N.Y. Considers National Guard to Replace Unvaccinated Health Workers

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Daily Covid Briefing

Sept. 25, 2021, 8:14 p.m. ET

Sept. 25, 2021, 8:14 p.m. ET

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Gov. Kathy Hochul of New York is considering calling in the National Guard and recruiting medical professionals from other states to cover looming staff shortages at hospitals and other facilities as the likelihood grows that tens of thousands of health care workers will not meet the state’s deadlines for mandated vaccinations.

In a statement released on Saturday, the governor’s office said Ms. Hochul was laying plans for an executive order to declare a state of emergency that would “allow qualified health care professionals licensed in other states or countries, recent graduates, retired and formerly practicing health care professionals to practice in New York State.”

Other options, the statement said, included calling in medically trained National Guard members to deliver care and to work with the federal government to deploy Disaster Medical Assistance Teams, which are operated by the Department for Health and Human Services.

New York State is one of the first major testing grounds for stronger vaccination edicts rolling in across the country in the health care sector. California and Maine have also set deadlines for health care workers to be vaccinated. President Biden has said his administration will issue a national vaccination mandate expected to ultimately affect some 17 million health care workers at hospitals and other institutions that accept Medicare and Medicaid reimbursements.

Hospital and nursing home employees in New York are required to receive a first dose of a Covid-19 vaccine by 11:59 p.m. on Monday night, while workers working in home care, hospices and other adult care facilities must do so by Oct. 7, according to state regulations and a mandate issued on Aug. 16 by former Gov. Andrew M. Cuomo.

State vaccination figures show that, as of Wednesday, 16 percent of the state’s roughly 450,000 hospital workers, or about 70,000, were not fully vaccinated. The data show that 15 percent of staff at skilled nursing facilities and 14 percent of workers at adult care facilities are also not fully vaccinated, representing another 25,000 or so workers.

The governor’s office said workers terminated because they refuse to be vaccinated are not eligible for unemployment insurance unless they provide a doctor-approved request for a medical accommodation.

In announcing New York’s determination to enforce its deadline, Ms. Hochul said, “We are still in a battle against Covid to protect our loved ones, and we need to fight with every tool at our disposal.” She also commended the vast majority of state health care workers for getting vaccinated and urged “all remaining health care workers who are unvaccinated to do so now so they can continue providing care.”

The Greater New York Hospital Association, which represents about 140 health systems and 55 nursing homes, had not issued a response to the governor’s plan but has supported the deadline for health care workers’ vaccinations, signaling that staffing shortages can be managed.

Michael A.L. Balboni, executive director of the Greater New York Health Care Facilities Association that represents about 80 nursing homes in the metropolitan area, applauded the governor’s effort to get more health care workers vaccinated but expressed concern about staffing shortages.

“This is a paradox, in that in trying to protect the residents and staff you don’t have enough people to provide the services and you could put people in jeopardy,” Mr. Balboni said.

Víctor Manuel Ramos

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Two federal judges in Tennessee have dealt blows to Gov. Bill Lee’s executive order that allows families to opt out of school mask mandates, ruling in separate cases on Friday that local districts could require face coverings to protect disabled children while legal challenges progress through the courts.

It was the third time in the last two weeks that a judge had suspended the governor’s order after parents of special education students filed lawsuits charging the order violates the Americans with Disabilities Act.

Mr. Lee is one of several Republican governors who have used their executive powers to stop school districts from implementing mask policies, playing to conservative voters who regard such rules as an infringement on parental rights and personal liberties.

The debate over masks in schools has become highly politicized, as tens of millions of students across the country have returned to the classroom. Texas, Florida, Arizona and Iowa are among the states where governors have tried to ban mask requirements in direct opposition to local school leaders who want them.

President Biden’s administration has waded into the fray. The federal Education Department is investigating orders issued by governors in seven states, including Tennessee, to determine if allowing parents to ignore mask mandates for their children discriminates against students with disabilities by restricting their access to education.

The same legal theory is at the heart of the lawsuits in Tennessee. Earlier this month, the Knox County Board of Education had voted against requiring masks in its schools, bucking guidance from local and federal health officials. The following day, families who have children with disabilities filed a class-action lawsuit, arguing that the school board’s decision did not create a safe, in-person learning environment for children during the coronavirus pandemic.

On Friday, U.S. District Judge J. Ronnie Greer, of the Eastern District of Tennessee, ruled that schools in Knox County must enforce a mask rule in order to help protect children with health problems while the lawsuit is pending. He prohibited the governor from imposing his order until the legal battle is settled.

A similar decision was handed down by U.S. District Judge Waverly Crenshaw, of the Middle District of Tennessee, who said on Friday that schools in Williamson County and in the Franklin Special School District can enforce mask mandates, also blocking the governor’s order.

Both school systems implemented strict mask policies through at least January of next year to combat surging infections in their districts, but Mr. Lee’s order, issued on Aug. 16, forced the school officials to amend their rules to let students forgo masks, no questions asked. Once again, parents of special education students filed a lawsuit, arguing that letting some students ignore the mask rules violated the rights of special education children.

Last week, a third federal judge, this time in the Western part of the state, indefinitely blocked the governor’s order in Shelby County, saying it was an impediment to children with health problems from safely going to school during the coronavirus pandemic.

Mr. Lee’s order is set to expire on Oct. 5, and he told reporters that he has not yet decided whether to renew it. A spokeswoman for the governor did not respond to a request for comment on Friday.

Justin Gilbert, a lawyer representing parents who filed suits in Knox, Williamson and Franklin counties, said that three federal judges “have saved children from an Executive Order built on wedge-issue politics, not on science.”

Jack Begg contributed research. Erica Green contributed reporting.

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Mayor Bill de Blasio’s administration has been temporarily blocked from enforcing a vaccine mandate for nearly all adults in New York City public school buildings, after a federal appeals court granted a temporary injunction on Friday.

The mandate, which affects well over 150,000 people working in the nation’s largest school system, was set to go into effect on Monday at midnight. Educators, parents and union officials have been bracing for the likelihood of staffing shortages and disruption in at least some schools where significant numbers of educators and staff members are not vaccinated.

A judge for the U.S. Court of Appeals for the Second Circuit granted the injunction on a temporary basis and referred the case to a panel of three judges for review. City officials said they expected the review and ruling to take place in the next few days, possibly even over the weekend, and anticipated that the mandate would be upheld. But it is not clear if the issue will be resolved before the Monday deadline.

Last week, a State Supreme Court judge ruled that the city could move forward with the mandate, after considering a separate but similar lawsuit filed by a coalition of unions that represents employees in public schools. The judge, Laurence Love, said state and federal courts have consistently upheld mandatory vaccination orders.

And on Thursday, a federal judge in Brooklyn, Brian M. Cogan, declined to grant the injunction sought by a group of teachers, calling the mandate “a rational policy decision surrounding how best to protect children during a global pandemic.” The teachers then appealed, successfully, to the Court of Appeals.

At least 90 percent of teachers and 95 percent of principals are already vaccinated. The rate is lower — about 82 percent — among staff members in school buildings.

The leaders of the unions representing the city’s teachers and principals have called on Mr. de Blasio to delay the implementation of the mandate, arguing that schools are not prepared to deal with staffing crunches.

The mandate, which was announced last month, requires all educators, along with staff like custodians, school lunch helpers and safety agents to receive at least one dose of a coronavirus vaccine by Monday night. It is the first vaccine mandate without a test-out option for any group of city workers.

“We’re confident our vaccine mandate will continue to be upheld once all the facts have been presented, because that is the level of protection our students and staff deserve,” a spokeswoman for the Department of Education, Danielle Filson, said in a statement.

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Norway on Saturday lifted social distancing rules, capacity limits on businesses and other pandemic-era restrictions that have been in place for more than a year.

“It is 561 days since we introduced the toughest measures in Norway in peacetime,” said Erna Solberg, the country’s prime minister, in announcing the moves at a news conference on Friday. “Now the time has come to return to a normal daily life.”

In Norway, new daily cases have dropped by 50 percent over the last two weeks. Sixty-seven percent of the population are fully vaccinated and another 10 percent have had a first dose, according to the Our World in Data project at the University of Oxford.

The changes also allow full capacity at sports and culture venues and restaurants, and the reopening of nightclubs. And the government also said on Friday that it would withdraw at the end of the month its global advisory against nonessential travel abroad.

“We will now go back to assessing countries on an individual basis to determine the need for travel advice,” Ine Eriksen Soreide, the minister of foreign affairs, said in a statement on Friday. “These assessments will incorporate issues relating to the pandemic, the health situation and the security situation in the country in question.”

Entry restrictions will remain in place for some countries, which the government said would be specified before next Friday.

Norway is the latest country in Europe to roll back pandemic-era restrictions. In Sweden, the government confirmed this week that it would proceed with the last stage of its reopening plan for the fully vaccinated, which represents 63 percent of its population.

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State health officials are rushing to roll out campaigns to provide coronavirus booster shots for millions of vulnerable people who got the Pfizer-BioNTech vaccine and to help a confused public understand who qualifies for the extra shots.

Among their challenges: making sure that recipients of the Moderna and Johnson & Johnson vaccines know that they are not yet eligible for boosters, reaching isolated older people, and informing younger adults with medical conditions or jobs that place them at higher risk that they might be eligible under the broad federal rules.

“Those of us overseeing vaccine rollouts don’t have a clear idea of what to do,” said Dr. Clay Marsh, West Virginia’s Covid czar.

In his state, pharmacies sent staff members into the largest nursing homes on Friday to administer booster doses. In Vermont, health officials opened booster shot appointments to people 80 and older on Friday, and said many other eligible people could get them starting next week. In virus-battered North Dakota, officials struggling to make sense of the federal guidance delayed a broad booster rollout until next week.

Many more people became eligible for boosters early Friday after the C.D.C. director, Dr. Rochelle P. Walensky, said people at greater risk of exposure to the virus “because of occupational or institutional setting” would qualify, opening up boosters to millions of people her advisory committee had left out.

People 65 and older and residents of long-term care facilities and adults who have certain medical conditions also qualify for the boosters.

President Biden said on Friday that 20 million people could get boosters immediately because they had gotten their second Pfizer-BioNTech shot at least six months ago. In all, he said, 60 million people will be eligible for a Pfizer-BioNTech booster over the coming months.

State and federal officials said the booster program would look much different than earlier coronavirus vaccination drives, which relied heavily on mass inoculation sites at sports stadiums and convention centers. Instead, pharmacies, primary care physicians and smaller vaccination clinics that have become accustomed to offering shots will deliver boosters.

As a practical matter, the official recommendations were unlikely to deter millions of Americans who might not be eligible yet from pursuing booster doses, by claiming medical conditions or weakened immune systems. The C.D.C. said on Thursday that millions of Americans had already received an extra shot.

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Nearly two years into the coronavirus pandemic — and weeks into another Covid-disrupted school year — school systems across the nation are struggling with the role of testing in keeping children safe and in class.

Some have gone all in on testing. Others offer no Covid testing at all. The numerous school districts in the San Antonio area reflect that stark divide.

Fox Tech High School, for example, offers weekly testing to every student and staff member. And a single positive result can prompt a contact-tracing effort that lasts for days.

But the program is largely voluntary, and despite the district’s efforts, many families have not enrolled; about 30 percent of students are participating.

But in the Boerne Independent School District, where masks are optional, testing is also optional and only available in the campus clinic by appointment.

While the district says that anyone who is sick should not come to school, symptomatic people will not be referred for testing or even sent home unless they are “unable to participate in instruction.”

Elsewhere in San Antonio, the Northside has taken a middle ground: rapid-testing students and staff members who are symptomatic, although students can only be tested if parents consent.

And about 290 miles north on San Antonio, in Grapevine, the school district’s testing center saw so much demand in early September that appointments were booked up days in advance. Amy Taldo, who runs the site, said she lacked the staff to expand. “I need an army,” she said.

Texas is a microcosm of the patchwork of programs at schools across the country.

In Illinois, for example, all public schools outside of Chicago are eligible for free SHIELD testing: weekly saliva tests developed by the University of Illinois at Urbana-Champaign. The program was bombarded by last-minute sign-ups; as of Sept. 21, 43 percent of participating public schools opted in after Aug. 23, a SHIELD representative said.

And in Fresno, Calif., the school district has been unable to replenish its stock of rapid antigen tests and has had to cut back on its testing of student athletes as a result.

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KIGALI, Rwanda — Bars in Rwanda resumed operations on Friday night, almost two years since they were forced to close as part of strict measures to curb the spread of the coronavirus pandemic.

For the first time since March 2020, dozens of bars and alcohol stores reopened for business, bringing a frisson of life to parts of the capital, Kigali. Dressed-up friends reunited, people shared their first drinks in groups, and disc jockeys welcomed back customers. Parking spots were full at some drinking locales, and motorcycles and taxis dropped off more delighted patrons.

“It’s like a new year,” said Alex Ndahiro, a radio host who was out in Remera, a Kigali neighborhood whose trendy, reopened bars and restaurants were popular with revelers.

As a group of friends swayed to pulsating music and took selfies nearby, he added: “I am having goose bumps as we speak.”

As the coronavirus swept into the country last year, Rwanda instituted one of the most stringent lockdowns in the African continent: closing borders and businesses, suspending learning and deploying drones to not only spread anti-Covid messaging but also catch those flouting rules. The lockdown and social distancing measures curtailed economic growth, pushing Rwanda into its first recession, according to the World Bank.

While authorities eased some of those restrictions along the way, infections fueled by the Delta variant and a shortage of vaccines pushed health officials to institute tighter lockdowns.

But a recent bump in inoculations and the reduction of positivity rates pushed the cabinet this week to ease limits. As of Friday, this hilly Central African nation of 13 million people had administered Covid-19 vaccines to more than two million — and more than 1.5 million of them have had two doses. That makes Rwanda one of the few African nations that have attained the World Health Organization’s goal for countries to vaccinate 10 percent of their population by September.

To reopen bars, authorities instituted rules including requiring that there be 1.5-meters, or five feet, between seats; that handwashing services be available, and that all bar employees be masked and vaccinated.

Owere Godfrey, who manages the Skylux Lounge in Kigali, said that he was happy to comply with the regulations to be able to fully reopen. The level of restrictions still in place until Friday meant that, even though he had 300 seats at the bar and restaurant, he was only able to fill 50.

“It’s been so bad,” Mr. Godfrey said. But in the coming days and weeks, he said, he hoped that business would pick up and that he would be able to hire more workers.

“Tonight is the beginning,” he said. “It will get better. It has to get better.”

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WASHINGTON — As he announced on Friday that booster shots would be available to some Americans, President Biden made a prediction: His administration was likely to soon provide third doses of the vaccine “across the board” to anyone who wanted one.

“In the near term, we’re probably going to open this up,” he told reporters at the White House.

That statement — a politically popular one in a country where most vaccinated people say they are eager for a booster — was the latest example of how Mr. Biden and some of his team have gotten ahead of the nation’s top public health scientists, who have emphatically said in recent days that there is simply not enough evidence that boosters are necessary for the entire American population.

Two panels of scientists — one for the Food and Drug Administration and the other for the Centers for Disease Control and Prevention — voted in recent days against recommending boosters for everyone after fierce public debates.

The president’s remarks were the second time in two months that he had suggested boosters would be available to everyone. And they came the same day that Dr. Rochelle P. Walensky, the C.D.C. director and one of the president’s political appointees, came under fire for allowing boosters for a broader group of people than her agency’s own immunization panel recommended.

The announcements by Mr. Biden and Dr. Walensky did not sit well with all of the scientists who advise them, raising questions about the president’s pledge to always “follow the science.” Some warned that politics had intruded on scientific decisions — something that Mr. Biden had promised to avoid after the blatant pressures seen during the Trump administration.

Michael D. Shear reported from Washington, and Benjamin Mueller from New York. Noah Weiland contributed reporting from Washington.

Renters living in apartment buildings with federally backed mortgages may get an eviction reprieve — even though a broad federal moratorium on evictions during the Covid-19 pandemic expired last month.

The federal agency overseeing Fannie Mae and Freddie Mac — the two big government-controlled mortgage finance firms — on Friday extended the time period for those firms to grant mortgage relief to apartment owners. Landlords that accept the relief cannot evict a tenant for nonpayment of rent.

Sandra L. Thompson, acting director of the Federal Housing Finance Authority, said the extension was needed given the “uncertain nature of this pandemic.” The forbearance period for apartment owners with federally backed mortgages was set to expire this month; it also includes an eviction ban.

The F.H.F.A. did not put an end date on the program, which is available to landlords showing a financial hardship because of the pandemic.

It is unclear how many owners would accept the forbearance offer and how many renters would be covered. When the U.S. Supreme Court ruled in late August that the Biden administration could not extend the federal eviction moratorium without congressional approval, it was estimated that hundreds of thousands of people were in immediate danger of eviction.

The extension comes as the federal government and states are struggling to deliver $46 billion in emergency rental assistance approved earlier this year as part the administration’s pandemic relief package. The Treasury Department on Friday said that as of the end of August, it had distributed $7.7 billion in aid to more than one million households.

Fannie and Freddie do not make home loans but instead buy mortgages and package them into government-backed securities that are guaranteed in the event of default.