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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?
When deciding who’s next in line for the coronavirus vaccines, Washington, as you probably could have guessed, is like Dr. Science. The people prioritized here for the next round of shots, seniors, are the ones who are mathematically the most at risk of death. So Washington is following pretty much the broad guidelines as laid out by medical ethicists for the federal government.
Oregon went more with its gut. Gov. 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.
“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,” Brown said.
Medical ethicists are slamming Oregon for this, arguing, bluntly, that it will kill people. About 80 percent of COVID-19’s 425,000 U.S. deaths were among people 65 and older. Our governor, Jay Inslee, on Tuesday 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.
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.
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.
“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 long way back in line but is nevertheless essential.
That’s a system that would answer the “who’s important” question. 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.
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