Over the past few weeks, administration officials have repeatedly briefed President Donald Trump on data showing that the steep uptick in COVID-19 infections and deaths would likely soon bring one of the darkest chapters of the pandemic to the country.
But Trump, according to three sources with knowledge of the situation, has remained unmoved.
“It has not changed his approach,” said one senior administration official, who works closely with the task force. The official added that Trump has, at times, responded to such warnings by insisting that his administration accomplished a “miracle” with the development of a COVID vaccine—an elixir for the pandemic fight that the president insisted Joe Biden, the man who bested him in the 2020 election, couldn’t have pulled off.
Trump’s nonchalance in the face of horrifying COVID news is hardly new. Nor are his optimistic boasts about a coming vaccine.
And yet, the latest round of downplaying has still sent tremors through the ranks of administration brass and senior public-health officials who not only fear the damage that will likely be done in coming weeks but also sense real, unappreciated hurdles with respect to getting a vaccine to the public.
Despite much-heralded breakthroughs in vaccine research, state and local officials across the country say they are still unclear about basic operational elements, such as exactly how many doses they will be receiving from the federal government, who specifically in their communities will receive the vaccine first, and how long immunization supplies will last.
The inability to get answers to those questions has caused confusion and frustration among those set to take over the COVID fight. And in the sharpest rebuke to date, a member of Biden’s own task force team attacked the Trump administration on Monday for failing to ensure states have what they need to distribute the COVID-19 vaccine.
“I keep seeing and hearing that Operation Warp Speed is... prepping airplanes and trucks with special freezer units. And we hear they're gonna drop the vaccine off at a warehouse full of deep freezers somewhere. But I don't hear much more detail about the plan after that,” said Rick Bright, the former director of the Biomedical Advanced Research and Development Authority and a member of Biden’s coronavirus transition task force. “It’s harder to address that last mile between the loading dock and the patient's arm. The other part that hasn't yet happened in this administration is making sure adequate financial resources have been made available to support immunization programs and to administer the vaccine.”
Bright’s warnings aren’t just the isolated frustrations of a now well-known critic of the current administration. (Bright resigned from the federal government in October after he submitted a whistleblower claim alleging his superiors removed him from his post because he pushed back on political pressure to support the use of hydroxychloroquine).
Officials across the country say that there’s been a lack of clear messaging from the federal government about how it envisions the country will prioritize the initial round of vaccine doses from Pfizer. While states throughout the U.S. have been in constant conversation with officials associated with Operation Warp Speed—the public-private partnership aimed at fast-tracking a coronavirus vaccine—there is widespread anxiety about the details of the vaccine distribution.
Every state and territory submitted their interim plans for vaccine distribution in October, many of them drawing on prior disbursement plans as a template for envisioning how a COVID-19 vaccine would reach the public. While most of those plans have been updated after further conversation with the Centers for Disease Control and Prevention (CDC) and Operation Warp Speed, without more guidance from the federal government on prioritization, plans can only go so far.
Last week, for example, a spokesperson for Republican Missouri Gov. Mike Parson said that the state “expected to receive approximately 185,000 doses on initial shipment,” but didn’t “know for sure.” In Pennsylvania, a spokesperson for the state health department said “there are still a number of details being worked through on the federal level regarding the vaccine distribution.” An executive summary of the department’s October vaccination plan anticipated “an extremely limited number of doses in the beginning of its vaccination program,” as it laid out its vaccination priorities.
While the White House’s coronavirus task force has urged states for months to try and build trust about the vaccine in their communities, local officials and individuals familiar with the administration’s planning said those efforts have fallen short.
“There’s been a total lack of communication from the state about how this is all going to play out,” one senior local official in New Jersey told The Daily Beast, requesting anonymity because they were not authorized to speak on the matter. “That’s probably because state officials are still trying to figure out how to configure who gets this thing first. But we got nurses and doctors asking us who in their hospitals are going to get it and we just don’t have answers right now.”
In an interim version of the New Jersey COVID-19 vaccination distribution plan, officials said the state plans to follow CDC recommendations for a phased approach to the vaccine rollout and that it will immunize healthcare workers first. But the state will need to prioritize which healthcare workers go to the head of the line “given expectation of scarce vaccine availability at the onset and potential for supply shortages throughout,” the interim report said. The report also added that New Jersey “does not anticipate that federal funding to NJ to-date will be sufficient to meet the resource needs for this complex, large-scale vaccination program.”
Inside President Trump’s COVID task force, vaccine distribution has taken on an increasingly important role and has become one of the most prominent discussion points in the semi-regular briefing with governors. Trump has mostly been MIA on those discussions and meetings and is convinced—according to two people who have spoken to him since Election Day—that some of the experts, chief among them Fauci, were “wrong” in the past and favored Biden anyway.
On Monday, Trump’s chief ally on the task force, radiologist Scott Atlas, announced he was resigning. Some Trump allies and advisers say they expect, or hope, the president will keep his distance from operations going forward.
“I’m not sure what the task force members want him to do at this point and why they might need face time. [Scott] Atlas is gone. Let [Vice President] Pence message and lead on COVID,” Joe Grogan, formerly a top domestic policy adviser to President Trump, said on Monday. “[Trump] can direct as president privately behind the scenes and keep the troops in line.”
Where Trump has shown some interest, however, is in the pace of vaccine production and distribution. As CNN reported, he had his chief of staff summon the head of the Federal Drug Administration to the White House to get an explanation as to why the agency hadn’t granted emergency use to Pfizer’s vaccine more quickly. Trump also plans to host a vaccine summit next week at the White House with manufacturers and distributors two days before the FDA’s meeting on Pfizer’s Emergency Use Authorization.
Some Trump administration health officials concede that the prioritization conversation has been slow-moving primarily because the FDA has yet to evaluate the Emergency Use Authorizations from Pfizer and Moderna. But others point to the CDC, saying the agency has been slow to finalize and announce its recommended prioritization scheme.
The CDC Advisory Committee on Immunization Practices, which helps inform the CDC on prioritization, is set to meet Tuesday afternoon to discuss the details of who within the first tier of COVID-19 vaccine recipients should receive the vaccine first. CDC Director Robert Redfield and Vice President Mike Pence have suggested that vaccination distribution could begin next week and that the “most vulnerable” Americans should receive it first. Both have said that those most vulnerable populations include frontline healthcare workers, nursing home residents and staff, and individuals over the age of 65 with comorbidities.
The problem, state and local officials say, is it’s unclear from the federal government’s perspective whether there will be enough vaccine availability to even fully reach that group of people. According to multiple state officials and state COVID-19 vaccination distribution plans reviewed by The Daily Beast, there is some concern that there will be shortages of vaccines in the initial round of immunization and that they expect there to be a degree of confusion among residents about not only who is eligible to receive the first doses but also how and when to follow up for a second shot of the vaccination. (The Pfizer vaccine requires two doses within three weeks of each other).
Lynn Sutfin, the public information officer for the Michigan Department of Health and Human Services, told The Daily Beast that officials expect the number of COVID-19 vaccination doses to be “very small” and “available only for front line healthcare workers.”
In Ohio, the state’s health department said if only small amounts of the vaccine become available, “those who are most at risk, including those that work in longer-term care facilities, nursing homes, and other congregate-care facilities, high-risk health care workers and first responders may choose to receive it.”
“Specific administration or vaccination details are unavailable until a vaccine is approved by the FDA,” Melanie Amato, a spokesperson for the Ohio Department of Health told The Daily Beast in an email. “We continue to wait for more guidance from the federal government.”
Looking forward to January, members of Biden’s COVID task force say they are already working with states to ensure how best to distribute the vaccine.
In an interview with CNN last week, Dr. Celine Gounder, a member of the Biden team, said the president-elect plans on “leaving it to the public health experts and scientists to figure out how best to allocate the limited supply first.”
"We want to make sure the science is leading and the politics are out the way, staying out of the way. And at the same time, we want to be communicating and coordinating with the states and at the local levels, in the hospitals and the tribal territories and across jurisdictions, so they don't feel like they're on their own, they don't feel like they have to come up with their own plan, independently,” Bright said. “We want to provide as much guidance and hand in hand coordination at the federal level all the way through to the patient, actually, to make sure there's a consistent, coordinated plan, and no one feels like they're on their own.”