Right now, the rollout of the vaccine is flailing. Alex Azar, the Trump administration’s secretary of health and human services, predicted in early December that 20 million Americans would be vaccinated by the end of 2020. In fact, that number barely reached 3 million. The situation has improved, but there is still chaos and confusion. The Trump administration’s mishandling of the vaccine rollout follows a string of other public health failures, such as bungling the policies on testing, tracing and isolation, as well as the supply of medical equipment. Although the administration did an admirable job funding vaccine development through Operation Warp Speed, it quickly fell back into its familiar hands-off mode once the private sector pulled off that feat. The states, whose varying standards and infrastructure make them ill-equipped for carrying out a mass vaccination campaign, have been forced to improvise — with predictable consequences.
And although the Trump administration has plenty of blame on its hands, this is a much larger failure. As I write in my latest book, “Ten Lessons for a Post-Pandemic World,” the U.S. government has in recent decades become good at just one thing: writing checks. Its major endeavors have centered around tax cuts and credits, bailouts and relief payments. The size of the covid-19 relief packages passed last year — including the money for Operation Warp Speed — is impressive. But other than dispensing cash, the federal government seems to be unable to administer anything. Forty years of Reaganism — defunding, dismantling and demeaning government — have taken their toll.
The capacity of the state to undertake large and complex projects cannot be rebuilt overnight. But some things can be changed right away. The Biden team is clearly well-qualified. Perhaps as important, his people believe in government and understand that getting it to work is a special challenge in the United States. Power is divided among three branches, dozens of federal agencies and thousands of local authorities. Corralling all these forces to work together requires strenuous, persistent efforts directed by the White House every day. If you view government as a reality television show, consisting mostly of symbolic gestures and signals to your base, little gets done.
The federal government has already paid for hundreds of millions of doses. It has funds available to vaccinate. It should take on the task of ensuring that Americans are vaccinated — and fast. The president should use every tool available, including the armed forces and the Federal Emergency Management Agency, as well as partnerships with private companies such as Starbucks and Federal Express. Drug store chains, by one account, have the capacity to administer more than 3 million vaccines a day.
This should be the equivalent of a wartime effort. Those who have worked on rapid vaccination programs in developing countries argue for an aggressive approach. We should set up thousands of vaccination sites, many running 24/7, and create mobile units to reach people far from population centers. The government should spare no expense in accelerating the vaccine rollout. The effort would easily pay for itself by saving lives, driving economic output and raising tax revenue along the way.
The United States’ handling of the pandemic in general has been a disaster and is widely seen as such. In a Pew Research Center survey across 13 major countries, 84 percent of respondents agreed that the United States had bungled covid-19, and every country believed it had done far better than the United States. Irish Times columnist Fintan O’Toole described the strange new attitude of the world toward the United States — not admiration or hatred or envy but, for the first time, pity.
In an essay in Foreign Affairs, Samantha Power, the incoming head of U.S. foreign aid programs, reminds us that the world has admired the United States most for its spectacular achievements. The United States was the arsenal of democracy during World War II, executed the Berlin Airlift, put a man of the moon and created the Internet. If the Biden administration can succeed spectacularly at the most pressing challenge facing the world, that will say loud and clear to everyone: The United States is back.