Last Monday I was among the lucky ones – I received my first vaccine shot. It was not an easy task to find a location dispensing the vaccine shots and to get an appointment. I was lucky.
Though the United States governments (federal, state and local) have had ten months to prepare for the vaccination of the public and while science miraculously performed the “impossible” during those same ten months and produced multiple effective vaccinations, our governmental apparatuses have utterly failed to construct effective information and delivery systems critical to the vaccination of the public and defeating Covid-19. As a result, I fear that many who are unable to navigate the utterly confusing, inefficient, and ineffective “system” (if you can call it a system) will give up and remain unvaccinated. This is especially concerning at a time when more infectious mutants of the Covid-19 virus are spreading throughout the world.
The following article from today’s Washington Post demonstrates the dire situation.
Vaccine rollout gets ‘below an F’ grade
Canceled appointments. Insufficient doses. Contradictory eligibility rules. Infuriating websites.
Multiple mishaps have mangled the region’s rollout of vaccine doses that an exhausted citizenry expects will end the pandemic. The problems, also evident nationwide, add to the list of failures that the world’s richest country has compiled in a year of battling the coronavirus.
“If I were a teacher, I’d give [the effort] whatever is the grade below an F,” said Kavita Patel, a physician at Mary’s Center in Prince George’s County and a former White House policy director in the Obama administration.
Much of the fault for the debacle lies with the Trump administration, which once again dumped responsibility onto state and local authorities for a national task that a centralized system would have handled better.AD
“I was surprised that the federal Operation Warp Speed of the previous administration did not include plans for the last 12 inches of the vaccine effort — getting doses into arms, arguably the hardest logistical path in the process,” said Michael P. McDermott, president of Mary Washington Healthcare in Fredericksburg, Va.
But our state and local authorities also share the blame. Despite months of advance notice that vaccines were coming, they failed to manage public expectations about how long it would take to procure the vials of vaccine to administer.
They also did not build user-friendly IT systems so people could easily schedule appointments.
They changed eligibility requirements in the middle of the process, partly under Trump officials’ prodding.
The result is that political and bureaucratic snags have dimmed the glow, for now, of the historic scientific achievement of developing vaccines in record time to protect against a new and deadly disease.
The problems are typical of others that have bedeviled the U.S. coronavirus response and led many abroad to experience a novel feeling about the country they once admired: pity.
In the spring and summer, we had similar delays and difficulties in launching testing and contact-tracing programs. Although the Washington area has done better overall than much of the country, the shortcomings reflect decades of underinvestment in public health.
“There has been no centralized, well-considered plan,” said J. Stephen Jones, president of the Inova hospital system in Northern Virginia. “It’s clear evidence that we have chosen as a nation to forgo public health, and we are paying the price today.”
All three of the region’s top leaders — Maryland Gov. Larry Hogan (R), Virginia Gov. Ralph Northam (D) and D.C. Mayor Muriel E. Bowser (D) — did damage control at news conferences last week.
They pleaded with the public to show patience, saying they couldn’t do much until the federal government sped up its delivery of vaccine doses to them.
Hogan: “The plain truth is that for at least the near future, the demand for vaccines will continue to far exceed the supply that will be available to us.”
Northam: “The biggest challenge that we have . . . is the supply.”
Bowser: “We will continue to have less vaccine than we need.”
All true, but questions remain. Why didn’t they warn the public ahead of time of how long it was going to take to get vaccinated? Why did they widen eligibility without having enough vaccine and, thus, give false hope to hundreds of thousands of people who weren’t at the front of the line to get shots?
“Expectations were never managed well,” said J.B. Holston, chief executive of the Greater Washington Partnership. “The public clearly was led to believe that once vaccines were available, it would be really clear who they were available for and how to sign up. That didn’t happen.”
Authorities expanded eligibility before they were sure of procuring enough vaccine doses to meet demand, partly because the Trump administration, in its waning days, urged states to include the elderly in addition to top-priority groups such as front-line health-care workers.
“This was a parting shot of the Trump administration,” said Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. “Governors started to feel pressure [to expand eligibility]. What our members found was, once the governors are feeling pressure, there’s not much you can do. There’s reason and science, and then there’s politics, and you’ve got to respond to all of them.”
The eligibility rules were especially chaotic in suburban Maryland. In Montgomery County, people 65 and older are able to get vaccinated at the county’s hospitals and pharmacies, where state rules apply. But the cutoff is 75 and older at the county’s health department facilities because Montgomery wants to be sure the most vulnerable population is vaccinated first.
At a facility in Prince George’s County, where state guidelines allowed for any Maryland resident to sign up, large numbers from outside the county did so. That led County Executive Angela D. Alsobrooks (D) to cancel nonresidents’ appointments, to ensure that her own constituents got first crack.
In Northern Virginia, Inova canceled thousands of vaccine appointments last week when the stateabruptly changed its distribution method and cut its delivery of doses to Inova from 19,500 in one week to zero the next.
For many residents, the biggest frustration has been spending hours at the computer trying to schedule appointments on unwieldy websites that weren’t designed to account for different priority groups and other features of the coronavirus vaccination process. It is necessary in many cases to seek appointments on a hodgepodge of websites, such as those for the state, county, individual hospitals and pharmacies.
Northam said Virginia will develop a statewide system for people to schedule appointments. Earl Stoddard, Montgomery’s emergency management director, said he hoped Maryland would do the same.
Again, that’s a need that should have been anticipated.
West Virginia, which has one of the nation’s best records so far in getting shots into arms, has drawn praise for, among other things, using a single, transparent website for scheduling appointments. As we continue flailing, perhaps we need to rethink all those jokes about how our mountainous neighbor is supposedly so backward.
We need to do better. Lives are at stake.