California became the first state to issue a vaccine mandate for all educators in public and private schools on Wednesday when Gov. Gavin Newsom ordered teachers and school staff members to provide proof of vaccination against Covid-19 or face weekly testing.
“We think it’ll be well-received to keep our most precious resource healthy and safe,” he said, “and that’s our children.”
The policy applies to staff members serving students in kindergarten through 12th grade and will go into effect on Thursday, with the deadline for full compliance being Oct. 15.
Similar mandates are gaining momentum among public and private employers as cases across the United States have jumped with the spread of the Delta variant.
In Hawaii, officials announced last week that all state and county employees, including public-school teachers, must be vaccinated or be tested weekly. But California’s policy goes a step further by including private schools.
While California officials initially emphasized they were merely encouraging everyone to get vaccinated, the governor announced late last month that the state would require vaccines or testing at least weekly for health-care workers and state government employees. Last week, state health officials made the requirement even more stringent, largely removing the testing option for more than two million health-care workers. But it wasn’t clear then whether California would extend a mandate to hundreds of thousands of educators.
Debate over how to safely reopen schools has been intense and ongoing for months, and decisions over whether to require inoculations have emerged as a recent flash point.
Over the weekend, Randi Weingarten, the head of the American Federation of Teachers, expressed her strongest support to date for mandatory vaccination of educators, saying she would urge her union’s leadership to reconsider its opposition to vaccine mandates.
“It’s not a new thing to have immunizations in schools,” Ms. Weingarten said on NBC’s “Meet the Press.” “And I think that on a personal matter, as a matter of personal conscience, I think that we need to be working with our employers, not opposing them, on vaccine mandates.”
Cecily Myart-Cruz, the president of United Teachers Los Angeles, said in a statement that the group “doesn’t oppose” the vaccine mandate — but it alone is not enough.
“Vaccines are like seatbelts: necessary but not invincible,” she said in a statement on Wednesday. The Los Angeles Unified School District’s practice of testing students and staff members weekly, even if they have been vaccinated, “exceeds the requirement announced by Governor Gavin Newsom today,” the statement said.
For Mr. Newsom, getting children back into classrooms is a task with particularly high stakes. Next month, voters will be asked whether they want to recall the governor, and frustration among parents over prolonged school closures has been a significant driver of support for his ouster.
Speaking in Oakland, on Wednesday, the governor was flanked by local elected officials who drew an explicit contrast between the pandemic response by Mr. Newsom, a Democrat, and states where conservative leaders are seeking to block vaccine mandates and masking requirements.
Schools were closed longer in California than in many other states in large part because of a brutal winter surge, but also because of protracted negotiations with teachers unions, who demanded extensive safety precautions.
On Wednesday, the president of the California Teachers Association, the state’s largest and an affiliate of the National Education Association, said it supported the vaccine mandate.
“Educators want to be in classrooms with their students, and the best way to make sure that happens is for everyone who is medically eligible to be vaccinated, with robust testing and multitiered safety measures,” the union president, E. Toby Boyd, said in a statement.
Hospitals in Texas are warning of strained resources during a week in which more than 10,000 coronavirus patients have been admitted to hospitals in the state.
At least 53 hospitals in the state were at maximum capacity in their intensive care units. Two in Houston have been so overwhelmed that officials ordered overflow tents to be erected outside. In Austin, intensive care units were running short of beds. And in San Antonio, virus cases reached alarming levels not seen in months, with infants as young as 2 months old tethered to supplemental oxygen.
“If this continues, and I have no reason to believe that it will not, there is no way my hospital is going to be able to handle this. There is no way the region is going to be able to handle this,” Dr. Esmaeil Porsa, president and CEO of the Harris Health System, in Houston, told state legislators on Tuesday. “I am one of those people that always sees the glass half-full, I always see the silver lining. But I am frightened by what is coming.”
In recent days, Texas has averaged about 12,400 new cases a day, nearly double the number seen just two weeks ago, according to a New York Times database. The spike comes as about one in five U.S. hospitals with intensive care units, or 583 total hospitals, recently reported that at least 95 percent of their I.C.U. beds were full as the highly contagious Delta variant fuels surges across the country.
The sudden increase of infections has refocused national attention on the efficacy of masks and comes as the state’s governor, Greg Abbott, remains firm in his refusal to enact any statewide mandates. To manage the surge, he appealed to out-of-state health-care workers to travel to Texas, where coronavirus-related hospitalizations are projected to exceed 15,000 by the end of August, according to the University of Texas at Austin’s Covid-19 model consortium.
Dr. David Persse, Houston’s chief medical officer, blamed state officials for giving inadequate attention to the importance and necessity of vaccinations to stem the surge. Governor Abbott’s framing of vaccinations as an issue of individual rights. is “the wrong approach,” Dr. Persse said. “The rhetoric around this has been such that people adhering to their right to make their own decisions are endangering themselves and their families.”
In a new and unnerving development, as of Tuesday, just shy of 240 Texas children were hospitalized with the coronavirus, according to the Texas Department of State Health Services. Citing those figures, President Biden on Wednesday told reporters that he was exploring whether the federal government has the authority to intervene in the orders issued by Mr. Abbott.
Earlier this week, at the Children’s Hospital of San Antonio, a growing number of children were being admitted with severe symptoms of coronavirus. Many arriving with unrelated illnesses were also testing positive for the virus, hospital officials said.
Dr. Abhishek Patel, who works in the hospital’s pediatric I.C.U., walked in and out of a room where a 6-month-old and a 2-month-old were battling severe Covid-19 infections and were breathing with the aid of supplemental oxygen. This week alone, he said, two teenagers who had other underlying health problems succumbed to the virus.
Federal health officials on Wednesday bolstered their recommendation that pregnant people be vaccinated against Covid-19, pointing to new safety data that found no increased risk of miscarriage among those who were immunized during the first 20 weeks of gestation.
Earlier research found similarly reassuring data for those vaccinated later in pregnancy.
Until now, the Centers for Disease Control and Prevention has said the vaccine could be offered during pregnancy; the recent update in guidance strengthens the official advice, urging pregnant people to be immunized.
The new guidance brings the C.D.C. in line with recommendations made by the American College of Obstetricians and Gynecologists and other medical specialty groups, which strongly recommend vaccination.
“At this time, the benefits of vaccination, and the known risks of Covid during pregnancy and the high rates of transmission right now, outweigh any theoretical risks of the vaccine,” Sascha R. Ellington, an epidemiologist who leads the emergency preparedness response team in the division of reproductive health at the C.D.C.
The risks of having Covid-19 during a pregnancy are well-established, she said, and include severe illness, admission to intensive care, needing mechanical ventilation, having a preterm birth and death.
So far, there is limited data on birth outcomes, she added, since the vaccine has only been available since December. But the small number of pregnancies followed to term have not identified any safety signals.
Pregnant women were not included in the clinical trials of the vaccines, and uptake of the shots has been low among pregnant women. The majority of pregnant women seem reluctant to be inoculated: Only 23 percent of pregnant women had received one or more doses of vaccine as of May, a recent study found.
Dr. Adam Urato, a maternal-fetal medicine specialist in Framingham, Mass., who counsels patients about the vaccine almost daily, said pregnant women are very wary of exposure to synthetic chemicals and want more solid scientific evidence that the vaccines are safe.
“The one question my patients ask me all the time is, are we absolutely sure that these vaccines won’t affect my baby?” he said.
The Pan American Health Organization plans to distribute millions of coronavirus vaccines in Latin America and the Caribbean starting this fall, an initiative that amounts to a tacit recognition that the United Nations-backed Covax program will not come close to providing the immunizations that the developing world needs.
The organization, which is part of the World Health Organization, intends to buy “tens of millions” of vaccine doses and start delivering them in October, its director, Dr. Carissa Etienne, said on Wednesday.
“It is an initiative that will benefit every country in the region but especially those that lack the resources and the negotiating power to secure the doses that they need to protect their people,” said Dr. Etienne.
So far, more than 20 countries have expressed interest in joining the program, she said. The latest data indicates about 20 percent of people in Latin America and the Caribbean have been fully immunized against Covid-19, with some countries reporting vaccination rates of less than 5 percent.
Covax remains far from its initial target of vaccinating at least 20 percent of the people in the world’s poorer countries, but even that would not be enough to control transmission of the virus, particularly as the highly contagious Delta variant starts to circulate in the region.
Dr. Jarbas Barbosa, assistant director at the Pan American Health Organization, said that to get the virus under control, “countries need to go further than 20 percent and it is not clear if Covax will offer more vaccines after this 20 percent.” He said negotiations to obtain the vaccines have begun with producers.
The officials did not provide details about how the organization would succeed where Covax has failed, but they said that the organization had decades of experience buying and distributing vaccines on behalf of countries in the region. The countries will have to pay for the vaccines, while Covax has mostly distributed them free to poorer countries.
“There is no path to recovery for any country while its neighbors remain vulnerable and while variants circulate and multiply,” Dr. Etienne said. “We must banish the idea that vaccine inequity is the problem of some countries and not others.”
Covid cases and deaths are rising in Central America and the Caribbean while the “trends are more promising in South America,” where there has been an overall decline in cases and deaths, Dr. Etienne said.
“There is clear evidence that wherever vaccines are available, they limit severe illness and save lives,” she said. “And that is why increasing access to vaccines remains our top priority. The disparity in who can access vaccines and who cannot is unacceptable.”
Across New York the Delta variant has caused a surge of new cases and rising hospitalizations, presenting New York’s incoming governor, Kathy Hochul, with a major public health challenge that is likely to grow between now and the day she officially takes office in two weeks.
Ms. Hochul, who is currently the lieutenant governor, declined to say much that was concrete about the direction she would take on the state’s Covid-19 policies when Gov. Andrew M. Cuomo steps down. Mr. Cuomo announced his resignation on Tuesday after a sexual harassment scandal.
But Ms. Hochul, a moderate Democrat from the Buffalo area who has kept a low profile as lieutenant governor, will soon confront a raft of difficult decisions on everything from guidance on mask rules to vaccine mandates.
In her first news conference on Wednesday as the soon-to-be-governor, Ms. Hochul did not say whether she would declare a new state of emergency to respond to rising transmission, as Mr. Cuomo did last year in March at the height of the pandemic, a restriction that was only lifted in late June of 2021.
She said she would use the next two weeks — while Mr. Cuomo remains governor — to consult with health experts and federal health authorities as she formulated a plan. She added that increasing vaccinations would be her focus.
“I can assure everyone that we’ll be looking at all options, but I believe that the key to get through this has been before our eyes for months,” she said. “It’s as simple as more people getting vaccinated.”
Though the number of new infections and hospitalizations recorded each day are well below the peaks of last winter, the current totals still represent a dramatic rise since late June, when the epidemic seemed to be waning.
On Tuesday, the seven-day average of new infections in New York State reached 3,088, up from a low point of 307 on June 26, according to a New York Times database. Hospitalizations rose to 1,478, from 823 over the same period.
Ms. Hochul said she would work in communities that have high rates of infection and low rates of vaccination to combat resistance to vaccination and increase access to the shots. The current vaccines authorized in the United States protect most fully vaccinated people from developing serious illness from Covid-19, including from the Delta variant.
But getting enough people vaccinated to curb the rise in cases and bring down hospitalizations may require more than just encouragement from officials.
In New York, elected leaders have been reluctant to impose a vaccine requirement on workers — whether in hospitals, schools or nursing homes. Instead, many unvaccinated government employees and health care workers are subject to rules requiring them to be tested weekly — or in the case of nursing home workers, monthly.
Public health experts predict that there may be greater willingness to impose vaccine mandates if cases and hospitalizations continue to climb. Across New York State, about 69.4 percent of people 18 and over are fully vaccinated, while in New York City the number is 67 percent.
Ms. Hochul also faces questions about allegations that Mr. Cuomo’s aides undercounted nursing home deaths from Covid-19 last year to cover up the true death toll. Asked on Wednesday whether she would release full data on nursing home deaths, Ms. Hochul sidestepped the question.
“My administration will be fully transparent when I am governor,” she said. “I’m not governor yet.”
As the Delta variant of the coronavirus spreads in the United States, some counties are reopening community testing sites that they shuttered last spring, when case counts were falling and attention was shifting to vaccination.
The demand for testing has been rising over the last month. By the end of July, an average of nearly 900,000 coronavirus tests were being performed daily, compared with 500,000 to 600,000 a day earlier in the month, according to the U.S. Department of Health and Human Services.
Several factors are likely responsible for the increase, including the spread of the highly contagious Delta variant, as well as new mandates that require unvaccinated people to take frequent tests. The Centers for Disease Control and Prevention also recently changed its guidance for vaccinated people, recommending that they be tested if they are exposed to the virus, even if they don’t have any symptoms.
Testing has been a trouble spot for the United States since the start of the pandemic. A flawed test, regulatory red tape and supply shortages initially led to hourslong lines at testing sites and dayslong waits for results.
Officials eventually ironed out some of these kinks and when infections were soaring last year, government-run mass testing sites, offering free virus tests to all comers, sprang up all over the country. Some delays and problems persisted, however, even as capacity increased.
When the vaccines were authorized, many of the large testing sites were converted into vaccination sites and some shut down entirely. Virus testing largely shifted to the private sector — to local pharmacies and commercial labs, for instance.
“There are far fewer testing sites, public testing sites, than existed six months ago,” said Mara Aspinall, an expert in biomedical diagnostics at Arizona State University. “So that to me is a concern.”
After residents began reporting a three-day wait for testing appointments at pharmacies in Hillsborough County, Fla., the county opened two free, walk-in testing sites last weekend. Officials had planned to administer about 500 tests a day at each site and ended up performing almost twice that many, said Kevin Watler, a spokesman for the Florida Department of Health.
“It was very, very busy,” he said. “So the demand is certainly there.”
Many other testing sites are springing up across Florida, where the virus is surging, as well as across the country. In California, San Diego County added five new test sites last week after an increase in traffic at its existing sites, officials said.
Other localities are expanding the hours at testing sites or deploying pop-up testing clinics, and some are combining their testing and vaccination services. Last week, Delaware’s Division of Public Health announced that it would begin offering tests at its vaccination sites, and a new drive-through testing and vaccination site opened in New Orleans.
“As we experience the fourth and most severe surge of Covid-19 in Louisiana, we must take a multipronged approach to combat the virus,” Dr. Jennifer Avegno, the director of the New Orleans Health Department, said in a statement. “Masking slows the spread, testing identifies cases and pandemic trends, and vaccines prevent hospitalizations and deaths. It only makes sense to co-locate these resources so that residents can access the tools they need to stay safe in one stop.”
Federal regulators are expected to authorize a third shot of coronavirus vaccine as soon as Thursday for certain people with weakened immune systems, in an effort to better protect them as the highly contagious Delta variant sweeps the nation.
The decision to expand the emergency use of both the Pfizer-BioNTech and Moderna vaccines is meant to help those patients with immune deficiencies who are considered most likely to benefit from an additional shot. It covers people who have had solid organ transplants and others whose immune systems are similarly compromised, according to an official familiar with the plan.
The development will give physicians latitude to recommend additional shots for those patients. At least 3 percent of Americans have weakened immune systems for a variety of reasons, from a history of cancer to the use of certain medications such as steroids.
Many scientists argue that the immunocompromised population is too diverse to uniformly recommend additional shots of coronavirus vaccine. Some may be protected by the standard vaccine dosage, despite their conditions. Others may be poorly shielded by the vaccines, but unable to benefit from an additional shot.
Studies suggest that patients such as organ transplant recipients are in between — often showing little immune response to the standard vaccine regimen, but benefiting from a third shot. One recent randomized, placebo-controlled study by Canadian researchers found that a third dose of the Moderna vaccine improved the immune response of people in that group.
The Food and Drug Administration’s decision to authorize a third shot for organ transplant recipients and those with similarly compromised immune systems will be considered by an advisory committee to the Centers for Disease Control and Prevention, scheduled to meet on Friday. Although the F.D.A.’s action is independent of the panel’s recommendation, in practice many physicians wait to act until the C.D.C. weighs in.
If the committee votes to endorse the shots, as expected, the C.D.C. could issue a recommendation the same day. That could give further guidance to physicians and pharmacists about how to proceed.
France has offered additional vaccine doses to certain people with poor immune responses since April, and Germany and Hungary recently followed suit.
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W.H.O. is Testing More Drugs in Search for Covid Treatments
The World Health Organization announced it is testing three more drugs in an ongoing global trial to find effective treatments for Covid-19. The drugs are currently approved for other uses — one for malaria, one for cancer and one for autoimmune diseases.
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We are pleased to announce the next phase in the Solidarity trial called Solidarity Plus. Solidarity Plus will test three drugs. Artesunate, a treatment for severe malaria. Imatinib, a drug for certain cancers, and infliximab, a treatment for immune system disorders such as Crohn‘s disease. These drugs were chosen by an independent panel of experts that evaluates all the available evidence on all potential therapeutics. The trial involves thousands of researchers at more than 600 hospitals in 52 countries.
The World Health Organization is testing three additional drugs as part of an enormous global trial to find effective treatments for Covid-19, the agency announced on Wednesday.
The trial, which involves researchers at more than 600 hospitals in 52 countries, will evaluate whether the drugs that have already been approved for other uses — one for malaria, one for cancer and one for autoimmune diseases — can reduce the risk of death in patients who are hospitalized with Covid.
Dr. Tedros Adhanom Ghebreyesus, the director general of the W.H.O., said Wednesday that he hoped that “one or more of the drugs” would prove effective in treating the virus.
Although there are already some treatments available for people with Covid-19, including steroids and monoclonal antibodies, Dr. Tedros said, “We need more for patients at all ends of the clinical spectrum.”
The first phase of the W.H.O.’s trials for new drugs, which it called Solidarity, yielded disappointing results. Researchers found that four different drugs, including hydroxychloroquine and the antiviral drug remdesivir, had few or no benefits for hospitalized Covid patients.
The three drugs in the new trial, called Solidarity Plus, were selected by an independent panel of experts and are being donated by their manufacturers, Ipca, Novartis and Johnson & Johnson. The drugs are artesunate, an antimalarial drug that may have an anti-inflammatory effect; imatinib, an anticancer drug that might help reverse lung damage; and infliximab, a drug for autoimmune disorders that might help tamp down an overly aggressive immune response to the virus.
In late July, Andrew Torba, the chief executive of the alternative social network Gab, claimed without evidence that members of the U.S. military who refused to get vaccinated against the coronavirus would face a court-martial. His post on Gab amassed 10,000 likes and shares.
Two weeks earlier, the unfounded claim that at least 45,000 deaths had resulted from Covid-19 vaccines circulated online. Posts with the claim collected nearly 17,000 views on Bitchute, an alternative video platform, and at least 120,000 views on the encrypted chat app Telegram, where it was shared mostly in Spanish.
Around the same time, Britain’s chief scientific adviser misstated that 60 percent of hospitalized patients had been fully vaccinated. He quickly corrected the statement, saying the 60 percent had been unvaccinated. But anti-vaccine groups online seized on his mistake, translating the quote into French and Italian and sharing it on Facebook, where it collected 142,000 likes and shares.
Coronavirus misinformation has spiked online in recent weeks, misinformation experts say, as people who peddle in falsehoods have seized on the surge of cases from the Delta variant to spread new and recycled unsubstantiated narratives.
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