Vanity Fair: “A Huge Potential for Chaos”: How the COVID-19 Vaccine Rollout Was Hobbled by Turf Wars and Magical Thinking
The Trump Administration Failed to Coordinate, Even Between Operation Warp Speed and the Coronavirus Task Force
Then-HHS Secretary Azar Refused to Heed Warnings of CDC Officials
Trump Administration Abdicated Vaccine Responsibility to Local Leaders Rather Than Provide Federal Support
The Trump Administration Failed To Communicate Within Itself, With Different Factions Hosting Separate Meetings To Solve The Same Problem.
- “On January 5, 2021, the day before an angry mob invaded the U.S. Capitol and called for him to be hanged for disloyalty to the president, Vice President Mike Pence convened his long-suffering COVID-19 task force at the White House to address a vaccine rollout that had devolved into chaos… Among those in attendance were the task force’s coordinator, Dr. Deborah Birx, and the director of the Centers for Disease Control and Prevention, Dr. Robert Redfield. But the person most responsible for the rollout, the secretary of health and human services, Alex Azar, was missing. Azar, along with the secretary of defense, was in charge of Operation Warp Speed, the federal government’s vaccine development and rollout program. So where was he? Sixty miles away, it turned out, inside a secure situation room at Camp David. There, Azar and a small group of top aides and military members of Operation Warp Speed were busy conducting their own analysis of the rollout’s problems. At least one blindsided White House task force member was “shocked” upon learning of the separate meeting.” [Vanity Fair, 2/5/21]
Former HHS Secretary Alex Azar Tapped Pharmacies To Assist With Vaccination Efforts, but Failed To Provide Info As To How Patients Would Flow Through Their Systems.
- “The Camp David group determined that the states were adhering too religiously to the CDC’s guidelines for who was eligible to be vaccinated first, according to one person present. The solution the group arrived at was to tap pharmacy chains to order and administer the vaccine. As part of this effort, the military performed a ‘geospatial analysis’ to identify the 19,000 pharmacies that were the closest to population centers. Weeks later President Joe Biden’s incoming administration began phone calls with those pharmacies and discovered that they had little understanding of how patients would flow through their systems.” [Vanity Fair, 2/5/21]
Operation Warp Speed Was Convinced That The Federal Government Should Limit Its Role In Vaccine Distribution To Simply Empowering The Private Sector, And Rebuffed Requests For Direct Federal Assistance.
- “Unlike many of the career health officials they worked with or oversaw, some political appointees within Operation Warp Speed held an ideological belief that the federal government should limit its role to empowering the private sector, handing off responsibility for actual vaccinations to the states. The program’s mantra— ‘federally assisted, state managed, locally executed’ —was adhered to so slavishly that urgent requests for direct federal assistance to states for vaccinations, from increased funding to additional manpower, were rebuffed, Vanity Fair has learned.” [Vanity Fair, 2/5/21]
Operation Warp Speed Prioritized Shipping Out Vaccines, Rather Than Actually Getting People Vaccinated.
- “General Gustave Perna, who headed Operation Warp Speed’s logistics, prioritized two key metrics for success, say two people involved in the program: to ship out vaccines within 24 hours of the Food and Drug Administration authorization and to develop a regular cadence for vaccine deliveries to the states. But his definition of mission accomplished didn’t seem to involve actually getting people vaccinated. In one tense meeting between Perna and the CDC, Perna’s staff had to explain to the four-star general that the CDC defined success by two entirely different metrics: the uptake of the vaccine and the elimination of the pandemic, said someone present at the meeting. Perna retained laser-like focus on what was called the N-hour sequence: the plan to move out the vaccine within 24 hours of its being authorized by the Food and Drug Administration.” [Vanity Fair, 2/5/21]
CDC Officials Were Restricted From Discussing Distribution Plans Until Very Late In The Game, And Just One Of Operation Warp Speed’s Board Meetings Addressed Distribution.
- “Based on past experience, public health officials expected distribution planning to take up a significant amount of their time. But officials at the CDC said they were restricted from discussing distribution plans with the states until very late in the game, and were told by Operation Warp Speed officials that any operational details were “close hold.” And from the program’s formal launch on May 15 to the start of the vaccine rollout seven months later, just one of the roughly dozen Operation Warp Speed board meetings addressed distribution, according to two participants.” [Vanity Fair, 2/5/21]
CDC Officials Were Determined To Develop A “Last-Mile” Plan, But Former HHS Secretary Azar Refused To Heed Their Warnings.
- “To officials at the CDC, creating a credible last-mile plan was an obvious imperative. Such a plan would have given the states detailed instructions on how to reach eligible vaccine recipients, how to formulate and deploy effective messaging, and how to enlist and assemble a force of vaccinators. It would be up to each state to tweak those instructions based on individual circumstances, but a clear blueprint needed to be in place, along with ample financial support. More than a month before Operation Warp Speed was formally announced, CDC officials worked through Easter weekend to assemble a preliminary last-mile plan. But it soon became clear that their belief in its importance was not shared by Azar and his Pentagon allies.” [Vanity Fair, 2/5/21]
Then-CDC Director Robert Redfield Asked Operation Warp Speed For Over $5 Billion To Support State Vaccination Efforts, But Azar Refused.
- “In May, Dr. Redfield asked Operation Warp Speed officials for $5.35 billion for states to build their last-mile capacity. It wouldn’t be his last request. He asked again repeatedly through September, each time running up against the same obstacle: Secretary Azar’s office didn’t think that the states needed the money.” [Vanity Fair, 2/5/21]
Operation Warp Speed Said Its Task Was “To Pick Up The Vaccine… And Drive It To State Health Departments And Drop It Off.”
- “On June 5, a CDC team traveled from its headquarters in Atlanta, Georgia, to Washington, D.C., to brief Operation Warp Speed officials on their view of the essential components of a successful vaccination plan. What they heard back was dismaying. ‘They told [us] their task was to pick up the vaccine and put it in the trucks and drive it to state health departments and drop it off,’ said one of the CDC team members. When Dr. Birx asked the officials leading Operation Warp Speed more granular questions about the distribution and administration of vaccinations, she was rebuked, said someone familiar with the exchanges. ‘If you’re questioning my judgment, maybe you should do this,’ one told her.” [Vanity Fair, 2/5/21]
Operation Warp Speed Relied On The Idea That “Local Leaders Are Best Positioned To Execute,” But That Notion Resulted In Too Few Vaccinators, Too Few Patients, Crashing Communication Systems, And Other Problems.
- “[Former HHS deputy chief of staff] Paul Mango defended the planning, saying that it was ‘all based on the fundamental belief that local leaders are best positioned to execute.’ … But by mid-December, as vaccines landed in hospitals and storage depots, the majority of states faced an almost immediate tangle of problems: too few vaccinators; in some cases, too few interested patients; threadbare public health departments, depleted by months of pandemic crisis; I.T. systems that were crashing in real time. Though several states—notably West Virginia and Connecticut—pulled off efficient and well-organized rollouts, they were the exceptions.” [Vanity Fair, 2/5/21]