What Is Biden Waiting For?

The Delta variant is making clear what the Administration should have done back in January: mandate vaccines, mandate passports and crack down on the denialists. Now time is running short.

Why is it taking the Delta variant to get the Biden administration to do what it should have done in January?

Why is this administration so hesitant about saving American lives? And the American economy?

Confusion about mask rules is now so great that enforcement anywhere but on airplanes will be impossible. Requiring weekly tests as a substitute for vaccination is doomed to fail because the Delta variant can turn someone from healthy to superspreader in less than four days.

The key to saving lives is vaccine. The key to reopening offices and factories is vaccine. The key to reopening schools is vaccine. The key to keeping bars and restaurants open in cold weather is vaccine. The key to travel and shopping is vaccine. Vaccine in everybody.

The Delta variant could have been just a speed bump on our road to ending the pandemic. But now it’s growing bigger fast. (See below at right.)

From The New York Times Covid-19 Tracker

As with real speed bumps, reaction times matter. Hit them going 80 and you’ll shatter your oil pan or lose control. Right now, we are still barely reacting.

We have the world’s best shots — the mRNA vaccines. After a year of humiliating failure, they let us finally pull ahead of China in showing the world how to control a pandemic: China proved itself the master at crushing outbreaks with lockdowns and mass testing. But our vaccines are far better than theirs.

Nonetheless, data from Israel suggests that mRNA vaccines start waning after six months. Israel is already offering booster shots to everyone over 60. We must do the same. (And ultimately not just to seniors — early hints suggest that the passage of time lowers everyone’s protection.)

Right now, “breakthrough infections” are usually mild. Young friends and relatives of mine have had them, and suffered only sniffles — and that was their booster shot. But that’s not the safest way to get boosted, especially as you age.

To save vaccine, perhaps booster doses can be smaller. Perhaps we can mix vaccines. I’ve had two Moderna doses, the last one in February. If I was offered a fractional Johnson & Johnson dose, I’d take it. Based on current testing, I’d probably take the AstraZeneca vaccine, the Russian Gamaleya vaccine and maybe the Novavax, even though they aren’t authorized here yet.

We are too fearful of very rare side effects. The smallpox vaccine of the 1950’s was much more dangerous than today’s vaccines; it could kill an immunocompromised recipient. And yet my mother’s notes — which I found recently — show that I had it three times as a child.

Not to mention eight doses of polio vaccine between 1956 and 1964, even though a bad polio vaccine batch in 1955 had paralyzed 200 kids and killed 10 of them. Plus six of the “triple shots,” the old diphtheria/tetanus/whooping cough mix that in those days triggered seizures in about 1 of every 2,000 doses.

Risky? Yes, somewhat. But that’s how you beat dangerous diseases.

You don’t beat them by offering Lotto scratch-off cards.

We need to get over the current “pretty please?” phase of this fight. Vaccination mandates change everything. Think how different our lives would be if smallpox vaccine was never invented and, every 20 years or so, one third of our children died. That was life before vaccines.

In this country, 99 percent of Covid deaths are now among the unvaccinated. Data doesn’t get more convincing than that.

Death has a false-positive rate of zero.

The alternatives to rapid vaccination are grim.

Soon, as schools open, we will almost undoubtedly have lots of sick kids. Under-12s are not vaccinated against Covid and only about 40 percent of teens are. Only about 350 children and teenagers have died of Covid-19 so far, but it won’t be the only virus adrift in the classrooms. Respiratory syncytial virus, parainfluenza and other causes of the common cold are already surging, especially among infants, because a year with no school or day care has left immunity unusually low.

It’s too early to tell how big a comeback flu will make. Australia, which is often a harbinger for us, is having a mild flu season thus far. But cases are already ticking up slightly in our Deep South — in August — and domestic flu seasons often start there. (The reasons are unclear, but it may be because school starts earlier in the South, or because health there is generally worse.)

Although children don’t normally get severe Covid disease, a surge of pneumonia hospitalizations caused by a combination of Covid plus respiratory viruses plus secondary bacterial infections could be quite scary. For kids, it may feel like a “multidemic.”

Then, by winter, if the Pfizer and Moderna vaccines start wearing off, we could see a new surge in nursing home deaths. Starting booster shots now and demanding that all nursing home employees and visitors be vaccinated could prevent that.

We are running out of time. Once again, we’re being lulled by a not-so-bad-except-in-the-South summer. With the two-shots-plus-two-weeks regimens, it takes at least six weeks for immunity to kick in.

To protect children from Covid, the Biden administration could press the Food and Drug Administration to speed up the pediatric testing and make an emergency authorization decision based on markers of immunity. The biggest fear we had about coronavirus vaccines a year ago — that they might increase the likelihood of severe disease — never materialized.

Thus far, the vaccines have proven remarkably safe. Tens of millions of Americans have had them. Serious side effects like myocarditis are very rare — far rarer than myocarditis in young people who get Covid.

The F.D.A.’s lengthy full-approval process, while understandable in normal times, could cost lives, even if it happens as soon as next month.

The administration also needs to roll out flu vaccines as soon as they’re ready while being honest about past mistakes, even if it’s painful. Last year, the C.D.C. raised fears of a flu-Covid “twindemic” that turned out to be a false alarm. To avoid losing credibility, it must admit that it’s sometimes wrong about flu — but make it clear that opting for the shot anyway is still the safe choice.

In most years, flu shots are only about 50 percent effective at preventing flu. But they are better than 80 percent effective at preventing hospitalization and death; many Americans finally understand that crucial difference.

The White House is still only creeping towards mandating vaccines for 11 million federal employees and contractors. It had to be shamed into going even that far by its own VA hospitals, which finally acknowledged a threat that had been obvious from day one: unvaccinated infected workers moving from room to room kill elderly patients.

States and cities run by governors and mayors who read hospital reports are issuing mandates. In states whose governors resist, like Florida and Texas, the hospitals are filling upagain. When will they learn? How many voters have to die for them to catch on?

All of which raises an obvious question: Why in the world do we not yet have federal vaccine passports?

In a land of block-chain currencies, QR code menus, encrypted texts and microchip credit cards, those little CDC-logo flashcards are just pathetic. Even World War II dogtags are harder to forge.

Mr. Biden’s advisors failed to develop a passport plan while he was running for President. His administration specifically rejected passports in April.

America is now paying the price for that mistake.

Now that most employers and retailers recognize the danger, we could be easily blocking the unvaccinated at the doorways to stores, restaurants, bars, theaters, airplanes, buses, subways, hotels, schools and other venues just as easily as Walmart and Target were eventually able to compel their customers to don masks. The vast majority of Americans have cellphones that could display something like New York’s Excelsior passport.

Yes, there will be statehouse demonstrations. And screaming matches and, sadly, even some shootings. Some people don’t like to wear masks or seatbelts; some don’t like gun background checks or paying taxes. But this is why we have store security guards, the police and the highway patrol, the I.R.S., A.T.F. and F.B.I. — and why every state passed quarantine laws back in the 19th century. Sometimes the unwilling must be given a stark choice: whether you are suffering from a sense of murderous rage or from a communicable disease, you can either abide by the law meant to protect your fellow citizens from you — or you can stay in your house. If you do come out and endanger others, you go to jail.

Instead, we’re on the honor system.

Huh? Do we just hand a license to everyone who says: “Yes, I can drive”? Do we admit everyone who walks up to the border and announces, “I am American citizen”? Do we say “Oh, no, we never withhold taxes from paychecks — we’ll trust you to pay it in full next April”?

It’s also time to drop “religious exemptions.” No major religion — not one, from Confucianism to Catholicism — opposes vaccination. This issue has been debated by the world’s top religious authorities ever since Edward Jenner controversially deliberately infected a boy with cowpox in 1796. Ultimately all faiths strongly endorsed vaccination because it saves lives, an ideal embraced by all faiths.

And, even if a truly anti-vaccine sect did exist, religious freedom is not absolute, despite what the First Amendment says. Remember, many of the world’s oldest religions once practiced human sacrifice. (Not just the Aztecs and Carthaginians. The Abrahamic religions — Judaism, Christianity and Islam — are founded on God’s covenant with Abraham, whose faith God tested by asking him to sacrifice his son.) We do not permit human sacrifice on religious grounds. We don’t permit bigamy either — we outlawed it in 1862, even though polygamy is common in the Old Testament and Mormonism permitted it. Religions have legal limits, even under the Bill of Rights.

And why are we leaving the job of policing lies about vaccines up to Mark Zuckerberg? What qualifies the staff of Facebook to do that, and what can they do beyond swatting flies? Where is the Justice Department?

Facebook, YouTube and Twitter are not at fault for the lies any more than papyrus, parchment and radio waves were in earlier centuries. They’re the mediums. If you sue a newspaper for libel, you don’t sue the maker of its printing press; you sue the author.

Lies have authors. Yes, some vaccine liars are Russian trolls and beyond the Justice Department’s reach. But the most prominent authors are right here.

Many writers, including Michael Fitzpatrick, author of “Defeating Autism, a Damaging Delusion” and Seth Mnookin, author of “The Panic Virus,” have shown that the anti-vaccine movement is not merely a self-help group of concerned mothers. It is a business pushed by millionaires: the sellers of vitamin and herbal supplements, the directors of unregulated clinics prescribing chelation drugs, detoxifying purges and hyperbaric chambers, the seekers of fame and tax-deductible donations.

The chief domestic purveyors have been dubbed the “Disinformation Dozen.” Their tactics have been described in detail.

In normal times, the harm they do is limited. The anti-vaccine movement helped bring measles back to America, and since 2010 about 3,000 cases have occurred, mostly in New York and California. But no children died in those outbreaks, though dozens were hospitalized. The movement has also helped weaken our national defense against whooping cough, which a handful of babies die of every year.

But now we are at war with a virus. More than 600,000 Americans have died. That’s 200,000 more than died in World War II. We need to treat deliberate disinformation for what it is: a betrayal of the American public.

In the 1930’s, in the name of free speech, this country tolerated the German-American Bund and the Silver Legion, even as they spread the lies that Hitler was America’s friend, that Naziism would save the world from communism, that F.D.R. was controlled by Jews and that George Washington was our “First Fascist.”

But when Americans actually began dying in the fight against Hitler, the nation’s patience ended. The leaders were investigated, their financial frauds exposed. The Legion’s founder was imprisoned, the Bund’s founder was deported to Germany. Newspapers didn’t do that, Facebook can’t do that. Only governments can do that.

President Trump never hesitated to use the full power of his office to punish his enemies, pardon his cronies, and re-assure his own re-election. Happily, he also spent $11 billion to make some of the most amazing vaccines the world has ever seen (for which he deserves credit even if he appears oddly ashamed of them.)

President Biden is now in charge of the same institutions. How about using those awesome powers for a good cause this time: protecting us?

New York Times, 1976–2021. Last beat: lead reporter on pandemic. 2020 Chancellor Award; 2021 NYT Pulitzer donaldgmcneiljr1954@gmail.com