America had no trouble reaching the horrific milestone of 20 million cases of coronavirus, but it was a big problem to reach the federal government’s own goal of vaccinating against 20 million people by 2020.
Just under three million Americans were vaccinated by the time the crystal-wrapped ball dropped on New Year’s Eve in New York’s nearly deserted Times Square at midnight to mark the end of a hellish year.
The U.S. distribution of the vaccine is now frequently described as ‘chaos’, with criticism that incompetent officials are making an effort.
More than 10,000 people have died in the United States in the last three days of 2020 alone, bringing the national death toll to close to 350,000 so far, including the worst 24-hour toll of the entire pandemic when more than 3,700 people died last Wednesday. to Johns Hopkins University data.
Vaccines are therefore the big hope to fight the outbreak. But experts warn that there could still be hundreds of thousands of deaths if the vaccination process does not get underway quickly and firmly.
“The federal government is basically addressing the explosion of vaccines,” said Ashish Jha, dean of Brown University’s School of Public Health.
“They thought their job would end when the vaccine arrived in the states, and there is actually no well-defined plan.”
He added: “What America has gone through is the result of incompetence in federal leadership – the whole pandemic has been damaged by a group of people, not just Donald Trump – who do not understand how things work and can not get anything. does not work effectively. ”
Jha noted that he does not include the top American expert on infectious diseases, Anthony Fauci, or Deborah Birx, coordinator of the Coronavirus task force Coronavirus.
If the rollout continues at the current pace, Jha said it could take ‘many, many months and years’ to reach the country’s vaccination targets.
And if this delay continues for months, it could cause the US to lose a few hundred thousand more people, he warned.
An NBC analysis earlier this week found that at the current vaccination rate, “it will take almost ten years to vaccinate enough Americans to get the pandemic under control”.
The breakthrough of new vaccines so far in the west from Pfizer / BioNTech, Moderna and Oxford University / AstraZeneca are lifesavers, and more are still being tried.
“The vaccine appears to reduce the risk of … symptomatic Covid,” said Bruce Y Lee, a professor at CUNY’s public health and health policy in New York.
But he warned: “Every week, two weeks, three weeks delay, as things push up further, it costs lives – and especially when we talk about health workers.”
The state of vaccines administered to the public in many U.S. territories stems from a combination of low funding and scattered logistics.
Public health in the US is chronically underfunded. Local and state officials have long warned federal authorities that they need more than $ 8 billion in extra money to build an infrastructure to get shots in the arms. Instead, the White House gave only $ 340 million for vaccination preparations.
Some lawmakers have struggled for months to raise more money for vaccine distribution. Only last Sunday, when the delay in the new coronavirus bill was signed by Trump, did an additional $ 8 billion in funding come through, STAT News explained.
However, more money to states will not completely solve the problem. Experts said a unified, national plan was needed to address logistical problems.
“Not enough doses have been produced and distributed,” Lee said. He is also executive director of public health informatics, computational and operational research at CUNY.
‘Of the doses distributed, the majority were not administered. They get either [caught] in the supply chain … or not applied, which is not too surprising because there was no clear, coordinated national plan. ”
The decision of the federal government to put the initiative on states on how they would administer the vaccine doses to people exacerbated these problems.
The Pfizer / BioNetch vaccine should be stored between minus 112F (minus 80C) and minus 94F (minus 70C), while Moderna’s sample should be stored at approximately minus 4F (minus 20C), which means that sites may struggle to adequately freeze find.
Federal coordination on vaccine accessories such as syringes, needles and alcohol wipes is also lacking.
“We have to remember that earlier this year the test went wrong because we ran out of cotton swabs,” Lee pointed out.
Numerous reports across the US paint a picture of random or limited rollout.
Texas residents have complained that providers do not pick up the phone when they call for information, that official websites are difficult to navigate – and that they do not know where to get the vaccine, reports Dallas ABC, WFAA-TV.
In Florida, where 65 people and older can also start vaccinating, the elderly have been seen camping out for the jab overnight.
Terry Beth Hadler, 69, lined up with hundreds of others in a parking lot outside the Bonita Springs Library in southwest Florida overnight.
She waited 14 hours and told the Associated Press that a fight broke out almost before dawn on Tuesday, when some people cut into the queue.
“I’m afraid the opportunity was a super-distributor, and I was petrified,” Hadler said.
In the Miami area, seniors have overwhelmed phone lines and a health department website in an often futile attempt to appoint vaccines, the South Florida Sun-Sentinel reports.
New York City, the world’s coronavirus hotspot in early spring, is also suffering from sluggish distribution.
The city received more than 340,000 doses, but administered only about 88,000, The New York Times reported Friday.
No one denies that it is challenging to carry out a massive vaccination campaign amid a public health crisis that has overwhelmed health workers and services in many parts of the country.
Claire Hannan, head of the Association of Immunization Managers, said in an email: “Doses distributed to hospitals will not be administered overnight. Hospitals are moving at a very deliberate pace. Providers need to be trained and healthcare professionals need to receive instruction on the vaccine. ”
She added: “Hospitals are currently very thin, we are asking a lot of their time, resources, space, energy and effort to coordinate the vaccine clinics. They need to get vaccinated amidst the care of patients.”
The pressure is intense.
“We expect to move at lightning speed, and I think they’re moving at a very good pace, as it’s a brand new vaccine,” said Jessica Justman, associate professor of medicine in epidemiology at Columbia Mailman School of Public Health.
This is not to say that delays, even if expected, should not be addressed immediately. Both facts are true: delays were virtually inevitable, but it would cost lives, she noted.
“Hundreds of thousands of people are dying and the implementation of the vaccine must take place as soon as possible,” Justman said.
Some public health experts believe the US should take a more innovative approach, including looking at the UK’s latest plan aimed at getting as many people as possible their first dose, rather than taking doses hold back in order to be ready scarce supplies for the administration of the second required shot to the same people several weeks after their first shot.
“In the UK, they space the amount of time between the first dose and the second dose, which is a very creative idea,” Justman said. “I trust that the UK will not make the decision without supporting data.”
Brown’s Jha said that the science that shows effectiveness with a single dose is not as strong, which is a dilemma. The US may continue to follow its current approach – reluctant to take any scientific risks and work ‘exactly according to the book’ on the distribution of vaccines or to see if anything new can stem the crisis.
“I think the British approach to getting a single dose out there is the right approach,” Jha said. “In my opinion, it is much more reasonable, given the situation we are in, that we should continue with this.”
On Friday, however, Fauci followed suit against the British model of delaying second shots to provide the partial protection afforded to more people by a single dose.
Meanwhile, the decision of some states to prioritize senior citizens over non-essential workers, which is contrary to federal recommendations, can create logistical challenges.
“As for the vaccination in the arms as quickly as possible, it might not be that bad,” Hannan said.
She added: ‘States have not had enough time or resources to set up these systems, so there will be hiccups. But once again, the crux of the matter, every day when the vaccine goes into the weapon, is a success. ‘
Brown’s Jha said the US could get back on track.
Even in the midst of suffering, he concluded: “I think you can make a moderate set of changes, and I think you can correct them.”