The White House says Biden will travel back to Washington from the Camp David presidential retreat to speak at 3:45 p.m. from the East Room. It will be his first public remarks on the Afghanistan situation in nearly a week. Biden and other top U.S. officials had been stunned by the pace of the Taliban’s swift routing of the Afghan military.

Senior U.S. military officials say the chaos at the airport left seven people dead Monday, including some who fell from a departing American military transport jet. The officials spoke on condition of anonymity because they were not authorized to publicly discuss ongoing operations.

Afghans rushed onto the tarmac of the capital’s airport as thousands tried to escape after the Taliban seized power. Some clung to the side of a U.S. military plane before takeoff, in a widely shared video that captured the desperation as America’s 20-year war comes to a chaotic end.

Another video showed the Afghans falling as the plane gained altitude over Kabul. U.S. troops resorted to firing warning shots and using helicopters to clear a path for transport aircraft.

The speed of the Afghan government’s collapse and the ensuing chaos posed the most serious test of Biden as commander in chief, and he came under withering criticism from Republicans who said that he had failed.

Biden campaigned as a seasoned expert in international relations and has spent months downplaying the prospect of an ascendant Taliban while arguing that Americans of all political persuasions have tired of a 20-year war, a conflict that demonstrated the limits of money and military might to force a Western-style democracy on a society not ready or willing to embrace it.

National security adviser Jake Sullivan said Monday that the “speed with which cities fell was much greater than anyone anticipated.” He blamed the government’s fall on the Afghans themselves, telling NBC’s “Today” show that the U.S. ultimately could not give Afghan security forces the “will” to fight to defend their fledgling democracy.

“Despite the fact that we spent 20 years and tens of billions of dollars to give the best equipment, the best training and the best capacity to the Afghan security forces, we could not give them the will and they ultimately decided that they would not fight for Kabul and they would not fight for the country,” Sullivan said.

The turmoil in Afghanistan resets the focus in an unwelcome way for a president who has largely focused on a domestic agenda that includes emerging from the pandemic, winning congressional approval for trillions of dollars in infrastructure spending and protecting voting rights.

Biden remained at Camp David over the weekend, receiving regular briefings on Afghanistan and holding secure video conference calls with members of his national security team, according to senior White House officials. His administration released a single photo of the president on Sunday alone in a conference room meeting virtually with military, diplomatic and intelligence experts.

He is the fourth U.S. president to confront challenges in Afghanistan and has insisted he wouldn’t hand America’s longest war to his successor. But he will likely have to explain how security in Afghanistan unraveled so quickly, especially since he and others in the administration have insisted it wouldn’t happen.

“The jury is still out, but the likelihood there’s going to be the Taliban overrunning everything and owning the whole country is highly unlikely,” Biden said on July 8.

Just last week, though, administration officials warned privately that the military was crumbling, prompting Biden on Thursday to order thousands of American troops into the region to speed up evacuation plans.

Presidents Barack Obama and Donald Trump also yearned to leave Afghanistan, but ultimately stood down in the face of resistance from military leaders and other political concerns. Biden, on the other hand, has been steadfast in his refusal to change the Aug. 31 deadline, in part because of his belief that the American public is on his side.

A late July ABC News/Ipsos poll, for instance, showed 55 percent of Americans approving of Biden’s handling of the troop withdrawal.

Most Republicans have not pushed Biden to keep troops in Afghanistan over the long term and they also supported Trump’s own push to exit the country. Still, some in the GOP stepped up their critique of Biden’s withdrawal strategy and said images from Sunday of American helicopters circling the U.S. Embassy in Kabul evoked the humiliating departure of U.S. personnel from Vietnam.

Senate Republican leader Mitch McConnell deemed the scenes of withdrawal as “the embarrassment of a superpower laid low.”

Senior administration officials believe the U.S. will be able to maintain security at the Kabul airport long enough to extricate Americans and their allies, but the fate of those unable to get to the airport was far from certain.

In the upper ranks of Biden’s staff, the rapid collapse in Afghanistan only confirmed the decision to leave: If the meltdown of the Afghan forces would come so quickly after nearly two decades of American presence, another six months or a year or two or more would not have changed anything.

Biden has argued for more than a decade that Afghanistan was a kind of purgatory for the United States. He found it to be corrupt, addicted to America’s largesse and an unreliable partner that should be made to fend for itself. His goal was to protect Americans from terrorist attacks, not building a country.

In July he said he made the decision to withdraw with “clear eyes.” His judgment was that Afghanistan would be divided in a peace agreement with the Taliban, rather than falling all at once.

“There’s going to be no circumstance where you see people being lifted off the roof of a embassy in the — of the United States from Afghanistan,” he said in July. “The likelihood there’s going to be one unified government in Afghanistan controlling the whole country is highly unlikely.”

Associated Press writers Michael Balsamo, James LaPorta and Mary Clare Jalonick contributed to this report.

Putin said there was “no hostility” during the talks that wrapped up more quickly than expected.

The two sides had said they expected to meet for four to five hours but spent less than three hours together, including an opening meeting with just the two presidents and each one’s top foreign aide.

When it was over, Putin had first crack at describing the results at a solo news conference, with Biden to follow with his own session with reporters.

Putin acknowledged that Biden raised human rights issues with him, including the fate of opposition leader Alexei Navalny. Putin defended Navalny’s prison sentence and deflected repeated questions about mistreatment of Russian opposition leaders by highlighting U.S. domestic turmoil, including the Black Lives Matter protests and the Jan. 6 Capitol insurrection.

Putin held forth for nearly an hour before international reporters. While showing defiance at queries about Biden pressing him on human rights, he also expressed a significant measure of respect for Biden as an experienced political leader.

The Russian leader noted that Biden repeated wise advice his mother had given him and also spoke about his family — messaging that Putin said might not have been entirely relevant to their summit but demonstrated Biden’s “moral values.” Though he raised doubt that the U.S.-Russia relationship could soon return to a measure of equilibrium of years past, Putin suggested that Biden was someone he could work with.

“The meeting was actually very efficient,” Putin said. “It was substantive, it was specific. It was aimed at achieving results, and one of them was pushing back the frontiers of trust.”

Putin said he and Biden agreed to begin negotiations on nuclear talks to potentially replace the New START treaty limiting nuclear weapons after it expires in 2026.

Washington broke off talks with Moscow in 2014 in response to Russia’s annexation of Ukraine’s Crimea and its military intervention in support of separatists in eastern Ukraine. Talks resumed in 2017 but gained little traction and failed to produce an agreement on extending the New START treaty during the Trump administration.

The Russian president said there was an agreement between the leaders to return their ambassadors to their respective postings. Both countries had pulled back their top envoys to Washington and Moscow as relations chilled in recent months.

Russia’s ambassador to the U.S., Anatoly Antonov, was recalled from Washington about three months ago after Biden called Putin a killer; U.S. Ambassador to Russia John Sullivan left Moscow almost two months ago, after Russia suggested he return to Washington for consultations. Putin said that the ambassadors were expected to return their posts in the coming days.

Putin also said the two sides agreed in principle to begin consultations on cybersecurity issues, though he continued to deny U.S. allegations that Russian government was responsible for a spate of recent high-profile hacks against business and government agencies in the United States and around the globe.

The meeting in a book-lined room had a somewhat awkward beginning — both men appeared to avoid looking directly at each other during a brief and chaotic photo opportunity before a scrum of jostling reporters.

Biden nodded when a reporter asked if Putin could be trusted, but the White House quickly sent out a tweet insisting that the president was “very clearly not responding to any one question, but nodding in acknowledgment to the press generally.”

Their body language, at least in their brief moments together in front of the press, was not exceptionally warm.

The two leaders did shake hands — Biden extended his hand first and smiled at the stoic Russian leader — after Swiss President Guy Parmelin welcomed them to Switzerland for the summit. When they were in front of the cameras a few minutes later—this time inside the grand lakeside mansion where the summit was held — they seemed to avoid eye contact.

For months, Biden and Putin have traded sharp rhetoric. Biden has repeatedly called out Putin for malicious cyberattacks by Russian-based hackers on U.S. interests, for the jailing of Russia’s foremost opposition leader and for interference in American elections.

Putin has reacted with whatabout-isms and denials — pointing to the Jan. 6 insurrection at the U.S. Capitol to argue that the U.S. has no business lecturing on democratic norms and insisting that the Russian government hasn’t been involved in any election interference or cyberattacks despite U.S. intelligence showing otherwise.

In advance of Wednesday’s meeting, both sides set out to lower expectations.

Even so, Biden said it was an important step if the United States and Russia were able to ultimately find “stability and predictability” in their relationship, a seemingly modest goal from the president for dealing with the person he sees as one of America’s fiercest adversaries.

Arrangements for the meeting were carefully choreographed and vigorously negotiated.

Biden first floated the meeting in an April phone call in which he informed Putin that he would be expelling several Russian diplomats and imposing sanctions against dozens of people and companies, part of an effort to hold the Kremlin accountable for interference in last year’s presidential election and the hacking of federal agencies.

The White House announced ahead of the summit that Biden wouldn’t hold a joint news conference with Putin, deciding it did not want to appear to elevate Putin at a moment when the U.S. president is urging European allies to pressure Putin to cut out myriad provocations.

Biden sees himself with few peers on foreign policy. He traveled the globe as a member of the Senate Foreign Relations Committee and was given difficult foreign policy assignments by President Barack Obama when Biden was vice president. His portfolio included messy spots like Iraq and Ukraine and weighing the mettle of China’s Xi Jinping during his rise to power.

He has repeatedly said that he believes executing effective foreign policy comes from forming strong personal relations, and he has managed to find rapport with both the likes of Turkey’s Recep Tayyip Erdogan, whom Biden has labeled an “autocrat,” and more conventional Western leaders including Canada’s Justin Trudeau.

But with Putin, who he has said has “no soul,” Biden has long been wary. At the same time, he acknowledges that Putin, who has remained the most powerful figure in Russian politics over the span of five U.S. presidents, is not without talent.

“He’s bright. He’s tough,” Biden said earlier this week. “And I have found that he is a — as they say … a worthy adversary.”

Biden had prepared for his one-on-one by reviewing materials and consulting with officials across government and with outside advisers. Aides said the level of preparation wasn’t unusual. Biden, in a brief exchange with reporters upon arriving in Geneva on Tuesday night, sought to offer the impression that he wasn’t sweating his big meeting.

“I am always ready,” Biden said.

Associated Press writer Zeke Miller in Washington and AP video journalist Daniel Kozin contributed reporting

This story has been corrected to show that Geneva is not Switzerland’s capital.

Biden’s sharp words for Russia and his friendly interactions with NATO allies marked a sharp shift in tone from the past four years and highlighted the renewed U.S. commitment to the 30-country alliance that was frequently maligned by predecessor Donald Trump.

Biden, wearing a NATO lapel pin, said that in his extensive talks with NATO leaders about his planned meeting with Putin on Wednesday, all were supportive of his plans to press the Russian leader to halt Russian-originated cyber attacks against the West, end the violent stifling of political dissidents and stop interfering in elections outside its borders.

“I’m going to make clear to President Putin that there are areas where we can cooperate, if he chooses,” Biden told reporters as he ended his day at NATO headquarters. “And if he chooses not to cooperate and acts in a way that he has in the past relative to cybersecurity and other activities, then we will respond, we will respond in kind.”

Biden is on an eight-day visit to Europe in which he is seeking to rally allies to speak with a single voice on countering Russia and China.

To that end, NATO leaders on Monday declared China a constant security challenge and said the Chinese are working to undermine global order, a message in sync with Biden’s pleas to confront Beijing on China’s trade, military and human rights practices.

In a summit statement, the leaders said that China’s goals and “assertive behavior present systemic challenges to the rules-based international order and to areas relevant to alliance security.”

The heads of state and government expressed concern about what they said were China’s “coercive policies,” the opaque ways it is modernizing its armed forces and its use of disinformation.

The NATO leaders also took a big swipe at Russia in their communique, deploring what they consider its aggressive military activities and its snap wargames near the borders of NATO countries as well as repeated violations of their airspace by Russian planes.

They said that Russia had ramped up “hybrid” actions against member countries by attempts to interfere in elections, by political and economic intimidation, by disinformation campaigns and “malicious cyber activities.”

“Until Russia demonstrates compliance with international law and its international obligations and responsibilities, there can be no return to ‘business as usual,’” they said.

The North Atlantic Treaty Organization is an alliance of European and North American countries formed after World War II as a bulwark against Russian aggression. The new Brussels communique states plainly that the NATO nations “will engage China with a view to defending the security interests of the alliance.”

Biden arrived at the NATO summit after three days of consulting with Group of Seven allies in England, where he successfully pushed for a G-7 communique that called out forced labor practices and other human rights violations impacting Uyghur Muslims and other ethnic minorities in China’s western Xinjiang province.

However, differences remain among the allies about how forcefully to criticize Beijing.

German Chancellor Angela Merkel said NATO’s decision to name China as a threat “shouldn’t be overstated” because Beijing, like Russia, is also a partner in some areas. China is Germany’s top trading partner, and she said it is important to “find the right balance.”

France’s President Emmanuel Macron urged the alliance not to let China distract it from what he saw as more pressing issues facing NATO, including the fight against terrorism and security issues related to Russia.

“I think it is very important not to scatter our efforts and not to have biases in our relation to China,” Macron said.

The Chinese Embassy to the United Kingdom on Monday issued a statement saying the G-7 communique “deliberately slandered China and arbitrarily interfered in China’s internal affairs.” There was no immediate reaction from the Chinese government to the new NATO statement.

Biden arrived at his first NATO summit as president as leading members declared it a pivotal moment for an alliance beleaguered during the presidency of Trump, who questioned the relevance of the multilateral organization.

Biden sat down with NATO Secretary General Jens Stoltenberg and underscored the U.S. commitment to Article 5 of the alliance charter, which spells out that an attack on any member is an attack on all and is to be met with a collective response.

“Article 5 we take as a sacred obligation,” said Biden. “I want NATO to know America is there.”

It was a marked contrast to the days when Trump called the alliance “obsolete” and complained that it allowed for “global freeloading” countries to spend less on military defense at the expense of the U.S.

Biden was greeted by fellow leaders with warmth and even a bit of relief.

Belgian Prime Minister Alexander de Croo said Biden’s presence “emphasizes the renewal of the transatlantic partnership.” De Croo said NATO allies were looking to get beyond four stormy years with Trump and infighting among member countries.

“I think now we are ready to turn the page,” de Croo said.

The alliance also updated Article 5 to offer greater clarity on how the alliance should react to major cyber attacks — a matter of growing concern amid hacks targeting the U.S. government and businesses around the globe by Russia-based hackers.

Beyond extending potential use of the mutual defense clause to apply to space, the leaders also broadened the definition of what might constitute such an attack in cyberspace, in a warning to any adversary that might use constant low-level attacks as a tactic.

The organization declared in 2014 that a cyber attack could be met by a collective response by all 30 member countries, and on Monday they said that “the impact of significant malicious cumulative cyber activities might, in certain circumstances, be considered as amounting to an armed attack.”

The president started his day meeting with leaders of the Baltic states on NATO’s eastern flank as well as separate meetings with leaders of Poland and Romania to discuss any threat posed by Russia and the recent air piracy in Belarus.

Biden also met with Turkey’s President Recep Tayyip Erdogan, on the summit sidelines.

Biden has known Erdogan for years, but their relationship has frequently been contentious. Biden, during his campaign, drew ire from Turkish officials when he described Erdogan as an “autocrat.” In April, Biden infuriated Ankara by declaring that the Ottoman-era mass killing and deportations of Armenians was “genocide” — a term that U.S. presidents have avoided using.

Associated Press writers Frank Jordans, Sylvie Corbet, Zeke Miller and Alexandra Jaffe contributed reporting.

In a summit statement, the leaders said that China’s goals and “assertive behavior present systemic challenges to the rules-based international order and to areas relevant to alliance security.”

While the 30 heads of state and government avoided calling China a rival, they expressed concern about what they said were its “coercive policies,” the opaque ways it is modernizing its armed forces and its use of disinformation.

They called on Beijing to uphold its international commitments and to act responsibly in the international system.

The statement comes as President Joe Biden has stepped up his effort to rally allies to speak in a more unified voice about China’s human rights record, its trade practices and its military’s increasingly assertive behavior that has unnerved U.S. allies in the Pacific.

Biden, who arrived at the summit after three days of consulting with Group of Seven allies in England, pushed for the G-7 communique there that called out what it said were forced labor practices and other human rights violations impacting Uyghur Muslims and other ethnic minorities in the western Xinjiang province. The president said he was satisfied with the communique, although differences remain among the allies about how forcefully to criticize Beijing.

The new Brussels communique states plainly that the NATO nations “will engage China with a view to defending the security interests of the alliance.””

The Chinese Embassy to the United Kingdom on Monday issued a statement saying the G-7 communique “deliberately slandered China and arbitrarily interfered in China’s internal affairs,” and exposed the “sinister intentions of a few countries, such as the United States.” There was no immediate reaction from the Chinese government to the new NATO statement.

Biden arrived at his first NATO summit as president as leading members declared it a pivotal moment for an alliance beleaguered during the presidency of Donald Trump, who questioned the relevance of the multilateral organization.

Shortly after arriving at the alliance’s headquarters for the first NATO summit of his presidency, Biden sat down with NATO Secretary General Jens Stoltenberg and underscored the U.S. commitment to Article 5 of the alliance charter, which spells out that an attack on one member is an attack on all and is to be met with a collective response.

“Article 5 we take as a sacred obligation,” Biden said. “I want NATO to know America is there.”

It was a sharp shift in tone from the past four years, when Trump called the alliance “obsolete” and complained that it allowed for “global freeloading” countries to spend less on military defense at the expense of the U.S.

Looking forward, Stoltenberg noted myriad challenges still facing the alliance.

“We are meeting at the pivotal time for our alliance, the time of growing geopolitical competition, regional instability, terrorism, cyber attacks and climate change,” Stoltenberg said at the start of a joint session of the NATO leaders. “No nation and no continent can deal with these challenges alone. But Europe and North America are not alone.”

Biden, who came to Brussels following three days of consultations with Group of Seven leaders in England, was greeted by fellow leaders with warmth and even a bit of relief.

Belgium Prime Minister Alexander de Croo said Biden’s presence “emphasizes the renewal of the transatlantic partnership.” De Croo said NATO allies were looking to get beyond four stormy years under the Trump administration and infighting among member countries.

“I think now we are ready to turn the page,” de Croo said.

Italian Prime Minister Mario Draghi made a not-so-subtle dig at Trump, while welcoming Biden.

“This summit is a continuation of yesterday’s G-7 and is part of the process of reaffirming, of rebuilding the fundamental alliances of the United States that had been weakened by the previous administration,” he said. “Think that President Biden’s first visit is to Europe and try to remember where President Trump’s first visit was?”

Trump’s first overseas visit as president was to Saudi Arabia.

Trump routinely berated other NATO countries for not spending enough on defense and even threatened to pull the U.S. out of the world’s biggest security organization and even questioned the mutual defense provision of the NATO charter, a central tenet of the alliance.

When alliance members last met for a summit in England in December 2019, Trump grabbed headlines by calling Canadian Prime Minister Justin Trudeau “two-faced” and French President Emmanuel Macron “nasty.”

Trump lashed out after Trudeau was caught on a hot mic gossiping with other leaders about Trump turning photo opportunities into long news conferences. Ahead of the summit, Macron had declared NATO “brain dead” because of a void in U.S. leadership under Trump.

The White House said the communique to be signed by alliance members at the end of the NATO summit is expected to include language about updating Article 5 to include major cyber attacks — a matter of growing concern amid a series of hacks targeting the U.S. government and businesses around the globe by Russia-based hackers.

The update will spell out that if an alliance member needs technical or intelligence support in response to a cyber attack, it would be able to invoke the mutual defense provision to receive assistance, according to White House national security adviser Jake Sullivan.

The president started his day meeting with leaders of the Baltic states on NATO’s eastern flank as well as separate meetings with leaders of Poland and Romania to discuss the threat posed by Russia and the recent air piracy in Belarus, according to the White House.

Biden’s itinerary in Europe has been shaped so that he would first gather with G-7 leaders and then with NATO allies in Brussels before his much-anticipated meeting with Russian President Vladimir Putin in Geneva on Wednesday. And with both summits, Biden aimed to consult European allies on efforts to counter provocative actions by China and Russia.

Biden will meet later on Monday with Turkey’s president, Erdogan, on the summit sidelines.

Biden has known Erdogan for years but their relationship has frequently been contentious. Biden, during his campaign, drew ire from Turkish officials after he described Erdogan as an “autocrat.” In April, Biden infuriated Ankara by declaring that the Ottoman-era mass killing and deportations of Armenians was “genocide” — a term that U.S. presidents have avoided using.

Biden has set the stakes for his eight-day trip in sweeping terms, believing the West must publicly demonstrate it can compete economically with China as the world emerges from the coronavirus pandemic. It is an open repudiation of his predecessor, Donald Trump, who scorned alliances and withdrew from a global climate change agreement that Biden has since rejoined.

The president’s first stop was a visit with U.S. troops and their families at Royal Air Force Mildenhall, where he laid out his mission for the trip.

“We’re going to make it clear that the United States is back and democracies are standing together to tackle the toughest challenges and issues that matter the most to our future,” he said. “That we’re committed to leading with strength, defending our values, and delivering for our people.”

The challenges awaiting Biden overseas were clear as the president and the audience wore masks — a reminder of the pandemic that is still raging around much of the world even as its threat recedes within the United States.

“We have to end COVID-19 not just at home — which we’re doing — but everywhere,” Biden said.

Shortly before the president spoke, people briefed on the matter said the Biden administration had brokered an agreement with Pfizer to purchase 500 million COVID-19 vaccine doses to be donated to 92 lower-income countries and the African Union over the next year.

National security adviser Jake Sullivan told reporters that Biden was committed to sharing vaccines because it was in the public health and strategic interests of the U.S. He added that Biden is aiming to show “that democracies are the countries that can best deliver solutions for people everywhere.”

“As he said in his joint session (address), we were the ‘arsenal of democracy’ in World War II,” Sullivan said. “We’re going to be the ‘arsenal of vaccines’ over this next period to help end the pandemic.”

After addressing the troops, Biden and first lady Jill Biden flew to Cornwall Airport Newquay, then traveled by car to Tregenna Castle in St. Ives, where they are staying until Sunday.

Building toward his trip-ending summit with Russian President Vladimir Putin, Biden will aim to reassure European capitals that the United States can once again be counted on as a dependable partner to thwart Moscow’s aggression both on their eastern front and their internet battlefields.

The trip will be far more about messaging than specific actions or deals. And the paramount priority for Biden is to convince the world that his Democratic administration is not just a fleeting deviation in the trajectory of an American foreign policy that many allies fear irrevocably drifted toward a more transactional outlook under Trump.

“The trip, at its core, will advance the fundamental thrust of Joe Biden’s foreign policy,” Sullivan said, “to rally the world’s democracies to tackle the great challenges of our time.”

Biden’s to-do list is ambitious.

In their face-to-face sit-down in Geneva, Biden wants to privately pressure Putin to end myriad provocations, including cybersecurity attacks on American businesses by Russian-based hackers, the jailing of opposition leader Alexei Navalny and repeated overt and covert efforts by the Kremlin to interfere in U.S. elections.

Biden is also looking to rally allies on their COVID-19 response and to urge them to coalesce around a strategy to check emerging economic and national security competitor China even as the U.S. expresses concern about Europe’s economic links to Moscow. Biden also wants to nudge outlying allies, including Australia, to make more aggressive commitments to the worldwide effort to curb global warming.

The week-plus journey is a big moment for Biden, who traveled the world for decades as vice president and as chair of the Senate Foreign Relations Committee and has now stepped off Air Force One onto international soil as commander in chief. He will face world leaders still grappling with the virus and rattled by four years of Trump’s inward-looking foreign policy and moves that strained longtime alliances as the Republican former president made overtures to strongmen.

The president first attends a summit of the Group of Seven leaders in the U.K., and then visits Brussels for a NATO summit and a meeting with the heads of the European Union. The trip comes at a moment when Europeans have diminished expectations for what they can expect of U.S. leadership on the foreign stage.

Central and Eastern Europeans are desperately hoping to bind the U.S. more tightly to their security. Germany is looking to see the U.S. troop presence maintained there so it doesn’t need to build up its own. France, meanwhile, has taken the tack that the U.S. can’t be trusted as it once was and that the European Union must pursue greater strategic autonomy going forward.

“I think the concern is real that the Trumpian tendencies in the U.S. could return full bore in the midterms or in the next presidential election,” said Alexander Vershbow, a former U.S. diplomat and once deputy secretary general of NATO.

The sequencing of the trip is deliberate: Biden consulting with Western European allies for much of a week as a show of unity before his summit with Putin.

Biden holds a sitdown Thursday with British Prime Minster Boris Johnson a day ahead of the G-7 summit to be held above the craggy cliffs of Cornwall overlooking the Atlantic Ocean.

The most tactile of politicians, Biden has grown frustrated by the diplomacy-via-Zoom dynamics of the pandemic and has relished the ability to again have face-to-face meetings that allow him to size up and connect with world leaders. While Biden himself is a veteran statesman, many of the world leaders he will see in England, including Johnson and French President Emmanuel Macron, took office after Biden left the vice presidency. Another, Germany’s Angela Merkel, will leave office later this year.

There are several potential areas of tension. On climate change, the U.S. is aiming to regain its credibility after Trump pulled the country back from the fight against global warming. Biden could also feel pressure on trade, an issue to which he’s yet to give much attention. And with the United States well supplied with COVID-19 vaccines yet struggling to persuade some of its own citizens to use it, leaders whose inoculation campaigns have been slower have been pressuring Biden to share more surplus around the globe.

Another central focus will be China. Biden and the other G-7 leaders will announce an infrastructure financing program for developing countries that is meant to compete directly with Beijing’s Belt-and-Road Initiative. But not every European power has viewed China in as harsh a light as Biden, who has painted the rivalry with the techno-security state as the defining competition for the 21st century.

The European Union has avoided taking as strong a stance on Beijing’s crackdown on Hong Kong’s democracy movement or treatment of Uyghur Muslims and other ethnic minorities in the western Xinjiang province as the Biden administration may like. But there are signs that Europe is willing to put greater scrutiny on Beijing.

Biden is also scheduled to meet with Turkish President Recep Tayyip Erdogan while in Brussels, a face-to-face meeting between two leaders who have had many fraught moments in their relationship over the years.

The trip finale will be Biden’s meeting with Putin.

Biden has taken a very different approach to Russia than Trump’s friendly outreach. Their sole summit, held in July 2018 in Helsinki, was marked by Trump’s refusal to side with U.S. intelligence agencies over Putin’s denials of Russian interference in the election two years earlier.

Biden, speaking at the Coast Guard’s sun-soaked Connecticut campus, told the 240 graduates that “the world is changing” and told them that they are at a “significant inflection point.”

“The best way to meet the wide array of threats we meet today is by investing in America’s enduring advantages,” said Biden, “and ensure we’re operating from a position of strength.”

The president used the speech to position the United States as a defender of global rules, trade and marine law, specifically in the South China Sea and the Arctic. Following the inward-looking presidency of Donald Trump, Biden has pushed for the U.S. to prove that democracy still works at home so it can lead by example across the globe and compete with rising autocracies.

But Biden made no mention of several current global hotspots, including the ongoing conflict between Israel and the Palestinians, for which hours earlier he called for a cease-fire. Biden, who also spoke at the New London academy as vice president in 2013, did stress that the Coast Guard played in responding to more frequent extreme weather, such as hurricanes, due to climate change.

In good spirts, Biden relished the stage, telling stories about his late son Beau — an Army veteran —and teasing the graduates for not laughing at his jokes, smiling as he declared them “a really dull class.” But he turned serious when he praised them for navigating the COVID-19 pandemic, declaring that “you met the threat head on, you adapted, you showed resilience, you led.”

Lemire reported from New York.

“This week we inaugurate a new administration and pray for its success in keeping America safe and prosperous,” Trump said in the video “farewell address,” released by the White House less than 24 hours before President-elect Joe Biden’s inauguration. “We extend our best wishes. And we also want them to have luck — a very important word.”

Trump, who spent months trying to delegitimize Biden’s win with baseless allegations of mass voter fraud, repeatedly refenced the “next administration,” but declined to utter Biden’s name. Many of Trump’s supporters continue to believe the election was stolen from him, even though a long list of judges, Republican state officials and even Trump’s own government have said there is no evidence to support that claim.

Trump was also expected to spend his final hours granting clemency to as many as 100 people, according to two people briefed on the plans. The list of pardons and commutations is expected to include names unfamiliar to the American public — regular people who have spent years languishing in prison — as well as politically connected friends and allies like those he’s pardoned in the past.

Trump in his address tried to cast his presidency as a triumph for everyday people as he highlighted what he sees as his top achievements, including efforts to normalize relations in the Middle East, the development of coronavirus vaccinations and the creation of a new Space Force. And he tried to defend the endless controversies that have consumed the last four years as justified.

“As President, my top priority, my constant concern, has always been the best interests of American workers and American families,” he said. “I did not seek the easiest course; by far, it was actually the most difficult. I did not seek the path that would get the least criticism. I took on the tough battles, the hardest fights, the most difficult choices because that’s what you elected me to do.”

Trump also made clear that he has no plans of going quietly into the night, telling his supporters that, as he prepares “to hand power over to a new administration at noon on Wednesday, I want you to know that the movement we started is only just beginning. There’s never been anything like it.”

Trump has remained largely out of sight since his supporters stormed the Capitol building earlier this month, trying to halt the peaceful transfer of power. Aides had urged him to spend his final days in office participating in a series of legacy-burnishing events. But Trump, who remains consumed with anger and grievance over his election loss, largely refused. He has not been seen in public since last week, when he traveled to Texas for one last photo opportunity at the border wall he pushed so adamantly throughout his presidency. In the end, he spent less than 45 minutes on the ground there and spoke just 21 minutes.

Trump is set to leave Washington early Wednesday morning after a grand farewell event at nearby Joint Base Andrews. Once there, he will board Air Force One for a final time, flying to Florida and becoming the first outgoing president in more than a century to skip the inauguration of his successor.

But it remains unclear how many people will be there to see him off. Several former administration officials-turned-Trump critics have expressed surprise that they received invitations. And even Vice President Mike Pence will be absent. A person familiar with his schedule cited the logistical challenges of getting from the base back to D.C. for Biden’s inauguration ceremonies, which Pence will be attending.

Trump has also refused to take part in any of the symbolic passing-of-the-torch traditions that have been the capstones of the peaceful transition of power from one administration to the next. He is boycotting not just the ceremony at the Capitol, but also passed on inviting the Bidens to the White House for a get-to-know-you meeting. And it remains unclear whether he will write Biden a personal welcome letter, like the one he received from former President Obama when he moved in.

Denied his Twitter bullhorn and with little else planned, Trump did participate in multiple meetings over the long weekend to discuss pending clemency actions, according to a White House official, who, like others, spoke on condition of anonymity because the action had yet to be made public.

Trump was personally involved in the effort to sift through requests, mostly from first-time drug offenders sentenced to life, rejecting some applications and greenlighting others, according to one of the people involved in the effort. Also playing a key role has been the president’s daughter, Ivanka Trump, who personally met with advocates, reviewed cases and brought them to the Department of Justice and pardon attorney.

Trump had been expected to move forward with additional pardons and commutations earlier this month, but discussions were put on hold after the insurrection at the Capitol by pro-Trump rioters incited by the president’s fiery and baseless election challenges. That threw an already paralyzed White House into even further chaos.

Trump has since been impeached for a second time and a sense of wariness has set in, with the president’s inner circle fearful of doing anything that could provoke a conviction in the Senate that would potentially bar him from ever holding office again.

That would curtail any chance of a 2024 comeback run that Trump had hoped would at least stoke the rumors of a campaign to remain relevant and a GOP kingmaker. Trump aides nervously watched Senate Majority Leader Mitch McConnell’s Tuesday denunciation of the president’s words that incited the riot; if McConnell, who has not signaled how he will vote in the trial, opts to convict, enough Republicans may follow suit to oust Trump, who does not have his Twitter account to keep his adopted party in line.

A long list of Trump staffers have already packed their offices and departed the White House, leaving the West Wing deserted — a warren of empty offices and bare walls — surrounded by an unprecedented security apparatus with National Guard troops, military vehicles and checkpoints aimed at staving off further violence.

Moving trucks were spotted in Florida on Monday arriving at Trump’s private Mar-a-Lago club.

Trump led off a video from the White House by condemning the violence carried out in his name a day earlier at the Capitol.

“I would like to begin by addressing the heinous attack on the United States Capitol, like all Americans, I am outraged by the violence, lawlessness and mayhem,” Trump said. “I immediately deployed the National Guard and federal law enforcement to secure the building and expel the intruders. America is and must always be a nation of law and order.”

Then, for the first time, he admitted that his presidency would soon end — though he declined to mention President-elect Joe Biden by name or explicitly state that he had lost.

“A new administration will be inaugurated on Jan. 20,” Trump said in the video. “My focus now turns to ensuring a smooth, orderly and seamless transition of power. This moment calls for healing and reconciliation.”

The address, which appeared designed to stave off talk of a forced early eviction, came at the end of a day when the cornered president stayed out of sight in the White House. Silenced on some of his favorite internet lines of communication, he watched the resignations of several top aides, including a Cabinet secretary.

And as officials sifted through the aftermath of the pro-Trump mob’s siege of the U.S. Capitol, there was growing discussion of impeaching him a second time or invoking the 25th Amendment to oust him from the Oval Office.

The invasion of the Capitol building, a powerful symbol of the nation’s democracy, rattled Republicans and Democrats alike. They struggled with how best to contain the impulses of a president deemed too dangerous to control his own social media accounts but who remains commander in chief of the world’s greatest military.

“I’m not worried about the next election, I’m worried about getting through the next 14 days,” said Republican Sen. Lindsey Graham of South Carolina, one of Trump’s staunchest allies. He condemned the president’s role in Wednesday’s riots and said, “If something else happens, all options would be on the table.”

Democratic House Speaker Nancy Pelosi declared that “the president of the United States incited an armed insurrection against America.” She called him “a very dangerous person who should not continue in office. This is urgent, an emergency of the highest magnitude.”

Neither option to remove Trump seemed likely, with little time left in his term to draft the Cabinet members needed to invoke the amendment or to organize the hearings and trial mandated for an impeachment. But the fact that the dramatic options were even the subject of discussion in Washington’s corridors of power served as a warning to Trump.

Fears of what a desperate president could do in his final days spread in the nation’s capital and beyond, including speculation Trump could incite more violence, make rash appointments, issue ill-conceived pardons — including for himself and his family — or even trigger a destabilizing international incident.

The president’s video Thursday — which was released upon his return to Twitter after his account was restored — was a complete reversal from the one he put out just 24 hours earlier in which he said to the violent mob, “We love you. You’re very special.” His refusal to condemn the violence sparked a firestorm of criticism and, in the new video, he at last denounced the demonstrators’ “lawlessness and mayhem.”

As for his feelings on leaving office, he told the nation that “serving as your president has been the honor of my lifetime” while hinting at a return to the public arena. He told supporters “that our incredible journey is only just beginning.”

Just a day earlier, Trump unleashed the destructive forces at the Capitol with his baseless claims of election fraud at a rally that prompted supporters to disrupt the congressional certification of Biden’s victory. After the storming of the Capitol and the eventual wee-hours certification of Biden’s win by members of Congress, Trump released a statement that merely acknowledged he would abide by a peaceful transfer of power on Jan. 20.

The statement was posted by an aide and did not originate from the president’s own Twitter account, which has 88 million followers and for four years has been wielded as a political weapon that dictates policy and sows division and conspiracy.

Trump couldn’t tweet it himself because, for the first time, the social media platform suspended his account, stating that the president had violated its rules of service by inciting violence. Facebook adopted a broader ban, saying Trump’s account would be offline until after Biden’s inauguration.

Deprived of that social media lifeblood, Trump remained silent and ensconced in the executive mansion until Thursday evening. But around him, loyalists headed for the exits, their departures — which were coming in two weeks anyway — moved up to protest the president’s handling of the riot.

Transportation Secretary Elaine Chao became the first Cabinet member to resign. Chao, married to Senate Majority Leader Mitch McConnell, one of the lawmakers trapped at the Capitol on Wednesday, said in a message to staff that the attack “has deeply troubled me in a way that I simply cannot set aside.”

Education Secretary Betsy DeVos followed. In her resignation letter Thursday, DeVos blamed Trump for inflaming tensions in the violent assault on the seat of the nation’s democracy. “There is no mistaking the impact your rhetoric had on the situation, and it is the inflection point for me,” she wrote.

Others who resigned in the wake of the riot: Deputy National Security Advisor Matthew Pottinger, Ryan Tully, senior director for European and Russian affairs at the National Security Council, and first lady Melania Trump’s chief of staff Stephanie Grisham, a former White House press secretary.

Mick Mulvaney, Trump’s former chief of staff-turned-special envoy to Northern Ireland, told CNBC that he had called Secretary of State Mike Pompeo “to let him know I was resigning. … I can’t do it. I can’t stay.”

And Mulvaney said that others who work for Trump had decided to remain in their posts in an effort to provide some sort of guardrails for the president during his final days in office.

“Those who choose to stay, and I have talked with some of them, are choosing to stay because they’re worried the president might put someone worse in,” Mulvaney said.

Mulvaney’s predecessor in the chief of staff job, retired U.S. Marine Corps general John Kelly, told CNN that “I think the Cabinet should meet and have a discussion” about Section 4 of the 25th Amendment — allowing the forceful removal of Trump by his own Cabinet.

Senate Minority Leader Chuck Schumer joined Pelosi in declaring that Trump “should not hold office one day longer” and urged Vice President Mike Pence and the Cabinet to act. But Chao’s departure may stall nascent efforts to invoke the amendment.

Staff-level discussions on the matter took place across multiple departments and even in parts of the White House, according to two people briefed on the talks. But no member of the Cabinet has publicly expressed support for the move — which would make Pence the acting president — though several were believed to be sympathetic to the notion, believing Trump is too volatile in his waning days in office.

In the West Wing, shell-shocked aides were packing up, acting on a delayed directive to begin offboarding their posts ahead of the Biden team’s arrival. The slowdown before now was due to Trump’s single-minded focus on his defeat since Election Day at the expense of the other responsibilities of his office.

Most glaringly, that included the fight against the raging coronavirus that is killing record numbers of Americans each day.

Few aides had any sense of the president’s plans, with some wondering if Trump would largely remain out of sight until he left the White House. White House press secretary Kayleigh McEnany read a brief statement in which she declared that the Capitol siege was “appalling, reprehensible and antithetical to the American way.”

But her words carried little weight. Trump has long made clear that only he speaks for his presidency.

Lemire reported from New York. Associated Press writer Jill Colvin contributed reporting from Washington.

It was unclear when or how quickly a winner could be determined. The latest vote counts in Michigan and Wisconsin gave Biden a small lead in those states, but it was still too early to call the races.

Trump campaign manager Bill Stepien said the president would formally request a Wisconsin recount, citing “irregularities in several Wisconsin counties.” The state allows for an apparent losing candidate to request a recount if the margin is less than 1 percent.

Hundreds of thousands of votes were still to be counted in Pennsylvania.

Neither candidate cleared the 270 Electoral College votes needed to win the White House, and the margins were tight in several other battleground states. Top advisers for both Biden and Trump on Wednesday morning expressed confidence that they respectively had the likelier path to victory in the outstanding states.

The margins were exceedingly tight in states across the country, with the candidates trading wins in battlegrounds. Trump picked up Florida, the largest of the swing states, while Biden flipped Arizona, a state that has reliably voted Republican in recent elections.

The high-stakes election was held against the backdrop of a historic pandemic that has killed more than 232,000 Americans and wiped away millions of jobs. Both candidates spent months pressing dramatically different visions for the nation’s future, including on racial justice, and voters responded in huge numbers, with more than 100 million people casting votes ahead of Election Day.

Trump, in an extraordinary move from the White House, issued premature claims of victory and said he would take the election to the Supreme Court to stop the counting. It was unclear exactly what legal action he could try to pursue.

Senate Majority Leader Mitch McConnell discounted the president’s quick claim of victory, saying it would take a while for states to conduct their vote counts. The Kentucky Republican said Wednesday that “claiming you’ve won the election is different from finishing the counting.”

The president stayed out of the public eye but took to Twitter to suggest, without basis, that the election was being tainted by late-counted ballots. Twitter flagged a number of Trump’s tweets, noting some of the information shared was “disputed and might be misleading about an election or other civic process.”

Biden, briefly appearing in front of supporters in Delaware, urged patience, saying the election “ain’t over until every vote is counted, every ballot is counted.”

“It’s not my place or Donald Trump’s place to declare who’s won this election,” Biden said. “That’s the decision of the American people.”

Vote tabulations routinely continue beyond Election Day, and states largely set the rules for when the count has to end. In presidential elections, a key point is the date in December when presidential electors met. That’s set by federal law.

Several states allow mailed-in votes to be accepted after Election Day, as long as they were postmarked by Tuesday. That includes Pennsylvania, where ballots postmarked by Nov. 3 can be accepted if they arrive up to three days after the election.

Pennsylvania Gov. Tom Wolf said he had “promised Pennsylvanians that we would count every vote and that’s what we’re going to do.”

Trump appeared to suggest those ballots should not be counted, and that he would fight for that outcome at the high court. But legal experts were dubious of Trump’s declaration. Trump has appointed three of the high court’s nine justices including, most recently, Amy Coney Barrett.

Democrats typically outperform Republicans in mail voting, while the GOP looks to make up ground in Election Day turnout. That means the early margins between the candidates could be influenced by which type of votes — early or Election Day — were being reported by the states.

Throughout the campaign, Trump cast doubt about the integrity of the election and repeatedly suggested that mail-in ballots should not be counted. Both campaigns had teams of lawyers at the ready to move into battleground states if there were legal challenges.

Trump kept several states, including Texas, Iowa and Ohio, where Biden had made a strong play in the final stages of the campaign. But Biden picked off states where Trump sought to compete, including New Hampshire and Minnesota. But Florida was the biggest, fiercely contested battleground on the map, with both campaigns battling over the 29 Electoral College votes that went to Trump.

The president adopted Florida as his new home state, wooed its Latino community, particularly Cuban-Americans, and held rallies there incessantly. For his part, Biden deployed his top surrogate — former President Barack Obama — there twice in the campaign’s closing days and benefitted from a $100 million pledge in the state from Michael Bloomberg.

Democrats entered the night confident not only in Biden’s prospects, but also in the the party’s chances of taking control of the Senate. But the GOP held several seats that were considered vulnerable, including in Iowa, Texas and Kansas. Disappointed Democrats lost House seats but were expected to retain control there.

The coronavirus pandemic — and Trump’s handling of it — was the inescapable focus for 2020.

For Trump, the election stood as a judgment on his four years in office, a term in which he bent Washington to his will, challenged faith in its institutions and changed how America was viewed across the globe. Rarely trying to unite a country divided along lines of race and class, he has often acted as an insurgent against the government he led while undermining the nation’s scientists, bureaucracy and media.

The momentum from early voting carried into Election Day, as an energized electorate produced long lines at polling sites throughout the country. Turnout was higher than in 2016 in numerous counties, including all of Florida, nearly every county in North Carolina and more than 100 counties in both Georgia and Texas. That tally seemed sure to increase as more counties reported their turnout figures.

Voters braved worries of the coronavirus, threats of polling place intimidation and expectations of long lines caused by changes to voting systems, but appeared undeterred as turnout appeared it would easily surpass the 139 million ballots cast four years ago.

No major problems arose on Tuesday, outside the typical glitches of a presidential election: Some polling places opened late, robocalls provided false information to voters in Iowa and Michigan, and machines or software malfunctioned in some counties in the battleground states of Ohio, Pennsylvania, Georgia and Texas.

With the coronavirus now surging anew, voters ranked the pandemic and the economy as top concerns in the race between Trump and Biden, according to AP VoteCast, a national survey of the electorate.

Voters were especially likely to call the public health crisis the nation’s most important issue, with the economy following close behind. Fewer named health care, racism, law enforcement, immigration or climate change

The survey found that Trump’s leadership loomed large in voters’ decision-making. Nearly two-thirds of voters said their vote was about Trump — either for him or against him.

Jaffe reported from Wilmington, Delaware. Associated Press writers Andrew Taylor and Aamer Madhani contributed reporting.

Trump’s doctors, speaking on the steps of the military hospital where he was being treated for a third consecutive day, refused to disclose the specific timing of the president’s dip in oxygen or whether lung scans showed any damage.

Navy Cmdr. Dr. Sean Conley acknowledged he was trying to downplay the severity of the president’s condition the day before.

“I was trying to reflect the upbeat attitude of the team, that the president, that his course of illness has had. Didn’t want to give any information that might steer the course of illness in another direction,” Conley said. “And in doing so, came off like we’re trying to hide something, which wasn’t necessarily true. The fact of the matter is that he’s doing really well.”

Conley said the president had a “high fever” and a blood oxygen level below 94% on Friday and during “another episode” on Saturday. He was evasive when asked whether Trump’s level had dropped below 90%: “We don’t have any recordings here on that.”

The level currently stands at 98%, Trump’s medical team said.

Trump offered his own assessment of his status the night before in a video from his hospital suite, saying he was beginning to feel better and hoped to “be back soon.” And he was back on social media early Sunday morning, sharing a video of flag-waving supporters, most not wearing masks, gathered outside Walter Reed National Military Medical Center. And again, later in the day, talking about how he understands COVID.

The changing, and at times contradictory, accounts created a credibility crisis for the White House at a crucial moment, with the president’s health and the nation’s leadership on the line. Moreover, the president’s health represents a national security issue of paramount importance not only to the functions of the U.S. government but also to countries around the world, friendly and otherwise.

Trump’s Democratic challenger, Joe Biden, pulled his attack ads off the air during Trump’s hospitalization, and on Sunday, he dispatched senior aides to deliver a largely friendly message.

“We are sincerely hoping that the president makes a very quick recovery, and we can see him back out on the campaign trail very soon,” Biden adviser Symone Sanders said on CNN’s “State of the Union.”

She added: “This is a glaring reminder that the virus is real.”

Biden was at home in Wilmington, Delaware, on Sunday with no plans for in-person campaigning or other public appearances. Having already tested negative, he is expected to release the results of a new coronavirus test later in the day, and the campaign has pledged to disclose those results and all other future test results for the 77-year-old candidate.

On Saturday, chief of staff Mark Meadows told reporters outside the hospital, “We’re still not on a clear path yet to a full recovery.” In an update Saturday night, Trump’s chief doctor expressed cautious optimism but added that the president was “not yet out of the woods.”

But Sunday evening, Trump briefly left the hospital in a motorcade to wave to supporters.

Meanwhile, Trump’s handling of the pandemic and his own health faced new scrutiny.

Trump’s medical care is far superior to the average American’s, with around-the-clock attention and experimental treatments. In the hospital video, he defended his decision to continue campaigning and holding large events during a pandemic.

“I had no choice,” said Trump, who refused to abide by basic public health recommendations, including mask-wearing. “I had to be out front. … I can’t be locked up in a room upstairs and totally safe. … As a leader, you have to confront problems.”

Trump is 74 years old and clinically obese, putting him at higher risk of serious complications from a virus that has infected more than 7 million people nationwide and killed more than 209,000 people in the U.S.

First lady Melania Trump remained at the White House to recover from her own bout with the virus.

Trump’s administration has been less than transparent with the public throughout the pandemic, both about the president’s health and the virus’s spread inside the White House. The first word that a close aide to Trump had been infected came from the media, not the White House. And aides have repeatedly declined to share basic health information, including a full accounting of the president’s symptoms, what tests he’s undertaken and the results.

Conley declined to say when Trump had last been tested before he was confirmed to have COVID-19 late Thursday. He initially suggested that Trump was 72 hours into the diagnosis — which would mean that he was confirmed infected Wednesday. Conley later clarified that Trump was administered an accurate test for the virus on Thursday afternoon.

The White House has said Trump was expected to stay at the hospital for “a few days” and would continue to work from its presidential suite, which is equipped to allow him to keep up his official duties.

On Saturday, Conley said Trump’s blood oxygen level was 96%, which is in the normal range. The two experimental drugs he has received, given through an IV, have shown some promise against COVID-19.

He noted that in many cases, COVID-19 can become more dangerous as the body responds. “The first week of COVID, and in particular day seven to 10, are the most critical in determining the likely course of this illness,” he said.

At the same time, the White House has been working to trace a flurry of new infections of close Trump aides and allies. Attention is focused in particular on the Sept. 26 White House event introducing Trump’s Supreme Court nominee.

That day, Trump gathered more than 150 people in the Rose Garden, where they mingled, hugged and shook hands — overwhelmingly without masks. There were also several indoor receptions, where Trump’s Supreme Court pick, Amy Coney Barrett, her family, senators and others spent time in the close quarters of the White House, photographs show.

Among those who attended and have now tested positive: former New Jersey Gov. Chris Christie, former White House counselor Kellyanne Conway, the president of the University of Notre Dame and at least two Republican lawmakers — Utah Sen. Mike Lee and North Carolina Sen. Thom Tillis. The president’s campaign manager, Bill Stepien, and the head of the Republican National Committee, Ronna McDaniel, have also tested positive, though they were not at the event. Another prominent Republican who has tested positive: Sen. Ron Johnson. R-Wis.

Colvin reported from Washington. Peoples reported from New York. Associated Press chief medical writer Marilynn Marchione in Milwaukee and Associated Press writers Bill Barrow in Wilmington, Del., and Zeke Miller in Washington contributed to this report.