The Biden administration on Wednesday released an updated National Covid-19 Preparedness Plan that focuses on four key areas—protecting against and treating Covid-19, preparing for new variants, preventing economic and educational shutdowns, and vaccinating the world.

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The Biden administration's new Covid-19 plan

In a press conference on Wednesday, White House Covid-19 response coordinator Jeff Zients said the United States is in a "new moment" in its fight against the coronavirus.

"Because of the significant progress we've made, the determination and the resilience of the American people, and the work we've done to make tools to protect ourselves widely available, we are moving forward safely and getting back to our normal routines," Zients said.

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Protect against and treat Covid-19

According to the plan, the Biden administration has ordered 20 million courses of Pfizer's Covid-19 antiviral pill Paxlovid, and 1 million of those doses will be available in March, with another 2.5 million coming in April.

In the press conference, Zients said the federal government will be ready to make Pfizer-BioNTech's Covid-19 vaccine available to children under the age of 5 as soon as FDA authorizes it. The government will also launch a website with information on where to find vaccines and masks "later this month," Zients said.

The White House's plan says it will work with Congress to increase manufacturing capacity in the United States "to reliably produce an additional 1 billion vaccine doses per year … and accelerate research and development of a single Covid vaccine that protects against [the coronavirus] and all its variants, as well as previous SARS-origin viruses."

The plan also emphasizes the administration's "Test to Treat" initiative President Joe Biden referenced in his State of the Union address. This initiative will allow people who test positive for Covid-19 at a pharmacy to also receive antiviral pills "on the spot at no cost," Biden said in his address.

Zients said that hundreds of "One-Stop Test to Treat" locations will be opening this month around the United States.

At the press conference, HHS Secretary Xavier Becerra added that HHS will make its logistics and operational hub for Covid-19 a permanent part of the agency, calling it the HHS Coordination and Response Element.

Prepare for new variants

Zients noted that HHS, CDC, NIH, FDA, and the Federal Emergency Management Association will have a "Covid Variant Playbook," which will assess any new variant's "transmissibility and severity" and contain "tabletop readiness and response exercises."

CDC Director Rochelle Walensky said the department will maintain several forms of enhanced surveillance to watch for new variants, including a national wastewater surveillance system, a national syndromic surveillance center, and a center for forecasting and analytics.

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The administration's plan said it will also utilize new processes to accelerate FDA review of variant-specific Covid-19 vaccines and treatments, if they are needed. The plan also notes the government will add at-home Covid-19 tests, antiviral pills, and masks for the general public to America's stockpile.

Prevent economic and educational shutdowns

According to Zients, the Environmental Protection Agency will issue a new "clean air in buildings" checklist to promote "quality ventilation practices" in schools and businesses.

The administration's plan also says it will work with Congress to ensure workers who miss work due to Covid-19 or needing to care for a loved one with Covid-19 receive paid sick leave. Zients said the administration will reinstate tax credits to help small and medium businesses pay for that sick leave.

Continue to vaccinate the world

The administration's plan notes that it has already committed to donating 1.2 billion Covid-19 vaccine doses to other countries for free, and has so far delivered more than 475 million of those doses to 112 countries.

The plan says the administration will work with Congress to ensure the 1.2 billion doses are donated to the rest of the world, increase efforts to vaccinate more people, and make emergency supplies like oxygen more widely available to other countries.

Reaction

A number of health experts praised the administration's plan. Rick Bright, CEO of the Rockefeller Foundation's Pandemic Prevention Institute, said the plan is a "great start" that should "serve as a firm foundation to build upon, to extend our preparedness posture beyond Covid."

Jeanne Marrazzo, an infectious disease physician at the University of Alabama at Birmingham, also praised the plan and called the test to treat initiative a potential "game-changer."

"If we could really roll it out, make it accessible and affordable, and use it intelligently, you could really interrupt the course of disease, especially in those who are immunocompromised and other vulnerable populations," she said.

Former FDA Commissioner Scott Gottlieb called the plan "comprehensive, forward-looking, [and] well-crafted," adding that it "focuses on key capacity building for future contingencies that'll provide greater assurance we're prepared whether Covid-19 remains a low-level threat or takes new, more menacing twists."

Megan Ranney, an emergency medicine physician and academic dean at the Brown University School of Public Health, said she is "thrilled to see President Biden's team putting real thought behind how to be better prepared should there be another surge or another variant."

"Should this plan be implemented as outlined, it's a big step forward to a better tomorrow," she added.

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the Biden administration put together "a very realistic message on [the importance of variants], saying we can hope the worst is behind us, but that we don't know. … I think that is a very important point, and all of the work that they're proposing be done is in fact about what still could be a real challenge." (Walker, MedPage Today, 3/2; Stolberg, New York Times, 3/2; Klein/Sullivan, CNN, 3/2; Abutaleb et al., Washington Post, 3/1; Facher, STAT News, 3/2; Carbajal, Becker's Hospital Review, 3/2)