The 2.9 million first batches of 2.9 million doses of Pfizer’s new two-dose coronavirus vaccine shipped from the company’s Kalamazoo, Mich. Plant on Sunday kick off a massive national project that officials health officials hope to end the pandemic by the end of 2021.
But some states are better prepared to turn off the coronavirus than others.
The United States Centers for Disease Control and Prevention divides the doses on a weekly basis as they leave the Pfizer plant and ship them via UPS and Fedex. Then it’s up to the authorities in each state and territory of the United States to decide exactly where those doses go – and who gets them first.
It’s a complicated process. States essentially decide who gets protection first – and who should continue to run the risk of catching COVID-19, and potentially dying from it.
“It’s emergency triage,” Irwin Redlener, founding director of Columbia University’s National Center for Disaster Preparedness, told The Daily Beast. “There are so many people at risk right now and so many areas that rightfully need attention with the early availability of the vaccine.”
“There will be people and populations who will be left behind,” Redlener said.
Perhaps no state illustrates this dilemma better than Florida. The state is particularly vulnerable to the coronavirus due to the combination of a huge population of elderly people – nearly 400,000 of whom live in nursing homes and other assisted living facilities – and a governor and a GOP legislature that downplayed the severity of the pandemic while actively resisting efforts by local authorities to control transmission through social distancing measures and masked warrants.
Florida is badly in need of the vaccine to contain a growing wave of infections – around 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. The additional death toll depends in part on which state authorities allow the vaccine to be vaccinated first as the vaccine supply slowly increases.
But Florida is already wrong, according to experts interviewed by The Daily Beast, and the results could be disastrous.
As states loosely align their own vaccine distribution policies with overall CDC guidance, four very vulnerable groups compete for the first batches of vaccine: frontline health workers, elderly nursing home residents, workers in essential industries and people of color.
The problem: Florida health officials under Governor Ron DeSantis are putting them in the wrong order, experts have said.
Neither the Florida Department of Health nor the DeSantis office responded to requests for comment on this story.
Florida’s strategy, a draft of which is available here, is to funnel 55% of its initial supply of 180,000 doses of Pfizer’s genetically modified “messenger RNA” vaccine – enough to immunize 90,000 people, assuming it doesn’t. there is no deterioration – towards the big hospitals to vaccinate their staffs.
The state is setting aside the remaining 45 percent of doses for people in nursing homes. It seems likely that this proportion will also apply to the remainder of the roughly one million doses Florida expects to receive from Pfizer before the end of the month.
But, as is the case in most states, none of Florida’s first doses go to essential workers such as grocery store staff, transit workers, drugstore workers, and teachers. What makes Florida’s plan so controversial is that, unlike many other large states, Florida authorities have refused to restrict businesses and schools or require masks to be worn. These policies have left Florida essential workers with no choice but to work among a particularly infected and at-risk public.
Likewise, DeSantis has not detailed a plan to ship the vaccines to communities of color who, due to structural disadvantages stretching back generations, are particularly vulnerable to the virus. In Florida, as in many other states, there is a significant overlap between essential workers and communities of color, further underscoring the importance of vaccinating these groups as quickly as possible.
“The need for strong equity strategies in Florida is extraordinary,” Lawrence Gostin, a public health expert at Georgetown University, told The Daily Beast.
As it stands, Florida’s hundreds of thousands of essential workers have to wait, possibly months, until Pfizer can produce and ship significantly more vaccine.
DeSantis and his health officials should change the order and bring essential workers closer to the front lines of the line, experts told The Daily Beast. “The moral claim that essential workers need to be on the front lines for vaccines is overwhelming,” Gostin said.
“We cannot once again leave the poor and low-wealth essential workers for the last,” said Reverend William Barber II, co-chair of the Campaign of the Poor. The New York Times.
It might be wise for Florida to ask essential workers to wait for their vaccines if the state was making other efforts to protect these workers. But it’s not. In September, DeSantis issued an executive order prohibiting cities in Florida from penalizing people who violate local mask mandates.
The same order has made it more difficult for cities and counties to close restaurants. “I’m opposed to warrants, 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 appeared to endorse a fringe proposition that people skip the second dose of Pfizer’s two-dose vaccine. Data from Pfizer’s large-scale Phase 3 trials have shown very clearly that without this second dose, the vaccine does not work.
With scientific denial in charge, Florida more or less forces essential workers to interact with an unmasked audience – and then refuses to help those same workers get vaccinated early.
Of course, experts have recognized that the displacement of essential workers online for the vaccine is pushing back other vulnerable people. It’s not that hospital staff and nursing home residents don’t deserve protection. They do. And it’s not that early vaccination of these populations won’t save lives. It will be.
But these groups have ways of protecting themselves that many essential workers do not.
“Healthcare workers in most settings will be fully equipped with the most advanced PPE available,” Redlener explained, using the acronym for personal protective equipment such as gloves, glasses, masks and face shields. “This is not the case with an employee of a grocery store or a pharmacy or a bus driver.”
Likewise, because nursing homes are highly controlled environments, staff may wear additional PPE and limit visits to protect residents and reduce the urgency to vaccinate them. “Nursing homes do a lot of testing on residents and staff,” Jeffrey Klausner, 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 vector of outbreaks in facilities, immunization staff offer protection to residents – potentially releasing doses that would go to residents to go to essential workers.
“If staff can be vaccinated and have protective masks, PPE, etc., then one should be able to control infection and death in these settings and use the early vaccine supply to immunize patients. other frontline groups and minorities, ”Edwin Michael, an epidemiologist with the Center for Global Health Infectious Disease Research at the University of South Florida told The Daily Beast.
Florida’s estimated 22 million people could benefit from greater and fairer overall protection against the state’s initial vaccine batches if authorities divert some of the initial doses to essential workers. But even this strategy won’t prevent the trials that all experts say will happen – or reverse the damage DeSantis has already inflicted on his condition.
“The upcoming vaccines are far too late and too low in terms of supply to prevent the third waves from coming to most countries in the United States, even though the planned phased rollout begins in earnest from January 2021,” Michael said. “Our simulations show that the only way to contain the waves to come is to increase social distancing measures, with even a moderate increase in the number of people complying with these measures able to suppress and even flatten these waves in long periods. many areas.
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