Krein has been an advisor to the Joe Biden 2020 presidential campaign on its COVID-19 pandemic response.[21][23][24] StartUp Health has been running an initiative to invest in health care startups offering solutions to the global pandemic since March 2020.[21] Krein's role with the Biden campaign while working as an executive of a health technology firm has led to speculation about a conflict of interest.[21][25][26][27] In 2011 StartUp Health had described Krein as an advisor to the Obama Administration.[21] Krein has stated that he does not have a formal role in the Biden campaign but has participated in briefings on the coronavirus based on his experience treating patients and coordinating Thomas Jefferson University Hospital's response to the outbreak.[21][26]