Why Covid-19 cases are rising in a ‘post-vaccine’ America
For some state leaders, ignoring government advice now means discouraging vaccination
Throughout 2020 and into early 2021, there was hope that with some luck and enough vaccines, it would be possible to end the Covid-19 pandemic in a quick and decisive manner.
By mid-year, it became clear that this would not happen in the US. The Delta variant represents an unfortunate turn of events, compounded by many people’s unwillingness to be vaccinated.
In view of these developments, how should US President Joe Biden’s administration adjust its Covid-related strategies?
For the most part, the administration’s approach is on track and having the best possible effect under the circumstances. Staying the course and ignoring detractors is the best way forward.
The federal government is, of course, limited in what it can do about public health.
Bipartisan support helped to produce several remarkably effective vaccines – the National Institutes of Health (NIH) should score highly in any assessment of its performance, including in how it mobilised and cooperated with private-sector companies.
This is exactly how the government and business should work together in a national emergency to ensure the use of all available scientific firepower.
The US Centers for Disease Control and Prevention (CDC) was hampered by political meddling and confusion at the very top throughout 2020.
New leadership and a much better approach by the White House have brought the situation under control. Not everyone agrees with all the advice given, but there is a general recognition that weighing the evidence and being careful about people’s health are once again the CDC’s predominant considerations.
The surgeon-general has also been busy, strengthening public health and providing sensible advice across a wide range of issues concerning the pandemic and beyond. Following this leadership, private-sector companies are increasingly encouraging and even pressing employees – particularly when they interact in person with colleagues or assume public-facing roles – to get vaccinated.
The laggards in the effort to combat Covid-19 have been at the state level. Some states have set a more positive tone, with more healthcare workers vaccinated and colleges that require vaccination for students and staff who want to be on campus.
There are always legal challenges in America, but the argument that “I should be free to infect my colleagues with a potentially fatal illness” is so far gaining little traction with the courts.
Unfortunately, some state leaders have continued to treat Covid-19 as a political football. Perhaps they feel that this worked for them in 2020, when they could argue that “opening” activities was good for local economies, even if infection rates increased.
But in 2021, post-vaccine, the situation is entirely different. Declining to follow advice from the NIH, the CDC and the surgeon-general now means discouraging vaccination, which will mean more infections, more pressure on hospitals, more deaths, and, one way or another, a more depressed local economy.
There are countermeasures that can be taken if low vaccination rates cause the disease to surge. But some state legislatures and executives oppose mask mandates and are lukewarm towards systematic testing in asymptomatic populations.
The upshot is that, in places with more negligent leadership, Covid-19 will have a greater negative impact on public health and the economy. People will die, visitors will stay away, businesses will not be able to stay open and workers will be laid off again.
Perhaps recalcitrant state leaders will change their minds when Covid-19 patients overwhelm their hospitals. But, given the lack of political accountability in modern America, it is more likely that most of them will find excuses or distractions.
The tragedy is that the disease will continue to infect vulnerable people – killing them or making them sick for a long time.
This is both completely avoidable and inevitable if healthcare and home health aides are not 100% vaccinated. National leaders in the nursing home and senior care industry, and many at the state level, have worked hard to persuade all workers to choose vaccination, but there is only so much they can do.
Private-sector employers are faced with a tough choice – if they require vaccination, some workers will quit. Nevertheless, companies are increasingly likely to follow Delta Air Lines by imposing additional fees on unvaccinated workers and requiring more testing for those people.
The one federal agency that still needs to do better is the Food and Drug Administration (FDA), which did not move fast enough to approve new tests and techniques that were appropriate for screening populations and reducing the spread of infections.
True, the FDA’s performance has improved – including the full approval of the Pfizer-BioNTech vaccine and now consideration of booster shots.
The situation around testing for Covid-19 has also become clearer. But a new head of this key agency needs to be appointed by Biden and confirmed by the US Senate soon.
The Biden administration inherited a public-health emergency that had been badly mishandled. Its response has been strong and effective. New variants continue to pose a threat. The only way forward is to follow through on the bipartisan commitment to free and effective vaccines for everyone. © Project Syndicate
Simon Johnson, a former chief economist at the International Monetary Fund, is a professor at MIT’s Sloan School of Management and co-chair of the Covid-19 Policy Alliance.