Dr. Atul Gawande on why COVID-19 vaccinations will test American society

The distribution of COVID-19 vaccines in America will test a deeply divided society, and not just because of mistrust in vaccinations, Atul Gawande, MD, told New Yorker Editor David Remnick. 

Dr. Gawande, longtime contributor to the New Yorker and member of President-Elect Joe Biden's COVID-19 task force, described the distribution of COVID-19 vaccines as the most challenging undertaking of the past year. 

"We have deployed north of 120 million coronavirus tests in the course of eight months. This is going to be 330 million vaccinations, done twice, and hoping to accomplish it in the course of six months or less," said Dr. Gawande, who is also a surgeon at Boston-based Brigham and Women's Hospital and a professor at Harvard Medical School. 

Clear challenges lie in vaccine production, FDA approval and the supply chain. But there is something larger at bay, too: The intensity of people clamoring for themselves and their families to be vaccinated as soon as possible will likely exceed the intensity of other divisions formed in 2020, such as those over lockdowns or face masks. Fierce public demand matched with a relatively subjective prioritization process runs the risk of people seeing the Great American Vaccination as rigged. To prove otherwise — that vaccines are distributed fairly and rationally — is the ultimate opportunity for leaders in healthcare, public health and government. 

"Think about it. The bus drivers never came before the bankers before," said Dr. Gawande. "You're going to have Zoom workers who want to go back to normal, and I cannot blame the number of people who will say, 'You know, thank God I can finally not be in fear. Let me get the vaccine. What do you mean, I have to wait five months?'"

"I can imagine a million ways [of jumping the line], people paying someone $2,500 to get your work I.D. tag. This is all about rallying people together. It can't just be about the rules. It has to be about how we all understand this and work together to say, 'These are the folks most at risk. They make our subways work. They make our buses work. They get our food supply to us. They make it possible for me to go grocery shopping, and I'll just have to wait three or four months for my turn.'"

And as for distrust in vaccinations and science, the recommendation from the CDC panel for healthcare workers to be among the first to receive the vaccine could be effective for social influence, Dr. Gawande says. "Healthcare workers are everywhere, which means we're all going to know people who got vaccinated, and we're going to see that they did all right."

Read Dr. Gawande's interview with Mr. Remnick in full here

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