By Yong-Bee Lim and Bill Beaver

Over a year into the COVID-19 pandemic, significant challenges remain on how to contain and learn lessons from a disease that has infected 110 million people and contributed to almost 2.5 million deaths worldwide. Adequate testing, including the acquisition of sufficient amounts of reagents for running tests, continues to hamper efforts to contain the pandemic. Despite the development of multiple vaccines in record time, supply chain coordination issues and evolving vaccine distribution plans have hampered developed nations in vaccinating their citizens. The lion’s share of vaccines have also gone to wealthy nations, which is a major gap in addressing a global pandemic on public health, economic, and humanitarian grounds. Most recently, the emergence of multiple novel COVID-19 strains in South Africa, the UK, Brazil, and the United States raises concerns that a return to the way the world operated pre-COVID-19 is still a distant achievement.

On February 17, 2021, the Biden Administration announced three actions to address some of these challenges in the United States. They stem from the goals the Biden Administration outlined in its “National-Strategy for the COVID-19 Response and Pandemic Preparedness” in January and aim to 1) improve the availability of tests; 2) increase domestic manufacturing related to tests and testing supplies; and 3) better prepare the nation to deal with the rise of COVID-19 variants. These actions include:

• Expanding COVID-19 testing for schools and underserved communities: The Administration is asking the Department of Health and Human Services (HHS) to partner with the Department of Defense (DoD) to make a $650 million investment in expanding testing opportunities for K-8 schools and underserved congregate settings, such as homeless shelters.
• Ramping up domestic manufacturing of testing supplies and raw materials to address testing shortages: HHS and DoD will make an $815 million investment to increase the domestic manufacturing of raw supplies and test materials to help create more domestic sources, as well as expand existing facilities to increase production capacity.
• Increasing genomic sequencing of the virus: The CDC will invest $200 million to expand genomic sequencing capabilities, including bioinformatics, reporting, and modeling. The Biden Administration sees this capability as particularly important in detecting and making plans to address new variants of SARS-CoV-2.

This $1.6 billion investment is in addition to the “American Rescue Plan.” Predominantly known for extending unemployment benefits and providing a stimulus check, this plan also incorporates funding to address COVID-19 through mounting a national vaccine program, scaling up testing and tracing of current and novel SARS-CoV-2 strains, addressing supply shortage issues through domestic manufacturing initiatives, and investing in high-quality treatments. The bill text was officially released to the public on February 23, 2021. It includes the following:

• COVID-19 Vaccine Activities: A proposed $7.5 billion is appropriated to the Secretary of Health and Human Services for FY 2021 to carry out activities to plan, prepare for, promote, distribute, administer, monitor, and track COVID-19 vaccines.
• COVID-19 Testing, Contact Tracing, and Mitigation Activities: A proposed $46 billion is appropriated for FY2021 to carry out activities to detect, diagnose, trace, and monitor SARS-CoV-2 and COVID-19 infections and related strategies to mitigate the spread of COVID-19.
• SARS-COV-2 Genomic Sequencing and Surveillance: A proposed $1.75 billion is appropriated for FY2021 to increase genomic sequencing capabilities, analytics, and disease surveillance by strengthening activities and expanding the workforce.
• COVID-19 Emergency Medical Supplies Enhancement through DoD and Defense Production Act: A proposed $10 billion is appropriated (through September 30, 2025), to carry out production-related activities to combat the COVID-19 pandemic through the Defense Production Act.

The actions that the Biden Administration has taken provide strong signals that they take the threat of COVID-19 seriously. Making an additional $1.6 billion investment in testing and genomic sequencing capabilities beyond those they are pushing for in the American Rescue Plan buys greater situational awareness of a rapidly-evolving natural biological threat. This situational awareness is not only necessary to inform the steps for containing and mitigating cases of COVID-19 in the coming weeks and months. It should also inform similar actions with a broader range of tools will be required to predict, detect, mitigate, respond to, and recover from future biological events.

We will continue to follow the progress of this bill and other measures as they come, with insights and advice from CSR’s Alliance to End Biological Threats, and our broader team and advisors. Stay tuned for more.