2021-03-17 BC

Vax Clinic Logistics

I escorted a friend to the clinic at Creekside Community Centre in Vancouver today. Here is what I learned about the logistics.

Yesterday, my friend escorted her slightly older husband to the same clinic, and she said there were far fewer people. Today, the line was much longer — in part because they were running about an hour behind.

The line extended outdoors. Today, it was a nice sunny day, but if it had been raining it would have been pretty miserable. I would guess that there were between 20 and 30 other people hanging around while we were outside.

In the line, I didn’t feel like people were maintaining 2m distance. More like 1m or 1.5m. This was in part because there just wasn’t enough room on the area which felt like it was inside the Community Centre grounds. There also were no “stand here” markers on the ground.

There was one greeter outside, and he was quite friendly, but he spent all of his time telling people that no, 1:15 was the time you were supposed to arrive, but your appointment is actually at 1:30, so you need to go to the back of the line over there.

I had expected to be surrounded by giddy, joyful people. Instead, I found myself surrounded by anxious, suspicious people. (“Hey, didn’t those people have a 1:40 appointment but cut in with the 1:20 people???”) This probably would have been much less of an issue if the line were moving quickly, the appointments were on time, and we didn’t have to stand.

Immediately inside the door to the community centre was a table with masks and hand sanitizer bottles. Everyone was asked to sanitize hands; if you were not wearing something that looked medical-grade (e.g. a cloth mask), they gave you a procedure mask and asked you to wear that).

Once we got inside, there was better distancing. There still were no “stand here” markers on the floor.

After about 10 minutes, we left the foyer and moved into the gym, where most of the action was. There were two sign-in tables — one on the left, one on the right, pick one — where they cross-checked your MSP number and your appointment time. I didn’t see anything which would have prevented you from giving your CareCard to someone else, who would then go to the table on the other side, but maybe they checked ID if you presented a CareCard which didn’t have a photo on it.

At the sign-in table, my friend was given a multi-layer form.

From there, we were guided by a person in a yellow vest to chairs and seated in order of our arrival. We waited.

There were 12 vaccination stations, though it seemed like an awfully high percentage of them were unstaffed and/or did not have any patients at any one time.

We were there after lunch, so maybe some of the vaccinators were off at lunch break. But I later noticed that the vaccinators cleaned each station quite thoroughly between patients, and they would also leave their table and go to the back corner to put a few needles into their tray. Back in the back corner, one guy was filling needles from a vial. That might have been a bottleneck; vaccinators would go get needles from him extremely regularly.

There were three or four people whose function was not immediately obvious to me. I am happy to believe that they had important jobs — some were undoubtedly watching the patients for bad reactions to the shot — but I just don’t know what the function was.

A few tables had signs saying, “Peer Immunizer” or something like that. Those appeared to be tables where a vaccinator was getting training. Those tables had two staffers, but all the other tables only had one person staffing it.

Along the back wall were three people working at laptops (and a fourth laptop with no person at that station). I do not know what those people were doing, but I assume it was data entry, probably some part of the multi-layer form that the sign-in desk hands out.

After a vaccinator finished cleaning from the last patient and refilled their stash of needles, they would hold up a sign with their station number. Another yellow-vested person near the seated waiting patients would eventually notice (sometimes it took a little while) and send the next person/pair (most people came with an escort) to that station. It would usually take about 20-30 sec for the person/pair to get to the station. Partly it took that long because the people were not always sprightly, but partly because it was up to 15m from chair to vax station.

Once the person/pair arrived at the station, they needed to take off coats and get ready to roll up sleeves. The vaccinator asked some questions about the patient’s health, and went through a bunch of information, including how the vaccine worked, what symptoms to watch out for, etc. I kind of deliberately did not listen, because it was none of my business what my friend’s medical history was. Also I was trying to stay 2m away, and it’s hard to hear what people with masks are saying from that distance. The vaccinator and my friend were between 1m and 1.5m apart. (NB: it came up in conversation that the vaccinator had been vaccinated. I was glad to hear that.)

The vaccinator then gave the shot. I was a little concerned because I saw the vaccinator stick it in, pull the plunger back slightly, and then push the plunger in. It looked really amateurish to me! I discovered later that you are supposed to pull the plunger back to make sure you did not hit a blood vessel. Phew!

The vaccinator then filled out the multi-layer form which the patient got at the check-in table, and gave the patient the yellow copy.

At one point, I timed how long it took between a vaccinator putting up their station sign to the next time they put the sign up, and it was like 12 minutes to vaccinate a pair of spouses. The actual shot was very quick; going through the questions took a lot of time (7m?); cleaning the station took some time (3m?), going and fetching more vax took some time (1-2m?), and getting a new client took some time (30s-1m?).

We were then directed to some chairs to sit and wait for 15 minutes. To the best of my knowledge, we were on the honour system to wait the whole 15 minutes. I also didn’t notice how many people were watching us, in part because we were facing away from the centre of the room.

We then walked out with no further interaction with the staff.

I assume that the number of vaccinators limits the speed one can go. If I were in charge and had a big budget, here is what I would change:

  • Tape on the ground inside and outside showing where to stand.
  • Different lines for different start times (e.g. 1:30), with signs which said where each time slot should queue up. If all in one line, signs for where each time slot started and ended.
  • Two greeters outside — one to answer questions and reassure people that they were in the right place and one to orchestrate the movement of people.
  • Light chairs or stools outside that people could move with them as the line moved, so they wouldn’t need to stand. (Less important for younger people.) An additional person to carry the chairs from the front of the line to the back and clean them. (A friend points out that the chairs might be burdensome for the elderly.)
  • Online registration should give the patient a barcode that the check-in table could just scan.
  • The vaccinator should vaccinate — nothing else.
    • The patient should go first to a table where they get asked questions and get given the information about the vax/side effects before going to the vax table. There should be more info tables than vax tables.
    • There should be a runner whose only job is to get needles to the vaccinators.
  • The info tables should ring a quiet, pretty chime when they are ready for the next patient, so that the guide by the seated patients notices when the ready sign goes up and can get the patient moving more quickly.
  • Lollipops on the way out. 🙂

Statistics

Today: +498 cases, +4 deaths, +19,623 first doses, +23 second doses (+1067 AZ doses). No info on VOCs.

Currently 281 in hospital / 83 in ICU, 4,851 active cases, 9,472 under monitoring, 83,083 recovered.

Charts

Yay! Another record day for doses in arms! Go go go go GO!

Bookings

The 3 day totals for each health authority’s vaccine bookings (Mon-Tues-Wed):

Health AuthorityMonTueWed
Vancouver Island5,3184,8093,988
Fraser8,2937,3056,578
Interior5,3943,9243,973
Vancouver Coastal3,5972,6262,240
Northern1,9741,2741,046

Okay, it’s embarrassing that Vancouver Island Health (population ~850K) and Interior Health (population ~800K) are booking more than Vancouver Coastal Health (population ~1.25M). Maybe Vancouver Island has more retirees than VCH. Maybe. But I have a hard time believing that Interior Health does.

Leave a comment

Your email address will not be published. Required fields are marked *