White House rushes to blunt potential Covid-19 surge

Each shot brings the United States closer to yet another deadly wave, but Biden officials know they are running against time.

“I think we have to be very humble with this virus,” CDC official Dr. Anne Schuchat told CNN. “As many indicators point in the right direction and more people are vaccinated every day, we need to be prepared for the wilds and the worsening.”

Bring up vaccines to hot spots

Just as federal officials mobilized testing resources and set up “surge” testing sites in hot spots across the country during the summer and fall, federal officials are preparing to deploy a similar effort using vaccination centers managed or supported by the federal government. A senior official said an example of this effort would be to vaccinate workers in high-risk environments such as a meat processing plant in areas where cases are starting to increase.

The federal government could also take advantage of an expanded, federally-controlled pipeline of vaccines to pharmacies nationwide – which is expected to grow to more than 20,000 soon – to increase doses in hard-hit areas, officials said.

An official said the administration is also considering administering monoclonal antibody treatments – the administration of which purchased an additional 100,000 doses in February – in hot spots as a prophylactic.

“We have different tools than last year,” the official said. “We cannot play yesterday’s game against this virus.”

To that end, the White House has invested hundreds of millions of dollars to strengthen surveillance testing and fill testing supply gaps, including $ 200 million to boost genomic sequencing to track the spread of variants. The US bailout, which Biden signed on Thursday, is investing an additional $ 47.8 billion in coronavirus screening measures. The bill also adds $ 7.66 billion to hire 100,000 public health workers to bolster vaccination and contact tracing efforts.

Consistent messaging

At the forefront of the administration’s efforts to prepare for a surge – and how its response would be different from that of the previous administration – is the radical shift to public messaging that has seen health experts and the president speak with one voice.

That’s why, last week, CDC Director Dr Rochelle Walensky, National Institute of Allergy and Infectious Disease Director Dr Anthony Fauci and Biden all warned of the dangers of variants. and the possibility of another push.

“A lot can happen. Conditions can change. Scientists have made it clear that things could get worse again with the spread of new variants of the virus,” Biden said during a prime-time speech to the nation. last Thursday. “If we don’t stay vigilant and conditions change, we may need to reinstate the restrictions to get back on track.”

While federal health officials have often found themselves covering up their public statements to avoid contradicting President Donald Trump, public health officials now find themselves allowed to stick to the data, which has resulted in a consistent message from the federal government on the threats of the pandemic and the actions that must be taken to address these threats.

“We now have a more cohesive message around the interventions that we know to work: masks, social distancing measures,” said Schuchat, who was also deputy director of the CDC under the Trump administration. “There is a strong commitment in the CDC and in this administration for transparent communication – if there is bad news, to share it, if there is good news, to be open and honest about it – to making sure we can communicate clearly and consistently about what we think is going on and what we think needs to be done. ”

White House rejects more aggressive strategies

On other fronts, the administration has refused to make a complete game-changer, rejecting calls to prioritize getting more first doses of two-dose vaccines into the arms of Americans and delaying the administration of drugs. second doses – as did the UK. Instead, the White House has prioritized full protection for fewer Americans, fearing that a single dose would be less effective against the more transmissible coronavirus variants.

They have also resisted calls for a more muscular role in compelling states to speed up vaccine administration and implement public health measures, refusing to tie funding or vaccine deliveries to either. other, considering these steps as counterproductive.

“Getting into a heated public discussion about this is exactly what sometimes plays into the hands of the people who make these decisions,” said a senior administration official. “The president’s general view of the world is not to take the bait, not to escalate the rhetoric, not to try to create a war.”

And while public health experts, including the Biden administration’s future surgeon general, Dr. Vivek Murthy, have called for clearer guidelines and federal government alert systems to indicate when states and Localities are expected to reimpose coronavirus mitigation measures – such as business closures and capacity restrictions – the Biden administration has so far opposed at this point.

Most states have already established their own trigger criteria at this point in the pandemic, and administration officials have said underreported vaccinations and the prevalence of home testing are complicating efforts to link case levels specific mitigation measures.

“We’re in a pretty unusual place right now, as more and more people are being vaccinated,” Schuchat said. “We are looking carefully at this moment of the pandemic and what are the best parameters to follow.”

Talk to States

Instead of prescriptive guidelines, the White House has sought to work more closely with state and local authorities. Senior White House officials participate in calls with state and local officials several times a week – including adding six regional meetings to the weekly calls between the White House and governors.

Biden officials say they have seen Trump try and fail to pressure states to pass or abandon certain public health measures and have sought to avoid putting themselves in a similar position – working instead to quietly influence and prepare governors’ decision-making behind the scenes. for a potential surge.

“We help them think and not paint themselves in a corner,” said a senior administration official. “But believe me, telling a governor that they can’t do something that they know they have the power to do – I don’t think that’s a fancy decision.”

Where the administration’s appeals to governors fail – as they did when the governors of Texas and Mississippi revoked their states’ mask mandates – the administration has turned to local officials and chiefs company to continue to demand masks and implement other mitigation measures.

But even as the White House seeks to prepare governors for a potential fourth outbreak, officials are also considering the possibility that a fourth outbreak will not strain hospitals or result in as many deaths as previous outbreaks.

“In 2020, we would say, okay, we’re seeing a growing number of cases, we know we’re going to see a growing number of hospitalizations and deaths,” a senior administration official said. “But today … it’s not a very clear picture.”