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Friday, February 23, 2024

OK, You've Just Won the Election. Now Fix Covid

On Election Day this year, some 100,000 Americans will be diagnosed with SARS-CoV-2, the virus that causes Covid-19. Perhaps 1,000 more will die from the disease. After every vote is cast and counted, and the future of the government decided, the pandemic will still be here.

The virus itself does not know that there has just been an election, of course. But the period after an election offers an important opportunity: Regardless of who emerges victorious, for a brief moment—though long may it last—our leaders will be liberated to think less about winning the next election than saving the current electorate. This post-election period is our best opportunity to depoliticize the pandemic, and it arrives just as the crisis is entering what looks to be its most dangerous phase yet. Now is the time to wage an intelligent campaign to minimize the damage while we await a vaccine and more effective therapeutics.


There are several actions the next administration must take. First, whoever is in power should use the Defense Production Act (DPA) to its fullest extent in order to obtain enough personal protective equipment for healthcare workers and other essential workers who interact with the public. Even seven months later, there are still shortages of PPE like masks, gloves, and face-shields—with increasing demand coming from non-hospital facilities such as nursing homes, homeless shelters, outpatient clinics and schools. The DPA must also be used to ramp up our testing capacity. More than a million tests are now being performed per day, but there are still significant delays in getting results, and our positivity (i.e. the number of positive tests divided by the number of tests) in the United States still suggests that we are not testing enough.

Even these seemingly straightforward measures have been politicized, almost from the start. When I asked a well-placed and concerned Republican strategist why the Trump administration had not used the DPA more aggressively in the spring, this person told me that doing so would have been seen as a big government solution, which runs against long-established principles of the American conservative movement. But once-per-generation challenges require thinking beyond the normal organizing principles we rely on to make policy decisions. Seeing to it that all medical workers have enough masks should not be treated as evidence that Keynesian economics works, or that the free-market system does not. The same is true in times of war: A centralized plan to defeat the Axis powers in World War 2 was not a nudge towards American communism. Nor should using the DPA in this moment be construed as a rubber-stamp for other big-government solutions.


Second, we must prioritize our spending to help support businesses that are affected by the virus, and which can have the greatest impact—both positively and negatively—on how much the virus spreads. For example, we know that indoor dining is a threat. In areas where case counts are too high, the next Congress must work with the next administration to extend and refine the CARES Act to address the financial well-being of bars and restaurants in particular, so that employers and employees are not forced into an impossible choice between keeping themselves safe by closing, and their families fed by remaining open. We can also help to save the travel and hospitality industry while simultaneously keeping the community safe. We have learned that at-home spread among families undermines efforts to isolate and quarantine infected people, and is a major problem. As my colleague Cass Sunstein and I wrote in March, the federal government should pay hotels to use their rooms as single occupancy dwellings for those with suspected or confirmed Covid-19, protecting their families while keeping tourism businesses and their employees afloat.

Third, we need to apply all we have learned to track this virus more accurately. For too long we’ve been measuring the spread of the pandemic by combining droves of data into a sloppy vat of numbers and then reporting the statistics. While it may seem counterintuitive, using every speck of reported data is likely to be less useful than carefully collecting a smaller sample that is designed to reflect reality. For example, if you wanted to determine which Major League Baseball team is the most popular nationwide, you’d do far worse by asking each of the 50,000 fans at Yankee Stadium than by asking 5,000 people spread around the country. Sure, a more sophisticated poll might take into account that there are more New Yorkers than Houstonians, but that is precisely the point. Pollsters like Gallup and others have long understood how to do this work. Teams of experts are starting to do just this, applying the long-honed tools of scientific polling to the problem of measuring the pandemic in real time. A recent study funded by the CARES Act demonstrated that obtaining antibody tests on a relatively small but truly representative sample of residents in Connecticut could generate accurate data about how many people have been infected by the coronavirus so far. But there is no one at the wheel in Washington to notice this approach, and extend it.

To aid in all of the above, a new White House Coronavirus Task Force should be convened in the coming months. Whether this is done by Donald Trump in preparation for his second term, or more informally, as part of Joe Biden’s transition team, this working group should be led by established experts in epidemiology, virology, emergency response, public health, health economics and logistics. Eventually, the new body should report to the President but also directly to the American people, on a daily basis. Imagine a morning briefing in which the latest undisputed facts of the outbreak were reported, and in which updates on previous and new initiatives were provided. How far would that go towards reassuring the public that its government is taking this problem seriously?

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The federal government must also bolster scientists and researchers, instead of threatening to fire them when their facts create friction with the opinions of our leaders. Rather than undermining the Centers for Disease Control and Prevention and the World Health Organization, the US should support and propel their work. At the CDC in particular, a major investment in real-time tracking and reporting must be made. This important task must not be reassigned to agencies or private contractors that are less prepared to carry it out. Moreover, local hospitals’ privacy concerns regarding real-time data cannot be said to outweigh the public’s right to know what is occurring around the country. If we are unable to measure the pandemic, and the data are not shared broadly, the public will be uninformed as to whether we are effectively combating it. Non-governmental online Covid-19 trackers have been a huge help, but it is a public health disgrace that we’ve been forced to use them.

Once we’ve truly begun to measure and report the scope of the problem at hand, we can turn to the computational experts. Their modeling work will help officials in any jurisdiction develop plans specifically tailored to the size of the local problem. This means we will at last be able to provide people with reasonably accurate expectations on what needs to happen next and why. Understanding why certain sacrifices are necessary—and why others that seem important are really not—will go a long way.

All this may feel like an argument for having the federal government do more, in general. But the abiding principle should be to elevate good science and good data over politics, so that when we choose to act—and also when we determine it is better not to—those decisions are transparent, and they make sense.

If the country’s leaders can instill a sense that science will be driving policy in 2021, a more united and safer nation will emerge.

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