PROVIDENCE, RI (AP) – Public health officials sounded the alarm for months, complaining that they did not have enough support or money to get COVID-19 vaccines quickly put into arms. Now, the slower-than-expected start of the largest vaccination effort in U.S. history is giving them the reason.
While working to increase firing, U.S. state and local public health departments cite several hurdles, most notably the lack of leadership from the federal government. Many officials worry that they are wasting precious time in the midst of the pandemic and that 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 devoted to education campaigns to alleviate the concerns of people who are wary of getting the shots. And, although the federal government recently approved $ 8.7 billion for the vaccination effort, it will take you to get to places that could have used the money months ago to prepare to offer shots more efficiently.
These complaints have become a common saying in a country 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 down the line, getting 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 the public health officer in Shawnee County, Kansas, until he retired last month.
Operation Warp Speed, the federal vaccine program, had promised to distribute enough doses to vaccinate 20 million people in the U.S. in December. He lost that goal, and as of Friday, about 6.6 million people had received their first shot, according to a tracker of the Centers for Disease Control and Prevention. About 22 million doses have been administered in the states.
The American Hospital Association has estimated that 1.8 million people will need to be vaccinated daily from Jan. 1 to May 31 to achieve widespread immunity during the summer. The current rate is less than a million people a day.
President-elect Joe Biden on Friday called the launch a “transvestite,” noting the lack of a national plan to get gun doses and reiterating its commitment to administer 100 million shots in its first 100 days. He has not shared details and was expected to discuss the effort this week. His office announced a plan to release most doses immediately, rather than keeping second doses in reserve, the more conservative approach taken by the Trump administration.
The Trump administration defined its primary role as the development of coronavirus vaccines and delivery to states, which would then take over and ensure vaccine doses traveled “the last mile” to the guns. Each state had to develop its own plan, including the publication of guidelines for those who are vaccinated first. Several health experts complained about this approach, saying it led to confusion and a patchwork response.
“Let’s say I was disappointed with the way the tests were handled and the deployment of the vaccine has reminded me of how disappointed I was when they handled the tests,” said Dr. Mysheika Roberts, health commissioner in Columbus, Ohio.
Several officials and public health experts say they believe some of the early failures are being smoothed out. Marcus Plescia, chief physician of the Association of State and Territorial Health Officials, said the slow start should come as no surprise given the immense scope of the task.
“It wasn’t going to be perfect,” he said.
Still, Plescia said the federal government could have advanced further in 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 detailed how local and state health departments have been underfunded for decades. Public health officials have warned since spring that they lack staff, money and tools they needed to deploy a vaccine. The money was not approved until the end of December.
Vaccine distribution involves a long and complex chain of events. All doses should be monitored. Suppliers need to know how much staff they will need. Eligible people should be notified to schedule their shots, taking into account vaccine handling requirements and the need to observe people for 15 minutes after the shot, all while observing social distancing.
It is difficult to plan too far ahead because the number of doses the state receives can fluctuate. Hospitals cannot fire all their workers on the same day due to possible side effects and staffing problems, so they must be separated.
Rhode Island health officials said it can take up to seven days for doses to be given to people once they are received. Officials from several states, including Rhode Island, Pennsylvania, Kentucky and New Jersey, said the lack of supply it is one of the biggest obstacles to vaccinating more people.
Some communities have seen a large number of medical workers deferred to receive the shot, even though they are the first in line. Columbus, Ohio, has had lower-than-expected demand among top-priority groups, including emergency medical workers.
A public education campaign could have helped resolve the hesitation of health care workers that has slowed the launch of the first shots, said James Garrow, a spokesman for the Philadelphia health department. Instead, officials talked for months about how quickly vaccines were being developed, which didn’t help alleviate concern that it might not be safe.
“There just hasn’t been a good message about security and the purpose of security protocols,” Garrow said.
The federal government has done little to provide information resources that local officials can tailor to their own communities, to address the concerns of people like pregnant women or black men living in rural areas, said Dr. Michael Osterholm, expert in infectious diseases of the University. of Minnesota, member of Biden’s COVID-19 advisory committee.
“You don’t need 50 different states trying to do this kind of work. What you want to have is a lot of sources of information that target different populations that any state can use, “Osterholm said.” That’s what we don’t have right now. “
Some states become creative. Oregon held a mass vaccination event at the state fairgrounds with the help of the National Guard. The governor said he aimed to vaccinate 250 people per hour. New Jersey plans to open six vaccine “megasites” where officials expect more than 2,000 people a day to be able to finish their shots.
But without a federal plan, those efforts could end up “throwing spaghetti at a wall to see what sticks in,” said Chrissie Juliano of the Big Cities Health Coalition, which represents metropolitan health departments.
What is needed is a national war-type effort to get the vaccines 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 member of the Kansas Health Institute. Why can’t vaccinations be made at this time?
“It’s possible. It’s doable,” he said. “I do not see the level of urgency, the feeling of urgency of anyone here. And that is, honestly, the only thing that can make a difference. “
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Choi reported from New York. Associated Press writer Ricardo Alonso-Zaldivar in Washington also contributed to this report.
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