By the time Joe Biden assumes the role of president of the United States, we are likely to be in the throes of a worsening epidemic, as COVID-19 cases, hospitalizations and deaths continue the upward trajectory begun this fall.

Biden’s approach to addressing the pandemic is crucial. The temptation will be to put the burdens on ordinary Americans, including some of our nation’s most economically marginalized communities. The stay-at-home orders this spring likely blunted the epidemic in many places across the U.S. However, the ability to stay home is something that is only feasible for some. Many Americans kept society afloat by continuing to deliver goods, support infrastructure and sustain essential services such as grocery stores, farms, home care medical services and pharmacies.

These jobs are twinned with physical contact, enhancing COVID-19 risk. And those filling these jobs, as University of Chicago labor economists Simon Mongey and Alex Weinberg have noted, are less likely to be white, to have a college degree or to have employer-provided health care. And they are more likely to be in the bottom half of the income distribution scale. They are also less likely to have had stable jobs, more likely to have been unemployed in the last year and less likely to be employed full-time. Moreover, this economic precarity often also intersects with crowded living environments, where people are less likely to have at least one room per person available in a household, which makes effective quarantine or isolation challenging, should someone in the household be exposed or fall sick.

The pandemic relief bills this spring had little in the way of sustained direct support for ordinary Americans.

President-elect Biden’s plans for COVID-19 must ensure that the social goods of effective quarantine and isolation are supported by society, including the provision of paid leave and temporary housing support, especially for those in multigenerational households, and alleviating barriers to testing and health care. He must address the economic and social insecurity millions of Americans are facing at the same time he seeks to scale-up basic public health measures. It’s not enough for him to clamp down on the virus or ensure effective distribution of a vaccine, he must lift up those in need across the country, not consider them unavoidable collateral damage in a pandemic.

The pandemic is the worst public health disaster in the U.S. in over a century, but the social and economic catastrophe beneath the surface, which was largely ignored by politicians since all this began, is devastating in its own right. President-elect Biden cannot delay addressing the historical causes of these disparities — including systemic racism, which we’ve seen demonstrated in lopsided counts of infections with SARS-CoV-2 and deaths from COVID-19 in many communities — with immediate relief, sustained and substantial, for those who need it.

Stefan Baral is an associate professor within the Johns Hopkins School of Public Health. Gregg Gonsalves is an assistant professor at the Yale School of Public Health.