Milestones and What’s Next

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Today is the first day that everyone in the United States 16 and over is eligible to be vaccinated. 25.4% of the US population is now fully vaccinated. But look a bit deeper and you see that as of this morning 50.4% of Americans 18 and over have now received at least one shot. 32.5% are fully vaccinated. Given the interval of 3 or 4 weeks between injections, we can figure that by mid-May around 50% of all adults will have been vaccinated.

This means we are approaching levels of vaccination where the society wide-impact should become more and more apparent. This doesn’t mean ‘herd immunity’. We’ve used that phrase imprecisely and often misleadingly during the last year of COVID. Herd immunity isn’t binary. There’s no magic percentage where it suddenly kicks in. Rather, each individual removed from the population of potential vectors adds an incremental level of friction to the potential spread of disease. Eventually you reach a tipping point where spread should drop precipitously. But well before that vaccination should slow the velocity of spread through the population.

The spring 2021 vaccination campaign has been remarkably successful. But there are signs now that we’ve reached a different tipping point: where the pace of vaccination is controlled not by the supply of vaccines or ability to distribute them but by the number of people willing to take them. That doesn’t mean we’re out of people ready to be vaccinated. But it does mean supply will be less and less of a constraint and public vaccination campaigns, especially among resistant populations, will become increasingly critical.

Let me add one more thing.

After a year of being more or less AWOL, the CDC has stood up a robust and very helpful portal covering all aspects of the COVID pandemic, including up to date information on numbers of cases, vaccinations, fatalities and more. Here for instance is the page with the top line data points I noted at the top.

This shouldn’t be remarkable. But it is.

I remain very proud that I was at least one of the first and I believe actually the first outside journalist to call attention to what would later be named the COVID Tracking Project (CTP). For most of 2020 it was the canonical source of data on testing, cases, fatalities and more in the United States.

The project always had a two-sided reality. It was perhaps the most important single journalistic effort of the COVID pandemic, truly a marvel of synthesis, data visualization and fact-checking. And yet it was a genuine disgrace that it had to exist at all. This kind of effort is an elementary governmental and public health function. But the CDC just didn’t do it.

The CTP discontinued its data collection work several weeks ago. And the key reason was pretty obvious. The CDC, under new management, started doing it. So the effort became more and more superfluous.

Looking back over the course of last year, disorganization and incompetence can have played some role at first in the CDC not taking up this task. But the fact that it still didn’t exist in June or September or December required a willful, persistent and repeated abdication.

The collection and publication of public information isn’t the most important job for the CDC and federal government. That is getting people tested, treated and eventually vaccinated. But I struggle to think of an illustration more palpable and easy to grasp. We can’t know to a certainty or with great precision how the COVID epidemic would have unfolded with a different administration in 2020. Nor can we say precisely how the vaccine distribution effort would be going if President Trump had been reelected. We’re on pretty firm ground saying it would have gone better in the first instance and worse in the second. But the precise degree is difficult to judge and impossible with any certainty.

Here though we see something very clear. This elementary data collection and distribution, which the federal government is uniquely capable of undertaking, just didn’t happen. For a year. That’s not just laggardness. It required an affirmative decision, revisited again and again, not to do the job. That was the case under Trump and it changed in short order under Biden. Not surprising perhaps but it captures the willful, clear-cut and disgraceful nature of the public tragedy more palpably than all the rest.

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