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Biden’s Inspiring and Aggressive COVID Response Plan

by |January 25, 2021

Better late than never, the United States finally has a national strategy for a COVID response. If you want to know why we are living in lockdown with millions sick, over 400,000 dead and millions of people out of work, it’s because this plan should have been released last spring not this winter. The substitution of spin for science is why so many have been infected and we can’t visit with our family and friends. But the Biden plan provides hope, and if it is rapidly implemented, normal life could come back sooner than we think.

Some of the plan requires action and funding from our barely Democratic Congress. I hope that the “problem solvers” caucus will look at the Biden $1.9 trillion dollar program and find the pieces of the proposal that can attract bi-partisan support. That should be enacted without delay, to ensure that the COVID response strategy is implemented quickly. A bi-partisan Zoom call this past weekend with key legislators and members of the Biden team was a good start.

The use of FEMA and the National Guard to mobilize the vaccination program can begin with existing resources but if done at scale will quickly require more funding. A bi-partisan endorsement of the program to vaccinate America and re-open its schools will provide an important signal about the need to mask up and avoid crowds. The White House hosted science-based briefings and a system of national response coordination promised in Biden’s strategy will provide the proper sense of urgency and the two-way communication needed to convey the sense of national mission. Our new president can find the unity he seeks by building an aggressive, but bi-partisan, approach to vaccination, public health and re-opening.

My guess is that the most contentious provisions of the $1.9 trillion recovery bill such as the $15 minimum wage and some (but not all) aid to the states will need to be enacted through the budget reconciliation process which only requires 51 votes and cannot be filibustered. I would save the contentious issues for a second bill passed after the two-week era of good feelings ends with the start of the second Trump impeachment trial. I know that splitting these pieces in two risks the wrath of the progressive wing of the Democratic party and could mean that these more contentious issues never reach the agenda. But the priority for everyone must be the war against this virus. We need a national, consensus-driven approach that depoliticizes the science and reinforces both vaccination and behavior-based public health measures. Unemployed people in a depressed economy won’t benefit from a $15 minimum wage.

Lurking, not far in the background, are anti-vaccination advocates and the ideologues who believe that mask mandates are an affront to freedom. A fiercely partisan COVID battle will reinforce those tendencies in America’s culture. A bi-partisan approach will delegitimize those extremists and increase the speed and probability of victory against the virus. With the virus on the run, normal life and our normally polarized politics may both return.

At the moment, the highest priority of the Biden team is to ramp up the manufacturing and distribution of the vaccine. To achieve that they must quickly create a national system of vaccination. Here in New York City, we do not need federal help in vaccinating people, we need vaccine. But in many rural parts of America, both supply and facilities are needed. As a classroom teacher born in 1953, I was lucky and received my first dose of the Pfizer vaccine last week. But vaccine is in short supply and last week New York City canceled thousands of vaccine appointments. We need to ramp up and accelerate the vaccination program. The goal of 100 million vaccinations in 100 days is shamefully slow. We can and must do better. The Biden plan recognizes the need to produce more vaccine. As the National Strategy notes:

“Timely vaccine production depends not only on sufficient supply of biological materials for the vaccine itself but also of appropriate equipment and materials for packaging the vaccine. Shortages of any of these materials can slow vaccine manufacturing and availability to the public. The United States will fully leverage its contracting authorities, including using the Defense Production Act, to strengthen the vaccination supply chain for raw materials and equipment and fill urgent vaccination-related supply and distribution gaps, anticipating a protracted requirement for vaccines. This will include supplies such as low-dead volume syringes with the ability to extract additional vaccine doses from vials. The Administration will also leverage all available authorities to support the expansion of lipid nanoparticle formulation capacity in order to scale mRNA vaccine production.”

The administration’s activist approach to vaccine supply is not limited to bolstering the supply chain but to building up manufacturing itself. Using War Production Act authorities, the federal government could direct American vaccine manufacturers to temporarily become subcontractors to firms manufacturing COVID vaccine in order to increase production. In other words, Pfizer could be directed to work with other companies not yet under contract to them to ramp-up production. The mechanism to undertake this effort is obliquely referenced in the strategy’s promise to: “Deploy onsite support to monitor manufacturing operations.” The Biden plan states that:

“Manufacturing facilities will continue to benefit from support for converting raw materials into vaccines. The federal government, through the Biomedical Advanced Research and Development Authority (BARDA), will work closely with the multitude of public and private actors involved in the end-to-end production of vaccines. The Administration will provide ongoing technical assistance and ensure that representatives are onsite at all contracted manufacturing facilities to monitor and support operations in order to support timely and effective production of vaccine supply.”

Contractors have already been involved in manufacturing the Pfizer and Moderna vaccines. As Mathew Dalton and Joseph Walker reported in the Wall Street Journal in December:

“High-profile drug companies have turned to a quickly assembled network of smaller, lesser-known manufacturers to mount an unprecedented effort to produce Covid-19 vaccines. The companies have been forced to rely on outside manufacturers world-wide because their new vaccine technology has never been used at industrial scale”. 

The Journal piece notes that the new vaccines are actually easier to manufacture than traditional vaccines “because manufacturers don’t have to work with live pathogens.” Dalton and Walker also reported that under Operation Warp Speed:  “U.S. Army officers who specialize in logistics are embedded across nine manufacturers to ensure production runs smoothly and safely, helping to address problems as they arise, such as machines breaking down or obtaining equipment or raw materials…”

While the Trump Administration was willing to leave vaccine manufacturing to the private sector (with government cash and assistance) and to leave vaccine deployment to the states, the Biden strategy is to declare war on the virus and employ a more aggressive and intrusive strategy to increase the pace of vaccination. The goal is to quickly restore America’s economy and way of life. The great success of the Trump effort was to develop the vaccine in record time. Their great failure was to constantly minimize the threat and to leave the process of vaccinating people to state governments without providing the resources needed to get the job done.

The implementation of Biden’s strategy is only days old. Vaccination is only one element of the plan, ramping up testing capacity is also called for. In a New York Times article on the new plan, New York Times reporter Sheryl Gay Stolberg quotes Biden’s new COVID response coordinator Jeffrey Zients who observed that:

“On the asymptomatic screening side, we’re woefully under capacity, so we need the money in order to really ramp up testing, which is so important to reopening schools and businesses… We need the testing. We need the money from Congress to fund the national strategy that the president will lay out.”

The plan artfully utilizes a wide variety of federal agencies, such as FEMA, OSHA and the Department of Defense. Most of these agencies can act immediately under existing authorities to implement elements of the plan. But as Zients stated, many of the strategy’s most important elements require additional federal resources.

The new president and his health advisors such as Dr. Fauci continue to urge patience and set expectations that the recovery process will extend into the fall. That may be true, and it makes sense to insist on continued vigilance. But if Congress acts quickly and our national, state, and local governments and companies like Amazon, FedEx, UPS, Walmart, CVS and Walgreen go all out, we could drive down this virus more rapidly than now expected. We have not seen a true national mobilization in a very long time. It’s not clear that this divided nation is even capable of one at this point. But this test of the new administration and of our national character has now begun. It is thrilling to see the experts and professionals hard at work. Soon it will be up to the rest of us. We need to vaccinate, test, mask-up, continue to practice social distance, and do all we can to rid America and then the world of this terrible virus.


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