Just two days after being declared victors in the US election, future president Joe Biden and vice-president Kamala Harris announced a COVID-19 advisory board stacked with infectious-disease researchers and former public-health advisers who will help them to craft a pandemic plan as they transition into office.
The speed of the announcement, alongside an updated COVID-19 plan, has scientists and doctors hopeful that the United States can correct its course in its handling of the outbreak: so far, 10 million Americans have been infected and more than 240,000 have died. And the numbers continue to rise.
“I really think they put together an outstanding and stellar team to advise the new administration on what is clearly one of their highest priorities,” says Helene Gayle, president and chief executive officer of the Chicago Community Trust and co-chair of a US National Academies of Sciences, Engineering and Medicine committee that recommended a coronavirus vaccine allocation plan for the country.
Eric Goosby, an infectious-diseases researcher at the University of California, San Francisco, who led past White House AIDS responses, and Vivek Murthy, a doctor who served as US surgeon general between 2014 and 2017, are among the 13 advisory board members who will brief the future leaders. Observers say the board members are an experienced and impressive team.
“It seems like a terrific group — it’s a real relief to have great experts providing guidance,” says Joshua Sharfstein, a health-policy researcher and vice dean at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, who served as principal deputy commissioner of the US Food and Drug Administration under former president Barack Obama.
The immediate naming of the board is a stark contrast to President Donald Trump’s efforts to contain the pandemic. He has been criticized for ignoring the advice of public-health specialists and downplaying the dangers of the coronavirus, worsening the pandemic’s toll on the country.
But if Biden and Harris follow the science, communicate honestly and openly and have an organized response, it would be “three big resets” from Trump’s administration, says Tom Frieden, who led the Centers for Disease Control and Prevention (CDC) as director from 2009 to 2017.
Communicating with the public
Among the Biden–Harris team’s top priorities is a strong COVID testing and contact-tracing strategy. The team says it will create a “Nationwide Pandemic Dashboard” to display transmission rates of the virus in regions across the country. Other nations, such as South Korea, have dashboards where officials report outbreaks and daily case numbers. The United States has been late or lacking in presenting disease-incidence data, in part because of political push-back and also because of decades of neglect of public-health infrastructure.
“It's critically important that we maintain a national surveillance system,” says Gayle.
But the public-health agency that would normally take charge in this situation, the CDC, has been sidelined during the pandemic by Trump’s administration. Instead, its parent agency, the Department of Health and Human Services, has taken charge of collecting coronavirus data from hospitals.
Once Biden and Harris are in office, the CDC will be in charge of announcing recommendations for when it is safe to open or close restaurants, schools and businesses, according to the updated plan. Frieden would like to see the CDC more frequently brief the press and the public about outbreaks — he sees it as a way to build trust in evidence and science, which scientists feel has eroded over the course of the past year.
Another update to the Biden–Harris pandemic strategy is the proposal to create a task force to address the coronavirus’s disproportionate effect on people of colour in the United States. The COVID-19 mortality rate for Black, Latino and Indigenous people in the United States is more than three times as high as the rate among white people.
Researchers who study health and racism have suggested that such a task force could build trust with minority groups in the United States who have been hit hardest by the pandemic because of the jobs they hold and the places they live.
“I hope that whatever shape or form the task force takes, that it will include people who are closest to that lived experience,” says Rachel Hardeman, a health-policy researcher who studies inequality at the School of Public Health at the University of Minnesota in Minneapolis. Quoting Massachusetts Representative Ayanna Pressley, she adds: “The people closest to the pain should be closest to the power.”
Hardeman would have liked that principle to be applied to the recently announced COVID advisory board, too: nurses have been on the front lines of responding to the pandemic, so that group should be represented better, she says. She would also have liked to see even more public-health researchers on the team, whose focus is preventing disease rather than treating it.
The Biden team won’t take the helm at the White House and install leaders at public-health agencies until Inauguration Day on 20 January. Trump, however, has so far refused to concede the election, delaying the typical transition of power. According to several US news reports, including in The Washington Post and The New York Times, a Trump appointee within the General Services Administration has not given Biden access to funding and office space typically provided to new administrations to ensure a smooth handover.
Meanwhile, Biden has echoed public-health advice in his own remarks. In a 9 November address, he urged people in the United States to wear masks — his plan proposes that all governors introduce mask mandates in their states. The Trump administration has presented conflicting advice on mask-wearing even though scientists have been saying for months that the coverings are a necessary first line of virus defence.
“This is just a simple thing that everybody can do,” says Gayle. “The fact that there’s a part of our population that has resisted that message is unfortunate.”
Nature 587, 339-340 (2020)