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Normal was the watchword, as White House officials unveiled an updated National COVID Preparedness Plan on Wednesday, which included increased access to treatment, enhanced surveillance, keeping schools open, and vaccinating the world.

White House COVID Response Coordinator Jeff Zients emphasized that this was a "new moment" in the fight against the virus, with a new plan that expanded on the future COVID strategy that President Biden touched upon in his State of the Union address on Tuesday.

However, Zients prefaced his remarks by saying it requires "additional congressional support and funding." Indeed, a statement released by the White House said that, "to fully execute on this plan requires Congress doing its part to invest in tools that work."

HHS Secretary Xavier Becerra made a rare appearance at the briefing, though when asked about his role in the pandemic, he reiterated that "HHS is a part of that team" assembled by the president to combat COVID, and that their efforts are "all about getting the job done."

COVID Treatment and Prevention

Zients touted the efficacy of antiviral nirmatrelvir/ritonavir (Paxlovid) against severe COVID and said that the White House ordered 20 million courses of the drug, with 1 million available this month and "more than double" that available in April.

He also referenced the Biden administration's "test-to-treat" initiative, with access to free testing and treatment in "one-stop sites" such as community health centers, long-term care facilities, veterans health centers, and pharmacies.

Regarding vaccines, Zients said the government would be ready to make Pfizer's vaccine for kids younger than age 5 available as soon as it is authorized by the FDA. He also noted a website launching "later this month" with information on vaccines and masks in any given area.

Becerra noted that the "next phase" of HHS' role in combating the pandemic is to make the logistics and operational hub they have built for COVID into a permanent part of the agency, entitled the "HHS Coordination and Response Element" (H-CORE).

He also discussed the role that HHS will play in addressing the long-term effects of COVID -- specifically, long COVID and mental health issues associated with the virus. In particular, the plan would provide "high-quality" care for long COVID, coordinate a "whole-of-government effort" to counsel children and families who have lost loved ones to COVID, and an expanded program to prevent job burnout, particularly for healthcare workers.

"We want every front-line essential worker to know that we're with you and we've got your back," Becerra said.

Preparing for New Variants

Zients went over the planned "COVID Variant Playbook" to assess a new variant's "transmissibility and severity," as well as "tabletop readiness and response exercises" conducted jointly by HHS, CDC, NIH, FDA, and the Federal Emergency Management Association, but left more details about enhanced surveillance to CDC Director Rochelle Walensky, MD.

Walensky discussed several methods of enhanced surveillance, including a national wastewater surveillance system, a national syndromic surveillance center, and a new center for forecasting and analytics. Specifically, she noted that the number of wastewater testing sites have risen from 400 to 647 sites reporting data.

In addition, a new syndromic surveillance system can collect data on COVID-related emergency department visits across the country. Walensky also said that their enhanced genomic surveillance system can "reliably identify" low levels of variants of concern -- "even those that account for 0.1% of cases," she added.

Walensky also discussed scaling up data-monitoring efforts that connect data from local public health systems to a national system to help "forecast and model public health threats" as well as "inform prevention recommendations."

In terms of detecting new variants, Anthony Fauci, MD, the White House chief medical advisor and NIAID director, discussed a plan that would allow "updated vaccines to be developed, approved, and manufactured in approximately 100 days." These vaccines would ideally be "broader and longer-lasting," providing protection against both the ancestral strain and new variants, he added.

Other Priorities

Another priority was preventing economic and school shut-downs. Zients said that the Environmental Protection Agency is issuing a new "clean air in buildings" checklist to promote "quality ventilation practices," and reinstate tax credits to help small and medium-sized businesses pay for sick leave for those who contract the virus.

Finally, Zients touched upon "vaccinating the world," saying that the U.S. would not only be providing more vaccines to other countries, but also "vaccinators in the field," and the ability to "set up vaccination sites."

The Fate of Travel Mask Mandates?

With all this talk of normalcy, officials received several questions about ending mask mandates on domestic travel, such as airplanes.

Walensky said that when evaluating these mandates, which are set to expire on March 18, they will be looking at "not only the science of transmission ... but also the epidemiology and frequency we may encounter in variants of concern in our travel corridors."

She also noted that Omicron is a milder variant, and the country has been doing "a massive amount of vaccination and boosting" and teased "more to come" about this issue.

"We want to revisit this in a separate way," Walensky said.

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