WASHINGTON - An at-times visibly irritated President Joe Biden on Thursday (Sept 9) issued a series of orders mandating Covid-19 vaccinations for federal government employees and contractors, and invoking the Defence Production Act to ramp up the production of rapid tests.

Additionally, the Transportation Safety Administration (TSA) will double fines on travellers who refuse to wear a mask.

"If you break the rules, be prepared to pay," the President said in his most forceful remarks to date as the country grapples with the Delta variant, but is hampered by misinformation and vaccine and mask resistance.

A clutch of south-east and mid-western states with high unvaccinated rates are seeing large case numbers.

Nationwide, more than 175 million Americans are now vaccinated, but nearly 80 million are not. Covid-19 deaths have now risen to roughly 1,500 a day - up from fewer than 200 in early July.

A Centres for Disease Control and Prevention (CDC) study last month showed that unvaccinated people are about 29 times more likely to be hospitalised with Covid-19 than those who are fully vaccinated. But vaccine scepticism for a range of reasons including religious, ideological and political ones - in many cases fuelled by rampant disinformation - has plateaued the vaccination rate.

In some states, including Florida and Tennessee, anti-mask and anti-vaccine groups have heckled others, including doctors and nurses, for wearing and promoting masks. There have even been bloody street brawls between pro- and anti-mask and vaccine groups.

"Based on available data from the summer, only one out of every 160,000 fully vaccinated Americans was hospitalised for Covid-19 per day" the President said. "This is a pandemic of the unvaccinated.

"To make matters worse, there are elected officials actively working to undermine the fight against Covid-19. Instead of encouraging people to get vaccinated and mask up, they're ordering mobile morgues for the unvaccinated dying from Covid-19 in their communities. This is totally unacceptable."

His message to the unvaccinated was blunt. "We've been patient, but our patience is wearing thin. And your refusal has cost all of us."

"The 25 per cent of adults who are unvaccinated are holding the rest of the county hostage. This has to end."

"Pandemic politics" was making people ill, he said. "This is not about freedom or personal choice, it is about protecting yourself and those around you."

The President's six-pronged plan includes vaccinating the unvaccinated, furthering protection for the vaccinated, keeping schools safely open, increasing testing and requiring masking, protecting the economic recovery in the country, and improving care.

The new measures won immediate praise from epidemiology experts, but howls of protest from Republicans.

"This is the testing plan that we've been waiting for," tweeted Dr Thomas Tsai, assistant professor of health policy and management at Harvard's T.H. Chan School of Public Health. "Defence Production Act to ramp up rapid antigen tests. Major retailers to sell Covid-19 tests at cost. Expanding free testing at pharmacies."

"I'm pretty thrilled," tweeted Dr Ashish K. Jha, dean of the Brown University School of Public Health. "Covid is killing 1,500 Americans. Every. Day.

"This is not about mandates. This is about creating safe work, hospitals, schools, houses of worship. Ramping up testing is exactly what our nation needs."

But he added: "The big controversial issues here will be vaccine mandates for private employers."

Arizona's Republican Governor Doug Ducey vowed to "push back".

"This is exactly the kind of big government overreach we have tried so hard to prevent in Arizona," he tweeted.

"Now the Biden-Harris administration is hammering down on private businesses and individual freedoms in an unprecedented and dangerous way.

"This dictatorial approach is wrong, un-American and will do far more harm than good."

Mr Robert Aderholt, Republican Congressman from Alabama, condemned the move as "unconstitutional" in another tweet, echoing Ms Kristi Noem, Republican Governor of South Dakota.

Mrs Noem tweeted: "My legal team is standing by ready to file our lawsuit the minute (President Biden) files his unconstitutional rule. This gross example of federal intrusion will not stand."