It's been three weeks now since the first FedEx shipments of the Pfizer COVID-19 vaccine from a Michigan warehouse inspired O.J.'s white Bronco-style coverage on cable TV. And while the number of doses of the two FDA-approved treatments delivered — more than 13 million by last weekend, according to the federal government — so far has been somewhat disappointing, the delays in actually jabbing Americans with these doses are quickly becoming unconscionable.
The number of people getting their first dose — mostly front-line health care workers, nursing home residents and some seniors — is just 4.2 million, according to trackers, or less than a third of the doses that have been delivered. As the calendar flipped into 2021, local scenes of confusion and chaos have become more common.
The moonshot of America finally turning the corner on the pandemic has been hijacked by the delays and other negative headlines — including a bizarre act of sabotage and signs that even some health care workers are balking at the shots.
What's gone wrong? There has been more finger-pointing than arm-jabbing. As Ashish K. Jha, the dean of Brown University's School of Public Health, noted Sunday in a Washington Post op-ed, the only thing that seems crystal clear is that nobody is in charge. Citizens who had been hearing about Operation Warp Speed from President Donald Trump for months weren't aware that the actual administering of shots was pushed onto the states, where public health departments were underfunded and overworked even before the surge in work around the coronavirus.
And within the states there's another layer of confusion over the role for counties, some of which are turning to low-budget websites like Eventbrite to sign up patients.
"The federal government and Operation Warp Speed saw their role as getting vaccines to the states, without considering what supports states would need to get vaccines to the people," Jha wrote, calling the push to blame states "political theater and obviously untrue." As Washington dithered on additional coronavirus relief over the course of 2020, one of its failures was boosting the paltry funds made available to the states to handle the vaccine rollout — although new dollars are on their way in the package belatedly approved and signed by Trump after Christmas.
Indeed, with two agonizing weeks left in his presidency, Trump is the easiest target to blame, and the worst president in American history deserves every ounce that he gets.
But like so many problems afflicting America as we sink deeper into these troubled 2020s, Trump might be the bleeding symptom, but he's not the disease. The United States is so far failing at the task of administering doses for the same reason it didn't know how to create the testing-and-tracing regimes that have largely worked across Asia, or avoid the embarrassing shortages of protective gear that had some nurses wearing trash bags.
This country has been waging war on the very concept of good government for 40 years, and public health has been in the front trench taking World War I-level casualties.
Trump might be finishing the job, but the president who created this mess was Ronald Reagan, who assured a similarly anxious nation upon taking office in 1981 that "in this present crisis, government is not the solution to our problem — government is the problem" and then put a lack of money where his mouth was.
The early years of Reagan's presidency saw a budget cut of 25% for the Department of Health and Human Services and, with that, the elimination of vital public health programs.
The Reagan-era cuts ended federal programs that sent physicians into isolated communities and contributed to the closure of 250 community health centers and about 600 rural and big-city hospitals. Infant mortality actually rose in the lower-income states. And this occurred even as a new virus — the HIV virus that causes AIDS — was killing tens of thousands of Americans.
"Twenty-five percent of the federal health budget disappeared in a single day!" the Pulitzer Prize-winning health journalist Laurie Garrett noted nearly two decades ago. Garrett, the modern-day Cassandra who's long warned that America was badly unprepared for a pandemic like the coronavirus, had just written a book called "Betrayal of Trust: The Collapse of Global Public Health" that chronicled America's retreat from public health that only worsened during the 1980s and '90s, spreading even to states with a liberal, good-government tradition like Minnesota.
By then, as now, the Reagan critique — made famous in his oft-repeated joke that "the nine most terrifying words in the English language are: 'I'm from the government, and I'm here to help' " — was so ingrained that even the next Democratic president, Bill Clinton, proclaimed "the era of Big Government is over."
Big Government has been nowhere to be seen in New York state, headed by a Democratic governor who served in Clinton's Cabinet, Andrew Cuomo, where New York City has only administered 88,000 of the 340,000 doses delivered so far. Officials in the Empire State say Cuomo had overridden a plan that would have seen counties in charge — the opposite of other states where the job was dumped on counties with no idea what to do.
All of these problems — the lack of leadership, of a well-thought-out plan, and of money and staffing for a World War II D-Day-type approach that the pandemic's mounting death toll demands — seem to stem from one big problem that it's way past time to acknowledge: America has forgotten how to govern, even in a life-or-death crisis.
The grim coronavirus death toll might pass 400,000 by the time Joe Biden takes the oath of office on Jan. 20, although he'll be taking over a vaccination effort that hopefully will have learned from these many early mistakes, and we'll suddenly have an engaged and activist government willing to call up the National Guard or other agencies to fill the gaps in distribution. Much as Franklin Roosevelt did in the first 100 days of the New Deal in 1933, it will be imperative to show a fear-wracked nation the power of a democracy actually helping people.
Actions will matter, but so will words. Biden must use his inaugural address to remind America — in some ways for the first time since 1933 — that you can sometimes ask what your country can do for you, and that in the present crisis, government has a critical role in any solution. Not a bloated or overreaching government, but a good government of the people, by the people and for the people — one that realizes that it will take a village and not rugged individualism to defeat the virus.