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Covid Updates: Vaccine Mandates and More

ImageTrash sits uncollected near a protest in Manhattan against a Covid-19 vaccine mandate for municipal workers. Rates of vaccination had risen dramatically by Friday’s deadline.
Trash sits uncollected near a protest in Manhattan against a Covid-19 vaccine mandate for municipal workers. Rates of vaccination had risen dramatically by Friday’s deadline.Credit…David Dee Delgado/Getty Images

New York City’s sweeping effort to compel most city employees to receive the coronavirus vaccine before Monday appears to have rapidly boosted inoculation rates and pressured thousands of police officers, firefighters and other government workers who had long held out to get the shot.

The vaccination rate among workers affected by the city’s mandate rose to 83 percent at the end of Friday, from 71 percent on Oct. 19, the day before the requirement was announced, according to city data. Some individual agencies reported jumps in vaccination rates of nearly 10 percentage points between Thursday and Friday alone.

The last-minute rush in the nation’s largest municipal work force mirrored similar patterns involving other vaccine mandates. Thousands of health care workers around the state rushed to get their first doses in the days before a requirement for employees at hospitals and nursing homes took effect last month.

Still, more than 25,000 city workers affected by the mandate remain unvaccinated and will be placed on unpaid leave on Monday if they do not receive the shot over the weekend. And speculation was fueled in recent days that some employees in agencies including the Sanitation and Fire Departments had already begun to slow down work in protest of the mandate.

New Yorkers across several boroughs, for example, have reported garbage pileups and significant delays in trash pickups in their neighborhoods.

Sanitation officials say the most severe delays have been seen across Staten Island and in parts of southern Brooklyn including the Bay Ridge and Bensonhurst areas. Data shows that overall 311 complaints soared last week with more than 1,000 reports of uncollected trash and recycling on some days, as the local news outlet Gothamist reported. (The number had hovered between 100 and 250 through the rest of October.)

Mayor Bill de Blasio said this week that he believes some of the delays may be attributed to declines from workers in protest of the vaccination requirement.

“I’m assuming it is related to people expressing their views on this new mandate,” Mr. de Blasio said at a recent news conference. “You want a protest, go protest. But when you’re on the clock, you have to do your job.”

Similar problems were reported among some workers in other agencies as the vaccination deadline approached.

Fire officials said that an uptick in sick calls among employees toward the end of the week was responsible for the temporary closures of several fire stations across the Bronx and other boroughs.

“The excessive sick leave by a group of our firefighters because of their anger at the vaccine mandate for all city employees is unacceptable, contrary to their oaths to serve and may endanger the lives of New Yorkers,” the fire commissioner, Daniel A. Nigro, said in a statement.

Union leaders for both fire and sanitation workers denied reports of the changes in work patterns.

Still, the overall rise in the vaccination rate for municipal workers offered a measure of optimism that significant disruptions to government agencies and city life could be avoided as enforcement of the mandate begins on Monday.

Before the requirement was announced on Oct. 20, and an option to opt into weekly testing was removed, only about 60 percent of employees in the Fire and Sanitation Departments had received at least one vaccine dose. The Police Department’s rate sat around 70 percent.

Holdout workers were offered $500 as a bonus if they got vaccinated by the end of the workday on Friday. By that deadline, more than 75 percent of fire and sanitation workers had been vaccinated — along with nearly 85 percent of the Police Department’s 36,000 uniformed and 15,000 civilian employees.

Joseph Goldstein contributed reporting.

A member of the Ministry of Emergency Situations disinfecting a waiting hall at a railway station in Moscow on Thursday.Credit…Emile Ducke for The New York Times

Russia announced a record number of new infections on Saturday ahead of a “nonworking week” that authorities hope will slow the spread of the coronavirus.

Authorities reported 40,251 new infections in the preceding 24 hours, a record, and 1,160 deaths. More than 237,380 people in Russia, a country of 144 million, have died of Covid-19 so far; that is the highest rate in Europe.

President Vladimir V. Putin has largely left it to regional governors to implement pandemic-related restrictions but has recently taken a more active role, ordering that all nonessential workers stay home from Oct. 30 until Nov. 7.

Moscow, with 7,267 new infections in the past 24 hours, has been an epicenter of the pandemic. The city had begun a light lockdown on Thursday. Schools, kindergartens, nonessential shops, restaurants, bars and gyms are closed, while museums and theaters remain open at 50 percent capacity.

As in other regions, the health care system is being put to the test.

“Health care is working to its limits,” Moscow’s regional governor, Andrei Vorobiev, told the government network Channel One earlier in the week.

He noted that more than 500 people were on ventilators, also a record number. He said that 80 percent of the 10,000 hospitalized Covid patients had not been vaccinated.

Anna Popova, the head of Russia’s consumer health watchdog, said the more contagious AY.4.2 strain of the Delta variant had been identified in the Moscow region.

Only about one third of Russians are fully vaccinated, though the rates in Moscow are higher. Scholars attribute this to mistrust in the authorities and in vaccines. Authorities hope the restrictions will motivate more people to get the shots.

Russia’s statistics agency said Friday that 44,265 people had died of Covid-19 or complications from it in September.

Moscow’s mayor, Sergei Sobyanin, has said he hopes that the city will reopen on Nov. 7, despite rumors swirling that the restrictions will be extended for several more weeks, or until the new year. He has also introduced free express Covid-19 tests and announced stricter enforcement of a mask mandate on the Moscow Metro.

The restrictions have polarized residents of the capital city. Travel agencies reported unusually high interest in package vacations for the week. Some residents complained about the fact that there is no system in place to allow vaccinated people to live normally and enter venues using QR codes as proof of vaccination, which could be an incentive to get the vaccine. Others complain that recent measures are too little, too late.

“We needed to do this sooner, because the numbers are scary,” said Anna Zhurba, a 33-year-old museum employee. “Today, we have the highest number of new infections yet. How will one week improve the situation?”

Institutions can decide independently to use QR codes, though there is no mandate. Ms. Zhurba said that when her museum announced a requirement to show a QR code upon entry, some responded by calling the restriction a “fascist way of dividing people.”

A Los Angeles police union objected to a requirement to use a city-mandated vendor for Covid-19 testing.Credit…Robyn Beck/Agence France-Presse — Getty Images

A Los Angeles police union sued the city on Friday over the implementation of a Covid-19 vaccination mandate for its employees, claiming that a city official stood to benefit from the terms of the policy.

The union, the Los Angeles Police Protective League, charged in the lawsuit that the city failed to disclose that the contractor hired to test employees for Covid-19 was partly owned by the commissioner of the pension fund for firefighters and police officers.

Police unions across the country, from Chicago to Washington State, are urging members to resist Covid vaccine requirements — despite the virus being by far the most common cause of officer duty-related deaths this year and last, according to the Officer Down Memorial Page, a nonprofit that tracks officers’ deaths across the country.

Some have resorted to the courts. Earlier this week, New York City police unions filed a lawsuit asking to allow unvaccinated police officers to continue working, despite the city’s recently imposed vaccine mandate, which requires all municipal workers to have received at least one coronavirus vaccine dose by Nov. 1.

In Los Angeles, the police union agreed in bargaining to the city’s requirement that unvaccinated employees have to be tested for the coronavirus twice a week. The $65 cost of the tests is deducted from the employees’ paychecks unless they are granted medical or religious exemptions to the mandate. About 74 percent of police department employees had received at least one dose of a Covid vaccine as of Friday, according to the Los Angeles Times.

The union’s lawsuit, filed in California Superior Court, says the city’s attempt to pass on the cost of testing to officers violates the state’s labor code.

But the police union went further, alleging that the testing plan involves “issues of conflicts of interest.” Earlier this week, it raised concerns that Bluestone, the company awarded a $3 million no-bid contract to do all the city’s tests, is co-owned by a commissioner who oversees the Fire and Police Pension, Pedram Salimpour.

“The City rejected every proposal to allow our members to test through their healthcare provider, the County of Los Angeles, or any other testing option,” the union said in a statement released on Friday.

The city has denied any wrongdoing. In a statement it said it vetted seven testing vendors, and that Bluestone was selected “because it was the only company that was able to offer the variety of needed services at a competitive rate.”

Tom Saggu, a spokesman for the union, said on Saturday the city had withheld the connection between Bluestone and Mr. Salimpour during collective bargaining over the terms of the mandate. He added that officers would not mind the testing if it did not come at a financial cost and if they could choose to get tested at other locations, like pharmacies.

Merck’s antiviral drug for Covid-19, molnupiravir.Credit…Merck

Britain, Australia and South Korea have reached agreements with the drugmaker Pfizer to purchase its antiviral pills used to treat Covid-19 once regulators approve them, the company said on Friday.

Under the terms of the agreements, Australia will buy 500,000 courses of Pfizer’s pill, known as PF-07321332, and Britain will purchase 250,000, the company said. Earlier this month, Australia secured 300,000 courses of another antiviral pill, molnupiravir, made by the drug manufacturer Merck, and Britain agreed to buy 480,000.

South Korea secured 70,000 courses of Pfizer’s pill, the health ministry said in a statement on Friday. It has also signed a purchase agreement with Merck for 200,000 courses of its pill.

The United States has not yet agreed to buy Pfizer’s pills, a spokeswoman for the company, Roma Nair, said by telephone on Friday. The United States has reached a deal with Merck to buy 1.7 million courses of molnupiravir.

Merck’s and Pfizer’s pills could be a milestone in the fight against the coronavirus because they do not require a visit to the hospital and are relatively inexpensive, unlike the antibody treatments currently being used.

Both pills are designed to interfere with viral replication. If approved by regulators, both pills could be prescribed at the first sign of infection or exposure without requiring hospitalization.

Merck has already reported data from its Phase 3 trials that showed molnupiravir reduced the risk of hospitalization or death by half. Merck has submitted an application to the U.S. Food and Drug Administration to authorize its pill. European Union regulators said on Monday that they had begun a review of molnupiravir.

Meanwhile, Pfizer said in a statement that it had begun Phase 2/3 trials to evaluate the efficacy and safety of its pill.

France has ordered 50,000 courses of Merck’s pills to be delivered starting in the end of November, the health minister, Olivier Véran, said on Tuesday.

The Philippines said this week that it had procured 300,000 courses of molnupiravir. Malaysia and Singapore have also secured supplies of Merck’s pills.

South Korea’s health ministry said it planned to purchase enough antiviral pills for 404,000 patients in total, and to have supplies available starting in the first quarter of 2022. It said it would closely monitor the progress of clinical trials for pills under development at several companies, including Merck, Pfizer and Roche, as it considers its options.

Abby Cooper of Bergen County, N.J., says she has been champing at the bit to have all five of her children — from left, Ilana, 12, Atara, 10, Shira, 2, Noam, 8, and Yair, 5 — vaccinated.Credit…Bryan Anselm for The New York Times

The Food and Drug Administration’s authorization of a Covid-19 vaccine for ages 5 to 11 on Friday makes 28 million unvaccinated children in the United States suddenly eligible for the shot and offers the country an opportunity to make big inroads in its efforts to achieve broad immunity against the coronavirus.

But in a nation that has already struggled mightily with public resistance to Covid vaccines, getting shots into those little arms may present health authorities with the toughest vaccination challenge yet.

Even many parents who are themselves vaccinated and approved the shot for their teenagers are churning over whether to give consent for their younger children, questioning if the risk of the unknowns of a brand-new vaccine is worth it when most coronavirus cases in youngsters are mild.

In announcing its authorization of a lower-dose shot made by Pfizer and BioNTech for the age group, the F.D.A. said clinical trial data showed the shot was safe and prompted strong immune responses in children. The most common side effects were fatigue, fever and headache.

To date, nearly two million children age 5 to 11 have been infected with the virus and 8,300 have been hospitalized. A third of those hospitalized were admitted to intensive care units, and at least 170 have died.

But a report this month from researchers at Northeastern, Harvard, Rutgers and Northwestern Universities found that parental concerns around the Covid vaccination had increased “significantly” from June through September. Chief among them, researchers said, were the newness of the vaccine, whether it has been sufficiently tested, efficacy, side effects and long-term health consequences.

According to a survey released Thursday by Kaiser Family Foundation, scarcely one in three parents will permit their children in this newly eligible age group to be vaccinated immediately. Two-thirds were either reluctant or adamantly opposed. An Axios-Ipsos poll found that 42 percent of parents of these children said they were unlikely to have their children vaccinated.

Dr. Cynthia Bader, a pediatrician in the Seattle area with an 8-year-old son, said that if her school district issued a vaccine mandate, she would clap her hands with joy but “then cringe at the idea of all the parents who will be coming to me seeking counseling for vaccine exemption forms.”

Relatives of certain foreign workers may soon be able to enter China for the first time in a year.Credit…Gilles Sabrié for The New York Times

Beijing has agreed to allow the relatives of certain foreign workers to enter the city, according to the American Chamber of Commerce in China, marking the first time in more than a year that many foreign residents will be able to reunite with their families.

The Beijing government has not confirmed the measure, which the American Chamber announced on its website on Thursday. But the chamber said it believed that applications for entry were already being processed.

“Foreign employees can now be reunited with their loved ones in China,” the statement read, and “new employees can now relocate to China together with their family members.”

China has implemented some of the world’s strictest pandemic-control rules, especially for foreign residents, and especially in Beijing, the capital. In March 2020, the government announced that virtually all foreigners would be barred from entering the country; previously issued visas were no longer valid.

A few months later, foreign workers were allowed to reapply for entry, though they would need special letters of invitation from the local government of the city where they were living. But the government would not issue those letters for spouses or children.

The international business community raised concerns; one survey of 191 businesses in southern China found that 70 percent had fewer than five expatriate employees at the end of last year, compared to 33 percent a year earlier.

But China, which has had remarkable success in containing the virus, has held to a policy of “zero Covid” — the last country in the world to do so — especially as it prepares to host the Winter Olympics in February.

Still, in recent weeks, some health officials have broached the topic of opening up, especially when vaccination rates increase. In September, Shanghai began issuing invitation letters for dependents of foreign workers again. The American Chamber of Commerce called the apparent loosening in Beijing a “significant breakthrough.”

Even so, those seeking to enter China must meet rigorous requirements, including quarantines of between two and four weeks.

A medical worker preparing a dose of the Sputnik V coronavirus vaccine at a department store in Red Square in Moscow.Credit…Pavel Golovkin/Associated Press

President Xi Jinping of China and President Vladimir V. Putin of Russia on Saturday called for “mutual recognition” of Covid-19 vaccines by global health authorities.

Both leaders delivered the remarks by video to the Group of 20 summit in Rome after deciding not to attend the meeting in person.

Mr. Putin said global access to Covid vaccines was suffering “in part because of protectionism, because of inability and unwillingness by some countries to recognize and register vaccines,” according to a video posted online by RT, a state-controlled Russian TV network.

A Russian vaccine, Sputnik V, has been authorized by 70 countries, Mr. Putin said. But it has not been authorized by the European Union’s main drug regulator, the European Medicines Agency, or the World Health Organization. Markus Ederer, the European Union’s ambassador to Russia, said this month that the Russian authorities had delayed inspections.

“The Russian side has repeatedly postponed the timing of the inspection requested by the E.M.A., which slows down the process,” Markus Ederer told the local outlet RBC. “These are the facts.”

Mr. Putin called on the W.H.O. to expedite the vaccine registration process. “As soon as this is done,” he said, “we will be able to restore and restart the economy.” He said he would also like the Group of 20 to “address the problem of mutual recognition of vaccine certificates.”

Over the summer, many countries opened to international travel, but the patchwork of rules regarding which vaccines would be accepted led to confusion and frustration for travelers, especially those who had received vaccines that were not widely accepted.

Two vaccines made by China, Sinopharm and Sinovac, are on the W.H.O.’s emergency authorization list. Across Asia and South America, millions of people have received doses of those vaccines, and millions more have received doses of vaccines, like Sputnik V, that have been authorized by individual governments only.

On Saturday, Mr. Xi said China had provided more than 1.6 billion shots to the world and was working with 16 countries on manufacturing vaccines, according to a transcript published by the official Xinhua news agency, Reuters reported.

Mr. Xi expressed support for a World Trade Organization decision that waived intellectual property rights for Covid-19 vaccines, Reuters said, and he called for vaccine manufacturers to transfer technology to developing countries.

A speech by President Xi Jinping in January, as seen at an exhibition center in January in Wuhan, China. The center was used as a temporary hospital early in the coronavirus outbreak.Credit…Gilles Sabrié for The New York Times

When the presidents and prime ministers of the Group of 20 nations meet in Rome this weekend, China’s leader, Xi Jinping, won’t be among them. Nor is he expected at the climate talks next week in Glasgow, where China’s commitment to curbing carbon emissions is seen as crucial to helping blunt the dire consequences of climate change. He has yet to meet President Biden in person and seems unlikely to any time soon.

Mr. Xi has not left China in 21 months — and counting.

The ostensible reason for Mr. Xi’s lack of foreign travel is Covid-19, though officials have not said so explicitly. It is also a calculation that has reinforced a deeper shift in China’s foreign and domestic policy.

China, under Mr. Xi, no longer feels compelled to cooperate — or at least be seen as cooperating — with the United States and its allies on anything other than its own terms.

Still, Mr. Xi’s recent absence from the global stage has complicated China’s ambition to position itself as an alternative to American leadership. And it has coincided with, some say contributed to, a sharp deterioration in the country’s relations with much of the rest of the world.

Instead, China has turned inward, with officials preoccupied with protecting Mr. Xi’s health and internal political machinations, including a Communist Party congress next year where he is expected to claim another five years as the country’s leader. As a result, face-to-face diplomacy is a lower priority than it was in Mr. Xi’s first years in office.

A protest against vaccine mandates in August outside a hospital in Des Moines. The State of Iowa joined the lawsuit that was filed on Friday.Credit…Bryon Houlgrave/The Des Moines Register, via Associated Press

Ten Republican-led states filed a lawsuit on Friday in federal court in Missouri accusing the Biden administration of a broad range of overreaches in mandating that employees of federal contractors be vaccinated against the coronavirus by Dec. 8.

The suit, filed in U.S. District Court for the Eastern District of Missouri, was led by Missouri’s attorney general, Eric Schmitt, and the attorney general of Nebraska, Doug Peterson. The other eight states are Alaska, Arkansas, Iowa, Montana, New Hampshire, North Dakota, South Dakota and Wyoming.

The White House has previously defended President Biden’s vaccination mandates as “clearly legal and needed to help save lives and stop the spread of Covid-19.”

Republican leaders in many states have adamantly opposed any measures that would require vaccines or masks, saying they infringe on personal liberties. Some have banned any such mandates, and legal challenges have been making their way through the courts for months.

Mr. Schmitt called the mandate for federal contractors an “absurd federal overreach” and warned that it could worsen problems with the nation’s supply chain and its labor supply that have arisen during the pandemic.

The lawsuit asserts that the executive order mandating vaccinations that President Biden issued in September violates the 10th Amendment, the Constitution’s separation of powers, and several federal laws.

Legal experts have said that similar lawsuits from other states were unlikely to succeed, including one filed by the administration of Gov. Ron DeSantis, Republican of Florida, on Thursday in Tampa.

One of the few approaches that seemed to offer such objections a chance at success — religious exemptions — suffered a blow on Friday when the Supreme Court declined to block Maine’s vaccination requirement for health care workers that did not include a religious exemption.

A mobile coronavirus testing site in Auburn, Maine, last year. The court’s three most conservative justices dissented from a ruling leaving the state’s vaccine mandate for health care workers in place. Credit…Robert F. Bukaty/Associated Press

The Supreme Court on Friday refused to block Maine’s requirement that health care workers be vaccinated against the coronavirus notwithstanding their religious objections.

As is the court’s custom in rulings on emergency applications, its brief order gave no reasons.

But the three most conservative members of the court — Justices Clarence Thomas, Samuel A. Alito Jr. and Neil M. Gorsuch — issued a lengthy dissent, saying the majority had gone badly astray.

“Where many other states have adopted religious exemptions, Maine has charted a different course,” Justice Gorsuch wrote for the dissenting justices. “There, health care workers who have served on the front line of a pandemic for the last 18 months are now being fired and their practices shuttered. All for adhering to their constitutionally protected religious beliefs. Their plight is worthy of our attention.”

Maine has required health care workers to be vaccinated against various contagious diseases since 1989, and eliminated exemptions on religious or philosophical grounds under a state law enacted in 2019, before the coronavirus pandemic began. The state does exempt workers for whom the given vaccine would be “medically inadvisable” in the judgment of a health care professional.

World leaders gathering for the official Group of 20 summit were joined by doctors and emergency medical workers for their “family photo” on Saturday at the La Nuvola convention center in Rome.Credit…Pool photo by Ludovic Marin/EPA, via Shutterstock

As President Biden and other leaders gathered on Saturday to discuss plans to protect against future pandemics, health experts and activists said that rich nations were still not doing enough to help people in poor nations survive the current one.

White House advisers said the president would spend his time at this weekend’s Group of 20 summit focused on fixing supply chains, securing a blessing on a global tax deal, and pushing to explore debt relief and emergency financing for poor countries whose economies have been battered by the pandemic.

From the start of the summit, leaders tried to telegraph the importance of ending the pandemic: During a group photo, they were joined on the dais by doctors in white coats and emergency medical workers from the Italian Red Cross. Prime Minister Mario Draghi of Italy, in his remarks opening the meeting, also pointed to the stark disparity in access to vaccines between richer and poorer countries.

While wealthy nations are offering people third doses and increasingly inoculating children, poor countries have administered an estimated four doses per 100 people, according to the World Health Organization.

And although Mr. Biden has promised to make the United States an “arsenal of vaccines” for the world, White House officials tried to manage expectations heading into the summit that there would be any large announcements on vaccine sharing.

Jake Sullivan, the president’s national security adviser, told reporters on Air Force One en route to Rome that “the main thrust of the effort on Covid-19 is not actually traveling through the G20.” He said that a virtual summit that Mr. Biden convened in September had set “more ambitious targets” for countries to pledge to share doses of vaccines.

Although Secretary of State Antony Blinken is scheduled to host a meeting of dozens of countries and nongovernmental organizations later this year to secure commitments on vaccine sharing, Mr. Sullivan said the focus for the G20 was on the future.

Mr. Biden said in June that the United States would buy 500 million doses of the Pfizer-BioNTech vaccine for poorer nations. He followed up in September by announcing an additional 500 million Pfizer doses, along with the promise of an additional $750 million for vaccine distribution, roughly half of it through a nonprofit involved in global vaccinations.

Only about 300 million of those doses are expected to be shipped this year, a number that experts say falls short of the amount needed for meaningful protection against the virus.

“You really have a failure of developed countries’ leadership post-Covid,” said Célia Belin, a visiting foreign policy fellow in the Center on the United States and Europe at the Brookings Institution. “This is going to have consequences.”

Since arriving in Rome, Mr. Biden has already heard a personal appeal to do more: During a meeting at the Vatican on Friday, Pope Francis pushed the president on the issue, a senior official said after the meeting.

And in an open letter to the G20, the head of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, urged the leaders of the world’s largest economies to “help stem the pandemic by expanding access to vaccines and other tools for the people and places where these are in shortest supply.”

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