November 30, 2021

Kentucky governor says the state’s Covid surge is ‘dire.’ – The New York Times

Daily Covid Briefing

Sept. 5, 2021Updated 

Sept. 5, 2021, 8:01 p.m. ET

Sept. 5, 2021, 8:01 p.m. ET

Gov. Andy Beshear speaking to reporters about the pandemic, in Frankfort, Ky., last month.
Credit…Ryan C. Hermens/Lexington Herald-Leader

Kentucky’s Democratic governor on Sunday described the state’s surge of Covid cases as “dire,” and pointed out that Republican state lawmakers had limited his options to control the record wave of infections there.

“If I had the ability to do it right now, we would have a masking order when you are in public and indoors,” said Gov. Andy Beshear, on NBC’s “Meet the Press” news program. “We know that’s a proven way to slow the spread of the virus and ultimately help our health care capacity.”

Kentucky recorded a seven-day average of 4,423 new daily cases on Saturday, according to a New York Times database. Deaths and hospitalizations have been rising, too. “Our situation is dire,” Mr. Beshear said.

The state Supreme Court recently ruled that a lower court could not block lawmakers’ attempts to curb Mr. Beshear’s emergency powers for dealing with Covid. He had attempted to impose a sweeping mask mandate in schools.

Mr. Beshear has called a special session of the state legislature to begin on Tuesday to address the crisis.

The National Guard, FEMA and nursing students have been dispatched across the state to help hospitals, Mr. Beshear said.

“When you’re at war, you don’t get to cry about what you can or can’t do,” he said. “You have got to do your very best every day because this is a battle of life versus death.”

In the state, 68 percent of those over 12 have received at least one dose of a Covid vaccine, and 58 percent are fully inoculated, according to a Times database. That puts Kentucky in the middle ground compared to other states’ vaccination rates.

“We are well past, I think all across America, the populations that are going to listen to a government official and take the vaccine because of it,” Mr. Beshear said. “We’re probably past even the point where a local official, a pastor or others.”

He attributed some of the state’s vaccine hesitancy to misinformation, and asked individuals to speak to their loved ones, on top of public information campaigns.

“People are going to have to break that Thanksgiving dinner rule,” he said. “They’re going to have to call or go see that person they love and care about that is unvaccinated. They’re going to have to put their relationship with that person on the line because they’ve never been at greater risk.”

“I think it’s that type of caring, and the person who is willing to do that and to make that sacrifice that will finally get through to those that are not vaccinated.”

He added, “You might lose a friend because of that conversation, but that friend might lose their life if they don’t get vaccinated.”

The Biden administration had planned to start offering boosters later this month. 
Credit…Oliver Contreras for The New York Times

The Biden administration will only offer Covid-19 booster shots once federal health regulators offer their support, the White House chief of staff said on Sunday, reiterating a pledge from administration officials.

“I want to be absolutely clear,” Ron Klain, the chief of staff, said on CNN’s “State of the Union” news program. “No one’s going to get boosters until the F.D.A. says they’re approved, until the C.D.C. advisory committee makes a recommendation.”

The pledge followed a report on Friday by The New York Times that top federal health officials had told the White House to scale back the planned booster campaign, arguing that regulators needed more time to collect and review all the necessary data.

In August, the Biden administration announced a plan to start offering boosters the week of Sept. 20 to adults who had received their second shot of the Pfizer-BioNTech or Moderna vaccine at least eight months earlier. In making the announcement, the administration said the plan was contingent on approvals from the Food and Drug Administration and recommendations from a Centers for Disease Control and Prevention advisory committee.

Some health experts have argued that before starting a booster program, the administration should push first to reach more unvaccinated Americans who have been stricken hardest by the highly contagious Delta variant in both hospitalizations and deaths.

Regulators are just beginning to review critical data that will help them determine how to proceed on the issue of boosters. Pfizer finished its booster application to the F.D.A. less than two weeks ago, and Moderna said on Friday that it had just completed its own.

Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said on the CBS news program “Face the Nation” on Sunday that it was possible that only the Pfizer-BioNTech booster would be approved by Sept. 20. But he said that any delay in approving the Moderna booster would be only a few weeks at most.

The F.D.A. has already approved a third dose of the Pfizer and Moderna vaccines for people who are immuno-compromised.

Brazilian health officials argue with Lionel Scaloni, the head coach of Argentina, center, as play is halted during the Brazil-Argentina match.
Credit…Alexandre Schneider/Getty Images

A World Cup qualification game between Brazil and Argentina, South America’s most successful soccer teams, was halted after only a few minutes on Sunday after Brazilian health authorities walked onto the field in an apparent dispute about coronavirus quarantine regulations.

In chaotic scenes in São Paulo, Brazilian public health officials entered the field minutes into the highly anticipated showdown and ordered Argentina’s players off the field as officials from both sides, a small crowd allowed inside the stadium and a global television audience struggled to comprehend what was taking place.

At issue was the status of four members of Argentina’s roster, including three starters who play club soccer in England’s Premier League. According to local regulations, foreign travelers who had spent time in Britain in the previous 14 days are required to quarantine upon arrival in Brazil.

Argentina arrived with four England-based players and started three on Sunday. All of the players had first traveled to Venezuela, where Argentina played a qualification game last week, before arriving in Brazil three days ago.

In images beamed live around the world, health officials and some of the Argentina players were involved in a brief altercation before the visiting team returned to its locker room. The on-field discussions involved officials from both teams and stars like Lionel Messi and Neymar.

The match’s referee eventually suspended the game. Once Argentina retreated to its locker room, Brazil’s players waited on the field before beginning a training session using half of the field to entertain the stunned crowd. Meanwhile, a police motorcade prepared to take Argentina’s players away from the stadium.

The events threaten to further damage relations between FIFA, soccer’s governing body and the organization responsible for the World Cup, and Europe’s top clubs and leagues, which have been embroiled in a dispute over the release of players for the qualification games.

Movie ticket sales have struggled this year amid the pandemic.
Credit…Leah Nash for The New York Times

Labor Day Weekend is typically a moment for Hollywood to take a breath and assess. After the big-budget escapism of summer and before the Oscar hopefuls of fall, what signals are moviegoers sending?

This year, in part because of the coronavirus, the only takeaway is that there are no takeaways.

The box office remains sunken and scattershot, with once-reliable audience patterns upended by the pandemic and, for many films, ticket sales cannibalized by instant availability on streaming services. North American movie theaters have sold about $2.2 billion in tickets so far this year, compared with $7.8 billion for the same period in 2019, according to Comscore, which collects ticketing data. (Many theaters were closed for most of 2020.)

This weekend presented a test of Americans’ willingness to go to the movies.

On Friday, Disney-Marvel released “Shang-Chi and the Legend of the Ten Rings” exclusively in theaters. Disney’s chief executive had called the old-fashioned release an “experiment.” Would the coronavirus keep people at home?

In surveys in late August of American moviegoers by the National Research Group, a film industry consultant, about 67 percent of respondents said they felt comfortable (“very or somewhat”) sitting in a theater.

And audiences flocked to “Shang-Chi,” which was on pace to collect $83.5 million from 4,300 theaters in the United States and Canada from Friday through Monday, according to Comscore.

A return to prepandemic times? Maybe. Or maybe Marvel, Hollywood’s most reliable hitmaker for 20 years, is an anomaly.

In truth, nobody in Hollywood has any idea. Citing continued uncertainty about the virus, especially overseas, Paramount Pictures on Wednesday bumped “Top Gun: Maverick” from November to May.

Students move back into the dorm for fall semester in August 2020 at the University of Michigan campus.
Credit…Emily Elconin/Reuters

Opening a window could reduce the amount of coronavirus in a room by half, according to a new observational study of infected college students in an isolation dormitory at the University of Oregon.

The study, which was posted online, is small and has not yet been published in a scientific journal. But it provides real-world evidence for several important principles, demonstrating that the virus spreads from infected people into the air in a room; that the more virus they’re carrying, the more virus builds up indoors; and that both natural and mechanical ventilation appear to reduce this environmental viral load.

“Ventilation is one of the most important mitigation strategies that we have at our disposal,” said Kevin Van Den Wymelenberg, who led the research and directs the Institute for Health in the Built Environment.

The researchers studied 35 University of Oregon students who tested positive for the coronavirus between January and May. All students subsequently moved into single rooms in a Covid isolation dormitory for a 10-day isolation period.

The scientists placed Petri dishes in each room and used an active air sampler to trap aerosols floating around the air. Several times a day, they also swabbed various surfaces in the room, as well as students’ noses and mouths.

Then they used P.C.R., or polymerase chain reaction, testing to determine whether the virus was present in each sample and, if so, at what levels.

The data confirmed that there was a clear link between the amount of virus that students were carrying and the environmental viral load. As the amount of virus in students’ noses and mouths decreased over their isolation period, so did the amount of airborne virus.

“There was a significant correlation between the nasal samples and the air samples in the room,” Dr. Van Den Wymelenberg said.

The viral loads in the rooms were higher, on average, when the students were symptomatic than when they were symptom-free, although the scientists stressed that even asymptomatic students emitted plenty of virus. Several self-reported symptoms, including coughing, were specifically associated with higher environmental viral loads.

The researchers also calculated the mechanical ventilation rate for each room, and asked students to report how often the windows were open. They found that viral loads were about twice as high, on average, in rooms that had the window closed more than half the time.

“Ventilation is really important, and I think we’re just starting to realize how important it is,” said Leslie Dietz, a study co-author and researcher at the University of Oregon.

The study had several limitations, including the fact that it included only young adults and that symptoms and window data were self-reported. The researchers also noted that they did not measure how much of the virus present in the room was viable, or capable of infecting other people.

Most of Guam’s luxury boutiques have been closed for months.
Credit…Anthony Henri Oftana for The New York Times

Just as tourists were starting to return to Guam, the island has reported a record number of new Covid cases, a surge that is filling up hospital beds and dashing hopes of an economic recovery despite a successful vaccination campaign.

The average number of daily new cases has more than doubled to 165 in the past two weeks, according to a New York Times database. The tourism-dependent U.S. territory in the Western Pacific has vaccinated 70 percent of its total population with at least one shot.

Guam’s pandemic response was lauded by some as a success story, as the government contained the virus with mask mandates, quarantines for travelers, temporary closures of nonessential businesses and daily vaccination drives organized by the Guam National Guard. But in July, after reaching its vaccination goals, the government began to relax its travel restrictions and lift social distancing measures.

With case numbers rising, the Centers for Disease Control and Prevention last week issued its highest-level warning about traveling to Guam. The local government began requiring workers and people 12 and older to show a vaccination card to enter restaurants, gyms, movie theaters, sports stadiums and other facilities.

The Guam Tourism Bureau has also suspended its Air V&V program, a vaccination-vacation deal that offered all visitors a vaccine for $100 or less per dose. Chartered flights from Taiwan brought hundreds of vaccine tourists to the island.

“We’ve just been watching the numbers go up and up, and I don’t think we’re going to get any more tourists with this,” said Bob Odell, the owner of a local water sports shop called Guam Ocean Adventures. “It’s really starting to take a toll economically.”

Cases began to rapidly rise in mid-to-late July. Public schools opened classrooms for the new year in mid-August, but they reverted to online learning this past week amid the surge.

Aaron TuQuero, a worker at the ExpressCare Clinic in the Micronesia Mall, said that his team tested about 30 to 50 people per day and had seen a “great number of positive patients.”

“We’re at a high risk of contracting the virus from other countries, and more tourists have been coming in,” he said. “There have not been a lot of live gatherings on the island itself, as far as I can tell.”

Even before the pandemic, Guam had a chronic shortage of nurses and doctors, with only two hospitals serving the entire population, in addition to a U.S. naval hospital that grants limited access. On Friday, the government said that 47 people were hospitalized for Covid and that four were in intensive care units.

“For a small island, that’s a lot,” Mr. Odell said. “You have to stay concerned about this. We can’t let our guard down.”

The Oculus, a $4 billion transportation hub designed by Santiago Calatrava, was meant to redefine an area destroyed by the Sept. 11 attacks. But the pandemic drained much of the vitality from Lower Manhattan.
Credit…Gabriela Bhaskar/The New York Times

The triumphant comeback of Lower Manhattan after the Sept. 11 attacks became a rallying cry for New York City. But offices have emptied out, tourists are gone and hundreds of businesses have closed.

Over the past 18 months, more than 350 retailers in the area have shut down. New malls built after 2001 have had few shoppers and landlords have sued retailers for not paying rent. Seven hotels have closed permanently, and others have yet to reopen.

Private-sector jobs have shrunk to 221,000, a smaller work force than in the months before 2001. Through the first seven months of 2021, daily ridership in the busiest subway stations in downtown reached just 6.3 million passengers, an 82 percent decrease from the same period in 2019, according to an analysis by The New York Times of subway ridership data.

“When the terror attacks happened, it was just a matter of how long it would take to rebuild,” said Mike Jording, the former general manager of the Amish Market, which shuttered after the attacks, reopened, boomed and then permanently closed last year. “This is a different enemy — it’s more prolonged and worse. It’s a slow death.”

The gloom that has pervaded the downtown area for much of the past year — intensified by the rise of the Delta variant, which has hobbled the city’s recovery — evokes the days when the ruins of the towers still smoldered and some people predicted that Lower Manhattan would never recover.

Over the next two decades, Lower Manhattan was not only restored but reinvented, with at least $20 billion in public and private investments helping to transform it into a flourishing neighborhood. The recovery became an emblem of the city’s resilience.

But the pandemic has drained a lot of life out of Lower Manhattan.

A crowd waits near an entrance to the international airport in Kabul in August.
Credit…Jim Huylebroek for The New York Times

As tens of thousands of people descended on the airport in Kabul, Afghanistan, in August to try to escape amid the Taliban takeover and the impending withdrawal by the United States, the coronavirus was hardly their only — or main — worry.

A look at the chaotic evacuation process and the conditions at a few military bases appears to only add to earlier concerns by the World Health Organization that the situation was impeding efforts to address the pandemic and other dire health crises.

As the exodus inundated American military bases in places like Qatar, two — Al Udeid Air Base and Camp As Sayliyah — did not test Afghan evacuees for the virus, according to reports from senior diplomats and military officers in Doha.

In late August, the White House press secretary, Jen Psaki, said that all evacuees would be tested and offered vaccines upon arrival in the United States. At Dulles International Airport in the Washington, D.C., area, health officials scrambled to set up space to process and test evacuees for the virus as well as to quarantine for 14 days those who tested positive. There have been some reports of virus cases among arrivals. A high-profile case among those who have recently left Afghanistan underscored the ongoing health risks: Ross Wilson, the chargé d’affaires of the U.S. Embassy and the last U.S. diplomat to leave Kabul, tested positive for the virus.

Clinicians suiting up at a free Covid-19 testing site in Oakland, Calif. Fewer Covid-related medical services will be free in the future.
Credit…Jim Wilson/The New York Times

Americans will most likely pay significantly more for Covid medical care during this new wave of cases — whether that’s a routine test or a lengthy hospitalization.

Earlier in the pandemic, most major health insurers voluntarily waived costs associated with Covid treatment. Patients weren’t responsible for co-pays or deductibles for emergency room visits or hospital stays, and most tests were free, too. But now, insurers are treating Covid more like other conditions, no longer fully covering the costs of care.

The federal rules that make coronavirus testing free include exemptions for routine workplace and school testing, which has become more common. Some patients have already received bills as high as $200 for routine screenings, according to documents patients submitted to a New York Times project tracking the costs of Covid testing and treatment. If you’ve received a bill, you can submit it here.

Some of the highest bills will probably involve Covid patients who need extensive hospital care now that 72 percent of large health plans are no longer offering free Covid treatment, a recent study from the Kaiser Family Foundation found.

This includes Blue Cross Blue Shield of Florida, the largest health plan in a state experiencing one of the country’s worst outbreaks. “When the Covid-19 pandemic began last year, we implemented several emergency provisions to temporarily help our members,” Toni Woods, a spokeswoman, said in a statement. She said the plan was now focused on encouraging vaccinations.

Oscar Health, which sells coverage in Florida and 14 other states, also ended free Covid treatment this week. It cited the widespread availability of the vaccine as a key reason. Jackie Khan, an Oscar spokeswoman, said, “We believe that the Covid vaccine is our best way to beat this pandemic, and we are committed to covering it and testing at $0 for our members.”

The new policies generally apply to all patients, including the vaccinated, people who get sick with a breakthrough infection, and children under 12, who are not yet eligible for the vaccine.

Dr. Kao-Ping Chua, a pediatrician at the University of Michigan who researches Covid care costs, said, “If you have a small kid who gets Covid at school and ends up at the I.C.U., that family is going to now be stuck with the bill even though that patient did not have the ability to get vaccinated.”

Highly concentrated veterinary ivermectin has been flying off the shelves of U.S. supply stores, despite its dangers to humans.
Credit…Denis Farrell/Associated Press

Public health warnings against using the anti-parasite medication ivermectin as a treatment for Covid, especially in the large doses meant for livestock, appear to have made little dent in its surging popularity in parts of the United States.

Hospitals and poison control centers across the country are treating a growing number of patients taking the drug, even though every clinical trial so far has failed to show that it helps patients with Covid.

And the Centers for Disease Control and Prevention reported that almost 90,000 prescriptions for ivermectin were being written per week in mid-August, up from a prepandemic weekly average of 3,600. Veterinary supply store shelves have been emptied of it.

The C.D.C. reported that one person had an “altered mental status” after apparently taking five ivermectin pills — which he had purchased on the internet — daily for five days. Another person drank an ivermectin formula intended for cattle and was hospitalized for nine days with tremors and hallucinations.

Despite the public health warnings, Ivermectin has been promoted by celebrities like the podcasting giant Joe Rogan, who listed it this past week among the treatments he was given after contracting the virus. Alex Jones, the conspiracy theorist who has been banned from Facebook, YouTube and Twitter, took out a box of ivermectin pills during one of his trademark rants and popped two tablets live on the show he streams.

Ivermectin was introduced as a veterinary drug in the late 1970s, and it was later approved for use in humans infected with parasites. Since 1987, its U.S. maker, Merck & Co., has donated billions of doses that have spared hundreds of millions of people from river blindness in Africa and other parasitic diseases. Two scientists shared a Nobel Prize in 2015 for their work in developing the drug. But in the United States, it has limited human applications, like treating lice and rosacea, and has been primarily used to deworm horses, cows and pets — until now.

On Twitter last month, the Food and Drug Administration warned that the drug was not approved for use against Covid and that taking large doses could cause serious harm. “You are not a horse,” its tweet read. “You are not a cow. Seriously, y’all. Stop it.”

In a statement on Wednesday, alarmed health experts from the American Medical Association, the American Pharmacists Association and the American Society of Health-System Pharmacists called for “an immediate end to the prescribing, dispensing and use of ivermectin for the prevention and treatment of Covid-19 outside of a clinical trial.”

Though it has not been shown to be effective in treating Covid-19, people are still clamoring to get the drug, trading tips in Facebook groups and on Reddit. Some physicians have compared the phenomenon with last year’s surge of interest in hydroxychloroquine, though ivermectin has undergone more clinical trials.

One of the largest trials, called the Together Trial, was halted last month because the drug had been shown to be no better than a placebo at preventing hospitalization for Covid. In July, a research paper indicating that the medicine reduced Covid deaths was withdrawn after questions arose about plagiarism and data manipulation.

Correction: Sept. 5, 2021

An earlier version of this article cited an Oklahoma doctor’s report that patients being treated for complications of ivermectin use were crowding emergency rooms. A hospital that once employed the doctor has issued a statement denying that it had treated any patients for complications related to ivermectin and saying the doctor had not worked there for two months. The doctor’s claim, which was widely reported, has been removed from the article. 

A July protest in Bangkok demanding the resignation of Thailand’s prime minister, Prayuth Chan-ocha.
Credit…Adam Dean for The New York Times

BANGKOK — In air heavy with monsoonal pressure and discontent, the riot police in Bangkok unleashed rubber bullets and tear gas. Tanat Thanakitamnuay, the scion of a real estate family, stood on a truck, where he had been excoriating Thailand’s leaders for their bungled response to the pandemic.

Then a hard object, perhaps a tear gas canister, struck his right eye, tearing his retina. Mr. Tanat, who once supported the 2014 coup that brought Prayuth Chan-ocha, now the prime minister, to power, says the injury on Aug. 13 cost him his vision in the eye. “I might be blinded but now I’m stronger than ever, I see things clearer than ever,” he said. “People knew a long time ago how incompetent this government is. Covid is just more evidence and proof.”

Thailand, which not long ago was seen as a virus-containing wonder, has become yet another example of how authoritarian hubris and a lack of government accountability have fueled the pandemic. This year, more than 12,000 people in Thailand have died of Covid-19, compared with fewer than 100 last year. The economy has been ravaged, with tourism all but nonexistent and manufacturing slowed.

Anger is spreading, and not only in the streets. Opposition lawmakers in Parliament tried to pass a vote of no confidence in Mr. Prayuth, accusing his government of squandering the monthslong head start Thailand had to fight the coronavirus. That effort failed on Saturday, even though some members of the prime minister’s coalition had briefly fanned speculation that they might support his ouster.