Administrations Public Health team. Former obama certainly vivek murthy has been asked to reprise his role, according to the washington post. And the president elect asked dr. Anthony fauci to stay on in his current position, in addition to an expanded role as the chief medical adviser. The Biden White House will need all the help that it can get. 200,000 americans are testing positive for the virus every single day. 3,000 are dying from it. Those numbers are only getting worse in the coming weeks. And even the muchtouted silver lining, an imminent vaccine, comes with massive challenges. A new report from nbc news outlines how unprepared the Trump White House is for the logistics of actually distributing this vaccine. And how much thats going to challenge the incoming administration, which will inherit the burden of getting the majority of americans vaccinated. As one former hhs official told nbc news quote, this, the team is going to have an amazing challenge of trying to get the publics confidence and overcome all the way thers being set up to fail. Nobody is anticipating smooth vaccine rollout over the next year, which is why the Incoming Biden Administration is hoping to increase mitigation efforts to slow this spread, including a Public Awareness campaign to rally americans, to voluntarily adopt universal mask wearing for the first 100 days of bidens presidency. So lets get into all of this now. Joining me now, nbc news political reporter, ali vitali, nbc news correspondent heidi przybyla, and dr. Vin gupta. Welcome to you all, guys. Heidi, i want to start you and your excellent reporting on this, especially with the ill preparedness, it seems of the Trump Administration, the steps forward for operation warp speed. After phase i, essentially, when the Health Care Workers get their first vaccine, what happens on january 21st . Talk us through this cliff that youre reporting on. Yasmin, phase i is essentially a shipping operation. We already have the infrastructure to vaccinate the Health Care Workers. We have the infrastructure to vaccinate those in longterm care facilities. Cvs and Walmart Associates will go out there and we know where to find them for the second doses. Thats expected to go pretty smoothly. After that, yasmin, and this coincides almost perfectly with february, when were looking at rolling out broader vaccination, to more groups, older people with preexisting conditions. First responders. This is a much broader population. Right now, my reporting is that there has really been a very, very significant gap in coordination with the localit s localities. A lot of places not knowing what the specifically guidelines are for who theyre supposed to be vaccinating. The money is a huge, huge issue. Hopefully this gets resolved in congress with the funding to the localities, given that they have to stand up an estimated 3,000 additional rapid vaccination clinics. But even if they dont do that, theres even if they get that done, theres going to be a lot more here that is lacking, yasmin. Specifically, the i. T. Infrastructure. Look, theyve got this system called titiberius. It is not the kind of tracking system they needed to have started, according to my sources, about nine months ago in order to share all of the information thats going to have to be exchanged between all of the administrators, the people who are giving the shots, the suppliers, the local Health Departments, which all have different systems. Take a listen to dr. Mandy cohen, the Health Secretary for North Carolina. Actually, when i spoke with her earlier, she said that this is going to be one of the main obstacles here, is not having that coordination to know, hey, we have to go into this specific community, because this is an underserved area. These people are skeptical of the vaccine. Were not going to be able to get this under control if we not only if we only give these people one vaccinate or no vaccination, we dont know where to find them for their second dose. Maybe they have side effects. This is all really critical infrastructure, yasmin, as well as that Public Relations campaign that we saw, for instance, with previous pandemics that have loomed, like with h1n1, when the Obama Administration really put together a summit, where they brought together governors, they brought together mayors, local stakeholders, Health Officials and war gamed all of this. They had grants to the states and they had a massive Public Relations campaign to make sure that the information got out to the public. All of those things right now being left to cashstrapped states, yasmin. So, heidi, we actually got that sound that you were referring to a little bit earlier. I want to play a bit of that, because i think its incredibly important in talking about this tracking effort. Lets take a listen to that. Theres a huge tracking effort that we all need to work on together. Because as you know, most of these vaccines are two doses. So its not just delivery on that first dose. Youve got to get that person back either 21 days or 28 days after that first visit. And then making sure that we have both the i. T. Systems that can track, but reminders and the right messaging and coordination across all of these different entities that are going to be doing vaccinations and have different types of vaccines. I think its going to be a huge communications challenge. I think that the federal government has a huge role to play in how they communicate. So dr. Gupta, its incredibly troubling, because if any of these steps go ahead, heidi. Go ahead. Well, i was told by experts who are following this that this Information Technology initiative should have started nine months ago when we knew that this was at the path that we were going down when we started developing the vaccines, that at some point, they need to be administratored. And yet that work really hasnt been done until the past couple of months. Im being told, in many cases, its just too late. Were not going to have that in place. So the Biden Administration will have to take off bitesized pieces of this and try to figure out how to communicate, how to make sure all of this works in a seamless way. So, dr. Gupta, you know, im going to speak pretty bluntly here. This is pretty scary to think about, if its too late at this point. That there is a lack of preparedness and weve gotten here. I mean, its taken nine months. They had so much time to prepare for this moment. For the distribution of this vaccine. The president has talked about this vaccine for so long, and yet they are ill prepared for this very moment. And it speaks to the management that they have had of this pandemic throughout. I actually want to read a piece of the Task Force Report that we obtained, nbc news obtained that was distributed to all states. In it, it reads this. If state and local policies do not reflect the seriousness of the current situation, all Public Health officials must alert the state population directly. It speaks to the fact that theres no National Effort onboard as to how to actually combat this pandemic. If, in fact, your governor is not instituting policies to protect individuals of that state, as a health care professional, in that state, it is incumbent upon you to inform your patients, the people in your community, to do certain things to protect yourselves, because the politicians in your state cannot . Well, thats exactly right, yasmin. Thats the situation we find ourselves in. Let me clear to everybody watching right now, its important that the Incoming Biden Administration, obviously, is embarking on a major pr, Public Health communications effort, i. T. Effort, just to make sure everybody gets a vaccine. The twodose vaccine regimen in most cases that they deserve to get, they need to get. But its going to take time to get to that point. And the university of washington just put out a new forecast, suggesting by april 1st, were so going to see upwards of 540,000 americans in total lose their life from covid19. It does not have to be that way, that we can mitigate that loss of life. But vaccines are not going to save us from the worst of this pandemic. That means every governor needs to think strongly about Indoor Dining and curtailing that. Every governor, every state and local Health Department needs to be messaging locally about not traveling. I talk to so many people who say, you know what, im still going to travel, but what if i do these set of things. Is it okay, doc, to travel . My answer is, no, its not okay. You cannot test or mask your way into safe travel. Everybody needs to be messaging on that. Were in the midst of a disaster, yasmin. As an icu doc, i can say this, that 48 states that were estimating are going to experience extreme stress in their icu dwebetween december a february. That is the window in which vaccinations will be ramping up, but people will have not have had the twodose regimen or the onedose regimen. So we have to keep our eye on the immediate priorities, which is mitigating loss of life. That means highquality masking, the threeply mask, the blue mask if you can get your hands on it. Face shielding if youre above 55. Doing basic things like grocery shopping. Covid19 does not respect curfews. It transmits in any indoor environment and please do not travel. The big supply chain limitation right now is adequately training Critical Care personnel. Im begging all americans here, please dont travel. Yeah the task force also basically said, if youre over 65 years old, you should get your groceries delivered and you shouldnt be leaving the house, at all, really. And if youre under the age of 40 and you celebrated with thanksgiving anybody outside of your household, you should essentially assume that you have covid right now and be quarantined at the moment. Ali, im going to go to you on this one. It all leads top biden. Another thing ill pull from heidis awesome piece. It says, the new team will have an amazing challenge in trying to get the publics confidence and overcome all the ways theyre being set up to fail. This is from a former senior official at department of health and human services. What is the plan here for the Biden Administration to bridge this gap . Reporter well, heidi teased out all the different layers. There are the logisticical and monetary challenges as they try to figure out what rolling out a vaccine looks like. But there are the trust concerns, as well as making sure this vaccine gets into these communities, mostly communities of color that have been hit so much harder by this virus than White Communities have across the country. But trust isnt built overnight, and neither is the habit of americans looking to the federal government for answers on this. What weve seen from the Trump Administration is not leading on this issue, not talking about trying to set a cohesive set of guidelines for americans to follow. Frankly, the white house response over the last few months has really been all over the place from the president at the top of this chain. And so what biden is trying to do is step into this breach and his team is making clear that they want to be an executive that leads on this shaissue by instituting 100 days of mask wearing at the start of his term. Making clear that they support the guidelines that weve all been talking about for so many months now, staying at home, social distancing, social distancing, staying away from Indoor Dining, if you can. At the same time, though, they are also being forced to deal with the hyperpolarization around so many of those guidelines that has been baked in over many, many months. Mask wearing has somehow become political. And so what youre watching this Biden Transition Team do is, yes, figure out the logistics, yes, push forward on stimulus spending, but also make it so theyre not lashing out at republicans. Theyre trying to build a bipartisan and sciencebased consensus around all of these things that mitigate the spread of the virus. Because thats their shortterm focus. Is how do you stop this very bleak situation from getting worse, while also pushing out into the medium and longterm of how do we push this vaccine out . And i would also note that when you talk about stimulus spending, the biden team has made clear that they like the 900 upwards of 900 billion deal thats moving its way through negotiations on capitol hill right now. But we just got off of a call with transition advisers who said, thats really just the starting point. Theyre making clear, and im sure well hear this from biden in a few hours, that theyll need to push for more stimulus spending. Yes, that goes to americans for direct relief, it goes to helping Small Businesses through this continued hard time, but its also going to go to putting money into getting an infrastructure in place, so they can put out that vaccine. It makes it a little bit harder, as you push forward. Everyone wants a vaccine, it doesnt matter, republican, democrat. It makes it harder to say no in those negotiations, when you see money like that, thats wrapped up in it. But then, again, everyones agreed that we need action on this for so many months and we still havent had it yet. Two things. Were actually going to be talking about the stimulus spending, so thanks for that tease there, ali, appreciate it. In the next block, you dont want to miss that conversation with our own Garrett Haake. And the one thing i worry about with bidens 100day mask mandate, is how many people are actually going to follow suit, especially in those trump states. That thats a major worry i have going forward. Thanks to you all, appreciate. It. Hospitals are the first line of defense when it comes to vaccine distribution, and theyre starting to make plans on their own with or without the help from the white house. Joining me now from North Carolina is nbc News Reporter dacia burns. Thanks for joining us. Talk us through what youre seeing so far there. Reporter hey, yasmin. At the end of this grim week where weve seen just these heartbreaking numbers, everybodys looking for a little bit of hope, right . And here at duke, this room im in right now, it kind of represents a little bit of hope here. This is a space where in just a couple of weeks, hopefully, people will be getting some of those first vaccinations. It may not look like much just yet, but even figuring out how to structure this room was a thoughtful planned out process. They have to find a space that was big enough to place these vaccination stations at least 6 feet apart. Theyre going to be able to move through people here in groups. There are about ten stations here. Now, getting a shot, thats going to take only a couple of minutes. But with this vaccine, theres going to be a 15 to 30minute monitoring period, because some people will likely experience some covidlike side effects. So theyre going to put people here to sit, get monitored, have a snack or two. And yasmin, this room was placed very close to the hospital, because the first people sitt tg in these seats, theyll be the front line Health Care Workers that are taking care of Covid Patients and most of them will have to go right back to work. This is one piece of the symphony that has to come together in perfect harmony here and the logistical layers are just incredible. Think about this. Weve been talking about these ultracold freezers. Right now duke is working out the delivery of two of those freezers to this facility. They have to get the right equipment to get those freezers installed. Right now those freezers are empty. Theyre trying to figure out when theyre going to get their supply, how much supply theyre going to get, how often theyre going to get it. That is all going to impact the planning here, because they have to make sure theyve got the right number of syringes, of sharps containers, all of those pieces coming together. And this is going to become even more complicated when you talk about getting the vaccine to the masses. This is just to vaccinate those front line workers here. You talk about getting it out to the community, so many more layers. I want you to take a listen to the emergency manager here and about how hes thinking about it right now. This is coordination between state, federal, local partners. I mean, thats the big thing that were trying to do in this scenario, is to be able to make sure that our local Public Health departments are prepared for this as well, because well be starting to vaccinate the community. You know, that is a big effort. How do you weigh in and how do you make sure that theres an equitable mechanism to provide vaccines for someone who might be older in age and have multiple comorbidities versus a Health Care Worker that could be seen as being young and relatively healthy . And at the center of all of this, yasmin, is staff. Right now, so many people are focused on taking care of Covid Patients. They need staffers here to vaccinate people. Theres a big recruitment effort to get people into these seats to vaccinate and theyre trying to even get retired nurses to come out of retirement. Its all hands on deck right now, yasmin. Certainly is, across the country, really. Dasha burns, thank you. Good to see you. Still ahead, everybody, a Health Official in Rural America speaks out about the damaging impact of pandemic politics. Even if were physically safe from the virus, there are a lot of hurt feelings. What i worry abou