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Emergency Doctor Weighs In On Biden's COVID Strategy

SCOTT DETROW, HOST:

Just yesterday alone, tens of thousands of new cases of COVID-19 cases were diagnosed, and more than 1,500 people died from the disease. It's all being driven by the highly infectious delta variant of the disease, and it represents a radical turn from where the country was just two months ago.

AILSA CHANG, HOST:

And this explosion of COVID cases has left local, state and federal leaders, including President Biden, trying to figure out how to stop it. Well, this afternoon, he is going to lay out what's been billed as a six-pronged approach to stopping the spread of this disease here in the U.S. We're going to talk about that plan and what it should include with Dr. Leana Wen. She was Baltimore city health commissioner, and she's a public health professor at George Washington University.

Welcome.

LEANA WEN: Thank you. Great to join you, Ailsa.

CHANG: Great to have you. OK. As we've said, we're learning some things about this plan. There's a vaccine mandate for all federal workers, and one of the biggest parts of this plan is a new rule that would require private sector businesses with at least 100 employees to make sure that their staff members get vaccinated. The administration is also going to require health care workers in facilities that get Medicare and Medicaid funding to be vaccinated. Let me ask you, is all of this enough to make a real substantive dent in cases?

WEN: I hope so. I mean, we know that vaccines are our best and only way out of the pandemic and also that, had we gotten many more people vaccinated earlier, we wouldn't be where we are now. I mean, we are only at 54% of the entire country fully vaccinated. And this is the reason why we've seen the scourge of the delta variant wreaking havoc here. I think it's - what the Biden administration is announcing is a lot. I mean, it will be good in particular to direct employers to either mandate vaccines or testing, or at least larger employers to do them. And I think it gives the employers cover who might have wanted to take this step, but now they can blame it on the federal government and say, hey, this is what the federal government is asking us to do.

But I actually wish that President Biden would go even further and use the full extent of his federal authority, and in particular, around interstate travel - planes and trains. That is in his power, to mandate vaccines for all eligible people to board a plane or a train. And I think it also sets the tone. If you want the privilege to travel, you need to get vaccinated.

CHANG: Well, in addition to vaccinations, I want to talk about testing. Because one thing that we know is that the administration is going to be taking steps to increase access to testing. Can you just explain real quick for us, Dr. Wen, how could that noticeably help at this point during the pandemic?

WEN: Testing in itself is not a preventive measure. Because if you test positive, you've already got COVID. However, if it's implemented throughout and used for routine surveillance, meaning that everyone, for example, going to work is tested once a week or every student going to school is tested once or ideally twice a week, then that's a way to identify individuals who have the infection before they actually enter that space. And testing can be and is an important layer of protection.

And I think this is the key here, that all of these things layer on top of one another. Think about it as, it's cold outside. You want to wear multiple layers of clothing. If you remove one layer, you have to replace it with another. And so in schools, for example, if we are removing the layer of distancing because we have to get all the kids back full-time, then you need other layers...

CHANG: Right.

WEN: ...Including testing and indoor masking and vaccinations for those who are eligible.

CHANG: But the tests (inaudible) available are rapid antigen tests, I understand. They're reliable, but they're not quite as reliable as the PCR test. Is that correct?

WEN: That's correct, although I am OK with that because I would much rather that we get a large number of people tested with an imperfect test rather than fewer number of people tested with a great test. I mean...

CHANG: Right.

WEN: ...If you get not that many people tested, you get 0%, as opposed to if you have a test that's 80%, you're still getting 80% of those who are infected. So regular testing, even with the cheaper, more readily available rapid antigen test, would be a huge game-changer.

CHANG: OK. Well, we're talking about some pretty aggressive steps - you know, pushing people to get vaccinated, get tested, wear masks. But let me ask you, after all of the politics that we have seen during this entire pandemic - varied politics across the country - do you think that this new plan can be successfully implemented?

WEN: I think it can be. But I also think that President Biden needs to be much more aggressive in how he delivers this plan. As I read the plan and what I understand of it now, it still reads like we've been there before. I mean, nothing here - the six prongs - we've all seen it before. Testing, vaccination, school safety - I mean, they're important. But altogether, they still sound like half measures.

I want the president to come out and say that we have reached the end of the line here. We can't do this anymore. This is killing 1,500 Americans a day, which is half a million Americans every year. I mean, we cannot sustain this. Our economy is suffering. We're all suffering. We can't do this unless we do something really dramatic. We need to put a hard reset here. And that's why I think the federal government really needs to use the entire power of its authority to mandate vaccines.

CHANG: But isn't that authority limited inherently? I mean, does the president need substantial buy-in from governors, other local leaders, local health departments, to really pull off a plan like this?

WEN: Yes, but he also - the federal government can also give locals cover. There are many localities that actually want to do these things, but they need to be able to point to the federal government and say, hey, this is something the federal government is asking me to do. And I actually think here, proof of vaccination is going to be really important. Israel, the EU - they have something more than a paper card that can easily be forged. We need to have that here in the U.S., too.

CHANG: Dr. Leana Wen was Baltimore city health commissioner and is an emergency room physician.

Thank you very much for joining us today.

WEN: Thank you. Transcript provided by NPR, Copyright NPR.

Ailsa Chang is an award-winning journalist who hosts All Things Considered along with Ari Shapiro, Audie Cornish, and Mary Louise Kelly. She landed in public radio after practicing law for a few years.
Courtney Dorning has been a Senior Editor for NPR's All Things Considered since November 2018. In that role, she's the lead editor for the daily show. Dorning is responsible for newsmaker interviews, lead news segments and the small, quirky features that are a hallmark of the network's flagship afternoon magazine program.