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In the first two weeks of America's vaccination campaign, just 2 million people have received the first of the two required doses for their vaccinations -- far short of the Trump administration's projections of 20 million vaccinations by the end of this year. William Brangham spoke to Dr. Carlos del Rio, a professor of global health at Emory University School of Medicine, to discuss.
While the U.S. struggles to distribute vaccines as quickly as possible, a third vaccine, this one from drugmaker AstraZeneca, was just approved for use in the United Kingdom.
William Brangham has the latest on the worldwide push to vaccinate against COVID-19.
As you reported earlier, Amna, and as we just heard from that doctor, in the first two weeks of America's vaccination campaign, just two million people have received the first of the two required doses for their vaccination.
That is far short of the 20 million people that the Trump administration said would be vaccinated by the end of this year. What's causing this backlog? And, also, what is happening globally with this vaccine rollout?
For that, we turn again to Dr. Carlos del Rio. He is an infectious disease specialist, professor of global health and epidemiology at Emory University School of Medicine,
Dr. del Rio, very, very good to see you again.
I can't help but be struck by this contrast that these vaccines were developed at near record speed, and it is truly an incredible achievement. And yet we are now stumbling so badly, it seems, to get that last mile, to get those vaccinations into people.
What is your sense of why this has taken so long and proven so difficult?
Carlos del Rio:
Well, I think there are several things.
Number one, I think you have sort of a glass-half-full event. We have a very broken health care system. We don't have a centralized health care system. And, therefore, there are some health care systems that are doing a really good job. But then some other positions and other people are simply not having access to the vaccine.
I think, from the start, we have missed having a national strategy. It's been all down to the states. And then states have sort of pieced it up piecemeal.
I think we have — we're really suffering the impact of not funding public health. Many public health agencies simply don't have the personnel, because, for years, they have been underfunded, and they have let go of a lot of personnel.
The Fulton County Health Department, for example, in the city of Atlanta used to have, I think, 20 or so contact tracing nurses in the past. Now they're down to four. If you don't have enough people, you can't hire them if you don't get the funding. So, funding is needed.
And the third thing is, I think we need transparency in the data. We need to know exactly where the vaccines are, how they're being used, how they're being distributed, and really have a very clear allocation process.
I would love to have had a Web site where I can go in and say, this is my zip code, and therefore be assigned specifically to a place to go. So, a lot more is needed, quite frankly.
I guess what I'm having a hard time understanding is, this is not like the immediate emergence of the virus, when we suddenly — when we didn't have a test for it and we didn't know we would need all this protective equipment.
We have known that this was going to be an issue for months. And states have been saying, we need this help, we need this aid. I mean, some of that is in the COVID relief bill. But is it your sense that things will start to get better, and this is really just the sort of early halting, faltering steps of this process?
I think so. I think things are going to get better over the next several weeks.
I will tell you, though, this is an incredibly complicated operation to conduct, especially when you have a vaccine that some need refrigeration, and some don't. Some need the two doses, et cetera.
Even for an incredibly competent government, this is not an easy thing to do.
Let's talk about that new vaccine that the U.K. government just approved, the AstraZeneca vaccine.
They are trying — it's a two-dose vaccine, as the ones here in the U.S. are, but they're trying an interesting approach. They're giving all of their doses out immediately, as quickly as possible, rather than holding back that second dose in reserve.
I'm curious what you make of that strategy. Is that something we would consider here?
You know, I think that's not a good strategy, and because it's simply not a strategy that's been tested.
And I think, if we're going to do things, we ought to do them the way they need to be done. So I rather just — I think there's going to be plenty of vaccine, but we have got to do it the way it was intended to be done.
So, while I see what the British are doing — I mean, clearly they're having a major surge, and they're having — they're very concerned. I think we need to — we need to do a better job with the vaccines we have right now. We're not even getting the ones we have out to the arms of people.
And, remember, vaccines don't save lives. You have got to vaccinate people. There are — at the most, four million Americans have received vaccines up to today. There's close to 20, 18 million that are already there ready to be administered.
So, let's get those vaccines to people. We have got to — I want to see the inventories to be essentially zero. What I would love to have places do is, if you get vaccine within a week, I want to see that vaccine in arms of individuals.
With regards to this AstraZeneca vaccine, you mentioned this before, but it is much cheaper, and it is much easier to store, so it doesn't have these problems that these others that need a deep freeze to transport and to store.
It is hard to see, when you look at the global rollout of vaccines, this disparity that occurs, with rich, wealthier nations seeming to be first in line for the initial doses, and the poor nations stuck in the back.
Help us wrestle with that. How do you — how should we wrestle with that disparity?
Well, we have to wrestle with this disparity by basically ensuring that everybody globally has access to the vaccine.
Latin America has been very severely affected by this pandemic. And if we don't work to get vaccines to Latin America, if we don't work to get vaccines to the low-income countries of the world, we're going to have a problem. We cannot just simply say, we will vaccinate Americans and forget about the rest of the world.
So, we need to work as a nation to ensure vaccination access to everywhere, to everyone around the globe. And that is one of the things that the U.S. should actually be doing.
Do you think that we are doing an adequate job of that? Because, right now, we have seen wealthier nations buying up large stores of the vaccines initially. And I know there is this international effort, the COVAX effort, to try to equalize that distribution.
But do you think we are going to be successful that way?
I tell you, the U.S. up to now has not done a good job. We did not sign on to COVAX, which was a big mistake, I think.
We have really — our international leadership has really gone away. I am hoping, with the new administration, with incoming President Biden, that will again assume the leadership we need globally, we will rejoin COVAX.
And I think we have the — sort of the emotional and intellectual desire to do this. And if we do it right, we can actually be leaders in getting vaccines globally.
I would remind everybody that the most successful global health program that has ever been implemented has been the PEPFAR program. And that is something that every American needs to be proud of.
So, we can take an example of PEPFAR and do a similar thing to getting the vaccine to people.
PEPFAR, for those who are following this, was the global AIDS initiative sponsored by the U.S. government and the federal government and funded all over the world.
Lastly, we have seen this emergence of a new variant of the coronavirus. We saw it in the U.K. and South Africa. And now we have spotted it here in the U.S.
Should we just assume that it is widespread here in the U.S.? And, if so, what does that do as far as our prevention measures?
Well, I think it's probably widespread in the U.S.
The fact that a person in Colorado had this virus and had no history of travel and no history of contact with anybody who has traveled basically tells you there is community transmission.
And look, sequence, and you will find. And I think one of the things we need to do as a nation is increase the amount of sequencing, genomic sequencing, we're doing.
But the other thing is, this virus, to be very clear, is more transmissible than the other virus. It has a better attachment to the ACE2 receptor. And, therefore, it increases the transmissibility.
But it does not produce more severe disease, and the vaccine is effective against it. So, what this is telling us is that we need to really hunker down on our prevention messages.
And, again, I would emphasize to people, with tomorrow being New Year's, we really have got to stop transmission. And we can do that by wearing a mask, by watching your distance, but, more importantly, by not going to closed, crowded environments with poor ventilation, because that — when I'm speaking about bars, nightclubs, restaurants, that is where most of the transmission is happening.
So, please avoid those settings, because a virus of high transmissibility is going to transmit even more in those kind of environments.
All right, Dr. Carlos del Rio of Emory University, as always, thank you very much for being here.
Delighted to be with you.
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