The adults are finally in charge

Admit the difficulties. Don’t overpromise. Yet set ambitious, but achievable goals.

The first public briefing by the Biden administration’s COVID-19 response team provided a welcome relief from the silence and obfuscation that marked the last six months of the previous regime. The five members from the task force appearing in a nationally televised briefing this morning provided a lot of data to back what amounted to plea for patience in the face of a virulent disease outbreak that has now cost over 425,000 Americans their lives.

Vaccinations are on the way and should move faster than the 100 million vaccinations administered within the first 100 days that had been initially promised by the incoming president, the team’s leaders said.

But will the administration be able to procure and deliver to states enough vaccines to vaccinate every person over age 16 by the end of June, the goal revealed by senior advisor Andy Slavitt, who served as interim administrator at the Centers for Medicare and Medicaid Services during the Obama administration? That would require a doubling of the current pace of distribution to states.

Slavitt said the administration will deliver about 10 million doses a week for the next three weeks on top of the 47 million doses delivered to date. With about 250 million people over 16, the U.S. will need about 500 million total doses by the end of June, which will require delivering an average of 20 million doses per week over the next five months.

And that’s where the most interesting part of the briefing comes into play. Pressed by reporters about the use of the Defense Production Act, response coordinator Jeff Zients warned manufacturers that the DPA, which gives the government the power to command production of necessary goods in a national emergency, could be invoked in the coming months if it looks like the administration will fall short of its goals.

“Everything is on the table with respect to the supply chain,” Zients said. “Anything we can do to increase the supply of vaccine is on the table and we will execute accordingly.”

He also gave the strongest argument yet for why the administration is unlikely to let Republican obstruction in the Senate to hold up the proposed $1.9 trillion American Rescue Act, which includes new funding for states and localities to set up vaccination sites, acquire personal protective equipment, and hire personnel to rapidly ramp up vaccine administration. The Democrats can use its slim majority in the Senate to include relief funding in a reconciliation bill that isn’t subject to the Senate’s filibuster rules.

“The funding is needed to expedite delivery,” Zients said.

Vaccines that are still undergoing clinical trials could be available by late spring

“I want my Maypo”

As I noted over the weekend, the biggest roadblock in the months ahead won’t be vaccine availability (except to those people who, like the little kid in the Maypo commercial, want it NOW!), but reaching the most vulnerable populations with high incidence of the disease. A shockingly high percentage of health care workers are reluctant to get vaccinated, and people in minority and poor communities – including in many rural white communities that voted overwhelmingly for Donald Trump – are either hard to reach or remain vaccine hesitant. 

Moreover, the Centers for Disease Control and Prevention is still flying half blind with regard to understanding where those hard-to-reach populations are. Only 16 states are releasing race and ethnicity data and, according to Marcella Nunez-Smith, the Yale public health professor who chairs the Covid-19 health equity task force, “even that data is incomplete.” 

The CDC is building a dashboard for states to compile accurate data about who’s gotten vaccinated so their public health officials can better target vaccine distribution as supplies become available. “I give kudos to all those states pushing to get to people in vulnerable communities,” she said. “We’re going to take an extra step to get to some of the people hardest to reach.”

Meanwhile, an unmuzzled Dr. Anthony Fauci offered cautious reassurance on the new vaccines’ efficacy against the mutant strains now beginning to circulate in the U.S. The CDC has identified 308 cases of the United Kingdom mutation in 26 states, but preliminary data suggest the vaccines produced by Pfizer/BioNTech and Moderna remain effective against that strain.

No cases have been reported of the more concerning South African mutation, which has proven more resistant to the new mRNA vaccines. But even there, Fauci said, their efficacy “may be still well within the vaccine protective range,” even if not better than 90%.

The preliminary data could prove false, and these mutant strains could require entirely new vaccines. There could still be huge hiccups on production, distribution and administration of the existing vaccines. The new administration COVID-19 team leaders admitted all these possibilities.

But what a refreshing change it was to see competent government officials treating the American people like adults. Now it remains to be seen if the public can respond in a similar fashion.