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With December on track to be the deadliest month for the virus since the outbreak began (more than 63K people have died in the US so far this month), Dr. Fauci and others have been in the press constantly warning that the situation is on track to worsen in January and February.

And on Monday, he was joined by Dr. Celine Gounder, a clinical assistant professor of medicine and infectious diseases at NYU’s Grossman School of Medicine and member of Biden’s COVID task force, who reiterated Dr. Fauci’s warnings about already-overwhelmed hospitals being poorly equipped to handle the next wave of patients.

But while the MSM focused on remarks about President Biden likely invoking the Defense Production Act to try to ensure the US catches up to its lofty vaccination targets (we’re already about 18MM behind the OWS target of 20MM doses by year’s-end), Dr. Gounder added an off-hand line about the need for using “genomic surveillance” to track mutations like the B.1.1.7 mutated “variant” that has been making headlines for the past week or so.

“We’re also going to see an increase in genomic surveillance which is where you track the changes in…virus genetic materials…we can do that…we have the technology…we just chose not to spend the money on public health surveillance…”

Offering up some math to demonstrate why the US needs to dramatically ramp up the pace of vaccinations if it wants to reach whatever the new herd immunity threshold is, Dr. Gounder insisted there is “no question” about another surge due to the number of people traveling during the holiday.

And when this next wave hits, more rural areas will likely scramble to convert hallways and stadiums into excess capacity wards. However, she warned that while NYC has plenty or resources – physical, and human –  many smaller cities will have a much harder time due to limited human resources.

“You can’t stand up new doctors and nurses the way you can with field hospitals…so this is going to be the limiting factor here in treating all of these patients,” she warned.

Dr. Gounder also told CNBC that Biden will almost definitely invoke the WWII-era “Defense Production Act” to help ensure America’s pharmaceutical companies have enough access to enough raw materials to keep cranking out new doses. An unanticipated shortage of raw materials was blamed by Pfizer earlier this month for cutting its year-end delivery target from the absurdly high 100MM doses, to the slightly more realistic target of 50MM.  The company has refused to say much more than that, with WSJ reporting that the company sources these raw materials from “the US and Europe.”

Biden will invoke the act to ensure that whatever these raw materials are, that Pfizer and Moderna have enough of the stuff on hand to keep production humming, while also controlling the number of tests and protective equipment to ensure supplies remain ample across the country.

“You will see him invoking the Defense Production Act,” Dr. Gounder said. “The idea there is to make sure the personal protective equipment, the test capacity and the raw materials for the vaccines are produced in adequate supply.”

NBC News reported last week that the Biden team was considering invoking the act, and this would appear to cement that notion.

If anything, it’s just the latest reminder of how wildly optimistic many of the vaccination timelines – timelines for the developed world, at least – have been.