On Covid messaging, Biden is caught between politics and public health

WASHINGTON — When it comes to Covid-19, President Biden is walking a tightrope.

The midterm elections are approaching, the economy is floundering, and the president’s approval rate is tanking. Looking for positives, the White House is taking pains to highlight its progress beating back the pandemic. But as Covid continues to spread at high rates, the administration is also working to remind Americans that the crisis isn’t over — and that things might get worse before they get better.

The two messages may not mix well in terms of politics or public health. But the White House, experts say, is backed into a corner.

“They’re in a tough position,” said Nicole Lurie, a physician who served eight years as President Barack Obama’s top pandemic-response official and advised Biden’s campaign on Covid-19 issues. “You don’t want to cry wolf, but you need to be prepared.”

Therein lies the problem: Covid alarmism could prove politically damaging, and might even lead more Americans to completely tune out the administration’s public-health guidance. Unbridled positivity, meanwhile, could lead the public to conclude that the pandemic is over.

Biden’s dilemma is just the latest in a string of pandemic-era communications challenges. At this moment, though, the politics of public health messaging may matter more than any other point in his presidency. In part because of Biden’s poll numbers, Democrats are widely expected to lose control of the House of Representatives, and perhaps even the Senate, in November’s election. Meanwhile, the White House is engaged in an ugly fight on Capitol Hill, where lawmakers’ unwillingness to spend more money on the federal Covid response might force the government to begin rationing tests, vaccines, and therapeutics.

Biden spent the 2020 campaign arguing that he was better equipped to handle Covid-19 than President Trump. But now, in the shadow of 1 million U.S. deaths, he’s facing a potentially impossible task: Touting his administration’s pandemic success even while reminding Americans that it’s nowhere near done.

In an interview with STAT, Ashish Jha, the Biden administration’s pandemic response coordinator, acknowledged the challenge of preaching optimism and caution at the same time.

“I don’t think of it as glass half-empty or glass half-full — we’re just trying to accurately describe the situation we’re in,” he said. “Obviously, we’re in a much better place than we were 16 months ago.”

At the same time, Jha said, the status quo of 100,000 new Covid cases and 300 deaths each day is “not acceptable.”

Still, there have been moments in recent weeks when key White House advisers — and even Jha himself — have made clear their preference for optimism.

In recent weeks, the president has boasted that his pandemic approach “brought down Covid deaths by 90%.” Jha appeared maskless and smiling at the White House Correspondents Dinner just days after the president announced his appointment. And Tony Fauci, the federal researcher advising Biden’s Covid response, was forced to walk back comments arguing the U.S. was “out of the pandemic phase.” (Roughly seven weeks later, Fauci himself announced that he had tested positive for Covid-19, with mild symptoms.)

My approach has brought down COVID deaths by 90%.

It’s opened schools and businesses that were shuttered.

And it’s created the greatest jobs recovery in American history. 8.7 million new jobs in just 16 months – an all-time record.

— President Biden (@POTUS) June 14, 2022

The optimistic tone, at times, has generated criticism from public health experts who say the administration is downplaying the pandemic’s continued gravity, like the Yale epidemiologist Gregg Gonsalves and the George Washington University professor Jonathan Reiner.

Biden does have reasons to celebrate. Since he took power, a large majority of the country has been vaccinated — many have received boosters, and some older or immunocompromised people have even had a fourth dose. Death rates have plummeted. Only about 25,000 people in the U.S. are currently hospitalized with Covid, compared to about 150,000 in January.

More recently, the Biden administration has touted its efforts to make the antiviral drug Paxlovid widely available, ship free rapid tests to Americans’ doorsteps, and offer Covid-19 vaccines to children under 5. Broadly, those advancements have allowed many people to return to something resembling a pre-pandemic “normal.”

Highlighting those achievements isn’t necessarily a political move, said Tom Inglesby, a Johns Hopkins epidemiologist and Biden’s former Covid-testing czar.

“I would not say the administration is trying to sell the story,” he told STAT in an interview. “They’re trying to describe where we are. It’s not easy to get it out in one sentence, but there’s a clear throughline: It’s a lot better, but a lot of people remain at risk.”

The political subtext is still clear. Throughout his presidency, Biden has cast himself as the antithesis of Trump, especially on all things pandemic-related. While Trump was quick to undercut public health officials, Biden has pledged to listen to “the docs.” While Trump minimized Covid’s seriousness at every turn, Biden hasn’t hesitated to warn Americans about the danger posed by the virus. While Trump diligently avoided wearing a mask, Biden is photographed wearing one almost daily.

But not every aspect of the new administration’s Covid response has gone well. Biden has taken flak for confusing messages on vaccines and suffered key court defeats about vaccine and mask mandates. He was also criticized for a July 4, 2021, address in which he said the U.S. was “closer than ever to declaring our independence from this virus.” The deadly Delta-variant wave that eventually caused over 2,000 deaths each day began just weeks later.

More recently, Congress has largely ignored Biden’s recent pleas to provide more pandemic-response funding, forcing the administration to reduce spending on tests in favor of vaccines and Paxlovid. And throughout Biden’s tenure, a torrent of misinformation has kept millions of Americans from being vaccinated, leaving them particularly vulnerable to recent waves.

The administration has also struggled, Jha acknowledged, to persuade many Americans to receive a third “booster” dose. Just 32% of the country has received an additional dose beyond the initial two-vaccine doses from Pfizer or Moderna, or Johnson & Johnson’s single-shot vaccine.

During a pandemic, public health experts concede, some infections and deaths are inevitable. But all told, far more of the country’s Covid deaths have occurred during Biden’s presidency than during Trump’s — roughly 600,000 to 400,000.

Of course, it’s not an apples-to-apples comparison: Biden has been in office for roughly 17 months of the pandemic. Trump was president during Covid-19 for less than a year, meaning the monthly death rate since Biden’s inauguration is dramatically lower than it was for most of 2020.

Vaccine misinformation has also played a major role in the Biden-era death toll, Jha said, citing models that show 300,000 fewer Americans would have died of Covid-19 if vaccine demand hadn’t fizzled in summer 2021.

Jha argued, also, that many of the early Biden-era deaths stemmed from Trump-era infections.

“I think it is an absurd comparison,” Jha said. “First of all, when the president came into office, thousands and thousands of people were dying every day — and those were infections that had happened in November and December” before Biden took office.

Even as the Biden administration takes credit for righting the ship, however, the president’s advisers have recently begun to paint a gloomier picture. Infections and hospitalizations have ticked upward with the rise of new forms of the highly contagious Omicron variant, and with most Americans using at-home tests, it’s hard to know precisely how big the current wave has become.

The White House has also warned that the U.S. could experience 100 million new Covid cases this fall and winter.

Many Americans see things differently. One recent Gallup study showed that more than one-third of Americans believe the pandemic is effectively over. Nearly 80% said their lives were either “back to normal” or “somewhat normal.”

It’s possible that the administration has been a victim of its own success. Since taking office, Biden has made good on promises to make tests, vaccines, and Covid medications widely available — perhaps emboldening many Americans to resume activities once seen as risky.

“The kind of interventions that people were willing to take during the first year of the pandemic — in terms of interruption of their lives — are no longer a thing,” Inglesby said.

The White House, however, is playing to two audiences: The general public and Congress.

Their message for each is distinctly different. While the administration is trying to sell the public on its pandemic successes, it’s trying to convince Congress to spend billions more dollars on measures meant to avoid a potential disaster this winter.

The White House has repeatedly asked Congress to allocate roughly $10 billion to support its pandemic response. Without that funding, Biden officials warn, the country could experience an acute shortage of vaccines, tests, and antivirals this fall and winter — when they project case rates could once again surge.

The disconnect leaves the White House operating via split-screen: a positive message for Americans and a negative one for the lawmakers who represent them in Washington. It is a needle, experts say, that might be impossible to thread.

“It’s hard, because Congress won’t pay attention,” Lurie said. “But by the same token, if you over-exaggerate it, then you’re not taken seriously.”