Why a vaccine distribution plan is key to saving the US from COVID-19
Early in April, Dr. Anthony Fauci, the top United States infectious disease expert, said that inability to quickly and efficiently test for COVID-19 was a failure early on. Now, months into the pandemic, what's holding us back is the lack of a working vaccine and an effective vaccine distribution plan.
COVID-19 testing developed and deployed effectively could have diminished the exposure, spread and fatalities around the country and the world. But now, we are left with continued surges, including this devastating second wave, which on Friday reached over 100,000 cases per day.
More than 10.1 million people in the U.S. have been infected with coronavirus, and recently, daily infections have reached peak numbers, which have led to at least 238,000 deaths.
This is a mortality rate similar to the 1918 Spanish flu (2.5%). The coronavirus crisis hit the world a century after the Spanish flu, at a time when humanity has significant health care and technology advances, yet we find ourselves in a situation where hundreds of thousands of people are dying and we are still trying to contain the virus and stop the spread.
As a country, we can't afford to replicate this failure in vaccine distribution. Vaccine safety, efficacy and adoption are essential, but none of that matters unless we have a plan for effective distribution.
Recent evidence suggests that the majority of COVID-19 infections and deaths were avoidable. This means that mothers, grandmothers, husbands, grandfathers, brothers, sisters, friends and loved ones could have been saved had the country been prepared for a health crisis. Now that we are getting closer to having life-saving vaccines available, we cannot manage vaccine distribution and administration the way we managed testing. We cannot allow for unnecessary deaths. We cannot fail America again.
The Trump administration has published a comprehensive and robust set of recommendations for jurisdictions regarding vaccine distribution. These recommendations (like the Centers for Disease Control and Prevention's COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations) are a good start, but are not practical for most jurisdictions to implement because of its complexity and lack of clear guidance. At the national, regional and local levels, it is clear we do not have the infrastructure needed to support these recommendations. We need a solution that will work on the ground to enable our nation to get safe and effective vaccines to people in densely populated urban areas and remote rural areas. We need a practical, last mile on-the-ground game.
President-elect Joe Biden told Americans Saturday that he will put together a group of experts to help him come up with a plan to fight COVID-19 in the country. He is expected to speak more about the issue on Monday.
Below are the three things that need to happen to ensure we don't fail America with the coronavirus vaccine like we failed it with testing:
1. The private sector must step up.
2. Large employers and real estate businesses must act as hubs.
3. National funding should be released immediately to support local communities.
This is why those three steps are essential:
Private sector should step up to effectively deliver, track vaccine last mile
The recommendations for local jurisdictions are excellent, however, the reality is that local health care organizations just don't have the resources to carry out these recommendations. They don't have sufficient refrigeration, transportation or technology capabilities to ensure community members can get the coronavirus vaccine safely and effectively. To ensure we can effectively vaccinate our communities, we need these businesses to step up and share their resources with the communities that surround them and engage in effective public-private partnerships. We need FedEx, DHL, Amazon and more to step up and enable the delivery of vaccines with proper refrigeration. We need Uber and Lyft to step up to ensure patients in hard-to-access areas can get to vaccination hubs. We need Apple, Google, Oracle, IBM and Epic to step up and provide technology services that allow the storing and sharing of data that will be key in helping us understand who's been fully vaccinated for effective tracking.
Large employers must serve as distribution hubs
To be a successful vaccination effort, this will need to be the largest health care effort in our nation's recent history. We will have to vaccinate millions of people. Again, we don't have space in most of our local health care centers to handle this type of patient flow. This is where large, local employers can play a big role in ensuring last mile success. Large companies that have many employees (for example, Disney, Los Angeles International Airport, universities, etc.), these should be set up to vaccinate their employees -- regardless of whether the employees are normally going into the physical office. This will help us get a significant number of people vaccinated in an organized way. Additionally, businesses that have access to large spaces or buildings, should use them as vaccination hubs. Places like stadiums, theaters and other venues that are not being used to capacity due to COVID-19 should be established as vaccination centers to help the community -- similar to what was done to help voters get their ballots counted this election season. Finally, it is important to build trust and meet the public where they find trust, such as in churches or other community venues, to enhance access and adoption.
Federal government needs to release funds for local infrastructure
Private sector businesses need to step up and serve the communities where they are located; however, this requires effective public and private partnership. Local government and health care organizations need funding and resources to manage this pandemic for the long term. Specifically, additional hiring and training is needed for education and vaccination administration. Large-scale refrigeration is needed to store vaccines and technology systems need to be built out to track who has been vaccinated and to manage the vaccine inventory. Currently, most local health care organizations do not have these capabilities at the appropriate scale, and therefore cannot manage vaccine distribution. Funds need to be made available to jurisdictions immediately so that local government, local health care workers and officials can start putting these infrastructure capabilities in place. The more we wait, the more people that are put at risk.
We have an opportunity to ensure vaccine distribution works effectively if we move now and leverage our learnings from the pandemic thus far. Furthermore, Biden's coronavirus task force can be well positioned to accelerate vaccine distribution by incorporating these recommendations.
Jay Bhatt is an internist, an instructor at the University of Illinois School of Public Health and an ABC News contributor. Asha S. Collins, Ph.D., is a health innovator fellow at the Aspen Institute.
