A shaken and emotional President Joe Biden declared that it is “time to turn this pain into action” Tuesday night as he addressed the nation following the slaughter of 18 elementary schoolchildren and a teacher in Texas.

“It’s just sick,” he said of the sorts of weapons that are easily available in the United States.

Biden spoke for just seven minutes, giving voice to the grief and anger and frustration of many Americans, asking: “Why? Why are we willing to live with this carnage? Why do we keep letting this happen?”

The president took direct aim at gun manufacturers and their representatives in Washington, urging politicians to stand up to the power they wield. But he made no specific gun control proposals nor called on Congress to vote immediately on legislation.

“The gun manufacturers have spent two decades aggressively marketing assault weapons, which make them the most and largest profit,” Biden said. “For God’s sake, we have to have the courage to stand up to the industry.”

He added: “Where in God’s name is our backbone?”

The president delivered his remarks from the Roosevelt Room of the White House less than two hours after returning from a five-day trip to South Korea and Japan. Noting his return home, Biden said no other country experiences the same kind of mass shootings.

But while Biden expressed horror and outrage at the shooting, he steered clear of using the moment to wade directly into the gun control debate, which has been one of the country’s most polarizing issues for more than a decade.

Biden was in the White House, as vice president, in December of 2012, when 20 young children were killed at the Sandy Hook elementary school in Newtown, Connecticut. He spent more than a month developing a list of gun control proposals, only to see most of them flame out in the Senate three months later.

In the years since, he has decried mass shootings again and again: at schools, churches, restaurants, nightclubs, workplaces and more. In his remarks Tuesday night, Biden repeatedly appeared to choke back tears as he was called to do it again.

“My fellow Americans,” he said, speaking slowly. “I’d hoped when I became president, I would not have to do this. Again.”

“Another massacre. Uvalde, Texas. An elementary school,” he said. “Beautiful, innocent, second, third, fourth graders. And how many scores of little children who witness what happened, see their friends die as if they’re on a battlefield for God’s sake.”

Speaking from personal experience, he added: “To lose a child. It’s like having a piece of your soul ripped away.” He did not mention the loss of his son Beau from cancer or the death of his first wife and young daughter in a car crash.

But he made it clear that he understands — and grieves — for the parents of the children who were killed Tuesday.

“The hollowness in your chest,” he said. “You feel like you’re being sucked into it and never going to be able to get out.”

A gunman killed at least 18 children and a teacher on Tuesday in a rural Texas elementary school, officials said, in the deadliest American elementary school shooting since the massacre at Sandy Hook Elementary a decade ago.

The slayings took place just before noon at Robb Elementary School, where second through fourth graders in Uvalde, a small city west of San Antonio, were preparing to start summer break this week.

The gunman, whom the authorities identified as an 18-year-old man who had attended a nearby high school, also died at the scene, officials said.

“He shot and killed horrifically, incomprehensibly,” Gov. Greg Abbott said in a news conference.

Biden reacting to the gruesome incident also tweeted, "Tonight, there are parents who will never see their child again. Parents who will never be the same. To lose a child is to have a piece of your soul ripped away forever. I ask the nation to pray for them — to give them strength in the darkness."

And he added, "As a nation we must ask: When in God’s name will we stand up to the gun lobby? When in God’s name will we do what needs to be done? I’m sick and tired of it. We have to act."

And he continued, "These kinds of mass shootings rarely happen elsewhere in the world. Why are we willing to live with this carnage? Why do we keep letting this happen? Where in God’s name is our backbone to have the courage to deal with it? It’s time to turn this pain into action."

Vice President Kamala Harris tweeted, "Tonight in Uvalde, Texas, there are parents who lost children. Families who have lost loved ones. And many who have been injured. As a nation, we must have the courage to take action and prevent this from ever happening again."

An infuriated Sen. Chris Murphy demanded answers following the shooting. “Why do you spend all this time running for the United States Senate...if your answer, is as the slaughter increases, as our kids run for their lives—we do nothing?”

With inputs from New York Times News Service