Going on four weeks into what should have been a mass vaccination program, it’s increasingly clear that the Cuomo administration did not have – and does not have – an adequate plan for immunizing 20 million New Yorkers.

Exhibit A is the slow pace of coronavirus vaccinations so far, which points to a completion date potentially years in the future.

Exhibit B is the number of policy decisions the governor announces on a daily basis – some of which could and should have been settled long ago.

Exhibit C is the lack of clear data on the state’s progress – or a bearable target date for returning to normal life.

New York is not alone in flailing. By one measure, it’s actually making better progress than most other states, having distributed 40 percent of its allotted vaccines compared to 32 percent for the country as a whole.

But faster than average is not fast enough. To achieve herd immunity, the state must deliver two doses each to 80 percent of its population – or a total of more than 31 million shots. After 24 days, however, the state has given 479,000 shots, or about 20,000 per day.

At this rate, it will take more than four years, until March 2025, to reach the herd immunity target.

In Friday’s briefing, Governor Cuomo warned that the federal allotment of 300,000 doses per week would not be enough to vaccinate the two highest-priority groups until April.

This sidesteps the more immediate crisis, which is that the state is delivering doses less than half as fast as Washington sends them.

A number of steps the governor announced today should at least begin to speed things up.

Most significantly, Cuomo opened the door to broader eligibility for early shots, acceding to pressure from Mayor de Blasio and others.

Previously he had insisted on completing group 1a (which includes health-care workers and nursing home residents) before doing anyone else. De Blasio and others said this restrictive policy was creating unnecessary delay and leading to some doses being wasted.

Now, the governor is allowing vaccination of group 1b (which includes first responders, teachers, transit workers and the general population over 75) starting next week.

After initially relying on hospitals to lead the vaccination effort – and expressing frustration with their progress – Cuomo promised to add thousands more vaccine providers.

Perhaps most significantly, he’s enlisting county public health departments, which have pre-existing mass vaccination plans that for some reason Cuomo chose not to use at first. He said he’s also adding thousands of pharmacies, clinics and doctor’s offices.

Other constructive steps due next week include: issuing an executive order authorizing more medical professionals, such as licensed practical nurses, pharmacy assistants and podiatrists, to administer shots; organizing an online reservation system for eligible recipients, and preparing a webinar to train providers in proper procedure.

These are obviously good ideas – and arguably should have been set in motion months ago, when it became clear that vaccines were coming.

Other moves raise questions.

Cuomo is giving large labor unions the option to take charge of vaccinating their members. He says this is intended to ease the pressure on other providers, but it also opens the door to favoritism. Vaccines in short supply would be set aside for members of some of the most politically influential organizations in the state, such as unions for public school teachers, even if they have no pre-existing capacity for administering shots. 

He also announced that he would “mandate social equity distribution” by local health departments, to make sure that vaccines reach the demographic groups that have suffered disproportionate rates of infection and death.

How this would work was not explained, other than to identify “public housing,” “houses of worship” and “low-income census tracts” as criteria to be considered. This risks adding a new layer of complexity to a distribution system that is already struggling to operate efficiently. 

Given the ongoing threat to New Yorkers’ health, and the collateral damage inflicted on businesses and the broader economy, there can be no higher priority than speed.

The sooner the state achieves herd immunity, the sooner the death rate will drop, the sooner businesses can reopen and the sooner life can go back to normal.

Along with other governors, Cuomo should be sparing no effort to build a vaccination system capable of injecting not tens of thousands, but hundreds of thousands of arms per day and put the onus on the Biden administration and manufacturers to come up with the necessary supply.

The governor promised an action-oriented State of the State speech on Monday. A credible plan to achieve herd immunity this year or better yet this summer –  should be the centerpiece.

 

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

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