New Zealand Will Reopen to Tourists Within Months

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Hospitals in Massachusetts will cut back on nonurgent scheduled procedures starting on Monday because of staffing shortages and longer patient hospital stays, according to the state’s health authorities.

Coronavirus cases have been rising in Massachusetts for several weeks, but hospitalizations have risen at a lower rate. The pressure on hospitals relates to other consequences of the coronavirus pandemic, the authorities said.

The staffing shortage, largely driven by the pandemic, has contributed to the loss of approximately 500 medical, surgical and I.C.U. hospital beds in Massachusetts, according to the state. And hospitals are seeing an influx of patients who need more complex treatment for health issues because they delayed visiting the doctor when Covid cases were higher.

The order, issued on Tuesday, applies to hospitals that have less than 15 percent of beds available, and applies only to procedures that are scheduled in advance and can be delayed without having a negative effect on patients’ health. It does not apply to urgent and essential procedures.

The authorities said the order would help prepare for the annual increase in hospitalizations typically seen after Thanksgiving and through January.

Marylou Sudders, the state’s secretary of health and human services, said in a statement on Tuesday: “Covid hospitalizations in Massachusetts remain lower than almost every other state in the nation, but the challenges the health care system face remain, and this order will ensure hospitals can serve all residents, including those who require treatment for Covid-19.”

In Massachusetts, new cases have risen from an average of about 1,300 early this month to more than 2,800, and hospitalizations are up 47 percent over the past 14 days, according to a New York Times database. As of Wednesday morning, 740 people were hospitalized for Covid-19, according to the Massachusetts Department of Public Health.

State officials worked with the Massachusetts Health & Hospital Association to develop the guidelines. Dr. Eric Dickson, the board chair of the association and the president and C.E.O. of UMass Memorial Health, said in a statement: “While we recognize that delaying some prescheduled surgeries may present a significant hardship for patients, we believe it is a necessary step to assure that all of the Commonwealth’s hospitals can continue to meet the needs of patients requiring emergency care.”

The burden on national health systems in Europe from Covid will be “very high,” in December and January unless governments ramp up prevention efforts, the European Center for Disease Prevention and Control warned on Wednesday.

European governments should accelerate their vaccination rates, administer booster shots and reintroduce restrictions, Andrea Ammon, the E.C.D.C. director said in a statement. “And all those three things have to be done now,” she said. “This is not pick and choose.”

Around 66 percent of the European Union’s total population has been fully inoculated, according to the E.C.D.C. data. This leaves “a large vaccination gap that cannot be bridged rapidly and gives ample room for the virus to spread,” Ms. Ammon said.

Recommended restrictions could include wearing face masks, working from home, keeping a safe distance and reducing social interactions. Lockdowns are like an “emergency brake,” Ms. Ammon said, used when “you want to bring down a very high case number in a short period of time.”

She added: “I am aware that it requires a significant effort from public health authorities and society at large to achieve this goal. But now is the time to walk the extra mile.”

Asked whether seasonal festivities should be canceled, Ms. Ammon replied: “We still have some time until Christmas. But if the situation doesn’t get better, it might mean that these measures should be taken over Christmas as well.”

On Wednesday, Italy announced new restrictions for the unvaccinated, barring them from dining indoors in restaurants and bars; attending shows, sport events and public ceremonies; and entering nightclubs.

The E.C.D.C. also recommended that booster doses should be “considered” for all adults, with a priority given to those above 40 years old. On Tuesday, Italy allowed vaccinated people to get a booster shot five months after the second shot of their initial vaccination. On Wednesday, Portugal’s health secretary said the country would give booster shots to a quarter of its population by the end of January, Reuters reported.

Europe has seen a sharp spike in the number of new infections, hospitalizations and deaths in recent weeks, prompting governments to impose new restrictions, including a lockdown in Austria, one of the first in Western Europe since vaccines became available. The German health minister, Jens Spahn, warned on Monday that by the end of this winter “just about everyone in Germany will probably be either vaccinated, recovered or dead.”

According to the World Health Organization, Europe accounted for more than half of the world’s reported Covid deaths this months, and more than two million new cases each week, the most since the pandemic began. On Tuesday, the World Health Organization said that Covid had become the leading cause of death in Europe, and that Europe’s Covid death toll would likely exceed two million by next spring.

Over the weekend, tens of thousands of Europeans across the continent protested, sometimes violently, against vaccine mandates and new restrictions, and on Wednesday, more than 1,000 people protested .

There are very high discrepancies in vaccination rates between different European countries. Only 24 percent of the total population in Bulgaria has been fully inoculated, contrasted with 81 percent in Portugal. But as vaccinated people can also transmit the disease, the E.C.D.C. said, it is important to put in place restrictions even in countries with high inoculation rates.

Over eight hours last Thursday night and into Friday morning, Representative Kevin McCarthy of California hit on many issues as he spoke on the House floor in an unsuccessful effort to thwart House passage of President Biden’s social safety net and climate change bill. But among his most audacious assertions was that Mr. Biden was to blame for the country’s failure to quell the pandemic.

Mr. McCarthy used this line of attack even as members of his own Republican Party have spent months flouting mask ordinances and blocking the president’s vaccine mandates, and the party’s base has undermined vaccination drives while rallying around those who refuse the vaccine. Intensive care units and morgues have been strained to capacity by the unvaccinated, a demographic dominated by those who voted last year for President Donald J. Trump.

As of mid-September, 90 percent of adult Democrats had been vaccinated, compared with 58 percent of adult Republicans.

Yet Mr. McCarthy, the House Republican leader, pressed his point: “I took President Biden at his word; I took him at his word when he said he was going to get Covid under control,” he declared in the dead of night. “Unfortunately, more Americans have died this year than last year under Covid.”

As cases surges once again in some parts of the country, Republicans have hit on a new line of attack: The president has failed on a central campaign promise, to tame the pandemic that his predecessor systematically downplayed. Democrats are incredulous.

Chris Taylor, a spokesman for the Democratic Congressional Campaign Committee, called House Republicans “Covid’s biggest promoter” for “recklessly hand-waving lifesaving vaccines” and for promoting ivermectin, an antiparasitic drug falsely said to cure Covid-19.

The nation’s 14-day average of new infections is up 25 percent, to over 94,000 new cases a day, with the upper Midwest again the hottest of hot spots. At the same time, the efficacy of the coronavirus vaccines is holding, according to the latest data from the Centers for Disease Control and Prevention. Unvaccinated people are 5.8 times as likely to test positive than fully vaccinated people, and 14 times as likely to die if infected.

The partisan gap in infection and vaccination rates is only slightly narrowing. The most Republican counties have 2.78 times as many new cases than the most Democratic counties, down from three times as many a month ago, according to the Democratic health care analyst Charles Gaba, using data from Johns Hopkins University. The death rate in those Republican counties is nearly six times as high as the death rate in the Democratic counties.

ROME — Trying to stem a resurgence in coronavirus infections and prevent closures affecting everyone, Italy announced new restrictions for the unvaccinated on Wednesday, barring them from dining indoors in restaurants and bars; attending shows, sport events and public ceremonies; and entering nightclubs.

“We want to be very cautious,” Prime Minister Mario Draghi of Italy said at a news conference on Wednesday. “We want to keep this normality.”

The decision came after presidents of the most infected Italian regions pressured the government to crack down on the unvaccinated, worried that new lockdowns and restrictions would hamper the economic recovery in a country that imposed Europe’s first lockdown and experienced some of the pandemic’s most devastating consequences.

“I don’t think that anyone prefers a lockdown to different measures for citizens who protected themselves with a vaccine and citizens who chose not to do it,” Giovanni Toti, the president of the northern region of Liguria, said last week. “We have to assure families, citizens and businesses that this country will not close again.”

Starting in the summer, Italy embraced the broad use of a health pass — called the Green Pass — as its primary strategy to fight the virus. People who want access to indoor dining, museums, gyms, theaters and high-speed trains are required to show proof of vaccination, a negative rapid swab test or recent recovery from the virus.

In October, Italy became the first major European country to require the Green Pass for all workers, private and public, to earn their salary.

Italy’s health authorities say the measure has largely pushed Italians to get vaccinated and reduced the severity of the fourth wave as compared with other European countries. But about 13 percent of the country’s adults have still not received a shot.

Under the new restrictions announced Wednesday, the unvaccinated will be barred from a wide range of social activities starting on Dec. 6, and lasting until Jan. 15. But if they have a negative swab test, they will be allowed to go to work.

If further spikes in Italian regions require tougher restrictions, those will apply only to the unvaccinated.

The government extended a vaccination mandate that was already in place for health care workers to schoolteachers and school staff, and to law-enforcement officers. The booster shot will also become compulsory for these categories.

The Green Pass will now also be required to use public buses and regional trains, and to stay in hotels.

Thousands of people gathered at the Circus Maximus in Rome and in Milan last weekend to protest the Green Pass, decrying a “dictatorship.”

But with hospital beds and intensive care units filling up with unvaccinated patients, Italy joined a group of countries that are toughening their approach toward citizens who shun the shot.

Italy’s announcement followed a groundbreaking decision by Austria to impose a lockdown for the unvaccinated, restricting their movement to traveling for work, school, buying groceries and medical care. Last week, Prime Minister Kyriakos Mitsotakis of Greece also announced more restrictions for the country’s unvaccinated, barring them from cinemas, theaters and gyms.

A spokesman for the French government said on Wednesday that the country would tighten its health pass, speed up its vaccination campaign and strengthen social distancing rules.

Constant Méheut contributed reporting from France

Since the first doses of Covid vaccines arrived in New Mexico last December, Uri Bassan, a pharmacist, has traveled the state to bring vaccines to those hardest to reach; nearly a quarter of the population lives in rural areas.

From the desert plains of the southeast to the snow-covered northern mountains, Mr. Bassan and a team of Medical Reserve Corps volunteers set up mobile clinics in all kinds of places — fire stations, motels, even his own backyard. Between December 2020 and May of this year, Mr. Bassan and his team logged more than 19,000 miles to administer 41,794 vaccines.

Now, with the state’s seven-day average of new cases up by 90 percent since October, he is rushing back into the fray, administering as many as 700 shots at a single event. “To me, it feels like the beginning all over again,” he said.

Despite improvements in the vaccine distribution infrastructure, Mr. Bassan said, the need is overwhelming. “We used to take the kids to the zoo in the minivan, with the strollers and the diaper bag,” said Mr. Bassan, a father of four. “Now the minivan has turned into a cargo van — it’s full of containers and syringes and Band-Aids.”

Most public health experts agree that it’s OK to make holiday plans with your favorite people, as long as you’re taking precautions. Answering a few simple questions can help you make safer decisions.

You can take the quiz by clicking below, or keep reading for an overview.

Will everyone be vaccinated?

If yes — or if the only unvaccinated people are young children — that will make the party safer for everyone, though if you want to reduce the risk even further, you may want to encourage every adult to get a booster shot. If unvaccinated adults will be there, on-the-spot rapid tests are a great way to lower risk. You can also improve ventilation by opening windows, using exhaust fans, adding portable air cleaners or moving the event outdoors if weather allows.

Are any guests at higher risk from Covid?

If everyone is at relatively low risk, you may decide that being vaccinated is enough, and that additional precautions aren’t needed. But if any of your guests are older or have underlying conditions that put them at higher risk, it’s important to plan the event around the most vulnerable person. That could mean using rapid tests and improving ventilation, or having the party at their home so they don’t have to travel.

Are you traveling?

Staying local is the lowest-risk option, and if you’re traveling farther, driving is safer in terms of Covid risk than taking public transportation.

If you have to fly or take a bus or train, you should take extra precautions. A high-quality medical mask like an N95, KN95 or KF94 can keep you safer; if those aren’t available, double mask with a surgical mask and quality cloth mask. If possible, you should keep it on the whole time. At airports and train or bus terminals, try to avoid crowds, keep your distance in screening lines and use hand sanitizer often.

What’s the Covid situation where you’re celebrating?

Check local Covid conditions like you would the weather, looking at vaccination rates, case counts and hospitalizations. If you’re headed to a Covid hot spot, it’s best to wear a mask in public spaces, and you may want to avoid indoor dining, especially if someone in your group is at high risk.

What’s it like where you live?

If you live in a Covid hot spot, the chance of bringing the virus with you when you travel is higher. Be vigilant about masking and avoid crowds in the days before you leave. Using rapid tests can also reassure everyone that you’re not infectious.

How big is the gathering?

When you limit a gathering to two households, it’s easier to keep track of risky behaviors and potential exposures. This doesn’t mean large families shouldn’t gather, but you may want to take extra precautions if more than two households will be present. Those precautions could include opening windows, turning on exhaust fans and using portable air cleaners. And the bigger the party, the more useful it is to have rapid tests on hand for everyone.

How long until your event?

Risk is cumulative. The choices you make before the party can help lower the risk for everyone. If you’ve been invited to other gatherings before you leave, consider skipping them, and be vigilant about reducing your exposures during travel.

In today’s edition of the Morning newsletter, David Leonhardt explains rapid Covid-19 tests, which have not been as readily available in the U.S. as they have elsewhere around the world. He writes:

If the U.S. government had done a better job making rapid Covid-19 tests available, the advice for how to use them this holiday weekend would be easy: Take one at the start of every day when you planned to spend time with people outside your household.

That approach is possible in other countries. In Britain, pharmacies offer free packs of seven tests that people can take at home. In Germany, rapid tests are also widely available and mostly free. In this country, the situation is different, largely because the F.D.A. has been slow to approve the tests.

The Biden administration has not been as aggressive in fixing the situation as it could have been, but it has made progress. A couple of months ago, tests were often impossible to find. Now, they are sporadically available at many stores. Friends and family around the country have told me this week that they have usually been able to find a test after looking in enough places.

The tests are not free, however. They typically cost about $25 for a pack of two. The combination of their cost and irregular availability means that Americans interested in rapid tests often must make choices about when to use them.

“Rapid tests can help reduce worries about gathering with loved ones for the holidays,” Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, told me. Nuzzo’s immediate family plans to take tests on Thanksgiving, before going over to their hosts’ for the meal. So do I.

Even with the limitations of rapid testing in the U.S., the tests can play an important role in slowing the spread of the virus. And the situation does seem to be improving. The F.D.A. approved three more tests this week, and the Biden administration continues to spend more to expand their availability.

By Christmas and New Year, tests should be easier to find than they are this week.

After a steady decline since mid-September, coronavirus cases are once again rising in most of the United States. New cases have increased by 25 percent nationally in the past two weeks. In 14 states, cases have climbed by 40 percent or more.

In the largest revision of state vaccination numbers to date, the Centers for Disease Control and Prevention updated those for Pennsylvania, which had counted about 1.2 million more doses than had actually been administered.

The C.D.C. said the data, updated almost every day on its website, had been corrected. As of Tuesday evening, about 81 percent of people in Pennsylvania had received at least one shot of a vaccine, according to C.D.C. data, whereas on Monday the data indicated that about 84 percent of people in the state had gotten a shot.

The agency has been periodically revising vaccination numbers in states since July 14. Altogether, the C.D.C. and the states have reduced the number of reported doses in the U.S. by about 2 million.

The C.D.C. has posted on its website that the revisions are part of a collaboration with states to gather their most “complete and accurate” data. Sometimes the revisions result in more shots being added to a state’s tally. Other times they result in a drop. Illinois, for example, revised its data to add about 316,000 doses in late October only to subtract about 214,000 doses a few weeks later.

Barry Ciccocioppo, communications director for Pennsylvania’s Department of Health, said that the department “continues to update and refine our vaccination data throughout the commonwealth to ensure duplicate vaccination records are removed and dose classification is correct.” He said that the C.D.C. had now begun to “rectify” the data.

“This is not a practice specific to Pennsylvania and the C.D.C. is going through a similar process with other states across the country,” he said.

Cindy Prins, a professor of epidemiology at the University of Florida, said she feared that people might jump to the conclusion that there were deliberate errors in the initial reporting, but she did not believe that was the case. “I think it’s just a process of cleaning up and making sure what is in there is accurate to the best of our ability to know that,” Dr. Prins said.

Still, without fully accurate and up-to-date vaccination rates, it would be difficult for counties to make informed health recommendations, she said. If vaccination rates were overreported, that could give counties a false sense of confidence that more people are vaccinated than actually were.

More than 230 million people across the United States have received at least one shot of a coronavirus vaccine, according to the C.D.C. Last week, the agency authorized booster shots for all adults. Across the U.S., Covid-19 infections have been rising, with more than 90,000 cases reported on average each day.

Lalisa Manoban, a global megastar who performs as Lisa in the K-pop group Blackpink, tested positive for the coronavirus on Wednesday, her production company announced.

The other members of Blackpink, a four-woman group whose fame and commercial success have traveled far beyond South Korea, were not listed as close contacts but were awaiting results of a PCR test, the production company, YG Entertainment, said in a statement sent to Korean news organizations.

As of Wednesday morning, Ms. Manoban, 24, had not yet addressed her nearly 68 million Instagram followers on the positive test.

A Thai-born singer and rapper, Ms. Manoban is among the most acclaimed faces of K-pop, with legions of fans. She is part of K-pop’s most globally successful all-female group; five of Blackpink’s videos have been watched more than 1 billion times on YouTube, including 1.7 billion views for “DDU-DU DDU-DU.”

Ms. Manoban’s debut solo album, “Lalisa,” was released on Sept. 10; her first single, “LALISA,” set a YouTube record for the most-viewed music video by a solo artist in 24 hours with 73.6 million views, dethroning Taylor Swift’s “ME!” in 2019.

With strict limits on international travel and consistent masking, South Korea has been among the world’s most successful countries at limiting coronavirus outbreaks, reporting about 3,300 total deaths. Cases have surged to record levels in the past two weeks, reaching a new high of 4,116 new cases on Tuesday, but they have remained relatively low compared to much of the world: currently six daily cases per 100,000 people, compared with 29 in the United States, 35 in Singapore and 158 in Austria.

Tickets! Vaccination passes! Covid tests! Starting Wednesday, ticket inspectors on public transportation networks in Germany began conducting random checks of passengers’ proof of vaccination, recovery from Covid or a negative daily test, as Germany confronts a worrying rise in its caseload.

Masks have been mandatory on public transportation since the early days of the pandemic, but transportation providers — and the current minister of transport — have pushed back against calls to require passengers to show proof of immunity to ride.

The decision to take the extra step was made last week when Parliament voted on a law proposed by the parties that are poised to take over the government after September’s election. The law also stipulates similar rules for the workplace.

On Tuesday, German health authorities registered 66,884 new cases, a daily record, and the country’s Covid death toll is nearing 100,000.

Documents will be checked at random, mostly by people responsible for checking tickets, although the police can be called in to help. Deutsche Bahn, Germany’s national railroad, said it would aim to run spot checks on 400 of its routes every day.

Children younger than 6 and schoolchildren, who are tested for Covid several times a week with their classes, are excluded. Other riders must prove either that they are fully vaccinated, that they have recovered from the disease less than six months ago or that they have a negative test result from an official testing site that is less than 24 hours old.

Initially, those who are caught without any of those documents will be asked to disembark at the next stop. Eventually, fines of up to several thousand euros could be levied.

Two actors have left one of America’s most popular soap operas after declining to comply with an on-set vaccination mandate.

The actors, Steve Burton and Ingo Rademacher, were fixtures of ABC’s “General Hospital,” a long-running daytime drama set in the fictional town of Port Charles, N.Y.

About one in five American adults has not received a single dose of a coronavirus vaccine.

Mr. Burton and Mr. Rademacher were outspoken opponents of a coronavirus vaccine mandate that applied to a part of the set where actors work unmasked, known in the industry as Zone A. The mandate took effect on Nov. 1.

“Unfortunately, ‘General Hospital’ has let me go because of the vaccine mandate,” Mr. Burton, who tested positive for the virus in August and filmed his last episode on Oct. 27, said in an Instagram video on Tuesday.

“I did apply for my medical and religious exemptions and both of those were denied — which, you know, hurts,” he added. “But this is also about personal freedom to me. I don’t think anyone should lose their livelihood over this.”

Mr. Rademacher’s departure from the show was made public earlier this month. He had also refused to comply with the show’s vaccine mandate. “I will stand with you to fight for medical freedom,” he wrote in an Instagram post.

Mr. Rademacher has also been criticized on social media in recent weeks for making comments that his critics perceived to be transphobic, a suggestion he has forcefully denied.

Representatives for ABC declined to comment on the record. Publicists for the actors could not be reached for comment late Tuesday.

Other Hollywood productions have imposed similar on-set mandates, but there is no universal vaccination requirement for people who work in film and television.

“General Hospital” has been on the air since 1963. Its episodes are filmed weeks before they air.

Mr. Rademacher played the character Jasper “Jax” Jacks on the show for 25 years. In his last episode, which aired on Monday, the character said — spoiler alert — that he would be returning to Australia.

“I’m kind of on the outs with everyone in Port Charles right now,” the character said. Some fans interpreted that as a reference to the actor’s real-life tension with his castmates.

In the same episode, Mr. Burton’s character, Jason Morgan, was caught up in a tunnel collapse.

Mr. Burton said in his Instagram video on Tuesday that he hoped the show’s vaccine mandate would be lifted so that he could finish his career playing Jason Morgan.

“And if not,” he added, “I’m going to take this experience, move forward and be forever grateful.”

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New Zealand Plans to Reopen to Foreign Tourists by the End of April

Fully vaccinated travelers entering the country next year will face significant restrictions, with a mandatory seven-day home isolation period, as well as tests on departure and arrival.

Today, I am confirming that fully vaccinated New Zealanders will find it easier to come home from January. And foreign nationals follow from April onwards, as we remove the requirement for managed isolation and quarantine for most travelers arriving into New Zealand. There will still be carefully managed processes for recent arrivals, including a mandatory seven-day self-isolation period for people who are not required to enter MIQ. We do know that the international restrictions we have had around our border have been tough for many people. That’s why we’re making this announcement today, to give families, businesses, visitors, airlines, airports and others the time to prepare.

New Zealand plans to allow most fully vaccinated travelers into the country by the end of April without a mandatory hotel quarantine, as it slowly emerges from what has been one of the world’s longest lockdowns.

But those entering the country next year will face significant restrictions, with a mandatory seven-day home isolation period, as well as tests on departure and arrival. The border will open in stages to different countries, with fully vaccinated New Zealanders and visa holders able to travel from Australia from Jan. 16 and from elsewhere in the world starting Feb. 13. Foreign nationals will follow from April 30.

Experts have for weeks questioned the need for requiring new arrivals to quarantine when the virus is already in the community, and experts say international arrivals seem to pose no additional risk. No fully vaccinated travelers from Australia, for example, have tested positive in New Zealand’s hotel quarantine system since Aug. 23.

Some 84 percent of people in New Zealand age 12 and up are fully vaccinated against the coronavirus. And representatives from the country’s tourism industry, which has struggled to contend with the long absence of foreign visitors, decried the seven-day isolation requirement.

New Zealand has been on edge since August, when an outbreak of the Delta variant erupted in Auckland and put an end to the country’s “zero Covid” approach.

“It’s very encouraging that we as a country are now in a position to move towards greater normality,” Chris Hipkins, the minister responsible for New Zealand’s pandemic response, said at a news conference on Wednesday. “I do want to emphasize, though, that travel in 2022 won’t necessarily be exactly the same as it was in pre-2020 travel.”

For over a year, New Zealand has operated a lottery system for citizens and permanent residents who want to return, locking people out of the country and creating a large backlog. The system has faced legal challenges from people desperate to return home from overseas and be reunited with their families.

New Zealand is waiting until April to fully open to permit time for airlines to plan, he said, as well as to allow a transition to the country’s new “traffic light” pandemic management system that starts Dec. 2. That system will end lockdowns and place significant restrictions on the unvaccinated, Prime Minister Jacinda Ardern announced at a news conference on Monday.

On Dec. 15, Auckland — where the country’s outbreak is concentrated — will open its border to the rest of the country.

Before the pandemic, tourism was a big part of the New Zealand economy, employing nearly 230,000 people and contributing 41.9 billion New Zealand dollars ($30.2 billion) a year. About 3.8 million foreign tourists visited between 2018 and 2019, with the majority coming from Australia. Though domestic tourism has surged while borders have been closed, the industry has struggled to make up its losses, as international tourists spend about three times as much per person as their domestic peers.

Defending New Zealand’s caution, Mr. Hipkins pointed to the new virus wave that is crashing through Europe. “As we move into 2022, we know that the pandemic is not over,” he said. “It’s not going to suddenly end, and we only need to look at Europe to know that the path out of the pandemic is not a straightforward one.”