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COVID-19: President’s Plan, Infection Control Guidance

President Joe Biden on Sept. 9 announced “Path out of the Pandemic,” a six-pronged plan to combat COVID-19 amid the rise of the delta variant.

The plan includes action steps for increasing vaccinations, further protecting those who are vaccinated, keeping schools open, testing and mask requirements, and economic recovery.

Vaccinating the Unvaccinated

Under the plan, companies with 100 or more employees must require proof of vaccination or negative weekly testing from employees. Employers must provide paid time off for workers to get vaccinated or recover from vaccine side effects.

The Department of Labor’s Occupational Safety and Health Administration (OSHA) plans to issue an emergency temporary standard (ETS) to implement these requirements. OSHA currently has in place an ETS for occupational exposure to COVID-19, on which America’s Essential Hospitals commented in August.

Notably, the Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) will require COVID-19 vaccination of health care facility staff as a condition of participation in Medicare and Medicaid. The mandate, previously for nursing homes, now expands to hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies. CMS will issue an interim final rule with comment period in October.

Biden also signed an executive order requiring all federal government executive branch employees and contractors to be vaccinated and called on large entertainment venues to require proof of vaccination or testing for entry.

Further Protecting the Vaccinated

The administration pledges to make vaccine booster shots available Sept. 20. Vaccine sites will be available on vaccines.gov or by calling 1.800.232.0233.

Keeping Schools Safely Open

Regarding keeping schools safely open, the administration:

  • mandates vaccination in schools operated by Head Start, the Department of Defense, and the Bureau of Indian Education;
  • calls on states to mandate vaccines for school employees;
  • provides funding to school districts for safe reopening;
  • calls on schools to set up regular testing congruent with CDC guidance; and
  • pledges support to the Food and Drug Administration for swift review of a vaccine for children under 12.

The administration also pledges to use Department of Education authority to investigate laws prohibiting mask mandates in schools in Iowa, Oklahoma, South Carolina, Tennessee, and Utah.

Increasing Testing and Requiring Masking

To expand access to COVID-19 tests, the administration has acquired 280 million rapid point-of-care and over-the-counter at-home tests and will authorize the Defense Production Act to support production. The administration will provide 25 million at-home rapid tests to community health centers and food banks and will expand to 10,000 the number of retail pharmacy sites offering free testing. Walmart, Amazon, and Kroger will sell rapid at-home tests at cost — up to 35 percent less than typical retail price — for the next three months. Medicaid also will cover at-home tests for free for beneficiaries. The administration will continue requiring masks on federal property and will double the fines for not masking during interstate travel.

Protecting our Economic Recovery

The plan strengthens the COVID-19 Economic Injury Disaster Loan program and streamlines the Paycheck Protection Program loan forgiveness process. The administration this fall will select trusted community partners in underserved areas to serve as Small Business Administration Community Navigators, who will connect business owners to federal, state, and local resources.

Improving Care for Those with COVID-19

The Department of Defense will double the number of clinician teams deployed to support hospitals battling a surge in COVID-19 cases. The administration will increase by 50 percent the weekly distribution of free monoclonal antibody treatment to states. The Department of Health and Human Services (HHS) has amended the Public Readiness and Emergency Preparedness Act Declaration to allow licensed pharmacists, pharmacy technicians, and pharmacy interns to administer monoclonal antibody therapeutics.

HHS Alters Monoclonal Antibody Distribution

As the delta variant causes a surge in the use of monoclonal antibody drugs in areas with low vaccination rates, HHS returns to a state- and territory-controlled monoclonal antibody distribution system similar to that used from November 2020 to February 2021.

Effective Sept. 13, antibody administration sites no longer will order directly from AmerisourceBergen. HHS will determine weekly distribution amounts for each state or territory based on COVID-19 case and hospitalization reports, as well as inventory and use data submitted in HHSProtect. State and territorial health departments then will identify which sites in their jurisdictions receive monoclonal antibodies and the amount each site receives.

For questions, contact the federal COVID-19 response team at COVID19therapeutics@hhs.gov.

CDC Updates Health Care Infection Prevention and Control Guidance

CDC updated its Infection Control Guidance for Healthcare Professionals about Coronavirus (COVID-19) to streamline guidance documents for specific health care settings into one infection prevention and control (IPC) guidance document.

Notably, health care facilities should continue following IPC recommendations for unvaccinated individuals, including transmission-based precautions for those who have had close contact with people infected with SARS-CoV-2, when caring for fully vaccinated individuals who have moderate to severe immunocompromise due to a medical condition or immunosuppressive treatments.

Fully vaccinated health care personnel should continue to wear masks in areas of the health care facility where they could encounter patients, including hallways and the hospital cafeteria. They may choose not to wear masks or physically distance when they are in well-defined areas restricted from patient access, such as staff meeting rooms or a kitchen.

Visit the America’s Essential Hospitals coronavirus resource page for more information about the pandemic.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Emily Schweich is a senior communications associate for America's Essential Hospitals.

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