It’s now officially summer and increasingly more states are reopening their economies after a winter and spring where the United States effectively shut down during the first wave of the COVID-19 pandemic.
At the same time that summer temperatures rise and the nation at large grapples with how best to handle the coronavirus outbreak and protect against surges in new cases, a divisive general election season is heating up.
President Donald Trump and presumptive Democratic Party nominee former Vice President Joe Biden are running against each other during a time when concerns over people’s individual health, the nation’s healthcare system, and state and federal response to COVID-19 all take center stage in both political and public health debates.
This spring, as criticism continued to build up over the federal government’s response to COVID-19 testing and tracing nationwide, the Biden campaign released its own coronavirus outbreak response plan. In a blog post published on Medium, the campaign’s public health advisory committee laid out an extensive COVID-19 testing plan.
In the post, the campaign asserts that reopening and strengthening the U.S. economy and protecting the public health of its citizens shouldn’t be mutually exclusive. They outline a range of proposals for crafting a better national COVID-19 response, from increased supply and access to personal protective equipment (PPE) to more rigorous testing and tracing for the coronavirus.
One focal point of this plan is the institution of a “Pandemic Testing Board,” which the campaign compares to the War Production Board President Franklin Delano Roosevelt established to increase production and distribution of supplies needed during World War II.
“The Board should have members from the public and private sectors — and involve state and local leaders, too,” the campaign writes.
“It would oversee a nationwide campaign to provide both diagnostic and antibody tests, which includes surging the production of test kits and lab supplies; coordinating the distribution to every state, tribe, and territory; identifying testing sites and sufficient trained personnel to staff them; ensuring adequate lab capacity and the swift reporting of results; and providing clear guidance on who needs a test.”
The plan also calls for using the capabilities of the labs at the nation’s top medical research universities to administer rigorous COVID-19 testing.
They also suggest “smart testing,” focusing on people who are most at risk, like those living in nursing homes and essential workers like grocery store employees and healthcare professionals. The campaign asserts that this hasn’t been enough of a focus of the Trump administration.
There is also a warning embedded in the plan: “Time is not on our side.”
They assert that this testing apparatus needs to be beefed up before flu season arrives this fall, which could coincide with a second coronavirus wave.
“We also need Apollo-like moonshots to develop and deploy proven therapeutics and vaccines globally if we are ever to gain the upper hand on this virus,” they write.
They propose the creation of a “U.S. Public Health Jobs Corp,” hiring members of communities hit hard by the virus to help implement contact tracing.
The campaign also calls for an increase in Occupational Safety and Health Administration (OSHA) investigators to enforce these guidelines.
“We want our country to get moving and healthy again. But we must take the necessary, rational steps, grounded in science, to do so safely, so COVID-19 doesn’t come roaring back, shredding our still-fragile health care system and the green shoots of an economic reopening,” states the campaign.
This proposal falls in with the Biden campaign’s overarching approach to healthcare reform.
The campaign has, over the course of this election season, moved to a focus on reforming some of the nation’s systemic healthcare flaws, proposing the institution of a public option to the Affordable Care Act, for instance, as well as addressing some of the problems inherent in the system that has made COVID-19 so disastrous for the country.
Some have argued these policies don’t go far enough, especially during a Democratic primary that saw Biden contrasted with ideas put forth by more progressive rivals like Sens. Bernie Sanders and Elizabeth Warren.
But, nevertheless, they do offer a big contrast to the current administration.
Dr. Lynn R. Goldman, MS, MPH, the Michael and Lori Milken Dean of the Milken Institute School of Public Health at the George Washington University and professor of environmental and occupational health, said the current health crisis has exposed deep fissures and imperfections in our healthcare system.
She told Healthline that the country doesn’t have a strong national healthcare or public health system to address a crisis like COVID-19 because of a clear leadership vacuum.
A lot of the response to health problems over the years has been left to the private sector, where we see so many people not fully covered by health insurance and a public health infrastructure weakened over decades by lack of institutional support.
“We could blame one administration or another but I don’t think that is particularly constructive,” said Goldman, who also served as assistant administrator for Toxic Substances in the Environmental Protection Agency (EPA) under President Bill Clinton’s administration. “We in public health have been doing our job very diligently but very much in the background and very poorly supported by governments at all levels for a long time.”
She said she’s now seen a shift during the coronavirus outbreak where suddenly public health experts are visible, no longer “blending into the landscape.”
Goldman added that the public at large is even more aware of epidemiology itself and the work that goes into responding to a crisis like this one.
It also exposes how little is being done to fix serious problems.
She said in the past, there was the Surgeon General who had a lot of power to address health crises and delegate and allocate support, responsibilities that were given more to the White House Pandemic Task Force under President Barack Obama. She added at other times the Centers for Disease Control and Prevention (CDC) has played a central role.
Basically, these individuals and organizations have jockeyed for power and shifted centralized power among themselves over decades, but regardless, all have been respected and given a clear role in releasing accurate public health information — all things that aren’t happening right now under the Trump administration.
Goldman said she was encouraged that this Biden plan emphasized listening to experts in the field and relying on a task force to monitor and bring about more serious COVID-19 testing procedures.
She emphasized that lack of proper oversight of testing and PPE led to deaths that could have been avoided.
“I do see the (Biden) plan addressing this, it’s so important — there should not have been hundreds of deaths in the meatpacking industry, should not have been hundreds of deaths among healthcare workers,” Goldman stressed. “Every healthcare worker should have had appropriate protection … they ran right to the pandemic to help people.”
As for the lack of testing and funding for testing resources, Goldman said she can “squarely put that in the bucket of failure of federal leadership.”
“In the middle of the pandemic, healthcare workers could not order a test for people who are ill or get results back in a timely fashion, and if you can’t see the disease you are fighting you can’t successfully be fighting that disease,” Goldman said. “I do think that in the Biden plan, they want to speed up the clinical trials and I think that it is important, too.”
Dr. Philip Chan, an associate professor in the Department of Medicine at Brown University and who also has a secondary appointment in the Department of Behavioral and Social Sciences at the Brown University School of Public Health, told Healthline that beyond the national government response there were some bright spots in individual states that could be a template for how to address crises like these better.
For instance, in Rhode Island, where Chan lives and works, an executive order to wear masks in public probably played a big role in some of the state’s relatively low COVID-19 numbers.
He said that an emphasis needs to be placed on PPE not only regarding masks, but also an adherence to making cleaning supplies available and putting preventive measures in place beyond hospitals to stores and businesses that are now starting to reopen nationwide.
This also involves an emphasis on safe physical distancing practices — something not necessarily seen nationwide right now.
“I think what we’ve seen in the Biden campaign strategy, something I certainly will support and echo, is that really two of the biggest challenges have been supply chains related to PPE and testing supplies as well,” Chan said. “A lot of countries around the world are testing huge percentages of their population, but early on in the pandemic here in the U.S., it was common knowledge that tests were incredibly limited everywhere.”
He said this hampered our response, with the lack of access to respirators and needed PPE.
While the Biden campaign offers policies for a hypothetical future in 2021, Chan said that in the immediate future while the pandemic is still at a high, “we have a long way to go.”
Goldman sees in the Biden proposals a “tremendous effort” to “restore our relationship with others across the planet who are trying to stop a global pandemic.”
She said that while the World Health Organization (WHO) is “not as strong as it ought to be” in how it addressed COVID-19 and other past pandemics, the correct solution is not what the current administration has leaned into, which is “to walk away from it.”
“I don’t think there is any conceivable way we control this thing just in our country and it’s no longer a problem for us. First, the moral and ethical implications of that ‘is it really true that American people don’t care about the health and wellness of people across the planet?’ I don’t think that’s true,” she said.
Goldman said being part of the greater global response to COVID-19 is a health concern as well as a national security concern and an economic concern.
“We are not an island, we are a nation that is highly interdependent on the rest of the world and actually care, most people in the country actually care about others across the planet,” Goldman explained. “I think that is a very, very important aspect of this plan in terms of public health in not only in bringing the country together in leadership and the country in pandemic response and preparedness, but they are thinking forward this is not our last pandemic.”
While public health becomes part of the political debate and needed pandemic response heading into the general election, Chan said he does think that questions about protecting individual health and the health of a society at large are more embedded in the public consciousness now.
“I think what we’ve seen is a culture shift for the better, especially what has been going on in the importance for public health to control COVID-19 as well as just being more aware of your surroundings and what you can do to protect yourself,” Chan said. “I think there is more appreciation for public health during this time.”
He added that while the Biden plan — especially its panel of pandemic response experts — would emphasize a better future for how to handle the continued threat of the coronavirus outbreak and others like it, he thinks an emphasis needs to be placed also on many of the unsung heroes beyond big political players.
“Some are named, but a lot of unnamed people out there at the public health level,” he said. “You have staff employees at departments of health across the country working 16 hour days, 7 days a week, and a lot are unsung and a lot are healthcare workers — I also want to really pay respect to the public health workers across the country doing that work,” Chan said.
Goldman said that taking an emphasis away from some of these discussions of who’s in power when and instead zeroing in on the systemic problems that have made COVID-19 so challenging for the kinds of unsung heroes Chan mentioned is crucial, too. She said the Biden plan offers some solutions, but a lot has to be done to address these flaws in our public health protocols in this country.
“Every fissure in the system, well it’s something that we have learned to live with — ‘oh, this group of people aren’t covered, the lack of good regulation of our assisted living facilitates, it’s a problem, oh, there’s an absence of strong OSHA guidelines in dealing with pandemics’ — the list goes on and on and on,” she said. “This pandemic opened up those fissures and turned them into vast chasms.”
She explained that it’s difficult for one single policy to address all of those issues.
“This virus exploits all these little cracks and fissures in our system — that’s how the virus lodges itself in and spreads itself,” Goldman added.
“Unfortunately, we have an endless flood, cracks in levies that we failed to fix before the flood. Well, it’s really hard to fix while the rain is pouring down. Now, the water levels are going down a little bit, now is a good time to patch some of that up before the next flood.”