We really really do not want to be in a situation where we have to go through this thing a second time. That means we should be very serious about getting the whole world inoculated as quickly as possible, even apart from the humanitarian interest that we should not want to see preventable illness and death anywhere.
Distributing the Vaccines
Perhaps the most mind-boggling aspect of the policy response to the pandemic has been the failure of the vaccine distribution process. In the United States we have a fairly straightforward explanation: Donald Trump. Trump made it clear that, under his leadership, the federal government was taking no responsibility for distributing the vaccine. However, even without the leadership of the federal government, it is disturbing that states have not been better in stepping up and filling in the gap.
Even more striking is the fact that United States is actually doing better in its vaccine rollout than countries like France and Germany, which do have national health care systems and generally competent governments. It is astounding that they seem to have been unprepared to deliver vaccines once they had been approved by regulatory authorities. It is striking that these countries did not seem to have plans in place to quickly deliver whatever vaccines they had available.
This means having concrete plans to distribute the vaccine immediately after the regulatory authorities gave the green light. That would mean having stockpiles available near distribution centers. It means picking locations -- nursing homes, hospitals, pharmacies, or mass inoculation points at sports stadiums or other facilities -- and then ensuring that the necessary personnel are at the site.
We have heard reports of shortages of everything from syringes to personnel trained in giving the shots. We had all fall to ensure that we had plenty of syringes. If enough people had not been trained to administer the shots (we give two million flu shots a day during flu season), then we should have trained more people. [2]
It is truly incredible that states did not make these preparations. Again, having a federal government that was completely AWOL on the vaccine distribution effort was a big handicap, but it is still surprising how most states seem to have fallen down so badly. [3] And, it is very hard to understand how competent governments in Europe seem to have also been unprepared to quickly deliver the vaccine doses that were available.
Conclusion -- The World Has Messed Up Big Time in Dealing with the Pandemic
It is hard to look at the track record over the last year and not conclude that governments failed badly in their efforts to control the pandemic. This is partly due to corruption and a failure of imagination, as in the decision not to open-source the development of vaccines, treatments and tests, and partly to a lack of competence, as in the failure to prepare in advance for the distribution of vaccines.
Some countries, especially those in East Asia, have done very well in limiting the spread of the virus and thereby minimizing deaths and economic damage. But few countries elsewhere have much to brag about. Donald Trump is of course a big part of the problem in the United States, but the failure goes well beyond Trump. There should be some real accountability once the pandemic is contained, which hopefully will be soon, if we start doing things right.
[1] I outline a system of publicly funded drug research in chapter 5 of Rigged.
[2] One of the amazing stories I've heard from public health people is that the coronavirus shots take longer to deliver because the shot giver has to make arrangements for a second appointment. If this is actually true, it is incredible that we would waste the time of a person giving shots, by having them make these arrangements, rather than having a separate person who checks people in doing this work.
[3] One explanation that I have heard is that states delayed making plans because they assumed there would be money for distribution logistics in the second pandemic rescue package that eventually passed at the end of December. The idea was that if they spent funds before the bill passed, they wouldn't be reimbursed, but if they waited, they could then have the Feds pick up the tab. If this explanation is right, then it shows the enormous cost of the long delay in passing this bill.
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