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America has had no trouble reaching the appalling 20 million coronavirus case, but meeting the federal government’s target of vaccinating 20 million people by the end of 2020 has proven to be a huge problem. .
Just under three million Americans were vaccinated as the crystal-encrusted ball fell in New York’s nearly deserted Times Square at midnight on New Years Eve to mark the end of a hellish year.
Today, the distribution of the vaccine in the United States is systematically described as “chaos”, with criticism that incompetent officials “gag” their efforts.
More than 10,000 people have died in the United States in the last three days of 2020 alone, bringing the national death toll to nearly 350,000 so far, including the worst 24-hour toll in the entire pandemic when more 3,700 people died last Wednesday, according to data from Johns Hopkins University.
Vaccines are therefore the great hope to fight the epidemic. But experts warn that hundreds of thousands more deaths are possible if the vaccination process does not proceed quickly and securely.
“Fundamentally, the federal government is shaking up the rollout of the vaccine,” said Ashish Jha, dean of the school of public health at Brown University.
“They thought their job was over when the vaccine arrived in the United States, and there really isn’t a clear plan.”
He added: “What America is suffering is a consequence of the incompetence of federal leaders – the whole pandemic has been ruined by a group of people, not just Donald Trump – who do not understand how things work and cannot not get something to work efficiently. “
Jha noted that he did not include U.S. infectious disease expert Anthony Fauci or White House coronavirus task force coordinator Deborah Birx in that group.
If the rollout continues at the current rate, Jha said, it could take “many, many months and years” to meet the nation’s immunization targets.
And if this delay continues for months, it could cause the United States to lose “several hundred thousand additional people,” he warned.
An NBC analysis earlier this week found that at this current vaccination rate, “it would take almost 10 years to inoculate enough Americans to bring the pandemic under control.”
The breakthrough new vaccines put into service so far in the west from Pfizer / BioNTech, Moderna and Oxford University / AstraZeneca are lifesavers, and more are still being tested.
“The vaccine appears to be able to reduce the risk of… symptomatic Covid,” said Bruce Y Lee, a professor at the CUNY Graduate School of Public Health and Health Policy in New York City.
But he warned: “Every week, two weeks, three weeks late, as cases increase further, costs lives – and especially if we’re talking about medical professionals.”
The state of publicly administered vaccines in many parts of the United States is a result of a combination of insufficient funding and dispersed logistics.
Public health in the United States is chronically underfunded. Local and state authorities had long warned federal authorities that they needed more than an additional $ 8 billion to build infrastructure for shooting guns. Instead, the White House gave states just $ 340 million for vaccination preparations.
For months, some congressional lawmakers resented providing more money for vaccine distribution. It wasn’t until last Sunday, when Trump’s new delayed coronavirus aid bill was signed, that an additional $ 8 billion in funding arrived, STAT News explained.
However, more money to the states will not completely solve the problem. Experts said a unified national plan is needed to address logistical problems.
“Not enough doses were produced and distributed,” said Lee, who is also executive director of public health informatics, informatics and operations research at CUNY.
“Of the doses that have been distributed, the majority have not been administered. They get either [caught] in the supply chain … or not to be administered, which is not too surprising, as there has not been a clear and coordinated national plan.
The federal government’s decision to leave the initiative to the states as to how they would deliver vaccine doses to people exacerbated these problems.
The Pfizer / BioNetch vaccine should be stored between minus 112F (minus 80C) and minus 94F (minus 70C), while Moderna’s jab should be stored at around minus 4F (minus 20C) – meaning that localities may have some difficult to find adequate freezing capacity.
Federal coordination on vaccine accessories such as syringes, needles and alcohol swabs is also lacking.
“We have to remember, earlier this year, that the tests went awry because we ran out of cotton swabs,” said Lee.
Numerous reports across the United States paint a picture of a haphazard or limited deployment.
Residents of Texas have complained that providers don’t pick up the phone when they call for information, that official websites are difficult to navigate – and that they don’t know where to get the vaccine, the report reported. subsidiary of Dallas ABC, WFAA-TV.
In Florida, where people 65 and older can also start getting vaccinated, older people have been seen camping overnight for the jab.
Terry Beth Hadler, 69, lined up in a parking lot overnight with hundreds of others outside the library in Bonita Springs in southwest Florida.
She waited 2 p.m. and told The Associated Press that a scuffle almost broke out before sunrise on Tuesday, when some people cut their tails.
“I’m afraid the event was a super-spreader, I was petrified,” Hadler said.
Near Miami, seniors overflowed phone lines and a health department website in an often unsuccessful attempt to secure immunization appointments, the South Florida Sun-Sentinel reported.
New York City, the global coronavirus hotspot in early spring, is also suffering from slow distribution.
The city has received more than 340,000 doses but only administered about 88,000, The New York Times reported on Friday.
No one denies that it is difficult to execute a mass vaccination campaign amid a public health crisis that has overwhelmed health workers and services in many parts of the country.
Claire Hannan, head of the Association of Immunization Managers, said in an emailed statement: “Doses distributed to hospitals will not be administered overnight. Hospitals are evolving at a very deliberate pace. Providers should be trained and health workers should receive training on the vaccine. “
She added: “Hospitals are also very large right now, we are asking a lot of time, resources, space, energy and effort to coordinate vaccination clinics, they have to tackle vaccination in the midst of patient care. “
The pressure is intense.
“We expect to be moving at lightning speed, and I think they are moving at a very good pace given that this is a completely new vaccine,” Jessica Justman, associate professor of medicine in epidemiology at the Columbia Mailman School of Public Health.
This is not to say that delays, even if expected, should not be addressed immediately. Both facts are true: Delays were virtually inevitable, but they will cost lives, she noted.
“Hundreds of thousands of people are dying and the vaccine rollout needs to happen as quickly as possible,” Justman said.
Some public health experts say the US needs to take a more innovative approach, including turning to the UK’s latest plan to get as many people as possible with their first dose, rather than withholding doses. to ensure ready amounts of the initial dose. – rare supplies to deliver the required second hit to the same people a few weeks after their first hit.
“In the UK they space out the time between the first dose and the second dose, which is a very creative idea,” Justman said. “I have no doubts that the UK would not make this decision without having the data to back it up.”
Brown’s Jha said the science demonstrating efficacy with a single dose is not as strong, which poses a dilemma. The United States could continue to follow its current approach – refusing to take scientific risks and operating “exactly by the book” on vaccine distribution or seeing if something new works to stem the crisis.
“I think the UK approach to getting a single dose is the right approach,” Jha said. “In my mind, it is much more reasonable, given the state of affairs in which we find ourselves, that we need to act on this point.
On Friday, however, Fauci spoke out against following the British model of delaying second injections in order to offer more people the partial protection conferred by a single dose.
Meanwhile, some states’ decision to prioritize older people over essential non-health workers, which runs counter to federal recommendations, could create logistical challenges.
However, “in terms of getting the vaccine out and getting it up to speed as quickly as possible, that might not be such a bad thing,” Hannan said.
She added: “States have not had enough time or resources to put these systems in place, so there will be a hiccup. But then again, at the end of the day, every day the vaccine kicks in is a success. “
Jha de Brown said the United States could get back on track.
Even in the midst of the pain, he concluded, “I think you can make a series of moderate changes, and I think you can fix this.”
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