As the nation recoils from the deadly insurrectionist attack on Congress and the United States Capitol, a direct line also must be drawn to the huge health harms that President Trump and his administration incited with a flood of falsehoods, relentless attacks on science and expertise, and the reckless politicization of public health.
This administration will leave office with the nation hurtling toward 400,000 coronavirus deaths and 22 million infections. The disease is unchecked. New cases and hospitalizations are breaking records by the instant. The situation is likely to worsen significantly before it improves, experts warn.
The best efforts to battle Covid-19 also — due to a shambolic and too often counter-factual federal response — must combat the misinformation, mistrust, and animus sown during a needlessly destructive presidential term.
Medical scientists may have pulled off a marvel in their rapid development of what appears to be safe and effective vaccines against a viral infection unknown to humankind just a year ago. Vaccine makers and logisticians have gotten tens of millions of doses out for use across the country.
Still, the much-promoted push to get hundreds of millions of us vaccinated persists as more promise than reality: As of Jan. 8, the federal Centers for Disease Control and Prevention reported that slightly more than 22 million vaccine doses had been distributed but only 6.7 million patients had gotten their first of two required shots.
Yes, the vaccination data lags. Officials in many areas have sought to hold back supplies to ensure patients got the needed two shots and so vulnerable residents and staff in nursing homes and long-term care facilities would be priority recipients. (Their vaccination also is lagging, by the way.)
Federal officials keep promising that the effort to vaccinate hundreds of millions of Americans soon will accelerate.
But somehow the toughest hurdle in the vaccination campaign has not become shipping products requiring super cold temperatures hundreds or thousands of miles. Instead, it is the ordeal of getting an inch of hypodermic needle into consenting patients’ arms.
Wide-spread hesitancy in key groups
Confusion and even consternation have built, for example, over the hesitancy by health workers and first responders to get vaccinated, especially as they stand first in line. Why in virus-savaged Southern California have as many as half of the eligible staff at some overwhelmed hospitals declined the shot? Why were gifts and prizes required to boost vaccinations among Los Angeles city fire fighters, many of whom experience routine exposure to sick and dying residents needing the help of an agency that has itself had hundreds of viral infections and a handful of deaths?
Last July, before rigorous studies would show the surprising success of vaccine candidates, public health and behavioral experts from Johns Hopkins and Texas State called on the White House to commit a significant part of the billions of dollars allocated to Operation Warp Speed (the nation’s vaccine development program) to pushing out crucial information. The public needed to know all it could about how the coronavirus vaccine was developed, how it worked, and what risks and benefits would be part of it. Patients needed to be informed about the safety, effectiveness, and cost of the shot, as well as that it would be given in a fair way, especially in communities most harmed.
Instead, as news organizations reported, the White House installed unqualified and extremist partisans in federal health agencies, notably the Health and Human Services agency, as well as the CDC. Trump minions belittled and battered medical scientists for months, undercutting their capacity to do their vital work. That effort included a plan to strip hundreds of millions of dollars from CDC disease-fighting efforts to fund a national ad campaign — not to tackle, say, informing Americans about vaccinations and their benefits, but, instead, to praise the president’s work on the coronavirus. The campaign, planned to roll out as part of Trump’s re-election effort, foundered.
Still, helpful efforts went undone, even as the president and political partisans assailed important public health measures. They made it a political, rather than a commonsense concern, for people to cover their faces, distance, practice great hygiene (especially hand washing), and avoid closed, poorly ventilated spaces for significant periods. Even after Trump himself fell ill with the coronavirus, he flouted scientific evidence and created multiple sickening and even lethal super spreader events. The Republicans in the Senate, led by Majority Leader Mitch McConnell, shoved through judicial confirmations while stalling for months pandemic relief measures, including money that states needed for vaccination programs.
As Americans wearied of public health restrictions and began to circulate and travel freely, the president and his staff have all but ignored the explosion of coronavirus infections and deaths, as well as the crumbling U.S. health system.
Jump-starting vaccination campaigns
What’s next? With viral variants starting to circulate — and some evidence that vaccines can be effective against what’s out there now — it is past time to make vaccination a real national priority. The paths to do so are well known, experts say. National leadership — not just shrugging giant problems off to states, cities, and local governments — is a must. So, too, are the influential voices in a range of communities, especially in those hardest hit. Hundreds of thousands of patients have gotten vaccinated, with rare ill effect. Care also must be exercised so vaccines don’t get blamed for incidental illnesses. Vaccines, like any medical intervention, carry risks. These are far outweighed by their benefits, and the coronavirus’s harms are writ large.
President-elect Biden has pledged to give unstinting support to vaccination campaigns, including invoking federal powers to ensure that makers rapidly boost their supplies, as well as dealing, finally, at a national level with shortages of personal protective equipment (PPE) and testing. He has said his administration will work with state and local public health officials and hospitals and others in the health system.
At the same time, with the virus tearing up huge chunks of the country and overwhelming doctors, clinics, hospitals, and public health personnel, Biden will need to prod other providers, including getting even more action from pharmacy giants like CVS, Walgreens, and Walmart. He may need to mobilize military resources, as well as a ready corps of able volunteers for mass vaccination campaigns at easy, convenient, and readily accessible sites.
Right places, right time
Benjy Renton, a collegian who has shown some chops in dealing with disease data already, has tapped his academic studies in geography to build on social media many advocates’ thought-provoking approach to boosting vaccination: He says that sports organizations and meeting planners nationwide need to get busy in throwing open arenas, stadiums, convention centers, and fairgrounds for mass programs. These facilities often are in or near poorer, hard hit neighborhoods. They are big and open, lessening infection spread. Teams and beloved athletes could generate huge goodwill by taking a leadership role in slashing the coronavirus’ wave of sickness and death — the Dodgers, for example, have seen their stadium become an even more prominent media landmark, open for voting and what journalists have deemed to be the nation’s largest Covid testing site.
The DMV (the District of Columbia, Maryland, and Virginia) have numerous sites that would fit the bill for donated space for mass vaccinations. Maybe mayors and governors asked yesterday for help from the Washington pro football team, as well as the Ravens, Orioles, Nationals etc. The area is flush, too, with other similar potential sites on university campuses.
By the way, doctors and others who are not on the front lines of treating coronavirus patients could assist at mass vaccination sites by being ready to deal with the rare cases of side effects. And, to their credit, all manner of health workers — doctors, nurses, physician assistants, techs, med students, and more — have posted on social media that they and their colleagues stand at the ready to volunteer to help in vaccination programs.
Where there is a will, there are ways to advance an important coronavirus-fighting effort.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent health care. This has become an ordeal due to the cost, complexity, and uncertainty of treatments and prescription medications, too many of which turn out to be dangerous drugs.
That said, we need to provide exponentially greater support to ensure the health care system does not collapse in the next few weeks. The coronavirus is taking a savage toll on the country, and it is hard to fathom that an administration that already has dealt with the pandemic is so unacceptable a fashion still has time to — well, to do far, far too little. Thousands more will die — with the present pace of ~4,000 coronavirus deaths daily, the disease may kill more people than live in Annapolis before Trump’s remaining time in office expires.
We’ve got a lot of work to do to defeat the virus, especially by getting us all vaccinated.