We began writing in this space eight months ago. At that time, we were appalled by the over 33,000 Americans dead and 650,000 people in the USA infected.  It was clear then and even more apparent now that the social determinants of health have resulted in massive disparate impact that this virus, and our nation’s response, have had on communities of color.  The mere numbers of 2.6 times the African American deaths reinforce that if “Racism is a killer; a pandemic is a mass murderer”. Currently, an unconscionable, over 334,000 Americans have succumbed to this virus. The already expected winter surge will be fueled by the Christmas travel, against CDC advice, and by unwise, yet expected, New Year’s gatherings. Despite CDC recommendations, air travel over Christmas was such that a pandemic record 1.3 million people were screened by TSA at the airports on the Sunday after Christmas. We are being warned that the number of ill, hospitalized, and deceased Americans will increase in January.  There have already been over 19 million Americans infected. Only five states are below the 5% infection rate, 27 states are above 10%, with 6 of those being above 35%. Hospitalizations in the US have reached a record 119,000 with ICU capacities being exceeded in southern California and other areas of our country. Multiple mutations of the SARS-Cov-2 have shown up around the world but so far scientists are confident that the available vaccines will provide immunity against these new variants.

Two still unresolved issues from early in the pandemic were the inadequacy of the personal protective equipment (PPE) and the lack of accurate rapid-result testing.  There are still not enough masks, face shields, gowns, and gloves necessary to care for the sick and carry out the upcoming massive vaccination campaign. Tests for COVID-19 remains woefully inadequate at 1.9 million per day. We need 6 million tests per day to stop outbreaks, protect the most vulnerable, surveil the asymptomatic, and allow a much-needed return to more normal work, school, and leisure activities. We continue to call for the full implementation of the Defense Production Act, a unique tool of the Presidency, to address the PPE, testing, and vaccine production supply chain.

Vaccinations are the key to our recovery from this pandemic.  Eleven million doses of the Pfizer and Moderna vaccines have been distributed in the United States but only 2 million vaccinations have been performed to date. Our government’s target is one million vaccinations a day and we are not even at the one million injections per week. Even when we will reach the daily vaccination target, it will still take 9 months before we have 80% of Americans vaccinated thereby reaching herd immunity.  The current rate of daily vaccination is particularly bothersome since we know the next phases of vaccinations will be performed on a population outside of hospitals and conjugate care facilities. This general population will be much harder to reach. It is therefore clear that relieving the pain of this virus requires a heretofore absent national approach to this pandemic.  Otherwise, vaccine administration will be disparate, inefficient, chaotic, and cost the unnecessary loss of lives and livelihoods. Fortunately, there are three other vaccine candidates in the developmental pipeline.  These include products by Johnson & Johnson, AstraZeneca, and Novavax. Hopefully at least one of these will become available by late January 2021.

As healthcare providers we continue to encourage everyone to get vaccinated against COVID-19.  We clearly understand the reluctance of African Americans to get the vaccination based on the historical and ongoing mistrust of the healthcare system. We ask that those who remain skeptical consider that the safety and benefits of the vaccines far outweigh the minimal number and severity of side effects.

With the new year, we hope that we the people have a new resolve to continue to WEAR, WASH, and WATCH, and WAIT for vaccination.  Getting our kids back to school, people back to work, and small businesses on the way to recovery is dependent upon us being patient.  We all want to see us back to a reasonable semblance of normalcy, travel, and leisure.  If we feign not, we shall reap! Happy New Year!

Clyde E. Henderson

Treasurer

Cincinnati Medical Association