The strategy is supposed to help the nation transition to what some are calling a “new normal,” but it will require funding from Congress.WASHINGTON — The White House unveiled its long-awaited new coronavirus response strategy on Wednesday, aimed at turning the corner on the worst public health crisis in a century while also preparing for the next threat.The plan, meant to help the United States transition to what some are calling a “new normal,” has four main goals: protecting against and treating Covid-19; preparing for new variants; avoiding shutdowns; and fighting the virus abroad.But there is a big hitch: Much of the plan requires funding from Congress. The administration recently told congressional officials it could need as much as $30 billion to sustain the pandemic response. One outside adviser to the White House, Dr. Ezekiel Emanuel, said in an interview that the United States needed to spend much more — on the order of $100 billion over the next year, and billions more after that — to be fully prepared.“Congress has to think of this as an investment in biosecurity for the country,” said Dr. Emanuel, who led a team of experts in developing a far-reaching coronavirus response plan that it shared with the White House. “We should not be penny-wise and dollar-foolish.”The strategy comes on the heels of the president’s State of the Union address on Tuesday night and as new U.S. cases decline, though deaths remain high. President Biden used the speech to spotlight a key component: a new “test to treat” initiative that he said would allow Americans to get tested at a pharmacy and, if they are positive, “receive antiviral pills on the spot at no cost.”Many of the other initiatives in the strategy — including a plan to accelerate research so that vaccines can be developed and deployed within 100 days of variants arising, which was announced in November — are not new. But taken together, they amount to a blueprint for the next phase of the response.“Make no mistake, President Biden will not accept just ‘living with Covid’ any more than we accept ‘living with’ cancer, Alzheimer’s or AIDS,” the plan declares. “We will continue our work to stop the spread of the virus, blunt its impact on those who get infected, and deploy new treatments to dramatically reduce the occurrence of severe Covid-19 disease and deaths.”The health secretary, Xavier Becerra, who has been criticized for keeping too low of a profile, made a rare appearance on Wednesday alongside the health officials who hold the weekly White House briefings.Mr. Becerra highlighted another element of the plan: boosting research into long Covid, the long-term symptoms some people experience after infection. He pledged to open “new centers of excellence” around the country to provide high-quality care to long-Covid patients — which will also require congressional buy-in.A bipartisan group, led by two former governors, has been pressing Mr. Biden to do more for tens of thousands of children in the United States who have lost parents or caregivers to Covid-19, and the White House apparently listened. The plan says the president will direct federal agencies to review their programs to formulate a more coordinated “bereavement response” for such children, who now number around 200,000.“This is all part of our commitment to be there for Americans who have long-term physical and mental health needs caused by Covid,” Mr. Becerra said.The idea behind the strategy is to get the nation out of crisis mode and to a place, Mr. Biden has said, where the virus will no longer disrupt everyday life. It includes a pledge for the administration to work with Congress to “give schools and businesses guidance, tests and supplies to stay open, including tools to improve ventilation and air filtration.”In interviews, experts generally praised the plan as a good step forward. Dr. Rick Bright, the chief executive of the Rockefeller Foundation’s Pandemic Prevention Institute, called it a “great start,” adding that the plan should “serve as a firm foundation to build upon, to extend our preparedness posture beyond Covid.”But Jay A. Winsten, the director of the Harvard Initiative on Media Strategies for Public Health, said the 100-day timeline for vaccine development might not be fast enough for a highly transmissible variant like Omicron. The first Omicron sample was collected in South Africa on Nov. 8, he said; the United States reached the peak of the Omicron wave just 67 days later, on Jan. 14.Mr. Biden came into office more than a year ago with a 200-page plan to combat the pandemic, which was the most pressing challenge in his nascent presidency. But a lot has changed since then.The Coronavirus Pandemic: Key Things to KnowCard 1 of 3A new U.S. strategy.

The White House, intensifying its efforts to develop a new coronavirus strategy, is evaluating a blueprint by outside experts whose recommendations include stronger air filtration systems in public buildings, billions of dollars in research and a major upgrade to the nation’s public health system.The team of more than two dozen experts was led by Dr. Ezekiel Emanuel, a University of Pennsylvania bioethicist who advised President Biden’s transition team. The group includes former federal officials who have served presidents of both parties. They have spent much of this week meeting behind closed doors with government scientists and top health officials.The New York Times obtained a draft copy of their 136-page plan from a person involved in the sessions, who said the White House has asked the Emanuel team to provide cost estimates for some of its recommendations.Entitled “Getting to and Sustaining the Next Normal: A Roadmap for Living With Covid,” the plan strikes the same “Things are getting better but we’re not out of the woods yet” tone that the president himself has adopted in recent weeks. It provides a guide for bringing the nation out of crisis mode at a time when, the authors write, the United States is still “far from a normal situation.”“The mood of the American public, the demands of the economy and society, and the challenges posed by a virus that constantly surprises the experts pose new and unique challenges,” the authors wrote. “Trying to eliminate Covid is not realistic. Instead, the nation must plan to mitigate its effects, prepare for variants, and build towards a next normal.”White House officials emphasized that Mr. Biden’s coronavirus response team has been engaged for weeks in discussions with governors, business leaders and health experts on how to revise its strategy for the next phase of the pandemic.Dr. Emanuel’s team settled on 10 broad recommendations. Its report assumes that there will be fewer deaths from Covid-19 in 2022 than in 2021 and calls for the federal government to develop key indicators that community health officials can use to decide when to impose or ease emergency measures like masking and social distancing.“Economists determine the health of the economy using multiple indicators, primarily unemployment, inflation, and GDP growth,” the authors write. “Similarly, a dashboard for respiratory viral illnesses will be composed of several critical metrics.”The authors also call on the government to start a new research initiative, modeled on the Trump Administration’s Operation Warp Speed, to develop new and more effective therapeutics and vaccines that might work against all coronavirus variants.They want the Environmental Protection Agency to develop new air quality standards to prevent viral transmission indoors, a stronger scientific response to “long Covid,” new regulations to make it easier for health care providers to conduct virtual visits, and initiatives to improve safety in schools and workplaces.“From now on, the nation must do far more to avoid closing schools,” the authors wrote.

President Biden has made “harm reduction” a central pillar of his plan to fight a record number of drug-related deaths, but a conservative backlash is threatening the effort.WASHINGTON — President Biden came into office vowing to make “harm reduction” — a public health approach geared toward helping drug users stay safe rather than abstain — a central pillar of his drug policy agenda, at a time when illicit fentanyl has driven a surge in overdose deaths.Instead, his strategy is in danger of being derailed by a Washington drama over “crack pipes” that is more about political gamesmanship than public health. The clash is a revival of decades-old fights over clean needle exchange programs that addiction experts hoped had finally been laid to rest.Lawmakers of both parties introduced legislation last week to bar federal funding for “drug paraphernalia” in response to a story in the Washington Free Beacon, a conservative website, asserting that federally funded addiction treatment programs would distribute pipes for smoking crack cocaine as part of “safe smoking kits.” In response, the White House said tax dollars would not be spent on pipes.But with the Beacon story ricocheting around the conservative ecosystem — amplified by Republican including Senators Tom Cotton of Arkansas and Ted Cruz of Texas — Congress is pursuing plans not only to bar federal funding for “crack pipes,” but to impose restrictions on a new program that would have, for the first time, allowed federal funds to be spent on sterile needles for “syringe services” programs.Multiple studies have shown that distributing new syringes to drug users reduces the spread of blood borne diseases among drug users, including H.I.V., hepatitis C and lethal heart infections. The programs also provide naloxone, the overdose-reversing drug, and connect drug users to treatment and other resources.Some harm reduction programs do include sterile pipes — which are used for smoking methamphetamine and fentanyl as well as crack cocaine — in such kits, with the intent of preventing infectious disease or injury in drug users who might otherwise rely on contaminated paraphernalia. Harm reduction workers often try to steer users toward smoking rather than injecting, which poses a higher risk of infection and overdose.But there is no evidence that the Biden administration intended to pay for distribution of pipes. Nonpartisan fact checkers have debunked the claim.“This is tragic — we’ve gone full circle,” said Donna E. Shalala, who fought — and lost — a battle to get federal funding for needle exchange programs in the 1990s, when she was President Bill Clinton’s health secretary. Harm reduction, she added, “is a respectable, important strategy.”Yet even now, decades into a pervasive opioid epidemic that has led to hundreds of thousands of overdose deaths from prescription painkillers, heroin and synthetic fentanyl, which now also frequently turns up in stimulants like methamphetamine and cocaine — and many more from infectious diseases stemming from drug use — addiction experts say the backlash is not entirely surprising.As Regina LaBelle, an addiction policy expert at Georgetown University and the architect of Mr. Biden’s harm reduction policy, said in an interview: “We knew it wasn’t going to be easy.”Roughly 100,000 Americans died last year from drug overdoses, according to preliminary data from the Centers for Disease Control and Prevention — a record number that has more than doubled since 2015.Emergency personnel responded to a call in 2020 for a drug overdose in Paterson, N.J.Chang W. Lee/The New York TimesThe crack pipe fracas arrived just as experts thought they were making progress in getting politicians, including conservative Republicans, to accept harm reduction as a valid strategy. A case in point is former Vice President Mike Pence.In 2015, when Mr. Pence was the governor of Indiana, H.I.V. was spreading with terrifying speed among intravenous drug users in Scott County, a rural pocket of the state. Local, state and federal health officials were urging Mr. Pence to allow clean needles to be distributed to slow the outbreak, but Indiana law made it illegal to possess a syringe without a prescription.Mr. Pence, a steadfast conservative, was morally opposed to syringe exchanges on the grounds that they enabled drug abuse. But when the county sheriff urged him to allow the programs, Mr. Pence prayed about it — then signed an executive order doing so. It helped slow the H.I.V. outbreak to a trickle.Nearly two decades earlier, in 1998, Mr. Clinton blocked federal funding for clean needle programs, despite a personal appeal from Ms. Shalala. In an interview, she said Mr. Clinton had buckled under pressure from Democrats in Congress, who worried they would lose elections by being portrayed as soft on crime.Undeterred, Ms. Shalala encouraged philanthropies to finance needle exchange programs, and instructed National Institutes of Health experts to conduct trainings on needle exchange. Mr. Clinton later said he regretted his decision.When Mr. Biden was elected, addiction experts were elated. The American Rescue Plan, the coronavirus relief package he signed into law last year, set aside $30 million for a new Harm Reduction Grant Program to “support community-based overdose prevention programs, syringe services programs, and other harm reduction services.”It was the first time Congress had created a specific grant for harm reduction programs — which often run on shoestring budgets — and the grant program was exempt from a longstanding ban, renewed annually in spending measures, on using tax dollars to purchase clean needles. Some experts thought the ban might be lifted for good.“We finally got to a place where that ban was going to be lifted, we would see sustainability, we would see a massive shift in our current state of infectious disease,” said Chad Sabora, vice president of government and public relations at the Indiana Center for Recovery, a treatment center. He called the new controversy “heartbreaking.”Safe smoking kits are often distributed by syringe service programs, and often include glass stems, which function as pipes, as well as lip balm, alcohol swabs, rubber tips and other items to protect against mouth sores and cuts that can spread disease. The guidelines for the new federal grant program are not specific about it about whether the kits can include pipes.The law is murky; a 1986 law classifies crack pipes (but not needles) as drug paraphernalia and makes it illegal to sell or ship them. Ms. LaBelle said that law, and similar state laws, arguably could preclude the government from funding the glass stems that serve as pipes.After the uproar over the Free Beacon article, the White House Press Secretary, Jen Psaki, said glass pipes were “never a part of the kit,” insisting the story was untrue.Conservatives accused the White House of reversing itself.“The Biden administration is in cleanup mode because they got caught funding crack pipe distribution,” Mr. Cotton wrote on Twitter.Many addiction experts saw the political blowup over crack pipes as having racist undertones. Dahlia Heller, an addiction policy expert at Vital Strategies, a global nonprofit organization that supports harm reduction, said the Beacon story was “calling up a racist trope, very clearly, of Black people smoking crack. It was dog whistling a 1980s war on drugs.”Mr. Cotton, who leads a bipartisan commission to combat the trafficking of synthetic opioids — particularly fentanyl — was among those who responded by introducing legislation to ban funding for drug paraphernalia. Yet even as he expressed his outrage over crack pipes, he issued a commission report citing needle exchange programs as a well-documented way to get people struggling with drug abuse into treatment.Drug treatment programs funded by the federal government also include the use of naloxone, or Narcan, which can save drug users who overdose.Whitney Curtis for The New York TimesMr. Cotton’s spokeswoman, Caroline Tabler, said the commission did not suggest expanding needle exchange programs. Mr. Cotton opposes syringe services programs, which he believes “would enable drug use, empower drug suppliers, and harm Americans,” she said. Mr. Cotton is not the only lawmaker parsing his words. Senator Joe Manchin III, Democrat of West Virginia, reacted to the Beacon story by joining with Senator Marco Rubio, Republican of Florida, to introduce the PIPES Act, which would bar federal funds from being used to purchase “drug paraphernalia, such as crack pipes or needles.” The initials stand for Preventing Illicit Paraphernalia for Exchange Systems.Mr. Manchin’s home state is West Virginia, a longtime epicenter of the opioid crisis. The state capital, Charleston shuttered its harm reduction program in 2018; by the end of the year Charleston was leading the state in overdose deaths. West Virginia is among a number of states that have recently passed laws making it more difficult for syringe services to operate, as state lawmakers continue to oppose them on the grounds that they enable drug use and draw community complaints.“Manchin was never going to save us, but now it looks like he is going to bury us,” said Joe Solomon, a founder of Solutions Oriented Addiction Response, or SOAR, a which ran a syringe exchange program in Charleston until last year, when the City Council imposed restrictions that effectively forced its closure.Yet in 2016, Mr. Manchin praised President Barack Obama for an initiative that included needle exchange programs. That program was the result of a compromise: after nearly 30 years of an outright ban on any funding for needle exchange programs, Congress agreed to pay for program operations — but not the needles themselves — so long as state and local authorities, in consultation with the C.D.C., determined that a community was in danger of an infectious disease outbreak.The Manchin-Rubio bill would retain the current language about the C.D.C., but would extend the ban on purchasing needles to the American Rescue Plan funding. Its fate, and the fate of bills like it, is uncertain. Mr. Rubio tried unsuccessfully to force senators to vote on the measure before passing a spending resolution last week, and Congress is now on recess until the end of the month.In the meantime, Ms. LaBelle said, she and other experts have some work to do.“We have a lot of ingrained ideas about substance use and people are working hard to make sure that the general public understands what addiction is, what a substance use disorder is — that it’s not a moral failing,” she said. “But we’re still not at that point.”

President Biden came into office vowing to respect science, but openings in crucial jobs could hamper progress on medical and technological research.WASHINGTON — President Biden, who came into office vowing to “reinvigorate our national science and technology strategy,” is now facing a leadership vacuum that may threaten his ambitious research agenda, which stretches well beyond fighting the coronavirus pandemic.Both the Food and Drug Administration and the National Institutes of Health lack permanent leaders. Mr. Biden’s health secretary, Xavier Becerra, has been criticized for his low profile. And on Monday, his science adviser, Dr. Eric S. Lander — the first such adviser to serve in the cabinet — resigned after acknowledging that he had bullied his colleagues.Dr. Lander’s departure leaves a particularly big hole. He was in charge of the “cancer moonshot,” an initiative to cut death rates from cancer in half over the next 25 years, and was behind a new pandemic preparedness plan that the White House has likened to the Apollo mission.Dr. Lander was also a driving force behind Mr. Biden’s proposal to create a new agency to propel innovation in medical research. Modeled after the Defense Advanced Research Projects Agency, the proposed agency, known as ARPA-H, was the subject of a House committee hearing on Tuesday. Dr. Lander, who was supposed to be the key witness, was not there.Dr. Eric S. Lander resigned on Monday after acknowledging that he had bullied his colleagues.Oliver Contreras for The New York Times“This was an administration that really committed to the primacy of science for the pandemic and also aspirations for well beyond the pandemic,” said Dr. Eric Topol, the founder and director of the Scripps Research Translational Institute. “And what it has been on is a self-inflicting harm mission.”Administration officials say the work will carry on. Kevin Munoz, a White House spokesman, said the administration has “exceptional leadership” at the Department of Health and Human Services, and “strong acting leadership” at the F.D.A. and the health institutes.The F.D.A. is being run by an acting commissioner, Dr. Janet Woodcock, and Dr. Lawrence Tabak is the acting director of the N.I.H. after its longtime leader, Dr. Francis S. Collins, stepped down late last year. Both Dr. Woodcock and Dr. Tabak are longtime officials at their respective agencies, regarded as steady hands.But Sudip Parikh, the chief executive of the American Association for the Advancement of Science, said he was deeply concerned that, without permanent leaders, it would be difficult for federal agencies to carry out Mr. Biden’s agenda with imagination and vision.In addition to considering whether to create and fund ARPA-H, the House and the Senate are working to reconcile their versions of legislation authorizing an increase in funding for the National Science Foundation, which would expand research in a range of science and technology fields, like quantum computing and artificial intelligence.“I am excited about what we have accomplished so far, but I am really worried about this next set of steps,” Dr. Parikh said. “We are on the cusp of some of the biggest changes to the way we do science in this country in 74 years, so we want Senate-confirmed scientific leaders that can put forth a vision.”Ellen Sigal, the chairwoman and founder of Friends of Cancer Research, an advocacy group in Washington, shares that concern.“They promptly need to have an F.D.A. commissioner confirmed, they have to have an announcement on who will direct the N.I.H. and then they are going to have to replace Dr. Lander and figure out who has the stature to bring these various initiatives together,” she said.After the administration of former President Donald J. Trump, who routinely spread misinformation about the coronavirus, scientists were thrilled and relieved when Mr. Biden was elected.“Our long national nightmare is over,” R. Alta Charo, professor emerita of law and bioethics at the University of Wisconsin, told Scientific American at the time.In an interview on Thursday, Ms. Charo said Mr. Biden had fulfilled his pledge of respecting scientific integrity, and his response to the pandemic, while not perfect, had been a big improvement. Still, she said, “I think it’s appalling that we have such a vacuum of leadership.”Others have been less charitable. Holden Thorp, a former chancellor of the University of North Carolina at Chapel Hill who is now the editor in chief of Science, published an editorial on Tuesday calling Dr. Lander’s departure “the latest disappointment from an administration that has been struggling to guide the nation with sound science and science leadership.”Some critics of the administration say Mr. Biden brought some of the problems on himself with the people he chose to put in various leadership positions.The Coronavirus Pandemic: Key Things to KnowCard 1 of 3Some mask mandates ending.

The Biden administration said federal masking guidance would not change for now, but was seeking advice from public health experts on the way forward.WASHINGTON — The White House has been meeting with outside health experts to plan a pandemic exit strategy and a transition to a “new normal,” but the behind-the-scenes effort is crashing into a very public reality: A string of blue-state governors have gotten ahead of President Biden by suddenly abandoning their mask mandates.The director of the Centers for Disease Control and Prevention, Dr. Rochelle P. Walensky, said pointedly on Wednesday that while Covid-19 caseloads are dropping overall and her agency is working on new guidance for the states, it is too soon for all Americans to take off their masks in indoor public places.Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said her agency was working on new guidance for the states, but that it was not yet time to lift mask mandates across the nation.Susan Walsh/Associated Press“Our hospitalizations are still high, our death rates are still high,” she said during a news briefing by the White House Covid response team. “So, as we work toward that and as we are encouraged by the current trends, we are not there yet.”The gubernatorial frenzy to drop mask mandates comes as the White House Covid response coordinator, Jeffrey D. Zients, and the government’s top doctors are soliciting advice from a wide array of public health experts, including some former Biden advisers who have very publicly urged the president to shift course. Mr. Zients referenced the sessions briefly on Wednesday, saying the White House is also reaching out to governors and local public health officials to talk about “steps we should be taking to keep the country moving forward.”The talks, according to numerous participants, are aimed at drafting a fresh playbook for the delicate next phase of the pandemic, when the coronavirus threat is likely to recede but the possibility of a new variant and another deadly surge remains very real. They are addressing a range of issues beyond masking and mitigation, from how to get new antivirals to people who test positive for the virus to whether to upgrade ventilation systems in schools.But the slow deliberations, within both the C.D.C. and Mr. Zients’ team, are putting the White House in a tough spot. As officials examine the science and chart a careful course, they run the risk of making the Biden administration look irrelevant as governors forge ahead on their own.New York is among the blue states that are dropping their mask mandates.Gabby Jones for The New York Times“The administration needs to read the room and see that nearly all elected leaders are moving on without them,” said Dr. Leana Wen, a former Baltimore health commissioner who has often been critical of the administration, adding, “No one is expecting the C.D.C. to say that everyone should go maskless right now. What they are looking for are clear metrics on when restrictions can be lifted and when they may need to return.”Governors have said so themselves. Last week, after a bipartisan group of governors met with Mr. Biden, Gov. Asa Hutchinson of Arkansas, a Republican, told reporters he had emphasized to the president that the nation needs to “move away from the pandemic” and asked him for “clear guidelines on how we can return to a greater state of normality.”Today’s 3 Key Reads About Covid1. School Mask Mandates: Health experts agree masks should come off in schools. But they differ on when.2. The Next Vaccine Debate: Should the F.D.A. authorize a vaccine for young children despite incomplete data, or wait?3. Canada’s Trucker Protests: With no end in sight, the demonstrations in Ottawa are reverberating beyond Canada’s borders.It is now clear the states have decided not to wait. On Wednesday, the governors of New York, Rhode Island, Massachusetts and Illinois joined a growing list of Democrats who have dropped either a general statewide mask mandate or one that applies to schools.Asked about the moves, Jen Psaki, the White House press secretary, said the president was committed to fulfilling his campaign promise to listen to scientists and follow the data.“That doesn’t move at the speed of politics,” she added. “It moves at the speed of data.”The internal debate comes as the latest Covid-19 surge, fueled by the highly infectious Omicron variant, abates in much of the country. The seven-day average of new cases was about 253,000 on Wednesday, down from an average 800,000 in mid-January, according to a New York Times database. Hospitalizations are also declining, although deaths, a lagging indicator, continue to rise.If the drop in cases and hospitalizations continues, as many experts expect, Mr. Biden himself will soon have some tough decisions to make: Should he declare an end to the national emergency that his predecessor, President Donald J. Trump, declared in March 2020? Should Mr. Biden lift the mask mandate that he imposed for travel on airplanes, trains and buses?If the drop in Covid-19 cases and hospitalizations continues, President Joe Biden will face some tough decisions, such as whether to drop the mask mandate for travel.Al Drago for The New York TimesMr. Biden must be careful to avoid a “mission accomplished” moment. In June of last year, with cases dropping, his advisers began predicting a “summer of joy,” and Mr. Biden himself declared on July 4 that the United States was “closer than ever to declaring our independence from a deadly virus.” Then the Delta variant surged across the country. In late fall, the emergence of the even more contagious Omicron variant also caught the administration off guard.Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said any new strategy must take that into account.“It has to acknowledge that we are entering a new phase of virus transmission in our communities, being forever mindful that we were in exactly the same place one year ago today, where cases were decreasing from a January peak, vaccines were flowing,” he said. “And look what that got us.”The C.D.C.’s masking decisions are especially fraught: It is difficult, experts say, to issue a one-size-fits-all prescription for a country as sprawling and varied as the United States.“It’s a challenging situation, because of course people are really anxious to get back to some sense of normalcy,” said Dr. Celine Gounder, an infectious disease specialist who recently joined Kaiser Health News as an editor at large. “It’s highly variable across the country — how much transmission there is, what vaccination uptake has been — but the C.D.C. produces guidance for the entire country, so it makes sense for them to be cautious.”Masking has been one of the most contentious issues of the pandemic. Many Republican governors cast aside their mask mandates long ago. Some, like Gov. Ron DeSantis of Florida, even banned mask mandates and threatened to penalize school officials who defied them. The actions drew fierce criticism from Mr. Biden, who directed his education secretary to bring federal civil rights actions to deter states from barring masking in classrooms.The Coronavirus Pandemic: Key Things to KnowCard 1 of 3Some mask mandates ending.

A broad, bipartisan group of senators is coalescing around a plan for an independent panel to investigate the origins of the coronavirus and the U.S. response.WASHINGTON — A broad and bipartisan group of senators is coalescing around legislation to create a high-level independent commission, modeled after the one that examined the Sept. 11 attacks, with broad powers to investigate the origins of the coronavirus pandemic and the response across the Trump and Biden administrations.Under a plan proposed by the top Democrat and Republican on the Senate Health Committee — Senators Patty Murray of Washington and Richard M. Burr of North Carolina — a 12-member panel would have subpoena power to “get a full accounting of what went wrong during this pandemic,” Ms. Murray said in an interview, and make recommendations for the future.The legislation, being circulated as a draft, is still in its early stages; Ms. Murray said she hopes to get feedback from colleagues within a month, followed by a hearing and a markup. In this highly polarized environment, both she and Mr. Burr acknowledged that politics could derail it.And even if the measure passes both houses of Congress and is signed into law, the panel itself could become bogged down in bitter partisanship, depending on who is appointed to it.But in interviews this week, more than a dozen senators from both parties embraced the idea, and none raised any substantive objections. More than half a dozen senators have similar proposals of their own that have produced some strange partnerships.“I’m all for it,” declared Senator Roger Marshall, Republican of Kansas, a medical doctor who is working with Senator Kirsten Gillibrand, Democrat of New York, and others on a similar bill. “As a doctor, if a patient dies and we don’t know why, we do an autopsy. In the military, when we have a major event we go back and figure out what we did right and what we did wrong.”The favorable reception from members of both parties is rare in a divided Capitol, and marks a significant turnabout. Bills introduced last year in both the House and the Senate, including one by Senators Susan Collins, Republican of Maine, and Bob Menendez, Democrat of New Jersey, have stalled, in part because Republicans feared they would target President Donald J. Trump’s early failures.But now President Biden has been in office long enough to have had failures of his own. And by explicitly stating that the origin of the pandemic must be investigated, the Murray-Burr bill appeals both to Republicans, some of whom theorize the virus emerged from a lab leak in China, and Democrats who want to put that theory to rest.“This is a crisis that has been shockingly polarizing,” said Philip D. Zelikow, the lawyer who led the 9/11 Commission and has been laying the groundwork for a pandemic inquiry. “This is the first signal that maybe leading Democrats and Republicans are now ready to come together. I think that’s really heartening. A lot of people would not have predicted it.”The Murray-Burr bill is carefully drafted to avoid partisan divisions. The panel would be made up of 12 “highly qualified citizens” — preferably, but not necessarily, nonpartisan subject matter experts in relevant fields like public health, manufacturing of medical products, supply chain issues and national security. They may not be government employees.Democrats and Republicans in Congress would each appoint half the members, who would name their own chairman and vice chairman. The White House would not make any appointments. The panel would hold hearings and take testimony, as the Sept. 11 panel did, and would be expected to produce a report within a year, with a possible six-month extension.“I think it’s a splendid idea,” said Senator John Kennedy, Republican of Louisiana. “I think we need to know what worked and what didn’t work. I think we need to be prepared for the next one. I would particularly like to know whether the lockdowns and the shutdowns we saw, whether the flame was worth the candle.”The measure avoids the use of the word “commission,” which acquired negative connotations in Washington after a bitter partisan debate doomed an effort to create a commission to investigate the Jan. 6 Capitol attack. Instead, the panel is called a “task force,” though Ms. Murray used the words “commission” and “task force” interchangeably.“We tried to structure it in a way that would make a partisan approach difficult,” Mr. Burr said.The proposal is part of a broader measure, the Prepare for and Respond to Existing Viruses, Emerging New Threats and Pandemics Act — or PREVENT Pandemics Act. It would require certain changes even before an inquiry has concluded, including making the director of the Centers for Disease Control and Prevention a Senate-confirmed position instead of serving at the will of the president.People familiar with the authors’ thinking say they want to put the measure on a fast track, possibly by attaching it to another must-pass piece of legislation.The Biden White House has been noncommittal. Jeffrey D. Zients, Mr. Biden’s coronavirus response coordinator, said this week that the administration was focused on the current crisis, but “over time we do look forward to engaging with Congress and reviewing lessons learned.”But Dr. Anthony S. Fauci, Mr. Biden’s top medical adviser for the pandemic, said it was important to investigate the origins of the pandemic. He said it took years after the coronavirus that caused SARS emerged in 2002 to determine that it had almost certainly jumped from bats or civets to humans at a wet market in China. That led to greater regulation of wet markets, he said.The 9/11 Commission, signed into law at the end of 2002 by an initially reluctant President George W. Bush, was an independent, bipartisan panel that spent a year and a half investigating the attacks and the country’s preparedness for them, holding public hearings in what amounted to a national reckoning.It produced an extensive report in book form — both a detailed analysis and a gripping narrative that was a surprise best seller and changed Americans’ understanding of the attacks, which killed nearly 3,000, and the terrorist threat. The report led to structural changes in government and in the way intelligence is evaluated and shared, as well as new cooperation among federal, state and local agencies.“We have prevented dozens of terrorist attacks in our city, because they work together,” Ms. Gillibrand said, referring to New York. “And so the same approach of a joint effort across government is necessary to stop the next pandemic.”Mr. Zelikow, who led the Sept. 11 panel, has laid the foundation for a commission to investigate the pandemic, with financial backing from four foundations and a paid staff that has already interviewed hundreds of public health experts, business leaders, elected officials, victims and their families.Mr. Zelikow, who has been consulting with Senators Burr and Murray, said he would be willing to turn his work over to a commission created by Congress. The pandemic has fundamentally challenged Americans’ trust in government, he said, and a thorough inquiry would be an important “bridge to trying to rebuild that confidence and that trust.”Covid-19 victims and their families, many of whom support the idea of a commission, are also eager for the kind of airing of grievances that the Sept. 11 panel provided the victims of the terrorist attacks two decades ago. And, they say, a nonpartisan, serious inquiry might be something the country could rally around.“I would like to see a narrative of what people have gone through to really help bring the data to life and to give a little bit of an on-ramp to healing for families and others,” said Kristin Urquiza, the founder of Marked by Covid, a victims group. “Right now we are so divided, but I firmly believe that through our loss and pain and grief, it’s actually an avenue toward seeing one another as humans and Americans.”

The president aims to revive the cancer “moonshot” program he headed as vice president.WASHINGTON — President Biden will unveil a plan on Wednesday to reduce the death rate from cancer by at least 50 percent over the next 25 years — an ambitious new goal, senior administration officials say, for the cancer “moonshot” program he initiated and presided over five years ago as vice president.Mr. Biden and his wife, Jill Biden, will also announce a campaign to urge Americans to undergo screenings that were missed during the coronavirus pandemic, according to the officials, who spoke on condition of anonymity Tuesday evening to preview the president’s announcement. Screening is important to reduce cancer deaths.The president has a deep personal interest in cancer research; in 2015, his son Beau died of glioblastoma, an aggressive brain cancer. The next year, President Barack Obama called on Mr. Biden in his State of the Union address to lead the moonshot program, with a goal of making “a decade’s worth of advances in cancer prevention, diagnosis and treatment” in five years.At the time, Congress authorized $1.8 billion over seven years; roughly $400 million of that money has yet to be allocated, and the National Cancer Institute, which oversees the initiative, says it has already spent $1 billion on more than 240 research projects. The senior officials said the White House would not be announcing any new funding commitments, but insisted that there would be “robust funding going forward.”Instead, the Bidens will set out broadly outlined goals in a showy White House ceremony to be attended by roughly 100 people, including Vice President Kamala Harris, patients, caregivers, family members, researchers and members of Congress.The White House is billing the event as a fresh push by the president to “reignite” the moonshot program and “end cancer as we know it.” Specifically, Mr. Biden will set a goal of cutting the age-adjusted death rate — a statistic that accounts for expectations that older people are more likely to grow ill and die — by more than half over the next 25 years. But there were few specifics about how that goal would be achieved.“These are audacious goals, and I have no doubt there will be mechanisms to achieve them,” said Ellen Sigal, founder of Friends of Cancer Research, which works to support cancer research and deliver new therapies to patients, who has been briefed on the plan.Mr. Biden has already named Danielle Carnival, who worked on the moonshot program during the Obama administration, to help oversee the new version of the effort. Now, the senior officials said, the president will create a “cancer cabinet” to coordinate the work of multiple government agencies.The White House says more than 9.5 million cancer screenings were missed in the United States as a result of the Covid-19 pandemic. Mr. Biden will call on the cancer institute, a branch of the National Institutes of Health, to coordinate with cancer treatment centers to offer screenings around the country, and to develop a program to fast-track the development of tests that can detect multiple types of cancer at once.Presidents since Richard M. Nixon have sought to tackle cancer, of which there are more than 100 types of disease that can vary in the way they grow, spread and respond to treatment. The cancer institute estimates that nearly 40 percent of men and women will be diagnosed with some type of cancer at some point during their lifetimes. The American Cancer Society estimates there will be 1.9 million new cases of cancer in the United States this year, and more than 609,000 cancer deaths.Most experts no longer talk of “curing” cancer; that language is far too simplistic, and the White House is not using it. But officials say it is possible to make substantial progress in the fight against cancer through early diagnosis and improved treatments.There have been great strides in cancer research, treatment and prevention in the five years since the original moonshot program was announced. Targeted therapies are helping cancer patients live longer. Doctors can now detect cancers through a simple blood draw. More refined colonoscopies are preventing more colon cancers.“The original moonshot demonstrated that it was possible to compress a decade’s worth of progress into a few short years,” Ms. Sigal said, adding, “We can’t afford to not make that opportunity a reality again.”

The masks will be distributed at pharmacies and community health centers, but some public health experts said the effort was coming too late.WASHINGTON — Two years into the coronavirus pandemic, Americans who have had a hard time getting their hands on masks and at-home tests are suddenly being showered with offers of freebies — courtesy of taxpayers and the Biden administration, which had come under sharp criticism for not acting sooner.On Wednesday, the administration announced that it would make 400 million nonsurgical N95 masks available free of charge at community health centers and retail pharmacies across the United States. The White House said that to “ensure broad access for all Americans,” there would be a limit of three masks per person.The news came a day after the administration rolled out covidtests.gov, its new website where Americans can order at-home coronavirus tests at no cost.Taken together, the moves represent a stepped-up effort by the White House to combat Omicron, the fast-moving coronavirus variant that first appeared in November and has fueled a spike in cases, hospitalizations and deaths across the country. But some public health experts said that while the efforts were welcome, they were too late.“It will not be as impactful as it would have been had we done it at the beginning of the Omicron surge or the beginning of the Delta surge,” said Julia Raifman, a health law and public policy expert at the Boston University School of Public Health.The White House called the distribution of masks the “largest deployment of personal protective equipment in U.S. history.” Wednesday’s announcement came days after the Centers for Disease Control and Prevention updated its mask guidance to acknowledge that cloth masks do not offer as much protection as surgical masks or respirators.The N95 masks will come from the Strategic National Stockpile, the nation’s emergency reserve of medical supplies. The stockpile was badly depleted at the outset of the pandemic, leaving health care workers without masks and other personal protective gear essential to fighting the coronavirus. As late as December 2020, the United States was still facing alarming shortages of personal protective gear.The decision to distribute masks from the stockpile to the public is a sharp departure from prior practice; in the past, they were reserved for health care workers.According to the C.D.C.’s new description of masks, well-fitting respirators, including N95s, offer the highest level of protection. Their name refers to their ability to filter out 95 percent of all airborne particles when used correctly.This month, in a series of opinion articles in the Journal of the American Medical Association, six former advisers to President Biden’s transition team called for a new pandemic strategy that would include making N95 masks free and easily available to all Americans, and vastly increasing the number of free coronavirus tests.But Mr. Biden faced challenges, particularly on the testing front. His administration had pledged to ramp up testing capacity but had not done so by the time the Omicron variant emerged. So while he announced shortly before Christmas that his administration would purchase 500 million rapid tests to distribute free to the public, Americans had to wait for them.“They talked a lot about substantially ramping up testing and it didn’t happen,” said Dr. Ashish K. Jha, the dean of the Brown University School of Public Health, adding, “I think that was a real failure of the administration, to not have more tests available by the time we got into the holidays.”N95 respirators, which can filter out 95 percent of all airborne particles when used correctly, were in short supply early in the pandemic.Brendan Mcdermid/ReutersLast week, Mr. Biden stepped up the testing initiative and announced that his administration would purchase another 500 million tests, bringing the total to one billion. Jeffrey D. Zients, the president’s coronavirus response coordinator, also told reporters last week that the administration was “actively exploring” ways to make high-quality masks available.The Coronavirus Pandemic: Key Things to KnowCard 1 of 4Omicron in retreat.

In a striking critique, six prominent health experts who advised President Biden’s transition team called for an entirely new domestic coronavirus strategy.WASHINGTON — On the day President Biden was inaugurated, the advisory board of health experts who counseled him during his transition officially ceased to exist. But its members have quietly continued to meet regularly over Zoom, their conversations often turning to frustration with Mr. Biden’s coronavirus response.Now, six of these former advisers have gone public with an extraordinary, albeit polite, critique — and a plea to be heard. In three opinion articles published on Thursday in The Journal of the American Medical Association, they called for Mr. Biden to adopt an entirely new domestic pandemic strategy geared to the “new normal” of living with the virus indefinitely, not to wiping it out.The authors are all big names in American medicine. Several, including Dr. Luciana Borio, a former acting chief scientist at the Food and Drug Administration, and Dr. David Michaels, a former head of the Occupational Safety and Health Administration now with George Washington University’s School of Public Health, have held high-ranking government positions. Dr. Ezekiel Emanuel, an oncologist, medical ethicist and University of Pennsylvania professor who advised former President Barack Obama, organized the effort.Like any White House, Mr. Biden’s prizes loyalty and prefers to keep its differences in house; in that regard, the articles are an unusual step. The authors say they wrote them partly because they have not made headway talking directly to White House officials.“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,” Dr. Borio said.The authors shared the articles with White House officials before they were published, but it was unclear whether the administration would adopt any of their suggestions. Dr. Anthony S. Fauci, Mr. Biden’s top medical adviser for the pandemic, declined to comment on the articles.The White House press secretary, Jen Psaki, told reporters she had not read the articles, and dismissed a question about whether the president “is coming around to accepting” that Covid-19 is here to stay, even though several recent media accounts suggested that the administration was beginning to operate under that assumption. Mr. Biden’s recent emphasis on keeping schools open and businesses running even when cases are soaring also suggests a recalibration, as does a recent decision by the Centers for Disease Control and Prevention to recommend that people with Covid isolate for five days instead of 10.“The president’s goal is to defeat the virus,” Ms. Psaki said, adding, “The president’s focus and objective now is to save as many lives as possible.”Outlining their ideas for the “new normal” strategy, Dr. Emanuel and two co-authors — Michael T. Osterholm, an epidemiologist at the University of Minnesota, and Dr. Celine Gounder, an infectious disease expert at New York University — pointedly noted that in July, Mr. Biden proclaimed that “we’ve gained the upper hand against this virus,” which in retrospect was clearly not the case.Now, with the Omicron variant fueling an enormous new surge, they wrote, the United States must avoid becoming stuck in “a perpetual state of emergency.” The first step, they wrote, is recognizing that the coronavirus is one of several respiratory viruses circulating, and developing policies to address all of them together.To be better prepared for inevitable outbreaks — including from new coronavirus variants — they suggested that the administration lay out goals and specific benchmarks, including what number of hospitalizations and deaths from respiratory viruses, including influenza and Covid-19, should prompt emergency mitigation and other measures.In addition to urging the administration to adopt a longer view, the authors took pointed issue with some of Mr. Biden’s current policies and stances — especially on political lightning rod issues. They called for more aggressive use of vaccine mandates, which have drawn fierce opposition from Republicans, and said the nation needed a digital verification system for vaccination — so-called vaccine passports — which Mr. Biden has resisted in the face of Republican attacks on the concept.“Relying on forgeable paper cards is unacceptable in the 21st century,” wrote Dr. Borio, Dr. Emanuel and Dr. Rick Bright, the chief executive of the Rockefeller Foundation’s Pandemic Prevention Institute.The most surprising thing about the articles is that they were written at all. Several of the authors said in interviews they were dismayed that the administration seemed caught off guard by the Delta and Omicron variants. Dr. Bright, who helped write two of the pieces, recalled the warning he issued when the advisory board had its last meeting on Jan. 20, 2021.“The last thing I said,” he recalled, “is that our vaccines are going to get weaker and eventually fail. We must now prepare for variants; we have to put a plan in place to continually update our vaccines, our diagnostics and our genomics so we can catch this early. Because the variants will come, and we should never be surprised and we should never underestimate this virus.”Mr. Biden published a pandemic strategy when he came into office, and Dr. Emanuel said the administration “executed very well on it through June,” until the Delta variant brought a new surge of cases. The president recently released a new winter strategy, just as the Omicron variant began spreading in the United States.Many of the steps the authors suggest — including faster development of vaccines and therapeutics; “comprehensive, digital, real-time” data collection by the C.D.C.; and a corps of “community public health workers” — are already part of Mr. Biden’s plans.He has taken steps to control the spread of Omicron and to ensure that hospital systems do not get overwhelmed. He has sent military troops to states including Wisconsin and Indiana to help out at hospitals, and has opened new testing sites in New York and elsewhere. He has insisted there will be no lockdowns, and has repeatedly pleaded with Americans to get vaccinated.“I honest to God believe it’s your patriotic duty,” Mr. Biden said recently.But Dr. Bright said such language was turning off Americans, including many Trump voters, who are resistant to vaccines.“The message continues to berate unvaccinated people and almost bully unvaccinated people,” said Dr. Bright, who led a federal biomedical agency during the Trump administration but quit the government after being demoted for complaining about political interference in science. “There are so many reasons people are unvaccinated; it’s not just because they follow Trump.”The authors say the administration needs to look past Omicron and acknowledge that it may not mark the end of the pandemic — and to plan for a future that they concede is unknowable. They also make clear that the current rate of Covid hospitalizations and deaths, an average of more than 1,300 lives lost each day in the United States, is unacceptably high.In the three articles — one proposing a new national plan, the others suggesting improvements to testing, surveillance, vaccines and therapeutics — the authors also make more specific suggestions.They call for next-generation Covid vaccines that would target new variants or perhaps take new forms, like nasal sprays or skin patches, that would be easier to distribute; for a “universal coronavirus vaccine” that would combat all known coronaviruses; and for major upgrades to public health infrastructure. And while they said the president’s pledge to buy 500 million rapid coronavirus tests and distribute them free was “an important step,” they wrote that “many more are needed.”The authors also said that vaccine mandates should be imposed more broadly, including for schoolchildren, and that N95 masks should be made free and readily available to all Americans, as should oral treatments for Covid. (Mr. Biden has imposed several vaccine mandates on workers, but they are tied up in court.)Dr. Gounder said she had been disappointed by the administration’s “single-minded focus on vaccines” and with its decreasing emphasis on mask-wearing. Dr. Borio said she had been “very frustrated” that there was no federal system linking testing to treatments, so that people who tested positive and were at high risk for Covid complications could get prescriptions on the spot for new antiviral medicines.Dr. Emanuel — brother to Rahm Emanuel, Mr. Obama’s first chief of staff and Mr. Biden’s ambassador to Japan — echoed that sentiment. If the distribution of new therapies is left to “the usual health care system,” he said, only “rich, well-connected people” would have access.The articles reflect both their frustrations and their desire to help, the authors said. They recognize that they have the luxury of taking a 30,000-foot view while administration experts are slogging it out in the trenches.“But at the same time,” Dr. Bright said, “we think a lot of work still needs to be done.”

The president is set to unveil his initiatives, which also include creating new federal testing sites and deploying federal vaccinators, in a speech on Tuesday.WASHINGTON — President Biden will announce new steps on Tuesday to confront a staggering surge in coronavirus cases, including readying 1,000 military medical professionals to help at overburdened hospitals, setting up new federal testing sites, deploying hundreds of federal vaccinators and buying 500 million rapid tests to distribute free to the public.The measures, outlined to reporters Monday night by two senior administration officials who spoke on condition of anonymity, come as coronavirus caseloads are rapidly rising around the country, particularly in the Northeast, fueled by the highly infectious new Omicron variant — just as Americans prepare to gather for Christmas.The 500 million tests that the administration intends to purchase will not be available until January, the senior officials said, adding that the government intends to create a website where people can request that tests be sent to their homes, free of charge. It was not immediately clear where the tests would come from.The plan for new federal testing sites will debut in New York City, where several new sites will be running before Christmas. And Mr. Biden intends to invoke the Defense Production Act, officials said, to accelerate production of tests.The plan has a more urgent tone than the winter pandemic strategy that Mr. Biden announced three weeks ago at the National Institutes of Health, just days after the new variant was discovered in South Africa. At the time, he promised that the 150 million Americans with private health insurance would be able to get reimbursed for at-home Covid-19 tests starting in mid-January, said his administration would improve access to booster shots and imposed new testing requirements for international travelers.But that plan — and Mr. Biden’s broader response to the Omicron variant — has drawn criticism from public health experts, who say the president has focused too heavily on vaccination as his central strategy. Many have called on him to be more aggressive about testing as a means of slowing the variant’s spread — including possibly sending rapid tests to the homes of every American, free of charge.Since Mr. Biden announced his winter strategy, the Omicron variant has exploded; the Centers for Disease Control and Prevention reported on Monday that it has raced ahead of other variants and is now the dominant version of the coronavirus in the United States, accounting for 73 percent of new infections last week.“We have to acknowledge the reality that unfortunately, with a heavy heart, the virus is in charge and we need to take back control, and the only way to do that as a society is to test and isolate, test and isolate, repeat, repeat, repeat,” said Mara Aspinall, an expert in medical diagnostics at Arizona State University.Mr. Biden was himself exposed to the coronavirus late last week but has tested negative, White House officials said on Monday. With Americans already jittery about their holiday plans, he will try to reassure the nation while reminding people, yet again, that their best defense against Covid-19 is to get vaccinated and, for those who are eligible, to get booster shots.The White House is trying to avoid talk of lockdowns at all costs, and, to the consternation of some, has stopped short of urging people to cancel travel plans, avoid public transportation and the like.“This is not a speech about locking the country down,” Jen Psaki, the White House press secretary, told reporters earlier on Monday. “This is a speech outlining and being directly clear with the American people about the benefits of being vaccinated, the steps we’re going to take to increase access, increase testing, and the risks posed to unvaccinated individuals.”But Mr. Biden will also acknowledge that the shape of the pandemic is shifting, the officials said. Breakthrough Omicron infections are common, though scientists believe that the vaccines will still provide protection against the worst outcomes. Many fully vaccinated and boosted people who are getting infected are experiencing mild symptoms or none at all.Mr. Biden will say that if people are vaccinated and follow other public health guidelines, including wearing masks in public places, “they should feel comfortable celebrating Christmas and the holidays” with their families, one of the officials said.But beneath those notes of assurance from the president is deep concern among his advisers — and public health experts — about the ability of the nation’s hospitals, which are already under great strain, to withstand an Omicron surge. Even if the variant ends up causing less severe disease and a relatively low percentage of those infected need to be hospitalized, experts say, the explosion in cases means it is still possible that hospitals will become overwhelmed.“That’s the big concern,” said Dr. Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials. “If there are a lot of people getting sick, even if only a small portion of them are getting severely ill, that could still be a huge number of people.”Mr. Biden intends to direct his defense secretary, Lloyd J. Austin III, to “ready an additional 1,000 service members — military doctors, nurses, paramedics and other medical personnel — to deploy to hospitals during January and February, as needed,” according to a fact sheet prepared by the White House.At the same time, Mr. Biden will announce that six federal emergency response teams, with more than 100 health professionals and paramedics, will deploy immediately to six states: Michigan, Indiana, Wisconsin, Arizona, New Hampshire and Vermont. Already, 300 federal medical workers have been deployed since Omicron was discovered in late November.A Federal Emergency Management Agency contractor administering a coronavirus booster shot on Monday in Federal Way, Wash. FEMA plans to stand up new pop-up vaccination clinics.Ted S. Warren/Associated PressMr. Biden will also direct the Federal Emergency Management Agency to work with hospitals across the country to make plans to expand capacity. FEMA will also stand up new pop-up vaccination clinics, the officials said, to handle hundreds of additional vaccinations per week.The Coronavirus Pandemic: Key Things to KnowCard 1 of 5The Omicron variant.