“I promise you, we will be judged, you and I, by how we resolve these cascading crises of our era. Will we rise to the occasion, is the question,” President Joe Biden said in his inaugural speech. “Will we master this rare and difficult hour? Will we meet our obligations, and pass along a new and better world to our children? I believe we must.”
The U.S. handling of the COVID-19 pandemic will be a lasting stain on the country’s history. More than 400,000 Americans have died from the virus and more will die still. The big question now is: Can Biden ensure hospitals overflowing with COVID-19 cases are able to access adequate supplies of tests, protective gear, vaccines, and health workers? Can he wrest back control of a vaccine rollout gone awry? At a minimum, can he convince Americans to wear masks?
Biden’s initial response to these questions includes a 198-page COVID-19 plan bolstered by a series of executive orders that he signed during his first two days in office. He mandated 100 days of masking among federal employees on federal lands and in federal buildings, and a restoration of the U.S. relationship with the World Health Organization. Americans will also be required to wear masks on trains, planes, and buses. He also ordered the reconstitution of the Directorate for Global Health Security and Biodefense, a group within the National Security Council that was responsible for following disease outbreaks around the world under President Barack Obama. The emphasis of these orders has been on embracing the wisdom of science and taking a more national approach to curbing the virus.
The splashiest headline is his promise to vaccinate 100 million people in his first 100 days. The U.S. is already close to administering a million doses per day. In the last week, more than 6 million people received the vaccine, according to data from the Centers for Disease Control and Prevention. If that rate continues, vaccine production allowing, everyone in the U.S. will be vaccinated by sometime in 2022.
The Biden White House has laid out specific goals for how to bring the pandemic under control through a $1.9 trillion stimulus package, which ultimately Congress will have to sign off on. Of that, the president wants to put $400 billion toward dealing with COVID-19 directly, including delivering the promised 100 million COVID-19 vaccine shots in the first 100 days of his term.
Pressed on whether Republicans will approve such an enormous financial commitment, White House press secretary Jen Psaki said that Republicans are looking to have a conversation about next steps and the president will be “rolling up his sleeves and will be quite involved.”
Already, Biden has said that he will open up vaccinations to more people, ramp up production of more vaccines, and withhold a small number of doses to ensure that people can get a second dose within the prescribed time period. The president also wants to increase the number of places where people can receive vaccines to include community health centers, mobile health units, pharmacies, and other locations like stadiums and school gymnasiums. He plans to erect a giant workforce of vaccinators using retired health workers, the national guard, military medical personnel, and first responders.
Biden’s team wants to invest $25 billion in vaccine manufacturing and distribution infrastructure. The president is invoking the Defense Production Act to do it. Another priority will be making the available COVID-19 vaccines more accessible, and to convince the public that they are both safe and effective.
Another big focus is on building up testing resources. There are 790 drive-through testing sites around the country, according to a tool developed by Johns Hopkins University Carey Business School. The White House says it wants to double that number. It also wants to expand how testing is done through an investment in rapid tests and at-home tests. As part of that expansion, Biden wants to create a Pandemic Testing Board, a civilian advisory board which he sees as similar in function to the War Production Board that President Franklin D. Roosevelt stood up to coordinate defense production resources. The White House has also promised to launch a U.S. Public Health Jobs Corps, which would amass a 100,000-strong workforce to “perform culturally competent approaches to contact tracing and protecting at-risk populations.”
The White House plans to supply personal protective gear to health systems, municipalities, and tribes across the U.S. and build the manufacturing capacity to provide more equipment. The administration says it will work with the CDC to create more specific national guidance on social distancing, mask wearing, and restrictions on businesses and schools.
As part of an address detailing his plan to get the COVID-19 pandemic under control, Biden made a pleading request that all Americans wear a mask for 100 days. He says that if Americans wore a mask every day from now until April, 50,000 lives could be saved.
Finally, the president promised transparency: about vaccine supply, distribution, and progress toward curbing the pandemic.
It is too early to say whether this massive federal effort will indeed curb the pandemic or how quickly it will be brought to heel, but experts largely see these efforts as positive. Dr. Peter Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering, is optimistic that Biden and the team of advisers he’s brought on will be able to bring order to the vaccine rollout.
However, Bach worries about the number of people who are refusing to get vaccinated. “We appear to have a pretty consequential vaccine uptake problem,” he says. Reports from the Kaiser Family Foundation show that 35% of Black Americans and those who live in more rural areas are unlikely to get the COVID-19 vaccine. Biden has put together a Health Equity Task Force, headed by Yale internal medicine doctor Marcella Nunez-Smith, which he says will combat vaccine hesitancy and actively fight anti-vaccine disinformation campaigns.
Experts would also like to see a national digital system where people can find vaccination locations and register for vaccines. They suggest the government should launch a data hub where local health officials and legislators can keep track of production and supply of vaccines, tests, and other medical equipment.
The White House highlights this kind of data-sharing in its COVID-19 plan. The document says the government will release regular reports about the state of vaccination, testing, supplies, contact tracing, and information for and about health workers. It will also develop a dashboard for state and local officials that tracks hospital admissions, hospital capacity, vaccine supplies, and medical equipment supply. State officials will also have a designated federal point of contact with whom they can coordinate their COVID-19 response. Lastly, the document says the government will improve COVID-19 websites, so that Americans can find testing and vaccination sites as well as public health guidance more easily.
“We will get through this and we will defeat this pandemic,” Biden said. Still, he expects the death toll in the U.S. to reach 500,000 next month. “It’s going to get worse before it gets better.”