WASHINGTON — Even many public health experts who celebrated President-elect Biden’s win this week turned their immediate focus to the crisis it might create: A 10-week transition period during which Covid-19 cases and deaths skyrocket, and the outgoing Trump administration doesn’t take additional action to stop the surge.
From a public health standpoint, the presidential election could not have come at a worse time. Health officials have long warned of a devastating winter, and case totals and deaths have spiked just as millions of Americans are set to congregate with their families over the holidays. President Trump’s persistent downplaying of the crisis, experts say, will continue to have deadly consequences — and as a result, leave Biden to inherit a country experiencing its worst Covid-19 crisis since the first recorded U.S. cases in late January.
“So many of us are worried that now that Biden has won, the Trump administration is going to take a scorched-earth approach,” said Saskia Popescu, a University of Arizona epidemiology professor and biodefense expert. “It’s going to be very, very scary.”
Even as election officials counted votes this week, the U.S. set multiple new records for Covid-19 infections. Health officials reported 102,831 new cases on Wednesday, the first time the country’s case count topped 100,000. The country set another case record Thursday with 121,888, and yet another on Friday with over 126,480.
Trump advisers were largely unmoved. Scott Atlas, the radiologist who has come to serve as the de facto leader of Trump’s coronavirus response, has downplayed the record-setting total of new cases by highlighting the comparatively low death toll. On Wednesday, 1,097 Americans died of Covid-19. Another 1,210 died Thursday, and another 1,146 died Friday.
Atlas’ rhetoric mirrors Trump’s closing campaign-trail message: That Covid-19 is overblown and poses minimal threat to most Americans. Now that Trump’s loss is official, the public health community has become fearful that his apathy for the ongoing pandemic will reach new heights, to deadly effect.
“I’m not going to sugarcoat it: It looks bad,” said Nahid Bhadelia, an infectious disease physician and associate professor at Boston University School of Medicine. “In a month, this country is going to be in a really bad place.”
The resulting void could leave Biden in a bind. Typically, a president-elect doesn’t publicly challenge the outgoing president on basic matters of governance until their inauguration. But a leadership vacuum at a critical point in the country’s pandemic response, Biden’s aides say, isn’t an option.
Many Biden health care advisers have already reached out to mayors and governors, and begun planning for a transition of power at health agencies like the Centers for Disease Control and Prevention and Food and Drug Administration. But until Biden is inaugurated, he won’t have any formal power when it comes to mask mandates, the manufacturing of protective equipment for medical workers, or Covid-19 testing.
Instead, words will be his only weapon. Biden is widely expected to continue receiving regular pandemic briefings from a slate of advisers that includes Vivek Murthy, the former surgeon general; Marcella Nunez-Smith, the Yale physician-researcher; Nicole Lurie, a top Obama administration pandemic-preparedness official; and Zeke Emanuel, a Biden adviser and Affordable Care Act architect.
That core group is likely to assume some public-facing role. If Biden appoints well-known public health experts to serve as de facto pandemic spokespeople, they could use their credibility to publicly stress the need for caution and compliance with public health guidelines in the weeks before Inauguration Day.
“I don’t know that he needs to name a CDC director, but he certainly needs to identify a couple of well-respected senior public health people who can begin to talk on a daily basis, from a science and public health point of view, with the American people,” said Ashish Jha, the dean of the Brown University School of Public Health. “Start explaining what’s going on, what the science is — all the stuff we have not had from the current team.”
Even before he was formally projected as the winner of the election, Biden sought to contrast his concern for mounting Covid-19 infections, hospitalizations, and deaths with Trump’s inattention. On Thursday, he and Vice President-elect Kamala Harris received a briefing from Biden’s Covid-19 advisers, and began his public remarks shortly after with a nod to the crisis. On Friday, Biden attempted to drive home his message, pledging to begin implementing his pandemic response plan immediately after his inauguration.
“We want everyone to know, on Day 1, we’re going to put our plan to control this virus into action,” he said during televised remarks. “We can’t save any of the lives … that have been lost, but we can save a lot of lives in the months ahead.”
Trump, meanwhile, did not mention the pandemic during his public appearances on election night and on Thursday evening. His coronavirus task force has held meetings and public briefings only sporadically in recent weeks, even as states have set new records for cases and hospitalizations.
Meanwhile, the Trump administration has experienced another Covid-19 cluster: In the days following the election day, a number of aides tested positive for coronavirus, including White House chief of staff Mark Meadows, who sought to keep the information from becoming public, Bloomberg reported.
The accelerating crisis has left many Biden advisers resigned to a grim reality: That they will likely take control of a crisis that will be difficult, if not impossible, to quickly slow.
“Somebody asked me if it was too late for the new administration to turn it around,” Lurie, the Biden campaign adviser, said in an interview on Election Day. “I don’t know, but I don’t think anyone expects a new administration just to throw up their hands and let people die.”