Politico

Biden health team weighs new mask distribution plan


Biden administration health officials are weighing whether to offer high quality masks, which could include KN95 or N95s, to all Americans, as the Omicron variant fuels a record surge of Covid-19, three people with knowledge of the deliberations told POLITICO.

The internal discussions come amid growing calls for the government to make the more protective masks more easily accessible, and as evidence mounts that the cloth masks many have relied on throughout the pandemic are less effective at protecting against the more transmissible Omicron variant.

The administration has so far resisted recommending that everyone shift to wearing the N95s or KN95s typically worn by health care workers, even with Covid-19 cases hitting new highs. Masking guidance has been a longstanding friction point between President Joe Biden and Republican governors going back to before he was sworn into office.

But some administration officials, led by Surgeon General Vivek Murthy, have advocated in the last week for launching an initiative to hand out better-quality masks to all who want them, said two people with knowledge of the deliberations, who were not authorized to speak publicly.

The White House has also fielded increasingly urgent pleas from outside allies such as Céline Gounder, an infectious disease specialist and former Covid-19 adviser to the Biden transition, to set up such a program. Within the last week, a group of health experts — including three former advisers to the Biden transition — publicly outlined a new Covid-19 response strategy that included making N95s or KN95s “readily available to all U.S. residents for free or very low cost.”

The Biden administration is in the process of developing a website where Americans will be able to request at-home rapid tests the federal government is purchasing. White House press secretary Jen Psaki told reporters Monday that people will be able to begin ordering the tests “later this month.”

“I told the White House Covid Response Team that they should provide N95 and KN95 masks through the website too,” Gounder told POLITICO.

Others, including former Trump-era Surgeon General Jerome Adams, have made similar proposals to the administration.

The White House is also facing rising pressure in light of a memo published by Congress’ attending physician telling lawmakers and staff that “surgical masks, cloth face masks and gaiter masks must be replaced by the more protective KN95 or N95 masks.” And people who interact with Biden, Vice President Kamala Harris or their spouses are supposed to wear an N95 mask.

The White House declined to comment.

Murthy and others in favor of distributing masks to the public have pushed for a decision as soon as Thursday, when Biden is slated to deliver an address on the state of the pandemic response.

Yet it remains unclear how the administration would implement such a plan and how long it would take to get up and running.

Jeff Zients, the White House Covid-19 response coordinator, is still “vetting” the idea and has not yet officially signed off on it, according to a person familiar with the conversations.

Among the details under debate are how exactly the government would make the masks available, as well as how to ensure that stockpiling supplies to give out to the public does not create mask shortages for hospitals and other health providers. Public health experts say the cost of more effective masks is also a barrier to use by low-income Americans.

The administration last spring distributed 25 million masks to community health centers, food pantries and soup kitchens in a bid to slow the spread among some of the nation’s poorest and most vulnerable Americans. But those were cloth masks, and the initiative ran for only a few months — making it a fraction of the size required for a sustained, national mask distribution program.

There is also uncertainty among some about how significant a difference distributing the more protective masks would make in the predominantly Republican areas of the country that are least vaccinated and most vulnerable to severe illness — especially given the politicization of masks and the resistance among conservatives to wearing them.

A senior administration official argued an effort to send N95 or KN95 masks to Americans would make little difference because “half the country won’t wear any mask.”

“It may be popular in certain corners of Twitter, but for masking to work as a public health tool, people need to actually wear them,” the official said. “To prevent spread, the focus should be maximizing the number of people simply wearing a mask in the first place, not shifting the goal posts to urge everyone to go above and beyond to use high filtration masks to make it less likely they themselves will inhale particles.”

The highly protective N95 and KN95 masks have become far easier for people to find compared to earlier in the pandemic, when severe shortages prompted the Centers for Disease Control and Prevention to hold off on recommending people use them for fear that health care workers would be unable to get them.

The CDC has yet to revise that guidance, though The Washington Post reported on Monday that the agency is now considering recommending people wear N95s or KN95s if they can do so consistently. CDC declined to comment when asked about the report.

Despite the wider availability, health experts still argue the government should be making the process smoother, especially as the nation enters its third year of the pandemic with the virus raging uncontrolled. It is still too difficult to find masks for reasonable prices, those critics say, and even tougher to figure out whether they are legitimate or counterfeit — persistent problems that they argue the administration has yet to prioritize fixing.

“The real challenge always comes back to, can they pull it off (logistically and supply wise) and is the upside of success for them greater than the risk of failure politically,” Adams said. “And recently the strategy seems to be push as much as you can off on the individual and take on only as much responsibility as you absolutely have to from a governmental perspective.”

Yet amid heightened concern over the strain on hospitals and disruption of essential services, the case for sending higher quality masks to Americans has become particularly acute during the Omicron wave, according to Abraar Karan, an infectious diseases fellow at Stanford University.

“What may end up happening is nothing happens, the surge passes, and then we’re left again for like the fifth or sixth time to say, ‘Well, are we really going to need these in the future? Is there any point in doing this now?’ And every time we said that, we have still had a use for it in the future,” Karan said.

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