Former Biden Advisers Urge Change in National COVID Strategy

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Medical experts who belonged to President Biden’s transition team are calling for a new national COVID-19 strategy that accepts “the new normal” of living with the virus for the foreseeable future.

Since wiping out the virus doesn’t appear to be realistic, the former advisers urged the setting of benchmarks that would trigger the enforcement or relaxation of public health restrictions, the health experts wrote in the journal JAMA. The benchmarks might include a certain number of COVID-related hospitalizations or deaths.

“The goal for the ‘new normal’ with COVID-19 does not include eradication or elimination … the ‘zero COVID’ strategy,” they wrote. “Neither COVID-19 vaccination nor infection appear to confer lifelong immunity. Current vaccines do not offer sterilizing immunity against SARS-CoV-2 infection.”

The health experts also urge more vaccine mandates, more vaccinations for children, an increase in free home testing, distribution of free N95 and KN95 masks, and improved air filtration systems in public buildings such as schools.

The six former advisers helped Biden put together his medical policies before he took office but aren’t working for the White House now. They made their new recommendations in three opinion pieces published in JAMA. One piece urges a whole new national strategy, while the other pieces call for improvements and wider distribution of testing, surveillance, vaccines, and therapeutics.

Health experts resorted to publishing the opinion pieces because they weren’t making progress in talking to the White House, according toThe New York Times.

“From a macroperspective, it feels like we are always fighting yesterday’s crisis and not necessarily thinking what needs to be done today to prepare us for what comes next,” Luciana Borio, MD, a former acting chief scientist at the FDA, told the Times.

The experts showed the opinion pieces to the White House before publication, the newspaper reported. Anthony Fauci, MD, the chief White House medical adviser, declined to comment.

When queried about the pieces by reporters, Jen Psaki, the White House press secretary, dismissed a question about whether the president “is coming around to accepting” that COVID-19 is here to stay.

The authors emphasized that the unpredictability of the coronavirus requires “humility” in policymakers.

Last July, when vaccinations were rising and infection rates were falling, Biden said that “we’ve gained the upper hand against this virus” while the CDC relaxed its guidance for mask wearing and socializing, the opinion piece on national strategy said.

“By September, the Delta variant proved these steps to be premature, and by late November, the Omicron variant created concern about a perpetual state of emergency,” the authors wrote.

One piece urged health organizations to change their statistical categories and focus on “the aggregate risk of all respiratory virus infections,” including COVID, influenza, and pneumonia, they wrote. The government should also establish a digital vaccination verification system so that showing paper vaccine cards would not be needed, the authors recommended.

The other experts were David Michaels, MD, a former head of the Occupational Safety and Health Administration now with George Washington University’s School of Public Health; Michael T. Osterholm, PhD, an epidemiologist at the University of Minnesota; Celine Gounder, MD, an infectious disease expert at New York University; Ezekiel Emanuel, MD, an oncologist, bioethicist, and senior fellow at the Center for American Progress; and Rick Bright, PhD, chief executive of the Rockefeller Foundation’s Pandemic Prevention Institute.

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