President Biden will announce Thursday that the more than 150 million Americans with private health coverage will be able to get at-home coronavirus tests reimbursed by their insurers, and that international travelers must show proof of a negative coronavirus test taken the day before departing for the United States.
The moves are part of a new winter strategy to combat the coronavirus pandemic just as the worrisome new Omicron variant circles the globe.
Senior administration officials, speaking on condition of anonymity to preview the president’s strategy, said the administration would also distribute an additional 25 million at-home tests to community health centers and rural clinics to make them more available to those who are not covered by private insurers, including Medicaid recipients.
Additionally, Mr. Biden will call on employers to provide paid time off to their employees to get boosted. And the administration plans “a new effort to launch hundreds of vaccination clinics around the country,” according to a fact sheet provided by the White House.
The Biden administration has relied heavily on vaccination as a strategy to end the pandemic — too heavily, in the view of some experts, who have been saying for months that testing and mask-wearing are also essential to containing spread of the virus, and will become even more so if the Omicron variant escapes protection from vaccines.
The variant, first spotted by scientists in southern Africa but now present in more than 30 countries including the United States, has mutations that scientists say may allow it to spread more quickly and cause more breakthrough infections in vaccinated or previously infected people, though neither characteristic has yet been confirmed.
In the United States, coronavirus tests have been hard to come by because of supply shortages, and they are expensive — as much as $25 apiece. Dr. Carlos del Rio, an infectious disease specialist at Emory University, said that rather than have people go through the cumbersome process of seeking insurer reimbursement for tests, “we should just subsidize them and make it incredibly cheap.”
In Britain, he noted, rapid tests are free, and in Germany they cost about $1.
The reimbursement will not happen immediately, and it will not be retroactive, the senior officials said, adding that three federal agencies — the Departments of Health and Human Services; Labor; and the Treasury — would issue guidance by Jan. 15 to clarify that insurers would have to reimburse people for at home tests during the Covid-19 public health emergency. It was unclear how many tests people would be able to buy.
Private insurers already cover coronavirus tests administered in doctor’s offices and other medical facilities. But there are now at least eight at-home tests on the U.S. market.
Looking forward, experts envision a world where people will test themselves as soon as they exhibit symptoms — and then, if they are positive, quarantine and seek treatment with new antiviral medicines that are in the development pipeline. The White House says it is taking steps to secure 13 million courses of antiviral treatments.
Mr. Biden’s new strategy will extend the current mask mandate for airplanes, trains, buses and transit hubs until mid-March.
Only six states require people to wear masks indoors regardless of their vaccination status. Three more — California, New York and Connecticut — require indoor masking for people who are unvaccinated.
As officials scrambled to contain alarm over the detection of a case of the Omicron variant in California, state leaders portrayed the finding as an encouraging — and inevitable — result of the state’s efforts to be prepared.
“This was predictable,” said Gov. Gavin Newsom, speaking at a news conference on Wednesday in the Central Valley, where he encouraged residents to get vaccinated and get booster shots. “And it was not surprising that the state of California detected it.”
State health officials said the discovery of the Omicron variant — in a traveler who returned to California from South Africa on Nov. 22 — would prompt increased Covid-19 testing at California airports, focusing on arrivals from countries identified by the Centers for Disease Control and Prevention as potential sources of the variant.
However, Mr. Newsom — who beat back a recall effort in September that was fueled in part by resistance to the state’s pandemic health restrictions — suggested that for now at least, the state would not tighten public health rules or close schools.
Mr. Newsom said there were “no indications” that such restrictions would be needed “as long as we continue our nation-leading efforts.”
State officials had said it would be only a matter of time until the Omicron variant appeared on the West Coast. California is a first U.S. stop or a destination for millions of global travelers, and as recently as Sunday, the state’s Department of Public Health had said that officials were monitoring for signs that the variant had arrived.
Mr. Newsom said the infected patient — a fully vaccinated resident of San Francisco between the ages of 18 and 49 — had been tested after traveling to South Africa, the region where the variant was first detected.
The patient, he said, had landed in California on Nov. 22, developed Covid-19 symptoms three days later and was tested on Nov. 28. The variant was confirmed by scientists at the University of California, San Francisco, the next day.
San Francisco public health officials said the individual was self-isolating, experiencing mild symptoms and assisting with contact tracing. The person had received two doses of the Moderna vaccine but was within the six-month window and had thus not received a booster, Mr. Newsom said.
The governor said the state has partnered with top scientists at the University of California, San Francisco, to sequence Covid-19 cases, built up testing and succeeded in vaccinating many of its residents.
Dr. Mark Ghaly, the state’s secretary of health and human services, went so far as to say that Californians were “proud” to have identified the Omicron case.
Almost 80 percent of California residents have gotten at least one dose of the vaccine, after months of campaigning by state officials. Cases and hospitalizations have been inching mostly downward since a summer rise driven by the Delta variant — though hospitals in areas like the Central Valley, where fewer residents are vaccinated, have filled.
In San Francisco, officials sought to reassure residents.
“San Francisco has one of the highest vaccination rates and lowest death rates in the country because of the actions our residents have taken from the beginning of this pandemic to keep each other safe,” Mayor London N. Breed said in a statement. “We knew that it was only a matter of time until the Omicron variant was detected in our city, and the work that we have done to this point has prepared us to handle this variant.”
In the Bay Area, longstanding mask mandates — some of the state’s most enduring restrictions — have recently been relaxed as the spread of the virus has slowed. Local governments in the Bay Area and in other parts of the state have begun to require businesses to verify vaccination status for entry, and more workers have been required to get their shots — a trend that officials have credited with helping to curtail the transmission of Covid.
When the United Nations made its last appeal for humanitarian aid funding before the pandemic, it asked donors for about $29 billion. But in the past year alone, there has been a huge jump in the number of people needing help. And so the United Nations is asking for more aid — $41 billion.
As the pandemic enters a third year, and the toll of conflicts and climate change rise, the United Nations said on Thursday that it needed to help 183 million people in 63 countries who are suffering the consequences. That compared with 100 million people at the time of the last appeal, in 2019.
More than 1 percent of the world’s population are now displaced by conflicts and disasters, Martin Griffiths, the United Nations emergency relief coordinator, told reporters in Geneva in announcing the organization’s 2022 funding drive. About 45 million people now face famine, some as a result of climate change.
The pandemic has already forced 20 million people into extreme poverty, he said, citing World Bank estimates, and the new Omicron variant would further ratchet up the economic damage. “With Covid continuing to threaten us and continuing to mutate, we will continue to see increased humanitarian needs,” he said.
New York City went from being an epicenter of the coronavirus outbreak early in the pandemic to now having a higher percentage of vaccinated residents than the national average. Today, the city is bracing for the arrival of the Omicron variant, which was just detected in California.
“We do anticipate detecting Omicron in New York in the coming days,” the city’s health commissioner, Dr. Dave Chokshi, said on Monday.
Three variants have already been detected in New York City so far this year — Iota, Alpha and Delta. Each new variant provoked worry, but ultimately, proved less devastating than anticipated, thanks, in part, to New York’s relatively high rate of vaccination. About 77 percent of residents have received at least one shot.
Considerable levels of natural immunity from the devastation of the first wave in spring 2020, widespread mask-wearing and robust testing were also factors.
“I think we are potentially more prepared than most,” said Dr. Bernard Camins, an infectious diseases specialist and medical director of infection prevention for the Mount Sinai Health System. “The question is whether at this point people are more fatigued from all those mitigation strategies, and they may not listen.”
New York City’s approach has been to focus on vaccines and boosters.
When asked by a reporter on Monday why he was recommending, rather than mandating, mask-wearing until more is known about Omicron, the mayor said, “What we do not want to do is mix messages about what’s the thing that actually has the most profound impact.”
He added: “The thing that we need to do with urgency is get people vaccinated.”
Elad Maor initially feared that he might have exposed hundreds of people to the virus when he became the first Israeli to test positive for the new Omicron variant on Saturday morning.
In the three days before his positive results, Dr. Maor, a cardiologist, had attended a large staff meeting at his hospital east of Tel Aviv. He had inserted stents into the arteries of 10 patients. And he had driven to a cardiology conference north of Tel Aviv, sharing the 90-minute car journey with a 70-year-old colleague, and lunched there with five others in a crowded canteen.
Dr. Maor, 45, had attended a piano recital with dozens in the audience, where his 13-year-old played a short piece by Stephen Heller, a Hungarian composer. And finally, last Friday night, Dr. Maor had eaten sea bass at the home of his in-laws, together with his wife and nine other family members.
But of these many people, most of whom had received three shots of the Pfizer-BioNTech vaccine, only his 70-year-old colleague has so far tested positive for the Omicron variant in the five days since.
That number may yet rise, as the virus can take several days to show up in tests, and not every contact has been tested. But at least 50 people have already been screened with a P.C.R. test by Dr. Maor’s hospital, the Sheba Medical Center, and at least 10 of those have been tested at least three times.
These initial results have led the infectious disease experts at Sheba, which houses one of Israel’s leading coronavirus laboratories, to cautiously hope that people who have been vaccinated three times may not be as vulnerable to Omicron as was first feared.
Though Dr. Maor met with many people last week, almost all of them were health care workers or close family members. And the people he had spent the most time with were fully vaccinated and had even recently had a third “booster” shot.
It is important not to extrapolate too much from isolated cases, said Prof. Gili Regev-Yochay, director of the infectious disease epidemiology unit at Sheba, who has helped lead research into the virus. “But this does tell us that, in some cases, Omicron is not as infectious if you’re vaccinated,” Professor Regev-Yochay said. “And I think that’s a major thing.”
To Dr. Maor, who was still in isolation at home on Wednesday night, it was still concerning that he had been hit so hard by the virus, despite being fully vaccinated himself, and despite being a fit nonsmoker without any chronic medical conditions. The cardiologist spent Saturday and Sunday in bed with a fever, sore throat and aching muscles — and only began to feel considerably better on Wednesday afternoon.
“Despite everything, despite the vaccines and the booster, I was in bed for 48 hours,” Dr. Maor said in a phone interview. “If I didn’t have the vaccine, I probably would have ended up in the hospital.”
To Professor Regev-Yochay, the coronavirus expert, her colleague’s experience highlighted the need for travelers to keep testing themselves and avoid busy places for a few extra days after arriving from a country with high infection rates.
Dr. Maor arrived back last Wednesday from London, where he had attended another crowded cardiology conference. Because he had tested negative twice in London, and a third time on arrival back in Israel, he had thought he was safe to operate as normal. But his experience highlighted how the virus may not show up in tests for several days.
That shows that ideally, each new arrival to the country would be tested every morning for at least five days after they land, said Professor Regev-Yochay.
“People should be cautious,” she said. “Every day on a daily basis.”
Source: NYT > Top Stories