News from the Columbia Climate School

Looking Ahead With Hope as the Catastrophe Continues

They boarded up Macy’s windows in Herald Square last week due to a fear of post-election violence. I may be naïve, but I don’t expect it in New York City. Still, after 2016, I stopped trying to predict elections, and I won’t predict their aftermath. America is not always easy to understand. Sometimes, I’m reminded of leaving Brooklyn back when I turned 17 years old to start college in Franklin, Indiana.  After living there for about a month I remember feeling as if I had been raised in another country. I came to love Indiana and its people, but it took me a while to understand them and see our shared and divergent experiences and values. Americans share many values, but we also differ, and in the half-century since I started college, I know that we have focused far more on our differences than our shared values. Still, the people I know in the middle of the country understand that we are in the midst of the worst public health crisis of our lifetime. They do not believe we have “turned the corner” on the disease. As hospitals in the middle of the country experience the stress we had here in New York last spring, the facts of this catastrophe are not in real dispute. We may disagree about how to address the crisis, but the reality of COVID-19 is clear to nearly everyone.

The questions on everyone’s mind is: What comes next and how long will this last? On June 15, I reflected on the first 100 days of this crisis and said then:

“While there are some fundamental facts that can form the basis for understanding what is happening to us and what is likely to happen, my overall assessment is that anyone who confidently predicts the second half of 2020, hasn’t been paying serious attention to the first half of the year. The warmer weather and longer days provide a sense of hope and normalcy. The streets are less deserted, traffic jams seem to be returning. But nearly 120,000 Americans have died from the virus and millions have lost their jobs. Racism has been restored to the political agenda, but it took an absolutely horrific act of violence to accomplish that feat. In academic terms, June seems like mid-term week, and I’m not really looking forward to the final exam.”

In mid-June, I confessed to having no idea what life would be like on November 1. Certainly, public health experts warned us that the disease might get worse with colder weather particularly when it was combined with the traditional flu season. The number of COVID-19 deaths in the U.S. has nearly doubled since mid-June, to 230,000 today and is now growing at a rate of nearly 1,000 per day. We are getting better at treating the disease, and so the death to infection rate is lower than it was in March and April, but the spread of the disease is continuing to increase. And as the days get shorter and colder, the hope we felt in the spring is difficult to maintain.

Life has changed dramatically and not for the better. My family Thanksgiving dinner will be limited to my wife and me and a Zoom cocktail hour with my family. The Hannukah menorah will be lit via FaceTime and I am sure that many family Christmas celebrations will also be virtual. If we get a new president or if by some miracle the current president decided to listen to medical science and truly fight a “war” against COVID-19, I believe we could bring the pandemic under control. This has been accomplished in New York and in several nations in Asia. The war on COVID would look a lot like the plan proposed by Joe Biden for testing, tracing, and the use of personal protection equipment. NPR’s Alison Aubrey has written an excellent summary of Biden’s plan. According to Aubrey:

“Biden’s plan says it would direct the CDC to provide specific guidance — based on the degree of viral spread in a community — for when to open or close businesses and schools, when to impose restrictions on gathering sizes or when stay-home orders may be called for…And, Biden is calling on every American to wear a mask when they are close to people outside their household. He says he’d work with every governor to make this mandatory in their state. Many states already have mask mandates… The Biden campaign says the goal is to “ensure that all Americans have access to regular, reliable and free testing.” It would work to double the number of drive-through testing sites and invest in “next-generation testing” including home tests and instant tests.”

Biden would provide funding for states to manage the response and would finally allow the CDC to provide detailed health guidance, free of politics, to states and localities. Increased testing and tracing would allow all states to follow New York’s practice of targeting shutdowns to areas where the disease spread is spiking. A national mask mandate would help drive down the spread of the disease as well. Research on treatments should also be funded and conducted, and hopefully the heavy investment in creating a vaccine at “warp speed” will succeed.

When an effective vaccine is available, there must be a national mobilization to vaccinate the U.S. and to provide the vaccine to the rest of the world. In the U.S., the president must utilize the Defense Production Act to ensure that the vaccine is manufactured rapidly and to vaccinate as many Americans as possible as quickly as possible. According to the Congressional Research Service:

“The Defense Production Act (DPA) of 1950 (P.L. 81-774, 50 U.S.C. §§4501et seq.), as amended, confers upon the President a broad set of authorities to influence domestic industry in the interest of national defense. The authorities can be used across the federal government to shape the domestic industrial base so that, when called upon, it is capable of providing essential materials and goods needed for the national defense….Gradually, Congress has expanded the term national defense, as defined in the DPA. Based on this definition, the scope of DPA authorities now extends beyond shaping U.S. military preparedness and capabilities, as the authorities may also be used to enhance and support domestic preparedness, response, and recovery from natural hazards, terrorist attacks, and other national emergencies.”

This law must be used to ensure that the vaccine is produced, distributed and administered in every state in the Union. Drug companies must be lined up ahead of time to rapidly produce the vaccine. Companies like Federal Express, Amazon and UPS that have mastered logistics should be paid to deliver the vaccine to hospitals, doctors’ offices, pharmacies and urgent care facilities. The Defense Act should be used to require that they prioritize these deliveries over all others. Doctors, nurses and pharmacists should be recruited by the government and urged to prioritize the administration of a free vaccine to all requesting it. A national or state-by-state electronic reservation and tracking system should be established to ensure that people and vaccine administration can be matched.

America has the capacity to deliver the vaccine quickly. There are five million Americans capable of injecting the rest of us with a vaccine once one is developed. One industry source estimates there are about 26,000 pharmacies and drugstores in the United States. According to Statista.com, there are over 311,000 pharmacists in the U.S. We have over a million doctors and over 3.8 million registered nurses in this country. In other words, with correct attention to manufacturing, delivery, storage and administration and the assumption that four (of the five) million people can administer vaccines, each of the vaccinators needs only administer 80 vaccines to deliver 320 million doses. At 12-13 a day, we could get that done in a week. Even If we only recruit two million “vaccinators” it would take two weeks. In any case, a national mobilization could vaccinate the nation in less than a month. If a second dose is required, we could ramp up twice.

The U.S. population is 331 million people. Lots of people are not certain they are willing to be vaccinated, and while the federal government should prepare a rapid mass national mobilization to administer the vaccine, the process of administering the vaccine must wait until a good one is ready. The government should prepare a communications strategy that relies on trusted scientists to promote the vaccine. The campaign should culminate with a live TV and streaming social media show featuring Anthony Fauci being injected with the vaccine. The moment I see the needle in Fauci’s arm is the moment I’d be ready to get vaccinated — and my hope is that so too would most other people.

The vaccine does not end the crisis, but it signals the beginning of the end. Testing and tracing would continue and as infection rates go down, we can slowly lift social distancing requirements and outdoor masks. When the pandemic is finally eliminated, the indoor masks will melt away as well. But the capacity for research, testing and tracing must remain. COVID-19 will not be the last highly contagious disease we will confront but let us hope it is the last one we allow to spread out of control.

That is the future I would like to see, and the probability of that happening depends on the election tomorrow and on a unified national mobilization to finally address the COVID crisis. I am an optimist by nature, and I believe we can do this. America has the organizational capacity and the resources to get this done. We only require rational leadership and political will.

Views and opinions expressed here are those of the authors, and do not necessarily reflect the official position of the Columbia Climate School, Earth Institute or Columbia University.

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