Two words: crush COVID
Its killing hundreds of thousands of Americans, costing millions of jobs and separating families everywhere.
Biden knows this. “Our work begins with getting COVID under control,” he said in last night’s victory speech.
Candidate Biden’s 7-point program however, does not deviate much from the current approach being conducted many of the states. It proposes a national mask mandate, guidelines on when to open and close (and how to safely operate) businesses and institutions, and rapid testing expansion. As Commander-In-Chief, Biden additionally pledges to increase PPE manufacturing via the Defense Production Act and to efficiently distribute working vaccines (when the time comes).
While a dramatic improvement over President Trump’s do-nothing approach, the bulk of the plan rests on a combination of behavioral encouragement and at-will testing that has so far failed to stem the virus in most of the competent (i.e. non-denialist) states.
Not only Biden’s legacy but his prospects for re-election (and thus, the survival of American democracy) hinge on suppressing COVID. To do so, he will have to go above and beyond the existing containment approach.
While social distancing and masking help limit the virus’ spread, they provide no surefire guarantee that infected individuals won’t spread the illness. While mass masking can limit transmission of the disease in public, studies suggest that a substantial amount of spread occurs between members of the same household.
Suppose everyone in the country avoids all non-essential business and dons a mask in public. The million-plus confirmed cases don’t just vanish into thin air. Rather they are largely confined to the abodes they share with their partner or family. Even the most careful patient risks infecting their partner or housemate through prolonged cohabitation in a poorly-ventilated indoor space.
Every country that has successfully suppressed COVID has used “central’ quarantines, mandating that positive cases isolate in designated “quarantine” facilities.
As it is, the CDC has 20 quarantine stations for travelers returning from abroad and many hotels lay vacant. While a federally-run quarantine system would be cumbersome to implement, both politically and logistically, it has sound constitutional merit. Biden and his team can release guidelines laying out standard procedures and best practices for states to follow and clarifying the constitutionality of various quarantine practices. They can supplement this with a federal quarantine program for travelers entering the country from overseas.
By publicizing and promoting quarantine policies, Biden and his team can significantly reduce the spread of COVID, to the point where the general public no longer has to socially-distance.
Alternatively, the federal government can enforce quarantines virtually. For instance, Taiwan (which has had the fewest COVID cases of any industrialized country) tracks incoming travelers, during their mandatory 14-day quarantine through cellphone geo-fencing. Such enforcement needs to be done carefully, to avoid infringing on civil liberties. It should be noted that even a seemingly-intrusive cell phone quarantine can increase civil liberty in the aggregate, by shortening or precluding lockdowns that impinge on personal and economic freedom.
Digital technology also plays a role in the second critical element in virus suppression, contact tracing. Each positive COVID-19 test is the tip of an infection iceberg. Unlike influenza, COVID-19 spreads unevenly, with as few as 10 to 20 percent of cases (“superspreaders”) responsible for 80 to 90 percent of infections. The focus of American contact tracing needs to shift from identifying the contacts of each discovered case to deducing which superspreader (or superspreading event) infected the individual, and subsequently testing anyone possibly infected as part of the spread. Such “backwards tracing” ensures that vectors of infection are swiftly tested and quarantined, limiting their potential for public spread. Countries such as South Korea use mobile notifications to warn citizens who may have been in contact with a superspreader. The Center for American Progress has proposed a similar “Surveillance Testing App” (run by a third-party non-profit organization that would guarantee privacy) for the federal level.’
Finally, Biden will have to work to limit spread between regions. One of the frustrating aspects of America’s fight against the virus is the matter in which states get the virus under control only to be re-infected by visitors from neighboring states. For instance, returnees from South Dakota’s Sturgis motorcycle rally re-introduced the virus to neighboring Midwest states.
To address this issue the federal government would either have to lock down the whole country or impose interstate travel restrictions, limiting travel to and from high-infection states or locations. The former would be more logistically challenging to implement than the latter. Restrictions on inter-regional movement have helped contain the virus in several countries.
Quarantining, backwards tracing and travel restrictions will all require significant coordination of federal and state resources. All three strategies are likely to face political pushback. Biden should make clear that these measures are the ONLY way we can shorten lockdowns that have separated families and hurt the economy.
When Biden’s efforts pay off, he might be able to show even the most dogged Trump supporter that his presidency works for everyone.