So now that Joe Biden was sworn in, it was inevitable he would come up with his own COVID-19 plan (PDF). It's not all terrible, but there are a number of troubling signs that he's about to adopt the kinds of stupid, bureaucratic responses that have hamstrung much of the local efforts, particularly with vaccination. An overview:
The first order of business is to "[r]estore trust with the American people." To do this, he proposes the government "Establish a national COVID-19 response structure where decision-making is driven by science and equity." Okay, let's step back a minute: what the heck is "equity"? As Andrew Sullivan recently wrote in his Substack space,
...[E]quity means giving the the named identity groups a specific advantage in treatment by the federal government over other groups — in order to make up for historic injustice and “systemic” oppression. Without “equity”, the argument runs, there can be no real “equality of opportunity.” Equity therefore comes first. Until equity is reached, equality is postponed — perhaps for ever.
Biden doesn't name his preferred groups, but I scarcely need to mention they're what the left refers to as People of Color. This was something the CDC tried and was forced to recant weeks ago in a draft vaccine rollout schedule. So once again, we're going to deal with more efforts to inject racialized everything at a time when vaccinations are ponderously slow.
The rest of that point is largely boilerplate and anodyne (although the continued use of "Biden-Harris administration" is a strong Tell that Joe doesn't intend to be around much longer). Perhaps more interesting is the plan to "Mount a safe, effective, comprehensive vaccination campaign."
Central to this effort will be additional support and funding for state, local, Tribal, and territorial governments improved line of ight into supply – to ensure that they are best prepared to mount local vaccination programs.
This legitimately will be a substantial improvement from the Trump administration's leave-the-vaccine-on-the-loading-dock-without-telling-the-hospitals approach. However, in the next graf on ensuring availability of vaccine, the piece once more raises the Defense Production Act as a means to increase vaccine manufacturing capacity. As with N95 masks, the problem isn't the will, but staffing and expertise necessary to build out specialized manufacturing capacity that doesn't yet exist. At best, it might help with simple things like stoppers, vials, or syringes, but the real bottleneck is on the vaccine supply side. With recent news stories of production difficulties with Pfizer (albeit in Europe), AstraZeneca, and newcomers Janssen (Johnson & Johnson) and Novavax, it's hard to imagine how anything else could be the case. (Michael Abramowicz gave a good background in Reason as to why the DPA is a non-solution to most production problems, and why it could actually exacerbate shortages if used incorrectly.)
As to the point to "[a]ccelerate getting shots into arms and get vaccines to communities that need them most", the "Administration will end the policy of holding back significant levels of doses." This is actually pretty funny, because the Trump administration drew significant criticism for doing exactly this over a week ago.
Skipping ahead to the next part, "Implement masking nationwide by working with governors, mayors, and the American people" is surprisingly good news coming from a Democratic president. It implicitly acknowledges, contrary to partisan fears of federal lockdowns and masking requirements, that the ultimate responsibility for such public health measures rests at the local level and not the CDC or FDA. Likewise, so is the emphasis on expanding testing — though the value of this depends heavily on whether the FDA persists in confusing diagnostic and surveillance testing.
As I've already covered the limitations of the Defense Production Act, I pass over Goal Four, "Immediately expand emergency relief and exercise the Defense Production Act". Goal Five, "Safely reopen schools, businesses, and travel, while protecting workers" seems oddly duplicative with prior efforts in this space. As with Biden's 100-day vaccination goal that was nearly met on the day he was inaugurated, his point here seems more expectations management than goal-setting. But Goal Six is a gallimaufry of "don't let a crisis go to waste" thinking, using the pandemic as an excuse to create a "COVID-19 Health Equity Task Force", followed by a call to "[s]trengthen the social service seafety net to address unmet basic needs", and "increasing data collection and reporting for high risk groups" (read: by race). "Ensure equitable access to critical COVID-19 PPE, tests, therapies, and vaccines" reads very like there will be a long list of rules for vaccine distribution of the sort that stalled vaccinations in New York.
The final section, Goal Seven, "Restore U.S. leadership globally and build better preparedness for future threats" is mostly about patching things up with the WHO, despite the latter's well-known failures. What's interesting about the "preparedness" part is that it doesn't even mention PPE stockpiles, a widely-remarked-upon failing early in the pandemic.
On whole, it's a political document more than it lays out a serious plan forward, with much derived from the Trump administration before it. There's some good parts (at least he didn't try to roll out a parallel federal health agency at the county level!), but there's serious risk of the Team Blue hidebound incompetence that has put California and New York near the bottom of arms vaccinated per capita statistics being nationalized. That must be resisted at all costs.
I tweeted about a couple (mostly better) alternative views here, and will eventually get a response to those out the door.
