This story was originally published by The Guardian on February 10, 2021.

It’s usually bad when West Virginia makes headlines. The state has a long, sad history of severe poverty, bad health outcomes, political corruption and disasters both natural and manmade.

But by mid-January, some very good news started coming from West Virginia: somehow the Mountain state was putting 81% of its available vaccines into the biceps of its citizens while bigger states struggled to distribute even half of their available vaccines.

As national media descended on the state to figure out why, much of the reporting focused on the state’s decision to distribute vaccines through local pharmacies, bucking the federal plan to use the national chains CVS and Walgreens.

That isn’t the whole story of West Virginia’s vaccine triumph, however. The state’s path to success started long before there was a thing called Covid-19, much less a vaccine to fight it, and was grounded in the state’s unique response to a series of tragic disasters. One that may be hard to replicate.

In March 2020, as Covid-19 cases crept higher, West Virginia’s governor, Jim Justice, established a “joint interagency taskforce” to oversee the state’s pandemic response.

It’s a simple idea borrowed from the world of military strategy: bring anyone involved in an operation to the same table, so everyone can share information and coordinate their efforts. This particular taskforce would be made up of federal, state and local government agencies, the West Virginia national guard, and groups representing hospitals, pharmacies and nursing homes.

“We took the construct of what the military does in operations, mission planning, and we applied it with our public health partners. We operationalized a public health emergency,” said Maj Gen James Hoyer, who serves as director of the Covid taskforce.

Hoyer, who recently retired from the military after 40 years in uniform, has participated in several joint interagency taskforces during that time, because West Virginia has suffered an extraordinary run of bad luck over the last decade.

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