BIDEN'S PANDEMIC PLAN MIGHT JUST WORK

It is hard to overstate the scale of the pandemic in America. On many days, a quarter of a million Americans become newly infected with the coronavirus, and four thousand die—numbers that dwarf the deadliest moments of last spring. The country’s covid-19 death toll has passed four hundred thousand and, according to Joe Biden’s chief of staff, will reach half a million in February; at any given time, more than a hundred thousand Americans are hospitalized with covid-19, and health systems are running out of space, equipment, and personnel. Meanwhile, a new coronavirus variant, thought to be fifty per cent more transmissible and possibly thirty per cent more deadly than the original, has been discovered in at least nine states. The U.S. has no genome-sequencing or reporting system in place, so it’s impossible to say just how widespread the new variant is, or whether other, more dangerous strains are already in circulation. In any event, the sheer contagiousness of the new version means that the death toll is almost certain to rise further and faster.

Vaccines are a reason for hope, and are already making a difference; nearly twenty million Americans have received a shot. But vaccine distribution has also proceeded chaotically and haphazardly. The problem isn’t strictly one of supply. Doses are being shipped as quickly as they can be manufactured, but only about half of the shots received by states have actually been administered. Meanwhile, four in ten people say that, even if vaccines were more widely available, they would hesitate to get innoculated, because they distrust the government and the approval process. Sixty per cent of older Americans—many of whom are now eligible for vaccination—say they don’t know where or when to get immunized.

It’s a strange moment in our nation’s history—a contest between error and effort. After a year of mismanagement, America is racing to vaccinate the vulnerable; a new Administration is taking over just as a vastly more contagious form of the virus threatens to accelerate the surge. The pandemic is a juggernaut, bearing down upon us. Can Joe Biden and his team stop it?

The new Administration has proposed a wide-ranging, two-trillion-dollar plan to turn things around. The plan includes stimulus checks, expanded unemployment benefits, a minimum-wage increase, and funding to help schools open safely. But its most important component is vaccination. Biden has pledged to deliver a hundred and fifty million shots in his first hundred days in office; he has also announced that his Administration is nearing deals with Pfizer and Moderna to secure an additional two hundred million doses by the end of the summer. Together with the four hundred million doses the companies already plan to deliver, that would be enough to vaccinate every American adult. But distribution is still a problem. The pace has been accelerating; on several days last week, more than a million Americans were vaccinated. Even at that rate, however, it will take a year and a half to vaccinate eighty per cent of the U.S. population. The pace must accelerate further.

The challenges of vaccine distribution are daunting and well known: the need for ultra-cold storage and shipping, the difficulty of coördinating multiple doses spaced weeks apart, an underfunded public-health infrastructure, the politicization of the pandemic, and growing vaccine hesitancy. “The vaccination campaign is going to be among the most complex tasks in American history,” Tom Frieden, who was the director of the Centers for Disease Control and Prevention under Barack Obama, told me. Still, Frieden believes that, with the right communication, funding, planning, and execution, these obstacles could be overcome. And, because the risk of life-threatening illness is concentrated in certain groups, targeted vaccinations will have an outsized effect on slowing deaths. Nursing-home residents account for some forty per cent of U.S. covid-19 deaths. Frieden said that, if most of this group were vaccinated by March, “You’ve protected your most vulnerable flank.”