Biden to Push for Stricter Vaccine Mandates

President Biden is expected on Thursday to detail his administration’s plan to put pressure on private businesses, federal agencies and schools to enact stricter vaccination mandates and testing policies as the Delta variant continues its spread across the United States.

The spread of the highly variant has pushed the country’s daily average caseload over 150,000 for the first time since late January, overwhelming hospitals in hard-hit areas and killing roughly 1,500 people a day.

Mr. Biden, who was briefed by his team of coronavirus advisers on Wednesday afternoon, is set to deliver a speech at 5 p.m. Eastern that will address about six areas where his administration can encourage — or, at this point, push — more eligible Americans to receive vaccines, according to the White House. Officials offered few specifics, stressing that the plan was still coming together, but said that its underlying message would be that the only way to return to some sense of normalcy was to get as many people vaccinated as possible.

“We know that increasing vaccinations will stop the spread of the pandemic, will get the pandemic under control, will return people to normal life,” Jen Psaki, the White House press secretary, told reporters on Wednesday. “That’s what our objective is, so we want to be specific about what we’re trying to achieve.”

When asked if Mr. Biden would be adding more detail to existing policies or would outline measures that would have an immediate and broad effect on Americans, Ms. Psaki replied: “It depends on if you’re vaccinated or not.”

Administration officials see signs that more people in the United States are open to receiving shots — some 14 million got their first shots in August, four million more than in July, Ms. Psaki said. But about 27 percent of the eligible U.S. population age 12 and older have not received any Covid vaccinations, according to data from the Centers for Disease Control and Prevention. In some of the hardest-hit states, the unvaccinated percentage is higher: 42 percent in Texas, for instance, and 38 percent in Florida.

About 1.3 million fully vaccinated people have received a third shot after federal officials approved them for people with compromised immune systems. Mr. Biden has publicly supported the idea of a broadening the availability of third shots as boosters for much more of the population, but health experts have advised the White House to hold off promoting that for now.

On Wednesday, Ms. Psaki said that the White House was working toward a plan for boosters, but did not give a time frame. She told reporters that Mr. Biden had chosen Thursday to deliver an extensive speech on the virus because he understood it was “top of mind for Americans” as they return to schools and offices.

The president will also be seeking to course-correct after a difficult month for his administration, directing the public away from a chaotic and violent end to the war in Afghanistan and back toward his administration’s efforts to curb a pandemic that has upended every facet of American life.

But amid renewed fears of the virus’s damaging effect on the economy and the prevalence of a troublesome variant, even Mr. Biden’s allies say it will take more than a speech to ease concerns that the virus has once again spiraled out of a president’s control.

“He ran on competence, bringing adults back into the room,” said Nick Rathod, a former domestic policy adviser to President Barack Obama. “This is something that he needs to take control of and show his level of competency. I think that’s why he was hired.”

A fire at a temporary hospital where coronavirus patients were being treated in North Macedonia has left at least 14 people dead, the country’s health minister said.

All 14 were patients, and 12 others being treated at the center suffered injuries in the fire that broke out Wednesday evening, the country’s health minister, Venko Filipce, said. No health workers were reported injured what Mr. Filipce described as a “terrible accident.”

The fire, which began at around 9 p.m. at a mobile hospital in Tetovo, in the country’s northwest, was extinguished within 45 minutes, but it had spread quickly through the building, one fire official told a local news outlet.

Footage from the scene showed a plume of black smoke rising as flames engulfed the hospital. Videos aired later on local news showed fire trucks at the scene and wheelchairs scattered around the burnt-out shell of the structure, a one-story modular building.

The blaze was driven in part by explosions, according to the country’s prime minister, Zoran Zaev, who immediately launched an investigation. The prime minister’s office said the cause of the fire had yet to be determined.

Oxygen tanks being used to treat patients with severe Covid-19 have been blamed for deadly fires at other coronavirus clinics around the world. In July, at least 39 people were killed at a hospital in southern Iraq after an oxygen tank explosion in a ward where Covid-19 patients were being treated. In April, a fire caused by an oxygen tank explosion at a coronavirus hospital in Baghdad killed at least 82 people.

In a statement posted on social media, Mr. Zaev called the fire a “great tragedy” and offered his condolences to the families of the dead.

“The fire has been extinguished, but many lives have also been extinguished,” he said, while adding that emergency workers had done their best to save lives.

He pledged that the authorities would determine the cause of the fire, and noted that investigators were already at the scene. “This is a truly tragic event and I can assure you that the entire state leadership is committed to rapidly resolving this situation,” he said.

North Macedonia, where just 27 percent of about two million residents have been fully vaccinated, has seen a wave of coronavirus infections since August.

Since achieving independence 30 years ago, North Macedonia has worked to develop its national health system, but experts say that major challenges remain. In a 2018 report, the World Health Organization said that the health system suffered from underfunding, a lack of adequate equipment and a shortage of health care workers.

Los Angeles is poised to become the first major school district in the United States to mandate coronavirus vaccines for students 12 and older who are attending class in person.

The district’s elected Board of Education will meet Thursday afternoon to vote on the measure, which is expected to pass with broad support. The Los Angeles Unified School District is the second largest in the nation, serving over 600,000 students, and the mandate could set an important national precedent.

Students would need their first vaccine dose by Nov. 21 and their second by Dec. 19 to begin the next semester fully inoculated. Those who turn 12 after those dates will have 30 days after their birthday to receive their first shot.

Students participating in in-person extracurricular activities will need both shots by the end of October. The resolution mentions “qualified and approved exemptions,” but does not offer details.

The district offers online independent study for those who opt out of in-person learning this year, but so far, only a tiny percentage of students have chosen it.

According to the Los Angeles County Department of Health, 58 percent of the district’s 12-to-18-year-olds have already received at least one vaccine dose.

“Our goal is to keep kids and teachers as safe as possible and in the classroom,” said Nick Melvoin, a Los Angeles school board member, in a written statement expressing support for the resolution. “A medical and scientific consensus has emerged that the best way to protect everyone in our schools and communities is for all those who are eligible to get vaccinated.”

Initial data on infections at Los Angeles schools this year has been reassuring. According to a Los Angeles Times tracker based on district data, 1,620 active Covid-19 cases had been identified at schools as of Sept. 6; only five were linked to on-campus transmissions, at two schools.

While it is typically states, not individual districts, that are responsible for school vaccine mandates, the Culver City school system, a small district also in Los Angeles County, announced a student mandate last month, and other California districts are considering similar requirements. Legal challenges are likely.

The Food and Drug Administration has approved vaccines on an emergency basis for children ages 12 to 15, but is expected to grant full approval in the coming weeks, which could pave the way for more school mandates.

The coronavirus pandemic could “wipe away 20 years of hard-fought gains” in reducing maternal mortality in Latin America and the Caribbean, and countries in the region should prioritize those who are pregnant and those who have recently given birth in their vaccination campaigns, officials at the World Health Organization warned on Wednesday.

“So far, more than 270,000 pregnant women have become sick with Covid in the Americas and more than 2,600 of them — or 1 percent of those infected — have died from the virus,” Dr. Carissa F. Etienne, the director of the Pan American Health Organization, a division of the W.H.O., said at a news conference.

Pregnancy enhances vulnerability to respiratory infections, including Covid-19.

Most countries have reported higher numbers of cases and deaths during pregnancy in 2021 than in all of last year, and in Mexico and Colombia Covid-19 has become the top cause of maternal death this year.

Dr. Etienne’s organization recommends that vaccinations be universal during the first trimester of pregnancy and for those who are breastfeeding, as breast milk confers the vaccine’s protection to newborns. That is guidance similar to that issued last month by the Centers for Disease Control and Prevention.

In Mexico which has prioritized shots during pregnancy for some time, Dr. Etienne said, “not a single vaccinated woman has died from Covid during pregnancy.”

However, less than half of the countries in Latin America and the Caribbean have set out specific vaccination guidelines related to pregnancy and birth, Dr. Etienne said.

At least 40 percent of the countries in Latin America and the Caribbean have reported disruptions to maternal and newborn care from the pandemic, Dr. Etienne said, and the region remains short of vaccines.

Only 28 percent of people in Latin America and the Caribbean have been fully inoculated against Covid-19, she said, with far lower numbers in some countries. Guatemala and Nicaragua have fully vaccinated less than 10 percent of their people, and Haiti less than 1 percent.

In the Caribbean, infections are dropping as a whole, although there is an increase in Covid-19 deaths in several islands, including Jamaica and Puerto Rico.

Infections are also rising in several Central American countries, including Costa Rica, Belize, and Guatemala, where half of hospitals are over capacity.

By contrast, in South America, with the exception of Venezuela, cases and deaths have been steadily dropping. Officials with the Pan American Health Organization did not address if testing volume in the region may have affected the number of reported cases.

— Daniel Politi

Senator Elizabeth Warren of Massachusets sent a letter to Amazon this week demanding the company do more to stop “peddling misinformation about Covid-19 vaccines and treatments” through dubious products sold on the site.

The letter, addressed to Amazon’s chief executive, Andy Jassy, and dated Sept. 7, asserts that the online retailer’s search algorithm contributes to the spread of misinformation about Covid-19 by promoting books on the site’s best-seller list that are riddled with falsehoods about the pandemic and vaccines.

Ms. Warren said her staff had searched Amazon using terms including “Covid-,” ““Covid-19 vaccine” and “pandemic,” they found that the top results included books like “The Truth About Covid-19: Exposing the Great Reset, Lockdowns, Vaccine Passports, and the New Normal,” which contains multiple claims that have been proven false. The book was also labeled a best seller in Amazon’s “Political Freedom” books category.

One of the book’s authors, Dr. Joseph Mercola, was issued a warning letter by the Food and Drug Administration in February accusing him of representing vitamin supplements for sale on his website as being effective against the coronavirus.

The searches by Ms. Warren’s office also yielded first-page results of books that claimed Covid-19 vaccines were “making people sick and killing them” and literature that touted ivermectin, a deworming drug often used for livestock, “as a Covid-19 miracle cure,” which it is not.

“Collectively, this is an astonishing sample of misinformation that appeared in only a few potential searches relating to Covid-19,” the letter states.

A search by The New York Times came up with similar results.

Ms. Warren acknowledged that Amazon had removed “sponsored” search results for pandemic-related terms and has made an effort to direct customers to accurate information by placing a banner at the top of all pandemic-related searches linking to the Centers for Disease Control and Prevention. “But the results of my staff’s review are nevertheless deeply troubling,” the senator wrote.

Ms. Warren asked Amazon to conduct a review within 14 days and provide public reports on both the extent to which Amazon’s algorithms are directing consumers products containing misinformation and on a plan to change the algorithms.

In a statement to The Times, an Amazon spokesperson said: “We are constantly evaluating the books we list to ensure they comply with our content guidelines. As an additional service to customers, at the top of relevant search results pages we link to the C.D.C. advice on Covid and protection measures.”