As the world continues to grapple with the deadly coronavirus pandemic, some potentially good medical news has developed.  In recent weeks, two major pharmaceutical companies claim to have developed vaccines that are far more successful than anyone had expected in protecting the public from COVID-19.

While these statements are welcome news, the reports are based on internal analyses that have not been independently reviewed.  Nevertheless, the reports – if borne out – are significant and potentially good news for the world.

Of course, it’s important for the public to stay vigilant.  These two companies – and the others that are sure to join with vaccines of their own – make money if their drugs are sold.  They have an incredible incentive to sugar-coat their findings and the underlying research.  The bad behavior of pharmaceutical companies over the decades should give all Americans legitimate concern over the release of as-yet-not-independently-verified data and should stiffen the resolve of federal regulators to rigorously validate safety and efficacy claims.

The two companies are longtime pharmaceutical giant Pfizer and Moderna.  Pfizer announced its results first soon followed by Moderna.  Each claimed that their vaccines are about 95 percent effective.  Assuming that these claims are verified by independent reviews, the nation would move to the distribution phase where there are immense logistical issues that will need to be addressed.  Both vaccines require two dosages, three or four weeks apart depending on the vaccine.  One important challenge will be ensuring that people get both shots and that they receive the booster that correctly corresponds with the strain in their initial vaccine.  Late last week, Pfizer submitted its research and findings to the Food and Drug Administration (FDA), which approves medicines in America.

Adding to the challenges, both vaccines require very careful handling.  Both must be kept cold, in refrigerators and freezers. Pfizer’s vaccine requires storage at an incredibly cold minus 94 degrees Fahrenheit.  Safely shipping and storing these vaccines for distribution will be an incredible logistical challenge. 

Then there is the challenge of distribution to people.  Under ideal circumstances the logistics of transporting these medicines from manufacturing facilities to the public would be daunting – in the U.S. alone that’s more than 600 million dosages, two for each American.  Misinformation, disinformation, public skepticism, and Trump’s mishandling of the pandemic, all exacerbate the challenge.

The challenges of getting the medicines from the factories to local storage facilities and then administered to hundreds of millions – billions worldwide – is going to be an incredible feat.

Government will, of course, be the linchpin for a successful national vaccination effort.  There are no other institutions with the capacity and authority to make it happen.

The Trump Administration’s plan is called “Warp Speed,” which aims to stockpile and distribute to the states the vaccines that are ultimately approved for use by the FDA.  The stated aim of this effort is to deliver 300 million doses of COVID-19 vaccine by January 2021.

According to statements from the Trump Administration, it says that it will work with states to distribute vaccines relying on pharmacies as the backbone of its efforts. 

Here in New York, according to the State Education Department which regulates pharmacies, there are over 5,300 licensed pharmacies in the state.  It is expected that they should have the capacity to handle the delicate vaccines.

While there are many pharmacies, the federal plan issued late last month by the CDC and the New York State plan issued in October recognize the limitations of relying solely on pharmacies and have identified additional routes to distribute the vaccines.

But the biggest challenge will be convincing the public that they should get the vaccine.  As in any other campaign, members of the public respond best when the public health message comes from a trusted source.  Americans are skeptical of statements from public officials and the Trump Administration’s tortured response to the pandemic and its reprehensible reactions to its re-election loss makes that situation worse.

In many ways, it will take a public outreach effort not unlike the one used to get people to comply with the census to educate New Yorkers about the vaccine.  Unless the vast majority of Americans are persuaded that the vaccine is safe and effective for them and their families, the pandemic fight will be needlessly prolonged, and more lives put at risk.

As the nation – and the world – tries to grapple with the COVID-19 pandemic, the fight to combat the ongoing climate catastrophe caused by global warming must be a priority. 

One crisis threatens tens of millions of people, the other threatens civilization itself.

Decisions must be made immediately to limit the damage caused by global warming – damages that the world is already experiencing.  The world must act now. 

A scientific study released last week argues that even if greenhouse gas emissions – those created by the burning of oil, gas and coal – were reduced to zero, global temperatures will continue to rise for centuries to come.  The report, published in the British scientific journal Scientific Reports, projects that the world is already past the point of no return for global warming. 

The study predicts that by the year 2500, the planet’s temperatures will be about 5.4 degrees Fahrenheit warmer than they were in 1850.  And sea levels will be roughly 8 feet higher. 

The report contends that global temperatures could continue to increase after human-caused greenhouse gas emissions have been reduced due to the continued melting of Arctic ice, increased water vapor in the warmer air, and the perpetual release of carbon dioxide from permafrost melt.

While there is no scientific disagreement that the world is experiencing harmful climate changes, some experts have challenged the report’s “doomsday” scenario.  These experts push back by saying that the predicted catastrophes can still be averted – if aggressive actions are taken now.

However dire the situation is, the report underscores the need to fundamentally reduce humanity’s reliance on fossil fuels to power the world.  The world must collectively act to shift investments away from old, dirty, forms of producing energy to new, green, energy sources.

And the report comes at a critical time in American politics.  The United States is the leading power in the world and leadership in taking on the climate crisis is sorely in need.  The Trump Administration’s approach to global warming was to tear up global treaties, undermine the science, muzzle the experts, and kowtow to the political power of the oil, gas and coal industries. 

While the incoming Biden Administration promises to rely on experts and to fill the leadership vacuum created by the Trump Administration’s willful opposition to sensible climate policies, it’s still too early to tell how this will all play out.

The Trump Administration walked out of the global Paris Agreement that pledged the world to reduce greenhouse gas emissions.  The incoming Biden Administration says it will rejoin the plan, which has been signed by 188 countries.  But the Paris Agreement will not solve the problem; it is essentially a promise to do better, not a worldwide, enforceable, action plan.

While the Biden Administration has pledged to follow the advice of climate experts, the President-elect’s inconsistent statements on allowing the expanded drilling of fracked gas, for example, could conflict with the science.  The world’s experts have made clear that the world must stop the expansion of the use of fossil fuels and instead cut back.  Expanding fossil fuel infrastructure – that effectively commit the nation to rely on fracked gas and oil for decades to come – merely accelerates climate carnage.

Instead, the nation should shift its support from oil and gas exploration to one that relies on energy efficiency and green sources of power.  And it should do so by shifting taxpayer support for the oil, gas and coal industries – the industries that have made global warming pollution possible.  For example, according to the International Monetary Fund, the U.S. spent $650 billion in fossil fuel subsidies in one year – far more than it invests in green technologies.  Here in New York, millions are doled out in tax expenditures to subsidize fossil fuel usage.

Without doubt the nation is in the grips of serious crises.  But we must keep global warming at the top of the list of items for urgent, immediate action.  As the nation grapples with how to balance its public health, environmental, and infrastructure needs, it should reduce support for the fossil fuel industry, eliminate those subsidies, and make those most responsible for the anti-science policies that have put us in this situation pay their fair share to unwind the damage they knowingly caused.

After all, it was – and is – the oil, gas and coal industries that provided the political and public relations muscle to attack science and install their cronies into running governments.  It’s now time for them to pay for the damages that they have caused.  It’s now time for the polluters to pay up.

Last week American voters chose a new President.  The impacts of President Trump’s tumultuous presidency may last long after he leaves the White House.  For example, this week the U.S. Supreme Court will take up the question of the constitutionality of the Affordable Care Act – known as “Obamacare.” 

Will they kill the ACA?

This fight has been going on for over a decade with opponents – including the President – arguing that it is time to “repeal and replace” the ACA.

The campaign has been one of the most cynical in modern American politics.  Opponents – including the Republican party leadership – have since 2010 had time to develop their own alternative, but they never developed one.  The President has claimed repeatedly that he has a “great plan” that he’ll soon roll out.  After all this time it is hard to conclude anything other than they have lied to the American public about their intentions. 

After failing to kill ACA in Congress, it is now clear that the Republican strategy is to get the Supreme Court to do it. 

If the lawsuit brought by states’ Republican Attorneys General – and backed by the President –succeeds, protections for those with pre-existing health conditions would be jeopardized, public health programs – like those that provide coverage for flu shots and cancer screenings – would face cuts in funding, and about 23 million Americans would lose their health insurance – while the world is in the middle of the coronavirus pandemic.

Eight years ago, the ACA survived a legal challenge and was found to be constitutional, with the Chief Justice writing for the majority in a 5 to 4 decision.  The Court that will hear the case on Tuesday, however, has three new, more conservative, judges.  The most recent Trump appointee, Justice Amy Coney Barrett, has criticized the Chief Justice’s legal reasoning in that case.

There is a lot riding on the decision.

Here in New York, under the ACA the federal government picks up half the tab for the state’s Medicaid costs.  Currently, New York’s Medicaid program costs over $67 billion.  So, if the ACA is struck down by the Supreme Court, New York could lose tens of billions of dollars in federal aid used to provide health insurance to New Yorkers.

And that potential loss of federal aid comes at the worst possible time.  New York is facing a budget shortfall of as much as $13 billion this year and that could hit $60 billion cumulatively over the next four years.

If the Supreme Court strikes down the entire law, it is possible that the incoming Biden Administration could cobble together a new response.  If Democrats manage to take control of the Senate along with the House, they could enact fixes to the Court’s decision.

However, if the Democrats fail to win run-off elections in early January resulting in a divided Congress, such moves seem unlikely.  While the law is very popular among independent voters as well as Democrats, and even most Republican voters support its pre-existing condition protections, Republicans overall still want to see the law overturned.  As a result, it is hard to imagine a Republican-led Senate approving an expansion of health coverage.

Moreover, a failure to hammer out a bipartisan agreement would devastate New York’s finances and threaten the health of tens of millions of Americans. 

The ACA may be imperfect, but millions of Americans rely on it for their healthcare and most of us benefit by the preexisting conditions protections.  The Supreme Court should tread lightly in its review considering the law has survived reviews by prior courts and the enormous positive difference it makes in the lives of tens of millions of Americans.

Instead, the new President and the Congress should expand health care coverage.  While there is no good time to take away people’s health insurance coverage, doing it during a global pandemic is uniquely cruel.  Universal coverage should be the goal of public policy.

Here’s hoping that the Court leaves the ACA in place.

Regardless of the election results, the verdict is in on New York State’s system of running elections: It fails and is in desperate need of overhaul. 

There have been many changes to voting in New York prompted by the COVID-19 pandemic.  Most notably, New Yorkers could vote by mail, thanks to changes to the absentee voting rules.  And early voting approved in 2019 not only added the convenience of casting a ballot by machine vote before Election Day, but also helped reduce poll-site crowding on Election Day.

Yet, even the Mayor of the City of New York stood online for over three hours to vote – at an early polling site.  Long lines were not unique to New York City; early voting polling locations across the state often saw New Yorkers waiting for hours – despite a state rule that voters should not have to wait more than 30 minutes. 

Moreover, the performance of the Boards of Elections failed us too.  One hundred thousand New York City voters got the wrong absentee ballot envelopes; tens of thousands of votes were tossed due to technical problems with postal deliveries and other issues during the primaries; early voting polling locations were often located away from population centers; and at least in one case, college students had to schlep to the polls far from campus, even during the COVID-19 pandemic.

Governor Cuomo’s steps to liberalize voting were advanced with no obvious plan for implementation and left the boards of election starved for funds.  Absent adequate funding, even the best elections system cannot function – and New York’s system is far from the best.

Serious problems existed prior to the pandemic.  New York State’s elections are run by the two major political parties.  Making matters worse, local elections commissioners are often party leaders who, at best, face a conflict of interest in running elections fairly.  At worst, the scandalous mismanagement of elections and lack of accountability have led to voter disenfranchisement.   

These problems have long been festering and the political leadership of the state has been unwilling to change a system they have mastered.

Sadly, many of these problems are found throughout the country.  It is obvious that the nation’s elections system has become a partisan weapon instead of the way for citizens to exercise a core constitutional right.  But New York has been notable for its long track record of poor voter participation. 

It’s time for New York to show the nation how to run elections properly and fairly from registration to ballot counting. Here are some ideas:

1. Get rid of political party control.  Elections are about a partisan fight over ideas and to get public support.  Running those elections, on the other hand, are about the public interest.  Elections should be administered by an independent board, one that is free from political pressure.  This won’t be easy to do since political party control is enshrined in the state Constitution, but it has to change.
2. Professionalize elections.  Currently, the state and local boards of elections have two sets of staff – one Republican and one Democrat.  Get rid of these patronage staff and replace them with those covered by civil service protections.  There are no state constitutional protections here, patronage and party control must be replaced by independent professionals.
3. Provide necessary resources.  New York has never properly funded elections.  Voting is the cornerstone of our democracy; it should be treated as such.  As mentioned, voters should never have to wait more than 30 minutes to vote.  That means more polling places, better trained and paid poll workers, and more voting machines.  That costs money and the state has been running elections on the cheap for too long.
4. Modernize the system.  The Legislature has advanced constitutional changes that would allow would-be voters to register and vote on Election Day and eliminate the current absentee ballot requirement that the voter present an excuse to vote by mail.  If New Yorkers want to vote by mail, they should be allowed to do so.  Let’s make sure that mail-in ballots can be easily tracked by the voters, that ballots postmarked before or on the election date but delivered after are counted, and that the state requires polling places on college campuses.

When it comes to the most fundamental act in a representative democracy, New Yorkers deserve less of the blame game from elected officials and more improvements.  Changes that embrace independence, competence, resources, and reform should be a priority before the next election cycle.  Anything else is simply a defense of the failing status quo.  It is long past time for action, for comprehensive changes that anchor our democracy and fix the state’s failing system.