Eli Hartman/Odessa American via AP
First100-012521
A long line of cars awaits vaccine distribution in Odessa, Texas.
It’s January 25, 2021 and welcome to First 100. By the way you can sign up to have First 100 delivered to your email by clicking here.
The Chief
You know you’re having a good rollout to your presidency when the biggest complaint is that you’re not being ambitious enough. In the case of Joe Biden, however, ambition is desperately needed, and heaven and Earth moved to reach that lofty goal.
A couple months ago, the Biden transition set a target of 100 million vaccinations in his first 100 days. It sounds like a big number and subsequently a major achievement. But I know my times tables enough to know that it comes down to 1 million shots a day. Well, in the first week of the Biden presidency, we’re tracking at about 1.2 million shots per day. That’s even with the alleged non-existent federal distribution plan. If Biden’s “wartime” strategy for COVID moves well beyond the Trump ineptitude, why is the target still behind the initial Trump pace?
In one sense, this is the classic political tactic of under-promising and over-delivering. Indeed, Biden officials are now re-casting it as more of a floor than a ceiling. (“That is our first goal, it’s not our final goal,” White House chief of staff Ron Klain told Meet The Press.) If they’re seen as building on progress, they can control the narrative of a successful rollout.
But 100 million shots translates to about 67 million people. (some will get two shots in that period, some just one). And 67 million people every 100 days means herd immunity sometime around the end of the year (depending on the level of natural immunity in the country, and of course you would see results in terms of lower hospitalizations much sooner). We can and need to do better than that; in fact lives are depending on a faster rollout, especially with more transmissible variants in the air.
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The problem with reaching even Biden’s more modest goal, of course, is not setting up an efficient and equitable distribution system; it’s supply. The U.S. was only distributing 36 percent of the shots allocated as of two weeks ago. Now we’re at 54 percent. Distribution is far outstripping supply, and we’re approaching having not enough shots to give within a month or so.
Unbelievably, Biden’s new head of the CDC told Fox News Sunday that she doesn’t know how much vaccine is in the country, throwing the numbers we have into question. And the supply challenge doesn’t have an easy fix. We thought that squeezing an extra dose out of every Pfizer vial would instantly add 20 percent to supply. But it’s going to take time to make enough low dead-space syringes to be able to squeeze out that extra dose, and Pfizer is counting every extra dose squeezed out toward their contractual goal of 200 million shots, meaning that every dose added on the front end will come out on the back end. States have been rumbling about trying to secure their own supply, which would have been another headache, but the Biden administration shut that down.
This gets at a growing sense that the drug manufacturers will not be able to fulfill their promises on shots. Pfizer is hoping for the squeeze play to save them. According to this Moderna production tracker, the company isn’t producing enough vaccine in the U.S. to hit their 100 million order. And AstraZeneca, whose vaccine was approved for use in Europe, is already admitting a shortfall, by as much as 60 percent. Even if the U.S. approved it, presumably not as much would be available as anticipated. (That the whole AstraZeneca gambit, grabbing exclusive rights to a vaccine developed at Oxford that was supposed to be free to donate to any manufacturer, is now ending with a massive shortfall is infuriating and tragic.)
There’s very little that can be done at this point to massively raise supply. Months and months ago, you could have retrofit pharmaceutical plants, as Pfizer did. Now that wouldn’t yield anything for a while. The Defense Production Act is being leveraged to create more of the raw materials used in production, hopefully reducing some supply bottlenecks. (However, Trump had already done this, so it probably won’t yield much.) A lot relies on Johnson & Johnson’s one-shot vaccine being approved for emergency use within the next month. That would get you some supply all at once, though not as much as expected. Of course, needing only one shot means that every J&J dose is worth two from Pfizer or Moderna.
Maybe the Moderna numbers are wrong. Maybe J&J gets approved. Maybe you can marry expanded supply to better distribution and double the 100 million challenge. Maybe, maybe not.
How Do You Spell Relief?
Judging from yesterday’s phone call with the White House, you don’t spell it “Gang of 16.” Centrist Senators from both parties questioned the American Rescue Plan as being “too generous” to higher-income Americans. The Gang of 16 appeared more interested in funding for vaccine distribution, but that’s only a portion of the $1.9 trillion bill.
This sets up well for the “checks and shots” strategy. Vaccination money can clearly get a supermajority in the Senate. The direct payments are incredibly popular in the country, polling at around 80 percent. It’s a different coalition of Republicans who support checks, but I can’t see Democrats who really want that vaccine money denying cash payments for the American people. It seems to me that checks and shots gets you to 60 votes. You might need to target the checks a little more (Read: give them out to fewer people) but you could also just dare anyone to vote against an 80/20 proposition.
Then, you get the rest of the bill through budget reconciliation, which Senate Budget Committee chair Bernie Sanders has already vowed to do. There’s a short window between now and the week of February 8, when the Senate impeachment trial begins. Democrats should take it, and put checks and shots on the floor.
Well Will You Look At Me
It was a real pleasure being part of Left, Right, and Center on KCRW last Friday, part of a residency that I believe will last a few weeks. Listen to last week’s episode here.
I was on the Bradcast with Brad Friedman on Friday talking about Biden’s first week. Listen here.
Alexander Heffner had me on the Open Mind podcast. Listen here.
I was also on The Young Turks last Friday but it’s unclear to me how that gets archived. UPDATE: that's here.
What Day of Biden’s Presidency Is It?
Day 6. Among the highlights today is a Buy American plan for federal procurement that strengthens what Trump put in place.
Today I Learned
- Lina Khan to the Federal Trade Commission looks real and would be a signature achievement. (Recode)
- It’s lower profile but Sam Bagenstos as a chief counsel at the Office of Management and Budget is pretty darn good too. (Detroit News)
- Yes, we absolutely should make the child tax credit a monthly payment. (Washington Post)
- Shifts in public lifestyle patterns will frustrate policy aims for the next four years. Exhibit A: urban transit. (Politico)
- We’ve built a debt overhang for many borrowers that looms once foreclosure and eviction moratoria end. (Wall Street Journal)
- No vaccine for poorer countries will hurt richer ones due to less trade. It’s urgent to open-source the vaccine. (Financial Times)
- It took Obama eight years to dump the top accrediting agency for for-profit colleges. After Trump brought it back, it took Biden three days. (New York Times)
- Every Cabinet job is a climate change job. (Washington Post)
- I can’t think of anything more misguided and politically motivated than Gavin Newsom lifting the stay at home order in California just as it’s beginning to work. (NBC Los Angeles)
