When President Joe Biden entered office, his administration made clear it intended to fight the Covid-19 pandemic by focusing on getting the country vaccinated.
With the Delta variant of the coronavirus now raging and a large chunk of Americans rejecting vaccines, that strategy is under scrutiny.
When Biden, a Democrat, took over from Republican President Donald Trump on Jan. 20, roughly 400,000 people in the United States had died from Covid-19 and thousands more were dying every day.
Inoculations had only just become available.
Biden’s team pushed a major vaccine rollout and incentive campaign involving 42,000 pharmacies, dozens of mass vaccination sites, ride-share companies and 5,100 active duty troops.
Top officials fanned out across the country to preach a well-honed message: getting vaccinated means a return to normal.
In many parts of the United States, it worked. Millions lined up for shots and, as the vaccination rate increased nationwide, daily Covid-19 cases, hospitalisations and deaths dropped.
But the focus on vaccines accompanied a decline in Covid-19 testing, mixed messages on masking, and a failure to anticipate potent anti-vaccination sentiment, misinformation and the virus’ own ability to mutate rapidly into more formidable variants, some critics said.
“To protect the country from Covid, you need to have multiple strategies,” said Dr Peter Chin-Hong, an infectious disease specialist and professor at the University of California, San Francisco. “We jumped on the vaccine bandwagon and excitement at the expense of other core strategies in the pandemic.”
Covid-19 cases are rising in nearly 90% of jurisdictions in the United States, according to the Centers For Disease Control and Prevention (CDC), with outbreaks in areas with low vaccination rates.
The new spike in cases has clouded what had been a full-steam ahead economic recovery, and could be especially risky if consumers become more cautious and spending slows as pandemic-era unemployment benefits, rent moratoria and other supports begin to expire.
“Vaccination remains the most important thing we can do to prevent the spread of the virus, and so we need to be pulling all levers to support vaccination,” said Carole Johnson, the White House’s co-ordinator on Covid-19 testing.
White House officials said Biden’s $1.9tn pandemic relief package, known as the American Rescue Plan, invested billions of dollars into Covid testing for schools and people who are uninsured.
Americans’ refusal to take free, widely available vaccines that shield them from serious illness and death has confounded the Biden White House.
While vaccines largely protect people from contracting and transmitting the Delta variant, there are rare cases where fully vaccinated people get the virus and may be able to pass it on.
Biden has increasingly referred to the pandemic as one of the unvaccinated.
Top US infectious disease expert Anthony Fauci said that the federal government would rely at least in part on vaccine mandates from schools and businesses for their students and employees to spur lagging vaccination rates.
“If you can’t get people on their own volition to do what is important for their own health and for that of the country, then you talk about pressure. And pressure is local mandates,” he said.
Many experts had suggested that vaccinating 70% or more of the population could help curb Covid-19 transmission through so-called herd immunity, when combined with people who developed immunity following an infection.
But the ability of the coronavirus to mutate quickly into new, highly transmissible variants has cast doubt on whether herd immunity can be achieved.