Where I went for my third, they'd taken over a small carpark and put up temporary canopies, so the "waiting area" is just a bunch of outside space, chairs, something to keep the rain off. People sit around on their phones, self-timing the wait. Throughput was their constraint, not capacity.

That setup was pretty low risk because it's naturally ventilated (even windy at times) and has lots of capacity because it's just a car park plus some canopies. But obviously in a city centre clinic it may be very hard to do this (my GP† is in the heart of the University where I work, set on the edge of a pleasant grassy leisure area with a stream, the car park is accessed from a service road behind) but I can imagine the city hospital couldn't do likewise, nor could GPs in other inner city areas of my own city.

† General Practitioner, ie the doctor who knows a little about almost everything that can go wrong with humans and works out in the community not at a hospital.

By Litte's Law, the arrival rate to the waiting room (l) is equal to the number of customers in the waiting room (L) divided by the amount of time a customer spends in the waiting room (W), ie., l = L/W. If the arrival rate to the post-injection waiting room is less than the throughput of the vaccination stations, then removing (or reducing) the waiting time after an injection is going to improve performance of the system.

I'm not sure what your maths is trying to but when I've been for jabs there have been queues for the injection but the waiting room has always had plenty of space. The waiting room was never a bottleneck so removing it would make no difference. I'm not sure where they got the 23% figure from.

Ah I just reread it:

> that under the conditions of a system working at full capacity (as is needed now) the 15-minute wait reduces throughput by 23%.

So they're saying if they add a load more vaccinators the waiting room may become a bottleneck. Fair enough.

My second dose was in Guy's, and the waiting area was at full capacity. (I would have quite happily gone to sit immediately outside the tent, but that was forbidden.) My third dose was in a community hall, with about the same number of vaccinators but 2x the available seating area, and throughput appeared massive by comparison. I think they must indeed have been limiting throughput at Guy's to avoid saturating the waiting area.

Currently there's an input limit because of this "buffer" (how full the waiting room is allowed to be), when I got my first dose 6 months ago there was a long line outside of the vaccination center (not in the UK), and people showing up at 5:20 for a 5:30 appointment was told to wait (the first limitation was probably only having x bookable appointments per time slot). The healthcare workers were going as fast as they can though, so I guess that's the real bottleneck.

I guess without the waiting area they can add more vaccination booths, but geez, that sounds stressful for the workers, imagine having a person every ~2 minutes for extended periods of time.

Which makes me think I should move my booster appointment to the morning...

>imagine having a person every ~2 minutes for extended periods of time.

For my 1s dose I was at a walk in that had announced a lower age range than rest of London and the entire twittersphere showed up as a result.

The docs must have been at <15 seconds each. Basically conveyor belt of people barely breaking their stride while walking past. They were still going at 19h00. Wild.

Though to be fair lots of volunteers on both before & after dealing with the logistics so that docs just did the needle part.

Definitely not sustainable pace especially if you expecting to do the same next day, but was impressive display of possible throughput

I had my booster this morning at a dedicated vax centre, there were two lines outside, one for pre-booked and a huge one for walkups. The whole thing was very slick, and extremely well marshalled by the volunteers, but you could definitely see a throughput issue with the waiting area - the movement of the queues wasn't constrained at all by the number of jabs they could give, but by the very large post-jab waiting area capacity. From entry to jabbed took maybe 3 minutes, but they couldn't move the queues any faster because of the backlog in the waiting area.

If you don't need to be observed, it would make it possible to be vaccinated in other settings than a big vaccine center. Like at your private MD, a mobile vaccine service, or something else.

> All that happened was people loitering & browsing on their phones a bit before buggering off. Removing that isn't going to tangibly speed up the roll-out of vaccines.

It's not generally a problem for mass vaccination centres, but it very much is for small GP practices and pharmacies.