Andrew Cuomo's vaccine disaster

New York Governor Andrew Cuomo sure is full of himself. The man overseeing the state with the second-worst rate of coronavirus deaths — about twice as bad as Florida — recently published a book boasting about his response to the pandemic, right before the virus got completely out of control in his state, again. Whereas nearby Philadelphia has got its numbers at least trending in the right direction over the last month, with a decline of about half since November, in New York City they have continued to increase steadily since October.

Now that the vaccine is available, Cuomo is making another entirely characteristic mess of things. He is not only meddling with every aspect of distribution, but is so hideously incompetent that shots are getting administered at a glacial pace. It's just what he does.

Long before the coronavirus pandemic began, New York state had a carefully-crafted mass vaccination plan, developed in part with federal grants, which was centered around county public health departments and had been practiced regularly for years. But since the coronavirus vaccine has been approved, Cuomo has seized control of the process without explanation, ignored the plan, and is running distribution through hospitals.

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Cuomo is so possessed by conservative desertist ideology, the idea that government benefits should only be allocated to people who deserve them, that until recently hospitals were supposed to use a Byzantine "matrix" to determine precisely who needs shots the most. The New York Times reports: "The state had advised clinics and other facilities to rank employees through a matrix that takes into account age, comorbidities, occupation, and the section of the facility where the person works." Cuomo threatened that any hospital caught ignoring prioritization rules would be fined $1 million. But then, because people were criticizing him about the slow pace of vaccination, he also said hospitals that failed to distribute their allotments within a week of receiving them would not get any more. The rules were loosened somewhat on Monday, but reportedly New York City still can't get approval for inoculating anyone in the general population over 75.

As a result, the rate of vaccination is pitiful: New York state had only used a third of its supply as of Tuesday morning, and New York City less than a quarter. About 1.5 percent of state residents have been vaccinated — half the rate of South Dakota or West Virginia. Shots are basically not happening outside of normal business hours. County officials are furious, though most will not go on the record for fear of Cuomo's notorious vindictive streak. "In Albany County, officials have privately said they could vaccinate the population of the southern half of the county in a few days if they were given the coronavirus vaccines and allowed to mobilize their plan," reports the Times Union.

When he isn't bungling the vaccine rollout, Cuomo is pointing fingers, mainly at hospitals and county officials. "This is a management issue for the hospitals," he said recently, neatly ignoring who dumped the responsibility in their laps in the first place, not to mention who saddled them with so many complicated requirements.

Perhaps the most maddening thing about this enormous mess is that distributing vaccines is quite easy. You send out the vaccine, and then — stay with me here — you inject it into people's arms. Back in 1947, New York City vaccinated 6.4 million people against smallpox in less than a month. Then-Commissioner of Health Israel Weinstein accomplished this by scouring the country for vaccines, distributing them across the city, and going on the radio to urge people to come get their shots, for free. We're not talking about the moon landing here.

Even today, when the reasonably competent government of the 1940s seems like an impossible dream world, this can be achieved. For instance, one hospital in Ukiah, California (population 16,000), recently had its freezer break down, thawing out its vaccine supply, and hurriedly vaccinated over 800 people in two hours so it wouldn't go to waste — or nearly 1 percent of what New York City has managed since mid-December. Most Americans are desperate for vaccines and will jump at the chance to get one.

This illustrates an important point: While obviously some people need the vaccine much more than others, the key thing is to get shots into arms as fast as we possibly can — especially when a new, more contagious strain is spreading fast. Once frontline health care workers have got theirs, the overwhelmingly vital task is to get to herd immunity at the greatest possible speed. Prioritizing distribution is supposed to help the most vulnerable, but when complicated rules snarl up the rate of vaccination, more of those people will be killed in the end.

Now, it's not all bad news. As Greg Sargent reports at The Washington Post, the incoming Biden administration is reportedly looking to drastically step up federal involvement in the vaccine rollout with money and coordination, which should help with both supply and distribution. Given that the Trump administration has done basically nothing, that should be a huge upgrade, even if it's short of Taiwan-style competence.

But Cuomo unquestionably could have done much better than he has. Unfortunately, his compulsion to constantly remind everyone that he is in charge is not coupled to even slight managerial competence. So long as he remains at the helm of New York state, he will be a hindrance to just or efficient government.