Former Biden advisers urge a Covid-19 pandemic strategy for the new normal

The administration needs to look past Omicron and to plan for a future that they concede is unknowable. PHOTO: NYTIMES

WASHINGTON (NYTIMES) - On the day President Joe Biden was inaugurated, the advisory board of health experts who counselled him during his transition officially ceased to exist.

But its members have quietly continued to meet regularly over Zoom, their conversations often turning to frustration with Mr Biden's coronavirus response.

Now, six of these former advisers have gone public with an extraordinary, albeit polite, critique - and a plea to be heard.

In three opinion articles published on Thursday (Jan 6) in The Journal of the American Medical Association, they called for Mr Biden to adopt an entirely new domestic pandemic strategy geared to the "new normal" of living with the virus indefinitely, not to wiping it out.

The authors are all big names in American medicine. Several, including Dr Luciana Borio, a former acting chief scientist at the Food and Drug Administration, and Dr David Michaels, a former head of the Occupational Safety and Health Administration now with George Washington University's School of Public Health, have held high-ranking government positions.

Dr Ezekiel Emanuel, an oncologist, medical ethicist and University of Pennsylvania professor who advised former president Barack Obama, organised the effort.

Like any previous administrations, Mr Biden's prizes loyalty and prefers to keep its differences with the White House; in that regard, the articles are an unusual step.

The authors said they wrote them partly because they have not made headway talking directly to White House officials.

"From a macroperspective, it feels like we are always fighting yesterday's crisis and not necessarily thinking what needs to be done today to prepare us for what comes next," Dr Borio said.

The authors shared the articles with White House officials before they were published, but it was unclear whether the administration would adopt any of their suggestions. Dr Anthony Fauci, Mr Biden's top medical adviser for the pandemic, declined to comment on the articles.

White House press secretary Jen Psaki told reporters she had not read the articles, and dismissed a question about whether the president "is coming around to accepting" that Covid-19 is here to stay, even though several recent media accounts suggested that the administration was beginning to operate under that assumption.

Mr Biden's recent emphasis on keeping schools open and businesses running even when cases are soaring also suggests a recalibration, as does a recent decision by the Centres for Disease Control and Prevention to recommend that people with Covid-19 isolate for five days instead of 10.

"The president's goal is to defeat the virus," Ms Psaki said, adding: "The president's focus and objective now is to save as many lives as possible."

Outlining their ideas for the "new normal" strategy, Dr Emanuel and two co-authors - Dr Michael Osterholm, a public health researcher at the University of Minnesota, and Dr Celine Gounder, an infectious disease expert at New York University - pointedly noted that in July, Mr Biden proclaimed that "we've gained the upper hand against this virus", which in retrospect was clearly not the case.

They called for Mr Biden to adopt an entirely new domestic pandemic strategy geared to the "new normal" of living with the virus indefinitely, not to wiping it out. PHOTO: NYTIMES

Now, with the Omicron variant fuelling an enormous new surge, they wrote, the United States must avoid becoming stuck in "a perpetual state of emergency".

The first step, they wrote, is recognising that the coronavirus is one of several respiratory viruses circulating, and developing policies to address all of them together.

To be better prepared for inevitable outbreaks - including from new coronavirus variants - they suggested that the administration lay out goals and specific bench marks, including what number of hospitalisations and deaths from respiratory viruses, including influenza and Covid-19, should prompt emergency mitigation and other measures.

In addition to urging the administration to adopt a longer view, the authors took issue with some of Mr Biden's current policies and stances - especially on political lightning rod issues.

They called for more aggressive use of vaccine mandates, which have drawn fierce opposition from Republicans, and said the nation needed a digital verification system for vaccination - so-called vaccine passports - which Mr Biden has resisted in the face of Republican attacks on the concept.

"Relying on forgeable paper cards is unacceptable in the 21st century," wrote Dr Borio, Dr Emanuel and Dr Rick Bright, the chief executive of the Rockefeller Foundation's Pandemic Prevention Institute.

Mr Biden published a pandemic strategy when he came into office, and Dr Emanuel said the administration "executed very well on it through June", until the Delta variant brought a new surge of cases. The president recently released a new winter strategy, just as the Omicron variant began spreading in the US.

Many of the steps the authors suggested - including faster development of vaccines and therapeutics; comprehensive, digital, real-time data collection by the CDC; and a corps of community public health workers - are already part of Mr Biden's plans.

He has taken steps to control the spread of Omicron and to ensure that hospital systems do not get overwhelmed. He has sent military troops to states including Wisconsin and Indiana to help out at hospitals, and has opened new testing sites in New York and elsewhere. He has insisted there will be no lockdowns, and has repeatedly pleaded with Americans to get vaccinated.

"I honest to God believe it's your patriotic duty," Mr Biden said recently.

But Dr Bright said such language was turning off Americans, including many Trump voters, who are resistant to vaccines.

"The message continues to berate unvaccinated people and almost bully unvaccinated people," said Dr Bright, who led a federal biomedical agency during the Trump administration but quit the government after being demoted for complaining about political interference in science.

"There are so many reasons people are unvaccinated; it's not just because they follow Trump."

The authors say the administration needs to look past Omicron and acknowledge that it may not mark the end of the pandemic - and to plan for a future that they concede is unknowable. They also make clear that the current rate of Covid-19 hospitalisations and deaths, an average of more than 1,300 lives lost each day in the US, is unacceptably high.

The articles reflect both their frustrations and their desire to help, the authors said. They recognise that they have the luxury of taking a 30,000-foot view while administration experts are slogging it out in the trenches.

"But at the same time, we think a lot of work still needs to be done," said Dr Bright.

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