Facing Surge of Cases, Colorado Hospitals Are Nearly Full

Colorado is experiencing its worst coronavirus wave in a year and its overwhelmed hospitals are now allowed to turn away new patients.

An executive order, signed on Sunday by Gov. Jared Polis, allowed hospitals to redirect incoming patients. Many medical facilities have reported being over 90 percent capacity, with severe staffing shortages.

Covid hospitalizations in Colorado have increased 14 percent in the last two weeks. The state’s new daily cases have also increased 14 percent in two weeks, and recently reached their highest level since their peak in November 2020, according to a New York Times database.

Hospitals in Larimer County, where vaccine hesitancy is fueling a surge, are using 110 percent of their I.C.U. beds, according to the local health department. That has forced some patients to double up in rooms, and hospitals in the area are close to turning patients away to prioritize emergencies, Tom Gonzales, public health director for Larimer, told CBS Denver.

At least 62 percent of the state is fully vaccinated, above the national average of 58 percent. Most hospitalized Covid patients are unvaccinated.

At UCHealth, one of the state’s biggest health systems, 76 percent of patients hospitalized with Covid-19 are unvaccinated, and over 86 percent of Covid-19 patients who are in need of a ventilator and are in intensive care are unvaccinated.Masks in the state are optional and restaurants are mostly running at full capacity; Mr. Polis, the governor, is reluctant to revive statewide restrictions.

The governor’s executive order coincided with a state mandate that required health care workers to be fully vaccinated against Covid by Oct. 31. More than 90 percent of Colorado’s hospital workers have now been fully vaccinated, according to the state’s health department.

Last month, the Centers for Disease Control and Prevention urged residents of high-transmission areas to wear masks in public indoor spaces, regardless of their vaccination status, citing evidence that vaccinated Americans with breakthrough infections can carry as much coronavirus as unvaccinated people do.

Other nearby states, like Arizona, are also enduring surges. New daily cases are rising faster in Arizona than any other state, up 50 percent over two weeks.

In Houston, Texas Children’s Hospital braced on Wednesday for nearly 30,000 pediatric Covid-19 vaccine appointments, a rush that officials said had been booked in just five days. Nationally, Walgreens and CVS pharmacies opened appointment lines for millions of miniature doses. And amid a deluge of demand from parents desperate to get their children at least partially inoculated by Thanksgiving, Dr. Eric Ball realized he would have to skip some of his friend’s daughter’s bat mitzvah.

“Yeah,” the Orange County, Calif., pediatrician said, laughing. “Looks like I’ll be vaccinating kids in my suit this Saturday.”

With the blessing of federal authorities — and just in time for yet another stressful holiday season — health care providers mobilized nationally this week for a fresh wave of inoculations, this time featuring smaller shots in smaller arms.

Late Tuesday, the Centers for Disease Control and Prevention recommended the Pfizer-BioNTech coronavirus vaccine for children ages 5 through 11. The decision was in line with the Food and Drug Administration, which on Friday authorized emergency use of the pediatric dose for the roughly 28 million children in that age group.

Polls indicate that roughly a third of U.S. parents plan to leave their elementary-school-age children unvaccinated. But the latest vaccine announcement came as a relief not only to millions of families exhausted by the pandemic, but to public health officials who said it might help prevent a repeat of the terrifying surge of disease that swept the country last winter.

The Biden administration has enlisted 20,000 pediatricians, family doctors and pharmacies to administer the shots and is shipping 15 million doses. About five million of them are allocated to pharmacies in the federal program that have been key to the adult vaccination rollout. The other 10 million are allocated to states.

The Netherlands has expanded some Covid measures, including requiring more mask wearing, in an effort to reduce the spread of the coronavirus and ease the growing pressure on the country’s health system.

Prime Minister Mark Rutte, in an announcement on Tuesday, described the changes as a “difficult message” to deliver, adding, “We’re going to have to ask more from people.”

Starting Saturday, the Netherlands will expand the list of places where masks are mandatory to include, for example, stores and university libraries and hallways. Face coverings were already required on public transport. Other places, such as museums and gyms, will not require masks, but visitors will need to show proof of vaccination, recovery from Covid or a recent negative test result, according to Mr. Rutte.

Mr. Rutte also emphasized the need for social distancing and urged Dutch people to work from home and to limit domestic travel.

“In this phase, everything depends on our own behavior,” he said.

Last week, about 54,000 people tested positive for the coronavirus, a 39 percent increase from the week before, according to Dutch government data, which also recorded a 31 percent rise in the number of Covid patients hospitalized week on week.

Hugo de Jonge, the Dutch health minister, said, “Beds are being freed up in hospitals for Covid patients again,” adding that the majority of those admitted had not had their shots.

“The inconvenient truth is that most of these patients would not have needed to be there if they had been vaccinated,” he noted.

President Rodrigo Duterte of the Philippines has warned local officials that they will be punished if they fail to meet vaccination targets as the country slowly reopens.

In a prerecorded meeting televised on Wednesday, Mr. Duterte said that his country had fully vaccinated just 27 million out of its population of 110 million. About 80 million people in the Philippines are eligible for immunization.

“As of today, nearly 109 million doses have arrived in the country and it is now our job to get these doses in the arms of every Filipino,” Mr. Duterte said.

But, he added, the government has seen “fault lines” in the overall vaccination program. “I am not contented,” about the speed with which inoculations are being undertaken, he said.

At first, vaccine hesitancy was a problem in the Philippines, with a large part of the public rejecting vaccines produced only by Chinese manufacturers. But as more vaccines from Western drug makers became available, the inoculation campaign has shifted its focus to eliminating supply bottlenecks at the local level.

Mr. Duterte noted that, with adequate vaccine supplies on hand, there should be no reason vaccinations could not be increased to an average of about a million per day. The current average is around 500,000.

Mr. Duterte said that he had ordered punishments against local officials who were underperforming or who were failing to use the doses given to them, but he did not specify what criteria would be used to assess them or which sanctions might be imposed against them.

It is not the first time that Mr. Duterte has used threats to address the pandemic. He has previously said that vaccine refusers should be forcibly detained at home, an unconstitutional proposal that his aides later sought to play down as an outburst.

The Philippines is among the Southeast Asian countries hit hardest by Covid. It has been in various stages of lockdown since last year, though the government has announced that nightly curfews will be lifted this week as part of efforts to revive the sagging economy.

Last year, pre-Thanksgiving concerns centered on social distancing and taking risks with the coronavirus. This year, the focus is inoculation; more than 192 million Americans had been fully vaccinated as of Sunday morning, but that is only about 58 percent of the total population.

Many Americans thinking about hosting or attending a bigger Thanksgiving celebration this year are considering a question that has become sensitive and often polarizing: Will they and other guests be vaccinated?

The age-old wisdom about dinner conversation “is to avoid sex, death and politics,” said Noel Brewer, a professor specializing in health behaviors at the University of North Carolina at Chapel Hill. “Vaccinations have moved onto that list.”

Still, immunization status threatens to complicate the holiday planning and the meal itself. “People who get vaccinated can also be self-righteous, and some people who haven’t been vaccinated can be belligerent,” Dr. Brewer said, adding, “That could really be a combustible mix.”

In interviews, many people — both vaccinated and unvaccinated — said that they were planning to tiptoe around the subject, in some cases avoiding a meal with those they might disagree with. Others, who are immunocompromised or have children too young to be vaccinated, are grappling with how to decline invitations from unvaccinated relatives. And some hosts, worried about safety, are drawing a line.

The Centers for Disease Control and Prevention’s guidance for the holiday season is that people should protect others ineligible for vaccines, such as young children, by getting inoculated and encouraging guests to be vaccinated. The C.D.C. also advises that people gathering with others from multiple households in different parts of the country consider taking additional precautions, like getting a coronavirus test beforehand.

But many people oppose the vaccines, for various reasons. Some said that stance had alienated them from their families and friends.

Two months after the Pentagon began requiring all troops to get the coronavirus vaccine or face dismissal, the vast majority have now had shots, in part because none received a religious exemption, military officials said.

While vaccine exemptions are often broadly worded, requests based on religious beliefs are coming under close scrutiny in the military and at the Department of Veterans Affairs, the first federal agency to impose a mandate.

About 97 percent of the country’s 1.3 million active-duty service members have had at least one dose of the vaccine, and roughly 87 percent have had both shots.

The widespread federal and private sector mandates pose a test for the country, and the military and Veterans Affairs are being closely watched by companies and legal experts. Across the country, there are at least 40 legal challenges to vaccine and testing mandates issued by cities, hospitals, universities and other employers that have yet to move forward, while others have been knocked back.

The leaders of most major religious organizations have recommended that their members get the vaccine. Officials say that no one is actively discouraging people in the military from seeking a religious exemption. But anyone seeking one from the Pentagon or Department of Veterans Affairs would be required to have an established history of adherence to a religion that prohibits vaccines, among other things.

Vaccine reluctance in the military and the Department of Veterans Affairs mirrors that of civilian society, where vaccine rates are largely lower without such mandates.

Over the summer, as the Delta variant surged, military officials became alarmed at the growing number of deaths; over the fall, more active duty members died from the virus than in all of 2020, none of them vaccinated.

The Navajo Nation managed to tame Covid-19 earlier this year, mounting a campaign that drove its vaccination rate far above the United States average, after the virus ravaged the Navajo people.

But now the nation — the largest reservation in the United States — is enduring yet another virus surge, and experts and tribal leaders aren’t sure why. Other highly vaccinated tribes are also contending with a resurgent virus.

Over the course of the pandemic, the Navajo went from having one of the country’s worst case rates in the spring of 2020 to being lauded in September by Dr. Anthony Fauci, the nation’s top infectious disease official, as an “example of success” in its fight against Covid-19. The rate of fully vaccinated tribal members — 70 percent, according to tribal data — is substantially higher than the nationwide rate of 58 percent.

Indigenous leaders around the country have pushed hard to vaccinate their communities, knowing that Covid has had a disproportionate effect on Native American people, who now have the highest vaccination rate in the United States, according to the Centers for Disease Control and Prevention.

Despite their successes in overcoming mistrust in the federal government and inoculating hard-to-reach communities, the Navajo and other highly vaccinated tribes find themselves experiencing yet another virus surge.

In addition to the Navajo Nation in Arizona, New Mexico and Utah, the Indian Health Service said on Friday that it was seeing “intermittent” increases in the Billings area, covering Montana and Wyoming, and in the Great Plains area, covering the Dakotas, Nebraska and Iowa. It said that tribal communities — though they tend to have high vaccination rates — were affected by the surrounding states and communities, which may have much lower vaccination rates.

Many tribal members also commute to work in urban areas or border towns, where they may be at higher risk of exposure.

The Blackfeet Nation of Montana, which has vaccinated nearly every eligible member, experienced a spike in August after recording few to no cases for weeks. That was after the tribe, confident after its successful vaccination campaign, voted to welcome back tourists by reopening its roads into the eastern section of the popular Glacier National Park. Cases are running relatively high among the Blackfeet as the virus surges throughout Montana, where vaccination rates in counties surrounding the reservation are as low as 38 percent.

In Minnesota, the White Earth Nation, where 60 percent of eligible members are vaccinated, recently recorded its highest-ever surge in daily cases, said Ed Snetsinger, the tribe’s emergency manager.

As for the Navajo, officials said that the latest surge had been less severe than the nation’s first two, which came last winter and in the spring of 2020, because 70 percent of eligible members are vaccinated.

The nation has exceeded 100 confirmed cases in a day several times recently, according to tribal data. Confirmed cases peaked at almost 400 a day in the winter, and reached a low point in single digits in June and July.

The Navajo Nation is the largest U.S. tribe, with an official enrollment of nearly 400,000 members as of May.

Jonathan Nez, the president of the Navajo Nation, said that some members had brought the virus back to the reservation after visiting neighboring communities in Arizona and New Mexico, which have looser Covid regulations than the tribe does. The Navajo have been required to wear masks in public since April last year, indoors and out, but there is no such outdoor mandate in surrounding areas.

“We do have multigeneration families living under one roof, and when someone brings Covid home, it spreads quickly in the house,” Mr. Nez said in an interview last week.

While tribes have largely been successful in vaccinating their members, pockets of people continue to resist getting the shots, said Dr. Mary Owen, the director of the Center for American Indian and Minority Health at the University of Minnesota medical school and president of the Association of American Indian Physicians.

“These pockets seem to be greater in the 17- to 45-year-old range,” said Dr. Owen, who is Tlingit. “From what I’m hearing and what I’m seeing in our clinic, is that people in this age group have a greater sense of invincibility and also seem to be relying more on social media for their news about the vaccine.”

Tangled supply chains, rising costs for raw goods and soaring consumer demand have combined to push prices rapidly higher in many wealthy countries, prodding central banks around the world to start dialing back some of the extraordinary economic support measures they put in place during the pandemic.

In the United States, the Federal Reserve is expected to on Wednesday announce a plan to slow its large-scale asset purchases, a process its officials want to complete before lifting interest rates down the line. Increasingly, markets expect the Fed to start to lift interest rates from near-zero in the second half of 2022.

The Bank of England is even further along: Investors expect it could raise its main interest rate as soon as Thursday. And in Canada, Australia, Norway and elsewhere, monetary authorities have also begun to dial back support or lay the groundwork for a step away from policy help.

The shift away from full-blast economic stimulus comes amid a burst in inflation that has no 21st century precedent. Price gains had been chronically weak for decades, but this year, they have rocketed above the 2 percent rate that most advanced economy central banks target, partly as government relief helped families to spend on everything from houses to furniture.

At the same time, supply has been limited after factories shut down to contain the spread of the coronavirus and shipping routes struggled to respond to rapidly changing consumption patterns. The combination has caused prices to move higher in many places. In the United States, inflation came in at 4.4 percent in the year through September.

Britain’s annual rate of inflation was 3.1 percent in September, and is expected to peak above 4 percent in the coming months. Supply bottlenecks have been exacerbated by Brexit, which has raised trade barriers and contributed to European Union workers leaving the country throughout the pandemic. And in the eurozone, inflation came in at 4.1 percent in October, matching the highest-ever rate of inflation for the bloc.

The Bank of England might become the first major central bank to raise interest rates if it meets investor expectations on Thursday. Andrew Bailey, the central bank’s top official, said the rate of inflation was concerning and that policymakers needed to prevent high inflation from becoming permanent, but the decision on Thursday is likely to split the nine-person monetary policy committee as some members haven’t expressed as much certainty that rates need to rise.

The path forward for the European Central Bank isn’t as clear cut. Last week, Christine Lagarde, the president of the bank, said higher inflation and supply chain bottlenecks would last longer than expected in the region, but would eventually ease over the course of 2022. Financial markets were wrong to expect an increase in interest rates next year, she added, because longer-term inflation expectations remain below the E.C.B.’s target.

European policymakers have taken a small step to prepare for the end of emergency-levels of support. Last month, they slowed their pandemic-era bond buying program, attributing the change to an improved outlook for the economy and higher inflation expectations.

Other central banks have been more blunt about their concerns. The Bank of Canada abruptly ended its bond-buying program last week and signaled that it could raise interest rates sooner than expected, as the forces pushing prices higher proved to be stronger and more persistent than anticipated.

Norway’s central bank has already lifted interest rates and is expected to raise them again in December. The Reserve Bank of Australia announced this week that it was ending its program to cap rates on certain types of debt, citing “earlier than expected progress” toward its inflation target.

U.S. policymakers are preparing to dial back their own bond-buying program in part because doing so will leave their policy in a more nimble position: Officials still expect inflation to fade substantially with time. If it does not, some policymakers want to be done with the bond purchases and in a position to raise interest rates to counteract heady price gains.

The inflationary moment confronting global central banks comes as a surprise. Many had spent years battling tepid inflation, trying to figure out how to coax price gains back to the levels that lay the groundwork for dynamic economies. That situation has rapidly reversed — many still expect the burst of pandemic price pressure to fade, but how quickly and how completely that will happen is perhaps the biggest question in global economics.

“The risks are clearly, now, to longer and more persistent bottlenecks and thus to higher inflation,” Jerome H. Powell, the Fed chair, said recently, adding that the Fed was “in a risk management business, not one of absolute certainty.”