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Out of frustration, I’ve consolidated my list of what would make me feel good about optimizing our way out of the pandemic. This is just my opinion and not complete.
Like @Farzad_MD I'm frustrated by the blame game about vaccinations. Most of the people working in the supply chain are doing so completely independent of political ideology. Painting everyone with a broad brush of “good guys” & “bad guys” is wrong.
However, identifying problems and keeping the public pressure on is important and good—we need all hands on deck. I have great confidence in the incoming Biden team. It will be good to get the transition done so they can enact their plans.
I made a list of some of the actions that would make me feel better. Just my opinion—I’m sure the Biden team has a better list, especially when combined with the composite wisdom of the civil servants and military deployment experts already in place.
Have a daily briefing that includes all the relevant numbers about vaccine deployment and disease outcomes. Also identify key problems and solutions underway. Sunshine will help a lot.
Consider doing this in a sequential manner every day-federal, state, county, health system-at a designated time daily. All these entities are relevant, & briefings could be done in an orchestrated manner that would inform people of both the big picture and the local situation.
Make the numbers explicit and public in a rejuvenated CDC driven dashboard that would enable federation with public and private entities. If the data could be downloaded easily, everyone could be involved in understanding the pandemic better with the best information.
A variety of additional information could be added—some of the best information has come from university and private aggregators and modelers, but a primary transparent government data source should be central.
Do everything possible to give a consistent message across these entities about what people need to do to optimize vaccine deployment & prevent infection & downstream severe illness and death. This will take an unprecedented amount of communication to overcome misinformation.
Our public health system is a federation of federal, state and local components—not a purely hierarchical relationship. Autonomy is an important part of the US ethos. Again--communication at every level is necessary, so everyone is acting on the best information.
A common set of consistent, repetitive messages at every level would impact vaccine readiness and use of masking & social distancing while vaccinations are revving up. Vaccines + previous infection + NPIs together would accelerate return to school, business and social.
Of course, dissent & recognition of scientific uncertainty should be part of the fabric, but it should be based on common, publicly available data. Mis and disinformation should be contrasted with evidence based messages from govt, public health, medicine & science authorities.
The messages need to be given in multiple ways for our many cultures and subcultures where what is said and what is heard can be different depending on the specifics of the message and the messenger.
I love the 3 themes being promoted during the transition, including by @RickABright & @vivek_murthy : 100 million vaccinations in 100 days, everyone wears a mask and open most schools. This will take a massive effort, taking into account a lot of what has already been done.
There is an element of the “hockey stick” phenomenon in mass deployment of medical interventions. It sputters early because everyone needs to get procedures in place & learning occurs. Then it takes off. We should recognize this as we correct inefficiencies & add resources.
Use Defense Production Act & volunteer support where it will make a difference. Many are underestimating the vast reach of our health systems + CVS + Walgreens, but the missing areas could be filled in and weaknesses should be shored up by deployment of additional people.
Matching vaccine production and availability with deployment is an immense logistics problem. It won’t help to have people deployed to vaccinate without vaccinations in the freezer and vica versa, but a lot of good ideas are circulating for public vaccination drives.
The emphasis on masking and social distancing could be increased with the motivation that its only until we reach needed levels of vaccination and it will enable opening of schools and businesses. I believe the power of consistent messaging is underestimated. We'll see!
And we need to rejuvenate our effort to solve the logistics of therapeutic antibodies in this period. People are getting very sick when antibody treatment would have been highly effective-& its being massively underused as pointed out by @ScottGottliebMD & others.
The one vs 2 dose argument continues and we'll learn as we go. It will be essential to collect and analyze the data as we go to adjust course on deployment & post-vaccination followup for duration of protection, side effects, etc.
I’m optimistic that the Biden administration will enhance the hard work of the many people who have gotten us positioned for mass vaccination and that consistent, transparent information and science based messaging will rally the country to combine efforts.
Adaptive science, transparency & public discussion should carry the day in 2021!
