Congress and the states must fix Trump’s COVID-19 mistakes
We face a crossroads today, with the pandemic growing significantly worse but hope for an end to the suffering – through a vaccine or the forceful action of a new president –higher than ever. But the reality is that the President-elect Biden will be able to do little until early next year, and a vaccine, even if approved today, would not be widely available until late spring or summer of 2021.
At current rates, at least 100,000 more Americans will be dead by Inauguration Day. By the time a vaccine is available to the public-at-large, several hundred thousand lives will also be lost. We need action now to solve our crisis: universal mask mandates, social gathering limits, restaurant and bar closures, travel restrictions, increased testing and isolation. To date, the executive branch has neglected to use the full power of the federal government to implement these policies. In its absence, Congress and the states must do the work instead and pass COVID-19 prevention policies to act as a bridge between now and the time a vaccine or more decisive federal leadership arrives.
The first is for Congress to create programs, raise funds and implement protective measures as a matter of law. It can do this now, even before power passes to the new administration, working closely with the Biden transition team and eventual administration to introduce bipartisan legislation.
By invoking the Defense Production Act, Congress could ensure the production and distribution of 150 million inexpensive, at-home, rapid antigen tests per day, as well as the development of technologies to track test results across the country. They should also consider drafting and passing legislation to give individuals who test positive and isolate $500 per day as they recover away from work.
Suppose a veto-proof majority cannot pass this legislation. In that case, Congress should have all COVID-related legislation ready for the Biden administration when it comes to power, so that a simple majority can pass these drafted policies for President Biden’s approval.
In the meantime, Congress should take federal charge of the vaccine program, both distribution and administration. Use the National Emergencies Act to ensure that vaccine policy, testing policy and COVID-19 data collection on vaccines and testing are uniform nationwide. A universal mask mandate may also be considered, to be enforced federally and locally, and depending on the intensity of spread in a particular state, lockdowns should return to affected areas. While congressional actions like these may seem unlikely with the current political gridlock, the option must be explored and attempted.
Coordinated action by regional governors
The second, and more realistic proposal is for governors to execute these plans themselves. Because the states have public health authority, governors may implement all the actions listed above without relying on the federal government to step in. State legislatures should pursue what I call COVID Control American Style — using universal, self-administered, inexpensive tests and assisted home isolation to contain the virus. Universal means available to everyone. Self-administered means at-home testing that takes at most fifteen minutes. Inexpensive means the real cost is about 50 cents each with current technologies.
Paid home isolation would be dependent on state budgets. At a minimum, states can pass legislation that ensures people receive full health benefits from their jobs, and employers cannot deny health benefits to an infected employee’s spouse. Ideally, sick individuals and their families could receive COVID-benefits from their state governments while isolating. Maximizing benefit capabilities can be more effective if states band together regionally to support their residents. For example, Midwestern states like Illinois, Michigan, Wisconsin and Iowa could work together to create regional legislation and standards. The state governments could pool funding to maximize home testing and isolation assistance equally and efficiently across the region.
The Northeastern states have already developed a blueprint for regional cooperation. The Coalition of Northeastern Governors (CONEG) “encourages intergovernmental cooperation on issues affecting the economic, social, and environmental well-being of the Northeast.” Regarding COVID-19, CONEG organized stay-at-home orders at the start of the pandemic and, after initial spikes, reduced positivity rates to some of the lowest in the country today.
The maritime provinces of Canada have achieved a similar end. Canada’s four Atlantic provinces closed their borders to the rest of the country and the world, allowing free movement only for those already within the region. As a result of regional cooperation, the four provinces have far lower positivity rates than the rest of the country and only a couple of thousand positive cases since the pandemic began. The nation as a whole has over 11,000 deaths and over 300,000 cases. All this to say, it seems regional cooperation may yield promising results.
Our COVID-19 situation in the United States demands a greater counter-effort. We cannot afford to wait for months to make a change. Everybody is waiting for the cavalry – the vaccine – to come, but there is no telling how many thousands of us will die as we wait. Calls for an effective executive response have fallen on deaf ears. In its absence, basic congressional countermeasures and state-coordinated regional responses would slow down rising infection and death rates.
William Haseltine is president of ACCESS Health International. An infectious disease expert, Haseltine was formerly a Harvard Medical School professor and founder of the university’s cancer and HIV/AIDS research departments.