Well, here's one option. Between Humble and Kingwood there are about half a dozen freestanding ERs in addition to a hospital ER at one of the Hermann branches. They would have been within 5-10 minutes of the vaccine's original location.
While freestanding ERs have a number of issues, there is a single attending on staff that is extremely easy to get hold of by another physician. He could have called at least one of them to see if there were eligible patients in the facility that would accept the vaccine. Yes, this takes time, but note that depending on traffic it takes about an hour to drive back to Sugar Land. I believe that if he would have dispersed the vaccines at one of those facilities, the story and perception of this physician would have been dramatically different.
My point in bringing this up is that there were other realistic options that he could have taken. It is not quite as simple as take the vaccine home or it goes to waste.
Interesting post, better than most making this side of the argument.
Do we know if those ERs would administer vaccines from another hospital's punctured vial in their facilities? Do we know how long it would take to get the answer to that question, trimming off the 42 minutes per person Dr. Gokal had to find, administer, and properly document the vaccine injection? And at the end of all that, would there be enough high-priority individuals on hand, ready and willing to be vaccinated? Was that clearly better than calling up people the doctor knew, and knew to be vulnerable?
Yeah, I don't think you know any of that. It's fine to speculate about the hypothetical optimal course of action in this situation, but it's deeply wrong to judge Dr. Gokal without certain knowledge of all those things.
I very much agree that we don't have all of the information here and that it's very easy to Monday morning quarterback a decision that was made under pressure without good guidance. Sadly, it's possible that this whole situation will turn into a trap where there all available options have some kind of negative outcome. That said, I don't think that it's entirely inappropriate to discuss or postulate other courses of action because it's something that can help other people in the same situation.
With respect to the freestanding ERs, I would contend that they would probably take it. A friend of mine owns a couple in Houston. My wife used to work off and on with a different company at them as the attending physician. That does not make me an expert in this area, but I can say with absolute confidence that getting hold of the physician on duty quickly with this kind of matter is guaranteed. Whether they would want the liability to give the vaccines is unknown to me. The next time I see my friend, I'll ask him because I'm genuinely curious.
I'll also mention that there are certain cultural biases that come into play here as well. I spent years doing federal contract work and it was well ingrained into me that avoiding the appearance of impropriety is important for a well functioning organization. As much as the organizations that I worked with don't want waste, the bias is to side with clean, unreproachable conduct even if this is more wasteful. Not all of the government works this way and the reality of life is that this isn't always so easy. I mention this because that kind of bias suggests a different way of looking at the problem and provides a different set of solutions. That's not a value judgement to say that these solutions are better or worse, but an implicit assumption that there has to be a different way.
> As much as the organizations that I worked with don't want waste, the bias is to side with clean, unreproachable conduct even if this is more wasteful.
The problem with this, which few in the government seem to understand, is that knowingly and wilfully letting people die needlessly in a pandemic is deeply reproachable conduct. Personally, I'd actually call such conduct despicable. But my personal standards of conduct could perhaps be much higher than average, so we can leave it at reproachable as a basline.
It turns out that Dr. Gokal was punished for "taking doses away from a vaccination site" [1]. So your proposal probably would not have kept him safe from firing or prosecution.
Other articles say that he was punished for violating a protocol which required that expiring vaccines be returned to a hub site (i.e. throw them away and let people die or be punished.)
While freestanding ERs have a number of issues, there is a single attending on staff that is extremely easy to get hold of by another physician. He could have called at least one of them to see if there were eligible patients in the facility that would accept the vaccine. Yes, this takes time, but note that depending on traffic it takes about an hour to drive back to Sugar Land. I believe that if he would have dispersed the vaccines at one of those facilities, the story and perception of this physician would have been dramatically different.
My point in bringing this up is that there were other realistic options that he could have taken. It is not quite as simple as take the vaccine home or it goes to waste.