Viewpoint: Rampant deaths loom as Trump stalls transition

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Karen Rubin, Columnist

“More people will die if we don’t coordinate,” President-Elect Joe Biden said, answering a reporter’s question about the ramifications of Trump and the GSA Administrator Emily Murphy refusing to allow the transition process to go forward.

The cost of “humoring” Trump in his campaign to overturn the will of American voters is that the incoming Biden administration has no official information about the true state of the COVID-19 pandemic and no role in organizing distribution of a vaccine. The cost will be paid in lives and livelihoods.

But, aside from a concept for distribution (Biden can watch “60 Minutes” for that), Trump has no actual plan for implementation. How do you transport and store the vaccines (Pfizer’s needs to be kept in super-cold conditions, at minus 94 degrees F). How do people get the shots, which require two doses? Do they have to travel to sites or can the vaccines be put into mobile carriers? How do you prioritize who gets the vaccine first since this will be a months-long process to manufacture and administer, during which people are still getting sick (over 150,000 a day) and dying (likely 2,000 a day by Inauguration Day)? Who administers the doses and who pays for that? It is estimated to cost $6 billion and states and localities are out of money. Who is manufacturing the supplies needed – gloves, syringes, PPE – all of which are already becoming scarce again because of the failure of the Trump administration to nationalize a strategy or implement the Defense Production Act as infections and deaths surge throughout the country?

“We can have a vaccine, but if no one is vaccinated, what is the use?” Biden said.

“This vaccination process has not been thought through at all,” said Gov. Cuomo (after Trump said he would withhold the vaccine from New York state). “It’s just what Trump did with the testing, the PPE and the masks. He has no idea how to govern and his government is, frankly, incompetent.” What is more, there is a high level of skepticism – 50 percent of Americans don’t trust the vaccine because they are suspicious of whether the approval process was rushed because of political and financial gain.

“Once you get past that, you have a scale that you haven’t even imagined,” Cuomo noted. “I’ve only done 12 million COVID tests in New York to date and I’ve done more tests than any other state. I now have to do 20 million vaccines? They’re talking about distributing it through Walgreens and doctor’s offices. That’s nice, but there are no Walgreens and national drug chains in communities of color and poorer communities” – communities that have been impacted at twice the rate and which represent a higher proportion of health care, frontline and essential workers.

And who pays? The CDC said administering the vaccine would cost about $6.2 billion, but Trump has only allocated $140 million so like with testing and PPE, he said the states were on their own to figure it out.

“Jesus couldn’t figure this out with loaves and fishes,” Cuomo quipped. “We’re broke. We haven’t gotten any stimulus and now we have a $6 billion vaccine distribution plan that no one has an idea about. It would be the largest government operation undertaken since World War II. It would go back to the old polio distribution days.

“The mechanism, the public trust, the reaching out to the communities – it’s a massive, expensive undertaking that nobody is even contemplating right now.”

It’s not just the logistics (and funding) to distribute the vaccine, it’s who is setting the goal behind the plan. If the goal of vaccination is to effectively end the pandemic through “herd immunity,” that requires 80 percent of the population to be vaccinated. That could take months, so there needs to be prioritization: health workers, essential workers and frontline workers (who are most vulnerable), workers who have lots of people contact (so they could be spreaders) and people most vulnerable to dying (older people and those with co-morbidities).

It took just two weeks to go from 9 million to 10 million cases and just one week more to blow past that to 11 million, as the average number of dead surged passed 1,000 a day, with hospitals and health care systems around the country reaching their limits of beds but more significantly, health care professionals.

The situation is so much worse than in the spring because instead of being confined to a few (mostly) blue states on the coasts, the surge is everywhere.

In the 50-plus days left to Trump, 50,000 more people could die, and tens of thousands more become sickened with likely long-term damage to health for millions more.

If Trump had a scintilla of care to protect lives (and rebuild the economy), he would invite the Biden team in to develop the distribution plan. Biden has said the first thing he will do is to enact the Defense Production Act, nationalize the testing and manufacture and distribution of PPE and make sure there is equitable administration and distribution as fast as possible.

”We’re entering COVID hell,” said Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota and a member of President-elect Joe Biden’s coronavirus task force. “The next three to four months are going to be, by far, the darkest of the pandemic.

“I don’t think America quite gets this yet. This is going to get much worse. This is not to scare people out of their wits. This is to scare people into their wits to understand that because we still have control.”

Dr Osterholm predicted that the country would soon look back at the figure of 100,000 daily cases and “wish to be back there.”

There may be a light at the end of the tunnel, but before that dark days loom ahead. Wear your damn mask, wash hands and keep socially distant.

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