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Biden Releases Long-Sought National Plan Against COVID-19
Roadmap Describes
What It Will Take To Defeat This Virus
Science, Data, and
Public Health To Be In The Driver’s Seat, Not Politics
If there is one
criticism which epidemiologists and other public health professionals
often made of the previous administration in 2020, it was the lack of
a coordinated national plan to attack COVID-19. That void has now been
amply filled with a detailed roadmap issued by President Biden which
attacks COVID-19 on 7 principal fronts. Each front includes an overall
goal describing key actions for that goal and even more specific steps
to be taken for each key action. Altogether, the 200 page document
entitled a “National Strategy for the COVID-19 Response and Pandemic
Preparedness” contains 7 goals, 43 key actions, and 183 specific steps
as well as a dozen or so executive orders and memoranda which are
described as immediate actions.
Seven Goals
The seven goals are in
the following areas:
1. Restore trust with
the American people.
2. Mount a safe,
effective, and comprehensive vaccination campaign.
3. Mitigate spread
through expanding masking, testing, data, treatments, health care
workforce, and clear public health standards.
4. Immediately expand
emergency relief and exercise the Defense Production Act.
5. Safely reopen
schools, businesses, and travel while protecting workers.
6. Protect those most
at risk and advance equity, including across racial, ethnic and
rural/urban lines.
7. Restore U.S.
leadership globally and build better preparedness for future threats.
Special Interest For
Epidemiologists
The first three of
these goals will be of particular interest to epidemiologists and are
described in more detail below.
Goal #1
1. Restore trust with
the American people
This the Biden
administration plans to achieve by carrying out five key actions,
including:
·
Establish a national COVID-19 response structure driven
by both science and equity.
This
structure’s main task will be to coordinate across the national
government and establish clear lines of communication with state and
local officials, including immunization program managers.
·
Conduct regular, expert-led, science-based public
briefings.
This action will bring
back the regular CDC public briefings that have been the all-important
single point source of reliable information Americans have had in
previous outbreaks.
·
Publicly
share data around key response indicators.
This action will
collect much needed real-time data to provide effective surveillance
of the pandemic and to track performance measures related to such key
activities as testing,
vaccinations, and hospital admissions.
·
Engage
the American people.
Recognizing that the
federal government cannot solve this crisis alone, outreach will be
prioritized and the input used to drive the response.
·
Lead
science-first public health campaigns.
Science and fact-based
public education campaigns will be carried out as will efforts to
dispel myths and misinformation about COVID-19.
Goal #2
2. Mount a safe, effective, comprehensive vaccination campaign
This goal will require 10 separate key actions to
succeed, including:
·
Ensure
the availability of safe, effective vaccines for the American public.
The Biden administration expects to do this by
expanding vaccine manufacturing and purchasing
·
Accelerate getting shots into arms and get vaccines to the communities
that need them
most.
The plan calls for
ending the holding back of significant levels of doses and moving
through the priority groups more quickly while remaining
“laser-focused” on vaccinating the highest risk persons. These goals
are to some extent in competition with one another and the plan does
not make clear how these can be accomplished unless the supply of
vaccine is greatly increased over a short period of time.
·
Create
as many venues as needed for people to be vaccinated.
The list of sites to
be used is very long and includes such places as physician offices,
pharmacies, and retail stores. The plan does not mention how all these
everyday sites will be prepared to handle any vaccine reaction
emergencies should they arise, particularly those around anaphylactic
reactions.
·
Focus on
hard-to-reach and high-risk populations.
The plan states that
the programs needed to meet these goals are being or will have to be
built, and local public health officials will have to play a critical
role. Perhaps the most prominent of these targeted programs are those
organized to vaccinate persons in long term care facilities. Less
publicity has been given to any programs being developed to reach
African Americans, the elderly in non-institutional settings, and the
large group of Americans who are “vaccine hesitant”.
·
Fairly
compensate providers, and states and local governments for the cost of
administering vaccinations.
While everyone has
heard that vaccines are free, the cost of administering them is not.
This plan recognizes that covering the costs of administration will be
critical to achieving high vaccination coverage. Several payment
schemes are described including the use of the FEMA Disaster Relief
Fund to reimburse state and local governments for vaccine
administration expenses.
·
Drive
equity throughout the vaccination campaign and broader pandemic
response.
The need for equitable
vaccination has been widely recognized as epidemiologists have
identified the hardest hit populations. This plan will assure the
hardest hit have been identified, make sure vaccines are sent there
and that cost barriers to administration are removed. The federal
government will have to rely on community-based organizations to
achieve this equitable vaccination coverage.
·
Launch a
national vaccination public education campaign.
The plan calls for an
“unprecedented vaccination public health campaign at all levels. There
is no mention of a target vaccination level needed to achieve herd
immunity, but it could be as high as 90% of adults if children are not
eligible for vaccination.
·
Bolster
data systems and transparency for vaccinations.
Vaccination progress
will be tracked and the data used to drive the vaccination program. As
mentioned above, no target level vaccination aim is given in the plan.
·
Monitor
vaccine safety and efficacy.
Trust in the vaccine
is considered essential and the plan calls for scientists to be in
charge of safety and efficacy decisions and for these data to be made
publicly available. A recent pause in vaccination with Moderna vaccine
in California (see article in this issue) is an example of the kind
of real-time safety monitoring that is needed to maintain public
trust.
·
Surge
the healthcare workforce to support the vaccination effort.
Special exemptions and
measures will be encouraged to allow more qualified people to
administer vaccines.
Goal #3
3. Mitigate spread through expanding masking, testing, treatment,
data, workforce, and clear public health standards.
Prevention through
vaccination will not be enough to address the COVID crisis.
Strengthened control measures will also be needed, including,
·
Implement masking nationwide by working with governors, mayors, and
the American people.
Everywhere he can, President Biden has made mask wearing mandatory and
is asking everyone to wear masks.
·
Scale
and expand testing.
There will be created
a COVID-19 Pandemic Testing Board to oversee a clear, unified approach
to testing seen as a cornerstone disease control activity.
·
Effectively distribute tests and expand access to testing.
Under this objective,
the administration will support multiple activities, including school
screening, create a dedicated CDC Testing Support Team, and spur
development of at-home tests.
·
Prioritize therapeutics and establish a comprehensive, integrated
COVID-19 treatment discovery and development program.
·
Develop
actionable, evidence-based public health guidance
Metric-driven
reopening guidance is called for for schools and businesses.
·
Expand
the US public health workforce and increase clinical care capacity for
COVID-19
Several activities are
planned to build and support an effective public health workforce to
fight COVID-19 and the next public health threat. Of special note, the
US will create a US Public Health Job Corps.
·
Improve
data to guide the response to COVID-19
To read the complete report, visit:
https://bit.ly/39rdj7v
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