President Biden traveled to Chicago on Thursday to encourage large companies and other organizations to impose vaccine requirements for their workers while a federal agency hammers out the details of the president’s vaccine mandate for private employers.
The president delivered his remarks after touring a construction site run by Clayco Construction, which announced it would implement a system of vaccinations or testing for all of their employees.
Mr. Biden said that encouraging Americans to get vaccinated had helped, but the only way for the United States to emerge from the pandemic would be for companies and other organizations to require the shots.
“Even after all of these efforts, we still have more than a quarter of the people in the United States who are eligible for vaccinations but didn’t get the shot,” Mr. Biden said. “And we know there is no other way to beat the pandemic than to get the vast majority of Americans vaccinated.”
“That’s why I’ve had to move toward requirements,” he added, noting that moving toward requirements had not been his first instinct.
A new report showed that “vaccination requirements result in more people getting vaccinated,” he continued, and that as more organizations had implemented them their vaccination rates had risen dramatically.
Last month, Mr. Biden that he would use his presidential powers to require two-thirds of American workers be vaccinated against the coronavirus. As part of those mandates he asked the Occupational Safety and Health Administration to develop rules for companies with more than 100 employees to require coronavirus vaccination or weekly testing, which would impact more than 80 million workers in the United States.
On Thursday, Mr. Biden said that the rule would be implemented in short order, but officials familiar with the process said was likely to take several more weeks. Defining those rules in a way that passes legal muster could take weeks, and attorneys general in 24 states have threatened to sue.
Since Mr. Biden announced the forthcoming OSHA rules a number of large employers have imposed vaccine requirements of their own, including 3M, Procter & Gamble and, as of Thursday, IBM. Others, like JP Morgan Chase and Walmart, have not detailed requirements of their own, and some employers may not act once OSHA’s rules are finalized, hoping that they will not be punished for violating them.
Some employers have expressed concerns that mandates could further diminish staffs that have already been battered, especially hospitals and other health care facilities. But so far fears that mandates would result in widespread exoduses of health workers largely appear to have been exaggerated.
Mr. Biden chose Chicago in part because it is the home of United Airlines, one of the first major carriers to require shots for its 67,000 U.S. employees. The company has said that it would terminate about 600 employees for not complying with its vaccination requirement, and that about 99 percent of its U.S. work force has been vaccinated.
Other airlines have followed with similar requirements, including American Airlines, Southwest, JetBlue and Alaska Airlines.
Mr. Biden has also moved to mandate shots for health care workers, federal contractors and most federal workers, who could face disciplinary measures if they decline to be inoculated.
“We have the tools, we’re using them and we’re making progress,” Mr. Biden said near the end of his remarks. “We just need to finish the job.”
Lauren Hirsch contributed reporting.
Over a 15-month period of the pandemic, more than 120,000 children in the United States had a parent or caregiver die from Covid-19, a loss that more severely affected racial minorities, according to a modeling study published in the medical journal Pediatrics on Thursday.
The study estimated that for every four Covid-19 deaths between April 1, 2020, and June 30, 2021, one child lost a parent or caregiver. The finding suggested that the ongoing pandemic, which has claimed more than 700,000 American lives thus far, could leave tens of thousands of children dealing with trauma for generations to come.
“It’s not just one of 500 are dead; one of 500 American children have lost their mommy or daddy or grandparents who took care of them,” Dr. Susan Hillis, the lead author and a researcher and epidemiologist at the Centers for Disease Control and Prevention, said in an interview.
In addition to the 120,630 children who were estimated to have lost a primary caregiver — a parent or grandparent responsible for providing housing, basic needs and care — 22,007 lost a secondary caregiver, or a grandparent providing housing but not most basic needs, the study projected. Dr. Hillis said the loss of such grandparents could lead to homelessness.
The new findings aligned with research that has repeatedly demonstrated that racial minorities have been disproportionately vulnerable to the pandemic.
According to the study in Pediatrics, one of every 168 American Indian/Alaska Native children, one of every 310 Black children, one of every 412 Hispanic children, and one of every 612 Asian children have lost a caregiver, compared to one in 753 white children.
ROME — The Italian government announced on Thursday that it would lift one of the country’s last coronavirus restrictions by permitting dancing in nightclubs, bringing relief to a sector of the economy that has lagged behind in Italy’s reopening.
“It’s a new beginning,” said Sergio Maria Ortolani, a publicist for several music venues in Rome, who welcomed the decision. This summer, the police shut down one club for five days after a group of customers danced to techno music. “It was a horror movie,” he said.
Starting on Monday, club owners can take down “Dancing Forbidden” signs, and bouncers will no longer need to rebuke patrons for moving with the music.
The government banned dancing in nightclubs in the summer of 2020 after several coronavirus outbreaks were linked to partying and unmasked teenagers. As Italy gradually lifted its second lockdown this spring, nightclubs, dance halls and theaters were allowed to serve drinks, host concerts and play music, but dancing remained prohibited.
At clubs, Italians nervously nodded to the music and tapped their feet as they sat in front of D.J. booths. Some invented sit-down choreographies in their chairs. Others tried to convince dubious bouncers that they just had a spirited way of walking.
Mr. Ortolani — whose business lost about 95 percent of its income during the pandemic — said he and his partner had glued down tables to clog up the dance floors in their nightclubs. They lowered the music’s tempo to make it less danceable and instructed security guards to “tackle” whoever would dance. When the guards couldn’t keep up, they stopped the music, to the crowd’s jeers.
“We tried to stop them in every way,” he said. “It was a war.”
The government’s announcement on Thursday followed similar decisions by Germany and France to allow fully vaccinated patrons, or those who have recovered from the coronavirus, to dance in nightclubs. In Britain, club patrons are not required to show the country’s Covid passport to enter.
The Italian government will require proof of vaccination, proof of recent recovery from the virus, or a negative swab test to enter nightclubs. Indoor venues will be limited to half of their capacity and those that are outdoors to 75 percent. Guests will be required to wear a mask when they are not dancing.
“Without #vaccines and with winter at the door we could have just dreamed of this,” Nino Cartabellotta, a prominent public health researcher, tweeted on Thursday.
The leader of the United Nations sought $8 billion on Thursday to help narrow the yawning divide between rich and poor nations in Covid-19 vaccinations, assailing the imbalance in uncharacteristically blunt terms as both immoral and shortsighted.
The funding sought by Secretary General António Guterres from member states and other sources is part of a new vaccine strategy undertaken with the World Health Organization to ensure that 40 percent of the world is vaccinated by year’s end and 70 percent by mid-2022.
“Instead of global coordinated action to get vaccines where they are needed most, we have seen vaccine hoarding, vaccine nationalism and vaccine diplomacy,” Mr. Guterres said, speaking at a news conference about the new strategy with the director general of the W.H.O., Tedros Adhanom Ghebreyesus.
Mr. Guterres’s frustration over vaccine inequity has become a defining theme of his tenure. Speaking to the United Nations General Assembly last month, he said that vaccine surpluses in wealthy countries and empty vaccine shelves in others amounted to a “moral indictment of the state of our world — it is an obscenity.”
His anger was more evident on Thursday in describing how the failure to vaccinate the developing world could spawn virus variants that are resistant to vaccines, putting the inoculated at risk as well.
“And all the vaccination effort made in developed countries to vaccinate the whole of the population, one, two or three times — all that effort will fall apart. And these people will not be protected,” he told reporters. “So, not to have equitable distribution of vaccines is not only a question of being immoral — it is also a question of being stupid.”
Mr. Guterres exhorted the Group of 20 wealthy nations to make good on their vow to “get the world vaccinated” when they convene for a summit meeting on Oct. 30 in Rome.
According to the Global Dashboard for Vaccine Equity, a database maintained by the United Nations Development Program, nearly 61 percent of people in high-income countries have received at least one dose of vaccine, while less than 4 percent in low-income countries have received at least one dose.
The W.H.O. plan calls for highly vaccinated countries to let deliveries of further doses to go first to poorer countries where they are more urgently needed, through the Covax global-sharing program and other distribution efforts.
Lockdowns helped keep last year’s flu season historically mild in both the United States and around the world, but U.S. officials fear a more serious season this fall and winter, with unmasked people out and about far more, and nearly half of adults in a new survey saying they are unlikely to get a flu shot.
At a news briefing to release the survey data on Thursday morning, top health experts said they were particularly concerned that, with the coronavirus still coursing around the country, nearly one in four people at higher risk for flu-related complications indicated they did not intend to get the flu vaccine.
Dr. Rochelle P. Walensky, head of the Centers for Disease Control and Prevention, noted that while experts did not yet know how severely the flu would hit the United States this fall, other respiratory infections had already returned, including RSV, a common cause of pneumonia and bronchitis in babies and a serious threat to older adults. The C.D.C.’s latest weekly flu report shows that only one state, Wyoming, had reached a “moderate” level of flu cases.
Because the flu was almost nonexistent last year, Dr. Walensky noted, people do not have the protective immunity they might have acquired if they had gotten sick, and she urged that everyone age 6 months and older be vaccinated. “The Covid-19 pandemic is not over, and the risk of both flu and Covid-19 circulating could put additional strain on hospitals and frontline health care professionals,” she said.
The survey was commissioned by the National Foundation for Infectious Diseases, a nonprofit organization. Its medical director, Dr. William Schaffner, said that overall vulnerability to flu could be higher this year, “with relaxed Covid-19 mitigation strategies, increased travel and the reopening of schools.”
For the survey, more than 1,110 respondents 18 and older from all 50 states and the District of Columbia answered questions in mid-August that explored attitudes about the flu; Covid-19; pneumococcal disease, which can cause pneumonia, sepsis and meningitis; and vaccination intentions.
The answers revealed a tension between beliefs about the value of the flu vaccination and the intention to get one: 61 percent of respondents agreed that a shot was the best protection against the flu, but 44 percent said they were either unsure whether they would get one or did not intend to do so.
The coronavirus pandemic, however, has had a positive effect on behaviors that could help lessen the impact of the flu. Nearly half of those surveyed said that because of the pandemic, they were more likely to stay home from work or school if they were sick, and 54 percent said they would wear a mask at least sometimes during the flu season.
But there were racial disparities: 73 percent of Black respondents and 62 percent of Latinos said they would wear a mask during flu season, compared with only 46 percent of white respondents. Black and Latino respondents were also more likely to be worried about being infected with Covid and the flu simultaneously than white respondents.
Dr. Walensky said that the flu vaccination rate nationally had held steady over the year before, at about 52 percent, but criticized what she called a “disparity gap” in flu vaccination: 56 percent for white people versus 43 percent among Black people.
Patsy Stinchfield, a nurse practitioner at Children’s Minnesota, a pediatric health care system, and the president-elect of the infectious disease foundation, said that it was safe for people to get flu and Covid shots — including boosters — at the same time.
Dr. Walensky also raised alarms about a decline in the flu vaccination rates among young children, to 59 percent from 64 percent the year before. In the 2019-2020 season, she said, 199 children died from the flu, about 80 percent of whom were not vaccinated.
WASHINGTON — Pfizer and BioNTech said on Thursday morning that they had asked federal regulators to authorize emergency use of their coronavirus vaccine for children ages 5 to 11, a move that could help protect more than 28 million people in the United States.
The companies have said they were submitting data supporting the change to the Food and Drug Administration. The agency has promised to move quickly on the request and has tentatively scheduled a meeting on Oct. 26 to consider it. A ruling is expected between Halloween and Thanksgiving.
Parents across the United States are anxiously awaiting the regulator’s decision, which could affect family life and the operation of schools. Clearance depends not only on the strength of the companies’ clinical trial data, but on whether they can prove that they are able to properly manufacture a new pediatric formulation.
Dr. Janet Woodcock, the acting F.D.A. commissioner, said last week that children might require “a different dosage or formulation from that used in an older pediatric population or adults.”
Pfizer has proposed giving children one-third of the adult dosage. That might require adding more diluent to each injection or using a different vial or syringe. The company was expected to describe the method it intended to use in its submission to the F.D.A.
JOHANNESBURG — Moderna said on Thursday that it planned to build a vaccine manufacturing facility in Africa, news that was welcomed for the long-term but that does not address the continent’s immediate need for Covid-19 vaccines.
The company said that a new “state of the art” facility would eventually produce up to 500 million doses a year of Moderna’s mRNA vaccine, which has shown an efficacy rate of more than 90 percent in preventing Covid-19. The plant will, in time, also produce other Moderna vaccines, the company said.
However, Moderna gave no time frame, and said it was only now beginning the process of identifying which country would host the plant.
Building vaccine manufacturing sites in Africa will increase the continent’s future access to the drugs. But that does not answer calls from African leaders and activists to waive patent laws that would give more drugmakers access to details on how coronavirus vaccines are produced. It also does not address the continent’s immediate Covid-19 vaccine shortages.
“It doesn’t necessarily solve our problems today,” Dr. John Nkengasong, the director of the Africa Centers for Disease Control and Prevention, said in a regular news briefing on Thursday. “The problems we have are quick access to vaccines, redistribution of vaccines, making sure that certain licenses are provided so that manufacturing can start regionally.”
Moderna’s announcement comes amid mounting pressure on biotech firms to share their expertise with manufacturers in countries that desperately need more coronavirus vaccine doses.
The drug makers Pfizer and BioNTech said in July that they had partnered with Biovac, a public-private partnership pharmaceutical company in Cape Town. In Gqeberha, the South African coastal city formerly known as Port Elizabeth, Johnson & Johnson has partnered with Aspen, a local manufacturer, in a fill-and-finish manufacturing process.
Moderna said that it expected to invest up to $500 million in its future site, and that its facility would manufacture the doses with fill-and-finish capacity, in addition to packaging facilities.
“While we are still working to increase capacity in our current network to deliver vaccines for the ongoing pandemic in 2022, we believe it is important to invest in the future,” said Stephane Bancel, Moderna’s chief executive.
African leaders had already established the Partnerships for African Vaccine Manufacturing, which works within an existing “ecosystem” of Africa’s vaccine needs. Launched in April, it has political backing from the continent’s leaders, including Presidents Cyril Ramaphosa of South Africa and Paul Kagame of Rwanda.
Moderna, an American drug company, developed its coronavirus vaccine with billions of dollars in taxpayer money and received initial research and development funding from Covax, the vaccine sharing facility supported by the global vaccine alliance Gavi and the World Health Organization.
Arkansas lawmakers approved legislation on Wednesday that would require employers to let their employees opt out of vaccination, an attempt to walk back the White House’s vaccine mandate for millions of Americans.
“I don’t believe in a federal mandate on vaccination,” Mr. Hutchinson said, referencing President Biden’s recent mandate that all companies with more than 100 workers require vaccination or weekly testing. “But I also don’t believe in state mandates as well on employers and defining the employer employee relationship.”
Mr. Hutchinson’s office did not immediately respond to requests for comment on the bill’s passage.
The sponsor of the bill, Sen. Kim Hammer, a Republican, said on Wednesday that it was unfair for employees to be terminated because of a “forced vaccine requirement on them.”
“What this does is protect those hard-working employees who are not looking to leave their employment,” he said.
Much of the discussion around the bill on Wednesday was about an emergency clause, which would have made the law go into effect immediately, if passed by the governor. The bill was ultimately approved without the clause, with the senate voting 23 to 10 and the house voting 61 to 25.
If the governor vetoes the legislation, lawmakers can try again to pass the bill with an emergency clause to put it into effect right away. “Then the door still has a crack open,” Mr. Hammer said in an interview on Thursday.
Employees would have two ways to opt out of getting vaccinated if the bill is implemented: They can test negative for antigens once a week, or they can prove that they have antigens in their system.
Jim Hudson from the Arkansas Department of Commerce said some small businesses were expressing confusion about which mandates they might need to follow: federal, state, or both?
“There’s going to be some questions about how you implement that, and how you implement this,” Mr. Hudson said. “And I think as a kindness to our business community, in particular, our small businesses, our restaurants, our hospitals, if we could give them just a little bit more time to study the bill and understand how to run it in their particular business, I think that would be helpful.”
Adeel Hassan contributed reporting.
One week after requiring more than 650,000 hospital and nursing home workers to get at least one dose of the vaccine, New York State’s pioneering mandate for health care workers is moving into a second and likely more difficult phase: requiring at least 250,000 home health care workers to get at least one dose of the vaccine before Friday or face the threat of losing their jobs.
While the first phase of the mandate was widely viewed as successful in pressuring thousands of nurses, doctors, technicians and orderlies to get the vaccine, many industry officials say they fear this second phase will result in thousands of workers simply quitting their jobs and finding new work in restaurants, retail or other industries. Most home health care aides, many of them immigrants, are paid about minimum wage and could find jobs paying similar wages elsewhere.
Without enough workers to go around, patients recovering from stints in the hospital or older New Yorkers who rely on long-term aides for assistance with everything from grocery shopping to bathing could find their care reduced or ended. The shortage could also exacerbate patient backlogs at hospitals, which often discharge patients with the support of in-home care.
“Even a small percentage of home care workers no longer working will impact thousands of homebound individuals,” said Dan Savitt, the president and chief executive of the Visiting Nurse Service of New York. “The rough math here is for every 1 percent of full-time aides unavailable, there are about 1,500 Medicaid members that will be impacted.”
With schools fully reopened last month, the Delta variant drove many worries: Would crowded classrooms run up infection rates? Would outbreaks keep many schools closed? Could there be a normal academic year — the first since the pandemic began?
The news so far has been reassuring: The vast majority of the nation’s 50 million public school students have been in classrooms, full time and mostly uninterrupted, this fall — whether students are masked or unmasked, teachers vaccinated or not. In fact, infection rates declined 35 percent nationally through the month of September, as many schools opened their doors.
Still, it hasn’t always been pretty. Parents protested at school board meetings over mask mandates, or the lack of them. Families had to scramble because of stay-at-home orders. And virus-infected students and teachers prompted worries about the possibility of a spread in schools.
Yet in the sometimes chaotic reopening, there has been dramatic progress. Virus-driven school closures declined steeply from the end of August to late September, from about 240 a week to about 25 a week, according to a survey by Burbio, a company that has monitored district responses to the pandemic. Many districts have relaxed quarantine guidelines, allowing more students to remain in classrooms. And three-quarters of the nation’s 200 largest school districts began October with a mask mandate.
More progress may be made, given that Pfizer and BioNTech asked federal regulators on Thursday to authorize emergency use of their vaccine for children ages 5 to 11.
Now schools face the question of what comes next. In conservative areas like Wyoming, with fewer safety measures, some schools want to figure out how to encourage more people to get vaccinated. In parts of Georgia that have started requiring masks in schools, there is debate over how much it will help. And in liberal districts like Boston, where infection rates are low, some parents are beginning to question how long masking will be necessary.
These debates reflect a larger societal question: How should we live with Covid, since it appears to be here to stay?
The World Health Organization said on Thursday that it had resumed shipments of medical supplies to North Korea to help its Covid-19 response, in what appears to signal a relaxation of the closed-border policies enforced by Pyongyang early in the pandemic.
The agency said its shipments of medical supplies, together with other international supplies destined for North Korea, had become stranded in China after Pyongyang sealed the country’s borders in January 2020 when Covid-19 was declared a public health emergency of international concern.
North Korea’s Ministry of Public Health told the agency several months ago that it would allow the stranded supplies to be transported through the northern Chinese port of Dalian, a W.H.O. spokesman, Tarik Jasarevic, said in an emailed statement.
As a result, the agency had sent some of the medical supplies and equipment to the North Korean port of Nampo, he said.
North Korea has not reported any Covid-19 infections, and it turned down several offers of vaccines, including ones from the United Nations-backed Covax facility and from Russia. But North Korea’s leader, Kim Jong-un, said in June that lapses in his country’s anti-pandemic campaign had caused a “great crisis” that threatened “grave consequences,” according to the state media. He did not clarify whether he was referring to an outbreak within the country.
The W.H.O. said its shipments to North Korea included health kits, medicines and other medical supplies that would support essential health services at primary health care centers.
The agency said it had been told that these supplies remained under quarantine in Nampo.
In other news from around the world:
The authorities in France announced that, as of Oct. 15, coronavirus screening tests would no longer be free for unvaccinated people, signaling a new phase in the government’s strategy to encourage inoculations. The change means that unvaccinated people will bear the financial burden of meeting the proof of coronavirus status required by a law enacted this summer before they can enter cafes, restaurants, theaters and many other indoor venues.
The 14-day average of new daily coronavirus cases in Spain dropped below 50 per 100,000 people on Thursday for the first time in more than a year, Reuters reported. Prime Minister Pedro Sánchez called the return to low-risk status “a crucial milestone on the road to recovery” on Twitter.
Starting on Saturday, Greece will begin a two-week test of lifting some pandemic restrictions in regions where coronavirus cases have been the highest, but for the most part, only vaccinated people will be able to enjoy the heightened freedom. The restrictions — notably a curfew from 1 a.m. to 6 a.m. and a ban on music in bars and restaurants — were imposed last month in “red areas” across much of the country’s north and parts of its center, as a way to fight a fourth wave of the virus. But unvaccinated people who cannot prove that they recently recovered from Covid remain barred from indoor venues like bars, cafes and restaurants.
The coronavirus seems to be in retreat in the United States, with instances of hospitalization and death both falling.
Although some states, such as Alaska, Maine and New Hampshire, are still seeing high figures, the number of virus cases across the country is down about 25 percent compared with a couple of weeks ago.
So, what stage is the country in with the pandemic? And how will developments such as a new antiviral treatment and the availability of booster shots affect things?