Washington – U.S. President Joe Biden, seeking to assert leadership over the coronavirus pandemic, signed a string of executive orders and presidential directives on Thursday aimed at creating the kind of centralized authority that the administration of Donald Trump had shied away from.
The orders included new requirements for masks on interstate planes, trains and buses, the creation of a national testing board and mandatory quarantines for international travelers arriving in the United States. Biden predicted that the U.S. death toll from COVID-19 would top 500,000 next month, refusing to play down the carnage that his predecessor was loath to acknowledge.
The mask requirement for public transportation, coupled with the order Biden issued on Wednesday requiring mask-wearing in all federal facilities, edges the country toward the kind of comprehensive mask mandate that has dominated debate at the state and local level between public health advocates and those defending what they called individual liberty.
Biden described his approach as a "full-scale wartime effort,” but his chief medical adviser for the coronavirus, Dr. Anthony Fauci, made it clear how difficult the task would be. Appearing in the White House briefing room for the first time since November, Fauci said powerful treatments using manufactured antibodies, which were used on Trump, were not effective against more infectious variants of the virus circulating in South Africa and Brazil, which have not yet emerged in the United States.
And while the current vaccines still work against the new variants, the immune response they induce might be slightly diminished, he said, adding even more urgency to quickly vaccinating people.
The nation, he said, is "still in a very serious situation.”
As thousands of Americans die every day from COVID-19 and the threat of viral mutations looms, the pandemic poses the most pressing challenge of Biden’s early days in office. How he handles it will set the tone for how his administration is viewed, Biden acknowledged.
"History is going to measure whether we are up to the task,” he said in the White House’s State Dining Room, with Vice President Kamala Harris and Fauci by his side.
The "National Strategy for the COVID-19 Response and Pandemic Preparedness” outlined the kind of centralized response that Trump long avoided. The plan instructed federal agencies to invoke the Defense Production Act if necessary to expand supplies; created a "pandemic testing board” to help expand access to testing; ordered the Occupational Safety and Health Administration to issue guidelines to protect workers; called for new guidelines on reopening schools and businesses; and said the government would begin fully reimbursing states for the cost of using the National Guard to accelerate the pace of vaccinations.
But the plan is in some respects overly optimistic and, in others, not ambitious enough, some experts say. It is not clear how Biden will enforce the new quarantine requirement for foreign travelers. The president has also promised to inject 100 million vaccines in his first 100 days. But that is actually aiming low. Over that period, the number of available doses should be enough for 200 million injections.
Beyond the 100-day mark is where the problem lies. Federal health officials and corporate executives agree that it will be impossible to increase the immediate supply of vaccines before April at the earliest because of lack of manufacturing capacity.
The Trump administration had already invoked the Defense Production Act, a Korean War-era law, to force suppliers to prioritize orders from Pfizer, Moderna and other vaccine-makers whose products are still in development. The Trump administration had looked at all available manufacturing capacity domestically and globally, but there was little space left to secure more production.
Biden seemed to acknowledge the problem. "The brutal truth is it’s going to take months before we can get the majority of Americans vaccinated,” he said.
Calls for unity were already fraying a day into the new presidency. Biden took a shot at Trump, saying, "For the past year, we couldn’t rely on the federal government to act with the urgency and focus and coordination that we needed, and we have seen the tragic cost of that failure.”
On Capitol Hill, Rep. Steve Scalise of Louisiana, the No. 2 House Republican, called Biden’s promise of "100 million shots” insufficient.
"Comments made about vaccine supply and distribution by the White House’s coronavirus czar are old Washington spin,” Scalise said in a statement.
"If President Biden wants to develop a new plan to administer 200 million vaccines in 100 days," he added, "congressional Republicans stand ready to work with President Biden to help further speed vaccine distribution.”
With the release of the national strategy, Biden tried to signal to the public that his approach would be far more assertive on a range of fronts — be it bolstering the manufacture of necessary supplies or requiring mask-wearing in airports, on commercial planes, trains, public maritime vessels including ferries, and on certain other modes of public transportation like intercity buses.
The Biden team said it had identified 12 "immediate supply shortfalls” that were critical to the pandemic response, including N95 surgical masks and isolation gowns, as well as swabs, reagents and pipettes used in testing — deficiencies that have dogged the nation for nearly a year.
Jen Psaki, the White House press secretary, told reporters Wednesday evening that Biden "absolutely remains committed” to invoking the Defense Production Act to bolster supplies.
Republican Sen. Marco Rubio praised Biden’s plan to use the act as a way to reverse "the hollowing out of America’s manufacturing," which "destroyed jobs, families and communities.”
Biden’s strategy is organized around seven goals, including restoring trust with the American people by conducting "regular expert-led, science-based briefings” — one reason Fauci appeared at the White House briefing — and advancing equity "across racial, ethnic and rural/urban lines.” Both are departures from Trump’s approach.
The administration is asking Congress for $1.9 trillion for pandemic relief, and White House officials said they would need much of that money to put their coronavirus proposal into place.
"On the asymptomatic screening side, we’re woefully under capacity, so we need the money in order to really ramp up testing, which is so important to reopening schools and businesses,” said Jeffrey Zients, Biden's coronavirus response coordinator. "We need the testing. We need the money from Congress to fund the national strategy that the president will lay out.”
Biden's executive orders run the gamut. He instructed the Occupational Safety and Health Administration to "immediately release clear guidance for employers” to protect the health of workers and directed the departments of Education and Health and Human Services to issue new guidance on how to safely reopen schools. That was a major point of contention during the Trump administration, which interfered with the school reopening guidance from the Centers for Disease Control and Prevention to press administrators to bring back students.
Biden also ordered the Department of Health and Human Services, working with the Centers for Disease Control and Prevention, to reassess and, if necessary, rewrite the CDC’s coronavirus testing requirements for international travelers. The CDC appears to have already done so; new guidelines to take effect on Tuesday, were on its website Thursday.
The new guidelines supersede those issued in December requiring travelers from Britain to show proof of a negative predeparture test for COVID-19. Now, airlines must verify that every international passenger age 2 or older "has attested to” either testing negative, or has been cleared to travel by a doctor or public health official after recovering from coronavirus infection.
The executive order to establish the testing board drew from President Franklin D. Roosevelt’s War Production Board. The board is responsible for ramping up testing and directing studies, including large-scale randomized trials, to identify treatments for COVID-19. He also created an COVID-19 equity task force to address racial disparities.
Dr. Marcella Nunez-Smith, who will lead the task force, told reporters this week that the committee would issue specific recommendations to the president, though she gave no timeline. Nor would she say whether vaccine recommendations would change; the current recommendations, drafted by a CDC committee, do not explicitly prioritize vaccination for people of color.
But Nunez-Smith, noted that they did prioritize front-line workers, many of whom are people of color.
The president has already directed the Federal Emergency Management Agency to begin establishing federally supported community vaccination centers, with the goal of having 100 centers in operation in the next month. And he intends to set up mobile vaccination units to reach underserved urban and rural populations.
Some of Biden’s actions echo those of Trump. For instance, Biden will move to expand eligibility for vaccination to people 65 and older, a step the Trump administration had already taken.
"We will encourage states to begin opening up eligibility to include folks over 65 and front-line essential workers like educators, teachers, first responders and grocery store workers,” said Dr. Bechara Choucair, a former Chicago public health commissioner who is now the coronavirus vaccine coordinator. "So, more people, more places, more supply.”
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