The rambling Rudy Giuliani press conferences and the slapdash, failing lawsuits may look like a political sideshow, but President Donald Trump's refusal to concede and begin the orderly transition of government is not a laughing matter. With the pandemic raging out of control and record numbers of people being diagnosed with Covid-19 each day, a bumpy handoff from one administration to the next will likely get people killed.
With the pandemic raging out of control, a bumpy handoff from one administration to the next will likely get people killed.
This is especially true given the timing of this transfer of power. At the very moment President-elect Joe Biden will take the reins of government, the federal government will be in the early stages of implementing the most complicated, most expensive and most important mass vaccination program in our nation's history. On Monday, General Services Administration signaled that it is ready to begin the formal transition process. There is not a moment to lose.
A competent president would have beaten the coronavirus by now. Our current crisis is of the Trump administration's making. His refusal to create a national testing, tracing and quarantine system, his regular attacks on mask wearing and social distancing, and his inability to confront equipment and funding shortages doomed the United States' Covid-19 response effort.
And with days before Thankgsiving, it looks like we are in the middle of the virus's devastating third wave (although the U.S. never really even got to a low enough number of daily cases to qualify as the end of the first wave).
One of the few glimmers of hope recently has been the positive results reported from Covid-19 vaccine trials. Preliminary data from Moderna shows its vaccine candidate is 94 percent effective. Pfizer's early data is similarly strong. And we will likely see additional vaccine candidates emerge in the coming weeks and months. On Monday, AstraZeneca said its Covid-19 vaccine could be up to 90 percent effective.
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But vaccines don't protect people; vaccinations do. And the effort to make sure that every person in America, as soon as possible, gets vaccinated, is a logistical project on par with then anything the American health care system has ever accomplished. Trump's teams at Health and Human Services, the Centers for Disease Control and Prevention and the National Institutes of Health have begun to develop and implement this system, but it will be barely up and running by Jan. 20. That means that there must be an errorless transition of responsibility from Trump's team to Biden's team. And yet for weeks, Trump's team refused to allow Biden's transition team access to the plan. Hopefully, the GSA's announcement means this will change. But we cannot just assume it will happen.
The effort to make sure that every person in America, as soon as possible, gets vaccinated, is a logistical project bigger than anything the American health care system has ever accomplished.
As leaders of Operation Warp Speed, the coalition of federal agencies overseeing the plan for vaccine distribution, told the Senate last week, Trump had been blocking them from communicating at all with the Biden-Harris transition team. Why? Because of Trump's petulant crusade against reality. Indeed, Trump is still refusing to accept the election results, hoping that desperate lawsuits and the bullying of local elections officials will somehow allow him to remain in office despite the fact that he lost the election convincingly.
It's hard to overhype the dangers such stonewalling posed to an efficient vaccine distribution plan. Distributing a Covid-19 vaccine will be a massive effort requiring a whole-of-government response. The federal government will likely have to manage the delivery of multiple different vaccines produced by different companies. Most of these vaccines require multiple doses and some require extremely cold storage. As more vaccines receive emergency approvals, they will be added into distribution. This is a project with countless moving pieces that will take careful coordination among the federal government, states, the public health community and health care partners.
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Withholding the current distribution plan from the transition team risked the president-elect's team not being ready to effectively implement the plan. But we're far from out of the wood yet — because it's entirely possible that Trump's plan is as unworkable as every other plan his team has devised for pandemic response. For instance, nine months into this pandemic, health care providers still don't have enough personal protective equipment, because the president has been unable to put together a plan to produce and distribute enough PPE. What if his plan for vaccine distribution is just as miserable as his plan for PPE production?
Biden needs to be read into the details of Trump's plan now, because the plan may need major alterations. And after hearing directly from Operation Warp Speed's top advisers on the vaccination plan, I can already see some major potential problems Biden may need to address.
First, the plan needs to clearly lay out who is in charge of each phase. Right now, the vaccine distribution plan creates confusion about whether the states or the federal government running the show. Currently, the CDC is leading teams to coordinate distribution plans being established by the states. But, the federal government also is contracting with pharmacies to receive direct vaccine allocations to help with distribution. There needs to be a clear delineation between the role of the states and the federal government so that this does not devolve into the same confusion we faced when trying to deploy tests and PPE.
Second, we need to decide ahead of time who is going to pay for this massive undertaking. Operation Warp Speed officials told the Senate that states do not need additional funding. That is blatantly false. State public health officials wrote to the Senate leadership last month requesting $8.4 billion for comprehensive vaccine distribution, well above the $200 million thus far provided nationwide by the CDC for this undertaking.
As it stands, the Operation Warp Speed plan only accounts for transporting the vaccines to the states. It is not clear how states, which are already cash-strapped due to the pandemic, will find the money to hire the public health personnel needed to oversee a program of this size, especially for the follow-ups required by a two-dose vaccine or equip themselves with things like cold storage. Congress needs to start planning for this funding now so that states don't have to scramble or worry that the money won't be there when the vaccine arrives. The last thing we want is for states to have vaccines but find themselves lacking the resources necessary to distribute them effectively.
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We've seen firsthand how Trump failed to manage the flow of critical supplies to states in the early days of the pandemic. But duct tape, garbage bags and donation drives won't be able to fix a vaccination plan that undermined by Trump obstructionism. Come Jan. 20, the Biden administration is going to take over — whether Trump acknowledges that fact or not. But by refusing to immediately share details of the vaccine distribution plan with the incoming administration, lives may have already been lost.
It's time for the transition begins in earnest. Any further delays, and Americans will continue paying the price for Trump's gross mishandling of Covid-19 even after he's left the Oval Office.
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