US economy

What Biden’s Chief of Staff Has Learned, One Year In

So now we’ve been through a yet larger pandemic. Are there things you’ve learned on how the U.S. government should structurally be set up to operate during a pandemic that we need to take into account, going forward? It can’t be that we are optimally set up for it, so are there ways the structure should change? Are there pandemic-specific modes that you should be able to impose with, say, an act of Congress? What have we learned about institutionally that we need to take away from this?

Well, look, I think what we’ve learned about institutionally, first and foremost, is that you always have to be in pandemic response mode or pandemic preparation mode. Covid is a good example of that. Which is, you can view Covid as one pandemic that we’re in the middle of, or you can view it as a series of discrete pandemics — the wild wave, Beta, Delta, now Omicron. And so maybe we look at this as multiple pandemics stacked up against one another.

And the point is that while you’re in the middle of the one, you need to really be getting ready for the next one and not waiting for the existing one to be quote, unquote “over.” That’s one thing we’re talking about as we think about pandemic prevention. Pandemic prevention and response isn’t just about quote, unquote the next one but about what happens as we proceed through this one.

And so we’ve set up a Pandemic Response Office in the White House, led by Jeff Zients. We brought in, for example, recently, Tom Inglesby from Johns Hopkins, one of the leading epidemiologists in the world, to run our testing unit. Tom’s not just focused on, obviously first and foremost, meeting our testing needs here in the U.S. but also thinking about this question of what the long-term testing needs are, how to innovate on testing, how to bring the cost of tests down, how to bring manufacturing of tests up. That’s a key competency we have to build.

Same thing as vaccines. You and I have been talking about the effort that Eric Lander is leading. So we’ve got a lot of folks in the White House focused on this, both in the context of fighting this pandemic, fighting potential future waves of this pandemic and fighting future pandemics.

Something that I’ve seen happening in the government with acceleration, actually, just in the past couple of weeks is a recognition that in pandemic periods, and maybe even not, the government needs to be the first-round supplier of important public health goods. So vaccines have, of course, been the single largest government distribution effort here. But as of this week, I can now go onto a website and order four rapid at-home tests from the government. I’d like to be able to order more, but that’s something pretty different.

Now I hear that you’re going to be trying to distribute 400 million good masks. This move towards an orientation where you can get the things you need for public health directly from the government, what does that represent? What lessons does it represent, and what kind of building there needs to be done?


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