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Behind The Scenes Of Pandemic Governing: Colorado's Polis On Tests Of Leadership

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Colorado Gov. Jared Polis opens the shipping box containing the state’s first shipment of COVID-19 vaccine at the Colorado Department of Public Health and Environment, Dec. 14, 2020, in east Denver.

David Zalubowski/AP

David Zalubowski/AP

A little more than a year into the pandemic in the U.S. and governors across the country continue to be thrust into the spotlight as they maneuver through vaccine distribution and decisions on opening up their states. During the public health emergency, governors have used extraordinary powers to shut down businesses and mandate masks and social distancing. No governor ever ran for office “expecting to lead a state through a pandemic,” says Colorado Gov. Jared Polis, a Democrat. “Somebody has to be governor and I happened to be here at this time, so I’m just going to do my best to make the most informed decisions I can.” Polis, a 45-year-old former congressman and tech entrepreneur, has issued hundreds of executive orders of his own but says he believes that persuasion, more than written policies, may be more important for taming the pandemic. “The policies matter a bit, and people focus so much on those. Do you tell people they have to wear masks? Do you close down? What capacity do you have at restaurants? But what really matters is, are people wearing masks?”

Like any other state, Colorado has seen its peaks and valleys. At times, it had among the highest death rates in the Intermountain West, but hospitals were never overrun. The governor has had his share of critics, though. Some local health departments complained they were caught off guard by policies. Then, there were anti-lockdown protests and even a recall effort called “Dethrone Polis” that failed to gather enough signatures for a vote.

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An event at Bandimere Speedway in Morrison, Colo., billed as a “COVID Chaos” protest against emergency public health rules issued by Gov. Jared Polis to deal with the COVID-19 pandemic. Speakers at the rally derided the governor’s actions.

Hart Van Denburg/CPR News

Hart Van Denburg/CPR News

Polis has stood in front of TV cameras more frequently than maybe any governor in Colorado’s history. All of those broadcast briefings have been a chance to provide facts, cajole, explain, and at times browbeat, the public into doing what he hopes they will do. Each time he’s addressed the state to release new data and implore Coloradans to stay safe, he’s known exactly who is his closest observer. “My mom always watches,” Polis says. Susan Polis Schutz, his 76-year-old mother, is no passive viewer. The governor’s communications director has gotten used to her instantaneous feedback. “My mom always texts in if there’s any problem at all. Like, ‘it showed the background too long,’ or, ‘There was a part you couldn’t hear.’ ” It’s just one way the governor’s personal and work lives have blurred over this unprecedented year, an experience familiar to many Americans. In the many high-level meetings that Colorado Public Radio observed, Polis is detailed and decisive. Early on in the pandemic, when states were scrambling to get respirators, masks and tests, he didn’t appear overly emotional or stressed. “You had every state competing against one another and often the federal government competing against us.” Polis’ quick decision-making was hard for some of his senior staff to get used to at first. “This sort of rapid decision-making, rapid ability to uptake information and make a decision, was certainly uncomfortable for me because I’ve been a person who wants to be very critically thinking about stuff,” says Stan Hilkey, the executive director of Colorado’s Department of Public Safety.

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Gov. Jared Polis poses for a selfie with health staffers at a mass vaccination clinic at the National Western Center in Denver on Feb. 6.

Hart Van Denburg/CPR News

Hart Van Denburg/CPR News

More than half of states are considering bills to limit governors’ use of executive powers — giving more say back to state lawmakers. But it’s harder for those policies to gain traction in places like Colorado where one party controls the government. Even so, Republicans pushed back against Polis’ broad use of executive authority. “People have asked, ‘Where is our legislature? Why aren’t the legislators doing things?’ ” says Senate Minority Leader Chris Holbert, a Republican. For Polis, he says the toughest time personally was when he and his long-time partner, Marlon Reis, both contracted COVID-19. After a week of quarantining with their two young children, he thought they were almost through it. That’s when Reis’ condition got worse. “We had these little home oxygenator things they usually get people with COVID. It went down from normally 95, 85, 84. So they said, ‘You better come in.’ ” Polis says at that point he hadn’t driven in about a year because his security officers prefer to drive him. This time, he insisted. “I didn’t want to expose our troopers to COVID.” But there was just one thing he wanted to do before taking his partner of 17 years to the hospital. That was, propose. “I’ve been thinking about it for a while,” Polis says. “I’d ordered the rings with an inscription from Isaiah and had them hidden and ready to go. He was going off to the hospital. I knew he’d probably get better,” but he says he didn’t want to take any chances. They’re hoping to hold a Jewish wedding in the fall and he says their six-year-old daughter is excited to be a flower girl. As the pandemic reached the one-year mark, Polis says he is still as busy as before. Rolling out the vaccine has come with enormous logistical challenges for states. On a daily basis, the governor’s administration is busy ordering doses, tracking and managing vaccine sites, monitoring new variants of the disease and trying to address persistent inequities over who is getting the vaccine. Despite the difficulties, Polis says it’s not a bad place to be. “Certainly [it’s] a more fun thing to contemplate than the dark days of the pandemic and hospital surges and [questions like] ‘where are these extra beds going to be and how are we going to fit all the patients?’ That’s a horrible, horrific thing to consider.”

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Gov. Jared Polis takes a swing at a piñata representing the COVID-19 virus, during a visit to the Adelante Community Development Clinic at Mile High Flea Market in Henderson, Colo. Feb. 26.

Bente Birkeland/CPR News

Bente Birkeland/CPR News

Polis does see a few good things coming from this incredibly difficult year. He thinks remote work and telecommuting have led to efficiencies, and families have found new ways to stay connected while apart. He recently attended a cousin’s virtual bar mitzvah. There have been moments of levity, too. On a recent visit to a vaccine clinic near Denver, volunteers presented Polis with a piñata in the unmistakable shape of the coronavirus. Instead of a stick, they handed him a large mock-syringe. In front of the laughing crowd, Polis whacked at the piñata again, and again, trying to break it apart. Eventually, one of his staffers had to pull him away.

Not Enough Vaccine Doses In Europe To Stop A 3rd Wave, German Health Minister Says

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“There are not yet enough vaccine doses in Europe to stop the third wave by vaccination alone,” German Health Minister Jens Spahn said Friday. Here, a health care worker displays a vial of the AstraZeneca COVID-19 vaccine in Stuttgart, Germany.

Marijan Murat/Pool/AFP via Getty Images

Marijan Murat/Pool/AFP via Getty Images

German Health Minister Jens Spahn is telling Germans to diligently follow coronavirus safety rules, warning that vaccines won’t arrive quickly enough to prevent a third wave of the COVID-19 pandemic. New infections in Germany are rising at a “very clearly exponential rate,” Spahn said. “There are not yet enough vaccine doses in Europe to stop the third wave by vaccination alone,” Spahn said at a news conference Friday, according to a translation by Deutsche Welle. “Even if the deliveries from EU orders come reliably, it will still take a few weeks until the risk groups are fully vaccinated.” Germany’s infection rate is rising at a pace not seen since the record spike it endured in December and January. The numbers fell sharply in February, but they’re now curving upward again as Germany enters a third wave of the pandemic, propelled by new variants and infections among people younger than 65. With Germany set for a four-day-weekend in early April due to the Easter holiday, Spahn said the country isn’t ready to relax travel and physical distancing rules. In fact, he said, Germans should be prepared to revert to tighter restrictions.

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A chart from the European Centre for Disease Prevention and Control shows the 14-day trends in Germany for new coronavirus cases (in red) and deaths (in blue).

European Centre for Disease Prevention and Control

European Centre for Disease Prevention and Control

Overall, the country has reported 2,639,258 total coronavirus cases and 74,405 deaths.

“Health experts are calling on the German government to order a third lockdown to prevent hospitals from being overrun,” NPR’s Rob Schmitz reports from Berlin. German Chancellor Angela Merkel is set to meet with the governors of Germany’s 16 states on Monday, when they will discuss whether to reinstate lockdown conditions. Germany and other European countries resumed administering the AstraZeneca COVID-19 vaccine on Friday after the European Medicines Agency reiterated that the vaccine is “safe and effective” in fighting the coronavirus. As it tries to boost its vaccine campaign, Germany is also moving ahead with talks to acquire Russia’s Sputnik V vaccine — with or without the rest of the EU’s involvement. Spahn said Friday that he believes a deal with Russia could be reached quickly once a delivery amount is agreed upon. “I am actually very much in favor of us doing it nationally if the European Union does not do something,” he added, according to Deutsche Welle. Across the EU, member nations have reported 24,175,984 confirmed coronavirus cases and 577,310 deaths, according to the European Center for Disease Prevention and Control.

Israel’s COVID-19 Vaccination Rollout Is Slowing at a Critical Moment. That’s a Warning for the Rest of Us

Now that nearly 60% of Israel’s roughly 9 million residents have gotten at least one shot of a COVID-19 vaccine, the New Jersey-sized Middle Eastern country is offering the rest of the world an enviable glimpse of a future where most people are inoculated against the coronavirus. While it’s still too early to tell the full extent to which vaccination is having an effect there, Israel’s rate of virus-related deaths has dropped faster than global figures since it started vaccinating (see chart below and methodology at bottom). Meanwhile, the latest real-world evidence collected in Israel suggests the Pfizer-BioNTech vaccine—the country’s most commonly administered shot—is preventing nearly 99% of deaths from COVID-19, while also curbing viral spread.

Israel’s mass vaccination efforts got off to an impressive start, with more than 10% of the population receiving their first dose fewer than two weeks into the national vaccination campaign. By comparison, it took the U.S. 57 days to reach the same mark, the U.K. 45 days, and the European Union still hasn’t matched it. Today, Israel is the worldwide leader in vaccinations per capita, at 108 doses administered for every 100 people, per the New York Times (the Pfizer vaccine requires two doses). But Israel’s breakneck rollout is beginning to slow, according to data from the Israeli Ministry of Health. While the country was administering first doses to as much as 1.5% of its population every day in early January, it’s now distributing fewer than 0.2% of initial doses daily.

That’s a problem, as Israel remains short of the 70% mark that public health experts say is the minimum required level for mass vaccination to turn the tide against the pandemic in a given country.

A closer look at the data reveals that not everyone in Israel has benefited equally from the vaccine rollout. Only 67% of Arab-Israelis and 70% of Israeli Haredi Jews (a group sometimes referred to as “ultra-Orthodox” Jews) over 16 were vaccinated or had recovered from COVID-19 as of March 4, compared to 90% of the rest of the population, according to data shared by Weizmann Institute computational biologist Eran Segal. However, Israel has recently had success targeting older—and thus more vulnerable—members of those communities. By March 4, 84% of Arab-Israelis and about 80% of Haredi Israelis over 50 were vaccinated, up from 68% and 72% respectively on Feb. 22, according to Segal’s data. Aside from being the right thing to do on moral grounds, better vaccinating these groups could push Israel over the critical nationwide 70% mark. To achieve that goal, Israeli public health officials have been working to address two major problems: vaccine hesitancy among these and other groups, and a failure to reach some residents who live in remote areas with less access to vaccination facilities and trustworthy information. Its efforts could be instructive for the U.S., which is also struggling with comparatively lower vaccination rates among some demographic groups, and for similar reasons. The Centers for Disease Control and Prevention only has race and ethnicity data for just over half of the vaccinations administered in the U.S. as of March 15, but of those shots, nearly two thirds have gone to white Americans, while less than 10% have gone to Hispanic or Black Americans, who make up 18.5% and 13.4% of the U.S. population, respectively.

In Israel, some groups are more vaccine hesitant or skeptical than others. A January survey from the Social Policy Institute at Washington University in St. Louis found that 51% of yet-unvaccinated Arab-Israelis and 42% of Israeli Haredi Jews weren’t planning to get the shot, for instance, compared to just 34% of those who identified as either secular, cultural, or Reform Jews. There’s a similar phenomenon occurring in the U.S., where 42% of Republicans, 35% of rural residents and 35% of Black Americans said in December that they probably or definitely will not get the vaccine, compared to just 27% of the general public, per the Kaiser Family Foundation. Only 29% of Israelis overall say they trust the government, while 25% of Arab-Israelis say the same, according to the 2020 Israeli Democracy Index. Some Arab-Israelis have been angered by discrimination and hostility towards their community, as well as by Israel’s treatment of the Palestinian territories like the West Bank and Gaza, where vaccinations have barely begun. Some Haredi Israelis, meanwhile, feel their culture and belief system is incompatible with what they view as Israel’s secular mainstream society, and many trust religious leaders over secular authorities. During the COVID-19 outbreak, Haredi groups have butted heads with government officials over lockdowns and restrictions; some have gathered for holidays and funerals despite restrictions against large groups. In an August poll, more than half of Israeli Haredim said their community’s trust in the current government was shaken amid the pandemic. All of this is relevant to the vaccine rollout, experts say, because people who distrust the government for any reason may be less likely to listen when it pushes a vaccine. “Sometimes, politics really goes against the interest of public health,” says Hadas Ziv, head of projects and ethics for medical nonprofit Physicians for Human Rights Israel. Arab-Israelis, Haredi Israelis and other Israelis have also been exposed to anti-vaccination messaging and misinformation on social media platforms like WhatsApp and via word of mouth. Some of the U.S. groups expressing relatively high vaccine hesitancy are similarly distrustful of the government—just 9% of Black Americans told Pew in 2019 that they trust Washington all or most of the time, compared to 17% of white Americans, for instance. Former U.S. President Donald Trump’s politicization of the virus and vaccine approval sowed further skepticism, experts say—after Trump promised a vaccine by last year’s Election Day, about 62% of Americans told Kaiser that they were worried a shot would be green-lit for political reasons before it was proven safe and effective. Moreover, inadequate access to care and longstanding mistreatment by medical institutions has contributed to distrust of healthcare providers among Black Americans and other non-white groups. Misinformation about COVID-19 vaccines, meanwhile, runs rampant on American social media networks, as it does in Israeli online communities. While vaccine hesitancy has been dropping in recent weeks, according to a TIME/Harris Poll conducted earlier this month, it remains a major issue for U.S. health officials.

To help solve the credibility issue, Israeli public health officials have turned to trusted voices in communities with low uptake. This approach “turns the gaze of the community to the experts to the local expert—and then the local expert does the persuasion,” says Saad Omer, director of the Yale Institute for Global Health. In December, Aida Touma-Sliman, an Arab-Israeli member of Israel’s national legislature, tweeted a picture of herself being vaccinated to encourage other Arab-Israelis to do the same. “As someone who is very well known as part of the opposition, saying that in this situation, do not follow your mistrust of the government, but follow the best interest of your health—it sounds more like something to believe, than coming from Netanyahu: that despite my opposition, I am telling you, you should do it,” she says, referencing Israeli Prime Minister Benjamin Netanyahu. Yitzchak Zilberstein, a prominent ultra-Orthodox rabbi, shared a similar message with his community in December. “The risk of the vaccine is minimal compared to the many risks of the corona epidemic,” he wrote. Prominent Americans from Michelle Obama to Dolly Parton have similarly shared photos of themselves getting the vaccine in recent days. Access is also emerging as an increasingly vital issue in Israel. Many of the country’s 9 million people live in urban centers, like Jerusalem and Tel Aviv; it’s been relatively easy for people there to walk into a vaccination site and get the jab. However, it’s been more challenging for the country to vaccinate people in historically underserved areas and communities, which are often largely Arab. “You can’t have places to get it in every tiny village,” says Orna Baron-Epel, a professor of health promotion at the University of Haifa. Similar patterns are playing out in the U.S., where access is suppressing vaccination rates in many predominantly Black neighborhoods, for instance. Israel has recently been working to make the vaccine easier to get across the country. Aiman Saif, a former government official who’s been tapped to lead Israel’s COVID-19 response among Arab groups, told Jewish-American news outlet The Forward in February that Israel boosted the number of vaccination locations in Arab-majority areas from five or six to over 50, while also adding 30 buses as mobile vaccination stations. Leaders in Israeli Orthodox communities have organized vaccination drives and seminars at religious schools and other locations to boost uptake as well. In the U.S., health systems and local governments have deployed mobile vaccination clinics in rural areas and high density, low-income areas, and the Biden Administration has spearheaded efforts to distribute vaccines at community health centers serving low-income and minority patients.

Although Israel has shown that a lot can be done to reduce vaccine hesitancy and improve access, public health outreach to each of these groups must make up for decades of lost trust. While Israel has been making inroads in vaccinating some of the most vulnerable members of underserved groups, critics say leaders there were too slow to address these often predictable problems. Baron-Epel, for one, fears the government failed to invest enough resources in Arab communities earlier on, in particular. “The ideas are good, what they’re doing is good,” she says. “But it’s not enough, you know, and not fast enough.” The key lesson from Israel for the U.S. and other countries, then, may be a challenging one: hesitancy and access need to be addressed well before they become stumbling blocks late in the vaccine rollout. Methodology note: The number of COVID-19 deaths in Israel peaked on Jan. 25 at 0.74 fatalities per 100,000 residents, compared to a global peak of 0.18 one day later, according to data from the Johns Hopkins Center for Systems Science and Engineering. While Israel’s peak value was much higher than the global average, its death rate has declined at a much steeper rate since the peak, though it’s too soon to know to what degree this can be attributed to vaccinations. For the sake of comparison, the first chart above presents both Israeli and global deaths as a percentage of the peak value—what’s called “normalizing” the data—so they can be easily compared. —With reporting by Chris Wilson

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