The pandemic, paired with natural disasters, drives a record number of illegal U.S. border crossings.
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France on Friday recommended people get shots against Covid-19 and the flu in the same visit to vaccination clinics, spurring one of its biggest winter vaccine drives yet.
The campaign is meant to prevent the continuing Covid pandemic and the onset of influenza cases from potentially combining to overwhelm the country’s medical system, the health ministry said.
While Covid measures kept flu cases and hospitalizations low in 2020, health experts have warned that there could be an upsurge this winter, as immunity has declined after months of social distancing and the easing of Covid restrictions.
Experts have said there is no danger in getting a flu shot and a Covid-19 vaccine at the same time. So those eligible for a Covid booster dose in France can receive it in one arm and a flu shot in the other on the same day. France has offered booster shots to people over age 65, pregnant women, people with certain comorbidities and recipients of the Johnson & Johnson vaccine.
Dr. Olivier Véran, the French health minister, went on TV on Friday to advocate getting both vaccines during one appointment.
“Already, 10 million doses are available in pharmacies, prioritized for the most vulnerable people,” he said. “This vaccination can be done at the same time as that against Covid.”
The new effort is expected to bolster the drive for Covid vaccines, in addition to encouraging those at risk to get the booster shots. So far, 68 percent of the people in France are fully vaccinated.
Health officials in other countries have also urged people to get vaccinated against both Covid-19 and the flu ahead of the winter.
On Friday, the British government started a national advertising campaign on billboards, radio stations, TV channels and social media platform urging people to get both vaccines.
“This is the first winter when Covid-19 and seasonal flu are expected to be circulating together, putting more lives at risk,” said Dr. Mary Ramsay, the chief of immunization at the U.K. Health Security Agency, in a statement. “Vaccinations are important to protect against both diseases.”
Britain began offering booster shots against Covid last month to people ages 50 and older, health and social care workers and others with medical conditions that put them at higher risk of severe illness.
City and state health departments in the United States have similarly encouraged people to get vaccinated against both viral diseases at the same time. Though some clinics only offer Covid shots, both flu and Covid vaccines are widely available at many pharmacies.
Some local health agencies have specifically promoted getting them in one trip. The city of West Hollywood, for example, held an outdoor clinic on Thursday, offering Covid vaccines and flu shots together. A health center in Grand Rapids, Mich., held a drive-through clinic earlier this month, administering Covid booster and flu shots.
Administering both together makes getting immunized more convenient for patients and eases the burden on clinics, because fewer appointments are needed, officials have said.
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A record 1.7 million migrants from around the world, many of them fleeing pandemic-ravaged countries, were encountered trying to enter the United States illegally in the last 12 months. The tally capped a year of chaos at the southern border, which has emerged as one of the most formidable challenges for the Biden administration.
It was the highest number of illegal crossings recorded since at least 1960, when the government first began tracking such entries. The number was similarly high for the 2000 fiscal year, when border agents caught 1.6 million people, according to government data.
Single adults represented the largest group of those detained in the fiscal year that ended Sept. 30, at 1.1 million, or 64 percent of all crossers. There were also large numbers of migrant families — more than 479,000, which is about 48,000 fewer than during the last surge in family crossings in 2019.
But the nearly 147,000 children whom agents encountered without parents or guardians was the largest number since 2008, when the government started tallying unaccompanied minors.
The crossers hailed from around the globe, many of them seeking economic opportunity as the coronavirus pandemic erased hundreds of millions of jobs. Agents caught people from more than 160 countries in Asia, Africa and Latin America, with Mexico accounting for the largest share.
In addition to the pandemic, two hurricanes destroyed livelihoods and homes in Guatemala and Honduras, where extortion and violence from gangs have persisted in many communities, further fueling an exodus.
A public health rule, invoked by President Donald J. Trump at the beginning of the pandemic in 2020 to seal the border, has remained in place under the Biden administration. Over the last 12 months, the Border Patrol has carried out more than one million expulsions of migrants back to Mexico or to the migrants’ home countries.
President Biden has walked a fine line between trying to control the influx and put in place a more humane approach to border enforcement. Republicans have blamed Mr. Biden’s promises to reverse Trump-era immigration policies for fueling the surge, as word spread that the country’s borders had become easier to breach.
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As tens of millions of Americans remain unvaccinated, state and local governments have introduced mandates requiring public employees be fully inoculated against the coronavirus. And while orders in some localities have translated into a last minute surge in vaccination rates, they are also met with steadfast refusal, leading to legal challenges or concerns over staffing issues.
Washington State’s mandate, one of the strictest in the country, went into effect on Monday. The order requires more than 800,000 public workers to be fully inoculated against the coronavirus, save for a religious or medical exemption, or risk losing their jobs. Yet as the mandate kicked in, some resistance remained firm.
The Washington State Patrol announced that 127 employees left the agency, or just under 6 percent of its work force. In one high profile case, Washington State University fired its football coach, Nick Rolovich, and four of his assistants, for their failure to comply.
Similar issues are playing out elsewhere across the country. In New York City, Mayor Bill de Blasio took one of his administration’s most aggressive steps yet by requiring that all municipal workers get at least one shot by the end of the month or risk losing their paychecks. The order was met with mixed reactions from unions representing those workers, though many agree that the move could burden city agencies by leading to widespread resignations or early retirements.
Nursing homes, hit hard by the pandemic, are also struggling with low vaccination rates among staff. Some operators across the country are waiting for the federal government to issue new rules around a mandatory vaccination program for their staffs, like the one President Biden announced two months ago for workers at facilities receiving federal funding, while other facilities and labor groups are still pushing for a testing alternative for their employees.
Here’s what else happened this week:
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Widespread public mistrust of the Russian government has translated into skepticism about coronavirus vaccines, experts say, leaving the country vulnerable to a surge in new cases that are now setting records for severity. For the first time in the pandemic, Russia recorded more than 1,000 deaths in a 24-hour period, though skepticism about the validity of the official numbers remains high. President Vladimir Putin announced a national “nonworking week” to begin next Saturday, and even stricter measures were planned in Moscow, including a citywide lockdown starting next Thursday.
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The World Health Organization warned that health care workers around the world are nearing a breaking point. Health care employees are plagued by anxiety, burnout, illness and death on the front lines, the agency said, and countries need to do more to protect them. In the United States, a group representing more than 3,000 local health departments urged the Justice Department to protect public health care workers who have faced threats of violence and harassment since the onset of the pandemic.
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A New York Times review of hundreds of health departments in all 50 states indicates that local public health departments across the country are less equipped to confront a pandemic now than at the beginning of 2020. The Covid death toll in the United States has now surpassed 735,000.
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Post-vaccination infections made headlines. Former Secretary of State Colin Powell, who was vaccinated but dealing with cancer, died on Monday from Covid-19 complications. Two other vaccinated figures tested positive: the Fox News anchor Neil Cavuto, and the director of homeland security, Alejandro Mayorkas.
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In a joint statement on Tuesday, leading U.S. medical groups declared a national emergency in child and adolescent mental health triggered by prolonged isolation, uncertainty and grief during the coronavirus pandemic, worsening an existing mental health crisis among children and teens.
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WASHINGTON — Federal regulators evaluated for the first time on Friday the safety and efficacy of a coronavirus vaccine for children 5 to 11, saying that the benefits of staving off Covid-19 with the Pfizer-BioNTech vaccine generally outweighed the risks of the most worrisome possible side effects in that age group.
The analysis came on the same day that the Food and Drug Administration posted data from Pfizer showing that the vaccine had a 90.7 percent efficacy rate in preventing symptomatic Covid-19 in a clinical trial of 5- to 11-year-olds.
The findings could add momentum for F.D.A. authorization of the pediatric dose on an emergency basis, perhaps as early as next week, opening up a long-awaited new phase of the nation’s vaccination campaign. The agency’s independent vaccine expert committee is set to vote Tuesday on whether to recommend authorization.
In a briefing document posted on the F.D.A. website, the agency said it had balanced the dangers of hospitalization, death or other serious consequences from Covid-19 against the risk of side effects. That included myocarditis, a rare condition involving inflammation of the heart muscle that has been linked to the Pfizer-BioNTech and Moderna vaccines, especially among young men.
“The overall analysis predicted that the numbers of clinically significant Covid-19-related outcomes prevented would clearly outweigh the numbers of vaccine-associated excess myocarditis cases,” regulators wrote.
As is customary, the regulators took no stance on whether the new use of a vaccine should be authorized.
If the F.D.A. rules in favor of authorization and the Centers for Disease Control and Prevention and its own panel of vaccine experts agree, the 28 million children in that age group could become eligible for shots in the first week of November.
“There’s a lot of data to be encouraged by,” said Dr. Kathryn M. Edwards, a professor of pediatrics in the division of infectious diseases at Vanderbilt University School of Medicine. She said the results exceeded the protection offered by the best flu vaccine and could eventually lead to the easing of restrictions intended to prevent elementary school children from contracting the virus.
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Ardern Announces New Covid Strategy
Prime Minister Jacinda Ardern of New Zealand stressed the importance of vaccinations as the country moved away from lockdowns, announcing a new, color-coded system of restrictions to be implemented when the country reaches its vaccination target.
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We can rightfully be proud of what our world-leading response has achieved. But two things have changed since then. The first is that Delta has made it very hard to maintain our elimination strategy. Its tentacles have reached into our communities and made it hard to shake, even using the best public health measures and the toughest restrictions we had available to us. But right as our long-standing strategy was challenged, we also had a new tool, one that means as Covid has changed, we could change too. And rather than being locked down, we could move forward safely and with confidence. That tool is the vaccine. Basically, if you want to be guaranteed that no matter the setting that we are in, that you can go to bars, restaurants and close-proximity businesses like a hairdresser, you will need to be vaccinated.
Rawiri Jansen, a Maori doctor, had an urgent message for the 150 people, mostly patch-wearing members of New Zealand’s plentiful street gangs and their families, who sat before him on a bright Saturday afternoon.
Covid-19 is coming for them, he said. Cases in New Zealand’s hospitals are rising rapidly. Soon, dozens of new infections a day might become hundreds or even a thousand. People will die. And vaccination is the only defense. “When your doctors are scared, you should be scared,” he said.
By the end of the day, after an exhaustive question-and-answer session with other health professionals, roughly a third of those present chose to receive a dose then and there.
Having abandoned its highly successful “Covid-zero” elimination strategy in response to an outbreak of the Delta variant, New Zealand is undergoing a difficult transition to trying to keep coronavirus cases as low as possible. On Friday, the country set a target of getting at least 90 percent of the eligible population fully vaccinated — a goal, the highest in the developed world, whose success hinges on persuading people like those who gathered to hear Dr. Jansen.
Already, 86 percent of the eligible population has received at least one dose. But the final few percent are the most difficult to reach, and one group of particular concern is the gang community, many of whose members are Maori or Pacific Islanders, who make up about a quarter of the overall population. In the past two months, multiple outbreaks have been reported among gangs, a subset of the population less likely to comply with official vaccination efforts, forcing officials to cooperate with gang leaders to reach their communities.
MADRID, Spain — The government will reimburse hundreds of thousands of residents who were fined for violating the rules of last year’s Covid-19 lockdown amid a surge of infections.
The measure, announced Friday by the ministry of territorial affairs, is set to benefit those who paid about 1.1 million fines in the spring of 2020. At the time, Spain found itself on the front line of the pandemic and imposed one of Europe’s toughest lockdowns, including on children, who were kept inside, unable to exercise or even go on errands with their parents.
The decision comes after Spain’s Constitutional Court ruled in July that the government had overstepped its powers and violated the rights of citizens to freedom of movement when it decreed a state of emergency in March 2020.
Although not all those who were penalized paid the fines, the government estimated in July that it had collected about 115 million euros during Spain’s initial state of emergency, which lasted three months.
In its ruling, the court’s panel did not condemn the government for forcing people to stay at home to stop the spread of the coronavirus, but the judges struck down the government’s interpretation of its right to decree a state of emergency as well as some specific measures, including stopping people from leaving their official residences to spend the lockdown in a second home.
The ruling followed a complaint filed by Spain’s far-right opposition party, Vox. Spain’s constitutional court must still issue a final ruling over the legality of the country’s second state of emergency, which was intended to contain another spike in Covid-19 cases and ran from November 2020 to May 2021.
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The Centers for Disease Control and Prevention said on Thursday that Americans could choose a booster dose of a vaccine different from the one they had initially received — the so-called mix-and-match strategy.
Is there an advantage to mixing vaccines?
Preliminary evidence strongly suggests that mixing two Covid vaccine types produces a stronger immune response than matching the booster to the initial vaccine.
Booster doses of an mRNA vaccine (Pfizer-BioNTech or Moderna) seem to raise antibody levels higher than a booster dose of the Johnson & Johnson vaccine.
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Who should get a booster shot?
Among Americans initially immunized with an mRNA vaccine, the following groups should receive a single booster dose six months or more after their second dose, the C.D.C. decided:
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adults over 65.
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adults who are 50 to 65 with certain medical conditions.
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those who reside in long-term care settings.
Adults ages 18 to 49 with certain medical conditions and those whose jobs regularly expose them to the virus may choose to get a booster. And recipients of the Johnson & Johnson vaccine should receive a booster shot at least two months after the first dose.
When am I considered fully vaccinated?
People who have received two mRNA vaccine doses or a single Johnson & Johnson dose should still consider themselves fully vaccinated.
Research indicates that, with the exception of adults over 65, the vaccines remain highly protective against severe illness and death in the vast majority of people.
What’s still unknown?
There is not much information available on the safety of the boosters, but they may have some of the same side effects experienced with the initial doses.
It’s unclear how long protection from a booster shot might last, and whether people who receive them will need another booster in the future.
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Scientists from the Centers for Disease Control and Prevention on Friday took aim at the question of whether the Delta variant of the coronavirus causes more severe disease, finding no significant differences in the course of hospitalized patients’ illnesses during the Delta wave compared to earlier in the pandemic.
But larger and more detailed studies from a number of other countries have found that people with Delta infections were considerably more likely to be hospitalized in the first place — a trend that the C.D.C. study was unable to address because of limitations in its data. The C.D.C. study also said that the proportion of older hospitalized patients needing intensive care or dying had shown some signs of increasing during the Delta wave.
Delta’s higher level of infectiousness has made it a far greater challenge than earlier versions of the virus, but the question of whether it also causes more serious disease has loomed as it swept around the world. The Alpha variant, an earlier version first detected in Britain, appeared to be linked to a higher risk of death, though scientists have also tried to understand whether factors besides the variant were playing a role.
Studies in England, Scotland, Canada and Singapore suggested that the Delta variant was associated with more severe illness, a finding that scientists have said raises the risk that outbreaks of the variant in unvaccinated areas may put a bigger burden on health systems. Unlike the C.D.C. study, those studies drew on genomic sequencing, allowing researchers to distinguish infections with the Delta variant and to track patients from before they enter a hospital.
Without access to sequencing data, the C.D.C. researchers could not determine which variants the patients may have been infected with. It also examined patients already admitted to hospitals, making it impossible to determine whether they were at higher risk of needing hospital care in the first place.
The study, released on Friday, examined roughly 7,600 Covid hospitalizations, comparing July and August — when Delta dominated — to earlier months this year, and found no significant change in hospitalized patients’ outcomes.
The study said that the proportion of hospitalized patients aged 50 and older who died or were admitted to intensive care “generally trended upward in the Delta period,” though the differences were not statistically significant and further work was needed. At the hospitals included in the study, roughly 70 percent of Covid patients were unvaccinated.
The researchers said the findings matched those of other C.D.C. studies using similar methods that showed no significant differences in the outcomes of younger people hospitalized before and during the Delta surge.
Outside scientists questioned the reliability of the study.
Dr. David Fisman, an epidemiologist at the University of Toronto, ran a larger study that found that people infected with the Delta variant had roughly twice the risk of hospitalization as people infected with variants that had not been labeled a concern. He said that such analyses needed to control for the range of factors that affect the course of Covid patients’ illnesses, and that the availability of vaccines, testing and treatments had all been changing during the pandemic.
“As this is the U.S. C.D.C., I’m really surprised at the small sample sizes for individuals with more detailed clinical information, as well as the use of such rudimentary statistical methods to deal with these data,” he said.
Dr. Fisman’s study, drawing on 200,000 cases and published this month, also showed significantly increased risks of intensive care admission and death among those infected with the Delta variant, after accounting for their age, sex, vaccination status and other factors.
Roughly 70 percent of people with Delta infections in the study were unvaccinated, and 28 percent were partially vaccinated. Fully vaccinated people are heavily protected from Covid.
Similarly, a study in Scotland from June based on 20,000 Covid cases showed that Delta infections were associated with an 85 percent higher risk of hospitalization, though it allowed for a wide degree of uncertainty about the precise figure.
And data from England, drawn from 43,000 cases and published in August, found that people infected with the Delta variant were just over twice as likely to be hospitalized as people with the Alpha variant, though the researchers in that study, too, were unsure of the precise figure.
Roughly three-quarters of the patients in that study were unvaccinated, and most of the rest were only partially vaccinated.
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By The Associated Press
Belarusian authorities on Friday horrified some of the country’s doctors by abolishing mask mandates, less than two weeks after their introduction during the pandemic and a day after the country registered a record number of new coronavirus infections.
The decision came after the nation’s authoritarian president, Alexander G. Lukashenko, dismissed the measures as unnecessary.
“It’s just over the top to send police to track down those who aren’t wearing masks,” Mr. Lukashenko said this week. “We aren’t the West.”
Dr. Nikita Solovei, a leading Belarusian infectious disease expert in the capital, Minsk, sharply criticized the decision. He described it as “madness” amid soaring contagion, and warned that “officials will bear responsibility.”
The mask mandates were introduced on Oct. 9, requiring Belarusians to wear masks in all indoor public areas, on public transportation and in stores.
On Thursday, the country officially reported 2,097 new Covid-19 infections, the highest number for the country so far. Many have criticized the official figures as an undercount.
When the pandemic struck, Mr. Lukashenko had dismissed concern over the coronavirus as “psychosis” and refused to impose any restrictions. The country was the only one in Europe to keep holding professional soccer games with fans in the stands while the outbreak was in full swing.
The 67-year-old former state farm director previously advised Belarusians to “kill the virus with vodka,” go to saunas and work in the fields to avoid infection. “Tractors will cure everybody!” he once proclaimed.
His attitude angered many Belarusians and contributed to the public outrage over Mr. Lukashenko’s victory for a sixth term in 2020 — an election the opposition and the West have rejected as a sham.
Belarusian authorities have registered a total of more than 580,000 Covid-19 infections and 4,482 deaths. Only about 20 percent of the population has been vaccinated, using vaccines made in Russia and China.
The authorities have stopped reporting daily deaths. Andrei Tkachev, the coordinator of Belarus’s Medical Solidarity Foundation — an association of volunteers and doctors that helps medical workers who faced reprisals from the government — and others have rejected the official statistics.
“Official statistics can’t be trusted,” Mr. Tkachev said. “Overcrowded hospitals are a testimony of that.”
Svetlana Tikhanovskaya, the main opposition challenger in the 2020 election, who was forced to move to neighboring Lithuania after the vote under official pressure, also dismissed the official numbers.
“People don’t believe the government and official statistics, and they see huge lines at clinics and hospitals,” Ms. Tikhanovskaya said during an online conference. “Belarus faces the worst wave of the coronavirus, and it’s not ready for that.”
Source: https://www.nytimes.com/live/2021/10/23/world/covid-vaccine-boosters
