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.
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.”
Two court rulings on Tuesday cleared the way for local leaders who oppose a ban by Gov. Greg Abbott of Texas, a Republican, on mask mandates to at least temporarily require face coverings to help curb a rise in coronavirus cases.
The first ruling came in Bexar County, which includes San Antonio. Masks can now be required in public schools and other public buildings there.
Masks will also be required for county and city employees, said Andy Segovia, the city attorney for San Antonio. The chief executive of Bexar County, Judge Nelson W. Wolff, said that the ruling was important because many students who are too young to be vaccinated would otherwise be coming back to school with no protection.
The second ruling was delivered by a district judge in Dallas County who said the ban prevented officials from protecting residents during an emergency.
“Dallas County citizens will be irreparably harmed” if local leaders cannot require face coverings to stop the transmission of the virus, the judge, Tonya Parker, wrote in the ruling.
In light of the decision, Clay Jenkins, the county’s chief elected official, said he planned to issue an emergency order on Wednesday.
On Tuesday, Texas recorded 20,000 new virus cases, nearly double the number of cases as two weeks ago, according to a New York Times database.
Some hospitals in the state are nearing capacity and are bracing for an influx of patients. The intensive care unit at Lyndon B. Johnson Hospital in Houston is at full capacity, and 63 percent of those patients are Covid cases, CNN reported.
While Mr. Abbott remains unmoved as one of the most strident opponents of mask mandates, he did put some restrictions in place in March 2020, such as limiting social gatherings to 10 people and closing some businesses, like gyms. Those that remained open operated at a limited capacity. Last July, as cases surged across Texas, he enacted a mask mandate.
The state lifted the mandate this past March, citing the presence of vaccine.
This week the governor appeared to acknowledge the growing burden on the health care system. He directed the state Health Department to find additional health care workers from outside Texas to provide reinforcements for overwhelmed hospitals statewide. He also sent a letter to the Texas Hospital Association telling hospitals to postpone elective medical procedures.
President Biden has recently criticized the governors of Texas and Florida, two states where virus cases have risen particularly sharply, for their pandemic response.
“I say to these governors, please, if you aren’t going to help, at least get out of the way for people who are doing the right thing,” he said at a news conference last week. On Tuesday, he encouraged people to get vaccinated as part of their preparation for hurricane and wildfire seasons.
Mr. Biden singled out Florida, Texas, Louisiana, Alabama, and Mississippi as states with low vaccination rates that are also more at risk from hurricanes.
On Tuesday, a temporary mask mandate for students, staff members and visitors to public schools in Dallas went into effect.
Brendan Steinhauser, a consultant who lives in a Republican-leaning suburb of Austin, said the rising number of cases had led more people to wear masks.
“It is palpable,” he said of his neighbors’ mask-wearing attitude. “I noticed it and it was like, ‘Whoa.’”
Correction: An earlier version of this item misspelled the surname of Bexar County’s chief executive. He is Judge Nelson W. Wolff, not Wolf.
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.
Bangladesh’s health care system is buckling under the ferocity of the country’s third, and by far deadliest, wave of coronavirus infections, and only 4 percent of the population is fully vaccinated. Yet the country of 165 million people lifted much of its lockdown on Wednesday.
And while health experts feared that the lifting of restrictions would worsen the outbreak, the effect of the restrictions on people’s livelihoods in Bangladesh has been devastating. The pandemic has pushed at least 24.5 million into poverty, according to an April study.
Government advisers say the country’s leaders have little choice but to reopen. “It’s not possible for the government to keep the country locked down forever,” Mohammad Shahidullah, the president of the government’s Covid-19 committee, told the local news media.