Responding to pandemic: Yale professors reflect on COVID-19 public service

On a very untypical August day in 2020, Marcella Nunez-Smith sat down in her office and prepared to join an important video call. A day earlier, a representative for Joe Biden, then the Democratic nominee for president, had asked if she could speak with the candidate about health inequities in the nation’s response to COVID-19. Now, as Nunez-Smith waited for the call to begin, her computer flashed a message that her internet signal was unstable. Then, mere minutes before Biden was set to arrive, a fire alarm sounded in her building.

But then, as she frantically texted colleagues to find out whether there was actually a fire, the room fell totally and blissfully silent.

“The fire alarm stopped, the internet became stable,” she said, chuckling at the memory. “And then Joe Biden and Kamala Harris sat down.”

The call went well. And soon after, the Biden team asked Nunez-Smith, the C.N.H. Long Professor of Internal Medicine at Yale and one of the nation’s foremost experts in disparities in health and health care access, to lead a new task force charged with helping to inform a more equitable COVID-19 response and recovery.

A few months later, she would be joined by Abbe R. Gluck, the Alfred M. Rankin Professor of Law, a professor of internal medicine, and an expert on health law, who was also asked to be part of the new administration’s response to the public health crisis.

Gluck joined the new administration’s COVID-19 response team during the Biden-Harris transition, and then took on the role as Special Counsel to the President and Special Counsel to the White House COVID-19 Response Team, as the team’s lead lawyer, once Biden took office. Over the next year, she would tackle every aspect of the administration’s COVID-19 response, from masking and vaccination to labor and immigration (while also serving in the White House Counsel’s Office, where she worked on additional health care legal issues, including ones related to the Affordable Care Act).

During the first year of the Biden-Harris Administration, it’s safe to say that one or both of these women were somehow involved with every national effort to mitigate or prevent the spread of COVID-19.

“It was an opportunity I didn’t expect, and I was so humbled to be able play a role in something so meaningful,” says Gluck, founding faculty director of the Solomon Center for Health Law and Policy at Yale Law School. “It was the one of the most extraordinary privileges I have ever had to offer this service at this critical moment in history.”

As the third anniversary of the start of the pandemic approaches, Gluck and Nunez-Smith, who have since returned to their duties at Yale, recently reflected on this role of a lifetime.

Preparing for Day 1

When Gluck joined the transition team for the COVID-19 response in late 2020, a time when the number of cases continued to rise, the incoming administration faced some daunting challenges. And the work was intense from the start.

During that period, everyone was still working remotely, and Gluck recalls days spent entirely on Zoom, with her daughter sneaking her bowls of pasta offscreen. Over the next year, the team often worked 20-hour days. Nights, weekends — it was all on the table.

But she says it was all toward a goal — to hit the ground running, to lose no time. Early on, much of the transition team’s work centered on what could be accomplished as early as Day 1 of Biden’s presidency.

Their efforts, among other things, led to a number of executive orders, more than a dozen in all, that formed the bedrock of the administration’s COVID-19 response. These orders established the position of the COVID-19 response coordinator, created the COVID-19 Health Equity Task Force, required for the first time that masks be worn on airplanes and other modes of transportation, and much more. The team also put together the 200-page National Strategy for the COVID-19 Response and Pandemic Preparedness that detailed each facet of the new administration’s response to the pandemic.

For Gluck, every day was different.

“As the lawyer-generalist on the team, I had a pretty special role because I got to work with everybody on everything,” she said. She might start a day with a call that related to Nunez-Smith’s equity work and end it with a meeting about travel policy.

“We had to work very quickly, and we had to engage in a lot of very practical problem solving in uncharted waters,” she said. “How are we going to do this legally, quickly, equitably, and effectively?”

Gluck’s role involved a blend of health law and policy, administrative law, constitutional law, employment law, labor law, education law, and more. Being a public law generalist and having a background in health policy prepared her for this role that spanned so many legal fields. Gluck said that her position at Yale, where she works in a highly interdisciplinary environment, helped.

“From a lawyer’s perspective, it was incredibly challenging intellectually,” she said. “Because it required using every single muscle in my legal brain to think about all these different fields at the same time.”

A single day could entail work spanning tax law, health law, constitutional law, labor law, homeland security, and immigration — an experience that challenged her but grew her abilities in ways that she hadn’t felt since her days as a recent law school graduate.

It also meant that, day to day, she worked with many different agencies and people from different fields, including doctors. At Yale, Gluck works with doctors quite a bit — she’s a faculty member at the Yale School of Medicine — and she says that experience was invaluable for her work with the Biden-Harris administration.

“Having that relationship with doctors already, knowing and respecting how they think and approach things, was really helpful because doctors play critical roles at the very top of the administration’s COVID-19 response,” she says. “So much of what we did was intensely collaborative.”

She worked closely with the Federal Emergency Management Agency (FEMA), the Department of Health and Human Services, the Department of Transportation, the Centers for Disease Control and Prevention, the Department of Justice, and more. Everybody, she says, came together toward a common goal with a real sense of camaraderie and commitment.

“We tackled the biggest health challenge of our lifetime and strove every day to make the most immediate impact on the lives of millions of people,” she said. “It was the most extraordinary team effort I’ve ever been a part of.”

Both Gluck and Nunez-Smith offered the highest praise for the leaders of the team they worked for — White House COVID-19 Response Coordinator Jeffrey Zients — who will serve as Biden’s next chief of staff — and Deputy Coordinator Natalie Quillian — who both departed last year. “Everyone was always driven to a common goal — there was no ego.” Gluck said. “It was all teamwork, with remarkable leadership at the very top driving it all.”

‘Every day was very different, every day was very long’

After that first Zoom meeting with Biden and Harris in August 2020, Nunez-Smith continued to provide regular briefings during the final weeks of the presidential campaign. After Biden’s victory, she was asked to co-chair the new administration’s COVID-19 Transition Advisory Board, during which she helped shape what would become the national strategy for COVID-19.

Then, as Inauguration Day approached, Biden’s team asked her to come on as senior advisor to both the White House COVID-19 Response Team and the Secretary for Health and Human Services and to chair the COVID-19 Health Equity Task Force.

Nunez-Smith, the associate dean for health equity research at Yale School of Medicine and founding director of Yale’s Equity Research and Innovation Center, studies health and health care equity and how to promote it for marginalized populations. COVID-19, since its emergence, has had a disproportionate effect on marginalized communities, with Black and Latinx populations in the U.S. dying at higher rates than white people, she said. Focusing on equitable access to testing, treatment, and, later, vaccines was and is critical to an effective pandemic response.

During her time with the Biden administration, her day typically started with a White House COVID-19 Response Team meeting. From there, the work could go in any number of directions. Because the president charged her and her colleagues with a “whole-of-government” approach, Nunez-Smith worked with many agencies, frequently meeting with the cabinet secretaries. She worked closely, for instance, with leaders in the Department of Health and Human Services and regularly briefed members of Congress. And each week she’d host five to seven round table conversations with 15 to 30 constituents who would share what they were seeing in their communities, what they were doing, and what they needed.

She also participated in hundreds of events and media conversations. And throughout the year, she continued to brief the president and vice president.

“Every day was very different, every day was very long,” said Nunez-Smith, who is also a professor of epidemiology and public health at the Yale School of Public Health. “I left with just an inordinate amount of respect for those in public service.”

Having studied issues related to equity for years, Nunez-Smith said it was incredible to see these questions at the center of federal leadership, to see equity in action. It was a thrill to be in spaces where she wasn’t the one person to raise her hand and bring up equity but was one of many voices to do so.

The Presidential COVID-19 Health Equity Task Force submitted 55 recommendations to the administration, most of which aimed to “disrupt this pattern of predictability of who is harmed worst and first” in matters of public health — typically, communities of color. Those recommendations themselves represented meaningful progress toward health equity, said Nunez-Smith.

That the majority of them have informed policy means even more.

The work ahead

For both Gluck and Nunez-Smith, the months spent tackling the COVID-19 challenge with federal leaders produced many moving and inspiring moments — so many that, for both, it can be difficult to narrow them down.

For Gluck, the launch of FEMA’s first mass vaccination sites, President Biden’s announcement that educators would be prioritized for vaccination, evolving travel policies, and the launch of the “We Can Do This” outreach campaign are among the many that have stuck with her. That’s in large part because they were critical early efforts for the new administration, and she knows just how much work and how many people it took to make them happen.

“It was so meaningful to see all of that come to fruition,” she said. “So many people worked tirelessly to figure out how to accomplish what we needed to get done, in ways that were legal, fair, workable, and made everyone involved comfortable.”

Both expressed gratitude for all of the people they worked with — including those who are in the public eye, and those who aren’t — and for the support they received from their Yale colleagues who helped make their public service possible.

They also both expressed a gratitude that they had the chance to work with each other on these big issues.

“There was something so special about being there with Marcella and being able to assist her in her tremendous efforts in the equity space,” said Gluck. “She’s one of the most incredible people I’ve ever met and a born leader. It’s beyond inspirational what she was able to accomplish.”

For Nunez-Smith, the admiration was mutual. Gluck’s commitment and dedication to the equity mission — and the work she puts in to make sure that mission is implemented — is something Nunez-Smith did not take for granted. “She is how it happens,” she said. “Getting to work with Abbe in that close way, it’s a gift I will hold forever.”

While they completed their service to federal government last year, the work continues. For those in public service still tackling challenges related to the pandemic — and for Gluck and Nunez-Smith. “I don’t think Abbe knows this yet, but our partnerships are not over,” Nunez-Smith said with a laugh. “I have a lot of plans for us!”

Gluck shared the same sentiment. “How lucky am I that this extraordinary colleague I cherished so much in the White House is also my colleague down the street in New Haven? I cannot wait for more collaborations with Marcella for years to come.”