Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. Now, we're taking a break from talking about the news coming out of Washington, though we will get back to it later this hour with Malcolm Nance. We'll talk now though about another important thing, and that is the latest vaccine news here in the area. New York City will now open five mass vaccination sites as they're being called, according to Mayor Bill de Blasio. The sites, which will be at locations not yet identified by the city will operate 24 hours a day, 7 days a week we are told.

In addition to the mass vaccination sites, the city also opened two pop-up sites, one in East Harlem, one in Lower Manhattan as part of a plan to open 250 vaccination clinics by the end of the month. Here with me now is New York City council member, Mark Levine. He is the chair of the Health Committee and represents Washington Heights, West Harlem, and the Upper Westside. He's been pushing for these sites and more action by the city to ramp up vaccine allocation. He says the city needs to add more like it did in 1947. Council Member Levine, welcome back to WNYC.

Council Member Levine: Thank you very much, Brian, happy to be here.

Brian: What happened in 1947?

Council Member Levine: Before I get to that, Brian, I can't not mention how dismayed and devastated I am by the attempted coup yesterday. There's got to be accountability for the insurrectionist, for everyone who was aided and abetted the Trump call, and of course, for the president himself, who is a danger to the republic and needs to be removed. We do have an ongoing pandemic and we can't take time off from that, so I'm happy to talk about that. Yes, we faced a very scary smallpox outbreak in 1947 and the city acted immediately and vaccinated 6 million people over 23 days.

This happened because we were out in neighborhoods all over the city, hundreds of locations with 24/7 vaccination. This is the kind of war-like effort we need today. We can do it. In fact, we have a plan that's in place now to respond to a bioterror attack in New York City, such as anthrax, and it calls for antibiotics to be delivered to the whole city, 8 million people in 72 hours. This plan has been drilled and practiced for. We have to go big at that scale, we're just not there yet.

Brian: You're pushing, I see for 400,000 doses of vaccines to be given every week. Right now, the city is averaging only 10% of that, about 40,000. How do we get there?

Council Member Levine: If we want to get the herd immunity by the middle of this year, that should be our goal, we need to be vaccinating at least 40,000 people a week that's first and second doses. Over the last seven days, we have vaccinated 52,000 people. We got to stop taking evenings, weekends, and holidays off. This needs to be a 24/7 operation, and we have to get beyond the hospitals which until now have really been the main driver here.

We need to be out in communities, in neighborhoods where people live, and we need to do this with an army of thousands, including mobilizing the medical volunteer corps. I put in several bills that would make this happen. One that would require a 24/7 vaccination site in every neighborhood. This is the scale of response we need if we're going to get to this goal of 400,000 per week.

Brian: Listeners, we can take your phone calls for City Council Health Committee chair, Mark Levine on vaccine logistics. This is not so much on the science of the vaccines, or the impact on your immunity and things like that. We did a science segment on that yesterday, a medical segment with a doctor as some of you heard. This is about vaccine logistics. This is what Council Member Mark Levine is trying to focus on, ramping up this very slow, so far, rollout.

If you have a question about that or a story, how's the vaccine rollout going in your hospital, for example, since so many that have been given so far have been hospital-based, tell us that story, especially if it contributes to a larger public understanding of what's happening and what needs to happen. We invite your calls. 646-435-7280, 646-435-7280, or tweet a comment or a question @BrianLehrer. Does the city have enough staff for these sites that are opening up and going to open up?

Council Member Levine: Well, the city has a workforce of 300,000 and what we did in 1947 was mobilize people from every department. We need to do that now and we need to go beyond city staff to mobilize volunteers to the medical volunteer corps. These are people who are ready and willing, and even volunteers more broadly for non-tactical positions. This will take thousands of people, and it's going to have to be around-the-clock undertaking.

I have just seen an outpouring of passion from New Yorkers who want to help. If we can mobilize them, we will, and that's actually one of the subjects of our legislation to require that there be a volunteer portal created and a system to train volunteers, so that people who want to help for things like signing people in or managing lines, that they can be part of this process, too.

Brian: Let me ask you about one particular group and their eligibility, and that is home healthcare workers. I see that that's gotten moved up in the past day. Home health aides were originally slated for next week. They are now eligible immediately. What can you tell us about that? For home health aides listening right now, or clients of home health aides who may want to have this conversation with them, where can they go to learn more?

Council Member Levine: This is so important. Prior to this week, almost all vaccination among healthcare workers was happening amongst people who work in hospitals. Of course, there's a whole world of people who work in private doctor's office, dentists, community clinics, and of course home health care aides, all of whom are exposed and at-risk and are out there serving us and deserve this vaccine, but they don't work in hospitals. That's going to require a system of community-based vaccination, and that's what's starting to come online now. We need to go much faster, but you mentioned some of the community-based sites. Those folks can sign up for appointments.

It's a little bit of a disjointed system for scheduling but the mayor announced a while ago that there's a website going to be up soon, nyc.gov/vaccinelocations where people can seek this. When I checked a few minutes ago, it wasn't up yet. I have to shout out the borough president, Gale Brewer, who fought really hard to accelerate the timetable for home health aides, and thanks to her advocacy. Yes, they're now eligible as of this week.

Brian: The two pop-up sites that I mentioned in the intro are in East Harlem and Lower Manhattan, is it as far as you know, only those two and only in one borough?

Council Member Levine: Those were the first pop-up sites open this week. There now are some additional locations coming online today at Department of Health clinics. Some community health clinics, what we called FQHCs are vaccinating, but you have to call them individually. They are listed on the city website and maybe Brian, I'll post this for you when we get off the interview, it's a little hard to find navigating. There are a small number of sites coming online, nowhere near the scale that we need and that's why I'm still pushing for a dramatic expansion.

Brian: Am I right that these are by appointment only, people can't just show up at these sites, even if they think they're in an eligible group?

Council Member Levine: Yes, that's right. Again, this is really only for healthcare workers and a few other related sectors, people working in the funeral business and people do have to demonstrate some documentation. You're going to have to fill out a form online that's mandated by the state. Then when you show up for your appointment, you're going to have to present something like a letter from your employer, or a pay stub, or an ID from your workplace.

This is still a very narrow vaccination effort at this point. It needs to go bigger. It needs to go bigger now, particularly the cohort of New Yorkers who are 75 and over that we're seeing, unfortunately, Brian, a very disturbing increase in the number of cases in New Yorkers who are over 75, positivity's rising, hospitalization is rising, and I'm sorry to say, fatalities are rising amongst people who are over 75. They need to be part of this first phase of vaccination.

Right now, the rules are so restrictive, that if a vaccination site has leftover time slots or vaccine doses at the end of the day, they cannot vaccinate a 75-year-old who's not part of the currently designated workforce group. That just makes no sense. We need flexibility. The most important consideration is moving fast and yes, prioritization is important, but we need to have the flexibility to do this right.

Brian: Is that up to the mayor? He's going to be on tomorrow. Should I ask him?

Council Member Levine: No.

Brian: I can't say, "Mark Levine says, Mr. Mayor, you should snap your fingers and include people over 75 today."

Council Member Levine: No. To his credit, he's calling for this as well. No, this is state rules. We need more flexibility from the state in the vaccination schedule, and the obvious big move that we need now is the ability to start with age-75 and older.

Brian: What does Governor Cuomo say in response to that?

Council Member Levine: Well, I think that he continues to make the point that healthcare workers are of unique importance and they are, because of the risk that they face, because of the service they've provided, and because also, they can be a source of spread if they are working with patients. They must be top priority, but we need the flexibility to do multiple cohorts simultaneously so that we don't leave any resources unused, whether it's time slots at vaccination sites or doses in a vial. We can still prioritize those workers who must come first, while having the flexibility to also serve the next level of high-risk groups,

Brian: Mark in Manhattan, a primary care physician, I think, you're on WNYC was City Council Health Committee chair, Mark Levine. Hello, Mark.

Mark: Hi, Brian. I want to thank you in particular for the tremendous service you've been to your listeners during the pandemic. I'm a first-time caller, but a long-time listener. I want to shout out to the people who staffed the pop-up clinic on Worth Street at the present time. I received my first dose of vaccine there on Tuesday morning. The process went very, very smoothly. They were very professional, and I can't say enough about how well it went. I think my colleagues who received vaccine there are equally impressed.

The point I want to make, however, is as a primary care physician, my colleagues and I are ready, willing, and able, to vaccinate large numbers of New Yorkers. Their process for becoming approved by the city to become administrators of the vaccine is a fairly complicated process. After three weeks, I only this morning became approved to do so, but I think a special effort needs to be made to recruit the tens of thousands of family doctors, internists, and other primary care physicians who are at the ready to provide vaccines to their patients 24 hours a day, 7 days a week. I know your guest has advocated on Twitter for 24/7 vaccine availability, and we certainly are at the ready to do that.

The other point I want to make is that there's a tremendous amount even here in New York of vaccine hesitancy. We know from surveys of hospital populations, 20% to 30% of hospital workers are declining vaccination. I think those of us who have a long-standing relationship with our patients can work hard to overcome that hesitation and get a greater number of people vaccinated. I'll take his answer and your answer offline, but again, I want just encourage your guest and the mayor to include primary care physicians in their efforts to vaccinate large number of New Yorkers. Thank you.

Brian: Doctor, can I follow up with one quick follow-up question? Are you still there?

Mark: Certainly, I'm here.

Brian: Are you talking about primary care physicians getting vaccine doses for their offices so the patients in their practices can go to their regular doctor instead of to clinics?

Mark: Precisely, precisely, so the program is being administered through the Citywide Immunization Registry, which has existed for years for the purpose of making vaccine records portable, so that if a family goes from one practice to another, their childhood vaccines, the records can be portable and be viewed by physicians other than the primary care physician who initially vaccinated that person.

This organization, which I might say is full of very hardworking, dedicated people, and they've been very helpful to me during the process of applying to become a COVID vaccine administrator, but they're simply overwhelmed right now. The pace at which they're approving individual practices, and they have a large number of criteria, justifiably so, to approve a doctor. They don't want people selling vaccine under the table. They don't want vaccine going bad in freezers. They want to make sure that we're using it according to the criteria set out by federal, state and city guidelines.

The process is a little bit challenging. I wish it could be made easier. I wish more primary care physicians can be approved to receive vaccine. I certainly hope that the pace of the rollout is accelerated as supplies become more available.

Brian: Thank you so much for your call. Council Member Levine, what do you say to anything that Dr. Mark brought up?

Council Member Levine: Well, thank you doctor for your service in this difficult time and for your willingness to step into this fight. First, I'll say that we have a medical volunteer corps that could be and should be deployed to city-run vaccination sites, so that healthcare professionals, including the corps ops also, by the way, includes people who are in medical school or in some kind of medical training, and they should be deployed. They should be out there 24/7, and folks like Dr. Mark could be part of that.

He brings up an even more important point, which is we need to be vaccinating for COVID in every single place that we vaccinate for flu. If you get a flu shot at your pharmacy, you should be able to get a COVID shot there. If you get it at your doctor's office, same thing. We're not there yet.

Brian: Do we have the -84 degree Fahrenheit freezers to go around?

Council Member Levine: No, we do not, but the Moderna vaccine is much easier to manage, and that opens up the possibility of point-of-care vaccination that we just can't do with Pfizer. We need to move to that immediately. We need pharmacies in their stores, vaccinating, and they're not yet. I'll just make this point. It can't only be chain pharmacies, because we have an equity issue in which chains are more concentrated in upper-income areas, and we need to be in low-income neighborhoods in not just equal, but greater numbers because of the increased risk there. That requires independent pharmacies. Frankly, [sound cut] community centers. Did I lose you, Brian?

Brian: No. We lost you for a second, but you're back. You're saying they need to be available in community centers.

Council Member Levine: Yes, absolutely. We should be in school gymnasiums, in night community centers and houses of worship, so that we are concentrated in the neighborhoods which are most vulnerable and so that we build trust by being in places which are familiar to communities. This ultimately needs to be a vaccination program occurring in hundreds of vaccination centers, and thousands of points of care if you account doctor's offices and pharmacies, et cetera.

Brian: Theresa in Brooklyn, you're on WNYC with City Council Health Committee chair, Mark Levine. Hi, Theresa.

Teresa: Hi, thank you for taking my call. I work with an organization that cares for a lot of members who are homebound. We provide social services and healthcare services to those members, so we have primary care workers who see our members in the home. I'm wondering with this vulnerable population, they often live in multi-generational households, they're also exposed to COVID in their own way, how are we planning to get the vaccine to these members who may not be able to go to one of the locations, which I'm really happy are being set up?

Brian: It's such an important question. Councilman?

Council Member Levine: Absolutely. Well, first we need to have prioritization available now for people who are 75 and older, which would include many of the homebound seniors I presume you serve. The next cohort will be 65 and over, not scheduled yet. Secondly, we need to have the capacity to go door-to-door. Already, some states are doing this. Rhode Island is already doing this. There are services already set up to care for people who are homebound. We have the personnel and the infrastructure, and they need to be able to do this. Again, the Pfizer vaccine, it would be too difficult, but the newer ones coming online make this possible.

There'll need to be resources on the table for that. They'll need to be compensated for that. These are private non-profits. That just brings up the bigger point about the cost of all of this, and yes, this is expensive, but so what. We need to be spending whatever it takes to ramp up for home care and for the broader distribution because lives are on the line and because Brian, every week we shorten this pandemic, it's probably worth billions of dollars in economic activity in New York City. Let's spend some money to get this door to door by building on the existing home care network.

Brian: On your Twitter, I see you singled out text scams that some people are receiving about vaccine registration. What can you tell us about those scams? Can you inoculate people against fraud?

Council Member Levine: Yes. This is really disgusting, Brian, that people are taking advantage of the desperation to get vaccines. There are various versions of this, but generally, people get a text message that appears to come from a contact tracer. Then when you make the call they tell you that you need to pre-register for a vaccine, and that you need to give a credit card to reserve your time slot. That's the general outline of the scam. First of all, there is no circumstance in which anyone will ever call you to ask for a credit card to pre-register for a vaccine appointment. That's not how this works. Vaccination is free, thank goodness. Furthermore, there is absolutely no city program that would require you to give a credit card. In fact, the way scheduling works right now is that you must seek out a time slot by using the online system or by calling one of the providers. That's where these texts from contact tracers, boy, they're really deceptive. I've seen at least one of them and I had to read it twice to really discern the signs of fraud.

If you get a call from a contact tracer then you can ask them for a verification code, and you can go to the Test and Trace website and enter the code and it'll return to you the name of the caller. That's the way of verifying that it is a bona fide contact tracer. Obviously, the fraudsters can't do that. There are ways to clearly seek this fraud if people are aware and I appreciate you giving me a chance to alert people about this.

Brian: We had a doctor call in a few minutes ago. Here's a nurse. Alyssa in Manhattan, you're on WNYC with City Council Health Committee chair, Mark Levine. Hi, Alyssa.

Alyssa: Hi. I just wanted to say that the MRC will be deployed, so we have been activated.

Brian: Remind us, MRC stands for?

Alyssa: The Medical Reserve Corps, and here in New York City, we have a very large and active chapter, and we are based out of the Department of Health.

Brian: Can you give us a picture of what that group does and what that deployment will look like?

Alyssa: I going to be a little cautious because I don't want to say too much. Well, MRC is an amazing group. It's made up of health corps, health professionals, also in various backgrounds and other people who just want to serve. We get a lot of training, but we also have a lot of deployments. We work in the community. We work with a lot of city groups. The Medical Reserve Corps came out after 9/11, a way to credential and activate people who want to serve in a crisis, but a way to do it organized and so that you knew who had their background. They had that some checking and things like that. In New York City, the Medical Reserve Corps does a lot of things in small and big ways.

Brian: Alyssa, thank you for that. Councilman, anything to add?

Council Member Levine: Alyssa, thank you for your service to the Medical Reserve Corps. I would just ask any listeners who work in healthcare and including students in health career programs, that we need you to sign up, and we need you to be deployed in this vaccination effort. I'll get the link to you after the segment, Brian, for where people can sign up. We encourage everyone who can, has got some medical training even if you're currently a student, to join this effort.

Brian: Karen in Harlem, you're on WNYC. Hi, Karen.

Karen: Hi, good morning, Brian. I just wanted to relay a story that was a dismaying story we heard over the weekend. My husband and I were taking a Lyft on Saturday and talking about how disappointing the rollout of the vaccination effort had been in the city. Our Lyft driver shared with us that he had a second job as an administrator with one of the pods to distribute the vaccine and how, because of the appointment system and the lack of planning around that, at the end of the day, when people didn't show up for their appointments, they had leftover doses that ultimately they ended up having to throw away because they weren't able to fill in with some additional patients from the cohort to use those vaccines and how heartbreaking it was to him.

They managed on that particular day to get it down to two doses that they had to throw away. I found it very surprising that this wasn't planned for, and that there isn't some kind of a waitlist, or a call-in list for the end of the day so that these doses actually can get used.

Brian: That's a great question. I heard that same story Council Member. Did that really happened, is that really happening?

Council Member Levine: Absolutely, it's happening. If you open a vial, you've got 10, 11 doses, and you have to throw them out if you don't use them. This is just outrageous, outrageous. There should be no higher priority than getting every dose in an arm. We need flexibility. Frankly, the rules are too restrictive and the fines are unhelpful. We are scaring providers who otherwise should think of nothing but getting this out the door. We need to not penalize providers for doing that. We need to give them the flexibility. Yes, I agree. Some sort of resource scheduling system would be a great way to do that. This is something that we need to change immediately.

Brian: Is there a certain contradiction then to Governor Cuomo's latest announcement that relates to this? Because on the one hand, I think he's telling hospitals to use all their vaccines or face a fine, but on the other hand, he's telling them if they mess up the prioritization, they can also face a fine. Are those competing principles there?

Council Member Levine: Yes. The problem is that then hospitals are going to say, and I believe already are saying, "Well, just give us less vaccine, because then we don't have to worry about either unused vaccine or being forced to give it to the wrong person." That is the worst possible outcome. In fact, we need hospitals to take a role in vaccinating beyond their own staff. They need to be vaccinating people in the community because they have that capacity.

We need to lessen the rules for them, and we need to incentivize them to do more and to give them flexibility, and not punish them if they use up their entire supply by going to people who are in the next line of priority. We can do that right now by focusing on people who are 75 and older. That's the obvious large high-risk group that's not currently included and who's eligible.

Brian: We're just about out of time and we have terrorism expert, Malcolm Nance, standing by to talk about America after the insurrection. I want to throw two quick questions from other callers at you because I think they might be useful for many people to hear answers to. I apologize, callers, I'm not going to put you on the air just for the efficiency of time's sake. One wants to know about when she would be eligible as a caregiver for her elderly and infirm husband. The other is somebody who's unemployed and wants to know if there are paid positions with this recruitment that you're trying to promote to get a lot of people in this vaccination corp.

Council Member Levine: Well, in terms of the individual who's homebound, and I'm very sorry to hear about that circumstance. I'm sure it's been a very frightening 11 months for that family. I think I would need to know a little bit more about questions of age and underlying condition, but at any rate, the cohort that will include people who are younger than 75, and do not work in one of the targeted professions, but have underlying conditions is not currently scheduled, Brian, until March or April and that's too slow. That's why we have to pick up the pace.

The second question was excellent. Absolutely. There should be employment opportunities in the vaccination effort. As I mentioned, not all the roles in a vaccine site are technical, and some of them can be for entry-level workers. Yes, let's hire people who maybe are out of work. Let's hire young people. This would be an entree into the world of public health careers, so it would be a win on many levels.

I know we're almost out of time, but just a couple of seconds, Brian. We have an ongoing crisis in the number of cases which are transmitting in New York City, and we cannot let our discussion of vaccination draw our eye away from the immediate threat that COVID is posing day-to-day. Vaccination is not a short term solution for that. We are seeing 5,000 cases a day on average in New York City. We have 3,100 people hospitalized, and this is growing at an alarming rate. We had the presence of the UK variant, which we should assume is in New York City. While we fight for faster vaccination, Brian, we need to double down on precautions against this very real threat. That's really the only thing that will save us in the weeks ahead.

Brian: Last thing, real quick, for my colleagues. Essential media, I understand is a relatively high priority category, that is, not people like me in the media who can do their jobs from home, but people who have to go into the station, reporters who have to go out on the street, what's up with them?

Council Member Levine: The next phase, which is phase 1B, Brian, will include the broader world of essential workers, but we have gotten no definitions yet on who that would include. Members of the press being one pending question. I have to mention another group, which we've had absolutely no confirmation on, reprehensibly in my opinion, which is people who are incarcerated. This is a congregate setting with high risk, and high rates of transmission. We have no information yet on the timeline for vaccinating people who are incarcerated, which is unacceptable.

We need clarification on these questions, Brian, so that we can plan, and so that we can inform the public, and we don't have it yet. We need to know who are the essential workers in phase 1B, when can we get vaccination in jail, and much else, so that we can plan this and not be caught off guard once again.

Brian: Should I ask the mayor that one tomorrow, or is that also up to the governor?

Council Member Levine: Questions of prioritization are driven by the state. I haven't heard the mayor weigh in yet on people who are incarcerated, but again, prioritization's driven by the state. We just need clarity, so that we can plan and inform the public.

Brian: I'm going to push him on that one tomorrow. We asked him a few weeks ago and he said he didn't know yet, but anybody in a congregate setting, and we know it's happened in jails and prisons around the country. That one definitely for Ask the Mayor tomorrow. Thank you for answering so many questions, New York City Council Health Committee chair, Mark Levine. Thank you.

Council Member Levine: Thank you, Brian. Be safe everybody.

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