Emergency use authorization next week. But there is a caveat, the efficacy of the j js vaccine dropped 57 from the highly contagious variant from south africa. Despite the travel van to stop that variant from coming over here, the new variant is already here. Two cases identified this week in South Carolina with two patients with no ties to each other and no travel history given that, signals community spread. During todays White House Briefing dr. Anthony fauci stressed the importance of vaccinating as many people as possible, as quickly as possible, before those mutant strains get out of control. Whether or not thats going to ultimately take over in the sense of being dominant is unclear by now. The projection that is made with regard to the uk is that probably by the end of march, the beginning of april, it actually will become more dominant in this country. The fundamental principle of getting people vaccinated as quickly and as efficiently as you possible can will always be the best way to prevent the further evolution of any mutant. Because when you do that, you prevent replication, and replication is essential for mutation. Still, the process is slow. States are still pleading for more vaccine. And mega vaccination sites, like this one in the meadowlands, is still sitting idle. For the most part. Thats not all, whats more frustrating more reporting that shots are being wasted because of the strict guidelines on who can get them and when. Joining me now is nbc news correspondent monica alba. Msnbc contributor dr. Natalie azar and a member of joe bidens covid19 Advisory Board during the transition dr. Ezekiel emanuel. Also viceprovost at the University Of Pennsylvania and all authorize of which country has the worlds best health care. So, monica, considering that the new strains are here. Considering that they are still trying to get up and running, getting the vaccine out as quickly as possible is the covid19 task force currently in the white house considering retooling its strategy . Reporter well, theyre thinking of a range of options, katy. Among that is exactly what you point out, the difficulty here with the mutant strains already here. That uk variant that was first identified a couple weeks ago, in 29 states. The south african one, just so far in South Carolina, dr. Walensky, the director of the cdc indicated its very likely thats spread beyond there, because the two people that did Test Positive for it. Didnt have any connection to each other and havent traveled outside of the united states. So we can expect to see more. Something else theyre monitoring very closely. The white house Officials Say there could be variants that come out of large cities in the united states. For instance, the los angeles variant something theyre examining. Could there be more of those. There were encouraging signs from the initial data, and the Johnson Johnson vaccine. Dr. Fauci touted the fact that even if the Efficacy Rate is lower, with pfizer and moderna, the fact that it is the ultimate shot, that it doesnt require the Temperature Storage and the fact its cheaper to produce means more of them can get potentially up to scale faster. Even though the approval process wont start until next week. That in itself can take weeks. It will be weeks or months before the general population has access to it. The white house is defending their slow and sluggish Vaccine Rollout and distribution. Theyre continuing to poke at promises that were made with the Trump Administration, goals they didnt reach. And they claim they inherited a system thats rather broken. Now, if we actually look at the data, some of the numbers in the last few days of the Trump Administration were nearing 1 million doses a day. Now, according to the white house, the Rolling Average is the last days is 1. 2 million. So that, they believe, will get them to that 100 million shots in arms in the first 100 days. Of course, the variants theyre worried about because that initial data from Johnson Johnson also shows a lower Efficacy Rate against the south african variant, for example. So, now, were talking about these potential boosters that will be needed. That was Something Else addressed in the Covid Vaccine briefing today earlier from the white house. Thats something that manufacturers and drugmakers are working on having scientists develop those. Even though the first rounds of vaccines are what most americans will get. Its very likely they will have to get a booster to deal with the emerging variants, katy. Joe biden was asked about the Johnson Johnson vaccine just a moment ago, were trying to turn around that tape so we can play it for you and get it to you. While were waiting for that, dr. Azar, this idea, the onedose vaccine, how much of a difference is that going to make in being able to track those who have been vaccinated. I know with the moderna and Pfizer Vaccine there can potentially be issues for getting people back for the second dose. Well, thats only one advantage. What monica pointed out there are a few very favorable characteristics of the Johnson Johnson vaccine. Yes, its one dose. It doesnt require the cold chain distribution. Its very inexpensive to make. And so production can certainly ramp up. You know, its definitely an important vaccine to have in the u. S. Arsenal. But i think its going to play a significant role, more globally. You think of lowincome countries. Warmer climates. Its a falsity to think that if we take care of americans and vaccinate us here without considering the global implication of the pandemic, were really doing ourselves a disservice. We are still awaiting that biden playback. So dr. Emanuel, if i interrupt you, im so very sorry. Given there are new strains out there. And given that the vaccines are potentially less effective against the new strains, how are you feeling today . Sorry, i didnt hear that. I got interrupted can you repeat that quickly . Dont worry about it. You had a phone call, how concerned are you about the vaccine heres biden, im sorry. Dr. Emanuel, hold on one second. At walter reed a lot. I spent almost six months there myself as a patient. And in addition to that, as Vice President , every single christmas we spent all of Christmas Day at walter reed. These kids are amazing. And thank god theres not as many people to visit. All of the people im seeing today who are being treated for four of them amputees are people who are in fact retired and theyre real heroes. And then were going to go see the vaccination distribution. So i spent a lot of time at walter reed. Theyre great americans. Theyre great people. Nice to see you all. Can you talk about the covid im sorry . With covid relief and reconciliation . I support Passing Covid relief with support from republicans if we can get it. But the covid relief has to pass. Theres no ifs, ands or buts. Thank you. All right. So that was pretty brief right there. Dr. Emanuel, back to you, on the new strains that are out there. And this news that the vaccine, at least the Johnson Johnson vaccine is not as effective on the south african strain. Well, first of all, lets back up. If you read the second line of the press release, it said that the effectiveness grew over time. That at 28 days, 85 effectiveness, regardless of place and age and gender. And thats important. And after 49 days, no one got a severe case. And i think thats pretty impressive, focusing on the 72 , missing the whole picture. And the whole picture is your actual immunity from this vaccine increases over time. And thats a really important factor. Second, on the variant, i think that there are three things we need to do to address them immediately. And i know the administration is working on this. The first is, we need more genetic screening, more strains, to know how many variants are out there. And to test them to see how serious they are in terms of debating diagnostic tests and monochromal antibodies. Second, were going toed me nor vaccines. And i know the administration is working on it part of it tested against what we had in the united states, part of it against the south african strain. And the ability to add more strains and variants that come about. And the last thing which has gotten no attention is, we need more therapies. More therapies that you can take orally or intranasally that are effective, in case the vaccine isnt working in your case. Those are the three things i would do about the variants. So theres been little news about regeneron, a guess more studies showing that it is quite effective, if youre able to use it early on. But thats something thats being given you can describe it better than i can, given in hospital. What news do you have . Or what do you know about the therapies that are being worked on given theyre not in the headlines every day . Thats true. The monochromal antibodies, if that targets, and regeneron is two Monoclonal Antibodies. We have the brazil variant, the los angeles variant. And there would be more variants, we can be guaranteed that. The other problem with Monoclonal Antibodies they take more Hospital Personnel to administer them, the patients, so its not like a pill that someone can take or Intranasal Administration or something that people can give to themselves. Those are really the kind of therapies we need that can be scaled to millions of people and dont require Health Care Personnel to administer them. So, weve had a recent report about culture, that needs to be evaluated, too. Dr. Emanuel, while i have you, briefly on schools, the cdc has said that the spread in schools is not to keep them close, essentially. Theres very little spread in schools. Are these new variants going to change that . Well, i think actually, the cdc report that was published in Jama Summarizing the data, i think its very, very impressive to restart inperson schools, in person classrooms, the data are, i think, pretty compelling. And one of the things that happened in schools is you enforce mask wearing. You enforce social distancing. You enforce small pods, you enforce handwashing and that keeps people safe. Its not absolutely safe but much safer being in the community where they could be haphazardly introduced and adhered to. Plus theres advantages to students. Theres education. Theres the Mental Health benefits. Theres food. So, i think we really do need to open up schools. And what the report also says is, look, wheres the big risk. The big risk is, Indoor Sports and we need to stop thats where the risk is in schools. Dr. Ezekiel emanuel, thank you for joining us, as to you, dr. Monica alba and dr. Azar, we appreciate it. While other states grapple with long lines and mass confusion, West Virginia was called out today by the white house on how well its doing with its own Vaccine Rollout. 81 of all vaccine doses delivered to West Virginia are already in peoples arms. And the reason for early success is empowering mom and pop pharmacies and communities that may have been skeptical of the shot. With me now from shepherdstown, West Virginia, is msnbc correspondent stephanie gosk. Stephanie, explain. Reporter katy, its remarkable. West virginia, the state, gets beaten up fairly often. They struggle with poverty. They have poor health. It was pegged early on as a state that was going to have a real problem in the Vaccine Rollout. Instead, theyre being held out as the shining example of what works. We spoke with the covid czar here, dr. Clay marsh who has been part of the rollout in the beginning. He said one of the reasons in addition to the program you just talked about with the pharmacists is that they set up an organization that was ready to be agile, he said. An organization that would be able to recognize problems when they happen, because this is an unpredictable pandemic. An unprecedented pandemic, then be able to shift and actually respond to them. Early on in the vaccination effort, they said, listen, weve got this option with cvs and walgreens to vaccinate in the state. But instead, they decided to go with a network of private pharmacies, theres quite a few of them in West Virginia, a 100 more or less. They asked those pharmacists to take care of vaccinating in their area. We visited with a husband and wife team. They are both pharmacists. They own five pharmacies in the panhandle of West Virginia. They have been getting up early in the morning. Driving all over the region, vaccinating people, getting home late at night. And they have said they moved quickly because there hasnt been a lot of bureaucracy. I asked how they were tapped to take this project on. This is a little bit of what they had to say to me. So, your phone rings, and what do they say to you . We need your help. And we said, sure. Yeah, it started out the first week with 16 pharmacies. Then expanded out to 60 the second week. And we crushed it. Has it helped you that youre from here . That youre visiting people who might be a little bit nervous that this is your backyard . Has thought been has that made it easier for you . Absolutely. Actually, half the staff most the staff they werent going to get the vaccine. And i pretty much talked them into it. Because we are local. Most of these people we know. Reporter so, its really that local kind of builtin trust that theyve been building for decades that allowed them to kind of move freely between the clinics, convince people that they needed the vaccine. Now theyre being pegged to go to social workers and schools and things because its worked so well. Katy. Stephanie gosk in west that. Thank you. What youre seeing in the lefthand side of the screen well, its suppressed now what you were seeing were joe biden at walter reed medical center. He didnt get there by a snap of the finger. The other video we had was a tape playback, played to us on his way to walter reed. Congresswoman cori bush is moving offices after a confrontation with Marjorie Taylor greene. She said Taylor Greene and her staff yelled at her in the hall. And the fbi raises concern for pipe bombs at the rnc and dnc, the day before the siege at the capitol. First up, though, posttrump civil war, inside the Republican Party. What exactly is happening there . Stay with us. Fine, no one leaves the table until your finished. Fine, well sleep here. Its the easiest because its the cheesiest. Kraft. For the win win. At tmobile, we have a plan built just for customers 55 and up. Saving 50 vs. Other carriers with 2 unlimited lines for less than 30 each. Call 1800tmobile or go to tmobile. Com 55. The Republican Party is, well, let me try to explain on the one hand, theres the debate over kuuan an supporter and congresswoman Marjorie Taylor greene and whether her trumpian politics and embrace of the Conspiracy Theory should have a place in the gop. On the hand a punishment of the leadership, congresswoman liz cheney for her support of the former president s impeachment. Yesterday, trump ally matt gates, travelled to wyoming, far from his native florida, to hold a demonstration against his gop colleague, against liz cheney in her home state. You can help me break a corrupt system. You can send a representative who actually represents you, and you can send liz cheney home. One of my next guests travelled to wyoming for that rally to see what was going on for herself, politico Tara Palmieri wrote, at Harvard Freight tools when i uttered liz cheney, a worker muttered an epithet. Joining me now, tara palmiri, and katie parker. Tara, given what you saw, whats your takeaway for the broader Republican Party within the house . I think if theres any doubt, like i said, trump does not control the party, he clearly does. From the people i spoke on the ground, trump is way more popular than wyomings only representative liz cheney who has this famous name shes been elected three times, these dick cheneys daughter and yet when i mentioned her name there was evisceral anger about her because theres more loyalty to President Trump through anyone who opposes them. These people dont even want to call themselves republicans, a lot of who i spoke to on the ground, they are members of the trump party. He won wyoming by 43 points. So, theres not surprising that there is this reaction. But it just showed theres a reason why a lot of these members of congress are reluctant to break from trump and some are running full force at him like matt gaetz, because hes popular on the ground. I struggled, katy, i went to so many places, gun stores, restaurants, bike shops, pawn shops, anywhere, trying to find someone who would defend liz cheney. If they didnt know her, they didnt care, they thought she was the mayor or senator. But who they did know was donald trump. And no one would get the vaccine of people i asked. I asked over two dozen people they would get a vaccine. They believed the election was stolen and they were spouting out a lot of talks points that you hear from what is becoming establishment Republican Party. These are the voices tha