AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman.

It was a year ago when the United States confirmed its first COVID-19 death and then-President Trump vowed the coronavirus was, quote, “very well under control in our country,” unquote. By the time President Joe Biden took the oath of office last month, the U.S. death toll from the virus had crossed 400,000. In the last month, 100,000 more people have lost their lives.

At a sunset ceremony at the White House, President Biden, Vice President Kamala Harris and their spouses led the country in a moment of communal mourning as COVID deaths passed half a million.

PRESIDENT JOE BIDEN: Today, we mark a truly grim, heartbreaking milestone: 500,071 dead. That’s more Americans who’ve died in one year in this pandemic than in World War I, World War II and the Vietnam War combined.

AMY GOODMAN: Biden has ordered flags on federal property to fly at half-staff for five days. The number of new COVID cases continues to fall across the United States, and the vaccine effort is speeding up. This comes as the head of the World Health Organization is calling on rich countries not to undermine efforts to get vaccines to poorer nations by buying up billions of doses — in some cases, ordering enough to vaccinate their populations more than once.

For more, we’re joined here in New York by Dr. Craig Spencer, director of global health in emergency medicine at Columbia University Medical Center. He’s been treating coronavirus patients since the pandemic began a year ago, his recent Medium piece headlined “Global Vaccine Inequities Are Dangerous for Everyone.”

Dr. Spencer, welcome back to Democracy Now! This is a horrific milestone, half a million people dead in the United States. We have less than 5% of the world’s population but about 20% of the world’s deaths and infections. How did we get to this point?

DR. CRAIG SPENCER: You know, a year ago, I remember in New York City we hadn’t had a case yet. We had been hearing about cases all around the country and, obviously, all around the world. Italy had been hit hard, was starting to be hit really hard. And we were prepared here. We knew that things in New York City would get bad, but we had no clue that they would get as bad as they got. And we certainly didn’t think that it was going to be this bad all around the country for so long. And a part of that is because this virus is really good at what it does. You know, a year ago — less than a year ago, Dr. Fauci said we may have 240,000 deaths. We’ve doubled that already, and there’s certainly going to be more.

But obviously and what I’ve been saying over the past year is that a lot of this, you know, this death toll, and a lot of this destruction that this virus has wrought on this country and this world was because of our failure to adequately respond and to treat this like the public health crisis that it was. You know, so much over the past year we have undermined the scientists. We have belittled the public health measures and the things that we could have done to get this virus under control. And because that wasn’t done, largely by this last administration, the Trump administration, what we have now is we have, as you’ve already noted, the most cases in the world, the most deaths in the world, and now passing this grim milestone of over half a million Americans, and counting, who have died from a virus that we could have certainly controlled a lot better, had we taken it seriously a lot earlier on.

AMY GOODMAN: I want to ask you about vaccines, first about what’s happening here and then in the rest of the world. You have two vaccines that have been approved in the United States. We still don’t quite understand what it means for the vaccines to outpace the variants, the British variant, the South Africa variant. Are they going have to change the formula in these vaccines to deal with this? And those that have these vaccines, will they have to get new shots? And then, how do more Americans get shot at this point?

DR. CRAIG SPENCER: Those are all great questions. And the one thing that I want to point out — because this can be a little unclear, right? We see a bunch of different headlines. And are the vaccines working? Are they not? Let me make this very clear. The vaccines that we have right now, the Pfizer and the Moderna vaccine, are both extremely, extremely, extremely effective at preventing you from getting infected with COVID and fantastic at preventing hospitalizations and deaths from COVID. I mean, they are truly miraculous. And the fact that they were done in such a short period of time is a game changer. So I want to encourage everyone to please get vaccinated when it’s your opportunity to do so.

Now, there have been some concern because there are these variants. We’ve heard of variants that have emerged out of the U.K., out of South Africa, now some out of California. There will likely be many more. And there have been some studies, both in the lab as well as in a larger population, showing that for some of the vaccines, their effectiveness may be blunted by some of these variants. That being said, they’ve still all prevented hospitalizations, and they’ve all prevented deaths. You know, the fact that there have been no deaths and no hospitalizations and severe cases in the vaccine arm of these research trials is truly, truly remarkable.

So, yes, there will have to be some update, likely over the next year and perhaps even going on in the next few years, in terms of the recipe or the formula for some of these vaccines. We know right now that they’re very protective. And we know that the FDA has already — you know, has given guidance saying that we’re not going to have to go through and do these whole 30,000-, 40,000-person trials like they did initially for these vaccines. They’ll be able to tweak the vaccine like they do on an annual basis for the flu shot, which should make it a lot easier for us to get kind of this updated vaccine out to make sure that people are protected, should variants emerge that undermine the efficacy of these vaccines.

AMY GOODMAN: So, these vaccines are based on a new technology, messenger RNA. That’s Moderna and Pfizer. On Friday, the FDA advisers will be meeting to discuss emergency use authorization for Johnson & Johnson’s COVID-19 vaccine, which is adenovirus, is that right? Can you explain the difference? That also is a one-shot.

DR. CRAIG SPENCER: Absolutely. So, the Pfizer and the Moderna vaccines have, up until now, been a bit complicated because they were two shots. They had previously been required to be at these really, really cold temperatures that made it logistically difficult for many people.

The beauty of the Johnson & Johnson vaccine is that it is a well-known, older technology that has been shown to be very effective. And as you pointed out, it’s a lot easier to transport. It’s a lot easier to manage. It’s a lot easier for smaller places, rural pharmacies, places internationally to manage. And it’s also great because it is just one shot. So you get rid of all those logistics of thinking about whether people need to come back in three weeks or four weeks and what happens if they miss that or it needs to be delayed.

So, there are multiple — thankfully, multiple vaccine candidates on the horizon. Hopefully, we’ll get a little bit more nuance in terms of which ones are better for certain populations. But what I’ve been telling people right now is that if you are due to get a vaccine, if you’re able to get a vaccine appointment, you should take whatever vaccine you can get. I wouldn’t wait to try to get a Pfizer or a Moderna or a Johnson & Johnson. All of them — and I want to repeat this — all of them have been proven to prevent severe COVID, prevent hospitalizations and prevent people from dying from COVID, which is obviously the most important as we pass this horrible milestone.

AMY GOODMAN: You wrote in your Medium piece that’s headlined “Global Vaccine Inequities Are Dangerous for Everyone,” “I’ve personally received more doses of a Covid-19 vaccine than 130 countries.” Dr. Spencer, explain.

DR. CRAIG SPENCER: I was lucky enough, as a healthcare worker here in New York City, to be part of the initial phase of the vaccine rollout. I was extremely eager, after having seen and been at the bedside of so many people dying over the past year from COVID, and worrying every time that I went into work that I’d get sick myself and pass it along to my family. I was one of the first in line to get vaccinated when I could.

That was two months ago. And in that time, there are still over 130 countries that have not received a single dose of vaccine. There was at one point, just a few weeks ago, where the only country in sub-Saharan Africa — one of the only countries in sub-Saharan Africa to get vaccinated was in Guinea, and they received 25 doses — not 2,500, not 25,000, but 25.

You know, we all knew that there was going to be an inequity. We knew that wealthy nations were going to gobble up vaccine doses like they’ve gobbled up many other technologies for time immemorial, quite frankly. But the inequities that we’ve seen here are just absolutely stunning. You know, the wealthy nations and advanced economies have bought up well over half of the vaccine doses, via prepurchase agreements, despite representing a fraction of the global population. Now, part of that is because COVID has been worse in places like the U.K., in Europe and in the United States. But that does not mean that it has not touched sub-Saharan Africa and other places around the world. There’s been nearly 4 million confirmed cases in Africa itself, with over 100,000 deaths, and there’s concern about a recent rise in cases there, as well.

My concern is that I’ve been vaccinated, thankfully, but my friends who work in a clinic in southern Burundi in East Africa may have to wait until 2022 or 2023 before they have a chance to get a vaccine, even as we’re being promised here in this country that everyone will have a dose by July. And we have, via prepurchase agreements in the United States, ordered way more vaccine doses than we have people who are even eligible to receive them.

AMY GOODMAN: According to President Biden, what, 600 million doses, the U.S. should have by July, which would mean 300 million people vaccinated, if it’s two-shot. Of course, one-shot, then it’s way more. But explain why people who, in this country, only care about what’s happening here, even using that criterion about survival of people in the United States, the worst hit in the world, should care about what’s happening to people all over the world.

DR. CRAIG SPENCER: That’s a great question, right? Because we have seen so much pain and suffering here at home, we’ve seen what’s happened with our economy, we haven’t been able to eat in a restaurant, we may have lost loved ones, it’s easy to see the proximate impact of COVID here and why we all want it to end as quickly as possible.

You pointed out that 300 million people by July will be able to get vaccinated. Well, that’s just for adults, right? So that’s 260 million people that we actually have eligible for vaccination in the U.S. We haven’t done trials on kids yet. So that means we have 40 million more doses, just of Pfizer and Moderna, than we do people who will be able to be vaccinated by that time. We also have Johnson & Johnson doses, others, you know, hundreds of millions of other doses that we have ordered.

Now, we can hold onto them and hoard them, or we can think about how we get other vulnerable populations around the world vaccinated. There are 59 million healthcare workers in the world. We could take a very small proportion of the doses that we have ordered, and we could help coordinate a program with the World Health Organization, with other international health bodies, to get those most vulnerable people in the world vaccinated, so that not only are we safe here at home, but others are safe everywhere else.

Now, there are other reasons why that’s important. Stopping the virus from replicating in Missouri is just as important as stopping the virus from replicating in Mozambique. You know, the more that this virus has a chance to replicate, it has more of a chance to mutate. And that’s where you can get these concerning variants, that may develop in other places, that could land here and could possibly undermine the efficacy of our vaccines.

The other really important thing is that we all want to get back to work. We think that getting vaccinated may be really the jumpstart to the economy here in the U.S., but so much of what we rely on in our U.S. economy comes from abroad — you know, car parts from other countries. Everything that we need largely comes from other places. And if those places aren’t being able to get back to work because they’re still dealing with COVID outbreaks, the economic toll here in the U.S. could be huge. It’s estimated that, you know, up to a $9 trillion hit on the economy will occur in 2021 alone. If we continue with this vaccine nationalism, just gobbling up all of these vaccine doses for use in wealthy countries and not thinking about other economies and other people around the world, the economic devastation could be huge, not just in those places, but here, as well. So it’s in our public health interest, it’s in our economic interest, and, I think most importantly, it’s really in our ethical and moral compass to be doing this. This is part of our role.

AMY GOODMAN: And finally, this has exposed the racial disparities in healthcare and economic disparities in this country, to say the least, like an X-ray. Dr. Spencer, can you talk about something that is left out of — I mean, on the networks, the corporate networks, there is a lot of discussion of the horror in this country. But what about the solution? What about Medicare for All?

DR. CRAIG SPENCER: It is unbelievable to me at this point that despite being the wealthiest country in the world, despite spending the most on healthcare per person by far of any country in the world, we still have tens of millions of people who every day remain unprotected and uninsured. Look, as you pointed out, this pandemic has really shone a light on how bad that was. We’ve seen Black and Brown populations who have been disproportionately impacted by the impact of this pandemic. A lot of that was because, yes, the virus itself and the conditions around it, but because of the system that existed and the infrastructure that existed — or didn’t exist — for those populations beforehand.

We need to do everything we can to recognize that, again, like vaccines, the economic benefit would be huge of making sure everyone had healthcare. We need to, from a moral and ethical perspective, to make sure everyone who lives in this country has access to a doctor and doesn’t have to worry about going bankrupt because they’re looking for treatment for something that has ailed them and prevented them from either working or going to school or contributing. It’s absolutely essential that on the other side of this we don’t just go back to normal, because normal was absolutely unsustainable, completely unacceptable. And we need to reimagine how we get everyone part of our economy, part of our workforce, but, most importantly, healthcare, and make sure that we provide, I think, really, what we should assume are the fundamental tenets of an advanced and humane healthcare system here in the U.S. And that doesn’t happen until everyone is covered and has health insurance.

AMY GOODMAN: Dr. Craig Spencer, President Biden has called this a war on the pandemic. Could you imagine a world where the United States pushes vaccine, both giving and selling vaccines around the world, as hard as it pushes selling weapons of war?

DR. CRAIG SPENCER: Well, we certainly would be a lot safer if we got everyone vaccinated. Look, there’s been — you know, here in the U.S., we’ve had 500,000 people die. We’ve had at least 2.5 million people die from COVID around the world. We’ve had over 100 million infections. And look at the economic impact that this has had here in the U.S. — $3.4 trillion already passed in stimulus, another $1.9 [trillion] likely coming very soon. You know, the impact has been huge, greater than many, many, many wars.

It is imperative that we get COVID controlled here in the U.S., but it’s also imperative that we get it controlled around the world, and, in addition, how we think about how we prepare and respond to the next crisis. We can’t build walls tall enough or moats wide enough to keep out the next invader, whether it’s a microbe or a virus. We need to be prepared, because we will see this again. We’ve had multiple public health emergencies of international concern over the past six years. We will have more of them again. We need to be prepared to make those investments now. Part of that is making sure people here at home have access to health insurance, as you’ve already pointed out. But part of that is making important investments in getting people vaccinated around the world, helping build health structures and health systems that can detect and respond to those threats before they reach our shores.

AMY GOODMAN: Dr. Craig Spencer, we want to thank you for being with us, director of global health in emergency medicine at Columbia University Medical Center, has been treating COVID-19 patients since a year ago almost exactly.

Next up, we honor Black History Month by remembering the visionary Black feminist science-fiction writer Octavia Butler. She died 15 years ago this week. Stay with us.