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Democratic U.S. presidential candidates former Vice President Joe Biden and Senator Bernie Sanders do an elbow bump in place of a handshake as they greet other before the start of the 11th Democratic candidates debate of the 2020 U.S. presidential campaign, held in CNN's Washington studios without an audience because of the global coronavirus pandemic, in Washington, U.S. March 15, 2020.KEVIN LAMARQUE/Reuters

Bernie Sanders argued that the coronavirus pandemic highlights the sweeping dysfunction of American society, from its private healthcare system to rising income inequality. But Joe Biden contended the crisis is an isolated problem that requires only a one-time response.

The two remaining contenders for the Democratic presidential nomination met for their first head-to-head debate Sunday in a country vastly changed from just a week earlier. Even the joust itself was affected, moved from Phoenix to Washington to cut down on travel, and held with no live audience.

But while COVID-19 overshadowed much of the debate, the pandemic did not change the tone. The leftist Mr. Sanders portrayed his moderate rival as beholden to big corporations and unambitious on climate change. Mr. Biden disparaged Mr. Sanders as an anti-capitalist and communist sympathizer.

The face-off was the first since Mr. Biden seized a commanding lead in the race over the last two weeks. While he aimed to solidify his position – including announcing partway through that he would choose a woman as his vice-presidential running mate – Mr. Sanders made a final bid to arrest his momentum ahead of primaries in vote-rich Florida, Illinois, Ohio and Arizona vote on Tuesday.

Even the coronavirus itself provoked a testy exchange. Mr. Sanders opened with an attack on President Donald Trump’s minimizing of the pandemic before arguing that the outbreak only reinforces the need to switch to a Medicare-for-all single-payer healthcare system and end the economic precariousness that leaves so many workers a paycheque away from financial ruin.

“Shut this President up right now, because he is undermining the doctors and the scientists who are trying to help the American people. It is unacceptable for him to be blabbering with unfactual information,” Mr. Sanders said.

“We’re spending more than twice as much per person on health care as the people of any other country … How come we don't have enough doctors? How come hospitals in rural areas are shutting down? How come people can't afford to get the prescription drugs they need because we have a bunch of crooks who are running the pharmaceutical industry ripping us off every single day?”

Mr. Biden fired back that Italy, which has a universal healthcare system, is not faring any better than the U.S. in the pandemic. That country has recorded more than 1,800 coronavirus deaths, the highest total outside of China.

“You have a single-payer system in Italy. It doesn't work there. It has nothing to do with Medicare-for-all. That would not solve the problem at all,” he said. “People are looking for results, not a revolution.”

Mr. Biden did, however, agree with Mr. Sanders that all coronavirus-related healthcare should be free of charge, and that people out of work because of the pandemic should be compensated.

Both candidates said they had overhauled their own campaigns to deal with the crisis. Instead of rallies, they are holding virtual townhalls. Their staff and volunteers are also working from home.

Almost immediately, they turned back to familiar territory.

Mr. Sanders claimed Mr. Biden wasn’t serious enough about tackling climate change because the former vice-president hasn’t explicitly promised an end to fracking for natural gas. The Vermont Senator pressed Mr. Biden to shut down his own SuperPACs. And in one tempestuous exchange, Mr. Sanders accused Mr. Biden of looking to cut social programs to secure budget deals with Republican legislators.

“Have you been on the floor of the Senate … time and time again talking about the necessity, with pride, about cutting Social Security, cutting Medicare, cutting veterans' programs?”

“No,” Mr. Biden replied.

“You never said that?” Mr. Sanders asked.

“No…what is true, in terms of negotiations that are taking place, how to deal with the deficit, everything was on the table,” Mr. Biden said.

“Whoa, whoa, everything was on the table,” Mr. Sanders said. “Including…cuts to social security.”

Mr. Biden returned fire by pointing out that Mr. Sanders previously voted against bills mandating background checks for gun purchases, which he now supports, and in favour of legislation to shield gun companies from legal liability in shootings.

He also slammed Mr. Sanders for voting against bailing out the big banks after the 2008 financial crisis. Without the bailout, Mr. Biden charged, people would have lost all their savings.

The former vice-president also hammered Mr. Sanders for praising Cuban literacy programs under Fidel Castro and the reduction of poverty in China under that country’s current dictatorship.

It was a much stronger performance for Mr. Biden than in previous debates, when he often lost his train of thought or became upset with the moderators for not giving him enough time to speak.

He also used a section of the debate on gender equality to announce that he would “pick a woman to be my vice president.” Mr. Sanders, who promised to appoint a gender-equal cabinet, said he would “in all likelihood” also choose a woman as his running mate.

And amid all the internecine fighting, Mr. Biden made one brief plea for unity.

“If Bernie is the nominee, I will not only support him, I will campaign for him…because the existential threat to the United States of America is Donald Trump. It’s critical,” Mr. Biden said. “We disagree on the detail of how we do [policy.] But we don’t disagree on the principle. We fundamentally disagree with this President on everything.”

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