President-elect Joe Biden announced a plan on Friday for what will likely be his most pressing challenge when he takes the White House next week: fixing America\u2019s messy Covid-19 vaccine rollout.<\/p>\n
The plan builds on Biden\u2019s $1.9 trillion economic stimulus proposal, which included a $400 billion Covid-19 plan, announced on Thursday. It seeks more support to states and lower levels of government, a greater expansion of vaccine eligibility, funding for more public health workers, a boost in vaccine production, better communication about the vaccines, an education and awareness campaign, and more. He promises 100 million vaccine doses delivered in his first 100 days in office.<\/p>\n
Above all, the plan aims for something that President Donald Trump\u2019s administration didn\u2019t do with Covid-19 more broadly and the vaccine in particular: greater federal involvement. The Trump administration has repeatedly pushed against a bigger federal role \u2014 even characterizing more support for states so they can get shots in arms as a \u201cfederal invasion.\u201d Biden has rejected that rhetoric, calling for a bigger role by the feds, and cementing it with his plan.<\/p>\n
The stakes are as high as they\u2019ve ever been. The country now averages 240,000 Covid-19 cases and more than 3,300 deaths each day. The American death toll is among the worst in the world, with the country now approaching a total of 400,000 dead. If the US had the same death rate per million people as Canada, over 230,000 more Americans would likely be alive today.<\/p>\n
The vaccine is America\u2019s \u2014 and the world\u2019s \u2014 chance at fixing this mess. Experts say the country must vaccinate at least 70 percent of its population, and possibly more, to reach herd immunity and protect a sufficient amount of the population from the virus. Only then can outbreaks truly be curbed.<\/p>\n
But the US has been slow in rolling out a vaccine. The Trump administration overpromised and underdelivered: It promised 40 million doses and 20 million people vaccinated by the end of 2020; two weeks into 2021, only 31 million does have been delivered and just 11 million Americans have received at least the first dose of a vaccine, according to federal data. The country is currently not on track to reach 70-plus percent vaccination rates by the end of the summer.<\/p>\n
Biden\u2019s immediate challenge is to clean this all up. His presidency may count on it \u2014 his handling of the country\u2019s most pressing crisis will likely be what Americans judge him on over the next year. <\/p>\n
More seriously, it\u2019s a matter of life or death: With thousands of people dying each day, ending the epidemic in the US even days or weeks earlier than otherwise could save up to tens or hundreds of thousands of lives.<\/p>\n
Here\u2019s how Biden plans to do it.<\/p>\n
What Biden\u2019s vaccine plan does<\/p>\n
Biden promises to leverage \u201cthe full strength of the federal government,\u201d in partnership with state, local, and private organizations, for a truly national vaccine plan. You can read the full proposal here, but these are some of the key points:<\/p>\n
All of that is on top of Biden\u2019s broader Covid-19 plan, which promises $400 billion more funds to combat the coronavirus and, specifically, $20 billion more for vaccine efforts.<\/p>\n
Biden\u2019s plan hits many of the marks that I\u2019ve heard from experts over the past few weeks as I\u2019ve asked them about what\u2019s going wrong with America\u2019s vaccine rollout. <\/p>\n
First, the plan has clear goals to address what supply chain experts call the \u201clast mile\u201d \u2014 the path vaccines take from storage to injection in patients \u2014 by making sure there\u2019s enough staff, infrastructure, and planning to actually put shots in arms. Second, it takes steps to ensure that supply chain problems are fixed proactively, with careful monitoring and use of federal powers when needed to address bottlenecks. Last, but just as crucially, there\u2019s a public education campaign to ensure that Americans actually want to get vaccinated when it\u2019s their turn.<\/p>\n
The question, of course, is if all of this can get implemented properly. As the US response to Covid-19 has floundered, a key question has been how much of the failure is attributable just to Trump versus bigger systemic problems, like the country\u2019s size and sprawl, fractured health care system, and fragmented federalist government. <\/p>\n
There\u2019s also the question of whether Biden can get the congressional support needed for all these efforts. Democrats will control both houses of Congress. But more moderate wings of the party may scoff at the high price tag: Biden\u2019s stimulus plan is estimated at $1.9 trillion and the Covid-19 plan alone (which is included in the bigger plan) at $400 billion. The cost of borrowing money is low, and Biden argues that the risk right now is doing too little instead of too much, but it remains to be seen if he gets enough backing in Congress.<\/p>\n
If he pulls it off, though, Biden has a chance to show how much of a difference true federal leadership can make \u2014 and demonstrate how much the previous administration failed by refusing to embrace a larger role for itself.<\/p>\n
Biden wants a federal role that Trump disavowed<\/p>\n
At the core of Biden\u2019s plan is a posture of more federal involvement that Trump has resisted at every step throughout the Covid-19 crisis.<\/p>\n
This was clear in Biden\u2019s broader Covid-19 plan, too: The ideas in the proposal aren\u2019t at all new. Experts have called for expanding testing, preparing for mass vaccination efforts, supporting schools, providing emergency paid leave, and much more in the past year. Biden himself proposed many of these things last March. You can see many of these ideas in article after article in Vox and elsewhere, dating back to early 2020.<\/p>\n
The Trump administration declined more aggressive steps, repeatedly taking a stance that it wasn\u2019t the federal government\u2019s proper role to get hands-on with the Covid-19 response. With protective equipment, Trump resisted using the Defense Production Act to get more masks, gloves, and other gear to health care workers. On testing, the Trump administration left the bulk of the task to local, state, and private actors, describing the federal government as merely a \u201csupplier of last resort.\u201d On tracing, the administration never had anything resembling a plan to make sure the country could track down the sick or exposed and help them isolate or quarantine.<\/p>\n
This kind of hands-off, leave-it-to-the-states attitude culminated in the messy vaccine rollout. While there are many factors contributing to America\u2019s slow vaccine efforts \u2014 including the country\u2019s size, sprawl, and fragmented health care system \u2014 a key contributor is the lack of federal involvement. In effect, the Trump administration purchased tens of millions of doses of the vaccines, shipped them to the states, and then left the states to figure out the rest.<\/p>\n
This was clear in the funding numbers. State organizations asked for $8 billion to build up vaccine infrastructure. The Trump administration provided $340 million. Only in December did Congress finally approve $8 billion for vaccine distribution, but experts say that money comes late, given that vaccination efforts are already well underway and the funds could\u2019ve helped in the preparation stages.<\/p>\n