The Wall.St Journal 21Feb2020

THE WALL STREET JOURNAL. Friday, February 21, 2020 |A

C

onventional wisdom has it
that the Democratic pri-
mary is little more than a
battle between moderates
and progressives. But
something else is going on here. Be-
yond ideology, the party is yet again
arguing about whether we’re more
apt to win as agents of change or as
beacons of the establishment. The six
candidates still standing line up on
different sides of that debate—but
not in the way you might think.
The atmospherics are important.
In the quarter-century since Newt
Gingrich became speaker of the
House, Washington has become in-
creasingly dysfunctional. Whatever
your theory for why that’s hap-
pened, Donald Trump’s surprise

election in 2016 was born largely of
presenting himself as a change agent
for those angry at Washington. Now
Democrats are faced with a funda-
mental choice: Should we promise to
return Washington to the pre-Trump
“normal,” or should we instead take
back the mantle of change?
Two mayors offer answers to that
question. Pete Buttigieg’s rise in
New Hampshire was extraordinary.
He had been deprived of the bounce
candidates typically get from win-
ning Iowa. His debate performance
was not his best. But he came within
a point of beating the senator from
next-door Vermont and easily bested
the senator from next-door Massa-
chusetts. Few have noted the chief
reason: Ahead of the primary, the
Biden campaign released a digital

Voters find ‘just fix the

damn roads’ a more

compelling pitch than

‘I wrote the damn bill.’

Bernie Sanders, Insider

spot diminishing his work in-

stalling streetlights, beautify-

ing downtown South Bend,

Ind., and improving the sys-

tem for locating lost pets. Far

from boosting the former

vice president’s campaign,

the ad redounded to Mr. Butt-

igieg’s benefit.

The central reason under-

pins a reality framing the

race. State and local govern-

ment today get things done,

while Washington so fre-

quently falls short. Recall

that Michigan’s Gov. Gretchen

Whitmer won office on the

strength of a simple slogan:

“Just fix the damn roads!”

Mr. Biden’s ad highlighted

Mr. Buttigieg’s core appeal—

his record of driving change

at the local level can be applied to

the nation as a whole. Mike

Bloomberg comes with an impres-

sive “get it done” record as mayor. If

he can brandish those accomplish-

ments on the campaign trail (and ac-

tually prepare for debates), he could

be a contender. The jury is still out

on that question.

Sen. Amy Klobuchar is a remark-

able case of a candidate who keyed

in on a winning message late in the

New Hampshire campaign. Through-

out the battle in Iowa, she focused

on the résumé she’d built in the Sen-

ate—which subcommittees she’d

served on, which bills she’d drafted,

which GOP co-sponsors she had.

That focus framed her as an insider.

Moderate or more progressive, her

Washington résumé made her an

embodiment of the status quo.

Then, ahead of the New Hamp-

shire primary, she abandoned her

Senate chamber tone and embraced

her Minnesota voice. She reidenti-

fied as a daughter of the Iron Range,

connecting her own parents’ hopes

and frustrations with those Ameri-

cans feel today. She shot to third in

New Hampshire. Yet at Wednesday

night’s debate she fell back on her

old bad habit and chided Mr. Butt-

igieg for knowing so little about

“the arena,” meaning Congress.

That’s not the message that has kept

her in the running so far.

Sen. Elizabeth Warren has taken

the same journey—in reverse. She

began her campaign by framing her-

self as a kid from Oklahoma, then

morphed into a creature of Washing-

ton. Months from now, many will

blame Ms. Warren’s Medicare for All

proposal for her tailspin—and they’ll

have a point. But you need only look

at what her campaign is putting out

now to see what’s wrong. In a re-

cently released digital primer on

redlining, she demands that the fed-

eral government make amends for

its legacy of discrimination in hous-

ing. The spot concludes with a tell-

ing phrase: “I’ve got a bill to do

that.” That may be true, but it sig-

nals, however inadvertently, that

she’s an insider.

Mr. Biden’s candidacy has taken

the same tack, highlighting his long

list of accomplishments in the Sen-

ate and as vice president. The Re-

covery Act. The auto bailout. The

Iran nuclear agreement. The as-

sault-weapons ban. The Violence

Against Women Act. It’s an impres-

sive list. But no matter how accom-

plished Mr. Biden and Ms. Warren

may be—and no matter how stri-

dent or collaborative their politics—

both campaigns have framed their

candidates as warriors from inside

the establishment.

Sen. Bernie Sanders is an anom-

aly. As someone who’s running for

the Democratic nomination without

even being a Democrat, he presents

himself as an outsider. But as Mr. Bi-

den has pointed out, Mr. Sanders

has been making the same argument

about profit-seeking corporations

and greedy executives for decades.

It’s pretty hard to maintain a legiti-

mate claim on the “change agent”

persona when your most memorable

line in the campaign is “I wrote the

damn bill!” Perhaps it’s no surprise

that his support in New Hampshire

fell from more than 60% in 2016 to

less than 26% this year. Radical as

his solutions may be, he is offering

voters a bridge to the past.

As Democratic voters in Nevada,

South Carolina and the Super Tues-

day states consider the can-

didates, they should be care-

ful to take the right lesson

from the elections that have

defined our party’s fate for

four decades. Jimmy Carter,

Bill Clinton and Barack

Obama ran as outsiders—

change agents promising to

steer the country in a new di-

rection. Vice President Al

Gore, Sen. John Kerry and

Secretary of State Hillary

Clinton leaned on their expe-

rience to win over the elec-

torate, a tack that framed

them as standard-bearers for

the establishment.

The party’s success will de-

pend on the nominee’s ability

to appeal to moderate swing

voters. But history suggests

that the outcome will also hinge on

whether we offer voters an agenda

that resurrects the normal that ex-

isted before Jan. 20, 2017, or a

change that moves us beyond Wash-

ington’s intense dysfunction.

Mr. Trump was the outsider in

2016 and is doing everything he can

to position himself as the change

agent again. When he does or says

something outlandish, he’s baiting

pundits to position him in opposi-

tion to establishment Washington.

Beyond the question of whether we

should nominate a moderate or a

more strident progressive, Demo-

crats need to claim the mantle of re-

form. Election years buttressed by a

strong economy tend to favor the in-

cumbent. My party’s best hope is to

nominate a standard-bearer capable

of convincing voters of all stripes

that Democrats can change Washing-

ton for the better.

Mr. Emanuel was a senior adviser

to President Clinton and chief of

staff to President Obama. He repre-

sented Illinois’s Fifth Congressional

District, 2003-09, and served as

mayor of Chicago, 2011-19.

By Rahm Emanuel

MIKE BLAKE/REUTERS

Sanders and Joe Biden at Wednesday’s debate in Las Vegas.

OPINION

Tensions With China Help Ease Trump’s Visit to India

When Donald Trump
makes his first visit
to India as president
next week, there will
be one thing keep-
ing U.S.-India rela-
tions on track:
China.
Bipartisan sup-
port for India has
weakened in the U.S.
Congress since the
Modi government’s hard-line Hindu
nationalist turn last year, and trade
squabbles between Washington and
New Delhi continue. But geopolitics
still binds the U.S. and India to-
gether even as economics and hu-
man rights threaten to drive them
apart.
In Gujarat, Prime Minister Naren-
dra Modi’s home state, Mr. Trump
will travel by road through a sea of
humanity and colorful tableaux
showcasing Indian culture before ad-
dressing a vast crowd in the world’s
largest cricket stadium. “Namaste
Trump,” reprises September’s
“Howdy, Modi!” rally in Houston,
where the president and prime min-
ister addressed about 50,000 cheer-
ing Indian-Americans.
The foregrounding of the rally has
led some observers to pooh-pooh

the visit as heavy on spectacle and

light on substance. This is mis-

guided. In foreign policy, symbolism

matters. That Mr. Trump is traveling

to India shows how the country has

grown in importance to the U.S.

since the end of the Cold War. Be-

tween Indian independence in 1947

and 1999 only three U.S. presi-

dents—Dwight Eisenhower, Richard

Nixon and Jimmy Carter—made the

trek to India. Starting with Bill Clin-

ton in 2000 every U.S. president has

visited.

The grandiosity of the Gujarat

rally may be designed to tickle Mr.

Trump’s vanity, but it also under-

scores an important truth: unlike

many peoples around the world, the

majority of Indians remain favorably

disposed toward America. Fifty-six

percent are confident Mr. Trump

will do the right thing in world af-

fairs, according to a January Pew

poll. It’s hard to imagine a Trump

rally in Islamabad or Beijing anytime

soon.

And Mr. Trump’s presidency has

strengthened the U.S.-India relation-

ship. Ashley Tellis, an expert on In-

dia and Asia at the Carnegie Endow-

ment in Washington, points out that

India and the U.S. have continued to

make “enormous progress” on “the

most important driver of the rela-

tionship”—strategic convergence.

In recent years, India has publicly

supported freedom of navigation in

the Indo-Pacific, signed two of three

so-called foundational military

agreements that allow closer cooper-

ation with the U.S., and stepped up

defense purchases from America, in-

cluding combat equipment such as

mountain artillery and attack heli-

copters. Brushing aside Chinese con-

cerns, India has also participated in

the elevation of an informal group-

ing known as the Quad—the U.S.,

Japan, Australia and India—to for-

eign-minister level.

During Mr. Trump’s visit, officials

expect the two governments to an-

nounce a $2.6 billion Indian pur-

chase of Seahawk naval helicopters

from Lockheed Martin. They may

also announce an agreement that

makes it easier to share geospatial

maps for military targeting.

The president’s blunt acknowledg-

ment that America sees China as a

competitor has elevated its role in

U.S.-India relations. “It was always a

kind of background condition,” says

Mr. Tellis. “But it’s front and center

today.”

This is part of a larger shift in

Washington. “There seems to be

broad acknowledgment that we’re

back in an era of great-power com-

petition and that China is the great-

est long-term challenge,” says Rich-

ard Fontaine, who heads the Center

for a New American Security. “Xi

Jinping’s policies have helped drive

this view in Washington. Whether

you’re skeptical about China on stra-

tegic, military, economic or human-

rights grounds, there’s something

for everybody.”

Acknowledging that Messrs.

Trump and Modi have strengthened

U.S.-India strategic ties—with a

helpful assist from Xi Jinping—does

not imply that the relationship is se-

cure. U.S.-India trade has grown

from $97.3 billion in 2013 to $142.

billion in 2018, but at the same time

trade frictions have worsened. Both

countries have placed tariffs on each

other’s goods, including steel and

aluminum from India as well as ap-

ples and almonds from the U.S. Last

year the U.S. ended Indian access to

the Generalized System of Prefer-

ences program, which allowed it to

export $5.6 billion of goods to the

U.S. duty-free.

The two sides have been unable

to seal even a modest trade agree-

ment ahead of Mr. Trump’s visit.

More broadly, Mr. Trump’s focus on

trade deficits—rather than on total

trade—and Mr. Modi’s reversal of

nearly three decades of Indian trade

liberalization mean these tensions

are likely to persist. In January, the

International Monetary Fund slashed

its 2019 growth forecast for India to

4.8%, an 11-year low.

To all this, add Mr. Modi’s adop-

tion of a hard-line Hindu nationalist

agenda in his second term. Western

human-rights groups, commentators

and politicians have castigated his

ending the Muslim-majority state of

Jammu and Kashmir’s autonomy and

passage of a controversial citizen-

ship law that critics say discrimi-

nates against Muslims.

“If India does not get its eco-

nomic act together, it will falter on

the capacity side and a weak India

becomes less interesting to the U.S.,”

says Mr. Tellis. “On the values side,

to the degree that India is seen as

less and less liberal it becomes less

and less attractive to the U.S.”

But Washington and

New Delhi have growing

differences over trade.

EAST IS
EAST
By Sadanand
Dhume

PUBLISHED SINCE 1889 BY DOW JONES & COMPANY

Rupert Murdoch

Executive Chairman, News Corp

Matt Murray

Editor in Chief

Robert Thomson

Chief Executive Officer, News Corp

William Lewis

Chief Executive Officer and Publisher

EDITORIAL AND CORPORATE HEADQUARTERS:
1211 Avenue of the Americas, New York, N.Y., 10036
Telephone 1-800-DOWJONES

DOW JONES MANAGEMENT:

Ramin Beheshti,Chief Technology Officer;

Natalie Cerny,Chief Communications Officer;

Kamilah Mitchell-Thomas,Chief People Officer;

Edward Roussel,Chief Innovation Officer;

Christina Van Tassell,Chief Financial Officer

OPERATING EXECUTIVES:

Kenneth Breen,Commercial;

Jason P. Conti,General Counsel;

Tracy Corrigan,Chief Strategy Officer;

Frank Filippo,Print Products & Services;

Kristin Heitmann,Chief Commercial Officer;

Nancy McNeill,Corporate Sales;

Thomas San Filippo,Customer Service;

Josh Stinchcomb,Advertising Sales;

Suzi Watford,Chief Marketing Officer;

Jonathan Wright,International

Barron’s Group:Almar Latour,Publisher

Professional Information Business:

Christopher Lloyd,Head;

Ingrid Verschuren,Deputy Head

Neal Lipschutz Karen Miller Pensiero
Deputy Editor in Chief Managing Editor
Jason Anders,Chief News Editor;Louise Story,Chief
News Strategist, Product & Technology Officer
Thorold Barker,Europe;Elena Cherney,News
Features & Special Projects;Andrew Dowell,
Asia;Anthony Galloway,Video & Audio;
Alex Martin,Print & Writing;Michael W. Miller,
Features & Weekend;Emma Moody,Standards;
Shazna Nessa,Visuals;Matthew Rose,Enterprise;
Michael Siconolfi,Investigations;Nikki Waller,Live
Journalism;Stephen Wisnefski,Professional News
Gerard Baker,Editor at Large
Paul A. Gigot,Editor of the Editorial Page;
Daniel Henninger,Deputy Editor, Editorial Page

WALL STREET JOURNAL MANAGEMENT:
Joseph B. Vincent,Operations;
Larry L. Hoffman,Production

Why Does the U.S. Have So Few Confirmed Coronavirus Cases?

A

mere 15 cases of the Wuhan
coronavirus have been diag-
nosed in the U.S., according to
the Centers for Disease Control and
Prevention, and that number hasn’t
budged in a week. But the true num-
ber of cases is unknown, because
the U.S. is testing only those who
recently arrived from China or have
been in close contact with con-
firmed patients. Public-health au-
thorities need to be prepared for a
wider outbreak.
The CDC says it will set up a pi-

lot program in five states to screen

some patients with unexplained

lung infections. But that program

hasn’t started, so we can only hope

that cases didn’t get into the U.S.

undetected and begin spreading. It’s

important not to overstate the dan-

ger: If thousands of people were in-

fected in, say, New York, more pa-

tients would be showing up at

hospitals with serious lung infec-

tions. The outbreak would be obvi-

ous. But since most people with the

virus suffer only a mild illness, doz-

ens and perhaps even hundreds of

cases may be circulating undetected.

Here are five steps public-health au-

thorities should take to get ready:

First, expand the types of diag-

nostic tests that can detect the vi-

rus. Right now the only test in use

is one developed by the CDC. It is

only conducted at CDC and at some

public-health labs, which limits how

many patients can be screened. The

novel coronavirus has been declared

a public-health emergency, which

means that other tests from com-

mercial and academic labs can’t be

used without Food and Drug Admin-

istration approval.

The FDA could permit more labs

to develop their own tests and also

use manufactured diagnostic test

kits that the labs can run on their

existing platforms. The FDA can

work closely with manufacturers of

these kits, including large commer-

cial labs, to make these tests more

available under the agency’s emer-

gency authority.

Second, make a plan for deploy-

ing vaccines. The National Institutes

of Health, the FDA and vaccine mak-

ers are working hard to expedite the

development of a vaccine. Once a

plausible vaccine candidate is iden-

tified, the early phases of safety

testing could take several weeks.

But the vaccine could be ready for

broader distribution soon after that

as safety and efficacy tests con-

tinue. Public-health officials need a

plan to roll out the first doses to

people at high risk of catching the

virus. Supply will be limited at first.

Health-care workers who care for

the sick are likely to be among the

first to receive it.

The same limitations may apply

to antiviral drugs. One promising

medicine, remdesivir, is in clinical

trials in China. Initial results are ex-

pected by April. If the findings are

promising, the U.S. needs to be

ready to test the drug in larger tri-

als in America. The CDC and FDA

need to be prepared to make prom-

ising therapies available broadly

while still collecting data on how

well they work. If clinical trials

show substantial benefit, the FDA

should invoke its emergency author-

ity to make the treatment available

to as many patients as possible.

Third, the CDC should develop

criteria for prescribing “community

mitigation strategies”—practical

nonmedical interventions intended

to slow the spread of an epidemic,

such as encouraging employees to

work from home or canceling large

gatherings. Several localities tempo-

rarily closed schools during the

2009 swine-flu outbreak. These

measures can relieve pressure on

hospitals and buy time to develop a

vaccine.

Fourth, doctors, clinics and insur-

ers need to develop strategies to al-

leviate the burden on hospitals,

which are already preparing for an

influx of sick patients. The highly

contagious swine flu overwhelmed

hospitals, even though it caused

only mild illness in most people.

More people were showing up at

emergency rooms and being admit-

ted to intensive-care wards that

typically operate at or near capac-

ity. Telemedicine was a nascent con-

cept in 2009 but should now be de-

ployed to try to prevent

unnecessary visits to the emergency

room.

Fifth, federal public-health au-

thorities should equip their local

counterparts with the funding, staff

and supplies they need to fight an

uncertain viral threat. Preventing

outbreaks will depend largely on

3,000 local health authorities across

the country. The federal government

should be in close communication

with local authorities in communi-

ties at risk.

The swine flu still circulates

around the globe, but nobody lives

in fear of it. It turned out to be less

virulent than was once dreaded, and

a vaccine has diminished the risk.

It’s too early to know whether that

will be the case for the Wuhan vi-

rus. The best protection may be a

head start on outbreaks.

Dr. Borio is a vice president at In-

Q-Tel and was director for medical

and biodefense preparedness policy

at the National Security Council,

2017-19. Dr. Gottlieb is a resident

fellow at the American Enterprise

Institute and a board member of

health-care companies. He was com-

missioner of the Food and Drug Ad-

ministration, 2017-19.

By Luciana Borio
And Scott Gottlieb

How officials can prepare

for a disease that’s likely

more widespread than

CDC numbers show.