In what would be the first time, the White House is drawing up plans to inject vaccines at emerging points in an attempt to block the path of the virus and protect those most at risk, two senior government officials told CNN.
While the number of daily coronavirus cases continues to decline and more than 2 million Americans are being vaccinated daily, the White House’s Covid-19 response team is preparing for the worst. The authorities have searched data to trace the path of the virus, mapping different scenarios and drawing up plans for how the federal government would take action.
“All we do is think there may be another outbreak,” said a senior government official, summing up the government’s efforts to fight the virus and prepare for an outbreak.
That focus has increased in recent weeks, as the decline in new daily cases has slowed, stabilizing at a worryingly high level. The United States Centers for Disease Control and Prevention believes that the most transmissible variant B.1.1.7, which was first identified in the United Kingdom, will be the dominant strain within weeks. There are also concerns about governors and local officials prematurely easing restrictions on public health in a number of states.
Each shot brings the United States closer to avoiding another deadly wave, but Biden officials know they are running out of time.
“I think we need to be very humble with this virus,” said Dr. Anne Schuchat, the CDC’s second official to CNN. “While many indicators are going in the right direction and more and more people are being vaccinated every day, we need to be ready for wildcards and it gets worse.”
Emerging vaccines for critical points
Just as federal authorities have mobilized test resources and set up “peak” test sites at critical points across the country during the summer and fall, federal authorities are preparing to deploy a similar effort using vaccination centers administered or supported by the federal government. A senior official said an example of such an effort would involve vaccinating workers in high-risk environments, such as a meat processing plant in areas where cases are beginning to rise.
The federal government could also leverage an expanded federally controlled vaccine line for pharmacies across the country – which is expected to increase to more than 20,000 soon – to increase doses in hard-hit areas, officials said.
An official said the government is also considering administering treatments with monoclonal antibodies – of which the administration bought another 100,000 doses in February – at critical points like prophylaxis.
“We have different tools than last year,” said the official. “We cannot play yesterday’s game against this virus.”
To that end, the White House has invested hundreds of millions of dollars to boost surveillance tests and close test supply gaps, including $ 200 million to boost genomic sequencing to track the spread of variants. The American Rescue Plan, which Biden signed into law on Thursday, invests another $ 47.8 billion in coronavirus testing measures. The project also adds $ 7.66 billion for hiring 100,000 public health professionals to increase vaccination and contact tracking efforts.
Consistent messages
At the forefront of the government’s efforts to prepare for a sudden increase – and how its response would be different from that of the previous government – is the dramatic shift in public messages that saw health experts and the president speaking with one voice.
That is why, last week, the director of the CDC, Dr. Rochelle Walensky, the director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci and Biden, warned about the dangers of the variants and the possibility of another outbreak.
“A lot can happen. Conditions can change. Scientists have made it clear that things can get worse as new variants of the virus spread,” Biden said during a prime-time speech to the country last Thursday. “If we don’t stay vigilant and conditions change, we may have to re-establish restrictions to get back on track.”
While federal health officials often found themselves protecting their public statements to avoid contradicting President Donald Trump, public health officials now have the power to follow the data, resulting in a uniform message from the federal government about the threats of the pandemic and the measures that need to be taken to deal with these threats.
“We have more consistent messages now around the interventions that we know work: masks, measures of social distance,” said Schuchat, who also served as deputy director of the CDC during the Trump administration. “There is a strong commitment at the CDC and in this administration to transparent communication – if there is bad news, to share it, if there is good news, to be open and honest about it – to ensure that we can communicate clearly and consistently about the that we think is happening and what we think needs to be done. ”
White House rejects more aggressive strategies
On other fronts, the government has refused to change the game entirely, rejecting calls to prioritize obtaining more first doses of two-dose vaccines in the arms of Americans and delaying the administration of second doses – as the United Kingdom has done. Instead, the White House has prioritized giving full protection to fewer Americans amid concerns that a single dose could be less effective against the most transmissible variants of the coronavirus.
They also resisted calls to take a more vigorous role in compelling states to speed up vaccine administration and implement public health measures, refusing to link funding or distribution of vaccines to any of them, considering these measures counterproductive.
“Getting into a heated public discussion about this is exactly what sometimes plays in favor of the people who are making these decisions,” said a senior government official. “The president’s general view of the world is not to take the bait, not to increase the rhetoric, not to try to create a war.”
And while public health experts, including the future Biden government surgeon general, Dr. Vivek Murthy, advocate for clearer federal government guidelines and warning systems to define when states and localities should reimpose coronavirus mitigation measures – such as closures of companies and capacity constraints – the Biden government has so far objected on that front.
Most states have already established their own blocking criteria at this point in the pandemic, and government officials said vaccinations and the prevalence of underreported home tests complicate efforts to link case levels to specific mitigation steps.
“We are in a very unusual place now, as more and more people are vaccinated,” said Schuchat. “We are carefully analyzing this moment of the pandemic and what are the best metrics to track.”
Talking 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 liaisons with state and local officials several times a week – including the addition of six regional meetings to weekly liaisons between the White House and governors.
Biden officials say they saw Trump try and failed to pressure states to adopt or rule out certain public health measures and avoid putting themselves in a similar position – instead, they worked to discreetly influence governors’ decision-making behind the scenes and prepare them for a potential increase.
“We are helping them to think things through and not to be trapped,” said a senior government official. “But believe me, telling a governor that they can’t do something that they know they have the authority to do – I don’t think it is a sophisticated attitude.”
Where government appeals to governors fail – as they did when the governors of Texas and Mississippi revoked their states’ mask mandates – the government turned to local officials and business leaders to continue to demand masks and implement other mitigation measures .
But even as the White House seeks to prepare governors for a potential fourth increase, officials are also contemplating the possibility that a fourth increase will not overwhelm hospitals or cause as many deaths as previous ones.
“In 2020, we would say, OK, we see an increasing number of cases, we know that we will see an increasing number of hospitalizations and deaths,” said a senior government official. “But today … it is not a very clear picture.”