A no-brainer. Sitting on tens of millions of doses that we can’t use because they haven’t been approved yet by the FDA while India melts down is an insane unforced error, one that would have inspired many an angry take about the callousness of “America First” if Trump were still president. It’s terrible diplomatically — and epidemiologically. Every outbreak around the world, especially in an enormous population like India’s, runs the risk of producing a vaccine-proof variant that’ll make its way back here and wreak havoc on America anew. Any vaccine surplus we have should be sent immediately overseas to help put out fires there before they start spreading.

It’s not charity. It’s self-defense.

Our internationalist president seems to have belatedly figured that out and is finally prepared to hand off our supply of AstraZeneca to those who need it more.

The Biden administration is preparing to send up to 60 million AstraZeneca doses to countries in need over the next several months, once a federal safety review is conducted, according to two senior Biden administration officials.

The company has produced about 10 million doses of the vaccine for the U.S. but the FDA has not yet authorized their use. The agency is still examining the doses to ensure they meet the necessary quality control standards. An additional 50 million doses are in production, one of the senior officials said…

It comes on the heels of the Biden administration’s announcement that it will send India raw materials and components to manufacture Covishield, a version of the AstraZeneca vaccine produced by the country’s Serum Institute.

It’s unclear where those 60 million doses might go but it’s perfectly clear which country needs them most. India had nearly 355,000 confirmed cases of COVID yesterday, nearly half of the entire planet’s total. Given that state services are overwhelmed and testing must be spotty in poorer areas, it’s highly likely that more than half of the world’s actual infections in the past 24 hours happened in that one country. How much can 60 million doses do for them?

Maybe not much. Start with the fact that AZ is a two-dose vaccine, which means there’s only enough from our supply to fully immunize 30 million people. There are around 1.4 billion people in India, which means just 2.1 percent of their population would be covered. Even if India took the UK’s approach and decided to treat all 60 million doses as first doses, to try to provide partial protection to as many people as possible as the virus burns through the country, that’s only 4.2 percent. Add to that the fact that it takes time for a dose of the vaccine to produce a degree of immunity and you realize that even if we had all 60 million doses in people’s arms there by tomorrow, it’d be weeks before it helped slow the spread at all.

And we don’t have 60 million doses right now. We have 10 million. And guess where those AstraZeneca doses were produced. Yep, the same Emergent BioSolutions plant in Baltimore that screwed up 15 million doses of the Johnson & Johnson vaccine. The quality-control inspection mentioned in the excerpt above isn’t a mere formality, in other words. The FDA may discover that the AZ doses were also botched, rendering them useless and slowing production potentially of the remaining 50 million. And even if they don’t, what sort of timeline are we looking at in terms of getting those doses shipped?

It won’t be tomorrow:

About 10 million doses of AstraZeneca vaccine have been produced but have yet to pass review by the FDA to “meet its expectations for product quality,” Zients said, noting the U.S. regulator is recognized as the “gold standard” for safety around the world. That process could be completed in the next several weeks. About 50 million more doses are in various stages of production and could be available to ship in May and June pending FDA sign-off.

I don’t know how India’s going to end the ferocious surge of infections that’s spreading through the country but it ain’t going to be with our AZ surplus. Maybe Russia or China has a few hundred million doses on the shelf that are ready to ship immediately. They’ve done much better than we have in using vaccines as a means to build goodwill with lesser powers.

A thought: Why doesn’t Biden announce that, due to slackening demand in the U.S. and desperate need overseas, he’s preparing to ship, say, 20 percent of the weekly Pfizer and Moderna supply to countries like India beginning a month from now? That may be the only way to get vaccine-hesitant Americans off the fence and into the pro-vax camp. Once a valuable commodity is at risk of becoming scarce, people scramble to procure it before it does. (Witness the national run on toilet paper last spring.) And he wouldn’t be lying about domestic demand. It really is trending downward, all but ensuring that we’ll have more mRNA doses soon than we know what to do with:

A new ABC/WaPo poll today found that, of the 120 million Americans who say they haven’t been vaccinated yet, a majority of 56 percent say they don’t intend to get the shots versus 41 percent who do. If rural Republicans don’t want to get vaxxed, it’d be a sin to leave our supply moldering in U.S. warehouses when it could do lots of good abroad.

If you want to have nightmares tonight, read this WSJ report on how bad things have gotten on the ground in India. Some hospitals are asking the families of patients to bring their own supplemental oxygen because the hospital has run out. “There are more than 300 bodies in waiting, they are lying everywhere on the grounds and even on the roads outside,” said one shopkeeper about the scene outside a crematorium in Delhi. Compounding the misery is the fact that India is the world’s largest vaccine producer and has now been forced to suspend exports in order to focus on its own needs. That means a slowdown in immunity abroad until India’s crisis is resolved, whenever that might be.

I’ll leave you with this, a short portrait of a country overwhelmed by sickness and death.