COVID-19: How Biden will handle the crisis
‘Pro-science messages’ expected to proliferate
The new administration is expected to dramatically change course in the fight against the virus.
The day President Donald Trump turns the White House over to Joe Biden, COVID-19 will remain just as big a threat to Americans. But the strategy for tackling it will change dramatically.
Public health experts expect a major reset, including a renewed emphasis on science, better communication and efforts to simultaneously boost the economy and public health rather than pitting the two against each other.
“The public will immediately notice a vast change in science messaging from the White House,” said Lawrence Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law. “The Biden administration will both convey pro-science messages and model the best behavior from among all White House and Cabinet staff.”
Biden has long been wearing face coverings and maintaining distance from others while in public, and he has said he plans to continue that practice.
Dr. Ezekiel Emanuel, chair of the department of Medical Ethics and Health Policy at the University of Pennsylvania’s Perelman School of Medicine, said he expects to see changes in role modeling, communications, spending and collaboration with industry.
“You’re going to see a very different approach here,” said Emanuel, an oncologist and former health policy adviser in the Obama administration.
A Biden administration will be much better at communicating with the public, said Dr. Tom Frieden, who ran the U.S. Centers for Disease Control and Prevention under President Barack Obama. “Of all the failures – and there are many in this (Trump) administration when it comes to dealing with COVID – the one that I think has been most costly in terms of undermining an effective response is the failure to communicate effectively,” said Frieden, now CEO of Resolve to Save Lives, an initiative to prevent epidemics and cardiovascular disease.
Biden has pledged to put scientists not politicians behind the microphone, make testing widely available and free, expand national surveillance programs, and restore the CDC’s realtime dashboard tracking virus-related hospital admissions.
He also has promised to quickly launch a national plan to distribute personal protective equipment to health care workers and first responders and ask for clear, national guidance from the CDC on containment, school openings, travel and gatherings.
Health officials, not surprisingly, are far more supportive of Biden’s approach than they have been of Trump’s. Now, several said, there has to be a process of rebuilding the public health system and the public’s faith in it.
“If we now prioritize science and public health the way we should have at the beginning, hopefully we can restore some strength to the system,” said Dr. Howard Koh, a faculty member at the Harvard T. H. Chan School of Public Health and the Harvard Kennedy School and a former assistant secretary for health for the U.S. Department of Health and Human Services.
Too many Americans have died unnecessarily during the pandemic, he and others said. “When a loved one dies, that’s a tragedy,” Koh said. “When a loved one dies from a death that could have been prevented, that’s a tragedy that haunts you forever.”
Communications shift
As soon as he takes office, Biden has vowed to restore the type of daily, expert-led briefings that were typical for previous epidemics, such as H1N1 and Zika virus. “One of the first things that will happen will be an unmuzzling of the scientific and technical personnel in the health agencies,” said Dr. Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security.
More than just vaccines
Vaccines likely will remain a top priority of the new administration but not the sole priority, as it was under Trump, Emanuel said.
That means other areas such as therapeutics, testing, hospital capacity and personal protective equipment will get more attention, Emanuel said. “Vaccines, it’s central, it’s fundamental, but it’s not the only game in town.”
Vivian Ho, a health economist at Rice University and Baylor College of Medicine, both in Houston, said she hopes the new administration will put more focus on testing, too. “This is something that has gotten a little bit of traction, but not enough,” she said.
Mask mandate
Biden has said he would be in favor of requiring every American to wear a mask when in a public place or business.
Some question whether the president would have the authority to do that, given the limitations on federal executive power. But Dr. Michael Ewer, a visiting professor in the Health Law and Policy Institute at the University of Houston Law Center, says Biden does.
“He has the power to say we will have a more uniform approach to public health measures,” Ewer said. There will be people who oppose that, he said, but “do they have a leg to stand on legitimately? The answer is, from a public health standpoint, almost certainly not.”
Reconnecting internationally
Biden has said he would rejoin the World Health Organization, which Trump began to withdraw from in July, and reestablish the White House National Security Council Directorate for Global Health Security and Biodefense, which was eliminated by the Trump administration in 2018. “I think the United States would rejoin WHO on the 21st of January,” Toner said.
He also expects the United States would strengthen its connections with the United Nations and join in the international effort to get COVID-19 vaccine to low- and middle-income countries.
The COVAX initiative is made up of every nation on the globe except the United States, Russia, Belarus, Kazakhstan, Malaysia and five small island countries or micro-states. A pandemic is by definition global, and if it’s not controlled everywhere it will continue to reinfect the United States, Toner said.
“We should do it not only for moral reasons but out of our own enlightened self-interest. We want to control disease outbreaks in all countries, especially those that don’t have the wherewithal to do it on their own,” he said.
Organization and coordination
Organized, coordinated management of the pandemic also will be a top Biden priority. The new administration consists of “people who know how to mobilize government, people who know how to have government connect to private industry,” Emanuel said.
Emanuel said he expects the Biden approach will be similar to what presidents Franklin Roosevelt or Lyndon Johnson would have done to respond to the biggest health threat in a century.
“They would just create a torrent and whirlwind of task forces: Bring the experts in and let ’ em at it,” he said. That wouldn’t be the most efficient approach, “but would it get across the finish line? Absolutely. They knew how to bring together the full force of the federal government, coordinate with private industry where that was possible, take over things where necessary.”
A tricky transition
Although most new administrations avoid directly contradicting their predecessors, Biden already has said he will keep or reinstate Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases. Trump recently threatened to fire Fauci, who remains one of the most trusted voices in the country on infectious diseases.
“Normally a president-elect would be pretty circumspect about what he would say that would contradict the sitting president,” Toner said.
Although Georgetown’s Gostin said the arrival of a vaccine plus Biden’s more aggressive approach will reduce infections by late next year, Americans shouldn’t expect a rapid turnaround in cases, hospitalizations or deaths.
“Sadly, the virus is already too deeply embedded in communities right across the country,” he said. “And safe behaviors are already too politically divisive to see uniform and consistent changes in personal behavior.”
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.