Trump Administration Offers No Plan or Support for Overwhelmed, Underfunded States
Life-Saving Vaccines Sitting in Warehouses, Pharmacy Shelves While Thousands Die in Overflowing ICUs
Doctors and Public Health Officials Demand “Much More Active Role From the Federal Government”
As the United States enters the pandemic’s most dangerous phase, Donald Trump is leaving behind a legacy of failure: he has completely abdicated responsibility for the distribution of a life-saving vaccine, and is forcing overwhelmed, underfunded states to fend for themselves during an unrelenting winter surge of infections.
Amid a vacuum of federal leadership, critically-needed doses are sitting in warehouses and on pharmacy shelves, some on the verge of expiration. States are struggling to scale up distribution and to convey essential information to the American people, as they face shifting expectations for how many doses will arrive, and when. Health care workers, over-stretched with spiraling caseloads, do not have the capacity to provide injections. And as the Biden Administration prepares to take office, the negligence of Donald Trump is creating chaos and continuing to endanger Americans.
State of Play: Record Numbers of Americans Died in the Final Days of 2020 as Pandemic Worsens and the Trump Administration Struggles to Scale Up Vaccine Distribution
On January 4, Over 128,000 People Were Hospitalized With COVID-19 In The United States — A Record Since The Pandemic Began, And An Increase Of 2,800 New Patients In A Day. “First responders in Los Angeles County have been told not to bring patients to hospitals if their survival chances are low, as health-care workers try to dig out from a deluge of covid-19 patients. More than 128,000 people across the United States were hospitalized with covid-19 on Monday, according to data tracked by The Washington Post. That number is a record and represents an increase of 2,800 patients in a single day.” [Washington Post, 1/5/21]
More Than 3,000 People Died On Each Of The Last Two Days Of 2020, Marking Some Of The Deadliest Days In American History. “More than 3,000 people died on each of the last two days of the year, higher than the death toll of either the Sept. 11 or Pearl Harbor attacks. Altogether at least 343,000 Americans have died of the coronavirus in the past year, and public health experts are concerned it will only get worse as they warn Americans not to gather for New Year’s celebrations.” [The Hill, 12/31/20]
The United States Is Reporting An Average Of Over 213,000 New Infections Each Day, With The Rate Of New Infections On The Rise. “The seven-day moving average, which smooths out irregularities in the data, was 213,437 as of Saturday, according to a Wall Street Journal analysis of Johns Hopkins data. That includes a surge in cases Saturday after the abnormally low number on New Year’s Day. The 14-day average was 198,781. When the seven-day average is higher than the 14-day average, it indicates cases are on the rise.” [Wall Street Journal, 1/5/21]
Promises Made, Promises Broken: President Trump Said Hundreds of Millions of Vaccine Doses Would Be Available in 2020 – But They Fell Far Short
In September, Donald Trump Contradicted The CDC And Promised 100 Million Doses Of The Vaccine Would Be Available By The End Of 2020. “President Donald Trump touted vaccine distribution plans in a Friday [September 18] news conference and pledged 100 million vaccine doses by the year’s end, a promise that contradicts the Centers for Disease Control and Prevention’s most optimistic projections… Internal CDC documents posted by The New York Times show that under the most optimistic scenario, if the two vaccines both prove to be safe and effective on an accelerated timeline, 35 million to 45 million doses could be available by late December. If just one of the vaccines is seen as safe and effective, only 20 million to 30 million doses will be available and if just the other vaccine is authorized, 15 million doses will be available, according to the documents.” [Roll Call, 9/18/20]
In December, The Trump Administration Promised That 300 Million Doses Of The Vaccine Would Be Available To Americans By The End Of 2020. “Pharmaceutical executive Moncef Slaoui spoke alongside the president and said he had ‘very recently seen early data from a clinical trial with a coronavirus vaccine, and these data made me feel even more confident that we will be able to deliver a few hundred million doses of vaccine by the end of 2020.’ Mr. Trump called on pharmaceutical giants to support his demands for 300 million vaccines by the end of the year, then invited his vaccine czar to speak from the White House podium about how those calls were allegedly being met in record time.” [The Independent, 12/6/20]
The Trump Administration’s Dr. Moncef Slaoui Then Promised That 20 Million Americans Would Have Received Their First Shot By The End Of 2020. The Trump Administration’s Dr. Moncef Slaoui told MSNBC on December 15: “Overall in the month of December, between the two vaccines — the Pfizer and Moderna vaccine — we expect to have immunized 20 million of our American people, and keeping 20 million doses for their second immunization a few weeks later.” MSNBC, Andrea Mitchell Reports, 12/15/20]
Far Short Of Initial Promises And Predictions, Only 4.33 Million Americans Had Been Vaccinated By January 4. “Vaccinations in the U.S. began Dec. 14 with health-care workers, and so far 4.33 million doses have been given, according to a state-by-state tally by Bloomberg and data from the Centers for Disease Control and Prevention.” [Bloomberg News, Accessed 1/4/21]
At The Current Pace Of Vaccinations, It Would Take The United States Roughly Ten Years To Inoculate 80 Percent Of Its Population. “The Trump administration’s Covid-19 vaccine distribution program needs a major shot in the arm because at the current rate, it would take almost 10 years to inoculate enough Americans to get the pandemic under control, a jarring new NBC News analysis showed Tuesday [December 29]. The goal of Operation Warp Speed, a private-public partnership led by Vice President Mike Pence to produce and deliver safe and effective Covid-19 vaccines to the public, is to ensure that 80 percent of the country’s 330.7 million people get the shots by late June. To meet that goal, a little more than 3 million people would have to get the shots each day, the math shows.” [NBC News, 12/29/20]
Despite a Final Hour Relief Package, States Still Lack the Funds Necessary to Ramp Up Distribution of the Vaccine
When The First Doses Of The Vaccine Were Being Distributed, States Had Only Been Allocated $340 Million In Funding To Ramp Up Distribution. “States and local public health officials have warned for months that they would need more than $8 billion in additional funding to stand up the infrastructure needed to administer vaccines. The Trump administration instead provided states $340 million in funding to prepare for vaccinations. Congressional lawmakers also balked for months at appropriating additional funding for vaccine distribution, although the coronavirus stimulus package signed by President Trump on Sunday included $8 billion in funding for that effort.” [Stat, 12/29/20]
Despite That The New Relief Bill Provides $8 Billion In Funding For Distribution, State Health Experts Are Unsure How That Money Will Be Allocated. “The vaccine effort represents a tremendous challenge for [Georgia’s Department of] Public Health, which is chronically underfunded and is dealing with other virus imperatives — tracking cases and overseeing contact tracing — along with its regular functions. ‘There likely isn’t the funding nor the infrastructure to support a statewide vaccination rollout at the speed that any of us would see as reasonable,’ Amber Schmidtke, a microbiologist whose Daily Digest tracks COVID in Georgia, said. ‘The coronavirus relief bill that was signed into law includes $8 billion for vaccine distribution, but we don’t yet know how that money will be allocated to the states.’” [The Albany Herald, 1/3/21]
Stimulus Funding For Vaccine Distribution Is Likely To Arrive Long After Overburdened Health Departments Have Begun Administering Vaccines. “Congress passed a stimulus package on Dec. 27 that will provide $9 billion toward vaccination costs, on top of $340 million that the Centers for Disease Control and Prevention sent to the states in September and December. But the new funds will arrive long after local health departments — already overburdened with mass testing and contact tracing efforts — had to begin planning for and administering vaccines.” [New York Times, 1/3/21]
President Trump’s Abdication of Responsibility for Vaccine Roll Out Undermining States’ Ability to Roll Out Shots
The Trump Administration Declined Between 100 Million And 500 Million Additional Doses Of The Pfizer Vaccine, Allowing Them To Be Shipped Overseas. “The government was in July given the option to request 100 million to 500 million additional doses. But despite repeated warnings from Pfizer officials that demand could vastly outstrip supply and amid urges to pre-order more doses, the Trump administration turned down the offer, according to several people familiar with the discussions.” [New York Times, 12/7/20]
The Federal Government Cut Shipments Of The Vaccine To Some States By As Much As 40 Percent, Complicating Distribution Plans. “Several U.S. states including New Jersey, California, Oregon, Nevada, and Washington state said the federal government has cut their expected allotments of the Pfizer Inc.-BioNTech SE vaccine for next week by about 40% without explanation. The Health and Human Services Department disputed that cuts had been made…. The conflict added to uncertainty for states and hospital systems administering the first doses and planning for more in the weeks ahead. New Jersey, for instance, expects 53,625 doses of the Pfizer shot next week, about 38% less than it had planned for, Health Commissioner Judith Persichilli said.” [Bloomberg, 12/18/20]
Even As The Federal Government Slashed Shipments To States, Pfizer Said Unused Doses Of Vaccine Were Sitting In Warehouses. “Pfizer said Thursday that millions of COVID-19 vaccines were sitting in storage because the US government hadn’t given it directions on where to send them yet. The statement was released a day after Health and Human Services Secretary Alex Azar suggested at a press conference that the drug company was having ‘manufacturing challenges,’ The Hill reported… Pfizer said in the Thursday statement that the company was ‘not having any production issues with our COVID-19 vaccine’ and that ‘no shipments containing the vaccine are on hold or delayed.’ ‘This week we successfully shipped all 2.9 million doses that we were asked to ship by the US Government to the locations specified by them,’ the statement added. ‘We have millions more doses sitting in our warehouse, but, as of now, we have not received any shipment instructions for additional doses.’” [Business Insider, 12/18/20]
After President Trump Spent Months Downplaying The Science And Attacking The Experts, Americans Are Hesitant To Get The Vaccine. “One reason for the partisan divide over vaccination, experts said, is the president himself. His repeated denigration of scientists and insistence that the pandemic is not a threat, they said, have contributed to a sense among his followers that the vaccine is either not safe or not worth taking.” [New York Times, 12/18/20]
- 60 Percent Of Nursing Home Workers In Ohio Have Declined To Be Vaccinated So Far. “In Ohio, for instance, Gov. Mike DeWine has said that about 60 percent of nursing home workers in the state have declined to be vaccinated so far, a statistic he repeated in a television appearance on Sunday. Mr. DeWine did not elaborate on where the figure came from; his office referred inquiries to the state’s Department of Health, which did not respond to inquiries about it on Sunday.” [New York Times, 1/3/21]
- Frontline Workers Across California Are Refusing To Take The Vaccine. “At St. Elizabeth Community Hospital in Tehama County, fewer than half of the 700 hospital workers eligible for the vaccine were willing to take the shot when it was first offered. At Providence Holy Cross Medical Center in Mission Hills, one in five frontline nurses and doctors have declined the shot. Roughly 20% to 40% of L.A. County’s frontline workers who were offered the vaccine did the same, according to county public health officials. So many frontline workers in Riverside County have refused the vaccine — an estimated 50% — that hospital and public officials met to strategize how best to distribute the unused doses, Public Health Director Kim Saruwatari said. [LA Times, 12/31/20]
- Nearly 40 Percent Of Americans Say They Will Definitely Or Probably Not Get The Vaccine When It Is Available To Them. According to a December survey undertaken by the Pew Research Center, nearly 40% of Americans say they will definitely not or probably not get the COVID-19 vaccine when it becomes available to them. Gallup polls put the number at 37%. That’s bad news not just for the vaccine refusers themselves but for the public as a whole. Experts including Dr. Anthony Fauci, head of the National Institute for Allergy and Infectious Diseases, had previously concluded that achieving herd immunity—the point at which a population is sufficiently vaccinated that a spreading virus can’t find enough new hosts—would require anywhere from 60% to 70% of Americans to take the vaccines. But lately, he and others have been inching that number upward, now estimating that herd immunity could require as much as 85% vaccine coverage.” [Time, 1/5/21]
Hospitals And Staff Are Struggling To Vaccinate Essential Workers As They Care For Patients Under The Strain Of A Winter Surge In Cases. “Hospitals, which are vaccinating the bulk of front-line health care workers, are under tremendous strain as the winter surge of COVID-19 cases engulfs them. ‘We’re launching a vaccine campaign in the midst of a pandemic surge after a year that’s drained and strained health care providers and public health departments. And we’re launching a vaccine campaign during the winter holidays,’ [National Center for Immunization and Respiratory Diseases’ Nancy] Messonnier said.” [USA Today, 1/4/21]
The Federal Government’s Abdication Of Responsibility For Vaccine Distribution Has Pushed The Responsibility To Underdeveloped Local Health Departments, Causing Discrepancies. The lack of a clear federal approach has also meant that the actual delivery of vaccinations has cascaded down to public health departments without adequate preparedness or vitally required support. Public health agencies at the state and local levels are chronically underdeveloped and underfunded. In some counties, there is not even a local public health department, leaving much of this work to fall to the state… This has led to a default reliance on hospitals to distribute vaccines, particularly with the nature of vaccine storage requirements. But hospitals lack the intrinsic structure and operational capacity to act as public health agents; they are simply not set up for this function. Vaccines are also being slowly distributed to retail pharmacies, which can open up new points of access, but coordination is in many ways even more complicated in these settings.” [MSNBC, 1/4/21]
Due To A Lack Of A Centralized Distribution Strategy, Information On The Vaccine Varies So Widely From County To County That Systems Are Becoming Easily Overwhelmed. “After months of anticipation, millions of doses of the two authorized coronavirus vaccines — made by Pfizer-BioNTech and Moderna — are flowing into hospitals and health departments across the nation, putting the end of the pandemic in sight. But Americans trying to access shots are encountering systems that vary widely county to county and that, in many places, are overwhelmed. Some counties and hospital systems launched reservation websites, only for them to quickly become booked or crash. Others announced appointments only through Facebook, with slots filling before some residents knew to look. And many have not revealed how the vaccine will be made available to anyone beyond health-care workers and long-term care residents and employees, the focus of the first round of vaccinations.” [Washington Post, 1/3/21]
The Federal Government Hasn’t Set Up An Emergency Communications System To Convey Localized Information About Vaccine Availability. “Local governments, already stretched by the crisis and reeling from Congress’s delays passing the latest COVID-19 relief bill, often lack the resources necessary to manage vaccine communication and coordination… Historically, the federal government has established systems to help local governments deploy emergency information, like tornado and hurricane warnings that are broadcast on local television, as well as localized text alerts.But the government hasn’t set up emergency communication systems to convey localized information about the vaccine, forcing citizens to turn to less reliable sources of information online.” [Axios, 1/5/21]
The Administration Hasn’t Helped States Secure Storage Facilities For Vaccines, And Some Could Expire As Biden Takes Office. “States have been rushing to build out their storage capacity, but have been warned of monthslong waits for ultracold freezers that could extend shelf life to about six months. That means that, in many places, this first batch of vaccine is set to expire in late January, around the time Joe Biden, who has been criticizing the rollout and promising to accelerate it, is set to take office.” [NY Magazine, 12/30/20]
- States Like Utah, Kentucky, And Indiana Are Struggling To Store Vaccine Doses Without Extra-Cold Facilities. “In Utah, sites to vaccinate teachers and first responders starting in January had no capability to store the Pfizer vaccine, although officials are trying to secure some ultra-cold storage, a state department of health spokesperson said. Very few of Kentucky’s local health offices could store the Pfizer shots, because of refrigeration requirements and the size of shipments, said Sara Jo Best, public health director of the Lincoln Trail District. Indiana’s state health department had to identify alternative cold storage options for 17 hospitals following changes in guidance for the vaccine thermal shippers.” [NBC News, 12/22/20]
Without Clear Federal Guidance On When And How To Vaccinate Primary Care Physicians, Only 23 Percent Of Primary Care Doctors Know Where They Will Get A Vaccine From. “Only 23% of primary care clinicians know where they’ll get a vaccine from, according to a survey of more than 1,400 such doctors from Dec. 11 to 15 by the Larry A. Green Center with the Primary Care Collaborative… So far, a ‘stark minority’ of the primary care physicians that [Emily] Maxson works with at Aledade have received their vaccine; most doctors are still waiting, she said. Federal guidance is subject to interpretation from states, the majority of which are distributing vaccines via major hospitals. And, without any clear state or federal government directive on when primary care doctors should be vaccinated, many independent physicians must rely on the goodwill of hospitals to receive their doses.” [Stat, 1/4/21]
Rural Hospitals Have Been Largely Excluded From Plans For Vaccine Distribution. “In rural parts of Texas, hospitals will have to wait a little longer for the vaccine for the Covid-19 vaccine. John Henderson, president and CEO of [Texas Organization of Rural and Community Hospitals] says rural hospitals are being left out. ‘It’s not that rurals were at the end of the list, it’s that rurals, as of this moment are not on the list of Texas hospitals to receive the vaccine.’ He says they can handle the Pfizer vaccine has to be kept at ultra cold temps. The bigger problem is it’s bundled in doses of 975 and most rural hospitals don’t have that many employees. ‘I understand that there are hard decisions, but I think any distribution philosophy that excludes rural is a mistake. We should have been included. I hope they see the Moderna distribution as an opportunity to rebalance and catch rural hospitals and providers up.’” [KRLD 1080, 12/16/20]
The Federal Government Is Slow To Deliver Doses To Cities That Have Already Distributed Most Of Their Supply. “Chicago has delivered 95% of the vaccine it’s received so far, but at the current rate of delivery, it would take a year to a year-and-a-half to vaccinate the city’s residents, Mayor Lori Lightfoot said Tuesday. ‘That is unacceptable,’ she said. ‘The federal government must absolutely, 100% step up.’ Chicago has built infrastructure to deliver the vaccine, Lightfoot said, but needs more doses. ‘The federal government has to step up, finally, and do a better job at protecting American lives from this terrible virus.’” [USA Today, 1/5/21]
In Other Places, Vaccine Doses Have Been Delivered But Up To 70 Percent Are Sitting On Pharmacy Shelves. “Doses have been distributed behind the government’s initial schedule, with 15 million, instead of the promised 20 million doses delivered by the end of 2020. And about 70% of those doses are sitting on pharmacy shelves, according to government data, with only about 14% of doses destined for nursing home residents and caregivers injected so far… Federal officials have focused on getting the vaccine onto hospital shelves but to get them off the shelves requires ‘an enormous human element,’ said [Kelly Moore, Deputy Director of the Immunization Action Coalition].” [USA Today, 1/5/21]
There Were No Explicit Directions Included With Vaccine Shipments. “Dr. [Karen] Kinsell and [Dr. Steven] Miracle said that when the [vaccine] shipments first arrived, there were no explicit directions included with them. ‘There was no clear instruction,’ Miracle said. ‘The expectation was to follow the [Georgia] Department of Public Health guidelines.’ The guidelines to enroll as a vaccine provider direct medical personnel to follow that state framework, Public Health said.” [Georgia Health News, 12/31/20]
Dr. Ashish Jha, Dean Of The Brown University School Of Public Health: “You Need A Much More Active Role From The Federal Government.” “Dr. Ashish Jha, a health policy researcher and dean of the Brown University School of Public Health, said the main problem is that states are not getting adequate financial or technical support from the federal government. Jha said the Trump administration, principally the Department of Health and Human Services, has set states up to fail. ‘There’s a lot states still need to do,’ he said, ‘but you need a much more active role from the federal government than what they have been willing to do. They’ve largely said to states, “This is your responsibility. Figure it out.”’” [Associated Press, 12/31/20]
Senator Mitt Romney (R-UT) Slammed The Administration’s Lack Of A Comprehensive Distribution Plan As “Inexcusable.” “Sen. Mitt Romney (R-Utah) slammed federal distribution of the coronavirus vaccine on Friday, calling the lack of a comprehensive strategy ‘inexcusable.’ …’The current program is woefully behind despite the fact that it encompasses the two easiest populations to vaccinate: frontline workers and long-term care residents,’ he said. ‘Unless new strategies and plans are undertaken, the deadly delays may be compounded as broader and more complex populations are added. We are already behind; urgent action now can help us catch up.” [The Hill, 1/1/21]
Snapshots: Leaving Vaccine Distribution to States and Localities Has Resulted in Chaos and Inefficiency
Florida’s County By County, First-Come, First-Serve Distribution Plan Forced Seniors To Wait For Hours At Vaccine Sites. “Florida’s county-by-county plan to vaccinate its elderly population has created a mass scramble for a limited number of doses, leading to hours-long lines at vaccination sites and overwhelmed county hotlines and websites. In southwest Florida, the Lee County Department of Health encouraged anyone 65 and older and high-risk frontline health care workers to come to one of seven vaccination sites. Each site had just 300 vaccine doses, and ‘no appointment is necessary,’ the county said. The first-come, first-serve plan led to huge lines forming overnight Tuesday as people camped out on lawn chairs and waited for hours.” [Fox 10, 12/30/20]
- Florida’s Problems Are The Result Of Inconsistent Federal Guidance And Governor DeSantis’ Departure From CDC Recommendations. “The issue is partly a consequence of the lack of consistent federal guidance in administering vaccines, as President Donald Trump deferred that decision-making to the states. In turn, Florida Gov. Ron DeSantis broke with recommendations from the Centers of Disease Control and Prevention to focus first on vaccinating the elderly rather than essential workers, and he has encouraged each county health department to make its own decisions on administering the vaccines.” [Fox 10, 12/30/20]
- Florida Senior Terry Beth Hadler: “I’m Afraid That The [Vaccine Line] Was A Super-Spreader… I Was Petrified.” “Terry Beth Hadler was so eager to get a lifesaving COVID-19 vaccination that the 69-year-old piano teacher stood in line overnight in a parking lot with hundreds of other senior citizens. She wouldn’t do it again. Hadler said she waited 14 hours and that a brawl nearly erupted before dawn on Tuesday when people cut in line outside the library in Bonita Springs, Florida, where officials were offering shots on a first-come, first-served basis to those 65 or older. ‘I’m afraid that the event was a super-spreader,’ she said. ‘I was petrified.’” [Associated Press, 12/31/20]
Some Counties In Tennessee Do Not Have Any Vaccines To Provide To Those Who Would Be Eligible. “COVID-19 vaccinations continued across the Tri-Cities with both those 75 and older and teachers being eligible in some Northeast Tennessee counties. However, some of those counties didn’t have any vaccines to give. ‘I’m really excited and grateful that I received word that vaccinations for our group continue today at one o’clock,’ said Sherry Cockerham who is a Johnson City Schools curriculum coach. ‘We hopefully will get in here and get our first round of vaccines.’ Cockerham was first in line Monday at Freedom Hall where COVID-19 vaccinations were supposed to continue, but that wasn’t the case. ‘A gentlemen from Freedom Hall came out and said that the vaccines they were counting on actually did not come in today,’ Cockerham said. Other counties in our region, including Greene and Johnson Counties, did not have vaccines available today.” [WJHL 11, 1/5/21]
Georgia Governor Brian Kemp Is Expanding Eligibility For Vaccines Amid Surpluses In Some Areas, As People In Other Areas Struggle To Access Information. “In Georgia, there are people who want to be vaccinated and can’t find out when and how they’ll get the shots. Meanwhile, some health care providers say they received hundreds more doses than they requested…The first doses of vaccines in Georgia were earmarked for health care workers and for residents and staff of nursing homes. But on Thursday, Gov. Brian Kemp and State Health Commissioner Dr. Kathleen Toomey said that the program would be opened to those over age 65, as well as to police officers and firefighters, in parts of the state — they didn’t specify which — where there were surplus supplies.” [AJC, 1/4/21]