Biden Drops the Vaccine Hammer
By Nayyer Ali MD
“Our patience is wearing thin”. With those words President Biden outlined an aggressive plan to turn around the current COVID surge and finally bring the pandemic to an end, at least within the United States.
The pandemic first reached the US in March 2020, and several hundred thousand Americans died before the first vaccine was approved in December 2020. A vicious winter wave took the lives of another 200,000 Americans but by the spring of 2021 it looked like a path to a COVID-free summer was open. Millions of Americans were getting vaccinated daily, while continued masking and social-distancing brought new cases down to the lowest levels since the first pandemic wave. The number of Americans in hospital with COVID had fallen from 130,000 at the peak to about 12,000 at the end of June. In many hospitals in California that had been inundated in January, there were no COVID patients at all.
But in July this began to change. Three big factors explain the fourth wave of COVID. First was the lifting of many COVID restrictions. Indoor dining and events resumed across the country, while mask wearing was dropped as a requirement in most states. The second event was the emergence of the Delta variant of COVID, the same variant that arose in India and drove the massive wave of infections there in the spring that killed roughly 3-4 million Indians in less than two months. Delta is much more infectious than the original “wild-type” COVID virus that first struck last year. Instead of each infected individual passing the virus on to 2-3 others, this variant spread to 6-8 people on average. This change resulted in a virus that had become immensely more contagious. But the final and most important factor has been the reluctance of about 25% of the adult population to get vaccinated. This group is driving the current wave. They make up over 90% of the new infections and 99% of the deaths. While vaccinated people can be infected by Delta COVID, the infection clears faster and does not put them in the hospital or kill them, except in rare cases, usually patients who are very elderly or frail.
These non-vaccinated people are circulating the virus at a tremendous rate. In addition, the vaccines have not been approved for children under age 12, so that part of the population is not only susceptible to infection, but can act as a vector passing the virus along to adults they come into contact with and further expanding the pandemic.
The unvaccinated are not a random group of people. They are mostly conservative White Americans who watch too much Fox News and support Donald Trump. Biden voters are 90% vaccinated while Trump voters are only 50% vaccinated. They simply have been completely deaf to all appeals by government officials, whether Federal or state, and to the recommendations of doctors and scientists. They live in their own bubble of misinformation and are literally being killed by it.
This fourth, and hopefully final, wave of COVID is therefore concentrated among Trump supporters and in Red states. But even conservative parts of Blue states, like rural northern regions of California, are seeing their hospital systems overwhelmed by COVID. The number of patients in hospital with COVID just recently peaked at over 100,000. New cases in early September hit an average of 165,000 per day while deaths hit over 1,300 per day.
To finally bring this pandemic under control, President Biden has decided to take decisive and dramatic action. Using the authority to regulate workplace safety under OSHA, the Federal government is now going to require that all businesses with over 100 employees require their employees to be vaccinated. All healthcare workers in the US will have to be vaccinated, as will all Federal employees and military service members. These mandates apply to over 100 million people.
These mandates are actually very popular with the business community. They realize that a normal economy requires this pandemic to end, and that means that vaccines have to reach 90% of the population. But businesses could not act on their own for fear of pushback or lawsuits or workers quitting. Having the government “force” them to require their workforces to be vaccinated is actually music to their ears.
The Republicans have been howling with outrage over this and claim that Biden has exceeded his authority and is trampling on American freedoms. But this claim is legally false. The government has long had authority from the Supreme Court to regulate public health and to require vaccinations during outbreaks of disease.
What the Republicans really fear is that Biden will succeed. In fact, Biden is timing this perfectly. The fourth wave of COVID has already peaked, with new cases declining, in some places rapidly. This is due to both infection control measures and to the virus burning through so many people that the number still able to be infected is falling. We saw this happen in India in May and June. The current COVID wave has also forced many anti-vaxxers to reconsider their opposition, as the virus takes the lives of so many patients that are only in their 30’s or 40’s. The number of new vaccinations has been rising for the last few weeks, even before Biden acted. This wave will come to a rapid end if Biden is able to carry out his policies. By October, new cases will have fallen substantially. We will also get approval to vaccinate children above the age of five, making schools much safer.
If Biden does finally bring this pandemic to an end before Christmas, his approval rating should rebound. Democrats will also reap the benefits of a strong economic rebound stretching into next year, giving them some wind in their sails before the crucial 2022 midterm elections.
For the COVID pandemic to truly end though, we need to vaccinate not just the US, but the entire world. Ramping up global vaccine production and distribution is critical. Given that the US has spent 5 trillion dollars on COVID relief packages since April of 2020, to spend 50 billion dollars to fully fund vaccines for the world is an obvious good investment. It not only serves the world’s population, it is profoundly in the interest of the US. Biden should do this too.
