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Dec. 7, 2020, 6:18 a.m. EST

Joe Biden’s pandemic plan: Restore Obamacare, mandatory masks, paid sick leave and free COVID-19 tests

The President-elect said: ‘Dealing with the coronavirus pandemic is one of the most important battles our administration will face’

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By Quentin Fottrell, MarketWatch


MarketWatch photo illustration/Getty Images, iStockphoto
Joe Biden: ‘I’ll go to every governor and urge them to mandate mask-wearing in their states.’

Joe Biden has a critical task ahead of him: containing COVID-19.

President-elect Joe Biden unveiled his full health team on Monday, bringing together a group of experts who will be tasked with addressing the coronavirus pandemic. “They are experts in their fields who will restore public trust in the pandemic response by leading with facts, science, integrity, and a laser-focus on bringing COVID-19 under control,” he said in a statement.

While the U.S. makes up 4% of the world’s population, it has had 20% of all COVID-19 cases. The WHO estimates that 16% of people are asymptomatic and can transmit the coronavirus and advises wearing masks. As of Monday, 67.1 million people worldwide had contracted COVID-19, with 1,537,260 deaths, with 14.8 million cases in the U.S. and 282,324 fatalities, just ahead of India (9.7 million cases to date), according to Johns Hopkins University. To put that in context: The U.S. has a population of 328 million people versus 1.35 billion in India.

Analysts say there were two issues on the ballot: the economy and coronavirus. The two, of course, are now inevitably, critically intertwined. Biden has already started working on the transition of power with his team, including coordinating his strategy for COVID-19. Biden’s transition team also announced a new coronavirus task force last month.

‘Since the pandemic began, IDSA has called for a comprehensive and well-coordinated response rooted in the best available scientific data.’

Amanda Jezek, Infectious Diseases Society of America

“Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts,” Biden said in a statement. “The advisory board will help shape my approach to managing the surge in reported infections; ensuring vaccines are safe, effective, and distributed efficiently, equitably, and free; and protecting at-risk populations.”

The Transition COVID-19 Advisory Board will be led by co-chairs Dr. David Kessler, a professor of pediatrics and epidemiology and biostatistics at UCSF, Dr. Vivek Murthy, who served as the 19th Surgeon General of the United States from 2014-2017, and Dr. Marcella Nunez-Smith, an associate professor of internal medicine, public health, and management at Yale University.

Biden has also asked Dr. Anthony Fauci, the nation’s top infectious disease expert, to be a chief medical advisor and part of his coronavirus response team when his administration begins on Jan. 20, 2021.

Biden has urged people to still take precautions. “It is also important to understand that the end of the battle against COVID-19 is still months away,” he said last month. “Even if that is achieved, and some Americans are vaccinated later this year, it will be many more months before there is widespread vaccination in this country.”

‘We’re about to see all of these little epidemics across the country, crossed and mixed, and it’s going to be an awful lot like pouring gasoline on a fire.’

Dr. Megan Ranney, an emergency physician at Brown University

The Infectious Diseases Society of America told MarketWatch that Biden’s plans for combating the pandemic reflects its own key tenets. “Since the pandemic began, IDSA has called for a comprehensive and well-coordinated response rooted in the best available scientific data,” said Amanda Jezek, IDSA’s senior vice president of public policy and government relations.

Jezek also said that the IDSA supported Biden’s promise to update the public regularly. “Clear communication with the public is an essential component of efforts to control the pandemic. Collecting and sharing data in a transparent manner is important to build public trust and to help people make informed decisions to reduce their risk of transmission,” she added.

While the scientific community has traditionally stayed out of politics, the medical journal Nature endorsed Biden’s bid for the presidency and his pandemic plan. “He has shown that he respects the values of research, and has vowed to work to restore the United States’ fractured global relationships. For these reasons, Nature is endorsing Biden,” it said in an editorial on Oct. 3 .

“Biden’s campaign has worked closely with researchers to develop comprehensive plans on COVID-19 and climate change,” it added. “He has pledged that decisions on the pandemic response will be made by public-health professionals and not by politicians; and he is rightly committing to restoring the ability of these professionals to communicate directly with the public.”

Echoing this sentiment, Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, a nonprofit, private foundation in Menlo Park, Calif., cited Biden’s pledge to put “scientists and public-health leaders front and center” to communicate with the American public and to ensure the federal government has primary responsibility on the coronavirus.

Related: What a Joe Biden presidency means for taxes, health care, housing, student debt — and another COVID-19 stimulus package

Here is a summary of Biden’s pandemic plan:

1. Push for a national mask mandate

Speaking in his home town of Wilmington, Del. on the campaign trail, Biden vowed to push for more Americans to wear masks. “First, I’ll go to every governor and urge them to mandate mask wearing in their states, and, if they refuse, I’ll go to the mayors and county executives and get local mask requirements in place nationwide,” he said. President Trump has described mask wearing is "politically correct.”

He will ask Americans to wear a mask for the first 100 days after he takes office and issue a standing order that masks be worn in places where he has jurisdiction, including federal buildings and interstate transportation, he said Thursday. “Just 100 days to mask, not forever: 100 days, and I think we’ll see a significant reduction,” he told CNN’s Jake Tapper.

Biden will have to persuade state governors to mandate their own mask-wearing policies, some political analysts say, and even then it will be a tough ask to get everyone to wear masks, particularly those in Republican states and areas loyal to President Trump, who himself has made a point of appearing in public more often than not without a mask.

Jezek said the IDSA supports this policy. “In August, IDSA began calling for a national mask mandate, as compelling scientific data indicate that masks significantly reduce the risk of COVID-19 transmission,” she said. “Further, modeling suggests that near universal masking could prevent 180,000 COVID-19 deaths. We continue to support a national mask mandate.”

2. Paid sick leave and caregiving leave

In addition to his pledge to raise the federal minimum wage to $15 an hour from $7.25 an hour, Biden has said the pandemic has highlighted the lack of labor protections for millions of workers, such as paid sick and caregiving leave, and he advocates hazard pay, for essential workers who risk their health and are typically paid low wages.

President-elect Biden’s goal of strengthening the workforce needed to respond to COVID-19 and prepare for future pandemics is laudable, and this workforce must include public health professionals, clinicians and scientists.” Jezek said. “Approximately 208 million Americans live in areas with little or no access to an infectious diseases physician.”

3. CDC tracker for coronavirus patients

Earlier this year, the U.S. Department of Health and Human Services temporarily changed the way hospitals reported critical information on the coronavirus pandemic to the government, taking the responsibility for data collection away form the Centers for Disease Control and Prevention. After a backlash from public-health officials, however, the department reversed that decision in August.

Biden wants more transparency. He said he will instruct the CDC to establish real-time dashboards tracking hospital admissions related to COVID-19, especially for ICUs and emergency departments, in concert with the American Hospital Association and large hospital chains and supply-chain information on personal protective equipment and other important supplies.

Former U.S. Food and Drug Administration Commissioner Dr. Scott Gottlieb told CNBC on Friday, “We’re going to see these case numbers really start to explode,” he said, adding that hospitalizations are also a key cause of concern. There are now nearly 57,000 people hospitalized with the virus. “That’s really the number to watch, he said. That’s a lot, and it’s growing very quickly.”

With no epicenter, health professionals have warned that it’s more difficult to share and pass along ventilators and other equipment from state to state.

Health professionals have warned that hospitals could become overwhelmed and, with the disease swarming the country, it’s more difficult to share and pass along ventilators and other life-saving equipment from state to state. During the first surge of the coronavirus in April, there were hot spots in places like New York, while many parts of the south and midwest were spared the worst.

But not this time. Dr. Megan Ranney, an emergency physician at Brown University, expressed optimism about Biden's pandemic plan to CNN on Sunday, but said she was concerned about the burden on the health-care system: “We’re about to see all of these little epidemics across the country, crossed and mixed, and it’s going to be an awful lot like pouring gasoline on a fire,” she said.

It will be “all hands on deck” for the Biden administration, said Dr. Jehan “Gigi” el-Bayoumi, a professor of medicine at George Washington University. She said she was “ relieved ” that Biden won the election. “We are in a four-alarm fire, and we need to not only get everybody to stop the fire, stop it from spreading, but also figure out what caused the fire in the first place.”

4. Protecting and restoring Obamacare

Protecting Obamacare will be one of the first priorities for President-elect Biden. He previously expressed fears that a U.S. Supreme Court conservative 6-3 majority, made possible by newly confirmed Justice Amy Coney Barrett, could finally dismantle former President Barack Obama’s Affordable Care Act, and deprive millions of people of health-care coverage.

Some 7.7 million Americans who were laid off during the pandemic lost their employer-sponsored health coverage as of June. Those plans covered some 6.9 million of their dependents, impacting up to 14.6 million individuals, according to a report published by the Commonwealth Fund, a private foundation that supports health-care issues.

5. Free COVID-19 tests for all

Biden has pledged free testing for all Americans, whether or not they have health insurance: that is, no co-payments, no deductibles, and no surprise medical billing. “We should be investigating a great deal more money in testing and tracing,” he told CBS News last month . “It’s not enough to know in seven days or five days or three days whether or not you have COVID.”

“IDSA agrees with increasing access to testing and testing capacity. In addition to ensuring that everyone who needs a test can get one, we must also improve turnaround time on tests to ensure results are sufficiently rapid to effectively inform contact tracing, isolation and quarantine,” Jezek said. “We also need a strategy to ensure a sufficient inventory of tests and testing supplies.”

Also see: Italy tightens COVID-19 restrictions, plunging Venice back into ‘victorious solitude’


Photo by Chip Somodevilla/Getty Images
Joe Biden is expected to announce the formation of a pandemic task force as soon as Monday.

Trump has defended his response to the coronavirus pandemic. He issued a partial travel ban on China on Jan. 31, with initial reports having emerged in late 2019 of the outbreak in Wuhan, China. Trump followed up with more travel bans in February and March that covered Europe and other hot spots where the virus was showing signs of spiking.

The president said his “operation warp speed” vaccine development is on track. “Under my leadership, we’re delivering a safe vaccine and a rapid recovery like no one can even believe,” Trump said ahead of the election, one week after he himself recovered from COVID-19. “If you look at our upward path, no country in the world has recovered the way we have recovered.”

However, billionaire philanthropist and Microsoft /zigman2/quotes/207732364/composite MSFT +0.44%  co-founder Bill Gates recently told a “Fox News Sunday” interview that the president’s partial travel ban on China and, later, other countries may have actually created a situation where people were rushing to get back to the U.S. and made the pandemic worse. “The ban probably accelerated that,” he said.

President Trump has defended his response to the pandemic. He issued a partial travel ban on China on Jan. 31, with initial reports having emerged in late 2019 of the outbreak in Wuhan, China.

“We created this rush and we didn’t have the ability to test or quarantine those people, so that seeded the disease here,” Gates said . He pointed to the two coasts, and said that travel from Asia and Europe cast the dye. “March saw this incredible explosion — the West Coast coming from China and then the East Coast coming out of Europe,” he added.

Dr. Anthony Fauci, an immunologist and the director of the National Institute of Allergy and Infectious Diseases and an expert in infectious diseases for the last four decades, has expressed concerns about a “twindemic” of COVID-19, especially given that the AAA said 50 million people traveled over the long Thanksgiving Day Weekend, and seasonal influenza as the U.S. enters flu season, and urged Americans to get their flu shots.

Fauci has said that he’s hopeful that a coronavirus vaccine could be developed by early 2021, but has repeatedly said it’s unlikely that a vaccine will deliver 100% immunity. He said the best realistic outcome, based on other vaccines, would be 70% to 75% effective. The measles vaccine, he said, is among the most effective by providing 97% immunity.

BioNTech SE /zigman2/quotes/214419716/composite BNTX +2.85% and Pfizer /zigman2/quotes/202877789/composite PFE +0.19% said in November that a final analysis of its vaccine showed 95% rather than 90% efficacy. The U.S. Food and Drug Administration is to meet on Dec. 10 to review the Pfizer–BioNTech vaccine candidate and could also issue an emergency-use authorization.

On Nov. 16, Moderna /zigman2/quotes/205619834/composite MRNA -1.47%  said its vaccine candidate was 94.5% effective.

A third vaccine being developed by AstraZeneca /zigman2/quotes/200304487/composite AZN +1.33%  with Oxford University — a viral vector-based vaccine — recently produced some confusing results, with the vaccine appearing 62% effective when tested as originally planned but 90% effective when a manufacturing error lead to a reduced initial doze for some volunteers.

Johnson & Johnson /zigman2/quotes/201724570/composite JNJ +1.13% ; Merck & Co. ID:MERK -1.50% ; GlaxoSmithKline /zigman2/quotes/209463850/composite GSK +1.54% ; and Sanofi /zigman2/quotes/202859081/composite SAN -2.79% are also working on fast-track coronavirus vaccines.

The U.K. plans to start inoculating frontline workers as early as next week, but many hurdles remain. The vaccine needs to be stored at minus 94 degrees Fahrenheit and must be transported to the U.K. from a facility in Belgium.

Last month, Fauci said he did not endorse Trump, or any candidate. “In my nearly five decades of public service, I have never publicly endorsed any political candidate,” Fauci told CNN. “The comments attributed to me without my permission in the campaign ad were taken out of context from a broad statement I made months ago about the efforts of federal public-health officials.”

Returning to a life beyond COVID-19 won’t happen until “the end” of 2021, Dr. Ezekiel Emanuel, an oncologist, adviser to Joe Biden and vice provost for global initiatives at the University of Pennsylvania, told MarketWatch. “But it’ll probably be enough to begin opening colleges and universities [and] schools.” That too will depend on any vaccine, its distribution and its effectiveness.

Emanuel has been critical of the government’s response to the pandemic thus far. “We never had an efficient testing regime so we could quickly identify people, isolate them and prevent spread,” he added. “We didn’t have effective implementation uniformly across the country, with the public health measures: physical distancing, face-mask wearing, limiting crowds is critical to that.”

Serving as advisers to Biden’s transition team on COVID-19 are Dr. Beth Cameron, former senior director for global health security and biodefense on the White House National Security Council staff, and Dr. Rebecca Katz, professor and director of the Center for Global Health Science and Security at Georgetown University Medical Center. They will work closely with the Advisory Board.

The Biden transition team said the new task force will consult with state and local officials: “President-elect Biden has pledged to bring leadership to the COVID pandemic, which continues to claim thousands of lives each week, by curbing the spread of the disease, providing free treatment to those in need, and elevating the voices of scientists and public health experts.”

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Quentin Fottrell is MarketWatch's personal-finance editor and The Moneyist columnist for MarketWatch. You can follow him on Twitter @quantanamo.

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