Thread by @ashishkjha

So a lot of chatter happening on the slow vaccine roll out

Personally, I'm incredibly frustrated.

Did we not know that vaccines were coming? Is vaccine administration a surprise?

Several complex issues so lets break things down a bit

Warning, this is a bit of a rant

Thread

First, we were told in October that we'd have 100 million doses by end of December

100 million

Who said that? @SecAzar

In The Hill. Like 10 weeks ago

Then, by november, Azar was saying 40 million doses ready to ship out by end of December

thehill.com/changing-ameri…

Here's Azar in @thehill saying 40 million by end of the year

In December, Operation Warp Speed says 20 million doses will be out by end of year, they'll keep the other 20M in reserve for 2nd dose. Fine

3/n

thehill.com/changing-ameri…

Now, we'll miss 20M deadline but might be able to get to 20M by sometime in early January

But this is really not the worst part

The worst part is no real planning on what happens when vaccines arrive in states

No plan, no money, just hope that states will figure this out

4/n

So who manages state level? Departments of Health mostly

These well-funded agencies (yes, I'm kidding) who manage all the testing, data analysis & reporting, providing advice to businesses, schools, doing public campaigns, etc

Non-stop. For 9 months

They get vaccines too

5/n

So DOHs adding vaccines to their plate

Most are super stretched and they are trying to make a plan

They are trying to stand up a vaccination infrastructure

Congress had given them no money. States are out of money

So many are passing it on to hospitals, nursing homes

6/n

Any of this familiar?

Like our national testing debacle, being repeated

And now, hospitals and clinics are scrambling to figure out how to implement

This article from @CNN is helpful

There is one line in this piece that drove me crazy

cnn.com/2020/12/23/hea…

The line when Mississippi health chief says its not state's job to ensure vaccines get into people's arms

What? Whose job is it?

Not the Feds. They just get vaccine to states

Not the states. They just get vaccine to hospitals, clinics

So its all on front line providers?

7/n

To be sure, many states are taking real responsibility

LOTS of overburdened public health folks are still making this work. Heroically

But now hospitals trying to figure out where to set up vaccination sites. And folks sorting out who can do vaccinations in care facilities

8/n

So that's where we are, but here are a few key data points

1. We have about 11.5 million doses distributed

2. About 2.1 million given

3. I think the real number of given is higher (reporting lag) but its still not that great

But here's the part that is so frustrating

9/10

There appears to be no investment or plan in the last mile

No effort from Feds to help states launch a real vaccination infrastructure

Did the Feds not know vaccines were coming?

Shouldn't planning around vaccination sites, etc not have happened in October or November?

10/11

Public health has always been a state/federal partnership

States are stretched

Feds are suppose to help

But same folks who blamed states for testing mess now ready to blame states for vaccine slowdown

They are again setting states up to fail

But now, there is hope....

11/12

Congress finally passed $ for vax distribution

States now building infrastructure. Should have been built by Feds months ago

After a slow ramp up, it'll get better

We're learning again we can't fight pandemic with every state on its own

An effective federal govt helps

Fin

Addendum

@SpoxHHS are pushing back on this thread

Their point?

Over past 9 months, on average, states/territories got $6M each, yes Million, for vaccine readiness

True

So not "no money" Just trivial $