President Biden won the White House on a pledge to crush the coronavirus through a commitment to science, testing for anyone who wants it, and a major vaccine sprint in his first 100 days in office.
Things haven’t quite gone as planned.
More than a year into the vaccine drive, and nearly 12 months since Mr. Biden and Vice President Kamala Harris memorialized 400,000 COVID-19 deaths on the eve of the inauguration, the U.S. is mourning another 400,000 lives lost to the disease and now grappling with another winter surge.
Pandemic-weary Americans face a third calendar year in which offices are shuttered, Broadway shows are postponed and schools struggle to wrangle outbreaks.
A push to mandate vaccines is sparking legal backlash, and Americans closed out the year wondering why a Christmastime push to make testing more available didn’t come months sooner, as lines snaked around blocks in New York City and Washington as if it were mid-2020.
“I think the top line is they overpromised and underdelivered. That’s not an earth-shattering conclusion,” said Paul Mango, who served as the liaison for the Trump White House’s “Operation Warp Speed” COVID-19 vaccine initiative and the Department of Health and Human Services.
Mr. Biden spent the post-2020 election period pledging to recommit the government to the virus fight and succeed where the Trump administration fell short, including on testing. Democratic allies cheered from the sidelines, making “crush the virus” their mantra.
Mr. Biden won kudos for making the vaccines accessible in early 2021, and the effort showed promise by spring. Case counts dwindled, and the White House celebrated progress at a July 4 cookout on the South Lawn.
But fortunes nose-dived at home and abroad over the summer. A variant first detected in India, known as delta, exploded across the South before blanketing the country, only to be upstaged by the new and faster-moving omicron variant, which played the Christmas grinch.
All the while, a mix of pleas and mandates from the White House failed to budge tens of millions of Americans who are eligible for vaccination but haven’t come forward, and only 30% of eligible people have gotten a booster shot.
Scientists said the major drivers of 2021 problems were the shape-shifting virus and outright resistance to the vaccine campaign, despite pleas from hospital leaders who say the unvaccinated are driving the crush of patients.
“I think it was a combination, to boil it all down to two things, of the vaccine hesitancy and very substantial portion of the population that hasn’t gotten dose-one yet, and then those two very big transitions in the virus — first delta and then omicron,” said William Schaffner, an infectious disease specialist at Vanderbilt University.
Specifically, too few people at high risk of disease got vaccinated, said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
While a spike in cases in the colder months was inevitable, he said the country wasn’t supposed to be worrying about hospital capacity at this juncture.
Experts said Mr. Biden‘s COVID-19 woes cannot be pinned on bad luck completely.
Inconsistent messaging around the virus, including a decision to let vaccinated people shed their masks — only to reverse it by midsummer when it appeared immunized people were transmitting the virus — is exhausting Americans.
In a more recent example, the administration was reluctant to redefine what it means to be fully vaccinated even as it calls extra doses necessary. The Centers for Disease Control and Prevention said it is reviewing the matter, but the conflicting signals are flustering scientists who say Americans and businesses deserve a clear picture of what amounts to full protection.
Experts also say federal and state leaders should start focusing on health outcomes from the vaccine campaign, instead of the number of shots delivered or the percentage of Americans covered. They say the government should bring home the horrors wrought by the virus by giving people an inside look at overtaxed ICUs or the potential impacts of persistent symptoms, known as “long COVID.”
“Psychologists have told us you need information, but it’s rarely sufficient to change behavior. You have to change how people feel about things,” Dr. Schaffner said.
Arthur Caplan, director of the division of medical ethics at the New York University Grossman School of Medicine, said the White House should emphasize the potential impacts of the virus on people over 65 and immunocompromised in its messaging — even gather dozens of elderly people as a backdrop at vaccine events.
“Bring it home,” he said in a recent interview. “We just had very intense one-week coverage of the tornadoes [in Kentucky]. We need those visuals in our minds about COVID. They need stories — personal stories, visuals.”
Mr. Mango said school officials wheeled a formaldehyde-preserved lung blackened with tar into his fourth-grade classroom, hoping to warn kids away from smoking cigarettes.
“This is 50 years later, I still remember it,” he said. “What we should have done is shown someone in the ICU gagging, who cannot breathe because of COVID.”
The White House has defended its approach to combatting the virus, starting with the herculean task of immunizing 200 million people.
In a year-end memo, the administration pointed to the 490 million shots that reached arms through primary vaccine series and boosters. The campaign may have saved 1.1 million American lives and prevented 10.3 million hospitalizations, according to estimates by the Commonwealth Fund, a research foundation for health care issues.
More than 7 in 10 U.S. adults and over 60% of the U.S. population are fully vaccinated compared to fewer than 1% of the population when Mr. Biden took over in January during the early days of the vaccination drive.
Arts venues and restaurants have been able to reopen alongside the vaccine campaign, and Major League Baseball staged a full season after an awkward 60-game sprint in 2020.
And while 69,000 U.S. hospitalizations for COVID-19 is no one’s idea of success, there were nearly double as many patients at this juncture last year, when the vaccine push kicked off.
“This is not March of 2020. Two hundred million people are fully vaccinated. We’re prepared. We know more,” Mr. Biden said in a Tuesday address on omicron. “We just have to stay focused. So that’s where we stand.”
Mr. Mango, the former Trump official, said the Biden administration did a “spectacular job” in distributing the vaccines early on but said the response has been too one-dimensional, without enough emphasis on therapeutics that backstop people who still get sick.
He also faulted the administration for thinking the federal government can “solve any problem” while, at the same, failing to nominate a commissioner for the Food and Drug Administration for months — even as the National Institutes of Health director steps aside and Health and Human Services Secretary Xavier Becerra keeps a low-profile on the virus.
“It’s a little bit of hubris to think you can manage this out of a single task force from the White House,” he said.
Some experts say a lack of testing, in particular, has been a blind spot in the U.S. response to the pandemic, pointing to European countries where rapid at-home testing is more plentiful and cheaper than in the U.S., where two-packs of test can cost over $20 and disappear quickly from store shelves.
“Trump was like, ‘All vaccine all the time.’ He did testing in the White House but didn’t promote it,” Mr. Caplan said. “But Biden didn’t pick up on testing, either.”
Mr. Biden is trying to play catch-up heading into the new year. The White House said it has quadrupled U.S. testing capacity in the final months of 2021 and it announced the purchase of 500 million rapid tests to send to Americans, for free, upon request. The decision to order tests for delivery by January comes two weeks after the administration seemed to dismiss the idea of sending tests to homes.
Experts welcome the development but wondered why it didn’t come months ago, or at least well before the omicron variant threatened Christmas gatherings.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said he isn’t sure what the COVID-19 team would have done differently to prepare for omicron when a reporter asked for one example of something that could have been done to avoid the pre-Christmas crisis.
“We jumped all over it. All of us spent the entire Thanksgiving weekend, getting enough information to be able to respond in an appropriate way to omicron,” Dr. Fauci said Wednesday. “So again, admittedly, we can always do better, but I can’t think of something, specifically that we would have done differently.”
Even so, the crisis is forcing Mr. Biden into a reactive mode. He’s retooling his plans and messaging every few months to keep up with the latest challenge from the virus, providing a political opening for GOP critics looking to retake control of Congress next year.
A tracker from the FiveThirtyEight website that averages polling found Mr. Biden’s approval rating on COVID-19 sank from 69% at his inauguration and the mid-60s in spring to shy of 48% now, putting it slightly above a disapproval mark of 45%.
“President Biden promised to ‘shut down the virus,’ but more Americans have died this year from COVID than the previous year. He promised to follow the science, but he allowed union bosses to dictate policy that tags parents as domestic terrorists and effectively keeps schools shuttered,” House Minority Whip Steve Scalise, Louisiana Republican, said recently, before faulting workplace rules that condition jobs on getting vaccinated. “President Biden threatens millions of Americans’ livelihoods through authoritarian vaccine mandates that would cause them to get fired, but he allows COVID-positive, unvaccinated illegal immigrants to be released into our communities.”
Mr. Biden continues to defend his vaccine mandate on federal employees and certain health workers and a rule that requires large businesses to test unvaccinated workers. The administration says the testing requirement is a simple step that will have a positive impact on safety in the new year.
Experts say diagnostics will also be critical in deploying “test to stay” strategies to keep classrooms open and correctly time the administration of COVID-19 pills in people who find out they are infected.
“There’s going to be a lot of motion in this space,” said Michael Mina, a former Harvard epidemiologist who now works at eMed, a digital health company.
With the right tools, 2022 could be a kind of transition year in which society will reach a level of comfort with COVID-19 — hopefully by the spring, after battling omicron and the winter wave.
The Food and Drug Administration on Wednesday authorized Pfizer’s antiviral pill for emergency use, clearing the way for U.S. doctors to use 250,000 courses of treatment by January and at least 10 million courses that Mr. Biden secured for the first half of 2022.
“In the United States, 2022 will be a year in which hopefully we have a much bigger toolbox to deal with COVID-19 with the appearance of oral antivirals,” Dr. Adalja said. “Hopefully more people will become vaccinated and we will transition out of the acute phase of the pandemic and no longer worry about hospital capacity. But, there will still be a baseline number of cases, hospitalizations, and deaths. More people will learn how to navigate the world in which COVID-19 is a threat but a very manageable threat.”
Part of that transition will be a focus on whether the virus still makes people sick or if there is enough population immunity that it is something manageable like a common cold.
“Cases shouldn’t matter. What should matter is how many folks we’re saving from hospitalization and death, through therapeutics and vaccines,” Mr. Mango said.
He said Americans seem to be grasping that message as they socialize and get on with their lives, and that small businesses will learn to adapt and survive without mandates.
“I think the American people are leading the administration through this,” he said, “instead of the other way around.”
For more information, visit The Washington Times COVID-19 resource page.
