“Make no mistake, President Biden will not accept just ‘living with COVID’ any more than we accept ‘living with’ cancer, Alzheimer’s, or AIDS,” the plan states. “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.”
The 96-page road map is part of a broader White House strategy to move the country from crisis footing and convince Americans that their lives can return to normal amid the president’s tanking approval ratings and Democratic anxiety that nosediving cases and school reopenings have not buoyed a dyspeptic public.
Biden and his administration said they are “clear-eyed that new variants might arise,” but that they have prepared by building out surveillance and amassing additional supplies of vaccine doses, antivirals, masks and tests.
Federal agencies have briefed lawmakers on a pricetag of more than $30 billion to cover the plan’s costs.
The road map focuses on four goals: protecting against and treating covid, including a “test to treat” initiative that would give people antiviral pills on the spot if they test positive at certain pharmacies and clinics; preparing for a potentially dangerous new variant; preventing economic and educational shutdowns; and expanding vaccinations worldwide — all elements Biden previewed on Tuesday night.
One element includes a “covid variant playbook” so that health officials catch new variants earlier. Federal officials said they will be able to produce and authorize new vaccines and treatments within 100 days if needed, and said they had put that playbook to the test over the last few weeks.
The delicate balance the administration is aiming to strike — highlighting the wide availability of vaccines, treatments, masks and tests that people can use to protect themselves, while urging continued vigilance — underscores the challenge Biden faces in coming weeks and months. The administration is simultaneously under pressure to ease restrictions and enable a return to normalcy while polls show that most Americans still want some mitigation measures in place as the virus continues to circulate.
The virus has claimed nearly 1 million American lives over the past two years and exacted an enormous toll on all facets of life. It has interrupted learning for tens of millions of schoolchildren, led to untold missed family gatherings, isolation and myriad other hardships.
The White House worked to acknowledge that toll while heralding a new future in which Americans could be assured that the era of shutdowns was over and that the administration is prepared in the event of another variant. Officials said the new plan would require funding from Congress to continue boosting supplies of vaccines, antivirals and other tools to fight the virus, but did not specify how much money would be requested.
The administration lacks money to cover purchases beyond its current orders of vaccines, antiviral drugs and monoclonal antibodies, according to a senior health official who spoke on the condition anonymity to discuss the budget situation. Those orders are not sufficient for the entire year, the official said.
Some of the White House’s new urgency about ensuring a less disruptive response reflects polls showing a continued slide in support for Biden’s handling of the crisis. A Washington Post-ABC poll published on Tuesday found that 44 percent of Americans approve of his management of the pandemic, while 50 percent disapprove despite the sharp decline in cases and an easing of restrictions in most parts of the country.
That’s a sharp decline from the summer before the arrival of the delta variant, when about 6 in 10 said they approved of the job he was doing. Every Post-ABC poll since has seen erosion of that support.
While there are numerous signs the country is in a far better place, most Americans do not seem to be giving Biden credit for the improvements.
“Presidents always get blamed for lots of things beyond their control, and the pandemic is a very good example of that,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, a nonpartisan health research group.
Explaining the rationale for the new strategy, administration officials said the country has entered a new, less dangerous phase of the pandemic where most of those who become infected will not end up hospitalized because of wide access to vaccines, booster shots, testing and new therapeutics — making covid-19 gradually less lethal until it comes to resemble other respiratory viruses such as the flu.
They noted the Centers for Disease Control and Prevention’s new approach to measuring the disease’s impact, announced last Friday, which emphasizes that hospitalizations and hospital capacity, rather than just case counts, are a better way to assess a community’s ability to withstand the virus — and how that data support easing restrictions.
Many outside experts said they endorsed the broad outlines of the approach.
“The way people approach covid-19 is going to be based on their individual risk tolerance, instead of some government mandate,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “We have to come up with an approach that reflects the fact that there will always be covid-19. It can’t be eradicated or eliminated.”
But some also expressed concern that it may leave vulnerable Americans at greater risk unless additional steps are taken to protect them. They noted that vaccines are less effective in certain populations.
Administration officials — and Biden himself on Tuesday night — disputed the notion that anyone was being left behind. Federal health officials noted new tools to treat those at high risk, especially antiviral pills. They also cited data showing that one-way masking with high-quality masks such as N95 respirators enable people to protect themselves even if others are not masked, CDC director Rochelle Walensky said at the briefing. Those masks are now easily to obtain and are available free at some pharmacies, federal officials said.
The new approach was shaped by feedback from experts in and out of the government, state and local officials, as well as a group of former advisers, including Ezekiel Emanuel, a University of Pennsylvania bioethicist, who in January called for a new approach to covid-19 that would focus on living with the virus, rather than eradicating it.
In the intervening weeks, members of the various groups have met regularly with the White House, talking through new initiatives to fight the virus, from the test and treat initiative to proposals to improve indoor air quality, according to two people who contributed to the plan.
Outside experts also helped federal health officials game out a range of future scenarios, including strategies to prevent a new variant from overwhelming the country the way omicron did.
In the best case, they said, infections might continue declining with no new variant emerging that would be capable of reinfecting large numbers of people, according to two individuals familiar with the discussions who spoke on the condition of anonymity. In the worst case, the administration would need to prepare for another omicron-like variant that is able to reinfect and sicken those who are vaccinated or had previous infections — feedback the White House appeared to implement in its new plan.
“We need to be prepared for our new normal, or another new surge,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and a member of Biden’s covid-19 transition task force. “We’ve got to do both.”
To prepare for the worst case, Osterholm and other experts said the administration needs to help states make better decisions about mitigation measures and ensure there are ample supplies of vaccines, tests, antivirals and masks. Some privately worry the administration has spent too much time addressing “yesterday’s problem,” rather taking more creative approaches, according to a person familiar with the discussions.
The administration had ramped up preparedness during the omicron surge, including purchasing hundreds of millions of rapid tests, making N95 masks freely available in pharmacies and boosting production of antivirals. While those steps came too late to really blunt the impact of omicron, experts and administration officials say it will help them be better prepared for another variant.
Also as part of the plan, Biden administration officials on Wednesday said they hoped to scale up research and treatments for “long covid,” the constellation of symptoms including brain fog, fatigue and heart-related problems that persist in many people for weeks or months after their initial infections.
“If we get the funding from Congress, we will launch new centers of excellence in communities across the country to provide high quality care to individuals experiencing long covid and to better understand the symptoms they’re facing,” said Xavier Becerra, Health and Human Services secretary.
The National Institutes for Health has been studying potential causes of long covid. . Breakthrough infections in vaccinated people are less likely to lead to long-haul symptoms, federal officials have said.
Polls show most Americans have already fully or mostly returned to their pre-pandemic activities. A Post-ABC news poll released on Tuesday showed that bipartisan majorities think the virus is only “somewhat under control” or “not at all” controlled — and most still wanted some restrictions in place.
And new CDC recommendations released Friday mean about 70 percent of Americans can take their masks off indoors, based on current hospital data and case counts, though the guidelines came weeks after many states already took steps to ease restrictions.
In this next phase of the pandemic, several administration officials suggested they would play more of a supporting role to the states, making sure they have the tools they need, including vaccines, tests, antivirals and masks.
Several local leaders, including Democrats, welcomed such a shift. They said the administration’s messaging and strategy has often been confusing, leaving state and local officials to fend for themselves when deciding what measures to have in place.
“I just don’t see broad-based public confidence in our national messengers at this point,” said Kansas City Mayor Quinton Lucas, a Democrat who lifted mask mandates in his city in mid-February. “I think the messaging has been jumbled, and that’s being charitable.”
But some public health experts express concern that the country is moving past the pandemic too quickly — repeating mistakes made several times over the last two years.
Abraar Karan, an infectious-disease physician at Stanford University, said he is worried that not enough has been done to protect the most vulnerable, who remain at high risk even as millions of Americans return to normalcy. He also criticized the administration’s messaging, including CDC Director Rochelle Walensky calling masks the “scarlet letter” of the pandemic.
“When you keep framing it as restrictions or getting your freedom back, people are going to buy into that and it’s so much harder when you need to put them back in place,” Karan said.
Katie Shepherd and Laurie McGinley contributed to this report.