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Dec. 11, 2020 10:40AM EST
Coronavirus vaccine line depends largely on the honor system
After the first round of coronavirus vaccines is administered, state and local officials largely will not be able to ensure that the rest of the process puts high-risk people first.
Between the lines: Experts have spent months debating the ins and outs of a complex prioritization system for these vaccines, all in the hopes of saving as many lives as possible. But the actual process will likely rely heavily on the honor system.
The big picture: It’ll be relatively easy to ensure that the highest-priority groups — health care workers and nursing-home residents — are the ones who actually receive the first vaccine doses, because hospitals and long-term care facilities can just go through their staff and resident rosters to figure out who should be offered a vaccine.
- “Right now we’re very much focused on getting it to the hospitals and the nursing homes, and they’ll be what we call a closed point of distribution,” said Bryan Mroz, Acting Assistant Secretary of the Maryland Department of Health.
But after that, enforcement gets harder. Experts have said the next round of doses should be focused on people who are most at risk to catch or spread the virus, or for serious illness. That would include many service workers and people with underlying health conditions.
- But there aren't great enforcement tools to make sure that's how things work.
- “Eventually you'll get to the point where there’s a lot of providers and distribution points involved in this plan, and it’s going to be harder and harder to ensure you adhere strictly to these priority groups. I’m sure there will be a point where we see line jumping,” said Josh Michaud, associate director of global health policy at the Kaiser Family Foundation.
- “As far as enforcement, states will try to direct vaccines as best as they can to reach the populations they want to, but once they’re at those distribution points, it’s hard to control this process,” he added.
How it works: Health care providers administering vaccines must enroll in a federal program and sign a provider agreement written by the CDC.
- The first stipulation is that providers must administer coronavirus vaccines in accordance with guidance by the Advisory Committee on Immunization Practices, the federal panel recommending how to distribute vaccines.
- But providers will likely have to take people’s claims that they’re members of certain priority groups at face value.
- “I doubt they’re going to require a lot of documentation. If you say you have diabetes, they’re not going to want to see your blood sugar,” said Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security.
- “I think we do have to depend to a significant extent on people’s honesty, and to some extent, it’s an honor system. You can check age…but the rest of it you really can’t.”
Yes, but: Given the level of vaccine hesitancy in the U.S., some experts said they’d be thrilled if line-skipping ends up being our biggest problem.
- “Of all the things that are keeping me awake at night, this is not one of them. If the order in which some people get vaccinated is different than the ideal, at least some people are getting vaccinated,” Toner said. “I’d rather have people so eager to get a vaccine that they find a way to game the system than people not wanting to get vaccinated.”
- “That’s a problem I kind of want to have — people lined up to get” vaccinated, Mroz added.
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Jan. 18, 2021 05:00PM EST
Biden Cabinet confirmation schedule: When to watch hearings
The first hearings for President-elect Joe Biden's Cabinet nominations begin on Tuesday, with testimony from his picks to lead the departments of State, Homeland and Defense.
Why it matters: It's been a slow start for a process that usually takes place days or weeks earlier for incoming presidents. The first slate of nominees will appear on Tuesday before a Republican-controlled Senate, but that will change once the new Democratic senators-elect from Georgia are sworn in.
The big picture: Biden's inauguration is in two days, and he plans to start his tenure with a shock-and-awe campaign through executive orders, federal powers, and speeches that signal a "radical shift" in his administration.
Schedule
Jan. 19:
- 10am: Alejandro Mayorkas, nominee for secretary of homeland security nominee, before the Senate Homeland Committee .
- 10 am: : Avril Haines, nominee for director of national intelligence, before the Senate Intelligence Committee
- 10 am: Janet Yellen, nominee for treasury secretary, before the Senate Finance Committee
- 2 pm: Antony Blinken, nominee for secretary of state, before the Senate Foreign Relations Committee
- 3 pm: Retired Gen. Lloyd Austin, nominee for defense secretary, before the Senate Armed Services Committee
This page will be updated as more hearings are scheduled.
Go deeper: Biden finalizes full slate of Cabinet secretaries
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Dec. 08, 2024 10:04PM EST
Dec. 17, 2020 11:53PM EST
Trump's Turkey sanctions could give Erdoğan and Biden a clean slate
President Trump’s imposition of long-awaited sanctions on Turkey this week over its purchase of a Russian S-400 missile defense system illustrates the fragile state of a critical relationship — but it may also allow President-elect Joe Biden to start fresh with Turkish President Recep Tayyip Erdoğan.
Why it matters: Erdoğan raged against the sanctions, which target Turkey’s defense procurement agency and the agency’s leaders, as a “hostile attack” from a NATO ally. Trump had resisted pressure to impose them, but Congress forced his hand.
The big picture: While Erdoğan maintained a strong personal relationship with Trump over the last four years, many others in Washington were growing increasingly concerned by his muscular regional policies and warming ties with Russia.
- Enter Biden. His promises to revitalize multilateralism and prioritize relations with countries that “share our democratic values” — not to mention his skewering of Trump for embracing “all the thugs in the world” — pose very different challenges for Erdoğan.
- The two also have a history. As vice president in 2014, Biden called Erdoğan an "autocrat" and said he would support the opposition's efforts to defeat him. (Biden later issued an official apology).
What to watch: Soner Cagaptay, a fellow at the Washington Institute and author of "Erdoğan’s Empire," expects Erdoğan to open with a charm offensive.
- The Turkish president is a “shapeshifter” who “becomes what every U.S. president wants to see in their Turkish counterpart” — in Biden’s case, an “internationalist, reformer, healer.”
- “He wants to reverse this narrative of free-falling ties,” Cagaptay says, because it’s damaging for Turkey’s struggling economy and leads others to question whether the U.S. military really stands behind Turkey.
Biden has incentives of his own to patch things up. Turkey could play the role of either facilitator or spoiler in two of Biden’s top foreign policy focuses: Iran and Russia.
- And while Biden will include human rights and democracy in the relationship, Cagaptay says, Erdoğan will attempt to placate him, perhaps by releasing some political prisoners.
Yes, but: This will be a deeply complicated relationship, and it could quickly turn contentious.
- Russia, which has massive geopolitical and economic leverage over Turkey, wants to expand the U.S.-Turkey divide. Moscow could pressure Ankara to switch the S-400 system on. That would provoke both the U.S. and NATO, which views the Russian system as a threat.
- Erdoğan would likely choose a fight with Biden over one with Putin, Cagaptay says. He’s already involved in squabbles with the EU over immigration and gas exploration that could also pull in the Biden administration.
- Further crackdowns by Erdoğan on the political opposition would also generate backlash.
The bottom line: “Erdoğan’s relations with U.S. presidents start well,” Cagaptay says. “They never end well.”
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