October 23, 2020

Weekly line: Trump, Biden paint starkly different pictures of the same epidemic

Daily Briefing

    On Thursday night, President Trump, the Republican candidate for president, and former Vice President Joe Biden, the Democratic candidate, squared off in their last debate before Election Day. Once again, America's coronavirus epidemic and the Affordable Care Act (ACA) were front and center—and perhaps the most striking takeaway from last night's debate was the candidates' drastically different assessments of where America's coronavirus epidemic stands.

    Candidates paint different pictures of America's coronavirus epidemic

    It's no surprise that Trump and Biden offered different assessments of how the country is handling the coronavirus epidemic, and both candidates largely stuck to the same messages heard during the previous debate and their separate town halls: Trump touted his administration's response, while Biden slammed Trump for not doing enough to address the epidemic.

    What was notable, however, was the candidates' strikingly different views of how America is currently fairing in its fight against the coronavirus.

    Trump says US is learning to 'live' with Covid-19

    Trump largely blamed China, where the first cases of the novel coronavirus were reported late last year, for the pandemic, saying Chinese officials allowed the virus to spread outside of their country and around the world.

    Trump acknowledged that the United States currently is seeing spikes in new cases of the virus, and he noted that "Europe and many other places" also are seeing spikes "right now." However, he indicated that he believes the U.S. spikes will subside. "There was a spike in Florida, and it's now gone. There was a very big spike in Texas, it's now gone. There was a very big spike in Arizona, it's now gone. And there were some spikes and surges in other places. They will soon be gone," Trump said.

    However, it's worth noting that the spikes seen in the states Trump mentioned subsided after public health officials in those states implemented measures to mitigate the coronavirus's spread, such as closing bars and indoor dining and urging residents to wear masks. Trump did not say how he planned to address the spikes in new cases that currently are happening throughout the country.

    Trump also said America has a vaccine against the novel coronavirus "that's coming, it's ready. It's going to be announced within weeks, and it's going to be delivered." When pressed on which coronavirus vaccine candidate would be ready, Trump responded, "Johnson & Johnson [J&J] is doing very well. Moderna is doing very well. Pfizer is doing very well, and we have numerous others. And then we also have others that we're working on very closely with other countries, in particular Europe."

    Notably, J&J last week paused clinical trials on its coronavirus vaccine candidate to investigate an illness that developed among a study participant. Pfizer this month announced that it won't seek an emergency use authorization from FDA for its coronavirus vaccine candidate before the third week of November, and Moderna CEO Stéphane Bancel this month said its coronavirus vaccine candidate will not be widely available to the general public until spring 2021 at the earliest.

    In addition, Trump pointed to new therapeutics that he's credited for helping him recover from his recent Covid-19 diagnosis.

    Overall, Trump said Americans are "learning to live" with the coronavirus. He added, "We have no choice." Trump also said that he doesn't believe the country should be locked down to mitigate the virus's spread. "We can't close up our nation, we have to open our school[s]," he said.

    Biden says US is learning to 'die' with the novel coronavirus

    Biden, on the other hand, offered a much bleaker outlook on how America currently is fairing when it comes to the epidemic, noting that more than 220,000 U.S. deaths have been linked to the novel coronavirus so far. "[Trump] says that we're, you know, we're learning to live with it. People are learning to die with it," Biden said. He added, "[A]nyone who is responsible for that many deaths should not remain as President of the United States of America."

    Biden also criticized Trump for downplaying the virus's threat to America, once again citing interviews in which Trump said he initially downplayed the epidemic to avoid creating "panic" in the United States. In addition, Biden said Trump doesn't have a "comprehensive plan" for addressing the resurging epidemic going forward. "We're about to go into a dark winter, a dark winter, and he has no clear plan and there's no prospect that there's going to be a vaccine available for the majority of the American people before the middle of next year," Biden said.

    In comparison, Biden noted that he has proposed plans that call for encouraging Americans to wear masks, broadening testing and contact tracing efforts, and ensuring businesses and schools have resources to reopen safely. "I will take care of this, I will end this, I will make sure we have a plan," he said.

    Where does America's coronavirus epidemic stand?

    For context, the United States in recent weeks has seen its number of newly reported coronavirus cases resurge, with the country on Thursday reporting more than 75,000 new cases of the virus—nearing the record-high numbers of new cases the country had reported during its peak over the summer and twice the amount of newly reported cases the country had seen when the epidemic first surged in the spring.

    Many public health experts have said the United States is in the midst of its third wave of the epidemic—and they've warned that this wave could be more widespread than those we saw earlier this year.

    One spark of good news is that doctors and researchers have learned more about the virus and how to treat Covid-19, the disease the virus causes. Because of their better understanding of the virus and new, promising therapeutics for treating Covid-19, research shows that the death rate among hospitalized Covid-19 patients is declining. Still, the United States has continued to report hundreds of new deaths linked to the coronavirus each day for the past several months.

    It's also worth noting that many patients—including some who are young and otherwise healthy—experience long-term and severe symptoms from Covid-19. And as Shannon Gulliver Caspersen—a 37-year-old physician who contracted "what was initially a fairly mild case of Covid-19 in early March" but has experienced "substantially debilitat[ing]" symptoms since—recently wrote in a piece for the New York Times, "[I]n addition to a disease's mortality rate, it's also important to consider its morbidity rate—the long-term consequences for those who do not die."

    Candidates clash over health care reform

    Trump and Biden also clashed over health care reform and the ACA during Thursday's debate and, again, the candidates largely stuck to the same messages they delivered during the previous debate and their separate town halls.

    NBC News' Kristen Welker, who served as the moderator of Thursday's debate, noted that the Supreme Court next month is scheduled to hear a lawsuit backed by the Trump administration that challenges the ACA's constitutionality and seeks to invalidate the law. She asked both Trump and Biden what they would do to replace the health reform law if the Court does strike it down.

    Trump offers limited details on ACA replacement

    As Trump did in the previous debate and his town hall, he said he had eliminated the ACA's individual mandate penalty, but he said the law remains problematic. "Obamacare is no good," he said. "Here's the problem. No matter how well you run it, it's no good. What we'd like to do is terminate it."

    To replace it, Trump said, "What I would like to do is a much better health care, much better. We'll always protect people with pre-existing [medical conditions], so I'd like to terminate Obamacare, come up with a brand new beautiful health care."

    Trump did not offer details on how he would replace the ACA if it is struck down or how he would ensure that the law's protections for people with pre-existing conditions remain in place. Many legal experts have noted that the actions Trump has taken so far regarding protections for people with pre-existing conditions have been largely symbolic, and haven't included detailed or binding proposals that would ensure those protections exist if the ACA is eliminated.

    Biden pitches 'Bidencare' as potential ACA replacement

    Biden said that, if the ACA is struck down, "[w]hat [he's] going to do is pass Obamacare with a public option—become Bidencare." Biden added that he also would seek to implement changes that would lower private health insurance premiums and prescription drug prices by increasing competition.

    Overall, the details Biden laid out for his replacement were largely in line with those described in his health reform proposal for creating a public option health plan. In addition, Biden during the debate stressed that his proposal would not eliminate private health plans—which Trump during the debate alleged that Biden supports.

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