That Was Bad.

The lack of handshakes—a COVID-19 prevention measure—was perhaps the most civil thing about the first presidential debate.

Dogged by shouting, cross-talk, and personal attacks, last night’s face-off between President Donald Trump and Democratic nominee Joe Biden was widely viewed as an embarrassment— “a hot mess inside a dumpster fire inside a train wreck,” according to CNN’s Jake Tapper.

One Fox News commentator described the president’s performance as that of a “bucking bronco”—which was intended as a compliment.

Somewhere in the firestorm, they revealed their case on key public health issues, from COVID-19 to the Affordable Care Act to racism, with Trump in particular singled out by fact-checkers for lying or bending the truth.

On the COVID-19 Pandemic:

The Vaccine Timeline:

“It’s a very political thing,” Trump said.  

Contradicting top officials who say a vaccine won’t be generally available until summer 2021, Trump doubled down on his narrative that one could be available before Election Day, a claim that has raised concerns a vaccine may be rolled out under political duress rather than on the basis of sound science.

Biden sought to temper Trump’s claim: Even if a vaccine is done by year’s end, “the distribution of that vaccine will not occur until sometime in the beginning or middle of next year to get it out,” Biden said, “if we get the vaccine, and pray God we will.”

Reopening:

The candidates made clear their fundamentally different approaches to reopening. In essence, Trump has left response efforts largely up to the states, while Biden has angled for expanding the federal government’s hand in states’ COVID-19 response.

“Those states are not doing well that are shut down,” Trump said, lamenting the economic impact of business closures that have turned New York into a “ghost town.” “People want their places open, they want to get back to their lives,” he said.

Biden’s approach: “You can’t fix the economy until you fix the COVID crisis.”

Masks:

In the wake of COVID-19 deaths topping 200,000 in the US, Trump defended his response while Biden lambasted him for not embracing mitigation measures earlier in the pandemic.  

“If we just wore masks between now—and social distanced—between now and January, we would probably save up to 100,000 lives. It matters,” Biden said, a point the New York Times fact checker endorsed.

“They’ve also said the opposite,” Trump responded, referring to experts like Anthony Fauci. But Trump was harking back to outdated guidance from early in the pandemic, when masks’ usefulness was less clear and the public was urged to reserve scarce supplies for frontline workers. 

While Trump said he thinks “masks are okay” and that he’ll wear one when necessary, his recent campaign rallies have been known for shirking mask orders and social distancing. Last night, Trump doubled down by mocking Biden’s penchant for face coverings: “He could be speaking 200 feet away from it, and he shows up with the biggest mask I've ever seen!”

On Racism:

While cities and counties across the US have declared racism a public health crisis, last night Trump refused to outright denounce white supremacy.

In one of the debate’s most extraordinary moments, moderator Chris Wallace asked Trump if he would condemn white supremacists and militia groups and call on them to stand down.

His response:

“Proud Boys? Stand back and stand by,” Trump said, referring to the far-right group known for engaging in violence in Portland and Kenosha. “But I'll tell you what: Somebody's got to do something about antifa and the left. Because this is not a right-wing problem — this is a left-wing problem.”

The Department of Homeland Security has listed white supremacy among the nation’s gravest threats.

On Trump’s Supreme Court Pick:

"We have the Senate, we have the White House, and we have a phenomenal nominee,” Trump said of his plan to move ahead with his Supreme Court pick to replace Ruth Bader Ginsburg,  the conservative federal appeals court judge Amy Coney Barrett.

Biden stressed that the next president should make the call, and framed Trump’s pick as a threat to Roe v. Wade.

“You don’t know her view on Roe v. Wade,” Trump clapped back—though Trump has pledged to only consider Supreme Court nominees who would overturn the landmark 1973 decision legalizing abortion. 

Judge Barrett has also openly criticized a previous SCOTUS decision upholding the Affordable Care Act, which will once again face the nation’s highest court a week after election day.

On the Affordable Care Act:

Trump claimed that Joe Biden would “extinguish 180 million people with their private health care”—which isn’t true, according to CNN’s fact checker Daniel Dale, who noted that Biden opposed a single-payer plan that would have nixed many private insurance plans. 

Biden argued that Trump’s effort to dismantle the Affordable Care Act in the Supreme Court would threaten the coverage of “a hundred million people that have pre-existing conditions…”—and that Trump had failed to provide a robust alternative.

Trump dodged the topic, diverting attention to claims that he has slashed drug prices. 

He said of insulin: “I’m getting it for so cheap it’s like water,” though a tweet from infectious diseases physician Jay B. Varkey suggested otherwise:

He also said that “drug prices will be coming down 80 or 90%”—though under Trump, prescription drug prices have risen 3%, according to The Washington Post’s fact-checker.

Other Reactions from the Public Health Twittersphere: