Roundup: As COVID-19 Situation Worsens, Election Results Offer Hope

Liz Borkowski, , UCS | February 4, 2021, 10:57 am EDT
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This post is part of a series of quarterly roundups on scientific integrity.

In the fourth quarter of 2020, the spread of COVID-19 worsened but the Trump administration continued to sideline science. Joe Biden’s victory in the presidential election provided hope that a new administration will use science more effectively to meet this challenge and others. While the Trump administration rushed to finalize rules based on insufficient or distorted evidence, nonprofit organizations offered advice to the incoming Biden administration and worked to document problems that require rapid resolution.

COVID-19 death toll mounts as vaccines rolled out

In December 2020, the U.S. passed 300,000 COVID-19 deaths and 19 million cumulative cases. News that vaccines from Pfizer/BioNTech and Moderna showed efficacy of greater than 90% in clinical trials demonstrated the power of scientific collaboration and offered hope at a bleak time; FDA quickly issued emergency authorizations for their use. However, insufficient leadership from the Trump administration and the Senate’s refusal to pass legislation equal to the scale of the crisis mean widespread coronavirus transmission and suffering will continue. Millions face hunger and financial crisis, and those who must leave their homes to work—a group disproportionately composed of Black and Latinx people—often do so without adequate protections from their employers. Healthcare settings still face shortages of personal protective equipment, and the problem is particularly acute at small facilities like community health centers. Healthcare, lab, and public health workers face burnout, and many public health officials receive threats of violence while attempting to protect their communities.

President Trump announced on October 2 that he and the first lady had been diagnosed with COVID-19; despite insufficient transparency regarding his illness and the timing of his contacts with others, evidence suggests that the virus spread during a Rose Garden event that did not conform to Washington, DC’s public health regulations. Trump received an experimental Regeneron monoclonal antibody treatment that he credited with speeding his recovery, and he then pushed FDA to quickly grant it emergency clearance—a political move that critics warned could further undermine public trust in regulatory agencies. The fact that the treatment was tested using cells derived from human fetal tissue also highlighted the hypocrisy of Trump administration policies that erected additional barriers to using fetal tissue in research.

Staff at CDC and other agencies worked hard to advance an evidence-based response to COVID-19, but they continued to face pushback from the White House. We learned that the White House Coronavirus Task Force, led by Vice President Mike Pence, blocked CDC from issuing an order requiring all passengers and employees to wear masks on public and commercial transportation. Detailed hospital data that CDC once reported publicly to help communities and researchers respond effectively to the crisis remains hidden because of a Department of Health and Human Services (HHS) policy change, and the data that HHS releases is of questionable quality. Radiologist Scott Atlas, who joined the White House as a coronavirus advisor despite his lack of relevant expertise, pushed a dangerous “herd immunity” strategy; thousands of public health experts immediately signed the John Snow Memorandum warning that it’s “a dangerous fallacy unsupported by scientific evidence.” Reporters detailed CDC’s shortcomings in addressing COVID-19 and pleas to agency head Robert Redfield to stand up to White House interference. The House of Representatives’ Select Subcommittee on the Coronavirus Crisis released an analysis that found “over the last eight months, the Administration engaged in a persistent pattern of political interference—repeatedly overruling and sidelining top scientists and undermining Americans’ health to advance the President’s partisan agenda.”

In one positive move, CDC started using age-adjustment when comparing COVID-19’s toll on different racial and ethnic groups. The agency made the change after Senator Elizabeth Warren urged them to do so, and CDC now calculates that Black and Hispanic people are dying at a rate nearly three times that of White people; the rate for American Indian and Alaska Native people is 2.6 times that of White people in the U.S.

The degree to which vaccines can help bring COVID-19 under control depends on how much the public trusts them, how efficiently they’re distributed, and how well we continue to use non-pharmaceutical measures to control the virus’s spread. Trump administration actions threatened the public’s trust in the vaccine, though. White House officials blocked Food and Drug Administration (FDA) guidance on the criteria the agency planned to use for COVID-19 vaccine authorization, seemingly because the strict criteria would have made it impossible for a vaccine to receive emergency use authorization (EUA) before Election Day. FDA scientists refused to weaken their criteria and quietly released the guidance as part of materials prepared for a vaccine advisory committee meeting. Hours later, the White House cleared the guidance for public release. Weeks later, Trump publicly pressured FDA administrator Stephen Hahn to speed up the Moderna vaccine EUA, which was already in process. Advocates have warned that such interference can weaken public confidence in vaccines and have called for FDA to coordinate with vaccine-makers to “make detailed information about vaccine clinical trial design, implementation, and data publicly accessible for scientific scrutiny as machine-readable open data.” The administration also didn’t confront medical racism with the seriousness needed to build trust in Black, Latinx, and Native American communities that have experienced discriminatory treatment from the medical and research communities.

The federal government is sending vaccine doses to states, although its distribution formula does not ensure equitable access across states for groups CDC has identified as high priority. Experts stress that even though vaccination has begun, prevention measures like wearing masks, ventilating indoor spaces, and limiting contacts outside of household remain essential. The emergence of the B.1.1.7 virus variant, which has spread widely in the United Kingdom and appears to be substantially more transmissible, reminds us that the more the virus spreads, the more opportunities it has to develop mutations that make it even more dangerous.

Looking ahead: The Government Accountability Office has accepted the request of Senators Gary Peters, Patty Murray, and Elizabeth Warren and will investigate “whether the CDC and FDA’s scientific integrity and communications policies have been violated and whether those policies are being implemented as intended to assure scientific integrity throughout the agency.”

Biden and Harris win election, underscore commitment to science

Scientists breathed a collective sigh of relief when Joe Biden and Kamala Harris won the 2020 presidential election and their transition team tweeted, “The Biden-Harris transition will listen  to science, be driven by honesty, and reflect the positive character of the American people.” In announcing a COVID-19 advisory board led by established public health experts, President-elect Biden stated, “Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts.”

While Biden emphasized the importance of evidence, President Trump refused to accept the results of the election and spread lies about the process. Although the election did involve voter intimidation and long lines in many polling places, particularly those serving large shares of Black voters, courts repeatedly struck down false claims of widespread vote fraud and noted a lack of evidence that any such problems occurred. Experts warn that these false claims are undermining public confidence in elections and laying the groundwork for future restrictions on voting.

The Trump administration’s refusal to accept election results led to a delayed release of federal resources to the Biden-Harris transition; weeks later, Biden reported that most agencies had shown “exemplary cooperation,” but that the Office of Management and Budget and Department of Defense were not providing all necessary information in “key national security areas.” Meanwhile, the Trump administration sought to place 32 political appointees into civil-service positions so they will remain in government jobs after Trump leaves office. This phenomenon, known as “burrowing,” is common at the end of administrations, and can interfere with new administrations making changes at federal agencies.

In the weeks following the election, Biden announced several nominations for agency leadership roles. Advocates have raised concerns about potential conflicts of interest among several nominees; they urge the Biden-Harris team to look beyond the typical “revolving door” candidates and appoint a diverse group of leaders with demonstrated records of working for the public interest. Nominations that have met with acclaim include California attorney general Xavier Becerra to lead the Department of Health and Human Services (HHS), Harvard medical school professor and infectious disease physician Rochelle Walensky to head the Centers for Disease Control and Prevention (CDC), and US Representative from New Mexico and member of the Pueblos of Laguna and Jemez Deb Haaland to lead the Department of the Interior. A Roll Call article about Michael Regan, Biden’s pick to head the Environmental Protection Agency (EPA), notes that he “has experience lifting a discouraged agency.”

Looking ahead: Victories by Raphael Warnock and Jon Ossoff in their runoff elections for Georgia’s Senate seats make Senate confirmation more likely for Biden appointees who require approval.

Preparing for a presidential transition

While the Biden-Harris team prepared to assume office, the Trump administration raced to cement changes. In October, Trump signed an executive order that allows agencies to strip civil service protections from large swaths of the federal workforce by creating a new “Schedule F” category of “policy-making” employees. These reclassified employees would no longer be hired under competitive procedures and would lose the rights to due process and appeals of personnel actions against them. The order would politicize public service by allowing administrations to dismiss scientists who provide answers they don’t want to hear and place unqualified appointees into career positions that outlast the administration. Additional departures would compound the existing problem of expertise exodus. The Office of Management and Budget has already identified 88% of its workforce as belonging to the new category. More than 60 organizations representing the federal workforce and policy groups urged lawmakers to block the order in must-pass spending legislation, warning that even if Biden reverses the order it could take months to bring back dismissed employees  (who would face breaks in their service records) as well as to reverse problematic new hiring actions. Congress did not undo the order.

The Trump administration finalized more rules in its last year than any other recent president. ProPublica and NYU School of Law’s State Energy & Environmental Impact Center have been tracking these “midnight regulations,” and advocates are explaining to journalists the challenges to undoing last-minute actions at HHS and EPA. Organizations such as the Government Accountability Project and Project on Government Oversight have created mechanisms for reporting wrongdoing during and after the transition. Many individuals, organizations, and collaborations have released recommendations for the new administration to advance scientific integrity, transparency, and accountability. They include:

Looking ahead: Advocates will be tracking executive orders and appointments in what is likely to be an eventful first 100 days of the Biden-Harris administration.

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