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Like so many others, I greeted the changing of the calendar year today with relief: there’s some psychic release associated with putting “2020” behind us.

Unfortunately we start the new year with lots of bad news.  A new virus variant first identified in the UK appears to be more transmissible, and it is already spreading in the US.  This means even more rapid spread of the disease, and substantially higher rates of immunity needed for herd immunity (90% or more of the population will need to be vaccinated or have immunity from prior infection).  Our runway for getting the vulnerable vaccinated just got shorter, and in the US I see no further willingness to engage in the sorts of broad public health measures that could have limited the spread in the last ten months.

Worse, the rollout of the vaccines has been disastrous.  Despite (or perhaps due to) a widely decentralized vaccine distribution process, few states have managed to inject more than a few tens of percent of the vaccines they have received to date–raising a real risk in some cases that the doses will expire, unused, in the fridge.  Some of this is attributed to growing pains and the holiday season–but why are we taking vacations from administering vaccines during a pandemic?

Public health experts (and Twitter logicians) are debating all aspects of the vaccine prioritization.  A major question raised by the UK variant is if we should administer only one shot of the two-dose regimen initially, with the thinking that ~80% effectiveness for twice as many people is more helpful than 95% effectiveness for fewer.

There’s more: sizable proportions of the first-tier groups are refusing the vaccine!  If 50% of health-care workers in hard-hit LA County won’t get the shot it’s hard to see how we are going to vaccinate ourselves out of this, even when there’s enough supply…

But still–small bright spots shine through.  My mother-in-law and two sisters-in-law have each had a first dose–here’s hoping we will all join them very soon.