Biden will announce new measures to try to curb the virus on Tuesday, the day after the CDC said the Omicron variant first identified in southern Africa now accounts for most new U.S. cases. He aims to boost testing, hospital care and vaccinations without any new lockdowns or closings.

He’ll also deliver a stark warning to the unvaccinated, a senior administration official said, telling them that they risk serious disease or death while assuring Americans who’ve gotten their shots that they can safely gather with their families over the holidays.

In the speech, the president will again seek to reassure Americans that his administration can combat yet another resurgence of the virus, the second of his presidency. But he confronts a perception that the government was caught flat-footed as cases began to mount earlier this month and Americans began complaining that test kits, crucial to control transmission, had become scarce. 

Vice President Kamala Harris told the Los Angeles Times that the administration was caught off guard by the emergence of the Omicron variant of the virus, which has now been identified in most states.

No Lockdowns

Biden’s strategy continues to depend on encouraging vaccinations, even as new infections stress the nation’s health-care system and Americans find tests in short supply and see their schools closing in response to the surge.

“This is not a speech about locking the country down,” White House Press Secretary Jen Psaki said. Biden intends to draw stark contrasts with similar spikes in cases earlier in the pandemic, she said. “To be clear: COVID-19 is not the same threat to fully vaccinated individuals that it was in March 2020.”

The White House has discouraged school closings, though Psaki said Monday that “local school districts will need to make the decisions that they feel are appropriate for their communities.”

The Centers for Disease Control and Prevention last week released studies supporting so-called “test-to-stay” strategies, in which students exposed to a case can remain in class under certain conditions. Still, there were 646 COVID-related school closings this week, up from 356 the week before, according to Burbio, a data service that aggregates calendars nationwide.

Biden’s new strategy includes the purchase of 500 million at-home tests, which will be distributed for free to Americans who request them, said the senior administration official, who briefed reporters on condition of anonymity ahead of the speech. 

The tests will be available beginning in January, and the administration plans to launch a website, though details are still being sorted out, the official said. The government will deploy as many as 1,000 military personnel to help at hospitals as needed. 

Biden will also set up federal testing sites, beginning in New York City this week, and direct the Federal Emergency Management Agency to help expand hospital capacity where needed and deploy ambulances to transfer patients from hot spots. 

The president’s moves are an acknowledgment that testing capacity isn’t sufficient. Public health experts have also questioned the administration’s messaging on booster shots, which were initially made available to a limited slice of the population—the CDC director overruled an advisory panel that wanted even narrower restrictions—before eligibility was widened earlier this month.

“We don’t have the testing right—now, two years in—and we don’t have our people vaccinated or boosted?” said Eric Topol, director of the Scripps Research Translational Institute. “Everything’s slipped.”

Booster shots should be treated as third shots in a three-dose series and be more emphatically recommended, he said. “We have not been aggressive and bold about any strategies, and that’s exemplified best by the botch job on the booster,” he said.

Hospitalizations Stable

The seven-day moving average of cases is rising, currently standing at about 133,000 cases a day, roughly double the levels of two months ago. The CDC announced Monday that Omicron accounted for about 73% of new cases from Dec. 12-18.

Francis Collins, the now-retired head of the National Institutes of Health, said last week the country could see as many as a million cases per day. 

The question remains how sick the infected will become. Anthony Fauci, Biden’s top medical adviser, has said it’s too soon to say, but that signs are omicron may be less severe. The national seven-day average of new hospitalizations has actually declined in recent days, though the metric typically lags case-number increases.

And soaring case loads, which Biden’s team expects, can fill hospitals even if the severity of the disease is reduced. 

Celine Gounder, a physician who served as an adviser to Biden’s COVID transition team, said a surge in cases in highly vaccinated areas can be manageable if hospitalizations don’t also spike. The White House has started to think of hospitalizations and deaths as a better metric for the severity of the pandemic than raw caseloads.

“Refocusing people’s attention on hospitalizations and deaths, as opposed to cases and infections, is really important for people to understand that vaccines are working,” Gounder said. 

She said she didn’t see a need for any new lockdowns. “There’s a real desire to avoid further social and economic distress with those kinds of draconian measures.”