TThe leading scientists and determined technocrats who run Joe Biden’s program to defeat Covid-19 know that they received a major boost from the brilliant invention in record time of multiple effective coronavirus vaccines.
In addition to two vaccines already approved for emergency use in the United States, “it is very likely that in the next three months there will be up to three others,” said Wayne Koff, an external expert and president of the Human Vaccines Project.
Therefore, the United States is firmly on track to produce more than enough coronavirus vaccine to immunize the population in a period of time that a year ago many would have considered impossible.
But as Biden prepares to assume the presidency on Wednesday, and his team prepares to radically expand the national vaccination project, officials warn that a failure on the part of the Donald Trump administration to properly plan the distribution and administration of doses vaccine threatens to squander the advantage gained from the rapid development of vaccines.
Biden advisers also warn that as fast as vaccine development is moving, the virus is also accelerating, with at least three variants spreading worldwide, and the imminent prospect in the U.S. of an explosion of coronavirus cases that no vaccine administration program could keep up.
“What Operation Warp Speed did is, they did all this work and spent many billions of dollars to get vaccines for manufacturing and approval status, and then they said, ‘Oh, the rest is just going to happen,'” he said Michael Osterholm, a member of Biden’s Covid-19 advisory board, in his podcast as director of the Center for Infectious Disease Research and Policy. Operation Warp Speed was the name given to the Trump administration’s vaccine development program.
The United States has witnessed “an incredible miracle of technology to bring these vaccines,” said Osterholm, but “an incredible failure of communication and implementation strategy.”
The planning gap for vaccine distribution before Biden took over appears to have been so vast that the challenges ahead are basic. In recent public statements, Biden’s team members described an advanced focus on who, where and why: who takes the shots, where the shots happen and explain why – for hesitant patients – vaccination is vital.
In a speech in Delaware on Friday, Biden provided some details of his plan, saying his administration would build up vaccine stocks, open new vaccination sites and hire more staff, answering basic questions from Americans about what is in the injections .
“One of the things that is really necessary, I think, right off the bat, is a communication approach so that everyone understands what’s going on, what the expectations are,” said Koff. “And they understand where they are in the queue.”
For now, people are confused. Each state has its own rules for who is eligible for vaccination, but these guidelines sometimes contradict federal guidelines, and the number of doses distributed to states by Washington in many cases does not align with the number of supposedly “eligible” state residents.
Fueling the confusion was a sudden and unforeseen change on Tuesday in Trump’s administration guidelines that exponentially increased the pool of eligible vaccine beneficiaries of healthcare professionals and long-term care facility residents – about 24 million people in the total – to include anyone aged 65 and over – essential health workers and young people with pre-existing diseases – about 180 million people.
There are not yet enough doses to vaccinate so many people, and no specialist has ever thought that there would be at this stage – but the hastily changed guidelines created a sense of false scarcity among the public. The states of New York, Florida, California and others have witnessed a wave of demand, endless waiting in lines or on the phone and online, adding to the frustration among residents and zero available appointments in many places.
“I think it was a very unfortunate step, it certainly did not correspond to reality, and I think what we will see is that state and local health departments will continue to be the buffers because they don’t have enough doses,” said Osterholm.
In other areas, overdosing has led to public calls for willing patients and, in some cases, patient shortages caused damage and dose discard. Hospitals and other health facilities, already overburdened by Covid patients, lack staff to administer vaccines, while plans to set up vaccination stations elsewhere, such as pharmacies, have not taken off.
As with most health issues in America, no one is sure how much health insurance will cost.
The complications left the vaccination effort far below projections. The Trump administration announced in November that 20 million Americans would be vaccinated by the end of the year. A fraction of that number – just over 1.3 million Americans – received the two doses of vaccine required by Friday, according to the Centers for Disease Control and Prevention (CDC).
“Right now, it’s like the wild west, with each state doing its own thing,” said Koff.
To tame the chaos, the Biden team described an approach that is aggressive and flexible, planning to move almost all of the existing vaccine stock out of the door immediately – relying on the manufacturers’ ability to keep up with demand for second doses – and adapt strategies for distribution on a local basis.
“Federal vaccination recommendations have been very difficult to operate in the field, very complicated,” said Biden consultant Celine Gounder, a clinic and professor of medicine in New York, on Thursday at a forum organized by the school of public health. Johns Hopkins. “And therefore, we essentially need to make things simpler, whether that means simplifying the supply chain or simplifying the levels of those who are eligible for vaccination.”
Revealing a new $ 1.9 trillion Covid-19 relief proposal Thursday night, Biden asked for $ 20 billion for vaccination efforts and $ 50 billion for testing, and he repeated his promise that 100 million injections would be administered in their first 100 days on the job – an achievable number at the current dose administration rate.
The moving parts of the Biden plan include coordination with states on the basics of who-where-why; communicate to the public what is happening; raise vaccination sites within pharmacies, school gyms, community centers and sports stadiums and establish mobile sites for marginalized communities and recruit community members to lead outreach. It will also attract personnel and resources from the Federal Emergency Management Agency, the CDC, the Pentagon and the National Guard, finance more medical staff in general and expand genomic surveillance to track variants of the virus.
Another Biden advisor, Loyce Pace, chairman of the Global Health Council, praised Biden’s choice of medical professor Marcella Nunez-Smith of Yale to lead the effort to ensure equal access for vaccines and treatments to racial and ethnic minorities.
“We hope this signals a central focus on communities that are advancing,” said Pace at the Johns Hopkins event.
But the hesitation of the vaccine in general, and especially in some colored communities, remains a major concern.
“If you consider which black communities were subjected to slavery and which black communities were victims of medical experiments, it was generally African-Americans and indigenous communities,” said Gounder. “So it is clear that you will see more hesitation in these communities. And I don’t think you can get over it just by educating, in quotes. “
Other key players on Biden’s team include Rochelle Walensky, designated director of the CDC; Vivek Murthy, designated surgeon general; Jeff Zients, coordinator for Covid, a veteran of the Obama administration who led the effort to fix health.gov after the site’s failed implementation; and vice-coordinator Natalie Quillian, a former partner at Boston Consulting Group. David Kessler, a former director of the Food and Drug Administration, was named chief of vaccine science for Covid’s response on Friday.
The team will take control at a time when the United States appears to be peaking in a new tsunami of virus cases. Covid-19 is currently the leading cause of death in the United States. The daily death rate exceeded 4,000 and new daily cases reached 300,000. Currently, more than 131,000 people are hospitalized for Covid.
A highly infectious variant of the virus first detected in the United Kingdom has been detected in at least 11 states and, assuming that the United States will not implement effective isolation measures, the variant could produce previously inconceivable peaks in new cases, hospitalizations and deaths, of according to health authorities.
“The good news is that current vaccines appear to be effective against the UK variant and it is really important that we do everything we can to speed up our current vaccine programs,” said Osterholm.
But research on two other variants, one linked to South Africa and one linked to Brazil and Japan, to determine whether they may be resistant to vaccines or drugs used for treatment has not been completed.
“This is a time to stay tuned,” said Osterholm.
In his speech on Thursday, Biden highlighted the magnitude of the challenge.
“This will be one of the most challenging operational efforts we have ever undertaken as a nation,” he said. “We will have to move heaven and earth to vaccinate more people.”