Most U.S. Health Workers Comply With Vaccine Mandates

ImageEmployees at a biomedical center in São Paulo, Brazil, where a Chinese vaccine is one of several produced.
Credit…Alexandre Schneider/Getty Images

The Pan American Health Organization has struck a deal with the Chinese manufacturer Sinovac to buy millions of Covid-19 vaccines for countries in Latin America and the Caribbean as part of an effort to make more shots available in a region where access has been highly unequal.

The agency, part of the World Health Organization, is negotiating with two other manufacturers and expecting to announce new deals soon, Dr. Jarbas Barbosa, its assistant director, said at a news conference on Wednesday.

Sinovac has offered to sell 8.5 million doses this year and an additional 80 million next year, he said. Countries in the region that want the vaccine will have to buy it from the health organization.

“This is a purchase — it isn’t a donation,” Dr. Barbosa said, noting that the Inter-American Development Bank was offering loans to countries that needed them.

The direct purchases begin at a time when, on average, only 35 percent of people in Latin America and the Caribbean have been fully vaccinated against Covid-19, said Dr. Carissa F. Etienne, the agency’s director.

And that coverage has been unequal. While some countries, including Chile and Uruguay, have fully vaccinated over 70 percent of their populations, she said, others have yet to reach the 20 percent mark. Countries on the lower end of inoculation rates include the Bahamas, Grenada, Guatemala, Haiti, Honduras, Jamaica, Nicaragua, St. Lucia, St. Vincent and the Grenadines, and Venezuela. Haiti is a particularly dire case, she said, with less than 1 percent of the population fully vaccinated.

The health organization, which is also working to expand vaccine manufacturing in the region, announced last week that a site in Brazil and another in Argentina would receive technical support to begin production of messenger RNA vaccines, the type used in the Pfizer-BioNTech and Moderna shots.

But for the time being, Dr. Etienne said, “vaccine donations remain the fastest way to support countries in our region.”

Credit…Michael A. McCoy for The New York Times

A small band of longtime AIDS activists, fed up with what they regard as President Biden’s failure to scale up coronavirus vaccine manufacturing for global use, deposited a fake mountain of bones outside the home of Ron Klain, his chief of staff, on Wednesday to represent the lives that they say have been lost to the president’s inaction.

The activists, some of them veterans of much larger protests that played out at the National Institutes of Health more than 30 years ago, had already made similar demands in private phone calls with administration officials, including Dr. Anthony S. Fauci, a target of early AIDS protests who later became the activists’ ally.

But the calls got them nowhere, they said. So they decided to try more old-fashioned, in-your-face tactics.

The mountain of bones, they said, was made by a set designer in New York. They planted it in front of Mr. Klain’s next-door neighbor’s driveway to avoid running afoul of the Secret Service agents guarding Mr. Klain’s house. The agents eventually asked them politely to leave.

“Nobody wants to be here in front of Ron Klain’s house, protesting a president that most of us all voted for,” said Gregg Gonsalves, a Yale University epidemiologist whose activism on behalf of people with AIDS led to a career in academia and a 2018 MacArthur “genius” grant. “But we’ve tried everything else.”

He defended the decision to show up at the private home of an unelected administration official.

“What is it — four million deaths, six million deaths, 10 million deaths — where we can show up on somebody’s lawn and hold them accountable?” Dr. Gonsalves said. More than 4.7 million people are known to have died worldwide from Covid-19, and analyses of excess mortalities around the world suggests that the actual number is far higher.

“They represent the public,” Dr. Gonsalves said of public servants. “We pay their salaries. They’re not listening to the American public, they’re not listening to the global public, they’re not listening to scientific advice. So this is the least we can do.”

A White House spokesman said in a statement that the administration had taken “decisive and urgent action to save lives,” including by buying more than one billion vaccine doses to donate overseas and working with manufacturers in India and South Africa to increase vaccine production.

“These are shots that are going into arms now and in the immediate months to come,” said the spokesman, Kevin Munoz. “We’re pushing the world to step and do more immediately as well.”

The protest at the Klain home in the Washington suburbs was one of two “vaccine equity demonstrations” on Wednesday by AIDS advocacy groups, including Prep4All and Right 2 Health Action. The other was at the Boston home of Stephane Bancel, the chief executive officer of Moderna, whose Covid-19 vaccine was developed with backing from American taxpayers.

With less than 10 percent of people in many poor nations fully vaccinated and a dearth of doses contributing to the suffering of millions, pressure has been growing on both Mr. Biden and drug makers to provide more low-cost vaccines to the world.

Mr. Biden says the United States is doing more than any other nation to address the pandemic. Last week, at a virtual Covid-19 summit that he convened on the sidelines of the United Nations General Assembly, he said that his administration had bought an additional 500 million doses of Pfizer-BioNTech vaccine to donate overseas, bringing the total to about 1.1 billion.




C.D.C. Urges Vaccinations for Pregnant or Breastfeeding Americans

Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said data showed that vaccines were safe and effective for any American who is pregnant, planning to become pregnant or currently breastfeeding.

We now have data that demonstrates that the vaccines, in whatever time in pregnancy or lactating that they’re given, are actually safe and effective and have no adverse events to mom or to baby. And we’ve actually seen that, in fact, some antibody from the vaccine traverses to the baby and, in fact, could potentially protect the baby. I think what’s really important here to emphasize is we know that about 30 percent of women who are pregnant right now are vaccinated, an extraordinarily low number, and about 15 percent of African-American women who are pregnant are vaccinated, and this puts them at severe risk of severe disease from Covid-19. In August this year, we lost 21 pregnant women to Covid-19, so we absolutely have the data that demonstrates the overwhelming benefit of vaccine and really very little safety concerns at all.

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Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said data showed that vaccines were safe and effective for any American who is pregnant, planning to become pregnant or currently breastfeeding.CreditCredit…Hannah Beier/Reuters

In an urgent plea, federal health officials are asking that any American who is pregnant, planning to become pregnant or currently breastfeeding get vaccinated against the coronavirus as soon as possible.

Covid-19 poses a severe risk during pregnancy, when a person’s immune system is tamped down, and raises the risk of stillbirth or another poor outcome, according to the Centers for Disease Control and Prevention. Twenty-two pregnant people in the United States died of Covid in August, the highest number in a single month since the pandemic started.

About 125,000 pregnant people have tested positive for the virus; 22,000 have been hospitalized, and 161 have died. Hospital data indicates that 97 percent of those who were infected with the virus when they were hospitalized — for illness, or for labor and delivery — were not vaccinated.

Vaccination rates among pregnant people are lower than among the general population. Fewer than one-third were vaccinated before or during their pregnancy, the agency said.

The rates vary widely by race and ethnicity, with the highest — nearly 50 percent — among pregnant Asian American people, and the lowest rates among pregnant Black people, at 15 percent.

Pregnancy is on the C.D.C.’s list of health conditions that increase the risk of severe Covid. Though the absolute risk of severe disease is low, pregnant patients who are symptomatic are more than twice as likely as other symptomatic patients to require admission to intensive care or interventions like mechanical ventilation, and may be more likely to die.

Some data also suggest that pregnant people with Covid-19 are more likely to experience conditions that complicate pregnancy — such as a kind of high blood pressure called pre-eclampsia — compared with pregnant people who don’t have Covid. Pregnant people with the disease are also at increased risk for poor birth outcomes, like preterm birth.

Clinical trials have a long history of excluding pregnant people from participation, and pregnant people were not included in the coronavirus vaccine trials. As a result, data on the safety and effectiveness of vaccines is limited in this group.

Studies conducted since the vaccines were authorized, however, have shown that the vaccines do not increase the risk of a miscarriage. Both the Pfizer-BioNTech and Moderna vaccines produced robust immune responses in pregnant people and did not damage the placenta, researchers have found.

“Pregnancy can be both a special time and also a stressful time, and pregnancy during a pandemic is an added concern for family,” said Dr. Rochelle Walensky, the C.D.C.’s director.

She encouraged pregnant people and those who may become pregnant “to talk with their health care provider about the protective benefits of the Covid-19 vaccine to keep their babies and themselves safe.”

Credit…Desiree Rios for The New York Times

YouTube said on Wednesday that it was banning the accounts of several prominent anti-vaccine activists from its platform, including those of Joseph Mercola and Robert F. Kennedy Jr., as part of an effort to remove all content that falsely claims that approved vaccines are dangerous.

In a blog post, YouTube said it would remove videos claiming that vaccines do not reduce rates of transmission or contraction of disease, and content that includes misinformation on the makeup of the vaccines. Claims that approved vaccines cause autism, cancer or infertility, or that the vaccines contain trackers will also be removed.

The platform, which is owned by Google, has had a similar ban on misinformation about the Covid-19 vaccines. But the new policy expands the rules to misleading claims about long-approved vaccines, such as those against measles and hepatitis B, as well as to falsehoods about vaccines in general, YouTube said. Personal testimonies relating to vaccines, content about vaccine policies and new vaccine trials, and historical videos about vaccine successes or failures will be allowed to remain on the site.

“Today’s policy update is an important step to address vaccine and health misinformation on our platform, and we’ll continue to invest across the board” in policies that bring its users high-quality information, the company said in its announcement.

In addition to banning Dr. Mercola and Mr. Kennedy, YouTube removed the accounts of other prominent anti-vaccination activists such as Erin Elizabeth and Sherri Tenpenny, a company spokeswoman said.

Global Roundup

Credit…Pool photo by Vladimir Smirnov

MOSCOW — President Vladimir V. Putin of Russia emerged on Wednesday from two weeks of isolation that began after a coronavirus outbreak in his entourage, holding a three-hour meeting with his Turkish counterpart, Recep Tayyip Erdogan.

The Kremlin said the meeting, in the Black Sea resort city of Sochi, marked the Russian leader’s return to public duties after the coronavirus scare.

With both countries battling the coronavirus, the pandemic played into at least some of their talks. News accounts included a description of the two men bantering about their antibody levels, and Mr. Putin urging Mr. Erdogan to get a booster dose of Russia’s Sputnik vaccine.

Infections appear to have been rising sharply in Russia. While the country’s official numbers have been viewed with skepticism going back to the Soviet era, they do suggest trend lines — and Russia on Wednesday reported 857 new Covid-related deaths, its highest number for a single day since the pandemic began. Turkey’s reported caseload had plummeted after an enormous spike in the spring, but new daily infections are rising.

But the two countries have urgent military and other frictions. They are on opposite sides in the wars in Syria and Libya, while both Turkish and Russian troops are serving as peacekeepers in a conflict in a disputed mountainous territory, Nagorno-Karabakh. Mr. Putin and Mr. Erdogan discussed weapons deals, trade and a nuclear reactor Russia is building in Turkey.

And Mr. Erdogan made it abundantly clear that Mr. Putin could serve as an alternative partner for trade and military deals as relations between Mr. Erdogan and the Biden administration remain frayed.

Here is what’s happening in other parts of the world:

  • In India, the health officials said on Wednesday that they had recorded the lowest number of new daily coronavirus infections in about six months, one day after the country reported its lowest daily Covid death toll since mid-March. The country’s official Covid figures have drastically understated the virus’s toll, but the new figures do suggest a positive trend.

  • Spain’s health ministry said on Wednesday that fans — so long as they wore masks —would be allowed to fill soccer stadiums again, another step in gradually removing restrictions after the country’s coronavirus infection rate fell to its lowest level in over a year. Starting on Friday, stadiums will no longer have to limit the number of spectators at soccer matches and other outdoor events. For indoor stadiums hosting basketball and other competitions, the limit will be 80 percent of capacity.

  • The Delta variant has shuttered or paralyzed factories in Vietnam, which in turn has disrupted global supply chains for the retail industry. The country has become the second-biggest supplier of apparel and footwear to the United States, after China, and American retailers are anticipating delays and shortages of goods in the coming holiday season.

  • In England, hospitals are relaxing Covid restrictions, such as social distancing, as the country tries to make room for a backlog of some five million patients waiting for planned surgeries or treatment, according to the National Health Service’s website. Hundreds of thousands of the patients have been waiting for at least a year.

  • The Premier League, England’s top league, is offering its 20 clubs an unspecified “reward” for getting more of their rosters immunized, amid concerns that a significant number of players remain unvaccinated. Only seven of the 20 teams had more than half their players fully vaccinated, a figure that alarmed the league officials because the players regularly cross national borders for competitions.

  • The London police officer who pleaded guilty to murdering Sarah Everard, whose charred remains were found stuffed in green trash bags in March, used the false pretense that she had violated Covid-19 regulations in visiting a friend to get her into his car before raping and killing her, according to a prosecutor at the sentencing hearing in London on Wednesday.

Alyssa Lukpat contributed reporting.

Credit…Andrea Morales for The New York Times

Hundreds of sought-after nurses are leaving some U.S. hospitals that have established vaccine requirements for all employees, involving some protests and legal opposition. But most workers, especially at large hospital chains, appear to be complying with the policies.

New York hospitals and nursing homes are grappling with the state’s Monday deadline for workers to have received at least one coronavirus vaccine dose, with thousands of workers remaining unvaccinated and at risk of being fired. Several other states and cities have also imposed mandates for health care workers, with deadlines approaching.

All are also facing a looming federal vaccine mandate for hospital and nursing home staff that President Biden ordered, though its exact scope and timing has yet to be announced.

The departures, especially of nurses, have compounded major staffing shortages over the course of the pandemic. The situation has become acutely difficult these past few months, particularly in regions where the Delta variant has overwhelmed hospitals and caused new spikes in Covid cases among nursing home staffs and residents. In one instance, a hospital in upstate New York said it briefly had to stop delivering babies after six of its employees left rather than get vaccinated.

At Novant Health, a large hospital group based in North Carolina, 375 workers were suspended after not meeting the system’s vaccination deadline this month. Another 200 agreed to comply, increasing the vaccination rate to over 99 percent of its more than 35,000 employees, according to Novant.

Yet the loss of some employees “is going to be the cost of doing business in a pandemic,” said Dr. Saad B. Omer, the director of the Yale Institute for Global Health, who has studied vaccine mandates. “I’m not seeing any widespread disruptive effect,” he said.

Dr. David H. Priest, an infectious-disease specialist and senior executive at Novant, said he believed that the hospital would persuade most of its workers by addressing their concerns. The hospital has “been working on this for weeks on end,” he said, by holding webinars and sending emails to help educate employees about the benefits of being immunized.

How the nation’s hospitals are handling the holdouts varies widely, and many facilities are waiting for federal guidelines. Others have set deadlines later this year.

Many hospitals are not establishing sharp cutoffs for when they might eventually fire someone.

UNC Health, another North Carolina group, said that it was confirming the status of about 900 employees. About 70 employees have left as a result of the system’s mandate, and the group has granted about 1,250 exemptions for medical or religious reasons. About 97 percent of its work force have complied. Those who still need to be vaccinated or qualify for an exemption have until Nov. 2, providing what UNC described as “a last chance to remain employed.”

At Trinity Health, one of the first major hospital chains to announce a vaccine mandate, the percentage of its vaccinated staff has increased from 75 percent to 94 percent, said the group, which operates in 22 states.

SSM Health, a Catholic hospital group based in St. Louis, also adopted a mandate but said that few of its workers had left because of its requirement.

Hospitals and nursing homes have raised concerns about their ability to find workers if they impose strict requirements. The situation may be worse in rural areas, where limited numbers of workers are available. But healthy vaccinated workers may also ease staffing shortages.

At Houston Methodist, where 150 employees left from a work force of about 26,000 people, the hospital said that there had been little lasting effect on its ability to hire people. And when Texas was hit with rising numbers of Covid cases over the summer, the hospital found that fewer of its workers were out sick.

“The mandate has not only protected our employees, but kept more of them at work during the pandemic,” a hospital spokeswoman said in an email.

ChristianaCare, a hospital group based in Wilmington, Del., said on Monday that it had fired 150 employees for not complying with its vaccine mandate. But the group emphasized that over the last month it had hired more than 200 employees, many of whom are more comfortable working where they knew their colleagues were vaccinated.

Credit…Go Nakamura for The New York Times

Mary Bassett, who won acclaim for leading New York City through a series of health crises, was named on Wednesday as the state’s new health commissioner.

Dr. Bassett ran the city’s health department for four years until 2018, and joins the state after a stint as director of Harvard’s FXB Center for Health and Human Rights.

The announcement by Gov. Kathy Hochul comes less than a week after Dr. Howard A. Zucker, the current health commissioner, announced he would resign in the wake of political pressure stemming from his role leading the state’s pandemic response under former Gov. Andrew M. Cuomo. Dr. Bassett’s appointment will take effect on Dec. 1.

“Our recovery from this pandemic requires tested leadership and experience to improve health equity and access across the state, and Dr. Bassett is perfectly equipped to lead the New York State Department of Health during this critical moment,” Governor Hochul said in a statement Wednesday. “Dr. Bassett is both a highly regarded public health expert and an exemplary public servant, and I look forward to working with her to keep New Yorkers safe and healthy.”

“I am humbled and honored to return to my home state of New York to lead the Department of Health at this pivotal time,” Dr. Bassett said in a statement.

Dr. Bassett was praised for her handling of the Ebola scare in 2014, as well as for steering the city’s response to an outbreak of Legionnaire’s disease and to the threat of Zika. She was known for taking racial justice and social equity into consideration when setting the city’s health policy, developing neighborhood health centers in an effort to better serve the most vulnerable New Yorkers.

But the health department also came under scrutiny during her tenure for its handling of lead paint inspections in New York City’s public housing system.

Early in the coronavirus pandemic, she was one of the authors of an op-ed urging Mr. Cuomo, who was then governor, to release older and high-risk inmates, as well as those incarcerated for noncriminal parole violations and those nearing release, from the state’s jails and prisons.

“This is not only an issue about the health of people in prisons, but also a public health crisis that threatens to become a humanitarian disaster,” the op-ed warned.

Dr. Bassett, who grew up in Washington Heights, served as a deputy health commissioner under Mayor Michael R. Bloomberg before being appointed to the city’s top role by Mayor Bill de Blasio.

She received degrees from the University of Washington, Harvard, and Columbia University, where she has also taught. She spent seventeen years in Zimbabwe developing interventions for the treatment of AIDS and consulting for nonprofits including Unicef and the World Bank.

Credit…Chris Helgren/Reuters

United Airlines said it would terminate about 600 employees for refusing to comply with its vaccination requirement, putting the company at the forefront of the battle over vaccine mandates as the economy moves through a bumpy pandemic recovery.

The airline said that 99 percent of its U.S. work force of 67,000 had been vaccinated, a sign that mandates could be an effective way for companies to ensure their employees get shots.

More large corporations have announced vaccine requirements as the government puts increasing pressure on them to help improve the country’s inoculation rate. This month, President Biden mandated that businesses with 100 or more workers require employees to be vaccinated or face weekly testing, helping to propel new corporate vaccination policies.

Some companies are still using a mix of incentives and deterrents, but many others have made vaccination a condition of work. On Wednesday, AT&T said it was extending its vaccination requirement to tens of thousands of unionized employees.

In August, United became the first U.S. carrier and one of the first large corporations to mandate a vaccine for Covid-19.

On Wednesday, a spokeswoman confirmed that the company had begun terminating 593 U.S.-based employees who had declined to be vaccinated. She said, “We will work with folks if during that process they decide to get vaccinated.” Unvaccinated workers can request an exemption based on religious or medical reasons, the company has said.

Roughly 350 workers in customer service, storekeeper and baggage service positions have not reported proof of vaccination to the airline, said Michael Klemm, district president of the machinists union.

“We’re not in agreement with United’s position,” he said. “We plan, through a collective bargaining agreement, to grieve this process.”

A spokesman for the union representing flight attendants said about 100 of its members had not reported proof of inoculation. “We are demanding that the company give the flight attendant every benefit and make sure they’ve researched every issue for every flight attendant before they’re terminated,” said Jeff Heisey, the secretary-treasurer of the union, the United Master Executive Council.

Any company is within its legal right to require employees to be vaccinated, barring any conflicting disability or religious belief, the U.S. Equal Employment Opportunity Commission has ruled.

Credit…Emily Elconin for The New York Times

AT&T announced on Wednesday that it was extending its coronavirus vaccination requirement to tens of thousands of employees who are members of the Communications Workers of America union.

Unionized workers who enter work locations and client or customer sites, or who are temporarily working from home, must be fully vaccinated by Feb. 1 unless they qualify for an accommodation, the company said. AT&T did not provide details on the exemptions.

The company had previously required that most managers be vaccinated by Oct. 11.

AT&T held negotiations with the communications workers union over the new policy this month. A union official who was not authorized to discuss the details said the company had made a handful of concessions, including pushing back the vaccination deadline and granting employees who don’t get vaccinated before the deadline an unpaid reconsideration period. But the union official said that the two sides had later reached an impasse and that the company had imposed the policy on its own.

The company did not immediately respond to a request for comment about the bargaining.

AT&T had about 230,000 employees as of Jan. 31, according to its most recent annual report, of which about 37 percent were unionized. It operates the only major wireless carrier that is heavily unionized. A large majority of unionized employees are represented by the communications workers union.

Credit…Mike Kai Chen for The New York Times

The share of Hispanic adults in the U.S. who say they have received at least one dose of coronavirus vaccine reached 73 percent in September, an increase of 12 percentage points from July, according to a Kaiser Family Foundation survey.

The increase was the fastest of any demographic group in the survey, and it put the reported vaccination rate for Hispanic adults slightly ahead of that of white adults.

Experts say that disparities in vaccination rates and access persist in may parts of the country. But they said that the strong increases among Hispanic and Latino adults in the national poll signaled that on-the-ground vaccination efforts focused on the group were paying off.

Dr. Marcella Nunez-Smith, the chair of President Biden’s Covid-19 Health Equity Task Force, said Tuesday at a White House news conference that the survey findings “represent much more than simply time passing — they tell the story of an all-of-society effort to get us to where we are today.”

Other surveys have also found high rates of vaccine uptake among Hispanic people. The Pew Research Center found in a survey of 10,000 adults released earlier in September that 76 percent of Hispanic adults were at least partially vaccinated.

“I think there have been some very concerted efforts,” said Dr. Bertha Hidalgo, an associate professor of epidemiology at the University of Alabama at Birmingham. Hispanic people, she noted, “were one of the most highly affected groups during the earlier parts of the pandemic, when there were really high numbers of cases and also large numbers of deaths in Latinos.”

Hispanic people in the United States have been 2.3 times as likely as non-Hispanic white people to die of Covid-19, according to the Centers for Disease Control and Prevention. A federal report found that from 2019 to 2020, Hispanic Americans experienced a drop in life expectancy of three years, compared with 2.9 years for Black Americans and 1.2 years for non-Hispanic white people.

Because they were disproportionately affected by the pandemic, it is possible that many Latinos have been driven by fearful memories to get the vaccine, said Dr. Jeffrey Klausner, a professor of medicine at the University of Southern California.

Hispanic people continue to lag behind in some places, like Los Angeles County, where about 62 percent of Latinos 12 and older have received at least one dose of vaccine, compared with about 72 percent for non-Hispanic white people, according to county data. In Colorado, Hispanic people make up 22 percent of the state’s overall population but only about 12 percent of the vaccinated population.

“We are seeing that Latinos are headed in a more positive direction,” said Dr. Amelie Ramirez of the University of Texas Health Science Center at San Antonio. “But it’s not everywhere, so that’s why we need to continue this effort.”

Dr. Hidalgo said that focused measures like walk-up vaccine clinics in church parking lots, making information available in Spanish and promoting vaccination on the widely watched Univision and Telemundo television networks had helped to persuade many initially hesitant Latinos to get shots.

Overcoming hesitancy fueled by misinformation continues to be a hurdle, she said, but support of vaccination by the Catholic Church, the predominant faith among Latinos, has helped.

Locally, community health workers known as promotores de salud who work in Spanish-speaking communities have had success easing anxieties about getting vaccinated, according to Kurt Organista, a professor of social welfare at U.C. Berkeley.

“They’re the ones who really go out with a personal contact to say, ‘Hey listen, you don’t need to worry about your immigration status or ability to pay,’” Dr. Organista said.

Credit…Chris Lee/Chelsea FC, via Getty Images

Concerned that a significant number of its players remained unvaccinated, the Premier League, the top tier of English soccer, is offering its 20 clubs an unspecified “reward” for getting more of their rosters immunized.

Only seven of the league’s teams have full vaccination rates of over 50 percent among their players, according to a letter sent last week that outlined the proposal. That figure has alarmed officials of a league that features players from all over the world who regularly cross national borders for competitions.

“It is increasingly clear that full vaccination will be the key criteria for government and health authorities, in terms of international travel and potential Covid certification at large-scale events,” the letter said.

The efforts of the Premier League, the world’s most popular domestic soccer league, to push for greater vaccine uptake mirror the challenges faced by other sports leagues, including the N.B.A. The N.B.A. players’ union has strongly opposed mandatory vaccinations, and unvaccinated players must submit to daily Covid testing.

The Premier League’s letter did not outline what type of reward teams with high vaccination rates could expect. Officials briefed on the matter said the rewards were likely to be a loosening of the stringent coronavirus protocols that have been in place since the league resumed play last year after being suspended because of the pandemic.

“We are considering if and how best we can ‘reward’ those squads/players who are most Covid-compliant,” the league told the clubs.

Many Premier League players also compete on national teams, whose next round of games begins in October. Some league clubs have refused to release players selected by national teams in South America, despite the threat of penalties from the sport’s governing body, because of concerns that when the players returned to Britain they would be subjected to quarantine, as other travelers are when arriving from that continent.

Premier League teams are tested regularly, and coronavirus cases have continued to occur. N’Golo Kanté, a star midfielder for Chelsea who is also on the French national team, tested positive for the virus this week, ruling him out of Chelsea’s Champions League match with Juventus of Italy on Wednesday. He will also miss a coming league game in England and a French national team match next week.

Thomas Tuchel, Chelsea’s coach, told reporters on Tuesday that he did not know how many of the players on his roster were vaccinated.

“We are a reflection of society, the players are adults and they have a free choice,” he said, adding, “I know the situation is far from over. It makes you very aware it is not over.”

Credit…Noam Galai/Getty Images

The “Aladdin” show on Broadway was canceled a half-hour before curtain on Wednesday, only a day into its new run, because of several positive coronavirus tests.

Disney Theatrical Productions announced the sudden cancellation, saying “through our rigorous testing protocols, breakthrough Covid-19 cases have been detected within the company of ‘Aladdin’ at the New Amsterdam Theater.”

Disney said it was refunding purchased tickets, and did not yet know whether or how future performances might be affected.

The cancellation is the first missed performance of a Broadway show for Covid-related reasons since theaters started reopening in late June.

But there have been missed shows Off Broadway — Second Stage canceled several performances of Rajiv Joseph’s “Letters of Suresh,” citing “an exposure of Covid-19,” and then postponed that play’s opening after resuming performances with an understudy. And in Atlanta, a touring production of “Hamilton” had to cancel a performance because of positive coronavirus tests.

All Broadway companies — cast and crew — are required to be fully vaccinated, as are all Broadway audiences. When breakthrough cases occur, some productions have been able to keep going with a combination of backstage testing and understudies.

“Aladdin” had been dealing with coronavirus complications in the run-up to its reopening performance. The raucous first night performance, with an audience that included Kristin Chenoweth and the show’s composer, Alan Menken, and librettist, Chad Beguelin, featured three understudies.

Credit…Mary Turner for The New York Times

LONDON — A police officer who pleaded guilty to murdering Sarah Everard in London this year used the false pretense that she was violating Covid-19 regulations to abduct her before he raped and killed her, a prosecutor told a London courtroom on Wednesday.

Ms. Everard’s abduction and murder in March galvanized a national movement demanding better protections for women, but the harrowing details of how the officer, Wayne Couzens, used his official police credentials, equipment and training to carry out the crime were detailed publicly for the first time during his sentencing hearing.

The prosecution called Mr. Couzens’ actions an attack of “deception, kidnap, rape, strangulation, fire.”

When Ms. Everard was abducted on March 3, Britain was in the midst of a national lockdown because of the pandemic. People’s movements were restricted, and the regulations were often enforced by the local police.

Tom Little, the prosecutor, described in court how Mr. Couzens confronted Ms. Everard in South London as she walked home from a friend’s house and conducted “a false arrest” for breaching lockdown guidelines to get Ms. Everard into his car.

Mr. Couzens, who was a diplomatic protection officer with the Metropolitan Police, used his warrant card — a type of police identification card — before restraining her with handcuffs and then driving away, according to the prosecutor.

Her remains were discovered seven days later in a wooded area in Kent, roughly 60 miles from London.


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Hua Chunying, the spokeswoman for China’s Ministry of Foreign Affairs, said the purpose of the strict health protocols, released by the International Olympic Committee, was to ensure safety at the Beijing Winter Games.CreditCredit…Tingshu Wang/Reuters

A preliminary set of health protocols for next February’s Winter Games in Beijing, released by the International Olympic Committee on Wednesday, suggest that the next Olympics could be the most extraordinarily restricted large-scale sporting event since the start of the pandemic.

The Beijing Olympic and Paralympic Games will take place in what organizers described as a “closed-loop management system” — a bubblelike environment in which athletes, officials, broadcasters, journalists and a large Games work force will have to eat, sleep, work and compete without leaving, from the day they arrive to the moment they depart.

Anyone, including athletes, intending to enter this bubble has two choices: arrive in China fully vaccinated, or prepare to spend the first 21 days in Beijing in solitary quarantine.

And while spectators will be allowed to return to competition venues after being largely barred from the recent Summer Games in Tokyo, entry will be limited to people who live in mainland China.

The Summer Olympics in Tokyo featured a far more porous health protocol. Participants were not required to be vaccinated and did not have to sequester if they were not. And while they were asked to try to remain within Games-affiliated venues, they still had plenty of opportunities to interact with the outside world, including at convenience stores and restaurants for takeout meals.

Members of the local news media and the venue work forces in Tokyo were allowed to commute to Olympic venues from their homes. And after a 14-day period of more harsh restrictions, all Games visitors were allowed to move about the city as they wished.

Credit…Alex Welsh for The New York Times

The city of Los Angeles appears close to enacting one of the strictest rules in the United States requiring proof of full vaccination against Covid to enter many indoor public spaces.

The ordinance would require people to provide proof to enter sites, including restaurants, gyms, museums, movie theaters and salons. The L.A. City Council debated it on Wednesday night in anticipation of its being approved next week. The ordinance would take effect on Nov. 4.

“We need to both limit the transmission of the virus as well as make it inconvenient for those that are unvaccinated to access indoor public venues, because they’re putting lives in jeopardy,” said Nury Martinez, the council president. “We have spent too much time placing restrictions on people who have done their part.”

The proposal would allow people with medical conditions that do not allow them to be vaccinated, or who have a sincerely held religious belief, to instead show proof of a negative coronavirus test taken within the preceding 72 hours.

In August, New York City became the first city in the nation to require proof that workers and customers at indoor sites for dining, physical fitness and entertainment had received at least one dose of a Covid vaccine. Not long after, some cities and counties in California, including San Francisco, followed suit. In Los Angeles, a growing number of bars and restaurants have voluntarily begun checking that patrons are vaccinated before allowing them indoors.

California now has one of the lowest rates for new cases in the United States. Almost 70 percent of Californians age 12 and older have been fully vaccinated. But public health officials in many parts of the state remain worried about the possibility of another surge of infections.

Some council members expressed concerns about imposing extra burdens on already struggling businesses.

“We say we support our essential workers,” said Joe Buscaino, a council member who moved to slow the passage of the ordinance on Wednesday. “We don’t want them to be on the front lines of enforcing this.”

But while other council members acknowledged the complexity of implementing the measure, they said its approval should not be delayed.

“It is an extreme measure,” said Bob Blumenfield, a council member, “but we are in an extreme crisis.”

Masks are still required in indoor spaces in Los Angeles County, including in the city of Los Angeles, when people are not eating or drinking, and that will continue to be the case until public health officials say otherwise, even with the new vaccination requirements.

Credit…LM Otero/Associated Press

The Justice Department signaled its support on Wednesday for the families of children with disabilities in Texas who are suing to overturn Gov. Greg Abbott’s ban on mask mandates in the state’s schools.

The department filed a formal statement on Wednesday with the federal district court in Austin that is hearing one of the lawsuits, saying that the ban violates the rights of students with disabilities if it prevents the students from safely attending public schools in person, “even if their local school districts offered them the option of virtual learning.”

The move signals a willingness by the federal government to intervene in states where governors and other policymakers have opposed mask mandates, using federal anti-discrimination laws like the Americans with Disabilities Act. The Justice Department has often used similar statements of interest to step in to cases involving civil rights.

“Frankly I’m thrilled,” said Juliana Longoria, 38, of San Antonio. Her daughter, Juliana Ramirez, 8, is one of the plaintiffs in a suit against the ban filed in August by the advocacy group Disability Rights Texas. “It gives me a lot more hope that the federal government is serious about protecting our children,” Ms. Longoria said.

Lawsuits against Mr. Abbott’s ban have also been filed in Texas state courts, and have sometimes found initial success, but the State Supreme Court has repeatedly sided with the governor by allowing his ban to remain in effect. The case in which the Justice Department intervened on Wednesday is federal, and is scheduled to go to trial next week.

The governor’s office did not immediately respond to requests for comment, nor did the Texas Education Agency or the office of Ken Paxton, the state attorney general.

Mr. Paxton has defended the ban in state court, saying that Texas law gives the governor broad powers to guide the state through emergencies like the Covid-19 pandemic.

But the Justice Department said in its statement that the civil rights protections afforded by federal anti-discrimination laws applied “even during emergencies.”

Dustin Rynders, a lawyer for Disability Rights Texas, said the department’s position put schools in Texas and beyond on notice that they had an obligation to accommodate people with disabilities, including through the wearing of masks.

“It would be discrimination for a state to prohibit ramps to enter in the school,” Mr. Rynders said. “And for many of our clients, people wearing masks to protect our clients’ health is what is required for our clients to be able to safely enter the school.”

Because masks are not required at her school, Juliana Graves, 7, has not been back to school in Sugar Land this year, according to her mother, Ricki Graves. The Lamar Consolidated Independent School District did not immediately respond to requests for comment.

Juliana has had a heart transplant, and the medication she takes to prevent rejection suppresses her immune system, her mother said. As a result, respiratory infections as simple as the common cold have landed Juliana in the hospital more than a dozen times, Ms. Graves said, adding that she worries that Covid-19 could kill her daughter.

Instead of going to school, Juliana has been receiving four hours a week of instruction from a teacher through homebound school services, Ms. Graves said. Her daughter is repeating first grade, she said, and might now be falling even further behind.

“She’s missing all her social interaction, she’s not able to go to school in person and be with her teachers and have recess and go to lunch,” Ms. Graves said. “It’s hard for her.”

Sept. 30, 2021

An earlier version of this item referred incorrectly to actions by the Texas Supreme Court. It has repeatedly allowed Gov. Greg Abbott’s ban on local mask mandates to remain in effect; it has not yet ruled on whether the governor had the authority to impose the ban.  

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