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Biden promises major changes for vaccine distribution amid skyrocketing deaths

Editor's Note: In our interview, the guest, Dr. Peter Hotez, misspoke and said the U.S. could be facing 400,000 deaths a day by Inauguration Day. Dr. Hotez meant to say the total death toll in the U.S. since the pandemic began is expected to reach 400,000 by then. Experts agree with that general projection.

One key piece of President-elect Biden's plan to fight COVID is to make major changes to how vaccines are distributed around the country. The plan comes amid a report that the vaccine reserves the Trump administration has promised to ship to states do not actually exist right now. Dr. Peter Hotez, an infectious disease specialist at Baylor College of Medicine, joins William Brangham to discuss.

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  • Judy Woodruff:

    As we reported, one key piece of president-elect Biden's plan to fight COVID is to make major changes to how vaccines are distributed around the country.

    It comes as The Washington Post reported that the vaccine reserve the Trump administration had just promised to ship to states does not actually exist right now. Several governors were furious, calling the administration's prior statements — quote — "lies and deception a national scale."

    William Brangham looks at what Mr. Biden hopes to do

  • William Brangham:

    Judy, the president-elect outlined these following steps and more.

    Allow more people to get the vaccine, including those 65 and older. Deploy FEMA to set up thousands of community-based vaccine centers in stadiums, in school gyms and community centers. Get national pharmacy chains involved as quickly as possible. And use the Defense Production Act to make more vaccine-related supplies.

    It's worth noting that, so far, only about a third of the 30 million vaccine doses that have been distributed have actually ended up in people's arms.

    Joining me now is Dr. Peter Hotez. He's the co-director of the Center for Vaccine Development at Texas Children's Hospital, and he's also the dean of the National School of Tropical Medicine at Baylor College of Medicine.

    Dr. Hotez, great to have you back on the "NewsHour."

    Before we get to the Biden plan and vaccines, I wonder if you could just give us a snapshot of the pandemic right now. I know people are frustrated and they're tired about this, but thousands of Americans are still dying every single day.

  • Dr. Peter Hotez:

    Yes, that's absolutely right.

    We are in a dire public health crisis right now, bordering on a homeland security crisis, because of the depth and breadth of this epidemic now. Right now, COVID-19 is the leading cause of death in the United States of a daily basis. It's been this way for about at least the last month, maybe six weeks.

    We are looking at 4,000 deaths per day. And that — so, the number is going to get to around 400,000 deaths per day by around the time of the inauguration, which is an important benchmark. That's the number of American G.I.s who sacrificed their lives in World War II. So, we're looking at something on that scale.

    And we're continuing to head to 500,000 deaths. So, this is a humanitarian tragedy, to say the least. And the numbers are extraordinary, 200,000 to 300,000 confirmed cases per day. And that's an underestimate by a factor of four. So, we're looking at a million new cases a day, and without any COVID-19 national program in place for 2020.

    We have squandered every opportunity to do that. We have missed the entry of the virus coming in from Europe back last spring. We never got diagnostic testing up to speed. We failed to stop that Southern surge in the summer, the fall surge in the Midwest. So, now our backs are against the wall.

    All we have left, our last arrow is to vaccinate the American people. And now we have learned that's — even that's not in place now. So, this is absolutely critical, what the Biden administration is doing, to — our last hope is to vaccinate our way out of this.

  • William Brangham:

    So many challenges ahead.

    As I mentioned, the incoming president announced more of his plans today. It sounds very similar to a plan that you laid out in The Washington Post.

    Can you briefly explain what you believe the Biden administration needs to do immediately to make sure as many vaccines are available as possible?

  • Dr. Peter Hotez:

    Yes, absolutely.

    I laid out a four-part plan in The Washington Post. And it looks quite similar to what the Biden administration is proposing.

    First of all, we don't have an adequate infrastructure for vaccinating lots of adults. We have to vaccinate 240 million adults, I estimate, we estimate, to interrupt virus transmission by August. So, that means, with two doses, two million Americans every day. We're not going to do that with the pharmacy chains alone and the hospital chains.

    Now, they're doing a good job. If you look, the pharmacies are doing all they can. And let's face it. Most adults get their vaccines through pharmacies oftentimes. But it won't be enough.

    We're still going to have to add additional vaccination hubs, large, high-throughput centers. Remember, huge undertaking. When we talk about two million Americans every day, that's 10,000 to 50,000 Americans per day in the large metro areas. We're just not even close to that.

    So, that's a major component of the Biden plan. I was happy to see that. We're also going to have to streamline guidelines, because they're a bit too fussy if you're trying to do something at that high throughput. We have learned in 2020 that our health system just cannot do complicated things. We have to keep it extremely simple.

    And the phase 1 A, B, C guidelines, I think, were well-intended. And if you had a functioning system in place, we could probably operationalize those, but not in this circumstance. So we're going to have to streamline that. That's the second point.

    The third is, we don't have enough vaccine, where the mRNA technology looks really great in terms of protective efficacy, but it's still a young technology and not robust enough to scale it to the level that we need.

    We're not going to be able to do this with mRNA vaccines alone. We have to get the other vaccines up there. We need the two adenovirus vaccines from J&J and AstraZeneca/Oxford, the particle vaccine from Novavax. We have a recombinant protein vaccine that we're developing and scaling up now with — to a billion doses with Biological E India. We have got to get those up to get the vaccines.

    And then, lastly, we have no communication plan. We have not conveyed any of this information to the American people or when they're going to have to get boosted with a third dose or what the durability of protection is, how we're going to manage all of these issues.

    And, of course, we have got a pretty aggressive anti-vaccine movement we have to counter, so a lot of work ahead.

  • William Brangham:

    A lot of work ahead, indeed.

    Dr. Peter Hotez, always good to hear your counsel. Thank you for being here.

  • Dr. Peter Hotez:

    Thanks so much for having me.

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