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特朗普政府承諾的“疫苗儲(chǔ)備”實(shí)為噱頭?美各州抗疫再度陷入混亂

David Z. Morris
2021-01-18

這種情況導(dǎo)致一線醫(yī)護(hù)人員和老年人可能面臨更加激烈的競(jìng)爭(zhēng),要與那些感染風(fēng)險(xiǎn)較低的美國(guó)人爭(zhēng)搶數(shù)量有限的疫苗。

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由美國(guó)聯(lián)邦政府提出的、讓各州擴(kuò)大疫苗接種資格的建議似乎并沒有可靠的依據(jù)——因?yàn)榇饲?,特朗普政府的高?jí)官員就“擴(kuò)大疫苗供應(yīng)范圍”的聲明模棱兩可。這可能會(huì)給美國(guó)已經(jīng)瀕臨崩潰的疫苗分發(fā)工作帶來更多的混亂,尤其會(huì)對(duì)一線醫(yī)護(hù)人員和老年人造成傷害——現(xiàn)在,他們可能面臨更加激烈的競(jìng)爭(zhēng),要與那些感染風(fēng)險(xiǎn)較低的美國(guó)人爭(zhēng)搶數(shù)量有限的疫苗。

1月12日,聯(lián)邦官員和美國(guó)疾病與預(yù)防控制中心(CDC)建議各州開始向年齡在65歲以上、或者更年輕,但感染風(fēng)險(xiǎn)較大的居民開放疫苗接種資格。當(dāng)天,美國(guó)衛(wèi)生與公共服務(wù)部(Health and Human Services)的部長(zhǎng)亞歷克斯?阿扎宣布,“曲速行動(dòng)”(Operation Warp Speed)將再投放一批庫存疫苗,以防供應(yīng)鏈中斷。同一天,美國(guó)公共衛(wèi)生局(U.S. Surgeon General)的局長(zhǎng)杰羅姆?亞當(dāng)斯說:“我們有足夠的(疫苗)儲(chǔ)備,可以開始投放使用?!?/p>

許多州已經(jīng)將疫苗接種資格擴(kuò)大到65歲以上的任何人。但是,也有其他一些州,包括紐約州、俄勒岡州和康涅狄格州都遵循美國(guó)疾病與預(yù)防控制中心先前的指令,重點(diǎn)為醫(yī)護(hù)人員和住院的病人接種。在1月12日的提議及隨之承諾的“更多供應(yīng)”之后,接種的大門才為65歲以上的全體人群敞開。

但是,根據(jù)1月16日《華盛頓郵報(bào)》(Washington Post)的報(bào)道,承諾的疫苗儲(chǔ)備根本就是空頭支票。盡管有阿扎和亞當(dāng)斯的聲明背書,但“曲速行動(dòng)”的負(fù)責(zé)人克里斯托弗?夏普斯滕告訴《華盛頓郵報(bào)》,任何所謂存在“聯(lián)邦疫苗儲(chǔ)備”的說法都是“不實(shí)的謠言”。據(jù)報(bào)道,在阿扎公開聲明后,一些州的衛(wèi)生官員就直接被“曲速行動(dòng)”的工作人員告知,他們的撥款實(shí)際上并不會(huì)增加。其他人則是直到幾天之后,才收到每周的疫苗分配計(jì)劃不會(huì)改變的消息。

各州官員的反應(yīng)一直很激烈。華盛頓州的州長(zhǎng)杰伊?英斯利在推特(Twitter)上發(fā)表聲明說:“必須立即對(duì)這種欺騙做出回應(yīng)?!倍砝諏莸闹蓍L(zhǎng)凱特?布朗是遵循建議、擴(kuò)大本州疫苗覆蓋人群范圍的州官員之一。她寫道:“我感到震驚至極,他們提出的是自己無法實(shí)現(xiàn)的期望,產(chǎn)生了如此嚴(yán)重的后果……俄勒岡州的老年人、老師,我們所有人,都仰賴著聯(lián)邦儲(chǔ)備中承諾給我們俄勒岡州的那部分疫苗?!倍砝諏菪l(wèi)生局(Oregon Health Authority)的發(fā)言人在接受《財(cái)富》雜志采訪時(shí),將這種反轉(zhuǎn)描述為“釜底抽薪”——把他們的家底都掀翻了。

擴(kuò)大疫苗接種資格的努力本身就是對(duì)疫苗開始分發(fā)流通的回應(yīng)——疫苗此前一直被批評(píng)太慢、審批太嚴(yán)格,因而各州都期望在聯(lián)邦政府只能提供較少援助的情況下,制定自己的機(jī)動(dòng)計(jì)劃。即將上任的拜登政府也已經(jīng)發(fā)出信號(hào),表示也有類似計(jì)劃,即擴(kuò)大接種人群資格的范圍。

但是,如果疫苗的供應(yīng)沒有隨之跟上,擴(kuò)大接種人群可能會(huì)讓本已不容樂觀的情況進(jìn)一步惡化。

紐約衛(wèi)生部(New York Health Department)在一份發(fā)出不久即被刪除的聲明中說,在該州擴(kuò)大了接種資格的幾個(gè)小時(shí)之后,未來14周的預(yù)訂就已經(jīng)滿員了。該部門指出,擴(kuò)大接種范圍的要求意味著現(xiàn)在有700萬紐約人有資格接種疫苗,但每周聯(lián)邦政府運(yùn)來的只有30萬劑新的補(bǔ)給。該聲明于1月13日發(fā)布,但在1月14日做出了一些修改,把某些用語說得更為含糊。

各州能夠通過取消此前擴(kuò)大的接種資格范圍來應(yīng)對(duì)供應(yīng)短缺的狀況,給聯(lián)邦政府敲響警鐘。但除此之外,特朗普政府的假承諾將對(duì)包括一線和基層醫(yī)護(hù)人員,以及75歲以上的老年人在內(nèi)的群體產(chǎn)生最壞的影響——如果沒有這種假承諾,他們將有資格接種到疫苗,而且現(xiàn)在不必與更多人競(jìng)爭(zhēng)。

“以這種方式擴(kuò)大疫苗接種范圍時(shí),最有能力利用新的優(yōu)先接種級(jí)別的人通常是那些有資源、有時(shí)間,并且往往有較高收入的人?!眲P撒家庭基金會(huì)(KFF,前名為Kaiser Family Foundation)的健康政策全球副總裁喬什?米肖說。“而沒有獲取信息的網(wǎng)絡(luò),沒有時(shí)間和耐心去解決這一切問題的人就會(huì)落后?!?/p>

這種情況還突出表明,總體而言,疫苗的供應(yīng)缺乏透明度。米肖說:“作為旁觀者,我們幾乎對(duì)這個(gè)‘曲速行動(dòng)’認(rèn)為他們可以拿到多少劑量一無所知。這是一項(xiàng)被重重包圍的秘密”,這讓各州不得不更加依賴官員的言論提供信息,無論他們的說是否屬實(shí)。(財(cái)富中文網(wǎng))

Sy Mukherjee提供了其他相關(guān)報(bào)道。

編譯:陳聰聰

由美國(guó)聯(lián)邦政府提出的、讓各州擴(kuò)大疫苗接種資格的建議似乎并沒有可靠的依據(jù)——因?yàn)榇饲埃乩势照母呒?jí)官員就“擴(kuò)大疫苗供應(yīng)范圍”的聲明模棱兩可。這可能會(huì)給美國(guó)已經(jīng)瀕臨崩潰的疫苗分發(fā)工作帶來更多的混亂,尤其會(huì)對(duì)一線醫(yī)護(hù)人員和老年人造成傷害——現(xiàn)在,他們可能面臨更加激烈的競(jìng)爭(zhēng),要與那些感染風(fēng)險(xiǎn)較低的美國(guó)人爭(zhēng)搶數(shù)量有限的疫苗。

1月12日,聯(lián)邦官員和美國(guó)疾病與預(yù)防控制中心(CDC)建議各州開始向年齡在65歲以上、或者更年輕,但感染風(fēng)險(xiǎn)較大的居民開放疫苗接種資格。當(dāng)天,美國(guó)衛(wèi)生與公共服務(wù)部(Health and Human Services)的部長(zhǎng)亞歷克斯?阿扎宣布,“曲速行動(dòng)”(Operation Warp Speed)將再投放一批庫存疫苗,以防供應(yīng)鏈中斷。同一天,美國(guó)公共衛(wèi)生局(U.S. Surgeon General)的局長(zhǎng)杰羅姆?亞當(dāng)斯說:“我們有足夠的(疫苗)儲(chǔ)備,可以開始投放使用。”

許多州已經(jīng)將疫苗接種資格擴(kuò)大到65歲以上的任何人。但是,也有其他一些州,包括紐約州、俄勒岡州和康涅狄格州都遵循美國(guó)疾病與預(yù)防控制中心先前的指令,重點(diǎn)為醫(yī)護(hù)人員和住院的病人接種。在1月12日的提議及隨之承諾的“更多供應(yīng)”之后,接種的大門才為65歲以上的全體人群敞開。

但是,根據(jù)1月16日《華盛頓郵報(bào)》(Washington Post)的報(bào)道,承諾的疫苗儲(chǔ)備根本就是空頭支票。盡管有阿扎和亞當(dāng)斯的聲明背書,但“曲速行動(dòng)”的負(fù)責(zé)人克里斯托弗?夏普斯滕告訴《華盛頓郵報(bào)》,任何所謂存在“聯(lián)邦疫苗儲(chǔ)備”的說法都是“不實(shí)的謠言”。據(jù)報(bào)道,在阿扎公開聲明后,一些州的衛(wèi)生官員就直接被“曲速行動(dòng)”的工作人員告知,他們的撥款實(shí)際上并不會(huì)增加。其他人則是直到幾天之后,才收到每周的疫苗分配計(jì)劃不會(huì)改變的消息。

各州官員的反應(yīng)一直很激烈。華盛頓州的州長(zhǎng)杰伊?英斯利在推特(Twitter)上發(fā)表聲明說:“必須立即對(duì)這種欺騙做出回應(yīng)。”俄勒岡州的州長(zhǎng)凱特?布朗是遵循建議、擴(kuò)大本州疫苗覆蓋人群范圍的州官員之一。她寫道:“我感到震驚至極,他們提出的是自己無法實(shí)現(xiàn)的期望,產(chǎn)生了如此嚴(yán)重的后果……俄勒岡州的老年人、老師,我們所有人,都仰賴著聯(lián)邦儲(chǔ)備中承諾給我們俄勒岡州的那部分疫苗?!倍砝諏菪l(wèi)生局(Oregon Health Authority)的發(fā)言人在接受《財(cái)富》雜志采訪時(shí),將這種反轉(zhuǎn)描述為“釜底抽薪”——把他們的家底都掀翻了。

擴(kuò)大疫苗接種資格的努力本身就是對(duì)疫苗開始分發(fā)流通的回應(yīng)——疫苗此前一直被批評(píng)太慢、審批太嚴(yán)格,因而各州都期望在聯(lián)邦政府只能提供較少援助的情況下,制定自己的機(jī)動(dòng)計(jì)劃。即將上任的拜登政府也已經(jīng)發(fā)出信號(hào),表示也有類似計(jì)劃,即擴(kuò)大接種人群資格的范圍。

但是,如果疫苗的供應(yīng)沒有隨之跟上,擴(kuò)大接種人群可能會(huì)讓本已不容樂觀的情況進(jìn)一步惡化。

紐約衛(wèi)生部(New York Health Department)在一份發(fā)出不久即被刪除的聲明中說,在該州擴(kuò)大了接種資格的幾個(gè)小時(shí)之后,未來14周的預(yù)訂就已經(jīng)滿員了。該部門指出,擴(kuò)大接種范圍的要求意味著現(xiàn)在有700萬紐約人有資格接種疫苗,但每周聯(lián)邦政府運(yùn)來的只有30萬劑新的補(bǔ)給。該聲明于1月13日發(fā)布,但在1月14日做出了一些修改,把某些用語說得更為含糊。

各州能夠通過取消此前擴(kuò)大的接種資格范圍來應(yīng)對(duì)供應(yīng)短缺的狀況,給聯(lián)邦政府敲響警鐘。但除此之外,特朗普政府的假承諾將對(duì)包括一線和基層醫(yī)護(hù)人員,以及75歲以上的老年人在內(nèi)的群體產(chǎn)生最壞的影響——如果沒有這種假承諾,他們將有資格接種到疫苗,而且現(xiàn)在不必與更多人競(jìng)爭(zhēng)。

“以這種方式擴(kuò)大疫苗接種范圍時(shí),最有能力利用新的優(yōu)先接種級(jí)別的人通常是那些有資源、有時(shí)間,并且往往有較高收入的人。”凱撒家庭基金會(huì)(KFF,前名為Kaiser Family Foundation)的健康政策全球副總裁喬什?米肖說?!岸鴽]有獲取信息的網(wǎng)絡(luò),沒有時(shí)間和耐心去解決這一切問題的人就會(huì)落后?!?/p>

這種情況還突出表明,總體而言,疫苗的供應(yīng)缺乏透明度。米肖說:“作為旁觀者,我們幾乎對(duì)這個(gè)‘曲速行動(dòng)’認(rèn)為他們可以拿到多少劑量一無所知。這是一項(xiàng)被重重包圍的秘密”,這讓各州不得不更加依賴官員的言論提供信息,無論他們的說是否屬實(shí)。(財(cái)富中文網(wǎng))

Sy Mukherjee提供了其他相關(guān)報(bào)道。

編譯:陳聰聰

A federal recommendation that states expand eligibility for the coronavirus vaccine appears to have been premised on inaccurate claims about expanded vaccine availability by high-ranking Trump administration officials. That could add even more chaos to a U.S. vaccine rollout already characterized by dysfunction, with particular harm to frontline workers and the elderly, who may now face much stiffer competition from lower-risk Americans for a place in line.

On January 12, federal officials and the CDC recommended that states open up vaccine eligibility to anyone over the age of 65 or younger residents with added risk factors. The same day, Health and Human Services Secretary Alex Azar announced that Operation Warp Speed would release a stockpile of doses that had been held as insurance against supply-chain disruptions. Also on January 12, U.S. Surgeon General Jerome Adams said that “we have enough [vaccine] in reserve that we can just start pushing those doses out there.”

Many states have already expanded eligibility to anyone over 65. But states including New York, Oregon, and Connecticut focused on vaccinating health workers and nursing home residents, following prior CDC guidelines. They opened the doors to those over 65 only after January 12’s recommendations and the accompanying promise that more supply was on the way.

But according to reporting on January 16 from the Washington Post, the promised vaccine reserves simply aren’t there. Despite the statements from Azar and Adams, Operation Warp Speed director Christopher Sharpsten told the Post that the existence of any federal vaccine reserve was a “false rumor.” After Azar's public statements, some state health officials reportedly heard directly from Operation Warp Speed officials that their allocations would not in fact increase. But others did not find out until days later when they received unchanged weekly distribution plans.

Response from state officials has been scathing. In a statement posted on Twitter, Washington Gov. Jay Inslee said, “The Trump admin. must answer immediately for this deception.” Oregon Gov. Kate Brown, whose state was among those who followed the recommendation to expand access, wrote: “I am shocked and appalled that they have set an expectation on which they could not deliver, with such grave consequences…Oregon’s seniors, teachers, all of us, were depending on the promise of Oregon’s share of the federal reserve of vaccines being released to us.” A spokesperson for the Oregon Health Authority described the reversal as "having the rug pulled out from under us" in an interview with Fortune.

The push to expand eligibility was itself a response to a vaccine rollout that has been criticized as too slow and restrictive, in part because every state has been expected to develop its own plans, with little federal assistance. The incoming Biden administration had already signaled that it planned a similar eligibility expansion.

But without expanded supply to match, the changes have likely made the already disheartening situation even worse.

In a since-deleted statement, the New York Health Department said that appointments were fully booked for the next 14 weeks, just hours after the state had expanded eligibility. The agency pointed out that the looser requirements meant 7 million New Yorkers were now eligible to be vaccinated, but only 300,000 new doses were being delivered from the federal government each week. The statement was posted on January 13 but replaced on January 14 with less specific language.

States may respond to the revelation of missing supplies by reversing their expansions of eligibility. But short of that, the head fake by the Trump administration will have the worst effects on groups including frontline and essential workers and those over 75, who would have otherwise been eligible and wouldn't have had to compete with the much larger group now in the running.

“When you open it up this way, often the people who are best poised to take advantage of the new prioritization are those who have the resources, have the time, and tend to have higher income,” says Josh Michaud, associate director of Global Health Policy for KFF (formerly the Kaiser Family Foundation). “People who don’t have the information networks, who don’t have the time and patience to go through and figure all this out, they get left behind.”

The situation also highlights the lack of transparency about vaccine supply in general. “From the outside looking in, we have very little visibility into how many doses Operation Warp Speed thinks they’ll be getting,” says Michaud. “This has been shrouded in secrecy,” leaving states more dependent on statements from officials—whether they’re true or not.

Additional reporting provided by Sy Mukherjee.

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