‘Cavalry may not be coming’: Former military Covid planner warns of nightmare of distributing vaccine in rural America

Incoming administration will inherit one of most daunting challenges any president has ever faced

A former US Army Covid-19 planner has warned that the development of a safe and effective vaccine is only the start because the challenge of distributing it will be enormous.

“The incoming administration will inherit one of the most daunting challenges any president has ever faced: planning and executing a national mass-vaccination campaign in the middle of a global pandemic,” writes Kris Alexander, formerly of US Northern Command, in The Daily Beast.

He notes that the biggest problems logistically are that many parts of the country are already chronically underserved from a medical standpoint and the vaccine will need to be transported  over enormous distances at low temperatures.

Giving his home state of Texas as an example, Mr Alexander notes that 235 out of Texas’ 254 counties are medically underserved according to the Department of State Health Services — some have little to no access to healthcare and even lack a doctor.

Texas budgeted $17.7 million for infectious disease surveillance, prevention, and epidemiology, but over $400 million for border security.

Lipscomb County, he notes, has a population of 3,300 people, but zero doctors. It is also 550 miles from Austin, the state capital — the same distance from Washington, DC, to Portland, Maine.

The logistics or curtailing and ending the coronavirus pandemic via a vaccine will therefore be extremely difficult.

“To deploy the Pfizer vaccine or any other one, health planners will have to figure out a way to deliver it to rural areas while maintaining its required temperature long enough to ensure that the population receives both doses,” says Mr Alexander.

“This scene will be repeated all across small-town America. This presents a big risk: An uncoordinated federal rollout of vaccines requiring ultra-cold storage could leave state and local governments competing for resources much like they were competing for PPE earlier in the pandemic.”

Those counting on the military acting as the nation’s saviour may be overestimating its capabilities. Usually, medical support can be surged into hotspots, but blanketing the nation with logistical support would be close to impossible. The military will also need to take care of its own personnel and their families on a global scale.

“So despite the promised of Dr Anthony Fauci, the literal Cavalry may not be coming, at least not as quickly as we might like,” says Mr Alexander, warning that the long winter could drag into spring and summer.

Ultimately, Mr Alexander argues that the military simply cannot replace state and local health planning and resource allocation. Instead of wishing for a miracle, it will take nearly flawless coordination between local, state, and federal governments.

“Getting this right is going to be hard, and given our climate of disinformation and vaccine scepticism, we may never get to the point where we are completely free from Covid,” he writes. “But maybe this is also an opportunity to show the world that Trump was an anomaly, and that we are ready to work to return to our normal—or normal-ish—role as a global leader.”