How much longer is this going to take?
I don’t like to complain, but it feels like we’ve known for months and months that we were going to need to roll out an effective way to administer vaccines equitably to everyone in the country.
I know we’ve been thwarted by a political system that’s jammed up, by federal, state, and local governments that disagree on the best ways to get this done. And some that even say we shouldn’t do it. We’ve lacked the planning and public health infrastructure needed to really get things going. We are hindered by delays in manufacturing and miscommunication and good intentions gone wrong. But finally now we have a different administration in place, and the time to take action is now.
Getting 100 million shots into the arms of Americans over the next 100 days should be an attainable goal. And then we need to do more. We need to harness the power of social media, of influencers, and everyone else, to make sure this happens. We need public service announcements and TV ads and people telling their stories. We need to take advantage of every type of infrastructure we can. If Amazon Prime can deliver razor blades and toilet paper and toothpaste overnight to every citizen at every address in every corner of this country, then surely we can build on and adapt existing systems to get the vaccine out there.
We’ve seen lots of models proposed which rely on various distribution systems, and of course all of these depend on having an adequate supply of vaccine, people to administer it, a way to track things, and a willing population. We’ve seen some incredible examples of vaccine sites set up already that are efficiently processing patients through, getting this incredibly important task completed. We need to reproduce this on a massive scale, treating this the way any wartime effort has been treated in the past. Because this is war.
In World War II, when American soldiers fighting abroad needed ships and tanks and bombers and bullets, overnight we flipped the might of our industrial complex to bear on this problem. Today, we need to figure out how to get large vaccine sites into place in every major population center, accompanied by moderate-sized sites and smaller local sites that spread out into every community, to reach everybody who needs it in every city, neighborhood, region, homeless shelter and street, every nook and cranny. So whether it’s taking over unused school gymnasiums, doing it in drugstores, commandeering post offices, or parking recreational vehicles on every street corner, we need to load them up, move them out, and get this done.
True, someone’s got to lean on the pharmaceutical companies, get them to figure out how to ramp up production, push whatever buttons need to be pushed to ensure they have the supplies they need to churn out adequate vaccine to get everybody safe. I can only hope that the new administration will continue to take this seriously, and prove it with actions and not just words.
We also need to continue everything else, enforcement of mask wearing, social distancing, handwashing, and all the rest. We need to find new models to safely get people back to work, and to do so in an equitable way. We need to continue to work on the public health infrastructure we need to do contact tracing, and to support people safely at home while they recover from this deadly disease. And we need to get our kids back in school safely, and pay whatever it costs to make sure our teachers are protected, as well as all those on the frontline helping to keep our society running smoothly.
In the longer term, we need to continue to address the healthcare inequities that have devastated communities across our country, and promise to do everything in our power to make sure these underlying barriers to health are removed forever. But for now, vaccinating enough of our population to get to herd immunity will be critical to helping us vanquish this terrible disease, and also prove to everyone, once and for all, the immense value of a vigorous and wide-ranging public health infrastructure.
It doesn’t get any more patient-centered than this.
Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what’s going on in the world of primary care medicine from the perspective of his own practice.