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. Read the first, second, and third parts here.
By Justin Feldman
On December 1, 2021, the CDC issued a press release announcing that it had identified a case of the Omicron variant in the U.S. for the first time.
White House insiders admit that they were unprepared for Omicron, just as they were unprepared for Delta. Vice President Harris recently told an interviewer that the administration was caught flatfooted because their scientific advisors never warned that such variants could crop up (at least two of these advisors, Rick Bright and Celine Gounder, begged to differ).
While vaccination still provides powerful protection against hospitalization and death due to infection from Omicron, protection against symptomatic illness is weaker than before, particularly among those who have not received boosters. And though evidence is mounting that the risk of hospitalization and death is lower for each person infected compared to Delta, Omicron’s extremely high transmissibility means that a large fraction of the population will become infected in a short time period, particularly in the absence of additional public health measures.
On December 21, as the highly contagious variant started to sweep the country, President Biden delivered remarks about the new threat. For the hundred million Americans who remain unvaccinated, the president’s speech warned of the imminent risk of hospitalization and death. For the vaccinated and boosted, Biden’s message was: Keep Calm and Carry On, all will likely be fine. And for Wall Street, the speech was meant to provide a crucial piece of reassurance: There would be no federal support for public health measures that restrict commerce.
The markets approved of this last message. As a MarketWatch headline put it, “Dow, S&P 500 book best day in two weeks after Biden vows no return to March 2020-style lockdowns as Omicron rages.”
But all was not well in the economy. In the following days, in places where Omicron got an early start like New York City, many businesses and entertainment venues shuttered. Nationally, thousands of flights were canceled, disrupting holiday travel. Workers, sick or exposed to the virus, stayed home.
The benefits of public health policies to slow the spread and flatten the curve have rarely been so clear. In just a couple of months, the production and distribution of two drugs that allow for effective outpatient treatment (sotrovimab, the only monoclonal antibody that is effective for Omicron, and nirmatrelvir, the powerful new antiviral) could ramp up. If the Supreme Court rules in the government’s favor, the OSHA vaccination-or-test mandate would go into effect in January 2022. The peak number of hospitalizations would be lower, easing the burden on the health care system. But measures to restrict business and school are expensive, and funds that would allow businesses and workers to lay low have been allowed to run dry.
The administration is further disincentivized from implementing policies to flatten the curve, such as another stimulus package, due to competing economic interests. Just last week, a senior Biden administration official told CNN: “There are millions of open jobs, and we do not believe people should be sitting at home if they are vaccinated and boosted, as most adults are… we are not going to write checks to incentivize people to sit at home.”
Indeed, inflation has become a key economic concern for the Biden administration. The rate of inflation was nearly 7% in 2021, which is unprecedented in recent economic history. The White House believes this inflation has been caused by increased consumer spending on manufactured goods, whose prices have risen sharply as pandemic-related supply chain issues have created shortages. In contrast, spending on in-person services has not been quite as robust due to concerns about patrons becoming infected with SARS-CoV-2 while participating in activities like going out to eat or on vacation. This creates a conundrum where a key economic goal — preventing further inflation — is at odds with public health policies or even messaging that would dissuade consumers from spending time in indoor commercial spaces.
In this context, the Biden administration decided to go full speed ahead into a wave of Omicron infection, even as other countries have introduced targeted restrictions on indoor dining and other high-risk settings. On December 27, 2021, the administration unveiled its policy response to help ensure that businesses and schools would stay open through the wave of infection. The policy can best be described as ‘go back to work or school while you still may be contagious.’ Most notably, CDC shortened the recommended isolation period to 5 days after testing positive (it was originally 10 days). There would be no need to test negative or even wear a more-effective N95 mask upon returning (CDC guidance states returning workers should wear a mask, but generally recommends less-effective cloth masks).
The policy change came after a lobbying campaign by the airline industry, which has canceled thousands of flights, and requests by Republican governors.
While the administration initially promised it would issue a scientific justification for the change, it walked that statement back and the justification may not be forthcoming. CDC’s counterpart in the U.K., the Health Security Agency, has stated it believes CDC’s policy would allow between 10 and 30 percent of workers to still be contagious upon return. Despite figures close to the White House suggesting a testing requirement would be added for return after 5 days, the CDC has declined to make the change owing to scarcity of testing. Instead, federal officials, including Anthony Fauci and CDC Director Rochelle Walensky are defending the policy based on practical economic concerns (“maintain[ing] the structure of society,” as Fauci told MSNBC viewers).
The talking points for the 5-day isolation period are simple to distill: Emphasize that Omicron is mild in relation to Delta, even if many will be hospitalized, die, or develop long COVID. Highlight the need to keep essential workers on the job, even as the guidance also applies to restaurant servers and all varieties of office workers. Frame the move as more “realistic” in terms of getting individuals to comply while obscuring the real purpose of this guidance: to change policies at the institutional level for workers and students. And for health care workers who received a different set of guidance, it opens the door for hospitals to make them work while they are sick, with no isolation requirements, if there is a critical shortage of workers. Despite 2021 seeing rising wages, the “Great Resignation,” and a number of strikes, it is hard to argue at the beginning of 2022 that the economic balance of power has shifted in favor of workers.
Conclusion
The political realities of the United States are such that we were never going to have a pandemic response as successful as New Zealand, Singapore, Vietnam, or Cuba. But I think, when you consider everything I have laid out in these four posts, it is hard to argue that the Biden administration could not have done any better.
It is worth looking at Canada — another settler-colonial state with a federal system and a number of right-wing provincial leaders — which has consistently maintained about half the mortality rate of the United States over the entire course of the pandemic. Even Doug Ford, Ontario’s premier who supported Donald Trump for most of his presidency, has been more amenable to public health measures that restrict commerce than nearly any Democrat in the U.S. Even the U.K. government, under a right-wing prime minister, has rejected the five-day isolation period embraced by a U.S. Democratic president.
Many of the failures of COVID Year 2 result from specific decisions by specific people in the Biden administration. The pandemic response could have gone another way, even in light of the many challenges of governance in the U.S. political economy.
The final point I’d like to make for those of us who are critical of Biden’s response is that we need to understand and learn from our own failures. There has been a failure of various social institutions — the media, the political left, scientists, and unions, to pressure the Biden administration into a course of action that would better prevent mass death.
In some other countries, scientists banded together to form organizations like the U.K.’s Independent SAGE that counters government policy with its own, more precautionary policy recommendations. This has not happened in any substantial way in the U.S., where scientists have made statements only as individuals or in informal, ad-hoc groups. To the extent they have weighed in, American unions have been narrow in their demands for the pandemic response and have not called major strikes over it. Progressive members of the Democratic Party have not put pressure on Biden over pandemic measures except in narrow ways, such as Bernie Sanders calling for an extension to unemployment programs or Cori Bush demanding the Biden administration fight for an extension of the eviction moratorium. Leftist groups like the Democratic Socialists of America have not developed a pandemic response platform, and to the extent they have politicized the pandemic, it has been to talk about long-standing policy goals like Medicare For All.
Instead, the loudest voices in civil society have largely supported Biden’s approach to the pandemic or pushed him to reject non-pharmaceutical interventions more fervently. This select group of media pundits, public health scientists, and economists has been in direct dialogue with White House officials. The administration has cited their opinion pieces in speeches, coordinated messaging on regular phone calls, and promoted these views on social media (one need only look at the Twitter timelines of Ron Klain, or communication staffers like Ian Sams or Ben Wakana).
Those of us who see ourselves as concerned scientists or leftists, or otherwise imagine ourselves to be part of an engaged civil society, should learn from this failure to respond to a crisis, particularly since we do not know how long this one will last. And we can only expect more crises on a 4-degree-warmer planet.
