With the coronavirus pandemic approaching 400,000 U.S. lives lost but the drugs that can halt the carnage finally in hand, California’s vaccine distribution system has spent the last 48 hours on the brink of collapse.
The outgoing presidential administration, it was revealed Friday, has exhausted a federal stockpile of doses that states were counting on to continue immunizing their front-line workers and most vulnerable residents. California’s governor gave residents false hope — unwittingly, at best — by announcing a vastly expanded pool of vaccine recipients without confirming the expected increase in supply.
That led to an infrastructure meltdown this week at some of the state’s most prominent health care systems, which left tens of thousands of people spending hours on hold on the phone or frantically refreshing crashing websites in a mad scramble to make appointments that were unlikely to be fulfilled.
San Jose resident Patty Lippe, who said she has hit nothing but walls in trying to get her 89-year-old mother vaccinated, struggled to grasp how this could happen.
“I have a sister in Arizona, she’s lined up to have a vaccine, and she’s 52. How stupid is that?” Lippe said. “None of this makes sense. This is all so poorly managed.”
There may be help on the horizon, with the new presidential administration announcing plans to use FEMA and National Guard troops to build coronavirus vaccine clinics across the country and a $1.9 trillion relief proposal to support a goal of issuing 100 million vaccines in Joe Biden’s first 100 days in office.
But Biden will have to first clean up the vestiges of the Trump administration’s virus response. Washington Post and Wall Street Journal reports Friday revealed that federal health leaders already have burned through a vaccine reserve they claimed was being kept to secure second doses and stalled vaccine distribution guidelines by the Centers for Disease Control and Prevention, contributing to the chaotically underprepared rollout happening now.
The reason for the delays is fairly simple, many experts have concluded: The Trump administration, which did good work pushing development of vaccines, botched the funding, the planning and the rollout.
In December, U.S. Department of Health and Human Services Secretary Alex Azar said 50 million people in the United States would have had the first of two COVID-19 shots needed for immunization by the end of January.
Tuesday, he issued new guidelines urging states to make everyone over 65 eligible — roughly 53 million Americans — to receive the vaccine. But as of Friday, the federal government has sent only 31 million doses to the states.
“There was not enough vaccine to accomplish what was politically expedient,” said Dr. John Swartzberg, a professor emeritus of public health at UC Berkeley. “They knew that there was not enough vaccine.”
He added that the absence of a national vaccination distribution plan was worsened by insufficient federal funding. In October, state health officials announced they would need $8.4 billion to carry out the enormous logistical effort of vaccinating most of America’s 320 million people. But until recently they’d received only $400 million.
Biden has called the Trump administration’s handling of the pandemic “a dismal failure.”
California has received just over 3 million doses, and counties and hospital systems have administered about 40% of them, Gov. Gavin Newsom said Friday at a Los Angeles news conference at Dodger Stadium, now a mass vaccination site. Newsom has been criticized for his announcement Wednesday to expand the pool of eligible vaccine recipients to include people 65 and over, which many understood to mean that they might actually be able to get a vaccine.
They immediately ran into roadblocks, with counties unprepared or unable to handle the crush of newly qualified people trying to make vaccination appointments while dealing with their own supply inadequacies.
Since Contra Costa County began allowing all residents 65 and older to sign up for vaccination appointments — in accordance with new guidelines released by U.S. and California health authorities — it has received a thousand requests an hour, enough to meet its weekly allocation of doses in 12 hours. The website of Sutter Health, a health care provider vaccinating people in multiple counties, crashed Thursday under such high demand from vaccination inquiries.
Santa Clara County Counsel James Williams stressed that the state’s expansion of vaccine eligibility to residents 65 and older — a population of 300,000 in the South Bay — does nothing to increase the available vaccine supply, so the county for now is holding fast to an age threshold of 75.
“The reality is we have nowhere near that amount of vaccine to deliver,” he said. “We’re seeing demand outstrip supply and outstrip basic capacity for things like scheduling.”
“It’s all about supply,” agreed Contra Costa County COVID-19 operations chief Dr. Ori Tzvieli at a news conference Friday morning, when asked if his county would create mass vaccination sites. “If I had an extra 20,000 doses, I would arrange that in a jiffy, but I just don’t have those right now.”
But Newsom defended his decision, saying the guideline expansion was meant to ensure that vaccines at risk of expiring, because some front-line health workers decided to forgo the shots, got used.
“The purpose was crystal clear, and that is to make sure the guidelines were not barriers,” he said. “We were heartened to see the president-elect double down on that call for 65 and over as well.”
Newsom said while he was troubled by the reports of a nonexistent federal vaccine reserve, he said for the moment there are enough vaccines to give the recommended second doses to Californians who already have gotten their first shots.
Despite the governor’s assurances, the impact of his decision was still being felt Friday. After Kaiser patients reported spending hours on the phone trying to make appointments, a recording on the HMO’s appointment and advice line said they were unable to immediately schedule appointments due to limited availability and urged callers to call back. The HMO’s online appointment page does not allow clients to schedule a shot.
In a statement Friday, Kaiser apologized to its members and said callers will be told “up front” if there are no available vaccination appointments to avoid lengthy hold times. The company also said the state’s eligibility expansion “challenged the entire health system.”
“At this time, we are awaiting additional vaccine delivery,” the statement reads. “As a result, most individuals will not be able to schedule a vaccine appointment.”
Sutter, another major provider in the Bay Area that includes Palo Alto Medical Foundation, said patients should not contact their doctor or clinic but should call a toll-free number or sign into their online account to schedule a vaccine appointment. As of mid-day Friday, a recording said the call system was at capacity.
Some health care veterans were gobsmacked Friday that these large providers weren’t further along in setting up their scheduling systems given their inevitable roles in a mass vaccination operation.
“I know what it’s like on the front lines, and I have a great deal of respect for Kaiser. However, they have had at least one year to know this vaccine was going to happen,” said a former Kaiser advice nurse in Santa Clara County who did not want to be identified. “Did they not think we were all sitting here waiting for a vaccine? Couldn’t they all sit down and talk?”
