Updated at 6:49 a.m. ET
As coronavirus cases surge around the country, President-elect Joe Biden says voters have given him a mandate to take action.
"Daily cases are skyrocketing," Biden said in remarks Friday evening in Wilmington, Del., as the nation waited for the election to be called. "I want everyone — everyone — to know on Day 1, we're going to put our plan to control this virus into action."
Early Monday, Biden announced a 13-member Transition COVID-19 Advisory Board, to be led by former Food and Drug Administration commissioner Dr. David Kessler, former Surgeon General Dr. Vivek Murthy and Dr. Marcella Nunez-Smith of the Yale University School of Medicine.
Many of the voters who helped propel Biden toward the presidency ranked the pandemic as the most important issue facing the United States, according to AP VoteCast data.
So how will Biden deliver on their hopes?
Specifically, Biden's plan calls for empowering scientists at the Centers for Disease Control and Prevention to help set national, evidence-based guidance to stop outbreaks as well as making significant investments in vaccine distribution, testing and the creation of a public health workforce to carry out contact tracing and other services.
"We have to function as one nation. That means having a national plan," Murthy, a key adviser to the Biden campaign, told NPR recently.
Murthy said Biden will focus on helping Americans get what they need to keep themselves and their families safe. "What you're going to see is a laser focus on ensuring that people get ... adequate testing and clear information," he said.
Murthy said a Biden administration will have a unified message and strategy on how to proceed. "Rebuilding public trust is about communication. It's about following the science," he added.
Ezekiel Emanuel, a physician and University of Pennsylvania professor who has briefed Biden on health policy, told NPR he got to see how Biden works during the Obama administration's economic recovery efforts in 2009, which Biden managed as vice president. "You're going to have rigorous evaluation and constant refinement" of policies and strategies, he said.
While working on the Recovery Act, Emanuel said, Biden "was constantly asking, 'Are we doing the right thing?' " and looking to adjust midcourse, if necessary. "He's a very practical guy," Emanuel said.
Here's a summary of Biden's proposals:
This report is drawn from a more extended analysis of the Biden pandemic plan published on Oct. 28.
1. Set shared guidance for slowing community spread
Under Biden's plan, the CDC will be directed to provide specific guidance — based on the degree of viral spread in a community — for "how to open schools, open businesses," Emanuel says, or when to impose restrictions on gathering sizes or when stay-at-home orders may be called for.
It would create a national "pandemic dashboard" to share this information with the public. This is a strategy recommended by a top group of public health experts, who released a framework for assessing community risk.
And Biden says he'd work with every governor to make mask-wearing in public mandatory in their state. Many states already have mask mandates, but though research suggests that universal masking could save more than 100,000 lives, there's currently no nationwide coordination or requirement.
2. Seriously ramp up testing
The Biden campaign has said the goal is to "ensure that all Americans have access to regular, reliable and free testing." His administration will work to double the number of drive-through testing sites and invest in "next-generation testing," including home tests and instant tests.
"It's not enough to know in seven days or five days or three days whether or not you have COVID," Biden recently said on CBS' 60 Minutes. If there's a long lag time, a person may spread the disease unwittingly while waiting for results.
There are currently several home test kits that give quick results without being sent to a laboratory in development, but none are yet approved by the Food and Drug Administration. While there has been a significant expansion in testing, "testing is still not available and affordable to all people across the country," Murthy told NPR.
3. Hire thousands of public health workers
The Biden team pledges to "mobilize" 100,000 Americans to work with local organizations around the country to perform contact tracing and other health services for populations at high risk for COVID-19.
The idea is to empower local communities and health departments to assist people with challenges such as food insecurity and affordable housing.
"Imagine a public health workforce that was also helping train school officials in how to reopen safely," Murthy told NPR. Or helping run public education campaigns about a vaccine and how to stay safe in the pandemic. "Think about a workforce that was diverse, that looked like the country that we're trying to serve," Murthy said.
4. Help people get health insurance
Millions of American have lost health insurance during the pandemic. Biden's coronavirus plan proposes to have the federal government cover 100% of the costs of COBRA coverage for the duration of the crisis. "So when people lose their employer-based health insurance, they can stay on that insurance, given the moment we are in," Stef Feldman, Biden's national policy director, told NPR.
In addition, Biden will push to strengthen the Affordable Care Act, expanding coverage by making more people eligible for premium subsidies. Biden hopes also to push for expansion of Medicaid in states that have yet to do so, and he has proposed making Medicare coverage available to Americans beginning at age 60 (instead of 65).
During the pandemic, several governors asked the Trump administration to reopen the federal Obamacare marketplace for a special enrollment period. Feldman has told NPR that Biden would do so immediately after his inauguration to allow those who've lost insurance to sign up for new plans. She called it "a basic step that President Trump has refused to do."
5. Create a caregiving workforce
During the pandemic, Biden says many families are struggling to find affordable care for their children, aging relatives or loved ones with disabilities. "At the same time, professional caregivers have either lost their jobs or continue to work while putting their lives at risk without sufficient pay," his campaign plan noted.
Biden plans to work with states to speed up waiting lists for Medicaid-paid care in homes. In addition, the president-elect supports a variety of steps to expand caregiving, including ensuring access to preschool for 3- and 4-year-olds and supporting caregivers through job training and improved benefits and protections.
Expanding opportunities in the female-dominated caregiving workforce would play a dual role in both helping families, and helping improve women's employment outlook, said Sherry Glied, dean of New York University's Robert F. Wagner Graduate School of Public Service, noting that this pandemic-fueled economic crisis has hit women harder.
6. Boost vaccine distribution and personal protective equipment production
States will need a lot of money to distribute a vaccine and make sure it gets to everyone who wants it. There are complex logistics that will require planning and resources. Currently state governors are asking for more guidance and financial assistance.
The Biden team proposes investing $25 billion in a vaccine manufacturing and distribution plan "that will guarantee it gets to every American, cost-free."
The president-elect also wants to solve the shortages of personal protective equipment that have plagued the U.S. health care system since the pandemic began. The Biden team says after the inauguration, it will work to make sure more of these critical supplies are produced and distributed "rather than leave states, cities, tribes, and territories to fend for themselves."
Biden says he'd use the Defense Production Act to increase production of masks, face shields and other personal protective equipment so that supply exceeds demand.
An earlier version of this story said the advisory board will have 12 members. It will have 13.
DAVID GREENE, HOST:
Nearly 10 million people in the United States have been infected with the coronavirus, and the spread right now is dangerously high. Over the weekend, new daily cases soared above 126,000. That is the highest yet since the beginning of this pandemic. We know the Trump administration's response, but what is President-elect Joe Biden's COVID-19 plan? Biden's team is promising to be ready on day one. Let's talk about all of this with NPR's Allison Aubrey, who is here as she is most Mondays. Hi, Allison.
ALLISON AUBREY, BYLINE: Good morning, David.
GREENE: Let's get the big picture first. I mean, how bad is this right now?
AUBREY: You know, the U.S. is averaging more than a hundred new - thousand new cases per day. That is more than a 50% increase, David, just compared to late October, a few weeks back. About a thousand people a day are dying from COVID in the U.S. in recent days. And as hospitalizations rise, there's pressure on hospital systems around the country. Here's former FDA Commissioner Scott Gottlieb. He was on CBS yesterday.
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SCOTT GOTTLIEB: We're going to have a record number of hospitalizations this week. Now 56,000 people are hospitalized, 11,000 are in the ICU - these are very big numbers nationally, and it's accelerating very quickly.
AUBREY: And we have not yet hit the peak of this surge, David.
GREENE: Well, and the surge is happening when we're having a leadership transition in our country.
AUBREY: That's right.
GREENE: President-elect Biden, I mean, he spoke about the urgency of this over the weekend in his victory speech. What do you know so far about his team's plan?
AUBREY: Well, the president-elect is well aware of the direction the nation is headed. Here he is.
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JOE BIDEN: Daily cases are skyrocketing, and it's now believed that we could spike - see as many as 200,000 cases in a single day. The death toll is approaching 240,000 lives lost to this virus. That's 240,000 empty chairs at kitchen tables and dining room tables all across America.
AUBREY: And today, the Biden-Harris transition team has just named a group of scientists and experts to a COVID task force. It will be co-chaired by Dr. Vivek Murthy, a former U.S. surgeon general, and Dr. David Kessler, a former FDA commissioner.
GREENE: And, I mean, action obviously is important. So is messaging, as we've learned through this public health crisis all this year. But when it comes to January, I mean, what sort of actions might we see here?
AUBREY: Well, for starters, mask mandates nationwide. Biden plans to work with governors and mayors to do this. Biden has said he will direct scientists at the CDC to set evidence-based guidance to help limit outbreaks so that leaders in every state, every community, are operating under the same standards in a much more unified way. He's also calling for significant investments in vaccine distribution, something many governors have been asking for. And he's calling for a major ramp up in testing.
Just before the election, I spoke to Dr. Vivek Murthy, who will co-chair Biden's task force. He says testing is a key priority.
VIVEK MURTHY: He wants to expand our testing capacity to ensure that people have access to reliable and affordable testing when they need it - and not just diagnostic testing, but also screening testing so that we can better open up schools and workplaces and other settings which have remained shut down.
AUBREY: And in addition to testing, David, comes tracing, right? The Biden team envisions the creation of a public health workforce, some 100,000 people or so to carry out contact tracing and other tasks to help communities hit hard by COVID and to get the U.S. where it needs to be with test, trace and isolate, to slow the spread here.
GREENE: I mean, this is like night and day. We had a president - we have a president who, I mean, has basically said that you can't take strong, aggressive action right now because it could damage the economy. I mean, that's the balance that he sees. Now we have Biden, who is basically saying, let's be as aggressive as possible because we have to confront this. I mean, what do public health experts say about such a shift in a moment like this?
AUBREY: You know, I spoke to physician Zeke Emanuel. He has briefed Biden on health policy. He worked with Biden in the past. I spoke to him just before the election. He said, in a Biden administration, expect this huge change - what you just said, David - aimed at a more unified and coordinated approach.
EZEKIEL EMANUEL: You'll see close work with states and the use of federal resources to get all the states singing from the same hymnal so that we don't have what has transpired, which is different states doing different things, and much more detailed guidance that the CDC normally develops for, like, how to open schools, how to open businesses.
AUBREY: We may also see a national pandemic dashboard - so a single site that everyone around the country can check to see the level of spread in their community or zip code.
GREENE: Let me ask you about another possible change. I mean, you have a president coming in, a president-elect, who has talked about expanding access to health insurance. I think about a lot of Americans who've lost their jobs and their employer-sponsored health care plans. I mean, how does Biden plan to address that?
AUBREY: You know, he has proposed the federal government cover 100% of the cost of COBRA coverage for the duration of this crisis. So when people lose their employer-based health insurance, they could stay on that insurance amid the pandemic.
In addition, Biden's folks say he'd like to strengthen the Affordable Care Act, expanding coverage by making people eligible for premium subsidies, more people eligible. During the campaign, Biden also proposed making Medicare coverage available to Americans beginning at age 60 instead of 65. And during the pandemic, several governors, David, have asked Trump to open - reopen the federal Obamacare marketplaces for a special enrollment period. This has not happened. Biden's advisers have told me this is something he could do immediately after his inauguration.
GREENE: I mean, just thinking broadly, our country is so divided right now. I mean, there was this national AP poll of those who voted in the presidential election. Among voters who said the pandemic is totally or mostly under control, 91% voted for President Trump.
AUBREY: That's right.
GREENE: How do you bridge this divide?
AUBREY: You know, I've been talking to public health experts and to Dr. Robert Winn, a physician in Richmond, Va., about this. He's been advising communities on just how to get people to follow evidence-based recommendations. And, basically, this is the deal - in order to get people to change their behavior, you need to do three things.
You need to give them information - say, the information or the studies - to show masks can help save lives. B, they have to have the wherewithal or the means. You need to be able to buy a mask and remember to wear it. And, C, you got to motivate people, and this has been the challenge, David. There are competing values and competing realities when it comes to mask wearing, when people view masks as an infringement of personal freedom. Winn says this has made it harder to manage the pandemic.
ROBERT WINN: We are living in two separate worlds, and I think that that is a symptom of the lack of leadership. When you have mixed messages coming out of the CDC, how can one fault people with alternative facts? So I think Biden offers us an opportunity now for many people to regain trust back in the federal government.
AUBREY: And Biden advisers say that starts by putting scientists first and giving people clear, consistent guidance.
GREENE: NPR's Allison Aubrey. Allison, thank you as always.
AUBREY: Thank you, David.
(SOUNDBITE OF LYMBYC SYSTYM'S "100 ARMS") Transcript provided by NPR, Copyright NPR.