Frustration over vaccine deployment grows as US new variant reported

As frustration over the rate of introduction of the Covid-19 vaccine continues to grow, health officials reported in Colorado on Tuesday on the first known U.S. case of the variant of Covid-19 discovered in the UK.

The British variant appears to be more transmissible than other variants of the virus seen so far, and has been detected in a number of countries worldwide. The Colorado case, which is currently in isolation, is a man in his twenties who does not land. The lack of a travel history means he contracted the virus in the US, indicating that the new variant would not be detected here.

The discovery will only contribute to the urgency of the Covid-19 vaccination campaign currently underway, which has been criticized by public health experts as being too slow. The Trump administration has sent more than 11 million doses of the two available Covid-19 vaccines, but just over 2.1 million people nationwide have been shot since vaccinations began on Dec. 14, according to data from the Centers for Disease Control & Prevention.

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Elected President Joe Biden chastised the Trump administration in a speech Tuesday for the slow deployment of the vaccine. He warned it the government’s effort to distribute and administer the vaccine is progressing “not as it should” and that if the pace of the vaccination effort continues, it will take years for the American people, not months.

He promised to ‘move heaven and earth to move us in the right direction’, and predicted a number of policies he is likely to take in the first 100 days in office, including the use of the Defense Products Act to accelerate the manufacture of vaccines and their establishment. a public health awareness campaign and sending mobile vaccination units to hard-to-reach communities. Biden also reiterated its previous promise to ensure that 100 million doses of the Covid-19 vaccine are administered in the first 100 days in office.

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However, he also tried to temper expectations.

“It will take more time than anyone would like and more time than the Trump administration’s promises suggested,” Biden said. “It’s going to be the biggest operational challenge we’ve ever faced as a nation, but we’re going to do it. It’s going to take a big new effort that’s not going on yet. ”

In interviews earlier this month, Moncef Slaoui, chief advisor on vaccine development and distribution, known as Operation Warp Speed, promised that 20 million Americans would be vaccinated against Covid-19 in December.

Michael Pratt, chief communications officer of Operation Warp Speed, insisted that the distribution of the vaccine was largely on schedule. He said the forecasts that Slaoui and others had previously shared only referred to the number of doses that were expected to be available by the end of the year, and not to the number of vaccinations taken during the first week of onset. not.

“Operation Warp Speed ​​remains on track to have approximately 40 million doses of vaccine and to allocate 20 million doses for the first vaccinations by the end of December 2020, with the distribution of the 20 million first doses extending to the first week of January, as states place orders for them, ”Pratt said.

Pratt pointed to a backlog in data reporting as part of the reason for the large gap between the number of vaccines delivered to states and those actually administered. However, state data compiled by the New York Times also shows that most states administered only a fraction of the vaccine doses they received.

“We are down where we want to be,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN on Monday. ‘I’m not responsible for the implementation myself, but I can not personally guarantee that we will catch up. I hope we do. ”

Some vaccine experts have said they are not surprised so far at the speed of vaccine distribution.

“It had to go this way,” Paul Offit, a professor of pediatrics at Philadelphia Pediatric Hospital, told STAT. “We had to stumble and fall and stumble and find out.”

Claire Hannan, executive director of the Association of Immunization Managers, said the gap between doses administered and delivered is likely due to a program offered by CVS and Walgreens to vaccinate those in nursing homes. States participating in the program must set aside 50% of their doses, which Hannan said could be part of the difference between doses sent and doses administered nationally.

“I don’t think it’s bad,” she said of the rate of spread so far. “I think it’s always going to be that way. And I think that’s actually the easy part. ”

The logistics of the implementation were largely left to states to navigate. States and local public health officials have been warning for months that they need more than $ 8 billion in additional funding to build the infrastructure needed to administer vaccines. The Trump administration has provided $ 340 million in funding to prepare for vaccinations. Congressional lawmakers also struggled for months to secure additional funding for the distribution of vaccines, although the coronavirus stimulus package signed by President Trump on Sunday included $ 8 billion in funding for the effort.

‘We try to do everything on a shoe ring, when we really need a lot of money. It was phenomenal, the needs that had to be met six months ago, so we are not continuing to build the system as we implement it, ”said Ann Lewandowski of the Rural Wisconsin Health Cooperative.

“There seems to be no investment or plan in the last mile,” tweeted Ashish Jha, dean of the Brown University School of Public Health. ‘No effort by the Feds to help states start a real vaccination infrastructure. Did the Feds not know that there would be vaccines coming? Had to plan vaccinations, etc. Did not take place in October or November? ”

Some public health officials, including former CDC director Tom Frieden, have publicly blamed the leadership of Operation Warp Speed ​​for the pace of implementation. Warp Speed’s distribution efforts are led by Gus Perna, a military general and logistics expert who has no previous experience with vaccination campaigns.

“What happens if a vaccination program is appointed by the White House as a logistics program with no experience with vaccination?” Frieden wrote on Twitter. “Not starting well.”

Other public health leaders have told STAT that a lack of communication with the federal government is hampering their initial proliferation efforts.

Anita Lundquist, executive director of pharmacy services at St Croix Regional Medical Center in Wisconsin, said she does not know what type of vaccine the center will receive, the amount of doses or the delivery time until the shipment arrives Monday. That uncertainty meant that the hospital had to constantly recreate the initial appointment of vaccines for staff. It also meant that hospital officials had to prepare plans for the administration of both the Pfizer and Moderna vaccines, which require different storage protocols.

The Department of Health in Wisconsin proposed at various points in December that the St. Croix Regional Medical Center received 200 doses of Pfizer vaccine. Instead, they received 100 doses of Moderna’s shots, less than a quarter of what is needed to vaccinate all clinical staff.

Those awaiting vaccine delivery should rely on their health departments for updates, as the federal government’s Tiberius tracking system is used nationwide to monitor the location of the doses, available only through the state, Lewandowski of Rural Wisconsin said. Health Cooperative said.

“The warnings are not working ideally, and the communication from CDC to the state is not ideal either,” Lewandowski said. One local hospital expected them to be vaccinated on Christmas Eve, only to find out after repeatedly emailing the state health department that the doses had been delayed because the FedEx truck they were transporting was involved in an accident.

Such last-minute delays have a significant impact on scheduling, especially since many healthcare systems plan vaccinations so that staff have free time to recover from some of the side effects. “It’s all going out the window,” Lewandowski said.

The snowstorms on the East Coast last week probably slowed the spread as well. The Wisconsin Department of Health has told hospitals there are delays in postponing the Moderna in a timely manner, Lundquist said. He meant that hospitals that would have received the vaccine last Wednesday would rather have sent on Monday or Tuesday.

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