Covid-19 Updates: White House Will Keep Travel Bans in Place

Covid-19 Updates: White House Will Keep Travel Bans in Place




White House to Continue Travel Bans Due to Delta Variant

Jen Psaki, the White House press secretary, said the administration would maintain existing restrictions on entry to the United States for Europeans and others, citing concerns over the spread of the Delta variant.

We will maintain existing travel restrictions at this point for a few reasons: The more transmissible Delta variant is spreading both here and around the world, driven by the Delta variant cases are rising here at home, particularly among those who are unvaccinated and appear likely to continue in the weeks ahead. The C.D.C. just advised Americans against travel to the United Kingdom this past Monday given the surge in cases. They will evaluate and make recommendations based on health data. But I don’t have a timeline to predict for you because it’s all about what success we have at getting more people vaccinated, getting more vaccines out to the world and fighting the virus.

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Jen Psaki, the White House press secretary, said the administration would maintain existing restrictions on entry to the United States for Europeans and others, citing concerns over the spread of the Delta variant.CreditCredit…Stefani Reynolds for The New York Times

The Biden administration will continue to restrict the entry of Europeans and others into the United States, citing concerns that infected travelers may contribute to further spread of the contagious Delta variant across the country, Jen Psaki, the White House press secretary, said Monday afternoon.

Concern about the variant had convinced officials not to lift the current travel restrictions on foreigners, Ms. Psaki said, some of which had been in place since the beginning of the pandemic. Vaccines remain effective against the worst outcomes of Covid-19, including from the Delta variant.

“The more transmissible Delta variant is spreading both here and around the world,” she told reporters, adding that cases are rising in the United States, particularly among the unvaccinated.

The decision is a blow to the travel industry, which hoped that a lifting of the travel bans could increase tourism for the remaining summer months, helping hotels, airlines and other businesses that have been struggling.

But Ms. Psaki said that it was unclear when the United States would remove the bans completely.

“I don’t have a timeline to predict for you because it’s all about what success we have at getting more people vaccinated, getting more vaccines out to the world and fighting the virus,” she said.

The United States began restricting travel from foreigners in January 2020, when former President Donald J. Trump restricted some travel from China in the hopes of preventing the spread of the virus. That effort largely failed.

But health officials pressed the Trump administration to expand travel bans to much of Europe during the first surge of the pandemic in the spring of 2020, and more countries have been added to the ban as the original virus and several variants have spread rapidly from country to country.

The Trump administration also used a public health authority known as Title 42 to effectively shut down the southern border to entry, citing worries that immigrants crossing on foot could bring the virus into the country. The Biden administration stopped enforcing the rule for unaccompanied children crossing the border alone and for some families.

But Ms. Psaki said that the Title 42 restrictions, like the other travel bans, would remain for the time being.

“We have never conveyed or announced a timeline for Title 42,” she said. “So nothing has changed in that regard, it remains in place, and it will remain in place as long as that is the guidance from our health and medical experts.”

Health care workers at the Portland Veterans Affairs Medical Center receiving coronavirus vaccinations in December. The mandate would apply to roughly 115,000 of the department’s employees.
Credit…Nathan Howard/Getty Images

WASHINGTON — The Department of Veterans Affairs will require 115,000 of its frontline health care workers to be vaccinated against the coronavirus in the next two months, making it the first federal agency to mandate that employees be inoculated, government officials said on Monday.

The move comes as concern is growing that the substantial portion of the population that has not been vaccinated is contributing to the rapid spread of the highly contagious Delta variant. While it was a sharp departure from the Biden administration’s reluctance to embrace mandates, it was part of a broader shift in which New York City, many hospital chains and some private employers are deciding that the time has come to make being vaccinated a requirement.

“I am doing this because it’s the best way to keep our veterans safe, full stop,” Denis McDonough, the secretary of veterans affairs, said in a telephone interview on Monday. The department is one of the largest federal employers and is the biggest integrated health care system in the country.

The mandate will apply to workers who are “the most patient-facing,” Mr. McDonough said, including doctors, dentists, registered nurses, physician assistant and some specialists. Beginning on Wednesday, those health care workers will have eight weeks to get fully vaccinated or face penalties including possible removal, he said.




N.Y.C. Will Require All City Workers to be Vaccinated or Tested Weekly

Mayor Bill de Blasio of New York said the city’s roughly 340,000 municipal workers must be vaccinated against the coronavirus by Sept. 13 or face weekly testing. The requirement coincides with the start of school.

On Sept. 13, the entire city workforce will be mandated under the Covid safety mandate to either get vaccinated, which is far preferable, or get tested once a week. September is the pivot point of the recovery. September is when many employers are bringing back a lot of their employees. September is when school starts full strength. September is when people come back from the summer. September is when it will all happen. And so on Sept. 13, which is the first full day of school, every single city employee will be expected to be either vaccinated or be tested weekly. This means everybody. This means, obviously, everyone who works in our schools, our educators and staffs — staff — it means the N.Y.P.D., the F.D.N.Y., it means all city agencies. It means people who work in offices and people work on the front line, everyone. So we’re going to keep climbing this ladder and adding additional measures as needed — mandates and strong measures whenever needed — to fight the Delta variant. No. 1 way to fight it is get vaccinated. We’re proving it. This is the reason life is as good as it is in New York City, right now, because we’re above the national average in vaccinations. But we need to do more. We have to take seriously, if someone’s unvaccinated, unfortunately, they pose a threat to themselves, but they also have a greater chance of spreading the disease.

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Mayor Bill de Blasio of New York said the city’s roughly 340,000 municipal workers must be vaccinated against the coronavirus by Sept. 13 or face weekly testing. The requirement coincides with the start of school.CreditCredit…Karsten Moran for The New York Times

The drive to get Americans vaccinated accelerated on Monday when the most populous state and largest city in the United States announced that they would require their employees to get vaccinated against the coronavirus, or face frequent tests.

All municipal employees in New York City, including police officers and teachers, and all state employees and on-site public and private health care workers in California will have to be vaccinated or face at least weekly testing.

The Department of Veterans Affairs on Monday also became the first federal agency to mandate that some of its employees get inoculated.

The mandates are the most dramatic response yet to the lagging pace of vaccinations around the country in the face of the highly contagious Delta variant, which is tearing through communities with low rates of vaccination and creating what federal health officials have called a “pandemic of the unvaccinated.”

Vaccines remain effective against the worst outcomes of Covid-19, including from the Delta variant, but only 49 percent of people in the United States are fully vaccinated, according to federal data.

Misinformation and skepticism have dogged the vaccine rollout, too, and in recent weeks new coronavirus infections and hospitalizations have risen, with a fourfold increase in new cases per day over the last month.

But both indicators, as well as new deaths, remain well below their winter peaks. Cities, private employers and other institutions have been grappling with whether to require vaccines to help get more people vaccinated.

Nearly 60 major medical associations, including the American Medical Association and the American Nurses Association, signed a joint statement on Monday calling for the mandatory vaccination of health care workers that described inoculation as “the logical fulfillment of the ethical commitment of all health care workers.”

Hospitals and health care systems like NewYork-Presbyterian and Trinity Health have already announced vaccine mandates, in some cases touching off union protests. The National Football League recently announced it could penalize teams with players who do not get vaccinated. Delta Air Lines will require new employees to be vaccinated, but not its current workers. And last week a federal judge ruled that Indiana University could require vaccinations for students and staff members.

New York City will require its roughly 340,000 municipal workers to be vaccinated against the coronavirus by the time schools reopen in mid-September or face weekly testing, Mayor Bill de Blasio said.

Enforcing the testing requirement there could be complicated, since the more than two dozen unions that represent municipal employees could take issue with the rule.

Mr. de Blasio said the new measures were first steps and that more would follow, and he reiterated a call to private employers to set vaccine mandates for their workers.

“Right now we are leading by example,” the mayor said. “A lot of times, that’s what private sector employers say that’s what they need.”

In California, where 75 percent of the eligible population has received at least one vaccine dose, the new requirement will apply to roughly 246,000 state employees and many more health care workers in the state, Gov. Gavin Newsom said.

“Everyone that can get vaccinated — should,” Mr. Newsom said on Twitter.

Gov. Andrew M. Cuomo of New York avoided supporting a statewide measure like Mr. Newsom’s and argued most “public-facing” employees are municipal, not state workers, suggesting mandates were more of a question for localities.

Mr. Newsom blamed misinformation for the pandemic’s persistence, slamming in particular Republican members of Congress and Fox News pundits who have questioned vaccines.

“We are exhausted — respectfully, exhausted — by the ideological prism that too many Americans are living under,” he said. “We are exhausted by the right-wing echo chamber that has been perpetuating misinformation around the vaccine and its efficacy and safety.”

On Monday, Jen Psaki, the White House press secretary, said vaccine mandates are meant to keep Americans safe, but she distanced the federal government’s vaccination efforts from such requirements, reinforcing comments she made last week that mandates were decisions best left to private sector companies, institutions and local communities.

“We are not going to judge our success here by whether we score political points,” she said on Monday. “We are going to judge it by whether we are able to save more lives, and if the health and medical experts suggest that’s the right way to go then we will support that.”

Eliza Shapiro contributed reporting.

Travelers were few on a recent Sunday at Ronald Reagan National Airport in Arlington, Va.
Credit…Stefani Reynolds for The New York Times

As coronavirus infections rise in the United States, concern is mounting among officials and health experts that a surge of cases could devastate unvaccinated populations and push some communities back into the types of lockdowns imposed at the peaks of the pandemic.

Although case numbers are still a fraction of what they were in the worst months, Dr. Anthony Fauci, the nation’s top infectious disease expert, told CNN on Sunday that the country was “going in the wrong direction.” And it is not just Dr. Fauci. Gov. Kay Ivey of Alabama, a Republican, told reporters last week that unvaccinated Americans “are letting us down.”

On Monday, U.S. officials matched the growing concern with steps aimed at controlling travel to and from the United States to stem the spread of the highly contagious Delta variant.

The Biden administration said it would continue to restrict the entry of Europeans and others into the country, citing concerns that infected travelers could contribute to Delta’s spread. And the Centers for Disease Control and Prevention urged Americans to avoid traveling to Spain and Portugal, saying that as cases rise in both countries, “even fully vaccinated travelers may be at risk for getting and spreading Covid-19 variants.”

Spain and Portugal reopened their borders to American tourists in June. But over the past two weeks, there has been a 74 percent increase in new cases in Spain and an 18 percent rise in Portugal, according to New York Times data.

Last week, the C.D.C. put out a similar Level 4 travel notice — the highest warning it issues — for Britain. Almost all Covid restrictions have been lifted in England, and case numbers have been high.

Restrictions on travel from Europe and other parts of the world to the United States will remain in place, Jen Psaki, the White House press secretary, said on Monday afternoon, adding that she had no information on when the travel bans would be lifted.

“I don’t have a timeline to predict for you, because it’s all about what success we have at getting more people vaccinated, getting more vaccines out to the world and fighting the virus,” she said.

The U.S. government began restricting travel from foreigners in January 2020, when President Donald J. Trump blocked some travel from China in the hopes of preventing the spread of the virus. That effort largely failed. But health officials pressed the Trump administration to expand travel bans to much of Europe during the first surge of the pandemic in the spring of 2020, and more countries have been added to the ban as the virus and variants have spread.

Controlling travel in and out of the country is proving to be less daunting for U.S. officials than other problems in the pandemic. Misinformation continues to undermine efforts to persuade people that the vaccines are safe, with wildly inaccurate claims of the health risks thriving in some corners of the internet.

In Louisiana, where the vaccination rate is just over 45 percent, according to New York Times data — among the lowest in the United States — public health workers are going door-to-door to counter the claims. As mass vaccination sites have closed, health workers are trying to persuade people who are hesitant, and people who outright refuse, to get the shots.

Some jurisdictions are adopting more aggressive tactics, such as insisting that employees be vaccinated. U.S. officials said on Monday that the Department of Veterans Affairs would require 115,000 of its frontline health care workers to be vaccinated against the coronavirus in the next two months, making it the first federal agency to issue such a mandate.

In New York City, all municipal employees, including police officers and teachers, will have to be vaccinated or face at least weekly testing. Similar rules will apply to state employees and on-site public and private health care workers in California.

Such steps could become more prevalent if the virus continues to spread through unvaccinated populations. Dr. Joseph Kanter, the top health official in Louisiana, lamented that his state had become “the leading edge of the Delta surge,” adding: “We lost all the progress we had made.”

California will require state employees and on-site public and private health care workers in California to be vaccinated or face at least weekly testing, Gov. Gavin Newsom said Monday.
Credit…Jim Wilson/The New York Times

California will require all state employees and on-site public and private health care workers to be vaccinated or face at least weekly testing, Gov. Gavin Newsom announced on Monday.

“This is a requirement, to prove you’ve been vaccinated — and if you have not, you will be tested,” Mr. Newsom said.

The California move came a few hours after Mayor Bill de Blasio of New York City announced a similar vaccine mandate for all municipal workers, to take effect by the time schools reopen in mid-September. Last week, Mr. de Blasio announced a vaccine requirement for public health care workers — part of an effort to speed up vaccinations as the city faces a third wave of coronavirus cases driven by the spread of the Delta variant.




California Will Require Vaccinations or Weekly Testing for State Workers

Gov. Gavin Newsom of California announced that all 246,000 state employees and health care workers must get the coronavirus vaccine or face regular testing one to two times per week.

246,000 Californians are state employees, 246,000 Californians should be vaccinated. And if they’re not vaccinated, and cannot verify that they’ve been vaccinated, we are requiring that they get tested. California is committed to vaccination verification and/or testing on a weekly basis. We’re not stopping just with state employees today. We’re also announcing partnerships that include those like Kaiser — private sector, now stepping up, organizations representing physicians and dentists, dialysis clinics, stepping up. Private-sector clinics are committing to the same. And we hope this example of public and private leadership as it relates to vaccine verifications, vaccine mandates and/or mandated testing one to two times a week with also commensurate P.P.P., or rather P.P.E., obligations as it relates to protective gear — N95 respirator masks as an example — will lead to others to replicate this example, in the private sector.

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Gov. Gavin Newsom of California announced that all 246,000 state employees and health care workers must get the coronavirus vaccine or face regular testing one to two times per week.

State and local officials, businesses and residents across the country are grappling with whether vaccines should be mandated. The city of San Francisco, several Bay Area counties, the University of California and various hospital systems around the country have recently announced similar mandates.

The new requirement will apply to roughly 246,000 state employees and many more health care workers in the state, Mr. Newsom said. State departments will be expected to begin verifying the vaccination status of all state employees by Aug. 2, while the verification program for health care workers will go into effect on Aug. 9 and by no later than Aug. 23.

More than 64 percent of California residents have received at least one dose of the vaccine, according to federal data, but the speed of inoculations has slowed. The number of virus cases in California has risen to more than 6,300 on average per day, more than double the daily average two weeks ago.

A nurse prepared treatment for a coronavirus patient at a hospital in Mountain Home, Ark., earlier this month. A wide array of medical professional associations signed a statement calling for vaccination to be mandatory for health care workers.
Credit…Erin Schaff/The New York Times

A group of nearly 60 major medical organizations, including the American Medical Association and the American Nurses Association, called on Monday for mandatory vaccination of health care workers. As the highly contagious Delta variant drives a new surge of coronavirus cases, vaccination is an ethical obligation for health care workers, the groups said in a joint statement.

The statement said that all health care and long-term care employers should require their workers to receive the Covid-19 vaccine. “This is the logical fulfillment of the ethical commitment of all health care workers to put patients as well as residents of long-term care facilities first and take all steps necessary to ensure their health and well-being,” the statement said.

The document was signed by a wide array of professional associations, including those representing doctors, nurses, pharmacists and infectious disease experts. It said that exceptions could be made for the small subset of employees who are unable to be vaccinated for medical reasons.

In recent weeks, more hospitals and health care systems have announced that they would begin employees to be vaccinated. The U.S. Equal Employment Opportunity Commission has said that the mandates are legal, and many hospitals already require employees to get flu shots.

“Health care organizations rarely agree on anything, but this is one thing where they are speaking with one voice and unanimity,” said Dr. Ezekiel Emanuel, an oncologist and bioethicist at the University of Pennsylvania, who organized the joint statement. “I think that attests to the wide recognition that this is the right thing to do for this country.”

Although many health care workers have been eligible for vaccination since December, when the first shots were authorized, a significant number remain unvaccinated.

In New York, for instance, roughly 1 in 4 hospital workers have not yet been vaccinated, according to state data. Nationwide, just 58.7 percent of nursing home employees have been fully vaccinated, according to the Centers for Disease Control and Prevention.

Some health care workers have pushed back against vaccine requirements. A small group of employees sued Houston Methodist Hospital over its mandate. The suit was dismissed last month, and more than 150 workers at the hospital were fired or resigned over their refusal to be vaccinated.

Some employers have been reluctant to require the vaccines, which currently have an emergency use authorization, until they receive full approval from the Food and Drug Administration. That approval is expected, but could be months away.

But the joint statement noted that the Covid-19 vaccines have a good track record so far. “We know the vaccines are safe and highly effective at preventing severe illness and death from Covid-19,” Dr. Susan R. Bailey, the immediate past president of the A.M.A., said in a statement.

Marisol Gerardo, 9, received a second dose of the Pfizer-BioNTech Covid-19 vaccine during a clinical trial for children at Duke Health in Durham, N.C., in April.
Credit…Shawn Rocco/Duke Health, via Reuters

At the urging of federal regulators, two coronavirus vaccine makers are expanding the size of their clinical trials for children ages 5 to 11 — a precautionary measure designed to detect rare side effects including heart inflammation problems that turned up in vaccinated people younger than 30.

President Biden promised at a meeting in Ohio last week that emergency clearance for pediatric vaccines would come “soon,” but the White House has not been specific on the timeline. It was unclear whether expanding the studies will affect when vaccines could be authorized for children.

The Food and Drug Administration has indicated to Pfizer-BioNTech and Moderna that the size and scope of their pediatric studies, as initially envisioned, were inadequate to detect rare side effects. Those include myocarditis, an inflammation of the heart muscle, and pericarditis, inflammation of the lining around the heart, multiple people familiar with the trials said.

Questions about vaccinating children — including those under 12 — are of huge interest to parents and teachers. Regulators will be required to balance potential side effects of coronavirus vaccination against the risks of Covid-19.

Members of a C.D.C. advisory committee have said that the benefits of shots for people older than 12 greatly outweigh the risks, including of heart problems.

The F.D.A. has asked the companies to include 3,000 children in the 5-to-11-year-old group, the group for whom results were expected first, according to people familiar with the situation. One of the people, granted anonymity to speak freely, described that figure as double the original number of study participants.

A spokesman for Moderna, Ray Jordan, confirmed that the company intends to expand its trial “to enroll a larger safety database which increases the likelihood of detecting rarer events” and expects to seek emergency authorization late this year or early next year.

The Moderna trial began recruiting patients in March with the aim of enrolling 6,795 participants younger than 12. The participants were to be split equally into three age brackets, including a 6 to 11 year old group, of 2,265 participants each. Mr. Jordan said the company is “actively discussing” a proposal with the F.D.A. to expand the trial.

Pfizer is on a faster timetable than Moderna, and may be able to meet the F.D.A.’s expectations on a bigger trial size and still file a request to expand emergency authorization of its vaccine by the end of September. Reviewing all the safety and efficacy data will likely take regulators at least a few weeks.

Pfizer has previously said it expects to have results for the 5-to-11-year-old group in September, with results for children aged 2 to 5 shortly after that. Results for the youngest children — 6 months to 2 years old — are expected in October or November. A spokeswoman said Monday that the company had no updates on its timetable.

In June, the Centers for Disease Control and Prevention published data showing that the two vaccines may have caused myocarditis and pericarditis in more than 1,200 Americans, including about 500 who were younger than 30. The symptoms typically appeared within two weeks and were more common in young men and boys.

The rate was low: Fewer than 13 cases per one million second doses administered. Most cases were mild and quickly cleared up, the researchers said.

Dr. Paul A. Offit, an infectious disease specialist who previously served on the C.D.C.’s Advisory Committee on Immunization Practices, noted that infection with the coronavirus also carries a risk and delays in authorizing vaccines because of expanded trials might also put children at risk. “There’s always a human price to pay for knowledge,” he said.

The F.D.A. authorized the Pfizer vaccine on an emergency basis for children ages 12 to 15 in April; the Moderna vaccine has been cleared only for people 18 and older. The agency attached a warning about potential heart problems to the fact sheets of the vaccines in June.

Many public health experts argue that, with so much attention focused on hospitalizations and deaths among older Americans infected with the coronavirus, the risk for children has been overlooked.

More than four million American children and adolescents have tested positive for the virus since the onset of the pandemic, the American Academy of Pediatrics reported last week. Of those, at least 346 have died.




Federal Disability Law Will Protect ‘Long Covid’ Patients, Biden Says

President Biden said the benefits and protections of the Americans with Disabilities Act would now extend to people facing ongoing health problems caused by a coronavirus infection that occurred weeks or months before.

Thirty-one years ago, after its passage, many Americans have never lived in a world without the A.D.A. Generations have grown up not knowing a time before it existed, but many of us can still recall in America, where a person with a disability was denied service in restaurants and grocery stores, and could be, where a person using a wheelchair couldn’t ride in a train or take a bus to work or to school, or an employer could refuse to hire you because of a disability — an America that wasn’t built for all Americans. Then we passed the A.D.A., and made a commitment to build a nation for all of us, all of us. For more than 60 million Americans living with disabilities, the A.D.A. is so much more than a law. It’s a source of opportunity, participation, independent living and respect and dignity, the bulwark against discrimination and a path to independence. I’m proud to announce a new effort, the first of its kind, to help Americans grappling with long-term effects of Covid-19 that doctors call “long Covid.” Many Americans who seemingly recover from the virus still face lingering challenges like breathing problems, brain fog, chronic pain and fatigue. These conditions can sometimes — can sometimes — rise to the level of a disability. So we’re bringing agencies together to make sure Americans with “long Covid” who have a disability have access to the rights and resources that are due under the disability law.

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President Biden said the benefits and protections of the Americans with Disabilities Act would now extend to people facing ongoing health problems caused by a coronavirus infection that occurred weeks or months before.CreditCredit…Tom Brenner for The New York Times

Americans suffering from “long Covid” — a term referring to new or ongoing health problems from a coronavirus infection that occurred weeks or months ago — will have access to the benefits and protection provided under federal disability law, President Biden said on Monday.

Speaking in the Rose Garden to celebrate the 31st anniversary of the Americans with Disabilities Act, Mr. Biden listed some of the lingering effects that have been seen in coronavirus survivors, including “breathing problems, brain fog, chronic pain or fatigue,” and noted that the effects sometimes rise to the level of a disability.

“We are bringing agencies together to make sure Americans with long Covid, who have a disability, have access to the rights and resources that are due under the disability law,” Mr. Biden said, noting that they would include special accommodations and services in the workplace, in schools and in the health care system.

In some cases, the health effects of Covid-19 can persist for months after initially causing only mild symptoms. A study published in April found that a coronavirus infection also appears to increase the risk of death and chronic medical conditions afterward, even in people who were never sick enough with the virus to be hospitalized.

The research, based on records of patients in the Department of Veterans Affairs health system, also found that non-hospitalized Covid survivors had a 20 percent greater chance of needing outpatient medical care in the six months following infection than did people who had not contracted the coronavirus.

Roberta Moses of Together Louisiana went door to door in a neighborhood in Shreveport, La., in an effort to get more people to sign up to get vaccinated earlier this month.
Credit…Emily Kask for The New York Times

Facing deep mistrust that has been stoked by conservative news outlets and lawmakers and by rampant misinformation online, local health officials around the country are fighting for influence when the only sure strategy for beating back the virus is getting more people vaccinated.

Some of those officials say that they consider themselves targets at a time when many of their colleagues around the country have resigned or been fired during the pandemic, including the top vaccine official in Tennessee this month.

A year and a half into the crisis, their battered departments are now struggling to contain the spread of the highly infectious Delta variant with testing and contact tracing — the best resources, despite their limited reach, in the many places where vaccination rates remain low.

They are facing new heights of hostility, and new battles are looming over what safety measures schools and businesses should put in place in the fall, decisions the Centers for Disease Control and Prevention has said should be made in consultation with local health officials.

Nowhere is the struggle as urgent as the northwest corner of Louisiana, one of the white-hot centers of what has become a two-track pandemic. Only 30 percent of the more than 500,000 people in the region are fully vaccinated, almost 20 points below national figures.

A recent study by researchers at Georgetown University showed that Shreveport was in the middle of one of five main clusters of unvaccinated people in the United States vulnerable to large surges and new variants, putting the rest of the nation at risk.

Louisiana ranks near the bottom in vaccination rates nationally, and cases are again multiplying, with the second-highest average daily case count per 100,000 people in the country.

“We are unfortunately the leading edge of the Delta surge,” said Dr. Joseph Kanter, the state’s top health official. “We lost all the progress we had made.”

The immediate crisis is confounding and demoralizing health officials in Shreveport, where just over half the population is Black and nearly 40 percent is white, with a mix of moderate Democratic and far-right conservative politics.

With so few of its residents vaccinated, the city is largely relying on the complex work of disease surveillance and intimate block-by-block, person-by-person engagement. And without as many resources as some larger health departments, the region has turned to other public institutions to fill the void.

The backbone of the city’s response in recent months has been a dilapidated former Chevrolet dealership converted to a vaccination and testing site by Louisiana State University Health Shreveport, where a team of workers weaves around test and vaccination kits stacked floor to ceiling, planning mobile unit outings.

The fight against the virus in the region is a study in the kind of small-scale response that has the best chance of working, albeit painfully slowly, at this stage of the pandemic, said Dr. John Vanchiere, a professor of pediatrics and infectious disease at L.S.U. Health Shreveport who works with Dr. Martha Whyte, the top public health official in the region.

A recent visit to a chicken processing plant, where a dozen presentations were delivered to groups of workers, led to gradual uptake of the vaccine, he said.

He and Dr. Whyte spoke last Sunday at a Black Baptist church to encourage vaccinations. Congregants raised claims that they had heard about the vaccine, including that it caused infertility and magnetized people’s bodies (both false).

Global Roundup

Health workers during the burial of a Covid-19 victim in Klang, near Kuala Lumpur, Malaysia, on Sunday. The country currently has the highest infection rate in Southeast Asia.
Credit…Ahmad Yusni/EPA, via Shutterstock

Malaysia reported a record number of new coronavirus infections on Sunday, taking the country past one million cases as it battles a major outbreak that has left doctors feeling helpless and the authorities scrambling to control the spread.

Officials reported 17,045 new cases and 92 coronavirus-related deaths. In a statement on Sunday, Noor Hisham Abdullah, Malaysia’s director general of health, urged residents to continue adhering to restrictions, avoid gatherings and book their vaccine appointments.

Malaysia currently has the highest infection rate in Southeast Asia, where a number of countries are facing their worst outbreaks of the pandemic after keeping cases relatively low for all of last year. The country of more than 30 million is vaccinating its population faster than many of its neighbors, with about 16 percent fully inoculated, according to a New York Times database.

On Monday, doctors working on contracts walked out of several hospitals, demanding improvements in pay, local news media reported. “Our strike is not about resistance,” one doctor told Free Malaysia Today, an independent news site. “We only want the government to give us the same rights and benefits that permanent doctors get.”

He added that 150 contract medical officers had quit “because they are tired of the system.”

Dr. Noor Hisham pleaded with health care workers to abstain from the strikes. “I urge all of you, please do not join the demonstration and abandon your duty to your patients,” he said on Facebook. “Remember many lives are on the line and the demonstration could affect their lives and even your career.”

Also on Monday, the Malaysian Parliament convened for the first time since January, when it was suspended after the king declared a national emergency amid the pandemic. The government said that it would not ask for a renewal of the emergency order, which is set to expire on Aug. 1.

In other developments around the world:

  • Officials in Pakistan said that citizens 18 years and older who are not vaccinated against Covid-19 would be barred from domestic air travel starting Aug. 1. In a statement, the National Command and Operation Center, the top body overseeing the country’s pandemic response, listed several categories of people who were exempted from the ban, including partially vaccinated individuals, foreign nationals and those who have medical reasons for not being vaccinated.

  • The authorities in Germany are considering reinstating some restrictions for adults who are not vaccinated if daily infections substantially increase in the coming months. In an interview on Sunday with Bild, Germany’s most widely read tabloid, Dr. Helge Braun, Chancellor Angela Merkel’s chief of staff, said, “Vaccinated people will definitely have more freedom than unvaccinated people.”

  • France passed a new Covid-19 law late on Sunday that makes health passes mandatory for a number of indoor venues as the country faces a fourth wave of infections. The vote came after days of heated parliamentary debates that lasted long into the night and protests against the measure in dozens of French cities.

  • China reported 76 new coronavirus cases on Monday, the highest one-day total since January. According to the National Health Commission, the number includes 40 local cases, all but one of them in the eastern province of Jiangsu. The provincial capital, Nanjing, where the cases are concentrated, has raised its virus threat level in some areas and is conducting a second round of mass testing of all nine million residents.

Dr. Anne Schuchat, who was principal deputy director of the Centers for Disease Control and Prevention, is one of the officials lawmakers want to interview.
Credit…Carlos Barria/Reuters

Eleven current or former top federal health officials were summoned by House Democrats on Monday for transcribed interviews with investigators, as part of a widening inquiry into the Trump administration’s political interference with the nation’s pandemic response.

Democratic members of the House Select Subcommittee on the Coronavirus Crisis sent letters seeking voluntary appearances from the officials, including two career scientists who recently left the Centers for Disease Control and Prevention: Dr. Nancy Messonnier, who was muzzled after she warned in February 2020 that the coronavirus pandemic would create serious disruption in Americans’ lives, and Dr. Anne Schuchat, who spent six years as the agency’s No. 2 official.

“Evidence previously uncovered by the Select Subcommittee and other sources shows that Trump Administration officials sought to suppress accurate scientific information and attempted to retaliate against officials, such as yourself, who provided truthful information to the public,” the Democrats wrote to Dr. Messonnier, who recently took a new position at the Skoll Foundation, a philanthropy in California.

The letters are a sign that, despite President Biden’s forward-looking approach, the Democrats on the panel are intent on looking back. The panel was appointed last year by Speaker Nancy Pelosi to investigate all aspects of the federal response.

Republicans on the subcommittee have accused Democrats of ignoring matters like the “lab leak theory,” a hotly disputed assertion that the pandemic stemmed from a virology laboratory in Wuhan, China, the city where the first Covid-19 cases were reported.

The Trump administration’s efforts to browbeat C.D.C. scientists, including Drs. Messonnier and Schuchat, have been reported extensively by The New York Times and other news outlets. On Monday, Democrats on the House panel released a new piece of evidence: an email from Dr. Paul Alexander, a part-time assistant professor of health research methods, who had a brief and controversial tenure as an official in the Department of Health and Human Services.

In the email, Dr. Alexander demanded that Michael Caputo, the department’s spokesman under Mr. Trump, put an “immediate stop” to publication of the C.D.C.’s weekly scientific reports until Dr. Alexander had approved them.

Credit…Albert Tercero

David Gross, an executive at a New York-based advertising agency, convened the troops over Zoom this month to deliver a message he and his fellow partners were eager to share: It was time to think about coming back to the office.

Mr. Gross, 40, wasn’t sure how employees, many in their 20s and early 30s, would take it. The initial response — dead silence — wasn’t encouraging. Then one young man signaled he had a question. “Is the policy mandatory?” he wanted to know.

Yes, it is mandatory, for three days a week, he was told.

Thus began a tricky conversation at Anchor Worldwide, Mr. Gross’s firm, that is being replicated this summer at businesses big and small across the country. While workers of all ages have become accustomed to dialing in and skipping the wearying commute, younger ones have grown especially attached to the new way of doing business.

And in many cases, the decision to return pits older managers who view working in the office as the natural order of things against younger employees who’ve come to see operating remotely as completely normal in the 16 months since the pandemic hit. Some new hires have never gone into their employers’ workplace at all.

A nightclub in London in the early hours of July 19, when England’s relaxed Covid restrictions went into effect.
Credit…Alberto Pezzali/Associated Press

LONDON — Even with the rain, lines at some night spots in England snaked around street corners. Patrons cheered and gyrated on dance floors on the first weekend that they were allowed into nightclubs after the easing of virtually all lockdown rules. The euphoria was evident, with many saying that it was the first true night of dancing, release and socializing they had experienced in over a year.

But starting in September, nightclubs and other crowded events will become more exclusive, with government officials, worried about transmission, saying that proof of vaccination will become a condition of entry.

Nadhim Zahawi, minister for vaccine deployment, told Parliament on Thursday, “We plan to make full vaccination a condition of entry to those high-risk settings where large crowds gather and interact.”

“Proof of a negative test will no longer be sufficient,” he added.

Prime Minister Boris Johnson said last week that vaccinations would most likely increasingly be needed for access to “some of life’s most important pleasures and opportunities,” including nightclubs.

The comments caused trepidation in an industry that has been battered by more than a year of forced shutdowns and delayed reopenings.

With 35 percent of people ages 18 to 30 having not yet received a single dose of a vaccine, Mr. Johnson said that entry requirements would encourage people to seek shots to “get back the freedom, the love.”

The sudden update was at odds with an earlier message from officials that proof of vaccination or negative tests would not be mandated, though they would be encouraged. Venue owners called the change another blow to the nightclub sector. Workers in the industry have in recent months protested the government’s decision to delay the reopening of nightclubs and other late-night venues while allowing sporting events to go ahead.

But in the prelude to the lifting of most restrictions on July 19, health experts had cautioned against the government’s decision to reopen almost all of the economy in England.

In a statement, Michael Kill, chief executive of the Night Time Industries Association, called the idea of requiring vaccinations as a condition of entry “another chaotic U-turn.” Most nightclubs did not want to implement passes showing proof of vaccination, he said, because it would be difficult to enforce and would put them at a disadvantage to pubs and bars, where passes are not required.

Hans-Christian Hess, director of the Egg London venue, which reopened as soon as it was allowed, said, “Nightclubs seem to be the dirty word.” He noted that clubs took as many precautions as sporting events like Wimbledon, which were allowed to go ahead. “We deserve our freedom just as much as anyone else,” he said.

Even without legal obligations, some venues have installed their own conditions of entry, such as evidence of a negative lateral flow test taken the same day.

In the case of Egg London, “We’re advising people to take lateral flow tests and advising people to stay home if they don’t feel too well,” Mr. Hess said. “All the staff are wearing masks.”

Mr. Hess said that the authorities had not yet offered clarity on how vaccine passes would be implemented, and he added that he would have preferred a system in which patrons could show certification of a negative test or full vaccination for entry.

“After 18 months of not doing any business, you can imagine how hard it is,” he said. “It’s been an amazing few days just to see the people and see all the youngsters enjoying themselves.”

Some other countries have been introducing passes as a condition of entry to social events. France, for example, has said that passes showing proof of vaccination, a recent negative test or proof of recovery from Covid would be required to enter potentially crowded venues such as museums and cinemas. But the moves have prompted backlash. Tens of thousands in France protested against the introduction of the new “health passes” this month, and in May, hundreds showed up at a similar demonstration in London.

About half of the British population is now fully vaccinated, but that rate is lower among younger age groups, many of whom only became eligible to book their first shots in June.

Representative Clay Higgins at the Capitol in Washington in May.
Credit…J. Scott Applewhite/Associated Press

Representative Clay Higgins, Republican of Louisiana and an outspoken coronavirus skeptic who has drafted legislation to make vaccine mandates a federal crime, announced this weekend that he, his wife and his son have Covid-19.

The announcement on Facebook, which did not provide details on symptoms, raised many questions. Mr. Higgins said he and his wife had previously been infected with the coronavirus in January 2020, at the dawn of the pandemic, when testing was not widely available. He did not say whether he had gotten an antibody test to confirm a previous infection, nor has he said whether he has been vaccinated against the coronavirus.

“This episode is far more challenging,” he wrote. “It has required all of my devoted energy.”

Mr. Higgins also asserted, without proof, that the Chinese Communist Party created the novel coronavirus as a biological warfare agent, calling it “weaponized.”

Republicans have increasingly stated, with no evidence, that the coronavirus is human-made and leaked from a laboratory in Wuhan, China — some say intentionally. Although President Biden has ordered an intelligence assessment of the theory, most scientists continue to believe that the virus emerged naturally from animals. A senior virologist at the Wuhan Institute of Virology has strenuously denied the virus was created or leaked from her lab.

Mr. Higgins boasted in May about his opposition to federal mandates to fight the pandemic.

“I do not support mandatory vaccines, mask mandates or any form of required vaccine passport,” he wrote on Facebook. “In fact, I am introducing legislation making mandated or forced compliance with medical procedures a federal crime.”

In May 2020, he questioned the use of face masks, despite widespread agreement among experts that their use was important in limiting the spread of the coronavirus.

Some public health experts think that a vaccine mandate could help nudge a greater share of the country toward receiving the inoculation. About 49 percent of people in the United States have been fully vaccinated, according to federal data.

It is unclear how many Republicans in Congress have been vaccinated. The No. 2 House Republican, Steve Scalise of Louisiana, received his first vaccine dose two Sundays ago — a remarkably late date, given that vaccines have been widely available on Capitol Hill for months and that one House Republican and one House Republican-elect have died of Covid-19.

Mr. Scalise had initially said he did not need the vaccine because he had previously been infected, an assertion also made by Senators Rand Paul, Republican of Kentucky, and Ron Johnson, Republican of Wisconsin. The Centers for Disease Control and Prevention recommends that anyone age 12 or older — regardless of whether they have had the virus — get a vaccination.

A bus ferrying workers and family members from Tijuana to the U.S.-Mexico border to receive a Covid vaccine this summer.
Credit…Meghan Dhaliwal for The New York Times

TIJUANA — On a recent morning, hundreds of Mexican workers from the factories here, known as maquiladoras, were waved across the border into San Diego, without visas or passports, and rolled up their sleeves to be vaccinated against Covid-19. An hour later, they were back on production lines in Tijuana.

The goal was to protect not just the workers, but also the intertwined U.S. and Mexican economies.

“If the maquiladoras can’t operate, then we don’t get our Coca-Cola,” said Lydia Ikeda, the senior director of Covid operations at the University California San Diego Health, which is helping run the program. “We cannot be isolated.”

The cross-border vaccination effort is meant to remedy the kind of disparity in access to the vaccine that economists have warned could keep a robust global economic rebound out of reach.

The Biden administration has pledged to send 80 million doses to other nations, including four million for Mexico, and to distribute 500 million doses of Pfizer-BioNTech’s vaccine among 100 countries over the next year.

Along the U.S.-Mexico border, however, a pandemic border closure and a dearth of vaccines in Mexico have threatened to keep local economic recovery at bay. And officials from both nations have found a way to share surplus vaccines from Texas and California with Mexicans on the other side.

“We are divided by a virtual line,” Dr. Ikeda said, gesturing to the border. “To get them vaccinated is the only way for us to get out of the pandemic.”

The idea of vaccinating workers just across the border occurred to Carlos González Gutiérrez, Mexico’s consul general in San Diego, when he watched as college students and undocumented workers plucking berries in California’s fields received the vaccines with relative ease while Mexico struggled to provide them for its older people.

Mr. González reached out to San Diego County officials, who had seen the closure of the border in March 2020 damage the region’s once-thriving economy, with a proposal: Why not give excess vaccines nearing expiration to the thousands of Mexican factory workers just across the border?

Soon, Mexican and U.S. officials agreed that San Diego’s excess vaccines, all Johnson & Johnson, would be sold to American companies with factories in Mexico. By May, San Diego County had received permission from the federal government — which owns the vaccines — to sell the shots, and worked with the Department of Homeland Security to allow Mexicans without visas to cross the border to receive them.

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