Shots. Into arms. NOW.

We are not vaccinating people quickly, and supercovid is coming

The top priority in America right now is getting vaccines into arms as quickly as possible. And we’re just not doing it.

The U.S. has vaccinated 0.78% of its population (actually just delivered the first shot, but one shot of these mRNA vaccines is so effective that I feel comfortable saying those people have been “vaccinated”). That’s more than most countries, but it falls far short of what Israel is doing, or even the UK.

Furthermore, as of the writing of this post it has been almost 3 weeks since the first vaccine (Pfizer) was approved. At this rate it will take a decade to vaccinate everyone.

And we do not have a decade. The third wave of COVID-19 is still raging, and an even more frightening menace is fast incoming: New, more transmissible variants of the virus, especially the new UK variant called 501Y.V1 (but which I have taken to calling, for lack of a better name, “supercovid”).

Here are some threads by experts describing why they believe this variant is much more transmissible than the COVID that has been ravaging our country heretofore:

Trevor Bedford @trvrb

With data that has emerged in the last week, I'm now 80-90% convinced that infections by the UK variant virus (Pangolin lineage B.1.1.7, @nextstrain clade 20B/501Y.V1) result in, on average, more onward infections, ie are more transmissible. 1/10

Trevor Bedford @trvrb

Following up on general thoughts on antigenic drift of #COVID19 from this weekend, I wanted to discuss what we know about the new variant of SARS-CoV-2 thats emerged in the UK. 1/17 https://t.co/AMxT5lWOVR

Kai Kupferschmidt @kakape

Finally read the new update on UK variant B.1.1.7, posted yesterday, which includes a study suggesting the variant is no more (or less) severe than prior virus variants. Just a very brief thread (or read the entire document here: assets.publishing.service.gov.uk/government/upl…)

I’m not an expert, but from eyeballing a graph it sure looks like supercovid, which now comprises most of the COVID in the UK, blew away all their containment measures:

Now the UK supercovid has been detected in California and Colorado. It’s here, and it’s spreading. The U.S. is even worse at containing the virus with public policy measures than the UK is, so this is very very bad news.

Given the U.S.’ failure to contain the normal virus variant, our chances of containing supercovid seem basically nil. So what we need to do is to get vaccines into arms immediately.

Unfortunately we’re not doing that either. The Trump administration set a goal of 20 million vaccine doses administered by year’s end. Well, year’s end is Friday, and while about 12 million out of the promised 20 million vaccine doses have been allocated, so far the number that has been actually administered is less than 3 million (a bit of an undercount due to patchy and slow reporting, but still). Shots are simply not going into arms.

Why not? Here’s a CNN article about it. Here’s a good Twitter thread by Ashish K. Jha about it. I’ll quote most of his tweets here.

Ashish K. Jha, MD, MPH @ashishkjha

Now, we'll miss 20M deadline but might be able to get to 20M by sometime in early January But this is really not the worst part The worst part is no real planning on what happens when vaccines arrive in states No plan, no money, just hope that states will figure this out 4/n

Ashish K. Jha, MD, MPH @ashishkjha

So who manages state level? Departments of Health mostly These well-funded agencies (yes, I'm kidding) who manage all the testing, data analysis & reporting, providing advice to businesses, schools, doing public campaigns, etc Non-stop. For 9 months They get vaccines too 5/n

Ashish K. Jha, MD, MPH @ashishkjha

So DOHs adding vaccines to their plate 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 6/n

Ashish K. Jha, MD, MPH @ashishkjha

The line when Mississippi health chief says its not state's job to ensure vaccines get into people's arms What? Whose job is it? Not the Feds. They just get vaccine to states Not the states. They just get vaccine to hospitals, clinics So its all on front line providers? 7/n

Ashish K. Jha, MD, MPH @ashishkjha

To be sure, many states are taking real responsibility LOTS of overburdened public health folks are still making this work. Heroically But now hospitals trying to figure out where to set up vaccination sites. And folks sorting out who can do vaccinations in care facilities 8/n

Ashish K. Jha, MD, MPH @ashishkjha

There appears to be no investment or plan in the last mile No effort from Feds to help states launch a real vaccination infrastructure Did the Feds not know vaccines were coming? Shouldn't planning around vaccination sites, etc not have happened in October or November? 10/11

Ashish K. Jha, MD, MPH @ashishkjha

Public health has always been a state/federal partnership States are stretched Feds are suppose to help But same folks who blamed states for testing mess now ready to blame states for vaccine slowdown They are again setting states up to fail But now, there is hope.... 11/12

Ashish K. Jha, MD, MPH @ashishkjha

Congress finally passed $ for vax distribution States now building infrastructure. Should have been built by Feds months ago After a slow ramp up, it'll get better We're learning again we can't fight pandemic with every state on its own An effective federal govt helps Fin

You don’t have to look far to find the reason that the federal government isn’t helping. Trump is simply doing the same thing he’s done throughout the pandemic — ignoring the virus, hoping it’ll just go away, and dumping the problem in other people’s laps.

Trump is completely focused on his doomed attempt to overturn the results of a free and fair election, and has been completely AWOL on the plague killing several thousand Americans per day.

So who can do something in the meantime? States are working as hard as they can, setting up mass vaccination sites, and learning how to deal with the logistics of the vaccine. What they need is more resources. As Matt Yglesias has pointed out, the biggest constraint is simply money — states and cities are cash-strapped, and can’t borrow like the federal government, which is why Trump’s dereliction of duty is so destructive. The relief bill that Congress just passed has some money for vaccination, but more would be very helpful.

Wealthy individuals and corporations might be able to fill some of the gap. Gates and Bezos and Musk and Zuckerberg and Bloomberg etc. need to be shoveling money to state departments of public health right now, and to anyone else who needs resources to get shots into arms. Google, Apple, Microsoft, etc. need to all be doing the same. Call your local bazillionaire or megacorporation and tell them to help get shots into arms!

Second, any vaccine doses that are on the brink of expiration should be given out randomly. We’ve had a tortured, contentious, and intellectually stimulating debate over priority allocation of vaccines, but if the doses rot in the fridge, none of that matters. The Moderna and Pfizer vaccines both have a shelf life of about 30 days when stored appropriately. If any vaccine dose is about to expire in one day, and public health agencies or hospitals or other providers are simply not able to get that dose to someone on the priority list, give it out randomly, like a Walgreens did in Kentucky. Better a shot goes into ANY arm than into the trashcan.

Finally, state and local governments that aren’t making COVID vaccination their top priority need to reprioritize, pronto. Stopping the virus before supercovid arrives is far more important than anything else those governments could be doing right now.

Oh, and the person who intentionally threw away 500 vaccine doses belongs in a jail cell.

Shots. Into arms. NOW.

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