Nat Covid 19 Preparedness Plan

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N ATIONAL

COVID-19
P REPAREDNESS
P LAN
M A R C H 2022
Table of Contents
Executive Summary ..................................................................................................... 4
GOAL ONE Protect against, and treat, COVID-19 ............................................... 20
GOAL TWO Prepare for new variants .................................................................. 60
GOAL THREE Prevent economic and educational shutdowns ........................ 78
GOAL FOUR Continue to lead the effort to vaccinate the world
and save lives .............................................................................................................. 87
Executive Summary
President Biden came into office facing the worst public health crisis in more than a
century. COVID-19 was wreaking havoc on our country – closing our businesses,
keeping our kids out of school, and forcing us into isolation and lockdown as our first
line of defense. Americans lacked the tools we needed to protect ourselves and our
families.

Our country needed an emergency response that was worthy of the crisis we faced. A
response that would leave no stone unturned, that would leverage the full force of the
federal government, the innovation of the private sector, and the determination of the
American people. On President Biden’s first full day in office, he released the first-
ever comprehensive National Strategy for the COVID-19 Response. This strategy
focused on building a response to this virus that would give people the tools they
needed to protect themselves, reopen our schools, and get our economy moving again.

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The U.S. government has spent the last year executing on that strategy. To get this
country moving in the right direction, we worked hand-in-hand with doctors, nurses,
businesses, unions, community organizations, governors, mayors, and citizens across
every state, Tribe, and territory.

As a result, today, 215 million people are fully vaccinated and two-thirds of eligible
adults have gotten their booster shot. We have multiple treatment options, including
life-saving pills, and continue to fill the nation’s medicine cabinet. Testing capacity
has dramatically increased and we have plenty of free, high-quality masks available to
the American people. Schools are open and the economy is experiencing the fastest
economic growth in four decades.

America must maintain the tools – vaccines, boosters, treatments, tests, and masks –
to protect against COVID-19 and dramatically decrease the risk of the most severe
outcomes. We must be prepared to respond to a new variant quickly and keep our
schools and businesses open.

Today, the U.S. government is releasing an update to our National Strategy – the
National COVID-19 Preparedness Plan – which will help move America forward
safely. This plan lays out the roadmap to help us fight COVID-19 in the future as we
move America from crisis to a time when COVID-19 does not disrupt our daily lives
and is something we prevent, protect against, and treat. We look to a future when
Americans no longer fear lockdowns, shutdowns, and our kids not going to school. It’s
a future when the country relies on the powerful layers of protection we have built
and invests in the next generation of tools to stay ahead of this virus.

The National COVID-19 Preparedness Plan is clear-eyed that new variants might
arise. And, with the support of Congress, it outlines a plan to ensure that vaccines,
tests, and treatments can be updated and deployed quickly to protect against a new
variant.

Make no mistake, President Biden will not accept just “living with COVID” any more
than we accept “living with” cancer, Alzheimer’s, or AIDS. We will continue our work
to stop the spread of the virus, blunt its impact on those who get infected, and deploy
new treatments to dramatically reduce the occurrence of severe COVID-19 disease
and deaths.

We are not going to just “live with COVID.” Because of our work, we are no longer
going to let COVID-19 dictate how we live.

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To fully execute on this plan requires Congress doing its part to invest in tools that
work. Additional funding will be necessary to provide critical treatments like pills and
monoclonal antibodies; to make further investments to shore up America’s testing
supply; to provide resources that guard against and prepare for new variants; and to
continue to fight this virus abroad. Without these investments, many of the activities
described below cannot be initiated or sustained.

America has made strong progress in our fight against the COVID-19 pandemic.
Congress providing the resources needed to execute this plan will be critical to getting
America back to our normal routines while protecting people from COVID-19,
preparing for new variants, and preventing economic and educational shutdowns.
Because of our work over the last two years, we can begin to move forward safely.

The President’s National COVID-19 Preparedness Plan focuses on four key goals:

1. Protect against and treat COVID-19

2. Prepare for new variants

3. Prevent economic and educational shutdowns

4. Continue to lead the effort to vaccinate the world and save lives

1: Protect against and treat COVID-19

The United States has experienced five waves of the pandemic since 2020, including
three in the past year that were driven by new variants. America experienced a wave
of COVID-19 cases driven by the Alpha variant in early Spring 2021 – a time when the
U.S. vaccination program was administering a record number of vaccines every day.
The Delta variant, which was more than twice as contagious as the original
coronavirus strain, then swept across the country starting in Summer 2021, beginning
in the South and spreading to the Midwest and Rocky Mountain regions.

Omicron represented another step in the virus’s evolution, and has been one of the
most contagious viruses in history, causing record numbers of infections around the
world over the past three months. However, because of both lower severity of the

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Omicron variant and a stronger level of population immunity from vaccinations,


Omicron has caused relatively fewer cases of severe COVID-19. Compared to prior
waves of COVID-19 in the United States, the Omicron wave has had a lower
proportion of cases resulting in hospitalization or death.

America has weathered the current Omicron wave with minimal disruption – schools
and businesses largely remained open. As the country emerges from the Omicron
wave, our path forward relies on maintaining and continually enhancing the
numerous tools we now have to protect ourselves and our loved ones – from vaccines,
to tests, to treatments, to masks, and more.

In January 2021, Americans had very few tools to protect against COVID-19, and the
tools we did have were in limited supply. Over the last year, together, with states,
localities, and public and private partners, the Administration has mobilized an
unprecedented, whole-of-society effort to give Americans the tools they need to
protect themselves.

The Administration has put vaccines at the center of our COVID-19 response because
vaccines are the best tool we have to prevent hospitalization and death. We stood up
the largest free vaccination program in our country’s history – mobilizing 90,000
vaccination locations, standing up dozens of federally-run mass vaccination sites with
the ability to administer more than a combined 125,000 shots a day, and deploying
over 9,000 federal personnel to support vaccinations nationwide – including over
5,000 active duty troops. As a result, today, the vast majority of Americans have the
protection of a vaccine – with 215 million Americans fully vaccinated, and an
estimated two-thirds of eligible adults having received their booster shot. Vaccinated
and boosted people are 41 times less like to die of COVID-19 than unvaccinated
individuals. And America’s unprecedented vaccination campaign has saved lives: a
December 2021 estimate suggested that vaccines saved over 1 million American lives
and successfully prevented over 10 million hospitalizations.

The Administration has also expedited the development, manufacturing, and


procurement of COVID-19 treatments, building a diverse medicine cabinet filled with
more treatments now than at any point in the pandemic. Today about 4 million
treatment courses are available to Americans, with 1 million additional courses of the
Pfizer antiviral available in March, and another 2.5 million additional courses of the
Pfizer antiviral available in April. In total, we have secured 20 million courses of
Pfizer’s life-saving antiviral pills, which have been shown to reduce the risk of
hospitalization or death by 89%.

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The nation’s testing supply has increased dramatically. We now have free testing sites
at 21,500 locations around the country. In January 2021, there were no rapid, at-home
tests on the market available to Americans; during January 2022, there were more
than 480 million at-home tests available to Americans on top of all other testing
options. And we stood up COVIDtests.gov so Americans could order tests that shipped
directly to their homes — for free. Private insurance and Medicaid now cover rapid at-
home tests for free, and Medicare will fully cover these at-home tests starting this
spring.

And the U.S. government has successfully put equity at the heart of a nationwide
public health response. Hispanic, Black, and Asian adults are now vaccinated at the
same rates as White adults. This is the result of an all-of-society effort that got
America to where it is today: employers who offered paid time off for their employees;
child care providers who offered drop-in services for caregivers to get vaccinated;
public transit authorities and ride-sharing companies that provided free rides to
vaccination sites; churches, civic organizations, barbershops, and beauty salons, who
opened their doors to be trusted spaces for vaccinations; and the families who made
vaccination a family affair.

The path forward in the fight against COVID-19 is clear: we must maintain and
continually enhance the tools we have to protect against and treat COVID-19. The
Administration looks forward to working with Congress to ensure that we have the
resources to do just that.

Because we have these tools, we can begin to get back to our more normal routines
safely and the use of public health mitigation measures like masking can be less
frequent. The Centers for Disease Control and Prevention (CDC) has updated its
framework for recommendations on preventive measures like masking, so masks are
recommended when and where they matter the most and Americans will be wearing
masks less often.

And make no mistake, as America moves forward we will leave no one behind. Equity
will remain at the very center of our path forward in the fight against COVID-19. And
we will be there to support Americans with the long-term impacts of COVID-19,
including people experiencing Long COVID or mental and behavioral health
challenges; as well as families suffering from the tragedy of losing someone they loved.

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The Administration will work with Congress to secure the


necessary funding to:

• Launch an effort to vaccinate America’s youngest children as soon as the


U.S. Food and Drug Administration (FDA) authorizes and the CDC
recommends a vaccine for that age group. If the FDA authorizes and the CDC
recommends a vaccine for children under five years of age, the United States is
prepared to immediately distribute vaccines through a network of thousands of
pediatricians’ offices, children’s hospitals, health centers, and local sites, so that
vaccines are made available conveniently to families across the country.

• Ensure that Americans – of all ages – can get the protection of an effective
vaccine. The Administration will continue to ensure that all Americans have
ready access to free and safe vaccines, because vaccines are the most effective
defense against COVID-19. The U.S. Department of Health and Human Services
(HHS) will also continue to monitor the efficacy and durability of currently
authorized vaccines against current and future variants and make
recommendations to optimize protection.

• Increase American manufacturing capacity to reliably produce an additional


1 billion vaccine doses per year – three times the U.S. population – and
accelerate research and development of a single COVID vaccine that
protects against SARS-CoV-2 and all its variants, as well as previous SARS-
origin viruses. To ensure that people stay protected, the U.S. government will
continue to use advance purchasing agreements when appropriate and work
closely with vaccine manufacturers to produce shots quickly and safely. Fully
supporting this effort to scale up domestic vaccine manufacturing will require
additional resources from Congress. Additionally, we will maintain a network
of tens of thousands of sites to deliver shots to the American people at any time
this effort is needed.

• Continue vaccination outreach and education efforts and combat


misinformation and disinformation. HHS will continue its work to equip
Americans with the tools to identify misinformation and to invest in longer-
term efforts to build resilience against health misinformation.

• Ensure there are enough treatments for Americans who need them. The U.S.
government will procure additional treatments; continue to utilize an

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expedited, streamlined process to review treatments for authorization by the


FDA; and accelerate research and development into next generation
treatments. These efforts will require additional funding and authorities from
Congress.

• Launch a nationwide Test to Treat Initiative so Americans can rapidly access


treatment, including by visiting a “one-stop” location to get a free test and
free treatment pills. The Administration will put forth new educational efforts
for the public and providers so that Americans can rapidly access treatments.
The Administration will establish “One-Stop Test to Treat” locations at
pharmacy-based clinics, community health centers, Long-Term Care Facilities,
and the U.S. Department of Veterans Affairs (VA) facilities across the country.
“One-stop” sites will be operational by March.

• Update the framework for recommendations on preventive measures like


masking to reflect the current state of the disease. Masks have been a critical
tool to protect ourselves, but they have a time and a place. With a broad range
of other protective tools in place, the CDC has announced an updated
framework for guidance on preventive measures like masking – moving away
from simply basing broad recommendations on case counts and test positivity,
and instead encouraging prevention measures like masking when they are most
needed to minimize severe disease and to keep our hospitals from becoming
overwhelmed in times when COVID-19 is surging. By monitoring community
risk, masks can be worn when the risk of severe disease in the community is
high and taken off when the risk is low. Overall, it means Americans will be
wearing masks less because so many people are protected from severe disease.

• Launch a one-stop-shop website that allows Americans to easily find public


health guidance based on the COVID-19 risk in their local area and access
tools to protect themselves. The Administration will launch a website where
Americans can find the level of COVID-19 risk in their community and specific
guidance based on that risk. The site will also point people to the tools we now
have to fight COVID-19, such as locating a vaccination site in their
neighborhood or finding a free high-quality mask at a local grocery store or
pharmacy.

• Sustain and increase American manufacturing of COVID-19 tests, so we can


continue to have a robust supply of tests. The Administration will continue to
utilize the expedited authorization process to help test manufacturers come to

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market quickly; maintain America’s network of thousands of free testing sites;


utilize the Defense Production Act (DPA) and other authorities, where
warranted, to increase manufacturing capacity; and invest in innovation to
make tests less expensive. These continued investments in testing will require
additional funding from Congress.

• Prioritize protections for immunocompromised people and take new actions


to protect individuals with disabilities and older adults. The Administration
will continue to provide strong support for the immunocompromised, including
providing prioritized access to treatments and preventive interventions –
pending additional funding from Congress – as well as ensuring access to
boosters. The Administration will also increase equitable access to testing and
COVID-19 mitigation resources for people with disabilities and older adults,
and engage industry to accelerate research and development of accessible self-
tests. Securing sufficient preventive treatments for people who are
immunocompromised will require additional funding from Congress.

• Help Americans with the long-term impacts of COVID-19. In recognition of


the wide-reaching long-term impacts of COVID-19 on our society, the President
will direct the U.S. government to accelerate efforts to detect, prevent, and
treat Long COVID; coordinate efforts to provide support to families who have
experienced the COVID-related loss of a loved one; and attend to the mental
health and well-being of our communities. The Administration will also
propose to make new investments in health care workers to support their
mental health and well-being.

• Ensure equitable access to COVID-19 health care and public health


resources. The Administration will continue to prioritize providing equitable
access to COVID-19 health care and public health resources – including
personal protective equipment (PPE), tests, treatments, masks, and vaccines;
and address COVID-related health inequities among communities defined by
race, ethnicity, geography, disability, sexual orientation, gender identity, and
other factors. The U.S. government will support dedicated resources for local
community-based organizations, community health centers, and rural health
clinics.

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2. Prepare for new variants

As we work to keep ourselves protected against COVID-19, America must remain


prepared for any new variant that may come our way. To do so, the Administration
has developed a comprehensive plan for how we monitor this virus to stay ahead of it,
adapt our tools swiftly to combat a new variant, and deploy emergency resources to
help communities.

Before January 2021, the federal government had insufficient data and sequencing
capabilities and was ill-equipped to respond to new variants. Electronic case reporting
was in place for only a handful of states in 2020 and the country could sequence only
3,000 viral isolates per week. America had no plan for responding to a new variant or
standing up comprehensive efforts to respond to a surge in COVID-19 cases.

The Administration has enhanced our collection, production, and analysis of data, and
expanded electronic case reporting to all 50 states, Washington D.C., Puerto Rico, and
thousands of health care facilities. The CDC now tracks a range of key COVID-19
response metrics including cases, tests, vaccinations, and hospital admissions in real-
time. Additionally, the CDC launched – and is continually enhancing – the National
Wastewater Surveillance System (NWSS) to track the presence of SARS-COV-2 in
wastewater samples collected across the country. And America has established a
world-class sequencing operation, sequencing up to 90,000 isolates a week. The
CDC’s sequencing efforts can now reliably detect variants that account for as little as
0.1% of all COVID-19 cases circulating in the United States. And when new variants
are identified, the federal government has a network of researchers – federal,
academic, and commercial – who are able to study the sequence and assess mutations
rapidly, allowing the government to respond quickly to concerning variants.

The Administration has also successfully built a robust emergency response


infrastructure. Our surge response – led by the Federal Emergency Management
Agency (FEMA) and HHS – developed capabilities to stand up over 100 federal mass
vaccination sites and federal surge testing sites; distribute millions of critical supplies;
and deploy thousands of federal clinical and non-clinical personnel to support states,
Tribes, and territories. Since July 2021, the federal government has deployed over
4,000 military and non-military personnel including doctors, nurses, and paramedics;
sent over 3,400 ventilators, ambulances, and other critical supplies; and shipped over
115 million pieces of PPE. And over the last year, FEMA has invested $300 million
dollars in state hospital preparedness to expand hospital capacity in 38 states.

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Moving forward, the Administration will maintain our proven data, sequencing,
variant response, and surge response capabilities. The CDC will continue to improve
COVID-19 data collection, reporting, and analysis so America is better informed and
ready to respond to new variants. And if new variants emerge, the federal government
will leverage established playbooks to assess a new variant’s impact on our vaccines,
treatments, and tests, and rapidly deploy the tools, personnel, and resources
Americans need. America will also retain a significant stockpile of tools to combat
COVID-19 that remain ready for deployment. The Administration will work with
Congress to secure the necessary funding to:

• Improve our data collection, sequencing, and wastewater surveillance


capabilities to immediately identify and detect new and emerging variants;
and strengthen pandemic preparedness. The U.S. government will continue
improvements to COVID-19 disease and vaccination data collection,
wastewater surveillance, and virus sequencing capacity so we are better
prepared to respond rapidly to emerging threats. This includes strengthening
data infrastructure and interoperability so that more jurisdictions can link case
surveillance and hospital data to vaccine data. The Administration is also
leveraging COVID-19 response capabilities into stronger pandemic
preparedness.

• Leverage a COVID-19 Variant Playbook to determine the impact of a new


variant on our vaccines, treatments, and tests, and shore up and update our
tools, if needed. The Administration has developed a variant playbook to assess
the disease severity and transmissibility of a new variant immediately, and to
expedite the rapid laboratory evaluation of the effectiveness of vaccines, tests,
and treatments against any variant. The U.S. government has also developed a
series of plans in coordination with manufacturers for the accelerated
development, approval, manufacturing, and delivery of updated vaccines, tests,
and treatments. These expedited plans and processes suggest that updated
vaccines could be developed, approved, manufactured, and delivered in 100
days instead of the 11 months that it has previously taken.

• Utilize new FDA processes to expedite regulatory review of variant-specific


versions of vaccines and treatments, so Americans can get them quickly if
needed. FDA has developed new approaches to accelerate the authorization of
a vaccine or treatment that targets any new variant while maintaining strict and
longstanding practices to ensure the safety and efficacy of the products.

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• Leverage a proven COVID-19 Surge Response Playbook. The Administration


has developed a comprehensive emergency response COVID-19 surge playbook
to stand up mass vaccination and testing sites, expedite deployments of surge
medical and emergency personnel, expand hospitals and emergency facilities,
and provide emergency supplies.

• Add at-home tests, antiviral pills, and masks for the general population to
America’s stockpile for the first time. America will stockpile new categories of
supplies including at-home tests, antiviral pills, and masks for the general
population for the first time. The Administration will also maintain a fully
stocked Strategic National Stockpile (SNS) with an inventory of masks,
ventilators, gloves, gowns, and hospital equipment. The U.S. government will
be ready to deploy supplies to the American people to ensure adequate supply
in times of surges, COVID-19 outbreaks, or new variants.

• The U.S. government has established a permanent logistics and operational


hub at HHS to ensure accelerated development, production, and delivery of
COVID-19 vaccines and treatments. The Administration has transitioned an
emergency logistics and operational organization into a permanent agency
structure at HHS, which has allowed the Administration to build on its
progress, retain expertise and skills, and continue providing the necessary tools
to the American people during this pandemic and for any future disease
outbreaks.

3. Prevent economic and educational shutdowns

Our path forward relies on giving schools and businesses the tools they need to
prevent economic and educational shutdowns, so that our students can remain safe in
school, our workers can be safe at work, and our economy can continue to grow. At
the beginning of last year, America was experiencing widespread school and business
shutdowns: only 46% of K-12 schools were open for in-person learning, and millions of
businesses had closed and tens of millions of Americans had lost their jobs in 2020.

Throughout the last year, the Administration worked to provide schools, child care
providers, and businesses with the necessary tools and resources to safely open, while
keeping our children, students, and workers safe. The Administration provided a

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historic investment of $130 billion from the American Rescue Plan to reopen schools
by improving school ventilation, accessing tests, and hiring more teachers, nurses, and
staff. And to protect workers and keep our businesses open, the Administration
launched the largest vaccination campaign in history – working hand-in-hand with
the business community; and requiring vaccinations where we could, including for
federal workers.

Today, about 99% of K-12 schools are open for in-person learning. And since President
Biden took office, there has been historic job growth. The U.S. economy created 6.6
million jobs in 2021 – the strongest job growth of any year on record – and grew 5.7%
in 2021, the fastest pace of economic growth in nearly four decades. The U.S. was also
the first major economy to exceed its pre-pandemic economic output.

The path forward in the fight against COVID-19 is clear: schools, workers, and
workplaces have resources and guidance to prevent shutdowns. The Administration
will work with Congress to secure the necessary funding to:

• Give schools and businesses guidance, tests, and supplies to stay open,
including tools to improve ventilation and air filtration. The U.S. government
will also provide a Clean Air in Buildings Checklist that all buildings can use to
improve indoor ventilation and air filtration and will encourage uptake of
ventilation improvements. The Administration will also provide technical
assistance that encourages schools, public buildings, and state, local, and Tribal
governments to make ventilation improvements and upgrades using American
Rescue Plan funds.

• Work with Congress to provide paid sick leave to workers who need to miss
work due to a case of COVID-19 or to care for a loved one who has COVID-
19. The Administration will work with Congress to reinstate tax credits to help
small- and mid-size businesses provide paid sick and family leave to deal with
COVID-related absences.

• Update guidance for employers to ensure safer workplaces. The Department


of Labor’s Occupational Safety and Health Administration (OSHA) will update
workplace guidance to better equip employers with the tools they need to
ensure safe workplaces, including guidance on how employers can continue to
support increased vaccination and boosting of their employees; support
workers such as people who are immunocompromised who choose to wear
high-quality masks; limit workplace-based infections; and enhance ventilation.

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• Engage early care and education providers to help them remain safely open
and help parents return to work with peace of mind. Early care and education
providers, including child care centers, family child care providers, pre-K and
more, have been essential in our fight against COVID-19. The Administration
invested $40 billion in American Rescue Plan funds to states, territories, and
Tribes to help child care providers and Head Start grantees keep their doors
open and provide safe care that is crucial for parents getting back to work.
Building on this funding, the Administration will continue to engage the
community of early care and education providers to ensure they have tools and
support to stay safely open and to continue supporting our families.
• With the vast majority of federal workers at their workplaces, substantially
expand levels of services at public-facing federal offices (like local Social
Security offices). COVID-19 no longer needs to dictate how we work. Federal
agencies will lead by example, increasing the hours public-facing federal offices
are open for in-person appointments and in-person interactions in the month of
April.

4. Continue to lead the effort to vaccinate the


world and save lives

Fighting this virus abroad is key to America’s effort to protect people and stay ahead
of new variants. To do so, we will continue to lead in providing vaccines to the world,
helping to get those vaccines into arms, and deploying emergency supplies to
countries experiencing surges in COVID-19. We will also continue to advance
sustainable capacity and financing for health security to fight COVID-19 variants.

The President committed that the United States would be the world’s arsenal for
vaccines – both because it’s the right thing to do and in our collective interest. And
America is delivering on that commitment. The United States stands alone in
procuring 1 billion vaccines for the sole purpose of donating them. And overall, the
Administration has committed to donating 1.2 billion doses to other countries – for
free, with zero strings attached, which represents the largest commitment of any
single country or group of countries in the world. As of today, the U.S. government has
delivered over 470 million free doses to 112 countries around the world – four times
the number of free doses shared with the world than any other country.

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In addition, the U.S. government has delivered life-saving resources like oxygen,
treatments, PPE, and other essential supplies worth more than $1 billion to countries
experiencing outbreaks. U.S. government public health experts from the CDC, U.S.
Agency for International Development (USAID), the U.S. Department of State (State),
HHS and the President’s Emergency Plan for AIDS Relief (PEPFAR) and other entities
are working side-by-side with on-the-ground providers, providing technical
assistance in vaccine program implementation, care provision, and outbreak
investigation. We have increased the world’s capacity to manufacture vaccines and
have fostered an enabling environment for innovation, including by spurring African
manufacturing.

Over the last year, the Biden Administration pioneered the model to donate and
deliver surplus vaccines to the rest of the world. America was the first country to
announce a purchase of doses solely for donation to other countries; the first country
to give up our place in line for vaccines – allowing the African Union to immediately
start receiving up to 110 million doses of Moderna at a reduced rate negotiated by the
United States; and the first country to negotiate a deal to send vaccines directly to
humanitarian settings and conflict zones to vaccinate displaced persons.

The path forward in the pandemic will require doubling down on our commitment to
help vaccinate the globe and to save lives by making tests, treatments, and PPE widely
available. The Administration will work with Congress to secure the necessary
funding to:

• Leverage the vaccine donation model America pioneered to deliver the 1.2
billion doses we committed to donate to the rest of the world. America will
continue to deliver the 1.2 billion doses we committed to donate to countries in
need, continuing to leverage the partnerships the U.S. government built to
donate and deliver vaccines to the rest of the world.

• Increase efforts to get shots in arms around the world. The U.S. government
will increase investment in the Initiative for Global Vaccine Access (Global
VAX), an ambitious global vaccination initiative to get doses into arms by
working with partner countries to more quickly implement their plans. This
includes supporting efforts such as jumpstarting communications campaigns,
providing and supporting vaccinators on the front lines, purchasing cold chain
supplies and syringes, paying for shipping and logistics to expedite vaccine
delivery to hard-to-reach areas, ensuring people at high risk of hospitalization
and deaths like the elderly and immunocompromised are vaccinated, and

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building vaccine confidence on the ground. Expanded global shots-in-arms


efforts will require additional funding from Congress.

• Save lives by solving the oxygen crisis and making emergency supplies
widely available. The U.S. government will make oxygen and PPE available;
enhance testing; provide treatments; strengthen global health systems to fight
COVID-19; protect health workers from COVID-19 and essential health services
from COVID-19 disruptions; improve detection, monitoring and mitigation of
new COVID-19 variants; and increase regional and local manufacturing of
countermeasures. These continued investments will require additional funding
from Congress.

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• Continue global leadership on the COVID-19 response and build better


health security for the future. The U.S. government will continue to work to
build better capacity to fight COVID-19, manage future variants, and advance
health security and preparedness for future pandemics. America is committed
to establishing a new health security financial intermediary fund at the World
Bank in 2022, and we call on all countries and public and private organizations
to commit to urgent action to assist in the global COVID-19 response.

NATIONAL COVID-19 PREPAREDNESS PLAN 19


GOAL ONE
Protect against, and treat, COVID-19

1: Protect against, and treat, COVID-19

America’s Progress to Date:


Vaccines:
ü 215 million Americans – and over three quarters of American adults – are fully vaccinated
ü Two out of three eligible adults – and over 80% of seniors – are boosted
ü Over 1 million American lives saved and over 10 million hospitalizations prevented
Treatments:
ü 20 million treatment courses of Pfizer’s oral antiviral secured
ü Worked with Pfizer to shave about seven months from original timeline of the clinical trial
process so the first antiviral pills shipped in December – months ahead of schedule
Tests and Masks:
ü 480 million rapid at-home tests available to Americans during January 2022, on top of all our
other testing options; up from zero at the start of last year
ü Over 20,000 free pharmacy and community testing sites nationwide
ü Private health insurance now covers rapid at-home tests and Medicare will soon
ü Shipped 240 million masks to 30,000 grocery stores, pharmacies and community health centers
so Americans can pick up free N95 masks
Equity:
ü Successfully put equity at the center of a public health response for the first time in the nation’s
history
ü Hispanic, Black, and Asian adults are now vaccinated at same rates as White adults
ü About 70% of tests at federal surge testing sites administered to people of color

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ü Over 80% of recommendations from the Administration’s COVID-19 Health Equity Task Force
fulfilled, with historic investments to drive equity in future public health efforts
Moving forward, the Administration will work with Congress to secure the necessary funding to:
Vaccines:
ü Launch an effort to vaccinate America’s youngest children as soon as the FDA authorizes and
CDC recommends a vaccine, ensuring that Americans – of all ages – can get the protection of a
vaccine
ü Accelerate research and development toward a single COVID vaccine that protects against SARS-
CoV-2 and all its variants, as well as previous SARS-origin viruses.
ü Increase American manufacturing capacity to reliably produce an additional 1 billion vaccine
doses per year – three times the U.S. population
ü Continue to mobilize our network of tens of thousands of sites to deliver shots
ü Enhance vaccinations outreach and education efforts to reach the unvaccinated, promote
boosters, get our kids vaccinated; and continue to combat misinformation and disinformation
Treatments:
ü Ensure there are enough treatments for Americans who need them
ü Launch a nationwide Test to Treat Initiative so Americans can get rapidly treated, including
options to visit “One-Stop” Test to Treat locations to get free tests and get free treatments
ü Explore public and private insurer coverage of COVID-19 treatments this year
ü Support the FDA’s expedited, streamlined process to review treatments for authorization
ü Accelerate research and development into next-generation therapeutics
Tests and Masks:
ü Sustain and increase American manufacturing so a robust supply of tests will be consistently
available
ü Build a large stockpile of rapid at-home tests for the first time
ü Utilize the expedited FDA approval processes to help test manufacturers come to market more
quickly
ü Maintain America’s network of over 20,000 free testing sites to provide free, efficient tests to the
American people
ü Invest in innovation to make tests less expensive
ü Continue to support testing, treatment, and vaccine administration for the most vulnerable
through the uninsured fund
ü Continue to provide insurance coverage for at-home tests and Medicare will cover
these tests soon
ü Update the framework for recommendations on preventive measures like masking to
reflect the current state of the disease
ü Launch a one-stop-shop website that allows Americans to easily find public health guidance
based on the risk in their local area and access tools to protect themselves
ü Continue to provide free, high-quality masks to the American public
Equity and Making Sure No American is Left Behind:
ü Ensure equitable access to COVID-19 health care and public health resources
ü Continue to address the needs of people with disabilities and older adults in response and recovery
from the virus
ü Prioritize protections for individuals who are immunocompromised so they have the support they
need to live their lives safely
ü Accelerate efforts to detect, prevent, and treat Long COVID
ü Launch new support for people dealing with behavioral and mental health issues
ü Support families dealing with COVID-related loss
ü Continue to support local, community-based organizations to improve health equity
ü Sustain critical efforts to build a representative health care and public health workforce
ü Expand health equity data to drive pandemic decision making

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Our path forward relies on maintaining and continuously enhancing the numerous
tools we now have to protect ourselves and our loved ones. In January 2021, fewer
than 1% of Americans were fully vaccinated, and there were not enough vaccines,
vaccinators, or vaccination sites around the country. Treatments were not widely
available. There were not enough places to get tested and zero rapid at-home tests on
the market. And where tests were available, they were often too expensive.

Over the last year, together, with states, localities, and private and public partners, the
Administration has mobilized an unprecedented, whole-of-society effort to give
Americans the tools they need to protect themselves against COVID-19.

From the beginning, the Administration put vaccines at the center of our COVID-19
response. From Day One, the President worked with vaccine manufacturers to
accelerate delivery timelines, ensuring that America continues to have a safe and
effective vaccine for every American. The Administration stood up the largest free
vaccination operation in our country’s history including dozens of mass vaccination
sites; and created unprecedented tools to support people who needed help finding a
vaccine. Americans could – and can continue to – find an available vaccine by going to
Vaccines.gov, texting their zip code to 438829, or calling 1-800-232-0233.

From Day One, the Administration knew vaccinating America would require building
public confidence. That’s why the Administration stood up an unprecedented public
education campaign that empowered local trusted messengers; and collaborated with
states, localities, Tribes, and community-and faith-based organizations to mobilize on-
the-ground, grassroots outreach efforts. This work paid off – in September of 2020
only 34% of Americans said they wanted to get vaccine; today, over 87% of adults have

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at least one shot. And America’s unprecedented vaccination campaign has saved lives:
a December 2021 estimate suggested that vaccines saved over 1 million American lives
and successfully prevented over 10 million hospitalizations.

At the same time, the Administration expedited the development, manufacturing, and
procurement of COVID-19 treatments, building a diverse medicine cabinet. In
January 2022, we doubled our purchase of effective treatments in our nation’s
medicine cabinet. The Administration has also established a world class distribution
strategy for treatments, and was able to distribute the first doses of monoclonal
antibodies within 48 hours of FDA authorization. To date, about 7 million patient
courses of treatments have shipped to over 34,000 locations across the country.

The U.S. healthcare system has treated more than 3.8 million high-risk COVID-19
patients, potentially preventing more than 150,000 hospitalizations since November of
2020. The average Medicare cost for a hospitalized patient is about $22,000; using this
value, treatments have helped to avoid $3.3 billion dollars in hospital costs. To provide
the widest, most fair and most equitable administration of antiviral treatments, we
have prioritized the distribution of treatments to include community health centers;
and for monoclonal antibodies, we established programs to expand distribution to
Long-Term Care Facilities, home infusion programs, and dialysis centers.

Testing also remains a critical tool in preventing the spread of COVID-19. The
Administration built a nationwide testing infrastructure from scratch, and free,
convenient COVID-19 testing is now available to all Americans. As America saw
demand for testing increase following the emergence of Omicron, the federal
government stood up new federal testing sites starting with new sites in New York
City in just 48 hours. As part of this effort, the Administration has worked with 27
states, Tribes, and localities to establish 65 free federal testing sites over the last two
months. And we stood up COVIDtests.gov so Americans could order tests to be
shipped directly to their homes — for free.

And the Administration revolutionized the at-home testing market. In January 2021,
there were no at-home rapid tests available to Americans; during January 2022, there
were more than 480 million available to Americans on top of all of other testing
options. To build this testing supply, the Administration worked with the FDA to
create a new, fast-track process that allows rapid at-home test manufacturers to
receive expedited FDA authorization. We also launched an innovative National
Institutes of Health (NIH)-FDA partnership to further accelerate new products
coming to market. Each newly authorized test has added to the number of tests
available at pharmacies and drug stores. And we have purchased $7 billion worth of

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tests right off of the manufacturing line, which created incentives for test
manufacturers to scale up their test production quickly. The Administration has also
reduced the out-of-pocket cost of testing by making laboratory and point of care
testing free for asymptomatic individuals through insurance coverage. Further,
private insurance and Medicaid now cover at-home rapid tests for free, and Medicare
will fully cover these at-home rapid tests starting this spring.

The Administration has successfully put equity at the heart of a nationwide public
health response. Our relentless focus on advancing equity and ensuring our COVID-19
response efforts reach the hardest-hit communities has closed the gaps in racial and
ethnic vaccination rates. Hispanic, Black, and Asian adults are now vaccinated at the
same rates as White adults. These numbers tell the story of an all-of-government
effort that got America to where it is today. We launched programs to get vaccines to
community health centers, rural health clinics, and dialysis centers, emergency rooms,
nursing homes and other Long-Term Care Facilities, and hard-to-reach areas through
40,000 mobile vaccination clinics. We launched federally-run mass vaccination sites
across the country located in high Social Vulnerability Index (SVI) communities that
centered equity through practices like community partnerships and language
translation services. We worked with federal pharmacy partners to prioritize local
pharmacies in high SVI communities, provide walk-in vaccinations, call center
services, and community partnerships. To address structural barriers to vaccinations,
the Administration provided paid leave, free child care, and transportation to
vaccination sites. And the Administration partnered with trusted messengers on the
ground, including faith leaders, community-organizations, local doctors, and barber
and beauty shops to build public trust and get shots into arms.

These are just some of the ways the Administration worked to ensure that gaps have
all but closed in communities of color in the recent months. And our efforts have
encompassed much more than just vaccinations. President Biden stood up a Health
Equity Task Force that has delivered recommendations to drive equity in future
public health efforts. Over 80% of recommendations from the Biden Administration’s
COVID-19 Health Equity Task Force have been fulfilled, with historic investments to
drive equity in future public health efforts. The Administration provided testing
resources, stood up testing sites, distributed treatments, and deployed surge resources
to hospitals with equity as the North Star of the COVID-19 response. Over the past
year, we made tremendous progress in our effort to protect and uplift the hardest-hit
and highest-risk communities. Over 40% of the orders for free tests placed on
COVIDtests.gov have been placed by Americans living in high-vulnerability zip codes.
And nearly all schools are open for in-person instruction, offering students more
equitable access to academic resources and allowing parents to go back to work.

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The path forward in the fight against COVID-19 is clear: we must maintain and
continually enhance the vaccines, tests, treatments, masks, and more to protect
against and treat COVID-19. When it comes to vaccines, all Americans will continue to
have a vaccine available for them. For those who do get COVID-19, we now have
numerous treatments at our disposal and there will be treatments available for
Americans who need them. Testing will continue to be an important tool to track and
slow disease spread – and should be available to all Americans.

And make no mistake, as America moves forward we will leave no one behind. Equity
will remain at the very center of our fight against COVID-19, we will protect and
support people who are immunocompromised, and we will be there to help Americans
with the long-term impacts of COVID-19, including families suffering from the
tragedy of losing someone they loved. In recognition of the wide-reaching, long-term
impacts of COVID-19 on our society, the President will direct the U.S. government to
accelerate efforts to detect, prevent and treat Long COVID; coordinate efforts to
provide support to families who have experienced the COVID-related loss of a loved
one; and attend to the mental health and well-being of our communities.

When it comes to vaccines, the Administration will work with


Congress to secure the necessary funding to:

Launch an effort to vaccinate America’s youngest children as soon as the FDA


authorizes and the CDC recommends a vaccine, ensuring that Americans – of all
ages – can get the protection of a vaccine. If the FDA authorizes and the CDC
recommends a vaccine for children under five years of age, the United States is
prepared to immediately distribute vaccines through a network of thousands of
pediatricians’ offices, children’s hospitals, health centers and local sites, so that
vaccines are made available to families across the country. Millions of children
between the ages of five and 11 have been vaccinated, and the Administration will
build on this progress to extend safe, effective vaccination to children under five.
Central to this work will be the Administration's efforts – in collaboration with states,
localities, providers, and other partners – to reach parents and guardians with the
information they need, from sources they trust, to make informed choices that keep
their children and their families healthy.

• Ensure states, localities, Tribes, and territories are prepared and have the
resources they need to vaccinate children under five. States, localities, Tribes,
and territories will continue to play a leading role in ensuring that vaccinations
are made available and that families have the information they need. If

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authorized by the FDA and recommended by the CDC, states will continue to
have access to federal support for pediatric vaccinations, and can receive
federal funding when they set up children’s vaccination sites, procure
equipment and supplies to store and administer the vaccine, provide family
transportation to and from a vaccination site, communicate with the public,
provide call center support, make public service announcements, and offer
translation services.

• Focus on making vaccinations available at pediatric and primary care sites. If


vaccines for our nation’s youngest children are authorized by the FDA and
recommended by the CDC, the Administration will make vaccinations available
to America’s youngest children at thousands of pediatric and primary care sites
across the country. Pediatricians continue to be one of the most trusted sources
of information about COVID-19 for parents and will play a critical role in the
effort to get our youngest children vaccinated. Nationwide, medical homes are
the most common, trusted location for routine childhood vaccines. For
example, more than three in four children under five receive their flu vaccine
in a doctor's office. Well-patient visits are also an opportunity for pediatric
providers to conduct recommended screenings and provide counseling. The
Administration will work hand-in-hand with states, localities, Tribes, and
territories to prioritize these providers in the distribution of vaccine and
ensure that they have the supply, resources, and support they need to lead the
way. The Administration will also continue to make vaccine doses available
directly to community health centers and rural health clinics, that together,
serve more than 2 million children under five nationwide. And the
Administration will continue to collaborate with trusted medical associations,
including the American Academy of Pediatrics, the American Hospital
Association, and the American Medical Association to ensure we are reaching
providers and their patients.

• Leverage children's hospitals and health systems to vaccinate America’s


youngest children. If vaccines for our nation’s youngest children are authorized
by the FDA and recommended by the CDC, the Administration will make
vaccinations available to America’s youngest children at children's hospitals
and health systems nationwide. Children’s hospitals play an essential role in
our efforts to ensure access for our nation's highest-risk kids, including those
with diabetes, asthma, and those who are immunosuppressed.

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• Make vaccinations for children age three and over available at local
pharmacies. If vaccines for our nation’s youngest children are authorized by the
FDA and recommended by the CDC, the Administration will make vaccinations
for children available at thousands of pharmacies nationwide through the
federal pharmacy program. Pharmacies that participate in vaccinating this age
group (typically only for children three and older) will offer vaccinations in a
more limited set of locations – in many cases, at clinics staffed by health care
providers with primary care experience. These pharmacies will offer
convenient hours and advanced scheduling to best meet the needs of parents
and communities.

• Build on partnerships with state and local public health departments to provide
vaccinations to the hardest-to-reach families through local public health
clinics. If vaccines for our nation’s youngest children are authorized by the FDA
and recommended by the CDC, the Administration will build on its long-
standing partnership with state and local health departments across the
country to ensure that we are reaching families who are the hardest-to-reach –
including families who may not have regular access to a pediatrician – through
local public health clinics. The Administration will support states as they stand
up and operate these clinics, and will work hand-in-hand with states to

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maximize vaccination coverage and availability, particularly in the hardest-hit,


highest-risk communities.

• Reach parents and families, build public trust, and advance equity. Central to
this work will be the Administration's efforts to reach parents and families with
the information they need, from sources they trust. While we know that many
parents are eager to vaccinate their children, we know that others have
questions. If vaccines for our nation’s youngest children are authorized by the
FDA and recommended by the CDC, HHS will launch a national public
education campaign to ensure that parents and guardians have access to the
facts and information they need to make informed choices for their families.
The Administration will also work with national organizations representing
health care providers and parents as well as family-friendly brands that parents
know and trust. And the Administration will remain laser-focused on equity,
making sure we reach those hardest-hit and most at-risk communities.

• Engage with families through trusted programs that reach millions of children
and their parents every day. If vaccines for our nation’s youngest children are
authorized by the FDA and recommended by the CDC, the Administration will
leverage the many channels the U.S. government has to engage parents of this
age group to reach children and their parents with the information they need.
For example, the Administration will engage families through the Special
Supplemental Nutrition Program for Women, Infants, and Children (WIC)
program, which serves over 6 million people. A longstanding partner of
immunization programs, WIC settings across the country will have access to
tailored resources for talking to families about the COVID-19 vaccine, and will
continue providing families with referrals to vaccination providers, including
those co-located with WIC settings. Through HHS's Administration for
Children and Families (ACF), the Administration will also work with Head
Start grantees to get critical vaccination information to the families of the
approximately 1 million children they serve. And the Administration will
engage families through HHS’s Maternal, Infant, and Early Childhood Home
Visiting (MIECHV) Program, which reaches more than 140,000 parents and
young children across the country each year. Working with families as
partners, MIECHV home visitors will leverage established relationships, to
provide information on benefits of vaccination and refer families to local
vaccination sites.

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Accelerate research and development toward a single COVID vaccine that protects
against COVID-19 and all its variants, as well as future emerging coronavirus
threats. The Administration has accelerated research and development toward a
universal SARS-CoV-2 coronavirus vaccine that offers protection against all new
COVID-19 variants. Together, these steps will help advance access to a vaccine that
will protect us against all mutations of this coronavirus, and future emerging threats.
Accelerating research and development toward a next-generation vaccine with broad
protection against variants will require additional funding from Congress.

• Strengthen existing partnerships with the global scientific and medical


research community. The Administration is taking a leadership role in
coordinating the global scientific and medical research community on a major
effort to understand the range of coronavirus disease pathogenesis; and to
apply this knowledge to the development of long-lasting, broadly protective
coronavirus vaccines.

• Continue investments in pan-coronavirus vaccine candidates. NIH have


invested in partnerships with academic research institutions to conduct
research to develop vaccines to protect against multiple types of coronaviruses
and viral variants, with an eye toward looking ahead and preparing for the next
threat of new coronaviruses with pandemic potential. NIH will continue to
administer grants to conduct research focused on discovering, designing, and
developing pan-coronavirus vaccine candidates that provide broad protective
immunity to multiple coronavirus strains. Additionally, NIH is also developing
new vaccine platforms and multivalent immunogens; and NIH – in close
collaboration with Biomedical Advanced Research and Development Authority
(BARDA) – is supporting research and facilitating advanced development of
promising candidates.

Increase American manufacturing capacity to reliably produce an additional 1


billion vaccine doses per year. The Administration is taking action to increase and
sustain American manufacturing of mRNA vaccines with the goal of being able to
produce an additional 1 billion doses per year – three times the population of the
United States – and meeting this target even in a scenario in which a modified vaccine
to address a new variant is necessary. The Administration will continue efforts to
sustain and expand vaccine manufacturing capacity. including supporting bulk drug
substance manufacturing and fill-finish line capacity. Fully supporting this effort to
scale up domestic vaccine manufacturing will require additional resources from
Congress.

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Continue to mobilize our network of tens of thousands of sites to deliver shots. The
Administration – with states and local partners – has established 90,000 convenient
locations that offer COVID-19 vaccines so that over 90% of Americans live within five
miles of a vaccination site. Local pharmacies; community health centers and rural
health clinics; state and local clinics at gyms, community centers, and libraries;
healthcare provider offices and hospitals; and thousands of mobile and pop-up clinics
are all offering shots. And the Administration has invested significant resources into
locating sites in high-risk areas to reach underserved communities. Our vaccinations
infrastructure – including standing up sites, facilitating ordering of vaccines,
delivering shots to locations, supporting vaccination administration and providing full
federal reimbursement to states, localities, Tribes, and territories – is strong, durable,
and able to scale up and down as necessary.

• Utilize our over 40,000 pharmacy locations to meet communities where they
are and scale capacity for more shots in arms as needed. President Biden
launched the Federal Retail Pharmacy Program in February 2021 – a landmark
partnership with 21 national pharmacy partners and independent pharmacy
networks spanning all corners of the country. Today, the program is a vast
network of over 40,000 retail and Long-Term Care pharmacy locations
nationwide. Altogether, our pharmacy partners have administered more than
225 million shots – more than 40% of all shots in our nation’s historic
vaccination effort. Pharmacy partners have hosted tens of thousands of on-site
clinics at Long-Term Care Facilities, schools, and trusted community locations;

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reached out to millions of their patients and customers through calls, texts, and
emails; offered millions of shots through walk-ins or through convenient,
expanded hours; and expanded operational capacity to meet demand as needed.
Today, the network is a highly-effective, well-tested infrastructure for
ordering, distributing, administering, and tracking vaccines; and a model that
can be activated at scale in the future.

• Ensure we can stand up mass vaccination sites if needed. FEMA has developed
the operational model to stand up a federal mass vaccination site rapidly upon
state request. Early in the Administration, FEMA, in coordination with HHS
and the Department of Defense (DOD), stood up dozens of these federally-run
sites across the country, with the combined ability to administer more than
125,000 shots per day. With equity driving this effort, FEMA partnered with the
CDC and state and local partners to locate these vaccination sites in places that
aim to reach hard-hit, high-risk communities, deploying the CDC’s Social
Vulnerability Index. These sites were designed not only to maximize the
number of shots in arms, but to ensure access – including through weekend and
extended hours, reserved registration slots for faith- and community-based
organizations, and the deployment of satellite mobile vaccination sites to offer
vaccinations even further into local communities. With this successful
playbook now in place, FEMA could launch mass vaccination sites in the future,
if needed.

• Ensure that community health centers, rural health clinics, and federal entities
are prepared to order and administer vaccines. In February 2021, President
Biden launched new programs to provide vaccines directly to community
health centers and rural health clinics nationwide in order to ensure that the
nation’s hardest-hit populations were able to access vaccinations. Today, HHS
has built a nationwide infrastructure of hundreds of community health centers
and rural health clinics that administer COVID-19 vaccines and specialize in
providing trusted, high-quality care for hard-to-reach populations. Altogether,
community health centers serve almost 30 million people across the country;
with two-thirds of this population living at or below the federal poverty line
and 60% representing racial and/or ethnic minorities. These centers have
played a critical role in getting shots in arms, building trust among their
patients and communities, and providing critical wrap-around services to
ensure that the needs of families are met – including by providing free at-home
tests and free high-quality masks. The federal government will also continue to
get shots in arms to local communities through federal entities. The VA, for
example, will continue to provide COVID-19 vaccinations to all veterans, as

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well as their spouses, caregivers and some beneficiaries. And the Indian Health
Service will continue to offer vaccinations across its facilities. Together, the
Administration has built a nationwide infrastructure for ordering, distributing,
administering and tracking vaccines. This is a model that can be activated and
reinstated at scale at any point during the course of the pandemic.

• Utilize a proven fleet of mobile vaccination clinics that are ready for
deployment. To reach people where they are, FEMA continues to stand up
mobile vaccination clinics that can be deployed in partnership with states and
Tribal nations. Some of these mobile clinics are on wheels; others are pop-ups
that can be set up and taken down in any building. FEMA, VA, pharmacies, and
community health centers have hosted 40,000 mobile clinics in total, and have
the contracts, infrastructure and networks in place – as well as communications
channels open – to continue to partner with state, local, Tribal, and territorial
partners to deploy mobile vaccination centers where they are needed.

• Draw on established channels to accelerate federal personnel and federal


financial support for state and local community vaccination sites. Channels are
in place for FEMA to deploy personnel and equipment and to provide financial
assistance to states, Tribes, and territories to support their own community
vaccination sites. During the last year, FEMA has deployed over 9,000 federal
personnel – including over 5,000 active duty military – and has provided more
than $6.5 billion in financial assistance to 58 states, Tribes, and territories to
support vaccination efforts. In total, thousands of local vaccination sites have
received federal support – in the form of federal personnel or federally-funded
National Guard support, or funding for costs like staffing, transportation, and
equipment to set up sites.

Enhance vaccinations outreach and education efforts to reach the unvaccinated,


promote boosters, and get our kids vaccinated; and continue to combat
misinformation and disinformation. The Administration continues to lead an
unprecedented public education and outreach campaign to reach people in every
region of the country with information to help build vaccine confidence. These efforts
include a focus on empowering local trusted messengers and providing educational
materials – translated into 14 languages – to community- and faith-based
organizations around the country, as well as doctors’ offices, pharmacies, health
centers, employers, and other groups. The Administration has also invested hundreds
of millions of dollars in funding and support to state, local and community-based
partners to support vaccine outreach, including to rural and hard-to-reach
communities. Moving forward, these education and outreach efforts will allow the

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Administration to reach the unvaccinated, deploy information about the importance


of boosters, support pediatric vaccination efforts, and provide other important
COVID-19 updates as needed through trusted community members. In addition, the
Administration is working to address COVID-19 misinformation through public
education and outreach, mobilizing trusted messengers, and accelerating information
integrity research.

• Leverage a community-based communications infrastructure to continue


reaching people of all walks of life and work to build vaccine confidence. The
Administration has built an extensive community-based communications
infrastructure to talk to the American people about vaccines and build
vaccination confidence. These efforts included deploying a vast network of
trusted messengers, spearheading a robust paid media campaign, and widely
disseminating educational materials to an unprecedented network of doctors’
offices, pharmacies, community health centers, health associations, unions,
businesses, non-profits, foundations, and community- and faith-based
organizations across the country.

• Utilize a proven network of 17,000 volunteers ready for more vaccinations


outreach and engagement. The Administration has developed a network of over
17,000 volunteers, including 1,000 local doctors to engage with their
communities to boost vaccine confidence. This network, called the COVID-19
Community Corps, empowers trusted voices in every state, Tribe, and territory
with the latest facts about COVID-19 so that they can share information with
their communities. Member organizations – big and small – as well as people in
communities around the country can sign up – with the goal of encouraging
vaccinations; and this network can be activated at any point so volunteers can
continue engaging with their communities.

• Continue efforts to monitor and combat misinformation. HHS has spearheaded


initiatives to address misinformation about COVID-19 vaccines, including
identifying trending inaccurate information and confronting it immediately.
The Administration has worked on public education and outreach to address
and stop the spread of misinformation, mobilized trusted messengers at the
community level to combat misinformation, and accelerated research on
combating misinformation. The Administration is continuing its work to equip
Americans with the tools to identify misinformation and to invest in longer-
term efforts to build resilience against health misinformation.

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• Issue a Request for Information (RFI) from researchers, healthcare workers,


tech platforms, and community organizations on the impact of health
misinformation during the pandemic. The Surgeon General’s office will issue a
Request for Information on the impact of health misinformation online during
the COVID-19 pandemic. The purpose of this RFI is to understand the impact of
COVID-19 misinformation on health care infrastructure during the pandemic
including quality of care, health decisions, costs, and worker morale and safety;
the unique role that technology platforms play in the societal response to the
COVID-19 pandemic and implications for future public health emergencies; and
the human impact of health misinformation and how access to accurate health
information impacts lifesaving health decisions such as whether Americans get
vaccinated. The Administration will use this information to address future
public health crises; and public comments and submissions will be made
available to the public and can be used for research purposes.

• Continue to monitor vaccine safety. The federal government has the most
robust safety and reporting system in history, with vaccine safety data openly
reviewed and available for the American public. Even after the vaccines are
rigorously studied during clinical trials, there is a vast network of safety

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systems that monitor vaccines once they are in use and safety protocols for
people who receive the vaccine. The Administration – through the FDA and the
CDC – will continue to implement a coordinated and comprehensive approach
for continuous safety monitoring of COVID-19 vaccines moving forward.

When it comes to treatments, the Administration will work with Congress to secure
the necessary funding to:

Ensure there are enough treatments for Americans who need them. America will
secure enough treatments so Americans diagnosed with COVID-19 who are at high
risk of severe disease can have access to safe and effective therapeutics. In total, the
Administration will have at least 20 million patient courses of the Pfizer antiviral and
the Administration has also built the infrastructure to ensure treatments are widely
and quickly distributed around the country. As more treatments become available in
the coming months, the U.S. government will continue to accelerate distribution, so
Americans who need treatments – including people who live in underserved
communities often at highest risk from the virus – can access one.

• Ensure that the Nation’s medicine cabinet contains a diverse portfolio of


treatments. In addition to 20 million courses of the Pfizer antiviral that have
been secured, the Administration is also ensuring we have a diverse portfolio of
additional treatments that are effective at protecting people from severe
disease, so we have many options that will remain effective against future
variants. These additional procurements will require additional funding from
Congress, and include additional antiviral courses, monoclonal antibodies that
are effective against current and future variants, and pre-exposure prophylaxis
to prevent infection in people who are immunocompromised. And the mix of
America’s medicine cabinet will continuously be adjusted so the country is
prepared to respond to potential future variants.

• Provide manufacturers with additional resources to expedite the production


and delivery of treatments. The Administration is working with treatment
manufacturers to accelerate the production and delivery of treatments. We are
also working closely with treatment manufacturers to provide any resources,
supplies, and investments needed to expedite production and increase
manufacturing capacity, including use of the DPA, if warranted.

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Launch a nationwide Test to Treat Initiative so Americans can get rapidly treated,
including options to visit “One-Stop” Test to Treat locations to get free tests and
get free treatments. For COVID-19 treatments to be most effective, they need to be
administered within days of the start of symptoms. To minimize the time between a
positive test result and receiving an effective COVID-19 treatment, the Administration
is launching a national Test to Treat Initiative aimed at providing treatments as
rapidly as possible to people at high risk from COVID-19. This effort is important for
both monoclonal antibodies and oral antivirals, as Merck and Pfizer oral antivirals
need to be initiated within five days of symptom onset. The Test to Treat Initiative
includes educating the public about the availability of new treatments and the
importance of starting them soon after the onset of symptoms; providing information
to health care providers about these new treatments, including who is eligible for
them, their contraindications, who can prescribe them, and where they can be
obtained; enabling rapid access to testing through a range of options; setting up
programs in community health centers where people can get both tested and treated;
distributing antiviral therapy directly to Long-Term Care Facilities; and establishing
programs for people who don’t have existing providers so they can get tested and
treated for free at “One-Stop” Test to Treat Locations at pharmacy-based clinics
across the country. All of this will continue to be done in partnership with states and
territories, with the goal of promoting equitable distribution.

• Launch an education and outreach campaign so Americans know that there are
effective treatments available for people at high risk of severe disease
progression. HHS will launch a public education campaign to ensure Americans
know that effective treatments are available for people at high risk of severe
disease progression and that these treatments are most effective within days of
symptom onset. These efforts will include updating test and treat language on
multiple governmental websites, creating shareable infographics with clear test
and treat messages, and promoting test and treat messages on social media.

• Work with health care providers to inform them about new treatments so they
can move quickly from a patient diagnosis to prescribing a treatment. It is
critical that health care providers be informed about these new treatments –
including their benefits, as well as their contraindications and side effects – so
they are in a position to quickly move from a patient’s COVID-19 diagnosis to
recommending and prescribing one of these new treatments, if appropriate. As
part of the Test to Treat Initiative, the Administration is actively engaging the
clinical community through professional medical associations to broaden
awareness and understanding of these treatments and to make sure that
doctors are counseling their patients about the best options and proactively

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linking people to treatment options in their communities. The Administration


has also created a Therapeutics Locator tool for providers, which is an easy to
use website that shows where treatments are located, with the recognition that
in the months ahead the number of places that will be able to dispense
treatments to people will increase dramatically.

• Establish “One-Stop” Test to Treat locations at pharmacy-based clinics around


the country. The authorized oral antivirals must be taken within five days of
symptom onset, so the Administration aims to make it as easy as possible to
move from a positive test to a prescription and pills. The Test to Treat Initiative
is working with pharmacy-based clinics around the country to provide “One-
Stop” Test to Treat locations to get tested and treated with an antiviral
treatment in a single stop, ensuring people who test positive can rapidly be seen
by a provider and dispensed antiviral therapy, all in one visit. These clinics will
be able to order antivirals directly, and then receive oral antivirals from the
federal government. There will be hundreds of “One-Stop” Test to Treat
locations – including pharmacy-based clinics – across the country in March.

• Provide “One-Stop” testing and treatment in community health centers. For


people who receive care in community health centers, the Test to Treat
Initiative will be providing combined testing and treatment. The
Administration is already shipping medications to 200 sites around the country,
with the number of sites to expand in March. These sites will be able to directly
order and receive oral antivirals based on this dedicated channel. This effort
will be a crucial part of ensuring access and equity for these important new
treatments.

• Provide “One-Stop” solution in Long-Term Care Facilities. Most people living


in Long-Term Care Facilities are living with increased risk of severe COVID-19
if they test positive. The Test to Treat Initiative will pre-position oral antivirals
in Long-Term Care Facilities to expedite access to medications. Hundreds of
facilities will be able to directly order antivirals and receive direct distributions
starting in March, with a plan to expand over time.

• Expand access to testing to ensure people can get a treatment as quickly


possible after the onset of COVID-19 symptoms. A key component of the
effective use of antiviral treatments is getting a diagnostic test as quickly as
possible after COVID-19 symptom onset, so continuing to have the broadest
possible access to testing will be critical. Fortunately, there are more options
for COVID-19 testing now than ever before, and the Test to Treat Initiative will

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be grounded in those options. About 60 million households have already


received at-home tests through COVIDtests.gov; and at-home tests are also
widely available in pharmacies around the country. The Administration also
continues to make testing free at more than 20,000 pharmacies and community
sites around the country. For people who do not have a current provider and
who cannot access a “One-Stop” testing and treatment program, a provider visit
with a telehealth program after a positive test would allow a telehealth
provider to prescribe these oral antivirals.

Explore public and private insurer coverage of COVID-19 treatments this year. The
Administration has worked during the pandemic to ensure that COVID-19 treatments
are free and accessible to all Americans. The Administration has both supported
promising treatment candidates to accelerate their development and scale up
manufacturing prior to authorization by the FDA, and – at an unprecedented scale and
speed – secured and distributed that limited supply for the American people once
these treatments have been authorized for emergency use. Under the Administration’s
current model for distributing effective treatments against COVID-19, treatments are
free to the public and distributed directly to states and territories and to community
health centers across the country to ensure equitable access in our hardest-hit
communities. The Administration also reimburses providers for the cost of
administering COVID-19 treatments to the uninsured. To ensure that these treatments
remain accessible and to reduce the ongoing costs to the federal government, the
Administration will work with insurers and Congress to explore public and private
insurer coverage of COVID-19 treatments this year.

Support the FDA’s expedited, streamlined process to review treatments for


authorization. The Administration has worked with the FDA to support a streamlined
process to ensure that new treatments are rapidly accelerating to market, so the
United States maintains a diverse portfolio of treatment options to maximize the
likelihood of having treatments that are effective against future variants. The federal
government has also developed a model to cut red tape and source key supplies for
manufacturers, which has accelerated the treatment clinical trial process and reduced
the manufacturing timeline. For example, the Administration worked in close
coordination with Pfizer to cut seven months off of the development, clinical trial,
manufacturing, and delivery timeline for its Paxlovid antiviral treatment by providing
key supplies and expediting government processes. As a direct result, the first Pfizer
Paxlovid pills were shipped in December – months ahead of schedule.

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• Accelerate the clinical development of treatments. To accelerate clinical


development, the Administration has built the infrastructure to support the
expedited development of treatment candidates that are most likely to have a
broad public health impact. The Administration has established a therapeutics
research team – which works in coordination with multiple agencies and
manufacturers to assess potential drug compounds to accelerate product
development. To date, these collaborations resulted in Emergency Use
Authorizations for monoclonal antibody treatments and antiviral pills, and the
structures are in place to continue to rapidly bring treatments to market.

• Leverage an existing public-private partnership to prioritize, streamline, and


speed the development of treatments in the research community. NIH has
established a public-private partnership to prioritize, streamline, and speed
development of treatments. The NIH partnership is using several tools to
accelerate the development of treatments, including developing a collaborative,
streamlined forum to identify preclinical treatments; accelerating clinical
testing of the most promising treatments; improving clinical trial capacity and
effectiveness; and coordinating the interpretation and results with the research
community. NIH has also streamlined processes to make the best use of
biomedical research resources and testing of preclinical compounds.

Accelerate research and development into next-generation therapeutics. The


Administration has accelerated investments in the research and development of new
COVID-19 treatments including oral antivirals, monoclonal antibodies, and other
biologics that are effective against a range of variants. We will perform the basic
research leading to targeted antiviral drug development aimed at vulnerable phases of
the SARS-CoV-2 replication cycle. We are also testing medications in combination,
using treatments that work by different mechanisms; and these combination
treatments may work more effectively, minimize chance of resistance, and result in
lower or fewer side effects. While current antivirals are highly effective at protecting
people from severe disease, next-generation antivirals could require dosing only once
per day over a short treatment course, could be created through more scalable
manufacturing and could have easier routes of administration. Most significantly,
next-generation therapeutics may also provide broader protection against new
variants. Continued investments in next-generation therapeutics will require
additional funding from Congress.

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When it comes to testst, he Administration will work with


Congress to secure the necessary funding to:

Sustain and increase American manufacturing so a robust supply of tests will be


consistently available. The Administration has dramatically increased testing
capacity and will continue to take action to sustain that manufacturing increase so a
robust supply of tests will be available to Americans well into the future. In addition
to using the DPA and other authorities to increase manufacturing capacity, we have
executed $7 billion in procurements, which created incentives for test manufacturers
to open manufacturing lines, increase staffing, and pull their manufacturing timelines
forward. And as the market for point-of-care and at-home rapid tests is dependent
upon consistent demand even as cases fall, we have already doubled down on
procurements to sustain the industrial base for the longer term and committed to
purchasing 1 billion at-home tests. Continued investments in testing will require
additional funding from Congress.

• Continue multi-billion-dollar test procurements and sustain the industrial base


in the longer term. The Administration will continue to procure at-home rapid
tests as needed, creating incentives for test manufacturers to accelerate rapid
test production to sustain the testing industrial base for the longer term. In
response to earlier procurements, manufacturers increased production, opened
manufacturing lines, increased staffing, and pulled their manufacturing
timelines forward. The market for point-of-care and at-home rapid tests is
highly volatile and heavily swayed by swings in market demand, so investment
in sustaining the at-home test domestic market is necessary to preserve
American manufacturing capacity over the longer run. The Administration will
continue to support investments in test supplies (including medical grade
resins, reagents, and pipette tips), manufacturing capacity, and the
procurement of tests. This month the Administration released a formal Request
for Information from the testing industry aimed at sustaining and expanding
domestic manufacturing and testing capacity built over this past year; and
seeking proposed solutions to manage market volatility, address supply chain
challenges, scale up manufacturing and bring new technologies and
manufacturing processes online.

• Sustain commercial and public health laboratory capacity. Approximately 1.5 to


2 million molecular lab-based tests are performed each day in the United States,
and the capacity for high-complexity nucleic acid amplification tests is at risk
of declining when testing demand wanes. Should surges arise in the future, labs
may be unable to meet demand without prolonged turnaround times related to

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staffing shortfalls or other challenges in inventory. That’s why the


Administration will continue to act to support investments in laboratory
capacity and will work with laboratory companies to develop solutions to
staffing shortages. The Administration is also continuing to invest in swabs,
reagents, and other materials to support laboratory testing capacity.

• Utilize the DPA and other authorities to accelerate production. The President
has pledged to continue using the DPA and other authorities to make sure the
U.S. is ramping up production until America has built a stockpile of tests and
sustained an industrial base for the longer-term. For example, through the
President’s aggressive actions this summer, including use of the DPA, the
Administration ramped up the monthly supply of at-home rapid tests more
than tenfold between August and January. The Administration will continue to
use the Defense Production Act to accelerate production where it can have
valuable impact.

Build a large stockpile of rapid-at home tests for the first time. New procurements
will allow the U.S. government to stockpile over-the-counter rapid tests in
preparation for surges, COVID-19 outbreaks, or new variants. The federal government
will determine the appropriate size and content of testing reserves moving forward
and procure tests to sustain a testing manufacturing base in the United States with the
flexibility to rapidly scale up manufacturing capacity if needed. Additionally, the U.S.
government has hundreds of millions of N95 masks, billions of gloves, tens of millions
of gowns, and over 100,000 ventilators in the Strategic National Stockpile — all ready
to ship out at a moment’s notice if and when they are needed.

Utilize the expedited FDA authorization processes to help test manufacturers


come to market more quickly. The Administration has developed an expedited FDA
authorization process that will help testing manufacturers come to market on
accelerated timelines and ensure America has a diverse portfolio of tests that are
likely to remain effective against future variants. The Administration has stood up a
permanent streamlined pathway – embedded within FDA processes – that allows at-
home antigen test manufacturers to receive expedited FDA authorization. Six of the
manufacturers that received FDA authorization have already benefited from these
faster authorization processes. Additionally, the Administration launched and
invested in an innovative NIH program called the Independent Test Assessment
Program (ITAP) that works to accelerate new manufacturer’s proposals to the FDA

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for Emergency Use Authorization (EUA); and successful test candidates in the
program have led to the expedited release of tests months ahead of schedule.
Sustaining this partnership to expedite new tests to market will require additional
funding from Congress.

Maintain America’s network of over 20,000 free testing sites to provide free,
efficient tests to the American people. The Administration has established over
20,000 free testing locations at pharmacies and state and local sites around the
country. When it comes to free testing at pharmacies, the Administration has
expanded the network of pharmacies offering free COVID-19 testing with more
expected in the months ahead. And for state and local-run community sites offering
free testing with FEMA or HHS funding support, FEMA and HHS have developed
channels of communications with jurisdictions that are looking for federal support to
set up local and community-based testing resources. In addition, HHS and FEMA have
developed a playbook, a process, and the infrastructure to stand up surge testing sites
quickly and efficiently upon state request. Moving forward, the Administration will be
able to draw on this pathway to stand up federal surge testing sites if needed.

• The U.S. government has built the capability to ship at-home tests to individual
households. The Administration has successfully launched a website –
COVIDtests.gov – where Americans can order at-home tests delivered directly
to their homes — for free. To date, about 65 million households – or more than
half the households in America – have received over 260 million tests. HHS, the
U.S. Postal Service (USPS), and DOD formed a highly effective partnership and
have collectively built a federal infrastructure to deliver rapid-tests directly to
homes for families who want them.

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• Continue to expand the number of free testing locations across the country
through the Community Access to Testing (ICATT) program. The
Administration has expanded the network of pharmacies offering free COVID-
19 testing to 11,500 with more expected in the months ahead. This program
supports no-cost testing for communities across the country, with a focus on
communities that are otherwise underserved in testing access or are at greater
risk of experiencing COVID-19 disease and poor health. The ICATT program
and its network of pharmacies across the country will continue to offer free
testing to the American people. Expansion and continuation of the free
pharmacy testing program will require additional funding from Congress.

• Ensure that new surge federal testing sites can be stood up quickly, if
needed. The Administration has built the infrastructure – through FEMA and
HHS – to quickly stand up free surge testing sites, at the state’s request. Sites
come with personnel and have the ability to administer hundreds of tests a day.
As of this writing, the Administration has stood up 65 free testing sites in 26
states; and 70% of the tests at federal surge sites have been administered to
people of color.

• Ensure that distribution channels are in place for the rapid delivery of tests to
community health centers. The Administration has set up channels for the
quick distribution of at-home tests to Americans through community-sites,
including community health centers and rural clinics. The Administration has
committed to the delivery of 50 million tests through the program, with a focus
on getting these tests to the homes of our hardest-hit communities and most
vulnerable populations.

• Continue no-cost school testing and testing in congregate settings. The


Administration continues to support no-cost school-based testing for child care
centers, K-12 schools, historically Black colleges and universities, under-
resourced communities and congregate settings, such as homeless shelters,
domestic violence and abuse shelters and non-Federal correctional facilities. As
Omicron surged, the Administration also provided access to an additional 10
million COVID-19 tests per month to K-12 schools for school testing, building
on the original March 2021 $10 billion commitment from the American Rescue
Plan to support school testing programs around the country.

Invest in innovation to make tests less expensive. The Administration is moving


forward on initiatives that promote innovations in testing technologies while
significantly expanding test manufacturing and distribution. In addition to making

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tests less expensive, the initiatives will also improve test performance and improve
access to tests, both in the United States and abroad. Extending and expanding these
initiatives to promote innovations in testing will require additional funding from
Congress.

• Continue innovation through investments in existing technologies. The


Administration has accelerated the NIH Rapid Acceleration of Diagnostics
RADx technology program that continues to work with government scientists,
academic research organizations, and the private sector. This wide-ranging
public-private partnership is advancing innovations in existing technologies to
make tests lower in cost, easier to use, and more accurate with expanded
capabilities for detecting new and multiple pathogens.

• Expand aggressive development of low-cost at-home tests. The RADx program


continues to create integrated cost-reducing strategies for developing,
manufacturing, and distributing rapid antigen tests. These investments will
reduce costs through efficiencies in the cost of antibodies, packaging and
distribution costs, and automation. These innovations are expected to lead to
widely-available, lower cost at-home tests.

• Accelerate new testing technologies through the development pipeline. The


RADx program continues to help move advanced diagnostic technologies
swiftly through the development pipeline toward FDA authorization,
commercialization, and broad availability. These new platforms offer patient-
and user-friendly designs that significantly improve test accessibility,
performance, and versatility in affordable over-the-counter home and point-of-
care settings.

Continue to support testing, treatment, and vaccine administration for the most
vulnerable through the COVID-19 uninsured fund. The Administration will work
with Congress to replenish the uninsured program, which supports vaccine
administration, testing, and treatment for the uninsured. With funding currently
projected to be exhausted as soon as this spring, additional funding will allow HHS to
continue to provide claims reimbursement to health care providers generally at
Medicare rates for testing uninsured individuals for COVID-19, treating uninsured
individuals with a COVID-19 diagnosis, and administering the COVID-19 vaccine to
uninsured individuals.

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Continue to provide insurance coverage for at-home rapid tests and Medicare will
cover these tests soon. In January 2022, the Administration required that private
insurance cover up to eight at-home rapid tests per person for free per month.
Medicaid already provides coverage of at-home rapid tests and Medicare will be
providing coverage of these tests by early spring. The Administration’s
implementation of this policy includes strong financial incentives for insurers to
create options to get tests covered directly at the point of sale without having to
submit for reimbursement; and point-of-sale options already exist now for insurers
covering an estimated 50 million people, with the expectation that more insurers will
soon follow.

When it comes to masks, the Administration will work with


Congress to secure the necessary funding to:

Update the framework for recommendations on preventive measures like masking


to reflect the current state of the disease. Masks have been a critical tool to protect
ourselves, but they have a time and a place. With a broad range of other protective
tools in place, the CDC has announced an updated framework for guidance on
preventive measures like masking – moving away from simply basing broad
recommendations on case counts and test positivity, and instead encouraging
prevention measures like masking when they are most needed to minimize severe
disease and to keep our hospitals from becoming overwhelmed in times when COVID-
19 is surging. By monitoring community risk, masks can be worn when the risk of
severe disease in the community is high and taken off when the risk is low. Overall, it
means Americans will be wearing masks less because so many people are protected
from severe disease.

• CDC has announced that the agency will recommend that children wear masks
in schools when it’s recommended for the community. With vaccines available
for all K-12 school aged children, masking will be recommended in schools
when the community burden of COVID-19 in the surrounding area is at its
highest level. Masks have been an important tool that have allowed America to
reopen our schools. No one wants our kids to be in masks forever if it’s not
absolutely necessary.

• Equip schools with guidance and support to keep vulnerable students safe and
learning in-person. Children learn best in-person, and are better able to engage
with rigorous instruction and access services and supports tailored to their
needs when they are learning alongside their peers. The President has been

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clear since Day One that we need students back to school for full-time, in-
person learning, and thanks to the unprecedented resources provided through
the ARP, schools have what they need to safely remain open, keep students and
staff safe, and address the impact of the pandemic on student learning and
mental health. Some students may need additional protections to ensure they
can remain safe in the classroom – including students who are
immunocompromised, with complex medical conditions, or with other
disabilities that may put them at higher risk of severe outcomes from COVID-
19. For nearly two years, educators across the country have provided services
and supports to children with disabilities in ways never anticipated prior to the
COVID-19 pandemic, and the Administration is committed to ensuring that
children with disabilities continue to receive the services and supports they
need so they can reach their highest potential. Toward that end, the
Department of Education will work with school administrators and educators
on strategies they can use to continue providing safe, in-person instruction for
all students in their classes. The Department will engage the CDC to ensure
that ED’s guidance is fully aligned with the latest public health guidance and
that schools have clear recommendations and strategies to help protect the
safety of and access to rigorous learning that all children deserve. The
Department of Education will also provide resources for parents who would
like additional support in understanding how to navigate their child’s in-person
learning experience through local regional parent training and information
centers. Parents may find their local center here and reach out for direct
assistance and referrals to other organizations, as well as to gain skills to
effectively participate in the education and development of their children.
States and school districts should use the unprecedented resources provided
through the American Rescue Plan to implement these recommendations and
ensure access to a high-quality education for all students, including students
with disabilities.

Launch a one-stop-shop website that allows Americans to easily find public health
guidance based on the COVID-19 risk in their local area and easily access tools to
protect themselves. The Administration will launch a website where Americans can
find the level of COVID-19 risk in their community and specific guidance based on
that risk. The site will also point people to the tools we now have to fight COVID-19,
such as locating a vaccination site in their neighborhood or finding a free high-quality
mask at a local grocery store, pharmacy, or community health center.

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Continue to provide free, American-made high-quality masks to the American


public. In January 2022, President Biden announced an unprecedented effort to make
available hundreds of millions of high-quality masks to the American public for free.
Today, these masks are available for the public to pick up for free at tens of thousands
of local pharmacies, grocery stores, and health centers in their communities. The
Administration will continue to distribute additional high-quality masks for adults
and children.

When it comes to equity and leaving no American behind, the


Administration will work with Congress to secure the necessary
funding to:

Ensure equitable access to COVID-19 health care and public health resources.
During the pandemic, communities across the country have faced a persistent need
for resources, tools, and support; and this need is greatest in the hardest-hit and
highest-risk communities, where social disadvantage, structural inequality, and
systemic racism often coalesce to create substantial barriers to access to COVID-19
health care and public health resources. To help ensure an equitable response to the
pandemic, the President signed an executive order on January 21, 2021 creating the
COVID-19 Health Equity Task Force to address COVID-19 related health and social
inequities. To provide equitable access, the Biden Administration has – and will
continue to – prioritize providing resources and supports to ensure community
health, including personal protective equipment, tests, therapeutics, vaccines, public
health services, and access to necessary health care. The Administration is sending
free, high quality masks to community health centers and pharmacies, and making
free at-home tests available at request to all individuals in this country. Programs have
been designed to ensure prioritization of hard-hit, high-risk communities for access to
tests and life-saving treatments like monoclonal antibodies and oral antivirals. The
Administration has also centered the design of the national vaccine distribution
operation on the needs of key populations too often left behind, with distribution to
community vaccination centers, mobile vaccination clinics, and dialysis treatment
centers; and the selection of locations of vaccination sites for the Federal Retail
Pharmacy Program, mass vaccination sites, and Health Center Vaccine Program in
high SVI areas. The Administration will continue to center communities of color and
other underserved populations in the design of all COVID-19 initiatives; address
COVID-related health inequities among communities defined by race, ethnicity,
geography, disability, sexual orientation, gender identity, and other factors; and
partner with Tribal nations, Indigenous communities and rural communities to design
equitable initiatives.

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• Continue work to reduce barriers to testing, treatment, vaccinations, and


boosters. The Administration will continue to prioritize ensuring access to
COVID-response health care and public health resources like testing,
treatments, masks, PPE, vaccines, and boosters for communities of color
hardest hit by the pandemic and other underserved populations, including
people who are uninsured or underinsured. For example, the Administration
will continue to work with states and partners to build confidence and bring
vaccinations to the hardest-to-reach communities through community
partnerships, mobile sites, and partnerships with trusted providers. The work
to reduce barriers to access will continue, as the tools in place to protect people
against COVID-19 are free, even without insurance coverage. Community
health centers will remain at the center of our efforts to reach communities
with the supports and services they need, including masks, tests, vaccinations,
and treatments. Additionally, the structural barriers that prevent people from
accessing these resources (e.g., cost, transportation) will continue to be
addressed and overcome through partnerships across the public and private
sectors.

• Leverage existing infrastructure to ensure equity continues to be at the center


of the COVID-19 response. The Administration has created an infrastructure
where equity is at the forefront of the pandemic response – from expanded data
reporting from states, the allocation of resources like vaccines, tests and
treatments, and the use of the social disadvantage indices in the placement of
surge sites or resource distribution locations, and the leveraging of networks
that serve underserved communities like community health centers, dialysis
centers, and rural health clinics. These innovations have been built into the
design of Administration policies, programs and operations to respond to the
pandemic; and equity will remain the North Star of the pandemic response

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Continue to address the needs of individuals with disabilities and older adults in
response to and recovery from the virus. The Administration recognizes that the
COVID-19 pandemic has resulted in new members of the disability community and
has had tremendous impacts on disabled individuals. Over the past year, the
Administration has collaborated and consulted with the disability community and
taken several key actions to address the unique needs of individuals with disabilities.
Among other actions, the U.S. government released key civil rights guidance to protect
disabled individuals during the COVID-19 pandemic or any public health emergency;
prioritized Long COVID services, supports, and research in the context of disability;
established a call line dedicated to ensuring individuals with disabilities can equitably
utilize the Administration’s at-home test distribution; ensured disabled individuals
and other high-risk individuals have access to at-home testing; and invested American
Rescue Plan resources to build COVID-19 vaccine confidence and access among
people with disabilities. Moving forward, the Administration will take several key
steps to further our work to ensure that disabled individuals, regardless of where they
live or the level of community risk, have equitable access to COVID-19 testing, masks,
and other critical mitigation strategies. The Administration remains committed to
implementing these policies and developing additional policies in close collaboration
with the disability community – keeping equity and accessibility at the center of our
COVID-19 response and beyond.

• Expand the HHS Administration for Community Living’s Disability Information


and Access Line to support people with disabilities who face difficulty using or
cannot use a self-test. The Disability Information and Access Line (DIAL),
available at 1-888-677-1199, is launching a new initiative to support disabled

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individuals who need assistance using at-home tests distributed by the


Administration or support in finding alternatives to at-home testing. For
individuals who can use an at-home test, DIAL operators are available to assist
with ordering free tests; understanding instructions for test administration and
test results; or providing alternative instructions for those unable to access, read,
or understand the manufacturer’s version. For those who cannot use an at-home
test, DIAL operators can assist individuals with ordering tests to collect a
specimen that can be mailed back for results. For individuals who cannot use
either an at-home test or an alternative “swab and send” test, DIAL operators can
assist callers with locating their state or local health department and/or aging and
disability resources for additional assistance with other testing options that may be
available in their community, including identifying potential in-home testing
options or assistance with transportation or companion support to visit a
community-based testing site.

• Launch new COVID-19 testing guidance in American Sign Language and reviewing
all existing COVID-19 guidance to confirm accessibility for all disabled individuals.
CDC recently released “How to Interpret Positive Self-Test Results” guidance in
American Sign Language (ASL), a first step towards ensuring that deaf or hard of
hearing individuals can access key information about how to protect themselves
and their communities. CDC is also collaborating with the CDC Foundation,
Georgia Tech’s Center for Inclusive Design and Innovation, and their partners
across HHS to pursue key improvements for all COVID-19 guidance available on
CDC’s website that cannot be accessed elsewhere: information in Braille, ASL
translation, simplified text, and other alternative formats.

• Execute a new effort to develop at-home COVID-19 tests that are accessible to all.
NIH’s RADx program recently launched a new effort to seek both short- and long-
term solutions to improve at-home test accessibility. RADx will consult and work
with national organizations that represent communities in need of accessible tests,
and test manufacturers to inform the modification or development of more
accessible at-home tests, including device design, packaging, and modes of
instruction, and challenges. Though at-home COVID-19 tests were only invented
last year, the Administration’s investment in this technology has rapidly scaled up
manufacturing to the millions per day. This effort strives to ensure that all
individuals have an option for at-home testing that can be used and interpreted
without assistance, and will set the course towards accessible testing in the weeks
and months to come.

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• Incentivize all at-home test manufacturers to prioritize accessibility of at-home


tests. The Administration recently published a formal Request for Information to
ensure the preservation and expansion of current domestic manufacturing
capacities for at-home rapid tests and point-of-care tests. The RFI specifically asks
manufacturers to prioritize the accessibility of at-home tests for people who are
blind or visually-impaired; individuals with physical, cognitive, or other
disabilities; and individuals who need non-English language or literacy support.
The Administration will use the information gathered in March 2022 to inform
near-term investments – towards ensuring that accessible at-home tests are
available for federal purchase.

• Request accessible instructions from manufacturers who have received an FDA


EUA. Earlier this month, the FDA reached out to all test developers that have
received an Emergency Use Authorization to request that they provide
instructions that are accessible and compliant with the Americans with Disabilities
Act, including alternative text for all images as well as html versions. FDA will use
all authority available to receive these accessible instructions as quickly as
possible, while working with RADx to identify other wraparound services that can
be provided immediately to make existing at-home tests more accessible.

• Distribute masks to disabled individuals through community-based organizations


and jurisdictions. As the President announced in January 2022, the Administration
is making 400 million N95 masks from the Strategic National Stockpile available to
all individuals in the United States for free. HHS is sending tens of millions of free,
high-quality masks to community health centers and rural health clinics –
organizations that play a critical role in serving communities across the country,
including individuals with disabilities. As health center distribution continues to
ramp up, HHS will support health centers and aging and disability networks as
they collaborate on efforts to distribute these masks to individuals with disabilities
who cannot leave their homes.

• Call on states to directly distribute high-quality masks through community-based


organizations serving individuals with disabilities. Over the past year, the
Administration has also sent millions of high-quality masks to states and territories
across the country. We encourage all jurisdictions to work in partnership with
community-based organizations to expand access for the hardest-hit and highest-
risk individuals — including people with disabilities who may be unable to leave
their homes.

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Prioritize protections for individuals who are immunocompromised so they have


the support they need to live their lives safely. The Administration will continue to
provide support to individuals who are immunocompromised so they have the
support they need to live their lives safely. This will include providing individuals who
are immunocompromised with an accurate understanding of the real-time risks of
COVID-19 exposure based on the area in which they live, communicating
comprehensive public health guidance for individuals who are immunocompromised
so they engage in appropriate safety protocols, ensuring there is clear guidance and
access to booster shots to provide increased protection to individuals who are
immunocompromised, expanding access to free tests so that visitors of individuals
who are immunocompromised can get tested, and providing prioritized access to
treatments and pre-exposure prophylaxis for individuals who are
immunocompromised. In addition, the Administration will engage physicians and
healthcare providers that serve patients who are immunocompromised to ensure they
understand the latest treatment and prophylaxis options available. Further
procurement of pre-exposure prophylactic treatments in the coming months will
require additional funding from Congress.

• Ensure individuals who are immunocompromised have easy access to


additional shots as well as clear guidance on when immunity may be waning.
The CDC has recommended that individuals who are immunocompromised get
an additional shot; and the CDC will conduct outreach with all providers,
pharmacies, and vaccination locations to ensure there is clear guidance on this
recommendation. The CDC will also prioritize communication with individuals
who are moderately or severely immunocompromised, ensuring that they
understand how and when vaccine protection may be waning over time. If an
additional shot is needed, the Administration will conduct outreach so people
who are immunocompromised understand how to stay protected against
COVID-19 and ensure that they can receive additional shots at a convenient
location.

• Prioritize individuals who are immunocompromised for access to treatments.


To do all the federal government can to ensure that immunocompromised
people can mount an adequate immune response to COVID-19, the federal
government will prioritize access to antiviral treatments and pre-exposure
prophylaxis drugs like Evusheld for individuals with moderate to severely
compromised immune systems. Securing sufficient supply of these treatments
will require additional funding from Congress.

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• Provide and ensure that there is clear guidance around the timing of
preexposure prophylaxis for individuals who are immunocompromised. HHS
will work through its research, public health, and health care delivery experts
to develop guidance for when individuals who are immunocompromised could
benefit from receiving therapeutics for pre-exposure prophylaxis of COVID-19
to help protect their health and safety.

• Make free testing widely accessible and convenient so that visitors of


individuals who are immunocompromised can get tested. The federal
government will support broad access to free testing for Americans across the
country so that individuals who are immunocompromised can ask their visitors
to test when needed in order to reduce the risk of exposure to the virus.
Ensuring continued access to free testing and sustaining testing capacity will
require additional funding from Congress.

• Ensure that individuals who are immunocompromised have a clear


understanding of risk and public health guidance. The Administration will
provide strong support to individuals who are immunocompromised – in close
coordination with CDC – so they have the tools and the support they need to
live their lives safely, including an accurate understanding of the real-time risks
of COVID-19 exposure based on health status and the area in which a person
lives. Tools like the one-stop-shop website will provide tailored risk
assessments to individuals who are immunocompromised so they have easy
access to information on the risks of exposure in the area and on tailored
mitigation strategies to avoid exposure to the virus.

Accelerate efforts to detect, prevent, and treat Long COVID. Millions of Americans
across the country are experiencing post-COVID conditions — a wide range of
physical and mental health symptoms that persist for weeks to months following
infection. The Administration has accelerated efforts across the NIH, CDC, and the
VA including the landmark $1.15 billion RECOVER Initiative out of NIH — to advance
our understanding of these conditions and catalyze scientific breakthroughs. The
Administration continues to support efforts to create incentives for and advance high-
quality care. And the Administration has mobilized agencies to support individuals
experiencing these conditions by providing information about where individuals can
access resources and accommodations and clarifying people’s rights for key health
and educational services and supports.

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• Pioneer a national research agenda to advance efforts to detect, prevent and


treat Long COVID. To accelerate scientific progress, the President will direct
the federal interagency to develop a National Research Action Plan on Long
COVID. For the first time, agencies — HHS, VA, DoD and other key partners —
will put forward a comprehensive plan to advance research efforts and data
sharing across the federal government and in collaboration with academic and
industry partners.

• Launch Centers of Excellence in communities across country to provide high-


quality care to individuals experiencing Long COVID. HHS, through the
Agency for Healthcare Research and Quality, will propose and seek resources
from Congress to launch a comprehensive initiative to fund institutions across
the country that provide high-quality, high-value care for individuals
experiencing Long COVID. These centers will bring together leading
researchers and care providers across health systems, health centers, and Long-
Term Care Facilities to study and promote evidence-based care for children,
older adults and high-risk populations.

Launch new support for people dealing with mental and behavioral health issues.
The COVID-19 pandemic has led to an increase in behavioral health conditions as too
many people have felt the effects of social isolation, sickness, economic insecurity,
increased caregiver burdens, and grief. The Administration has increased investments
in mental health and substance use prevention, treatment, and recovery support for
Americans dealing with COVID-19 and COVID-related loss, including expanding
access to community-based behavioral health services. Moving forward, the President
will direct the federal government to further advance these mental and behavioral
health efforts, in order to better identify the impact the COVID-19 pandemic has had
on mental health, substance abuse, and well-being, and to take steps to address these
impacts.

• Launch an expanded program to prevent burnout and support mental health


and well-being in the healthcare workforce. The Health Resources and Services
Administration (HRSA) will propose and seek resources from Congress to
launch an expanded grant program to support health systems, provider groups,
health centers, first responders, and other healthcare organizations that
support the healthcare workforce. With this funding, healthcare organizations
would undertake initiatives to improve mental health by launching new
workforce training programs, relieving workplace stressors, conducting mental
health programming, and providing access to high-quality mental health
support. This will build on ongoing efforts by the National Institute for

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Occupational Safety and Health (NIOSH) to address the mental health of health
workers by raising awareness, eliminating barriers to accessing care,
identifying workplace and community supports, reducing stigma and
strengthening data and resources. Together, these resources will ensure that
we are supporting our healthcare workers on the frontline on this pandemic.

• Continue to make investments in mental health and substance use prevention,


harm reduction, treatment, and recovery services. The Administration has
made continued investments in mental health and substance use services, with
a focus on the difficult conditions of the pandemic, and delivering resources to
states and local communities to provide services like screening, outpatient
treatment, crisis support, and prevention. Additionally, the Administration
continues to provide flexibility for states to use Medicaid funding to provide
community-based mobile crisis intervention services for people experiencing a
mental health crisis.

• Continue to focus on youth mental health challenges during the pandemic. Our
children and youth have been particularly affected by the mental health
challenges posed by the pandemic. That is why the Administration provided
relief funds for schools to help them re-open safely and address the needs of
students, and promoted the use of these funds to hire school psychologists and
counselors and to address the mental health needs of students. The
Administration also invested in a grant program for state education agencies to
advance wellness and resiliency for youth in school-based settings; increased
funding for the Pediatric Mental Health Care Access program, which promotes
integration of behavioral health into pediatric primary care settings; and
invested in efforts to support youth suicide prevention programs and the
National Child Traumatic Stress Network, which raises the standard of care
and improves access to services for traumatized children, their families, and
their communities.

Support families dealing with COVID-related loss. The Administration will continue
providing financial assistance for COVID-related funeral expenses and further
develop a bereavement response to support children and families who have lost loved-
ones to COVID-19. The President will direct agencies to comprehensively review their
programs, funding, and other supports they can make available to families
experiencing loss due to the COVID-19 related death of a family member, further
developing a response to support the pressing needs of children and families – both
for operational needs like financial resources to cover funeral costs, and mental health

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and healing needs like trauma and grief informed services – in consultation with
states, tribal, and local government resources and other community efforts.

Continue to support local, community-based organizations to improve health


equity. The Administration has provided hundreds of millions of dollars in funding
directly to community-based organizations to increase COVID-19 vaccinations in
underserved communities. This funding helped community-based organizations hire
and mobilize community outreach workers, community health workers, social
support specialists, and others. Due to the success of the program, the Administration
provided an additional $140 million dedicated to community-based organizations in
November to hire local community outreach workers that educate individuals,
provide resources and address barriers to getting vaccinated in underserved
communities. The Administration will continue to support community-based
organizations and to facilitate community-led solutions in the fight against COVID-19.

• Support community-based organizations to expand vaccination and boosters to


underserved groups. To date, the Biden Administration has provided dedicated
resources directly to local community-based organizations to increase COVID-
19 vaccination and boosters in underserved communities by assisting
individuals in getting the information they need about vaccinations and
boosters, making vaccine appointments, and providing transportation and
other support that may be a barrier to vaccination. This funding is allowing our
community-based organizations that work with communities of color and other
underserved populations to build vaccination capabilities, and establish
connections for the COVID-19 response, which will build coalitions for
inclusion in pandemic preparedness, response, and recovery activities so that
care is brought closer to the communities served and in settings that people
trust.

• Prioritize inclusivity in public health campaigns. During the COVID-19


response, the Administration has built a multi-pronged COVID-19 response
education, outreach, and communications campaign tailored to communities.
The campaign has used science-based, non-political sources by working with
state, local, Tribal, and territorial health care institutions, community
organizations, and other trusted sources to promote public health prevention
behaviors, such as vaccine awareness and uptake, testing, masking, and social
distancing; paying particular attention to institutions and organizations that
serve communities that have been hardest hit by COVID-19 exposure, illness,
and death. And educational materials and community-toolkits on COVID-19
vaccines were translated in 14 languages and provided to doctors’ offices,

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pharmacies, community health centers, and organizations across the country.


The Administration will continue to ensure language access and cultural
competence in outreach strategies to reach all people, including people with
disabilities. Additionally, the Administration has prioritized providing
accurately translated information, employing trained interpreters, and
advertising that services for people with limited English proficiency or who are
more comfortable with another language are available.

Sustain critical efforts to build a representative health care and public health
workforce. Building a representative health care and public health workforce has
been a top priority of the Administration. The American Rescue Plan invested in the
public health and health care workforce to recruit, hire, and train public health
workers from underrepresented backgrounds into critical public health professions;
and also invested in the National Health Service Corps and Nurse Corps to bring more
doctors and nurses from diverse backgrounds to underserved areas around the
country. Building on that success, in November, the Administration announced
hundreds of millions of dollars to expand the public health workforce by creating a
new pipeline program for 13,000 community health workers from
underserved communities. This program will support apprenticeship programs at
over 500 health care and public health sites nationally, including emergency
departments, health centers, state and local public health departments, community
health centers, mobile health clinics, shelters, housing programs, faith-based
organizations and other locations where high-risk populations access care and receive
services. The Administration also announced $210 million to expand the public health
workforce in the Indian Health Service and across indigenous communities and an
investment for CDC to improve diversity in the public health workforce. As we move
forward, the Administration will continue to focus on efforts to build representative
health care and public health workforces.

• Continue to make investments so our public health and medical workforce


better reflects the diversity of our country. The Administration has invested in
– and will continue to invest in – building capacity for the public health
workforce to recruit, hire and train public health workers from
underrepresented backgrounds – including Black, Hispanic and Native
Americans students – into critical public health professions; and has invested in
the National Health Service Corps and Nurse Corps to bring more doctors and
nurses from diverse backgrounds to underserved areas around the country.

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CDC is also investing resources to expand activities in recruitment and pipeline


programs to support diversity, equity, and inclusion in the public health
workforce and increase awareness and interest in public health among
underrepresented groups.

• Continue to expand the public health and health care workforce in Tribal
communities. The COVID-19 pandemic has highlighted and exacerbated
preexisting inequities facing Tribal Nations. The Administration will continue
to make investments to enhance public health capacity and build better
emergency preparedness for Indian Health Service (IHS) and Tribal Nations;
and will support IHS’s ability to recruit and retain highly-skilled health care
professionals, in IHS, Tribal, and urban Indian health programs. Additionally,
the Administration has invested millions in supporting core epidemiology work
for American Indian and Alaska Native populations. The Indian Health Service
(IHS) will also continue to make significant investments to hire school nurses
that can provide critical testing, contact tracing, case management, vaccination,
and overall school health support to Bureau of Indian Education K-12 schools.

Expand health equity data to drive pandemic decision making. The Administration
has made significant investments to increase health equity data collection and
reporting for high-risk groups, and to make this new data publicly available. The
Administration increased the completeness of race/ethnicity vaccination data from
53% in February 2021 to over 74% in February 2022, which now includes new
reporting of data from several states that were not initially reporting any vaccine data
by race or ethnicity. To date, health equity data has driven decision-making during the
COVID-19 response, including the distribution of vaccines, treatments and surge
resources. The effort to improve health equity data collection continues, and the
Administration will continue to prioritize building a data ecosystem that promotes
equity-driven decision making.

• Invest in equity-centered data collection. The Administration continues to


expand the federal government’s data infrastructure to increase collection and
reporting of health data for high risk populations, while reaffirming data
privacy. HHS continues work to optimize data collection from public and
private entities to increase the availability of data by race, ethnicity, geography,
disability, and other demographic variables, as feasible. The Administration
will continue to support and invest in an equity-centered approach to data
collection, including collecting data for groups that are often left out of data
collection.

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• Ensure data continues to inform equity-centered pandemic response decision-


making. The Administration will continue to leverage existing sources of
quantitative and qualitative data, including location information, to make data-
informed, timely, and accurate equity-centered decisions regarding outreach,
planning activities, and resource allocation and distribution. In addition, the
Administration will use the expanded equity-centered data infrastructure to
identify high-risk communities and evaluate the effectiveness of the response.

• Track health outcomes for people in congregate and high-risk settings. The
Administration has worked with state, local, Tribal, and territorial health
departments to establish efforts to track and report the health and health status
and outcomes of people in congregate settings (e.g., nursing and Long-Term
Care Facilities, foster care facilities and group homes, correctional facilities,
and homeless shelters) and other settings with increased risk of exposure in
real time, and to develop and research evidence-based interventions.

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GOAL TWO
Prepare for new variants

2: Prepare for new variants


America’s Progress to Date:
ü During the last year, we went from sequencing 3,000 cases a week to 90,000 cases a week; CDC’s
national genomic sequencing efforts can reliably detect very low level of variants, including variants
that account for as little as 0.1% of all COVID-19 cases in the U.S.
ü Developed U.S. government playbooks for variant preparedness and surge response
ü Since July 2021, we have deployed over 4,000 federal personnel, sent over 3,400 ventilators,
ambulances, and other supplies; and shipped over 115 million pieces of PPE
ü FEMA has invested $300 million dollars in state hospital preparedness to expand hospital beds in
38 states
Moving forward, the Administration will work with Congress to secure the necessary funding to:
• Improve COVID-19 data tracking so we are better prepared to respond rapidly to emerging threats
• Expand domestic and global sequencing capacity so the country is able to better identify hotspots,
track disease trends, and respond immediately to new variants
• Leverage a COVID Variant Playbook to determine the impact of a new variant on our vaccines,
treatments, and tests, and shore up our tools, if needed
• Leverage new processes to expedite development and clinical testing of variant-specific versions of
vaccines and treatments

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• Utilize established plans to manufacture and deliver updated vaccines, treatments, and tests
quickly, if needed
• Build a large national stockpile of new categories of supplies – including at-home tests, treatments,
and masks for the general population – and pre-position supplies for immediate deployment
• Leverage a proven COVID Surge Response Playbook and maintain America’s strong emergency
response capabilities
• Continue to support and invest in the health care and public health workforce
• The U.S. government has established a permanent logistics and operational hub at HHS for
accelerated development, production, and delivery of COVID-19 vaccines and treatments

As we work to keep ourselves protected against COVID-19, America must remain


prepared for any new variant. To do so, the Administration has developed a
comprehensive plan for how we monitor this virus, share what we know with the
American people, adapt our tools swiftly, and deploy emergency resources to help
communities.

Before January 2021, the federal government had insufficient data and sequencing
capabilities and was ill-equipped to respond to new variants. Electronic case reporting
was in place for only a handful of states in 2020 and the country could sequence only
3,000 tests per week. America had no plan for responding to a new variant or standing
up comprehensive efforts to respond to a surge in COVID-19 cases.

During the last year, the Administration has enhanced federal agencies’ collection,
production, sharing, and analysis of data. The Administration has successfully
expanded electronic case reporting to all 50 states, Washington, D.C., Puerto Rico, and
thousands of health care facilities in 2022. The CDC now tracks a range of key COVID-
19 response metrics including cases, testing, vaccinations, emergency department
visits, and hospital admissions in real-time; and this information is readily available to
inform policymakers at the federal, state, and local level. A public dashboard tracking
key COVID-19 metrics is also available at the county level, so that Americans can
gauge the level of community burden and vaccination in their own communities.

America has established a world-class surveillance operation, bolstering our ability to


detect surges and emergence of new variants. The country went from sequencing
3,000 cases a week to 90,000 cases a week. CDC’s national genomic sequencing efforts
can reliably detect very low levels of variants, even variants that account for as little as
0.1% (with 95% confidence) of all COVID-19 cases, circulating in the United States.

And when new variants are identified, the federal government has a network of
researchers who can rapidly study the sequence and assess mutations, allowing the

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government to respond to concerning strains. CDC has also built a comprehensive


network where local jurisdictions work in partnership with the federal government to
promptly report on newly emerging variants across the country. America has also
invested in global surveillance and built and strengthened international
communication channels – including with United Nations organizations such as the
WHO and networks of governments and scientists around the world – to understand
and respond to COVID variants.

And when Omicron was identified in November, the Administration was able to
quickly assess the effectiveness of our vaccines, tests, and treatments and issue
guidance to clinicians and the general public. The Administration stood up networks
of government, and academic and company scientists to quickly conduct these
assessments and provide real time information to policymakers and regulators.

And during the last year, the Administration successfully built an emergency response
infrastructure that the federal government can activate for future surges. Our surge
response – led by FEMA and HHS – developed capabilities to stand up federal mass
vaccination sites and federal testing sites; distribute critical supplies; and deploy
thousands of federal clinical and non-clinical personnel to support states, Tribes, and
territories to address critical needs on the ground, including addressing hospital
personnel shortages, providing treatments, and administering vaccines. Since July
2021, the federal government has deployed over 4,000 military and non-military
personnel to 46 states and territories; sent over 3,400 ventilators, ambulances, and
other critical supplies; and shipped over 115 million pieces of PPE.

Moving forward the Administration will maintain our proven data, sequencing,
variant response, and surge response capabilities. The CDC will continue to improve
COVID-19 data collection, reporting, and analysis so America is better informed and
ready to respond to new variants. And if a new variant emerges, the federal
government will leverage established playbooks to assess its impact on our vaccines,
tests, treatments and deploy the tools, personnel and resources Americans need.

The Administration will work with Congress to secure the


necessary funding to:

Improve COVID-19 data tracking so we are better prepared to rapidly respond to


emerging threats. The Administration will continue efforts to enhance federal
agencies’ collection, production, sharing, analysis of, and collaboration with respect to
data to increase our federal government’s long-term pandemic preparedness

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capabilities, with a focus on rapid-response capabilities when new variants emerge.


Ensuring the CDC can continue critical monitoring and data analysis functions will
require additional funding from Congress.

• Make improvements to state-level and local-level data systems and


infrastructure. The Administration will continue to prioritize modernizing our
state and local public health data systems to move from siloed and outdated
public health data systems to connected, resilient, adaptable, and sustainable
‘response-ready’ systems. CDC will support the development of modern,
secure, interoperable, real-time systems needed to respond to COVID-19.
These foundational efforts are crucial to timely and effective disease control,
whether for current COVID-19 strains, emerging variants, or other public
health threats

• Continue to standardize data systems and to build early-warning networks.


The Administration will continue to work to standardize data systems across
states, Tribes, territories and localities – which could facilitate sharing,
aggregating, and analyzing data across states to act as early-warning networks.
This includes further expansion of national systems tracking leading
indicators of disease spread, including wastewater monitoring by the National
Wastewater Surveillance System and syndromic surveillance in emergency
departments through the National Syndromic Surveillance Program (NSSP).
The federal government will develop updated recommendations and standards
that consistently reflect the current disease threats in the United States.

• Continue to work to modernize the public health data infrastructure


workforce. The Administration will continue work with the Office of the
National Coordinator for Health Information Technology to invest tens of
millions of dollars to train public health professionals to help modernize the
public health data infrastructure, including investments in the development of
the existing public health workforce and expanded recruitment of public
health professionals who reflect the diverse communities in which they serve.

• CDC will continue to expand scientific and programmatic capabilities to


respond to new variants. The CDC will continue to improve existing scientific
and programmatic efforts to better understand the threat posed by COVID-19
and nimbly respond to new variants. Specifically, through new efforts such as
the Center for Forecasting and Outbreak Analytics, CDC will partner with
public and private health systems to conduct rapid studies that assess the

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impact of COVID-19 variants, such as Delta and Omicron, on clinical severity


and vaccine effectiveness.

Expand domestic and global sequencing capacity so the country is able to better
identify hotspots, track disease trends, and respond immediately to new variants;
and strengthen pandemic preparedness. The CDC has and will continue to track
disease trends to respond immediately to new variants, including continuing
improvements to national wastewater surveillance for early insights into community
transmission; continue to strengthen processes and the infrastructure for the
immediate identification and characterization of variants; continue to expand
genomic sequencing to better monitor for COVID-19 hotspots and variants of concern;
and maintain a network of local jurisdictions capable of promptly reporting emerging
cases nationwide. The Administration has also supported improvements to global
surveillance of variants and built and strengthened international communication
channels – including with UN organizations and networks of governments and
scientists around the world – to understand and respond to COVID-19 variants as they
emerge in real time. Ensuring the CDC can continue critical sequencing functions will
require additional funding from Congress.

• Work with states to expand state-level sequencing. The Administration will


continue to expand genomic sequencing to monitor for COVID-19 hotspots and
respond with rapid epidemiological field investigations, variants of concern,
and emerging infectious disease threats. Additionally, to address the
inconsistent coverage of genomic sequencing capabilities at the state level,
which can create a skewed picture of prevalence in the early stages of variant

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emergence, the Administration will continue to work with states to expand


state-level sequencing capabilities. The Administration has built a robust
sequencing infrastructure to support early identification and characterization
of novel variants, and will continue to invest in sequencing and laboratory
testing to monitor variants that may impact transmissibility; disease severity;
and the effectiveness of vaccines, therapeutics, diagnostics, and mitigation
strategies.

• Ensure America continues to have the tools to quickly identify variants and
understand their spread. Early identification and classification of variants is
essential to drive immediate action to respond to variants. The Administration
is working to accelerate collection and reporting of domestic data to expedite
the assessment and classification of variants. The Administration will also
continue to work to expand our disease forecasting capabilities.

• Expand national wastewater surveillance for better insight into community


transmission. CDC has launched the National Wastewater Surveillance System
to coordinate and build the nation’s capacity to track the presence of SARS-
CoV-2, the virus that causes COVID-19, in wastewater samples collected across
the country. CDC’s NWSS works with health departments to track SARS-CoV-2
levels in wastewater so communities can act quickly to prevent the spread of
COVID-19. The Administration will continue to expand the NWSS; and work
with state, county, and city jurisdictions so the federal government can
transform independent local efforts into a robust, sustainable national system,
and help expand local public health infrastructure. Wastewater surveillance
can provide an early warning of COVID-19’s spread and decline in
communities, and the Administration will continue to prioritize this important
initiative.

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• Strengthen partnerships to prepare for the effective global surveillance of


variants. Early detection and sequencing of variants around the world can help
accelerate the effective domestic and global response. The Administration will
continue to strengthen core global public health infrastructure for surveillance
and laboratory capacity to detect emerging variants, drawing from CDC
partnerships with local jurisdictions that have facilitated prompt reporting of
newly emergent cases. The federal government will improve the collection and
characterization of pathogens, expand and enhance laboratory capabilities to
detect and monitor respiratory and other pathogens, target sequencing and
other surveillance efforts in high-risk transmission zones, and strengthen
multinational data systems to detect, characterize, and communicate rare
events. These efforts will be coordinated through the SARS-COV-2 Interagency
Group (SIG) which includes experts from BARDA, CDC, DOD, FDA, HHS, NIH
and the Department of Agriculture (USDA), who collaborate to continuously
monitor and assess emerging variants in the United States and around the
world.

• Enhance communication channels with the WHO and global networks that
monitor variants and their risk potential. The United States has established –
and will continue to strengthen – strong channels of communication to WHO
Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE) to assist
with enhanced responsiveness to variants of concern, variants of interest, and
variants under monitoring. This collaboration will assist with early detection
and enhanced early warning of new variants and their risk potential. In
addition to better communication with the WHO and better communication
among member states; the United States continues to work to invest in a global

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pandemic surveillance infrastructure by strengthening local capacity and


coordination with international networks on research and development and
product approval.

• Translate the U.S. government’s COVID-19 capabilities into stronger pandemic


preparedness. Leveraging the enhanced capabilities built during the COVID-19
response, the Administration will build future pandemic preparedness
capabilities to detect, prevent, and respond to new emerging threats. As laid out
in the American Pandemic Preparedness: Transforming Our Capabilities plan,
the Administration is working with our scientific and public health agencies to
enhance our nation’s biodefense and pandemic readiness. The U.S. government
will continue to strengthen capabilities including improved data tracking
systems; expansion of the public health workforce; redoubled investments in
research, advanced development, and accelerated manufacturing of
countermeasures; enhancement of America’s Strategic National Stockpile; and
strengthened international public health partnerships. The Administration has
also assembled scientific expertise across the U.S. government in a Pandemic
Innovation Task Force, which is identifying critical actions for
innovation. These actions will not only ensure we have better tools to respond
to future pandemics, but also that equity is prioritized so that technological
advances benefit all Americans.

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Leverage a COVID-19 Variant Playbook to determine the impact of a new variant


on our vaccines, treatments, and tests, and shore up our tools, if needed. The
Administration has developed a variant playbook to expedite rapid laboratory
evaluation of the effectiveness of vaccines, tests, and treatments against new variants.
Networks of researchers are ready and can be activated immediately to evaluate the
effect on testing, treatments, and vaccines – and to accelerate that work we have
established channels of communication with providers of viral genetic sequence and
analysis so the providers are able to prioritize delivery to labs immediately upon the
U.S. government’s request. Channels of communication have also been established
around the world with labs to expedite the secure delivery of live virus to assess the
impact of new variants on tests, treatments, and vaccines. Once evidence is available
on vaccine, tests, and treatment effectiveness, the Administration has developed a
coordinated infrastructure – across NIH, FDA and CDC – to quickly and effectively
issue guidance informing clinicians and the general public, ensuring transparent
distribution of critical public health data. Support of these efforts when new variants
emerge will require additional funding from Congress.

• Strengthen existing collaborations with providers of genetic sequence and


analysis and our network of labs so the government can immediately test the
effectiveness of our vaccines, treatments, and tests. The federal government –
coordinating with CDC, NIH, BARDA, and FDA – has developed effective
collaborations with a network of academic labs and developers, to drive rapid
assessment of vaccine, treatment, and test performance against variants. To
enable rapid assessments, the U.S. government has developed effective
collaborations with providers of genetic sequence and analysis to prioritize labs
most critical to evaluating the impact of new variants on tests, treatments, and
vaccines. These channels of communication ensure that when a new variant
emerges we are immediately able to evaluate the effectiveness of our vaccines,
treatments, and tests. In addition, the Administration – in coordination with
CDC, NIH and FDA – has expanded our network of labs to shave days off of
test, vaccine, and treatment evaluations.

• Execute proven plans, if needed, that enable the rapid laboratory evaluations of
vaccine effectiveness, treatment effectiveness, and test effectiveness. The
Administration has established close collaborations with current vaccine
manufacturers and made significant investments in research and development
to ensure immediate evaluations of vaccine effectiveness against new variants.
HHS will also monitor – on an ongoing basis – the efficacy and durability of
authorized vaccines against current and future variants and make
recommendations to optimize protection. Additionally, the Administration has

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made investments in advanced research and development to build faster


capabilities to determine if particular treatments are ineffective against certain
strains. And finally, the Administration is continuing to invest in validation of
test performance against variants and is continuing to invest in the RADx
program that monitors and evaluates SARS-CoV-2 variants for their impact on
diagnostic test performance.

Leverage new processes to expedite development and clinical testing of variant-


specific versions of vaccines and treatments, so America can get these tools in
place quickly, if needed. The U.S. government is ready to proactively respond to
variants that may arise in the future. FDA will work closely with manufacturers to
maximize the protective effect of vaccines to avoid or minimize future waves of
COVID-19. This would include utilizing new frameworks from FDA to expedite
development and regulatory review of variant-specific versions of vaccines and
treatments, so that America can get them in place, if needed. These new frameworks
allow for even more efficient development of variant-specific vaccines and new
monoclonal antibody treatments in the case of emerging variants that challenge the
existing arsenal of vaccines and therapeutics. Leveraging what is already known about
the prototype vaccines allows for a parallel development process to move the variant-
specific vaccines along as efficiently as possible. This approach relies on significantly
smaller clinical trials and enables manufacturing scale up while clinical trials are
being conducted. FDA will also continue to work to further expedite the authorization
of COVID-19 therapeutics such as was done in the recently authorized monoclonal
antibody from Eli Lilly & Co.

Utilize established plans to approve, manufacture, and deliver updated vaccines,


treatments, and tests quickly if needed. The Administration has developed plans that
can be activated in coordination with vaccine, test, and treatment manufacturers for
the accelerated development, manufacturing, procurement, and delivery of updated
products, if needed, so these critical tools can be available quickly. As a result, updated
vaccines could be ready in 100 days, instead of the 11 months that the original
prototype vaccines took to prove safety and efficacy. The expedited timeline is
approximately twice as fast as the manufacturing of an annual update to flu vaccine.
The Administration has been in conversations with manufacturers to accelerate
manufacturing updated vaccines, tests, and treatments at industrial scale if needed –
offering significant federal government support for manufacturing, equipment, staff
hiring and training, raw-material sourcing, tech transfer, bulk product processing, and
the acquisition of supplies – while pursuing regulatory review simultaneously.
Procurement of additional vaccines – if additional boosters, variant-specific doses, or
multivalent vaccines are needed – will require additional funding from Congress.

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• Ensure that operational and logistics plans are in place to move new vaccines,
tests, and treatments from the factory to the frontlines immediately. The
Administration has developed operational and logistics plans and distribution
strategies to deliver an updated vaccine, test, or treatment to the American
people, if needed. Each of these plans expedites contracting and acquisition and
leverages major distributors and existing distribution networks. Additionally,
the Administration – as standard practice – has regularly initiated reviews and
exercises to rehearse emergency distribution plans, commencing vaccine and
treatment distribution within 24 hours of an FDA Emergency Use
Authorization. Preparations have been made for the communication, education,
and support needed for states, localities, Tribes, territories, and health care
providers -- along with materials for the general public – if an updated vaccine,
treatment or test is needed.

Build a large national stockpile of new categories of supplies – including at-home


tests, treatments, and masks for the general population – and pre-position supplies
for deployment. In 2020, our National Stockpile was depleted. Over the course of
2021, ASPR utilized approximately $12 billion from COVID-19 supplemental
appropriations to restore or exceed pre-pandemic levels on key supplies: N95
respirators, procedure face masks, face shields, gowns and ventilators. ASPR has
initiated procurements to stockpile new categories of supplies, including rapid at-
home tests to ensure adequate supply in times of surges, COVID-19 outbreaks, or new
variants. The federal government will create testing reserves of the size and content
necessary to meet demand for future surges and have plans in place to rapidly scale up
manufacturing capacity if needed. The Administration is also in the process of
restocking N95s following the distribution of N95s to the American people as well as
sourcing new high-quality masks for children – a first for the SNS.

• Build a strong national stockpile and add new categories of supplies. Thanks to
the President’s leadership, the U.S. government has hundreds of millions of N95
masks, billions of gloves, tens of millions of gowns, and over 100,000 ventilators
in the Strategic National Stockpile—all ready to ship out at a moment’s notice if
and when they are needed. The Administration has ensured – and will continue
to ensure – that the Strategic National Stockpile is fully stocked and that
supplies, medicines and devices are ready to be deployed. The Administration
has also made plans and initiated procurements to build a strong stockpile of
new categories of supplies, including rapid at-home tests, pills, and masks for
the general population to ensure adequate supply in times of surges, COVID-19
outbreaks, or new variants.

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• Continue to provide free, high-quality masks to the American public and add
masks for the general public, including kids, in the Strategic National Stockpile.
In January, President Biden announced an unprecedented effort to make
available hundreds of millions of high-quality masks to the American public for
free. Within days, the Strategic National Stockpile had shipped millions of
masks to be available across thousands of trusted, convenient locations
nationwide. Today, these high-quality masks are available for the public to pick
up for free at tens of thousands of local pharmacies, grocery stores, and health
centers in their communities. The Administration will procure additional high-
quality masks – for adults and children –for any future surge. The
Administration will also continue to make these masks available to health
centers over the coming months to ensure that we are reaching the hardest-hit,
highest-risk communities with the protection that they need. And the
Administration is also stockpiling high-quality masks for the general
population, including children.
• Pre-position all supplies so they are ready for immediate deployments. The
Administration has pre-positioned stockpiled supplies in strategic locations so
we can send them to states that need them immediately. Since July 2021, the
U.S. government has sent over 3,400 ventilators, ambulances, and other critical
supplies; and shipped over 115 million pieces of PPE.

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Leverage a proven COVID Surge Response Playbook and maintain America’s strong
emergency response capabilities. The Administration has developed a
comprehensive emergency response COVID-19 surge playbook to stand up mass
vaccination sites and surge testing sites, deploy federal medical and emergency
personnel, distribute emergency supplies, and expand hospitals and emergency
facilities.

• Leverage existing DOD and FEMA partnership to deploy active duty military
medical personnel to COVID-burdened hospitals, if needed. The President,
working closely with the Secretary of Defense – has established a system in
which the President can immediately call upon active duty military medical
personnel to deploy to over-burdened hospitals as part of the COVID-19
response. FEMA and DoD have developed a system by which states can request
and receive deployments of federal personnel to support strained hospitals.
During Omicron, Secretary of Defense Austin immediately readied an
additional 1,000 service members — military doctors, nurses, medics, and other
medical personnel — to deploy to hospitals during January and February.
Systems are now in place to ensure that these military deployments to support
states and hospitals are available moving forward as needed.

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• Ensure non-military federal medical personnel are available to support states


upon request. In addition to the active duty military COVID response teams —
the U.S. government has created a permanent structure to deploy clinical
personnel and paramedics to states in need. The Administration has
strengthened our national volunteer emergency medical response corps to
support communities that ask the federal government for assistance. To help
local municipalities strengthen their health preparedness and response, the
Administration has also strengthened the Medical Reserve Corps (MRC), a
network of medical and public health volunteers organized locally to improve
the health of their communities. Investments in this network have supported –
and will continue to support – the roughly 300,000 MRC medical and public
health professionals who have already volunteered more than 2 million hours
toward local COVID-19 response. Additionally, HHS will continue to lead a
national effort to mobilize volunteers, including retired doctors and nurses, to
assist in areas with rising COVID-19 cases.

• Leverage existing plans in all 50 states to add hospital capacity, if needed. The
Administration has worked with the FEMA to activate additional staffing and
capacity for the National Response Coordination Center (NRCC) and FEMA
regions, and to mobilize planning teams to work with every state and territory
to assess hospital needs ahead of surges, and to start expanding hospital bed
capacity. FEMA has already provided states hundreds of millions of dollars to
expand hospital capacity, and states and territories now have plans in place for
immediate hospital expansion – through retrofits and expansions – to build
additional hospital beds if needed.

• Deploy an established fleet of hundreds of ambulances and Emergency Medical


Teams ready to transport patients to open beds, if needed. To get ahead of
surges, FEMA has built an arsenal of hundreds of ambulances and emergency
medical teams ready for deployment to states, so that if one hospital fills up,
they can transport patients to open beds in other facilities.

• Ensure Federal vaccinators are ready for deployment across the


country. Departments and agencies from across the U.S. government have
contributed their own health care and support personnel to help surge the
national vaccinator workforce. During the last year, the Administration has
deployed over 9,000 personnel to support COVID-19 vaccinations, including
from the National Disaster Medical System and U.S. Public Health Service
Commissioned Corps within the HHS, Department of Homeland Security, VA,
DOD, USDA, and the U.S. Forest Service. These federal vaccinators and health

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care professionals remain available if needed and include physicians, physician


assistants, nurses, pharmacists and pharmacy technicians, veterinarians, and
EMTs. The federal government has hundreds of additional interagency
vaccinators ready to deploy as further needs are identified.

• Ensure we can stand up mass vaccination and testing sites if needed. FEMA has
developed the operational model to stand up a federal mass vaccination site
rapidly upon state request. With this successful playbook now in place, FEMA
could launch mass vaccination sites, in the future, if needed. Similarly, HHS
and FEMA have developed a playbook, a process, and the infrastructure to
stand up surge testing sites quickly and efficiently upon state request.

• Rapidly respond to reported disease outbreaks, by surging targeted virus


sequencing when needed and deploying expert public health professionals to
support state and local health officials. The Administration will mobilize timely
outbreak investigations by deploying investigators and other experts from CDC
and other federal agencies, to verify new outbreaks, provide technical
assistance with epidemiological investigations, and support early outbreak
control efforts. For new variants, this includes the initial assessment of key
variant characteristics including its contagiousness, severity of illness, and its
impact on tests, treatments, and vaccines.

Continue to support and invest in the health care and public health workforce. The
Administration will continue to expand the public health and health care workforce to
maintain strong public health and health care systems and increase clinical care
capacity for COVID-19. The American Rescue Plan invested $7.6 billion in the
recruiting, hiring, and training of public health workers, including public health
workers from under-represented backgrounds; provided mental and behavioral health
resources to our frontline medical workers to support them in the critical work they
do; and invested in the expansion of nurses in schools, and we will continue to work
with the academic and public health communities to advance this investment. We
have also strengthened our national volunteer emergency medical response corps to
support communities in need, and grown our network of medical and public health
volunteers so they are prepared to respond to a new variant or surge.

• Launch an expanded program to prevent burnout and support mental health


and well-being in the healthcare workforce. HRSA will propose and seek
resources from Congress to launch an expanded grant program to support
health systems, provider groups, health centers, first responders, and other
healthcare organizations that support the healthcare workforce. With this

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funding, healthcare organizations would undertake initiatives to improve


mental health by launching new workforce training programs, relieving
workplace stressors, conducting mental health programming, and providing
access to high-quality mental health support. This will build on ongoing efforts
by NIOSH to address the mental health of health workers by raising awareness,
eliminating barriers to accessing care, identifying workplace and community
supports, reducing stigma and strengthening data and resources. Together,
these resources will ensure that we are supporting our healthcare workers on
the frontlines of this pandemic.

• Continue to support expansions of state and local public health staffing. State
and local public health departments have provided critical services during the
pandemic, including setting up testing sites, leading local vaccination efforts,
and delivering personal protective equipment, therapeutics, and care to those
in need. These state and local public health heroes have helped lead the fight
against COVID-19, despite the fact that these departments are often
understaffed and lacking resources. The Administration has invested billions in
the public health workforce to recruit, hire and train state and local public
health workers, including public health workers from underrepresented
backgrounds. The Administration will continue to support new hiring for state
and local public health departments to quickly add staff – including
epidemiologists and data scientists – to support critical COVID-19 response
efforts, including vaccination outreach and administration efforts, testing,
outbreak investigations and other vital public health functions.

• Finalize protections for health care workers. The Administration will finalize
worker protections at health care workplaces and vigorously enforce other
existing rules, including the rule requiring workers at health care facilities
participating in Medicare or Medicaid to be fully vaccinated to ensure patient
health and safety. The rule covers approximately 76,000 health care facilities
and more than 10 million health care workers, and will continue to enhance
patient safety in health care settings.

• Continue to recruit and train new public health leaders to respond to local
outbreaks. The American Rescue Plan invested $7.6 billion in the recruiting,
hiring and training of public health workers, including public health workers
from unrepresented backgrounds. The Administration has supported and
invested in the CDC’s workforce programs, including the Epidemic Intelligence
Service (EIS), Field Epidemiology Training Program (FETP) and Laboratory

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Leadership Service (LLS). EIS is a national, deployable, cutting-edge public


health workforce of disease detectives that respond to local outbreaks. Over the
past seven decades, EIS officers have served as boots-on-the-ground
epidemiologists during some of the most severe outbreaks and public health
emergencies, including the Ebola outbreak, H1N1, the Flint water crisis, Zika,
and the COVID-19 pandemic. Similarly, CDC’s FETP program works globally,
and has helped train more than 18,000 disease detectives in over 80 countries
around the world. LLS fellows merge laboratory science with public health,
allowing fellows to provide daily mission-critical technical expertise and
service to federal, state, and local public health laboratories and support public
health investigations. CDC has increased support for programs including EIS,
LLS, the Undergraduate Public Health Scholars Program, and the Dr. James A.
Ferguson Emerging Infectious Diseases RISE Fellowship, which offers students
from underrepresented background the opportunity to study infectious
diseases and health disparities.

The U.S. government has established a permanent logistics and operational hub at
HHS to ensure accelerated development, production, and delivery of COVID-19
vaccines and treatments. On January 1, 2022, the Administration launched a
dedicated logistics and operational hub at HHS – the HHS Coordination Operations
and Response Element (H-CORE) – responsible for the rapid development,
production, and delivery of COVID-19 vaccines and therapeutics. H-CORE builds on
the previous successful partnership between the DOD and HHS. Since the beginning
of the pandemic, H-CORE and the former DOD/HHS team has helped deliver over 675
million doses of vaccine and approximately 4 million treatment courses to protect the
American people. H-CORE is providing critical support for the Administration’s
commitment to deliver 500 million free at-home tests to American households
through COVIDTests.gov and assisting with efforts to procure and distribute an
additional 500 million tests. It is also supporting the delivery of hundreds of millions
of N95 masks from HHS’s Strategic National Stockpile to pharmacies and health
clinics nationwide – providing a high-quality mask for free to any American who
wants one.

• A highly skilled, well-resourced, and nimble team is in place to anticipate


and respond to current and future vaccine and therapeutic needs. The H-
CORE team is made up of logisticians, contracting officers, supply chain
experts, data analytics experts and public health officials with liaisons from
multiple industries and government agencies, that coordinate and track the
movements of vaccines and therapeutics from the manufacturer, to distribution
centers, and finally to more than 90,000 vaccine administration sites. The team

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has a strong track record of delivering the right product to the right locations at
the right time.

• Flexibility to expand the scope of work to meet emergent COVID-19


priorities. While H-CORE’s focus is on the quick, safe, and efficient
development, production and delivery of COVID-19 vaccines and therapeutics,
it can also be leveraged to support emerging priorities. H-CORE is playing a key
role in the delivery of 500 million at-home tests to American households in
partnership with the U.S. Postal Service, and assisting with efforts to procure,
stockpile and distribute as needed an additional 500 million tests. It’s also
providing technical support to the Strategic National Stockpile team that has
already shipped more than 200 million N95 masks to locations nationwide.

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GOAL THREE
Prevent economic and educational
shutdowns

3: Prevent economic and educational shutdown


America’s Progress to Date:
ü Today about 99% of schools are open
ü $130 billion was sent to schools through the American Rescue Plan for new ventilation systems,
vaccination, more teachers, PPE, testing, and more
ü Nearly 40% of Fortune 100 companies have put in place vaccination requirements to protect our
workers
ü Since President Biden took office, there has been historic job growth – more than 6.6 million jobs
created – and the unemployment rate has fallen to its lowest level since before the pandemic
We will work with Congress to secure the necessary funding to:
• Provide paid sick leave to workers who need to miss work due to a case of COVID-19 or to care for a
loved one who has COVID-19
• Give schools, universities, businesses, and other facilities the tools they need to improve their
ventilation, and develop a recognition program to demonstrate the results
• Ensure schools have access to funding, tests, guidance, and supplies they need to stay open
• Update guidance for employers to ensure safer workplaces
• Engage early care and education providers to help them remain safely open and help parents return
to work with peace of mind
• With the vast majority of federal workers at their workplaces, substantially expand levels of
services at public-facing federal offices (like local Social Security offices)

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Our path forward relies on giving schools and businesses the tools they need to
prevent economic and educational shutdowns, so our students can stay in school, our
workers can be safe at work, and our economy can continue to grow. In December
2020, America was experiencing widespread school and business shutdowns: only
46% of K-12 schools were open for in-person learning, millions of businesses had
closed, and tens of millions of Americans had lost their jobs in 2020.

Throughout the last year, the Administration has worked to provide the funding,
tools, and resources necessary to keep schools and businesses open, while protecting
students and workers. The Administration provided $130 billion from the American
Rescue Plan to enable schools to reopen and stay safely open – through new
ventilation systems, more teachers, vaccinations, PPE, testing, and more. These
historic investments helped schools open and stay open safely, even in the face of the
highly transmissible Omicron variant. Today, 99% of K-through-12 schools are open
for full-time in-person learning.

To protect workers, the Administration launched the largest vaccination campaign in


history – working hand-in-hand with the business community. The President called
on every employer in America to offer full pay to their employees for any time off
needed to get vaccinated, and for any time it took to recover from the after-effects of
vaccination. He announced a paid leave tax credit to offset the costs for small- and
mid- sized businesses to provide full pay for any time their employees needed to get
the COVID-19 vaccine or recover from vaccination.

The Administration also required vaccinations where it could, including for


servicemembers and federal workers – the largest and most diverse workforce in the
country. Today, over 98% of federal workers have complied with these requirements.
The President also encouraged the private sector to require vaccinations and nearly
40% of Fortune 100 companies have a vaccination requirement in place. Additionally,
more than 1,000 institutions of higher education established vaccination requirements
for their students and/or staff. And the Administration also implemented an
emergency rule requiring workers at health care facilities participating in Medicare or
Medicaid to be fully vaccinated. This covers approximately 76,000 health care
facilities and more than 10 million health care workers.

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And as America gets back to work, the President has focused on jumpstarting the
economy and rebuilding it from the bottom up and the middle out. Since President
Biden took office, there has been historic job growth — 6.6 million jobs created, and
the unemployment rate has fallen to its lowest level since before the pandemic. The
average number of new unemployment insurance claims has fallen by 70% since
President Biden took office, and more than 70% of Americans say that now is a good
time to find a quality job, up from less than 30% this time last year. The U.S. was also
the first major economy to exceed its pre-pandemic economic output.

When it comes to protecting our workers, students and all Americans – the path
forward in the fight against COVID-19 is clear. Vaccinations, masks, treatments, and
tests are widely available; worker protections are now in place; and schools have the
resources they need to make sure they can remain safely open. The country has made
investments in a strong set of tools and is continuing to build a public health response
that provides all Americans with multiple layers of protection. The path forward in
the fight against COVID-19 is clear: schools, workers, and workplaces need the
resources and guidance necessary to prevent shutdowns.

The Administration will work with Congress to secure the


necessary funding to:

Provide paid sick leave to workers who need to miss work due to a case of COVID-
19 or to care for a loved one who has COVID-19. The Administration will work with
Congress to reinstate tax credits to help small- and mid-sized businesses provide paid
sick and family leave to deal with COVID-related absences. Earlier in the pandemic,
Congress enacted a paid sick and family leave policy on a bipartisan basis to help
workers out sick with COVID-19 or taking care of family members with COVID-19 and
to reimburse small and mid-sized businesses for the cost – and this policy was
continued in the American Rescue Plan. Empirical research has shown that this policy
helped reduce the spread of COVID-19 earlier in the pandemic. Reinstating the policy
will also provide critical support for employees of small- and mid-sized businesses
who would otherwise have to take unpaid leave while sick or caring for a sick child or
family member due to COVID-19.

• Provide refundable tax credits to small- and mid-sized business to provide


workers paid time off for sick leave and family leave related to COVID-19. The
Administration will work with Congress to reinstate refundable tax credits for
small and mid-size employers that reimburse them, dollar-for-dollar, for the
cost of providing paid sick and family leave wages to their employees for leave

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related to COVID-19. If the program is reinstated, businesses with fewer than


500 employees can receive reimbursement to provide employees with paid sick
and family and medical leave for reasons related to COVID-19, either for the
employee's own health needs or to care for family members. Specifically, these
businesses can claim up to $17,110 for 14 weeks of paid leave for each affected
employee to take time off if they have COVID-19 symptoms and are going to the
doctor; are getting tested for COVID-19; are under quarantine or isolation order
by the government or a doctor (or are caring for someone who is); or have to
care for a child whose school or child care provider closed, due to COVID-
19. Paid leave has been shown to be a critical tool for stopping the spread of
COVID-19, including one study showing that the paid leave provisions put in
place prevented approximately 400 COVID-19 cases per day and prevented one
COVID-19 case per day per 1,300 workers.

• Conduct outreach to make sure businesses and Americans are aware of paid
sick and family leave for leave related to COVID-19. When enacted, the
Administration will make sure that Americans and small- and mid- sized
businesses are aware of this tax credit and that Americans take this paid sick
and family leave when they are eligible. Consistent paid leave will be a critical
component of ensuring that Americans can reenter or stay in the workforce as
we continue to fight the virus and recover from the economic effects of COVID-
19.

Give schools, universities, businesses, and other facilities the tools they need to
improve their ventilation, and develop a recognition program to demonstrate the
results. Improvements to ventilation systems can maximize health outcomes. When
indoors, effective ventilation strategies can help reduce viral particle concentration as
well as other indoor air contaminants, which is why the Administration will continue
to provide support in improved ventilation, so Americans can remain safely indoors as
they proceed with their lives. To encourage good ventilation and improve indoor air
quality, the U.S. government will launch a Clean Air in Buildings Challenge, a call for
all building managers/engineers, business owners, or organization leaders to take on
key strategies to improve ventilation in buildings and implement cost-effective
ventilation and air filtration improvements in buildings across the country. To further
increase uptake of ventilation improvements, the government will also launch a new
initiative to recognize steps taken by organizations and buildings to improve
ventilation in alignment with industry-recognized standards. In addition to promoting
ventilation system upgrades and improvements in schools and public buildings, the
Administration will also provide guidance and technical resources to help building
managers implement ventilation solutions, and encourage state, local, and tribal

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governments and school districts to undertake improvements in ventilation and air


filtration as a critical component of reducing disease spread through use of American
Rescue Plan funding.

• Provide clear guidance and recommendations all buildings can use to improve
ventilation, and call on building managers, building engineers, businesses, and
organizations to take part in the Clean Air in Buildings Challenge. While
ventilation systems and equipment vary widely across building types, they play
an important role in keeping building occupants safe. Strong ventilation
practices can reduce the number of virus particles and contaminants in the air,
and thereby reduce the risk of virus or disease transmission. To promote
ventilation improvements, the EPA will issue a Clean Air in Buildings Checklist,
a set of recommendations that any building can undertake to improve indoor
air quality through effective ventilation and filtration practices. The Checklist
will link to federal government resources from the CDC, EPA, DOE, and other
agencies with detail on how to implement these steps, and make suggestions on
where it will be helpful for building managers to connect with HVAC and other
ventilation experts to make more extensive improvements, upgrades, or
replacements to ventilation systems, fixtures, and equipment. The Checklist
will include steps such as increasing outdoor air coming into buildings (e.g.,
through safely opening windows, doors, dampers, and other air openings;
enabling cross ventilation; and installing window/box fans); improving air
filtration (e.g., through proper installation and maintenance of MERV-13 air
filters; operating HVAC systems with increased introduction of outdoor air;
investing in HVAC infrastructure and improvements); supplementing air
handling with portable air cleaners (e.g., through assessment of current
ventilation and filtration levels; and deploying portable air cleaning devices
with HEPA filters). The U.S. government will also call on building
managers/engineers, business owners, or organization leaders to take on key
strategies outlined in the checklist to improve ventilation and implement cost-
effective ventilation and air filtration improvements in buildings across the
country as part of the Clean Air in Buildings Challenge.

• Support State, local, and Tribal governments as well as school districts to make
ventilation improvements and upgrades using American Rescue Plan funds.
The American Rescue Plan provided $350 billion for state and local
governments, as well as $130 billion for schools, which is available to support
making ventilation improvements and upgrades. Through the Clean Air in
Buildings Challenge, the Administration will encourage state, local, and Tribal
government partners to advance effective ventilation practices in all of the

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buildings they operate. The Administration will also work closely with public
sector partners like schools to provide guidance and technical assistance to
make these improvements and connect them to agency resources on indoor air
quality.

• Build public awareness around ventilation and filtration improvements to


reduce disease spread in buildings. To complement the efforts of building
managers and engineers making ventilation improvements, the Administration
will build public awareness and communicate with the public on how
ventilation is a key factor in keeping Americans safe while inside buildings. The
Administration will explain what good ventilation and air filtration look like as
an important component of helping to reduce disease spread, and how
buildings of any kind can pursue improvements to their ventilation and air
filtration strategies.

• Highlight actions taken by buildings to achieve clean, healthy air quality


through a recognition program. While the Administration invites all buildings
to take actions from the Clean Air in Buildings Checklist, the Administration
will also foster ways to recognize steps taken by buildings to improve indoor air
quality and protect their communities. The CDC, EPA, DOE, and other federal
agencies already provide significant support to advance strong ventilation in
buildings – including through funding, technical assistance, and other
resources. Building on the expertise of federal government experts, the
Administration will also engage industry, scientific, academic, and labor leaders
to identify ways to recognize the efforts of buildings and leaders across sectors
and around the country to achieve high standards in ventilation and indoor air
quality, as well as improvements in ventilation systems from their current
levels. The Administration will use this opportunity to encourage further
uptake of ventilation improvements and step up efforts to recognize
accomplishments in the indoor air quality space. Similar to how programs like
LEED, Fitwel, and WELL recognize buildings for their environmental and
health impacts, this new effort between the federal government and external
experts will develop ways to recognize steps taken by building owners for the
health and safety of their communities and their achievements in improving air
filtration and ventilation systems to protect and promote public health.

Ensure schools have access to funding, tests, guidance, and supplies they need to
stay open. Since Day One, the Administration has worked with schools to implement
strategies to keep students and staff safe, and doors open – including work on hiring
additional staff to support school safety and student needs, implementing screening

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and diagnostic testing programs, and supporting school-located vaccination clinics to


get kids vaccinated and staff boosted. The Administration will continue to work with
schools so they have access to the resources they need to stay safely open and keep in-
person learning strong. Thanks to the President’s American Rescue Plan, the
Administration has provided states and schools $130 billion in funding to implement
science-based measures that work to keep kids safe and schools open – like
vaccinations, testing, improved ventilation, and use of PPE – and to meet an
unprecedented level of student need following two years of interrupted learning by
addressing student academics, mental health, and social/emotional development. The
Administration has also developed the infrastructure to support our schools on an
ongoing basis and will continue to make additional COVID-19 tests available to
schools every month this school year.

• Continue to provide schools with the support and guidance they need to keep
students safe and schools open. The Administration made the largest-ever one-
time investment in schools in the history of our nation through the passage of
the American Rescue Plan, including $122 billion in funds for schools and
states, in addition to another $8 billion to address the needs of special student
populations. The American Rescue Plan was deliberately crafted to adapt to the
variability of local needs and circumstances, giving states and districts
significant flexibility in how they spend their money to prevent, prepare for,
and respond to the pandemic. As intended, the American Rescue Plan was
crafted to allow school districts not just to address the health and safety needs
of students during the COVID-19 pandemic, it was also designed to address
urgent learning and mental health needs of students. American Rescue Plan
funding is being used in schools right now to hire and retain staff, provide PPE,
implement evidence-based interventions to address students’ academic and
mental health needs, improve ventilation, implement screening and testing
programs and keep up with rigorous health and safety protocols. The
Administration is working with states to ensure funds are spent quickly and
efficiently in ways that keep schools open and students safe.

• Ensure school districts have the testing resources they need to test students
and staff and keep transmission low. The Administration has also provided
unprecedented funding to make sure schools can launch and maintain COVID-
19 testing programs that meet the needs of their communities. The
Epidemiology and Laboratory Capacity grant has provided funding for states to
establish screening testing programs for students and school staff; and the
American Rescue Plan included additional funding for Operation Expanded
Testing that provides free lab-based (PCR) testing to schools, child care and

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other congregate settings. In addition, the Administration is now sending


schools across the country 5 million free point of care rapid tests per month, as
well as making available 5 million additional free PCR lab tests for schools per
month. This assistance will continue through the rest of the current school year
and we will work with the CDC to assess ongoing need for testing subject to
public health guidance in the time beyond. The CDC and Department of
Education have been closely coordinating to assist schools in launching school
testing programs, with tailored assistance to school leaders in designing and
implementing programs like test-to-stay that best align with individual schools’
needs and that can be supported through American Rescue Plan investments.

• Continue to make investments so schools can hire additional school nurses. The
Administration has invested $500 million in funding for the hiring of school
nurses, who can offer medical expertise to support parents and children during
the pandemic and provide information on vaccines as more students have
become eligible for vaccinations. The $122 billion investment in the Elementary
and Secondary School Emergency Relief Fund can also be used for school
nurses. As demonstrated throughout the COVID-19 pandemic, nurses are
invaluable assets to our school communities, advancing the health and safety
needs of students and families in the pandemic and far beyond. The
Administration will continue working with local and state health departments
and other partners to advance the number of schools with nurses on staff to
address their students’ needs.

Update guidance for employers to ensure safer workplaces. The Department of


Labor’s Occupational Safety and Health Administration will update workplace
guidance to better equip employers with the tools they need to ensure safe
workplaces, including guidance on how employers can continue to support increased
vaccination and boosting of their employees, support at-risk workers like the
immunocompromised who choose to wear high-quality masks, limit workplace-based
infections, and enhance ventilation.

Engage early care and education providers to help them remain safely open and
help parents return to work with peace of mind. Early care and education providers,
including child care centers, family child care providers, pre-K and more, have been
essential in our fight against COVID-19. The Administration invested $40 billion in
American Rescue Plan funds to states, territories, and Tribes to help child care
providers and Head Start grantees keep their doors open and provide safe care that is
crucial for parents getting back to work. Building on this funding, the Administration

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will continue to engage the community of early care and education providers so they
have tools and support to stay safely open and to continue supporting our families.

With the vast majority of federal workers at their workplaces, substantially


expand levels of services at public-facing federal offices (like local Social Security
offices). The Administration will announce that employers can safely increase in-
person work and that COVID-19 no longer needs to dictate where Americans work.
Federal agencies will lead by example, increasing the hours public-facing federal
offices are open, in-person appointments, and in-person interactions in April, building
on the innovations and online tools developed during the pandemic to deliver high-
quality services. For example, in early April, local Social Security offices will add more
in-person appointments and will again offer in-person walk up services for those who
need them.

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GOAL FOUR
Continue to lead the effort to
vaccinate the world and save lives

4: Continue to lead the effort to vaccinate the


world and save lives
America’s Progress to Date:
ü Committed to donate 1.2 billion doses for free, with no strings attached – the largest commitment
of any country, with over 470 million doses shipped to 112 countries
ü Built the playbook to vaccinate the rest of the world when it comes to shipping and donating
vaccines to other countries.
ü First country to give up our place in line for vaccines, allowing the African Union to immediately
start receiving up to 110 million doses of Moderna at a reduced rate negotiated by the United
States
ü America’s Quad partnership with India, Japan, and Australia is on track to help produce at least 1
billion vaccine doses in India to boost the global supply
ü U.S. investments strengthened manufacturing in South Africa, which will produce more than 500
million doses of J&J in Africa, for Africa
Moving forward, the Administration will work with Congress to secure the necessary funding to:
• Leverage the vaccine donation model America pioneered to continue to deliver 1.2 billion doses of
vaccine we committed to donate
• Accelerate efforts to get shots in arms around the world
• Continue to support the development of regional vaccine manufacturing capacity to ensure more
countries have a home-grown supply of safe and effective vaccines

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• Donate supplies, humanitarian assistance, and additional vaccines that will help save lives around
the world and protect against new variants
• Continue to save lives now by focusing on reducing hospitalizations and deaths, working to solve
the oxygen crisis, and improving supply chains for tests, treatments, and PPE.
• Continue global leadership on the COVID-19 response and build better health security for the
future

Fighting this virus abroad is key to America’s effort to protect people and stay ahead
of new variants. To do so, we will continue to provide vaccines to the world and work
to help get those vaccines swiftly into arms, lead global emergency response efforts,
and deploy emergency supplies to countries experiencing surges in COVID-19.

The President committed that the United States would be the world’s arsenal for
vaccines – both because it is the right thing to do, and because it is in our interest to
minimize future variants; and we are delivering on that commitment. The United
States has committed to donating 1.2 billion doses to other countries – for free, with
zero strings attached. That’s the largest commitment of any single country or group of
countries in the world; and as of today, we have delivered over 470 million doses to 112
countries. And we have done so in collaboration with the COVID-19 Vaccines Global
Access (COVAX) initiative, the Caribbean Community (CARICOM), the African Union
(AU), the Pan American Health Organization, and other World Health Organization
regional bodies.

In addition, America has delivered life-saving resources like oxygen, PPE, and other
essential supplies to countries experiencing outbreaks. U.S. government public health
experts from CDC, USAID, State, HHS, and PEPFAR and other entities are working
side-by-side with on-the-ground providers, providing technical assistance in vaccine
program implementation, care provision, and disease surveillance. We have increased
the world’s capacity to manufacture vaccines and have fostered an enabling
environment for innovation, including by spurring African manufacturing.

Over the last year, the Administration pioneered the model to donate and deliver
vaccines to the rest of the world. America was the first country to announce a
purchase of doses solely for donation to other countries and executed the largest-ever
purchase of doses of vaccines by a single country for donation. America was the first
country to give up our place in line for vaccines – allowing the African Union to
immediately start receiving up to 110 million doses of Moderna at a reduced rate
negotiated by the United States; and the first country to negotiate a deal with J&J and
COVAX to send vaccines directly to humanitarian settings and conflict zones to
vaccinate displaced persons.

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America built an all-of-government infrastructure to donate vaccines to other


countries, and developed the model for surplus global vaccine donations that is now
used by the rest of the world. The United States is also the only country in the world
that has worked with countries to deliver predictable, consistent shipments every two
weeks of fresh doses of mRNA vaccine with a long shelf-life with the intention of
building and developing countries’ domestic vaccinations programs through stable
and predictable supply. And building on that foundation, the Administration is
working with countries and our UN and NGO partners to get shots in arms;
accelerating vaccine access and delivery assistance around the world.

And America has increased the world’s capacity to manufacture safe and effective
vaccines for the COVID-19 response as well as future pandemics, spurring African and
South Asian manufacturing; ramping up domestic vaccine manufacturing for global
use; and building out a sustainable supply chain, including the critical raw materials
needed to make and administer vaccines. We will continue our work to invest in
companies that have experience manufacturing mRNA vaccines to help them expand
capacity domestically by an additional 1 billion doses per year for doses that can be
used around the world.

And we aren’t stopping there. The United States is the world’s largest financial
contributor to the COVAX facility, the global mechanism to secure and deliver
COVID-19 vaccines. In addition, to help countries manage ongoing COVID-19
transmission and to respond to immediate emergencies and outbreaks around the
world, the U.S. has delivered life-saving supplies – including oxygen, PPE, and other
essential supplies – worth more than $1 billion to provide urgent relief to partners
experiencing surges of COVID-19.

The path forward in the pandemic will require doubling down on our commitment to
help vaccinate the globe, as well as save lives around the world by making tests,
treatments, and PPE widely available when our partners need support.

The Administration will work with Congress to secure the


necessary funding to:

Leverage the vaccine donation model America pioneered to continue to deliver 1.2
billion doses of vaccine we committed to donate. America will continue to deliver
the 1.2 billion doses of vaccine we committed to countries in need. The Administration
has created an all-of-government infrastructure to ensure the expedited donation and
delivery of vaccines to other countries and solidified channels of communication with

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international partners to accelerate the delivery of doses around the world. The
integrated team engages and collaborates with other countries in setting a schedule of
predictable, consistent shipments every few weeks of fresh mRNA doses. Through this
schedule, the program offers countries a reliable supply of high-quality vaccines
around which to build their vaccination plans. To date, we have delivered 470 million
donated doses, and we will continue to deliver on America’s commitment of 1.2 billion
doses to the rest of the world.

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• Continue unprecedented, demand-driven vaccine donation program of 1 billion


Pfizer doses to the poorest countries in the world. The United States has made
the largest-ever purchase and donation of vaccines by a single country in
history, which reflects a commitment by the American people to help protect
people around the world from COVID-19. To distribute the doses, the
Administration has developed a program with USAID and the COVAX facility
that allows all low and lower-middle-income countries to draw down as many
Pfizer doses as needed for 2022, and then set their own delivery schedule of
consistent shipments of Pfizer doses. And all doses in the Pfizer program are
fresh doses of mRNA vaccine with long shelf-life. This is the first global
demand-driven COVID-19 vaccine donation program, and the security of a
long-term supply has helped countries build and develop their domestic
vaccinations and boosters’ programs and get shots in arms.

• Leverage the effective pipeline that has been established for bilateral donations
of vaccines to other countries. In addition to America’s contract with Pfizer for
1 billion doses to donate to the rest of the world, the United States has donated
doses from our domestic supply. The Administration has developed an all-of-
government vaccine operation in coordination with HHS, State, USAID, CDC,
and DOD to coordinate the delivery and shipment of donated J&J, Moderna,
AstraZeneca, and Pfizer vaccines from the domestic surplus to other countries
around the world.

• Utilize the historic deal brokered by the United States to vaccinate people in
conflict zones and other humanitarian settings. The U.S. government helped
broker a historic deal with J&J and COVAX to facilitate the first ever delivery

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of J&J COVID-19 vaccine to people in conflict zones and other humanitarian


settings. The U.S. government pioneered a novel legal approach with J&J and
COVAX for the COVAX “humanitarian buffer.” As the first pilot, the U.S.
government has made doses available to COVAX that will be administered to
people living in these dire circumstances. The U.S. government established this
permanent pathway that allows humanitarian organizations to receive vaccine,
and the Administration will continue to make doses available to the
humanitarian buffer as needed. In addition, the U.S. also facilitated a
trailblazing deal to make available 300,000 doses of J&J available to
humanitarian, UN peacekeeping, and other frontline workers around the
world. These workers are often in areas hit hard by crisis, whether due to
conflict, natural disaster or other causes.

Accelerate efforts to get shots in arms around the world. The Administration – in
collaboration with countries and partners around the world – has developed an
ambitious global vaccination initiative to get doses into arms with support tailored to
specific country-led plans. The Administration’s Global VAX initiative, led by USAID
and CDC, leverages the strengths and capabilities of our teams on the ground,
including the President’s Malaria Initiative and PEPFAR. Lines of effort range from
jumpstarting communications campaigns, to providing and investing in vaccinators on
the front lines, to the purchasing of cold chain supplies and syringes, to paying for
shipping and logistics to expedite vaccine delivery to hard-to-reach areas, to building
vaccine confidence on the ground in other countries. Global immunization experts
from the CDC, USAID, and the Department of State through PEPFAR will provide
technical assistance in areas including safety monitoring and reporting, bolstering of
data systems and vaccine microplanning. In addition to donating a record number of
vaccines to other countries – the United States is already providing $1.7 billion to
support the delivery of vaccine, and the Administration has stood up multiple efforts
to increase global COVID-19 vaccine readiness and technical assistance. Continuing
the Global VAX initiative will require additional funding from Congress.

• Invest in getting shots in arms. As more vaccine supply flows to low- and lower-
middle income countries, USAID, CDC, and PEPFAR have launched a historic
initiative to help countries efficiently and effectively receive, distribute, and
administer vaccine doses. The United States has committed – and will continue
to commit – significant financial support to help get shots into arms around the
world.

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• Help countries with cold chain, supply, logistics, and delivery of vaccines. As
part of the global vaccination initiative, the Administration supports the
operational and logistics of getting shots in arms by making targeted
investments around the world to bolster the cold chain, supply and logistics to
support vaccine delivery and to get shots in arms in low and lower-middle
income countries. These activities also include investing in cold chain and
supply logistics to safely store and deliver vaccines.

• Support national vaccination campaigns and building infrastructure to get to


hard-to-reach population. As part of the global vaccination initiative, the
Administration continues to support national vaccination campaigns; launch
mobile vaccination sites for hard-to-reach and rural populations; assist
countries in vaccine policy-making, database management, and sequencing
capacity, and planning for strategic health care worker and resource
deployment; and support the development of health information systems to
better evaluate vaccine distribution equity and monitor vaccine safety.

• Provide tailored toolkits to other countries outlining best practices from


America’s vaccination campaign. The Administration has catalogued key
lessons from America’s vaccine rollout, packaging them into tailored toolkits

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that can be used for international partners. For example, FEMA drafted the
Community Vaccination Centers Playbook, which includes blueprints for
vaccination sites of various sizes. Similarly, the Administration has catalogued
lessons on effective vaccine confidence campaigns and outreach to vulnerable
communities. The learnings are being shared with the Administration’s global
immunization teams, as they work to improve coverage abroad.

• Call on other countries to step up investments in shots in arms. The U.S.


government will continue its leadership role in the global vaccination effort.
Just as we successfully challenged nations to step up and donate their surplus
vaccines, the U.S. government will continue to call on all countries to step up
actions and commitments toward getting shots in arms in countries with low
vaccination rates, including through the Department of State’s COVID-19
Global Action Plan for Enhanced Engagement.

Continue the development of regional vaccine manufacturing capacity to ensure


more countries have a home-grown supply of safe and effective vaccines. The
Administration will continue working with partner nations and manufacturers to
increase capacity to produce safe and highly effective vaccines in other countries. Our
Quad partnership with India, Japan, and Australia is on track to help produce at least 1
billion vaccine doses in India to boost the global supply by the end of 2022. And the
Administration will continue to provide financing and help strengthen manufacturing
in South Africa, which will produce more than 500 million doses of J&J in Africa, for
Africa.

• Continue to scale regional manufacturing through the Quad partnership.


Through the Quad partnership with India, Australia, and Japan, the
Administration is supporting a collaborative effort that is on track to produce at
least 1 billion vaccine doses by the end of 2022. The Quad partnership continues
work to expand manufacturing in India aiming to produce at least 1 billion
doses of COVID-19 vaccines.

• Continue investments to bolster South Africa and Senegal’s vaccine


manufacturing capacity. The Administration is committed to expanding access
to vaccines around the world by boosting manufacturing capacity in multiple
regions, in large and small countries, and with different technologies. The
Administration has provided financing to a South African company that will
enhance manufacturing capacity and allow the company to produce more than
500 million J&J doses – in Africa, for Africa. And the DFC is continuing to
invest in a vaccine manufacturer in Senegal to build a manufacturing hub for

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COVID-19 and other vaccines. In addition to expanding access to COVID-19


vaccines, the new manufacturing hub will bolster long-term health
infrastructure on the continent and build resiliency to address future health
challenges.

• Support in-country vaccine manufacturing. The Administration has made


targeted investments to support countries poised to produce vaccines to help
them build regulatory capacity, transfer “know-how” to train emerging
manufacturers, and provide strategic planning and other assistance. These
continued investments will enable countries to boost vaccine manufacturing
locally, which not only diversifies international production, but also has the
potential to drive new investments in local economies and create jobs.

Donate supplies, humanitarian assistance, and additional vaccines that will help
save lives around the world and protect against new variants. The Administration
will continue to provide additional vaccines – on top of the 1.2 billion doses already
committed – to vaccinate the world. In addition, the Administration will procure
supplies and invest in additional response activities to save lives (e.g., oxygen, tests,
sequencing supplies, ancillaries, and personal protective equipment); and will
continue to provide lifesaving humanitarian assistance to mitigate the impacts of
COVID-19 on vulnerable populations globally to support the provision of food,
healthcare, clean water, and protection services to support vulnerable populations.
Continued deployments of emergency supplies and humanitarian assistance will
require additional funding from Congress.

• Send additional support to countries in need. The United States has invested
significant resources to reduce COVID-19 deaths and mitigate transmission
through bulk oxygen support, expanded testing, and strengthening healthcare
systems and more; and the Administration will continue these investments.
Additionally, USAID’s Rapid Response Surge Support also continues to deliver
life-saving resources – like expanding access to oxygen treatments – to COVID-
19 hotspots or areas experiencing surges in cases.

• Invest in global vaccine readiness, including funding for shipments and


delivery. The Administration has committed additional funds to support global
vaccine readiness and delivery, including through support to UNICEF. The
Administration has also provided assistance to GAVI, The Vaccine Alliance in
the form of political risk insurance to facilitate shipment of vaccines to nine
countries across three continents.

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Continue to save lives now by focusing on reducing hospitalizations and deaths,


working to solve the oxygen crisis, and improving supply chains for tests,
treatments, and PPE. The Administration is working to ensure that countries have
access to the supplies they need to respond to COVID-19, building stocks before
surges and providing emergency assistance as needed. Specifically, the Administration
is working to solve the oxygen crisis on a global and local level; and to improve supply
chains for tests, treatments, and PPE to ensure that these key tools are widely
available by expanding domestic and international manufacturing bases for these
supplies.

Continue global leadership on the COVID-19 response and build better health
security for the future. The U.S. government will continue to lead the global response
to COVID-19, through urgent vaccine access, treatment improvements, and support to
country responses. The Administration will also work to establish a sustainable health
security financing mechanism and call on all countries and public and private
organizations to commit to urgent action to assist in the global COVID-19 response.

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