Covid-19 News: Young People Crowd a Florida FEMA Site in Hopes of Vaccination

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People waited to be vaccinated at a new FEMA site that opened March 3 at Miami-Dade College.
Credit…Cristobal Herrera-Ulashkevich/EPA, via Shutterstock

Few eligible people were trickling in to a remote Federal Emergency Management vaccination site in South Florida on Saturday. So when some younger people without proof of eligibility showed up, workers at the site went ahead and gave them shots, thinking there was no danger of running out for the day.

Word quickly spread around town: The site in Florida City, just north of the Florida Keys, was vaccinating any state resident 18 or older. Get down there fast.

It was a rare — and ultimately short-lived — opportunity for younger people to get shots in Florida, which for two months has concentrated almost exclusively on vaccinating older residents, who tend to be more vulnerable to Covid-19. Unlike every other state, Florida had not released a priority order for making more categories of people eligible, according to the Kaiser Family Foundation, leaving younger people in the dark about when their turn might come.

The state loosened its restrictions last week to allow people with certain medical conditions and a doctor’s note to get a shot and lowered the minimum age of eligibility to 50 for teachers, police officers and firefighters.

Those steps coincided with the arrival of FEMA, which opened mass vaccination sites in Miami, Orlando, Tampa and Jacksonville, each able to administer 3,000 shots a day. All four also have two 500-shot-a-day satellite sites that will move from one underserved community to another every week. The one in Florida City, a majority Black city, was a satellite site.

Things soon started getting confusing. At first, any doctor’s note would do. Then the state required a specific form filled out by the doctor. Later, teachers and day care workers regardless of age became eligible, but only at FEMA sites and pharmacies participating in the federal vaccination program.

Public anger mounted with reports that the state was steering vaccines to affluent, predominantly white retirement communities linked to powerful business people and political donors.

Still, demand seemed to be soft. Before Saturday, only one FEMA site — the mass site in Orlando — had ever used all of its daily allotment of shots, according to Marty Bahamonde, a FEMA spokesman. That was especially worrisome in the Miami area, which for weeks has seen persistently high numbers of new cases, including more transmissible virus variants.

So on Saturday, when word got around that the Florida City satellite site appeared to be relaxing its eligibility restrictions, hundreds of people flocked there — so many, in fact, that the staff started taking down names and asking them to come back on Sunday. By the end of the day, the site had administered 483 shots, its biggest day so far.

When the site reopened Sunday at 9 a.m., people were lined up around the block. By 9:30 a.m., workers and police officers were waving copies of Gov. Ron DeSantis’s executive order on eligibility and telling people who did not qualify that they would be turned away, said Julio E. Ligorria, 34, who had made a 45 minute drive to get there.

Mr. Ligorria said he had a medical condition, but did not have a primary care physician to sign his eligibility form. One doctor told him he would first need a physical and $3,000 worth of tests, which Mr. Ligorria’s insurance would not cover.

“I’ve been trying so hard to do this the right way,” he said. But he left without a shot.

A grand opening event at a barbecue restaurant in Hernando, Miss., on Saturday.
Credit…Rory Doyle for The New York Times

The Centers for Disease Control and Prevention is expected this week to issue eagerly awaited guidance regarding how or whether Americans vaccinated against the coronavirus may set aside restrictions adopted to slow its spread.

More than 30 million people in the United States — more than 8 percent of the population — are fully vaccinated, and many are wondering if it is safe to get together with friends and family, to travel or stop wearing masks, or to resume activities like going to gyms and restaurants.

“Those guidelines are coming out from the C.D.C. really imminently,” Dr. Anthony S. Fauci, President Biden’s chief medical adviser on Covid-19, said on Sunday on the CBS program “Face the Nation.”

He suggested that the recommendations could be issued within the next couple of days.

The new advice had been expected last week, but Dr. Rochelle P. Walensky, the C.D.C. director, said in a White House briefing on Friday that “these are complex issues, and the science is rapidly evolving.”

“Our goal, and what is most important, is that people who have been vaccinated and those not yet vaccinated are able to understand the steps they can take to protect themselves and their loved ones,” she added. “We are making sure and taking the time to get this right.”

The clamor for federal guidance comes as some governors have begun lifting state restrictions, despite warnings from health officials that it is much too soon and criticism from President Biden that such actions represent “Neanderthal thinking.”

Last week, Texas and Mississippi, both Republican-led states, lifted statewide mask mandates. Restaurants have reopened for limited indoor dining in New York City. Officials in Connecticut plan to end capacity limits on restaurants, gyms and offices this month. In at least a half-dozen states, officials are insisting that schools offer in-person instruction for at least some grades.

“We need the country open,” Senator John Barrasso, Republican of Wyoming, where the mask mandate has not yet been lifted, said Sunday on NBC’s “Meet the Press.”

“We need kids back in school every day with a mask, without a mask. We know how to stay safe. We know what we need to do: get vaccinated.”

Asked if lifting mask mandates would inspire some people to stop taking protective measures, Mr. Barrasso, an orthopedic surgeon, said, “Well, people need to take precautions. I have my mask with me right here. I’m going to continue to wear a mask. And I think people will use good judgment to do so.”

On Sunday, Gov. Jim Justice of West Virginia, who recently loosened restrictions on businesses but has kept the state’s mask mandate, said that other governors needed to be more incremental in lifting mandates.

“I don’t like the mask, either,” Mr. Justice, a Republican, said on CBS’s “Face the Nation,” adding that he believed the mandates were still necessary for probably at least another month.

“I have a saying — ‘one robin doesn’t make spring,’” he said. If Americans start to celebrate too early, he added, there will be consequences: “You’re about to get hit by a winter storm.”

There is still some scientific ambiguity around which behaviors are safe for people who have been vaccinated. While the vaccines are highly effective at preventing serious illness and death, there is not yet sufficient evidence on whether vaccinated people may still transmit the virus to others.

Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said Sunday on “Meet the Press” that it was important that the C.D.C. issue guidelines that are pragmatic and recognize the conundrums faced by Americans trying to navigate a society in which some people are vaccinated while others await their turn.

“If we just tell people that they’ve got to stay cocooned, that they’ve got to stay in their homes, that they’ve got to continue to wear their masks, even though they’re fully vaccinated — they’re not going to do that,” Dr. Osterholm said. “They’re going to disregard the public health recommendations, so we have to get real.”

The guidelines should address questions like whether grandparents who are vaccinated can see their grandchildren, he added. And the recommendations should distinguish between activities that might be relatively reasonable for vaccinated people and those that should still be off-limits, like going to crowded restaurants.

As of Sunday, Biden administration officials still were urging American communities to maintain precautions until more progress has been made.

“We just need to hang in there a bit longer,” Dr. Fauci said. “We will be pulling back on these mitigation measures. It’s not going to be this way indefinitely, for sure.”

Gov. Asa Hutchinson said businesses in his state needed more flexibility.
Credit…Staci Vandagriff/The Arkansas Democrat-Gazette, via Associated Press

Gov. Asa Hutchinson of Arkansas said that if his state maintained its current progress on key measures of the coronavirus — like test positivity rates and hospitalizations — he would make wearing masks in public voluntary rather than mandatory by the end of the month.  

The plan seemed to seek a middle ground between abruptly announcing the end of mask mandates, as Texas and Mississippi did last week, and retaining them indefinitely in the face of growing pressure from businesses, as New York and other states are doing.

“We didn’t want a cliff,” Mr. Hutchinson said on “Fox News Sunday.” “I wanted an off-ramp.”

The Texas and Mississippi moves were criticized as premature and reckless by public health officials, and President Biden called them the product of “Neanderthal thinking,” because the virus is still infecting tens of thousands of people in the country every day and new, more contagious variants are spreading widely. Several governors have said in recent days that their states were definitely not ready to drop mask mandates.

But more broadly, many states, including Arkansas, have recently been relaxing some restrictions on businesses despite the warnings from public health officials that it was too soon to let the nation’s guard down.

“Our businesses have taken the right measures,” Mr. Hutchinson said on Sunday, but “there’s just a limit as to how much the restrictions can be placed on business and for how long. They’ve struggled, they’ve suffered, and so we wanted to give more flexibility.”

“That’s not caveman thinking,” he added. “That’s common sense.”

He said people in his state needed to know that an end was in sight: “For me in Arkansas, I wanted to set a goal, and give people hope that we can end a mask mandate if we get to this place where we feel more comfortable and our hospitalizations are still down.”

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Despite coronavirus concerns, thousands of people convened at a stadium in Erbil, Iraq, on Sunday as Pope Francis said Mass. The service capped the first papal visit to Iraq.CreditCredit…Ivor Prickett for The New York Times

Pope Francis’s three-day visit to Iraq was a boon to the diminishing Christian community, a boost for the beleaguered Iraqi government — and a possible health hazard, as many participants found social distancing impossible and disregarded masks.

The trip, the first papal visit to the country, came at a vulnerable time. Iraq reported record daily highs of more than 5,000 infections this week, and its leaders have implemented curfews. The country’s vaccination campaign began only last week, and many Iraqis are wary of government health programs, so few in the population of nearly 40 million have received even a single shot.

The pope and his entourage were vaccinated, and the Vatican had dismissed fears that large events during the trip might spread the virus, saying that precautions would be taken to minimize risk.

But Iraqis are generally unaccustomed to wearing masks and many live and work in crowded conditions, so they are also unused to social distancing. When they gathered in large numbers to see the pope, mask-wearing was far from universal.

The virus is far more easily transmitted indoors than outdoors, but most Iraqis wrongly believe that there is no outdoor transmission at all. In some cities where the pope appeared, thousands of people jammed together in the streets to await his arrival. At services, choirs were generally unmasked.

At a Mass in the town of Qaraqosh, about half the congregation was unmasked. Another service, on Sunday, was held in a stadium in Erbil, the Iraqi Kurdistan regional capital. Church officials had said that about 5,000 tickets would be distributed, but Kurdish television reported that about 10,000 people attended.

In the streets of Ankawa, the Christian enclave of Erbil, thousands of people holding flowers and olive branches stood behind plastic tape strung between barriers, hoping to catch a glimpse of the pope as he drove to the stadium. Musicians played drums and flutes as children danced on the sidewalk.

The pope himself was sometimes masked, sometimes not. He did not wear one when first arriving in Baghdad. Photos and a brief video of a meeting with one of Iraq’s most revered and vulnerable residents, 90-year-old Grand Ayatollah Ali al-Sistani, showed neither the pope nor the Shiite cleric masked.

Ayatollah Sistani has not been vaccinated, with his office saying he wants to make sure others have access first. He has declared the vaccine religiously permissible.

A research facility at Duke University in Durham, N.C., where positive coronavirus tests are sequenced.
Credit…Pete Kiehart for The New York Times

The Centers for Disease Control and Prevention has been warning about it since January: A more contagious and possibly deadlier variant of the coronavirus, first found in Britain, is likely to become predominant in the United States, perhaps leading to a wrenching surge in cases and deaths.

The first part of that warning seems to be coming true: The variant, known as B.1.1.7, is doubling its share of all new U.S. cases about every 10 days.

But the second part is harder to make out, at least so far. The steep fall in new cases from the January peak halted in mid-February, but the trend since then has been roughly steady or only slightly downward, rather than a feared “fourth wave.”

Experts are not sure why. The accelerating pace of vaccinations and the remaining virus-control measures in much of the country might be balancing out the spread of the more contagious variant, so that total cases neither rise nor fall very much. But it is difficult to know how long that equilibrium might last, or whether the next clear turn in the trend will be upward or downward.

The risk of a surge has by no means passed, Dr. Anthony S. Fauci, President Biden’s chief medical adviser on Covid-19, warned on Sunday.

The nation was averaging about 60,000 new cases a day as of Saturday, according to a New York Times database. That is the lowest seven-day average since October and about 10 percent below the average on Feb. 21, when the steep decline slowed. Still, the figure is close to the peak level of the surge last summer. Death reports are also falling but remain high, regularly topping 2,000 a day.

In an interview Sunday on the CBS program “Face the Nation,” Dr. Fauci said that over the past week and a half, the decline in cases had stalled. “We’re plateauing at quite a high level — 60 to 70,000 new infections per day is quite high,” he said.

This trend is particularly worrisome, he said, because in the United States over the past year, when the daily level of new infections plateaued at a high level, surges in cases followed. And recently in Europe, infection levels were declining, then plateaued and “over the last week or so, they’ve had about a 9 percent increase in cases,” Dr. Fauci said.

Experts say they need more data to understand why the United States has not yet seen a surge in cases as the fearsome B.1.1.7 variant has spread so rapidly, already accounting for more than one-fifth of new cases.

William Hanage, a Harvard epidemiologist, said there could be several reasons B.1.1.7 has not started ravaging the United States the way it consumed Britain, including more widespread vaccination, improving weather and the patchwork of pandemic restrictions across the states.

Florida, Mr. Hanage and other experts say, is an interesting example, because infections have not surged even though restrictions are looser than in other states and the variant makes up at least an estimated 30 percent of cases, the highest proportion in the nation.

Dr. Fauci said on Sunday that a variant first identified in New York is “not widespread yet, but it seems to be spreading pretty efficiently through the New York City metropolitan area and beyond.”

He said there is evidence that the variant may partly elude protection conferred by vaccines and monoclonal antibody treatments, although the variant does not evade vaccines and treatments as much as one first identified in South Africa.

The best way to prevent further spread is to “get people vaccinated as quickly and as expeditiously as possible and, above all, maintain the public health measures that we talk about so often: the masking, the physical distancing, and the avoiding of congregate settings, particularly indoors.” Dr. Fauci said. “That’s what you can do to prevent the spread of a worrisome variant.”

The corporate headquarters of Emergent BioSolutions in Gaithersburg, Md.
Credit…Samuel Corum for The New York Times

A year ago, as the coronavirus spread unchecked, sending thousands of dying people to the hospital, desperate pleas for protective masks and other medical supplies went unanswered. Today the shortage of basic supplies, alongside inadequate testing and the slow vaccine rollout, stands as a symbol of the broken federal response to a worldwide calamity that has killed more than a half-million Americans.

An investigation by The New York Times found a hidden explanation as to what went wrong: Government purchases for the Strategic National Stockpile, the country’s emergency medical reserve where such equipment is kept, have largely been driven by the demands and financial interests of a handful of biotech firms that have specialized in products that address terrorist threats rather than infectious disease.

Chief among them is Emergent BioSolutions, a Maryland-based company now manufacturing Covid-19 vaccines for AstraZeneca and Johnson & Johnson. Last year, as the pandemic raced across the country, the government paid Emergent $626 million for products that included vaccines to fight an entirely different threat: a terrorist attack using anthrax.

Throughout most of the last decade, the government has spent nearly half of the stockpile’s half-billion-dollar annual budget on the company’s anthrax vaccines, The Times found. That left the government with less money to buy supplies needed in a pandemic, despite repeatedly being advised to do so.

Former Emergent employees, government contractors, members of Congress, biodefense experts and current and former officials from agencies that oversee the stockpile described a deeply dysfunctional system that contributed to the shocking shortages last year. Their accounts were confirmed by federal budget and contracting records, agency planning documents, court filings, corporate disclosures and transcripts of congressional hearings and investor presentations.

Purchases are supposed to be based on careful assessments by government officials of how best to save lives, but many have also been influenced by Emergent’s bottom line, the documents and interviews reveal.

In the two decades since the repository was created, Emergent’s aggressive tactics, broad political connections and penchant for undercutting competitors have given it remarkable sway over the government’s purchasing decisions related to the vaccines, the interviews and documents show.

While national security officials still consider anthrax a threat, it has not received specific mention since 2012 in the intelligence community’s annual public assessment of dangers facing the country, a report that has repeatedly warned of pandemics.

“The risk of a serious terrorist attack with anthrax is real, but that doesn’t mean you buy unlimited quantities of vaccine,” said Dr. Thomas Frieden, the director of the Centers for Disease Control and Prevention under former President Barack Obama. “It is a zero sum. There’s only so much money, and so if you buy more of one thing, you have to buy less of another.”

Israelis show their “Green Passes” to gain admittance to a concert in Tel Aviv on Sunday as the country reopened to those who are fully vaccinated.
Credit…Jack Guez/Agence France-Presse — Getty Images

JERUSALEM — Prime Minister Benjamin Netanyahu of Israel enjoyed a cappuccino and cake on the terrace of a Jerusalem cafe on Sunday morning to mark the broadest reopening of the country’s economy since the first coronavirus lockdown began a year ago.

For the first time in months, restaurants have reopened, with restrictions on occupancy and social distancing and with indoor seating available only to so-called Green Pass holders, meaning people over 16 who are fully vaccinated.

Israel has outpaced the rest of the world in vaccinations, with 55 percent of the population having received one dose of the Pfizer-BioNTech vaccine and more than 41 percent two doses. It is now an international laboratory for the efficacy of the vaccine, and is becoming a test case for the practical, legal and ethical issues arising from a tier system for the vaccinated and unvaccinated.

Event halls are reopening for Green Pass holders and gatherings of up to 1,500 people will be allowed in stadiums and arenas. And after weeks of tight restrictions on entry to the country that left thousands of Israeli citizens stranded abroad, all citizens and permanent residents will be allowed to enter the country, but with a cap on numbers that will increase over the week from 1,000 to 3,000 people per day.

“This is a great day,” Mr. Netanyahu said, as he supped in the spring sunshine alongside the mayor of Jerusalem, Moshe Leon. “We are coming back to life.”

The “Back to Life” program is central to Mr. Netanyahu’s election campaign, with another ballot scheduled for March 23, Israel’s fourth in two years.

With new daily infections still in the thousands, health officials and experts have warned against opening up the airport to passengers from abroad who may carry contagious virus variants, and against relaxing restrictions too rapidly out of political considerations. But the government has also come under pressure from Israelis wanting to return to the country to vote.

Hundreds of people gather in downtown Asunción, Paraguay, in protest of the government's lack of management and transparency during the pandemic and to demand the end of Mario Abdo Benitez's presidency on March 5.
Credit…Maria Magdalena Arrellaga for The New York Times

President Mario Abdo Benítez of Paraguay faced calls for his resignation and large street protests over the weekend as Paraguayans decried the dismal state of the public health system, under strain amid a record number of coronavirus infections.

Paraguay, one of the poorest countries in South America, has received just a few thousand doses of Covid-19 vaccine. Julio Mazzoleni, the health minister, resigned Friday as critical care units in hospitals became full and doctors ran out of basic drugs.

Hours after Mr. Mazzoleni stepped down, thousands took to the streets in downtown Asunción, the capital, to call for the resignation of Mr. Abdo Benítez, a conservative leader who assumed office in August 2018.

Protesters and opposition lawmakers said the country’s health crisis had been exacerbated by pervasive corruption at all levels of public procurement and spending.

“Paraguayans have already paid for drugs and vaccines that aren’t here,” said lawmaker Efraín Alegre, the head of the main opposition party, the Liberal Party. “It’s not the fault of Paraguayan people — it’s a serious corruption problem.”

As lawmakers called for his impeachment, Mr. Abdo Benítez on Saturday called on all his ministers to draft resignation letters. By the end of the day, he accepted the resignations of three ministers, including the minister of education.

The outcry began on Wednesday when medical professionals held a protest in Asunción to call attention to the scarcity of basic medical supplies. The health care workers said they had run out of drugs for chemotherapy treatment and sedatives for patients who needed to be intubated.

For now, Mr. Abdó Benítez appears to have enough support in Congress to avoid impeachment. But protesters across the country have said they intend to continue holding demonstrations until his government falls.

Paraguay shut down its borders and implemented strict measures early in the pandemic, which spared it initially from the large outbreaks seen in neighboring countries like Brazil and Argentina. But infections have surged in recent weeks, reaching a peak on March 4, when health officials reported 1,439 new cases.

The health ministers of three other countries in South America — Peru, Ecuador and Argentina — have stepped down in recent weeks amid scandals and criticism of the ways in which governments have handled vaccine distribution and other aspects of the response to the pandemic.

People praying outside Hasan Anani mosque in Jiddah, Saudi Arabia, in January.
Credit…Amr Nabil/Associated Press

Saudi Arabia on Sunday lifted most restrictions that had been imposed to slow the spread of the coronavirus, permitting indoor dining at restaurants and allowing gyms and barbershops to reopen.

After getting hit hard by the virus last summer, the kingdom has done comparatively well at controlling its epidemic with on-again, off-again restrictions. The country of 34 million, more than one-third of them noncitizens, has recorded more than 379,000 cases and 6,500 deaths.

After a rise in cases, the government on Feb. 3 imposed restrictions on recreational activities that were supposed to last 10 days but were extended for another 20 days.

Under the new rules, indoor dining at restaurants has resumed, with mandatory temperature checks upon entry and no more than five people at tables that must be three meters apart. Movie theaters, gyms and sports centers have also reopened.

Larger events such as weddings, banquets and corporate conferences are still banned, with a 20-person cap on other events.

Saudi Arabia and its wealthy Gulf Arab neighbors have generally fared better against the virus than other countries in the Arab world.

The United Arab Emirates has heavily invested in vaccination and is now a world leader, having given more than 6.2 million vaccines and reaching rate of 63 doses per 100 people, according to government figures.

Kuwait on Sunday imposed a 5 p.m. to 5 a.m. curfew for the next month after a rise in cases. Last month, the country had reduced opening hours for nonessential business and barred noncitizens from entering the country. Kuwait also has a strict mandate on face masks in public places; violators can be fined up to $16,000 and given three-month jail terms.

The pandemic has put economic pressures on Gulf states since it has reduced demand for oil and gas, on which the nations rely heavily for income. The pandemic has also increased stress on the millions of low-paid foreign laborers, mostly from South Asia, who do a range of essential jobs. Across the region, many such workers have seen their wages cut, been laid off or had to return home because of lost jobs.

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Senate Narrowly Passes Biden’s Pandemic Relief Plan

The Senate passed President Biden’s sweeping $1.9 trillion stimulus bill on Saturday, with a party-line vote of 50-49. The package must now move back to the House before being signed into law.

“The pandemic has affected nearly every aspect of American life, so this bill spans the gamut and provides support to every part of our country. For Americans who doubted that the government can help them in this time of crisis, you’ll be getting direct checks. Your schools will receive assistance to reopen quickly and safely. Your local businesses will get another lifeline. And the day when you receive the vaccine will be a lot sooner. The American Rescue Plan will go down as one of the most sweeping federal recovery efforts in history. Our job right now is to help our country get from this stormy present to that hopeful future. And it starts with voting ‘aye’ on the legislation before us. Vote ‘yes’ on the American Rescue Plan.” “Voters gave Senate Democrats the slimmest possible majority. Voters picked a president who promised unity and bipartisanship. Democrats’ response is to ram through what they call, quote, ‘the most progressive domestic legislation in a generation’ on a razor-thin majority in both houses. We could have worked together to speed up victory, but our Democratic colleagues made a decision. Their top priority wasn’t pandemic relief. It was their Washington wish— wish list. So Mr. President and colleagues, I strongly recommend a ‘no’ vote.” “The yeas are 50. The nays are 49. The bill as amended is passed.”

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The Senate passed President Biden’s sweeping $1.9 trillion stimulus bill on Saturday, with a party-line vote of 50-49. The package must now move back to the House before being signed into law.CreditCredit…Erin Schaff/The New York Times

The Senate passed its version of the $1.9 trillion American Rescue Plan on Saturday. The pandemic relief bill now goes back to the House of Representatives, which must approve the Senate’s changes before it can go to President Biden’s desk. Here are some answers to some frequently asked questions.

The stimulus payments would be $1,400 for most recipients. Those who are eligible would also receive an identical payment for each of their children.

To qualify for the full $1,400, a single person would need an adjusted gross income of $75,000 or below. For heads of household, adjusted gross income would need to be $112,500 or below, and for married couples filing jointly that number would need to be $150,000 or below.

If you’re already receiving unemployment benefits, payments would generally be extended for another 25 weeks, until Sept. 6. The weekly supplemental benefit, which is provided on top of your regular benefit, will remain $300 but run through Sept. 6.

Although unemployment benefits are taxable, the new law would make the first $10,200 of benefits tax-free for people with income less than $150,000. This applies to 2020 only.

Buying insurance through the government program known as COBRA would temporarily become a lot cheaper.

COBRA, for the Consolidated Omnibus Budget Reconciliation Act, generally lets someone who loses a job buy coverage via the former employer. But it’s expensive.

Under the relief bill, the government would pay the entire COBRA premium from April 1 through Sept. 30.

A person who qualified for new, employer-based health insurance someplace else before Sept. 30 would lose eligibility for the no-cost coverage. And someone who left a job voluntarily would not be eligible, either.

A fisherman in Hoi An, Vietnam, last month.
Credit…Rehahn C for The New York Times

On March 11, 2020, the World Health Organization declared that the coronavirus outbreak had reached the level of a pandemic, with “alarming levels of spread and severity.” Almost immediately, international travel ground to a halt, as countries closed their borders, airlines canceled flights, and cities around the world went into lockdown.

The losses in life, health and people’s livelihoods continued to mount. The blow to the travel industry and all who depend on it was stunning: International arrivals at United States airports fell by 98 percent in April 2020 compared to the previous year, and stayed at that level for months.

According to the Organisation for Economic Co-operation and Development, the global tourism economy is expected to shrink by about 80 percent when all the data for 2020 is in.

With the one-year anniversary of the pandemic approaching, The Times Travel Desk looked at places around the world that are heavily dependent on tourism to see how they have adapted.

Carla Brown of Canon Hospice speaks with workers at the East Baton Rouge Council on Aging while waiting with one of her patients.
Credit…Abdul Aziz for The New York Times

BATON ROUGE, La. — Flossie West was not at all interested in taking the coronavirus vaccine. Carla Brown, the nurse overseeing her care, was determined to change her mind.

Ms. West, 73, has ovarian cancer, congestive heart failure and breathing difficulties — conditions that place her at grave risk should she contract the virus. But her skepticism about the new vaccines overshadowed her fears of Covid-19.

“I’m just not interested, because everyone tells me the virus is a hoax,” Ms. West said. “And besides, that shot is going to make me more sick than I already am.”

On Thursday morning, Ms. Brown, 62, breezed into Ms. West’s apartment and delivered a stern lecture: The virus is real, the vaccines are harmless, and Ms. West should get out of bed, grab her oxygen tank and get into her car.

“I’ll be darned if I’m going to let this coronavirus take you,” Ms. Brown said.

Even as vaccine supplies become more plentiful, African-Americans are being inoculated at half the rate of whites, according to an analysis by The New York Times. The disparities are especially alarming given the disproportionate impact of the pandemic on communities of color, who have been dying at twice the rate of whites.

The racial gap in vaccination rates is no less stark in Louisiana, where African-Americans make up 32 percent of the population but just 23 percent of those who have been vaccinated.

In recent weeks, Ms. Brown has been frenetically working to persuade her patients to get inoculated, and her one-woman campaign provides a glimpse into the obstacles that have contributed to the troublingly low rates of vaccination in the Black community.

Part of the problem is access. In Baton Rouge, the majority of mass vaccination sites are in white areas of the city, creating logistical challenges for older and poorer residents in Black neighborhoods who often lack access to transportation. Older residents have also been thwarted by online appointment systems that can be daunting for those without computers, smartphones or speedy internet connections.

But much of the racial disparity in vaccination rates, experts say, can be tied to a longstanding mistrust of medical institutions among African-Americans. Many Baton Rouge residents can readily cite the history of abuse: starting with the eugenics campaigns that forcibly sterilized Black women for nearly half of the 20th century, and the notorious government-run Tuskegee experiments in Alabama that withheld penicillin from hundreds of Black men with syphilis, some of whom later died of the disease.

“The distrust among Black Americans comes from a real place and to pretend it doesn’t exist or to question whether it’s rational is a recipe for failure,” said Thomas A. LaVeist, an expert on health equity and dean of the School of Public Health and Tropical Medicine at Tulane University.

A child tossed a surgical mask into a fire during a protest at the Idaho Statehouse in Boise on Saturday.
Credit…Nathan Howard/Getty Images

A group of parents urged their children to burn masks on the steps of the Idaho State Capitol on Saturday, videos show, in a state that has never had a statewide mask mandate.

“Destroy them! Feed them to the fire! We don’t want them in our world anymore!” young children are heard shouting as they grab handfuls of surgical and cloth masks and toss them into a barrel of flames. Adults in the background cheer them on.

Gov. Brad Little, a Republican, has resisted a mask mandate in Idaho, despite research showing mask mandates are linked to fewer infections and Covid-19 deaths in counties across the United States. Conservative lawmakers in the state have nonetheless pushed legislation banning any such measures, The Associated Press reported.

The videos, taken by an Oregon Public Broadcasting reporter and a New York Times contributor, Sergio Olmos, show about 100 people on the steps of the state capitol building.

In one video, several children not much taller than the burning barrel itself approach to drop in masks. “Here fire, you hungry?” says one child. In another video, police officers approaching a woman about a fire are repeatedly told to back off. “Leave her alone!” protesters call out. Idaho State Police said in a statement that open flames were not allowed on State Capitol grounds and that the incident was under review.

The demonstrations were in part organized by Darr Moon, the husband of Dorothy Moon, an Idaho State representative.

In a video posted to YouTube on Friday, Ms. Moon, along with another state representative, Heather Scott, called the demonstrations a “grass-roots project that we have become aware of and fully support.”

Ms. Moon claimed in the video that the state has a low caseload that doesn’t justify protective measures. A total of 1,880 people in Idaho have died from the coronavirus, according to a New York Times database.





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