Dear Joe,

Congratulations on winning the recent US Presidential Election. Now the work begins. You have tremendous challenges on the domestic front, with foreign policy and with an economy that is staggering. Your country is divided. Schools are closing. People are dying.

But the health of your citizens and a single-minded focus on the healthcare system is the only way out. You are no stranger to the importance of individual health. You suffer from asthma and have undergone two surgeries for intracranial aneurysms and a pulmonary embolism. So,
you know that if you have your health, nothing else matters.

And if you don’t have your health, nothing else matters. You also most certainly know about the gravity of a strong US healthcare system since you were part of the administration that crafted the Affordable Care Act in 2010.

The importance of protecting pre-existing conditions and expanding access to affordable health insurance. You have spoken about a new ‘public option’ and tax credits to help working class families along with the elimination of surprise medical billing. You have promised to reverse the US administration’s withdrawal from the World Health Organization. Your goals are high. And your aim is far. Bravo.

But COVID-19 is the problem. It is here today. And it is not going anywhere soon. How you deal with it is the singular answer to how everything else goes in 2021.

While PPE procurement may seem like a conversation from a different time, reports suggest that this is still a problem. Ensuring that healthcare and frontline workers can safely do their jobs is paramount to dealing with the virus in the here and now.

Vaccines are coming. Preparing the supply chain and understanding the logistics of getting these vaccines to the people is a gargantuan task. You have selected amazing people for your taskforce. But you must also use the collective experience of other countries that have rolled out complex, large-scale public health vaccination programmes.

Vaccines are great. Vaccinations are better. The sad truth is that many Americans have expressed a distrust in science and in the development
of these vaccines. Experts have stated that, in order for the economy and the workplace to return to normal, at least 70% of society needs to get vaccinated in order for herd immunity to take effect.

Having enough doses to make this happen does not appear to be an issue based on long-term manufacturing projections that we have been given. But after a full year of anti-science rhetoric and deception in your country, the messaging and education campaign will be more important than the logistics and supply chain discussions. Take my word for it.

And here’s a suggestion for the key messaging elements of your campaign to the American people: Trust and Two. In order to establish trust in the vaccines, your administration must put epidemiologists and doctors at the forefront to share information and data with the general public.

The Food and Drug Administration (FDA) and Centers for Disease Control (CDC) must be part of this campaign, after being sidelined for the past year, or used exclusively as vehicles to misinform and confuse. You must have independent scientists and form review committees to validate the information that is shared with the American public.

And you must have a plan to work with local leaders in communities of colour and with visible minorities who, for too long, have been on the fringes of healthcare communication and who have become understandably leery.

Two. This key element of the messaging campaign should not be overlooked. Pfizer’s vaccine requires two shots, three weeks apart. Moderna’s vaccine requires two shots, four weeks apart. And AstraZeneca’s vaccine is being studied in a protocol where two shots are given one month apart. You see why ‘two’ is important?

Two shots. Not one. An individual gets immunity with two shots and only with two shots. Research has shown that other immunisation programmes are plagued by patients who initiate but do not complete a vaccine series. This could be the biggest hidden issue with the COVID-19 vaccines and it is not being forcefully messaged or communicated.

Call it compliance. Or adherence. Or whatever you wish to call it. The key is that ‘two’ will be the most important number of 2021. You have been dealt an exceedingly difficult hand, with the outgoing administration effectively relinquishing any action on controlling COVID-19, which has allowed the infection to run rampant to the tune of one million cases per week.

Good luck. The world is rooting for you and your administration.


An open letter to the incoming President of the United States on COVID-19 messaging priorities


This article was originally published here.