With the Nov. 3 general election looming in just a couple of weeks, President Donald Trump and former Vice President Joe Biden are making their final pitches to American voters.
While a range of issues have been front and center in our election discourse, almost everything comes back to how each prospective administration would handle the most pressing issue of this era: the COVID-19 outbreak.
Over the course of 2020, the virus has disrupted everything. It’s filtered through all aspects of daily life, from education, socializing with loved ones, and exposing inequities in our healthcare system to even the health of the president himself.
Essentially, the current presidential election hinges on a referendum on this country’s response so far and how it will respond to this public health crisis moving forward.
As the coronavirus threat continues to sweep through the United States, do American voters stick with the haphazard response of the current federal government, or choose something different?
Throughout the presidential campaign, Biden and his running mate, Sen. Kamala Harris, have explained that their COVID-19 response would mark a departure from what we’ve seen so far from the Trump administration this year.
An emphasis has been placed on a reliance on science and the expertise of public health officials, a laser-eyed focus on wearing protective masks, and a commitment to engage with the rest of the world on finding solutions for this pandemic.
“I think in general, the ‘Achilles heel’ in our response has been a lack of federal strategy to guide us through this pandemic,” Dr. Amanda D. Castel, MPH, a tenured professor in the department of epidemiology at the Milken Institute School of Public Health at George Washington University, told Healthline.
“My perspective on the [Biden-Harris] plan is that it is not earthshakingly innovative or anything like that — it’s just the basic work of public health. It’s not like we don’t know how to do this,” added Dr. Ira B. Wilson, professor and chair of the department of health services, policy, and practice at the Brown University School of Public Health, as well as professor of medicine at the Alpert Medical School.
Both Castel and Wilson reviewed the campaign’s seven-point plan to “beat COVID-19.” They share their assessment of the plan with Healthline here.
1. Addressing testing and tracing
The Biden campaign is suggesting the United States beef up its COVID-19 testing and tracing response.
This includes doubling the number of drive-thru testing sites in the country; investing in an expansion of testing, including at-home and rapid tests; and instituting a Pandemic Testing Board modeled after President Franklin D. Roosevelt’s War Production Board during World War II.
That board boosted the production of tanks, uniforms, and supplies during the war, and Biden and Harris imagine applying that same approach to mass-producing and distributing “tens of millions of tests,” according to the campaign’s website.
They also plan to establish a U.S. Public Health Jobs Corps to organize about 100,000 Americans nationwide to help with contact tracing, especially in communities that are highly at risk and often underserved by the federal government.
As COVID-19 has raged on, health experts have routinely criticized the Trump administration’s lack of robust testing and tracing. It’s an approach that Wilson calls a “testing and tracing fiasco.”
He added that the Biden-Harris approach is nothing “complicated or even controversial” for anyone who “knows anything about public health.”
Wilson explained that as with everything in this current era, the COVID-19 response became heavily politicized.
What should have been objectively viewed as a health crisis that needed the unbiased attention of the federal government has become an issue divided by Republican and Democrat political lines.
States less in favor with this administration, mainly those with leaders in political opposition to the president, were underserved.
“Most federal governments don’t care if it’s a ‘red or a blue state.’ They care about the ‘American states.’ For that matter, most presidents actually know Puerto Rico, for instance, is part of the American government,” Wilson said.
Castel said that the plan provides “an excellent starting point” to increase testing and tracing capacity. She said what needs to happen, however, is the government making sure people who don’t have easy access to testing resources get it.
Castel stressed that the proposed testing and tracing corps of 100,000 people needs to be closely linked and unified in its responsiveness. They have to be able to reach people quickly, and also destigmatize the politicized COVID-19 response so people share information about whom they’ve been in contact with and when they might have been exposed.
“That in and of itself is a challenge,” she said.
2. Produce more personal protective equipment (PPE)
The second point in the Democratic Party candidate’s plan is to increase PPE production. The focus would be federal guidance, rather than the current focus, which has been to let states determine how they will provide needed PPE themselves.
The campaign’s website states that a potential Biden administration would “fully use the Defense Production Act,” which would increase national production capabilities of PPE like masks and face shields, with the country’s total supply exceeding demand.
This would make sure stores, state stockpiles, and health facilities would be fully stocked. It would also prepare for future pandemics and public health crises.
The goal would be to “build now toward a future, flexible American-sourced and manufactured capability to ensure we are not dependent on other countries in a crisis,” the website reads.
Wilson said that, again, this should be standard for any nation’s public health response to a pandemic.
He said that questions such as “how do you plan how many ventilators will be available, how do you make sure you have a national reserve of PPE, how do you move manufacturing onshore to the U.S. to make sure PPE is here in case of a crisis” are all important for a government to ask.
Wilson added that had mass production and accessibility of PPE been enforced from the beginning, it could have helped ease Americans back to work, giving them access to masks and protective gear that would have enabled them to “be protected and still work.”
3. Guidance from the top down
The third piece of the plan advocates for “consistent, evidence-based national guidance” for how people across the nation can respond to the pandemic, including frameworks that schools, small businesses, families, and community centers can follow.
While the Centers for Disease Control and Prevention (CDC) has offered guidance for dining establishments and nightlife, schools, and businesses and workplaces, that messaging has often been diluted by President Trump’s early public mockery of physical distancing and mask wearing, as well as commentary on COVID-19 itself being a “hoax.”
States have had to step in to improvise their own protocols and guidance for how teachers could reenter schools or bar owners could open their businesses safely during the pandemic.
The Biden plan emphasizes the federal government would set up a “renewable fund” for state and local governments to support their budgets, which otherwise could lead to cuts to first responders and educators.
A potential Biden administration would also reach out to Congress to pass an emergency package so that schools would have the right resources, and would also extend support to small-business owners to cover their operational costs to buy protective plexiglass or masks, for instance.
Castel said this kind of national guidance would be “extremely important.”
“It would be interesting to see if he [Biden] can bring together governors and mayors to have an opportunity to share lessons learned and best practices to then inform how we should go about this at the national level,” Castel added.
She explained that any administration response would be wise to look at how other countries offered guidance at the federal level to local communities. What nation was successful, what one failed, and how could we learn from those other models?
Wilson said that a challenge for a Biden-led government would be to rebuild trust in institutions like the CDC.
As with most nonpartisan agencies during the Trump years, the CDC has become politicized to an extent where trust in its ability to protect the nation’s public health has been put into question by some groups.
“The CDC has been invaded by politicians to the extent where I don’t always trust that what I am hearing is based in science,” Wilson said. “We’ve seen so many times these last several months political interference with what the CDC is doing.”
4. Ways to distribute an effective vaccine
The fourth piece of the Biden-Harris COVID-19 response plan is one of the most crucial. It zeroes in on vaccine distribution once one becomes available.
It calls for an investment of $25 billion in a vaccine manufacturing and distribution plan, which would ensure all Americans receive one at no cost. The proposal states that “politics should play no role in determining the safety and efficacy of any vaccine.”
To that end, the plan asserts that a Biden administration will put scientists in charge of all vaccine-related decisions, clinical data will be released for any vaccine the Food and Drug Administration approves, and the scientists behind it will prepare a written report for public release, appearing before Congress to “speak publicly uncensored.”
This Biden-Harris plan also states that all Americans — not just “the wealthy and well-connected” — have access to the COVID-19 protection they need, and “consumers are not price gouged as new drugs” are released.
Wilson cautioned that, as with the issue of national COVID-19 response guidance, it’s crucial that the CDC is trusted during the time of a vaccine release.
“We’ve built this jewel of a resource and now we are just undermining and ignoring it, and we need it as we plan for a vaccine,” he added.
Castel said this portion of the plan has to be enacted with extreme care. She emphasized that it has to be carried out so that all Americans receive the vaccine free of charge, and a new administration needs to do everything it can to make sure there is “equitable distribution.”
Communities that are most vulnerable to COVID-19 need to be prioritized, and a significant amount of education and literacy around a vaccine needs to be developed to try to reach those who “don’t believe in vaccines,” she added.
5. Protect older adults and others most at risk
This next portion of the plan would put in place a “COVID-19 Racial and Ethnic Disparities Task Force,” first proposed by Harris, which would offer recommendations on how to address public health and economic disparities in a COVID-19 response for vulnerable communities.
The campaign states that once this specific public health crisis comes to a close, this task force would remain in place and be converted to an “Infectious Disease Racial Disparities Task Force,” something not currently in place in our federal government.
Additionally, a Biden administration would create a Nationwide Pandemic Dashboard online so that Americans could easily access real-time information on local transmission rates in their ZIP codes.
“This information is critical to helping all individuals, but especially older Americans and others at high risk, understand what level of precaution to take,” according to the plan.
Castel echoed her earlier point about vaccine distribution: Vulnerable communities, especially poor communities and communities of color, seriously need better outreach from the federal government when it comes to COVID-19 relief and response.
Within these vulnerable groups, older people find themselves at greatly elevated risk for more serious disease.
Wilson added that this is far from a “controversial” or groundbreaking proposal. It follows common-sense public health protocols that at-risk individuals and older adults would be given priority when it comes to disease prevention, education, and support.
This is something the current federal government has been lax and seemingly unwilling to engage with.
6. Improve national response to impending global public health threats
The penultimate piece of the plan involves restoring the White House National Security Council Directorate for Global Health Security and Biodefense. It was created during the Obama administration and disbanded 2 years ago by the Trump administration.
Beyond this, the plan calls for the nation to restore its relationship with the World Health Organization (WHO) as well as strengthen PREDICT, the U.S. Agency for International Development’s pathogen-tracking program, also eliminated by the current government.
Finally, they would expand the amount of “disease detectives” from the CDC who are embedded where public health crises might begin. This means strengthening the organization’s office in Beijing, also diminished by the current administration.
“This is actually really important,” Wilson said. “Trump did a lot to destroy — not only prior to the pandemic but during the pandemic — the very pandemic response infrastructure that exists to be triggered during a time like this.”
Castel added that reestablishing our relationship with the WHO so that we have a comprehensive pandemic preparedness initiative moving forward is necessary.
She said the lack of these frameworks in place has “disrupted our lives and our economy” and “we have to prepare for the next crisis.”
7. Mandate masks
The final piece of the Biden-Harris plan goes back to masks.
One of the most difficult-to-digest aspects of the U.S. response to COVID-19 has been how some segments of political discourse demonized wearing protective masks.
The proposal from the Biden-Harris campaign asserts that a new government would implement a nationwide mask mandate, working with governors and local mayors to ensure more Americans wear masks and do their part to prevent the spread of COVID-19.
“Experts say that if 95 percent of Americans wear masks between now and December, we can save almost 70,000 lives,” the campaign website reads.
The goal of a mask mandate is to ensure all Americans wear a mask when outside their homes. Governors would enforce this in their states, with local authorities collaborating in this enforcement.
Castel said it is “great to have people be exposed to a mask mandate,” but there has to be enforcement.
Especially after the politicization of masks in the United States, a new declaration from a Biden administration would need to be followed up by some sort of enforceable measure.
Castel said that whether that comes in the form of a fine, for example, there needs to be some way to make sure people respect the orders.
“It’s interesting that the campaign has to actually say something like this,” Wilson said.
He noted how during a recent televised town hall, Biden himself said that the federal government can’t enforce this, and it would have to fall on states to enforce guidance from his administration.
Wilson explained that a new federal government should lean into education, emphasizing how science indicates masks are necessary.
“Historically, by and large, the regulation of health and public health issues has been left to localities, and that is where the expertise lies,” Wilson added.
He stressed that a farming community in Iowa needs different guidance for COVID-19 than a neighborhood in Brooklyn — the outbreak has affected both communities differently, and the response needs to be tailored accordingly.
That being said, unified messaging at the federal level about masks is necessary.
“The emphasis has to be on the collective. Like air pollution has nothing to do with individual states; you make pollution, it goes in the air and travels five states away. We have national defense, we have national taxation, and I would argue healthcare falls under the same kind of framework as well,” he said. “That’s why we have federal proposals to federal problems.”
Wilson added that is why it has been frustrating to witness a federal government completely abdicate its responsibilities when it comes to a COVID-19 response.
Instead, the current administration has been using its energy to politicize and obfuscate something like the common-sense importance of wearing a protective mask.
Looking for change
A recent survey in the American Journal of Public Health reveals that, since the pandemic hit, Americans are now looking for the federal government to play a larger role in improving people’s lives than before.
The researchers found the proportion of U.S. adults who want a more active overarching government role increased by more than 40 percent during the initial wave of the pandemic this past spring.
It’s just one study, but it signifies that Americans are looking for the federal government to play a bigger role in response to crises like COVID-19, not less.
Wilson said he’s concerned about what will happen in January if there’s a new administration in place and this plan is enacted.
He said the “cat is out of the bag” in the sense that COVID-19 has been put through partisan lenses.
Instead of being seen as a public health threat we all collectively need to address, it’s been filtered out as either a Democrat or Republican concern. He said none of this is a “quick fix.”
“You have to rebuild infrastructure, rebuild the FDA, rebuild trust and confidence in the CDC, reenter WHO, rebuild relationships around the world that are shattered, maybe irretrievably, with our allies who no longer trust us. With the Chinese, with whom we had lots of scientific dialogue and corroboration,” he said.
He added that he thinks this set of proposals can be implemented and will be “super helpful,” but the polarized nature of the United States as it stands right now will make it more challenging.
“I have learned so much from this pandemic. I’ve done this a long time — I’m a physician, I’m not naive about human behavior and people’s ability to do risky things. But I’m shocked and stunned about a number of Americans who will believe a guy who blatantly lies about everything no matter what,” he added.
Castel said it’s crucial that vulnerable communities aren’t left behind.
If there’s a new administration, these communities need to be centered, and outreach must be done immediately. She said the big challenge is all the “inconsistent messaging” we’ve received since the start of the pandemic.
“You’ll hear people like Dr. Fauci who lead with the science and then see our leadership and our president and people in the administration either don’t adhere to some of the guidance or they are recommending counter-information or messages that are false or misleading,” she said.
Moving forward, she wants to see a consistent message from the federal government. She said she also hopes the government makes clear to the American people that this is a new virus. More information is being learned on a monthly, weekly, sometimes daily basis.
“We have to be adaptable and flexible to integrate all of this incoming information into a response. There is a learning curve, and I know it’s hard, but there has to be some messaging to the American people where we say, ‘As we learn more, we will implement new measures. We may change the guidance that we started with,’” Castel added.
The ever-evolving nature of COVID-19 and how it keeps upending our lives makes it a challenge for any government.
For a Biden-Harris administration to enact these recommendations, if it’s in place in January, the challenge will be to respond to this constantly shifting crisis while rebuilding what was dismantled, and at the same time forging a path forward as the pandemic continues on.
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