The first 2.9 million doses of Pfizer’s new two-dose coronavirus vaccine shipped from the company’s factory in Kalamazoo, Michigan, on Sunday, kicking off a large-scale national project health officials hope the pandemic will end sometime in late 2021.
But some states are better placed to get rid of the coronavirus than others.
The U.S. Centers for Disease Control and Prevention distribute the doses weekly as they leave Pfizer’s factory and ship them via UPS and Fedex. Then it’s up to the authorities in every state and territory of the US to decide exactly where those doses go – and who will be first in line to get them.
It’s a messy process. States are essentially deciding who gets protection first – and who should remain at risk of contracting and possibly dying from COVID-19.
“This is an emergency triage,” Irwin Redlener, the founder and director of Columbia University’s National Center for Disaster Preparedness, told The Daily Beast. “So many people are now at risk and so many industries rightly need attention with the early availability of vaccines.”
“There will be people and populations that will be left out,” said Redlener.
Perhaps no state illustrates that dilemma better than Florida. The state is particularly vulnerable to the coronavirus because of the combination of a massive elderly population – nearly 400,000 in nursing homes and other assisted living facilities – and a GOP governor and legislator who downplayed the severity of the pandemic while actively resisting . local authorities’ efforts to control transmission through social distancing measures and masking mandates.
Florida desperately needs the vaccine to stop a rising wave of infections – about 9,000 new cases a day in recent weeks – and prevent a nightmarish spike in deaths. The state has already lost nearly 20,000 people. How many more die depends in part on who the authorities allow to get vaccinated first, as the stock of the vaccine grows slowly.
But Florida is already wrong, according to polled experts at The Daily Beast, and the results could be disastrous.
As states loosely align their own vaccine distribution policies with broad guidelines set by the CDC, four highly vulnerable groups compete for the first batches of vaccines: primary health care workers, elderly nursing home residents, workers in essential industries and people of color.
The problem: Florida health officials led by Governor Ron DeSantis are putting them in the wrong order, experts said.
Neither the Florida Department of Health nor DeSantis’ office have responded to requests for comment for this story.
Florida’s strategy, a draft of which is available here, is to send 55 percent of the initial supply of 180,000 doses of Pfizer’s genetically engineered ‘messenger RNA’ vaccine – enough to vaccinate 90,000 people, assuming no spoilage – to major hospitals. to have their own vaccine vaccinated. staff.
The state reserves the remaining 45 percent of the doses for people in nursing homes. It seems likely that this share will also apply to the remainder of the approximately one million doses Florida expects to receive from Pfizer by the end of the month.
But, as is the case in most states, none of Florida’s early doses go to essential workers such as grocery store personnel, transit personnel, pharmacy employees, and teachers. What makes Florida’s plan so controversial is that, unlike many other major states, Florida authorities have refused to restrict corporations and schools or make masks compulsory. That policy has left Floridian essential workers no choice but to work among a highly contagious audience and exposure to risk.
Likewise, DeSantis has not worked out a plan to send vaccines to communities of color that, due to structural disadvantages that go back generations, are uniquely vulnerable to the virus. In Florida, as in many other states, there is significant overlap between key workers and communities of color, underscoring the importance of vaccinating these groups as soon as possible.
“The need for strong Florida equity strategies is extraordinary,” Lawrence Gostin, a public health expert at Georgetown University, told The Daily Beast.
As it stands, Florida’s hundreds of thousands of key workers will have to wait, likely for months, for Pfizer to manufacture and ship much more of the vaccine.
DeSantis and his health officials should change the order and move key workers closer to the front lines, experts told The Daily Beast. “The moral claim that essential workers should be front line for vaccines is overwhelming,” said Gostin.
“We cannot leave the poor and low-yielding essential workers last again,” said Reverend William Barber II, co-chair of the Poor People’s Campaign. The New York Times.
It may make sense for Florida to have essential employees wait for their photos if the state made other efforts to protect these workers. But that’s not it. In September, DeSantis issued an executive order prohibiting Florida cities from punishing people for not following local mask mandates.
The same order made it more difficult for cities and counties to close restaurants. “I am against mandates, period,” said DeSantis, a close ally of President Donald Trump. “I don’t think they work.”
DeSantis has repeatedly demonstrated a poor understanding of the basic science of a viral pandemic and vaccines. He even seemed to support a marginal proposal that people skip the second dose of Pfizer’s two-dose vaccine. Data from Pfizer’s large-scale Phase 3 studies made it very clear that without that second dose, the vaccine will not work.
With a science denier in charge, Florida more or less forces essential workers to deal with an unmasked audience – then refuses to have those same workers vaccinated early.
Experts, of course, recognized that essential workers needed to move up in line for the vaccine means other vulnerable people are being bumped back. It’s not that hospital staff and nursing home residents don’t deserve protection. They do. And it’s not that vaccinating these populations early won’t save lives. It will.
But these groups have ways of protecting themselves that many key workers do not.
“Healthcare workers in most facilities will be fully decked out with the most advanced personal protective equipment available,” explains Redlener, using the acronym for personal protective equipment such as gloves, goggles, masks and face shields. “That does not apply to a clerk in a supermarket or pharmacy or a bus driver.”
Likewise, because nursing homes are highly controlled environments, staff can wear additional personal protective equipment and limit visits to protect residents and reduce the need for vaccination. “Nursing homes do a lot of testing of residents and staff,” Jeffrey Klausner, a professor of medicine and public health at UCLA who previously worked at the CDC, told The Daily Beast.
And since nursing home staff are a major cause of outbreaks in the facilities, vaccination staff provides protection to residents – potentially releasing doses that would go to residents to go to essential workers.
“If staff can be vaccinated and provided with protective masks, personal protective equipment, etc., then one must be able to control infection and deaths in these environments and use the early supply of vaccines to vaccinate the other frontline and minority groups”, Edwin Michael, an epidemiologist at the Center for Global Health Infectious Disease Research at the University of South Florida, told The Daily Beast.
Florida’s nearly 22 million people could receive more and fairer overall protection from the state’s first batches of the vaccine if authorities diverted some of the early doses to key workers. But even that strategy won’t prevent the hardships all experts say is coming – or undo the damage DeSantis has already done to his state.
“The upcoming vaccines are far too late and too low in terms of supply to prevent the next third waves in most US provinces, even if the planned phased rollout begins in earnest from January 2021,” Michael said. “Our simulations show that the only way to contain the coming waves is to take more measures to distance themselves from society, with even a modest increase in the number of people following these measures being able to take these measures. suppress and even smooth out waves in many areas. “