Hello April! Happy National Minority Health Month!

This month the HHS Office of Minority Health (OMH) is leading efforts to advance further the critical need for vulnerable and underserved communities to get vaccinated through their #VaccineReady campaign. On Wednesday, the National Institute on Minority Health and Health Disparities released its new NIH Minority Health and Health Disparities Strategic Plan 2021-2025 to chart a path to advance the science of minority health and related disparities.

NCSD is mindful of this transformational moment in time and stands alongside activists and allies supporting calls for the strategic reorientation of our nation’s moral fabric. We support the advancement of self-determined narratives to guide future frameworks grounded in community, dignity, and equitable health outcomes for traditionally underserved communities and communities of color. 

The Biden Administration’s Recess Push to Rebuild American Infrastructure  

While members of the House and Senate are not set to return for legislative business until April 12, this week’s Hill activity was all but stagnant. Rather, federal efforts continued at a breathtaking pace with the Biden administration’s announcement and release of its $2.25 trillion infrastructure proposal on Wednesday from “The City of Bridges,” Pittsburg, PA. Proponents claim the administration’s enormous proposed investment in public infrastructure would be the most significant investment since World War II.  

A Few Major Highlights:  The four-part, eight-year plan includes proposals to significantly increase federal focus and investment in:  

• Transportation: Provides $620 billion – including $115 billion to improve bridges and highways, $20 billion to upgrade 20,000 miles of roads and highways, $80 billion for Amtrak, $25 billion for airports, and $20 billion investment in transportation projects for disadvantaged communities.  
• Electric Vehicle Tax Incentives: Directs $174 billion that includes rebates and tax incentives to buy American-made cars and grants for state and local governments (and the private sector) for 500,000 charging stations by 2030. 
• Workforce Development: $100 billion for programs, including apprenticeships and training programs for those who have lost their jobs. 
• Higher Workplace/Labor Standards: Allows for those employed on infrastructure-related projects to collectively bargain and directs $16 billion to clean up abandoned mines and gas wells. 
• Clean Drinking Water: Invests $45 billion in a lead pipe elimination initiative. 
• Greater Broadband Accessibility: Designates $100 billion to expand broadband access for all Americans alongside pricing/competition transparency and short-term subsidies for low-income households. 
• Schooling & Child Care: Provides $100 billion for public school building renovations, including $50 billion in direct grants, $12 billion for community college facilities and tech, $25 billion for upgrades to childcare facilities, and employer incentives for offering on-site childcare. 
• Elder Care & VA Hospitals/Clinics: Sets aside $400 billion for elderly and disabled housing and care and $18 billion for VA hospital and clinic modernization. 
• Corporate Taxation: The plan includes a proposed increase in the corporate tax levy from 21 percent to 28 percent and would impose a minimum tax on corporate profits earned overseas (an increase of 8 percent) to disincentivize offshore preferences.  

Despite former assumptions of bipartisan buy-in, Congressional Democrats are already probing the possibility of using the reconciliation process again – short after successfully advancing the administration’s popular American Rescue Plan. Reports this week indicate Senate Majority Leader Schumer has recently asked the Senate parliamentarian if the 2021 budget resolution could be used to pass two additional bills (one under FY 21 and another under FY 22) to advance this latest push for American infrastructure.  

But this latest push will not come as easily. Already, three House Democrats — Reps. Pascrell (D-N.J.), Suozzi (D-N.Y.), and Gottheimer (D-N.J.) — have voiced opposition to the plan’s proposed corporate tax hikes and have pledged not to support the initiative unless a future version include a repeal of the $10,000 state and local tax deduction (SALT) cap. Other top Democrats have alternatively concluded that the proposed $2 trillion investment is not enough. 

Vaccines and Vaccinations

President Joe Biden’s remarks on Monday, alongside reiterated pledges that most American adults will be eligible for vaccination within weeks, included the administration’s announcement of an effort to increase the number of pharmacies in the federal vaccination program from 17,000 to 40,000 pharmacies. Monday’s remarks also included an announcement of the planned construction of 12 additional mass vaccination sites bringing the total number of mass vaccination sites up to twenty-one. Combined, the 21 mass vaccination sites will be able to administer nearly 80,000 shots per day. Most notably, the efforts will ensure that 90 percent of U.S. adults would be within five miles of a vaccine site, according to administration officials. 

By mid-week, more than 15 percent of U.S. adults (or 51 million Americans) were fully vaccinated. And currently, 31 states have announced plans to beat the May 1 deadline that the president imposed on states last month by opening eligibility to all their respective residents by April 19 at the latest.  

“Impending Doom”

The weeks encouraging inoculation-related news, however, accompanied new, stark warnings of an emerging surge in COVID-19 infections. The president and federal public health officials highlighted new (somewhat expected) statistics revealing a reported seven-day, 10 percent surge in new infections due to what many officials blame on the various jurisdictions across the nation currently relaxing previously implemented pandemic mitigation/restriction policy measures. Expressing his concern in Monday’s White House press briefing, the president solemnly noted “…cases are going back up and, in some states, deaths are as well. You know, we’re giving up hard-fought, hard-won gains.”   

The concerns are well placed. In just the past two weeks, COVID-19 infections have risen more than 20 percent across the U.S. and more than 40 percent in nine hotspot states like Michigan (133 percent increase), Connecticut (62 percent increase), New York (40+ percent increase), Pennsylvania (40+percent increase), North Dakota (near 60 percent increase), and Minnesota (47 percent increase). 

COVID-19 Vaccine “Passports”

As a growing number of large companies announce that they will require proof of vaccination as a condition for work, HHS and the White House COVID Response Coordinator, Jeff Zients, are leading efforts to develop tangible and digital credentials analogous to initiatives launched by the World Health Organization and IBM. Numerous organizations, including The MITRE Corporation and the Vaccination Credential Initiative, a coalition seeking to standardize vaccination data record tracking, are distilling the many anticipated challenges that will come with the development and implementation of an officially recognized COVID-19 credentialing system. Congressional Republicans have opposed proposals for a credentialing system, deeming such proposals as invasive. Similar sentiments have led local and state policymakers like Florida Republican Governor Ron DeSantis to urge members of the state’s GOP-dominant legislature to pass legislation that would forbid vaccination passports or alternatively threaten executive action to prohibit the implementation of a credentialed “proof-of-vaccination” approach. 

Education: CDC Guidance for Schools and Vaccines 

Last Friday, the CDC revised its in-person school instruction guidance by relaxing the previous six-foot guidance for elementary school students to three feet when all students are masked. Moreover, the new relaxed guidance is also applicable for middle and high school learning environments that exist in communities where transmission rates are “not high.” 

The relaxed guidance for school-aged children preceded an additional age-related announcement from Pfizer and BioNTech reporting that results from their Phase III trials studying the company’s vaccine in adolescents aged 12-15 years concluding that the vaccine is 100 percent effective in children. The welcomed results should inform the priorities the Biden Administration has directed its attention toward within its first 100 days, including the safe reopening of schools. 

Recent Burbio’s School Opening Tracker statistics show that as of March 14, nearly 50 percent of U.S. K-12 students currently receive “traditional” in person instruction five days each week, approximately 30 percent of students are currently learning under “hybrid” instruction models, and one-fifth (20.8 percent) of students currently remain under socially distanced “virtual-only” instruction.   

Nominations and Appointments 

NCSD congratulates Dr. Rachel Levine on her recent Senate confirmation as HHS’s next Assistant Secretary of Health. Dr. Levine’s historical confirmation makes her the first openly transgender federal official ever confirmed by the United States Senate.