BP2C Executive Director Dr. Scott C. Ratzan contributed an Op-ed to The Daily Beast on December 2 titled, “Biden’s New Omicron Winter Plan for America Simply Isn’t Enough.” The Op-ed was co-written by Lawrence O. Gostin and Kenneth H. Rabin. According to Ratzan, Gostin, and Rabin, Biden’s plan is certainly science-based and unobjectionable, but it is little more than a tweak of what we’re already doing, with limited success. The first knee-jerk response was a travel ban from southern Africa. That may be politically expedient but it’s ineffective and discriminatory. Now, CDC will require a negative test within 24 hours of departure, which may pick up a few more cases missed under the prior 72-hour time window. Biden’s also extended the airport and airline mask mandate—no surprise. Within our borders, Biden will continue to urge vaccinations, but little more. He wants kids to be vaccinated and adults boosted. We agree, but wanting that result won’t achieve it. Maybe his idea for a booster vaccination campaign will work, but many vaccinated people are eager for boosters anyway. Have any of our previous Covid vaccine communications campaigns been particularly effective? Family vaccination clinics are nice, but that assumes families want to get the jab. For the full story, read below.
After all the urgency expressed over the new Omicron variant originally identified in southern Africa and now present in more than 30 countries, including the United States, President Biden has announced his plan. The administration says it is “pulling out all the stops” but its plan is frankly underwhelming and won’t prevent Omicron’s spread.
Biden’s plan is certainly science-based and unobjectionable, but it is little more than a tweak of what we’re already doing, with limited success.
The first knee-jerk response was a travel ban from southern Africa. That may be politically expedient but it’s ineffective and discriminatory. Now, CDC will require a negative test within 24 hours of departure, which may pick up a few more cases missed under the prior 72-hour time window. Biden’s also extended the airport and airline mask mandate—no surprise.
Within our borders, Biden will continue to urge vaccinations, but little more. He wants kids to be vaccinated and adults boosted. We agree, but wanting that result won’t achieve it. Maybe his idea for a booster vaccination campaign will work, but many vaccinated people are eager for boosters anyway. Have any of our previous Covid vaccine communications campaigns been particularly effective? Family vaccination clinics are nice, but that assumes families want to get the jab.
The real problem is that too many Americans still refuse, though Omicron seems to have persuaded at least 30% of refusers to reconsider the jab, as Biden noted in his remarks on Thursday. His new plan will require insurance companies to reimburse home testing kits. Again, there’s nothing wrong here, but it’s hard to see the unvaccinated rushing to get tested, notifying their contacts, and self-isolating.
The president’s lack of boldness may simply be political fatigue. He’s tired of having every public health measure greeted with howls of protest and legal challenges brought before hostile judges. The courts have already blocked Biden’s two signature vaccine initiatives—OSHA’s vaccine-or-test rule and CMS’ vaccine requirement for healthcare facilities. Both those initiatives stand on rock-solid legal grounds, but not with judges with a political axe to grind.
The bottom line is Americans are nearly ungovernable in a pandemic, refusing to do the simplest things like wear a mask or get a jab. But Biden must keep fighting for America’s health, and to end the pandemic globally.
We need a 21st century equivalent of the post-WWII Marshall Plan to protect Americans and the world against the Omicron variant now. Here are four big ideas that the president could still advance.
First, we need a much smarter travel policy. Biden’s announced travel ban from southern Africa was late and porous. It’s late because Omicron is already circulating in the US, and it’s porous because travelers from Europe and elsewhere are still being allowed to travel in. Travel policies that pick and choose among nations are ineffective. Instead, we should require all arriving international travelers (including US citizens) to be fully vaccinated, and tested pre- and post-arrival, perhaps with a quarantine period. It’s astonishing that 51 infected people could board a flight from South Africa to the Netherlands. And Biden can also make domestic travel safer. Just as the president can legally require masks in airports, he can require vaccinations for all international and interstate transportation (as in Canada). This means everyone boarding a plane, train or bus across state lines or national borders should be fully vaccinated.
Second, CDC should urgently provide technical guidance, models, and funding for vaccine credentialling systems, like the kinds already used in Europe, the United Kingdom, and Israel. Vaccine passports offer validated proof of vaccination for entry to crowded indoor settings, like airports, workplaces, restaurants, or dining, and entertainment venues. Cities, states, and the private sector could use verifiable vaccine credentials with up-to date requirements (fully boosted) to make us all safer.
Third, CDC should update the definition of “fully vaccinated” to require third mRNA doses or second doses of J&J (mixed or matched with mRNA doses). While the evidence isn’t all in, we have good reason to be concerned that the multiple spike protein mutations in Omicron variant will reduce vaccine-induced immunity. That means boosters are needed urgently, and for all eligible Americans.
Fourth, and most importantly, America must lead on global vaccinations. We don’t know for sure how SARS-CoV-2 mutated to become the Omicron variant, but the extraordinarily low vaccination rates in sub-Saharan Africa surely played a major role. Viruses mutate far more quickly in the presence of many susceptible hosts. That’s why it’s very much in America’s national security and economic interests to vaccinate the world. Biden’s plan simply expresses a “continued commitment to global vaccination.”
It’s true that our commitment to provide vaccines to developing countries is greater than that of any other nation, but it’s still woefully inadequate. So far, we’ve pledged 1.2 billion doses, and delivered around 270 million—nowhere near the 11 billion doses needed to vaccinate even 70% of the world’s population. We also seem to have magical thinking on how vaccinations get into people’s arms. You cannot just deliver a large shipment to a dock, and miraculously expect people to get jabs. Lower-income countries have the same logistical problems as we do, only more of them. They need a start-to-finish vaccine infrastructure, including cold storage, reliable transportation, trained vaccinators, and health education. Unlike past US leadership, we haven’t invested in helping health systems deliver shots.
The Western model of charitable vaccine donations is also antiquated. Donations always come too little and too late. We must force US pharmaceutical companies like Pfizer and Moderna to share their vaccine technology, now. Ironically, Omicron just caused the World Trade Organization to postpone a ministerial meeting about waiving intellectual property rights during the COVID-19 pandemic. Countries are clamoring for the vaccine recipe, including the WHO-backed mRNA hub in South Africa.
In short, when the global economy faces $7 trillion loss in economic activity from the pandemic, the US should not be too self-congratulatory about a $9 billion contribution to world’s fight against COVID-19.
Our only realistic tool now is to vaccinate—at home and abroad. Vaccines have eradicated smallpox and are close to eradicating polio. The US and many countries have eliminated dreaded childhood diseases like chickenpox and measles. For those who say we can’t contain COVID-19 through vaccination before the Pandemic Grinch steals any more Christmases, all we can say is that you lack the imagination and will needed here. President Biden, the ball is still in your court.