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The world is now a year and a half into the COVID-19 pandemic, and the virus is still raging. In the United States, just 64 percent of adults are fully vaccinated, and the highly contagious delta variant has kept case counts high across the nation. The US has had more than 40 million cases since the pandemic began and the average number of new daily cases has increased throughout the summer.

As Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Axios this week, “Right now, we’re still in pandemic mode, because we have 160,000 new infections a day. That’s not even modestly good control … which means it’s a public health threat.”

On Thursday, President Biden addressed the nation with a multi-point plan to help the US gain control of the virus and find our way out of the pandemic, which was among his promises to the American people upon election. Among the most important parts of his plan are new vaccine mandates for private businesses as well as requiring vaccines in schools, and increasing testing and access to booster shots. Here’s everything you need to know about the plan.

New vaccine requirements for most American workers 

Vaccination rates reached a plateau in the middle of the summer, and while they have slowly begun to increase, there are still a large number of eligible Americans who remain unvaccinated.

Under Biden’s new mandate, all private businesses with more than 100 employees will be required to enforce vaccination, and provide paid time off to do so. If an employee refuses to get a COVID-19 vaccine, that person will be required to show proof of a negative COVID test once a week. Because the incubation period for the SARS-CoV-2 virus can range from anywhere from 2 to 14 days, weekly testing is unlikely to catch all cases in the workplace, and is therefore not a perfect substitution for vaccination.

This mandate will affect about two thirds of the American workforce, or some 80 million people. 

Another executive order will require all executive branch and federal contractors to get the vaccine—with no weekly testing alternative.

Under a previous mandate, Biden had required all healthcare workers who treat patients on Medicare and Medicaid to get vaccinated. He’s now extending that mandate to all Americans who work in hospitals, home health care facilities, and other medical facilities. This includes about 17 million people.

When announcing these new rules, Biden made a plea with unvaccinated Americans: “My message to unvaccinated Americans is this: What more is there to wait for? What more do you need to see? We’ve made vaccinations free, safe and convenient. The vaccine is FDA approved. Over 200 million Americans have gotten at least one shot. We’ve been patient, but our patience is wearing thin. And your refusal has cost all of us.”

[Related: The US has had more than 40 million COVID cases since the pandemic began]

Making schools safe 

Many young students in the US are back to in-person classes after more than a year of remote learning. To keep them safe, Biden announced that all teachers who work in federally-funded schools will be required to get a COVID-19 vaccine. He noted that about 90 percent of school staff and teachers are already vaccinated. 

While kids 12 and older are authorized to get the COVID-19 vaccine, it’s still unclear when children younger than age 12 will gain access to the vaccine. Biden touched on this, noting that vaccines for kids were still under scientific review and that “we can’t take shortcuts of that scientific work.” 

Some researchers surmise that the vaccines could be available to kids younger than 12 as soon as early 2022, but that largely depends on the pace and results of independent research.  

Fighting COVID-19: Booster shots, monoclonal antibodies, and more testing  

With nearly 160,000 cases per day, on average, the US is far from beating COVID-19. To end this public health crisis, Biden stated that he will increase the availability of novel treatments that have been shown clinically to help treat COVID-19: “we’re increasing the availability of new medicines recommended by real doctors, not conspiracy theorists.” 

These treatments include monoclonal antibodies which, when given at the right time (early in the course of treatment) have been shown to reduce the risk of hospitalization in unvaccinated people. Studies to determine if these antibodies can be used as a way to prevent COVID-19 in people exposed to the coronavirus are currently underway. 

Unfortunately, there’s been an uptick in the use of treatments for COVID-19 that have not been shown to be effective, and, in fact, can be harmful. For example, Ivermectin, an anti-parasitic drug, has been used by laypeople and even doctors around the country, despite repeated warning from the CDC and FDA that its use—especially formulations meant for large animals like horses—can be extremely dangerous and potentially deadly. There is no indication that Ivermectin prevents COVID-19 infection or improves outcomes once infected.

[Related: All your COVID booster shot questions, answered]

Booster shots are also on many Americans’ minds, including the President’s. In his speech, Biden announced that he would continue to work with scientists at the FDA and the CDC to understand whether booster shots are needed for Americans, and if so, when they should be administered. 

In late August, the government announced that it would provide boosters to all Americans starting six months after people received their second shot (or after their only shot of the Johnson & Johnson vaccine). But since then, scientists both within and outside the FDA have noted that it’s still unclear how effective extra doses are. Meanwhile, the World Health Organization has pleaded with the US to withhold extra shots from people who are not immunocompromised, as much of the world remains unvaccinated due to lack of access.

Biden also announced plans to ramp up testing by using the Defense Production Act “to increase the production of rapid tests, including those that you can use at home.” He also plans to reduce the price of at-home tests by up to 35 percent and expand free testing to more pharmacies around the nation.

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