The ungovernable mess to the south, the city of Los Angeles, will never eradicate COVID-19. Why? Consider the present approaches taken to vaccinate the general population.
Mass vaccination sites where thousands wait in line for shots. Community sites where smaller numbers line up at local landmarks. Pop-up sites that appear on short notice to vaccinate small numbers of people, usually from the immediate area. Mobile sites, buses that transport a vaccination team to a neighborhood. The goal of all approaches is to vaccinate the maximum number of eligible people in the shortest time. All the present approaches except the mobile sites depend on motivated people to come to the site using private or public transport and in a limited way, on foot. What happens when all the motivated people in the city have been vaccinated but some people in politically unimportant and economically desolate areas remain unvaccinated? If enough city dwellers have been vaccinated to achieve herd immunity, why be concerned about isolated pockets of the unvaccinated?
First, how can you find areas where the residual unvaccinated exist? The L.A. County Public Health Department publishes maps highlighting areas with high incidence of nasty diseases. The U.S. Census Bureau publishes maps highlighting areas with high concentrations of liquor stores, known as areas with high alcohol outlet density. Correlating that data, the National Institutes of Health and academia have published studies concluding that areas with a lot of nasty diseases also have a lot of liquor stores. And also much domestic abuse and other crimes, but that’s a topic for another conversation.
Despite the efforts of county Public Health’s clinics and educational outreach, nasty communicable diseases persist in these areas, leading to a suspicion that inhabitants won’t search out COVID-19 vaccination sites. What do these areas look like?
Consider an example, drawn from my 25 years employed by a defense contractor to visit and support suppliers. Driving down main streets in light traffic, there are no pedestrians, no cops, no grocery stores, no pharmacies, the occasional fast food outlet, gas station/liquor/convenience stores and lots of abandoned buildings. Turning down a typical potholed alley, an open garage door reveals people stripping stuffing from old mattresses to expose the mattress springs for recycling. Across the alley a homeless person sleeps on a pile of discarded mattress stuffing. At the alley’s end sits a nondescript cinderblock building flanked by older cars, one leaking green antifreeze. Inside, two generations of a family toil long hours, elbow to elbow, machining parts. The owner, as a low bidder, has been awarded a contract to supply parts for my employer. My job requires me to visit her shop several times during the production run and at the end to review the finished parts prior to shipment.
How many of the people we have encountered in this example will probably be vaccinated using the present approaches? People at the shady mattress recycler are probably paid a pittance in cash, are local and are going nowhere far from home. The homeless person lives in the alley and only visits the closest liquor/convenience store. The owner of the machine shop and her relatives commute to a safer area at night. With commuting and work hours they have limited time to be vaccinated at work or at home. Their “time is money.”
So far, the mass sites have used a limited number of National Guard to supplement civilian medical personnel. As an Army veteran, I feel the unique training, capability and experience of the National Guard are being underutilized. Since the liquor/convenience store is the social hub of these distressed areas, small teams of National Guard could be deployed to liquor stores to inject vaccines, perform administrative tasks and provide vaccine security. Starting with vaccinating the store owner, employees and regular customers, word of mouth could spread through the community that the Guard is rotating from store to store.
Since liquor stores are usually on main streets, the National Guard deployment will be highly visible to anyone solvent enough to be commuting into the area. Store schedules could be printed out in area languages and made available in every liquor/convenience store. Will liquor store owners want to temporarily share refrigerator and parking lot space with National Guard troops? What owner wouldn’t want onsite vaccine injection, increased foot traffic and military-grade security?
Back to the question posed earlier, why worry about small pockets of the unvaccinated? Medical research on COVID-19 virus mutation has led to theories that people with compromised immune systems harbor the virus for extended periods of time, resulting in many virus replication cycles in their bodies and a greater chance of virus mutation, possibly resulting in a more dangerous strain or variant. The worst alcohol outlet density areas have populations suffering from alcoholism, nasty communicable diseases, mental stress and lack of access to healthy food, putting a heavy load on their immune systems.
Any dangerous mutation that arose could be spread to the surrounding area and into the general population by vulnerable delivery people, commuting workers and transients, reinfecting the previously vaccinated who have no effective immunity to the new variant.