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Incompetence of the Trump administration including lack of interest by Trump himself is hampering vaccinations as thousands of Americans die in the pandemic each day. The Trump Administration promised 20 million vaccinations by the end of 2020, but fewer than 3 million have actually received their first shot.

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In Florida, less than one-quarter of delivered coronavirus vaccines have been used, even as older people sat in lawn chairs all night waiting for their shots. In Puerto Rico, last week’s vaccine shipments did not arrive until the workers who would have administered them had left for the Christmas holiday. In California, doctors are worried about whether there will be enough hospital staff members to both administer vaccines and tend to the swelling number of Covid-19 patients.

As a new, more contagious strain of Covid-19 is starting to make the rounds, Trump spends all of his time on a doomed attempt to overturn his election loss, giving pardons to his friends, and tweeting threats to Republicans who are drifting from his party line.

Trump’s delay in signing the relief bill that contained some funding for the vaccinations as well as turning over responsibility to the states for planning the vaccinations has created a mess.

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In the absence of clear federal guidance, the vaccine rollout has devolved into a patchwork response that varies by state, said Dr. Marissa Levine, a public-health professor at the University of South Florida, told Business Insider.

Local health officials have been tasked with coordinating vaccination timelines while caring for sick patients. Many health departments lack the funding to hire enough staff to administer doses in large waves. Others lack the expertise to seamlessly transfer thousands of doses from local warehouses to the arms of individuals – what experts call the “last-mile” challenge.