Jan. 27, 2021
To Members of the Baylor College of Medicine Community:
"We choose to go to the moon in this decade and to do the other things not because they are easy, but because they are hard; because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win...."
As I write this message, I sit less than a mile away from the football stadium at Rice University, where John F. Kennedy delivered his stirring "moon speech," a national call to action that set the United States on the path to landing a man on the moon. We will land a man on the moon and return him safely to earth. Three decades later, Jim Collins would use this as an example of a Big Hairy Audacious Goal (BHAG). A goal that is simple and compelling. A goal that instantly resonates and is readily understood. A goal that creates a frame of reference for all future planning, decisions, and action. It is a call to arms.
As our viral numbers in Houston now thankfully seem to be in decline, it seems to me the United States needs a national BHAG. Throughout history we have taken pride in ourselves as a nation that could do great things. As a nation that could simultaneously give voice to dissenting opinions yet pull together in times of crisis. Now we seem to be a nation that is half a step behind much of the world, one committed to polarization rather than unity. We should demand more of ourselves. We need a call to arms.
Here is my goal: Declare July 4, 2021 COVID-19 Independence Day – the day we drive the virus to a low enough level we can safely resume our lives. Businesses can reopen. People can work. Travel can resume. Grandchildren can visit grandparents. People can congregate in places of worship, graduations, theaters, sports venues, and even bars.
To declare this goal last January would have been unrealistic. One year later, we are driven by both opportunity and urgency. Opportunity in that we have the tools necessary to succeed. Urgency in that we are in a race against emergence of new viral strains.
It is easy to declare a goal, but much harder to create a national unity of purpose. In my view, here is what needs to be done:
- Declare a six-month COVID-19 bipartisan truce: national, state, and local. At the highest possible level, leaders of both parties should link arms and publicly commit to a spirit of cooperation in fighting the virus. Draft a written pledge. Encourage leaders across the political spectrum to sign. Work collaboratively. Focus legislative efforts on doing everything necessary to exceed the July 4 goal. On the federal level, work relentlessly to guarantee a steady vaccine supply. On a local level, drive collaborative efforts to get vaccine into arms.
Whatever label describes you – liberal, conservative, progressive, populist – whether you gravitate towards the political center or tilt towards the extremes, whatever policy goals you want to achieve, let us publicly and deliberately remind ourselves that our clear and present danger is a microscopic virus. What is the single most important thing we can do to promote social equity? Eliminate the virus. How do we best provide relief to those impacted by the pandemic? Eliminate the virus. How can we aggressively promote economic growth and full employment? Eliminate the virus.
- Turbo-boost the CDC. If this were a moonshot, the CDC would be our NASA, and would impact every objective on this list. Short-term, the CDC should have no financial constraints. The agency should have access to the best minds in the country. The CDC should be contained within a political firewall and serve as our trusted arbitrator of scientific truth. Remember science is more than sequencing the viral genome. It is providing evidence-based guidelines across the entire spectrum of infection control activities, from the basic science of vaccine development, to the social science of overcoming vaccine hesitancy in minority populations.
- Define national, state, and local metrics for success. To achieve our goal, every community should understand their existing disease burden. Everyone should understand what we are measuring, and what result constitutes success.
One metric we should track, but not the only one, should be vaccine administration progress. One hundred million doses over 100 days (one million per day) is not a stretch goal, it is the minimum necessary. We are already administering shots at that pace. To achieve herd immunity by our July 4 date we need a more aspirational target – something in the range of 2 million doses administered per day, seven days a week.
- Take the new variants seriously. One big threat to our goal is the potential emergence and spread of more infectious variants, or variants that are less suspensible to current vaccinations. Testing, sequencing, surveillance, containment. We failed this national test a year ago when SARS-CoV-2 first burst onto the scene. Now we have a chance to get it right. We should do everything possible to contain its emerging and potentially more lethal cousin.
- Pursue equity without sacrificing speed. We cannot leave vulnerable populations behind, but our experience to date has shown that states with overly nuanced, complex, and precise rules regarding vaccine eligibility have a much lower rate of vaccination. Keep it simple.
- Promote individual responsibility. Everyone must do all they can to keep from being infected and from infecting others. This is a challenging message. We all have COVID fatigue. However, I believe the message is more palatable if there is a defined endpoint.
It is within our power to bring this to an end. Calm the bipartisan rancor – improbable. Maintain public support around disruptive infection control practices – unlikely. Much is stacked against us. The 24-hour news cycle with its insatiable thirst for a whiff of controversy or conflict. Our addiction to social media platforms that amplify our differences rather than promote real dialog.
We should embrace this challenge not because it is easy, but because it is hard. Because the goal will serve to organize and measure the best of our energies and skills. Because it is a challenge, we are willing to accept, one we are unwilling to postpone, and one which we intend to win.
James T. McDeavitt, M.D.
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