EA - Some observations from an EA-adjacent (?) charitable effort by patio11

Link to original articleWelcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Some observations from an EA-adjacent (?) charitable effort, published by patio11 on December 9, 2022 on The Effective Altruism Forum.Hiya folks! I'm Patrick McKenzie, better known on the Internets as patio11. (Proof.) Long-time-listener, first-time-caller; I don't think I would consider myself an EA but I've been reading y'all, and adjacent intellectual spaces, for some time now.Epistemic status: Arbitrarily high confidence with regards to facts of the VaccinateCA experience (though speaking only for myself), moderately high confidence with respect to inferences made about vaccine policy and mechanisms for impact last year, one geek's opinion with respect to implicit advice to you all going forward.A Thing That Happened Last YearAs some of the California-based EAs may remember, the rollout of the covid-19 vaccines in California and across the U.S. was... not optimal. I accidentally ended up founding a charity, VaccinateCA, which ran the national shadow vaccine location information infrastructure for 6 months.The core product at the start of the sprint, which some of you may be familiar with, was a site which listed places to get the vaccine in California, sourced by a volunteer-driven operation to conduct an ongoing census of medical providers by calling them. Importantly, that was not our primary vector for impact, though it was very important to our trajectory.I recently wrote an oral history of VaccinateCA. It may be worth your time. Obligatory disclaimer: I'm speaking, there and here, in entirely my personal capacity, not on behalf of the organization (now wound-down) or others.A brief summary of impact: I think this effort likely saved many thousands of lives at the margin, at a cost of approximately $1.2 million. This feels remarkable relative to my priors for cost of charitably saving lives at scale in the US, and hence this post.Some themes of the experience I think you may find useful:Enabling trade as a mechanism for impactTo a first approximation, Google, the White House, the California governor's office, the Alameda County health department, the pharmacist at CVS, and several hundred thousand other actors have unified values and expectations with regards to the desirability of vaccinating residents of America against covid-19.They are also bad at trading with each other. Pathologically so, in many cases.One of the reasons we had such leveraged impact is that we didn't have to build Google, or recruit a few hundred million Americans to use it every day. We just had to find a very small number of people within Google and convince them that Google users would benefit from seeing our data on their surfaces as quickly as possible.Google and large national pharmacy chains cannot quickly negotiate an API, even given substantial mutual desire to do so. As it turns out, pharmacists already have a data store—pharmacists—and a transport layer—the English language spoken over a telephone call—and if you add a for loop, a cron job, and an SFTP upload to that then Google basically doesn't care about pharmacy chain IT anymore.Repeat this by many other pairwise interactions between actors within an ecosystem, and we got leveraged impact through their ongoing operations, with a surprising amount of insight into (and perhaps some level of influence upon) policy decisions which your prior (and my prior) would have probably suggested "arbitrarily high confidence that that is substantially above your pay grade."We didn't have to be chosen by e.g. the White House as the officially blessed initiative. We just had to find that initiative and be useful to it. (Though, if—God forbid—I ever have to do this again, I would give serious consideration to becoming the national initiative prior to asking for permission to do so and then asking the White House whether the ...