The COVID-19 pandemic presents the United States not only with its worst public health crisis in a century but also the most formidable challenge to its democracy since World War II. How can an open and free society summon the discipline and cooperation needed to confront this pandemic? How can our medical providers, our emergency responders, our police, and our armed forces, continue to do their jobs if large numbers of them are falling ill and even dying? How long can we shut down most commerce and services before our economy, and with it our social fabric, comes undone? How can people vote freely and safely in the remaining primary elections, and in the general election on November 3, if we continue to need pervasive physical distancing and quarantines? How can the United States Congress function as our legislative branch if many of its members—whose jobs require them to commute back and forth from Washington—fall ill or, God forbid, die?
We cannot overcome this crisis with anything like the levels of vengeful partisan polarization, win-at-any-cost politics, and presidential deceit and wishful thinking to which we have become accustomed. The crisis poses an existential challenge to our democracy, our prosperity, and our global leadership. We have to get this right, fast. And we need to come together as a nation around a strategy and a set of basic principles. Hopefully, the passage of the $2.2 trillion economic relief bill will show what we are capable of.
Any strategy requires clear goals, and the means and sequence of steps to get there. Our goals must be to minimize deaths while protecting the health of our democracy, our economy, and our social fabric. Here is what a national strategy might look like.
Managing the Health Crisis
Today, the first step—Phase I—must be an all-out collective effort to “flatten the curve” of the contagion through a broad but temporary suspension of in-person social and economic life. (This is normally referred to as “social distancing,” but since virtual social interaction remains both possible and, for mental and societal health, essential in this crisis, I prefer the term “physical distancing.”) Even if, as some medical scientists are now suggesting, the death rate from the virus proves to be only a fraction of the initially reported 1 to 3 percent of all cases of infection, no country in the world—and certainly not the United States—seems to have sufficient medical-care capacity (hospital beds and staff, protective gear for medical workers, medicines, and ventilators) to manage the surge in critical cases that would result from a laissez faire posture of just letting the virus take its course. One of the most respected epidemiological centers in the world, at Imperial College, London, estimated earlier this month over two million Americans and half a million Britons could die in such a scenario.
How long radical, “stay-at-home” distancing should go on is now at the crux of the debate. Faced with the staggering implications of the virus coursing through a country with much weaker infrastructure and health care capacity, Indian Prime Minister Narendra Modi has ordered his entire country—1.3 billion people—to stay at home for three weeks. After first pursuing a “herd immunity” strategy that was pretty close to letting the virus take its “natural” course, British Prime Minister Boris Johnson—himself now diagnosed with the virus—has imposed a near-total lockdown on the entire United Kingdom that, The Telegraph reports, “will be reviewed every three weeks but is likely to last for months.” Many American institutions, such as universities and school systems, are planning for a months-long shutdown of most in-person activity.
Yet, as Dr. David L. Katz wrote recently in a provocative New York Times op-ed, it may be possible, and in fact advisable, to take a more targeted approach to distancing once the curve of contagion has been flattened and our health care facilities have been shored up with the vast increases in safe testing and treatment capacity that they need. Then, we could open up the economy and society to normal life for most but by no means all Americans. As long as the virus is still spreading, the key in that Phase II would be to selectively continue physical distancing by “preferentially protecting the medically frail and those over age 60, and in particular those over 70 and 80, from exposure.” For the roughly 70 million Americans who are over age 60 (or the more than 50 million over age 65), this would still mean fairly radical quarantine, with potentially significant costs to individual physical, mental, and economic well-being, but it could at least enable economic and social life to return to something closer to normal for the rest of society. If they are still in the work force, some of those older Americans could continue working from home. Others would need special support. With—and only with—a surged capacity for more widespread testing, we would know who would be safe to physically engage and assist those under quarantine.
Phase III—general relief—might come as early as summer, when high heat and humidity might slow the spread of the virus in those parts of the world with temperate climates, such as the United States and Europe. But this might only be a partial and temporary respite, until the virus returns with a vengeance in the fall, like the influenza did in 1918. Unless the virus mutates in the next season into something with a much lower mortality rate for the elderly and impaired, tens of millions of Americans would, under this scenario, need to remain quarantined from contact with anyone who could not be shown (as the result of a recent test) to be free of the virus. Such broad quarantining of the vulnerable population would need to continue until a vaccine was tested and made available.
Biomedical science is working now at lightning speed to search for such a vaccine, with four variants already being tested in animals. But the necessary testing process makes it unlikely that a vaccine will be available before the fall of 2021. And even then, there could be a desperate scramble for supply. That would also be the case for any antiviral drugs that are discovered to be effective in treating COVID-19. The United States and many other countries must begin now—with government direction and assistance—to develop large-scale domestic production capacity for the vaccine and other critical pharmaceuticals. Otherwise, the world could enter the 2021-22 virus season facing two types of equally agonizing “beggar-thy-neighbor” scenarios: the rich countries of the world cornering all available supplies, while poor countries were left defenseless, or some large countries that produce vaccines, such as China and India, only exporting them after all their domestic needs (for more than two billion people) were met.
Long before we reach that point—in fact, now—the President should invoke the Defense Production Act to direct American manufacturing companies to surge production of essential medical supplies, especially testing kits, respirators, protective masks, goggles, gowns, and ventilators (to keep the most critically ill breathing), as well as diagnostic and other equipment. We are already over a week past President Trump’s pledge to invoke the act, yet incredibly, the self-proclaimed “war-time President,” whose country is facing a real war-like emergency, is now hesitating to exercise the legitimate war-like powers he has to expedite production of these materials. No American car manufacturer has yet risen to the production challenge; although Ford, General Motors and Tesla have pledged to make masks and ventilators, they have not yet done so, as the typical production plant could take months to retool. There is no time to lose, even if it means constructing plants from scratch. In addition, the President should answer New York Governor Andrew Cuomo’s call to have the U.S. Army Corps of Engineers build temporary hospital facilities where the needs are greatest. Trump said a week ago he is “looking into” the possibility of such deployment, but time is of the essence as illnesses proliferate to near-catastrophic proportions in some states.
Protecting our Democracy
We also need to act urgently, now, to secure the most critical functions of our democracy: our legislative process, our party nominating conventions, and not least, our elections.
The Congress must move as quickly as possible to change its rules so it can function, and most of all vote on resolutions and legislation, from a physical distance. We don’t have the time in this crisis to wait the three years that it took for the House of Representatives to change its rules in 1973 to adopt electronic voting in the chamber. The 116th Congress is one of the oldest in history. Nearly half the Senate (48 members) and a third of the House (147 members) are over 65. Mitch McConnell recently turned 78 and Nancy Pelosi just turned 80. A few members of Congress have already been diagnosed with the virus and at least 35 members of the House and Senate are self-quarantining and so cannot vote. It is long past time for Congress to develop electronic means to deliberate publicly and then verifiably vote from a distance (which should have been instituted after 9/11). We are at risk of losing the capacity for Congress to function legally and legitimately if it does not adopt this vital change in its rules. That could accelerate a dangerous slide toward unchecked executive power at precisely the moment in history when we have a President who is deeply disrespectful of institutional checks on his power.
Although they are still months away, it may also be necessary for the two party conventions to be held virtually, and planning for this must begin soon. Imagine that the virus is still spreading when the Democratic Convention is supposed to take place in Milwaukee in mid-July, or that new infections are popping up when the Republicans meet in Charlotte in late August, in each case in indoor NBA basketball arenas. The virus could sweep through and devastate an entire party leadership—governors, senators, local officials, party activists, and their support staff, as well as journalists and observers. The two parties now have several months to prepare to stage virtual events in which committees can meet, platforms can be adopted, delegates can caucus, the presidential and vice-presidential candidates can be nominated, and keynote and acceptance speeches can be given—all through internet meetings, distance voting, and studio television broadcasts that will be widely viewed as legitimate across the country.
That leaves the biggest challenge, and the one with the greatest potential to generate a crisis—the November 3 election. Nine states (soon to be ten) have already postponed their remaining presidential primaries, mostly to June 2. These were the right decisions from both a political and public health perspective. But we still have plenty of time to ensure that the general election on November 3 takes place as scheduled. For the legitimacy and integrity of our democracy (as hundreds of political scientists have recently declared), it must not be postponed.
To ensure that a fair November election amid an ongoing or resurgent pandemic, Americans must be able to vote at home (returning ballots by postage-free mail or drop-off). Some states (Colorado, Oregon, and Washington) have been doing this uniformly, and others (Hawaii and Utah) were already set to switch to vote by mail this year. Senators Amy Klobuchar and Ron Wyden have proposed legislation that would “guarantee every voter a secure mail-in paper ballot and help states cover the cost of printing, self-sealing envelopes, ballot tracking and postage.” Unfortunately, this non-partisan initiative appears stillborn due to partisan politics and ideological resistance to federal mandates in election methods. Yet, as former Republican Party Chairman Michael Steele and conservative writer Eli Lehrer observe in their endorsement of it, “vote-by-mail does not favor any particular political party” and appears to increase turnout across the board. Hence, we at least need to strongly encourage, and provide federal aid to enable, states to give all voters the option of voting by mail in November, as the bipartisan leaders of the 2013-14 Presidential Commission on Election Administration, Bob Bauer, Ben Ginsberg, and Nathaniel Persily, have just urged. The $2.2 trillion relief bill provides $400 million for election assistance. This is only a small down payment on the need, which the above authors put at $2 billion. With his fellow election scholar Charles Stewart III, Persily has recommended a level of federal assistance to state and local electoral administration similar to the $3 billion Congress authorized in the wake of the 2000 election debacle. This could enable states to acquire the ballots and equipment necessary for large-scale voting by mail, and to educate the public about the process of casting (and counting) mail ballots.
Where voting proceeds in person, early voting at central locations should be expanded (as the Wyden-Klobuchar bill provides), polling stations should be sanitized, poll workers should wear protective masks and gloves, and lines should be managed so that voters are spaced apart. We may also need to recruit non-traditional poll workers, such as college students, who are less at risk of growing seriously ill from the virus than the more common poll workers of advanced age.
In addition, the Brennan Center urges expanded online voter registration, extended voter registration deadlines, and extending the deadline for the Electoral College vote (which this year falls on December 14) to the end of the calendar year to allow for the resolution of any electoral disputes arising from the slower pace of counting mail ballots.
These are no longer theoretical issues for election specialists, just as the question of how to contain a pandemic is no longer just an academic matter for public health specialists. We are facing a grave crisis on multiple fronts. The President’s cavalier disregard for intelligence briefings squandered precious weeks when we could have better prepared for the public health challenge. But we can still prepare to conduct the party conventions and the November 3 election on time, in safe, inclusive, and transparent fashion. And we still have time (though precious little) to keep this virus from killing Americans on a massive scale. For the sake of our democracy, our economy, and the people and country we love, we must put partisan politics aside and act on these imperatives now, before it is too late.