Covid Updates: Oregon to Send National Guard Troops to Hospitals

Covid Updates: Oregon to Send National Guard Troops to Hospitals

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Credit…Arden Barnes/The Herald and News, via Associated Press

Oregon will deploy at least 500 National Guard troops to help its hospitals deal with a flood of coronavirus patients, as the state faces the largest wave of infections it has seen during the pandemic, the state’s governor said on Friday.

The governor, Kate Brown, said that hospitals were at risk of becoming overwhelmed, with 733 Oregonians hospitalized with severe cases of Covid-19, including 185 in intensive care.

The surge comes despite Oregon’s relatively high rate of vaccination, a fact that Ms. Brown noted in a videotaped address.

“I know this is not the summer many of us envisioned with over 2.5 million Oregonians vaccinated against Covid-19,” Ms. Brown said. “The harsh and frustrating reality is that the Delta variant has changed everything.”

Ms. Brown said that up to 1,500 National Guards members could be deployed to help at hospitals around the state, and that she had reached out to the Federal Emergency Management Agency for further support and funding.

The Delta variant has driven infections and hospitalizations to all-time highs in some Southern states, so much so that “pandemic of the unvaccinated” has become Biden administration shorthand for the latest wave. But it has also begun to hammer states with relatively high rates of vaccination, like Oregon and Hawaii.

In recent days, those two states have recorded their highest number of cases since the start of the pandemic. The seven-day average of cases in Hawaii has been above 500 for nearly a week, about double the peak the state reached in August 2020.

Oregon narrowly surpassed its highest previous average, reaching a seven-day average of 1,540 cases on Thursday, according to a New York Times database. Over the past two weeks hospitalizations have risen nearly 130 percent in Oregon and 140 percent in Hawaii.

Earlier this week Ms. Brown announced an statewide indoor mask mandate, which took effect on Friday. Under the new rules, everyone older than five needs to wear a mask in most indoor settings; children older than two will need to wear them on public transportation.

Hawaii has had the country’s fewest reported cases per capita for most of the pandemic.

But earlier this week, Gov. David Ige imposed new social distancing and gathering restrictions. Before that, Mr. Ige announced that state and county employees would have to show proof of vaccination by next Monday or be tested weekly.

The vast majority of people hospitalized with Covid-19 in Hawaii had not been vaccinated, according to a message on Twitter from the state’s lieutenant governor on Tuesday.

A back-to-school event that included coronavirus testing, vaccines, and free backpacks in Los Angeles last week.
Credit…Patrick T. Fallon/Agence France-Presse — Getty Images

As schools prepare to reopen five days per week amid an alarming surge in the coronavirus, Los Angeles and Chicago, the second and third-largest districts in the nation, announced on Friday some of the strongest teacher vaccine mandates to date.

Educators and school staff in both cities will have to be fully vaccinated by Oct. 15. School begins in Los Angeles on Aug. 16 and in Chicago on Aug. 30.

In Los Angeles, district employees will also have to submit to regular virus testing, regardless of vaccination status. In Chicago, staff will be tested weekly until the vaccine deadline. Both systems said there will be an exemption process for those with disabling medical conditions or sincerely held religious beliefs.

California and Illinois are also both requiring everyone to use masks inside schools when they reopen.

The new vaccine mandates will put pressure on other large school systems, particularly those in liberal states, to institute similar policies. New York City, the nation’s largest district, is currently planning to offer teachers the choice of either vaccination or weekly virus testing.

Leaders of both national teachers’ unions, the National Education Association and the American Federation of Teachers, have said they support vaccine mandates, but that details should be negotiated locally.

Nearly 90 percent of the nation’s educators are vaccinated, according to a survey from Education Week. Yet a small but vocal group of rank-and-file educators oppose vaccine requirements.

After 18 months of classroom closures and hybrid schedules, families and schools had been planning for a return to normalcy this fall. Research from the previous academic year had shown that schools could be operated relatively safely with mitigation strategies such as masking, distancing, hand washing and ventilation.

There is some reassuring evidence from the United Kingdom that during its Delta surge in June, schools remained among the safest places for children to spend time. But it is unclear whether the Delta variant presents more danger in American schools, given the patchwork of mitigation strategies.

Before the Chicago vaccine mandate was announced, Kenzo Shibata, a high school social studies teacher in the district, had considered requesting a leave of absence. A colleague with whom he worked closely had been “steadfast” in her refusal to be vaccinated, he said — a source of major anxiety for Mr. Shibata, whose wife is undergoing cancer treatment and has compromised immunity. Their son is too young to be vaccinated.

On Friday, Mr. Shibata said he was hopeful about the district’s mandate, though he remained concerned about fellow teachers asking for exemptions.

“I think this will cut back risk dramatically,” he said. “I’m still not feeling like five days a week in person is a good idea, but this is a step in the right direction.”

Secretary of Education Miguel Cardona delivered remarks at Graceland Park-O'Donnell Heights Elementary Middle School in Baltimore, Md., earlier this month.
Credit…Sarahbeth Maney/The New York Times

WASHINGTON — The Biden administration admonished the Republican governors of Texas and Florida on Friday for blocking local school districts from requiring masks or taking other measures to protect students from the coronavirus in the coming school year.

The secretary of education, Miguel Cardona, sent a pair of letters to the governors and their education commissioners, writing that he was concerned about recent executive actions taken by both governors.

Those orders, he wrote, prohibited districts from “voluntarily adopting science-based strategies for preventing the spread of Covid-19 that are aligned with the guidance from the Centers for Disease Control and Prevention,” like universal masking. The letters were made public late Friday.

The debate over whether local school districts should be able to require masks has become highly partisan. Republicans have cast mask rules as an infringement on parental rights, while Democrats have said they are a matter of public health.

Last week President Biden also sharply criticized Republican governors like Gov. Ron DeSantis of Florida and Gov. Greg Abbott of Texas who had banned mask mandates, saying they “are passing laws and signing orders that forbid people from doing the right thing.”

“If you aren’t going to help, at least get out of the way,” Mr. Biden said.

In one letter released Friday, Dr. Cardona criticized Governor DeSantis for threatening this week to withhold the salaries of district superintendents or school board members who defied his order.

The education secretary noted that the American Rescue Plan Act passed by Congress allocated more than $7 billion to the state for safety measures. None of the money has been made available to local districts, Dr. Cardona wrote, and it could be used to pay the salaries of school officials.

“In fact, it appears that Florida has prioritized threatening to withhold state funds from school districts that are working to reopen schools safely rather than protecting students and educators and getting school districts the federal pandemic recovery funds to which they are entitled,” Dr. Cardona wrote.

In his letter to Texas officials, Dr. Cardona criticized Governor Abbott’s executive order blocking mask rules in schools as well as other state guidance that makes contract-tracing optional.

Dr. Cardona said Governor Abbott’s order “may infringe upon a school district’s authority to adopt policies to protect students and educators as they develop their safe return to in-person instruction plans required by federal law.”

The offices of Governor DeSantis and Governor Abbott did not immediately respond to a request for comment.

He suggested that the state’s actions might imperil its federal relief funding. The policies, he wrote, appeared to “restrict the development of local health and safety policies and are at odds with the school district planning process,” which are required under the Education Department’s rules for receiving the relief funding.

Dr. Cardona said his department’s rules emphasize that districts have discretion over how to use their funding, and that contact tracing, indoor masking policies, and other C.D.C recommendations are permitted and encouraged.

Dr. Cardona added that the Biden administration would “continue to closely review and monitor” whether both states were meeting requirements under federal funding laws.

Dr. Cardona also expressed support for districts in both states that have defied the governors’ orders.

“The Department stands with these dedicated educators who are working to safely reopen schools and maintain safe in-person instruction,” he wrote.

Once a new mandate takes effect this month in San Francisco, unvaccinated people will not be allowed at indoor bars and restaurants.
Credit…Justin Sullivan/Getty Images

As the Delta virus variant gathers speed, so are Covid-19 vaccine mandates: from the local level, like San Francisco’s strict mandate for indoor public spaces, to the vast federal bureaucracy.

The flurry of increasingly strict vaccine rules for public workers, private companies and colleges comes as virus cases and hospitalizations have risen sharply, reaching rates not seen since their winter peak and testing the limits of hospitals across the United States. The mandates are only expected to accelerate once the Food and Drug Administration grants full approval to the vaccine in the coming weeks.

About 50 percent of Americans are fully vaccinated, and vaccination rates have begun climbing again, to nearly 700,000 new doses administered every day. But tens of millions of Americans are still holding out.

On Thursday alone, Covid vaccine mandates proliferated and gained support with a stunning swiftness:

  • San Francisco leaders unveiled some of the nation’s toughest restrictions on unvaccinated people, barring them from indoor dining, bars, nightclubs, gyms, large concerts, theaters and other events held inside. The new rules, which take effect on Aug. 20, would apply even to people who can show they have tested negative for the coronavirus. City employees and restaurant and bar workers will be given a grace period.

  • The Department of Health and Human Services said it would require more than 25,000 health workers — including contractors and volunteers — to receive coronavirus vaccines, becoming the latest federal agency to implement such a mandate. That goes beyond President Biden’s announcement last month that civilian federal workers would either have to be vaccinated or submit to severe restrictions. The mandate applies to members of the Indian Health Service and the National Institutes of Health who work in federally run facilities and deal with patients, and the U.S. Public Health Service, which is led by the surgeon general.

  • The Department of Veterans Affairs will require nearly every worker, volunteer and contractor within its vast health care system to be vaccinated against the coronavirus over the next eight weeks. Last month, the department began requiring shots for 115,000 of its frontline health care workers, making it the first federal agency to mandate that employees, including doctors, dentists and registered nurses, be inoculated. The expansion will impact about 245,000 more workers.

  • The Supreme Court allowed Indiana University to require students to be vaccinated against the coronavirus. Justice Amy Coney Barrett, who oversees the federal appeals court in question, turned down a request for emergency relief from a group of eight students who had sued, saying the requirement violated their constitutional rights to “bodily integrity, autonomy and medical choice.”

  • The nation’s largest teachers’ union, the National Education Association, offered its support to policies that would require all teachers to get vaccinated against Covid or submit to regular testing. The announcement comes after Randi Weingarten, the powerful leader of the American Federation of Teachers, another major education union, signaled her strongest support yet for vaccine mandates on Sunday.

When it comes to our children and Covid, we have more questions than answers. How will new variants affect them? How will they go back to school safely? Join Dr. Anthony Fauci and Times journalists (who are parents themselves) for a vital Q&A session for parents, educators and students everywhere.

Demonstrators protesting against evictions in New York this week.
Credit…Spencer Platt/Getty Images

A federal judge on Friday ruled that the Biden administration’s latest moratorium on evictions in counties where coronavirus is raging could remain in place for now, saying that she lacked authority to block such an emergency public-health policy.

But the judge, Dabney L. Friedrich, expressed doubts in her 13-page ruling about the legality of the policy. She said she believed “the government is unlikely to prevail” when the matter returns to the Supreme Court.

The Centers for Disease Control and Prevention imposed the ban on evictions on Aug. 3 in counties where Covid-19 is surging.

The ban replaced an expired, nationwide moratorium first imposed last September to prevent a surge of people crowding into homeless shelters and relatives’ homes, spreading the virus. The new one is narrower because it applies only where transmission rates are high. Still, that category currently covers about 91 percent of counties in the United States.

In May, Judge Friedrich had blocked the nationwide the moratorium, but the federal appeals court for the District of Columbia Circuit overruled her, and the Supreme Court let that decision stand in June.

On Friday, she ruled that the replacement policy was similar enough to the original one that the earlier appeals court ruling controlled the case — for now.

“Absent the D.C. Circuit’s judgment,” she wrote, she would immediately block the government from enforcing the new evictions ban. “But the court’s hands are tied.”

The Justice Department declined to comment. But in a statement, Jen Psaki, the White House press secretary, said: “The administration believes that C.D.C.’s new moratorium is a proper use of its lawful authority to protect the public health.”

The plaintiffs, led by the Alabama Association of Realtors, are expected to swiftly take the case back to the appeals court in an effort to speed its way to the Supreme Court, where five of the nine justices appear likely to agree with Judge Friedrich that the ban exceeds the government’s emergency powers under a broadly worded, but vague, 1944 public health law.

People wait in line to receive the Pfizer vaccine in Queens on Tuesday.
Credit…Byron Smith for The New York Times

An independent panel advising the Centers for Disease Control and Prevention on Friday recommended third doses of coronavirus vaccine for certain people with weakened immune systems, giving more backing to doctors and patients considering the opportunity for extra protection.

The recommendation came a day after the Food and Drug Administration authorized third doses for people with solid organ transplants and others with similarly weakened immune systems.

After nearly three hours of presentations and discussion, the committee of medical experts voted unanimously to recommend third shots for people in this group who have already received the two-dose vaccines made by Pfizer-BioNTech or Moderna.

While the panel’s guidance is nonbinding, it is followed closely by physicians and public health departments. The vote is expected to be followed by a formal recommendation from the C.D.C.

About three 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.

The group now eligible for third shots would include people with advanced or untreated H.I.V. infection, those who have undergone certain types of stem cell transplants within the past two years and those receiving certain kinds of chemotherapy, among others, Dr. Neela D. Goswami, a C.D.C. official, said.

Patients slated for treatments that weaken the immune system should get a third dose before they begin, Dr. Goswami said. And everyone eligible for a third shot should wait at least 28 days after their second dose before getting it, according to the C.D.C.

People will not need a doctor’s permission or a prescription to get a third shot, C.D.C. officials said; they will need only to attest that they meet the eligibility requirements for an additional dose. Anyone else, including people with chronic medical conditions, like diabetes or asthma, should not be getting third shots at this point, they said.

The updated F.D.A. authorizations do not apply to patients who received the single-dose Johnson & Johnson vaccine, and the C.D.C. panel did not recommend additional shots for members of that group, leaving them in limbo. Officials say they are waiting for more data from clinical trials.

Dr. Kathleen Dooling, a C.D.C. official, said that patients who qualify for a third dose should ideally seek out the vaccine they already received, but that they could take the other two-dose vaccine if the first was unavailable.

Dr. Dooling emphasized that immunocompromised people who receive a third dose should still wear a mask, maintain social distancing with people they do not live with, and avoid crowds and poorly ventilated indoor spaces. People with weakened immune systems face a higher risk of breakthrough infections and severe Covid-19.

Dr. Dooling said that early studies of how some such patients responded to third doses made clear that there could be some benefit, raising antibody levels.

Studies have also shown that third doses are safe for patients.

The recommendation from the panel, the Advisory Committee on Immunization Practices, comes as health officials are grappling with whether people vaccinated early in the nation’s inoculation campaign may need booster doses soon, a move that scientists and public health experts argue is not yet supported by data.

Some individuals are taking matters into their own hands. Just over a million people who received a two-dose vaccine in the United States have already received a third dose, Dr. Dooling told the C.D.C. panel.

Still, officials at the C.D.C. and F.D.A. have been careful to frame the third-dose authorization for people with weakened immune systems as a separate issue.

“Other individuals who are fully vaccinated are adequately protected and do not need an additional dose of Covid-19 vaccine at this time,” Dr. Janet Woodcock, the acting F.D.A. commissioner, said in a statement Thursday.

Over the past week, an average of roughly 125,800 coronavirus cases has been reported each day in the United States, an increase of 76 percent from two weeks ago.

The number of new deaths reported is up by 92 percent, to an average of 616 deaths per day for the past week.

Three states — Florida, Mississippi and Oregon — have reported more coronavirus cases in the past week than in any other seven-day period.

Roughly 71,500 patients per day, on average, have been in the hospital with coronavirus during the past week, an increase of 80 percent from two weeks ago.

Finally, the number of vaccine doses administered per day is also up in recent weeks, from an average of around 615,000 on July 29 to an average of 699,000 on Aug. 12.

A nurse checking Covid patients at a hospital in Tehran last month.
Credit…Wana News Agency/Reuters

Hospital medics in Iran are triaging patients on the floors of emergency rooms and in cars parked on the roadside. Lines stretch for blocks outside pharmacies. Taxis double as hearses, transporting corpses from hospitals to cemeteries. In at least one city, laborers are digging mass graves.

Iran is under assault from the most cataclysmic wave yet of the coronavirus, according to interviews with physicians and health workers, social media postings from angry citizens, and even some unusually frank reporting in the state news media. The aggressive Delta variant has led to record numbers of deaths and infections, and appears to be overwhelming the health system of a country that has been reeling from Covid-19 since the scourge began.

The latest phase of the crisis has intensified the challenges facing Iran’s new hard-line president, Ebrahim Raisi, testing his abilities just days after he took office.

“The situation we are facing is beyond disastrous,” said Dr. Mahdiar Saeedian, a 39-year-old physician in Mashhad, Iran’s second-largest city. “The health care system is on the verge of collapse.”

The official virus death toll is 500 to 600 people a day, but even these record-high figures are disputed as low by some government media. Frontline doctors in Tehran, Isfahan, Ahvaz and Mashhad told The New York Times that the real death toll was closer to 1,000 a day.

In Midtown Manhattan this week.
Credit…Spencer Platt/Getty Images

Even as many tech companies announce delays to their return-to-office dates in the face of the Delta variant, it appears that most companies’ plans have not yet changed, according to several weeks of surveys by Morning Consult.

Every week for three weeks, Morning Consult asked a nationally representative panel of 1,000 adult American workers when their employer was planning to have them return to their workplace either full time or part time. The first survey began on July 16 and ended Aug. 5.

The most recent one found that most workers were already in the office. Eight percent of workers said that their companies had adopted a permanent work-from-home policy. And 7 percent said their companies had not yet announced a policy.

The survey was not able to break out workers by industry, but it does have information on education. Splitting the survey by education shows that as educational attainment increases, there’s a significant decline in the share of workers who are in the office. Yet even among workers with graduate degrees, return dates are still concentrated in August and September.

Devising a return-to-office policy is hard. It requires executives to watch the development of the virus, monitor the attitudes of their workers and sort through thorny legal and personnel issues regarding the virus, said Tsedal Neeley, a Harvard Business School professor who studies remote work.

“What companies are grappling with is the question of: Do you mandate vaccines? Is it legal? If you mandate it, how do you do it? If you don’t, how will you ensure everyone feels psychologically and physically safe?” Professor Neeley said.

Migrants who test positive for the coronavirus are quarantined at Anzalduas Park in South Texas.
Credit…Sarahbeth Maney/The New York Times

On the edge of the Rio Grande in South Texas, sprawling Anzalduas Park has long been a popular spot for bird-watching, family cookouts and fishing. But earlier this month, the grassland expanse with barbecue grills and picnic tables was put off-limits, transformed into a large Covid-19 quarantine camp for migrants who have crossed from Mexico.

By this week, at least 1,000 migrants were housed at the teeming camp, erected by the nearby city of McAllen as an emergency measure to contain the spread of the virus beyond the southwestern border. About 1,000 others are quarantined elsewhere in the Rio Grande Valley, some of them in hotel rooms paid for by a private charity.

Cities in South Texas, the busiest crossing points along the border, are now at a harrowing place where two international crises intersect: an escalating surge of migrants and the rise of the Delta variant of the virus.

A New York Times reporter was granted exclusive access to the quarantine camp on a recent weekend. It could be mistaken for a sprawling recreational campsite. Residents were picking up food under a white event-style tent, children climbed on a jungle gym and families lounged in the shade. Some people appeared lethargic and unwell.

Of the 96,808 migrants who have passed through McAllen this year and been checked for the coronavirus, 8,559 had tested positive as of Tuesday.

Yet the prevalence of the virus among migrants thus far has been no greater than among the U.S. population overall, according to medical experts, and the highest positivity rates in the country are not in communities along the border. Rather, they are in areas with low vaccination rates and no mask mandates.

Linda Qiu contributed research.

The Bobcat fire in Juniper Hills, Calif., last September.  
Credit…Eric Thayer for The New York Times

Exposure to wildfire smoke during last summer’s wildfire season could be associated with thousands of additional coronavirus infections as well as hundreds of deaths, potentially causing an even greater challenge to public health officials in Washington, Oregon and California, a new study has found.

Wildfire smoke contains high levels of the smallest, most dangerous type of soot known as PM 2.5.

Researchers at Harvard University estimated that there were nearly 20,000 extra coronavirus infections and 750 Covid-19 deaths associated with exposure to wildfire smoke between March and December 2020 in the American West. The paper was published Friday in the journal Science Advances.

Exposure to smoke, whether from air pollution or cigarette smoke, is believed to impair the function of white blood cells in the lungs, blunting the body’s immune response. The chemicals in particulate matter can also inflame cells lining the airways and lungs. In both cases, if the body is exposed to a virus in addition to air pollution, the immune response may be slowed and the person may develop a more severe illness than they would have otherwise, researchers say.

The findings build on the well-established connection between air pollution and respiratory-tract infections and conditions such as asthma. But the study is the first to show a statistical link between wildfire smoke and Covid-19 caseloads and deaths.

“These results provide strong evidence that, in many counties, the high levels of PM 2.5 that occurred during the 2020 wildfires substantially exacerbated the health burden of Covid-19,” the authors wrote.

Some places experienced levels of air pollution that were dangerously high. In September 2020, Mono County, Calif., had four days where PM 2.5 levels exceeded 500 micrograms per cubic meter, a “hazardous” level, according to the Environmental Protection Agency. By comparison, on days when wildfires were not burning, the average daily level in the three states was 6 micrograms per cubic meter.

To arrive at their conclusion, the researchers used satellite data of smoke plumes from the National Oceanic and Atmospheric Administration to identify the locations and days affected by wildfires. They paired those readings with PM 2.5 data from ground-level air quality monitors in each of the counties and Covid-19 cases and death rates from data compiled by the Centers for Disease Control and Prevention.

Their statistical model accounted for other factors such as weather and the amount of time people were at home, and included a four-week lag to capture the virus’s incubation period as well as the additional time it can take for infected people’s health to deteriorate.

The same team of Harvard researchers also published the first study to find a clear connection between long-term exposure to air pollution and Covid-19 death rates last year.

The new study included reported infections, not just deaths, which makes it especially interesting, said John Balmes, a professor of medicine at the University of California, San Francisco, and an expert on the health effects of pollution who was not involved in the research. “It’s one thing for air pollution to be increasing the severity of the coronavirus infection, it’s another for it to be increasing reported cases,” he said.

After decades of tightening air quality regulations, the air in many American cities is cleaner now than it’s been in 50 years. But in the West, increased wildfire smoke threatens to undo those advances, said Loretta Mickley, an atmospheric chemist at Harvard’s John A. Paulson School of Engineering and Applied Sciences and one of the paper’s authors.

As the planet warms, droughts intensify and the West becomes drier, wildfires are starting earlier, growing larger, spreading faster and reaching higher elevations. In California alone, a record 2.5 million acres burned during the 2020 wildfire season, 20 times what had burned the previous year.

“We are really talking about climate change,” said Francesca Dominici, a biostatistician at Harvard’s T.H. Chan School of Public Health and senior author of the paper. “I hope that this is providing an additional piece of evidence for why it’s important to get our act together to combat climate change.”

Wildfire smoke may contribute up to half of the PM 2.5 in some parts of the western United States. It is so far unclear whether wildfire smoke is more or less toxic than smoke from diesel combustion or power plants.

Dr. Dominici noted that the analysis did not include individual patient data or consider other factors such as mask mandates.

Researchers are currently investigating whether fine particulate matter can spread the coronavirus.

The research does not bode well for this year, Dr. Dominici said, as wildfires started early and the pandemic is still raging in the United States, with a Delta variant that tends to be more contagious. She added: “I think the wildfires will have the same, if not worse impact on Covid-19 cases and deaths among the unvaccinated.”



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