President Biden’s plan for a comprehensive vaccination campaign would dramatically expand the federal government’s role in distributing and administering COVID-19 vaccines.
On January 21, 2021, one day after his inauguration, President Joe Biden unveiled the National Strategy for the COVID-19 Response and Pandemic Preparedness. The National Strategy, which includes directives and executive orders and totals 200 pages, details President Biden’s plan for combating COVID-19 and preventing a future pandemic. The foundation of the National Strategy includes seven key goals, which we summarize below.
Goal 1: Restore Trust with the American People
The foundation of the first goal is rebuilding expert leadership across the federal government and regaining the trust of the American people. President Biden issued the Executive Order on Organizing and Mobilizing the United States Government to Provide a Unified And Effective Response to Combat COVID-19 and to Provide United States Leadership on Global Health and Security (January 20, 2021), which established a White House COVID-19 national response structure to coordinate across the federal government. This executive order creates the position of COVID-19 response coordinator and a deputy coordinator within the Executive Office of the President. The COVID-19 response coordinator reports directly to President Biden and assists him and the executive departments and agencies in responding to the pandemic. Additionally, the executive order restored the White House National Security Council Directorate for Global Health Security and Biodefense, which monitors current and emerging biological threats.
President Biden also issued the Executive Order on Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats (January 21, 2021), which directs steps to enhance the collection, production and analysis of COVID-19 related data between federal agencies. The Biden administration believes metric-driven public health guidance is essential to controlling the pandemic.
Goal 2: Mount a Safe, Effective, Equitable Vaccination Campaign
President Biden’s plan for a comprehensive vaccination campaign would dramatically expand the federal government’s role in distributing and administering COVID-19 vaccines. While the Trump administration had largely delegated operational authority for vaccine administration to state and local governments, President Biden’s plan contemplates provision of additional federal resources and greater federal operational control.
To support state and local government efforts, President Biden is asking Congress for an additional $20 billion as part of a broader pandemic relief package. The president also plans to deploy thousands of federal employees, contractors and volunteers to support existing vaccination efforts and to fully reimburse states for the costs of deploying their national guards to assist in those efforts. President Biden has also signaled his desire for the Centers for Medicare & Medicaid Services to increase the payment rate to health providers for vaccinations, and for increased reimbursement rates to state governments for vaccinations of Medicaid enrollees.
President Biden also proposes having the federal government take a much more active role in directly administering vaccines. By the end of February, his plan promises to establish at least 100 federally operated vaccination centers across the country, in facilities such as school gymnasiums, sports stadiums and community centers. The federal government will partner directly with pharmacies, grocery stores and other retail storefronts to establish convenient vaccination sites, and will work with local health providers to deploy mobile vaccination clinics in harder-to-reach areas. The Biden administration recommends that essential frontline workers now begin receiving the vaccine, although authority for prioritization decisions will ultimately remain with the states.
Finally, President Biden’s plan calls for increased reliance on federal authorities such as the Defense Production Act (DPA) to intervene in support of the national vaccination effort. The Biden administration is particularly concerned about bottlenecks in the supply of equipment like glass vials and syringes, as well as raw materials, and is willing to use DPA authority to mandate these supplies be provided to the vaccination effort. President Biden also promises to use his authority under the Public Readiness and Emergency Preparedness Act to expand the pool of vaccination personnel who are immune from potential liability related to vaccine administration.
Goal 3: Mitigate Spread Through Expanding Masking, Testing, Treatment, Data, Workforce and Clear Public Health Standards
The Biden administration is focused on curbing the spread of COVID-19 by encouraging and supporting efforts to maintain safe practices in day-to-day living. The administration intends to partner with leaders at the local level to implement a cohesive strategy to reduce the spread of infection, including mask-wearing, increased data flow, developing preclinical tools to create new antivirals to COVID family viruses, and providing overall clear public health guidance for the public. To achieve these goals, President Biden has issued a number of executive orders outlining his strategy:
- Executive Order on Protecting the Federal Workforce and Requiring Mask-Wearing (January 20, 2021): Requires compliance with CDC guidelines―including mask-wearing and physical distancing―on federal lands, in federal buildings and by federal employees and contractors. The scope of this executive order encompasses military bases as well as overseas locations.
- Executive Order on Promoting COVID-19 Safety in Domestic and International Travel (January 21, 2021): Mandates applicable agencies to implement mask-wearing on planes, trains and other forms of public transportation, including maritime vessels and intercity bus services.
- Executive Order on Establishing the National Pandemic Testing Board and Ensuring a Sustainable Public Health Workforce for COVID-19 and Other Biological Threats (January 21, 2021): Directs applicable agencies to facilitate free testing for those who lack health insurance, as well as clarify health insurers’ responsibilities to cover testing.
- Executive Order on Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats (January, 21, 2021): To promote scientific research, the Biden administration calls on agencies across government to produce and share their data and collaborate on the COVID-19 virus, without sacrificing privacy and confidentiality. The goal is to have this information readily available to the public.
- Executive Order on Improving and Expanding Access to Care and Treatments for COVID-19 (January 21, 2021): Seeks to strengthen clinical care capabilities, including providing assistance to long- and intermediate-care health facilities for people with disabilities, especially supporting access to COVID-19 therapeutics. To achieve this policy, President Biden outlines steps to deploy federal assets and manpower to hotspot states, including medical reservists and active duty military and National Guard members.
Goal 4: Immediately Expand Emergency Relief and Exercise the Defense Production Act
Responding to concerns about shortages in major COVID-19 relief supplies, President Biden issued the Executive Order on a Sustainable Public Health Supply Chain (January 21, 2021), which directs the federal government to conduct an immediate inventory of pandemic response medical supplies. The order authorized the government to invoke the DPA to initiate contracts, enter into purchase commitments and make investments necessary to close critical supply gaps in N-95 masks, PCR sample collection swabs, rapid test kits and low dead-space needles for vaccine administration. The newly appointed COVID-19 response supply coordinator will coordinate all agencies involved in acquisition, supply and any DPA activity under a single national pandemic supply process. The executive order also calls for the development of a Pandemic Supply Chain Resiliency Strategy that would sustain both short- and long-term capability to manufacture pandemic supplies for COVID-19 in the United States.
To curb concerns about hoarding and price gouging, President Biden’s executive order directs the Departments of Defense, Health and Human Services and Homeland Security to develop recommendations to address pricing of COVID-19 supplies. Finally, President Biden offers assistance to state, local and tribal governments in acquiring COVID-19 response supplies via his Memorandum to Extend Federal Support to Governors’ Use of National Guard to Respond to COVID-19 and to Increase Reimbursement and Other Assistance Provided to States (January 21, 2021). The memorandum authorizes FEMA to fully reimburse the cost of National Guard personnel who are supporting vaccination efforts and the cost of emergency supplies, including full access to disaster relief and emergency assistance for K-12 schools to supply PPE and cleaning products.
Goal 5: Safely Reopen Schools, Businesses and Travel, While Protecting Workers
The Biden administration aims to safely open the majority of K-8 schools in 100 days and vows to allocate COVID-19 tests and other supplies to schools. In furtherance of that goal, President Biden issued the Executive Order on Supporting the Reopening and Continuing Operation of Schools and Early Childhood Education Providers (January 21, 2021), which directs the Department of Education to issue guidance to schools on how to best conduct distance learning and how to address any learning loss sustained over the course of the pandemic. Specifically, the president has ordered the Department of Education, in conjunction with the CDC, to issue a handbook on a national strategy for reopening schools.
In an effort to increase protections for essential workers, Biden issued the Executive Order on Protecting Worker Health and Safety (January 21, 2021), which directs the Occupational Safety and Health Administration (OSHA) to consult with the CDC to issue updated guidance on COVID-19 worker protections, including whether to issue temporary emergency standards. The order calls for OSHA to strengthen its current enforcement efforts, and launch a National Emphasis Program to focus enforcement resources on violations that put large numbers of workers at serious risk. The executive order also states that COVID-19 safety protocol guidance will be disseminated to small businesses through the Small Business Administration. Additionally, the Biden administration is spearheading the development of a safe standards certification program for businesses, which would allow a business to certify that it is following public health standards aligned with forthcoming OSHA guidance. President Biden also vows to work with large employers and labor unions to establish on-site vaccination centers and to prioritize high-risk industries and occupations. Furthermore, the Biden administration asks businesses for a national pledge to ensure employees and contractors can take paid time off to get vaccinated. Finally, President Biden calls for Congress to reestablish the emergency paid leave program first created by the Families First Coronavirus Response Act, but eliminate exemptions, as well as expand the emergency paid sick and family and medical leave benefits to over 14 weeks. Meanwhile, the Biden administration is currently assessing whether federal contractors should be required to offer emergency paid leave.
To control further spread of the virus, President Biden issued the Executive Order on Promoting COVID-19 Safety in Domestic and International Travel (January 21, 2021), which requires mask-wearing in airports and on certain modes of public transportation, including airplanes, trains, maritime vessels and intercity buses. The order also requires international air travelers to produce a negative COVID-19 test prior to departing for the United States, as well as compliance with CDC rules for self-isolation and self-quarantine upon arrival.
Goal 6: Protect Those Most at Risk and Advance Equity, Including Across Racial, Ethnic and Rural/Urban Lines
To combat racial, ethnic and geographical disparities in health outcomes, President Biden signed the Executive Order on Ensuring an Equitable Pandemic Response and Recovery (January 21, 2021), establishing a high-level task force to help coordinate an effective response. The task force will consist of diverse experts from around the country―as well as the Departments of Health and Human Services, Education, Housing and Urban Development, Agriculture and Labor―who will organize to understand and discuss how best to address these inequities. The Biden administration offered a glimpse of one way it hopes to address these inequities via Executive Order on Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats (described in Goal 3), which it hopes will foster the collection of data identifying high risk communities and overseeing resource distribution to these areas to ensure an effective response.
Additionally, the Biden administration will attempt to expand access to healthcare across the country. Specific actions that the administration hopes to take include increasing funding to the 1,400 community health centers across the United States, the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration. Likewise, using congressional appropriations, the Biden administration hopes to provide paid sick leave support, child care support and rental assistance to better help those struggling to follow appropriate health guidance.
Goal 7: Restore U.S. Leadership Globally and Build Better Preparedness for Future Threats
The Biden administration seeks to restore U.S. leadership globally and improve long-term biopreparedness. On January 21, 2021, President Biden issued a National Security Directive, which emphasizes the administration’s commitment to working with other nations to combat COVID-19. As part of this goal, President Biden ceased the previous administration’s process of withdrawal from the World Health Organization. Additionally, the Biden-Harris administration has committed to working with partners across the globe, including the G-7, G-20, the UN, African Union and ASEAN, to support the global response to the pandemic.
To counter COVID-19 and future biological threats, President Biden also restored the White House National Security Council Directorate for Global Health Security and Biodefense, established during the Obama administration.
To control further spread of the virus, President Biden issued the Executive Order on Promoting COVID-19 Safety in Domestic and International Travel (January 21, 2021), previously discussed herein. The order requires international air travelers to produce a negative COVID-19 test prior to departing for the United States, as well as compliance with CDC rules for self-isolation and self-quarantine upon arrival.
What This Means for the Public, Schools, Businesses and Other Employers
We should all be prepared for major changes related to the COVID-19 pandemic as implementation of the National Strategy occurs in the coming weeks and months through legislation, regulations, executive orders and guidance. Schools, businesses and other employers will need to be prepared to incorporate these changes, both mandated and recommended, along with applicable state and local requirements and guidance. Duane Morris attorneys will continue to monitor these developments and provide additional updates and analysis on the interplay of these federal level changes with existing requirements.
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