Kathleen Sebelius: ‘Trickle-Down Chaos’ Led to Poor COVID Response

To get past the COVID-19 pandemic, the U.S. needs strong federal leadership, which President Joe Biden will deliver, Kathleen Sebelius, who served as Secretary of Health and Human Services under President Barack Obama from 2009 to 2014, told GLG.

Sebelius is one of America’s foremost experts on national and global health issues, human services, and executive leadership. During her time in the White House, she worked to pass and implement the Affordable Care Act and helped in the fight against the H1N1 pandemic. Prior to her time in Washington, she served as the Governor of Kansas.

In the Q&A below, GLG’s Michael Weissman, Vice President & Healthcare Content Team Leader, spoke with Sebelius about the COVID-19 pandemic and the rollout of vaccines. Following are a few select excerpts from the broader conversation.

January 7 saw the deadliest day of the pandemic yet with a reported 3,775 Americans dying from COVID-19. What will be needed to help put the pandemic in check while vaccinations are being distributed?

We’re at a very dangerous period, not just in our dealing with COVID but also in our democracy, and they’re kind of linked together. We had a president who pushed misinformation and disinformation about the virus, which in part has led us to being the country in the developed world that has done the worst with deaths and hospitalizations and a lack of equipment and supplies.

The Trump administration never had a national plan. The beginning of the vaccine rollout is an indication of that. The only plan that seemed to be of great concern to the Trump administration was the rapid development of a vaccine. Putting government resources, the clearing of regulatory barriers, and efforts in the scientific community together in a kind of unprecedented way and making a prepaid bet on several candidates has gotten us to the point where we now have two approved vaccines and hopefully more on the way. That was successful.

But that doesn’t get shots in the arms of individuals. We now have more than 500,000 deaths in the United States [ed. note: this number has been updated since the teleconference date], just an unheard of loss in less than a year. We’re at a very precarious point. Hospitals are filled. There is a lot of strain on healthcare workers. There are no extra beds. Nursing homes are once again running out of PPE and we’re beginning to feel the accumulation of Christmas and holiday travel, where people unfortunately defied public health advice and got on airplanes and went to gatherings.

That’s why we need a coordinated, consistent communication plan, which is always a huge part of public health and certainly has to be a huge part of this massive vaccination campaign, the likes of which we’ve never done before in this country.

Strategies have differed widely by state. How impactful will a national strategy be when we’re already seeing fissures among the responses of various states and legislatures?

I’ll put my governor hat on for a bit. First, we are in a pandemic that no one has ever experienced before. The way disaster response works typically is that the federal government, particularly if the entire country is affected simultaneously, leads the response effort using the unique resources that are financial and logistical and mobilizes all the public and private resources available to put forward a plan. At that point, states are clear about what they can and cannot do, what help they’re going to receive, and how they can mobilize efforts using their resources and calling out the National Guard if needed.

When states are missing that federal piece, there’s chaos. We saw it with PPE where states were competing against one another and the federal government. We’re seeing the same thing with vaccines that states have been given information that basically says, “You’re on your own. We’ll get a vaccine to a couple of storage places in your state, and then you figure out the rest, but we won’t be able to tell you how many doses you’ll get, when you’ll get it, or which vaccine it will be.’ ”

All of that should change with the Biden administration. There will be a clear definition of what it is the federal government will do, and there should be a rapid mobilization of public and private resources. We really had trickle-down chaos, and I think governors, Republican and Democrat, welcome a federal strategy that tells them what they can expect and when they can expect it, and gives them resources to mobilize within their own states and borders.

When do you expect vaccines to be rolled out?

From what I can ascertain and from listening carefully to the best scientific advisors, it appears that an optimistic timetable is the summer of 2021 for when many people will be vaccinated. By fall of 2021 you might be close to herd immunity in the 70% to 75% range. That’s dependent on a whole series of factors. Hopefully, additional candidates come online, with manufacturing capacity working at overtime speed, and no batches or sites going down. Then there’s the ability to mobilize a workforce that is able to quickly and efficiently vaccinate folks.

There’s also overcoming some of the vaccine hesitancy that exists in various communities and still is driven by a lot of misinformation. That can stop quickly, and governors will be helpful in pushing that. Employers, faith leaders, trained healthcare providers, and community trusted leaders can be helpful there, but there must be a coordinated and mobilized effort that I think Joe Biden recognizes and is ready to engage in.

About Kathleen Sebelius

Kathleen Sebelius is one of America’s foremost experts on national and global health issues, human services, and executive leadership. As CEO of Sebelius Resources LLC, she provides strategic advice to companies, investors, and nonprofit organizations. From April 2009 through June 2014, Sebelius served in President Barack Obama’s Cabinet as the twenty-first Secretary of the Department of Health and Human Services, where she worked to pass and implement the Affordable Care Act. Having served as Governor of Kansas from 2003 to 2009, Sebelius is the only daughter of a governor to be elected governor in American history; her late father, John Gilligan, was Governor of Ohio.

This healthcare policy article is adapted from the January 22, 2021, GLG webcast “U.S. Healthcare Outlook.” If you would like access to this teleconference or would like to speak with healthcare policy expert Kathleen Sebelius, or any of our more than 900,000 industry experts, contact us.