with Alexandra Ellerbeck

The first three million doses of coronavirus vaccine could be approved in the United States and shipped out as early as this week.

That’s a hopeful sign, as the nation awaits relief from a virus that has caused the greatest health and economic crisis of a lifetime. Yet there are some fresh doubts about whether the government will be able to sustain the rapid vaccine acceleration it's promising.

Pfizer, the maker of a vaccine that could be approved for emergency use this week, has told the Trump administration it cannot provide much beyond the 100 million doses it is already contracted for until late June or July because other countries have rushed to buy up most of its supply, my colleagues report. One hundred million vaccine doses are enough for just 50 million people, because a full course requires two shots.

“That means the U.S. government may not be able to ramp up as rapidly as it had expected … raising questions about whether it can keep to its aggressive schedule to vaccinate most Americans by late spring or early summer,” Laurie McGinley, Yasmeen Abutaleb and Carolyn Y. Johnson report.

Operation Warp Speed has asked to double the Pfizer order but it's too late.

Last summer, federal officials opted to purchase 100 million doses instead of the 200 million doses Pfizer urged them to buy, my colleagues reported.

It was only last weekend, with Food and Drug Administration clearance expected any day, that federal officials reached back out to the company asking to buy another 100 million doses. By then, Pfizer said it had committed the supply elsewhere but might be able to provide 50 million doses at the end of the second quarter, and another 50 million doses in the third quarter.

“The government had a different type of contract with Pfizer than with other companies involved with Operation Warp Speed,” Laurie, Yasmeen and Carolyn report. “Pfizer was the only company that did not take government money for research and development, which meant U.S. officials have had less insight into its decisions than it does with the other companies.”

Administration officials told reporters yesterday the story, first reported by the New York Times, was “false.” They noted Operation Warp Speed has contracted with five additional vaccine makers. One of those companies is Moderna, whose request for emergency use will be considered by an FDA advisory panel next week.

The officials insisted there will be no vaccine pipeline problem.

“We feel confident we will get the vaccine doses for which we’ve contracted and will have enough doses to vaccinate all Americans who want one before the end of the second quarter 2021,” one official said.

“I’m not concerned about our ability to buy vaccines to offer to all of the American public,” Gen. Paul Ostrowski, who oversees logistics for Operation Warp Speed, the government’s initiative to expedite vaccine development, said yesterday. “It’s clear that Pfizer made plans with other countries. Many have been announced. We understand those pieces.”

Yet officials presented a somewhat slower timeline for vaccine rollout. 

In a Washington Post Live interview last week, Warp Speed chief Moncef Slaoui said monthly production in February could be between 90 million and 120 million doses.

But yesterday, officials said production will ramp up to 60 million doses a month in January and February, followed by another uptick in March when 100 million doses will be ready. One hundred million doses would be enough to vaccinate just 50 million people, because a full course involves two shots spaced three weeks apart.

There’s a lot going on this week on the vaccine front.

The next few days will be hopeful — yet nerve-racking — for public health officials and regular Americans, as many look to the rapidly developed yet promising vaccines to stem covid-19’s climbing death toll and help return life to normal.

First up: An evaluation of how effective Pfizer’s vaccine is.

Today, the FDA will give its first public signal of how it views the experimental coronavirus vaccine developed by Pfizer and German biotech firm BioNTech. The evaluation of the vaccine’s safety and effectiveness data could provide many more details about it, as well as the agency’s own opinion of the data.

Two days later, an independent advisory committee to the FDA will debate the data and whether the agency should authorize the vaccine for emergency use. The agency will likely follow the recommendations of its advisers — although it doesn’t have to — and could authorize the Pfizer vaccine within days of a favorable recommendation.

“Agency officials will be looking for the panel to say the Pfizer safety and efficacy data justifies an emergency use authorization for the vaccine,” Laurie writes. “They are likely to consider a broad ‘label,’ saying the vaccine should be used to prevent covid-19 … in people from ages 16 and up.”

The White House will hold a summit to explain and publicize the vaccine distribution process.

President Trump will today sign a largely symbolic executive order saying all Americans will have access to a coronavirus vaccine. He’ll likely use the opportunity to take a few victory laps celebrating the success of Operation Warp Speed.

But the summit will also feature several key officials closely involved in the process, who can explain in detail the plans for getting initial and secondary vaccine doses administered to growing numbers of Americans every month, senior administration officials told reporters yesterday. 

Speakers and moderators will include Slaoui; Warp Speed chief operating officer Gustave Perna; Department of Health and Human Services Secretary Alex Azar; Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research; and the governors of Texas, Florida, Tennessee and Louisiana. The summit will also feature representatives from companies involved in transporting and administering vaccines, including UPS, McKesson, Thermo Fisher Scientific, CVS and Walgreens.

Ahh, oof and ouch

AHH: The Post spoke to ICU nurses across the country about their experience with the coronavirus.

“While politicians argued about masks, superspreader weddings made the news, a presidential election came and went, and at least 281,000 Americans died, nurses reported for work,” The Post reports.

Kori Albi, 31, a covid unit intensive care nurse at Saint Alphonsus Regional Medical Center in Boise, Idaho, spoke about the emotional burden in caring for patients who were not allowed to see their families.

“Death is a very intimate event that normally involves a lot of family members that help bring closure and that helps everyone process. In normal circumstances, health care providers form these relationships with the family at the bedside. All of that has been removed,” Albi said. “It’s a slow, lonely death.”

Albi also said that rigorous precautions meant that doctors and nurses were not getting the coronavirus from the hospital. 

“Our staff are getting sick. Our physicians are getting sick. And they’re not getting it from the hospital. They’re getting it from the community. We are almost lucky to care for the covid patients because we know who they are,” Albi said. “Going out into the community is scarier than coming into work every day. Because you don’t know who has it.”

Catie Carrigan, 28, an ICU nurse at the University of Mississippi Medical Center, sounded the alarm over decreasing hospital capacity.

“There are no ICU beds in the hospital. None. When there are no ICU beds, we hold them in the ER, or we hold them in the PACU (post-anesthesia care unit). … We are treating patients in the hallway,” Carrigan said. “There is no room left, essentially, and I think that’s really what people don’t seem to understand.”

OOF: Doctors and scientists are working to increase confidence in coronavirus vaccines among Black Americans.

“Black people are nearly three times more likely than Whites to die of covid-19 because of health-care disparities, preexisting conditions and increased exposure at jobs deemed essential. Black children are losing more ground than their peers because of school shutdowns, and Black workers have been devastated by pandemic-related job losses,” The Post’s Lola Fadulu reports.

“Yet fewer than half of Black Americans say they would get a coronavirus vaccine, compared with 63 percent of Hispanic people and 61 percent of White people, according to a December report from the Pew Research Center,” she continues.

Reed Tuckson, the founder of the D.C.-based Black Coalition Against Covid-19, said that the mistrust stems from a history of mistreatment in the medical system and that many Black Americans are scarred by the legacy of the Tuskegee Study, in which federal health officials lied to Black men and denied them treatment for syphilis as part of an experiment.

“We are taking great pains to help folks understand that what existed in the 1930s is very different today, in 2020,” said Tuckson, a doctor and former D.C. health director. 

OUCH: Democrats told their constituents to make tough vaccine sacrifices, then ignored their own advice.

Some Democratic lawmakers have been caught violating the spirit, and sometimes the letter, of the public health guidance that they’ve promoted. California Gov. Gavin Newsom (D) has come under fire for dining at the French Laundry restaurant, even as he was urging Californians not to meet with people outside their household. Austin Mayor Steve Adler, meanwhile, called his decision to travel to Mexico in November for his daughter’s wedding a “lapse in judgement.”

Some politicians tripped up over Thanksgiving, including Denver Mayor Michael Hancock, who flew to Mississippi for the holiday and San Jose Mayor Sam Liccardo, who gathered with five households.

As coronavirus cases surged, Democratic politicians enacted guidelines to slow the spread. But at times, those same politicians ignored their own guidance. (The Washington Post)

Hospitals on the frontline

The fact that the coronavirus hospitalization rate is dropping is not good news.

Ashish K. Jha, a physician, health policy researcher and the dean of the Brown University School of Public Health, writes in an op-ed for The Post that the decline in hospitalizations stems from the fact that they are admitting fewer patients as they run out of capacity.

“Critically ill patients will always be admitted. But as hospitals start to fill up, less sick patients — younger covid patients, or those whose oxygen levels haven’t yet sunk critically low — get sent home. These patients would be safer in a hospital bed, but there isn’t one available for them anymore,” he wrote.

Hospitals are deciding who will get the vaccine first.

There won’t be quite enough vaccines to cover all front-line medical professionals and long-term care residents, so hospitals are having to prioritize who should go first. The December vaccine deliveries are expected to cover 20 million people, slightly less than what is needed for an estimated 21 million health care workers and three million residents of long-term care facilities.

“That leaves hospitals with the task of deciding who among their high-priority employees should go first,” the Wall Street Journal’s Melanie Evans reports. “Nebraska Medicine, the hospitals and clinics affiliated with the University of Nebraska Medical Center, will likely use a lottery. The Mayo Clinic is combing through data on occupational risks to decide who to put at the top of the list. Mass General Brigham in Boston is prioritizing the hospital units where workers have the most exposure to those with Covid-19.”

The pool of priority workers also goes beyond doctors and nurses and includes people who clean rooms, deliver foods and register patients.

The Centers for Disease Control and Prevention has said that health care workers in direct contact with covid-19 patients and their families who have not already been infected with the virus in the last 90 days should receive first priority. Emory Healthcare, however, plans to prioritize workers in essential units, whether or not they are dedicated to covid-19 patients, given an analysis that found most infections in their workforce came from the community.

More in coronavirus

State officials raided the home of Florida health data scientist Rebekah Jones.

The Florida Department of Law Enforcement alleged that the former Department of Health data analyst may have broken into a state email system and sent an unauthorized message to employees. The message urged members of the State Emergency Response Team to speak up “before another 17,000 people are dead.”

“Rebekah Jones, who was fired from her job in May as the geographic information system manager for health department’s Division of Disease Control and Health Protection and who has since filed a whistleblower complaint against the state, denied having any role in the alleged intrusion into the state web site and instead said she believes Monday’s action was intended to silence her,” the Tampa Bay Times’s Mary Ellen Klas and Ana Ceballos reports.

Jones was fired in May from her job at the state’s health department. She claims the firing was because she refused to manipulate data in the Florida’s coronavirus dashboard, which she had helped create. She also claimed officers pointed a gun at her and her children:

After Giuliani tested positive for the coronavirus, the Arizona legislature shut down.

GOP lawmakers in Arizona and Michigan who met last week with Trump’s personal attorney, Rudolph W. Giuliani, are now scrambling following news that Giuliani tested positive for the coronavirus. Giuliani is currently hospitalized for the virus, The Post's Jaclyn Peiser reports.

President Trump's lawyer Rudolph W. Giuliani spent the week traveling the country claiming the election was rigged. Now Trump says he has the coronavirus. (The Washington Post)

Giuliani convened with GOP lawmakers in Arizona for over 10 hours on Nov. 30 to hear testimony related to election fraud. Images from the meeting show that most lawmakers were not wearing masks. The following day, he traveled to Michigan to meet with the state’s House Oversight Committee.

Trump tweeted on Sunday:

Arizona announced a week-long closure of its House and Senate. On Monday, Michigan followed suit, canceling a voting session that was scheduled for today.

Sugar rush

Medical dramas and sitcoms are looking to the coronavirus pandemic for material for their 2020 plots. Here is how covid-19 is shaping TV. (The Washington Post)