The United States finally has a president who seems to understand the threats posed by Covid-19. The new government also has the people’s mandate and legislative power to address the crisis. As Americans, we are relieved and cautiously optimistic for the first time in many months.
As epidemiologists, however, we fear that President Joe Biden’s current pandemic strategy will not be enough to avert further disasters. To prevent unnecessary deaths and give the vaccine a chance of success, Biden must encourage states to shut down four to six weeks by providing generous economic support to people and businesses.
The Biden team inherited an incredibly difficult situation. The coronavirus is circulating at an uncontrolled level in almost every US community. More transmissible variants such as strain B.1.1.7 first identified in the UK are here and could become the dominant strains sometime in March. To date, around 440,000 people have died of Covid-19 in the United States, with the highest fatalities being borne by people of color. We could reach half a million deaths by mid-February.
Even with Biden’s vaccination schedule, only a small fraction of Americans – perhaps one in eight – would receive both doses of vaccine by May. It is risky to allow high levels of virus transmission before large-scale vaccinations are given. First, hundreds of thousands more people could die if the virus spreads unabated. Second, incremental vaccination applies selective pressure on the virus, increasing the likelihood that new mutations could weaken the vaccines’ effectiveness. Suppressing transmission is the best way to reduce the chance of the coronavirus mutating during the vaccine launch, and the best way to suppress transmission is to implement policies that allow large numbers of people to pass personal Avoid contact with other people.
The White House 200-page strategic plan because the pandemic response does not go far enough. It contains mask mandates, test programs and specific restrictions. But an emphasis on masking, for example, will bring limited returns as a large fraction of Americans – 73 percent according to a recent poll– Already wear masks when you leave the house. The new OSH policy is important, but needs contextualization: the OSH has limited enforcement powers and fewer than 900 inspectors covering the entire country.
As written, the strategic plan will not allow so-called “safe reopening” of businesses, schools and travel. Early, large-scale return to indoor shared spaces with only incremental harm reduction measures runs the risk of worsening the pandemic and pushing our buckling health systems further past the point of collapse. For example, New York Governor Andrew Cuomo plans to allow indoor dining to resume at 25 percent capacity on Valentine’s Day. This poses a reckless and unnecessary risk to restaurant staff, diners, and the introduction of the vaccine. Similarly, California Governor Gavin Newsom overturned the stay at home recommendations on Jan. 24. Closing unnecessary businesses to control transmission is a requirement for schools to open safely. The movements of these governors are steps in the wrong direction. Strict federal guidelines are needed not only to reduce transmission, but also to control the prioritization of allowable personal activities during the vaccine launch.
Earlier this winter, many countries had hoped to keep the pandemic under control through targeted measures such as those proposed by the Biden government. But country by country – the UK, Germany, Australia, Israel – have found that containing the virus will require stay-at-home contracts, combined with widespread shutdowns of unnecessary businesses and other institutions. These public health measures are not all effective. they also Survey good with the public: Sixty-one percent of Americans support closing unnecessary stores, while only 32 percent oppose closing. Orders that stay at home enjoy a similarly high level of support.
Despite the public support, President Biden has withdrawn from the extensive public health actions he originally supported. In August the then presidential candidate Biden replied to an interviewer’s question about whether he would support a national shutdown if scientists supported it by saying, “I would shut it down. I would listen to the scientists. ”
In November, a member of the President-elect’s Coronavirus Task Force, Michael Osterholm, proposed a national shutdown of four to six weeks to bring transmission under control while covering losses to workers, businesses, and state and local governments. President-elect Biden quickly distanced himself from Osterholm’s views, saying, “I’m not going to close the economy, period. I’m going to shut down the virus.”
Osterholm’s proposal was correct in November and now even more correct. While Candidate Biden said he was “ready to do anything to save lives,” President Biden’s opposition to stoppages could kill hundreds of thousands of Americans.
While federalism prevents Biden and Congress from decreeing comprehensive national public health measures, the White House is far from powerless. The President can advocate national and regional shutdowns. Democratically controlled Congress can provide generous economic and logistical assistance that allows non-essential workers to stay at home and keeps businesses alive during temporary closings. Congress can also pass federal laws to pay workers in non-essential companies to stay at home during a public health emergency, even if some governors choose not to cooperate.
Biden’s proposed $ 1.9 trillion Pandemic Bill provides much-needed relief, but is primarily intended as an economic incentive rather than a tool to enable public health action. In addition, Biden has reportedly chosen to work with Republicans rather than passing the law through reconciliation, a process that would not require assistance from either party. These negotiations can delay the bill, limit its scope and reduce its funding. This unnecessary, preventive compromise will lead to many more unnecessary deaths.
It has been a year since the first confirmed death from Covid-19 in the United States. With Trump out of office and with a new Democratic-majority Congress taking place, there is no excuse to tolerate more than 4,000 Covid deaths a day. Americans don’t really want to risk exposure and death, and neither would they if their incomes and health care didn’t force them to. The science is clear: Short-term cessation of unnecessary activities with generous economic support can contain the pandemic. Biden’s Covid-19 plan and relaxed state-level restrictions will cause death and devastation, especially when we are so close to being safe again.
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