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Photo illustration: Eniola Odetunde/Axios. Photos: the Washington Post, Pool/Getty Images

Despite the slow roll out of vaccines so far, NIAID director Anthony Fauci says the COVID-19 vaccination campaign will ramp up fast enough that Americans should see "a degree of normality in the fall."

Driving the news: President-elect Biden is planning a program that will have "much more interaction between the federal government and the states than there are right now" in order to reach his goal of 1 million vaccines a day for 100 days, Fauci tells Axios.

What's happening: Millions of available vaccine doses haven't been administered, raising questions about what went wrong with Operation Warp Speed.

  • Americans are "paying the consequences" of having a "program being run like a supply distribution program and not a vaccination program," says Carlos del Rio, distinguished professor of medicine at Emory University School of Medicine.
  • "Our approach in which public health is run by the states doesn't work in a pandemic. You cannot respond to a pandemic with 50 different plans," del Rio says. "The lack of federal leadership, in my mind, is one of the most important lessons going forward."
  • The U.S. needs to coordinate state sites and enough staffing to give people the shots, as well as logistics like freezer requirements, del Rio points out.

Yes, but: Fauci says he expects changes under the new administration and asks if it's "fair" to say there's a bottleneck in vaccinations, or if it's more about experiencing normal "bumps and hiccups" for a massive program launched during the holidays.

  • This week, the inoculation rate went up to half a million doses a day, he points out.
  • "Are we going to clear the bottleneck in a couple of weeks? I hope so. Are we going to get to 1 million a day in a couple of weeks? I doubt it. But I think by the time President-elect Biden gets in, he hopes to be able to have a system going that he can get 1 million a day for the first 100 days," Fauci says.

The problem right now in the U.S. is not lack of supply. But that may become an issue once the vaccination program ramps up and as urgency grows under the pressure of more transmissible variants that the CDC is monitoring closely.

  • Some nations are considering stretching out doses, giving people half doses or allowing a mix of vaccines — the latter is an option Fauci strongly opposes.
  • NIH is running a study to see how effective Moderna's vaccine is if the dose is halved.

What to watch: Public health scientists hope pandemic preparedness will become a top national priority.

  • "The first lesson learned is that pandemic preparedness is worth the investment. This pandemic and the inability to respond effectively has cost us not only lives, but the economy has taken an incredible hit," says Tara Kirk Sell, senior scholar at Johns Hopkins Center for Health Security.
  • Better diagnostics will be key to fighting future outbreaks, Sell says. Rapid antigen tests and other measures "can really change the game."

For now, though, Fauci says if herd immunity can be achieved by vaccinating 70%–85% of people by the end of this summer, "I think we'll start approaching a degree of normality in the fall and the winter, such that by this time next year, 2022, we will be very close to a return to normal."

Go deeper: Fauci sees greater China role in COVID-19 spread, one year on

Go deeper

Updated 11 hours ago - Health

Hong Kong puts tens of thousands on lockdown as coronavirus cases surge

Hong Kong health workers patrol a street where COVID-19 cases have been confirmed. Photo: Anthony Kwan via Getty Images

Hong Kong has placed tens of thousands of residents on lockdown to contain a new coronavirus outbreak.

Why it matters: It’s the first time Hong Kong has imposed a lockdown since the pandemic began. The restrictions are expected to last 48 hours.

Updated 15 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Eniola Odetunde/Axios

  1. Health: Most vulnerable Americans aren't getting enough vaccine information — Fauci says Trump administration's lack of facts on COVID "very likely" cost lives.
  2. Education: Schools face an uphill battle to reopen during the pandemic.
  3. Vaccine: Florida requiring proof of residency to get vaccine — CDC extends interval between vaccine doses for exceptional cases.
  4. World: Hong Kong puts tens of thousands on lockdown as cases surge — Pfizer to supply 40 million vaccine doses to lower-income countries — Brazil begins distributing AstraZeneca vaccine.
  5. Sports: 2021 Tokyo Olympics hang in the balance.
  6. 🎧 Podcast: Carbon Health's CEO on unsticking the vaccine bottleneck.

DOJ: Capitol rioter threatened to "assassinate" Alexandria Ocasio-Cortez

Supporters of former President Trump storm the U.S. Captiol on Jan. 6. Photo: Kent Nishimura / Los Angeles Times via Getty Images

A Texas man who has been charged with storming the U.S. Capitol in the deadly Jan. 6 siege posted death threats against Rep. Alexandria Ocasio-Cortez (D-N.Y.), the Department of Justice said.

The big picture: Garret Miller faces five charges in connection to the riot by supporters of former President Trump, including violent entry and disorderly conduct on Capitol grounds and making threats. According to court documents, Miller posted violent threats online the day of the siege, including tweeting “Assassinate AOC.”