Covid News: Judges Rule New York City Vaccine Mandate for School Workers Can Proceed

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ImageCredit…Gabby Jones for The New York Times

New York City’s vaccine mandate for nearly all adults working in its public schools can proceed as scheduled, a federal appeals panel ruled on Monday, reversing a decision made over the weekend that paused enforcement of the mandate until later this week at the earliest.

Mayor Bill de Blasio had originally ordered well over 150,000 educators and staff in the nation’s largest school system to receive at least one dose of a Covid-19 vaccine by tonight at midnight.

But on Monday evening, he said he would extend the deadline until the end of the day Friday, meaning that the mandate would take effect next Monday morning, Oct. 4.

The leaders of the unions representing city teachers and principals have spent the last week calling on the mayor to delay the deadline to give schools more time to prepare for potential staffing shortages caused by workers who refuse to get vaccinated.

The original deadline was put on hold late Friday by a judge of the U.S. Court of Appeals for the Second Circuit. The three-judge panel was scheduled to take up the issue on Wednesday, but it appears to have ruled early.

The vaccine mandate for city educators and school staff has been upheld twice in state and federal courts in recent weeks. The Department of Education mandate is the first strict vaccine requirement for any group of city workers, and it could clear the path for a much broader mandate for all city employees in the coming weeks.

Mr. de Blasio said Monday that roughly 97 percent of principals and about 95 percent of teachers had been vaccinated, according to estimates from the city and unions representing teachers and principals, and that 87 percent of non-teaching school staff had received at least one shot. Roughly 8,000 Department of Education employees received a vaccination dose over the weekend in anticipation of the deadline.

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 were not prepared to deal with staffing crunches.

Michael Mulgrew, the president of a powerful teachers’ union in the city, United Federation of Teachers, said in a statement that “the city has a lot of work before it to ensure that enough vaccinated staff will be available by the new deadline.”

The New York City Department of Education said in a statement that the court’s ruling “is on the right side of the law and will protect our students and staff.”





New York Readies to Enforce Vaccine Mandate for Health Care Workers

Gov. Kathy C. Hochul said New York would work with hospitals to address potential staffing shortages as a mandate requiring health care workers to have received at least one dose of a coronavirus vaccine goes into effect.

Can’t we just say that that is a basic right that everyone has, to know that they’ll be safe when they enter a health care facility, or you have your elderly parents or grandparents in a nursing home, that they will not get sick because of someone who’s charged with their care? I need to keep people in this state safe, and we’ll be nation-leading with our mandate, which strikes at midnight tonight when everyone is expected in a hospital in the State of New York or a health care facility to have been vaccinated. And so I’m calling on all the health care workers. First of all, those of you who’ve been vaccinated, I thank you from the bottom of my heart for doing what was right and helping lead the way so we do have the confidence we need. And to those who’ve not yet made that decision, please do the right thing. I will be signing an executive order to give me the emergency powers necessary to address these shortages where they occur. That’s going to allow me to deploy the National Guard, who are medically trained, deploy people who’ve been retired, who may have had a license lapse, bring in people from elsewhere. It’s not a role I relish. My default position is to ask people, please do this. This is why it’s been proven to be safe. The vaccine’s been out there a long time now. There are not legitimate religious exemptions because the leaders of all the organized religions have said there’s no legitimate reason, and we’re going to win that in court in a matter of days. And so this is so unnecessary. We’re taking all the steps preemptively in anticipation of what I call a preventable staffing shortage. Still preventable — enough hours in a day. Come on down. Go to this place. There’s plenty of places that can make this be a preventable — something that we just went through an exercise for but didn’t need to. But I also am realistic to know that there are people who will not come back to their jobs.

Video player loadingGov. Kathy C. Hochul said New York would work with hospitals to address potential staffing shortages as a mandate requiring health care workers to have received at least one dose of a coronavirus vaccine goes into effect.CreditCredit…Dave Sanders for The New York Times

Tens of thousands of health care workers in New York appeared to be risking their jobs by defying a state mandate to receive a dose of a coronavirus vaccine by Monday, setting up an early test for similar employer mandates across the United States.

Gov. Kathy C. Hochul’s success at enforcing the mandate could shape how other states proceed, as President Biden pushes for every person working in a health care setting to be fully vaccinated against Covid-19.

In New York, Rhode Island, Maine, Oregon and the District of Columbia, health care workers must get vaccinated to remain employed. In California, New Jersey, Pennsylvania, Maryland and Illinois, workers have the option to be tested regularly if they choose not to get inoculated.

On Monday, Mayor Bill de Blasio said he hoped that health care workers in New York City would agree to get vaccinated this week to avoid losing their livelihood. His administration said that about 5,000 employees at the city’s public hospital system — roughly 10 percent of the work force — had not been vaccinated and could not come to work or get paid.

Health officials in New York City said on Monday that they had not heard of any major staff shortages at public or private hospitals so far. The city’s health commissioner, Dr. Dave Chokshi, said that some hospitals might have to make operational adjustments in intensive care units or operating rooms.

“I do believe that hospitals will be prepared to get through this without a major impact to patient care,” Dr. Chokshi said at a news conference Monday morning.

Resistance to vaccine mandates has deterred most states from threatening to fire unvaccinated workers, even though employers (or state governments, in their capacity as employers) are legally allowed to require workers to get vaccinated, according to the U.S. Equal Employment Opportunity Commission.

Mass firings have begun in some states. A hospital system in Delaware, ChristianaCare, announced on Monday that it had fired 150 employees, including 90 full-time positions, for not complying with its Covid-19 vaccine mandate. And in North Carolina, the Novant Health hospital system announced that more than 175 of its workers have been fired for violating its vaccine mandate, The Associated Press reported.

New York’s mandate and the state’s refusal to allow religious exemptions are the subject of at least two lawsuits. A vaccine mandate for the more than 150,000 adults working at New York City’s public schools was delayed by a federal appeals court on Friday.

Many of New York’s health care workers have resisted the order because they are worried about potential side effects from the vaccines, or have challenged it because they say it violates their personal freedom. Covid vaccines have proven to be highly effective at preventing symptomatic infections, severe illness and death, and side effects of the vaccine, if any, tend to be minor and short-lived.

New York officials are bracing for possible staffing disruptions at health care facilities. Ms. Hochul said last week that she might declare a state of emergency and deploy National Guard troops, or even recruit temporary workers from the Philippines or Ireland, if they are needed to replace unvaccinated health care workers.

Jen Psaki, the White House press secretary, said on Monday that President Biden’s administration supported vaccine mandates, including New York’s and those in other health care systems around the country, as well as contingency plans to ensure adequate staffing if the mandates resulted in personnel shortages.

Many hospital systems had imposed vaccine mandates with relatively little impact on the size of their staffs, Ms. Psaki said.

On Monday, Ms. Hochul reiterated that the state was prepared to work with hospitals to address any staff shortages, and repeatedly labeled potential shortages as “preventable.”

“It’s not a role I relish,” Ms. Hochul said about enforcing the state mandate. “But I also realistically know that there are people who will not come back to their jobs.”

In interviews, doctors and nurses in New York City said that some holdouts were getting vaccinated as the deadline neared. At St. Barnabas Hospital in the Bronx, the percentage of employees with at least one dose jumped from 88 percent on Friday to 94 percent by late Monday morning, the hospital’s chief medical officer, Eric Appelbaum, said in an interview. He noted that many of the holdouts had gotten vaccinated at pharmacies over the weekend. “I did not think it would be this good,” he said, adding that he had worried the vaccination rate would stall before reaching 90 percent.

Ms. Hochul said she had heard anecdotally from medical practitioners and hospital systems that some facilities, especially those located in the downstate region, were seeing an increase in the number of health care workers getting vaccinated on Monday. She said, however, that there would be some lag time in compiling updated statewide figures.

Ms. Hochul, who has said she intended to seek election to a full term as governor in 2022, thanked workers who had already gotten vaccinated on Monday, and pleaded with holdouts to join them.

“To those who have not yet made that decision, please do the right thing,” she said during a news conference in the Bronx. “We have a lot of facilities. A lot of your employers are anxious to just give you the jab in the arm and say you’re part of the family. We need your help to continue on.”

Ms. Hochul, who has been in office for just over a month, taking over after former Gov. Andrew M. Cuomo resigned, faced her first crisis earlier this month when Hurricane Ida’s downpours led to at least 15 deaths in the state. Pushback over the vaccine mandate is likely to be her next major test.

In New York City, public health workers who refused to get vaccinated were not being fired on Monday. City officials said they hoped that workers would get vaccinated this week and return to work.

Mr. de Blasio said on Monday that he was optimistic that his vaccine mandate for school employees would hold up in court. He said that 90 percent of teachers in the city were already vaccinated.

“We are very, very confident that the city is going to prevail,” Mr. de Blasio said.

Daniel E. Slotnik contributed reporting.

Correction: Sept. 27, 2021

An earlier version of this item referred incorrectly to when Gov. Kathy Hochul discussed measures New York State might take to deal with shortages of health care workers that might arise because of the state’s vaccine mandate. The governor mentioned the possibility of recruiting workers from countries like the Philippines or Ireland on Thursday, and mentioned plans to use National Guard troops if necessary in a statement on Saturday; she did not speak of both measures on Friday. 





Biden Gets Pfizer-BioNTech Booster Vaccine On Camera

President Biden received his third dose of the Pfizer-BioNTech coronavirus vaccine, days after federal regulators approved Pfizer boosters for Americans 65 years and older, as well as those with medical conditions and jobs placing them at higher risk.

“You’re eligible for a booster if it’s been six months since your second Pfizer shot, and if you fall into one of these categories: people over 65, which is hard to acknowledge, adults — I’m only joking folks — adults with certain underlying health conditions like diabetes and obesity, and those who are at increased risk of Covid-19 because of where you work or where you live, like health care workers, teachers, first responders, grocery store clerks. Now I know it doesn’t look like it, but I am over 65. I wish — way over — and that’s why I’m getting my booster shot today. Boosters are important, but the most important thing we need to do is get more people vaccinated. The vast majority of Americans are doing the right thing. Over 77 percent of adults have gotten at least one shot. About 23 percent haven’t gotten any shots. And that distinct minority is causing an awful lot of us, an awful lot of damage for the rest of the country. This is a pandemic of the unvaccinated. That’s why I’m moving forward with vaccination requirements wherever I can.” Reporter: “Is the first lady getting hers as well today, Mr. President?” “She’s going to get one, I think she’s teaching, but she’s going to get one, yes.” Reporter: “Mr. President, what do you say to world health leaders like the World Health Organization who’s saying wealthy nations should help more countries without vaccinations to get vaccinated before they give out boosters here in America?” “We are helping, we’re doing more than every other nation in the world combined. We’re going to have well over a billion, 100 million shots, and we’re going to continue going. We’re going to do our part. We’ve also given a great deal of funding to Covax, which is a vehicle that does this. So we have plenty, plenty of opportunity to make sure we get everyone in the world to play our part, the largest part in the world of getting everyone vaccinated.”

Video player loadingPresident Biden received his third dose of the Pfizer-BioNTech coronavirus vaccine, days after federal regulators approved Pfizer boosters for Americans 65 years and older, as well as those with medical conditions and jobs placing them at higher risk.CreditCredit…Doug Mills/The New York Times

President Biden may have gotten ahead of the government’s scientists in announcing prematurely that virtually all Americans would begin getting coronavirus booster shots this fall, but he made a show of getting his own. The president spoke briefly before he received a Pfizer-BioNTech booster on Monday afternoon.

“Let me be clear,” Mr. Biden said before he got the shot. “Boosters are important. But the most important thing we need to do is get more people vaccinated. The vast majority of Americans are doing the right thing.”

His third shot came only days after federal regulators moved to allow millions of Americans to get Pfizer booster shots if individuals received a second dose of that vaccine at least six months ago and met new eligibility rules. Frontline workers, older people and younger adults with medical conditions or jobs that place them at higher risk got the green light following weeks of intense debate within regulatory agencies that left much of the American public confused about the specifics of the booster plan.

Mr. Biden, eligible for a booster at age 78, has been vaccinated in public before when he got his first Pfizer dose last December, a contrast to his predecessor, Donald J. Trump, who received an early vaccine at the White House but did not talk about it at the time. But Mr. Biden has pursued the opposite strategy.

The White House press secretary Jen Psaki said on Monday that Mr. Biden had gotten his booster on camera “to make clear it’s safe, it’s effective, it’s something you should do if you’re in one of these categories.”

Senator Mitch McConnell of Kentucky, the minority leader, announced on the Senate floor that he had also received a booster shot — “an easy decision,” he added, particularly as a survivor of polio.

On Monday, Mr. Biden added to the air of nonchalance around the booster by answering reporters’ questions — about critiques of vaccine policy, infrastructure negotiations and other topics — while getting injected.

World Health Organization officials have called for a global moratorium on booster shot programs until the end of the year, describing them as an unequal and ineffective use of the limited pool of available vaccines. Asked about the criticism, Mr. Biden reiterated that the United States had provided more vaccine doses to the global effort than all other countries combined, and would continue to do more.

Mr. Biden said that about 23 percent of adult Americans had not received a single dose of the vaccine, and they were causing “an awful lot of damage for the rest of the country.”

Asked what vaccination percentage would get things back to normal, Mr. Biden said he was not a scientist, but that so many people “can’t go unvaccinated and us not continue to have a problem.”

Mr. Biden said that he was moving forward with vaccination requirements where he could impose them, and that he planned to travel to Chicago on Wednesday to talk about individual businesses implementing their own vaccination mandates.

A Reuters/Ipsos national survey conducted Aug. 27-30 found that 76 percent of Americans who have received at least one shot of a vaccine want a booster. Only 6 percent do not, the poll found.

Mr. Biden asked on Friday for people who were not yet eligible to be patient. He said that his administration was “looking to the time when we’re going to be able to expand the booster shots, basically across the board,” and that boosters for the Moderna and Johnson & Johnson vaccines were likely in the offing.

“So I would just say, it’d be better to wait your turn in line, wait your turn to get there,” Mr. Biden said.

Zachary Montague and Emily Cochrane contributed reporting.

Credit…John Minchillo/Pool

Jair Bolsonaro, Brazil’s proudly unvaccinated president, is contending with more fallout from his visit to New York last week to speak at the United Nations: A fourth member of his entourage has tested positive for Covid-19, and his wife, Michelle, opted to get vaccinated before they returned home.

Pedro Duarte Guimaraes, an economist who is the chief executive of Caixa Economica Federal, a leading Brazilian banking institution, disclosed on Sunday that he had tested positive, joining Brazil’s health minister, Marcelo Queiroga, Mr. Bolsonaro’s son Eduardo and a Brazilian diplomat. Mr. Queiroga, who was diagnosed during the visit, remained in isolation in a New York hotel.

Mr. Guimaraes and Mr. Queiroga have said they were fully vaccinated. Mr. Bolsonaro, whose insistence on downplaying the pandemic has been widely criticized, has declined to be vaccinated, contending that his own recovery from a Covid infection last year gave him resistance to a recurrence.

Defying a United Nations honor system requiring proof of vaccination, Mr. Bolsonaro was the first leader to address the General Assembly last Tuesday when it commenced the annual high-level week of speeches by representatives of its 193 members.

His delegation’s visit to New York also created an uproar from a widely circulated photograph showing him and subordinates eating pizza on the sidewalk. The host city of the United Nations requires proof of vaccination for indoor restaurant dining.

The potentially infectious Brazilians prompted United Nations officials to notify all diplomats at the organization who may have been in contact with them. As of Monday, none had reported testing positive, said Stéphane Dujarric, the U.N.’s chief spokesman.

Mrs. Bolsonaro’s vaccination, disclosed by Mr. Bolsonaro on Thursday after their return home, generated more adverse publicity, apparently revealing the couple’s lack of solidarity on that subject and — to some Brazilians — a disrespect by the Brazilian first lady for her country’s own health system.

“So what happened with my wife, just now in the United States. She came to me to ask: ‘Should I take the vaccine or not?’” he said during his weekly Facebook live chat. “I gave her my opinion. I’m not going to say what my opinion was. I’m going to say what she did. She took the vaccine.”

Mr. Bolsonaro, 66, also said: “She’s an adult, she’s 39, she knows what she’s doing and she got the vaccine.”

The president’s office sought to clarify the circumstances, explaining in a statement Friday night that all members of Mr. Bolsonaro’s entourage had to take a Covid test before boarding the plane back to Brazil. The statement said that during the test, the doctor administering it asked Mrs. Bolsonaro if she would like to be vaccinated.

“Since she had already been thinking about getting a shot, she decided to accept,” it said.

The statement did not identify the vaccine administered to her. Senator Omar Aziz, head of a parliamentary commission examining Mr. Bolsonaro’s handling of the pandemic, suggested she could have performed a patriotic duty by having been vaccinated at home.

“I congratulate Mrs. Michelle, who, unlike her husband, was vaccinated,” he told Brazilian media, but “someone should have told her that the vaccine applied in the United States is the same as in Brazil.” (In addition to the vaccines approved in the United States, Brazil has also used the Coronavac and AstraZeneca vaccines.)

Both Mr. and Mrs. Bolsonaro both tested negative on Sunday, his office said.

Nearly 600,000 Brazilians have died from Covid, the second-highest toll behind the United States, where more than 688,000 have died, according to a New York Times database, and only 41 percent of the Brazilian population has been fully vaccinated.

Ernesto Londoño contributed reporting.

Credit…Anna Moneymaker for The New York Times

Dr. Peter Marks, one of the Food and Drug Administration’s highest-ranking regulators, on Monday took over the agency’s vaccines office, whose two leaders had publicly questioned whether the general population needed coronavirus booster shots.

Dr. Marks said in an email to staff that the move, which makes him acting director of the office, would allow the two — Marion Gruber, the director of the vaccines office, and Dr. Philip Krause, her deputy — to “take care of close-out activities prior to departing and help to assure a smooth transition.”

Dr. Gruber recently announced plans to retire at the end of October, and Dr. Krause in November.

Both have evaluated vaccines for decades at the agency’s Office of Vaccines Research and Review, and were said to have been upset at the Biden administration’s announcement last month that booster shots would be available to most adults by the week of Sept. 20, contingent on F.D.A. clearance.

The two regulators wrote in The Lancet earlier this month that there was no credible evidence yet in support of booster shots for the general population, and that more data and public discussion were needed. Their position was shared by many independent scientists, who have said that coronavirus vaccines continue to be powerfully protective against severe illness and hospitalization.

After a tense meeting of the F.D.A.’s vaccine advisory panel, Dr. Gruber last week signed the agency’s decision memo behind its authorization of Pfizer-BioNTech booster shots for people 65 and older, people at high risk of severe Covid-19 and others at risk of serious complications from Covid-19 whose jobs frequently expose them to the virus.

The C.D.C.’s vaccine advisory panel delivered a similar vote, but not did endorse offering boosters based on one’s job. Dr. Rochelle P. Walensky, the agency’s director, overruled the advisers and recommended shots for people based on “occupational or institutional setting.”

President Biden said last week that 60 million people would be eligible for a Pfizer-BioNTech booster over the coming months.

The F.D.A.’s vaccines office has more important decisions ahead, including whether to authorize the Pfizer-BioNTech vaccine for children ages 5 to 11 and booster shots for recipients of the Moderna and Johnson & Johnson vaccines.

As director of the F.D.A.’s Center for Biologics Evaluation and Research, Dr. Marks, a hematologist and oncologist, has supervised the vaccine office’s reviews for the entirety of the pandemic. He is credited as the architect of the Trump administration’s vaccine program, Operation Warp Speed, that developed and funded coronavirus vaccines.

But Jesse Goodman, a former chief scientist at the agency, said that Dr. Marks’s decision to take over the office was “extremely unusual and concerning.” He said that the F.D.A. needed to offer a clear explanation, or else it could “erode trust” in the agency. “This just doesn’t make sense to me,” he said.

“These are the two people who know the most about vaccines at the F.D.A., and they should be doing everything they can to keep them involved in all the critical activities,” he said, referring to Dr. Gruber and Dr. Krause.

Some administration officials said Dr. Marks’s action made sense because the upcoming departures of Dr. Gruber and Dr. Krause could delay critical decisions on vaccines if someone else were not in charge. Dr. Eric Topol, a professor of molecular medicine at Scripps Research in La Jolla, Calif., praised Dr. Marks’s experience, and said that “new leadership was vital” after Dr. Gruber and Dr. Krause so strongly expressed that booster shots were not justified for everyone.

But Dr. Luciana Borio, a former acting chief scientist at the F.D.A. under President Barack Obama, said Dr. Marks could have tapped someone else. “There are several well-qualified individuals in the office,” she said, “and I was surprised that one of them wasn’t being elevated to acting director.”

An F.D.A. spokeswoman said in a statement Monday that “a smooth transition is particularly important given the critical regulatory submissions that the Office of Vaccines Research and Review will need to work through as a team over the coming months that will affect the health of nearly every American.”





Sydney to Phase Out of Lockdown

Gladys Berejiklian, the premier of New South Wales, Australia, said restrictions in Sydney and other areas of the state still under lockdown would start lifting in October when officials expect 70 percent of residents over the age of 16 to be fully vaccinated.

A double dose has been confirmed now at 60 percent. We are literally just a few weeks away from having that 70 percent double dose, and 12 to 15 year olds, already 40 percent have received their first dose, which is fantastic. Let’s not think about this as a freedom day, but let’s think about this as a stage reopening to getting back to normal. But there’s no doubt that for those of us who are fully vaccinated at the 70 percent double dose, life will feel so much better. Life will feel getting back to normal. And obviously a number of things kicking in at 80 percent, including community sport, regional travel and a whole range of other things. And then on the 1st of December, will be the final stage of reopening where unvaccinated people will be able to participate.

Video player loadingGladys Berejiklian, the premier of New South Wales, Australia, said restrictions in Sydney and other areas of the state still under lockdown would start lifting in October when officials expect 70 percent of residents over the age of 16 to be fully vaccinated.CreditCredit…Dan Himbrechts/EPA, via Shutterstock

Three months after Australia’s biggest city locked down to contain its latest coronavirus outbreak, the authorities have outlined a path to reopening. If it reaches a series of milestones in vaccination rates, Sydney will see restrictions start to lift in early October, with the aim of returning to normal life by December.

The city’s five million residents will begin to emerge from lockdown on Oct. 11, Gladys Berejiklian, premier of the state of New South Wales, said on Monday. That is the date by which officials expect to have vaccinated 70 percent of the state’s population over the age of 16, she said. Residents of Sydney, as well as some parts of rural New South Wales still under lockdown, will once again be able to go to hairdressers and attend weddings, funerals and small gatherings.

By late October, when 80 percent of the state is projected to be fully vaccinated, Sydney residents will be able to drink standing up in restaurants and bars, and attend larger events. Unvaccinated people will still be barred from those activities, officials said, but they will be able to attend places of worship. And New South Wales will allow more Australians stranded overseas to return.

On Dec. 1, most venues including cinemas, nightclubs and museums will reopen, masks will no longer be mandatory indoors and restrictions will be lifted for unvaccinated residents. Melbourne, Australia’s second biggest city, is set to start emerging from lockdown on Oct. 26, when 70 percent of residents aged over 16 are expected to be fully vaccinated.

Nationwide, 41 percent of Australia’s population is fully vaccinated and 63 percent have had at least one dose.

Prime Minister Scott Morrison has said that before the end of the year, he expects to reopen the border to foreign visitors and allow Australians to travel abroad again.

Credit…Mario Tama/Getty Images

For months, the world economy has expanded at a torrid pace, as industries that were shut down in the pandemic reopened. While that process is hardly complete — numerous industries are still functioning below their prepandemic levels — further healing appears likely to be more gradual, and in some ways more difficult.

Reopening restaurants and performance arenas is one thing. Fixing extraordinary backups in shipping networks and shortages of semiconductors, among the most vivid examples of supply shortages, is harder.

And a range of risks, including the hard-to-predict dynamics of coronavirus variants, could throw this transition to a healthy post-pandemic economy off course.

The Organization for Economic Cooperation and Development last week projected that the world economy would grow 4.5 percent in 2022, downshifting from an expected 5.7 percent expansion in 2021. Its forecast for the United States shows an even steeper slowdown, from 6 percent growth this year to 3.9 percent next.

Of course, a year of 3.9 percent G.D.P. growth would be nothing to scoff at — that would be much faster growth than the United States has experienced for most of the 21st century. But it would represent a resetting of the economy.

After the global financial crisis of 2008-9, the great challenge for the recovery was a shortfall of demand. Workers and productive capacity were abundant, but there was inadequate spending in the economy to put that capacity to work.

Now there is plenty of demand — thanks to pent-up savings, trillions of dollars in federal stimulus dollars and rapidly rising wages — but companies report struggles to find enough workers and raw materials to meet that demand.

Dozens of container ships are backed up at Southern California ports, waiting their turn to unload products meant to fill American store shelves through the holiday season. Automakers have had to idle plants because of semiconductor shortages. Builders have had a hard time obtaining windows, appliances and other key products needed to complete new homes. And restaurants have cut back hours for lack of kitchen help.

These strains are, in effect, acting as a brake that slows the expansion. The question is how much, and for how long, that brake will be applied.

Credit…Emily Kask for The New York Times

As closed offices cautiously debate the merits and logistics of reopening, a parallel sphere of workers — retail employees, day laborers, emergency personnel, medical staff — seemingly inhabit another country entirely. In their case nothing ever closed. Often their jobs just got really, really hard.

In some parts of the country, the conversation has begun to move away from early Covid-19 alarm and into something more guardedly speculative. What will post-pandemic life look like? How have our priorities shifted? But for vast swaths of the nation, where vaccinations lag, it remains late 2020 in many ways.

“A lot of people here still don’t believe the virus is real — even when the hospitals are full, even when they have family dying,” said Peter Naughton, a cashier and self-checkout host at a Walmart in Louisiana. “With the vaccines, one co-worker told me getting it would go against her faith. Another told me it contains baby fetuses and mercury.”

The conversations Mr. Naughton describes may be epidemiologically out of step, but he and thousands of others seem trapped in an America-right-now vortex, a swirl of politics, belief, resentment and fear.

At fast food restaurants, grocery stores, warehouses, nursing homes and anywhere else frontline workers show up each day, a deep schism has taken hold. Workers nervous about the virus find themselves at the mercy of those who aren’t.

“If I ask people to wear a mask or socially distance at work, they get mad and tell the manager. Then I have to get coached. If you get coached too many times, you lose your job,” Mr. Naughton said, referring to the company’s system for managing worker infractions. (Charles Crowson, a Walmart spokesman, did not dispute that an accumulation of coachings could lead to termination.)

With nearly 1.6 million workers, Walmart is the largest private employer in the country. It employs 35,954 people in Louisiana alone, working for one of the 137 Supercenters, discount stores, neighborhood markets or Sam’s Clubs across the state.

Covid appears to have been good for the bottom line: During fiscal 2020, the company generated $559 billion in revenue, up $35 billion from the previous year. But labor activists say too little of that money has gone toward work force protections, which in turn has prolonged the pandemic.

Credit…Prakash Mathema/Agence France-Presse — Getty Images

Nepal has reopened to tourists in a bid to revive an industry battered by the Covid-19 pandemic.

The government began offering visas to foreigners who land at Kathmandu airport last week, said Narayan Prasad Bhattarai, director general of the immigration department. Vaccinated tourists and those with negative PCR tests will no longer have to quarantine in hotels, he said.

The decision has lifted the hopes of tourism operators and Nepalis who saw the pandemic decimate their livelihoods. More than a million people in Nepal work in the trekking and climbing industry, which brings about $2 billion a year into one of Asia’s smallest and poorest nations. Climbers spend tens of thousands of dollars each to attempt to scale one of the eight peaks in Nepal above 8,000 meters (26,000 feet).

Trekking regions, including Mount Everest, emptied out at the start of the pandemic as Nepal canceled all expeditions. The country then introduced mandatory quarantines and stopped issuing visas at the airport. Companies laid off workers, and sherpa guides were forced to return to their villages in the mountains, many growing potatoes to make their living.

This spring, Nepal allowed expeditions for some mountains, including Everest. Large outbreaks at the base camp marred the attempts, leading some climbers to abandon their efforts.

Tourism entrepreneurs were elated by the recent government decision. “It will certainly take some time to return to normalcy,” said Samsher Parajuli, managing director of Global Holidays Adventure Nepal. “Nevertheless, this is a good decision to save the tourism industry.”

Nepal, a country of 30 million people, has fully vaccinated just 21 percent of its population, and is adding fewer than 900 new infections a day, according to health ministry statistics. Although the authorities say that the virus’s spread is under control for now, they have asked people to follow health protocols and social distancing to avoid outbreaks during religious festivals.

Credit…Matthew Busch for The New York Times

A pharmacy owner in San Juan, P.R., faces up to five years in prison and a $250,000 fine after pleading guilty to giving coronavirus vaccine shots to children under 12, and then submitting Medicaid claims for them, according to federal prosecutors in Puerto Rico.

The San Juan pharmacy administered full adult doses of the Pfizer-BioNTech vaccine to 24 children aged 7 to 11, prosecutors said.

No Covid vaccine has yet been authorized in the United States for use in children under 12.

Pfizer-BioNTech announced last week that clinical trials showed its vaccine to be safe and highly effective in young children aged 5 to 11 years, but at one-third of the dosage given to adults and older children. At higher doses, trial researchers observed more side effects in younger children, including fever, headache and fatigue, though none were severe.

The United States attorney’s office in San Juan said that no serious medical conditions were identified as a result of the illegal vaccinations in Puerto Rico.

Other countries have recently begun vaccinating young children against the coronavirus. Cuba is using vaccines developed on the island in children as young as 2. China and the United Arab Emirates are vaccinating children as young as 3. Even so, many European countries, like the United States, still offer the vaccine only for people 12 or older as they await trial data from manufacturers.

Once Pfizer and BioNTech apply to the Food and Drug Administration for authorization, which they are expected to do in the next few days, the regulatory process could move swiftly, potentially allowing millions of elementary school students to begin to receive shots around the end of October.

Credit…Adam Hunger/Associated Press

More than 90 percent of N.B.A. players have been vaccinated against Covid-19, according to the league, and all referees and key team personnel without exemptions will be, too, by the season’s start in three weeks. But a few high-profile players, including the Nets star guard Kyrie Irving, have expressed skepticism about vaccines or been evasive about their vaccination status.

Because the Nets are projected to be a top championship contender, and the team is one of just three whose players must be vaccinated to play in their home arenas, Irving’s vaccination status could be as much of a factor in the N.B.A. rankings as his team’s play.

“I would like to keep all that private,” Irving told reporters on Monday in response to a question about whether he expected to play home games this season. “Please just respect my privacy. All the questions leading into what’s happening, just please. Everything will be released at a due date once we get this cleared up.”

While the Nets held their media day at Barclays Center on Monday, Irving answered questions from reporters by video conference instead of in person. Multiple reports said that Irving was not present because of the league’s health protocols. In Rolling Stone magazine over the weekend, Irving’s aunt Tyki Irving was quoted as saying that Irving was unvaccinated for reasons “not religious-based, it’s moral-based.” It’s not clear when the interview took place.

Since Sept. 13, Barclays Center and Madison Square Garden, where the Knicks play, have required all employees and guests ages 12 and up without a religious or medical exemption to show proof of having received at least one vaccine dose, to comply with a mandate from Mayor Bill de Blasio regarding sports arenas.