AMY GOODMAN: As the U.S. death toll from COVID-19 tops 223,000, President Trump and former Vice President Joe Biden met in Nashville, Tennessee, Thursday in the second and final debate of the 2020 campaign. They sparred over the Trump administration’s response to the pandemic, healthcare, climate change, racism and U.S. immigration policy. Thursday’s matchup was originally scheduled to be the third and final debate, but Trump scuttled a second appearance earlier this month after refusing to take part remotely following his hospitalization with COVID-19.

Thursday’s debate was moderated by NBC’s Kristen Welker, who began by asking President Trump about his handling of the COVID-19 crisis. Trump praised his response while falsely claiming that 2.2. million people were expected to die, and falsely claiming a vaccine was, quote, “ready.”

PRESIDENT DONALD TRUMP: We have a vaccine that’s coming. It’s ready. It’s going to be announced within weeks, and it’s going to be delivered. We have Operation Warp Speed, which is — the military is going to distribute the vaccine.

I can tell you from personal experience that I was in the hospital, I had it, and I got better. And I will tell you that I had something that they gave me, a therapeutic, I guess they would call it. Some people could say it was a cure. But I was in for a short period of time, and I got better very fast, or I wouldn’t be here tonight. And now they say I’m immune. Whether it’s four months or a lifetime, nobody has been able to say that, but I’m immune. More and more people are getting better.

We have a problem that’s a worldwide problem. This is a worldwide problem. But I’ve been congratulated by the heads of many countries on what we’ve been able to do with the — if you take a look at what we’ve done in terms of goggles and masks and gowns and everything else, and in particular ventilators. We’re now making ventilators all over the world, thousands and thousands a month, distributing them all over the world.

It will go away. And as I say, we’re rounding the turn. We’re rounding the corner. It’s going away.

KRISTEN WELKER: OK. Former Vice President Biden, to you: How would you lead the country out of this crisis? You have two minutes, uninterrupted.

JOE BIDEN: Two hundred and twenty thousand Americans dead. If you hear nothing else I say tonight, hear this: Anyone who is responsible for not taking control, in fact, not saying I’m — “I take no responsibility,” initially — anyone who’s responsible for that many deaths should not remain as president of the United States of America.

We’re in a situation where there are a thousand deaths a day now. A thousand deaths a day. And there are over 70,000 new cases per day. Compared to what’s going on in Europe, as The New England Medical Journal said, they’re starting from a very low rate, we’re starting from a very high rate. The expectation is we’ll have another 200,000 Americans dead between now and the end of the year.

If we just wore these masks, the president’s own advisers have told him, we could save 100,000 lives. And we’re in a circumstance where the president thus far, and still, has no plan, no comprehensive plan.

AMY GOODMAN: Later in the debate, former Vice President Joe Biden criticized Trump for downplaying the pandemic.

JOE BIDEN: He did virtually nothing. And then he gets out of the hospital, and he talks about, “Oh, don’t worry. It’s all going to be over soon.” Come on. There’s not another serious scientist in the world who thinks it’s going to be over soon.

KRISTEN WELKER: President Trump, your reaction?

PRESIDENT DONALD TRUMP: I didn’t say “over soon.” I say we’re learning to live with it. We have no choice. … Ninety-nine-point-nine of young people recover. Ninety-nine percent of people recover. We have to recover. We can’t close up our nation. We have to open our school, and we can’t close up our nation, or you’re not going to have a nation. …

JOE BIDEN: He says that we’re — you know, we’re learning to live with it. People are learning to die with it. You folks home will have an empty chair at the kitchen table this morning. That man or wife going to bed tonight and reaching over to try to touch there, out of habit, where their wife or husband was, is gone. “Learning to live with it”? Come on. We’re dying with it, because he has never said — you see, you said, “It’s dangerous.” When’s the last time? Is it really dangerous still? Are we dangerous? You tell the people it’s dangerous now. And what should they do about the danger? And you say, “I take no responsibility.”

KRISTEN WELKER: Let me talk about your —

PRESIDENT DONALD TRUMP: Excuse me. I take full —

KRISTEN WELKER: Very quickly.

PRESIDENT DONALD TRUMP: I take full responsibility. It’s not my fault that it came here. It’s China’s fault.

AMY GOODMAN: President Trump and former Vice President Joe Biden at last night’s debate in Nashville.

To get response, we are joined by Dr. Ali Khan. He is an epidemiologist and the dean of the College of Public Health at the University of Nebraska Medical Center. He’s the former director of the CDC’s Office of Public Health Preparedness and Response, where he oversaw the Strategic National Stockpile. He’s joining us from Omaha, Nebraska. Nebraska is one of seven states now seeing a record level of COVID hospitalizations.

Dr. Ali Khan, welcome to Democracy Now! Can you respond to that last comment of President Trump’s, as he says he is not responsible for this?

DR. ALI KHAN: Well, good morning, Amy. And thank you very much for the opportunity to join you this morning.

Before I respond to the last comment, let’s step back a little bit and think how unusual this would be if we replaced COVID with polio or cholera or dysentery, that we would have a presidential debate and two different opposing political opinions about a disease that’s the third leading cause of death in America now, that was unknown 10 months ago, and we would be having a debate on whether or not it’s killing people and how it’s killing people. It’s unimaginable, if you just replace COVID with anything else. But that’s essentially what’s happening.

And what COVID has done very effectively is it has taken advantage of every splinter in our society, first, in terms of biologically — you know, elderly males, we know, are at higher risk — then social politically, economically. It’s extremely unfortunate, what’s going on in America, with over — actually, it’s 300,000 deaths right now.

AMY GOODMAN: Explain what you mean by 300,000 deaths.

DR. ALI KHAN: So, the 220,000 deaths that are reported are an underreport of deaths. And what you really need to look at, in addition to the actual individual cases that are reported, is excess deaths. And CDC has recently done a very nice analysis of looking at all excess deaths. So, these are people who would not have died. So, it’s not as if you — I often hear that, “Oh, they were elderly. They were going to die anyway.” That’s not true. These are individuals who would not have died this year, who are dead. And that’s over 300,000. And, yes, while absolutely there’s a lot more elderly people who have died, if you look relatively, there’s more deaths amongst the 25-to-44-year-olds, and there’s more deaths around Latinos, are more likely to die. So, yes, approximately 300,000 deaths in America, third leading cause of death, for a disease that was unknown in December.

AMY GOODMAN: Can you respond to the Columbia University report that just came out, the study, where researchers blasted the Trump administration over its disastrous handling of the pandemic? The authors write, “We estimate … at least 130,000 deaths … perhaps as many as 210,000 could have been avoided with earlier policy interventions and more robust federal coordination and leadership. Even with the dramatic recent appearance of new COVID-19 waves globally, the abject failures of U.S. government policies and crisis messaging persist.” Talk about what this means, what Trump did and didn’t do, as he talks about how well he dealt with the pandemic.

DR. ALI KHAN: So, Amy, this paper that came out of Columbia University by Dr. Irwin Redlener really puts estimates on how many people have unnecessarily died of this disease, and it tries to estimate those preventable deaths.

So, it’s always good — you know, I appreciate American exceptionalism, but you just need to go look at what’s going on in the rest of the world. China, zero deaths, their economy in the third quarter increased 4.9%, OK? And it’s not just China. New Zealand, Taiwan, Singapore, Uruguay, Uzbekistan — I can go on and on, all over the world, where countries where they had a robust public health strategy to decrease cases in their countries, and they are down to zero to no cases.

So, what this new paper says is, if we had just followed what we know the science is — so, the science, we know how to get rid of this disease: test, trace and isolate; community engagement, that’s masks, social distancing, handwashing; and excellent leadership at the national, state and local level. You put that controlled triad together, and the U.S. would not have had these preventable deaths.

And again, this is what happened in the past. I’m worried now about what’s happening in the future. We continue to see approximately 700 deaths, preventable deaths, every day in America because we still don’t have a containment strategy in America, we still don’t have that leadership, not just at the national level, state and local level, because public health is a local activity. So, where is that test, tracing and isolating happening? Where are those national and state and local mandates for masks, handwashing, social distancing? We know what it takes to get this disease under control. It is not a secret from a scientific standpoint.

AMY GOODMAN: This is the key point, Dr. Khan, that you say not just about the past here, but the future. As President Trump goes around the country now with his rallies, not clear when the last time was he met with the coronavirus task force, we’re talking about possibly as many people dying in the next few months as have died so far in this country, right? Over 200,000 people — you say 300,000 — since the beginning of the pandemic. What can be put in place right now? You were head of the National Stockpile. You worked at the CDC for years. Can you talk about, even if it is late, what President Trump needs to do, with invoking the Defense Production Act, still getting millions of tests and masks to people? He keeps saying anyone can get a test. It is just an absolute lie.

DR. ALI KHAN: So, you’re quite right, Amy. Even we can start today to prevent these 700 to a thousand deaths that are happening every day. We have the tools. We’ve always had the tools. It starts at the top, and then it cascades to the national, state, local, county, city, tribal, territorial level, which is, you need that unified leadership. As I said, just think about it. We’re arguing about a disease. This is great for COVID-19. It’s not good for us, right? That leadership, that we are going to contain this disease, we know what the science is to get this disease under control, we’re going to use evidence, we’re going to use metrics, we’re going to use data, and we’re going to drive down this disease.

The second thing we’re going to do — need to do is we need to ramp up test, trace and isolate. So, there is, obviously, gaps in testing in the United States, but there’s a lot of testing in the United States. But you have to link the testing with action. It’s not just about anybody who wants a test can get a test, because many people don’t even need a test. But the ones who do need a test, if they’re positive, have you made sure that they’re isolated? Have you found their contacts? Have you quarantined their contacts in a socially viable manner? And if you don’t do that, then why bother to test people, right?

And then the third thing is, at the — starting at the local level, where are mask mandates to make sure people are wearing masks, making sure they’re social distancing, whatever that looks like in that community based on what’s going on, and then making sure that they’re washing hands? I mean, we have the tools to get America back to work, to get all the kids back in school, and to get people, fans, back in stadiums. We have those tools right now, if we wanted to use them.

AMY GOODMAN: Quickly, if you could respond to what Trump is using as a pretext for not doing anything, and that is saying “herd immunity,” let the population get sick?

DR. ALI KHAN: Oh my gosh. That is the most unethical, disastrous approach that’s possible. So, herd immunity is a wonderful concept when we use vaccine to get herd immunity. However, herd immunity has never been used previously. It would be analogous of saying there’s an Ebola outbreak, and we go, “Oh, let’s go infect everybody so that it’s less disruptive in our society.”

So, herd immunity is the maximum death strategy, which is, you kill as many people as possible until potentially people are immune. Well, A, that’s so ludicrous, nobody has ever tried it before. B, it ignores the fact that you may have long-term sequela. So, I know people like to say 99% of people survive. Well, at a population level, unfortunately, 1% is still 3 million people in the U.S. But we do know that potentially a third of people, a quarter of people may have long-term heart, lung, kidney and brain damage. So, there’s still these long-term side effects that we’re not accounting for. And then, finally, if this disease really causes reinfections in four to six months, herd immunity can’t work. We get the cold every year. We have not yet had herd immunity to the cold virus, which is another type of coronavirus.

AMY GOODMAN: Which goes to —

DR. ALI KHAN: So, herd immunity is unethical.

AMY GOODMAN: Which goes to one of the first things President Trump said last night. He said, you know, he had COVID, and now he’s immune.

DR. ALI KHAN: And he may not — president or not, you know, if you get infected, you may not be immune forever. And we don’t know how long that immunity lasts. We know that there have been some cases of reinfection. So, that again says, how can you have herd immunity if you can get reinfected? So, correct, we hope that you’re protected for a very long period of time, but we need to get disease down to zero so that we don’t have infections in our community.

AMY GOODMAN: Before you go, I wanted to ask you about the Affordable Care Act. At one point in the 90-minute debate, Trump conflated Biden’s call for a government-run public option healthcare plan with a Medicare for All bill authored by Bernie Sanders.

PRESIDENT DONALD TRUMP: When he talks about a public option, he’s talking about destroying your Medicare, totally destroying —

JOE BIDEN: Wrong.

PRESIDENT DONALD TRUMP: — and destroying your Social Security. And this whole country will come down. You know, Bernie Sanders tried it in his state. …

KRISTEN WELKER: Vice President Biden, your response?

JOE BIDEN: He’s a very confused guy. He thinks he’s running against somebody else. He’s running against Joe Biden. I beat all those other people because I disagreed with them.

AMY GOODMAN: Dr. Ali Khan, I’m wondering if you could comment overall about Medicare for All. As President Trump went after socialized medicine, he didn’t talk about being at Walter Reed [hospital], where he dealt with his COVID-19. Isn’t that the epitome of socialized medicine, and very fine socialized medicine at that?

DR. ALI KHAN: Yeah, actually, quite — military medicine is quite excellent medicine, as is Medicare in the United States, which is an excellent healthcare system in the United States for the elderly and select others, that’s actually cost-effective. And again, American exceptionalism: If you look outside the U.S., numerous countries have figured out how to solve this universal access issue. And we need to solve that problem in America.

People like to talk about the new normal. I like to talk about the better normal, because there’s lots of things about the old normal I didn’t like. You know, institutional racism would be one of them. But, again, everybody needs to have access to healthcare in our better normal.

AMY GOODMAN: Dr. Ali Khan, I want to thank you for being with us, epidemiologist, dean of the College of Public Health at the University of Nebraska Medical Center, former director of the CDC’s Office of Public Health Preparedness and Response, where he oversaw the Strategic National Stockpile. He is in Nebraska, which is one of the seven states right now with record hospitalizations.

This is Democracy Now! When we come back, we continue with the excerpts of last night’s debate. Stay with as.