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Alex Azar’s resignation letter paints a misleading picture of Trump’s coronavirus response

The HHS secretary warns Trump against inciting more violence but obscures the reality of his own legacy.

HHS Secretary Azar Speaks At Vaccination Kickoff At GW University Hospital
Health and Human Services Secretary Alex Azar speaks at George Washington University Hospital on December 14, 2020 in Washington, DC.
Jacquelyn Martin-Pool/Getty Images

Health and Human Services Secretary Alex Azar this week warned President Donald Trump that, despite what he described as achievements by HHS under his watch, Trump’s “actions and rhetoric following the election ... threaten to tarnish these and other historic legacies of this administration.”

“The attacks on the Capitol were an assault on our democracy,” Azar said in a letter released this week ahead of his departure from the government on January 20. “I implore you to continue to condemn unequivocally any form of violence ... and continue to support unreservedly the peaceful and orderly transition of power.”

Despite its rebuke of Trump, however, Azar’s letter of resignation, effective at noon on Inauguration Day, is more of a formality than anything. Two Trump cabinet secretaries resigned in protest earlier in January following the deadly attack on the US Capitol, but Azar was not among them.

In December, President-elect Joe Biden nominated California attorney general Xavier Becerra to replace Azar as HHS secretary in the Biden administration.

Political appointees usually submit resignation letters well before a new administration takes power, but until recently, according to the New York Times, Trump had been reluctant to request them as he continued to wage a doomed crusade against American democracy in a futile attempt to stay in office.

Last week, however, the Trump administration conceded to reality and requested those letters from the 4,000 or so political appointees currently serving in government — including Azar.

In addition to using his letter as a warning to Trump — who this week was impeached for a second time for inciting insurrection — Azar also rattled off a list of accomplishments in his approximately three-year tenure with HHS (Azar is the second HHS secretary of the Trump administration).

A diverse collection of initiatives — drug pricing, the opioid crisis, and rural health care disparities, to name a few — get a mention, but the Trump administration’s failed coronavirus response receives top billing in the letter.

“While we mourn every lost life,” Azar wrote of the coronavirus pandemic, which has now killed more than 392,000 people in the US, “Our early, aggressive, and comprehensive efforts saved hundreds of thousands or even millions of Americans lives.”

In reality, much of the Trump administration’s coronavirus response — from its earliest days to the present day, when the country is reporting an average of 231,675 cases per day — has been flailing and incompetent, and even the US vaccine rollout has devolved into something of a disaster, with early vaccination numbers badly lagging administration targets and even some doses of the vaccine being discarded unnecessarily.

Nevertheless, Azar lauded Operation Warp Speed — the Trump administration’s vaccine push — in his letter, which he claims “achieved in nine months what many doubted would be possible in a year and a half or more.”

That’s not entirely untrue: As Vox’s Umair Irfan explained in December, developing a vaccine as quickly as the Pfizer-BioNTech and Moderna coronavirus vaccines were created is, in fact, an “unmatched scientific feat.”

But again, the part of the vaccine effort meant to be directly handled by the Trump administration — namely, the distribution of the vaccine created by scientists in the private sector — has been full of costly mistakes.

Even as recently as this week, as the US approaches the one-year anniversary of the first known Covid-19 case in the country, there have been fumbles. Though Azar told states earlier this week that the administration would begin releasing vaccine doses previously held in reserve for a second shot, it turns out there aren’t any to release.

According to a Washington Post scoop Friday, the Trump administration had already begun shipping those doses late last year, leaving the vaccine stockpile largely depleted.

The miscommunication will likely have consequences at a state level. According to Oregon health director Patrick Allen in a letter to Azar, the lack of additional doses “puts our plans to expand eligibility at grave risk. Those plans were made on the basis of reliance on your statement about ‘releasing the entire supply’ you have in reserve. If this information [about the depleted vaccine reserve] is accurate, we will be unable to begin vaccinating our vulnerable seniors on Jan. 23, as planned.”

Biden has an ambitious plan to fix the US Covid-19 response

The incoming Biden administration, however, has pledged to fix the US coronavirus response and accelerate the pace of vaccinations, with a target of 100 million vaccine doses administered within the first 100 days in office.

“This will be one of the most challenging operational efforts we’ve ever undertaken as a nation,” Biden said Thursday of the US vaccine effort. “We’ll have to move heaven and earth to get more people vaccinated, to create more places for them to get vaccinated, to mobilize more medical teams to get shots in peoples’ arms.”

Rather than inheriting Operation Warp Speed, according to incoming Biden press secretary Jen Psaki, the new administration will create its own vaccine program, with former Chicago health commissioner Bechara Choucair spearheading the effort as vaccine coordinator.

According to Vox’s German Lopez, the federal government will also take a more prominent role in administering vaccines under the Biden administration, with the Federal Emergency Management Agency and National Guard units both helping to set up new vaccine clinics.

Additionally, the Biden plan, the most detailed form of which yet was released on Friday, calls for expanded vaccine eligibility, more rigorous use of the Defense Production Act to accelerate vaccine production, more public health workers, and an education campaign promoting vaccination.

Those initiatives will likely also be backed by a major infusion of funding: Biden announced a $1.9 trillion stimulus package plan this week, including — should Congress approve it — $400 billion for the US coronavirus response.

As Lopez writes, it’s a promising start:

Biden’s plan hits many of the marks that I’ve heard from experts over the past few weeks as I’ve asked them about what’s going wrong with America’s vaccine rollout.

First, the plan has clear goals to address what supply chain experts call the “last mile” — the path vaccines take from storage to injection in patients — by making sure there’s enough staff, infrastructure, and planning to actually put shots in arms. Second, it takes steps to ensure that supply chain problems are fixed proactively, with careful monitoring and use of federal powers when needed to address bottlenecks. Last, but just as crucially, there’s a public education campaign to ensure that Americans actually want to get vaccinated when it’s their turn.

Still, implementation won’t be easy, and there’s need for haste: The US reported more than 4,000 deaths in a single day for the first time ever earlier this month and continues to report well over 200,000 new cases per day on average.

The Centers for Disease Control and Prevention also warned this week that a recently discovered more transmissible strain of Covid-19 is spreading quickly in the US and could lead to even more catastrophic numbers of cases and deaths in the near future. Rapid vaccination is seen as the best way to limit the threat posed by this new strain and to reduce the number of new cases overall.

“We’re about to be in the worst of it,” CDC Director Robert Redfield warned Friday in an NPR interview. “And I think if you’d listened to my comments in August and September, I told people that I really thought that the, December, January and February were going to be the roughest time this nation’s ever, ever experienced from a public health point of view.”

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