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Here comes the vaccine

Houston’s first doses have arrived.

Months of waiting for a COVID-19 vaccine to arrive in Houston are almost — but not quite — over, as hospitals prepare to move the first doses from sealed subzero shipments and into the arms of thousands of front-line health care workers this week.

About 19,500 doses of Pfizer’s vaccine will arrive Monday at four medical centers in Texas: MD Anderson Cancer Center in Houston, Methodist Dallas Medical Center, Wellness 360 at UT Health San Antonio and UT Health Austin’s Dell Medical School, according to the Texas Department of State Health Services, which is overseeing deliveries of the first vaccine approved and shipped in the United States.

Another 75,075 doses will arrive at 19 additional sites on Tuesday, including seven in the Houston area. By midweek, 27 hospitals in the Houston region, most of them Texas Medical Center hospital system flagships or suburban campuses, will have received doses.

Officials on Sunday at some Houston hospitals compared it to waiting on an Amazon delivery: The package is confirmed, but the email with the tracking number and details hasn’t arrived. The first inoculations in Houston could happen in days, depending on when those shipments appear, said Dr. Marc Boom, president of Houston Methodist.

“If it arrives tomorrow, we will have a full day of vaccinations on Tuesday,” Boom said Sunday. “If it’s Tuesday, depending on what time, we could have some people come in. … I have people scheduled literally in five-minute slots.”

[…]

Under a tiered plan developed by public health leaders, the first vaccine doses will be given to front-line hospital workers. Later shipments will allow hospitals to administer doses to patients at high risk of contracting COVID-19 and developing serious complications, likely in January.

And after that it gets trickier. And it could get even trickier still.

Here are some basic outlines of what’s happening. As we learned last week the Trump White House skimped on actually buying enough doses of vaccine from Pfizer. But the federal government will cover the actual purchase of vaccines. The White House says the military is in charge of and has a plan to actual get the supplies to the states. And though we don’t know all the details let’s assume they have that covered. But that only appears to be getting the crates of supplies to a central staging point in each state. That’s not a negligible job. But it’s only a relatively small part of actually getting the country vaccinated. You need public health campaigns. You need staging areas and distribution from wherever the military drops it off to actual health centers and vaccination centers around each state. And finally you need a small army of medical professionals to actually administer the doses. It’s a big job and the Trump administration hasn’t funded any of that or devised any national plan.

In the absence of any federal plan or budget the CDC and HHS have cannibalized existing budgets to get some money to states for planning. But the sums are by most estimates an order of magnitude less than the amount needed.

State governments would be hard pressed to fund an operation like that during the best of times. But states and local governments around the country are already pushing massive cuts because of the dislocations caused by the pandemic. Through much of the latter part of 2020 the assumption was that this would be dealt with in a follow-up stimulus plan. But of course that never happened.

What the White House has arranged funding for is a critical but relatively small part of the vaccination effort: vaccinations for people in assisted living facilities and health care workers. Those are the two most critical populations. They should go first, and the plan is to get those people vaccinated in December and January. But that leaves the great bulk of the population unvaccinated. The plan is for that phase to end around Feb 1. Meanwhile CARES Act funding, which states can use for various purposes, has to be spent by Dec. 31.

That’s all that’s funded. It’s like a trap door set up for Biden to fall through. So as you can see, today’s excitement and anticipation over the vaccine is cued up to turn sharply to disappointment in February when people start asking where their shots are and blame the train wreck on President Biden. No plan. And no funding to implement a plan. Of course that is potentially catastrophic in human terms. But a lag in vaccination means not only more suffering and death but more delay in allowing the economy to get back on its feet, since people aren’t going to go to restaurants and participate in public life until case numbers drop dramatically.

That…would be bad. I suppose as long as there are still talks for another COVID relief bill, or if Dems win both Georgia Senate runoffs, we still have hope. But yeah, that could be a problem.

Also a problem:

The White House Coronavirus Task Force is increasingly suggesting that states including Texas begin shutting down again, saying in reports sent to state leaders this month that they aren’t doing enough to slow the worst surge in COVID cases that the country has seen.

“This surge is the most rapid increase in cases; the widest spread of intense transmission, with more than 2,000 counties in COVID red zones; and the longest duration of rapid increase, now entering its 8th week, that we have experienced,” say the reports, sent to Texas and other states on Dec. 6. “Despite the severity of this surge and the threat to hospital systems, many state and local governments are not implementing the same mitigation policies that stemmed the tide of the summer surge; that must happen now.”

Texas, the report says, “must increase mitigation to prevent ongoing community spread,” including “significant reduction in capacity or closure of public and private indoor spaces, including restaurants and bars.”

The task force’s reports over the last several weeks, meanwhile, have consistently pointed to the success of European countries — many of which have shuttered restaurants, bars and other businesses — in stemming the outbreak.

“The majority of the United States is not mitigating similarly,” Dec. 6 state report says.

You know how I feel about this. Do your best to take care of yourself, because Greg Abbott isn’t going to do anything to help you. The Trib has more.

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