Thread by @AndrewMakeTweet

Cases are surging.
10,000+ people are dying each week.
Thousands of people are developing long COVID.
Schools and businesses disrupted.

We needed a course correction.

Instead it's another round of too little, too late from @POTUS @WhiteHouse @WHCOS @CDCDirector. 🧵

The vaccine-focused approach of the last 8 months has failed.

It overly focused on vaccines to control spread and stop severe illness. It ignored and relaxed NPI (non-pharmaceutical interventions) policies e.g. mask mandates, venue restrictions, and contact tracing.

Vaccine policy has been inadequate.

First inequitably delivered, then with wide availability with little attention to needed outreach and supports, and now with mandates that coerce and divide. This approach has not succeeded in reaching the 85-90% needed for herd immunity.

Meanwhile, we sat on the sidelines (and withheld vaccine access globally) as rampant spread occurred worldwide, leading to the Delta variant.

Now with Delta's increased infectiousness and deadliness, our waning behaviors and policies, and inadequate vaccination rates, we're hit hard with a Delta surge that risks 100,000+ deaths, tens of thousands with long COVID, and disrupted learning and business.

We needed action many weeks ago. The first issue is why is this happening on September 9th?

The writing was on the wall.

We lost the critical window for tens of thousands of people who lost their lives and to make schools safe.

https://twitter.com/AndrewMakeTweet/status/1418167728817512449

But fine. They're acting too late, but they could still have corrected course to halt the current surge in its tracks and to prevent future surges while maximizing vaccination.

To do that we needed these 13 things:

https://twitter.com/AndrewMakeTweet/status/1435936809708625923

What are we getting instead?

Here's the full plan so you can read it yourself.

It includes...

whitehouse.gov/covidplan/

– OSHA rule requiring vaccination for large employers (with testing opt-out)
– Federal worker vaccine mandate (ending testing opt-out)
– Vaccine mandates for settings receiving Medicaid/Medicare payments
– Suggesting (not requiring) vaccine passports (or testing) for large events

Vaccine mandates are net good (not my preferred policy but they do help).

But:
– absolutely numbers affected are unclear, very unlikely to get us to herd immunity
– testing opt-outs are non-sense
– likely will face legal challenges from governors and corporations

One very good rule:

OSHA rule for paid time off to get vaccinated and for side effects.

But only for large companies and again will face legal issues.

– Federal (pre)schools will have vaccine mandates
– Suggesting to states they enact school vaccine mandates for employees
– (nothing new) reiterating there's funds from American Rescue Plan for safe schools
– Investigating if state mask mandates bans violate disability rights

and...
– (nothing new) reaffirming that there is some money for screening testing in schools

These do not discuss ventilation or move the needle on widespread undermasking in schools.

– (excellent!) using Defense Production Act to ensure more at-home/rapid tests
– Public-private partnership selling rapid tests at-cost for 3 months, at most 35% off
– (good) Free rapid tests given at community clinics and food banks
– Expansion of pharmacy-based testing

This all is fine, but there's nothing here on ensuring testing access or time to results for PCR testing, nothing on contact tracing or quarantine guidance to ensure testing helps control spread.

– (no change) reaffirming federal property mask mandate and interstate mask mandate
– increasing the fine for interstate travel mask mandate (which by all reports is horribly enforced)

Masks are essential and this is utterly inadequate federal action.

Should have done a national mask mandate and, given legal vulnerability of such a move, concurrently changed CDC guidance from mask guidance for individuals to *mask mandate* guidance for state/local gov.

That's it on the "stop spread" front and it is woefully inadequate.

The omissions here are crucial, a policy approach of mass death by neglect, specifically...

The @POTUS @WhiteHouse @WHCOS @CDCDirector plan is missing these 13 items:
1) messaging, guidance, regulations on high risk venues
2) implementation of OSHA safety standards for all workers re: PPE or ventilation
3) shifting from *mask* to *mask mandate* messaging/guidelines

4) improving vaccine outreach with more attention/funding for community health workers, and community orgs
5) improving vaccine supports to include cash payments and, for businesses with <100 employees, paid leave

6) policies to spur ventilation/filtration system changes for schools, businesses, and public settings
7) expanding (and countering the shrinking of) contact tracing system, and improving them to be less like call centers, more like trusted community outreach

8) using tools (patent waiver vote at WTO, diplomacy for other countries' patent waiver votes, compelling sharing of production tech) to end global vaccine shortages driving variants
9) reducing forced congregate living in prisons/shelters

10) owning the need for communications from WH/CDC that are more clear, honest, nuanced, urgent, frequent, and timely
11) promising to act quickly and appropriately in the future (unlike this set of actions that are 7 weeks late, and inadequate)

12) countering the narrative and policies of magic bullets, explaining need for a "full toolkit" approach
13) explaining that the vaccine-only approach has failed, and that we need to seriously discuss new moment & strategy to control and, where possible, eliminate transmission.