President Joe Biden’s heartfelt plea for national unity will be immediately tested by the American people in how they respond to his plan for ending the COVID-19 pandemic.
As expected, the president in his inaugural address put fighting the pandemic at the top of his four major agenda items. The other three were restoring the economy, tackling the climate crisis and ending racial injustice and white supremacy.
Those four worthy goals are intimately linked. You can’t return the economy to full employment without getting the virus under control. And you can’t get the virus under control without addressing conditions in minority communities, which have borne the brunt of disease incidence and suffered a disproportionate share of the 400,000-plus fatalities.
Fighting and winning the war against this and future pandemics also requires global cooperation, just like winning the war against the climate crisis. In a modern world with mass international travel, a new virus can travel to every corner of the globe within days.
In executive orders issued shortly after taking office, the president ordered a national mask mandate on federal property. He authorized the U.S. to rejoin the World Health Organization, the only institution with the capacity (but not yet the resources) to coordinate vaccination efforts in the developing world.
He also pledged to reach 100 million vaccinated people in the U.S. within the first 100 days of his administration.
That’s an average of 1 million vaccinations per day. This ambitious goal will require tripling the current pace.
The logistics behind a mass vaccination campaign are daunting, but achievable. Biden has promised to mobilize the Federal Emergency Management Agency and the National Guard. Healthcare supply chain organizations across the U.S. will no doubt be asked to play a role.
That’s great for logistics, but soldiers don’t administer shots. One group of health experts estimates it will require at least 400 temporary vaccination sites operating 12 hours a day with a total staff over 100,000, including 17,000 qualified to administer the vaccines, to reach the 3-month goal. This is in addition to the current rollout effort, which recently expanded to include all older Americans in addition to healthcare workers and the elderly in nursing homes.
Even after the government, working in concert with providers, sets up that infrastructure, people must show up. Polling on the issue isn’t encouraging. Only 47% of respondents in the latest YouGov poll (released Jan. 6) said they are willing to get vaccinated.
That number has never risen above 50% over the last six months. Health experts estimate vaccination rates must reach 70% or higher to achieve herd immunity. Polls also show there’s a die-hard group of people–about 1 in 5–who continue to resist the necessary interim steps of masking and social distancing.
With vaccines still in short supply, public health agencies administering the vaccination sites will have to set priorities. This has the potential to alienate people denied immediate access in the name of the greater good. Communication will be key.
Immediately expanding access to everyone over 65, for instance, runs the risk of temporarily crowding out younger people with multiple comorbidities, who face a much greater risk of dying. The same is true for people who live or work in prisons, meatpacking plants or neighborhoods with high infection rates.
Near the end of his speech, the president addressed America’s role in the world. “We’ll lead, not merely by the example of our power, but by the power of our example,” he vowed.
Over the next few months, we’ll find out if a bitterly divided America is ready to set that example. The first great test will be whether its people can adhere to the basic principles of public health.