Dr. Zeke Emanuel, one of the key architects of the Affordable Care Act and a special adviser to the director general of the World Health Organization, said on ABC News’ "Powerhouse Politics" podcast that he doesn’t anticipate life fully returning to normal for another 18 months, based on guidance from health professionals in the Trump administration.
"The kind of normal where we go traveling, we go to restaurants, we go to concerts, we go to religious services, we go on cruises, until we have a vaccine that protects everyone. That's 18 months, it's not going to be sooner," Emanuel told ABC News Chief White House Correspondent Jonathan Karl and Political Director Rick Klein.
"Anyone who tells you we're going to have a vaccine in three or four months, that's just not the reality of how biology and research works," the oncologist, bioethicist and professor and vice provost at the University of Pennsylvania said.
Emanuel joined the show to promote his new podcast, "Making the Call," where the hosts evaluate the ethics surrounding governmental responses to the pandemic. He is a former special adviser on health policy to the director of the Office of Management and Budget and National Economic Council in the Obama administration. His brother, ABC News contributor Rahm Emanuel served as President Barack Obama's chief of staff.
For the nation to be prepared to operate normally, Emanuel said, the number of new cases needs to be brought down to zero -- but the United States doesn’t have the infrastructure in place to handle that kind of oversight.
"You have to have a structure and infrastructure that allows you to test and quickly quarantine and isolate people who are suspected or test positive for COVID. We're not there yet," he said.
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Karl highlighted that the Centers for Disease Control and Prevention guidelines for how the nation functions are set to expire on April 30.
"What happens on April 30?" Karl asked.
The plan is going to expire, Emanuel said. The government has no choice but to renew it.
"We're going to have to renew it because some places in the country will have reached the top of the curve and coming back back down, some patients in the country won't have reached the top of the curve," Emanuel said, adding that rural areas of the country likely won’t have reached their peak by the time the guidelines are set to expire.
"We watch the daily response from federal health officials. What goes through your mind, what are the things that should be said now, and done now, from the federal level that are glaring in your mind that that aren't happening?" Klein asked.
"Well, I do think we need a more strategic plan for what do we do in the next 18 months," Emanuel said.
"I noticed that every bailout bill seems to be … we have this bailout for small businesses, keeping people on their payroll (for) eight weeks, we have an extension of unemployment (for) 13 weeks, as if somehow at the end of three months it's going to be magically different. This is an18-month process," Emanuel said.
He also called on the federal response for distributing ventilators and personal protective equipment to be stronger.
"The federal government in this case is competing with the states for new ventilators, for PPE. And that's not helpful. The federal government ought to be bulk purchasing it and ought to be then distributing it based upon need at the moment," Emanuel said.
If life can’t return to normal for 18 months, that has key implications for November, Karl said, "What's the outlook there? It's obviously going to be well before we have a vaccine."
"I think we need to plan now -- you're going to have to have a different model, either voting by internet, voting by mail, voting early, so that people have a chance to go over time," Emanuel said.
"I think this is, you know, this is unfortunately a perfect model for Republican suppression of voting," he said.
On Tuesday, Wisconsin held in-person voting after Republicans blocked Democrats from delaying the election or moving to an entirely mail-in system.
"This is a perfect storm situation for, you know, just not getting a lot of those people who want to vote, even though everyone was predicting this would be a super record turnout because of the high stakes of this election," Emanuel said.
Emanuel, who helped build the Affordable Care Act, a topic of discussion in recent weeks as Americans struggle with health care coverage, said a universal health care system is the best way to fill in the gaps during a pandemic.
"COVID-19 is a great argument for universal health care coverage that isn't 'hole-y' and doesn't allow, you know, millions of people to slip through. It is an argument for simplification of the system," Emanuel said.
"Sen. (Bernie) Sanders is right, we definitely need to have a universal coverage system where all 100% of people in the United States are covered," he continued. "Certainly the Affordable Care Act was not put in place thinking about a pandemic, I can say that categorically having been involved and also having thought about pandemics."