There Is No Alternative

Take the matter of lockdowns or stay-at-home orders. Before Trump was a lame duck, there was wide agreement that, with the pandemic burning through the country after the orders were lifted too early, the only way to get control of the virus was to do it again, but properly. In late July — when US average daily cases and deaths from the virus were less than half of what they are right now — more than 150 medical experts, nurses, scientists, and others signed a letter addressed to the country’s political leaders, urging them to “shut it down now, and start over.”

“Non-essential businesses should be closed. Restaurant service should be limited to take-out. People should stay home, going out only to get food and medicine or to exercise and get fresh air,” the letter read. “We need that protocol in place until case numbers recede to a level at which we have the capacity to effectively test and trace.”

This advice was echoed by prominent experts. As late as October, Andy Slavitt, Barack Obama’s administrator for the Centers for Medicare and Medicaid Services in the final years of his presidency, was still calling for the plan he had urged back in July: a “90 percent lockdown” of four to six weeks, including closing bars, restaurants, churches, and public transit, as well as travel within and into the country. In September, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, insisted that the United States had to “impose real and stringent lockdowns across the country for roughly two months,” and that “in areas where the disease is still rampant, masks and physical distancing alone will not get the job done.”

These were arguments based on copious data gathered over the course of the pandemic this year. Though the lockdowns imposed in China were far too strict, the scientific consensus is that they worked. As explained in one October article in the medical journal Lancet summarizing the “current evidence-based consensus on COVID-19,” lockdowns were “essential to reduce mortality, prevent health-care services from being overwhelmed, and buy time to set up pandemic response systems to suppress transmission following lockdown,” with the negative effects of lockdown actually prolonged in countries that failed to do this. In the fall, three separate studies emerged showing the effectiveness of stay-at-home orders for taming the virus.

From Southeast Asia to New Zealand, the countries receiving the greatest praise from the American press for their pandemic handling embarked on this strategy to get the virus under control, a strategy that, not surprisingly, closely followed scientific recommendations. European countries, meanwhile, defied the advice of their scientists and eased restrictions too early, leading to a renewed uptick in cases, and criticism from that same media.

We should look, in particular, at the case of the United Kingdom. Early last month, the right-wing Boris Johnson government finally listened to a month of pleas from government scientists, abandoning the piecemeal approach that was causing the virus to spin out of control, and going into a second lockdown. Things had gotten so bad that there was, as University College London virologist Deenan Pillay explained, no alternative to another one, which experts hoped would serve as a “circuit-breaker” for the virus’s spread, which it did. It’s worth noting that, relative to each country’s population, the UK’s weekly numbers on the eve of that lockdown were arguably better than where the United States is now — Americans are currently dying at nearly twice the rate that the British were at the end of October — let alone where it will be by the time Biden takes office.

Yet in the face of this overwhelming scientific consensus and evidence, Biden and his team are refusing to commit to a national stay-at-home order.

Even after an election victory built almost entirely on a science-based, radically different approach to wrestling the virus from Trump’s, Biden has repeatedly ruled out the policy, going so far as to say there would be “no circumstance” under which he would implement it. In August, Biden had told ABC — ironically, in an interview conducted indoors without masks, whose distancing would have done little to stop a virus that can travel “tens of meters” inside — he would “listen to the scientists” and “shut it down,” before walking it back ever since in the face of swift Republican attacks.

Now some experts appear to be following Biden’s lead. “You can get a lot done without necessarily locking down,” top US infectious disease expert Anthony Fauci said in November, after having said in April that “I just don’t understand” why the United States wasn’t putting in place a national stay-at-home order. The lockdown mysteriously disappeared from Slavitt’s policy recommendations. The once-widespread calls to “shut it down” from medical experts seem to have evaporated.

Some of this has been downright Orwellian. After Osterholm — now on Biden’s COVID-19 advisory board — told Yahoo Finance the US government should financially cover workers and businesses for a four-to-six-week national lockdown, he was not only swiftly contradicted by both Biden’s spokesperson and Fauci and forced to walk the comment back, but by other science advisers on Biden’s task force, too, who quickly closed ranks and insisted on the same strategy Boris Johnson had pursued in defiance of scientific advice: a more limited, “targeted” approach.

It’s remarkable to watch, after months of entirely accurate criticism of Trump’s misleading solutions and Republicans’ general meddling with science.

Of course, scientists have long said another lockdown was a political impossibility, complaining in September that there was no appetite among US political leadership to impose one. But this is quite distinct from what Biden and his experts are now saying, which isn’t that it can’t be politically done, but that it isn’t even necessary. And even then, experts had acknowledged that if the situation became more dire over the end of Trump’s presidency, the political difficulties would become irrelevant.

“While experts all agreed that there’s zero political appetite for a lockdown right now, a massive surge in the fall and winter could leave the US with no other option,” wrote Vox in September.

Three months and nearly a hundred thousand deaths later, that may well be where we’re at. A four-university survey of nearly twenty thousand people across all fifty states over November found that large majorities of Americans across racial, gender, and even partisan lines approved of a host of restrictive measures for thirty days, from staying at home and avoiding large gatherings to canceling sports events and limiting travel.

In short, Biden and his science advisers’ anti-lockdown stance is neither pegged to what the science or data tells us, nor to where the majority of the American public is. Rather, it seems calibrated to attacks from elected Republicans and a right-wing minority.

No Magic Cure

Biden’s wager may be to simply hold out as best as possible until a vaccine is rolled out and returns everything to normal. But even before Trump’s rejection of Pfizer’s offer of millions in backup vaccines, there were serious doubts this would be as simple as it sounds.

As Biden’s own adviser, Osterholm, and other experts have pointed out, there are countless variables involved with the eventual vaccines, including whether they will be equally effective for all age groups; what, if any, side effects they may cause; and how long immunity will last. Several studies have found that the virus infects the brain, where antibodies can’t get to it, which could make an eventual vaccine less effective than predicted. Then there’s the problem of growing anti-vaccination sentiment, which, if large enough, could seriously set back efforts to eliminate the pandemic.

On top of this, state governments expect to vaccinate all of their residents over the course of anywhere between six and twelve months. As Pennsylvania’s health secretary warned last month, it will take “months and months and months” to distribute the vaccine to all Pennsylvanians alone. And even then, it will not “be a magical cure for coronavirus and will not immediately end the pandemic,” and may be more like the flu vaccine, which weakens symptoms and protects against only some strains.

In other words, there’s a good chance the existence of even the most effective vaccine isn’t going to eliminate the need for the kind of “circuit-breaker” shutdown the Johnson government was forced to do in England at the urging of scientists, particularly by the time the US winter is done. As University College London’s Dr Amitava Banerjee said as the virus raged through England in October:

Even if vaccines and better treatments for severe [COVID] infection are developed, the way to minimize excess deaths is to reduce the infection rate through population level measures (including lockdown), protecting and treating those at higher risk, and implementing and maintaining adequate “test, trace and isolate” systems as a matter of urgency. Without these three strategies, more cases and excess deaths will occur.

But rather than use his electoral mandate to sell the public on the need for temporary restrictions and build popular support for an economic package to underwrite them, Biden and his team are inadvertently lending weight to right-wing attacks on these measures. Worse, the president-elect has done the same for the broadly supported policy of mask-wearing, assuring Americans they only need to wear a mask for one hundred days — at odds with not only the vaccine rollout timeline, but the pre-election opinion of scientists, who see mask-wearing as potentially a necessity for the medium term at least.

This messaging may not only make a national lockdown and continued mask-wearing a harder sell down the line but could pose problems long term. If the virus becomes a seasonal part of life, or new pandemics emerge, then a combination of restrictions, an accompanying government safety net, and behavioral changes may have to become a semi-permanent part of politics. Sowing the seeds for their right-wing-led rejection could prove harmful for both public health and trust in government. The Federalist is already charging that Biden’s hundred-day masking plan “will inevitably last longer” — and, unfortunately, they’ll most probably be proven right.

No Exit

Throughout his career, rather than trying to shift public opinion or stand his political ground, Joe Biden has more often pandered to the most extreme right-wing elements of the country, an approach that has been disastrous when it comes to economics, criminal justice, and war, just to name a few. We’re now seeing the beginnings of what it looks like when applied to this pandemic.

Maybe it’s possible that the United States, with what is already arguably the world’s worst pandemic response and only getting worse, will do what no country on Earth has done: halt and reverse a surging coronavirus through targeted, piecemeal measures that avoid a full “lockdown,” and with only a brief period of mandatory mask-wearing. But if so, it would be not just an unprecedented, pathbreaking achievement, it would refute months of scientific advice in both the United States and around the world.

If scientists’ warnings and what we’ve watched happen across the world is anything to go by, there is a better chance this strategy could see the virus continue to spread and kill in high numbers, creating a drawn-out crisis whose human devastation and protracted restrictions leave a worse economic toll than a short, relatively strict national stay-at-home order. As Andrew Goodwin, chief UK economist at forecast firm Oxford Economics, told CNN in October:

The number one priority is getting control of the virus. And the quickest, [most] aggressive, way you can do that is the best thing for the economy. . . . The longer this goes on, the worse it is for the economy and for public finances.

This scenario could mean an eventual U-turn on both of these policies, further eroding the US public’s faith in government, and adding to the whiplash of contradictory official and public health advice they’ve been given since the start of the pandemic. More than this, it could fuel the ongoing politicization of, and public loss of trust in, science.

There could be another way. Both experts and political flacks are talking about the power of Biden’s words and the presidential bully pulpit, and we keep hearing about the impressive electoral mandate he secured. He could use those to build the case for such controversial measures, instead of feeding into right-wing fearmongering.

Instead, the US public could be forced to muddle through who knows how many more months of herky-jerky pandemic conditions, until enough people have been vaccinated to put it to bed for the time being. Those who once assailed Trump’s response may well feel the need to hold their tongues the whole way, out of a misplaced sense of duty. They’ll be doing neither the administration nor the American people any favors.