The Morning Dispatch: The First COVID Vaccine Has Shipped

Happy Monday! So that’s what competent football looks like!

Quick Hits: Today’s Top Stories

• Doses of the Pfizer-BioNTech COVID-19 vaccine are en route to all 50 states after the FDA approved the first coronavirus vaccine for emergency use in the United States on Friday.

• The U.S. Supreme Court declined to take up the lawsuit filed and led by Texas Attorney General Ken Paxton that sought to overturn President-elect Joe Biden’s victory in four decisive battleground states. The court decided not to hear the case on the grounds that Texas had “not demonstrated a judicially cognizable interest in the manner in which another State conducts its elections.”

• Despite reaching an agreement to extend talks aimed at retaining an economic partnership between the United Kingdom and the European Union post-Brexit, Prime Minister Boris Johnson and European Commission President Ursula von Der Leyen indicated such a deal is not likely. Johnson said the two sides remain “far apart on key issues” with limited time to resolve discrepancies.

• The members of the Electoral College will meet in their respective states today to cast their ballots for president. The Michigan State House and Senate office buildings will be closed all day Monday as the electors meet due to “credible threats of violence.”

• The Senate passed and President Trump signed into law a one-week government funding bill Friday, narrowly averting a government shutdown and allowing Congress to continue negotiating on a $1.4 trillion spending package.

• The Washington Post reports that Russian government spies were behind a series of hacks of U.S. agencies and companies, including the Treasury and Commerce departments and the private cybersecurity firm, FireEye. FireEye said in a blog post that all of the organizations were breached via “trojanized updates to SolarWind’s Orion IT monitoring and management software,” which is used by more than 300,000 customers—including 425 Fortune 500 companies, the Pentagon, State Department, NASA, NSA, Postal Service, NOAA, Department of Justice, and the Office of the President of the United States.

• Following a rise in COVID-19 hospitalizations, Gov. Andrew Cuomo moved on Friday to shut down indoor dining in New York City indefinitely, beginning today. Restaurants can continue takeout, delivery, and outdoor dining. 

• The United States confirmed 187,918 new cases of COVID-19 yesterday per the Johns Hopkins University COVID-19 Dashboard, with 11 percent of the 1,715,181 tests reported coming back positive. An additional 1,362 deaths were attributed to the virus on Sunday, bringing the pandemic’s American death toll to 299,163. According to the COVID Tracking Project, 109,331 Americans are currently hospitalized with COVID-19.

COVID-19 Vaccine Rollout: “So Many Pieces Have to Work Just Right.”

The FDA officially granted emergency use authorization for the Pfizer-BioNTech COVID-19 vaccine on Friday, writing that “in making this determination, the FDA can assure the public and medical community that it has conducted a thorough evaluation of the available safety, effectiveness and manufacturing quality information.”

“The tireless work to develop a new vaccine to prevent this novel, serious, and life-threatening disease in an expedited timeframe after its emergence is a true testament to scientific innovation and public-private collaboration worldwide,” FDA Commissioner Stephen Hahn said.

Trucks began dispatching shipments from Pfizer’s production plant in Kalamazoo, Michigan, to all 50 states on Sunday morning.

Gen. Gustave Perna, chief operating officer for Operation Warp Speed, said during a Saturday morning news conference that 2.9 million doses of the Pfizer vaccine will be sent this week, including to 145 vaccination sites designated by the states on Monday, and an additional 491 sites on Tuesday and Wednesday.

Trump administration officials remain confident they will hit their goal of 20 million inoculations by year end. 

“We’ll be getting more and more Pfizer product, and we’ve got 12.5 million [doses] of Moderna product, assuming that we get approval at the end of this week,” Health and Human Services Secretary Alex Azar said yesterday. “So yeah, 20 million vaccinations this month. And then we think we’ll be up to 50 million total vaccinations—of people—by the end of January. And 100 million shots in arms by the end of February, just with the Moderna and Pfizer vaccines.”

Most states are expected to follow CDC recommendations by administering vaccines to health care workers and long-term care facility residents on Monday. The New York Timesreported Sunday that White House officials working in close proximity to the president will also be among the first Americans to receive Pfizer’s vaccine, but President Trump later said he requested an “adjustment be made” so that White House officials “receive the vaccine somewhat later in the program, unless specifically necessary.”

Distributors have developed contingency plans to prepare for inclement weather, refrigeration mishaps, or logistical miscommunications that could delay shipments or destroy entire batches of the vaccine. Local government officials have also taken steps to ensure that doctors’ offices, clinics, and pharmacies are sufficiently equipped with the proper quantities of masks, dry ice, needles, alcohol swabs, and syringes required for proper vaccine administration.

“We’re launching a very complex nationwide distribution program,” Azar said Sunday. “Do it right, do it measured, get the job done right, anticipate problems. But know there are going to be hitches and hiccups as we go, and we will work to solve it. This is the U.S. military that is running this operation. It’s what they do.”

“So many pieces have to work just right,” said Yossi Sheffi, director of the MIT Center for Transportation & Logistics and author of The New (Ab)Normal: Reshaping Business and Supply Chain Strategy Beyond Covid-19.

The Pfizer-BioNTech vaccine must be stored at minus-94 degrees Fahrenheit, which presents unprecedented challenges to supply chain management. Cargo planes and delivery trucks have been equipped with special dry ice containers that can be opened only twice per day to preserve their ultracold temperatures.

Once the vaccine vials are thawed and diluted with a 0.9 percent sodium chloride solution, they must be stored between 35 to 77 degrees Fahrenheit and administered within six hours. “The issue is that right now, the vaccine is coming in packages of about 1,000, and you have to dilute it to get about 5,000,” Sheffi told The Dispatch. “So 5,000 people have to come more or less the same day at the same time, same place. If only 4,000 people show up after six hours, you throw out 1,000 vaccines.” 

With the Pfizer vaccine—and the (hopefully) soon-to-be-approved Moderna vaccine—a second dose (either 21 or 28 days after the initial shot) is required to reach full efficacy. And this adds an additional level of complexity to distribution logistics. “The Johnson & Johnson vaccine has one huge advantage: You need one dose, not two,” Sheffi pointed out. “When you need two doses, you don’t only need all these 5,000 people to come to one place at one time. Three to four weeks later, you need exactly the same 5,000 people to come to the same place at the same time.”

Early trials show that Pfizer-BioNTech’s mRNA vaccine is 95 percent effective at preventing the spread of COVID-19 when administered in two doses. According to an FDA briefing report published Thursday, that efficacy rate drops to just 52.4 percent when a person receives only one dose (though that number may be higher, it’s skewed by the trial being designed for two doses). The government’s plan, as of now, is to only distribute half the vaccines available in December, saving the other half to provide initial recipients with their second dose.

But some argue we should be getting that first dose to as many people as possible now, and trust manufacturing will ramp up enough to have additional supply later on. “The idea that we need to cut [the doses] in half and give half of it now and hold onto it, so we have supply in January to get the second dose,” former FDA commissioner and Pfizer board member Scott Gottlieb told USA Today last week. “I just fundamentally disagree with that.”

The problem with that approach, however, is Pfizer and Moderna have not conducted any single-dose trials, and we don’t know the true effectiveness of the vaccines sans booster shot. Journalist Zeynep Tufekci makes the case here for beginning a single-dose trial, but most vaccine experts are hesitant to stray from the recommended guidelines. 

The next several months will bring with them incredible amounts of pain and suffering, and it’s a near certainty that things will go wrong in the vaccine distribution process. But today is a momentous day, and it could well be the beginning of the end of this dark period that began in March.

Operation Warp Speed head Moncef Slaoui told Fox News Sunday that the federal government hopes to immunize 100 million people with two doses of vaccines by the end of the first quarter of 2021. “Long-term care facility people, the elderly people with comorbidities, the [front-line] workers, the health care workers,” Slaoui said. “[That’s] about 120 million people.”

“We need to have immunized about 75 or 80 percent of the U.S. population before herd immunity can really be established,” Slaoui added. “We hope to reach that point between the month of May and the month of June.”

Gen. Perna made clear on Saturday that the country’s nationwide vaccine campaign will be one of the largest mass mobilizations of federal resources in decades. “D-Day was the beginning of the end. And that’s where we are today,” he said. “We are not taking a victory lap. We know that the road ahead of us will be tough. We know that situations will occur. But we will figure it out together collectively.”

Supreme Court Declines to Hear Texas v. Pennsylvania

On Friday, we filled you in on how a massive chunk of the national Republican Party apparatus—18 states and nearly two-thirds of the House GOP Conference—had thrown their weight behind Texas’ moonshot direct-to-SCOTUS lawsuit to throw out the election results in four swing states that voted for Joe Biden.

But by Friday night, the affair was already over. In a terse, half-page statement, the Supreme Court stated that Texas “had not demonstrated a judicially cognizable interest in the manner in which another State conducts its elections,” and declined to hear the case. Justice Alito, joined by Justice Thomas, wrote that he would have permitted Texas to file its complaint, but added that “I would not grant other relief.”

For all intents and purposes, this was the end of the line for Trump’s legal effort to overturn Biden’s electoral win. A number of lawsuits brought by the Trump campaign and affiliated entities have yet to be fully resolved, of course. But with the safe harbor date passed and state electors convening across the country to cast their votes today, the chance that any of those lawsuits will result in a second Trump term has fallen to zero.

After the electors vote, congressional Republicans will have one more procedural tool in their toolkit to gum up Biden’s election—at least for a bit. That opportunity will come January 6, the day Congress will gather to count the electoral votes. At that time, any one member of the House and one of the Senate can join forces to contest the electoral results from any state as not having been “lawfully certified,” compelling several hours of congressional debate and a vote in both chambers on the question.

Such a challenge would not go anywhere. As a legal matter, all Biden’s electors will have been lawfully certified, a fact reaffirmed by numerous courts over the last few weeks. More to the point, an objection to the electors would need to pass a vote in both the Republican-controlled Senate—already a tall order, although stranger things have happened—and the Democrat-controlled House. Let’s just say House Speaker Nancy Pelosi is unlikely to clamber aboard.

Still, such a maneuver would offer one more opportunity for Republicans to declare their ongoing loyalty to Trump in an official setting. Rep. Mo Brooks of Alabama has already stated his intention to go forward with the stunt; whether he’ll receive an assist from the upper chamber remains to be seen.

But the fact that this procedural move is the last option available to the stop-the-steal crowd makes one thing clear: The Supreme Court’s rejection of the Texas lawsuit has closed the door on any real hope Trump and his supporters had of eventually pulling off a miracle eleventh-hour victory over Biden.

As this fact becomes apparent even to the most confident true believers, tensions may continue to rise. In Washington, things were already at the boiling point over the weekend following the Supreme Court’s decision. Trump supporters—including members of the far-right group the Proud Boys—rallied in front of the Supreme Court and near the White House Saturday. Counter-protesters and members of Antifa assembled across the city as well. Although police tried to keep the factions apart, violence broke out at several points; several police officers were injured and several protesters were stabbed.

Worth Your Time

• If—even after today’s TMD write up—you still have lingering questions about the vaccine approval process and next steps, we can’t recommend this Ari Melber interview with Dr. Tony Fauci highly enough. He walks through each bar the Pfizer vaccine had to clear to get to this point, and why we can trust that it is safe and effective.

• On October 15, Andrew McCarthy made the case for voting for Donald Trump in the pages of National Review. He has supported the president for years now. But in a piece published yesterday, he shreds the Trump legal team for failing to present evidence in court of the widespread voting fraud claims it makes on social media and on TV. “Every time a court offers [the president] an opportunity to establish by proof what he is promoting by Twitter, Team Trump folds. Why is that?”

• In the final entry of his “Letters to Washington” series, Politico’s Tim Alberta recounts the innumerable conversations he’s had with voters around the country this year, and settles on 20 who best explain the 2020 election. “They are not a statistically perfect sample of the electorate. They will not check every box or speak to every possible viewpoint of the roughly 160 million Americans who voted this year,” he writes. “What they will do, both individually and collectively, is provide a depth of perspective that cannot be captured in infographic maps or exit polls or social media posts. With half of this country bewildered by the motivations and rationales of the other half, these 20 citizens can help us understand this moment in America—and maybe, just maybe, understand each other.” 

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Toeing the Company Line

• In the wake of the “Jericho March” featuring Eric Metaxas and other Christian leaders, David’s Sunday French Press looks at the “frenzy and the fury of the post-election period,” and how it has “laid bare the sheer idolatry and fanaticism of Christian Trumpism.” Evangelicalism is currently being mobilized in support of “a form of fanaticism that can lead to deadly violence,” David argues. “While I hope and pray that protests remain peaceful and that seditious statements are confined to social media, we’d be fools to presume that peace will reign.”

• In his Friday G-File, Jonah explains why he has never been more disgusted by his own “side” than in the aftermath of this year’s election. “Asininity is gaining steam,” he writes, and it’s evidenced by the ever-growing pool of Republican senators and representatives hopping aboard the “rigged election” train. “These right-wingers are running in terror from doing the right thing while telling themselves that it’s okay, because the Supreme Court will do their work for them. They don’t care about the damage they’re doing to conservative arguments, because they either never really cared about those arguments in the first place, or because they don’t care enough about them now to speak up.” Jonah expands on this—and more—in Saturday’s episode of the Ruminant.

• Ilya Shapiro, director of the Robert A. Levy Center for Constitutional Studies at the Cato Institute, joined Sarah and Steve on Friday’s Dispatch Podcast to chat through Texas Attorney General Ken Paxton’s attempt to undermine the outcome of the election.

• In the Late Week Mop-Up, Andrew spoke with Baoky Vu, the Republican-appointed vice chair of the board of elections in Georgia’s DeKalb County, about the systems in place to prevent fraud and the signature matching process. “The funny thing,” Vu said, “is that the initial opening of [ballot envelopes] requires that we have vote review panels to review that already. And it was actually the Republican legislature and Republican officials who in years past passed decisions that basically said ballots can’t be opened and you can’t verify a ballot to a signature, because that would defy privacy requirements.”

Let Us Know

Where do you fall on the one-dose, two-dose question? Would you prioritize getting at least one shot to as many people as possible (without necessarily knowing how effective or long-lasting it will be), or maximizing efficacy by following the clinical trial guidelines?

Reporting by Declan Garvey (@declanpgarvey), Andrew Egger (@EggerDC), Haley Byrd Wilt (@byrdinator), Audrey Fahlberg (@FahlOutBerg), Charlotte Lawson (@charlotteUVA), and Steve Hayes (@stephenfhayes).