Don’t send a puppy to do an old dog’s work

I am surprised that Philadelphia, a city that has medical schools and hospitals, turned to a small group of enthusiastic college kids to help with their rollout of the COVID vaccine. Enthusiastic volunteers are great, but these young people were in charge of the management of the vaccinations, and that wasn’t a very good idea.

Philadelphia is home to some of the most venerated medical institutions in the country. Yet when it came time to set up the city’s first and largest coronavirus mass vaccination site, officials turned to the start-up Philly Fighting COVID, a self-described “group of college kids” with minimal health-care experience.

Chaos ensued.

Seniors were left in tears after finding that appointments they’d made through a bungled sign-up form wouldn’t be honored. The group switched to a for-profit model without publicizing the change and added a privacy policy that would allow it to sell users’ personal data. One volunteer alleged that the 22-year-old CEO had pocketed vaccine doses. Another described a “free-for-all” where unsupervised 18- and 19-year-olds vaccinated one another and posed for photos.

Again, tapping into youthful energy is a great idea, expecting youthful energy to manage a serious enterprise responsibly is not wise. I’ve known some 22 year olds who’d definitely have taken the job very seriously, but the guy who ran this show comes off as a glad-handing entrepreneur-type, which Drexel has in spades, and sounds like someone who is eager to self-promote himself into a CEO position for anything.

Just a few weeks ago, Philly Fighting COVID was receiving glowing coverage from the likes of NBC’s “Today.” The group had a compelling story: Doroshin, a graduate student at Drexel University, helped orchestrate an effort to use 3-D printers to make free face shields for hospital workers at the start of the pandemic. By summer, he and his friends were running their own pop-up testing sites citywide.

But as Philadelphia magazine reported, the group’s “executive team” lacked anyone with a medical degree or advanced degree in public health. Doroshin himself listed a résumé that included stints teaching a high school film class, producing videos of people longboarding and practicing parkour, and founding a nonprofit that, according to Philadelphia magazine, “mostly consisted of a meme-heavy Twitter account, some minor community lobbying, and a fundraiser with a $50,000 goal that netted $684.”

After all, who needs expertise?

Speaking to “Today,” Doroshin said that his lack of a traditional public health background allowed him to “think a little differently” and speed up the vaccination process. In another interview, he expressed hopes of setting up a McDonald’s-like franchise and suggested that best practices for administering vaccine doses “can go out the window.”

It may also be that the group was superfluous, leaving open the question why they were given this job.

When asked why the city didn’t initially partner with Penn, Temple, or another medical powerhouse for the vaccine rollout, Farley [Philadelphia Health Commissioner] said he wasn’t sure whether the organizations would have agreed to help when they were already tasked with vaccinating their own staff.

“In retrospect, I wish we hadn’t worked with Philly Fighting COVID,” he said. However, Farley said the fractured partnership “will not overall slow down our vaccination process,” adding that the city is limited by the number of vaccine doses it has, not by the number of people who can administer it.

Identifying the mission-critical bottlenecks seems like a job for an experienced manager, and Doroshin wasn’t it. My own experience here in Minnesota is that we don’t have a surplus of vaccine at all, and our queries about getting it have been met with recommendations that we just sit and wait patiently for everyone with higher priority to get theirs, and while I’m sure we’ve got plenty of college students who’d be willing to help, there just isn’t any vaccine for them to help with.


  1. says

    What makes you think that way about Drexel? I mean, you’re right, but what’s been your experience.

    I’m not sure that going with “professionals” would have helped in any case. In my not inconsiderable experience with the health system in and around Philly, there are deep administrative problems in a lot of places in city proper.

  2. PaulBC says

    I am a big believer in youth and in entrepreneurship (I’m in Silicon Valley and wouldn’t fit in if I weren’t) but the solution has to fit the problem.

    If you are looking for brand new ways of doing things and the risk of failing is limited to something like customers being disappointed with the pizzas the robot made for them, then fine, keep failing till you get it right.

    If you’re trying to do something that’s been done effectively before, like holding an election, providing disaster relief, or distributing vaccines, where the risk of failure is highly detrimental if not deadly, then an entrepreneurial free-for-all is not your best choice.

    (And I guess I’m just restating the subject line, but seriously it amazes how wrong people get this. Time-tested, repeatable methods done by people with training are “boring” but sometimes boring is exactly what you’re looking for.)

  3. wzrd1 says

    What happened was nothing less than public endangerment!
    Where they were lucky is, they had no anaphylaxis events, which can rapidly turn lethal.
    Whoever thought of placing untrained, non-medical types in charge of handling and administering vaccines without professional medical supervision really needs to terminated for gross incompetence.
    Even money, they didn’t follow proper storage and handling procedures and many doses were administered that were ineffective.
    Equally concerning, the legal liability incurred by the city due to HIPAA violations. That’ll likely return to bite all involved, from the county level to their McVaccine stand.

  4. says

    “suggested that best practices for administering vaccine doses “can go out the window.””

    As an engineer I have to say “Oh my frigging god!”

  5. garnetstar says

    Young people haven’t been alive long enough to have learned that no plan survives the fog of combat.

  6. eurosid says

    Sounds like Elizabeth Holmes has taught us nothing. Young “Entrepreneurs” are magic. Watch ’em go!

  7. JustaTech says

    To echo PaulBC, corporate philosophies like “move fast and break things” works fine when you’re talking about a website of cat photos, and is completely unacceptable when you’re talking about, say, commercial jets. Or medical treatments. Or public health.

    I get that the vaccine rollout has been a mess everywhere. I feel that it is important to note that the last time the US had a major nation-wide vaccine rollout to the whole country was what, polio? And then it was only to children, and safe to stand in line.
    Yes, NYC vaccinated pretty much everyone against smallpox in 1947, but that was 1) right after WWII when there were still a lot of structures for this stuff in place 2) with less distrust of the government and 3) for a very scary, very visible disease. (Maybe people would take COVID more seriously if it made you hideous?)

    Should we as a country (and individual cities and counties) been better prepared? Of course. But preparation takes resources, and those resources haven’t been available recently. And it is hard to convince people to spend money on a “someday” event when you’ve got other problems now.

    But you can’t just hand off important work to a bunch of people who have no experience and a “what’s the worst that could happen” approach.

  8. unclefrogy says

    But you can’t just hand off important work to a bunch of people who have no experience and a “what’s the worst that could happen” approach.
    unless you are trying to find out what the worse outcome would be (or getting a kickback)
    uncle frogy

  9. DanDare says

    The responses to covid when mixed with commercialism have been terrible.
    Australian experience:
    Government wants a tracking app on peoples phones. Senditive info about where you have been and who you were with. Secure server with military grade security and data locked down tight? No. Commercial server in the US and access to undisclosed 3rd parties. Nobody would use the app.
    Contact trace by having sign in at cafes etc. Simple system thats easy to use, encouraging it and minimising hassle? No. Multiple businesses with different collection systems, lousy UI and full of advertising road blocks to completion.

  10. garnetstar says

    JustaTech @10 “Maybe people would take COVID more seriously if it made you hideous?”

    You’re quite correct. That’s one reason why smallpox was so feared. It wasn’t that much more fatal than most of the other diseases people died of.

    It was because you would have to live without what humans seem to value almost above all else: one’s beauty.

  11. rabbitbrush says

    Well, some place that fucked-up vaccine distribution/implementation worse than Washington State? Guess I shouldn’t complain, then?

  12. PaulBC says

    West Virginia apparently did a successful rollout. There’s probably a lesson here somewhere.

    I’m not going to say the whole explanation is that they didn’t buy into corporate snake oil, but this is interesting.

    While other states chose the federal plan, which partnered with Walgreens and CVS to inoculate people in nursing homes around the country, officials decided the idea made little sense in West Virginia, where many communities are tucked into the hills, miles from the nearest big box store, and about half of pharmacies are independently owned.

    California hasn’t done well. I know that. At this point, I wish I could get vaccinated, though I’m prepared to keep up current measures indefinitely.

  13. blf says

    @16, Another factor which may have helped in W.Virginia is that they, along with Mississippi, were, for years, the only two states which did not allow non-medical vaccination exemptions. In both states, as I recall, an important part of the reasoning was that since the medical infrastructure was so bad, and the residents not too wealthy, it was overall much more sensible to insist on preemptive prevention rather than trying to deal with numerous cases of the diseases and the after-effects.

    Since the Disneyland measles outbreak a few years ago, several other states have eliminated non-medical exemptions, or made them very very difficult to obtain.

  14. mattmatt says

    So the whole problem was caused by incompetent Health Commissioner who didn’t have the foresight to realize that maybe a company with 22-year-old CEO isn’t the best one for the job. Good thing that he realized the problem early and started fixing the situation proactively as soon as media made the situation public.

  15. JustaTech says

    @garnetstar: I was really talking about the “during illness” part of smallpox, which is not nice to look at, very obvious to any observer, and painful for the sufferer. I wasn’t talking about the side effects of potential scarring ( it could be quite disfiguring and that should not be discounted when we consider the costs of a disease), because that didn’t always happen.

    Also, there’s a difference between “beauty” and “not being so different in appearance that you are shunned”.

  16. Eric says

    I just worry how many people, over the scope of other articles related to the vaccine rollout, have been wasted because of incompetence.

    I get that this a worldwide endeavor and doses will be lost, but maybe I’m just reading too many article on the bungling and not enough on how many people have been vaccinated so far. Hopefully, the news is better than it seems.

  17. Eric says

    @20: I did not proofread. I meant to say: “…how many doses, over the scope of other articles…”, not people.

    I was going to to type a correlating sentence to tie doses back to people, but I was so annoyed by what I’ve been reading that I overlooked that.