The United States leads the world in COVID-19 deaths and infections.

The high court blocked a Dec. 17 decision by the Cincinnati-based 6th U.S. Circuit Court of Appeals that had allowed the mandate to go into effect.

The court’s order blocking enforcement while litigation continues in a lower court likely signals doom for the administration’s attempt to boost vaccination numbers by harnessing federal powers to protect workplace health and safety.

‘DO NO HARM’

In the healthcare facilities case, the court’s differently comprised majority concluded that the regulation “fits neatly” within the power Congress conferred on the government to impose conditions on Medicaid and Medicare funds, which includes policies that protect health and safety.

“After all, ensuring that providers take steps to avoid transmitting a dangerous virus to their patients is consistent with the fundamental principle of the medical profession: first, do no harm,” the court said.

The justices lifted orders by federal judges in Missouri and Louisiana blocking the policy in 24 states, allowing the administration to enforce it nearly nationwide. Enforcement was blocked in Texas by a lower court in separate litigation not at issue in the case before the Supreme Court.

Workers must be vaccinated by the end of February under the mandate.

The White House has said the two mandates will save lives and strengthen the U.S. economy by increasing the number of vaccinated Americans by the millions. U.S. Solicitor General Elizabeth Prelogar told the justices that the pandemic poses a particularly acute workplace danger, with employees getting sick and dying every day because of their exposure to the coronavirus on the job, with outbreaks across all industries.

The challengers argued that the two federal agencies overstepped their authority in issuing the mandates without specific authorization by Congress.

The Supreme Court’s consideration of the challenges to the mandates underscored how divisive the issue of vaccination has become in the United States, as in many nations. Many Republicans have been critical of vaccine mandates imposed by governments and businesses.

The pandemic has presented an ongoing test for Biden since he took office in January 2021, having promised to improve the federal response to the crisis after an approach by his predecessor Donald Trump that critics called disjointed. But like many other countries the United States is still struggling to overcome the pandemic and is facing an upswing in COVID-19 cases driven by the fast-spreading Omicron coronavirus variant.