February 26, 2021

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Power Up: Biden will inherit a raging pandemic. This Yale doctor will be key to his efforts

10 min read

After the outgoing president’s sluggish rollout, the Biden-Harris administration vows to administer 100 million doses of coronavirus vaccine in its first 100 days. Marcella Nunez-Smith, the chair of Biden’s covid-19 equity task force, will be a key part of the scramble to ensure fair access to vaccines and combat skepticism among Black, Latino and Native American communities dying of the coronavirus at almost three times the rate of White people. 

A Yale physician and professor who has long studied racial disparities in health care, Nunez-Smith’s historic appointment signals Biden’s commitment to health equity — a focus largely absent from the Trump administration’s efforts. 

In an interview with Power Up, Nunez-Smith called for a speedy ramp up of “equitable and efficient” access to vaccinations, testing, and treatment in communities of color during Biden’s first 100 days in office by targeting structural issues health-care system.

  • “I always acknowledge that the health-care system is a microcosm of our larger society — so we will see interpersonal bias and individual level bias,” Nunez-Smith told us. “But so much of this is really about structures, right?” 

Without mentioning the Trump administration, Nunez-Smith called out shortcomings in efforts thus far to provide trusted messengers with information needed to overcome “structural barriers” — like vaccine skepticism or adequate resources — that prevent people of color from getting vaccinated. Nunez-Smith says addressing the “information vacuum” is a high priority: “This is a matter of science … We have to make sure that scientists and those who deliver health care have the information that they need.” 

  • I’ve had many trusted messengers reach out to me to say, you know, ‘We haven’t gotten anything yet.’ ‘I’m getting questions about the vaccine.’ ‘But I haven’t seen the data myself.’ ‘I don’t know what to say,’” Nunez-Smith said.
  • “It is the responsibility of the federal government to be providing some clear and consistent and coordinated messaging here,” she added.

Working closely with and distributing information directly to trusted messengers, community leaders and influencers who have “the lived experience” to “link policy to what is actually happening on the front lines” is key to overcoming vaccine hesitancy, along with testing and treatment, according to Nunez-Smith.

  • “We cannot address what we cannot see,” Nunez-Smith said in December, according to Stat News’s Lev Facher. “We are making a choice every time we allow poor-quality data to hinder our ability to intervene on racial and ethnic inequities.”

Nunez-Smith argues improving access to treatment and testing in Black and Brown communities should be as much of a priority as vaccination efforts. That includes targeted outreach and health-care infrastructure in hard-to-reach communities, but also high-risk facilities like homeless shelters and jails, according to Nunez-Smith. But it also could mean some changes to Medicaid.

  • “We’ve seen the inability to transfer patients and get them to hospitals that could maybe provide more care, because of the insurance and reimbursement and denying Medicaid on transfer,” Nunez-Smith told us.
  • “I worry we talk a lot about vaccinations … But the reality is that we have to recommit to all of the things that we’ve been doing and we can’t turn our eye on testing and treatment,” she added. “So many patients of color their first covid-19 test is at the time of inpatient admission. So that’s wrong, right?” 
  • By the numbers: “Black Americans are especially likely to say they know someone who has been hospitalized or died as a result of having the coronavirus: 71% say this, compared with smaller shares of Hispanic (61%), White (49%) and Asian American (48%) adults,” according to Pew.

Nunez-Smith also shed light on her holistic approach to recovery from the pandemic. “Recovery is going to mean there are pathways to both educational and economic opportunities in these hardest hit communities,” she told us. 

  • “Now, is that something that is a day one solution? But we have to be putting in place our thinking around that on day one.”

At the White House

THEIR FINAL DAYS: Trump is having trouble fleshing out his guest list for his farewell ceremony, slated to happen at 8 a.m. on Wednesday at Joint Base Andrews. He is not attending Biden’s swearing-in ceremony in an unusual snub and instead will fly to Mar-a-Lago beforehand.

Even Trump’s former White House director of communications-turned-vocal-Trump critic, Anthony Scaramucci, was invited to the event: 

  • “Trust me, that had to be a mass email if one of them got sent to me,” he told Inside Edition.
  • The Wall Street Journal’s Rebecca Balhaus reported “some recipients” on Wednesday’s guest list “have been surprised the invite offered them five guests.”
  • One person invited told me he wasn’t even going — much less inviting five others!” our colleague Josh Dawsey tweeted.

No poker face: “Since Jan. 6, every day has dumped more bad news on the president, including his historic second impeachment. But one person close to the president said it can be hard to predict what will bother him most and that even with all that was going on, he was particularly upset that Lady Gaga, Jennifer Lopez, Tom Hanks and other stars agreed to perform as part of Biden’s inaugural celebrations,” our colleague Mary Jordan reports.

But First Lady Melania Trump has appeared “completely unfazed” by “the intense criticism both she and her husband have gotten since the deadly Jan. 6 Capitol riot,” according to Mary. 

  • Sources in touch with FLOTUS told Mary “she would have been happy to attend [Biden’s] swearing-in ceremony, as every outgoing president and first lady have for the past 152 years. But rather than dwell on what could have been, she focuses on what she has control over: choreographing her own exit, trying to cement her legacy as a first lady who devoted much time to renovations of the White House, and making plans to continue her ‘Be Best’ initiative. Quietly, she has also been working with Chief Usher Timothy Harleth to facilitate the move-in of the Bidens.” 
  •  
  • “…the announcement of the pardons will likely come in one large batch on Tuesday, but there is a slight chance the White House will wait to make them official Wednesday morning.”
  • “Fox News has also learned that rapper Lil Wayne is expected to be on the list, while former Trump associate Steve Bannon is described as being ‘TBD.’”

On the Hill

THE CONFIRMABLES: After a slow start, a flurry of Biden nominations are scheduled to move forward on the Hill today. Those being vetted for top jobs in national intelligence and the heads of the departments of Homeland Security, Treasury, State and Defense will appear before the Senate both virtually and on the heavily fortified Capitol grounds.  

  • 10 a.m.: Alejandro Mayorkas, nominee for secretary of homeland security, before the Senate Homeland Committee.
  • 10 a.m.: Avril Haines, nominee for director of national intelligence, before the Senate Intelligence Committee
  • 10 a.m.: Janet Yellen, nominee for treasury secretary, before the Senate Finance Committee
  • 2 p.m.: Antony Blinken, nominee for secretary of state, before the Senate Foreign Relations Committee
  • 3 p.m.: Retired Gen. Lloyd Austin, nominee for defense secretary, before the Senate Armed Services Committee

Biden cannot officially ask the Senate to confirm his nominees until he is sworn in as president at noon Wednesday, Karoun Demirjian reports, but a spokesman for the transition team implored the Senate to act with haste: 

  • “With our national security at stake, the pandemic costing thousands of lives every day, and our economy in a historic recession, there is absolutely no justification for Republicans to jeopardize the ability of the United States government to keep the American people safe, distribute vaccines, and put Americans back to work,”  Andrew Bates said in a statement. “ It is essential that key national security and economic leaders are confirmed and in place on day one.”

Biden’s Cabinet picks are being ushered into office while Trump’s impeachment trial looms in the backdrop, a process that some, like Sen. Joe Manchin III (D-W.Va.) say could further hamper the confirmation proceedings. 

FILLING THE CABINET: On Monday, Biden announced a number of other people to fill key posts in his administration.

  • Elizabeth Klein, deputy secretary of the Interior
  • Jewel Bronaugh, deputy secretary of Agriculture
  • Andrea Palm, deputy secretary of Health and Human Services
  • Polly Trottenberg, deputy secretary of Transportation
  • Cindy Marten, deputy secretary of Education
  • Rohit Chopra, director of the Consumer Financial Protection Bureau 
  • Gary Gensler, chair of the Securities and Exchange Commission 

FIVE WOMEN POISED TO SERVE: In addition to having one of the most racially diverse Cabinets in history, Biden plans to nominate five women to serve in the No. 2 spots at key Cabinet agencies, Lisa Rein reports

  • “The moves, which will install deputies with hands-on experience in critical departments, reflect Biden’s push to elevate women and his desire to quickly tackle the nation’s crises and repair agencies suffering from morale and other problems.”
  • Four of the women — Bronaugh, Trottenberg, Palm and Klein — held roles in the same departments during the Obama administration
  • Bronaugh, would be the first woman of color to serve as Agriculture’s deputy secretary and “could help blunt criticism of  [secretary] Tom Vilsack’s nomination to lead the agency, especially from Black farmers who said Vilsack was inattentive to their needs during his first stint as secretary.”

Notable: Chopra, Biden’s pick to helm the CFPB, is a progressive ally of Sen. Elizabeth Warren (D-Mass.) and helped launch the agency after the 2008 financial crisis and the passage of Dodd-Frank. He also served as the agency’s student loan watchdog. 

  • “The pick comes as Democrats are eyeing ways to provide student loan relief to millions of Americans as part of a COVID-19 relief package,” the AP reports
  • The pick is also notable as the CFPB saw its role diminished under the Trump administration.
  • Chopra’s confirmation could be difficult: “The CFPB, Warren’s brainchild, was long a favorite target of GOP lawmakers, who slammed the agency’s tough regulations as executive overreach,” Politico reports

The campaign

This year’s Inauguration Day will look very different than in years past: Instead of a mass of humanity, there will be a “Field of Flags.”

 “Nearly 200,000 flags are on display at the National Mall ahead of Joe Biden’s inauguration. The Field of Flags represents the American people who were unable to travel to Washington, D.C. for Inauguration Day amid the coronavirus pandemic and security threats,” NBC Washington reports

INSIDE TROUBLE: ““The FBI privately warned law enforcement agencies Monday that far-right extremists have discussed posing as National Guard members in Washington and others have reviewed maps of vulnerable spots in the city — all signs of potential efforts to disrupt  Wednesday’s inauguration, according to an intelligence report obtained by The Washington Post,” Carole D. Leonnig and Matt Zapotosky report. 

  • The document warned adherents of the QAnon conspiracy theory, some of whom joined in the violent siege on the Capitol Jan. 6, and “lone wolves” have indicated they plan to come to Washington for Biden’s swearing-in ceremony.
  • The FBI also said it had observed people downloading and sharing maps of sensitive locations in Washington and discussing how those facilities could be used to interfere with security during the inauguration. 
  • Context: “In the wake of the Capitol attack, the FBI has scrutinized members of extremist groups such as the Oath Keepers, the Three Percenters and the Proud Boys, a far-right group with a history of violence, making numerous arrests in recent days,” our colleagues report.

SERVICE MEMBERS AMONG RIOTERS: “Concern about potential internal threats has intensified as investigators have identified a growing list of people with law enforcement and military ties, including at least two service members, among the rioters who stormed Congress in their effort to overturn President Trump’s electoral loss,” Missy Ryan reports. 

  • No stone unturned: “While we have no intelligence indicating an insider threat, we are leaving no stone unturned in securing the capital,” acting defense secretary Christopher C. Miller said in a statement.
  • An FBI inquiry “has identified at least six suspects with military links out of the more than 100 people who have been taken into federal custody or the larger number still under investigation,” the New York Times reports. “They include a retired Air Force lieutenant colonel from Texas, an Army officer from North Carolina and an Army reservist from New Jersey. Another person with military service was shot and killed in the assault.”
The heart of the nation’s capital is a maze of fences, concrete barriers and security checkpoints ahead of President-elect Joe Biden’s inauguration on Jan. 20. (The Washington Post)
  • Irving, who has since resigned, balked at former Capitol Police chief Steven Sund’s request to bring in the guard two days before the Jan. 6 event because he was concerned about the “optics” of such a move. 
  • Irving, Sund and Irving’s Senate counterpart Michael Stenger, were all comfortable with the security arrangements in place before Jan. 6 — and thought the National Guard would be on alert if needed, said Bill Pickle, who served as the Senate sergeant-at-arms from 2003 to 2007 and spoke to The Post at Irving’s request. 

Nope: As rioters lay siege to the building, Irving and Stenger issued an urgent request for the National Guard, but the Defense Department did not immediately approve the request, the report says. 

  • Key Quote: “The thing that bothers him is that because he used the word ‘optics,’ everyone is focused on that,” said Pickle. But as the riot was unfolding, he said, “It was like everyone was watching the house burn down, but no one was throwing any water on it.”

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Jacqueline Alemany


2021-01-19 06:42:21


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