Covid-19 Global Live Updates: Booster Shots, Putin Covid News and the Latest

Alaska’s largest hospital announced Tuesday that a relentless coronavirus outbreak driven by the highly contagious Delta virus variant has left emergency room patients waiting hours in their vehicles and forced medical teams to ration care.

At Providence Alaska Medical Center in Anchorage, the hospital said it was now operating under “crisis standards of care” — procedures put in place to prioritize resources in a way that may leave some patients with substandard care.

Alaska is just one state among many with relatively low vaccination rates where the Delta variant has run rampant, straining hospitals to their breaking points. Last week, Idaho announced that medical centers in the northern part of its state would move to crisis standards of care. In Alabama, all I.C.U. beds are occupied, as hospitals in Southern states run dangerously low on space in intensive care units.

In Anchorage, Dr. Kristen Solana Walkinshaw, a senior leader at the Providence hospital, wrote in a message to the community that the hospital did not have the necessary staff, space or beds to keep pace with demand.

“Due to this scarcity, we are unable to provide lifesaving care to everyone who needs it,” Dr. Walkinshaw wrote.

The hospital said that with an emergency room overflowing, patients have to wait in their cars for hours to see a physician for emergency care. Elective surgeries continue to be postponed. Dr. Walkinshaw said rationing care may include dialysis and “specialized ventilatory support.”

Providence Alaska Medical Center is a critical hub for patients from all over the state, serving as the destination for many people who need a higher level of care that can’t be provided in their home communities. Dr. Walkinshaw said the hospital has been unable to accept patients from other facilities.

Alaska has been reporting record hospitalization numbers in recent days. New daily case numbers have also been on the rise, but Alaska Gov. Mike Dunleavy has resisted implementing mitigation measures — such as mask mandates — that other states have embraced.

On Tuesday, Dr. Walkinshaw pleaded with members of the public to wear masks, even those who are vaccinated, and encouraged vaccinations in a state where only 48 percent of the population is fully vaccinated. She also encouraged people to avoid potentially dangerous activities because people who get seriously injured may not get access to a bed at the hospital’s trauma center.

Dr. Walkinshaw said the hospital expects an escalation in Covid hospitalizations in the coming weeks.

“What is already a stressful situation could rapidly progress to a catastrophe,” Dr. Walkinshaw wrote.

Credit…Jon Cherry/Getty Images

The U.S. military’s largest service branch has announced an extensive timeline for troops to get vaccinated against Covid-19, and what they can expect to have happen if they don’t.

Army officials said Tuesday that all active-duty units are expected to be fully vaccinated by Dec. 15, and Reserve and National Guard members by June 30. Those who refuse to be vaccinated and have not been given an exemption will face suspension or even dismissal, according to the guidelines.

“While soldiers who refuse the vaccine will first be counseled by their chain of command and medical providers,” the Army guidelines say, “continued failure to comply could result in administrative or nonjudicial punishment — to include relief of duties or discharge from the service.”

Since the Pentagon mandated coronavirus vaccinations last month, the percentage of all military service members with at least one shot has risen to 83 percent from 76 percent, according to Defense Department data. By comparison, in the general American population only 63 percent have gotten at least one shot and 54 percent are fully vaccinated, according to a New York Times database.

The possible consequences for not complying in the Army vary somewhat by role. Army commanders, command sergeants major, first sergeants and officers on track for future command assignments who refuse to be vaccinated and are not given an exemption face suspension and relief from duty. Soldiers of all ranks who are not in command positions can receive a general order of reprimand, which may be removed from their file when they are next transferred or may be placed into their permanent file, affecting future assignments and promotions.

The Army is the last branch of the military to issue guidelines following the Pentagon’s announcement last month that active-duty military personnel would be required to be vaccinated.

The Navy and Marines have already informed their rank and file that the clock is ticking on their vaccinations.

All active-duty Air Force troops must be fully vaccinated by Nov. 2, and Air National Guard and Air Force Reserve members by Dec. 2. The directive has had immediate impact in the Air Force: 74.5 percent of active-duty members have now had at least one vaccine shot, up from 65.2 percent last month.

Active-duty sailors and Marines must be fully vaccinated within 90 days of Aug. 30, while reserve Navy service members have 120 days to comply. Refusal without an approved exemption may result in administrative action, according to the Navy plan.

All Navy coronavirus deaths have been among troops who were not fully immunized; one was partially vaccinated.

Vaccination rates in the military already outpace much of the rest of the country, but commanders are seeking nearly total compliance, as the military does with many other vaccines, fearing that failure to get everyone inoculated would imperil readiness.

“This is quite literally a matter of life and death for our soldiers, their families and the communities in which we live,” Lt. Gen. R. Scott Dingle, the Army Surgeon General, said in a news release. “Case counts and deaths continue to be concerning as the Delta variant spreads, which makes protecting the force through mandatory vaccination a health and readiness priority for the total Army.”




Britain’s Prime Minister Lays Out Winter Plan to Fight Covid-19

Prime Minister Boris Johnson announced a plan to offer those age 50 and older a booster vaccine shot, as part of a winter strategy to prevent a new surge in coronavirus cases and to avoid another lockdown in the country.

I want to set out our plan for managing Covid this autumn and winter. In essence, we’re going to keep going. We will continue to offer testing. We’ll continue to urge everyone to be sensible, to be responsible. Wash your hands. Use ventilation. Consider wearing a face covering in crowded places with people that you don’t know. Stay at home if you feel unwell. Download and use the app. We are confident in the vaccines that have made such a difference to our lives, and we’re now intensifying that effort, offering jabs to 12 to 15-year-olds on the advice of the chief medical officers who’ve given that advice based on the health, well-being and educational prospects of the children themselves. And for over 50s, and the under 50s who are at risk or more at risk, we’re now motoring ahead with the booster program — a third dose six months after your second dose. And so that’s going to mean we’re going to be building even higher walls of immunization of vaccine protection in this country.

Prime Minister Boris Johnson announced a plan to offer those age 50 and older a booster vaccine shot, as part of a winter strategy to prevent a new surge in coronavirus cases and to avoid another lockdown in the country.CreditCredit…Henry Nicholls/Reuters

Prime Minister Boris Johnson of Britain announced a plan on Tuesday to offer all those age 50 and older a booster vaccine as part of a winter coronavirus strategy — plunging Britain into a growing debate over whether lower-income countries should get shots first.

The prime minister is taking the step to try to prevent a new surge in cases from overwhelming the National Health Service, and to avoid another lockdown in a country wearied by the pandemic and earlier measures that included some of the strictest restrictions in the world.

The additional vaccine doses will start being offered next week to older members of that group, health workers and those with underlying health conditions across Britain, with the aim of giving all those over 50 a booster shot of the Pfizer-BioNTech vaccine, regardless of which vaccine an individual received previously, by the end of the year. Most people in Britain have received the two-shot vaccines of either the AstraZeneca or Pfizer vaccines. The decision follows an announcement on Monday that one vaccine shot will be offered to healthy children aged 12 to 15.

Speaking at a Downing Street media conference, Mr. Johnson hailed the vaccination campaign for producing, he said, “one of the most free societies and one of the most open economies in Europe.”

However the decision puts Britain among a growing group of countries that are offering booster shots to their own citizens before many people in large parts of the world have received even one dose. The World Health Organization has warned that offering booster shots in wealthy countries could divert vaccines from poorer countries that need doses, and last week called on governments not to administer boosters for healthy patients until at least the end of the year.

“I’m a bit upset, frankly, to hear that Britain is going into boosters, when this is simply going to take really precious vaccine away from people in other parts of the world who can’t get their basic two doses, and therefore going to be at risk of death,” David Nabarro, a special envoy on Covid for the World Health Organization, told Times Radio.

Despite the flurry of booster programs in wealthier nations, the science of whether they are needed by most healthy people is not yet clear.

Some studies suggest that the protection that the vaccines provide against infection and mild disease may be waning. But they remain highly effective at preventing the worst outcomes, including severe disease and death, and scientists have said that a blanket recommendation for boosters is premature.

Experts generally agree, however, that a third shot is warranted for people with compromised immune systems, who may not have mounted a strong immune response to the initial doses. W.H.O. officials are not opposed to additional doses for the immunocompromised, and several countries, including the United States, are now offering additional shots to this vulnerable group. Britain has released official advice to offer extra shots to the group as well.

In the United States, there is a roiling debate over the use of boosters for most people. The Biden administration announced a proposal in August to begin administering vaccine boosters eight months after people had received second shots, but some scientists have opposed that, saying the vaccines already protect many people against severe illness and hospitalization.

Britain is now averaging about 30,000 new coronavirus cases and about 1,000 hospital admissions each day, according to government data. And while that is significantly fewer than the 100,000 cases predicted by some experts, government officials know that another surge is possible as children return to school and the weather worsens through the fall and winter.

Officials in Britain are looking to avoid the type of restrictions that for months blocked people from seeing family and friends even in most outdoor settings, while also preventing another catastrophic winter surge like the one that pummeled the country last year.

Although the government has not ruled out another lockdown completely, it presented that as a last resort that would be considered only if England faces a new and highly transmissible variant.

“When you’ve got a large proportion of the country, as we have now, with immunity, then smaller changes can make a bigger difference and give us the confidence that we don’t need to go back to the lockdowns of the past,” Mr. Johnson said.

Mr. Johnson also said that the government was preparing a “plan B” as a contingency in the event that cases rise significantly, as some experts fear they will in the winter months. This includes reintroducing a requirement to wear face coverings in indoor spaces and on public transportation, and advising people to work from home when possible.

On Sunday the government said it would not proceed with a vaccine passport plan that would have forced nightclubs and some other venues in England to check the status of those trying to enter. But it has kept open the option of reviving the strategy should the situation deteriorate.

Credit…Jutharat Pinyodoonyachet for The New York Times

The longest shutdown in Broadway history is over.

Tonight, some of the biggest shows in musical theater, including “The Lion King,” “Wicked” and “Hamilton,” resume performances 18 months after the coronavirus pandemic forced them to close.

They are not the first shows to restart, nor the only ones, but they are enormous theatrical powerhouses that have come to symbolize the industry’s strength and reach, and their return to the stage is a signal that theater is back.

Of course, this moment comes with substantial asterisks. The pandemic is not over. Tourists are not back. And no one knows how a long stretch without live theater might affect consumer behavior.

But theater owners, producers, nonprofits and labor unions have collectively decided that it’s time to move forward. The reopening of Broadway comes as a variety of other performing arts venues, in New York and around the country, are also resuming in-person, indoor performances: In the days and weeks to come the Metropolitan Opera, the New York Philharmonic, New York City Ballet, Carnegie Hall and the Brooklyn Academy of Music will all start their new seasons.

“Broadway, and all of the arts and culture of the city, express the life, the energy, the diversity, the spirit of New York City,” Mayor Bill de Blasio said at a news conference Tuesday. “It’s in our heart and soul. It’s also so much of what people do to make a living in this town. And that makes us great. So, this is a big night for New York City’s comeback.”

Those attending shows on Broadway will find the experience changed: every show is requiring proof of vaccination (patrons under 12 can provide a negative coronavirus test) and every patron must be masked.

Even before tonight, four shows had begun: “Springsteen on Broadway,” which had 30 performances between June and September, as well as a new play, “Pass Over,” and two returning musicals, “Hadestown” and “Waitress,” all of which are still running. None has missed a performance; “Waitress” managed to keep going even after a cast member tested positive by deploying an understudy.

The returning blockbusters opening tonight will be joined by “Chicago,” a beloved musical which this year marks 25 years on Broadway, and a new production of “Lackawanna Blues,” an autobiographical play by Ruben Santiago-Hudson.

At stake is the health of an industry that, before the pandemic, had been enjoying a sustained boom. During the last full Broadway season before the outbreak, from 2018 to 2019, 14.8 million people attended a show — that’s more people than the combined attendance for the Mets, Yankees, Rangers, Islanders, Knicks, Liberty, Giants, Jets, Devils and Nets, according to the Broadway League. And that attendance translated to real money — the industry grossed $1.83 billion that season.

This season is sure to be different. The League is concerned enough about revenue that it has decided not to disclose box office grosses this season.

Credit…Pool photo by Sergei Savostyanov

President Vladimir V. Putin of Russia said he is isolating because several members of his inner circle tested positive for the coronavirus.

Mr. Putin canceled a planned trip to Tajikistan this week for a Central Asian security summit, the Kremlin said, describing a phone call that Mr. Putin had on Tuesday with Emomali Rahmon, the Tajik president.

“Vladimir Putin said that in connection with identified cases of the coronavirus in his environment, he must observe self-isolation for a certain period of time,” the statement said.

In a televised videoconference later Tuesday with senior officials, Mr. Putin said that one of the people who tested positive was a vaccinated staff member with whom he had recently interacted “very closely in the course of the whole day.” Mr. Putin has said he was vaccinated with the two-dose regimen of Russia’s Sputnik V vaccine, but he has continued to be extraordinarily careful in his public appearances, often requiring people he meets to quarantine beforehand.

“We’ll see how Sputnik V works in practice,” Mr. Putin said in the videoconference, adding that his antibody levels were still high.

Mr. Putin’s spokesman, Dmitri S. Peskov, said Mr. Putin would continue working while in isolation and expressed confidence that the vaccine would protect him from a serious case of the disease.

“We all know that the vaccine is guaranteed to protect you from serious consequences, but cases of illness are still possible,” Mr. Peskov said. “The president is absolutely healthy.”

Mr. Putin had been scheduled to attend a summit on Friday of the Shanghai Cooperation Organization, a regional security group. He will still participate in the meeting, but will do so by video link, the Kremlin said. Prime Minister Narendra Modi of India and President Xi Jinping of China are also scheduled to address the gathering remotely.

Mr. Putin’s isolation — the first time he has taken such a step because of potential exposure — underscores the pandemic’s continuing severity in Russia. Widespread vaccine hesitancy and lax mask-wearing have allowed the Delta variant of the coronavirus to spread largely unchecked.

Russia’s officially reported mortality from the coronavirus has been essentially flat, at just below 800 deaths per day, since July. The remarkable stability of the daily toll has led some analysts to question its veracity, though officials insist it is accurate.

Mr. Putin had several in-person events on Monday as officials were deliberating over whether he should go into quarantine, including a meeting with President Bashar al-Assad of Syria, a close Russian ally. That took place “before the decision was made about the necessity of self-isolation,” Mr. Peskov said, adding, “No one’s health was put in danger.”

Both Mr. al-Assad and his wife, Asma, contracted the virus but quickly recovered, officials said in March. There was no word from Syria on Tuesday that Mr. al-Assad would need to self-isolate after the meeting with Mr. Putin.

“We are working together on solving the most important problem that all of humanity faces today — the fight against the coronavirus infection,” Mr. Putin told Mr. al-Assad, according to a transcript published by the Kremlin on Tuesday. “I hope that, with our joint efforts, we will be able to help the Syrian people get back on their feet in every sense of the word.”

Russia intervened in support of Mr. al-Assad in Syria’s civil war in 2015 and turned the tide of the conflict in his favor, amid heavy criticism from human-rights groups of a brutal bombing campaign. Russia delivered 250,000 doses of its one-shot Sputnik Light vaccine to Syria in July.

Ivan Nechepurenko contributed reporting.

Credit…Ramon Espinosa/Associated Press

Cuba will begin vaccinating children as young as 2 against the coronavirus this week, making it the only country so far to immunize children that young.

The United States and many European countries currently allow Covid-19 vaccinations for children 12 and older. U.S. regulators could authorize a vaccine for children 5 to 12 later this year.

Chile has begun vaccinating children 6 and older. China and the United Arab Emirates are now vaccinating children as young as 3.

Cuba’s health regulator, the Center for State Control of Medicines and Medical Devices, approved pediatric vaccination at the beginning of September. Last week, the country started immunizing 13- to 17-year-olds.

Coronavirus cases are skyrocketing in Cuba as the Delta variant spreads rapidly across the island. Cuba has recently been reporting an average of 70 new infections a day for every 100,000 residents, one of the highest rates in the Western Hemisphere.

Cuban children are being immunized with Soberana 2 and Soberana Plus, two domestically developed vaccines. Clinical trials in adults, and to a limited extent in children, have shown that the combination is more than 90 percent effective at protecting against the coronavirus, Cuban officials have said. But data from the trials have not been published in peer-reviewed international journals.

Dr. Jarbas Barbosa, assistant director of the Pan American Health Organization, a division of the World Health Organization, called on Cuba in June to “publish the data in a transparent way.”

“There’s a lot of things going for it, there is a need, and they are using established technology,” Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, said about the Cuban program. “But I’m concerned about the level of regulatory oversight.”

Cuban scientists said that they have submitted papers to peer-reviewed journals, and are awaiting publication. They stressed that the Soberana vaccines use a technology similar to the one already in use in Cuba’s vaccines against other diseases.

“This is not an RNA vaccine, with no history, being administered to children,” said Dr. Vicente Vérez, the lead developer of the vaccines.

Early trials in children have shown only routine side effects and “a high degree of safety, which is what’s most important,” said Dr. José Moya, the Pan American Health Organization representative in Cuba.

Schools in Cuba have been closed through most of the pandemic, and the high cost of internet access has made online learning impossible for most children. Officials and frustrated parents are keen to get children back to school, but the reopening of classrooms has been postponed repeatedly.

So far, 56 percent of Cuba’s population has received at least one dose of a Covid vaccine, and 37 percent are fully vaccinated. The country’s health ministry aims to vaccinate more than 90 percent of the population by December.

The pandemic has pushed Cuba’s vaunted health system to the breaking point. A shortage of medicines, medical oxygen and coronavirus tests has increased social tensions, prompting anti-government protests in July. Mexico shipped supplies of oxygen to Cuba last month, and activists in the United States sent two million syringes.

U.S. economic sanctions imposed during the Trump administration have slowed vaccination efforts by making it more complicated and expensive to import materials. Production of Soberana 2 was halted for weeks in the spring when supplies of a vital component dwindled, Dr. Vérez said.

Credit…Chang W. Lee/The New York Times

Vaccine mandates for two groups of public employees in New York hit legal roadblocks on Tuesday as judges temporarily blocked the requirements from taking effect as scheduled later this month.

Late in the day, a state court judge in Manhattan, responding to a lawsuit filed last week by a group of labor unions representing public employees in New York City, issued a temporary restraining order covering Mayor Bill de Blasio’s requirement that all workers in the city’s schools get at least one dose of a Covid-19 vaccine by Sept. 27.

The judge, State Supreme Court Justice Laurence L. Love, scheduled a hearing in the matter for Sept. 22.

Earlier in the day, a federal judge in upstate New York, David N. Hurd, issued a similar ruling that temporarily blocks the state government from forcing medical workers at hospitals and nursing homes to be vaccinated by Sept. 27.

The order came in response to a lawsuit filed by a group of health professionals, including doctors and nurses, who say the state requirement violates their constitutional rights because it does not allow for religious exemptions.

Bill Neidhardt, a spokesman for Mr. de Blasio, said in a statement that the ruling on the requirement for school employees — including teachers, principals, custodians, school safety agents and central office staff members — would not keep it from being imposed as planned.

“New York City’s education worker vaccine mandate, which has been embraced by the White House, goes into effect on Sept. 27,” Mr. Neidhardt said.

Henry Garrido, the executive director of one of the unions, District Council 37, welcomed the ruling.

“The fight is not over,” Mr. Garrido said in a statement. “But we are energized by this decision and ready to keep going on behalf of our members.”

In their suit, the unions say they “support vaccination and encourage all employees to vaccinate if they are able.” Nonetheless, they argue, the city’s requirement is “extremely coercive” because it forces workers to choose between their jobs and doing something that violates their “bodily integrity and right to refuse medical treatment.”

The roughly 148,000 employees of the Department of Education are the first group of municipal workers in New York City to face a full vaccine mandate. The city’s other public employees can choose to be tested weekly for the virus rather than being vaccinated.

JERUSALEM — As recently as late August, Hai Shoulian, a prominent opponent of coronavirus vaccination policies in Israel, was demonstrating in Jerusalem and describing the country’s electronic pass system, which allows vaccinated people access to leisure venues, as “coercion” and “fascism” and “a dictatorship.”

Credit…Avi Shoulian

Mr. Shoulian died of Covid-19 on Monday, after being hospitalized and placed on a respirator.

He did not express any regret over his decision not to be vaccinated. Instead, in a video message from his hospital bed on Sept. 3, the day he said he was admitted and tested positive, he accused the police of trying to poison him.

Police officers arrested Mr. Shoulian at the end of the demonstration on Aug. 26. He was released the next day after going before a judge.

In the video, he said that the day after he was released, he felt so ill that he was on the verge of collapsing. Speaking between coughs, he claimed that officers had placed a knee on his neck, and complained of broken toes.

Credit…Avi Shoulian

“I am telling you this was an attempt to assassinate me,” he said in the Sept. 3 video.

Israel led the world with its early and rapid coronavirus vaccination program. Two-thirds of its population has received at least one vaccine dose, 61 percent are fully vaccinated and nearly one-third have received booster shots.

Even so, despite the Pfizer-BioNTech vaccine being freely available, hundreds of thousands of Israelis who are eligible to be vaccinated have so far chosen not to do so. And the country is battling a severe fourth wave of the virus.

Mr. Shoulian’s brother, Avi Shoulian, told Israel’s public radio broadcaster on Tuesday that the family had warned Hai Shoulian that it was only a matter of time before he would become infected.

Avi Shoulian said he did not believe that his brother had been poisoned by the police. He appealed to everyone who had not had a shot yet: “Go get vaccinated. Save your lives and the lives of your loved ones.”

Credit…Alexandros Avramidis/Reuters

The authorities in Greece on Monday introduced new measures banning unvaccinated people from indoor venues, including cafes and restaurants, and obliging employees who have not had their coronavirus shots to undergo regular tests at their own expense.

The measures, which are to remain in place through March, are aimed at flattening a fourth wave of the virus.

The new regulations bar unvaccinated people from the indoor areas of cafes, restaurants and bars. They will only be able to enter theaters, cinemas, gyms and museums with proof of a negative rapid coronavirus test conducted within the previous 48 hours or with a certificate verifying that they have recovered from Covid-19 within the previous six months.

The new rules will also apply to workplaces. All employees who do not have a certificate of vaccination or recent recovery from Covid-19 will have to undergo at least one rapid screening per week at a private clinic, at a cost of 10 euros (about $11.80) per test. Unvaccinated people working in tourism, education and food service will be required to take two tests per week, along with school and university students. The tests will be free for children.

Schools in Greece reopened on Monday, prompting concern that the virus could get fresh impetus. Children ages 12 and older in Greece are eligible for doses, though only 13 percent of those ages 12 to 14, and 25 percent of those ages 15 to 17, are fully vaccinated, according to figures announced by the country’s Health Ministry on Monday.

Matina Pagoni, head of a union of doctors in Athens and Piraeus, told Greek television last week that face masks and social distancing were crucial to averting a spread in classrooms, adding that windows should remain open. Her union has proposed that mobile vaccination centers be set up outside schools to increase the uptake of the vaccine among children.

Vaccine hesitancy is relatively strong in Greece, where only 55 percent of the population of 10.7 million have been fully vaccinated, compared with about 59 percent across the 27-nation European Union, according to figures from Our World in Data. More than 6,000 Greek health workers have been suspended without pay after refusing to get shots despite a law that requires them to be vaccinated.

Credit…Brad Trone for The New York Times

In September 2020, eight months before a deadly Covid-19 second wave struck India, government-appointed scientists downplayed the possibility of a new outbreak. Previous infections and early lockdown efforts had tamed the spread, the scientists wrote in a study that was widely covered by the Indian news media after it was released last year.

The results dovetailed neatly with Prime Minister Narendra Modi’s two main goals: restart India’s stricken economy and kick off campaigning for his party in state elections that coming spring.

But Anup Agarwal, a physician then working for India’s top science agency, which reviewed and published the study, worried that its conclusions would lull the country into a false sense of security.

Dr. Agarwal took his concerns to the agency’s top official in October. The response: He and another concerned scientist were reprimanded, he said.

In the wake of the devastating second wave, which killed hundreds of thousands, many in India are asking how Mr. Modi’s government missed the warning signs. Part of the answer, according to current and former government researchers and documents reviewed by The New York Times, is that senior officials forced scientists at elite institutions to downplay the threat to prioritize Mr. Modi’s political goals.

Senior officials at Dr. Agarwal’s agency — called the Indian Council of Medical Research, or I.C.M.R. — suppressed data showing the risks, according to the researchers and documents.

Credit…Karan Deep Singh/The New York Times

Agency scientists interviewed by The Times described a culture of silence. Midlevel researchers worried that they would be passed over for promotions and other opportunities if they questioned superiors, they said.

Credit…Jae C. Hong/Associated Press

While tens of millions of Americans continue to decline even a first dose of Covid-19 vaccine, a small but growing number have sought out additional shots beyond those needed for full vaccination, even though the Food and Drug Administration has not yet approved extra shots for most people and it remains unclear who would need one or when.

Studies in the United States have found that the vaccines in use in the country continue to provide robust protection against severe disease or hospitalization from Covid-19, especially for those younger than 65, even though there is growing evidence that the vaccines’ effectiveness against infection declines over time.

A review published on Monday by an international group of scientists, including two from the F.D.A., found that none of the data available so far provided credible evidence to support administering booster shots to the general population.

Even so, many people are seeking early boosters, out of fear that breakthrough infections could inconvenience or sicken them — or worse, they say, could sicken someone they love. Most do not feel they would be taking a dose away from someone else, because vaccines are widely available in the United States and local pharmacies would not be in a position to divert doses to nations that need them.

The number of Americans who are not immunocompromised and have obtained extra shots is unclear. About 1.8 million people have gotten extra shots since mid-August, according to the Centers for Disease Control and Prevention, but that count is likely to include many with weakened immune systems. The F.D.A. authorized additional shots for that group last month.

The Biden administration announced in August that it hoped to start offering booster shots on Sept. 20 to people who had received a second dose of the Pfizer-BioNTech or Moderna vaccine at least eight months earlier.

But the leaders of the F.D.A. and the C.D.C. then said they needed more time to evaluate safety and other data.

For many Americans — particularly those over 65, who were among the first in the country to be vaccinated — the shifting plans for booster shots were another case of inconsistent information coming from the government about the pandemic.

Credit…Source: U.S. Department of Health and Human Services data. Notes: Some patient counts are not available because H.H.S. obscures weekly totals lower than four. Data is as of the week ending Sept. 9. Hospital locations are adjusted so that all hospitals are shown without overlapping.

Hospitals in the southern United States are running dangerously low on space in intensive care units, as the Delta variant has led to spikes in coronavirus cases not seen since last year’s deadly winter wave.

One in four hospitals now reports more than 95 percent of I.C.U. beds occupied — up from one in five last month. Experts say it can become difficult to maintain standards of care for the sickest patients in hospitals where all or nearly all I.C.U. beds are occupied.

In June, when Covid-19 cases were at their lowest level, less than one in 10 hospitals had dangerously high occupancy rates.

In Alabama, all I.C.U. beds are currently occupied. In recent days, dozens of patients in the state have needed beds that were not available, according to data published by the Department of Health and Human Services.

“It means they’re in the waiting room, some are in the back of ambulances, things of that nature,” said Jeannie Gaines, a spokesperson for the Alabama Hospital Association.

In Texas, 169 hospitals have I.C.U.s that are more than 95 percent full, up from 69 in June. There are only about 700 intensive care beds remaining across the entire state, according to recent data.

Hospitals in Houston constructed overflow tents last month to handle the influx of patients, and the rate of hospitalizations in the state is now 40 percent higher than when the tents were built.

Unvaccinated Americans are 10 times more likely to be hospitalized with Covid than the vaccinated, according to a recent study by the Centers for Disease Control and Prevention. Several of the states with the highest rates of I.C.U. occupancy, including Alabama and Mississippi, are also among those with the lowest vaccination rates.

Credit…Edgar Su/Reuters

Singapore began administering additional Covid-19 shots to residents ages 60 and older on Tuesday as virus cases there are surging.

About 900,000 seniors will be eligible for a third dose of Moderna or Pfizer-BioNTech, the Ministry of Health said, along with people with weaker immune systems. Singaporean officials say they are especially worried about a series of outbreaks at nursing homes.

New cases in the city-state have nearly quadrupled in the past two weeks despite one of the world’s most successful vaccination campaigns, which has fully inoculated more than 80 percent of people against the coronavirus. Other nations, including Israel, France and Germany, started offering additional doses to vulnerable groups as fears grew of waning immunity to variants of the virus.

Politicians and health officials globally are debating the value of offering third doses of vaccines to the general population. Advocates of booster shots contend that additional doses will better protect people from the virus, while opponents argue that available doses should be prioritized for poorer nations that have only been able to inoculate small percentages of their populations.

In response to the outbreaks in nursing homes, Singapore’s Ministry of Health announced that it would institute new protections for seniors residing in those facilities, including a suspension of visits until early October and increased coronavirus testing for residents and staff members.

Credit…Aaron Favila/Associated Press

As jubilant students across the globe trade in online learning for classrooms, millions of children in the Philippines are staying home for the second year in a row because of the pandemic, fanning concerns about a worsening education crisis in a country where access to the internet is uneven.

President Rodrigo Duterte has justified keeping elementary and high schools closed by arguing that students and their families need to be protected from the coronavirus. The Philippines has one of the lowest vaccination rates in Asia, with just 16 percent of its population fully inoculated, and Delta variant infections have surged in recent months.

“I cannot gamble on the health of the children,” Mr. Duterte said in June, rejecting recommendations by the health department to reopen schools.

The move — which has kept nearly 2,000 schools closed — has spawned a backlash among parents and students in a sprawling nation with endemic poverty. Many people, particularly in remote and rural areas, do not have access to a computer or the internet at home for online learning.

It also makes the Philippines, with its roughly 27 million students, one of only a handful of countries that has kept schools fully closed throughout the pandemic, joining Venezuela, according to UNICEF, the United Nations children’s agency. Other countries that kept schools closed, like Bangladesh, Saudi Arabia and Kuwait, have moved to reopen them.

Some countries, like Britain, have taken an aggressive approach to keeping schools open, including from late spring into early summer, when the Delta variant surged. While many elementary school students and their teachers did not wear masks, the British government focused instead on other safety measures, such as rapid testing and widespread quarantining.

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