Inauguration Day marks both a grim milestone in the coronavirus pandemic and a new chapter in the U.S. response to it.
On January 19, the United States surpassed 400,000 coronavirus deaths. A day later, newly sworn-in President Joe Biden was poised to launch an ambitious plan to tackle the public health crisis, including distributing 100 million vaccine shots in his first 100 days, issuing a “100 Days Masking Challenge” to encourage the public to wear masks and requiring people to keep physically distant and wear masks in federal buildings and on federal lands.
The President also intends to ask Congress to spend $400 billion to kick-start his national COVID-19 response. The plan includes:
- $20 billion for a national vaccine program that would partner with states, localities and tribal nations to fast-track vaccine rollout. The plan calls for more vaccination sites, including mobile centers, and expanded efforts to reach underserved communities. The National Guard will also be made available to states to assist with the effort;
- $50 billion to expand testing, including bolstering support for laboratories and purchasing rapid antigen tests;
- Funding 100,000 public health workers to aid in contact tracing, vaccine distribution or other needs of local health departments;
- Expanding paid leave programs to allow more workers to stay home if sick.
Exactly how much money goes toward these, and other, efforts depends in part on Congress, and the details will likely change in the coming weeks. Science News talked with Michael Osterholm, an epidemiologist at the University of Minnesota in Minneapolis and an adviser to the Biden transition team’s COVID-19 advisory board, about the new administration’s plans to handle the pandemic. This interview has been edited for brevity and clarity.
SN: How would you describe the overall state of the pandemic, and pandemic response, that the Biden administration now faces?
Osterholm: There are two components. The first is the overall lack of a national plan [from the previous administration] and the lack of coordination in terms of the delivery of vaccines. There hasn’t been enough investment in state and local delivery systems, there hasn’t been enough attention paid to vaccine hesitancy. Expectations have been mismanaged. They’re inheriting an incredible challenge on the vaccine side, and it’s going to take a while to right that ship.
The additional challenge, which is in some ways my worst nightmare, is the B.1.1.7 strain that’s impacting the U.K. and Ireland so hard right now. It could take the pandemic to a whole new level. It’s possible that by mid- to late-February we could see a period where what’s happening right now seems not so bad. And all of this is falling right into the Biden administration’s lap.
SN: How can the Biden administration improve vaccine rollout in the United States?
Osterholm: First of all is just transparency. The administration just has to be honest with the American people about what’s realistic in terms of production timelines and when certain people can get vaccinated. The previous administration has sometimes overpromised how many vaccines will be available when. When you create that kind of short-term excitement about the vaccine being available when it’s just not, it creates long-term confusion, anger and lack of trust. [The Biden administration is] going to have to manage [those feelings].
The next big thing is providing support to state and local health departments who are really the air traffic controllers in our communities for vaccination. All public health is local, and it varies dramatically across the country. To deliver a vaccine to a given local area, you’ve gotta know the area and how to best get the vaccine delivered there. Local public health departments know how to do that. They know what volunteer organizations to call on, what community centers they can use, whether they can get help from emergency response corps at universities or medical schools.
There has never been much support from the federal government. Local health departments are stretched to near-breaking points. [Biden’s] plan acknowledges the critical role health departments play, and provides support in terms of funding and also people.
SN: How can the Biden team ensure that people actually take the vaccines?
Osterholm: The first thing is to understand why people are vaccine hesitant, and there is no one answer. It’s different for different groups. Health care workers may be hesitant for different reasons than essential workers; it may be different for younger Black men versus older white men. Some people may be concerned with safety, others may have heard misinformation about mRNA vaccines altering DNA.
The different concerns of different groups have to be ascertained, then you can figure out how to provide this kind of information to that group, figure out who are the peers you can bring together to build trust. For example, major pro sports heroes could publicly promote the vaccine. That kind of trust building is really important.
SN: What other big pandemic challenges does the Biden team face and what can it do to best meet those?
Osterholm: Managing the potential impact of the B.1.1.7 variant. There are going to be calls for many additional measures to reduce transmission in a country that has gone way beyond pandemic fatigue and is almost in a stage of pandemic anger. How do you respond to that?
You have health care workers begging people not to put themselves at risk because of what they’re experiencing in the hospitals, working 16- to 18-hour days just trying to keep people alive. At the same time, you have people saying, “My small business shut down, I’ve lost my livelihood, I’m done. And I’m angry.” And that anger and frustration often gets put on the government, and I’m sure will spill over to the Biden administration.
This administration sees it and is prepared to deal with it. [Biden] acknowledges that this is tough.