The Washington PostDemocracy Dies in Darkness

The Health 202: Pence spins criticism of Trump coronavirus response as insult to Americans

with Alexandra Ellerbeck

Here's how Mike Pence brushed off criticism about the federal response to the coronavirus pandemic at last night’s vice presidential debate: Americans should be trusted to handle their own health. 

And any suggestion the Trump administration failed in responding, Pence suggested, is a slam on Americans themselves.

It's a savvy messaging tactic for Pence, seeking to spin his leadership role in a pandemic that has killed more than 210,000 Americans.

Throughout the 90-minute debate with Sen. Kamala Harris (D-Calif.), Pence presented an alternate history of a federal government that responded rapidly and effectively to control the virus and restore Americans to normal life. In reality, schools and businesses remain shuttered or scaled back around the country and the virus is still spreading – including in the White House, the center of an outbreak now reported to have infected nearly three dozen people, and where President Trump and First Lady Melania Trump are themselves recovering. 

As leader of Trump’s coronavirus task force, Pence is perhaps in a stickier position than anyone else in talking about covid-19 – a highly infectious illness that has frequently exposed an administration characterized more by its infighting and catering to the president’s various whims than in mounting a coordinated, effective response to it.

When Harris said the administration’s response clearly “hasn't worked when you're looking at over 210,000 dead bodies in our country,” Pence framed her remarks as being critical of Americans themselves. 

“When you say what the American people have done over these last eight months hasn't worked, it's a great disservice to the sacrifices the American people have made,” Pence said. “The American people, I believe, deserve credit for the sacrifices that they have made.” 

Pence had to answer for the hugely disruptive pandemic while sitting next to a visual reminder of it.

Two plexiglass dividers separated the two candidates, who were also standing 12 feet apart. While health experts said they were essentially useless, the Biden campaign pushed for them, citing Pence’s recent exposure to people infected with the virus – including Trump himself. 

Pence initially opposed adding the dividers but eventually acquiesced. Yet he and other administration officials have routinely shunned preventive measures such as mask-wearing and social distancing, as the White House has alternately undermined the pandemic and claimed it was nearly over. The next debate between Trump and Joe Biden will be held virtually, 

Pence and Harris tussled over the pandemic in the debate’s first segment – and returned to the topic throughout the evening.

Moderator Susan Page from USA Today kicked things off by asking Harris how a Biden administration might do things differently. Harris focused most of her response on the administration’s delayed response as the virus was initially circulating in Wuhan, China, in January and February. Several times, she referenced a report by The Post’s Bob Woodward that Trump was warned of the seriousness of the threat on Jan. 28 yet intentionally downplayed it to the public.

“They knew and they covered it up. The president said it was a hoax. They minimized the seriousness of it,” Harris said.

One tricky moment for Harris did come when Page asked her whether she would agree to take a coronavirus vaccine should it be ready before Election Day. Harris had previously suggested she wouldn’t trust it, prompting indignant responses by Republicans that she was hurting public confidence in vaccines.

“If the public health professionals, if Dr. Fauci, if the doctors tell us that we should take it, I'll be the first in line to take it. Absolutely,” Harris said, referring to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “But if Donald Trump tells us I should – that we should take it, I'm not taking it.”

Pence pounced on Harris for “undermining confidence in a vaccine” while asserting several times that one will be ready “before the end of this year.” He also repeatedly slammed Biden for the Obama administration's handling of the 2009 H1N1 flu, which killed fewer than 12,500 Americans over its entire course.  As The Post's fact-checking team points out, that total was “an after-the-fact report, based on statistical modeling of excess mortality. The death toll at the time was much lower.” 

Vox's Matt Yglesias:

Vox founder Ezra Klein:

Harris’s most memorable jab at Pence was over Obamacare.

Aside from the pandemic response, the Trump administration’s refusal to defend the health-care law before the Supreme Court is the topline message from Democrats this year. Pence has long criticized the Affordable Care Act, and he did again last night, claiming the law “was a disaster.”

The Washington Examiner's Phil Klein:

Harris steered a question about the economy toward the lawsuit, in which Republican-led states are trying to get all of the ACA declared unconstitutional including its protections for patients with preexisting medical conditions.

“If you have a pre-existing condition, heart disease, diabetes, breast cancer, they're coming for you,” she said. “If you love someone who has a pre-existing condition, they're coming for you. If you're under the age of 26 on your parents' coverage, they're coming for you.”

It’s possible the court could strike down those protections offered by the ACA, although if it did, states could still put such protections in place. There are also multiple ways Congress could step in and pass legislation to render the lawsuit moot.

The Post's Bob Costa:

Harris ducked a question on expanding abortion rights.

At one point, the debate turned to Trump’s pick of Amy Coney Barrett as his Supreme Court nominee. Barrett, who has made strong statements against abortion, would increase the court’s chances of eventually overturning Roe v. Wade and kicking abortion rights decisions back to the states.

Page asked Harris whether, under that scenario, she would like her home state of California to “enact no restrictions on access to abortion.”

Harris didn’t answer the question, instead bringing things back to the Obamacare lawsuit. 

“I will always fight for a woman's right to make a decision about her own body,” Harris said. “It should be her decision and not that of Donald Trump and the vice president, Michael Pence. But let's also look at what also is before the court. It's the Affordable Care Act.” (Pence also notably did not answer the question about what he would like his home state Indiana to do if Roe were overturned, but later circled back to declare himself unapologetically pro-life.) 

In the past, Barrett has indicated she sympathized with a 2015 challenge to the Affordable Care Act and disagreed with the court’s 2012 decision upholding it – comments that heightened fears by ACA advocates that she might rule against the law in yet another challenge to the law to be heard after the election. 

But in a conversation yesterday with Sen. Chris Coons (D-Del.), Barrett wouldn’t say whether she believes the court should reconsider whether the health-care law is constitutional. Coons pressed her on the matter, but Barrett repeatedly declined to speak to the specifics of a case, saying “she wouldn’t get into the details of how she might rule,” The Post’s Seung Min Kim reports.

Ahh, oof and ouch

AHH: Trump called Regeron’s coronavirus treatment a “cure” and the company filed for emergency use.

Trump credited drug maker Regeneron’s antibody cocktail, which is still in clinical trials, with his recovery from covid-19 in a video released on Wednesday. That same evening Regeneron sent an application to the Food and Drug Administration requesting emergency authorization for use of the treatment, the New York Times’s Katie Thomas writes.

“To me it wasn’t therapeutic — it just made me better, OK? I call that a cure,” Trump said in the video, in which he also described getting the virus as a “blessing from God.”

President Trump on Oct. 7 called catching coronavirus a "blessing from God" and said he felt "perfect" after taking the drug made by the company Regeneron. (Video: @realDonaldTrump/Twitter)

Regeron’s treatment is a combination of two drugs known as monoclonal antibodies, manufactured versions of the immune system’s natural response to infection. Early results suggest that the treatment is promising, but the company has not yet released detailed data to back up its claims that the antibody mixture reduces virus levels. There’s also no evidence that the treatment played a determinative role in the course of Trump’s illness. 

Emergency use authorizations can help doctors get potentially lifesaving treatments to patients, but they also risk advancing therapies that have not been fully vetted and can sometimes make it harder to recruit patients for large clinical trials. There’s also an issue of availability. Monoclonal antibodies are challenging to produce, and Regeneron says it has only enough doses for 50,000 patients, although it intends to ramp up production to have 300,000 doses within the next few months. 

“The news of Regeneron’s application on the same day that Mr. Trump effusively praised the unproven drug is likely to intensify fears that the president is pressuring federal health agencies to make decisions aimed at benefiting him politically,” Thomas writes.

OOF: Too much confidence in rapid testing, failing to follow mask and social distancing guidelines contributed to White House outbreak.

While rapid coronavirus tests can be an important tool in detecting and controlling outbreaks, the White House's overreliance on these tests left officials vulnerable. Antigen tests are less reliable that lab-based tests, and many of the people who interact with officials close to the president did not receive regular tests, CNN’s Jeremy Diamond and Kevin Liptak report.

“It's a question of layering all of these really imperfect interventions on top of each other. No one thing is going to work itself,” Celine Gounder, an epidemiologist and CNN medical analyst, told CNN. “They should've all been wearing masks as a backup for the possibility that some cases, some infectious persons got through the testing program.”

It’s also unclear how often Trump received tests. The White House has refused to disclose the date of the president’s last negative test, raising doubts about whether he was tested before his debate with Biden last week.

“Ultimately, the regularity of Trump's tests was unknown to most White House officials, who say they trusted the building's leadership to ensure he was being properly monitored for contagion,” Diamond and Liptak write. “While senior aides said they were tested on a practically religious basis, they never saw Trump himself receive the test — a fact they wrote off as related to medical privacy,” 

At least 34 people have been infected by the White House's coronavirus outbreak, according to an internal FEMA memo obtained by ABC News.

OUCH: States vary widely in how they classify coronavirus outbreaks.

While some states define a coronavirus outbreak in a workplace or school as two people being infected, others set the threshold much higher. Iowa, for instance, will not announce an outbreak until 10 percent of students or workers have been infected, The Post’s Chris Mooney, Sarah Kaplan and Juliet Eilperin write.

“The nation’s patchwork pandemic response has led to wide disparities in data reporting and even in definitions for basic medical concepts. In the absence of federal standards, states have adopted divergent and sometimes scientifically questionable approaches to disease control, which experts say have allowed the virus to spread,” Mooney, Kaplan and Eilperin report.

These definitions affect crucial decisions about opening schools or shutting down businesses. A case rate of 9 positive cases per 100,000 residents might be considered “low” in one state but “very high” in another. The threshold for classifying a cluster of cases as outbreak can also determine what data gets reported publicly. Iowa, for instance, used its loose definition of an outbreak to justify withholding information about 117 people sickened with the virus at one meatpacking and poultry plant.

CDC in the spotlight

CDC director Robert Redfield is under fire for a letter greenlighting Pence to debate.

In a three-paragraph letter released Tuesday evening by the White House, Redfield proclaimed Pence safe to attend the debate against Harris. The CDC director said he had determined Pence was not in “close contact” with anyone who had been infected after a “detailed discussion” with Pence’s doctor about the vice president’s recent activities.

“The letter is raising concern within the CDC and among public health experts about the propriety of Redfield’s actions, especially after President Trump and at least nine White House employees have tested positive for the novel coronavirus. The CDC is not involved in investigating the scope and source of the outbreak linked to the White House,” The Post’s Lena H. Sun and Yasmeen Abutaleb report.

Other public health experts have raised doubts about whether Redfield could truly confirm Pence had not been in close contact with an infected person, given his presence at a Rose Garden event where several attendees later tested positive. 

Alex Merz, a professor of biochemistry at the University of Washington:

Redfield has faced scrutiny both from within the Trump administration and from outside experts. On Tuesday, a letter came to public light in which former CDC director William H. Foege blasted Redfield for “acquiescing” to political interference by Trump administration officials. Foege – famous for his work to eradicate smallpox – called on Redfield to publicly denounce the Trump administration’s response to the pandemic, even at the cost of being fired.

A medical journal weighs in

The New England Journal of Medicine says it’s time to vote the Trump administration out.

The medical journal weighed in for the first on an election with a blistering critique of U.S. leaders’ response to the coronavirus. The editorial neither explicitly endorsed Biden, nor did it mention Trump by name, but the message was a clear rejection of the current administration.

“When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs,” the editorial said.

The scathing editorial claims that failures in U.S. leadership — including the politicization of the vaccine development process, testing and policies mistakes at the CDC, and messaging from political leaders discouraging the use of masks — will be measured in lives lost to the virus.

“Although it is impossible to project the precise number of additional American lives lost because of weak and inappropriate government policies, it is at least in the tens of thousands in a pandemic that has already killed more Americans than any conflict since World War II,” the editorial reads.

More takes and analysis

  • The Council on Foreign Relations released a report analyzing failures in the global response to the pandemic and calling for renewed U.S. preparedness at home and leadership abroad.
  • Democrats are pushing misleading information and rumors about Trump's health online. While not as dangerous as the extremist -movement around the QAnon conspiracy, the left-wing rumor mongering seems like a symptom of a larger force “that is pulling us all toward conspiracy theories these days, no matter our political persuasion,” the New York Times's Kevin Roose writes.
  • Teachers unions have disadvantaged students during the pandemic with staunch opposition to school reopening, despite advice from public health officials that the risks for in-person schooling can be managed in most cases, New York Magazine's Jonathan Chait opines.

In the states

  • The Virginia Department of Health has alerted doctors to prepare for a coronavirus vaccine as soon as Nov. 1, although officials say that they are not privy to specific information about when a vaccine will be available, The Patch's Mark Hand writes.
  • Nevada cited a spate of false-positive results in its decision to halt the use of rapid coronavirus tests in nursing homes, the New York Times's Katherine J. Wu reports.
  • Experts warn that state plans to independently vet vaccines for safety and efficacy risks confusing the public, Kaiser Health News's JoNel Aleccia and Liz Szabo report.

Sugar rush