View this email in your browser

Unsanitized: The COVID-19 Report for Jan. 4, 2021

America's Vaccine Rollout Should Infuriate You

A host of problems have hindered our national response in inexcusable
ways

 

Putting this into a needle and putting it into peoples' arms shouldn't
be quite this difficult. (Robert Michael/dpa via AP)

First Response

As of Sunday, 4.33 million Americans have received a dose

of one of the two coronavirus vaccines made available for emergency use.
Trump administration officials with Operation Warp Speed initially
promised 20 million people vaccinated

by the end of the year, meaning 40 million shots. We didn't get within
10 percent of that goal. Only one state, South Dakota, has administered
doses for as much as 3 percent of the population, and in deep South
states stretching from North Carolina to Mississippi, the number's
closer like 0.75 percent. Georgia and Kansas have only used 17 percent
of their allotment
;
the average usage rate is around 30 percent.

This is an abjectly terrible, inexcusable performance. If we need 85
percent immunization

for true herd immunity, after three weeks of vaccinations we're barely
above 1 percent. That puts us in good shape for herd immunity by June
2025.

It's made worse by the fact that a more transmissible variant

of the virus has established itself in the country. If this was a race
between immunization and mutation, the mutation would be Secretariat
and
immunization would be the rest of the field. With more transmissibility,
hundreds of thousands of people could die

before we start to reach enough at-risk communities to get those numbers
down. Moreover, the more botched the rollout looks at the early stages,
the more fuel given to anti-vaxxers to demonize the value of the effort.

Support Independent, Fact-Checked Journalism

We knew this vaccine effort was coming really since the first
declaration of a pandemic. We've had months to strategize and plan and
work out the logistics. We deliver hundreds of millions of flu shots
every year; while this was a heavier lift, it's not that much heavier.
In that context, the lack of preparedness is unbelievable and yet also
perfectly predictable and a fitting coda to a year of deep exposure to
the realities of our frayed social structure.

When you have such a full-spectrum disaster, there are a thousand
reasons why. Let's go over some of them, in an effort to figure out if
we can rebound from the failures:

A Complete Lack of Leadership: This is really the big one. The president
is too busy leaning on Secretaries of State

like the world's worst mob capo to care about vaccinations. If the
vaccines aren't golf balls he doesn't know about them. The one time
he's bothered to make any excuses
,
it was to correctly, and horrifyingly, explain the mass immunization
process: the federal government supplies an allocation to each state,
and it's up to them
to figure
out how to get it into people's arms. Sometimes they're only given a
couple days notice to the states before that allocation goes out. Then
the states have to manage keeping doses ultra-cold in storage, shipping
to every part of the state, finding the trained professionals to give
the shot, working up priority lists, educating people on the importance
of the vaccine, keeping track of recipients who need to come back for a
second dose, etc., etc.

**Read all of our Unsanitized reports here**

Click to Support The American Prospect

No Money: Before the COVID relief bill was finally signed December 27,
states had received only around $340 million

to pull this off. For the whole country. There's another $8 billion on
the way with the relief bill but even that's an undercount. For those
who say this is a miniscule part of state budgets, reallocation amid
severe revenue shortfalls, especially when the feds were promising
distribution support, isn't realistic. Donald Trump walking away from
his responsibilities is the biggest factor in the disastrous rollout.

Bad Process: Public health departments, which have been doing testing
and tracing and recommendations for distancing, and are already pretty
stressed ,
have to handle all this. Some states have shifted to hospitals to take
the lead in distributing the vaccine, rather than public health
departments. Hospitals, you might recall, are busy with trying to save
people from dying from the virus; they don't have the capacity to take
on this project. In states with severe outbreaks like California, too
many health workers are attending to patients to pull some off to give
the vaccines. That's why a Public Health Jobs Corps

should have been stood up months ago. Other hospital networks just
don't have the facility with mass immunization; that situation in West
Virginia, where patients got monoclonal antibodies

instead of the vaccine, is an example of what can happen when you throw
responsibilities onto overwhelmed entities at the last minute. The chaos
of long lines

and unclear delivery timing is another example.

Hostile Takeover: The overcorrection to Donald Trump's complete
absence has been something like what we're seeing in New York
,
where Andrew Cuomo blustered into a process health officials had been
preparing for years and took it over. He's now building the plane
while it's in the air, when county officials had the plane already
prepped for takeoff.

We Depend on Your Donations

Holding Back: A large segment of doses have been deliberately held back,
about half to give to nursing home facilities

administering through a separate federal process with CVS and Walgreens
that could take months. (So much for handing over immunization to chain
pharmacies
;
they're performing perhaps worst of all! The "private sector is
always more efficient" religion is pernicious.) Other doses are being
held back to ensure enough doses are available to give out the second
shot. That seems like a significant mistake. Just today, the U.S. has
floated cutting the Moderna dosage in half
,
instantly doubling the available amount. Between that and the extra
doses found in Pfizer vials
,
I don't see the necessity in holding back doses for the second shot,
as more product continues to roll

off assembly lines.

The Vagaries of Prioritization: We have a sick society caught up too
much with whether someone, somewhere is getting a better deal than us.
This manifests itself in the endless discussions of priorities and
"line jumping," when every shot in every arm is marginally better
news for everyone in the country. The aforementioned Cuomo is mandating
criminal penalties
for not
following prioritization, which seems like a popular idea but is one
that guarantees throwing lots of shots in the garbage when they expire.
The least effective shots are the ones not distributed. Tying oneself up
in knots to ensure the perfect rollout has corrupted the rollout
.
America doesn't do such nuance well.

Holiday Hours: Seriously, holiday hours! There wasn't enough staff
around to administer vaccines because of Christmas and New Year's.
That will self-correct of course but it's really shocking, especially
because we had a few months' warning that the vaccine was likely to be
active around that time. In Israel, they opened 24-hour pop-up clinics
and got rabbinical dispensation to keep them open on Shabbat as a
medical emergency. Well over ten percent of the population

is vaccinated as a result.

We Can't Do This Without You

The Resistance: There have been health care workers who have refused to
take the vaccine
.
This is a minor issue that will be ameliorated as more become
comfortable

with its effectiveness, but the problem is that the system in place
appears paralyzed over what to do in such a situation, and this could
lead to spoilage rather than just getting the shots out to whoever wants
one.

This was always going to be a bumpy rollout
,
because we have historically underfunded the entities most responsible
for distribution, and we have an executive branch that's checked out.
I wrote in September

that "the last people you would trust to execute this well would be in
a Trump administration consumed with clinging to power post-election."

Can Biden turn it around? He's committed to using the Defense
Production Act

to increase vaccine supply, but it's the distribution plan that's
needed. Mitt Romney has a thumbnail of a plan

that at least understands the urgency required. We are treating
something that will save millions of lives and our economy with the
nonchalance of a half-planned dinner date. This should be the only thing
government is doing for the next 4-6 months.  

Days Without a Bailout Oversight Chair

There is no more bailout to oversee, so this feature is officially
retired! I'll find something else to count down tomorrow.

Support Independent, Fact-Checked Journalism

Today I Learned

* Cenk Uygur had me on TYT's The Conversation before the new year.
Here's that video
.
(YouTube)

* Coming up on a year into this and the long-term health consequences
,
like the loss of smell and taste for some, are still not fully
understood. (New York Times)

* Faster line speeds at chicken processing plants also create an
accelerated COVID contraction factory
.
(Washington Post)

* Stunning story about suicides among cruise ship workers
who have
been floating around nation-less for months. (Bloomberg)

* Up to $36 billion in unemployment fraud
,
per one account. (USA Today)

* Significant under-reporting in Africa
.
(New York Times)

* Commutes are better under COVID
,
and if working from home is here to stay, probably permanently. (Wall
Street Journal)

* Best wishes to Larry King
.
(Los Angeles Times)

**Click the social links below to share this newsletter**

 

[link removed]

 

[link removed]

 

[link removed]

 

[link removed]

 

[link removed]

 

[link removed]

YOUR TAX DEDUCTIBLE DONATION SUPPORTS INDEPENDENT JOURNALISM

Copyright (C) 2021 The American Prospect. All rights reserved.
_________________

Sent to [email protected]

Unsubscribe:
[link removed]

The American Prospect, Inc., 1225 I Street NW, Suite 600, Washington, DC xxxxxx, United States