The COVID-19 vaccine will be good medicine. Equitable distribution of it will be good policy.

“There is no such thing as a national solution to a global crisis,” says a report from the Bill & Melinda Gates Foundation, “COVID-19: A Global Perspective,” released in September.

We believe this is true.

“The COVID-19 pandemic has taught us that just as everything collides into everything else, everywhere collides into everywhere else,” the report says. “No matter how good any individual place is at testing, contact tracing, and quarantining, a person who has no idea they are contagious can still get on an airplane and be in another place in a few hours.”

We have seen this here in New York State as plane loads of travelers from Europe landed in New York this spring while the federal focus was still on China. Once the state got the virus under control, travel restrictions were applied — first a list requiring quarantine for travelers from places where infection rates were too high, which became unworkable when nearly every state was listed, and now a requirement to display a recent negative test result on arriving in New York State.

New York State is not hermetically sealed, as Governor Andrew Cuomo is fond of saying.

Neither is the United States hermetically sealed.

To our country’s detriment, President Donald Trump began withdrawing from the World Health Organization in July. In September, the Trump administration said it wouldn’t join COVAX (COVID-19 Global Access Facility), which almost every country in the world — minus the United States and Russia along with a handful of smaller countries — has joined.

We have hope and take Joe Biden at his word that he will have the United States rejoin the World Health Organization and join the COVAX initiative.

But with Pfizer’s announcement on Monday that it has developed a 90-percent effective vaccine for COVID-19 — pending final test results — the distribution of the vaccine becomes an immediate problem.

With President Trump not yet even conceding he lost the election, it is hard to imagine his administration would work with his successor on a more fair plan for distribution here in the United States, not even considering the rest of the world.

Albany County officials said on Tuesday they are “ready to roll” with administering a vaccination — drills are held regularly — at public-health clinics but questions remain about supplies.

The Gates Foundation report predicts that twice as many people could die from COVID-19 if richer countries hoard the first 2 billion vaccine doses rather than distributing them equitably. In the long run, fair distribution will help the United States in its economic recovery because we are part of a global economy.

Just as there is no such thing as a national solution to a global crisis, there is also no such thing as a state-by-state solution to a national crisis. The Trump administration has largely left control of the pandemic up to individual states.

We took heart in Biden’s promise, throughout his campaign, that his administration would use a science-based approach. The Trump administration has set up a false dichotomy, making it seem like controlling the coronavirus would kill the economy. In reality, the only way to restore the economy is to control the virus.

As New York State’s approach has shown, the virus can be controlled if citizens buy into preventative measures like wearing masks, washing hands, and staying six feet from one another, and if the government provides widespread testing, tracks contacts to be quarantined, and places restrictions in areas where clusters appear.

Once a safe and effective vaccine is developed, it will be months or perhaps years before enough people are vaccinated to achieve herd immunity. The task of reaching 328 million Americans is herculean, especially since so many citizens have doubts about a vaccine.

We wrote at length last week about criticisms Cuomo raised over the Trump administration’s vaccine distribution plan: The proposed system isn’t robust enough to handle the volume of vaccinations and would jeopardize testing, which uses the same system; funding for states distributing the vaccine is inadequate; the plan is unfair to Black, brown, and poor communities; and information that states must provide — particularly individual identification numbers — could be used to deport people.

A spokesman at the White House, Michael Bars, responded only to the final concern. We worry about these unanswered concerns, and more, if the Trump administration begins rolling out its vaccination plan before Biden is inaugurated on Jan. 20.

Bars did share a document outlining the Trump administration’s response to 30-some questions posed by Cuomo in his role as chairman of the National Governors Association. The document was silent on an important concern, that of racism, which we will highlight here because it seems to us Albany County has anticipated the problem and taken the right approach. It may serve as a model.

Cuomo held a press briefing on Nov. 1 with the state’s attorney general, the president of the NAACP, and the chief executive officer of the National Urban League — all of whom said the Trump administration’s plan for distributing vaccines is unfair because it ignores the same Black, brown, and poor communities that had been overlooked for COVID-19 testing.

“Why was the COVID infection rate so much higher in communities of Black and brown people? Because they’re health-care deserts,” Cuomo said.

While chain drugstores and private providers that Trump’s plan says will administer the vaccine are found in wealthy and middle-class communities, often they are not found in poor neighborhoods.

In mid-April, as the COVID-19 death toll for Albany County rose to 20 — it now stands at 144 — Albany County Executive Daniel McCoy announced a program that would test people for COVID-19 in “the most underserved communities in the county.”

The county continues to run the testing program, in partnership with the Whitney M. Young, Jr. Health Center, and pays for anyone who does not have insurance.

Albany County’s health commissioner, Elizabth Whalen, along with McCoy had pushed for more community testing after initial testing had been narrowed to hospital patients and exposed health-care workers since federal test kits were limited.

On April 6, the state opened a drive-through testing facility in tents at the University of Albany’s uptown campus but the facility would only test “individuals that could drive,” said Whalen.

The tests are important, Whalen said in April, so her department could identify people who have COVID-19 and reach the people they have been in contact with so those contacts can be put under quarantine to prevent further spread of the coronavirus.

“Another core function of local public health is really to assess the health of the community,” said Whalen. Every three years, her department puts out a community health assessment to identify high-needs neighborhoods “where citizens have disparate health outcomes and underlying health conditions so we can target these neighborhoods.”

Whalen said working toward “test equity” had taken a great deal of discussion and planning and that the mobility of this plan — tents and a mobile unit from Whitney Young are used — make the sites easily accessible. Residents walk up rather than drive through to be tested.

“Across the nation, we’re hearing about disparate outcomes of COVID-19 dependent on race,” said Whalen over six months ago. “The data we have so far is not robust enough to see how this is playing out in Albany County.”

As of Nov. 11, the county had amassed significantly more data, which shows that, although a disproportionate number of Black patients have been hospitalized with COVID-19, a disproportionate number of Black residents have not died from the disease.

Albany County is 71.6 percent white and 11.4 percent Black.

The county’s dashboard shows that 63 percent of residents hospitalized with COVID-19 have been white and 26 percent have been Black. Among the Albany County residents who have died of the disease, 88 percent or 120 people were white while 10 percent or 15 people were Black.

We have no scientific cause-and-effect proof that this equity in testing has meant Blacks in Albany County are not dying disproportionately from COVID-19 as they are in many other places in our nation, but we believe Albany County’s approach is the right one.

After the end-of-May protests in Albany, spurred by the murder of George Floyd, Commissioner Whalen described racism as a public-health threat. “Racism is real,” she said.

Her department’s mission is, in part, to “reduce health disparities and promote health equity,” Whalen said. “Equity,” she said, is different from “equality.”

“Equity means the absence of avoidable, remediable differences among groups of people whether those groups are defined socially, economically, demographically, or geographically,” said Whalen. “Equity is a process, and equality should be the outcome of that process. It is a difficult process.”

She said her department engages in that process every day. It hosts listening forums on maternal mortality. Staff go door-to-door in high-risk neighborhoods to address disparity in conditions like asthma, diabetes, and heart disease. The department educates the public and works on task forces designed “to help bridge the gap,” Whalen said.

Perhaps most importantly, Whalen said in June, is the need “to listen to the communities of color, to listen to the very real concerns that they have, and to work hand in hand with them to come up with better strategies to close these gaps, to help this anger, and to make sure that we are all working every day on solutions.”

The pandemic has laid bare many inequities, here in Albany County, across our nation, and around the world — in housing, in education, in food security, and in economic security. Whalen’s advice is on point: We need to listen to concerns with an intent to understand and then come up with solutions, together, to close the gaps.

Marc Morial, the former mayor of New Orleans and the current head of the National Urban League, noted that, in March, the White House announced the partnership with chain pharmacies to provide testing. “A month later, out of 63 that opened, only eight were in black neighborhoods,” he said.

About the Trump administration’s proposal for vaccine distribution, he said, “This plan to rely on the current health-care infrastructure which has not served us well is thoughtless, it’s careless and it needs to be taken back to the drawing board and a new plan needs to be designed.”

For the sake of saving American lives, the Trump administration should allow the incoming Biden administration to have a say in vaccination distribution. That is what the majority of Americans voted for.

Albany County is ready to hold “mass vaccination clinics,” says Commissioner Whalen, noting her staff is highly trained to vaccinate a large number of people in a short period of time. This approach would reach people in the same underserved neighborhoods that Albany County has already been testing for COVID-19 rather than reserving the vaccine for people who can drive to suburban pharmacies.

Morial said there is already great resentment and fear that the vaccination process has been politicized. He recalled how, as a child, he received a polio vaccine at his neighborhood school in New Orleans and asked, “Why not learn from what was done in the past?”

Now is the time to set aside our political differences, rely on science, and follow directives on preventing the spread of the coronavirus. Each of us can make a difference by doing so.

“How bad the pandemic gets and how long it lasts is largely within the world’s control,” says the Gates Foundation report. “Ultimately, businesses and governments must really believe that the future is not a zero-sum contest in which winners win only when losers lose. It is a cooperative endeavor in which we all make progress together.”

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