America is caught in its own version of pandemic purgatory. Cases are declining, lifesaving vaccines are now widely available to anyone over the age of 12, and yet we are consumed with confusion over camps, schools, workplaces and when, or even whether, to wear a mask.
This is the backdrop for what might be the most difficult immunization effort ever witnessed.
As a fully vaccinated health care professional with a degree in public health and experience in pandemic preparedness, I, too, have felt shame for not wearing my mask outdoors and have been rebuked in public. The Centers for Disease Control and Prevention has been criticized for overly cautious guidance, and the perception that it lacks transparency. And that doesn’t even take into account the ongoing barrage of disinformation and politically motivated lies.
Frustrated political leaders have ignored their own medical officers and increased indoor capacity and removed mask mandates. This is the backdrop for what might be the most difficult immunization effort ever witnessed, as officials try to reach the tens of millions of Americans who either feel the need to vaccinate, or who reject the science. As demand drops, states are returning vaccines.
So the multitrillion-dollar question for President Joe Biden and team is: Where do we go from here? That’s also the question Americans will be looking for Biden to answer Wednesday as he faces the nation during MSNBC’s “Vaccinating America” town hall.
Moving the vaccination effort into the hands of trusted messengers such as doctors and community members is certainly an important step — campaigns will only go so far when they fall on deaf ears. But the confusion is palpable. Employers are getting desperate for guidance; Coast Guard officials are still mandated to issue citations if fully vaccinated fishermen are not wearing masks. Americans deserve to understand how life might look with higher vaccination rates. What can be done to get kids back to school and parents back to work? Can the public health messaging be improved and restore faith in agencies and scientific advisers?
Obviously, Biden’s team knows it has a lot to answer for. And Wednesday’s town hall is as good an opportunity as any. Here are five big questions I’d like to see the president and his administration answer on Wednesday night.
- How are we preparing for the inevitable rollout of coronavirus booster shots this fall and winter? Biden inherited a national plan (or lack of one) from the Trump administration that deferred all initial vaccine planning to states. But boosters are a different situation. Can the Biden administration learn from the past year and improve the process in time?
- How can we tackle racial disparities when we only have 60 percent of states reporting racial data? Given the tremendous toll Covid-19 has taken on Black, brown and other communities of color, it stands to reason that the federal government should focus on bridging these gaps.
- What is our best wall of defense against the threat of variants? The United States was caught flat-footed by variants because of our lack of a genetic surveillance infrastructure and continues to lag behind other developed countries — we currently sample 1.6 percent of Covid-19 lab samples for variants, compared to the 5-10 percent sampled by our global peers. Experts have been clear that the U.S. needs to engage universities and private labs to work together to increase our genetic testing of lab samples; the CDC will not be able to do this alone.
- What is the administration doing to deal with health care worker burnout? Congress has introduced legislation named in honor of Dr. Lorna Breen, an emergency physician who died by suicide last year. The legislation is aimed at improving mental health resources — this is a necessary step, but it is not sufficient. It is likely that many health care workers will leave medicine altogether from the stress of the past year, further worsening access issues and problems with care that plagued us before the pandemic. What is the plan?
- Finally, what actions will be taken to help manage the pandemic in the rest of the world? The virus knows no borders and uncontrolled cases in other countries will have a devastating effect on education and economic mobility, as well as provide a rich environment for robust variants to develop that could then pose a domestic threat.
There are plenty of reasons to celebrate right now — the development of a highly effective vaccine, an administration that promotes science and glimmers of hope as generations reunite for the first time in 15 months. But the Biden administration can and should do more to prepare for the future. Answering these questions is a good place to start.
Watch “Vaccinating America: An MSNBC Town Hall” tonight at 10:00 p.m. ET/9:00 p.m. CT.
Dr. Kavita Patel
Dr. Kavita Patel is a teaching professor of medicine, Division of Hospital Medicine, at Stanford University and a board-certified internal medicine physician. She served in the Obama administration as director of policy for the Office of Intergovernmental Affairs and Public Engagement in the White House. Her area of expertise is around the intersection of health policy, clinical medicine and innovation. She also spends time advising venture capital and is a medical contributor for NBC News.