To tackle pandemic, Biden must overcome distrust and division

doi:10.1126/science.370.6518.750

GSTDTAP > 气候变化

DOI	10.1126/science.370.6518.750
	To tackle pandemic, Biden must overcome distrust and division
	Meredith Wadman; Warren Cornwall
	2020-11-13
发表期刊	Science
出版年	2020
英文摘要	President-elect Joe Biden wasted little time this week in following through on his promise to put science first in confronting the coronavirus pandemic, naming a 13-member COVID-19 advisory board of prominent researchers and public health experts and unveiling new details of his evidence-based battle plan. Many observers, however, say executing that plan will require not just technical know-how, but also plenty of public persuasion and political savvy. And they worry the pandemic will get much worse before Biden takes office on 20 January 2021, further complicating efforts to end the crisis, which was growing by more than 100,000 cases a day and had killed at least 238,000 people in the United States as Science went to press. “Biden's got a bigger challenge than any other country in the world,” says Nahid Bhadelia, medical director of the Special Pathogens Unit at Boston Medical Center. Biden said his advisory board, unveiled on 9 November, will rely on a “bedrock of science” and “help shape my approach to managing the surge in reported infections; ensuring vaccines are safe, effective, and distributed efficiently, equitably, and free; and protecting at-risk populations.” It has three co-chairs: Marcella Nunez-Smith, an internist and health equity researcher at the Yale University School of Medicine; former Obama administration Surgeon General Vivek Murthy; and David Kessler, who ran the Food and Drug Administration under former Presidents George H. W. Bush and Bill Clinton. The same day, Biden's transition team updated its existing pandemic plan. It now says Biden will push every governor to require people to wear face masks around anyone outside their household and will work to provide an additional $25 billion in federal funding to manufacture, distribute, and administer a free vaccine or vaccines. That pledge came as Pfizer announced that interim data from a key clinical trial showed its vaccine is likely effective (see p. [748][1]). The moves came just 48 hours after news networks declared Biden the winner of the election and highlighted his emphasis on fighting the pandemic. They were designed to show he will mount a far more muscular federal response than President Donald Trump, who has largely left matters to state and local officials. Among other things, Biden's plan calls for standing up a 100,000-person corps to trace people who have been in contact with an infected individual, massively increasing the availability of COVID-19 tests, and using the full power of the Defense Production Act to replenish depleted stocks of personal protective equipment. Once sworn in, Biden will be able to quickly realize some of these plans through executive action. Other efforts, however, will require Congress to approve new funding or pass legislation. And winning such approval could take time, and prove difficult, if Republicans maintain control of the Senate. That will be decided by the results of two runoff elections in Georgia set for early January 2021. In the meantime, observers hope Biden's team will begin to correct one of the Trump administration's biggest missteps: its chaotic, contradictory, and often false messaging, which has sown confusion about the course of the pandemic, bolstered opposition to masks, and raised fears that vaccines would be rushed through the approval process. Pew Research Center polling, for example, has found the number of Americans saying they would be willing to take a vaccine fell from 72% in May to 51% in September. “The overarching issue is the need to rebuild trust” in what the federal government is saying, says Tom Frieden, CEO of Resolve to Save Lives, who directed the Centers for Disease Control and Prevention (CDC) under former President Barack Obama. “Social cohesion is essential to the control of infectious diseases.” To build that cohesion, Biden's team should be enlisting messengers, including public health experts, “who are trusted by liberals and conservatives,” says Ellen Peters, a social scientist at the University of Oregon who has been surveying people's perceptions of the pandemic. Biden's effort to increase the use of masks could prove an early test of whether his administration can overcome the political and cultural divides in a nation where more than 71 million people voted for Trump. Legal experts have concluded that Biden cannot impose a national mask mandate. He can, however, require the use of masks on federal property and during interstate transportation. But such mandates could flop without a concerted effort to persuade people to embrace masks, says Harvard University health care economist James Stock. If people are ordered to wear masks, they “just won't do it, it's been so politicized.” Biden's history of finding common ground with political opponents could serve him well in this arena, noted Andy Slavitt, head of the Centers for Medicare and Medicaid Services during the Obama administration, during a 5 November presentation at the University of California, San Francisco (UCSF). During the transition, Biden could “lean in hard on this, … doing listening tours” and meeting with governors to firm up support for mitigation measures. “It won't work with all of them, but we don't want to let the perfect be the enemy of the good,” adds Eric Toner, an emergency physician and expert on pandemic preparedness at the Johns Hopkins University Center for Health Security. As president, Biden could use pressure as well as persuasion, by requiring states to follow CDC guidance if they want to qualify for certain kinds of federal funds. “The way the CDC establishes trust and establishes its primacy is to begin to act more aggressively, as long as it has a credible leader,” says Robert Wachter, an internist who chairs the UCSF department of medicine. Biden could name his nominees to head key pandemic-fighting agencies, such as CDC and the Department of Health and Human Services, before his inauguration, Ezekiel Emanuel said at the 5 November UCSF event. Emanuel, a University of Pennsylvania oncologist, is now a member of Biden's new task force. Observers differ on just how much emphasis the Biden administration should place on contact tracing, given that the rapidly rising number of infections could overwhelm any contact tracing system. “Its value is limited unless everything else is going well, too,” says Harvard epidemiologist Marc Lipsitch, who compares tracing during a massive outbreak to “trying to clean up a tanker spill with a paper towel.” By the time Biden takes office, many experts fear the United States will be experiencing unprecedented caseloads. Bhadelia says she is particularly frightened by the specter of overwhelmed hospitals and tens of thousands of additional deaths by late January 2021. She predicts “a huge surge in the need for … everything from personal protective equipment to health care workers to medications.” Biden has vowed to marshal the needed response, but, Bhadelia says: “The trouble is, we need all those things now.” Even if the Biden administration makes all the right calls once it takes charge of the pandemic fight, many experts expect the battle to be lengthy and grueling. Turning the pandemic around “is gonna be hard,” Toner says. “It's gonna be slow.” [1]: http://www.sciencemag.org/content/370/6518/748
领域	气候变化 ; 资源环境
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引用统计
文献类型	期刊论文
条目标识符	http://119.78.100.173/C666/handle/2XK7JSWQ/304093
专题	气候变化资源环境科学
推荐引用方式 GB/T 7714	Meredith Wadman,Warren Cornwall. To tackle pandemic, Biden must overcome distrust and division[J]. Science,2020.
APA	Meredith Wadman,&Warren Cornwall.(2020).To tackle pandemic, Biden must overcome distrust and division.Science.
MLA	Meredith Wadman,et al."To tackle pandemic, Biden must overcome distrust and division".Science (2020).