Designed to run like clockwork But small delays at downtown vaccine clinic can throw it out of gear By: Danielle Da Silva Posted: 7:00 PM CDT Thursday, Apr. 1, 2021

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This article was published 31/03/2021 (1268 days ago), so information in it may no longer be current.

A small whiteboard was the only reference for the dozens of people who entered Winnipeg’s convention centre of just how long they would wait before being pricked by a syringe loaded with the Pfizer-BioNTech COVID-19 vaccine.

Handwritten block letters in blue ink declared a zero-minute wait on both floors of the mass vaccination clinic as of 9 a.m. Thursday.

After a week of significant and frustrating delays at the clinic — which forced hundreds of people to contend with long queues, sometimes stretching outside the building — on Thursday morning, many clients received their shot as scheduled.

“It was nice, it was orderly, and there was no big lineup,” said Eslin Jones, 79, after her appointment. “It was right on time.”

When the clinic works as intended, clients spend 35 minutes in the facility, including a 15-minute observation period, with their dose administered at, or very close to, their appointment time, provincial officials say.

However, even small delays in the flow of clients, described as a “butterfly effect” by vaccine task force operations lead Johanu Botha, can double, or triple that wait time.

On March 23, the province introduced an accelerated vaccine program at the clinic, which is meant to reduce the overall number of immunizers needed during a shift, while still pushing through a high volume of clients in the same time period.

“What we discovered is that it’s highly sensitive to ad hoc adjustments,” Botha told reporters on Wednesday.

On Thursday, the provincial government invited the Free Press to tour the clinic to see the operation first-hand. Photos were not permitted inside the clinic and comments by a government official could not be attributed.

“What we discovered is that it’s highly sensitive to ad hoc adjustments.” – Vaccine task force operations lead Johanu Botha

People who entered the convention centre from York Avenue were greeted by two staff members who confirmed their appointment time and turned away anyone who arrived more than 15 minutes in advance. Following a “quick triage” of accessibility requirements, clients were directed to either the first- or third-floor clinic.

After taking two escalators to the top floor, past multiple hand-sanitizing stations and staff directing the flow of patients, more than 160 people with 9 a.m. appointments passed through a set of double doors into the massive convention hall.

However, the centre was once again short on staff. There weren’t enough clinicians to deliver immunizations, fill syringes or provide medical consultations, the official said.

Despite that, lineups did not extend outside of the hall and into the corridor, as was the case at times earlier in the week.

Once inside the clinic, anyone without a consent form was offered a clipboard, form and pen to complete their form in an area off to the side. The others joined a socially distanced queue of more than 75 people that stretched the width of the hall.

At the head of the line, a single employee inquired about COVID-19 symptoms and checked the consent form before allowing people to enter a holding corral where they would stand for a brief time before moving on to one of 14 registration desks.

However, clients who stopped to ask the staffer questions slowed down the flow of people into the holding area, which emptied as people moved on to registration.

“The managers and the leads are circulating and always trying to figure out that bottleneck,” the official said. “And so you spend the whole day moving through the cycle, trying to figure out which backlog needs to be moved at any given time.”

Some of the available registration desks and medical consultation stations were not staffed Thursday morning.

Soon, a line of about 25 people who were flagged for an additional check by a clinician formed in the area leading to the immunization floor, as staff jumped in to assist.

“The managers and the leads are circulating and always trying to figure out that bottleneck.” – Clinic official

“It’s a very industrial process,” the official said. “Every 30 to 60 seconds, everyone needs to move to the next spot and as long as everyone moves to the next spot every minute, the system flows well.”

“In a perfect world, between 8:45 and 9 a.m., 160 people would get through this whole process and into their chair,” he said.

Behind the temporary privacy wall that divides the sprawling hall, roughly eight immunizers delivered shots to about 80 people waiting in their seats. On Thursday, the immunization floor was set up to accommodate 160 chairs, divided into eight sections.

The province said at least two clinical staff members are assigned to each section of 20 chairs and offer the shots to people within five minutes of sitting down.

One staff member collects the consent form while another plunges the vaccine into their arm. After 15 minutes, the client can leave and the chair is sanitized for the next person. Meanwhile, in another part of the clinic, about a dozen clinical staff fill syringes for immunizers.

“The limiting factor is always our clinicians. We will likely see our wait times creep up through the day from 10 (minutes) to 20 to 30, we’ll get to shift change and get them back down.” – Clinic official

“The limiting factor is always our clinicians,” the official said. “We will likely see our wait times creep up through the day from 10 (minutes) to 20 to 30, we’ll get to shift change and get them back down.

“It’s very difficult once that wait time grows to bring it back down because the whole system then gets backed up,” he said.

On the main floor, the same process is underway, but at half the scale.

The first-floor clinic is slower, largely due to more people requiring a discussion with a health-care provider, the official said. It is also better suited for people who cannot walk long distances or stand for an extended period of time, and a seating area is available on the first floor if there are delays.

Ninety minutes into the clinic, the white board that advertised the zero-minute wait time had not yet been updated as people continued to stream into the building, and others, with a shot in their arm, waited in the foyer for their lift home.

Bruce Quesnel, 74, was one of the hundreds of people immunized Thursday morning.

Quesnel said he was happy to have received his first shot of the vaccine and said the experience overall was good, even though his 9:30 a.m. appointment had been 15 minutes behind schedule.

“It’s kind of a relief,” he said, before heading to his vehicle. “For now.”

danielle.dasilva@freepress.mb.ca

Danielle Da Silva
Reporter

Danielle Da Silva is a general assignment reporter.

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