Where We Stand with the Vaccinations

The vaccine is out there. It’s not being administered fast enough. But now there’s a plan. From The New York Times [with commentary included]:

President Biden’s promise to administer 100 million vaccines by his 100th day in office is no longer a lofty goal; it is attainable at the current pace at which shots are going into arms. In fact, some experts have suggested that the president’s ambition is far too modest. [His ambition is to get the whole country vaccinated; his promise was to do 100 million by late April.]

Federal data shows that the United States is already administering about one million doses a day, and even doubling that rate would not cause the country to fall short of distribution capacity or supply. . . . 

Mr. Biden made the 100-day pledge in early December, before any vaccine had been authorized for use in the United States. At the time, experts called the goal “optimistic” given their concerns about manufacturing and distribution capacity.

Since then, two vaccines have been approved and the United States has secured contracts for deliveries of doses through July. And while some jurisdictions have said that they are running out of doses, states and U.S. territories are using only about half of the shots that the federal government has shipped to them, on average. . . .

Pfizer and Moderna have pledged to deliver a combined 200 million doses by the end of March, with an additional 200 million doses to be delivered by the end of July.

Under those circumstances, it is feasible that up to two million doses could be given per day, and Mr. Biden’s goal of 100 million shots could be reached by early March.

But ramping up vaccinations will not be easy. And national supply and distribution figures do not reflect the often complicated local realities.

“The complexity of administering vaccines may grow over the coming weeks as we open up a lot of new provider sites,” said Dr. Julie Swann, an industrial and systems engineering professor at North Carolina State University who was an adviser to the C.D.C. during the 2009 H1N1 pandemic.

Getting shots in arms has already been hard, Dr. Swann noted. Providers get little notice of how much vaccine they will receive, making it difficult to plan and set up appointments. Estimating demand can be tricky too, which means that vaccines may be used more quickly in some locations than others, leading to wasted doses.

“The administration needs to be both fighting immediate fires and putting in the infrastructure to make this work better, too,” Dr. Swann said [which is what the president and his staff are doing, three days after the inauguration].

Unquote.

The new administration has issued a “National Strategy for the COVID-19 Response and Pandemic Preparedness”. This is the summary of the plan to “mount a safe, effective, comprehensive vaccination campaign”:

The United States will spare no effort to ensure Americans can get vaccinated quickly, effectively, and equitably. The federal government will execute an aggressive vaccination strategy, focusing on the immediate actions necessary to convert vaccines into vaccinations, including improving allocation, distribution, administration, and tracking. Central to this effort will be additional support and funding for state, local, Tribal, and territorial governments — and improved line of sight into supply — to ensure that they are best prepared to mount local vaccination programs. At the same time, the federal government will mount an unprecedented public campaign that builds trust around vaccination and communicates the importance of maintaining public health measures such as masking, physical distancing, testing, and contact tracing even as people receive safe and effective vaccinations. To mount a safe, effective, comprehensive vaccination campaign, the United States will:

  1. Ensure the availability of safe, effective vaccines for the American public.
  2. Accelerate getting shots into arms and get vaccines to the communities that need them most.
  3. Create as many venues as needed for people to be vaccinated.
  4. Focus on hard-to-reach and high-risk populations.
  5. Fairly compensate providers, and states and local governments for the cost of administering vaccinations.
  6. Drive equity throughout the vaccination campaign and broader pandemic response. Launch a national vaccinations public education campaign.
  7. Bolster data systems and transparency for vaccinations.
  8. Monitor vaccine safety and efficacy. Surge the health care workforce to support the vaccination effort.

The plan is only 200 pages long.

Yeah, we’re finally getting an administration that’s competent and wants the government to work. Patience is a virtue.

Biden’s Questions for His Top Science Adviser

Joe Biden plans to make the director of the Office of Science and Technology Policy a Cabinet-level position for the first time. Last week, he sent a letter to Eric Lander, the geneticist who will hold that position, asking how the United States should address scientific and technological issues in the coming decades. I’m sure the president-elect didn’t write every word, but he put his name on it:

In 1944, President Franklin D. Roosevelt authored a letter to his science advisor, Dr. Vannevar Bush, posing the question of how science and technology could best be applied to benefit the nation’s health, economic prosperity, and national security in the decades that would follow the Second World War. Dr. Bush’s response came in the form of a report, titled Science—the Endless Frontier, that would form the basis of the National Science Foundation and set the course of scientific discovery in America for the next 75 years.

Those years have brought about some of the most consequential scientific advancements in human history with America leading the way. But three quarters of a century later, the contours of our lives have changed. . . . And the nature of discovery itself has changed by leaps and bounds—reaching celestial heights, and microscopic complexities, that were unimaginable not so long ago.

For this reason, I believe it is essential that we refresh and reinvigorate our national science and technology strategy to set us on a strong course for the next 75 years, so that our children and grandchildren may inhabit a healthier, safer, more just, peaceful, and prosperous world. This effort will require us to bring together our brightest minds across academia, medicine, industry, and government—breaking down the barriers that too often limit our vision and our progress, and prioritizing the needs, interests, fears, and aspirations of the American people.

President Roosevelt asked Dr. Bush to consider four specific questions. Today, I am tasking you and your colleagues with five. My hope is that you, working broadly and transparently with the diverse scientific leadership of American society and engaging the broader American public, will make recommendations to our administration on the general strategies, specific actions, and new structures that the federal government should adopt to ensure that our nation can continue to harness the full power of science and technology on behalf of the American people.

1. What can we learn from the pandemic about what is possible—or what ought to be possible— to address the widest range of needs related to our public health?

Even as we work urgently to overcome the coronavirus pandemic, we must learn from this moment by grappling with the challenges, inequities, and opportunities we’ve seen in order to better prepare for the future. How can we dramatically improve our ability to rapidly address threats from pathogens, including emerging pandemics, potential bioweapons, and antibiotic resistance? How can we dramatically speed our ability to develop and conduct clinical trials of therapies for other types of diseases like cancer? How can we enable the rapid sharing, with patient consent, of health information to build a smarter and more effective healthcare system? . . .

2. How can breakthroughs in science and technology create powerful new solutions to address climate change . . .?

Climate change represents an existential threat that requires bold and urgent action. But at the same time, the necessity of solving it also presents us with an extraordinary opportunity to make groundbreaking investments in our infrastructure, enhance America’s resilience, promote environmental justice, and create new cutting-edge industries and millions of good-paying jobs that will advance American leadership for generations to come.

Achieving our commitment of net-zero carbon emissions by 2050 will require deploying existing, cost-effective clean energy technologies manufactured in America; drawing on innovative solutions to capture and store carbon; and spurring American technological ingenuity to develop new zerocarbon technologies that can reshape the marketplace. . . .

The United States has a long, successful, and bipartisan history of using federal research, purchasing, and policies to help jumpstart critical industries—including, for example, when we pioneered and led the semiconductor industry. How can we refresh that model to deliver a healthier, safer, more prosperous, and sustainable future for our children, while preserving our natural environment for future generations?

3. How can the United States ensure that it is the world leader in the technologies and industries of the future that will be critical to our economic prosperity and national security, especially in competition with China?

. . . New technologies are emerging in increasingly rapid cycles that promise to transform our lives. Each arrives with a distinct set of promises and challenges—and each carries the capacity to dramatically impact job creation, equity, and national security. Other countries—especially China—are making unprecedented investments and doing everything in their power to promote the growth of new industries and eclipse America’s scientific and technological leadership. . . .

What is the right level of national investment, and what are the pillars of a national strategy that will rapidly propel both research and development of critical technologies? What structures, infrastructures, and policies are needed to accelerate the path from research laboratories to development projects to the marketplace? How can we strengthen and expand the connections between academia, industry, and government . . .? And, importantly, how do we ensure that technological advances create rather than diminish high-quality jobs?

4. How can we guarantee that the fruits of science and technology are fully shared across America and among all Americans?

The benefits of science and technology remain unevenly distributed across racial, gender, economic, and geographic lines. How can we ensure that Americans of all backgrounds are drawn into both the creation and the rewards of science and technology? How can we ensure that science and technology hubs flourish in every part of the country, driving economic development in every American hometown? How can we ensure that advances in medical science benefit the health of all Americans, including substantially reducing racial and socioeconomic health disparities?

5. How can we ensure the long-term health of science and technology in our nation?

Science and technology have flourished in the United States because of a rich ecosystem of people, policies, and institutions. This ecosystem must be nurtured and refreshed . . . How can we protect scientific integrity within government—and make government a premier destination for scientists and technologists to work? . . . How can we ensure the United States will remain a magnet for the best and brightest minds throughout the world?

I believe that the answers to these questions will be instrumental in helping our nation embark on a new path in the years ahead—a path of dignity and respect, of prosperity and security, of progress and common purpose. They are big questions, to be sure, but not as big as America’s capacity to address them. I look forward to receiving your recommendations—and to working with you, your team, and the broader scientific community to turn them into solutions that ease everyday burdens for the American people, spark new jobs and opportunities, and restore American leadership on the world stage.

The Start of a New Deal for America

Nicholas Kristof of The New York Times favorably compares Biden’s “American Rescue Plan” to the first days of Franklin Roosevelt’s New Deal. One reason is that it would seriously reduce child poverty:

Coverage of Biden’s $1.9 trillion plan has understandably focused on the $1,400 payments to individuals, the increased unemployment benefits, the assistance to local governments, the support for accelerated vaccine rollout and the investments to get children back in schools. But there is so much more: food assistance, policies to keep families from becoming homeless, child care support, a $15 federal minimum wage and an expansion of the earned-income tax credit to fight poverty.

To me, the single most exciting element of the Biden proposal is one that has garnered little attention: a pathbreaking plan that would drastically cut child poverty.

It is a moral stain on America that almost one-third of people living in poverty are children, a higher share in poverty than any other age group.

So it’s exhilarating that Biden included in his plan a temporary expansion (I hope it will be made permanent) of the child tax credit in a way that would do more than any other single policy to reduce child poverty and make America more truly a land of opportunity. In effect, Biden is turning the child credit into something like the child allowances that are used around the world, from Canada to Australia, to reduce child poverty.

The Biden child poverty plan was previously offered as legislation backed by Senators Michael Bennet of Colorado and Sherrod Brown of Ohio, and a Columbia University analysis found that it would reduce child poverty in the United States by 45 percent. For Black children, it would reduce poverty by 52 percent, and for Native American children, 62 percent.

This is the boldest vision laid out by an American president for fighting poverty, and child poverty in particular, in at least half a century,” said Luke Shaefer, a poverty expert at the University of Michigan.

Americans too often accept poverty or race gaps as hopeless and inevitable. In fact, the evidence suggests they are neither. As Britain’s prime minister, Tony Blair cut child poverty by half with a strategy that included Biden-style child allowances.

[Another] example is the New Deal . . . . Results of Roosevelt’s boldness included Social Security, rural electrification, jobs programs, networks of hiking trails, the G.I. Bill of Rights and a 35-year burst of inclusive growth that arguably made the United States the richest country in the history of the world.

Yet for the last half-century, we mostly retreated. We overinvested in prisons and tax breaks for billionaires while underinvesting in education, public health and those left behind.

So we think of the United States as No. 1, but America ranks No. 28 worldwide in well-being of citizens, according to the Social Progress Index. And the United States is one of only three countries to have gone backward since the index began in 2011.

Americans are less likely to graduate from high school, more likely to die young, less safe from violence and less able to drink clean water than citizens in many other advanced countries. And then along came Covid-19 and magnified the disparities.

As Biden noted in his speech Thursday night, one in seven households in America now report that they don’t have enough food. Some 12 million children live in households that lack enough food. . . . 

Yes, Biden’s proposal would be costly, but a major study from the National Academies of Sciences, Engineering and Medicine found that child poverty is even more expensive, costing America at least $800 billion a year in diminished productivity, higher crime and elevated medical costs.

Helping people is often harder than it looks. But it is difficult to overstate how much difference Biden’s child poverty plan would make for Americans, for economic growth, for the country’s international competitiveness — and, let’s acknowledge it, for the moral framework of the United States. In the long run, this would do more to advance American equality, opportunity and decency than almost anything else.

Unquote.

There will be Republican opposition to Biden’s plan, of course, which will almost certainly mean that it’s effectiveness is reduced. But it’s encouraging that the U.S. Chamber of Commerce, not exactly a hotbed of socialism, has endorsed it (to some extent):

The U.S. Chamber of Commerce welcomes the introduction of President-elect Biden’s American Rescue Plan. Specifically, we applaud the President-elect’s focus on vaccinations and on economic sectors and families that continue to suffer as the pandemic rages on. We must defeat COVID before we can restore our economy and that requires turbocharging our vaccination efforts.  We look forward to working with the new administration and Congress on the details and in ensuring that any additional economic assistance is timely, targeted, and temporary.

It Wouldn’t Be Hard to End Poverty in America

If we were willing to share the wealth. From Jacobin Magazine:

The poor in our nation are often blamed for their own crises, with lawmakers and even service providers citing bad behavior or ignorance as the cause of individual poverty.

In Broke in America, Joanne Goldblum and Colleen Shaddox reject that narrative. US policies that benefit the wealthy cause poverty, they insist — and changes to those policies can end it.

Fran Quigley interviewed Goldblum and Shaddox for Jacobin.


FQ

Almost immediately in this book, you confront the maxim, “Give a man a fish, and you feed him for a day; teach a man to fish, and you feed him for a lifetime”: “Antipoverty efforts should stop making assumptions about people’s fishing abilities,” you write. “It’s past time to stop judging and give that hungry person a fish.” Why did you take that on?

CS

That saying summarizes everything that’s wrong with how the United States addresses poverty: we say the problem is the person, so we need to fix the person and what that person lacks in skills. But does he even have a fishing pole? Is he too weak with hunger to go fish? Is the “he” in question actually a woman, and women aren’t allowed to fish there?

It’s so paternalistic and so horrible. Yet people say it all the time, like they’ve said something wise and caring.

JG

At the policy level, we create systems that actually make it harder for people to be self-sufficient.

For example, many people who are part of the TANF (Temporary Assistance for Needy Families) or workforce development programs are trained to become certified nursing assistants, CNAs. That’s a very important job that we need to do. But it is a poverty-wage job. By and large, people who work in those positions don’t have workplace benefits and are not paid a living wage. But the government trains someone to be a CNA and then it can feel like it’s done something because it’s gotten that person off of the rolls.

FQ

You devote a good deal of the book to reviewing the data and the stories that describe US poverty, but you always circle back to solutions, refuting the idea we often hear that “the poor will always be with us.” Why do you think we can, as your subtitle promises, end poverty in the United States?

JG

Because poverty is simply not having enough money to meet your needs. There is nothing more complicated about it than that. And we live in the richest nation in the world, where there is plenty of money. So if we have the political will, we could end poverty.

There are lots of different ways to do it. A living wage is necessary . . . We talk in the book about universal health care, housing supports, about making water and electricity and heat a public good. Other countries do all this, and there is no reason we could not do so as well. If we just tax people appropriately, we can have the money to do all this.

CS

We write about challenges in affording car insurance in places where you need a car to get to work, the difficulty in keeping the lights on, not being able to afford medicines. Being in poverty is like walking across a rotted floor — there are so many ways you can fall through. And it all comes down to money.

[There] is a lot of money that’s churning around in our economy, but it’s not being shared appropriately. And by “shared,” I don’t mean some generous act. I mean that the worker in the warehouse who is making everything run deserves a fair share of the revenue he is generating. We don’t have that now.

FQ

You both have worked with poor people in the United States for a long time. But you write that it took a while for you to come to your own realizations that our approach to confronting poverty is fundamentally flawed.

JG

I was a social worker doing direct service with chronically homeless families. When they did have homes, they often did not have heat and hot water. One mom who I worked with never had toilet paper and often did not have clean diapers. . . . It turned out there was no choice involved: there was nothing more than the fact that she couldn’t afford these basic necessities. . . .

CS

At the soup kitchen where I worked, you would always have people after the meal asking, “Do you have 75 cents for the bus?” I used to think, gosh, we should teach them planning skills, how to think more long-term. Because they knew when they came to the soup kitchen, they had to get back home. Later on, I realized: they were hungry, and they got 75 cents somehow to come to the soup kitchen to eat in the first place. That was the wise survival strategy.

So often we make judgments about poor people’s motivation and cognition that are really a reflection of not having resources. I do a lot of work in the criminal legal system, and motivation is a big deal. Do they show up for their appointments? Do they return phone calls?

Well, to show up for an appointment, you need transportation and childcare. To return phone calls, you need a working phone. The written notices may be written in a language they don’t speak. And on and on. It’s very much like that woman who didn’t have toilet paper: she didn’t need a lecture on being a better parent; she needed toilet paper. And the guys at the soup kitchen that I was making judgments about — they needed 75 cents for the bus.

FQ

You have your own experiences addressing poverty, you spoke with experts, and you did your own policy research. Why did you consider it important to include in the book the stories of people living in poverty?

JG

These stories matter. There is a certain symbolic annihilation of people in poverty in this country. You watch a situation comedy, and everybody lives in a house with a glittering kitchen with granite countertops. We don’t represent poor people in the world in either nonfiction or fiction terribly much. And when we do, we often reduce them to stereotypes. Colleen really insisted that we interview people from all over the country, to make it clear that poverty exists everywhere in the United States, and that it is not one community, one group, one area, one city. You can go anywhere and find people who are experiencing these issues.

FQ

As frontline service providers who have dealt with these practical problems of poverty, why did you include chapters on racism, sexism, and denial of political power?

CS

When you look at any indicator of poverty — who doesn’t have water in their house, who has food insecurity, who dies sooner — you see that race matters. And you can say the same for gender. Women are more likely to be in poverty, more likely to be in extreme poverty. It’s not just that the world is unfair to poor people. It’s doubly unfair when you belong to another oppressed group. There were some communities that are not just left behind, but consciously excluded from prosperity.

JG

That means that part of ending poverty is taking down structures that block access to the political process, educational opportunities, and on and on. For example, we write in the book about redlining and racism in housing policy at all levels. Colleen and I were very intentional about saying these things out loud and clearly, so people cannot pretend that racism and other structural inequalities don’t impact the struggles we are talking about.

FQ

You mention other nations’ approaches to basic needs. The United States has a dramatically higher poverty rate than other wealthy nations and dramatically greater levels of income and wealth inequality. What are other countries doing right that we don’t do here?

JG

They establish some sort of floor. There is no floor in the United States — there is no depth of poverty that you can’t fall to. We have made TANF time-limited, we have enacted policies to make SNAP [Supplemental Nutrition Assistance Program, formerly Food Stamps] time-limited. You can be literally left out in the cold here.

One of the biggest things that’s different about the United States than most other countries is that you can become bankrupt due to medical debt. Not having guaranteed health care and the likelihood of accumulating debt related to health care is uniquely American and incredibly dangerous. . . .You talk to people around the world, and they just are gobsmacked that we allow this. . . .

FQ

What led you down the path of devoting your professional careers to anti-poverty work?

JG

From the time that I can remember, the work that I felt called to do was being a social worker. My mother was a social worker who focused on reproductive rights, and my father was an attorney who did a lot of pro bono work with the ACLU and other causes. . . .

I grew up in New Jersey and was very lucky to go to Hunter College School of Social Work, which teaches what they refer to as Jane Addams social work: not therapy in an office, but changing systems and working to support people.

CS

Probably the defining moment of my life was when I was a very young child, about five or six. My mom was a waitress who worked incredibly hard to support us all. At night, when her feet were just aching, she would put her feet in a tub of Epsom salts. One night I was sitting on the floor playing next to her and I saw the basin fill up with blood because her calluses and blisters had cracked. And I remember thinking: People don’t know how hard her life is, because if they knew they would help. When I grow up, I’m going to write stories about people like my mom. . . .

FQ

I know Colleen is an active Democratic Socialists of America member, and Joanne describes herself as “a little left of liberal.” How far removed from our current U.S. political reality are your prescriptions for ending poverty?

CS

I am a socialist. But you can have onions in a soup without it being onion soup, right? Many of the policies we’re calling for are things that could be labeled socialist, but they’re going on in other capitalist countries. For example, Japan is a very capitalist country where childcare is free. We have just taken capitalism to a really toxic extreme in the United States.

FQ

There have been a lot of books written on poverty, and certainly a lot of media coverage. Who were you aiming to reach with this book?

JG

We wrote this for people who consider themselves to be progressive and may be sympathetic to the poor. But they also have heard the line that poverty is an individual failing or think that it is unsolvable. It’s not.

A Few Words from Martin Luther King and Jamaal Bowman (Redux)

[Apologies for sending this again, but the video of King’s interview didn’t show up in the email that goes out to some of this blog’s vast public]

From an interview in May, 1967:

[The interview]

From Jamaal Bowman, who will now represent New York’s 16th District in Congress:

We can’t talk about the attacks against “Socialism” without talking about white backlash to demands for investment in communities of color.

Government programs, or what they call “Socialism,” is apparently fine for white people but no one else.

Was the GI Bill socialism?
Was the Works Progress Administration socialism?
Was the Homestead Act socialism?

These programs built the middle class and American wealth. But we’re letting ourselves get played by the GOP’s divide-and-conquer strategy if we don’t tell it like it is.

If we let Republicans and their billionaire friends on Fox News and corporate America divide us up, working people of all backgrounds can’t come together to fund our schools, demand millions of green jobs, and investment in ALL of our communities.

Let’s complete the work of our ancestors in this struggle.

For every step our nation takes forward on racial and economic justice, the forces of backlash will try to divide-and-conquer us all.

But we have to stay focused because I truly believe that we will win.

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