Florida Covid Cases and Deaths Hit a Record

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Illinois Governor Orders Indoor Mask Mandate

Gov. J.B. Pritzker announced new coronavirus restrictions, requiring all state residents ages 2 and older to wear masks indoors and all educators to be vaccinated or face regular testing as new infections surge in the state.

In Illinois, vaccines will be required for all P-12 teachers and staff, all higher education personnel, all higher education students and health care workers in a variety of settings, such as hospitals, nursing homes, urgent care facilities and physicians’ offices. Effective September 5th, individuals working in these settings who are unable or unwilling to receive their first dose of vaccine will be required to get tested for Covid-19 at least once a week. Illinois will join several other states that have reinstituted statewide indoor mask requirements, regardless of vaccination status, effective on Monday.

CHICAGO — Gov. J.B. Pritzker of Illinois announced on Thursday a new, stricter set of coronavirus restrictions, ordering a statewide indoor mask mandate and requiring that all educators be vaccinated or face regular testing.

The mask mandate applies to all Illinois residents age 2 and older and begins on Monday. The vaccine rule, effective Sept. 5, affects all teachers and staff in schools from kindergarten through college.

“Unfortunately, we are running out of time as our hospitals run out of beds,” Mr. Pritzker said at a news conference on Thursday. “Hospital staff are becoming overwhelmed and overburdened. People are dying who don’t have to die.”

Mr. Pritzker, a Democrat, has taken an aggressive approach to restrictions intended to slow the spread of the coronavirus, which has spiked in Illinois in recent weeks, particularly in the downstate region, where intensive-care beds are scarce. Illinois reported a seven-day average of 3,547 cases on Wednesday, more than three times the average cases reported one month ago.

Earlier this month, Mr. Pritzker issued a mask mandate for students, faculty and staff in preschools, elementary and high schools throughout the state. He has also mandated masks in state-run nursing homes and similar facilities, and required vaccinations of people who work there. The Centers for Disease Control and Prevention has recommended masking for everyone in schools, regardless of vaccination status, and several states, including California and Connecticut, have school mask mandates in place.

Under the new vaccine rule in Illinois, educators who decline to be vaccinated will be required to submit to testing at least once a week.

The move comes as other states and cities weigh vaccine mandates after the Food and Drug Administration this week granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and older, making it the first to move beyond emergency-use status in the United States.

Earlier this week, Gov. Philip D. Murphy of New Jersey said that all teachers in that state would have to either be vaccinated or submit to weekly testing. California and Hawaii have similar mandates in place. And the cities of Los Angeles and Chicago, as well as Washington State and Oregon, have also recently announced full vaccine mandates for teachers.

On Wednesday, Mayor Lori Lightfoot of Chicago said she would require all city employees, including police officers, sanitation workers and park employees, to be fully vaccinated by Oct. 15. Chicago and Cook County already have indoor mask mandates in place.

One year after becoming ill with the coronavirus, nearly half of patients in a large new study were still experiencing at least one lingering health symptom, adding to evidence that recovery from Covid-19 can be arduous and that the multifaceted condition known as “long Covid” can last for months.

The study, published Thursday in the journal The Lancet, is believed to be the largest to date in which patients were evaluated one year after being hospitalized for Covid. It involved 1,276 patients admitted to Jin Yin-tan Hospital in Wuhan, China, who were discharged between Jan. 7 and May 29, 2020.

The researchers, who also evaluated the patients six months after hospitalization, found that while many symptoms improved over time and many of the 479 people who had been employed when they got Covid had returned to their original job, 49 percent of patients still had at least one health problem.

And shortness of breath and mental health issues such as anxiety or depression were slightly more prevalent 12 months later than at the six-month mark, the researchers reported, saying the reasons for that “worrying” increase were unclear.

The researchers also compared the patients in the study with people in the community who had not had Covid but had similar pre-existing health conditions and other characteristics. After 12 months, Covid survivors had worse overall health than people who had not been infected. They were also much more likely to be experiencing pain or discomfort, anxiety or depression, and mobility problems than those who had not had the disease.

The patients, whose median age was 57, were given physical exams, lab tests and a standard measure of endurance and aerobic capacity called a six-minute walk test. They were also interviewed about their health.

The study involved patients who were sick enough to be hospitalized, but who were generally not the most severely debilitated. About 75 percent required supplemental oxygen when they were hospitalized, but most did not need intensive care, ventilators or even high-flow nasal oxygen, a noninvasive method.

Women were more likely than men to have some lingering symptoms, including mental health issues and lung function problems. One of the most common symptoms was fatigue or muscle weakness, reported by 20 percent of patients. But that represented a significant decrease from the 52 percent who reported such symptoms six months after hospitalization.

Some issues, like shortness of breath, were more common in people who had been more severely ill. But some issues did not correlate to severity of the initial illness. For example, 244 patients underwent a lung function test, which found that from six months to one year after hospitalization, there was no decrease in the proportion of patients with reduced flow of oxygen from their lungs to their bloodstream — regardless of how ill the patients had been initially.

“The need to understand and respond to long Covid is increasingly pressing,” said an editorial The Lancet published about the study. “Symptoms such as persistent fatigue, breathlessness, brain fog, and depression could debilitate many millions of people globally.”

It added: “Long Covid is a modern medical challenge of the first order.”

The Supreme Court on Thursday rejected the Biden administration’s latest moratorium on evictions, ending a political and legal dispute during a public health crisis in which the administration’s shifting positions had subjected it to criticism from adversaries and allies alike.

The court issued an eight-page majority opinion, an unusual move in a ruling on an application for emergency relief. The court’s three liberal justices dissented.

The decision is likely to have immediate real-world consequences, putting hundreds of thousands of tenants at risk of losing shelter, while the administration struggles to speed the flow of billions of dollars in federal funding to people who are behind in rent because of the coronavirus pandemic and its associated economic hardship. Only about $5.1 billion of the $46.5 billion in aid had been disbursed by the end of July, according to figures released on Wednesday, as bureaucratic delays at the state and local levels snarled payouts.

The majority opinion, which was unsigned, said the Centers for Disease Control and Prevention had exceeded its authority.

“The C.D.C. has imposed a nationwide moratorium on evictions in reliance on a decades-old statute that authorizes it to implement measures like fumigation and pest extermination,” the opinion said. “It strains credulity to believe that this statute grants the C.D.C. the sweeping authority that it asserts.”

Justice Stephen G. Breyer, writing for the three dissenting justices, faulted the court for its haste during a public health crisis.

“These questions call for considered decision-making, informed by full briefing and argument,” he wrote. “Their answers impact the health of millions.”

Proponents of the moratorium said the court’s ruling would devastate impoverished Americans dealing with the economic fallout of a pandemic now in its fourth wave.

Owners and realtors, who had challenged the moratorium, hailed the court’s move.

Facing a tenfold increase in coronavirus hospitalizations since July 9, Oregon leaders have deployed the National Guard to hospitals, dispatched crisis teams to the hardest-hit regions of the state and ordered educators and health care workers to get vaccinated or lose their jobs.

Now, Gov. Kate Brown has gone beyond what any other state has done in battling the summer surge, requiring that both vaccinated and unvaccinated people wear masks when gathering closely in public, even when outdoors. The measure takes effect on Friday. She said more restrictions might be needed as the coming days unfold and the state tries to keep in-person schooling on track.

“All options are on the table,” Ms. Brown said in an interview this week.

Oregon’s aggressive approach in restoring pandemic safety rules is a stark divergence from states in the South, where outbreaks have been even worse but where many governors have resisted requirements for masks and vaccinations. But with the arrival of the Delta variant, Oregon has become one of a handful of states where cases and hospitalizations have escalated beyond even the records set during the worst part of the pandemic last year.

The virus is rampaging through rural communities where vaccination rates remain low. Hospitals across the state are near capacity, almost 50 percent beyond the state’s previous peak in December. Last week, a coronavirus patient in Roseburg died while waiting for an I.C.U. bed.

The Oregon Health Authority director, Patrick Allen, said the situation was so “dire” that he was urging unvaccinated people to avoid engaging in any nonessential activities.

“It’s that simple. It’s that urgent,” he said.

Mayor Bill de Blasio of New York City laid out a series of long-awaited safety protocols for schools on Thursday as he seeks to reassure parents who are concerned that the Delta variant of the coronavirus will upend the school year.

The mayor’s announcement follows weeks of rising alarm from parents and educators about the city’s plan to reopen its schools at full capacity, without a remote learning option. The first day of school for city’s roughly 1 million students is Sept. 13.

“Think about a child who hasn’t been inside a classroom in a year in a half, that’s not supposed to happen, we can’t let that happen anymore,” Mr. de Blasio said during a news conference.

As part of the new protocols, the city will test a random sample of 10 percent of unvaccinated people in schools every other week, a group that will include only students later this fall, when all adults will be required to be fully vaccinated, the mayor said. That means all children in elementary school will be subjected to testing, pending parent consent, while only unvaccinated middle and high schoolers will be tested.

Children 12 and older have been eligible to get vaccinated since mid-May, but it remains unclear when those younger than 12 might become eligible.

The testing program is more modest in scope compared to last year, when there were roughly 600,000 fewer children in schools because so many families chose remote learning. Last school year, the city initially tested 10 percent of all people in schools, but increased it to 20 percent in the spring, when the mayor relaxed quarantining rules.

The mayor defended the plan on Thursday, saying the city did not need as much testing with all staff and many students vaccinated. He said the city could increase testing in schools or neighborhoods as needed.

Mr. de Blasio is also aiming to avoid the frequent classroom and school closures that proved so disruptive for children and educators during the last school year. This year, when someone in a classroom tests positive, only unvaccinated close contacts will have to quarantine for 10 days. (It was unclear who would be considered a close contact.) That system is more conservative than the Centers for Disease Control and Prevention recommends, but health officials said they were trying to strike a balance between safety and minimizing disruption.

The mayor also hopes to skirt the bitter fights about masks and vaccinations in schools that have roiled so many other areas, as districts across the country have adopted a range of approaches in response to the threat of Delta. Some plans have been heavily shaped by politics, as some parents in districts controlled by Republican mayors and governors have pushed back against restrictions.

Middle and high school students in New York City who are unvaccinated but are considered close contacts of an infected person can leave quarantine early if they receive a negative test result five days into their quarantine.

Buildings will close for 10 days if there is evidence of widespread transmission as determined by the city’s disease detectives.

Elementary school students learning at home during quarantine will receive live online instruction from their teachers, but quarantined older students will work on their assignments on their own at home. The city is still finalizing details with unions on who will teach remote classes.

The city is planning to expand an existing program that allows medically vulnerable children to get a few hours of in-person, at-home instruction a week or online learning. More students will qualify for that program this year compared to previous years, and the city expects several thousand students to participate.

All students and staff will be required to wear masks, and each classroom will also have two air purifiers. Principals have been instructed to keep three feet of distance between students everywhere possible, and city officials said distancing will be possible in the vast majority of classrooms. Recent federal guidance called for universal masking in schools, regardless of vaccination status, with a focus on returning to in-person learning in the fall.

City schools saw extremely low virus transmission last year; the test positivity rate was .03 at the end of the school year in June.

Maryland on Thursday prepared to join a growing list of states that have decided to require students and teachers to wear masks in school to combat the wave of coronavirus cases sweeping the country.

The state’s board of education voted in a special meeting to approve a statewide school mask mandate. The emergency regulation will move to a legislative committee for final approval, which is expected within days.

Gov. Larry Hogan, a Republican, has said he would not order a school mask mandate and has left the decision up to schools boards. In the early days of the pandemic, Governor Hogan drew bipartisan praise for his aggressive response, but this year he surprised public health experts and state officials when he suddenly loosened Covid restrictions in March.

The issue of masks in schools has become a partisan battle in several states. Republican governors in Florida and Texas have tried to stop local districts from implementing mask requirements, casting them as an infringement on parental rights and individual freedom. They have faced resistance from some districts in Democratic strongholds, who have the support of the Biden administration.

In Maryland, Democrats control both houses in the state legislature, and the leaders have signaled their support for masks. On Thursday, Senate lawmakers issued a statement urging the board to implement the mask policy, which they said recognizes “the importance of keeping Maryland students in the classroom through proven mitigation strategies.”

Board of Education members said they hoped the mask rule would lessen the risk of disruptive quarantines for students. “I believe that having an in-school mask mandate is going to help us to meet our goal to have students stay in classrooms,” said Rachel L. McCusker, a school board member and Carroll County teacher who introduced the motion.

The C.D.C. has advised schools to quarantine all students in a classroom if they are unmasked and have come in contact with a person who tests positive for coronavirus. But if all students and staff are masked, only those who have been in close contact with an infected person are required to be quarantined. The guidelines say students must remain in quarantine for at least seven days, though often longer under most circumstances.

Kevin Bokoum, a student member of the Maryland board of education, said he supported the rule. “Anything is better than having to go back online,” he said. “It’s not even a burden.”

Health officials in Nebraska are so desperate for staff that they are recruiting unvaccinated nurses, an unconventional attempt to plug the shortage of nurses as the state battles a surge in coronavirus cases.

The advertisements for unvaccinated nurses are popping up on postcards, on Facebook and on state job postings: “$5,000 sign-on bonus!” and “No mandated Covid-19 vaccinations,” the notices say. The ads are for positions in veterans’ homes, psychiatric treatment facilities and other locations.

State Senator Carol Blood first heard about the advertisements on Monday, she said, when she was inundated with messages from constituents criticizing the outreach.

“Our health care professionals were calling my office in tears,” she said. “It’s a slap in the face to them. ”On Thursday, Gov. Pete Ricketts of Nebraska declared a staffing emergency for the state’s hospitals. New cases in Nebraska have jumped, with hospitalizations rising to the highest level since January, according to a New York Times database.

The governor said he would issue an executive order that will make it easier for hospitals to hire nurses. The order will waive licensing requirements for hospitals in order to authorize credentials for retired or inactive nurses, defer some continuing education requirements and suspend statutes concerning new health care providers who are seeking a license to practice.

Nebraska’s nurses, like health care workers across the country, are a year and a half into a relentless battle to care for Covid patients. The latest and most severe cases, across the country, are among those who have yet to be vaccinated.

As the highly contagious Delta variant pummels the United States, nurses are reporting that they feel depleted and traumatized, their ranks thinned by early retirements or career shifts that traded the emergency room for less stressful jobs.

Gov. Ricketts, a Republican, directed the state authorities to recruit unvaccinated nurses, said Taylor Gage, a spokesman for the governor.

“The state responded with this campaign so nurses throughout Nebraska know that state government is an alternative career choice,” Mr. Gage said in a statement.

The decision came after eight state hospitals mandated vaccines for their employees, KETV reported.

Ms. Blood, a Democrat, wrote a letter to the governor on Monday criticizing the recruitment scheme, saying the state’s decision was “of grave concern to myself and countless people in my district.”

“I do understand that we have a serious shortage of staff,” she wrote. “With that said, putting those who live in these facilities at risk because we need to find bodies to hire is not acceptable.”

Ms. Blood said on Wednesday night that she had not received a reply from the governor’s office.

The surge is being driven by the highly contagious Delta variant and low vaccination rates, health experts said. The authorities in Nebraska are struggling to vaccinate its citizens, with only 57 percent of people at least partially vaccinated. The national rate is 61 percent, according to the Centers for Disease Control and Prevention.

Gov. Ricketts also announced Thursday a directed health measure to limit elective surgeries that will take effect on Monday.

The statewide limitations comes days after Nebraska Medicine, Methodist Health, and Bryan Health announced that they would suspend elective surgeries to preserve hospital capacity. Nebraska Medicine cited the nursing shortage as a factor in its decision.

The governor said on Thursday that he is “still against” mask mandates, vaccine requirements and the use of vaccine passports but he urged all Nebraskans to get vaccinated.

After weeks of stagnation, the United States vaccination campaign has had a relatively successful month, with vaccine uptake rising from early-summer lows in every state in the country.

The upswing in vaccinations has come alongside an extended, and much more pronounced, increase in coronavirus cases, hospitalizations and deaths in the United States over the past two months. Public health officials say that in their communities, residents have been driven to get the vaccine by worries that the more-transmissible Delta variant might make them, or their loved ones, sick.

“The reason why we’ve seen the marked increase in demand is fear, it’s the Delta variant,” said Robert Ator, the retired National Guard colonel who runs Arkansas’ vaccination effort.

The increase in vaccinations has been especially pronounced in states where immunization levels were (and remain) below the national average of 61 percent. Many of those states have felt the effects of the Delta-led fourth wave most acutely.

Public health officials said that some areas with lower vaccine coverage, especially rural ones, just hadn’t been severely affected by the virus until the Delta surge.

“Some communities are seeing Covid close up now,” said Dr. Mandy Cohen, the secretary of the North Carolina Department of Health and Human Services. “They’ve seen it on the news, but that’s not the same as seeing it close up.”

States that have seen larger increases in new cases since their early-summer nadirs, such as Alabama, Georgia and Mississippi, tend to be those with bigger increases in new vaccinations.

Catrike has 500 of its three-wheeled bikes sitting in its workshop in Orlando, Fla., nearly ready to be sent to expectant dealers. The recumbent trikes have been waiting for months for rear derailleurs, a small but crucial part that is built in Taiwan.

The company’s problems offer a window into how supply-chain disruptions are rocking companies in the United States and around the world, pushing inflation higher, delaying deliveries and exacerbating economic uncertainty.

It is unclear when the snarls will clear up, and it’s possible they will get worse before they get better. The holiday season is right around the corner, American companies are running light on inventory, and coronavirus outbreaks continue to shut factories around the world.

Demand for goods remains strong as households use money saved during months stuck at home to buy athletic equipment, couches and clothing.

That could keep pressure on global goods producers and the transportation routes that serve them.

The critical questions for economic policymakers are how long the problems will last and how much they will feed into consumer prices, which have jumped sharply this year, both because of data quirks and bottlenecks.

Federal Reserve officials regularly say they expect the faster price gains to prove “transitory,” but they are careful to stress that supply chains are a major source of lingering uncertainty, making it unclear how quickly rapid gains will fade.

Container costs have rocketed up. Earlier this month, container shipping rates from China and East Asia to the United States’ East Coast climbed above $20,000, compared with about $4,000 a year ago, according to data from the freight-tracking firm Freightos.

Those attractive high prices are encouraging ships to abandon other routes, causing the problem to spread. And shipping issues have been exacerbated by related imbalances: Boats are backing up at ports, and as demand for goods booms in the United States, empty shipping containers haven’t been able to get back to China fast enough.

Joe Caramagna, a man who searches “doughnuts near me” when he travels, had never lived a short walk from a doughnut shop. This was a problem.

But one morning in April, he took a walk near his home in Paramus, N.J., and spotted on a building, written in crisp red cursive script, a sign he never thought he would see less than a mile away. “Krispy Kreme,” it read.

The chain had recently announced that vaccinated people could get one free glazed doughnut a day until the end of the year. Mr. Caramagna had received his second dose of the Pfizer vaccine a few days before.

“It was kismet,” he said.

Realizing the stars had aligned and popped him into the vacant center of his doughnut-obsessed world, he decided to channel his sweet cravings for a bigger purpose.

Mr. Caramagna, a comic book writer whose fans give him doughnuts at conventions, set out on a mission that spring day: He would eat one free Krispy Kreme doughnut a day until the end of the year. For each doughnut devoured, he would donate a dollar to charity. He picked the Ronald McDonald House Charities of the Piedmont Triad, a nonprofit organization that helps children access medical care and supports their families.

On a GoFundMe page where he has raised about $500, he says that beyond trying to encourage people to get vaccinated, he hopes others will “DOUGH-nate (har har)” to the Ronald McDonald House in Winston-Salem, N.C., the city where Krispy Kreme is based.

Mr. Caramagna, 45, is one of the thousands of people across the nation and around the world who have started their own small vaccine campaigns. They hope to persuade even a few people to get the shot, raise money for charities, or, if nothing else, offer their friends and neighbors a little cheer in a dark time.

The U.S. Open welcomed almost 750,000 fans onto its grounds in 2019 during its two-week run, and comparable numbers are expected to attend this year.

But two years ago, there was no coronavirus pandemic. Last year, the tournament was held without fans, and this year the United States Tennis Association will allow them back into what could be one of the most heavily attended mass gatherings in New York since the pandemic began in 2020.

With the tournament set to begin in earnest on Monday, the association issued protocols for fans and players on Tuesday, and the policies are far more relaxed than they were last year.

No proof of vaccination or a recent negative coronavirus test will be required for fans to enter the grounds, and no masks will be required when they are outdoors. Guidelines issued by the Centers for Disease Control and Prevention recommend wearing masks outdoors.

Much of the event is held outdoors, and the two roofed stadiums — Arthur Ashe and Louis Armstrong — will be considered outdoors, too, even if the roofs are closed. That is because the stadiums’ ventilation systems are considered adequate, U.S.T.A. officials say.

Players will be granted more freedom of movement than they were given last year, when many complained about isolation because they had been sequestered in a hotel in Long Island. All players will be tested upon arrival and then tested every four days after that. If they test positive, they will have to withdraw from the tournament, regardless of what stage the event is in, according to Stacey Allaster, the tournament director.

The player would also have to go into isolation for 10 days at his or her hotel or accommodation.

The qualifying rounds started on Tuesday, without fans. But once the main event begins on Monday, it will almost be business as usual, with maskless fans roaming the grounds and sitting next to one another, much as it has been with New York City’s two baseball teams, the Mets and the Yankees.

global roundup

Since May, a third wave of the pandemic has ripped through countries in southern and eastern Africa. One country in North Africa — Tunisia — is experiencing its fourth wave.

The continent, with a population of 1.3 billion people, has recorded almost 7.6 million cases and at least 191,000 Africans have died. A brutal wave of infections driven by the Delta variant has strained health systems in countries from South Africa to Tunisia, and from Zambia and Senegal, where vaccination rates are far lower than in Europe and North America.

But the World Health Organization said on Thursday that coronavirus infections in the continent had stabilized and the once slow vaccination rate has picked up pace.

Dr. Matshidiso Moeti, the W.H.O. regional director for Africa, told an online news conference that nearly 248,000 new cases had been reported in the past week, down from 282,000 in mid-July. At the same time, the number of vaccinations in the continent had tripled to 13 million.

“The third wave appears to be stabilizing but cases are still very high,” she said.

Many of the administered vaccine doses arrived as donations and sharing arrangements through the Covax program. Originally, the program hoped to vaccinate 20 percent of the African population this year. But Covax, co-led by the W.H.O. to provide vaccines to poorer countries, has been plagued by delays.

The W.H.O. now aims to vaccinate 10 percent of people in Africa by the end of September, according to Dr. Moeti. “117 million doses are due to arrive in the coming month and up to 34 million additional doses will be needed to reach that target,” she said.

Dr. Moeti called the goal a very daunting task and urged countries to continue sharing supplies. “With international solidarity we can protect those at highest risk of Covid-19 in all countries in the world,” she said.

In other developments around the world:

• As of Friday, 33 American service members on the Osan Air Base in Pyeongtaek, South Korea, tested positive for the coronavirus, according to military and health officials. The cluster infection broke out after a “no-mask party” last Saturday in a club on the base, according to reports from state media. South Korea is experiencing its worst wave of the pandemic, with much of the country under its strictest social distancing regulations. The cluster of infections came as joint military drills wrapped up between South Korea and the United States. South Korean military officials have conducted pre-emptive tests on 800 people: No Korean military personnel have tested positive.

• Thailand will lift most coronavirus restrictions on retail and dining beginning in September and permit gatherings of up to 25 people in Bangkok and other high-risk areas, Reuters reported. The country’s Covid-19 task force said on Friday that the changes were necessary to revive the Thai economy safely. But the country is battling its worst coronavirus outbreak and struggling to ramp up vaccinations, with only one in 10 people inoculated so far.

Jin Yu Young contributed reporting.