Special Edition: The White House’s Winter Preparedness Plan
Volume 6, Issue 18 | December 16, 2022
Updated with the correct link and website for ordering four free at-home COVID-19 tests.
The Biden administration just announced a comprehensive COVID Winter Preparedness Plan. The big themes: 1) Increase access to testing and vaccination, both across the board and in ways targeted to ensure access to the most vulnerable; and 2) keep an eye out for variants that could cause major-league surges, and be prepared in case one shows up.
That’s the “What.” The “How” comes in four parts:
#1 Testing:
COVIDTests.gov has reopened; every American household can order four free home tests.
Additional tests are available at “trusted locations”: schools, health centers, long-term care facilities, and up to 500 food banks, plus through Housing and Urban Development’s 6,500 rental housing properties.
#2 Vaccination (and a bit of Treatment):
HHS Secretary Becerra is asking governors to set up mobile vaccination sites, surge testing sites, and more Test To Treat locations.
The feds are reaching out to local leaders (including tribal) to make sure they’re aware of federal resources to help set up more vaccination sites.
$125 million is going to community-based organizations to help them set up accessible vax clinics or bring vaccines to elderly and/or disabled folks.
The list of provider types that may administer COVID-19 vaccinations has been expanded - it now includes nursing home staff, home health agencies, and emergency medical technicians.
#3 A focus on nursing homes and other long-term care facilities:
A specialized playbook for nursing homes and long-term care facilities will be sent out, with a focus on education, vaccination, and improving indoor air quality.
In his letter to governors, the HHS secretary is also appealing to their competitive side by showing each governor how their state ranks vs. other states on vaccinating residents of long-term care facilities.
#4 Preparation for the future:
The federal government will help states with clinical staffing as needed - especially in the midst of surges.
PPE and ventilators from the Strategic National Stockpile have been “pre-positioned” around the country so they can arrive as quickly as possible if and when states need them.
Variant surveillance is ongoing, both through wastewater and through the Traveler-Based Genomic Surveillance Program, which collects samples from international air travelers at several major US airports.
Finally, the White House is recommending that each person come up with a COVID-19 Personal Action Plan, for which CDC has developed a handy guide. (It reads like a mashup of an info flyer from a doctor’s office, a natural-disaster emergency-preparedness plan, and a medical form you have to fill out before sending your kids to camp.)
Commentary:
Thumbs Up for: Creating a plan. Publishing a plan. Focusing on testing in the plan (we’re thrilled to see it as #1). Integration with community organizations and health centers in the plan. Having the plan keep an eye on the future, using genomic surveillance and wastewater.
Thumbs Down for: We would have liked to see more on surveillance, including wastewater testing, and on ventilation and air cleaning. We would love to see an initiative to sequence every hospitalized patient. These are the sickest patients - what variants might they have, and could one of those be the next Omicron - or Pi?
New FDA Guidance (Aug 11, 2022) makes it clear that “rapid, lateral-flow antigen tests” (i.e.. “at home” tests) critically underperform when not used serially. To gain more certainty, one would need to test 3-times, 48 hrs apart – by then it is often too late for family gatherings and corporate events, etc. – and the cost of 3 tests approaches or exceeds the cost of better commercial testing. https://www.fda.gov/medical-devices/safety-communications/home-covid-19-antigen-tests-take-steps-reduce-your-risk-false-negative-results-fda-safety