On Jan. 21, President Biden issued additional executive orders and directives instructing various federal agencies to take specific actions to address the COVID-19 pandemic, including expanding testing and vaccination capacity, increasing personal protective equipment (PPE) and other necessary materials to combat the pandemic, slowing the spread of COVID-19, and addressing inequitable outcomes.
Below is a summary of key details from the various orders and directives.
Improve the Supply Chain: Given the continuing shortfalls of PPE, vaccination supplies, and testing materials, the President issued an executive order directing key agencies to use their authorities — including the Defense Production Act — to accelerate the manufacture and delivery of supplies to respond to the pandemic. The President’s COVID-19 response strategy specifically identifies these as focus items: N95 masks, isolation gowns, nitrile gloves, PCR sample collection swabs, test reagents, pipette tips, PCR testing equipment, high-absorbency foam swabs, material for rapid antigen tests, rapid test kits, and all the material necessary manufacture and administer vaccine supplies.
The order also instructs the Secretaries of Defense, Health and Human Services (HHS), and Homeland Security to provide recommendations for how to address the pricing of pandemic response supplies. This includes the potential use of the General Services Administration schedules to facilitate state, local, tribal, and territorial government buyers and compacts in purchasing pandemic response supplies using federal supply schedules.
Increase Federal Emergency Supplies and Personnel: The President instructed the Federal Emergency Management Agency (FEMA) to increase federal reimbursement to states and tribal governments from 75% to 100% of the cost of National Guard personnel and emergency supplies. Additionally, the President’s COVID-19 response strategy states that FEMA will establish 100 federally supported community vaccination centers by the end of February. The Centers for Disease Control and Prevention (CDC) has also been instructed to launch a federal program that will make vaccines available to communities via local pharmacies.
Expand Access to Testing, Treatment, and Care: The President creates a COVID-19 Pandemic Testing Board. The board is responsible for increasing testing capacity by developing strategies to procure more tests and expand manufacturing capacity. This order also expands the public health workforce, supports screening for schools, and ensures that priority populations have access to testing. This executive order also instructs the secretaries of HHS, Treasury, and Labor to – within the confines of current law – facilitate free COVID-19 testing for the uninsured and clarify health insurers’ obligation to provide coverage for testing.
A separate executive order directs research studies to identify COVID-19 treatments. It specifically requires the development of a plan to support research in rural hospitals and rural care locations and include populations that have historically been underrepresented in clinical trials. HHS is also tasked with identifying barriers to increasing the use of existing COVID-19 treatments and work with state and local governments to overcome those barriers.
The order also instructs the secretaries of Defense, HHS, and Veterans Affairs to provide targeted surge assistance to nursing homes, skilled-nursing facilities, assisted living facilities, intermediate care facilities for individuals with disabilities, and residential treatment facilities to reduce the spread of COVID-19. To address workforce issues, HHS is directed to present recommendations on how states and providers can increase workforce capacity to address the pandemic.
Finally, the order instructs HHS to take steps to promote access to and coverage of COVID-19 treatments and clinical care for those who are insured by Medicare, Medicaid, and commercial coverage and improve the accessibility of the COVID-19 Uninsured Program for both patients and providers.
Enhance Data Collection and Reporting: The various federal agencies are instructed to enhance data collection, analysis, and dissemination by working with state, local, tribal, and territorial governments. The President’s COVID-19 Response Strategy emphasizes tracking a range of performance measures, including cases, testing, vaccinations, and hospital admissions. Real-time information will be made available to the public and to policy makers at the federal, state, and local levels.
Protect Workers and Travelers from COVID-19: The President signed an executive order instructing the Occupational Safety and Health Administration (OSHA) to issue revised, science-based guidance intended to help employers keep workers safe from COVID-19 exposure. Additionally, OSHA is asked to determine whether to establish emergency temporary standards on COVID-19 (including masking in the workplace) and issue them by March 15, 2021, if necessary. The order also instructs OSHA to launch a national program to focus enforcement efforts on violations that put the largest numbers of workers at serious risk.
Following the President’s Jan. 20 executive order mandating mask wearing by federal employees and on federal property, a separate order issued on Jan. 21 requires mask wearing in airports and on trains, commercial aircraft, and intercity buses. It also requires international travelers to produce proof of a negative COVID-19 test prior to departure for the U.S. and comply with CDC guidance on self-quarantine upon arrival.
Advance Health Equity: The President issued an executive order creating a Health Equity Taskforce. The task force will provide recommendations for mitigating the health inequities caused or exacerbated by the pandemic and for preventing them in the future. This includes recommendations for allocating resources and relief funding to communities that have experienced inequitable COVID-19 outcomes. The order also directs HHS to provide recommendations to state and local leaders on how to facilitate the placement of contact tracers in communities that have been hardest hit by the pandemic, recruit workers from those communities, and connect them to workforce training programs.