EIGHTEEN
“Deep in the heart of Delaware, Joe Biden sits in the heart of his basement. Alone. Hiding. Diminished,” declared one Trump ad. “Punxsutawney Joe,” was another barb, referring to the Pennsylvania groundhog, Phil, who emerges from his underground burrow once a year to predict the length of the winter. And Trump’s campaign tweeted daily about how many days had passed since Biden’s last news conference.
Democrats, too, were worried about Biden’s months-long disappearance from the campaign trail. He was a candidate known for engaging voters at town halls and with handshakes. His six-point lead in March 2020 was smaller than Hillary Clinton’s at that same marker in 2016.
But the strategy of letting Trump run against himself seemed to be working. Biden’s lead widened to double digits as the president continued to mismanage the pandemic. At a press conference on April 23, 2020, Trump mused about injecting bleach to fight the virus.
Meanwhile, Biden, who could be a gaffe-machine himself, was using the isolation as an unexpected gift. Normally, candidates barely have a moment’s rest from their campaign travels.
Unknown to the public and media, Biden was receiving daily briefings on the virus from two of the country’s top medical experts: Dr. Vivek Murthy, Obama’s former surgeon general, and Dr. David Kessler, former commissioner of the Food and Drug Administration, known for his war against tobacco.
Each day, Murthy and Kessler prepared a written Covid-19 report for Biden based on the most up-to-date information, gleaned from their hours of research on the phone with government and industry experts around the country and supplemented with data provided by a small team of confidential volunteers who scoured public and private information. Initially, the daily report ran up to 80 pages with maps, charts and diagrams.
Scheduled for 45 minutes on the phone or Zoom, the oral briefings routinely extended to an hour and a half. Kessler and Murthy were both deeply alarmed by Trump’s attitude and failure to comprehend what he and the world were facing.
“I wanted to always play it down,” Trump told Woodward in a March 2020 interview. “I still like playing it down, because I don’t want to create a panic.”
Trump had tweeted earlier that month about his view: “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!”
Trump shut down the country a week later, but almost immediately began talking about opening it back up. “Our country wasn’t built to be shut down. This is not a country that was built for this,” Trump said on March 23, during a White House press briefing. “America will again and soon be open for business.”
Murthy knew Trump had it all wrong. A coronavirus was like an iceberg. So few reported cases of an airborne, highly contagious virus and limited testing meant that there were many, many, more undetected cases. It was already here in the United States, and would soon spread.
Biden dove into the science with Murthy and Kessler, seeking a daily tutorial. He was a question machine. He asked, how does the virus attack the body?
Droplets from an infected person’s cough or sneeze, or even normal breath, enter the nose and throat and attach to the plentiful cell-surface receptors called ACE2, taking over the cell and multiplying, they told him. Since the lungs are like a respiratory tree ending in small air sacs, also rich in the ACE2 receptors, the virus moves there and can destroy the lung cells.
They also described how the virus can attack different cell types and tissues, including blood vessels and the heart.
How about the vaccines being developed? Biden asked.
There are two types, the doctors said. The first was an adenovirus-based vaccine that enables the cells to produce spike proteins that build up antibodies, effectively soldiers, to defend against the virus.
The second was the mRNA—the “m” is for messenger. This vaccine activates immune responses by giving cells the instructions to produce a spike protein. It’s like a recipe of your DNA. The body then remembers how to fight off the virus if later infected. The mRNA formulation can be changed in the vaccine if a variant of the virus pops up. Viruses often mutate.
“That’s not detailed enough,” Biden said at one point. “That doesn’t make sense” at another. “Why?” or “How does the science work?”
During an interview with Trump on March 19, Woodward asked the president if he ever sat down with Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, to get a tutorial on the science behind the virus.
“Yes, I guess,” Trump said, “but honestly there’s not a lot of time for that, Bob. This is a busy White House. We’ve got a lot of things happening. And then this came up.”
Woodward asked, was there a moment where you said to yourself, this is the leadership test of a lifetime? “No,” Trump said.
Murthy was surprised at the level of detail Biden wanted. He picked through their explanations with more questions. Why does the virus affect people of color, Black Americans and Brown Americans, more severely?
The doctors explained that entrenched inequities in health care, education and financial resources made already vulnerable populations more vulnerable. Black and Brown people were exceedingly more likely to be hospitalized or die from the virus.
If a vaccine could be created, equitable distribution would be essential, Biden said.
“If we are blessed to have the chance to lead,” he said, “we all have to figure out how to execute together, and how to take on this pandemic and turn it around together.” They began to develop a detailed virus response plan.
Murthy was sure their daily briefings would soon come to an end. They were taking too much campaign time. Instead, the briefings grew longer and more detailed.
“Sir,” Murthy said, “you know we’re coming to the end of our time. We’re happy to hold some of this over until tomorrow.”
“No, no, no,” Biden said. Let’s talk this through.
Do you want us to try to pull these back, curtail them? Murthy asked Jake Sullivan, the Biden campaign’s policy director.
He drives the boat on this, Sullivan said. He wants to get into this. He cares deeply about it. So let him drive.
Murthy could see that candidate Biden seemed to understand that the virus was going to define not just his campaign, but if he won, his presidency.
Murthy was “Mr. Bedside Manner,” with a soothing voice. As a practicing physician, he had learned to spend abundant time listening to patients because he found they often gave an accurate self-diagnosis.
Before Biden had announced his decision to run for president a third time, Murthy had visited him in Wilmington. He would write a book, Together: The Healing Power of Human Connection in a Sometimes Lonely World, and discussed with Biden how loneliness and isolation affects mental and physical health.
In their virus briefing sessions, Biden alluded frequently to friends who were calling him to chat—he had a habit of giving his cell number to people he spoke to on the campaign trail. It was evident, he said, the virus was isolating people and affecting their mental health. Children missed the social contact in classrooms, as did office workers. The pandemic was eating away at the social fabric, Biden said.