    I posed several questions several times over a number of months on several platforms for the arm chair experts, as well as Bishop/Seymour-esque type politicians. 1. what vaccines would they want NZ to purchase 2. what price would they think was acceptable and 3. how would they get us to the front of the queue for that purchase. To date pretty much silence on those points. Lots of moaning and whining, little actual detail.

    One person I did see suggested NZ should not wait for Pfizer vaccines and instead purchase Sinovac Coronavac as it was '90 plus % effective against the virus'. A little bit of knowledge trumps ignorance thats true, but it can be also be a dangerous thing.

    Sinovac isn't 90% plus effective against the virus in the same way as Pfizer is (or was until Delta anyway). Pfizer is somewhere around 90% effective at stopping someone getting the Wuhan strain of the virus. Sinovac around 50-60% depending on what studies you read. Sinovac IS around 80-90% effective at keeping people out of hospital who have the virus and at the higher end of preventing death. Pfizer is I think a little better still. So no, no thanks, I am not really keen on NZ buying large stocks of Sinovac. If it was the only thing on offer, sure, I would take it. But it's not.

    So if some moron person is moaning like heck because they missed a booking for their Pfizer jab the last couple of days, or someone is whinging about the time it has taken to get a jab, or is whining about some other related type thing, why not be proactive. Hop on a plane and fly to China and get a dose of Sinovac, or the Minhai vaccine, or the Cansino Vaccine. Or try your luck in Iran with their newly approved vaccine. Or head off to Russia and get a shot of Epivaccorona and then try to find any hard and uncontestable evidence of how effective that vaccine is. Or fly to India and hang around a few days until the Zydus Cadilla vaccine is approved for emergency use there. Or maybe do some reading online about vaccines and vaccine supply and stop being so ignorant.

    • I Feel Love 9.1
      20 August 2021 at 12:57 pm

      I had my first jab cancelled yesterday, totally my fault is I could have booked it a week earlier, but wanted it to fit into my plans. They're going to ring me to book my next one, this time I'll take earliest possible app. No moaning from me!

  10. Simbit 10
    20 August 2021 at 5:03 am

    Why feck is NZ vaxing Europeans! 😉

  11. dv 11
    20 August 2021 at 7:47 am

    Covid-19: Reports of vaccine online booking confusion as people race to get jabs

    https://www.stuff.co.nz/national/health/coronavirus/126119968/covid19-reports-of-vaccine-online-booking-confusion-as-people-race-to-get-jabs

    I rebooked on site took 5 mins on wed

    Then got a call to say my original appointment was on. The procedure was smooth and easy.

    Came home and cancelled the new appointment in 5 mins. (Only issue was I tried to put my phon no instead of email first time, and didn't know me DUH)

  12. Jenny how to get there 12
    20 August 2021 at 7:52 am

    This country has a lot to be proud of.

    Thanks for this Lprent.

    Wonderful stuff.

    Here’s another little data list to cheer us up as well, as a gift in return.

    • ianmac 12.1
      20 August 2021 at 5:42 pm

      Yes Jenny. Thanks for the clarity LPrent.

      • Jenny how to get there 12.1.1
        21 August 2021 at 7:13 am

        Reasons to be cheerful part 4

        Can Delta be beaten?

        The answer is yes.

        Again Taiwan is the leader;

        The Delta variant can be beaten,…

        Charlie Mitchell – Aug 21 2021

        ….Taiwan has become renowned for its management of infectious diseases, including Covid-19.

        Similar to New Zealand, Taiwan pursued an elimination strategy, which successfully kept the virus out for long stretches of time…..

        ….in early May, an outbreak formed, originating from an airport worker. It was the Alpha variant, not Delta – but cases rapidly rose, and the self-governing territory had its first major outbreak, which many suggested was the result of complacency.

        It was during this outbreak, on June 26, that Delta appeared in the community, too.

        While some feared the worst – vaccination rates in Taiwan at the time were remarkably low, with only 0.1 per cent of the population fully vaccinated– the outbreak has, for now, been contained.

        Two weeks after it was detected, the Delta cluster appears to have been stamped down, and vaccination rates are increasing rapidly…..

        https://www.stuff.co.nz/national/health/coronavirus/300387254/covid19-the-delta-variant-can-be-beaten-but-its-also-defeated-some-countries-previously-successful-at-fighting-off-coronavirus

        Reasons to be cheerful part 5

        Compared to Taiwan that had a vaccination level of 0.1% of the population when Delta struck, New Zealand has a current level of vaccination of over 30% which gives us a more than even chance of stamping out this outbreak.

        If you are not an essential worker, stay home, leave only to do the shopping or go to the Dr. or vaccination centre. If you are an essential worker stick to your bubble, as much as possible.

        And keep your fingers crossed. Because luck too, will play a role.

        But never forget, 'Luck favours the bold'.

        And our leaders have displayed remarkable boldness in fronting to this crisis.