PROVIDENCE, RI (PA) – Public health officials have been sounding the alarm for months, complaining that they do not have enough support or money to get COVID-19 vaccines in their arms quickly. Now, the slower-than-expected start to the largest vaccination effort in US history proves it.
As they work, the US state and local public health departments cite a number of obstacles, most notably the lack of leadership from the federal government. Many officials worry that they are wasting precious time at the height of the pandemic, and delays could cost lives.
States lament the lack of clarity on how many doses they will receive and when. They say more resources should have been allocated to education campaigns to ease people’s concerns about the contempt for taking pictures. And, although the federal government recently approved $ 8.7 billion for the vaccination effort, it will take time to get to places that could have used the money a few months ago to prepare to deliver photos more effectively.
Such complaints have become a common refrain in a nation where public health officials have been left largely alone to solve complex problems.
“The recurring theme is the lack of a national strategy and the attempt to get the dollar on the line, lower and lower, until the poor people at the receiving end have no one else to send the dollar to,” said Gianfranco Pezzino. who was a public health officer in Shawnee County, Kansas, until his retirement last month.
Operation Warp Speed, the federal vaccination program, had promised to distribute enough doses to immunize 20 million people in the United States in December. He missed that target, and as of Friday, about 6.6 million people had received the first blow, according to a tracker from the Centers for Disease Control and Prevention. About 22 million doses were administered to states.
The American Hospital Association estimates that 1.8 million people must be vaccinated daily from January 1 to May 31 to gain widespread immunity by summer. The current rate is more than 1 million people a day below this level.
President-elect Joe Biden called the launch a “transvestite” on Friday, citing a lack of a national plan to take up arms and reiterating its commitment to manage 100 million shots in its first 100 days. He did not share details and was expected to discuss the effort this week. His office announced a plan to release most doses immediately, rather than keeping the second dose in reserve, the more conservative approach taken by the Trump administration.
The Trump administration has defined its primary role as the development of coronavirus vaccines and their delivery to states, which will then take over and ensure that vaccine doses have traveled the “last mile” in their arms. Each state had to develop its own plan, including developing guidelines for who gets vaccinated first. Several health experts have complained about this approach, saying it has led to confusion and a patchwork response.
“Let’s just say I was disappointed with how they handled the test, and the implementation of the vaccine reminded me how disappointed I was when they did the testing,” said Dr. Mysheika Roberts, health commissioner. in Columbus, Ohio.
Several public health officials and experts say they believe some of the early mistakes are calming down. Marcus Plescia, medical director of the Association of State and Territorial Health Officials, said the slow start should not come as a surprise, given the sheer scale of the pregnancy.
“It wasn’t going to be perfect,” he said.
However, Plescia said the federal government could have done several things before the launch – such as releasing billions of dollars earlier to help with personnel, technology and other operational needs.
An ongoing investigation by the Associated Press and Kaiser Health News detail how state and local health departments have been underfunded for decades. Public health officials have warned since spring that they lack staff, money and tools they needed to launch a vaccine. The money was not approved until the end of December.
The distribution of the vaccine involves a long and complex chain of events. Each dose should be monitored. Suppliers need to know how much staff they will need. Eligible people must be notified to schedule their fire, given the vaccine handling requirements and the need to observe people for 15 minutes after the shooting – all while observing social distancing.
It is difficult to plan too far because the number of doses received by the state can fluctuate. Hospitals cannot give all workers the same day due to possible side effects and staffing problems, so they must be distanced.
Rhode Island health officials say it can take up to seven days to receive doses for people after they are received. Officials in several states, including Rhode Island, Pennsylvania, Kentucky and New Jersey, said the supply was lacking it is one of the biggest obstacles to vaccinating more people.
Some communities have seen a large number of medical workers delayed in receiving the shot, even though they are the first in line. Columbus, Ohio, had lower-than-expected demand among priority groups, including emergency medical workers.
A public education campaign could have helped address the hesitation among health care workers, which slowed the launch of the first photos, said James Garrow, a spokesman for the Philadelphia Department of Health. Instead, officials talked for months about the speed with which vaccines were developing – which didn’t help allay concerns that he might not be safe.
“There simply weren’t any good messages about the safety and purpose of security protocols,” Garrow said.
The federal government has not done much to provide information resources that local officials can tailor to their own communities to address the concerns of people such as pregnant women or black men living in rural areas, said Dr. Michael Osterholm, an expert in infectious diseases at the University. from Minnesota, who is a member of Biden’s COVID-19 Advisory Committee.
“You do not need 50 different states to try to do this. What you want to have is a lot of sources of information that address different populations that any state can use, “Osterholm said.” We don’t have that now. “
Some states become creative. Oregon hosted a mass vaccination event at the state fair with the help of the National Guard. The governor said he was looking to vaccinate 250 people an hour. New Jersey plans to open six “megazites” for the vaccine where officials hope more than 2,000 people a day will eventually be able to shoot themselves.
But without a federal plan, such efforts can be tantamount to “throwing spaghetti on a wall to see what’s sticking,” said Chrissie Juliano of the Big Cities Health Coalition, which represents metropolitan health departments.
What is needed is a national, war-like effort to get the vaccines out to as many people as possible, several experts said. Medical emergencies can be covered 24 hours a day, seven days a week, said Pezzino, who is also a senior at the Kansas Health Institute. Why not make vaccinations available in that program?
“It’s possible. It’s feasible,” he said. “I don’t see the level of urgency, the sense of urgency of anyone here. And that’s honestly, that’s the only thing that could make a difference.”
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Choi reported from New York. Washington Associated Press writer Ricardo Alonso-Zaldivar also contributed to the report.
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