Biden openly wears a mask, and has urged Americans to do the same. He has released a sound COVID-19 plan that, he said during his acceptance speech, is “built on a bedrock of science.” He has assembled a coronavirus task force composed of 13 people with medical expertise. He has committed to rejoining the World Health Organization. His presidency, many health-care workers hope, will mark a newfound commitment to stopping the pandemic, restoring the humbled Centers for Disease Control and Prevention, and ending a steady stream of gaslighting and misinformation from the federal government itself. “I slept this weekend like I haven’t slept since February—without the same demons,” Choo says. “I woke up doped up on sleep.”
Choo also studies the impacts of health-care policy, and has found that health-care systems sometimes react to imminent policies months before they are actually come into force. Could that happen with Biden’s pandemic plan? “It absolutely could, and there’s precedent for it,” she says. She expects that state leaders will start to coalesce around his plan and consult with his task force.
Still, “you can’t just fix a pandemic this far down the rabbit hole,” Popescu says. “I’m hopeful, but I don’t expect this to suddenly turn itself around overnight.” Biden will inherit a health-care system that is battered at best and broken at worst, a polarized electorate, and many local leaders who are doubling down on bad policies. Trump won Iowa by eight points, which Governor Kim Reynolds took as validation of the state’s COVID-19 response thus far. Bars, restaurants, and schools in Iowa are still fully open, and a recently announced mask mandate applies only for gatherings of 25 people or more. “That takes away my hope,” Perencevich said.
“We can’t just sit on our hands and wait for Jan. 20 to come,” said Megan Ranney, the Rhode Island physician. Several health-care workers I spoke with are trying to keep mild cases of COVID-19 from becoming severe enough to warrant an ICU bed. In Ohio, Fayanju’s primary-care centers deliver fluids, pulse oximeters, and smart tablets to the homes of newly diagnosed COVID-19 patients, so doctors can check on their symptoms virtually. In North Dakota, South Dakota, and Minnesota, the Sanford Health network has set up outpatient “infusion centers” where elderly COVID-19 patients or those with chronic illnesses can get drugs that might slow the progression of their disease. These drugs will include the antibody therapy bamlanivimab, which received an emergency-use authorization from the FDA on Monday, Suttle told me.
But the best strategy remains the obvious one: Keep people from getting infected at all. Once again, the fate of the U.S. health-care system depends on the collective action of its citizens. Once again, the nation must flatten the curve. This need not involve a lockdown. We now know that the coronavirus mostly spreads through the air, and does so easily when people spend prolonged periods together in poorly ventilated areas. People can reduce their risk by wearing masks and avoiding indoor spaces such as restaurants, bars, and gyms, where the possibility of transmission is especially high (no matter how often these places clean their surfaces). Thanksgiving and Christmas gatherings, for which several generations will travel around the country for days of close indoor contact and constant conversation, will be risky too.
Preliminary results suggest that at least one effective vaccine is on the way. The choices made in the coming weeks will influence how many Americans die before they have a chance to receive it, and how many health-care workers are broken in the process.