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

OASHINGTON — 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 rating is plummeting. Looking for positives, the White House is scrambling to highlight its progress in pushing 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 things could 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.

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“They’re in a tough position,” said Nicole Lurie, a doctor who for eight years served 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 have to be prepared.”

Therein lies the problem: Covid alarmism could prove politically damaging, and could even lead more Americans to ignore the administration’s public health guidelines altogether. Unbridled positivity, meanwhile, could lead the public to conclude that the pandemic is over.

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Biden’s dilemma is just the latest in a series of communication challenges in the age of the pandemic. Right now, however, the politics of public health messaging may matter more than any other time in his presidency. In part because of Biden’s polls, Democrats are expected to lose control of the House of Representatives, and possibly even the Senate, in the November election. Meanwhile, the White House is engaged in an ugly fight on Capitol Hill, where lawmakers’ reluctance to spend more money on the federal Covid response could force the government to start rationing tests, vaccines and therapeutics. .

Biden has spent the 2020 campaign claiming he is better equipped to handle Covid-19 than President Trump. But now, in the shadow of a million deaths in the United States, he faces a potentially impossible task: to tout his administration’s pandemic success while reminding Americans that it’s far from over.

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 it’s a glass half empty or a glass half full – we’re just trying to accurately portray the situation we find ourselves in,” he said. “Obviously we are in a much better situation than 16 months ago.”

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

Still, there have been times in recent weeks when top 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 “has brought Covid deaths down by 90%”. Jha appeared maskless and smiling at the White House Correspondents’ Dinner just days after the president announced his nomination. And Tony Fauci, the federal researcher advising Biden’s Covid response, was forced to backtrack on his comments that the United States was “out of the pandemic phase.” (About seven weeks later, Fauci himself announced that he had tested positive for Covid-19, with mild symptoms.)

The upbeat tone has at times drawn criticism from public health experts who say the administration is downplaying the ongoing severity of the pandemic, such as Yale epidemiologist Gregg Gonsalves and George Washington University professor Jonathan Reiner .

Biden has reason to celebrate. Since he took power, a large majority of the country has been vaccinated – many have received boosters, and some elderly or immunocompromised people have even received a fourth dose. Mortality rates have plummeted. In the United States, only around 25,000 people are currently hospitalized with Covid, compared to around 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 age 5. something resembling pre-pandemic “normal”.

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

“I wouldn’t say the administration is trying to sell the story,” he told STAT in an interview. “They try to describe where we are. It’s not easy to put it in one sentence, but there is a clear guideline: it’s much better, but many people are still at risk.

The political subtext is always clear. Throughout his presidency, Biden has presented himself as Trump’s antithesis, especially on all things pandemic. While Trump was quick to undermine public health officials, Biden pledged to listen to “the docs.” While Trump has downplayed the severity of Covid at every turn, Biden hasn’t shied away from warning Americans of the danger posed by the virus. While Trump diligently avoided wearing a mask, Biden is pictured wearing one almost daily.

But not all aspects of the new administration’s Covid response have gone smoothly. Biden has come under fire for his confusing messages about vaccines and suffered key court defeats over vaccine and mask mandates. He also came under fire for a July 4, 2021 speech in which he said the United States was “closer than ever to declaring our independence from this virus.” The deadly wave of the Delta variant that eventually caused more than 2,000 deaths every day began a few weeks later.

More recently, Congress has largely ignored Biden’s recent calls for more pandemic response funding, forcing the administration to cut testing spending in favor of vaccines and Paxlovid. And throughout Biden’s tenure, a torrent of misinformation has prevented millions of Americans from being vaccinated, leaving them especially vulnerable to recent surges.

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

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

Of course, this isn’t an apples-to-apples comparison: Biden has been in office for about 17 months of the pandemic. Trump was president during Covid-19 for less than a year, which means the monthly death rate since Biden’s inauguration is considerably lower than it was for most of 2020.

Vaccine misinformation also played a major role in the Biden-era death toll, Jha said, citing models that show 300,000 fewer Americans would have died from Covid-19 if demand for vaccines did not change. hadn’t lasted long in the summer of 2021.

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

“I think that’s an absurd comparison,” Jha said. “First of all, when the president took office, thousands and thousands of people were dying every day – and these were infections that had happened in November and December” before he took office. Biden.

Even as the Biden administration takes credit for righting the ship, the president’s advisers have recently begun to paint a bleaker picture. Infections and hospitalizations have increased with the rise of new forms of the highly contagious variant of Omicron, and with most Americans using home testing, it’s hard to know precisely how big the current surge is.

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

Many Americans see things differently. A recent Gallup study showed that more than a third of Americans believe the pandemic is indeed over. Nearly 80% said their life was either “back to normal” or “fairly normal”.

It is possible that the administration was a victim of its own success. Since taking office, Biden has delivered on promises to make Covid tests, vaccines and drugs widely available — perhaps encouraging many Americans to return to activities once considered risky.

“The kind of interventions people were willing to take in the first year of the pandemic — in terms of having their lives cut short — is no longer a thing,” Inglesby said.

The White House, however, caters to two audiences: the general public and Congress.

Their message for each is distinctly different. As the administration tries to sell its pandemic successes to the public, it tries to convince Congress to spend billions more on measures to avert a potential disaster this winter.

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

Disconnecting leaves the White House operating on split screen: a positive message for Americans and a negative message for the lawmakers who represent them in Washington. It’s a needle, experts say, that might be impossible to thread.

“It’s tough, because Congress won’t pay attention,” Lurie said. “But by the same token, if you exaggerate too much, then you are not taken seriously.”

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