The White House on Thursday ramped up Covid-19 vaccine and testing mandates in a campaign due to be outlined by President Joe Biden that will affect some 100 million people, including employees at many private companies, federal workers and healthcare staff.
While the US government has yet to consider the kinds of national mandates seen in some other countries, Biden's new "six-pronged" plan amounts to his most aggressive steps so far against the surging Delta variant.
One element set to be announced by the president in a major speech will be mandatory vaccinations for all federal employees and federal contractors, the White House said. Currently, government workers either need to have a vaccine or submit to regular testing, whereas the new rule will enforce virtually total vaccination.
In another measure, companies with at least 100 employees will be required to ensure all workers are vaccinated or tested weekly, to be enforced by the US agency in charge of workplace safety. This will impact more than 80 million people in the private sector, the White House estimated.
Biden is also requiring vaccinations for around 17 million health care workers at facilities receiving government Medicare or Medicaid program funding.
Only limited exemptions will be allowed for religious reasons or for people with disabilities — a strict approach sure to put Biden on a collision course with right-wing media and other powerful groups arguing that mandates amount to an attack on individual freedoms.
Biden's press secretary, Jen Psaki, said the overall thrust of the plan will be to attack the coronavirus simultaneously from different angles, as infections and deaths return to crisis levels, following what had been steep declines in the early summer.
"That means reducing hospitalisations. That means putting in place more testing requirements and putting in place more protections in the form of boosters to make sure people have an even greater level of protection," Psaki said on CNN.
The administration's early success in rolling out vaccinations and promoting mask wearing gave Biden a lift after taking office in January.
After leading the world in coronavirus deaths under former president Donald Trump, the United States became a model for how to beat the pandemic.
On July 4, Biden even held a big White House barbecue to celebrate US Independence Day and freedom from lockdowns.
But the emergence of the hard-to-stop Delta variant over the summer has filled intensive care units again.
Seeing his entire agenda on things like the economy or climate change overshadowed by the pandemic, Biden badly needs to change its course or at least demonstrate he is in charge.
Much of the problem is beyond Biden's reach.
The federal government has distributed free vaccine supplies across the country and also became the world's largest donor to poorer nations.
However, state governments, notably in Republican Texas and Florida, have actively resisted imposing mask mandates, while swaths of their populations refuse to get vaccinated -- even as cases around them soar.
Biden and his supporters have taken to calling the current virus surge a "pandemic of the unvaccinated."
Psaki expressed "frustration" at the vaccine refusers, telling reporters "the reason we are here is because people have not gotten vaccinated, 80 million of them."
Despite the role played by Republican leaders, Biden, who is simultaneously taking a hit from the traumatic US exit from Afghanistan, is getting much of the blame.
In the latest Washington Post-ABC News poll, 52 per cent approved of Biden's handling of the pandemic, down from 62 per cent of adults in June.
Biden's overall approval average ratings are firmly below 50 per cent for the first time in his presidency.
According to the Washington Post-ABC News survey, only 44 per cent approve of his performance, compared to 50 perc ent in June.
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