WASHINGTON — President Joe Biden outlined his plans Thursday to combat the coronavirus this winter with measures that would largely put the U.S. out of step with other countries that are clamping down with the arrival of the new omicron variant.
The administration’s strategy will focus mostly on ramping up existing Covid-19 procedures and promoting vaccinations and booster shots. It will also aim to make testing more accessible by requiring health insurers to reimburse customers for the cost of at-home tests. The administration will also send 50 million at-home tests to community health centers and rural clinics for free distribution.
"I know Covid-19 has been very divisive in this country, has become a political issue, which is a sad, sad commentary. It shouldn't be, but it has been," Biden said. "Now, as we move into the winter and face the challenge of this new variant, this is a moment we can put the divisiveness behind us, I hope."
To try to slow the spread of the new omicron variant, which was detected in a second U.S. patient Thursday, Biden said that starting next week, all international travelers — regardless of nationality or vaccination status — will be required to test negative within a day of their departures to the United States. The requirement will be enforced starting with flights that arrive on Monday.
In addition, the mask requirement for domestic travel will be extended through mid-March.
"This new variant is cause for concern, but not panic," Biden said Thursday. "We knew there would be cases of this variant here in the United States and it's here, but we have the best tools, the best vaccines in the world, the best medicine and the best scientists in the world. We're going to fight this variant with science and speed, not chaos and confusion."
The scale of the administration’s approach puts the U.S. at odds with Israel and many European allies. Many foreign governments are requiring proof of vaccination for airline travel and restaurant dining, as well as stricter rules for travelers from southern Africa, where the omicron variant was first detected.
The Biden administration finds itself caught between measures supported by public health experts and the reality of what it can achieve politically in the face of widespread Republican opposition to vaccination requirements and mask mandates.
“We must do something because of politics, but we can’t do what would really work because of politics,” said Dr. Celine Gounder, an infectious disease specialist at New York University who advised the Biden transition team.
Biden said this week that he was not considering additional lockdowns, travel restrictions or vaccination requirements for domestic airline travel. The Centers for Disease Control and Prevention also continues to recommend that people who are vaccinated can go without masks outdoors, where transmission rates are low.
“Most of the measures discussed are extensions of existing policies, which will likely do very little to truly curb the effects of surging variants and those that threaten to escape current immunity,” said Dr. Kavita Patel, a physician who worked in the Obama administration.
Cases are already surging in states like Michigan, where the hospitalization rate is its highest since Covid-19 took hold. Gov. Gretchen Whitmer, a Democrat, got death threats and threats to her family after she imposed mask mandates earlier in the pandemic, and the Republican-controlled Legislature revoked some of her emergency powers to require indoor masking. Now, masks or proof of vaccination are not required, even in congregate settings, such as nursing homes.
“The U.S. is lagging behind,” said Sigal Atzmon, the chief executive of Medix Global, a health management company that works in 90 countries helping data systems track the pandemic. “In a lot of different countries, everyone went back to work from the office, they're meeting each other again, they have a social life again, everything has gone back to normal for vaccinated people.”
France, which experienced a strong vaccination backlash, instituted a so-called green pass, a paper document or an app that proves that the holder has been fully vaccinated or has recovered from Covid. France's vaccination rate went from 20 percent to 82 percent in three months, Atzmon said.
In the European Union and Israel, it’s nearly impossible to live a normal life without proof of vaccination. Citizens and residents who want to travel or visit restaurants and large venues in Israel are required to get QR codes to share through a centralized system that proves their vaccination status or whether they have recently tested negative.
The E.U. is considering taking the passport a step further by limiting its lifespan to nine months so it expires as people’s immunity wanes.
In the U.S., Republicans have objected to a national vaccination passport, saying it would violate civil liberties. Instead, the U.S. has relied on a patchwork of systems to prove vaccination status; many businesses rely on paper vaccination cards or cellphone photos of people's cards.
In response to the omicron variant, the Biden administration banned air travel from eight African countries, taking a step similar to the Trump administration in the early stages of the pandemic.
At least 20 other countries, including the United Kingdom, Ireland and Canada, have gone further by not just banning all noncitizens from those countries but also mandating quarantines for their citizens and permanent residents returning from them. In the Netherlands, people coming into the country who have recently been in southern Africa must quarantine at a government-selected hotel, and several people have been arrested for violating the mandate.
Gounder and other public health experts said the recent U.S. travel ban should have gone further if the goal was to significantly slow the spread of the virus.
“They had to do something, even if not science-based and with little if any real public health impact, to neutralize Republicans ready to criticize any response they take,” she said.
After the emergence of the omicron variant, Germany’s government this week will consider requiring all of its citizens to be vaccinated, a step neighboring Austria has already taken.
Biden has relied heavily on vaccination mandates, requiring companies with at least 100 employees to ensure that all their workers are vaccinated or tested regularly, but the move has been challenged in court by Republican state attorneys general.
“There’s limitations to what we can do under our federalist system,” said Dr. Irwin Redlener, the founding director of the National Center for Disaster Preparedness at the Earth Institute at Columbia University. "But that doesn’t mean he shouldn’t try,” said Redlener, who said he backs “the all-out deployment of mandates and requirements,” beginning with airline travel.
“I don’t think any person should be allowed on any airplane in the world if you have not been vaccinated and can prove it,” he said.