The political battle in Florida over masks in schools escalated this week, as the state Board of Education voted to authorize sanctions on eight local school districts for not following instructions from Gov. Ron DeSantis’s administration that make masks optional.
The eight districts, whose boards all voted to require masks in school buildings, could face cutbacks equal to their school board members’ salaries unless, according to the Tampa Bay Times, they show within 48 hours that they are in compliance with state orders. The districts are in Alachua, Brevard, Broward, Duval, Leon, Miami-Dade, Orange and Palm Beach Counties.
The measure was approved unanimously during a conference call meeting on Thursday by the State Board of Education, all of whose members are appointees by Republican governors. The vote came after superintendents from the eight districts argued their mask policies had been effective at curbing the spread of the virus.
After the vote, one of the superintendents, Alberto M. Carvalho of Miami-Dade County Public Schools, noted on Twitter there had been “no major outbreaks” in his district and that student cases had been declining after a spike in early September.
“We disagree with today’s State Board of Education’s recommendation and wholeheartedly believe that we are in compliance with law, reason, and science,” he said in a Twitter post.
But the state board said that the county school boards had “willingly and knowingly violated the rights of students and parents by denying them the option to make personal and private health care and educational decisions for their children.”
Masks in schools have become the center of a fiercely partisan debate in Florida, Texas, Arizona and other states whose Republican governors oppose mask mandates as an infringement on personal liberties. In late July, Governor DeSantis, a possible Republican presidential candidate, signed an executive order directing state officials to ensure parents have the power to decide whether children wear masks in school.
The Centers for Disease Control and Prevention recommended that all students, teachers and employees wear masks, regardless of their vaccination status. Most masks offer far more protection to others than to the person wearing them, dispersing the exhaled aerosols that carry the coronavirus in an infected person. So individual masking undermines the protection the masks offer.
President Biden, a Democrat, has openly criticized the Republican governors blocking local mask mandates, and the federal Department of Education has started investigating whether such policies in five states violate the civil rights of disabled students.
Lawsuits have also been filed in a number of states, including Florida, challenging bans on mask mandates. In late August, a federal judge said that Florida’s state constitution allowed school districts to impose strict mask mandates on students, handing Mr. DeSantis a defeat. The state asked an appellate court to reverse the ruling, which has been stayed temporarily pending a final decision.
On Thursday, the Florida school board maintained that a “parents’ bill of rights” enacted by state lawmakers earlier this year gave parents the sole right to decide if their children should wear masks. The board’s statement said that the law requires districts and schools to “protect parents’ right to make health care decisions such as masking of their children in relation to Covid-19.”
“Every school board member and every school superintendent has a duty to comply with the law, whether they agree with it or not,” the chairman of the state board, Tom Grady, said in the statement.
The sheriff of Los Angeles County reiterated this week that he would not compel members of his staff to be inoculated against the coronavirus, in defiance of the county’s order that all of its 110,000 employees show proof of vaccination by Oct. 1.
“No, I am not forcing anyone,” said Sheriff Alex Villanueva, after reading aloud a submitted question in a town hall-style event streamed live on Facebook on Wednesday. “The issue has become so politicized there are entire groups of employees that are willing to be fired and laid off rather than get vaccinated,” the sheriff said, adding that he could not afford to lose any staff over the county mandate.
The L.A. County Sheriff’s Department has more than 10,000 officers and 8,000 civilian staff members. It has suffered at least 18 coronavirus outbreaks, accounting for 334 cases, according to an investigative report in the Los Angeles Times last month.
The defiance of Sheriff Villanueva — a politically divisive figure — underlines the difficulty of trying to lift lagging vaccination rates among law enforcement officers across the country. In many cities, officials are worried about losing officers.
The New York Police Department, the nation’s largest, said that 67 percent of its staff have had at least one dose. That’s despite a city mandate that went into effect last month that requires city workers to get vaccinated or submit to weekly testing. “I would be supportive of a vaccine mandate,” Dermot F. Shea, New York’s police commissioner, said on Thursday during a news conference with Mayor Bill DeBlasio.
The Fraternal Order of Police, a national union that represents 356,000 officers, estimates that 724 officers have died from Covid-19 since the pandemic began.
In Los Angeles, Hilda Solis, the chair of the county’s board of supervisors, signed an executive order in August directing all county employees to show proof of a coronavirus vaccination by Oct. 1. The order did not provide for a testing option as some other local governments have done.
Sheriff Villanueva’s refusal to enforce that requirement is familiar. In July, when Los Angeles County became the first major county to revert to requiring masks for all people indoors in public spaces, he said that his officers would not be enforcing the mandate.
“Forcing the vaccinated and those who already contracted Covid-19 to wear masks indoors is not backed by science,” Sheriff Villanueva wrote in a statement on his website, adding that his department “will not expend our limited resources and instead ask for voluntary compliance.”
With the Nets star Kyrie Irving potentially set to lose more than $380,000 for missing a preseason game Friday night, the N.B.A. players’ association pushed back on the league’s plan to dock the pay of unvaccinated players for any games they miss this season because of local coronavirus ordinances.
Irving, a union vice president, has not spoken publicly about his vaccination status, instead asking for privacy. New York requires most teens and adults to have at least one vaccination shot to enter facilities such as sports arenas, and Irving has not practiced with the Nets in Brooklyn. The team listed him as “ineligible to play” in its injury report before Friday’s preseason home opener against the Milwaukee Bucks at Barclays Center.
For Irving, the $380,000 represents about 1 percent of his base pay for the 2021-22 season. A disagreement between the league and the players’ union over lost pay hinges on a section of the collective bargaining agreement that allows the league to discipline players who, “without proper and reasonable cause or excuse,” fail to fulfill their contractual obligations.
Mike Bass, a league spokesman, said last week that “any player who elects not to comply with local vaccination mandates will not be paid for games that he misses.”
The union has rejected instituting a leaguewide vaccine mandate.
Irving’s indefinite absence from home games — and from practices — has created a predicament for the Nets, a team with championship aspirations that must weigh whether having him around only half the time is worth it. His teammates have said they support him.
Steve Nash, the Nets’ coach, said the team would not move its practices to a location outside of New York to accommodate Irving. The Nets, who have not said publicly whether Irving is vaccinated, held their training camp in San Diego.
“No, this is our home,” Nash said. “This is where we’re going to practice, and we have almost a whole group. So that’s a positive, and we’re just working at getting better every day and focusing on the things we can control.”
Barclays Center and Madison Square Garden, where the Knicks play, require all employees and guests 12 and older to show proof of having received at least one vaccine dose, to comply with a city mandate, unless they have a religious or medical exemption. San Francisco has a similar requirement that applies to Chase Center, where the Golden State Warriors play. The mandates in both cities mean that the players from the Knicks, Nets and Golden State cannot play in their teams’ 41 home games without being vaccinated.
The Russian authorities have repeatedly delayed inspections by the European Union’s main drug regulator that are required for the approval of its Sputnik V Covid-19 vaccine, the bloc’s ambassador to Russia told the country’s news media on Friday.
Moscow has criticized the bloc for not approving the vaccine’s use sooner, but the ambassador, Markus Ederer, said that the extended timeline was not politically motivated.
“The Russian side has repeatedly postponed the timing of the inspection requested by the E.M.A., which slows down the process,” Mr. Ederer told the local outlet RBC, referring to the European Medicines Agency. “These are the facts.”
Sputnik V has been approved for use in more than 70 countries, according to the Russian Direct Investment Fund, the sovereign wealth fund that backed the vaccine’s development. But it has not been approved by the European regulator or the World Health Organization. That creates difficulties for Russians traveling to the European Union and to the United States.
Mr. Ederer pushed back against regular assertions by the Russian authorities that the lack of approval was political.
“This is a technical rather than a political process,” he said. “When Russian officials talk about the process being delayed and politicized by the European side, I sometimes think they are largely referring to themselves, because it is they who make this about politics.”
Russia’s health ministry said in a statement carried by the state news agency TASS on Friday that the European regulator had received the required documents by the end of September. E.M.A. officials could visit in December, it said.
Separately, a spokeswoman for the World Health Organization said on Friday that the agency was “near” to resolving outstanding issues with certifying Sputnik V.
“We are slowly solving most of the issues,” the spokeswoman, Fadéla Chaib, said at a news briefing in Geneva, without elaborating on a timeline.
Russia’s health minister, Mikhail Murashko, said last week that all that remained for the W.H.O. certification was some paperwork. Once the United Nations agency receives all of the necessary data and inspects the production sites, it can schedule a meeting to validate a vaccine for an emergency-use listing.
In Russia, vaccine skepticism and nonchalance about the virus have led to climbing infection rates. On Friday, the country recorded a record 936 Covid deaths and 27,246 new infections.
A surge driven by the Delta variant is receding in the United States, but officials and experts say that increased transmission during the coming colder months remains a threat and that steady rates of vaccination are key to keeping the coronavirus at bay.
The Centers for Disease Control and Prevention said on Thursday that about 56 percent of the U.S. population was fully vaccinated. Providers are administering an average of about 949,000 doses per day, including first, second and additional doses, far below the April peak but higher than the recent Sept. 28 low point of about 625,000, according to a New York Times database.
Surveys from the Kaiser Family Foundation show that vaccine support has been rising out of fear of the Delta variant: Almost 40 percent of newly inoculated respondents said they had sought the vaccines because of the rise in cases, and more than a third said they had become alarmed by overcrowding in local hospitals and rising death rates.
The number of people eligible for vaccinations could also soon increase substantially: Pfizer and BioNTech asked federal regulators on Thursday 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 say they are 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. An F.D.A. ruling is expected as early as the end of this month.
Rupali Limaye, a behavior scientist at Johns Hopkins Bloomberg School of Public Health who studies vaccine hesitancy, said that parents’ getting their children aged 5 to 11 vaccinated would be a “huge game changer” because they represent a large proportion of population.
Vaccine mandates have also been taking effect recently, with federal workers and contractors, teachers, health care providers and others compelled to get immunized or risk losing their jobs. Such a requirement for New York teachers spurred thousands of last-minute vaccinations. Tyson Foods reported a 91 percent vaccination rate ahead of a November deadline, compared with less than half before its mandate was announced in August.
President Biden appealed on Thursday for more companies to mandate Covid vaccinations for employees, asking them to take initiative because an effort that he announced last month to require 80 million American workers to get the shot undergoes a rule-making process and may not go into effect for weeks.
A report released by the White House on Thursday sought to show how vaccine mandates had helped persuade more people to receive their shots: Seventy-eight percent of eligible adults have had at least a first dose.
As the country nears colder temperatures that will push many indoors, Dr. Yvonne Maldonado, an infectious disease epidemiologist at Stanford, said that the next few months would be critical, but that the combination of increased vaccinations and natural immunity from infections could prevent another catastrophic wave like the one that struck last year.
“Most of us don’t think we’re going to see the terrible surge we saw last winter,” she said. “That was horrific. I hope we never have to live through something like that again.”
While wealthier countries with higher coronavirus vaccination rates are increasingly reopening their borders and their economies, nations with more restricted vaccine access are having to make tougher moves.
In Mozambique, that has meant closing popular beaches this week over fears of spreading the virus, less than two weeks after they were cautiously reopened. The authorities fear that beaches along the Indian Ocean — which are at the center of the country’s tourism industry and its communal life — could become infection hot spots or encourage a lax attitude toward Covid-19 regulations.
Just 5 percent of Mozambique’s adult population is fully vaccinated against the virus, according to the Africa Centers for Disease Control and Prevention. And the authorities have warned that life cannot yet return to normal, even as temperatures rise and summer approaches.
The Mozambican government announced the closure on Wednesday, immediately shuttering 18 beaches around the capital, Maputo, and in resort towns like Xai Xai and Tofo, for at least two weeks.
It’s a stark contrast with neighboring South Africa, which has the continent’s highest number of Covid-19 infections but has eased restrictions and kept its beaches open as vaccination rates climb steadily. Other popular Indian Ocean tourist destinations, like the islands of Mauritius and the Seychelles, have welcomed the return of tourists after successful vaccination campaigns.
Mozambique has recorded an average of just 30 daily coronavirus cases in the last seven days and no new Covid deaths, according to the World Health Organization. Still, the country, which has recorded 150,899 cases since the start of the pandemic, has enforced strict measures to keep infections low.
The authorities reopened the beaches on Sept. 23 as the country emerged from a third wave of infections, although the reopening came with a warning that the easing of restrictions did not mean the end of the pandemic. Officials continued to impose strict regulations on beaches in particular, banning the consumption of alcohol, gatherings and games, and imposing a 5 p.m. closing time.
Beachgoers were warned that flouting the rules would lead to swift action. And that came this week as a government spokesman, Filimão Suazi, announced the closing of some of Mozambique’s most popular beaches, blaming “bad behavior.”
Mozambique entered its third wave of infections earlier this year, with over 4,400 new cases reported in the first week of July. With only three doctors per 100,000 people, according to the U.S. Embassy in Mozambique, the country’s health facilities were strained. The authorities moved quickly to close schools, limit shopping times at markets and impose an overnight curfew.
England has reduced to just seven the number of “red list” countries that it considers the highest coronavirus risk and from which it requires travelers to quarantine in government-designated hotels upon arrival.
The change, announced on Thursday, removes 47 countries and territories from the list, including Afghanistan, Brazil, Mexico and South Africa. Taking effect on Monday at 4 a.m. local time, it lifts a set of restrictions that have separated family members and thwarted business travel and vacations.
Residents and officials in restricted countries have in recent months called for the measures to be lifted as their infection numbers have fallen and vaccinations have risen. One online petition asking that Turkey be removed from the list gained nearly 49,000 signatures.
“We’re making it easier for families and loved ones to reunite, by significantly cutting the number of destinations on the red list, thanks in part to the increased vaccination efforts around the globe,” Grant Shapps, Britain’s transportation secretary, said in a statement.
The countries remaining on the list are all in Latin America or the Caribbean: Colombia, the Dominican Republic, Ecuador, Haiti, Panama, Peru and Venezuela.
Fully vaccinated people arriving from countries not on the red list will no longer be required to take a coronavirus test before traveling to England, although they must still pay for a test on the second day after their arrival.
Unvaccinated people traveling from these destinations will still have to take a pre-departure test, plus tests on their second and eighth days after arriving, and will still be required to isolate for 10 days.
The changes followed an announcement this week that England’s three-tiered traffic light-inspired system was being reduced to a single “red list.” Testing and quarantine requirements for fully vaccinated arrivals were also eased.
Sajid Javid, Britain’s health secretary, cited what he called the country’s “phenomenal progress” in vaccination. Seventy-three percent of people in Britain have received a single dose, and 67 percent are fully vaccinated, according to figures collated by Our World in Data.
Singapore is adding the United States and seven other countries to its list of places where two-way travel for fully vaccinated people can occur without needing to quarantine, officials announced on Saturday, as the Southeast Asian country begins to cautiously reopen.
“We are charting a course for the new normal, toward living with Covid-19,” S. Iswaran, the transportation minister for Singapore, said in a post on Facebook. “This is how we must move forward to protect both our lives and livelihoods, to learn to live with the virus, and to journey toward a Covid-resilient nation.”
In addition to the United States, the new countries in this arrangement are Canada, Denmark, France, Italy, the Netherlands, Spain and Britain, according to Mr. Iswaran. Singapore already announced similar arrangements with South Korea, Brunei and Germany.
Under the plan, known as Vaccinated Travel Lanes, fully vaccinated people traveling between Singapore and those countries will subject only to PCR tests for the coronavirus instead of quarantining, according to the transportation ministry. Those travelers will also have no restrictions on their purpose of travel and will not be required to have a controlled itinerary or sponsorship, the ministry said.
The expanded travel plan will start on Tuesday, according to the ministry.
Email messages to the ministry seeking comment were not immediately returned.
The Vaccinated Travel Lanes are one of the biggest reopening steps being taken by Singapore, a major economic and transportation hub, after early successes in thwarting the coronavirus and then a sharp setback in controlling its spread.
Singapore was widely considered a success story in its initial handling of the pandemic, closing its borders, testing and tracing aggressively, and ordering vaccines early.
Singapore has now fully inoculated 83 percent of its population, and a top politician told the public in August that an 80 percent vaccination rate was the criterion for a phased reopening.
But in September, with cases doubling every eight to 10 days, the government reinstated restrictions on gatherings. The United States said its citizens should reconsider travel to the country, emergency departments in several Singapore hospitals were crowded, and people were once again told to work from home.
The country’s experience has become a sobering case study for other nations pursuing reopening strategies without having had to deal with large outbreaks in the pandemic. For Singapore residents, there were nagging questions about what it would take to reopen if vaccines were not enough.
For many, the repeated tweaks to the restrictions have taken a toll. The number of suicides in 2020 was the highest since 2012, a trend that some mental health experts have attributed to the pandemic.
Tesla will move its headquarters from California to Austin, Texas, the company’s chief executive, Elon Musk, said on Thursday, a move that makes good on a threat that he issued more than a year ago when he was frustrated by coronavirus lockdown orders that forced Tesla to pause production at its factory in Fremont, Calif.
Mr. Musk was an outspoken early critic of pandemic restrictions, calling them “fascist” and predicting in March 2020 that there would be almost no new cases of virus infections by the end of April. In December, he said he had moved himself to Texas to be near the company’s new factory.
His other company, SpaceX, launches rockets from the state.
“There’s a limit to how big you can scale in the Bay Area,” Mr. Musk said at Tesla’s annual shareholder meeting on Thursday, adding that high housing prices there translated to long commutes for some employees.
The company’s Texas factory, which is near Austin and will manufacture Tesla’s Cybertruck, is minutes from downtown and from an airport, he said.
Tesla is one of several California companies to say they were moving to Texas in recent months. Hewlett Packard Enterprise said in December that it was moving to the Houston area, and Charles Schwab has moved to a suburb of Dallas and Fort Worth.
Tesla is on track to sell about a million cars this year and is planning a major expansion. In addition to the Austin factory, Tesla is building one near Berlin. Its headquarters have been in Palo Alto for more than a decade.
The unexpected drop in hiring in September may have been a result of quirks in the way the government reports the data. But the broader recent slowdown is no statistical fluke — the rise of the Delta variant has clearly taken a toll on the economy.
The Labor Department said on Friday that government employment fell by 123,000 jobs in September, with most of the losses coming in education.
But public schools didn’t actually lay off tens of thousands of teachers, custodians and other workers. That figure is seasonally adjusted, meaning that it tries to account for predictable annual patterns in hiring and firing. One of the most predictable patterns of all: Schools hire lots of workers in September, and lay them off in June and July.
The pandemic, however, has disrupted those patterns. Early in the pandemic, many schools laid off workers earlier than usual. This year, some schools started hiring earlier than usual, meaning they also did less hiring in September than in most years. (Another possible factor: Many school districts have reported having difficulty hiring bus drivers and other workers, which could be holding down job growth.)
On an unadjusted basis, the government actually added close to 900,000 workers in September. Because that’s fewer than in a typical September, the seasonal adjustment formula interprets it as a loss in jobs.
Seasonal adjustment can help explain why job growth was weaker in September than in August, but it can’t explain why job growth in the last two months has been weaker than in the spring and early summer. That slowdown is real, and it reflects the impact of the Delta variant.
Employers in leisure and hospitality, one of the sectors hit hardest by the pandemic, added hundreds of thousands of jobs per month from February through July, as restaurants reopened and Americans began traveling more. But the sector added just 38,000 jobs in August and 74,000 in September.
Overall, private sector job growth has slowed to a pace of a bit above 300,000 a month over the last two months, from more than 800,000 a month in June and July.
Job growth in sectors less affected by the pandemic was relatively strong in September, however. Construction companies, manufacturers and retailers all added jobs, suggesting that the effects of the latest virus wave have been fairly contained.
San Francisco plans to ease face-mask requirements in limited settings, health officials said on Thursday. The change, set to take effect on Oct. 15, is dependent on coronavirus cases and hospitalization rates remaining stable or declining.
In settings such as offices, gyms, fitness centers, religious gatherings and college classes, people will be permitted to remove their mask if everyone present is vaccinated and their status has been verified. The new rule applies only to gatherings that do not exceed 100 people.
The employer or host is also required to ensure proper ventilation, verify that there have been no recent Covid-19 outbreaks and make sure that no children under 12 are present, among other safety measures.
California is among the states with the lowest number of newly reported coronavirus cases per 100,000 residents, according to a New York Times database. In San Francisco County, 74 percent of residents age 12 and older are fully vaccinated.
“I’m excited that we’re once again at a place where we can begin easing the mask requirements, which is the direct result of the fact that we have one of the highest vaccination rates in the country, our cases have fallen, and our residents have done their part to keep themselves and those around them safe,” said Mayor London Breed.
Ms. Breed called the eased restrictions “yet another milestone in our recovery” and said that “the City feels like it is coming alive again” on Twitter.
Indoor mask mandates remain in place for most other public settings, including retail stores and other common areas like building elevators, lobbies and restrooms, and masks continue to be required at bars and restaurants except when patrons are eating or drinking.
Proof of vaccination or a negative Covid-19 test has been required to go indoors at bars, restaurants, clubs, gyms and large indoor events in San Francisco since late August.
“Vaccines continue to be our path out of the pandemic, but masks have blunted the Delta-driven surge and protected our vital hospital capacity, while allowing businesses to remain open and children to return to school,” said Dr. Susan Philip, the city and county’s health officer.
For many college students, the pandemic’s arrival did more than disrupt their studies, threaten their health and shut down campus life. It also closed off the usual paths that lead from the classroom to jobs after graduation. Campus recruiting visits were abandoned, and the coronavirus-induced recession made companies pull back from hiring.
But this year seniors and recent graduates are in great demand as white-collar employers staff up, with some job-seekers receiving multiple offers.
The demand for college students at this stage of the pandemic — when overall U.S. employment remains more than five million jobs below the level in early 2020 — underscores the longstanding economic premium for people with a college education over holders of just a high school diploma.
The unemployment rate for all workers with a college degree stood at 2.8 percent in August, compared with 6 percent for high school graduates with no college.
What’s more, the spread of the Delta variant of the coronavirus has been a one-two punch for those lacking a college degree, hitting the sectors they depend on the most, like restaurants and bars, hotels and retail businesses.
Over the summer, many countries across the world opened to international visitors following the successful rollout of vaccination programs. But fragmented rules about which vaccines will be accepted and what documentation is required, as well as a lack of compatibility between vaccine apps, have left many travelers confused and frustrated over where they can visit without extraordinary headaches and restrictions.
More than 2.7 billion people around the world have been fully vaccinated with a range of vaccines that vary in degrees of efficacy, according to Our World in Data, an Oxford University Covid-19 database. Across Asia, the United Arab Emirates and South America, millions have received Sinopharm, Sinovac and other vaccines manufactured in China, but concern over their efficacy has resulted in many countries not recognizing them for the purpose of travel. Millions more who received domestic vaccines like the Sputnik V in Russia and Covaxin in India, which have not received approval from the World Health Organization, are also limited in where they can go.
Britain eased its travel rules this week, expanding the list of vaccination certificates it recognizes from other countries and territories, including Turkey and India, but certificates from many nations in Africa and South America were excluded. In terms of vaccines, the United Kingdom, the 27-member European Union and the 26-country Schengen Area accept the four vaccines approved by the European Medicines Agency — AstraZeneca, Pfizer-BioNTech, Moderna and Johnson & Johnson — but Britain and many E.U. states do not recognize the Sinopharm and Sinovac vaccines, despite their approval by the World Health Organization.
The United States is still in a “regulatory process” to determine which vaccines it will accept when the country opens to fully vaccinated travelers in November, the Centers for Disease Control and Prevention said in a statement. But vaccines listed for emergency use by the W.H.O. will be recognized, the agency said. Besides the three authorized for use in the United States — those made by Moderna, Pfizer-BioNTech and Johnson & Johnson — they are AstraZeneca, the version of AstraZeneca made in India, and two Chinese vaccines: Sinopharm and Sinovac.
The Sputnik V vaccine, which has been approved in more than 70 countries but not yet by the W.H.O., is unlikely to be accepted by the United States as it initially reopens for international travel.
These confusing rules over approved vaccines are not limited to Britain and the United States. Experts warn that the haphazard and preferential approach to travel regulations is creating a two-tier system where people vaccinated with the most effective vaccines — mainly in the west — are able to cross borders freely, while those in developing countries, who have received vaccines with a lower efficacy, are not.
While the Delta variant-driven surge is receding in much of the United States, it rages on in less-vaccinated states like North Dakota, to the point where the state’s governor and health professionals have asked people to avoid risky activities that could add to the burden on hospitals.
The plea to maximize capacity for the crush of Covid patient came last week from Gov. Doug Burgum and doctors and administrators from some of North Dakota’s largest hospitals. They asked the public to drive defensively, skip dangerous activities that could lead to injuries, regularly visit primary care physicians and make sure all their vaccinations were up to date.
“The pressure on hospitals and clinics in both our urban and rural areas is reaching critical levels, and we all need to do our part to avoid hospitalization and prevent further strain on these facilities and their staff as we work through this incredibly challenging time,” said Mr. Burgum, a Republican.
The problem has been compounded by health care worker shortages and a wave of patients who can no longer delay care for other conditions, said Dr. Joshua C. Ranum, the vice president of the North Dakota Medical Association.
North Dakota’s caseload — 81 cases per 100,000 residents — trails only those of Alaska and Montana, according to a New York Times database, a 25 percent increase over the past two weeks. And Covid-related hospitalizations are up more than a fifth in the past two weeks.
Nationally, the United States is averaging below 100,000 new daily cases for the first time since Aug. 4. The average of 97,933 cases is down 20 percent from two weeks ago. New daily deaths are down 14 percent, to an average of 1,770.
Covid caseloads remain high in North Dakota and Western states like Wyoming, Montana and Idaho, where vaccination rates are relatively low. Some areas have had to ration care and send patients to distant hospitals for treatment.
Just 45 percent of North Dakota’s population is fully inoculated, according to federal data, compared with 56 percent nationally.
Mr. Burgum has asked North Dakotans to get vaccinated, but he has resisted mandating vaccines and threatened legal action after President Biden announced vaccination requirements last month that Mr. Biden said would affect 100 million workers.
In North Dakota, Dr. Ranum said most hospitals were being forced to get by with the staff members they had, sometimes training them to work in different parts of the hospital to fill gaps. Reinforcements from elsewhere are rare because demand for traveling nurses and other health workers is so high, he said.
Dr. Michael LeBeau, president of Sanford Health Bismarck, North Dakota’s second-largest hospital, said the facility’s staff was depleted and exhausted as it reckoned with overdue care amid the surge.
“We spent the better part of a year where we had a hard time keeping up with standard health maintenance, yearly physicals, the stuff that prevents hospitalization,” Dr. LeBeau said.
Just a day after President Biden visited Chicago to plead for vaccine mandates, saying they were the only way to defeat the coronavirus, Mayor Lori Lightfoot on Friday said public workers could opt out of the city’s mandate until the end of the year by getting regularly tested.
The mayor announced the mandate for Chicago workers in August. But the proposal was met with immediate pushback from employees and labor groups, including the Fraternal Order of Police and the Chicago Federation of Labor.
Now, workers who are not fully vaccinated by Oct. 15, including those who have sought medical or religious exemptions, must get tested twice a week, separated by three to four days, at their own time and expense, the mayor’s office said.
Employees who fail to report their vaccination status by the Oct. 15 deadline will be placed on unpaid leave.
The test-out option will remain in place until Dec. 31, after which employees must be fully vaccinated unless they have received a medical or religious exemption. It was unclear what the consequences will be for those who refuse to comply.
Cities and states around the country have introduced vaccine mandates for their workers, and some have been met with legal challenges.
After being delayed by the courts, a vaccine mandate for educators and staff in New York City public schools was cleared to proceed after a ruling by a federal appeals panel last week. Though it faced opposition, the mandate pushed tens of thousands of Department of Education employees to get their shots.
Municipal workers in Seattle and in Los Angeles are required to be fully inoculated against the virus by next week, though unlike Chicago’s policy, there is no test-out option. Both mandates allow for religious or medical accommodations.
Chicago had been negotiating with labor unions since the August announcement.