The pair, along with a growing cadre of volunteer health experts, have been working behind the scenes to craft plans that could take effect Jan. 20, when the next president will take the oath of office, said Jake Sullivan, a senior policy adviser on the Biden campaign.
Biden has laid out a far more muscular federal approach than President Trump, whose “failures of judgment” and “repeated rejection of science” the Democrat first pilloried in a Jan. 27 op-ed about the crisis. Biden has said he would urge state and local leaders to implement mask mandates if they are still needed, create a panel on the model of President Franklin D. Roosevelt’s War Production Board to boost testing, and lay out detailed plans to distribute vaccines to 330 million people after they are greenlighted as safe and effective.
The Democratic presidential nominee’s “public pronouncements are not just about laying out an agenda for voters, but giving shape to an operational plan that he’s already starting to think about now for what Day One is going to look like,” Sullivan said.
Yet experts caution that even the best-laid plans will be challenged in a politically fractured nation in which rampant disinformation about the novel coronavirus — often exacerbated by Trump himself — has complicated efforts to have people follow safety protocols like wearing masks and practicing social distancing.
“A lot of it is going to be out of Biden’s hands,” Angela Rasmussen, a virologist at the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health, said of restoring faith in federal health officials. “It’s going to take time and he is going to have to demonstrate that he’s restoring these agencies to their prior reputations through actions.”
Lindsay Chervinsky, author of “The Cabinet: George Washington and the Creation of an American Institution,” said only a handful of incoming presidents have faced challenges as complex and dire as the one Biden would inherit if elected.
“With Biden, because this has been going on for a while, he would almost have to treat it as though he were starting from scratch and come up with a full-scale government response,” she said.
At a campaign event Wednesday in Warren, Mich., he called Trump’s assertions in taped interviews with writer Bob Woodward that he had intentionally played down the lethality and rapid spread of the coronavirus last winter as “beyond despicable. . . . He knew how deadly it was. He knew and purposely played it down. Worse, he lied.”
Biden has also hammered Trump’s failure to take decisive steps to stem the spread of the virus. If the administration had acted early on, he said last week, “America’s schools would be open, and they’d be open safely. Instead, American families all across this country are paying the price.”
The Democratic nominee would have the federal government take the lead on many aspects of the response, from scaling up testing and contact tracing to setting strong national standards, drawing a contrast with Trump who has ceded many of those issues to the states, with the federal government serving as “backup” and “supplier of last resort.”
Trump dismisses Biden’s criticisms, citing his decision to seal U.S. borders, suspending entry from China on Jan. 31. But with community transmission of the coronavirus already underway in the United States by then and difficulties screening passengers, experts have said those restrictions were ineffective.
Amid the outcry about the lack of availability of tests, he also appointed Vice President Pence to oversee a high-level task force to respond to the virus. But Trump has often downplayed or contradicted the advice of health officials on that panel whether on treatments such as hydroxychloroquine or on reopening the economy.
Above all else, the president has insisted the country’s economic crisis is as critical as its health woes and urged Americans to return to school and work as the best way to salvage a faltering economy. (Most public health experts and economists argue there cannot be a true economic recovery without first bringing the outbreak under control.) In recent months, Trump has also focused single-mindedly on the pursuit of a coronavirus vaccine, which he predicts will win approval by year’s end or sooner, as part of the expedited research, development and distribution of vaccines and treatments under Operation Warp Speed.
“Americans have seen President Trump out front and leading the nation in the fight against coronavirus . . . while Joe Biden has been behind the curve and fearmongering to discredit the president,” said Trump campaign spokeswoman Samantha Zager.
The Biden campaign said the virus’s toll speaks for itself.
“With nearly 200,000 dead, more than 6 million infected with the virus, and nearly 30 million on unemployment, we desperately need action and new leadership now,” said Jamal Brown, the Biden campaign’s national press secretary.
As Biden and his aides piece together a national strategy, they are contemplating myriad questions: How many tests a day can the country conduct? Will states and health- care workers have needed protective equipment and supplies, or will they still be battling shortages and competing against each other? Might cases plateau at 40,000 a day or more, climb higher or finally begin to taper?
“There’s a huge amount of preparation that needs to be done given the complete absence of leadership from the current administration and no time to waste,” Sullivan said.
Among the campaign’s top priorities are planning for the complex challenge of distributing one or more coronavirus vaccines to tens of millions of Americans; appointing a “supply commander” to coordinate the distribution of supplies to states and localities; and, perhaps most importantly, unifying the country and restoring public trust in the federal government’s message.
The last may be the most difficult, aides acknowledge. To that end, immediately upon taking office, Biden would call Democratic and Republican governors and mayors across the country to ensure that not only does the federal government speak with one voice, but that Americans hear the same message from their state and local leaders, Sullivan said. He would urge state and local leaders to issue mandatory mask orders if they are still needed, and to work together on a nationwide vaccination campaign.
Biden has also vowed to have public health experts and doctors hold regular news conferences on the pandemic.
With the situation rapidly evolving, Biden and Harris continue to receive regular briefings on the state of the pandemic.
Beginning in March, Kessler and Murthy prepared briefing documents of 80-plus pages that set the agenda, Kessler said. Biden peppered them with questions, several campaign aides said. How do you keep essential services going? How do you keep people safe? What kind of equipment do we need to provide for front-line workers and their families?
Around the same time, the campaign put together a six-person advisory committee of health experts that in addition to Kessler and Murthy, includes former Obama advisers Lisa Monaco and Ezekiel Emanuel; Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University Medical Center; and Irwin Redlener, a professor at the Columbia University Mailman School of Public Health.
The roster of experts offering advice, guidance and policy ideas has continued to grow rapidly, said several people familiar with the campaign.
Among Biden’s first appointments would be a supply commander, who would evaluate persistent shortages in equipment and test supplies, including swabs and reagents, his aides said.
That person would have to be able to identify bottlenecks and shortages in the supply chain for every component of tests and protective equipment and other material in short supply — whether for the fabric used in N95 masks or reagents for diagnostic tests, said Nicole Lurie, a former Obama assistant secretary for preparedness and response and another campaign adviser.
Biden’s advisers have also prioritized planning for vaccine distribution on the assumption one or more vaccines would be authorized, or close to such approval, by early next year.
“We’ve talked mostly about what’s going to be necessary to get a vaccine up and running, not just have a vaccine but actually produce it, bottle it, ship it out and vaccinate others,” said Emanuel, chairman of medical ethics and health policy at the University of Pennsylvania. “The logistics behind getting a vaccine to people is much more daunting than what people have thought through. . . . I don’t think our current infrastructure is sufficient.”
The Trump administration has a detailed vaccine distribution plan underway that the CDC is overseeing. At a news briefing last month, Trump said the United States is on pace to have more than 100 million doses of a vaccine ready before year’s end, and the federal government was partnering with health-care giant McKesson to rapidly distribute one as soon as it is approved, with backup from the Defense Department.
Unifying a bitterly divided nation might be the most difficult challenge of all, said aides and outside experts.
The single most important thing a President Biden must do is get buy-in for a new strategy from governors and mayors, as well as from the American people, said Leana Wen, an emergency physician and public health professor at George Washington University who was previously Baltimore’s health commissioner and is not part of the campaign.
Biden needs to be “the communicator in chief to turn this around,” Wen said. He needs to convince people that they need to do what’s needed, while the government does what it needs to do.”
Otherwise, “if he orders a shutdown and 80 percent of people don’t comply, what good will that be?” she said, adding it will be “a monumental task to get everyone on board.”
Biden’s advisers acknowledge that frequent and frank conversations that level with the American public will be essential.
“Lots of other countries have succeeded in controlling this, not because they have medicine we don’t, or a magic vaccine that we don’t,” Emanuel said. “They’ve been clear about the message, they’ve enforced it, and I think that’s what the future president is going to have to make clear to the American people — short-term pain for long-term gain.”