Biden Warns of ‘Dark Winter’ as Covid Cases Top 10 Million

By Yuval Rosenberg

Biden Warns of ‘Dark Winter’ as Covid Cases Top 10 Million

President-elect Joe Biden made clear Monday what he sees as Job.
1: addressing the coronavirus pandemic that just reached a new
milestone, topping
10 million confirmed cases.

After a victory speech Saturday in which he urged a polarized
nation to come together and renewed his promise to try to be a
president for all Americans, Biden began his transition to office
on Monday by signaling just how different his approach to the virus
would be. He warned that the United States faces “a dark winter”
ahead, pleaded with Americans to wear face masks, emphasized that
his response would be informed by science and announced a new
advisory board of public health experts to help guide his
efforts.

Biden lauded drugmaker Pfizer’s announcement that its Covid-19
vaccine was more than 90% effective in a trial, but noted that even
if the vaccine is approved, it won’t be widely available for
months. Pfizer said Monday that it aims to deliver 100 million
doses of the vaccine, enough for 50 million people, by March.
Biden, who has mapped out a
coordinated national strategy to combat the virus,
warned Monday that hundreds of thousands more could die if the
public grows complacent before the vaccine arrives.

“We could save tens of thousands of lives if everyone would just
wear a mask for the next few months. Not Democratic or Republican
lives, American lives,” Biden said. “Please, I implore you, wear a
mask.”

A new advisory board: In a 5 a.m. news release, Biden
formally announced that the new Transition COVID-19 Advisory Board
will be co-chaired by:

  • Dr. David Kessler, who served as commissioner of the Food
    and Drug Administration under Presidents George H.W. Bush and Bill
    Clinton;
  • Dr. Vivek Murthy, who was Surgeon General under President
    Obama from 2014 to 2017;
  • Dr. Marcella Nunez-Smith, associate dean for health
    equity research at the Yale School of Medicine.

Others on the 13-member task force include:

  • Dr. Luciana Borio, who was director for medical and
    biodefense preparedness on President Trump’s National Security
    Council until 2019;
  • Dr. Rick Bright, the former head of the Biomedical
    Advanced Research and Development Authority, who filed a
    whistleblower complaint against the Trump administration’s approach
    to the pandemic;
  • Dr. Ezekiel Emanuel, chair of the Department of Medical
    Ethics and Health Policy at the University of
    Pennsylvania;
  • Dr. Atul Gawande, a surgeon at Brigham and Women’s
    Hospital and a professor at Harvard Medical School who is also a
    noted author and former head of health care venture
    Haven;
  • Dr. Celine Gounder of New York University’s Grossman
    School of Medicine;
  • Dr. Eric Goosby, global AIDS coordinator under President
    Barack Obama and professor of medicine at the University of
    California at San Francisco School of Medicine;
  • Dr. Julie Morita, executive vice president of the Robert
    Wood Johnson Foundation and former Chicago health
    commissioner;
  • Dr. Michael Osterholm, director of the Center for
    Infectious Disease Research and Policy at the University of
    Minnesota;
  • Loyce Pace, president and executive director of the
    Global Health Council, a nonprofit dedicated to global health
    issues;
  • Dr. Robert Rodriguez, a professor of emergency medicine
    at the UCSF School of Medicine.

Multiple challenges ahead: We only have one president at
a time, so even as Biden looks to take an assertive role in the
nation’s pandemic response, time and the Trump administration may
complicate his plans. With more than two months until Biden is set
to take office, the surge in virus cases is expected to continue,
given that Trump is unlikely to enact more aggressive efforts to
curb it.

“The reality is that by the time the president-elect takes
office, we’ll probably be at the sort of apex, if you will, of what
we’re going through right now,” Dr. Scott Gottlieb, former
commissioner of the Food and Drug Administration, told CBS’s

“Face the Nation” on Sunday. “You know, this is
going to play out over the next couple of months. And I think as
the president takes office, we'll be coming down the other side of
the epidemic curve, hopefully. And the only question is going to be
how many people have died in the course of this and how many people
have been infected.”

And as President Trump contests the election results,
cooperation between the current administration and the incoming one
remains a question. The head of the General Services Administration
— Emily Murphy, a Trump political appointee — still needs to
“ascertain” that Biden won the election, and without that ruling,
the Biden team won’t be able to access nearly $10 million in
transition funds “and resources such as briefing books prepared by
career federal employees,” Government Executive
reports.

Biden has called for ramping up the country’s testing and
contact-tracing efforts, and he is reportedly looking to take a
role in the congressional negotiations over a new coronavirus
stimulus package. But securing the funding necessary to enact his
initiatives could also be a challenge.

Planning executive orders: As he prepares to take office
and strategizes how best to advance his agenda in the face of
likely Republican control of the Senate, Biden reportedly is also
readying a series of executive orders that he can sign quickly
after taking office. From
The Washington Post:

“He will rejoin the Paris climate accords, according to
those close to his campaign and commitments he has made in recent
months, and he will reverse President Trump’s withdrawal from the
World Health Organization. He will repeal the ban on almost all
travel from some Muslim-majority countries, and he will reinstate
the program allowing “dreamers,” who were brought to the United
States illegally as children, to remain in the country, according
to people familiar with his plans.”

The bottom line: He’s not president
yet, so all Biden can really do for now is lay the groundwork for
his plans and use the bully pulpit he now has to encourage a new
approach to the virus.

Quotes of the Day

“This is a historical moment. This was a devastating
situation, a pandemic, and we have embarked on a path and a goal
that nobody ever has achieved — to come up with a vaccine within a
year.”

– Kathrin Jansen, head of vaccine research and development at
Pfizer, discussing positive preliminary results for a vaccine
candidate in an interview with
The New York Times.

“Going into Thanksgiving people are going to start to see
family and get together indoors. Then the cases will spread from
that and then five weeks later we have another set of holidays and
people will gather then and by January, we will be exploding with
cases.”

– David Eisenman, director of the UCLA Center for Public Health
and Disasters, quoted in
Politico.

“If you want to have a better 2021, then maybe the
rest of 2020 needs to be an investment in driving the virus down.
Otherwise we’re looking at thousands and thousands of deaths this
winter.”

– Cyrus Shahpar, a former emergency response leader at the
CDC who now leads the outbreak tracker Covid Exit Strategy, also in

Politico.

On Health Care, Biden May Focus on Reversing Trump’s
Changes

Biden has major plans to enhance health care in the U.S.,
but his options may be limited if, as expected, Republicans
maintain their hold on the Senate in the next Congress.

Given the likelihood of what amounts to a GOP veto over
major changes in policy, the Biden administration is expected to
focus more on undoing much of what Donald Trump has done over the
last four years,
says Paige Winfield Cunningham of The Washington
Post, while leaving more substantial changes such as the creation
of a public option for health insurance to a future date, if or
when Democrats gain control of both houses of Congress.

Larry Levitt of the Kaiser Family Foundation
said Monday that Biden “can and probably will reverse
much of what President Trump has done in health care
administratively.” In addition to changing the federal approach to
the coronavirus pandemic so that it includes “facts, science, and
empathy,” Levitt said that Biden could make meaningful changes to
health care policy without congressional approval in multiple
areas, including:

  • restoring funds for Obamacare outreach;
  • requiring short-term health care plans to cover
    pre-existing conditions;
  • rolling back work requirements in Medicaid;
  • eliminating restrictions on the use of health care for
    immigrants;
  • reversing Trump rules on abortion and birth
    control.

“Beyond using administrative authority to undo much of
what President Trump has done,” Levitt added, “I’d look for
President-Elect Biden to use executive powers creatively to expand
coverage, increase consumer protections, and make health care more
affordable.”

Backing up the ACA: Winfield
Cunningham says Biden is expected to rely on many former Obama
administration officials to staff the Department of Health and
Human Services and to provide advice to the White
House. This will mark a significant change in the administration of
the Affordable Care Act, which was targeted for elimination during
the Trump years – a multi-pronged Republican effort that will reach
the Supreme Court Tuesday, when the justices will hear arguments
about the constitutional validity of the ACA in a suit backed by
the White House.

The high court isn’t expected to render a verdict in the
case until next spring, but the Biden administration could take
steps to defend the ACA before then. “There are a couple of things
Congress could do to make it so there's actually nothing to
litigate — so the Supreme Court wouldn't have to decide this case,
it would just go away,” Sabrina Corlette of the Center on Health
Insurance Reforms at Georgetown University,
told NPR. “I don't think the litigation is a win
for Republicans politically, and so they may just be perfectly
happy to work out a deal,” she added.

If Biden is unable to make a deal and the Supreme Court
decides against the ACA, lawmakers would have to scramble next year
to address the expected fallout, which could include the loss of
health insurance for roughly 20 million people and the elimination
of protections for patients with pre-existing
conditions.

Number of the Day: $2,458,764,169

Private health insurers owe nearly $2.5 billion in rebates to
consumers under the Affordable Care Act’s “medical loss ratio”
rules requiring the companies to spend a minimum percentage of
their income from premiums on health care claims and quality
improvement, according to Centers for Medicare and Medicaid
Services
data. That’s nearly double the previous record,
according to the Kaiser Family Foundation’s Cynthia
Cox.

“Next year's rebates will be even larger as insures are
profiting with the pandemic,” Cox said on Twitter. “Before the ACA,
if insurers had extremely profitable years, they kept the $. Now,
insurers return the excess to individuals and businesses.”

More than 11.2 million consumers will be eligible for
rebates across the individual, small group and large group markets.
The average rebate is $219 per person, with Obamacare enrollees set
to get $332 on average — though the numbers vary widely from state
to state.

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