This series, which will run in four parts, has been adapted from “A year in, how has Biden done on pandemic response?” which was originally published on January 5, 2022 on Medium.
By Justin Feldman
Welcome to our “winter of severe illness and death.”
Hospitals are becoming overwhelmed in various parts of the U.S., and one model predicts more than 120,000 COVID deaths will occur in the first two months of 2022.
How did we get here? How is our Democratic president — who ran, in part, against Trump’s horrid pandemic response — letting the virus rip? How did we get to a point where a key organizer of the Great Barrington Declaration, a right-wing libertarian campaign opposed to public health measures, has stated that Republican and Democratic states alike have adopted policies in line with their philosophy? As hospitals fill up around the country, why are political leaders doing nothing to at least try to “flatten the curve”?
In this four-part series, I offer a comprehensive timeline of the Biden administration’s policy choices during the ongoing COVID-19 pandemic.
I argue that Biden’s advisors chose a narrow path of pharmaceutical intervention (i.e., a “vaccine-only” approach) because they saw the politics of a comprehensive public health response as a losing proposition.
Biden’s gamble made sense on a political level, because a more comprehensive public health response would have required new laws and regulations, many of which are costly to business owners and run the risk of energizing the far-right Republican base. Some of these measures would require support from the Senate’s slim and unreliable Democratic majority. Pursuing a comprehensive public health approach would have also involved expending political capital, which ran the risk of displacing Biden’s Build Back Better agenda.
The White House did not want the pandemic to define Biden’s presidency. The virus, however, had other plans.
Part 1: Shutting down the virus or shutting down the economy (Biden’s First 100 Days)
As a presidential candidate, Biden made it clear that his pandemic response would focus on economic concerns using an approach that his advisors branded “safe reopening.” A guiding principle was that there would be no closures or restrictions on businesses. Advisories against travel would be lifted and fully in-person school would return.
Even this last aspect, school reopening, had an explicit economic angle. Biden’s transition team worked closely with the Rockefeller Foundation to develop a coronavirus mitigation plan for schools (it was never implemented). Early in the winter, the Foundation warned that in addition to concerns about education quality, a central problem with remote instruction was that “tens of millions of adults cannot work effectively, or at all until their children are back in the classroom consistently.”
Rather than pursue public health measures that impede commerce, the Biden administration promised to speed up vaccination while supporting masking and mask mandates, protecting workers through occupational health regulation, and expanding testing availability. They would deploy a new federal public health service corps of 100,000 workers to help with tasks like contact tracing and vaccination. Biden’s campaign message went, “I’m not going to shut down the economy. I’m going to shut down the virus.” There would be a cautious “return to normalcy,” with the emphasis decidedly on the normalcy.
This tone was struck early, even before Biden assumed office. First, the transition team distanced itself from one of its scientific advisors who, in a New York Times op-ed, called for a national shutdown of four to six weeks. Later, after internal debate, Biden’s transition team decided not to warn the public against attending social gatherings during the 2020 holiday season, even as few were vaccinated and hospital beds were quickly filling. When Biden assumed office in January, he warned the public that, “There’s nothing we can do to change the trajectory of the pandemic in the next several months.” For his top pandemic policy advisor, Biden appointed Jeffrey Zients, a wealthy campaign donor with a background in private equity and management consulting, not public health. Zients has been known as the “ambassador to the business community” under the Obama administration.
In the first months of Biden’s presidency, the administration’s focus was almost exclusively on speeding the pace of vaccine distribution. Vaccination far surpassed the initial target of 100 million doses in the first 100 days. Around this time, polls demonstrated consistent public support for public health measures that restricted commerce — for instance, one survey found that the percentage of Americans who supported non-essential business closures was double that of those who opposed. There were few such measures in place, however. In Republican-dominated states, many of which had implemented restrictions for at least several weeks in the spring of 2020, these policies had become untenable for various reasons. On top of pressure by business interests, the far-right electoral base that can make or break governors in primaries had come to reject many public health measures.
In Democrat-dominated states, the rationale was more likely a simple economic calculation. The assistance programs to businesses and unemployed workers that made restrictions on business palatable during the spring of 2020 had run out. Many public health measures had therefore become far more expensive than when they were implemented earlier in 2020. When I counted in early January of 2021, only four states in the entire U.S. had fully closed indoor dining. Then-Governor Andrew Cuomo of New York put it bluntly, “We simply cannot stay closed until the vaccine hits critical mass. The cost is too high. We will have nothing left to open.”
The first apparent Biden administration policy towards non-pharmaceutical intervention policies was to gently recommend that states avoid lifting business restrictions or end mask mandates too soon. Rochelle Walensky, Director of the Centers for Disease Control and Prevention (CDC), was circumscribed in her public statements (her off-script note of “impending doom” aside) and did not recommend new restrictions nor single out specific states. More than 130,000 people died of COVID in the first two months of the Biden presidency, many of whom did not yet have the opportunity to get vaccinated.
In February and March of 2021, Biden went to Congress with his proposed spending bill, dubbed the American Rescue Plan. The bill was mainly aimed at giving people money: more stimulus payments, the return of pandemic unemployment boosts, and new, largely unrestricted funding for state and local governments. Notably, there were few carrots or sticks in the bill designed to promote the adoption of public health measures by state and local governments. A few examples:
- Little funding (compared to the CARES Act) was made available to businesses through the Paycheck Protection Program. This made it difficult to close or restrict businesses, because it would not be sufficiently subsidized.
- The Rockefeller Foundation estimated that widespread COVID testing in schools would cost $8.5 billion per month. But the American Rescue Plan allocated $10 billion total, one time, for school testing.
- Funding was not contingent on adopting particular public health policies or triggered by increases in viral transmission.
- There were no occupational health regulations in the bill. While these could be issued without the support of Congress (more on that later), enshrining COVID safety regulations into law would sidestep numerous obstacles.
- There were no paid sick day requirements for employers (a requirement was passed in March of 2020 but expired on December 31 of that year, replaced with a much weaker voluntary tax credit).
The American Rescue Plan passed on a party-line vote in the Senate as a spending bill, meaning it did not need the 60 votes that a filibuster would have required. One could argue that the bill could not have gone any further given various political and legal obstacles. Budget bills are limited in the kinds of provisions they can contain (though this is not always cut and dry, and there is recent precedent for sidestepping the filibuster tradition) and there may not have been support from right-wing Democrats like Joe Manchin.
But at the same time, there was no visible attempt by the Biden administration, or even any of the more progressive Democrats, to improve the bill from a pandemic response perspective. We know what failed efforts look like: certain senators dissent, the Senate Parliamentarian rejects provisions, statutes are blocked by courts. None of these happened in this case, and, as I’ll show in the next post in this series, the Biden administration has maintained a pattern of declining to use its power and influence to promote public health measures beyond vaccination.