There is little debate that the rapid development of the covid-19 vaccine has been the bright spot in a dark and dreadful pandemic. Victory has 1,000 claimants, and certainly in this instance some of America's notable villains, President Donald Trump and Big Pharma, deserve credit.
Operation Warp Speed smartly invested and incentivized pharmaceutical companies with more than $10 billion for research and guaranteed payments for the developed vaccine. It was a race to the top, a concept antithetical to the Trump administration's overall pandemic response. But the results speak for themselves: We have two vaccines in distribution and potentially three more on the way.
The good news stops there. More than a month ago, Americans were told that 20 million doses of the vaccine would be administered before the end of 2020. By the time the ball dropped in Times Square, the number was less than 3 million.
Americans, unsure about what was happening, are in limbo. One of the many follies of Trump's covid-19 response is his abdication of leadership in a time of crisis. Rather than take charge of the problem, mitigate it, and potentially cruise to re-election, he tossed the matter to the states, refusing to employ the unique tools at his disposal to address PPE shortages, testing, and contact tracing. As of this writing, over 350,000 Americans are dead.
We have learned that an aspect of this is punitive, at least politically. Jared Kushner and other senior Trump advisers believed that covid-19 was a blue state problem, and allowing them to flounder was justifiable in our increasingly polarized nation.
Red state governors, including Asa Hutchinson, took premature victory laps in the national press, oblivious to the notion that a virus that originates at international ports of call in California and New York would ultimately migrate inland.
That happened, predictably, and today Arkansas is one of the most impacted states per capita in the nation. As Republican state legislators continue to posture about hydroxychloroquine, mask mandates, and restrictions, hospitals are full and the death toll rises. A patient whose health declines rapidly from the virus may not receive immediate and intensive care. What about those who suffer medical emergencies unrelated to covid-19?
Dr. Moncef Slaoui, the head of Operation Warp Speed, made clear recently on "Face the Nation" that administration of the vaccine was a state matter. As of the beginning of the new year, Arkansas has administered only one-third of the vaccine doses it has received.
According to the state plan, the first rounds, rightfully so, are administered to front-line health care workers, nursing home patients and staff. It seems relatively straightforward. Yet two-thirds of the vaccines sit idle.
It is difficult to ascertain the cause of the delay. On the one hand, national pharmacy chains, like CVS and Walgreens, aren't moving as quickly as local pharmacies, which is hurting nursing homes acutely.
On the other, hospitals didn't develop detailed protocols, leaving workers unsure about when or how to receive the vaccine. Rural hospitals, unable to store the Pfizer vaccine, had to wait on approval of the Moderna vaccine, which can be stored at a warmer temperature. And some people, averse to vaccines generally, have refused to take it.
All of that may be true, but it doesn't fully explain the delay in administering the current supply.
Arkansas, as with other states, informed the federal government where it wanted its vaccine supply sent. If vaccine doses are sitting idle, it is a state problem. Slaoui, appearing on CBS on Jan. 3, made the point that if Arkansas needed help, it should ask. He said Arkansas had not.
In many ways, the vaccine delay is on par with Arkansas' tepid attitude to covid-19 in the spring of 2020. Governor Hutchinson and Nate Smith, then the director of the state Health Department, adopted in my view a laissez-faire approach in those early and critical months. Arkansas continues to suffer the consequence of those decisions. But hope is on the horizon.
Vaccine distribution and administration is the state's greatest 2021 priority (sorry, tax-cut fans), and it is not too late to change course. Arkansas needs an aggressive, empowered vaccine administrator whose task it is every day to coordinate, micro-manage, and measure the program.
This involves addressing supply and demand, as well as making aggressive calls to move beyond early phases quickly. Think of what I'm recommending like Nolan Richardson's transformative "Forty Minutes of Hell" approach to basketball in health-care terms: innovative, fast, reasoned, thorough, aggressive, attentive to detail, team-oriented, and most importantly, well-designed.
The present circumstances demand intense coordination among state and local governments, health-care organizations, the non-profit community, religious institutions, business groups, professional associations, and private industry.
Without an aggressive and designed effort that provides efficiency, accountability, and transparency, Arkansas runs the perilous risk of falling farther behind. Meanwhile, in South Africa, a new strain of the virus has international health experts more fearful than at any time during the pandemic.
Leadership is required, and not the kind that is intimidated by Trump, or ideological state legislators, or the prospect of higher office. Trump has done a lot wrong, and soon, mercifully, he'll be an afterthought. But that doesn't alter the state of play.
Covid-19 rages on, and Arkansas needs a new game plan.
Blake Rutherford, a native of Little Rock, is co-founder and executive editor of SourceStream, the first bipartisan interactive political live streaming network in the United States. He lives in Washington, D.C., and can be reached at Rutherford.Blake@gmail.com.