Health Care

The job crunch hits the White House as Biden searches for a new pandemic czar

“They approached everyone.”

President Joe Biden meets with the White House COVID-19 Response Team on the latest developments related to the Omicron variant.

President Joe Biden has a vision for the next stage of his administration’s pandemic response — if only he can find someone to lead it.

A week before Biden is set to declare an end to the nation’s public health emergency and dissolve his current Covid team, the White House still hasn’t found a director to run the new office charged with keeping up the fight, four people with knowledge of the matter told POLITICO.

The fledgling Office of Pandemic Preparedness and Response was intended to serve as a permanent command center for federal efforts to keep Covid under control, coordinate pandemic work across the government and guard against future public health threats.

The team would be central to the development of next-generation vaccines and, critically for Biden’s campaign prospects, responsible for preventing a Covid resurgence that could spoil his reelection run.

But the White House’s search for a top official to lead the office has been hindered by concerns over whether it will have the influence within the administration and the financial resources needed to fulfill its broad mission — especially as Covid plummets down the list of political priorities.

“They approached everyone,” said one of the people with knowledge of the matter, all of whom were granted anonymity to discuss the search process.

The slow progress now threatens to dash Biden aides’ hopes of orchestrating a May 11 handoff from the current Covid team to the incoming pandemic preparedness chief, a way to reassure Americans that the White House is still closely monitoring the virus even as it dismantles its emergency response apparatus.

It’s also alarmed outside public health experts who worry the Covid team’s dissolution will create a vacuum at the government’s highest levels, increasing the odds of strategic missteps and further diminishing political will in the White House and on Capitol Hill to continue the battle against Covid. While Congress authorized the creation of the new pandemic preparedness office late last year, it did not put any new funding behind it.

“I don’t know what the plan is going to be,” said Ezekiel Emanuel, a bioethicist who advised Biden’s transition team on Covid. “So many things are going away, and it’s not clear either side — the Republican Party or the Democrats — are really sussing out what the whole situation will require.”

In a statement, spokesperson Kelly Scully said the White House is standing up the office “as required by law” and that the office would work with the Department of Health and Human Services “and other agencies on continued COVID response work — including prep for future surges.” It will also be the White House’s lead division for other pandemic preparedness efforts, she said.

Among the candidates that Biden officials have pitched on the job is Food and Drug Administration Chief Medical Officer Hilary Marston, who turned down the role, the people with knowledge of the matter said. Marston had previously worked on the White House’s global Covid response and directed the National Security Council’s medical and biodefense preparedness efforts.

The White House currently is in talks with Tom Inglesby, a former White House Covid team member and current director of the Johns Hopkins Center for Health Security. Officials also have discussed the possibility of promoting Dawn O’Connell, who runs the preparedness and response office at HHS.

Others floated senior Centers for Disease Control and Prevention official Demetre Daskalakis as a candidate on the strength of his largely successful turn helping coordinate the administration’s mpox response — though he remains a long-shot candidate.

FDA spokesperson Michael Felberbaum declined to comment on Marston’s behalf. Inglesby and Daskalakis did not respond to requests for comment. HHS referred questions about the search process to the White House.

In the interim, a few of the remaining Covid team members are expected to transfer to the pandemic preparedness office to function as a skeleton crew. But Covid response coordinator Ashish Jha plans to resign later this month, raising the prospect that the White House could temporarily be without a pandemic czar for the first time since Biden took office.

White House chief of staff Jeff Zients and his deputy Natalie Quillian have personally led the effort to shape the pandemic preparedness team’s structure and ambitions, mindful that administrations rarely get the opportunity to create an entirely new White House office.

Zients, who was Biden’s first Covid response coordinator, has also emphasized the need for the White House to stay involved in the pandemic response effort even as it declares the public health emergency over. There is fear the government may otherwise miss signals of a resurgence that could plunge the U.S. back into crisis — as well as undermine Biden’s case for reelection.

In addition to supervising the ongoing Covid response, the new office is charged with advising Biden on other pandemic and biological threats and ensuring the administration maintains the supplies and procedures needed to respond to future public health crises. Rather than hurriedly appointing a czar to grapple with emergencies like Ebola, mpox and Covid, the pandemic preparedness director would serve as the de facto coordinator for whatever new threat might emerge.

“This is a critical resource to ensuring there is awareness for biopreparedness at the highest level,” said Saskia Popescu, an epidemiologist and assistant professor in George Mason University’s biodefense program, adding that among its chief jobs will be breaking “a cycle of neglect in preparedness efforts.”

Still, the top job is proving a difficult sell amid worries the director will get stuck with a long to-do list and little influence to get it done.

Biden’s distance from the pandemic issues that once drove his candidacy may even end up being physically apparent too, officials have noted. In the administration’s initial discussions, the preparedness office was tentatively slated to be housed not in the West Wing or even the Eisenhower Executive Office building next door, but in the New Executive Office Building across the street.

The new office also has no funding of its own, meaning its success will depend on wrangling cooperation out of a health department whose leaders have previously bristled at the White House’s heavy-handed role in setting the administration’s pandemic priorities.

And in an ominous early sign, the White House office’s most immediate Covid goal — overseeing the development of next-generation vaccines — is tied to a $5 billion pot that health experts worry Congress could end up clawing back as part of a compromise deal on the debt ceiling.

“So much of what they’re looking toward in terms of preparedness is through next-gen [vaccines],” said Michael Osterholm, an epidemiologist and former Biden transition Covid adviser. “If we have a misstep in trying to get early work done for new vaccines then that’ll be a big challenge — and that again will fall back on being their responsibility.”

It all amounts to a job with few clear advantages — and all of the blame if Covid comes roaring back or the government is caught off-guard by a public health emergency once again.

“The challenge for the office going forward is, is the next big one 100 years from now or two years from now?” said Bob Wachter, chair of the department of medicine at the University of California at San Francisco. “And of course, you have no idea.”