When will the pandemic end?

Rebecca sits down with Be A Hero’s Matthew Cortland for a look at the challenges with the vaccine rollout so far, and what it would take to get to the vaccination rates we need in the U.S. and globally to bring the COVID-19 pandemic to an end. Subscribe to Off-Kilter on iTunes.

The rate of coronavirus vaccinations in the U.S. is steadily growing, with the number of people who have received at least one shot now greater than the total number of reported U.S. coronavirus infections — offering a glimmer of hope against the backdrop of a vaccine rollout marred by fragmentation and confusion.

Meanwhile, according to Bloomberg’s Vaccine Tracker — the largest database of COVID-19 vaccine shots given around the world — if vaccinations continue at their current pace, it will take the U.S. another 11 months to hit the 75% coverage rate that Dr. Anthony Fauci and other public health officials have estimated it will take the U.S. to return to “normal” life.”

And with vaccinations being administered more rapidly in wealthy Western countries than in poorer nations, it will take the world seven years to hit 75% across the globe at the current pace.

To dig deeper into what’s going on with the vaccine rollout in the U.S. and globally; the options policymakers have to dramatically pick up the pace — which will require increasing supply of the vaccine; and the continued toll that COVID-19 will take in preventable loss of life if vaccinations continue at their current rate, Rebecca sat down (virtually) with Matthew Cortland, a public health expert and the policy director at Be A Hero, an organization co-founded by Ady Barkan that fights for the realization of health care as a human right. Let’s take a listen.

This week’s guest:

• Matthew Cortland, policy director, Be A Hero (@mattbc)

This week’s resources:

• Learn more about Prep4All.org, an organization of patients, health care professionals, lawyers, and academics pressing the federal government to end profit-fueled and unnecessary shortages of lifesaving medications, including the COVID-19 vaccine
• Here’s the Bloomberg Vaccine Tracker, a database of COVID-19 vaccine shots given around the world
• Follow #HighRiskCA to learn more about California’s decision not to prioritize people with high-risk health conditions for the vaccine (PS: if you’re not following the campaign’s creator Alice Wong, founder of @DisVisibility, you’re doing it wrong)
• Here’s the global survey on vaccine trust finding that the number of people who say they are willing to get a vaccine is on the rise
• And follow @mattbc for real-time updates on COVID relief package currently being debated in Congress — and key components like urgently-needed Home and Community-based Care (aka HCBS) funding

TRANSCRIPT:

♪ I work and get paid like minimum wage

Sights to hit the clock by the end of the day

Hot from downtown into the hood where I slave

The only place I can afford ’cause my block ain’t safe

I spend most of my time working, tryna bring in the dough…. ♪

REBECCA VALLAS (HOST): Welcome to Off-Kilter, the show about poverty, inequality, and everything they intersect with, powered by the Center for American Progress Action Fund. I’m Rebecca Vallas.

The rate of coronavirus vaccinations in the U.S. is steadily growing, with the number of people who have received at least one shot now greater than the total number of reported U.S. coronavirus infections, offering a glimmer of hope against the backdrop of a vaccine rollout marred by fragmentation and confusion.

Meanwhile, according to Bloomberg’s vaccine tracker, the largest database of COVID-19 vaccine shots given around the world, if vaccinations continue at their current pace, it will take the U.S. another 11 months to hit the 75 percent coverage rate that Dr. Anthony Fauci and other public health officials have estimated it will take the U.S. to return to quote-unquote “normal” life. And with vaccinations being administered more rapidly in wealthy Western countries than in poorer nations, it will take the world seven years, Bloomberg estimates, to hit 75 percent across the globe at the current pace.

To dig deeper into what’s going on with the vaccine rollout in the U.S. and globally, the options policymakers have to dramatically pick up the pace and the continued toll that COVID-19 will take in preventable loss of life if vaccinations continue at their current rate, I sat down virtually, of course, with my good friend Matthew Cortland. He’s a public health expert and the policy director at Be a Hero, an organization co-founded by Ady Barkan that fights for the realization of healthcare as a human right. Let’s take a listen.

Matt, thank you so much for taking the time to come back on the show. You’re always one of our favorite guests. And this is our first time having you on since you actually joined Be a Hero.

MATTHEW CORTLAND: It is so good to be with you. It’s always really good to be with you, but now more so than usual, because I haven’t seen you in, I guess, it’s well over a year at this point.

VALLAS: It’s definitely over a year. Whether you would recognize me at this point, I’m not entirely sure, given that I don’t even look anything at all like I did before. The blond pixie is like deep in the rearview mirror, and I now have, like, long brown hair. That’s how long it’s been since we actually hung out.

CORTLAND: My hair is rapidly approaching my shoulders. It’s time for another at-home trim. And you’d think that we’d be getting better at it, and yet. And yet.

VALLAS: And yet. And also, you know, it’s hard not to miss each other as much as we do, obviously, right? I mean, and that’s, you know, obviously we’re going to get into some of the solutions to the problem there. But I know you’re you’re sick of this. I know I’m sick of this. I miss — I’ll give a shout out to our producer, Will — Will, I miss you, too, you know, and being in the radio studio with you.

But Matt, that’s a big part of why you and I actually thought it was worth doing a conversation for Off-Kilter about where things stand with the vaccine and the rollout of the vaccine. So, I mean, talk a little bit about where we are and the state of play with the vaccine rollout. We’re a little less than two months in since the U.S. started administering COVID-19 vaccines, obviously through a state-led process. Talk a little bit about where we are and how the rollout is going so far.

CORTLAND: Absolutely. Where we are is not in a good place. The rollout, to no one’s surprise who actually follows these things, is not going well. The Trump administration completely, you know, I don’t want to say they dropped the ball because that would let them off too easily. They just massively failed. It’s just a massive failure. And the Biden administration is doing their best, I think, to try to get us, to fix the very basic problems that were a result of the sort of Trump malevolent incompetence. But Bloomberg, interestingly, has this tracker up saying, and, you know, they’re projecting how long it will take for the United States to get to about 75 percent of people here vaccinated. And when I looked at it yesterday, it was 11 months. 11 more months of this. I, you know…it’s a lot. It’s just a lot. I am so…so — I can’t even words. That’s where I am personally. That’s where I am emotionally.

It’s difficult to sort of talk about this stuff because, yes, I miss my friends. I miss hanging out with you. I miss seeing Will in the studio. I miss being in the studio! I miss my family. I miss going to the Cheesecake Factory and reading their novel of a menu. I miss being able to go into a supermarket and not fear for my own life as someone who, every other week, injects myself with medications that suppress my own immune system to treat a serious chronic illness. I am like everyone, I think, just so, so sick of all of it.

And I was thinking about this the other day. I have been to…. There were days in the before times when I went to more medical appointments than I have in the entirety of the last year. There were single days when I went to more medical appointments in the before times than I have in this entire year of pandemic. And I’m not alone in that. A lot of people in the disability and chronic illness community are suffering from having to delay or defer medical care. You know, it’s not a scientific instrument, but I did throw a poll up on Twitter. And it got almost 8,000 responses to @MattBC. And a lot of people have had to postpone medical care that they desperately need. People are replying to me who have cancer and have had to delay chemotherapy, who have MS and have had to delay infusions to prevent the disease from progressing, have had to put off surgery that, although vital to their own health and welfare, it wasn’t considered urgent, and so got deferred. And so, like so many people, I am, I’m, it’s just so much.

And so, where we are is we’re not close enough to ending it, ending this pandemic. And it’s funny: Right before you reached out yesterday to ask if I could come talk to you, I had a conversation that, for the first time in months, left me feeling hopeful. I felt hope. And it was such a strange, like I had forgotten what that emotion feels like. But I talked to a couple of people from a group called PrEP 4 All, which is initially, an advocacy organization that was focused on AIDS medications. That’s where the “PrEP” comes from. They are at, on Twitter, they are @PrEP4AllNow, PrEP4AllNow. And I talked to these folks, and they had a plan, like an actual plan, for how the United States can start just ramping up, massively ramping up vaccine production because we just don’t have enough vaccine.

And they are proposing that the United States government should start manufacturing vaccines itself through a contract or arrangement with one of these companies. We can dive into the weeds if you’re interested. But it was the first time in several months that I felt help on the pandemic front, like real meaningful hope that the United States, for very little money in terms of COVID, in COVID terms, I think they’re projecting about $4 billion could create the capacity, the manufacturing capacity, to produce 16 billion doses of mRNA vaccine per year, enough to vaccinate basically everyone in the world. And it just, I forgot how much I miss hope, not just my friends and my family and The Cheesecake Factory, but hope.

VALLAS: Well, and it’s a wonderful place to start, right, because if that is what could be achievable, if we were to make that choice, it sort of, it helps us test the reality or kick the tires of that 11 months to get to 75 percent number. I mean, I want to talk a little bit more about the hopeful things, and I want to get into the weeds. You know, I’m always here for the weeds. But I want to also offer listeners as they hear that and as they maybe get some hope from that, the backdrop of what that kind of proposal is coming against and the context in which that proposal is an alternative to the path that we’re currently on.

CORTLAND: Of course. So, as we are talking right now, about 450,000 Americans have died since the start of the pandemic due to the pandemic. That is a number that we refer to as excess mortality. It looks at the number of people who are statistically expected to sort of, in a one-year period, to die and compares that statistical number with the number that have died during the pandemic period. And you can arrive at an estimate of the total number of lives lost due to the pandemic. And right now, that number’s about 450,000 people just in the United States.

But, of course, the suffering isn’t distributed equally, right? And it’s not just mortality that we are concerned with. First, it’s not distributed equally in that a disproportionate share of those deaths have occurred in what we sort of wonkishly refer to as congregate settings. And that’s places like nursing homes. You know, CMS, the government entity that pays for most nursing homes and regulates that space, they’ve tracked 100,000 deaths. About a quarter of all mortality in the United States has been associated with these nursing quote-unquote “homes.” These are places where disabled and elderly folks, my…. So, this is hard to talk about because I have three family members who are in a nursing home because we ran out of services that were available to them to keep them at home. And so, three of my own family members are in one of these facilities because we, as a society, have made the choice not to provide the resources for home care. But these facilities are associated with about a quarter of COVID mortality.

It’s not just nursing homes, of course. Prisons and jails are horrible, horrible sites where COVID is being transmitted, and the people in those facilities can’t take basic steps to protect themselves. Like the design of the facility that we have locked these human beings inside of prevents them from taking basic measures to [protect] themselves, like social distancing, like handwashing, like all of the mask-wearing stuff that we are being told by public health experts and professionals and leaders that we need to do at home. And it’s not just prisons and in jails. It’s meatpacking plants where we’ve seen outbreaks. It’s other group home facilities for disabled folks. It’s immigration detention centers, which are, you know, have many of the same sort of deplorable conditions that allow the spread of COVID.

And outside of congregate settings, we have seen disproportionate what, in the jargon we call morbidity and mortality, which is sort of illness and death from COVID associated, associated with COVID on communities that are systematically shoved to the margins in the United States. So, Black and brown communities, Indigenous communities are disproportionately bearing the brunt of COVID sort of death and suffering.

And so, it was with great sort of hope and optimism, I think, that a lot of people welcomed recent vaccine developments. Since last time we talked, you and I, since I was on [00:14:08]Off-Kilter [0.0s] last, we have the FDA giving emergency-use authorization to what are called mRNA vaccines. There’s the Moderna vaccine and the Pfizer vaccines. And there was a lot of hope and optimism there. And that has sort of faded, sort of quickly fizzled out, because we are, to your question, we’re doing a terrible job on vaccine rollout. There was no national plan. The Trump administration just didn’t bother, I guess. And states, states are dropping the ball, and we are seeing them drop the ball in ways that are, again, disproportionately harming marginalized people, harming disabled folks, chronically ill folks, Black and brown folks, Native folks, the folks who tend to be just shoved to the margins in favor of white, wealthy, non-disabled folks who are trying to game the system in some cases. And in some cases, it’s just that the system is not performing as we need it to.

And so, against that backdrop, we’re not producing enough vaccine. And so, because we don’t have enough vaccine to vaccinate everyone, we are having states, individual states, having to prioritize vaccine, the order in which different groups get the vaccine. Initially, we started with healthcare workers. That makes total sense from a public health medical standpoint, right? In an infectious disease pandemic in which your healthcare system is being stressed, it’s absolutely imperative that you have every possible healthcare worker available to try to help patients. And if they’re sick, they can’t do that. If they themselves are spreading the pathogen, if they are infecting other people with COVID, they can’t do that. We need to protect the healthcare system. And doctors, nurses, PAs, NPs respiratory technicians, there we dropped the ball. In some places with Stanford University, didn’t have a plan to vaccinate medical residents. These are the junior doctors who do the bulk of patient care, bedside care. I’ve been in inpatient more times than I can count, and it’s always the resident physicians that are called, the trainees, who show up first thing in the morning, who stay after to answer questions at the bedside, who write the bulk of orders, who do this really intense patient-facing care.

And Stanford, for reasons that I don’t really fully understand, decided that those people weren’t going to be eligible for vaccination right away. And we saw a great deal of pushback, and they reversed course. But that’s not the only place where we’ve seen this sort of systemic failure. Certain hospitals have tried to distribute vaccine using employee email accounts where you would get an email to sign up for your vaccine slot. Well, in some hospitals, housekeeping, as they’re called, or janitorial or environmental services, they don’t get email accounts. They don’t get a hospital email account. And so, they were left behind. That one smarts personally because my grandmother was a hospital housekeeper, and that job gave her the flexibility to get me to school every day and pick me up. And I know how hard she worked and how many patients she helped doing her job. And to see those people who are not particularly well paid most places just, and who are, in COVID times, at as much risk of contracting COVID in hospitals as anyone else because they are where the patients are, be left behind, was really deeply distressing. So, even the healthcare worker rollout didn’t go well.

We’ve also seen a rollout to these long-term care facilities, nursing homes, that should’ve happened quicker. The government contracted with Walgreens and CVS, I believe. And there was one of the days that I felt the greatest sense of relief in my life was when the pharmacists went to my grandmother’s nursing home and distributed the first dose of vaccine there. But there’s still problems there. The vaccine estimates are off, so either some places were supplied with too much vaccine or too little vaccine. And that’s solvable, and some problems are to be expected. But what we’ve really seen just fall apart are these, that the rest of the vaccination programs that states are running.

A friend of ours, Alice Wong, is really doing fantastic work in California, calling attention using the hashtag #HighRiskCA to the fact that disabled folks were pulled out of the vaccine prioritization scheme that Governor Newsom had in California. What do I mean? Well, if you are disabled and at greatly heightened risk of serious illness if you get COVID because of your disability or chronic illness, you are no longer prioritized for vaccine in California. They were a part of the initial prioritization groups, and they were just deleted, just pulled right out of line. And so, if you are a 25-year-old who has survived cancer, gone through maybe an organ transplant, maybe a bone marrow transplant, and every single day of your life, you take incredibly powerful drugs that suppress your immune system, really dampen down your ability to fight an infection with something like COVID, you are no longer prioritized to get the vaccine in California because they’ve gone to this just aged-based system.

And so, the system looks at you, sees that you’re 25, and says, oh, you’re not a priority. Even though you are at much greater risk than most people who are 25 years old or 35 years old or 45 years old or 55 years old. And Alice is calling attention to that and really pressuring the governor in just a really, really good way, using this #HighRiskCA hashtag. We’ve seen other activists in other states, particularly New York, start their own version: #HighRiskNY, because Governor Cuomo doesn’t seem to think that people who are immunocompromised should be prioritized either.

And that really points to, a, the fact that we need much more vaccine. We need the government to just start producing vaccine in just massive quantities so that we’re not talking about an 11-month wait, during which time thousands of people will die every day. Instead, we’re talking about a much shorter time frame. And so, these decisions about who gets the vaccine now and who gets the vaccine in 11 months aren’t quite so challenging if that 11 months is instead two months or three months.

The other thing that we’re seeing, that’s really sort of distressing is this other leftover sort of failure of the Trump regime, which is the technical assistance the federal government provides to states around which groups to prioritize isn’t very good. CDC has a lot of work to do. Their list of which medical conditions qualify to put you in a tier or whatever, depending on which state you’re in, it might be Tier 2A or Tier 1B or Tier 1C. This whole thing is confusing. If it sounds confusing, it’s because it is confusing. There’s a real lack of federal leadership in providing the sort of really wonky technical assistance that states need from the federal government to know which medical conditions, which disabilities do we really need to prioritize in terms of getting people with those chronic illnesses, those disabilities vaccinated immediately because they are at such increased risk of COVID.

And CDC is just, under the Trump administration, Dan Diamond, a reporter at Politico, had FOIAed — Freedom of Information Act requested — some emails that showed that Trump political appointees were pressuring CDC to give bad guidance on exactly that question of trying to figure out which disabled and chronically ill people are at really, really, really high risk from COVID-associated morbidity and mortality, suffering and death. And so, there’s just so much that was broken by having an entire, basically a year of of Trump’s failed leadership running this pandemic that, you know, we’re not in a good place. We’re just not in a good place. But there is hope because hopefully, the Trump admin — Sorry. Just that was a Freudian slip.

VALLAS: It’s going to take a minute. We’re going to have to rewire our brains, Matt, because I still do the same thing. And I love that I’m not the only one. So, now do it again, but do it with much more hope!

CORTLAND: The Biden administration! And that feels so good to say, doesn’t it?

VALLAS: It does.

CORTLAND: The Biden administration can do something that the Trump administration was utterly incapable of doing. The Trump administration was was always going to do the wrong thing, but the Biden administration can do the right thing. The Biden administration can say, “Actually, we think that ending this pandemic by the government producing billions of doses of vaccine is the right thing to do. And we’re going to spend just a relatively small amount of money, maybe four or five billion dollars, to build up the production facility. We’re going to contract with one of these corporations that really knows how to manufacture pharmaceuticals.” It’s the same thing that Moderna’s doing. Moderna is contracting with a company called the Lonza. Maybe the U.S. government contracts with Lonza as well and really ramps up production of this mRNA vaccine in a like super quick, super fast, just massive way to end the threat of this pandemic in the United States for all of us here and globally.

Because if we don’t, if we don’t put out the fire across the entire globe, what is likely to happen is that COVID, if allowed to continue in some parts of the world, low-income countries, will mutate. And it is likely that some of the variants that develop would be more transmissible, more lethal, and might evade our vaccines. Our vaccines may no longer be effective on variants of COVID that develop if we don’t vaccinate the entire world. And so, the Trump — I did it again. I’m going to rewire my brain. I’m going to have to like, I don’t even know how to do this one. But the Biden administration has the opportunity to really fix this. They can say to pharma, they can say to Moderna, “We care more about ending this pandemic, we care more about saving lives, we care more about ending lockdowns and sending our kids back to school than we do about extracting every possible cent of profit for your shareholders.”

And so, I am hopeful that we will do the right thing, and we will produce enough vaccine to vaccinate everyone in the United States, and that importantly, we will work with the World Health Organization and global partners in this space to give the intellectual property, the know-how, the cookbooks, the manuals for making this vaccine, make it available throughout the entire world so that countries everywhere can produce enough vaccine to vaccinate everyone, and so that we don’t end up with a nightmare scenario where even though everyone in the United States might eventually be vaccinated 11 months from now, by the time everyone is vaccinated, because we have ignored the rest of the world, mutants, mutant strains of SARS-CoV-2 develop in those countries and then find their way back to the United States, and our vaccines aren’t effective against them. That is my hope.

VALLAS: And for folks who are listening and taking this in and saying, OK, that gives me hope too. This is an alternate universe that I would very much like to picture. But what was that group again that you mentioned? It’s called PrEP 4 All U.S. Tell folks where they can learn a little bit more about the campaign that you mentioned that is trying to create sufficient external pressure that we see the federal government take the steps that you just outlined.

CORTLAND: Yeah, of course. Their website is PrEP4All.org. PrEP4All.org. They’re on Twitter. On Twitter, they’re @PrEP4AllNow. Again, it’s the number 4: PrEP4AllNow. And it was honestly, the first time I met with them was the first time that I have felt real, meaningful hope that maybe we will not be stuck in a perpetual pandemic hellscape for the rest of our lives.

VALLAS: What is your message to state policymakers right now in, California, sure, but New York, as you mentioned, and elsewhere, lots of places that you haven’t named yet, states that you haven’t named by name, but who also would be folks who should be receiving advice from, you should know to call you, should definitely be listening to this? What are the best practices? How should states be handling prioritization in this moment? Recognizing that there’s the bad policy that’s worth calling out, but maybe worth spending a couple of minutes on what states should be doing.

CORTLAND: On one hand, state leaders are in a very difficult position. There’s not enough vaccine. There hasn’t been transparency between the federal government, which is controlling the flow of vaccine, and states, although the Biden administration is changing that. Is giving states a three-week look ahead at how much vaccine they can expect to receive at any given time. And so, I want to be clear that some of this is just very difficult, and it’s difficult for reasons that state leaders couldn’t control. There were federal failures of the Trump administration.

Having said that, it is incredibly important that governors and public health officials in all of our states recognize that not everyone is at equal risk of COVID-19-associated morbidity and mortality. What do I mean by? BIPOC communities are at, also are at increased risk of COVID-associated morbidity and mortality, of suffering and death. And so, we need state policymakers, since they are essentially in charge of vaccine distribution, to try to the best of their ability, with all of the resources and tools that they have, to ensure that vaccine distribution occurs equitably. This cannot be a process that favors white, wealthy, non-disabled people to the exclusion of those who are at the most risk of COVID-associated morbidity and mortality. And yet, we see state policymakers, state leaders failing to take the measures necessary to ensure that vaccine distribution is equitable, is racially equitable, is equitable for people with disabilities, for people who are in immigration detention.

We just, we keep seeing them fail this test over and over and over again. And people are going to die who did not need to die as a result. It’s just…it just does not have to be this way. And so, you know, what I would say is that whatever experience you, governor, you, public health commissioner, may have had working with CDC, the leadership over there has changed. You don’t need to be fearful about retaliation, political retribution from the White House. You should be partnering with the federal public health agencies that can provide the best information for you to use to make sure that you are distributing vaccine in a way that is equitable, in a way that does not leave disabled folks, chronically ill folks, communities of color behind.

And we’ve seen from this White House, from the Biden White House, a real change in the emphasis that they’re placing on equity. You know, there’s now a White House Coronavirus Equity Task Force. There are senior advisers in the administration whose job it is to ensure that vaccine distribution occurs equitably, that the whole response to the pandemic is taking into account the need to not leave people behind, to not exclude communities of color, to not leave disabled folks behind. And so, that’s a real change of pace. And so, what I would say to state policymakers is, you can do better. And you have more tools now to do better, and you’re being told by your own citizens — Alice in California is a prime example — to do better. And the reward for doing better is that you get to save lives. You get to save lives. It’s a privilege you should take advantage of immediately.

VALLAS: Now, Matt, we’re going to run out of time, and there’s a ton of additional ground that I know both of us would want to cover, including some of the interesting survey data that’s been coming out, actually, some of which just was released this morning right before we started talking, looking at the trust in the vaccines and the number of people both in the U.S. and around the world who say that they’re willing to get a vaccine. Now that those numbers are actually starting to rise, that’s maybe another source of hope that we’re not going have time to get into. But I do want to give you a chance just in the last maybe two minutes that we have to put in a little bit of a plug for, and provide listeners with just a little bit of a heads up of, what’s going on in Congress right now that is not directly related to the vaccine. It’s not exactly the four corners of what we’ve been talking about so far, but it’s very, very related and also incredibly important both for the disability community, and in particular, gets into some of the themes you were raising up at the top, which are especially difficult for you to talk about.

I also have a loved one in one of these facilities. Many of our listeners do as well. I’m talking about quote-unquote “nursing homes.” And right now, as Congress is hotly debating what to do around economic recovery relief in the form of the package that Biden sent to the House and the Senate — $1.9 trillion in economic relief is what he proposed — Congress is now debating their own versions of what that package is going to look like. And Home and Community-Based Services, sometimes called HCBS, is an aspect of that debate. Definitely not getting nearly the attention that, say, $1,400 checks or some of the other kinds of front-page, above-the-fold subjects are getting. What is going on with HCBS, and what to listeners who care about that issue and who care about the disability community, or many of whom are members of the disability community, what do folks need to know about the state of play of that aspect of this debate and how it’s being centered as lawmakers decide what to include in a package that hopefully will ultimately make it over the finish line and to Biden’s desk to sign?

CORTLAND: Now is the perfect time to call your member of Congress and call your senators and tell them that you want that Home and Community-Based Services money to make it into this package, because that money, that money will keep people alive. That money will pay for the services that enable people to stay in their own homes. In their own homes! Imagine now, during a pandemic, being told, “Well, there’s actually no more money for the home nursing aides, the direct service providers, the people that you are employing to come into your home to enable you to live here independently. We’ve run out of cash for that. Sorry. You have to move into a nursing home where over 100,000 people have died in those facilities in just the last year.” That is cruel and unconscionable and relatively easy to solve. We are asking for, out of a like $1.9 trillion package, about $10 billion. That’s it. That is the ask for HCBS funding. We’d love more money. But what’s in the bill right now is just shy of $10 billion.

So, now is the time to deliver that message to your representative and your senators that you care about HCBS funding, and you want that money to be in the bill. And you’re counting on your representative and your senators to make that happen. Because that is a phone call. If you if you make that phone call, you send that message via Resistbot, that’s something that will help keep people alive who are at just incredible danger of COVID if they are forced into an institution during a pandemic. It’s a very easy thing for the federal government to do. It’s not a lot of money. You know, we’re talking about a plan that is almost $2 trillion, and we’re asking for about $10 billion. It’s money that, to be quite honest, the disability community has been lobbying for since March of last year. And so far, Congress has not come through for us, even though our community has been disproportionately bearing the brunt of COVID suffering and death. Even though it’s not a lot of money, even though it would definitely keep people alive, Congress has yet to come through for us. So, now is the time to reach out to your electeds and demand that they advocate for this money to stay in the bill and to get to people who need it to be able to stay in their own homes, living safely and independently.

VALLAS: And we’ll have a little more information on that in our nerdy syllabus on Medium as well for folks who are hearing that and going, oh, wait, wait. I need to know more about the state of play. We don’t have time to do it now. But that’s why we’re going to send you to our nerdy syllabus page.

And if you’re not already following him on Twitter, you should be. Matt Courtland is @MattBC, @MattBC. He’s a total must-follow on Twitter, on HCBS and so many other issues that are so important for the disability community. And his Twitter feed, I’m going to brag since he won’t, is one of the best ways to stay up to date on what’s going on with both federal and sometimes state policy when it comes to disability priorities like HCBS.

So, Matt, I know you keep me up to speed. It’s why we love having you on the show, among many other reasons. But thank you so much for taking so much time to walk us through a very complicated and frustrating and complex and confusing state of play that also, I’m really grateful has a beacon of hope in the form of a path that the U.S. could be taking if they listen to PrEP 4 All U.S. Which is also something we’ll encourage folks to go learn about and also amplify as well as hopefully external pressure grows sufficient for the Biden administration, who we know is trying to clean up quite a substantial mess. We know they’re listening. We know they’re trying to get it right. And this would be something for them to take up and pay attention to, stat.

Matthew Cortland is the policy director at Be a Hero. It’s an organization co-founded by Ady Barkan that fights for the realization of healthcare as a human right. Matt’s also a good friend of the show and a good friend of mine whom I appreciate so, so much. Matt, thank you so, so much for taking the time. And I am just, I guess, really grateful that there is more hope in this conversation than the last time that we had you on to talk about COVID. So, that’s something?

CORTLAND: Thank you for having me. It is always so good to talk to you. And I am hopeful that we have a pathway so that you and I can hang out again in person sometime before 2030.

VALLAS: And we can figure out who has longer hair at this point. It’s not a bet that I’m going to make without seeing some pictures.

CORTLAND: [laughs]

VALLAS: Matt, be well. Sending love.

And that does it for this episode of Off-Kilter, the show about poverty, inequality, and everything they intersect with, powered by the Center for American Progress Action Fund. I’m Rebecca Vallas. The show is produced by Will Urquhart. Find us on the airwaves on the We Act Radio Network and the Progressive Voices Network, and say hi and send us your show pitches on Twitter @OffKilterShow. And of course, find us anytime on iTunes or wherever you get your podcasts. See you next time.

♪ I want freedom (freedom)

Freedom (freedom)

Now, I don’t know where it’s at

But it’s calling me back

I feel my spirit is revealing,

And now we just tryna get freedom (freedom)

What we talkin’ bout….