President Biden’s healthcare team

The new President’s success in confronting and solving problems depends on his choice of capable leaders to assist and guide him.

An incoming President always faces serious challenges. Some years they take on wars, economic downturns, civil unrest, corruption, terrorist acts, natural disasters, unstable foreign affairs, or environmental accidents.

But 2020 beat all expectations with a viral pandemic that the world has not faced for over a hundred years. Add to that

  • a contentious presidential election
  • peaceful protests and raucous riots
  • racism confrontations and reconciliation attempts
  • health inequities battles and health reform initiatives
post updated January 25, 2021
The Biden-Harris Administration

The Electoral College met and voted on December 14, 2020, affirming the election of President-elect Joe Biden and Vice President-elect Kamala Harris. They were inaugurated on January 20, 2021.

They inherit a country divided in many ways-politically, economically, racially, and even in regards to health and medical care. The new President’s success in confronting and solving problems depends on his choice of capable leaders to assist and guide him.

Our health team will be ready on day one to combat our most pressing health challenges. They will lead with science, expertise, and integrity.

President-elect Joe Biden

In this post I review some of the key government positions that manage the “health and welfare” of the United States and will be critical to getting us through the pandemic and beyond. As more positions are filled, I will update this information.

The Presidential Oval Office at the Reagan Library
a replica of the White House Oval Office at the Ronald Reagan Presidential Library , by Dr. Aletha
Office of Science and Technology Policy (OSTP)

The US Office of Science and Technology Policy (OSTP) assists the President on science and technology issues and coordinates science initiatives among other government agencies. Its leader serves as science adviser to the president but President Biden elevated this position to cabinet level.

He appointed Eric Lander, a geneticist, to this job. Mr. Lander studied and earned degrees in mathematics, economics, and molecular biology and participated in the Human Genome Project.

Addressing the COVID-19 CRISIS

President-elect Biden named Jeff Zients as the White House coordinator of the coronavirus reponse. In this role, Mr. Zients will oversee vaccine distribution and direct and troubleshoot supply chain issues.

In a new position, Dr. Marcella Nunez-Smith will direct a task force to identify and address disparities in preventing, diagnosing, and treating COVID-19.

David Kessler, M.D. , Chief Science Officer of COVID Response, serves as a co-chair of the COVID-19 Task Force. He was the Commissioner of the Food and Drug Administration from 1990 to 1997.Mr. Biden wants Dr. Kessler to lead efforts to develop and distribute Covid-19 drugs and vaccines.

Department of Health and Human Services

Most of the health care activities of the federal government fall under the agencies of the Department of Health and Human Services or HHS. The Secretary of HHS serves in the President’s Cabinet.

President-elect Biden has chosen Xavier Becerra, currently the Attorney General of California, as the head of HHS.

Due to the COVID-19 pandemic, we’ve heard more about the HHS in the news than usual; maybe you’ve never heard of these agencies. Generally, management of a pandemic or other public health emergency falls within the work of the CDC, a sub-agency of HHS.

For fiscal year 2020, HHS budgeted $ 1.293 trillion for its services.

public health service

The Public Health Service, PHS, is a division of HHS concerned with, public health, obviously. Within the PHS is the Commissioned Corps, which is one of the uniformed services, like the military. Thus it’s head is known as the Surgeon General.

Assuming this role will be Dr. Vivek Murthy who previously served as Surgeon General under President Obama. Prior to the pandemic, Dr.Murthy authored a book on loneliness and the value of human connection, little imagining how important a topic it would be this year.

Together: The Healing Power of Human Connection in a Sometimes Lonely World

The lessons in Together have immediate relevance and application. These four key strategies will help us not only to weather this crisis, but also to heal our social world far into the future. They are

  • Spend time each day with those you love.
  • Focus on each other .
  • Embrace solitude.
  • Help and be helped.

This is an affiliate link.

Centers for Disease Control and Prevention

The CDC’s mission is simple but encompasses many facets of health

“to work 24/7 to protect America from health, safety and security threats, both foreign and in the U.S.”

The CDC website devotes an entire section now to information, guidelines, and news about the SARS-CoV-2 virus and COVID-19.

illustration showing the coronavirus which causes COVID-19

The goal of public health is to avoid or prevent health threats from becoming public health emergencies, like the COVID-19 pandemic. If they accomplish the mission, we hardly notice. But when an outbreak occurs, their work suddenly becomes visible, scrutinized, and debated.

Dr. Rochelle Walensky will take over as Director of the CDC. She is chief of Infectious Disease at Massachusetts General Hospital and teaches at Harvard Medical School.

National Institutes of HealthNIH

The National Institutes of Health, part of the Public Health Service,

  • supports biomedical and behavioral research with the United States and abroad,
  • conducts research in its own laboratories and clinics,
  • trains promising young researchers, and
  • promotes collecting and sharing medical knowledge.

And within the NIH is the NIAID– the National Institutes of Allergy and Infectious Diseases, which has been an invaluable source of guidance as the United States and the world works to understand and manage this new infectious disease.

Dr. Anthony Fauci, who has worked at the NIAID for 50 years and directs it now, will serve the new President as Chief Medical Adviser.

 Fauci: the first-ever audio biography of Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases and one of the most prominent voices in the US response to the COVID-19 pandemic.

Written and narrated by New Yorker staff writer Michael Specter, Fauci combines Specter’s unparalleled reporting with exclusive new interviews and archival audio of Dr. Fauci; his wife, Christine Grady, RN, PhD; key colleagues; and peers. Listeners will hear Dr. Fauci speak firsthand about the harassment and death threats he has received as a result of his leadership and about the stress of simultaneously combating the COVID-19 pandemic and an information war waged by his boss, the president of the United States. 

Specter has covered Dr. Fauci – and global public health – for more than three decades. In Fauci, Specter traces the doctor’s life from his childhood as a basketball-loving kid in Brooklyn through his leadership during the AIDS epidemic in the 1980s to today, when the response to the COVID-19 pandemic and the future of viral research are shaping humanity. With its chorus of voices, archival recordings, and original score, Fauci brings the immediacy and energy of the best documentary podcasts to the audiobook format.(review from Amazon for this affiliate link)

Novel Coronavirus SARS-CoV-2
This scanning electron microscope image shows SARS-CoV-2 (orange)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (green) cultured in the lab.
 
Credit: National Institute of Allergy and Infectious Diseases-Rocky Mountain Laboratories, NIH

Dr. Francis Collins , Director of the NIH, will serve on President Biden’s Science team.

NIH director Dr. Francis Collins speaks with Dr. Idowu Aimola of Nigeria, one of 10 fellows participating in a new program, the African Postdoctoral Training Initiative (APTI). Fellows spend 2 years in the lab of an NIH senior investigator, learning cutting-edge science while working on a research project of mutual interest. The immersion is intended to give the fellows the expertise to become research leaders when they return home and to foster collaborations between NIH scientists and institutions in Africa.

Credit: National Institutes of Health, public domain

centers for Medicare and Medicaid services(CMS)

This sub-agency of HHS administers three government healthcare programs- Medicare , Medicaid , and the Health Insurance Exchanges. President Biden will appoint a new CMS administrator.

Medicaid provides insurance coverage for adults and children who are unemployed or low income.  

Medicare covers disabled children and adults and persons 65 years and older.

The Health Insurance Exchanges work with the states to provide health insurance as established by the Affordable Care Act.

Food and Drug Administration– FDA

The FDA joined the pandemic response by

  • reviewing and approving diagnostic tests for the coronavirus
  • protecting consumers from fraudulent products for COVID-19.
  • issuing Emergency Use Authorizations (EUAs) for ventilators
  • sampling and testing of respirators for importation

The FDA’S current challenge is to review, and ultimately approve a safe and effective SARS-CoV-2 vaccine to the American people.

Mr. Biden will name a new FDA Commissioner to replace Dr. Stephen Hahn; the Senate must approve his choice.

We are committed to expediting the development of COVID-19 vaccines, but not at the expense of sound science and decision making. We will not jeopardize the public’s trust in our science-based, independent review of these or any vaccines. There’s too much at stake.”

Stephen M. Hahn, M.D., FDA Commissioner, and Peter Marks, M.D., Ph.D., Director, Center for Biologics Evaluation and Research
COVID-19 Diagnostic Test Attire
FDA Commissioned Corps officer RADM Estella Jones, DVM, OCET Deputy Director and Co-Chair of the FDA Animal Welfare Council, oversees Commissioned Corps officers as they practice proper fitting of protective items. Healthcare workers testing patients for COVID-19 novel coronavirus infection must wear specific protective gowns, gloves, ventilation masks, and full facial shields as shown, and must replace these items after each patient is tested. credit FDA, public domain

investing in healthy communities

Besides the ones I’ve already mentioned, other executive departments’ roles contribute to our health and welfare-Education, Homeland Security, Energy, and Transportation.

Social determinants of health are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes. We broadly characterize these as

  • economic stability
  • education access and quality
  • healthcare access and quality
  • neighborhood and built environment
  • social and community context
Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved [date graphic was accessed], from https://health.gov/healthypeople/objectives-and-data/social-determinants-health

The President-elect has selected one of his opponents for the Democratic presidential nomination to be Secretary of Transportation. Former mayor of South Bend, Indiana Pete Buttigieg, a veteran, made infrastructure and internet access a focus during his campaign for the nomination.

Mr. Biden plans to appoint Ohio Representative Marcia Fudge as Secretary of HUD. She was elected to Congress in 2008 and has served on several committees focusing on agriculture, education, nutrition, civil rights, health, and employment.

US government photo

Biden’s choice for Energy Secretary is former Michigan Governor Jennifer Granholm. She served two terms as the first female governor of Michigan.

For Agriculture Secretary, Biden’s choice is Former Iowa Governor Tom Vilsack. Mr. Vilsack served as Agriculture Secretary from 2009-2017.

Keep an appliance thermometer in your refrigerator to check the temperature. The temperature in the refrigerator should be set at 40 °F or below. USDA Photo. public domain

The President-elect will name Miguel Cardona for Secretary of Education. Mr. Cardona became the top education official in Connecticut in 2019 after being an assistant superintendent in Meriden, Conn., which serves nearly 9,000 students. Cardona attended school and taught elementary education there. Serving as a principal for 10 years, he was named the state’s principal of the year in 2012.

These appointees require Senate confirmation.

Occupational Safety and Health administration-OSHA

OSHA is part of the United States Department of Labor. OSHA’s administrator answers to the Secretary of Labor, also a cabinet member. Mr. Biden has chosen the Mayor of Boston, Martin Walsh, for this job.

Congress created the Occupational Safety and Health Administration (OSHA) in 1970 to

ensure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.

For the pandemic response, OSHA offers guidance on

  • returning to work
  • preparing workplaces for COVID-19
  • worker exposure risk to COVID-19
  • for specific industries including airlines, farms, retail, corrections
  • use of respiratory protection equipment

caring for Veterans and the Military

The two largest healthcare systems in the United States are the Department of Defense Military Health System and the Veterans Administration Healthcare .

Military healthcare serves more than 9.6 million active duty personnel, military retirees and their families. The VA is responsible for caring for some 9 million veterans nationwide, including some 800,000 aging Vietnam War veterans, as well as some dependents.

Mr. Biden intends to nominate retired general Lloyd Austin to head the DOD and Denis McDonough for the VA position.

Welcome Home Heroes- military sign at a VA medical
at a VA medical clinic , photo by Dr. Aletha

The other Cabinet positions, though less directly involved with health issues, can impact health through policies and actions. The appointees are 

  • State-Anthony Blinken 
  • Treasury-Janet Yellen
  • Commerce- Gina Raimondo
  • Justice (Attorney General)- Merrick Garland 
  • Homeland Security-Alejando Mayorkas 
  • Interior- Deb Haaland
  •  Energy -Jennifer Granholm 
Read more about the Biden-Harris healthcare team at this link

Health Nominees and Appointees

Public vs Private-not a perfect Union

The United States government invests heavily in its citizens health, both directly and indirectly. Congress, the legislative branch, makes laws and approves funding for the services delivered by the executive branch. Here is a link to help you understand exactly the responsibilities of the executive departments.

the executive branch

The United States’ healthcare system combines public health efforts with mostly private delivery of health care. Usually they coexist side by side with some but infrequent interaction.

The public health emergency created by the pandemic forced them into a “union” that quickly became politicized, and unfortunately diminished the effectiveness of the response.

But despite the lack of coordination and cooperation between all levels of government and private citizens, our health care professionals, in both public health and private medical practice stayed true to their calling.

Many risked their own lives to care for COVID-19 victims. Others sacrificed time and finances to lead the pandemic response in their communities and on social media- maybe not perfectly, but definitely UNITED in resolve to lead, help, and heal their fellow citizens through this unprecedented health emergency.

exploring the HEART of healthcare

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .

Dr. Aletha 

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Fighting COVID-19 in 2021-it’s not over yet

In this post, I’m offering a graphic review of COVID-19 and what we can still do to prevent infections IN ADDITION TO getting vaccinated. Until we achieve wide spread immunity through vaccination the risk of infection and death are still present and still just as real.

This time a year ago, no one in the United States, or even anywhere in the world, knew about a novel coronavirus, except a handful of physicians and scientists. Perhaps not even they knew we were facing a viral pandemic that would turn our lives upside down.

That unknown virus, SARS-CoV-2, has sickened 90 million people world wide and caused almost 2 million deaths. In the United States it has infected 22 million people, killing 370,000.

In the United States, the healthcare systems in many places, including our most populous states, are overwhelmed with COVID-19 patients, so much so that it impairs their ability to care for them and other patients. Cases are at an all time high across the entire country.

illustration showing the coronavirus which causes COVID-19
a model of the structure of the SARS_CoV-2

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses.

Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. In this view, the protein particles E, S, and M, also located on the outer surface of the particle, have all been labeled as well.

A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19). CDC/ Alissa Eckert, MS; Dan Higgins, MAMS, public domain.

Finally, a vaccine for SARS-CoV-2

There is hope for an end to this nightmare now that two vaccines are available and being dispensed. I feel fortunate to have received my first dose of the Pfizer-BiONTech vaccine but I know for many others it will be weeks if not months before they will be vaccinated.

Dr. Aletha inspecting her arm after a COVID-19 shot
Three days after my first vaccination the soreness in my arm is almost gone, and I had no redness or swelling.

Let’s review COVID-19

In this post, I’m offering a graphic review of COVID-19 and what we can still do to prevent infections IN ADDITION TO getting vaccinated. Until we achieve wide spread immunity through vaccination the risk of infection and death are still present and still just as real.

Please note I am not addressing management of COVID-19 in this post. Your best source of information for treatment of symptomatic COVD-19 is from a physician familiar with your symptoms and underlying health.

The timeline of a COVID-19 infection-from exposure to immunity

Other common symptoms include
  • headache
  • muscle and/or joint aches
  • nasal congestion and drainage
  • sore throat
  • nausea/vomiting/diarrhea
  • loss of taste or smell-this almost always means you are infected
  • fatigue
  • there may be no symptoms at all

Steps to prevent infection from coronavirus-

Wash your hands, Wear a mask, Watch your distance

Practice social distancing and wear a mask.
What to do if you think you have COVID-19 or have been exposed
You should also contact your physician for advice, especially if you have chronic medical conditions which might make you at greater risk of severe disease.

Base your actions on FACTS, not FEAR

MANAGE ANXIETY-DON'T BE AFRAID-BE SMART

Learn about the vaccines from Dr. Gupta and Dr. Fauci

Throughout the pandemic, I have depended on the reports from Dr. Sanjay Gupta, neurosurgeon and medical correspondent for CNN. I don’t miss his daily podcasts called Coronavirus: Fact vs Fiction.

In this episode, Dr. Gupta interviewed Dr. Anthony Fauci about the coronavirus vaccine. I suggest you listen to this 12 minute podcast, as well as the others in this series.

A Q&A on vaccines with Dr. Anthony Fauci

exploring the HEART of controlling a pandemic

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .

And if you found this information interesting and helpful, please share with your friends on social media and elsewhere. They and I will appreciate it.

                              Dr. Aletha 

And if you found this information interesting and helpful, please share with your friends on social media and elsewhere. They and I will appreciate it.