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The COVID-19 pandemic is the worst health care crisis in a century. In my 43 years as a primary care physician, I have never faced the challenges I face today. Overseeing a practice of nine providers with 10,000 patients and with more than two-thirds of my panel of about 1,800 patients at high risk for contracting COVID-19, I am confronted on a daily basis with unrelenting questions and demands for a plan to provide a vaccine to our anxious patients. Yet due to disorganization and politics in Washington and the seemingly dilatory approach of local government and health care leaders, I have nothing to offer those who have relied on me for guidance and care.

My gratitude is boundless to my colleagues on the front lines of this public health crisis. Medical workers have been working tirelessly through the worst of this pandemic. I am in awe of the commitment in creating a vaccine at lightning speed by people in biopharma. Now it’s on public health agencies to make good on the promise to meet the demand and distribute the vaccine as quickly and efficaciously as I know we can.

I recently attempted to come up with a plan to vaccinate the 1,200 or so highest-risk patients I care for and realized that to do this on my own, even working 12-hour days doing nothing but vaccinating, would take weeks, while neglecting the routine and urgent care of all my patients. This is not a reasonable option. I know those on various state, local, and institutional committees that are working on delivery and implementation understand the need to get this done quickly. I also know there has been little transparency by the government and institutional leaders other than empty assurances that “we are working on it” and that federal agencies are responsible for the delay.

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Front-line health care providers need a clear plan to present to the public, and we need it now. If there is vaccine available, we need to deliver it to patients immediately. In order to reach any level of herd immunity, we need to have a clear plan to begin vaccinating as many as 50,000 Massachusetts residents daily — starting now.

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I understand everybody is under tremendous stress as a result of social, economic, and political disruption caused by this pandemic. But the only way to solve this is to get the public vaccinated. There is nothing more important. Recording 4,000 confirmed deaths a day in the United States when more than 370,000 have already died of COVID-19 is unacceptable. This is an international emergency as great as any war or catastrophe faced by our nation or the world. We need action now. We need strategies to combat this. If people choose not to be vaccinated, there should be consequences relating to work, access to public services, and public safety. You are either part of the problem or part of the solution. In an airborne pandemic, those words have never been more accurate.

A careful reading of John M. Barry’s “The Great Influenza” makes clear that we are doing no better now than the country did during the 1918 pandemic and that the number of unnecessary deaths will only continue to grow without prompt, decisive, and courageous action. Give us a plan now, however imperfect. We can fix it as we go along. The longer we delay, the more will die or suffer the long-term consequences of this infection.

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Dr. Martin P. Solomon is the medical director of Brigham and Women’s Primary Care of Brookline.