The New Biden Administration Plans For COVID-19

IRA FLATOW: This is Science Friday. I’m Ira Flatow. It’s been less than a week since it became clear that Joe Biden is the President-elect. And while President Trump and his allies continue to push, with no evidence, unsubstantiated claims of election misdeeds, the Biden transition team is moving into action.

For example, this week with coronavirus numbers continuing to spike alarmingly around the country, the President-elect unveiled his own coronavirus task force, a team of experts to help guide the incoming administration’s COVID response. Joining me now to talk about the task force and what, if anything, it can do to stem the overwhelming COVID numbers, is Dr. Celine Gounder. She is assistant professor at the NYU Grossman School of Medicine and a newly named member of the Biden coronavirus task force. Welcome to Science Friday, Dr. Gounder.

CELINE GOUNDER: It’s great to be here, Ira.

IRA FLATOW: You know, the months ahead look really bad. Numbers like 400,000 deaths are being talked about by January. What do you see the task force’s role in the coming months?

CELINE GOUNDER: The task force is really going to be focused on issues like testing and contact tracing. How do we scale up new therapeutics like the monoclonal antibodies? And how do we get a vaccine distributed to the public once it has been approved for use by the FDA?

We’re also very focused on health disparities. We know that the coronavirus has had a disproportionate impact on communities of color, for instance. And so we’re going to be very focused on making sure that those disparities are addressed.

There is a much deeper bench of doctors, scientists, public health experts that comprise the transition team who’ve been working on policy and plans for months now. And so some of our role as the advisory board is to lay a second set of eyes on these plans, to be sort of the big thinkers, big idea generators, and to raise questions about the implementation of these plans. But there are many people who have been working on how do we implement the nuts and bolts of this in the coming months. So the plan is to be ready on day one to jump right in on this.

IRA FLATOW: Do you have any indication that anybody, until day one, from the White House transition team, might soften up and give you any help on this?

CELINE GOUNDER: Well, I certainly hope so. I am optimistic that there will be an understanding that this is the right thing to do in service of the nation and to protect both the nation’s health and economy.

IRA FLATOW: Do you think that we will need more than one vaccine, one type of vaccine? Because the one that we talked about this week needs to be kept at 100 degrees below zero. I mean, how can you transport that and give it out to the rest of America if it really needs that kind of condition to survive?

CELINE GOUNDER: Well, it certainly will make distribution much more complicated. The average general practitioner or family doctor does not have that kind of deep freeze capacity. You’re really looking at commercial pharmacy and hospital kinds of facilities that would be able to do that.

But I do think it’s important to remember that the Pfizer vaccine is not the only promising vaccine in the pipeline. It might be the one that’s coming out first with the FDA emergency use authorization, but there are a number of others in the pipeline, some that do not require deep freezing. Some that are only a single dose as opposed to two doses. So I think what you’re going to see is the distribution of a number of different vaccines, and these will be targeted to different populations, to different geographies, based on what makes sense in terms of the characteristics of the vaccine and also the supply chain.

IRA FLATOW: So you’re hopeful about all of this progressing?

CELINE GOUNDER: I am cautiously optimistic. And I think what I’m most optimistic about is that science, and not politics, is really going to lead the way here.

IRA FLATOW: I can’t remember the last time I ever heard a President-elect and a Vice President-elect mention the word science in their speeches.

CELINE GOUNDER: You know, it’s funny. I had some friends reach out, and they were congratulating me on the role. And they said that they had tears in their eyes, not just that it was me, but rather that scientists and doctors and public health experts were going to be leading the charge. These are friends of mine who are also health care providers, who’ve been working in the trenches, who have felt completely disempowered and neglected for months, and have really been terrified by what they’re seeing ahead in terms of new infections. And I can’t tell you how relieved they were to hear that people were really going to be pushing for a scientific approach to this.

IRA FLATOW: What a concept, science. Thank you, Dr. Gounder.

CELINE GOUNDER: My pleasure.

IRA FLATOW: Dr. Celine Gounder is an assistant professor at the NYU Grossman School of Medicine and a newly named member of the Biden coronavirus task force. Thank you again for taking time to be with us today.

CELINE GOUNDER: Good to be here.

IRA FLATOW: Joining me now to talk more about the task force and the government’s COVID policy during the presidential transition is Lev Facher, Washington correspondent for STAT. Welcome to Science Friday.

LEV FACHER: Thanks so much for having me.

IRA FLATOW: Let’s talk about some of the members of the task force named by the Biden team this week. Who are they? Is there any common theme here?

LEV FACHER: I think the common theme– I’ve heard the term a lot this week, the A team. I think people are really, really pleased at the caliber of scientists and public health officials from academia, from past administrations, from local governments, from the federal government. There are some expected choices and some surprises.

So for instance, a few of Biden’s longtime COVID advisors, folks who’ve been counseling him about pandemic issues throughout the campaign, are the co-chairs. So Vivek Murthy, he’s the former surgeon general from the Obama administration. He’s one of them.

Marcella Nunez-Smith is a physician and a researcher at Yale. She is one of the co-chairs as well. And I think that’s really telling. Her focus is health equity, health disparities, which of course, sadly have been very prevalent in COVID-19 data.

And David Kessler, who’s a former FDA commissioner. So you know, I think people are just in general impressed at the caliber of advice that Biden is going to be getting. Of course, the question is, how soon can these people start to effect change? And there are about 10 weeks until Biden takes office. So they might be waiting a while to put some of these plans into place.

IRA FLATOW: You know, I think what a lot of people may be noticing is a large absence of one name in particular, and I’m sure you know who I’m talking about, and that’s Anthony Fauci. Why is he not on that team?

LEV FACHER: The short answer is that there’s one government at a time. Anthony Fauci works for the federal government. He technically works for Donald Trump. So there’s a decorum that has to be observed.

Fauci can only serve one president at a time. Assuming Trump doesn’t actually attempt to fire Tony Fauci between now and inauguration day, I think it’s fair to expect that he will maintain his very prominent role in this pandemic response. But it’s not a surprise to me that he’s not on the Biden task force, just because practically he can’t be, yet.

IRA FLATOW: Is this panel going to be hobbled at all by the unwillingness of the Trump transition team to work with the incoming president?

LEV FACHER: I think in some ways, yes, and in some ways, no. Of course, these people aren’t in government yet. They’re advising a President-elect who is preparing to take office. So as of today, the most potent tool they have at their disposal is, I think, messaging, and just stressing to people the importance of mask use and social distancing.

I think that aspect of the transition won’t be hobbled at all. I expect Vivek Murthy, I expect Dr. Nunez-Smith, I expect David Kessler, all these folks to have the opportunity to speak publicly. Atul Gawande is another name. Zeke Emanuel, Julie Merida, the former Chicago public health commissioner– these are all people very experienced in public speaking, in messaging, on these health issues.

On the other hand, are there issues more at the practical level in terms of how the Department of Health and Human Services is run? CDC, FDA, that are hobbled by the Trump administration’s unwillingness to hand over the keys. Yeah, probably, but it’s still early.

And I would just remind people that a lot of the people at those agencies– in fact, the majority of people– are not political appointees. They’re career civil servants who– are they going to take instructions from the Biden task force before inauguration day? No, I don’t think so at all.

But there are some cues to be picked up on. For instance, Biden is not going to withdraw from the World Health Organization. He’s made that very clear.

So I think government scientists who have partnerships now with WHO researchers, they know that they don’t have to be in the process of winding down their work, even if no one says that explicitly. It’s just been made very clear. So there are things they can do, things they can’t, but I think they have a lot of opportunity to effect change prior to January 20.

IRA FLATOW: And that’s a very important point, because we have, what, three months to go until a change of administration? And with COVID just out of control, the public is going to look for some reliable science-based information to work through during these months.

LEV FACHER: Absolutely. And I’ve spoken to Dr. Murthy a few times during the campaign, and transparency and straightforward communication have been really big themes for him– so telling Americans when they can expect a vaccine to be available, what therapeutics are available if someone does get sick, what the data is in terms of who is most likely to become severely ill or need oxygen or a trip to the hospital. And I think that’s really key, because there’s been so much top down messaging in the Trump era.

President Trump will tweet about how a vaccine is coming soon. He’ll say so in an address. And he wants it to be a reassuring message. Of course, in many ways it is, to hear that a vaccine is coming soon.

But we’ve also seen confidence in the safety of whichever COVID vaccine is first approved really plummet, and the number of Americans who want that vaccine once it’s available really take a nosedive, I think because of some of that overaggressive messaging from people like Donald Trump, who are not science communicators. So this is something they’ve really stressed. And yeah, it’s going to be a scary 10 weeks or so that the numbers are really awful, and there’s a lot of fear, frankly, that Biden is just going to inherit an impossible situation.

IRA FLATOW: I want to play a clip from Michael Osterholm from the University of Minnesota. He was on this program last week before being named to the task force, talking about what he saw as a key priority.

MICHAEL OSTERHOLM: You know, what we need right now more than anything in the world, I think, is not just more science. We need an FDR-like moment. We need someone that can tell a story about where we’re at, where we’re going, why we’re going there, how we’re going to get there, how we’ll make things different, and believe in it. And I think that, by itself, could be a dramatic improvement on what’s happening right now.

That is my hope. We need a story. And we need it very, very quickly.

IRA FLATOW: Is there anyone who can tell that kind of story?

LEV FACHER: I think it’s really an open question whether anyone on this task force– and maybe whether anyone at all– can convince the entire country to buy into COVID mitigation, which means, of course masks, and distancing, and not gathering indoors in large groups, and maybe restricting your own travel. Because of course, Joe Biden is going to be able to convince his own voters, to a degree, at least, to do those things. I think the question though, is, can Joe Biden convince people who didn’t vote for him to buy into a FDR-type moment approach?

And as qualified as all the people on this task force are, I don’t know that any of them are able to do that. I don’t know if anyone at all can, just because we’ve seen incredibly qualified researchers and public health officials and government officials just kind of have their message rejected when it comes to COVID.

You know, of course, Joe Biden is a Democratic president. He’s going to enact policies aligned with the Democratic Party. But the virus doesn’t care about politics, and he’s going to need both halves of the country to buy in. And I’m going to be really curious to see how this task force approaches that problem, because as qualified as these folks are, I don’t know that any of them are authoritative enough in communities that have been resistant to COVID mitigation strategies, to get those folks to reconsider how they approach the next few months.

IRA FLATOW: I’m Ira Flatow, and this is Science Friday from WNYC Studios. In case you’re just joining us, I’m talking with Lev Facher, Washington correspondent for STAT, about the presidential transition and what it means for COVID response. The incoming Biden team also announced two health advisors who will be involved in the COVID response, but they’re not on the task force. Can you tell us something about them?

LEV FACHER: Right. I think that’s fascinating, actually, because there are now basically three groups. There’s Biden’s COVID task force. There’s a separate group with a tiny bit of overlap, but really not much, that is advising his transition for the Department of Health and Human Services, which is the parent agency of the CDC and the FDA. And then there are two outside advisors who you’re referring to.

Beth Cameron, she worked for a White House biodefense council that actually has been really controversial throughout the pandemic because the Trump administration wound it down essentially. And people have criticized them for saying there was this Global Health Security Council that existed to warn us and help keep us prepared for pandemics exactly like the one we’re currently experiencing. So that’s a notable pick.

There’s also Rebecca Katz, who’s a Georgetown professor, well-known in health security issues in DC circles. I’m curious to see what their involvement turns into, because there are three groups, like I mentioned. So I’m not sure what the distinction is going to be between their role in the task force itself.

IRA FLATOW: Now Washington loves setting up task forces. I’m wondering how much impact do they really have, or are they just sounding boards for whatever policy and administration wants to implement? I’ve seen lots and lots of task forces do stuff, and then they put it on the shelf somewhere.

LEV FACHER: I think even if they just serve as sounding boards they could have a huge impact. Of course, an instant question is, how many of these people are actually going to serve in the Biden administration– whether any of them are going to play formal government roles in the response. So I think in a way there’s an expectation that this is kind of prep, a way to hit the ground running for people who will play roles in the administration’s response.

I think that Vivek Murthy is certainly someone people expect to actually end up working for Biden after inauguration day. So yeah, there’s a lot of hatching plans. There’s a lot of making personnel decisions about who’s going to run the various agencies. Decisions about how to message to the public just about basic safety practices through the pandemic.

I think this could be a really influential group, even if the impacts aren’t overt, not direct policy issuances or government action. I think they’re going to be making really a lot of key decisions about how the Biden administration takes over the pandemic response on day one.

IRA FLATOW: And we have to say goodbye. We have run out of time. Thank you, Lev, for taking time to be with us today.

LEV FACHER: Great to talk to you, Ira. Thank you.

IRA FLATOW: Lev Facher, Washington correspondent for STAT.

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