COVID-19: The Way Forward

COVID-19: The Way Forward

February 18, 2022
COVID-19: The Way Forward
Introduction
Department of Health and Human Services (HHS) agencies,
The Coronavirus Disease 2019 (COVID-19) pandemic is in
mostly as emergency supplemental appropriations. Much of
its third year. The number of new cases from the Omicron
this funding is available for multiple years and has been
variant appears to be ebbing, but the daily death toll
allocated for vaccines, treatment, tests, health care services
remains high. Domestically, a weary public hopes for a full
and supports, among other activities. As the pandemic
return to economic and civic life. Many low- and middle-
continues, Congress may consider whether remaining
income countries have limited access to COVID-19
balances are adequate, and whether and how to finance
vaccines, therapeutics, personal protective equipment
some long-term public health activities through
(PPE), and other countermeasures. Some of these countries
nonemergency means.
have correspondingly low vaccination rates, when
compared to high-income countries. At this stage of the
Select Executive Branch Actions to Address the
pandemic, it remains unclear when the crisis period,
Pandemic and Related Litigation
including factors such as level of strain on health systems,
The executive branch has undertaken numerous measures to
health workers and daily death tolls, will end. Questions
address the pandemic. Some of these actions—based on
remain about whether new variants will emerge and
certain general legal authorities Congress granted to
whether they will be more or less lethal than the currently
executive officials and agencies within specific statutory
dominant Omicron variant.
schemes—have been the subject of legal challenges. One
example is reliance on Section 361 of the Public Health
This In Focus accompanies the CRS Issues and Policy
Service Act, which authorizes the Centers for Disease
Seminar “COVID-19: The Way Forward,” in which CRS
Control and Prevention (CDC) to issue regulations
analysts and attorneys present on various aspects of U.S.
necessary to prevent the interstate spread of communicable
government domestic and global pandemic responses and
disease. The CDC issued (1) an eviction moratorium in
congressional actions and options.
September 2020 halting most residential evictions for
nonpayment of rent, and (2) a transportation mask mandate,
The U.S. COVID-19 Pandemic: A Quick Recap
effective since February 1, 2021. Relying on various
The COVID-19 pandemic has unfolded in three waves,
statutes, executive agencies and officials have also imposed
fueled by three dominant viral variants—Beta, Delta, and
several employment-based vaccination mandates. While the
Omicron—each with its own transmission and virulence
Supreme Court blocked enforcement of some of these
characteristics. At this time, the official U.S. death toll from
measures (including the eviction moratorium and a
the COVID-19 pandemic has surpassed 900,000.
vaccination-and-testing requirement for large employers) as
exceeding the relevant agency’s statutory authority, the
As the Omicron wave ebbs, policymakers are considering
Court permitted other measures to move forward (i.e., a
what the future holds, and how they can best ensure
vaccination requirement for Medicare- and Medicaid-
national readiness. Despite the desire of many to resume
certified providers and suppliers). As litigation concerning
economic and social activities, there is no biological bright
most of these measures continues, courts may provide
line to signal when normal activities might resume without
further clarification regarding the scope of relevant
levels of COVID-19 transmission that place a high burden
agencies’ and officials’ statutory authority under applicable
on health systems and impede societal functioning. Some
laws.
policy choices would seem straightforward: maintain
surveillance of the virus and its variants, and remain
Select Issues for Domestic Preparedness and
flexible in developing countermeasures such as vaccines
Response Reform
and treatments. Other policy choices are less clear in the
As hospitalizations from COVID-19 begin decreasing
face of uncertainty. These include public health control
again, stakeholders are increasingly considering whether
measures (including masking and physical distancing),
the nation’s public health emergency management system
ongoing funding, the use of emergency authorities and
needs reform. A number of nongovernmental organizations,
assistance, stabilization of the health care and public health
public health emergency management experts,
workforces, and the transition of emergency-use federally
governmental agencies, and other entities have suggested
purchased countermeasures to typical commercial products
reforms to broad areas of public health emergency
and payment systems.
management. These reforms include clarifying leadership
roles and authorities in a public health response,
Congress’s Domestic Public Health Response to
strengthening the supply-chain, promoting the development
the Pandemic: A Brief Overview
of medical countermeasures, and expanding upon domestic
Since March 2020, Congress has appropriated over $400
and international public health data systems to enhance
billion for domestic COVID-19 public health response to
real-time situational awareness, including through a “One
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COVID-19: The Way Forward
Health” approach. According to the CDC, a “One Health”
CRS In Focus IF11951, Domestic Funding for COVID-19
approach recognizes that the health of people is closely
Vaccines: An Overview
connected to health of animals and shared environments.
CRS Report R46481, COVID-19 Testing: Frequently Asked
Congress’s Global Public Health Response to the
Questions
Pandemic: A Brief Overview
Globally, the official COVID-19 death toll is roughly 6
CRS Report R46711, U.S. Public Health Service: COVID-
million; experts believe the true figure is several times
19 Supplemental Appropriations in the 116th Congress
higher. Countries began the pandemic in differing
situations, with disparities in health systems strength and
CRS Report R46834, American Rescue Plan Act of 2021
capacity, and economic position, among many other issues.
(P.L. 117-2): Public Health, Medical Supply Chain, Health
Many countries are struggling to balance public health and
Services, and Related Provisions
containment measures with societal and economic needs. In
the majority of low-income countries, access to affordable
CRS In Focus IF12050, Federal Support for Domestic
vaccines, therapeutics, and other COVID-19 mitigation
COVID-19 Test Availability
tools remain out of reach.
CRS Report R46745, State and Federal Authority to
Since March 2020, Congress has appropriated roughly $17
Mandate COVID-19 Vaccination
billion for global COVID-19 response to the United States
Agency for International Development (USAID) and CDC.
CRS Report R46861, Health Equity and Disparities During
Emergency response funds build on existing U.S. global
the COVID-19 Pandemic: Brief Overview of the Federal
health investments in pandemic preparedness and through
Role
the Global Health Security Agenda (GHSA). Funds from
emergency supplemental appropriations include $4 billion
CRS In Focus IF12013, The U.S. Government’s Role in
for Gavi, the Vaccine Alliance for U.S. membership in the
Domestic and Global COVID-19 Vaccine Supply and
Global COVID-19 Vaccines Access Facility (COVAX).
Distribution: Frequently Asked Questions
Fund have also been allocated for bilateral response
activities including to procure PPE, COVID-19 therapeutics
CRS In Focus IF11905, Liability Issues Related to COVID-
and medical countermeasures (such as medical oxygen),
19 Vaccine Manufacturing and Global Distribution
strengthen supply chains and data collection, and research
COVID-19. Funds are also being used to assist with
Sara M. Tharakan, Coordinator, Analyst in Global
development of national vaccination strategies, so that
Health and International Development
countries may successfully carry out COVID-19
Hassan Z. Sheikh, Coordinator, Analyst in Public Health
immunization campaigns and get shots into arms. As the
Emergency Management
pandemic continues, Congress may consider the balance
between domestic and global responses to the pandemic, as
Sarah A. Lister, Specialist in Public Health and
well as how to overcome challenges to U.S. foreign
Epidemiology
assistance priorities exacerbated by COVID-19, among
Kavya Sekar, Analyst in Health Policy
other issues.
Wen W. Shen, Legislative Attorney
Selected CRS Products
IF12051
CRS In Focus IF11789, COVID-19 Variants: Vaccines,
Diagnostics, and Therapeutics

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COVID-19: The Way Forward

Disclaimer
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