Thread by @celinegounder

1/ @POTUS Biden's 6-point Delta plan has much of what I've been wanting to see:

Making use of the ENTIRE toolbox against COVID, including but not limited to vaccines.

Here's a summary and some comments:

whitehouse.gov/covidplan/

2/ Vaccinating the unvaccinated:
- Requiring employers with 100+ workers to ensure workers are vaxx'ed or tested weekly
- Requiring employers with 100+ workers to provide PTO to get vaxx
- Requiring vaxx for all federal workers & contractors that do business with federal gov't

3/ Vaccinating the unvaccinated (cont):
- Requiring COVID vaccination for healthcare workers at Medicare/Medicaid participating hospitals and other health care settings (e.g. dialysis centers, ambulatory surgical settings, home health agencies)

4/ Vaccinating the unvaccinated (cont):
- Calling on large entertainment venues to require proof of vaccination or testing for entry

5/ Further protection for the vaccinated:
- Boosters available starting the week of September 20th (pending FDA and CDC review).

*** This is the one part of the plan about which I have serious reservations. ***

https://twitter.com/celinegounder/status/1433812745544216576?s=20

6/ Keeping schools safely open
​- Requiring staff of Head Start programs, DOD schools, Bureau of Indian Educations schools to be vaccinated
- Calling on all states to adopt vaccine mandates for all school employees

7/ Keeping schools safely open
- Additional funding for school districts for safe reopening, including to backfill salaries and other funding withheld by states for implementing COVID safety measures
- Using DOE legal authority to protect access to in-person instruction

8/ Keeping schools safely open (continued)
- Getting students and school staff tested regularly
- Providing every resource to the FDA to support review of applications for vaccines for <12

9/ Increasing testing and requiring masking:
- Expand production of rapid & in-home tests
- Make at-home tests more affordable➡️Medicaid must cover for free to beneficiaries
- Send free, rapid, at-home tests to food banks & community health centers
- Expand free pharmacy testing

10/ Increasing testing and requiring masking (continued):
- Require masking for interstate travel and double fines
- Continue to require masking on federal property

11/ Protecting our economic recovery:
- New support for small businesses
- Streamlining PPP loan forgiveness
- Community Navigator program to connect small businesses to get help

12/ Improved care for those with COVID:
- Increasing support for COVID-burdened hospitals: DoD clinicians, VA hospital beds
- Increase availability of monoclonal antibodies and set up mAb strike teams to assist in delivering treatment

13/ What's missing?
- Just as there are pay-for-performance incentives around other health care quality measures, there should be incentives for hospitals to vaccinate patients prior to discharge.

14/ What's missing? (continued)
- Mandating vaccination for interstate travel... but it's a tough one politically & it may make more sense to start with less contentious mandates.
- If vaccination is mandated for interstate travel, vaccinations should be given at travel hubs.

15/ What's missing? (continued)
- There should also be incentives for large venues to require vaccination/testing
- There should also be incentives for states to mandate vaccination of school staff.

16/ What's missing? (continued)
- Not all school districts have been able to access American Rescue Plan funds to repair facilities & upgrade ventilation/air filtration in K-12 schools.

17/ What's missing? (continued)
- Just like the proposed strike teams for monoclonal antibodies, we need strike teams that go to school districts, assess buildings/classrooms, come up with a plan, & contract with vendors to get the work done.

18/
- Better-resourced school districts have the staffing/expertise/bandwidth to do this.
- Less well-resourced school districts do NOT have the staffing/expertise/bandwidth to do this.
- This bottleneck reinforces existing disparities.

19/ What's missing? (continued)
- A plan scale up global vaccine manufacturing to vaccinate the world.

20/ I do not think the data supports giving additional doses of vaccine to the general population... only to highly immunocompromised persons, the elderly, and nursing home residents at this time:
theatlantic.com/ideas/archive/…
nytimes.com/2021/08/09/opi…

21/ Big picture, this is a very strong plan to optimize use of all the tools at our disposal:
- Vaccines
- Masks
- Testing
- Ventilation and air filtration
- Hospital staffing
- Economic support for small businesses