Before getting to the latest in the concern over Donald Trump’s attempt to turn everything about a public health crisis into a political football, it seems appropriate to give out a state-level special achievement award. Because Alabama Gov. Kay Ivey has managed something very, very … special.
The rate of testing in Alabama was down this week. The rate of testing in Alabama was down the week before. The rate of testing in Alabama was down the week before that. After peaking at just over two tests per 1,000 people in mid-August—a rate that still put the state in the bottom third when it came to tests—Alabama has now dropped to the amazingly tiny level of 0.3 tests per 1,000 citizens. That’s less than half the rate in “we’re still pretending it won’t get us” Wyoming, and less than a third the rate in any other state. But Alabama managed this while still logging over 1,000 new cases of COVID-19 per day.
So what do you get when you combine an astoundingly low testing rate with a high rate of new cases? You get a 90% positive rate. That’s right. The rate of positive tests yesterday in Alabama was over 90%, a number that’s absolutely an accomplishment if the goal was to have not the slightest damn idea what’s really going on in the state. Congratulations, Gov. Ivey.
Now … on to the vaccine news.
All the way back in February, Donald Trump had this to say about the proximity of a vaccine on COVID-19: “In fact, we’re very close to a vaccine.” The White House later claimed that Trump was talking about an Ebola vaccine, because Trump spent a good part of that day’s press conference attacking President Obama’s handling of Ebola. Spoiler: One (1) American died. The only problem with that excuse is that an Ebola vaccine was released months before that February appearance.
Actually, that’s not the only problem. Trump made the same claim repeatedly over the following days while Health and Human Services (HHS) Chief Alex Azar sat down to explain to Congress that this vaccine might not be affordable to everyone because “we can't control that price because we need the private sector to invest.” On the same day, Trump had this to say: “We're rapidly developing a vaccine. The vaccine is coming along well, and in speaking to the doctors we think this is something that we can develop fairly rapidly."
That was the same day, Trump said: “When you have fifteen people, and the fifteen within a couple of days is going to be down to close to zero, that's a pretty good job we've done." Of course, it was a couple of weeks before he decided that letting thousands die would be a good political move. Also on that day, medical experts including Dr. Anthony Fauci tried to warn the public that it would take a year to 18 months before a safe and effective vaccine might be expected.
On March 2, one week after the White House denied Trump promised a speedy vaccine, Trump was back to say: “We’re moving aggressively to accelerate the process of developing a vaccine. … A lot of good things are happening and they’re happening very fast. I said, ‘Do me a favor, speed it up, speed it up.’ And they will — they’re working really hard and quick.” The next day, Trump held a “vaccine roundtable” with pharmaceutical execs, where he asked if they could just give people the flu vaccine to fight the coronavirus. Told that it would take a specific vaccine, Trump’s response was “How fast can you get it done?” He leaped onto a statement about the possibility of having some doses ready in August, not understanding that these were for a phase 2 trial, and he had to be corrected by Dr. Fauci, who gave Trump the 12 to 18 month-timeframe face to face. Despite what he was told, Trump called a year “an outside number” and insisted a vaccine would come sooner.
"I don't know what the time will be. I've heard very quick numbers, that of months. And I've heard pretty much a year would be an outside number. So I think that's not a bad range. But if you're talking about three to four months in a couple of cases, a year in other cases," said Trump.
Trump continued to insist that a vaccine was coming sooner despite frequent efforts to correct his statements. Days after the roundtable, he was still claiming: “They’re going to have vaccines, I think relatively soon” at a North Carolina rally. A week later came claims that Trump had offered a German firm $1 billion for an early shot at their vaccine while continuing to promise the public it was coming “soon.” By that point, researchers were already warning that Trump was trying to “rush science” and making promises that could not be met.
But no matter how many times he was told that it wasn’t possible to produce a vaccine that was known to be safe and effective in a shorter timeframe, Trump continued to insist it would happen. In May, as COVID-19 briefings were on hold following Trump’s suggesting that Americans might be cured by injecting disinfectant, or getting sunshine “on the inside,” Trump told his supporters that he expected a COVID-19 vaccine “by the fall” while dismissing the statements from Fauci and other experts.
And … that’s still where he is. Just as pharmaceutical insiders told Trump back in March, there are doses of vaccine available, but those vaccines are still going through testing to see if they are safe enough, and effective enough, to be distributed to hundreds of millions of people. Unlike treatments designed to address an illness, vaccines are given to healthy people, in large numbers, so they have to be tested at a very high level. Only every sign indicates that Trump does not want to wait. He wants to make his predictions true, and deliver a “miracle” before the election by releasing a vaccine without completing phase 3 trials. After all, Vladimir Putin did it, so why not Donald Trump?
The threat posed is generating a huge pushback from healthcare experts. As The Washington Post reports, scientists and bioethicists want FDA Chief Stephen Hahn to promise that he will not use one of the agency’s Emergency Use Authorizations to make a vaccine available before the Nov. 3 election. Meanwhile, the Centers for Disease Control and Prevention (CDC) has already prompted states to be ready to deliver vaccine by Nov. 1.
Behind the scenes, Trump’s desire to deliver a vaccine—tested or not—is being flogged on by the enormous money race between vaccine manufacturers AstroZeneca, Pfizer, and Moderna. All their vaccines are in phase 3 trials, but if one can get early release, the payday would be in the billions. For Moderna and Pfizer, who are hoping to release a type of vaccine never before produced for any disease in humans, getting an early ticket would be a huge windfall, allowing them to bypass further questions about their novel techniques. Drugmakers can’t be expected to put the brakes on Trump, because for all of them, the accelerator is just too tempting.
Even so, there are still voices from within the White House calling for calm. Not only is Fauci still talking about a vaccine being available in early 2021, The New York Times reports that chief adviser for the White House vaccine program Moncef Slaoui said Thursday that it was “extremely unlikely” a vaccine could be ready by the Nov. 1 deadline set by the CDC. But then … Slaoui also said it was “not impossible.” And in an NPR interview, he went on to say that “[i]t would be irresponsible not to be ready” if a vaccine is available by that date. Maybe it was too much to expect a reasoned response from the head of “Operation Warp Speed.”
At the moment, the signs that Trump will proceed prudently while keeping the science in mind are … about as good as any situation that requires Trump proceed prudently while keeping the science in mind. Rushing a vaccine could not only mean releasing something that is unsafe or ineffective, it could also do so much damage to the vaccination program that it could actually extend the COVID-19 crisis, causing more American deaths.
But then, Trump isn’t concerned about those losers and suckers who die. He’s only after the losers and suckers who vote for Trump.