A few months ago, the United States seemed well on its way to beating Covid-19.
While the pandemic had taken a particularly heavy toll there by global standards, with more than 600,000 Americans dead and millions still unemployed, the country’s vaccine rollout was proceeding at a rapid pace.
Every American adult was eligible for the shot, and more than half had received at least one dose. Restrictions around mask wearing and social distancing, for so long a source of political tension, were being loosened at last.
But now, approaching the end of July, the US still hasn’t managed to finish the job. And it is suffering the consequences.
A steady slowdown in the vaccine rollout, coupled with the spread of the highly infectious Delta variant, has resulted in renewed outbreaks across the country, with cases rising in all 50 states.
Put simply, the US had a chance to stamp out covid, and blew it.
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The demand dilemma
Before Delta became the most prevalent strain in the US, it did genuinely feel as though the country was on the cusp of being post-covid.
Masks were still required on planes, trains and buses, but were otherwise optional in most settings for fully vaccinated people.
I recently spent time in Rhode Island, Massachusetts, Illinois and California – all Democrat-run states with Democrat-leaning populations whose restrictions throughout the pandemic have generally been on the tougher side. I live in New York City.
All of these places were practically back to normal, with indoor venues open at full or near-full capacity and mask-wearing at a minimum.
On most days, the biggest imposition you’d face would be masking up on the subway, or using a QR code instead of a physical menu in a restaurant. Not exactly a tough ask.
All of this was possible because of the covid vaccines, developed at great pace under former president Donald Trump and distributed, with equal haste, under his successor Joe Biden.
It’s hard to overstate just how readily available the vaccines are across most of the country.
As a healthyish 30-year-old foreigner – hardly at the front of the queue – I received my first Pfizer dose in mid-April and was fully vaccinated by early May.
At this point, most government-run vaccination sites are offering jabs to anyone who walks in without an appointment.
Obviously, vaccination sites are sparser in rural areas. But if you’re a resident of the US, whatever your income level or immigration status, you can get a covid vaccine, for free, without much trouble. It’s been that way for months.
This isn’t like the situation back in Australia, where there aren’t enough vaccines for the whole population. The problem in the US is a lack of demand, not supply: Vaccines are available, but too many Americans are either reluctant or refusing to take them.
In mid-April, the US was averaging more than three million vaccinations per day. That figure has fallen steadily since, and is now hovering at just over 500,000.
The country missed Mr Biden’s goal of giving at least 70 per cent of adults their first dose by Independence Day on July 4, having blown past previous targets with ease.
As things stand, more than a fortnight later, 66 per cent of adults have received their first shot, and 49 per cent of the population is fully vaccinated.
And those numbers are inching up slowly, as other countries accelerate their own vaccine rollouts. The US was just passed, in fact, by its smaller neighbour, Canada, which has now fully vaccinated more than half its people.
It’s a symbolic blow for the American psyche, roughly equivalent to Australia getting embarrassed by New Zealand.
There is no single explanation for the slowdown.
Some of the vaccine-hesitant are younger Americans who don’t think they need it. Others are uninformed and unaware they have access to the vaccines. The vaccination rate is lagging noticeably in some minority communities, where trust in the government is low.
These groups are all open to persuasion, which is why reaching out to them is the government’s main focus at the moment.
Naturally there is also a subset of full-on anti-vaxxers who are opposed to all vaccines, not just the covid ones. Obviously these people are not persuadable.
The biggest factor, however, appears to be politics.
Polling on the vaccines has consistently shown a sharp divide between Democratic and Republican voters.
As an example, let’s take the most recent Washington Post-ABC News survey. It found that 86 per cent of Democrats had received at least one dose of a Covid vaccine, compared to 45 per cent of Republicans.
More worrying: While just 6 per cent of Democrats said they weren’t likely to get vaccinated, that number rose to 47 per cent among Republicans, 38 per cent of whom said they definitely wouldn’t get the shot.
This polling is backed up by the public health data. Of the 25 states with the lowest percentage of their people fully vaccinated, 22 voted for Mr Trump in last year’s presidential election. The 20 most vaccinated states all voted for Mr Biden.
The two maps below illustrate the point. Note the correlation between states’ vaccination rates and their political leanings.
There are a couple of exceptions, such as Florida and Ohio. But the trend is clear: Democratic states are highly vaccinated; Republican states are not.
Go down to county level and you see the same pattern.
‘They’re killing people’
Why does this political divide exist?
Mr Biden blames misinformation, particularly on social media, where many Americans go to get their news each day. Last week the President accused Facebook of “killing people”, though he’s since walked that back after an angry response from the company.
White House Press Secretary Jen Psaki has cited a recent report that found 12 people, dubbed the “disinformation dozen”, were responsible for two-thirds of the anti-vaccine misinformation that spreads online.
“It’s important to take faster action against harmful posts,” Ms Psaki said.
“Information travels quite quickly on social media platforms. Sometimes it’s not accurate. And Facebook needs to move more quickly to remove harmful, violative posts.
“Posts that will be within their policies for removal often remain up for days. That’s too long. The information spreads too quickly.”
Facebook, for its part, has said it will not be “distracted” by “accusations which aren’t supported by the facts”.
“The fact is that more than two billion people have viewed authoritative information about Covid-19 and vaccines on Facebook, which is more than any other place on the internet,” company spokesperson Dani Lever said recently.
“The facts show that Facebook is helping save lives. Period.”
But it isn’t just social media. Like masks and lockdowns before them, the vaccines have been politicised, becoming another battleground in the broader American culture war.
Consider this rather innocuous quote from the President on July 6.
“We need to go community by community, neighbourhood by neighbourhood, and oftentimes door to door, literally knocking on doors, to get help to the remaining [unvaccinated] people,” Mr Biden said.
So the government is doorknocking people to inform them about the vaccines. Seems like a sensible effort to reach people.
Now let’s run through some of the reactions from Republican politicians.
Colorado Congresswoman Lauren Boebert said Mr Biden had “deployed his Needle Nazis”, describing the outreach as “coercion by federal agents”.
“Did I wake up in Communist China?” she said.
North Carolina Representative Madison Cawthorn suggested the move was a precursor to the government taking away Americans’ guns and Bibles.
“They’re starting to talk about going door to door to be able to take vaccines to the people. Think about the mechanisms they would have to build to be able to execute that massive of a thing. And think about what those mechanisms could be used for,” he said.
“They could then go door to door to take your guns. They could then go door to door to take your Bibles.”
Georgia Congresswoman Marjorie Taylor Greene, already notorious for espousing conspiracy theories, also ran with the Nazi comparison.
“People have a choice, they don’t need your medical brown shirts showing up their door ordering vaccinations. You can’t force people to be part of the human experiment,” Ms Greene said.
This sort of rhetoric, painting the effort to vaccinate Americans and protect them from the deadliest pandemic in a century as an authoritarian attack on personal freedom, has become unsettlingly common.
So has misinformation about the efficacy and safety of the vaccines.
Here, for example, is Charlie Kirk – founder of the conservative student group Turning Point USA and a speaker at last year’s Republican National Convention – wrongly implying the vaccines are killing people.
Not all voices on the right are indulging in such rubbish. Several prominent Republican politicians have urged their constituents to get vaccinated.
“These shots need to get in everybody’s arm as rapidly as possible, or we’re going to be back in a situation in the fall that we went through last year,” the party’s leader in the US Senate, Mitch McConnell, said this week.
“Getting the covid vaccine only takes a few minutes. It’s effective, safe and doesn’t cost you a dime,” said one of his colleagues, Senator Tommy Tuberville.
“I got mine, and I encourage you to talk to your doctor about getting yours.”
These are good statements. But for a large chunk of Republican voters, they are just not getting through.
A rare silence
If an unvaccinated American won’t listen to the Joe Bidens and Mitch McConnells of the world, who will he listen to? Donald Trump, perhaps?
After all, Operation Warp Speed, the US government program which helped researchers quickly develop effective covid vaccines last year, was one of the great successes of Mr Trump’s presidency.
As you probably noticed during said presidency, when Mr Trump is passionate about something, he tends to talk about it a lot, loudly and publicly. He has yet to discover any such passion for convincing Americans to get vaccinated.
To be fair, he has endorsed the vaccines a couple of times since leaving office in January.
“I would recommend it. And I would recommend it to a lot of people that don’t want to get it, and a lot of those people voted for me, frankly,” he told Fox Business in March.
“But, you know, we have our freedoms and we have to live by that, and I agree with that also. But it’s a great vaccine, it’s a safe vaccine, and it’s something that works.”
The former president also phoned New York Post columnist Michael Goodwin in April to back the newspaper’s pro-vaccination campaign.
“I’m all in favour of the vaccine,” he told Goodwin.
“It’s one of the great achievements, a true miracle, and not only for the United States. We’re saving tens of millions of lives throughout the world. We’re saving entire countries.
“The vaccine is a great thing and people should take advantage of it. Nobody should be forced, we have our freedoms. But I strongly recommend it.”
Again, good statements. But a handful of quotes in six months is hardly a concerted effort.
Mr Trump’s pro-vaccine message has also been muddled by his eagerness to criticise the Biden administration and the news media.
“People are refusing to take the vaccine because they don’t trust this administration, they don’t trust the election results, and they certainly don’t trust the fake news,” he said on Sunday, without adding any words encouraging those people to take it.
A day later, during the White House media briefing, press secretary Jen Psaki was asked whether Mr Biden would ever call Mr Trump to ask him for help promoting the safety of the vaccines.
“What we have seen and our data is that the most trusted voices are local officials. Doctors, medical experts, civic leaders, clergy from time to time. And that is where we’ve really invested our funding and time,” Ms Psaki replied.
“We’ve seen almost every former president play a role in terms of making sure people understand the vaccine is safe and effective. We don’t believe that requires an embroidered invitation.”
That’s a no, then.
‘This suffering is preventable’
All of this leaves the US in a grim position, with the Delta variant spreading and a very real possibility that the federal and state governments will need to reimpose the restrictions they lifted a few months ago.
The Americans who are refusing to get the vaccine, citing their personal freedom, may soon find themselves living under mask mandates again.
Worse, they may find themselves infected with Covid, which poses little threat to the vaccinated but a mortal one to them.
A month ago, on June 21, the US was averaging 12,000 new Covid cases a day. That figure has since tripled; it is now sitting around 38,000. The overwhelming majority of new infections, 83 per cent, are the Delta variant.
Hospitalisations have also spiked. Deaths, which always lag behind cases by at least a couple of weeks, are rising more slowly.
Here are the two key statistics though: Of the people in hospital with covid, about 97 per cent are unvaccinated. And among those who died recently, 99.5 per cent were unvaccinated.
“This is becoming a pandemic of the unvaccinated,” Dr Rochelle Walensky, director of the Centres for Disease Control and Prevention (CDC), said during a public health briefing on Friday.
“We are seeing outbreaks of cases in parts of the country that have low vaccination coverage, because unvaccinated people are at risk, and the communities that are fully vaccinated are generally faring well.
“The good news is that if you’re fully vaccinated, you are protected against severe covid, hospitalisation and death, and are even protected against the known variants, including the Delta variant.
“If you are not vaccinated, you remain at risk. And our biggest concern is that we’re going to continue to see preventable cases, hospitalisations and, sadly, deaths among the unvaccinated.”
In testimony before Congress yesterday, Dr Walensky said the CDC’s top two priorities were “tracking and preventing” any further spread of covid and creating access to “and confidence in” the vaccines.
She expressed frustration
“The majority of these deaths could be prevented with a simple, safe, available vaccine,” said the CDC director.
“The overwhelming number of deaths from Covid-19 are now occurring in unvaccinated people. Vaccines are widely available across the country, and this suffering and loss is simply and entirely preventable.”
She said the CDC was engaging “trusted community leaders” to reinforce messages about the efficacy and safety of the vaccines.
We’ll end with the words of Dr Brytney Cobia, from Alabama. Her heartwrenching account of treating unvaccinated Covid patients already featured in another story on this site, but deserves to be read as widely as possible.
“I’m admitting young, healthy people to the hospital with very serious covid infections,” Dr Cobia said.
“One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late.
“A few days later when I call time of death, I hug their family members and I tell them the best way to honour their loved one is to go get vaccinated and encourage everyone they know to do the same.
“They cry. And they tell me they didn’t know. They thought it was a hoax. They thought it was political. They thought because they had a certain blood type or a certain skin colour they wouldn’t get as sick. They thought it was ‘just the flu’.
“But they were wrong. And they wish they could go back. But they can’t. So they thank me and they go get the vaccine. And I go back to my office, write their death note, and say a small prayer that this loss will save more lives.”
This didn’t need to happen. Millions of Americans have chosen it.
Sam Clench is news.com.au’s US correspondent | @SamClench