WASHINGTON — President-elect Joe Biden’s administration will face a daunting task when he takes office: vaccinating more than 300 million people against the coronavirus as quickly and as safely as possible.
But trying to get detailed information from the outgoing Trump administration has proven impossible, hampering the Biden team's ability to begin planning, according to several health officials advising the incoming president's team.
The information Biden's team wants includes:
- The total number of N95 masks, plastic gloves and syringes available for medical professionals nationwide.
- Information on the size of the nursing staff available to administer millions of doses of the vaccine, including in rural areas.
- An understanding of where existing supplies are stored, whether they meet the projected demands of all 50 states, how quality control checks will be conducted, and how to prevent state and hospital system bidding wars.
- Terms of vaccine contracts with pharmaceutical companies, including logistics, and the role of the Department of Defense.
- Existing databases on testing, vaccinations and protective gear.
The information black hole continues because of the General Services Administration's refusal to certify Biden as the president-elect and allow transition activities to commence, a decision fueled by President Donald Trump's unwillingness to concede defeat.
Biden has argued that delays in getting his team involved in the planning process could result in more people dying from the coronavirus.
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“There’s no visibility into the supply chain,” said Dr. Nicole Lurie, who was the assistant secretary for preparedness and response at the Department of Health and Human Services under former President Barack Obama.
Biden's team would like to know “where the supplies are, how much of it the federal government has bought, how they might allocate it and what models they’re using," Lurie, who’s been advising the incoming administration on its Covid-19 response, said. "You need all of those things if you’re really going to hit the ground running. People have been digging for it for months.”
Biden's team also has not had access to analysis about "all the things that could go wrong and how we mitigate those risks," she said.
The White House is arguing that there is publicly available information, and that planning continues in the current administration to distribute the vaccine.
Trump spokesman Judd Deere noted in a statement that the Centers for Disease Control and Prevention has published a distribution “playbook.” In partnership with the CDC, McKesson Corp., which has a long-standing contract to distribute the vaccines, is also prepping kits that include needles, syringes, surgical masks and other items.
Yet none of that, public health officials say, gives the Biden team the operational information it will need to distribute and administer millions of doses of vaccine.
“You need to know what everyone needs and you need computer programs for this and just understanding the landscape of what’s needed: swabs, vials, gowns, gloves, syringes, freezers, training. This is complex and interlocking set of things and they change; so the notion that it’s been published is just not accurate,” Leslie Dach, a former Health and Human Services senior aide to Obama, said.
“They’re denying the ability of the people to do the work,” Dach added.
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Biden transition officials worry they could encounter legal trouble if they try to begin coordinating before the GSA approval, according to multiple officials aware of their efforts. Government officials could run afoul of laws designed to protect sensitive information if they talk with Biden's team before they are given formal approval.
“We are losing very valuable time,” said Dan Mendelson, who served as associate director for health at the Office of Management and Budget in the Clinton White House.
'A hostile takeover'
While Biden's team waits to be included, planning continues in the Trump administration by nonpolitical officials and experts who have been “largely left alone” to do their work, according Dr. James Lawler, an infectious disease physician who served as a national security adviser to both Obama and former President George W. Bush.
Dr. Marcus Plescia, medical director for the Association of State and Territorial Health Officials, told NBC News he was on two calls in the last week with state health officials and two CDC officials.
“We have not seen any problems so far,” Plescia said, but added his main concern is that states will need about $8.4 billion in federal funding to distribute the vaccine.
The quality of health care infrastructure and access to supplies varies by state, with many already struggling with budget shortfalls caused by the pandemic. The Pfizer vaccine has significant distribution hurdles, chiefly that it requires storage at extremely low temperatures.
“The details about what exactly has been set up in terms of transport logistics, what are the various plans the governors have already submitted, what do they say? Let the Biden team communicate directly with the governors, they are going to be the on-the-ground recipients, and need to set up the logistics,” said Kathleen Sebelius, a former Kansas governor who served as health and human services secretary under Obama.
Transition officials are finding other ways to gather information, including from former public health officials close to career staff members within agencies, according to an emergency medicine doctor who was contacted by the Biden team but spoke on the condition of anonymity because they were not authorized to speak publicly about the planning.
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Biden’s team is less concerned about the vaccine approval process because pharmaceutical companies such as Moderna and Pfizer are expected to apply for emergency use authorization before the Thanksgiving holiday, meaning the approval will likely be given before he takes office.
Yet, in a briefing last week with reporters, Sebelius warned that the Biden administration may need to keep officials from the Trump administration employed at Health and Human Services to ensure critical information isn’t lost.
“There are 11 operating agencies under that umbrella,” Sebelius noted, adding she is “sure there is consideration being given" by Biden to keeping the current heads of agencies like the National Institutes of Health, CDC and FDA.
“I can’t begin to imagine what it would be like to deal with” what she described as essentially “a hostile takeover” by the outgoing administration, Sebelius said.