The history of the pandemic in the United States has always had 50 versions: as many as the number of states. A panoply of strategies that sometimes had nothing to do with each other, and which the Biden Administration is trying to harmonize with a good injection of federal steroids, especially when it comes to vaccination. Washington is opening vaccination centers in schools, universities and stadiums, such as the Yankees baseball team’s stadium in the Bronx; chain pharmacies will participate in the effort; and the Pentagon will dispatch 1,110 troops to help distribute doses in the hardest-hit regions.

The Democrat has given himself war powers, invoking the National Defense Act, to boost production of Pfizer vaccines and medical supplies, although he has been very cautious about making promises: a way of guaranteeing that he will more than deliver. His goal of vaccinating one million people a day was already virtually met by the previous president; injections are now hovering around 1.3 million a day, which could soon rise to 1.5 million. The goal is to administer 150 million doses in the first three months of his term.

Part of his strategy depends on the new stimulus package being negotiated by Congress, which would be the third since the first impact of the pandemic last April. It is expected to devote part of its $1.9 trillion to accelerate vaccination and strengthen the fight against the virus; $350 billion would relieve the battered public coffers of states and local governments.

The Administration is also trying to restore health multilateralism. As soon as he took the oath of office, Biden interrupted the process of leaving the World Health Organization and announced the joining of the Covax project, aimed at achieving equal global distribution of the vaccine. His government, however, retains some nationalistic tics and will purchase 200 million more doses of Moderna and Pfizer-BioNTech vaccines, which will bring the national stockpile to 1.2 billion doses. Twice what is required to immunize the entire U.S. population.

For now, distribution is being uneven, depending on each state and ethnic group. The black population is being vaccinated in smaller quantities, proportionally, than the rest. For that reason, D.C. City officials have begun distributing the vaccines door-to-door in neighborhoods of color. In Virginia counties, free transportation to vaccination centers is being offered, and in others, preference is being given to residents of neighborhoods most affected by covid.

Each state has its own priorities when it comes to vaccination. In Nebraska or South Dakota, workers in the meat industry, central to their local economies and the U.S. food supply chain, are high on the list of essential groups. Every sector, from manufacturing to agriculture, dentists to home delivery, is lobbying authorities to be among the first to receive the vaccine. It is also a way to ensure the stability of their businesses.

The gold medal for vaccinations goes to West Virginia for the moment. This mountainous state, with an aging population and large pockets of poverty, has managed to use 83% of the doses it has received, a higher proportion than the rest of the states. Instead of going with the federal plan, which was supported by the big pharmacy chains Walgreens and CVS, West Virginia operated on its own: enlisting the small pharmacies and clinics unique to the Appalachian Mountains, where population centers tend to be scattered across valleys and hills. Local officials also mention the close personal and family ties that are still preserved here, which would have served to include everyone in the distribution plans.

One of the most common barriers to vaccinating vulnerable groups is the internet itself. According to data from the agency Older Adults Technology Services, 42% of those over 65 do not have access to a good online connection, and many of those who do have one report difficulties when it comes to registering for an appointment. Eighty percent of covid deaths have occurred in this age group.

Meanwhile, the US pandemic landscape is slowly improving. New cases of covid-19 have dropped by almost half since their highest peak, marked last January 8. The reduction in cases in some Midwestern counties has been 80%. Infections, in fact, are not rising in any of the 50 states. The number of hospitalizations nationally has also fallen, down nearly 30% from a month ago.

Over the horizon we also hear the trot of cavalry reinforcements. Pharmaceutical company Johnson & Johnson has asked regulators for the green light for its vaccine, which would consist of a single dose. It is possible that the government will give the go-ahead by the end of February and that the company could begin distributing the doses in March. The latest trials of its vaccine were around 85% effective.
Two masks

Authorities, however, continue to urge caution. Washington has been warning for weeks that new variants of the virus, especially the South African variant, of which several cases have already been detected in the United States, could slow down vaccination progress. “If variants emerge that are not prevented, against which vaccines don’t have much efficacy, we will have to change [strategy] quickly,” said Janet Woodcock, acting commissioner of the Food and Drug Administration, which is charged with approving vaccines. The challenge would be to expand testing and hastily manufacture vaccines tailored to the new strains.

The government’s chief epidemiologist, Dr. Anthony Faucci, recommends wearing two masks instead of one, and Biden’s entourage is considering sending masks to all Americans: a complement to the mandate to cover one’s face on public transportation and in federal buildings. A University of California poll shows that while more than 80% of Americans support the use of face masks, only half do so.

Mutations of the virus have put predictions about when the crisis will end on hold. There is already talk of two pandemics, one with the original virus and one with the new, more contagious strains, which could force faster vaccination and raise the herd immunity ratio to 85%. The next few months, as doses are deployed, will be the time when we will be wondering whether or not 2021 will be the year of liberation.