President Joe Biden has a new national plan when it comes to vaccines. Which is to say, he has plan. 

In his first 100 days in office, Biden wants to spend $20 billion with the mission of getting 100 million doses of the vaccine into American arms. It's part of the $400 billion in spending he's asked of Congress to stop Covid-19 in its lethal tracks. "This will be one of the most challenging operational efforts ever undertaken by our country," Biden said on January 15. "You have my word that we will manage the hell out of this operation." 

He's going to have to. While 100 million vaccinations is a good start, the U.S. still has a long way to go, and that number is definitely not enough for the country to reach herd immunity, notes Dr. David Battinelli, chief medical officer for Northwell Health. "We're not getting out of this until we have upwards of 200 million people fully vaccinated." That's out of a total population of about 331 million. 

Biden's Covid-19 response coordinator, Jeff Zients--who served as chief performance officer and deputy director for management of the Office of Management and Budget under President Obama--said in a briefing this past weekend that the administration plans to use federal muscle to increase manufacturing, expand eligibility, set up more vaccination sites, and train more people to administer vaccines. 

That's a big ask, and a big shift in policy from the Trump administration. Under Donald Trump, the federal government left responsibility for vaccine distribution largely to state and local governments, which are widely undersourced and overstretched. According to data from the Centers for Disease Control and Prevention (CDC), approximately 36 million vaccine doses have been distributed, but only were 16.5 million administered as of January 21. "Vaccines don't save people; vaccinations do," wrote New York Times columnist Ezra Klein, pointing out the weak link in American pandemic efforts to date. "And vaccinating more than 300 million people, at breakneck speed, is a challenge that only the federal government has the resources to meet."

Though the goal is attainable, it won't be easy. David Savitsky, CEO of ATC Healthcare Services, a health care staffing company, notes that while Biden's "four bucket" plan makes a lot of sense, getting it operational will likely be challenging because different communities have differing needs. "We have to bring vaccines to people where they live, where they work, and even where they vacation, or else it will be years before we vaccinate enough people to truly achieve any meaningful result."

He also notes that partnering with companies to get the workforce vaccinated may help the government speed the process while bolstering the overall health of the economy. Many workplaces already arrange for flu shots for employees, so they already understand the process. 

Biden also signed an executive order to require social distancing and the wearing of masks on all federal property, and by all federal employees. He is also initiating a "100-day masking challenge" urging the public to wear masks. Some Republicans have made not wearing a mask a political statement, one reason, say medical experts, that the U.S. leads the world in Covid-19 deaths.