Nat Covid 19 Preparedness Plan
Nat Covid 19 Preparedness Plan
Nat Covid 19 Preparedness Plan
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.
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.
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:
4. Continue to lead the effort to vaccinate the world and save lives
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
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 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.
• 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.
• Ensure there are enough treatments for Americans who need them. The U.S.
government will procure additional treatments; continue to utilize an
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.
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:
• 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.
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
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.
• 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.
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.
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
• 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.
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
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
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
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.
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.
• 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
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.
• 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
• 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.
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.
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;
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
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.
• 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
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.
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
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.
• 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.
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.
• 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.
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 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.
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.
• 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
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.
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.
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.
• 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.
• 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.
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.
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.
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 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
and healing needs like trauma and grief informed services – in consultation with
states, tribal, and local government resources and other community efforts.
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 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.
• 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.
• 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
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.
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
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.
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.
• 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.
• 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
• 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
• 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 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.
• 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.
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.
• 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.
• 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.
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.
• 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
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.
has a strong track record of delivering the right product to the right locations at
the right time.
GOAL THREE
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 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.
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.
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.
• 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
• 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
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.
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
• 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
• 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.
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 so they
have tools and support to stay safely open and to continue supporting our families.
GOAL FOUR
Continue to lead the effort to
vaccinate the world and save lives
• 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.
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.
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
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.
• 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
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.
• 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.
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.
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.
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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