Let's start with the vaccination rollout first. As recently as early October, Health and Human Services Secretary Alex Azar said we’d have 100 million doses of vaccine by the end of 2020. One month later, that was reduced to 40 million doses. As recently as Dec. 21, Vice President Pence, the head of the White House coronavirus task force, said that we were on track to vaccinate 20 million Americans by Dec. 31. The actual number turned out to be roughly 2.8 million.
In the meantime, long lines are evident where the vaccinations are given out, such as in Fort Myers, FL where seniors have had to wait up to 10 hours to get jabbed. Nor is there any sign this is going to get better. None. There are now millions of doses actually sitting on shelves while millions of citizens wait. What gives? Basically not enough workers, volunteer or other, to actually give the shots. Our niece, Heidi, an ER nurse in Arizona, plans to volunteer to help give vaccinations. She said she has it on good faith that hospitals across the nation need at least 10,000 - 12,000 volunteers to help get the shots into arms. Why volunteers? Because the Trump administration and Repuke congress did not provide sufficient money to the states, cities for new medical hires to perform the task. Meanwhile, as the WSJ has noted (Jan. 2-3, p. A6) the regular hospital staff are preoccupied with treating Covid patients.
The Trump bunch, woefully incompetent as ever, fucked it up as far as the distribution leg of the vaccine rollout and left it all to the states. Indeed, neither they or the Senate Repukes acted to provide the added money needed for state and local governments - which are already operating on fumes. As Dr. Ashish Jha put it in a Sunday WaPo op-ed;
"How did we get from 100 million promised doses to just a few million people vaccinated? It is a lesson in misunderstanding American federalism and a failure of national leadership. The federal government and Operation Warp Speed saw their role as getting vaccines to the states, without considering what supports states would need to get vaccines to the people. The Trump administration is now blaming the slow rollout on states. This is political theater and obviously untrue."
Vaccinate up to 2 million in each state with limited resources, overflowing ICUs, and not enough funds to even keep the fire departments going? You have to be kidding. One huge hole- as I noted- is in the manpower to do the shots. Consider, Boulder County here in Colorado has 30,000 seniors over 65 in line for vaccination.
Consider that if it takes 25 minutes to prepare and deliver each dose of vaccine, including social distance practice, possible pre-shot Covid test and 15 minutes allowed per patient recovery (to see if side effects occur) that translates into 12,500 hours needed just to inoculate Boulder County's eligible seniors. If all Boulder's vaccine-equipped medical facilities together currently have only 25 available competent medical people to do the job, that translates into 500 total hours just for vaccinations - and that assumes no supply hitches. If the actual allocated (dedicated) daily vaccination time amounts to 5 hours per day on average that means a minimum of 100 days would be needed to complete the shots. Is 5 hours per day of dedicated vaccinations a lowballed estimate? No, not when one considers (WSJ, ibid.) that "hospitals and other sites have had to stagger appointments to avoid pulling too many workers from caring for Covid patients."
You see where this is going.
Meanwhile, our governor (Jared Polis) last week announced a change to the Phase 1 distribution, to now include 1.19 million more citizens - including anyone 70 or older - to the existing stage (of 1st responders, frontline workers). This despite the vaccine supply being severely limited. We were both contacted by UCHealth and advised of the change, but the notice made clear we could not make an appointment yet, likely because the needed extra vaccine supplies were unavailable.
Dr. Ashsish Jha, Dean at the Brown University School of Public Health Brown University, has already voiced his concern that underfunded health departments in individual states will have a hard time "adding vaccines to their plate." He added:
"Most are super stretched, and they are trying to make a plan. They are trying to stand up a vaccination infrastructure. Congress had given them no money. States are out of money. So many are passing it on to hospitals, nursing homes."
Hospitals, Jha adds, are now "trying to figure out where to set up vaccination sites."
The frustrating part is that "there appears to be no investment or plan in the last mile" and "no effort from feds to help states launch a real vaccination infrastructure."
Jha elaborated:
"Public health has always been a state/federal partnership. States are stretched. The Feds are supposed to help. But the same folks who blamed the states for the testing mess are now ready to blame them for the vaccine slowdown. They are again setting the states up to fail."
What might be done as a first step to salvage the situation and get vaccination momentum? Both niece Heidi and Janice suggest recruiting thousands of military medical personnel to begin aiding in the actual vaccination process. I.e. getting doses of the vaccine ready and jabbed into the tens of thousands of arms needing it. We don't have a moment to spare because at the slow rate now - and with the anti-vaxxers and super spreader morons to contend with - we may not reach herd immunity for years. I estimate not until 2025, and that's assuming no more screw-ups. But then the existing screw-up of inadequate funding ($340 million disbursed so far) also needs to be corrected - as in increased by at least a factor 4.
That extra money will be needed to hire more medical personnel and train and equip them to deliver the millions more vaccines needed. And that assumes we can get the vaccine supply to where it needs to be. In addition, as Dr. Jha observed in a Sunday WaPo op-ed, funds will be needed to expand infrastructure to accommodate tens of thousands of people, waiting in lines or cars, to get jabbed. Right now, hospital space is at a premium so capacity dedicated to administration of shots is extremely limited.
One more thing: Until a level of herd immunity is reached (70-75%) , no vaccine will replace the wearing of face masks, social distancing or more potential lockdowns.. This is especially as we have millions of morons still willing to engage in reckless super spreader parties and other events. As Barbara Ferrer, Director of the Los Angeles County Health Dept. put it: "It's almost unfathomable to me that these events are still happening." This is after cases doubled to 20 million in just 8 weeks as reported by ABC News Saturday night.
But they are and so long as they do, that behavior will cancel out any small benefit derived from a subset of vaccines given before the entire population is inoculated. Especially as the new, more contagious (by 70 %) virus variant appears to be spreading in this country - and another even more contagious (South African) mutation looms. Both making the racc to vaccinate enough people even more critical.
Dr. Anthony Fauci believes the U.S. can reach 1 million vaccines delivered per day from this month. But that is a pipedream so long as there aren't enough medical staff delivering the shots, and the vaccine supplies are low. (Now there is even talk of splitting each dose between 2 people). In regard to the latter, Pulitzer-Prize winning medical journalist and author Laurie Garrett ('The Coming Plague') pointed out a looming vaccine shortage over 2 weeks ago. Then Ms. Garrett noted the same reagents used in Covid testing were also part of the production of the vaccine and the double demand was limiting supply of available vaccine. (See also: 'Vaccine Scarcity Means Tough Choices', WSJ, 12/15, p. A7).
As also reported in the WSJ:
Pfizer sources its raw materials from providers in the U.S. and Europe. Scaling up production of these components proved challenging last month as the company awaited the results of its trials, which came in to be 95% effective and well-tolerated in a 44,000-subject trial.
Pfizer wouldn’t say where shortfalls over ingredients arose as it ramped up production. Vaccines typically contain materials from suppliers that can include antivirus agents, antiseptic liquids, sterile water and elements of the DNA of the virus itself that won’t cause serious symptoms but trigger the immune system to make antibodies."
As reported in the past weekend's WSJ Business Exchange (p. B7):
"In the U.S. airline executives and industry observers say pent up demand for travel could be unleashed in a fury this summer when more people are expected to be inoculated."
True, but that doesn't mean flying will be safe by then. (1.3 million also took to the skies this past weekend, oblivious to warnings from medical specialists.) So long as most of the world remains unvaccinated, that will be the case, and the sooner people come to grips with that, the better. They need to also grasp that until the virus is controlled - and that means most of the population having immunity - the economy will remain in an unstable condition. See e.g.
See Also:
by Lynn Stuart Parramore | January 5, 2021 - 8:05am | permalink
The Haves and the Have-Nots
Excerpt
Developing countries have reason to be concerned as the WSJ headline suggests. If the consortium led by the United States beats the WHO to the punch, the less developed countries will be left out. As the assistant director-general at the WHO said, when discussing the upcoming competition to develop the vaccine: "Next year is a year of scarce resources. Whatever we have, it won't be enough to vaccinate everyone. It is in everybody's self-interest to collaborate globally because we need this pandemic controlled in all countries." Trump and his cronies are oblivious to this need. In a press briefing in June, an administration official said: "Let's take care of Americans first. To the extent there is surplus, we have an interest in ensuring folks around the world are vaccinated." As with so many Trumpian statements and actions, Trump and his cronies have shown us yet another way Trump is making America great again. And it gives us all the rest of us cause to pause and consider whether we want to continue to live in a country the greatness of which is being defined by a man of no character and puny intellect.
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