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US President Joe Biden on Thursday announced a major escalation in the national Covid immunization campaign with strict new vaccination rules affecting tens of millions of workers, as he hardened his tone towards Americans who refuse the shots.
The six-point plan targets businesses with more than 100 employees, in the United States' most aggressive steps taken so far against the surging Delta variant.
"A distinct minority of Americans supported by a distinct minority of elected officials are keeping us from turning the corner," the Democratic president said in a televised address from the White House.
"The unvaccinated overcrowd our hospitals, are overrunning emergency rooms and intensive care units, leaving no room for someone with a heart attack or pancreatitis or cancer," he added.
The most expansive of the actions involves requiring private companies with more than 100 workers to ensure they are vaccinated or tested weekly. The federal measure will impact an estimated 80 million people.
Republican lawmakers immediately slammed the administration and claimed it was overstepping its authority.
"Sounds a lot like a dictatorship," House Republicans tweeted on their official account.
The plan also mandates vaccinations for all federal employees and contractors.
Currently, government workers either need to have a vaccine or submit to regular testing, whereas the new rule will enforce virtually total vaccination.
Some 17 million health care workers at facilities receiving government Medicare or Medicaid program funding will also require vaccination.
Only 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.
For its part, the US Chamber of Commerce "will work to ensure that employers have the resources, guidance and flexibility necessary to... comply with public health requirements," its executive vice president Neil Bradley said.
Some 80 million Americans remain unvaccinated. Research shows they tend to be younger, less educated, and more likely to be Republican.
White people account for the largest share of people who remain unvaccinated, but Black and Hispanic people are less likely than their white counterparts to have received a vaccine, according to the Kaiser Family Foundation.
- Biden's competency scrutinized -
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 -- and some 1,500 people are dying every day, according to Johns Hopkins data.
Seeing his entire agenda on topics like the economy or climate change overshadowed by the pandemic, Biden badly needs to change its course or 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.
On Thursday, the Los Angeles school district, the nation's second largest, voted for children age 12 or over who attend public schools to be fully vaccinated against Covid-19 by the start of next year.
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."
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 percent approved of Biden's handling of the pandemic, down from 62 percent of adults in June.
Biden's overall approval average ratings are firmly below 50 percent for the first time in his presidency.
According to the Washington Post-ABC News survey, only 44 percent approve of his performance, compared to 50 percent in June.