If you’ve tried to get a COVID-19 vaccine appointment, you know how frustrating the process can be. People are spending hours obsessively refreshing websites, hoping an appointment will open up somewhere. They scan Facebook groups for tips and insider information. One writer compared it to Soviet-style queues for cabbage.

The competition for slots will only worsen when the COVID-19 vaccination priority list opens to the broader public.

It doesn’t have to be this way. Much of this misery comes from poorly designed vaccine sign-up websites, but the problem is more fundamental.

As an expert in health care operations and vaccine supply chains, I have closely followed the difficulties in connecting COVID-19 vaccine doses with people. I believe the best solution to vaccine appointment scheduling lies in building a trustworthy one-stop preregistration system.

The U.S. has now surpassed half a million deaths from COVID-19, and new fast-spreading variants of the coronavirus are adding to the urgency. As states scramble to speed up vaccinations and try to prevent their limited doses going to waste, a handful of them are testing this approach.

Why did the traditional model go so wrong?

The traditional vaccine sign-up model does not work when the demand for vaccines far exceeds supply.

Under that model, the only way to get vaccinated is to reserve an appointment slot. Naturally, the fear of being left out drives people to attempt to sign up as soon as appointment slots become available. This leads to a rush of people endlessly refreshing the same websites for the few appointments available.

Even if all states had one-stop appointment websites that did not crash under high volume, the limited vaccine supply would mean most appointment slots would quickly be taken. That could make it even harder for people who aren’t tech-savvy to get the vaccine.

To fix the broken vaccine scheduling system, we need to break this cycle.

What preregistration can solve

Most people have fairly realistic expectations about when they will be vaccinated. Their anxiety comes from the fear of being left out. To address this anxiety, the system must be designed to reassure people that they will receive vaccines within a reasonable time frame.

In Israel, which leads the world in COVID-19 vaccination, citizens do not need to actively sign up for vaccine appointments. Rather, they are notified when they become eligible via text messages and can then make an appointment.

States can echo this “push” system by creating a one-stop preregistration portal where everyone registers once and is notified to schedule appointments when their turn arrives. The preregistration step helps avoid waves of people trying to get appointments at the same time, which can crash computer systems, as Massachusetts experienced on Feb. 18.

A good system will make it easy for people to check their position in the vaccine queue at any time, provide an estimated time to vaccination based on frequently updated supply information and then send notifications when their date is getting close. Underlying the system, vaccine doses can be allocated among eligible users on the registry using a lottery system.

A well-designed preregistration system can also help avoid vaccine doses going to waste because of no-shows. With an active waitlist, vaccine planners can match supply with demand in an agile manner and offer appointments to people a few days in advance rather than scheduling appointments weeks out when the supply isn’t certain. Research in appointment scheduling has shown that no-shows are more likely under long lead times.

West Virginia sets an example

West Virginia uses a statewide preregistration system and has so far been more successful at vaccinating its population than almost every other state. It controls the process from preregistration to appointment. To get the vaccine, almost all residents, with a few exceptions, are required to use the state system, with options to register either online or by phone.

Minnesota just launched a similar system. “We still have a frustratingly limited vaccine supply from the federal government, but every Minnesotan should know their chance to get a vaccine will come. Today, we are connecting them directly to that process,” Minnesota Gov. Tim Walz said in announcing the preregistration system on Feb. 18.

More states should follow their lead as more of the general population becomes eligible for the vaccine in the coming months.

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In Massachusetts, where a vaccine sign-up website crashed shortly after launching, nearly every member of the state’s congressional delegation has urged Gov. Charlie Baker to launch a preregistration system. A few other states already have limited preregistration systems that could be expanded.

It still takes coordination

Preregistration can still create confusion if the process isn’t coordinated and users don’t know what to expect.

In Virginia, for example, counties created their own preregistration systems, but when the pharmacy chain CVS announced it was taking appointments, users didn’t know what to do. Most Virginia counties are now shifting to a statewide preregistration system. In Santa Cruz County, California, residents have struggled with a preregistration portal that doesn’t provide confirmation or an estimated time to vaccination.

“Efficiency-equity trade-off” has become a buzzword in discussing COVID-19 vaccination. With limited vaccine supply, the traditional sign-up model has proven to be both inefficient and inequitable. Moving away from that model and establishing one-stop preregistration systems is one key to resolving the painful vaccine scheduling process.

Tinglong Dai, Associate Professor of Operations Management & Business Analytics, Johns Hopkins Carey Business School, Johns Hopkins University School of Nursing

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The pandemic has taken a heavy toll on Main Street, with small businesses across the U.S. closing by the thousands.

But as bad as the overall scene is, for minority-owned businesses the picture is even bleaker. A survey released on Jan. 27 by advocacy group Small Business Majority found that almost 1 in 5 Black and Hispanic entrepreneurs expected to permanently close their business over the course of the next three months – a rate higher than for white business owners. It comes on the back of a report by the Federal Reserve of Cleveland that suggested that the impact of the coronavirus could be over two times larger for Black- and Hispanic-owned businesses than for white-owned enterprises.

As scholars who research racial inequities and entrepreneurship, we know that even before the pandemic, Black- and Hispanic-owned businesses were more vulnerable to economic downturns. Minority-owned businesses tend to have lower levels of capital – the amount of equity relative to debt – than white-owned businesses, making it harder for them to safeguard against unexpected economic downturns. In addition, Black- and Hispanic-owned businesses tend to concentrate in areas and industries that have been especially heavily affected by the pandemic, such as retail and the restaurant business.

Lower income, less capital

The gap in capital available to Black and Hispanic business owners is in large part a result of long-standing disparities in homeownership rates.

Lower levels of homeownership among Black and Hispanic Americans compromises their ability to use home equity to start or maintain businesses. Even for those who are homeowners, higher mortgage rates, mortgage insurance premiums and property taxes mean they are likely to have less home wealth at their disposition to keep businesses afloat in tough times.

Data from the 2019 Survey of Consumer Finances shows that white business owners had almost five times the amount of home equity as their Black and Hispanic counterparts. At the same time, minority-owned companies generated 10 times less income than white-owned ones.

In short, this means white-owned businesses typically have more liquidity to weather a sharp decline in revenues, such as has been experienced during the pandemic.

Our analysis of data shows that Black and Hispanic entrepreneurs are 25 percentage points less likely to have emergency savings than white business owners, and similarly hold far fewer stocks or other liquid assets.

As a result, minority business owners are more often forced to rely on nonbusiness income, such as other family members’ income earnings and debt to fund their operations. But making interest payments on higher levels of debt drains cash at a time when entrepreneurs may need it the most.

Decline in business

Compounding the problem is the impact the pandemic has had on clients and customers of small businesses.

A large number of minority-owned businesses operate in neighborhoods with high minority populations – the very communities that have been disproportionately affected by the pandemic, through job loss and illness.

This in turn affects demand for products and services provided by minority small businesses, especially as recessions tend to hit Black and Hispanic communities in the U.S. harder and earlier.

Data from analytics website SafeGraph shows that foot traffic for businesses in minority neighborhoods has declined more sharply than those in white neighborhoods. Small businesses in all-white neighborhoods experienced nearly no decline in foot traffic during the pandemic. In contrast, small businesses in neighborhoods with a 20% minority composition saw a decline in foot traffic of almost 40%.

The sectors that Black- and Hispanic-owned enterprises tend to concentrate in also contribute to the racial disparity in closures. Figures from American Community Survey show that sectors that have been particularly vulnerable in the pandemic, such as retail and restaurant, comprise a larger share of minority ownership. As such, it is no surprise that job losses at the onset of the recession were larger in industries with the highest share of minority business owners.

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Targeted assistance

Minority-owned businesses in need are also less likely to benefit when the government offers aid in a crisis.

And that’s what appears to be happening during the pandemic. The federal government created the Paycheck Protection Program last April to provide assistance to small businesses hurt by the coronavirus lockdowns.

Administered in two rounds, it offered more than US$500 billion worth of loans that could be forgiven if funds were used to cover payroll. These loans have provided a lifeline to many small businesses.

But research found that the first round of the stimulus package was inequitably distributed, with the bulk of the funds given to businesses in neighborhoods with low shares of Black and Hispanic residents. The delay in federal help to minority business owners may have been critical, given the large fraction of business closures that took place in the early months of the pandemic.

To mitigate the disproportionate effects of this downturn on minority-owned businesses, we believe it is crucial that the Biden administration begin to target more of its small business aid to Black and Hispanic enterprises and to the worst-hit communities. The consequence of not ensuring that aid is more equitably delivered is further suffering in the Black and Hispanic business community.

Carlos Avenancio-Leon, Assistant Professor of Finance, Indiana University and Isaac Hacamo, Assistant Professor of Finance Department: Finance Campus: Bloomington, Indiana University

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Protecting forests is an essential strategy in the fight against climate change that has not received the attention it deserves. Trees capture and store massive amounts of carbon. And unlike some strategies for cooling the climate, they don’t require costly and complicated technology.

Yet although tree-planting initiatives are popular, protecting and restoring existing forests rarely attracts the same level of support. As an example, forest protection was notably missing from the US$447 million Energy Act of 2020, which the U.S. Congress passed in December 2020 to jump-start technological carbon capture and storage.

In our work as forest carbon cycle and climate change scientists, we track carbon emissions from forests to wood products and all the way to landfills – and from forest fires. Our research shows that protecting carbon in forests is essential for meeting global climate goals.

Ironically, we see the U.S. Strategic Petroleum Reserve as a model. This program, which was created after the 1973 oil crisis to guard against future supply disruptions, stores nearly 800 million gallons of oil in huge underground salt caverns along the coast of the Gulf of Mexico. We propose creating strategic forest carbon reserves to store carbon as a way of stabilizing the climate, much as the Strategic Petroleum Reserve helps to stabilize oil markets.

Carbon stockpiles that grow

Forests pull about one-third of all human-caused carbon dioxide emissions from the atmosphere each year. Researchers have calculated that ending deforestation and allowing mature forests to keep growing could enable forests to take up twice as much carbon.

Half of a tree’s stems, branches and roots are composed of carbon. Live and dead trees, along with forest soil, hold the equivalent of 80% of all the carbon currently in Earth’s atmosphere.

Trees accumulate carbon over extremely long periods of time. For example, redwoods, Douglas firs and western red cedars in the coastal forests of the Pacific Northwest can live for 800 years or more. When they die and decompose, much of that carbon ends up in soil, where it is stored for centuries or millennia.

Mature trees that have reached full root, bark and canopy development deal with climate variability better than young trees. Older trees also store more carbon. Old-growth trees, which usually are hundreds of years old, store enormous quantities of carbon in their wood, and accumulate more carbon annually.

There are many fallacies about forest carbon storage, such as the concern that wildfires in the American West are releasing huge quantities of carbon into the atmosphere. In fact, fires are a relatively small carbon source. For example, the massive Biscuit Fire, which burned 772 square miles in southwest Oregon in 2002, emitted less than 10% of Oregon’s total emissions that year.

Another false claim is that it’s OK from a climate perspective to cut trees and turn them into furniture, plywood and other items because wood products can store substantial amounts of carbon. These assertions fail to count cradle-to-grave emissions from logging and manufacturing, which can be substantial.

The wood products industry releases carbon in many ways, from manufacturing products and burning mill waste to the breakdown of short-lived items like paper towels. It takes decades to centuries for newly planted forests to accumulate the carbon storage levels of mature and old forests, and many planted forests are repeatedly harvested.

In a review that we conducted with colleagues in 2019, we found that overall, U.S. state and federal reporting underestimated wood product-related carbon dioxide emissions by 25% to 55%. We analyzed Oregon carbon emissions from wood that had been harvested over the past century and discovered that 65% of the original carbon returned to the atmosphere as CO2. Landfills retained 16%, while just 19% remained in wood products.

In contrast, protecting high carbon-density western U.S. forests that have low vulnerability to mortality from drought or fire would sequester the equivalent of about six years of fossil fuel emissions from the entire western U.S., from the Rocky Mountain states to the Pacific coast.

Focus on big trees

In a recently published analysis of carbon storage in six national forests in Oregon, we showed why a strategic forest carbon reserve program should focus on mature and old forests. Big trees, with trunks more than 21 inches in diameter, make up just 3% of these forests but store 42% of the above-ground carbon. Globally, a 2018 study found that the largest-diameter 1% of trees hold half of all the carbon stored in the world’s forests.

Findings like these are spurring interest in the idea of proforestation – keeping existing forests intact and letting them grow to their full potential. Advocates see proforestation as an effective, immediate and low-cost strategy to store carbon. Older forests are more resilient to climate change than young tree plantations, which are more susceptible to drought and severe wildfires. Like the 2,000-year-old redwoods in California that have survived recent wildfires, many tree species in old forests have lived through past climate extremes.

Creating forest carbon reserves would also conserve critical habitat for many types of wildlife that are threatened by human activities. Connecting these reserves to other parks and refuges could help species that need to migrate in response to climate change.

Using forests to meet climate goals

More than half of U.S. forested lands are privately owned, so strategic forest carbon reserves should be established on both public and private lands. The challenge is paying for them, which will require a major shift in government and societal priorities. We believe that transferring public investment in oil and gas subsidies to pay private land owners to keep their forests growing could act as a powerful incentive for private land owners.

Many researchers and conservation advocates have called for comprehensive actions to slow climate change and reduce species losses. One prominent example is the 30x30 initiative, which seeks to conserve 30% of the world’s land and oceans by 2030. In an executive order on Jan. 27, 2021, President Biden directed his administration to develop plans for conserving at least 30% of federally controlled lands and waters by 2030.

Recent projections show that to prevent the worst impacts of climate change, governments will have to increase their pledges to reduce carbon emissions by as much as 80%. We see the next 10 to 20 years as a critical window for climate action, and believe that permanent protection for mature and old forests is the greatest opportunity for near-term climate benefits.

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Beverly Law, Professor Emeritus of Global Change Biology and Terrestrial Systems Science, Oregon State University and William Moomaw, Professor Emeritus of International Environmental Policy, Tufts University

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