America Needs More Than Vaccines to Cure the Pandemic

By: Prema Rahman, MPAC Human Security Program Manager

iStock.com/Mongkolchon Akesin

Ahead of the March 14 deadline for President Biden to sign the new COVID relief package into action, MPAC is releasing a 3-part analysis of the expected legislation through a human security framework. This piece is the first in the series.

The coronavirus pandemic has exposed some of the deepest cracks in America’s public health system. Since the virus first swept across our nation around this time last year, we spiraled from an inadequate emergency response to an overburdened and under-equipped healthcare system to an economic crisis to disproportionate rates of infection and death to slow and inequitable vaccine distribution nationwide. In spring of 2020, the Muslim Public Affairs Council (MPAC) swiftly assessed the state of our nation through the lens of human security. Whereas traditional national security involves the maintenance of a strong military, vigilant law enforcement, and secure borders, human security is an equity-based, people-centric approach to protecting Americans from fear and want of basic rights and needs, including access to medical care and proper nutrition. To resolve issues of epidemic insecurity, such as health inequality and police reform, in a more comprehensive, holistic fashion, MPAC advocates for the adoption of the human security framework.

The glaring absence of human security in the wake of the pandemic threw America into a state of fear and confusion. Despite the near trillion dollars allotted for our national security budget, Americans were not safe from the life-threatening or financial impact of the virus, compounded by our profit-driven, inaccessible healthcare. Strengthening human security will not only help Americans in the short term, but also serve as a safety net for the nation should we be ever thrown into a similar state of emergency again. As Congress determines funding for the various components of President Biden’s American Rescue Plan, our next COVID-19 relief package, this framework serves as a litmus test to determine if the provisions of the latest package address the pressing needs and insecurities of the American people.

On his first day in office, President Biden announced his comprehensive emergency relief package, the American Rescue Plan. In addition to the $1,400 stimulus checks, the $1.9 trillion legislative plan seeks to stimulate the economy, fund vaccinations, provide relief for working families, support small businesses, and address vaccine disparities brought on by medical racism. The Senate recently passed the budget resolution for fiscal year 2021, endorsing the Biden relief bill and setting off the House budget reconciliation process to allocate money for the bill. As a part of this process, 12 House Committees have completed marking up their sections of the bill. The relief package is slated for passage on the House floor next week, with a targeted deadline of February 22. The final version will need to reach Biden’s desk by March 14.

The foreword to the American Rescue Plan clearly paints the need to strengthen human security for the American people, making special note of the racial injustice in our healthcare system and the “lines at food banks, the small businesses that are closed or closing, and the growing number of Americans experiencing housing insecurity.” At MPAC, we have identified three major pandemic-induced issues that are obstructing human security for Americans:

1. discrepancies between and inequities in state vaccination distribution,
2. the struggle to meet the needs of communities most vulnerable to COVID-19, and
3. the plight of small businesses in the face of lockdowns and widespread economic insecurity.

These cross-cutting issues inevitably impact every American and therefore need immediate attention from all levels of government and relevant civil society actors — that includes organizations like MPAC. To effectively develop solutions and advocate for meaningful legislation, it is imperative to first get the lay of the land and analyze to what extent the next COVID relief package resolves these problems.

Issue 1: Discrepancies Between State Vaccine Distribution

Most states continue to prioritize frontline workers, care home residents, and those aged 65 and above in setting their vaccine eligibility guidelines, but there is an overall lack of national coordination and standardization in COVID-19 vaccine distribution and administration. About 20% of states are allowing for high-risk adults to get the jab. Following widespread criticism against California Governor Gavin Newsom for allegedly neglecting people with chronic illnesses or disabilities, California plans to broaden its requirements to include high-risk adults by mid-March. With a 72% rate of doses used, however, the state is struggling to keep up with other states like Washington (81%), Virginia (85%), and New Mexico (a whopping 98%). At the same time, several vaccination sites run by the city of Los Angeles had to shut down last week due to supply shortages. This paradox is symptomatic of a multi-layered problem driven by a lag in CDC data reporting and confusion in state logistics.

In some instances, there is a palpable tension between state and local governments. In Dallas, Texas, for example, when local officials tried to allocate vaccines to minority neighborhoods, state officials threatened to take away the supplies if they were not given out according to state eligibility guidelines. Similarly, the Georgia Department of Public Health seized vaccine doses from the Medical Center of Elberton for vaccinating teachers and thereby breaking state eligibility protocol.

The deeper concern with discrepancies in vaccine distribution is that high-risk populations and communities more susceptible to COVID-related deaths are not being vaccinated at optimal rates. Not only does this not bode well for equity in America, but it also hinders our efforts to achieve herd immunity, whereby enough Americans will be vaccinated to reign in the rate of infections. Especially with the virus already mutating into more advanced forms, we cannot afford to risk the lives of many more Americans through inefficient logistics or a dearth of vaccine accountability.

Good news is, the American Rescue Plan includes provisions to alleviate this first issue. The President plans to invest “$20 billion in a national vaccination program in partnership with states, localities, Tribes and territories.” Through this program, the government will launch community vaccination centers nationwide and send mobile vaccination units to more inaccessible areas. Additionally, the proposal also “includes funding to provide health services for underserved populations, including expanding Community Health Centers and investing in health services on tribal lands.” Investing more in community-oriented programs will certainly alleviate the burden of understaffing and underfunding in disadvantaged communities. It will hopefully also diminish resulting logistical pressures. While this is definitely the right approach, something needs to be done about the disparate and erratic state eligibility criteria.

In a previous piece, “National Vaccine Distribution: Where Have We Gone Wrong?”, we advocated for a balance between a centralized and decentralized approach for distribution. This way, the federal government would mitigate discrepancies like varying state eligibility criteria and streamline efforts to address weaknesses in administering doses, and state governments would be involved in strategizing how best to deliver the vaccines to the communities that need them most.

Even if we smooth out our vaccine distribution process, we cannot achieve herd immunity until we address medical racism and vaccine hesitancy. Tune into our next issue of DC News and Views for our second installment for this 3-part analysis, where we will focus on Issue 2: the struggle to meet the needs of communities most vulnerable to COVID-19.