Dr. LaQuandra Nesbitt, director of the Washington DC Department of Health, shares her insights into battling the pandemic. Washington is the opposite of self-contained. Protesters of many stripes transport their grievances to Washington, often stoking “strife and agitation” with little regard for the health of the community. Emergency preparations intensified beginning in 2015: “We were ready” in 2020 but had “still so much to learn” as the pandemic unfolded. Messaging in the fog of a pandemic is difficult, in need of constant refinement. Testing got off to a halting start. But as swabs, reagents, and skilled staff became available, the city quickly scaled its testing. It also raised a caution: testing is costly and long-term. How to sustain? Vaccine distribution, including to high numbers of non-residents who work in the Capitol, has been a challenge. Equity and accountability concerns continue to dominate. One reality persists: “We simply do not get enough vaccine here in the District.” And when doses move through retail pharmacies and hospitals with insufficient oversight and coordination, equity suffers. Luckily, ”demand is so high” for vaccines.   Dr. LaQuandra Nesbitt is Director of the District of Columbia Department of Health in Washington, D.C., a position she has held since January 2015.