How Delta Beat Biden
Joe Biden’s “mission accomplished” moment came on the Fourth of July.
Standing behind a lectern adorned with the presidential seal, he peered out at the hundreds of maskless guests drinking beer and eating pulled pork on the South Lawn of the White House. “Thanks to our heroic vaccine effort, we’ve gained the upper hand against this virus,” Biden said. “We can live our lives, our kids can go back to school, our economy is roaring back.” Surely there was reason to celebrate. When he’d taken office six months earlier, more than 3,000 people were dying from COVID-19 each day; the death toll was now down to about 200 a day. When Donald Trump left Washington, D.C., on the morning of Biden’s inauguration, new cases were averaging 195,000 a day; by July 4, that figure had plunged to about 12,000. Biden’s tone was triumphant. The disease hadn’t “been vanquished,” he said, but the bands and the red-white-and-blue lanterns served as a festive promise that the isolation and fear wrought by the pandemic would soon subside. He mingled with the crowd, unmasked, shaking hands and signing autographs. “Biden Declares Success in Beating Pandemic in July 4 Speech” read a Bloomberg headline.
How did everything go so wrong, so quickly?
Within days of Biden’s speech, the highly contagious Delta variant would become the dominant strain of the virus in the United States, accounting for more than half of infections. If trends persist, 116,000 more people will die from the disease between the end of August and December 1, or about 1,230 people a day. New infections have been climbing steadily since Biden proclaimed that “we’re closer than ever to declaring our independence from a deadly virus,” much as “we declared our independence from a distant king.” Hard-hit southern states are running out of ICU beds, a sign that the virus is proving more resilient than Biden hoped.
“This is not easy work,” Brett Giroir, who headed the COVID-19 testing program in the Trump administration, told me. “It’s wrong to think the pandemic would magically go away once Trump was gone and someone else came in, because this was all our fault.”
No doubt some of it was. The Trump administration successfully undertook “Operation Warp Speed” to quickly vaccinate Americans, but one study showed that the president himself was the leading source of misinformation about the pandemic. He repeatedly told the nation that the virus would vanish, belittled masks, bullied health officials, and suggested that household disinfectants might be an antidote to the virus (later he said he was merely being “sarcastic”). Biden, for his part, mobilized a mass vaccination program that has given nearly two-thirds of the population at least one dose. Complicating the mission is the stubborn reality that a substantial chunk of Trump’s base refuses to get vaccinated under any circumstances. “In some ways, [Biden] has never been able to recover from the politicization of the virus by the Trump administration,” Senator Chris Murphy of Connecticut told me. “It’s really difficult to run a national response when a large swath of the electorate is infusing so much politics into scientific questions of mask wearing and vaccinations.”
Voters haven’t been so understanding. A recent NBC poll showed that, in matters related to COVID-19, Biden’s approval rating fell 13 points between April and August, from 69 percent to 53 percent. Americans are plainly unnerved by the pandemic’s persistence, but the administration’s miscues haven’t helped. Messages from government officials have zigzagged between dread and overconfidence. A unified government response has frayed as the White House continues to clash with federal agencies eager to affirm their independence in the post-Trump era. Even as Biden vows to let science steer the fight against COVID-19, politics also seems to have influenced his strategy.
Anyone who’s been following the administration’s periodic updates on the virus may understandably feel confused. On March 18, Biden delivered a hopeful message: “This is a time for optimism, but it’s not a time for relaxation.” Eleven days later, CDC Director Rochelle Walensky confided at a press briefing that she had a feeling of “impending doom.” On May 13, the CDC said that vaccinated people could comfortably forgo masks in many settings. On July 27, the same agency advised vaccinated Americans to re-mask. On August 18, Biden announced a plan to give booster shots to those who have been fully vaccinated, starting the week of September 20. Last week, Walensky and the Food and Drug Administration’s acting commissioner, Janet Woodcock, quietly went to the White House and told officials they wouldn’t have the data needed to approve a booster program on the scale and timetable Biden envisioned.
“The pandemic is a tough problem,” Stephen Hahn, who was FDA commissioner in the Trump administration, told me. “It’s a tough problem from a medical and scientific point of view. It’s a really tough problem from a communications point of view. That interface between medicine and politics, which we know exists, makes it a lot more difficult.” (The FDA did not respond to a request for comment.)
Inside the White House, Biden aides have been annoyed with some of the conflicting advice coming from the acronym agencies running the pandemic response, said a person familiar with the internal conversations who, along with others, spoke on condition of anonymity to talk more freely. A particular irritant has been the CDC’s fluctuating guidance when it comes to masks. “There’s been frustration on the part of the White House that messages have been confusing to the American public,” this person said. “When the CDC abruptly came out and said, ‘You don’t have to wear a mask when you’re vaccinated,’ and then said, ‘Oops, you’d better wear a mask indoors,’ it took the White House by surprise.” (The CDC changed its guidance in July as the more transmissible Delta variant triggered a surge in infections. The agency did not respond to a request for comment).
Others were equally surprised. “There were health officials who, 12 hours prior to that announcement, were on state television with their governors telling people to wear masks,” Michael Fraser, chief executive officer of the Association of State and Territorial Health Officials, told me. “I’m not sure anybody was ready for that.” (A White House official said, “The science changes all the time and CDC public-health guidance, whether it’s this pandemic or another issue, changes along with the science.”)
Tensions between the White House and federal agencies are nothing new. But they hit a nadir in the Trump administration, when the former president once browbeat the FDA to speed up vaccine development by baselessly claiming that the “deep state” forces at the agency were delaying in order to hurt him in the 2020 election. Trump political appointees sought to alter scientific reports coming out of the CDC to square them with his political positions on the coronavirus, a congressional investigation showed.
Kathleen Sebelius, health and human services secretary under former President Barack Obama, told me that she faced pressure from the White House to close schools in 2009 amid the H1N1 flu outbreak. The CDC didn’t believe nationwide school closings were necessary, she said, because “the virus was not breaking out simultaneously everywhere.”
“There were political folks in the White House who wanted me to tell CDC to do X, Y, or Z,” Sebelius said. “I was not willing to do that, and I don’t think the CDC would have done it even if I’d asked them to do it.”
A similar face-off is unfolding right now over booster shots. When the Biden administration rolled out a plan last month to give extra doses to everyone who has already gotten the vaccine, it was with the condition that the FDA and a CDC advisory committee would need to approve the program. But Biden left no doubt about the outcome he preferred. “You know, this shot will boost your immune response,” the president said. “It will increase protection from COVID-19.”
Those pronouncements didn’t sit well with career health officials. Two respected vaccine regulators working at the FDA, Marion Gruber and Phil Krause, submitted their resignations last week in part because the White House unveiled the booster program before the FDA could review all the data to make sure it was justified. “When you see Marion Gruber and Phil Krause step down from the FDA, that shows you they are enormously frustrated by the way this process has played out,” Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia, told me. Giroir posed a thought experiment: What would have been the reaction if Trump had done something similar, say by laying out a vaccine program months before the FDA had even approved a vaccine? Answering his own rhetorical question, Giroir said there would have been “outrage over political pressure on FDA.”
Defending the booster program, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and Biden’s chief medical adviser, has cited studies coming out of Israel showing that those receiving a booster shot face a lower risk of infection and serious illness. Other medical experts aren’t convinced that the broader population needs an extra shot; the vaccines already provide sufficient protection to keep people alive and out of the hospital, they argue. The odds are low that those who have been vaccinated will contract COVID-19 —depending on the circumstances, they appear to be lower than one in 5,000.
“Whether it’s the Pfizer, Moderna, or Johnson & Johnson vaccine, you consistently have excellent protection against severe illness,” Offit said. “That hasn’t changed. If that hasn’t changed, then why the need for the third dose?” Indeed, the focus on booster shots may be undermining confidence in the very vaccines the White House is promoting. Offit said he’s heard from people who now worry that if they don’t quickly get a booster shot, they’ll lose their immunity. “We’ve scared people into thinking they’re no longer protected,” he said.
If you consider the unvaccinated adult population to be Trump’s base, the vaccinated population would be Biden’s, a reality that some experts believe isn’t lost on the White House. “They’re caving to anxious Americans who want as many doses of the vaccine as possible because they’re fearful of what breakthrough infections could mean,” Céline Gounder, an infectious-disease specialist and epidemiologist who was a member of Biden’s transition-team COVID-19 advisory board, told me. “And if you look at who votes and who their constituency is, that’s their constituency.”
(The White House official scoffed at the notion. “The recommendation [on booster shots] came from the top public-health officials in the country, and it was based on science,” said the official. “There was a robust presentation of data laid out when this decision was announced … This is by no means a political decision. As has been very clear, science continues to lead this process.”)
Anyone holding high elective office naturally wants to tout their successes. But one of Biden’s promises was to level with Americans: In his inaugural address, he said that leaders must “defend the truth” and “defeat the lies.”
“When the president said on July 4 that we’re declaring independence from the coronavirus, that was so reminiscent of Trump saying it’s going to be over in two weeks,” Carlos del Rio, a professor of medicine at Emory University, told me. “I would have expected this White House not to do that, and I was disappointed that they did.”
Another approach would be admitting the obvious fact that the virus still has the “upper hand” and that we don’t yet know when the pandemic will fade. Biden will be giving a major speech on COVID-19 and the Delta variant tomorrow, a chance for a reset. “No one wants to be the person who says, ‘I don’t know what the future is going to bring,’” Nirav Shah, president of the Association of State and Territorial Health Officials, told me. And yet, “humility and comfort around scientists not knowing all the answers on day one would go a long way toward reducing some of the whiplash you’re seeing.”