WASHINGTON — The incoming Biden administration has been blocked from coordinating with the federal government’s civil servants who are planning a massive vaccination campaign, forcing the president-elect’s team to meet with local health leaders and pharmaceutical companies to piece together information in an attempt to get around President Trump’s obstruction.
The delay caused by Trump’s continued false insistence he won the election is putting lives at risk, President-elect Joe Biden declared this week.
“More people may die if we don’t coordinate,” Biden said on Monday. “How do we get over 300 million Americans vaccinated? What’s the game plan? It’s a huge, huge, huge undertaking.”
That undertaking is being mapped out by health and defense officials in the government who are currently not allowed to coordinate with Biden’s team — an unusual politicization of the transition process that is coming at a perilous time for the country. The Trump appointee in charge of authorizing the transition has yet to formally acknowledge Biden as the apparent winner of the election, preventing the incoming administration from meeting with Trump administration officials and receiving classified briefings.
Some of those officials are starting to speak out and say they believe the Biden administration should be read in on the plans, despite the president’s contention that he won the election.
“Of course it would be better if we could start working with them,” Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said on CNN this week. He compared the process to handing over a baton in a relay race: “You want to just essentially keep going.”
Two pharmaceutical companies — Pfizer and Moderna — announced preliminary data from clinical trials in recent days that suggested their vaccines were 90 percent or more effective at preventing COVID-19. The announcements lifted hopes that an end to the pandemic could be in sight, but also turn attention to a massive manufacturing and distribution challenge the likes of which experts say has not been seen in this country for decades.
“I think we’re looking here at a scale of mobilization that we haven’t seen since the Second World War,” said Lauren Baer, a former State Department senior adviser who worked on the US response to the Ebola virus outbreak in 2014. “This is going to be a period of time when we are going to have to muster all of the resources of the federal government for the collective good of the American people.”
As the Trump administration delays the transition, the COVID-19 picture in the country is getting bleaker. The United States passed the milestone of 150,000 daily cases just about a week after it hit 100,000 for the first time, showing the acceleration of the outbreak. More than 14,000 Americans are in critical care for the coronavirus in hospitals, according to the Covid Tracking Project, the most since the first peak of the crisis in April.
“They will be taking over at a dire time,” said Dr. Nicole Lurie, who was assistant secretary for preparedness and response at the Department of Health and Human Services during the Obama administration.
So far, Biden and his aides only have access to publicly available information on COVID-19 as they prepare to implement a vaccine rollout as well as a testing and contact tracing plan when they take over on Jan. 20. Experts say that leaves the team blind on key metrics, including the exact status of the nation’s personal protective equipment (PPE) stockpile as well as detailed distribution plans for therapeutics and vaccines.
“What are we going to do when we start running out of PPE again if that happens? What are the plans?" said Dr. Krutika Kuppalli, an infectious disease physician and professor at the Medical University of South Carolina.
The White House has defended locking Biden’s team out during a pandemic by essentially suggesting that the Biden team “Google it."
“What should they meet about?” a White House spokesman, Brian Morgenstern, said on Twitter of Biden’s team and the outgoing administration. “Here is the publicly available distribution plan.”
The vaccine plan Morgenstern referenced is preliminary, and leaves key questions about the complex undertaking unanswered. Basic decisions have not been made, such as which Americans would get the vaccines first, and whether to distribute the vaccines equally around the country or instead focus on areas with high case counts, according to the interim playbook on vaccines published by the Centers for Disease Control and Prevention. Those unanswered questions hang in the air even as Fauci and others say they want some high-risk Americans getting vaccinated as soon as December.
“The administration will say all the plans are on the website, but none of us have any idea what kinds of problems have been anticipated and what the mitigation plans for them are,” said Lurie.
She pointed out that the details of vaccine contracts with the pharmaceutical companies are opaque. If a company has trouble delivering its vaccine doses on time, what happens then?
Biden’s staff is meeting directly with representatives from pharmacy chains and drugmakers as well as local health care associations in an attempt to piece together its COVID-19 response and vaccine campaign Experts say this is a good step, but is no substitute for a full transition.
Groups representing health care workers and hospitals are raising the alarm about the Biden administration being left in the dark.
“Real-time data and information on the supply of therapeutics, testing supplies, personal protective equipment, ventilators, hospital bed capacity and workforce availability to plan for further deployment of the nation’s assets needs to be shared to save countless lives,” the American Medical Association, American Hospital Association, and American Nurses Association wrote in a letter to the Trump administration on Tuesday.
The Biden administration will also face the formidable task of educating the public about the vaccine while battling misinformation about it online. As Biden’s chief of staff Ron Klain said this week, a vaccine only works if people get vaccinated, and surveys suggest many Americans are resistant to the idea of getting the shot.
“We spent billions of dollars on Operation Warp Speed but we really haven’t spent on community engagement,” Kuppalli said of the federal government’s program to speed development and production of coronavirus vaccines. “Public confidence in the vaccine has really gone down since early in the pandemic. This would have been a perfect time to spend funding and resources to really try to ramp up community engagement for a vaccine.”
Educating health care workers is another key piece of the puzzle that appears to not have taken place under the Trump administration.
“As far as I can tell there’s been next to no education in either health care workers or the general public,” Lurie said.