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Saturday, July 31, 2021

Covid Live News: Latest Updates on Delta, Hospitalizations and Masks - The New York Times

Daily Covid Briefing

July 31, 2021, 11:25 p.m. ET

July 31, 2021, 11:25 p.m. ET
Ayana Campbell, 14, received a Covid shot at Jackson State University in Mississippi on Tuesday.
Rogelio V. Solis/Associated Press

Vaccinations are rising in U.S. states where lagging demand left entire regions vulnerable to a Delta-driven surge of coronavirus cases. The shift offers a sign of hope, even as the country’s known cases since the start of the pandemic surpassed 35 million on Saturday.

For the third consecutive week, states with the highest number of coronavirus cases also had the highest vaccination rates, Karine Jean-Pierre, the deputy White House press secretary, said on Friday.

In Mississippi, where 44 percent of adults have been fully vaccinated, the seven-day average of people receiving a first dose was 5,203 on July 27, more than triple the average from July 1, according to data from the Centers for Disease Control and Prevention.

The same pattern is in play for other less vaccinated states where infections are surging. From July 1 to July 28, Louisiana almost quadrupled its seven-day average of administered first doses. And in Missouri, where the Delta variant spurred an outbreak in early July, the number of first doses administered daily almost doubled over a month.

Still, compared with the rest of the country, these states’ vaccination rates remain low. And their rates of hospitalizations and deaths are higher compared with states with more vaccinations.

More than 850,000 shots were recorded on Friday, raising the daily national average to more than 650,000 from about 500,000 three weeks ago. But the overall rate is less than a fifth of the U.S. peak average of 3.4 million shots, reached in mid-April.

The C.D.C. said on Friday that about 190.5 million people had received at least one dose of a Covid vaccine, and about 164.2 million people were fully vaccinated, some by Johnson & Johnson’s single-dose vaccine but many more by the two-dose series made by Pfizer-BioNTech and by Moderna.

That still leaves more than half the country not fully vaccinated, including about 48 million children under 12, who are not eligible. Only full vaccination affords high protection from severe disease if someone infected with the Delta variant.

The national outlook is quickly worsening. Louisiana, which was averaging fewer than 400 cases a day at the start of July, is now averaging more than 4,100 cases a day, the most ever. The county that includes Jacksonville, Fla., is averaging almost 1,200 cases a day.

As a whole, daily case reports in the United States have risen 150 percent over the past two weeks, pushing the known pandemic total past 35 million.

Between 75 and 80 percent of staff members who tested positive for the coronavirus at Zuckerberg San Francisco General Hospital were fully vaccinated. 
Jeff Chiu/Associated Press

At least 233 staff members at two major San Francisco hospitals, most of them fully vaccinated, tested positive for the coronavirus this month, and most, according to a hospital official, involved the highly contagious Delta variant.

Some of the cases were asymptomatic, most involved mild to moderate symptoms and only two required hospitalization, officials said. The infections were determined to be Delta-related because most samples in San Francisco were tested for the variant, which is now dominant in the city.

About 75 to 80 percent of the more than 50 staff members infected at Zuckerberg San Francisco General Hospital were fully vaccinated, Dr. Lukejohn Day, the hospital’s chief medical officer, said in an interview on Saturday. The University of California, San Francisco Medical Center said in a statement issued on Friday that 153 of its 183 infected staff members had been fully vaccinated.

The statement from the U.C.S.F. Medical Center said that two of the infected staff members required hospitalization. None of the infected staff members at San Francisco General have been hospitalized and most had mild to moderate symptoms, Dr. Day said. The asymptomatic cases were discovered through contact tracing.

Without vaccinations, Dr. Day said, the hospitalization rate would be much worse.

“We’re concerned right now that we’re on the rise of a surge here in San Francisco and the Bay Area,” Dr. Day said. “But what we’re seeing is very much what the data from the vaccines showed us: You can still get Covid, potentially. But if you do get it, it’s not severe at all.”

On July 11, San Francisco ordered that workers in high-risk workplaces, including hospitals, be vaccinated by Sept. 15. The U.C.S.F. statement said that the hospital was “doubling down on our efforts to protect our staff. This includes requiring all employees and trainees to comply with the new UC-systemwide Covid-19 vaccination mandate, with limited exceptions for medical or religious exemptions.”

Staff members at both hospitals have continued to wear personal protective equipment, Dr. Day said. But the number of staff infections reported in July is about as many as during the peak of the winter surge.

“We’re nervous that we could potentially exceed it,” Dr. Day said.

The highly contagious Delta variant is now responsible for almost all new Covid-19 cases in the United States, and cases are rising rapidly. On Tuesday, for the first time since February, the country logged more than 100,000 confirmed cases.

Many places in the United States with some of the country’s lowest vaccination rates are seeing more new cases than at any point in the outbreak. For example, the areas encompassing Branson, Mo., and Harrison, Ark., have set records this month, and Louisiana now has daily case rates more than 10 times higher than in June.

And in low vaccinated areas, deaths are also on the rise.

A new internal report from the Centers for Disease Control and Prevention cited evidence that vaccinated people experiencing breakthrough infections of the Delta variant, which remain infrequent, may be as capable of spreading the virus as infected unvaccinated people.

Vaccines remain effective against the Delta variant, particularly against hospitalization and death. About 97 percent of those recently hospitalized by the virus were unvaccinated, the C.D.C. said.

Demonstrators in Paris protested against France’s health pass and other coronavirus protocols on Saturday. Similar protests took place in other cities, including Marseille, Rennes and Strasbourg.
Alain Jocard/Agence France-Presse — Getty Images

PARIS — Pascale Collino, 64, is far more afraid of the Covid-19 vaccines than of the disease itself. So when the French government decided to implement a new health pass policy barring those without proof of vaccination or a recent negative test from many indoor venues, she took to the streets in protest.

“We have to be on the front-lines of this fight,” Ms. Collino said on Saturday near the French health ministry in Paris, where a large crowd had converged, banging pots and cowbells.

For the third week in a row, thousands took to streets around France to protest against the government’s health pass law, which was passed by Parliament recently but still needs a final greenlight from a top constitutional council, expected next week, before it can be fully enforced.

The protests come as authorities try to stem a new wave of infections that is starting to put pressure on France’s hospitals, where 85 percent of Covid-19 patients are unvaccinated, according to a government report published this week.

Over 200,000 people marched in Paris, where 3,000 police officers were deployed, and in other cities, including Marseille, Rennes and Strasbourg, according to the French interior ministry. The growing size of the protests from week to week and their motley mix of demonstrators have become an increasing source of concern for the government.

The demonstrators are united in their distrust of the media and of President Emmanuel Macron’s government, but that is where the similarity ends. They include far-right and far-left activists, Yellow Vest members and vaccine conspiracy theorists, as well as vaccinated people who argue that the health pass is oppressive and unfair. They also encompass families angry over new rules dictating that unvaccinated middle and high school students, but not vaccinated ones, will be sent home if a coronavirus infection case is detected in their class.

One march that started in northern Paris ended with violence on the Place de la Bastille, where some protesters set trash cans on fire and threw projectiles at riot police, who responded with tear gas and water cannons.

Around France, three police officers were injured, and 19 people were arrested, the interior minister said.

In southern Paris, Ms. Collino, maskless and carrying a French flag, said she was angry that health workers were forced to get vaccinated by this fall, and that access to bars, restaurants, movie theaters, museums, gyms and other indoor venues would be restricted.

Around her, families waved French flags and protesters shouted “freedom” and “resistance” while carrying makeshift cardboard signs with slogans like “Don’t give in to blackmail” or “No to segregation.”

When the protesters passed a statue of Louis Pasteur, the renowned 19th-century French scientist credited with discovering the principles of vaccination, few seemed to take notice. One elderly man, who was walking past the demonstrators, did. “Pasteur must be turning over in his grave,” he grumbled.

The march there was organized by Florian Philippot, a former member of the far-right National Rally party who has become a figurehead of the anti-health pass movement. Two video journalists for the Agence France-Presse left the march after protesters insulted them, spat on them and prevented them from filming, the agency reported.

“We no longer have the freedom to seek the treatment that we want,” said Ms. Collino, a retired I.T. specialist who lives in the nearby town of Sèvres. She did not trust officials to tell the truth about vaccines and said that she had taken it upon herself to seek out information about the pandemic online.

Her attitude, however, has isolated her from some friends and family who favor the health pass policy, as do a majority of French people, according to recent polls. Millions have rushed to get their Covid shots since the pass was announced. But Ms. Collino said she would rather die than get vaccinated.

“I don’t understand why they are in favor while I’m against,” she said.

A coronavirus testing clinic at a high school in Brisbane, Australia, on Saturday.
Jono Searle/Getty Images

Parts of the Australian state of Queensland entered an emergency three-day lockdown on Saturday after authorities found six cases of the coronavirus, the latest setback to the country’s efforts to get the highly infectious Delta variant under control.

The lockdown covers Brisbane, Australia’s third-largest city, and surrounding areas, and is the strictest that officials have imposed. Nonessential businesses were ordered to close, and residents prohibited from having visitors or traveling more than about six miles from home.

“I know that the news of a snap lockdown may come as a shock to many families, but we know that this Delta virus is incredibly contagious, and we have to go hard and we have to go fast,” the Queensland premier, Annastacia Palaszczuk, said on Twitter.

Cities and states in Australia have gone in and out of lockdown for several weeks as outbreaks driven by the Delta variant outpace the country’s sluggish vaccination effort.

Australia’s most populous state, New South Wales, reported another 210 cases of the Delta variant, bringing the total number of infections in its accelerating outbreak to more than 3,000. Of the cases reported on Saturday, nearly two-thirds were in people younger than 40, health officials said.

A weekslong lockdown in greater Sydney, where the state’s cluster is centered, has been extended until Aug. 28. On Saturday, a week after a demonstration against the lockdown led to dozens of arrests, police set up checkpoints and enforced a no-go zone in central Sydney to deter plans for a follow-up demonstration.

About 300 Australian troops also began deploying to New South Wales to help enforce the lockdown. A statement from Australia’s defense department said the soldiers would help state police ensure that residents were following stay-at-home directives.

Other countries in the Asia Pacific region have also tightened restrictions in recent days in response to surges of the Delta variant. Japan on Friday expanded a state of emergency to four more areas in addition to Tokyo, and said that the measures in the capital would be in place at least until the end of August. Authorities in the Philippines said that the capital, Manila, would enter a strict two-week lockdown beginning Aug. 6.

In China, as an outbreak of the Delta variant spread on Saturday to Fujian province and the city of Chongqing, authorities were conducting mass testing in several provinces. Only about 200 cases have been found so far across the country, but it is the largest outbreak in China in months.

A commuter wearing a face mask arriving in downtown Chicago on Tuesday.
Scott Olson/Getty Images

What a difference a week makes. In just a few days, state and local authorities have imposed mask mandates, companies have put off returning workers to their offices, and the federal government and the military have pressured their employees to get vaccinated.

It started on Tuesday when the federal health officials reversed themselves and recommended that even people fully vaccinated against the coronavirus should wear masks again in public indoor spaces in parts of the country where the highly contagious Delta variant of the virus has been surging. They also said everyone in public schools should wear a mask, sparking heated debates across the country.

Some state and local governments, schools and businesses scrambled to follow the new guidelines, while others defiantly declared they would not. On Friday, Cornell University directed all faculty, staff, students and visitors to wear masks inside campus buildings and facilities, while Gov. Ron DeSantis of Florida signed an executive order giving parents the final say on whether their children wear masks in school.

By Friday, government documents leaked to the media had painted a grim picture of the Delta variant as more contagious, more likely to cause severe illness and more able to break through vaccines than other known versions of the virus. One document said officials must recognize that “the war has changed.”

“This virus is in the driver’s seat and we are chasing it,” said Dr. Ali Mokdad, an epidemiologist at the University of Washington and former C.D.C. scientist. “The only way we stay ahead of it is through vaccination and wearing a mask. If we don’t, we will always be catching up.”

It was a sharp turnaround from the national mood in early July, when President Biden had promised Americans that a more normal life would resume in time for Independence Day parties, describing the holiday as the start of a “summer of freedom.” Instead, in one episode in Provincetown, Mass., an outbreak that began after the town’s Fourth of July festivities has grown to more than 880 cases — almost three-quarters of them among fully vaccinated people.

In recent days, Atlanta and St. Louis have reissued mask mandates that apply to teens and adults. An indoor mask mandate will be reimposed in Washington, D.C., on Saturday. Nevada’s new mask mandate went into effect on Friday for counties with substantial or high transmission, which includes Las Vegas. The mandate in Kansas City will resume on Monday.

Both New York City and Los Angeles, the nation’s two biggest public school systems, had previously announced they would maintain universal masking policies. This week, The Los Angeles Unified School District took precautions further and announced that weekly coronavirus testing would be required for in-person instruction.

Vaccines are effective against the worst outcomes of infection, even with the variant, reducing the risk of death. But the lagging vaccination effort has fallen behind the ever-evolving virus. Fewer than half of adults are fully vaccinated.

This week, vaccine mandates gained momentum. Mr. Biden announced Thursday that all civilian federal employees must be vaccinated against the coronavirus or be forced to submit to regular testing, social distancing, mask requirements and restrictions on most travel. The Pentagon announced a similar vaccine policy hours later. New York, California, Puerto Rico and others followed suit.

Employers held off for months on making decisions about vaccine mandates, worried about legal and political pushback. But this week ushered in a steady stream of announcements from Walmart, the Walt Disney Company, Google, Facebook, Uber and others introducing new requirements that some employees be vaccinated. And The New York Times indefinitely delayed its return to office, which had been scheduled for September.

“Once you get a little momentum, you get a sort of tidal wave,” said Dr. Ezekiel J. Emanuel, who was a member of Mr. Biden’s Covid-19 Advisory Board during the transition between presidential administrations.

Over the past week, more than 77,200 coronavirus cases, on average, have been reported each day, up 150 percent from two weeks ago, according to a New York Times database. Reported new deaths are up 10 percent, to an average of 301 per day for the past week. Hospitalizations are up, to an average of roughly 39,400 per day, a 74 percent increase from two weeks ago.

Experts predicted that cases would peak around mid-August, and that there would be new surges tied to a return to schools and the holiday season this winter.

An electronic information board warning of a “variant of concern” circulating in Blackburn, England.
Oli Scarff/Agence France-Presse — Getty Images

The spread of the super-contagious Delta variant has prompted new restrictions around the world and spurred stark new warnings from public health officials.

“It is one of the most infectious respiratory viruses we know of and that I have seen in my 20-year career,” Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said last week.

The variant is as transmissible as chickenpox — meaning far more than the common cold virus, SARS, smallpox and seasonal flu. And even though the vaccines still provide strong protection against severe illness and death, fully vaccinated people can still be infected by and transmit Delta to others, according to an internal C.D.C. document obtained by The New York Times.

Fatality rate

(log scale)

More

deadly

1918 “Spanish” flu

Spreads faster

Delta variant

More transmissible than Ebola or smallpox, and as contagious as chickenpox.

Original

version of

coronavirus

Seasonal

flu

Chickenpox

Common cold

Average number of people infected by each sick person

Fatality rate

(log scale)

More

deadly

1918 “Spanish” flu

Spreads faster

Delta variant

More transmissible than Ebola or smallpox, and as contagious as chickenpox.

Original version of corona-

virus

Seasonal

flu

Common

cold

Chickenpox

Average number of people infected by each sick person

Fatality rate

(log scale)

More

deadly

Spreads faster

1918 “Spanish” flu

Delta

variant

As infectious as chickenpox.

Original

version of

coronavirus

Seasonal

flu

Common

cold

Chickenpox

Avg. number of people infected by each sick person

Here are answers to some common questions about the Delta variant.

Delta, formally known as B.1.617.2, is believed to be the most transmissible variant yet. It is believed to be roughly twice as contagious as the original virus. An internal C.D.C. document, a copy of which was obtained by The New York Times, said that Delta was as transmissible as chickenpox.

People who are infected by Delta may carry 1,000 times more virus, and for a longer period of time, than those infected by the original virus. Other evidence suggests that the variant may be able to partially evade the antibodies made by the immune system after a coronavirus infection or vaccination.

Delta has been reported in 182 countries, and is now the most common variant in many of them. Over the past month, infections have nearly doubled in most regions of the world, the W.H.O. said at a news briefing on Friday.

Delta was first identified in the United States in March. It spread quickly. In early April, Delta represented just 0.1 percent of cases in the United States. The C.D.C. now estimates that the number has hit 82.2 percent.

There is not yet good data on how all of the vaccines hold up against Delta, but two doses of several widely used shots, including those made by Pfizer-BioNTech, Moderna and AstraZeneca, appear to retain most of their effectiveness against the Delta variant, research suggests.

Delta may cause more frequent infections in people who have been fully vaccinated than other variants. However, these infections tend to be mild or asymptomatic. The vaccines prevent more than 90 percent of severe disease, the C.D.C. document notes.

The C.D.C. believes it’s possible. Although vaccinated people are less likely to become infected by Delta than those who are unvaccinated, those who do contract the virus may carry just as much of the virus in their noses and throats as unvaccinated people, Dr. Walensky said this week.

“Delta variant vaccine breakthrough cases may be as transmissible as unvaccinated cases,” the internal C.D.C. document said.

After a long and steady decline, cases are on the rise again in the United States, likely fueled by Delta. Roughly 71,000 new infections are reported each day, up from about 11,000 a day a little over a month ago.

But case numbers remain far below last winter’s peak, and experts do not expect them to rise that high again. However, Delta is driving outbreaks in areas where vaccination rates are low.

Get vaccinated. Inoculation is likely to slow the spread of variants and reduce the odds that more dangerous variants emerge. Face masks can provide additional protection.

Researchers at Wuhan University sequenced short stretches of the coronavirus from early cases. Some of those genetic sequences then went missing.
Roman Pilipey/EPA, via Shutterstock

A batch of early coronavirus data from China that went missing for a year — prompting questions about whether they had been purposely deleted — has emerged from hiding.

Last month an American scientist discovered that more than 200 genetic sequences from Covid-19 patient samples isolated in Wuhan, China, early in the pandemic had puzzlingly been removed from an online database.

A Seattle virologist, Jesse Bloom, managed to track down 13 of the sequences on Google Cloud. In an online report, he wrote that it “seems likely that the sequences were deleted to obscure their existence.”

But now an odd explanation has emerged, stemming from an editorial oversight by a German scientific journal called Small. And the sequences have been uploaded into a different database, overseen by the Chinese government.

The story began in early 2020, when researchers at Wuhan University sequenced a short stretch of genetic material from virus samples at a Wuhan hospital.

They posted their findings online in March 2020 and uploaded the sequences to an online database maintained by the National Institutes of Health. Their results were published in June 2020 in Small.

But a year later, Dr. Bloom, who was researching the origin of Covid-19, could not find the sequences in the database, and the N.I.H. said the authors of the study had asked that the data be withdrawn.

On July 5, more than a year after the Wuhan University researchers withdrew the sequences from the N.I.H. database and two weeks after Dr. Bloom’s report was published, the sequences were quietly uploaded to a different database maintained by China National Center for Bioinformation.

On July 21, the disappearance of the sequences was brought up during a news conference in Beijing, where Chinese officials rejected claims that the pandemic started as a lab leak. A high-ranking Chinese health official, Dr. Zeng Yixin, said the authors had asked for the data to be removed after editors at Small deleted a paragraph in which they were described.

An editor at Small, which specializes in science at the micro and nano scale and is based in Germany, confirmed that account.

On their own, the sequences can’t resolve the open questions about how the pandemic originated, whether through a contact with a wild animal, a leak from a lab or some other route.

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Dr. Tedros Adhanom Ghebreyesus, the World Health Organization’s director general, said a worldwide rise in Covid-19 cases has disparately impacted poorer countries with lower vaccination rates, and that deaths in Africa have spiked 80 percent in four weeks.Leo Correa/Associated Press

Confirmed coronavirus infections have jumped in much of the world, and deaths from the disease in Africa have increased by 80 percent over the last four weeks, the director-general of the World Health Organization said on Friday.

The continued spread of the virus and its variants, and its disparate impact on poorer countries with lower rates of vaccination, reflect a global failure, said Dr. Tedros Adhanom Ghebreyesus.

“The pandemic will end when the world chooses to end it,” he said at a news conference. “It is in our hands. We have all the tools we need. We can prevent this disease, we can test for it, and we can treat it.”

Dr. Tedros said that nearly four million new infections had been reported to the W.H.O. in the past week, and the organization expected the world to surpass 200 million total known cases in the next two weeks. However, the totals are underestimates, because countries often undercount cases — sometimes by very large margins. The known global death toll of roughly 4.2 million is assumed to be similarly skewed.

The global spread of the virus is now largely driven by the highly transmissible Delta variant and worsened by inconsistent use of public health measures, increased social mixing and mobility, and the inequitable use of vaccines and other treatments, Dr. Tedros said.

“Hard-won gains are in jeopardy or being lost, and health systems in many countries are being overwhelmed,” he said.

Things are still not as bad as they were not long ago; more than 500,000 new cases are being recorded daily, compared with more than 800,000 three months ago, according to data from the Center for Systems Science and Engineering at Johns Hopkins University.

Vaccines remain powerfully effective against severe illness and death, but some highly inoculated countries have recently seen sharp rises in caseloads in recent days. A report published by the Centers for Disease Control and Prevention on Friday showed that fully vaccinated people with “breakthrough” infections of the Delta variant, while still thought to be comparatively rare, may spread the virus to others as easily as unvaccinated people.

Vaccination rates range greatly, from more than 80 percent of adults in some countries to less than 1 percent in some of the world’s poorest nations, according to the Our World in Data project at the University of Oxford.

And even with increased vaccine production and more generous donations to Covax, a vaccine sharing initiative, meeting the needs of lower-income countries with large unvaccinated populations would be difficult, Dr. Tedros said.

He pointed to Africa, where cases have skyrocketed in July and where less than 1.5 percent of the continent’s population is fully vaccinated, as a particularly stark example of the problem.

“Many African countries have prepared well to roll out vaccines, but the vaccines have not arrived,” Dr. Tedros said, calling for a donation of $7.7 billion to a partnership for tests, treatments and vaccines, as well as more financing for Covax.

Carmele Ameda, a registered nurse, checked in on coronavirus patients at Jackson Memorial Hospital in Miami last week.
Scott McIntyre for The New York Times

MIAMI — The resurgence of the coronavirus has burdened hospitals anew across the country, with a rush of patients fueled by the virus’s virulent Delta variant catching doctors off guard. Florida has reported the highest daily average hospitalizations in the nation, 36 for every 100,000 people over the past two weeks, according to data compiled by The New York Times. In Jacksonville, hospitals have more Covid patients than ever before, despite the availability of vaccines.

Health workers like Alix Zacharski, a nurse manager at Miami’s Jackson Memorial Hospital, feel disbelief that they must endure another surge. She remains tired from the previous one. And she cannot get her head around having to treat patients the same age as her adult children who are gasping for breath because of a preventable infection.

Last year, Ms. Zacharski feared the unknown. Now she is armed with hard-earned knowledge from the past 14 months — and vaccinated, as a sticker on her hospital badge boasts. But the virus continues to move into uncharted territory.

“We are scared of seeing what we saw, and this time affecting the younger population,” she said. “This is the hardest thing I’ve ever done in my entire career.”

Jackson, Florida’s largest public hospital, had 232 Covid-19 patients on Friday, still half the 485 it had on July 27, 2020, its pandemic peak. But a sharp rise in recent hospitalizations prompted administrators to limit visitors and warn that more stringent measures could soon be necessary.

Jackson has also admitted some vaccinated people, but almost all have been transplant patients with compromised immune systems.

Carlos Migoya, Jackson’s chief executive, said the vaccination rate among the hospital’s employees — 60 percent as of Thursday — was too low, a problem plaguing many hospitals, which have started to mandate the shots.

About 61 percent of Miami-Dade County residents are fully vaccinated, higher than the state average of 49 percent. Miami-Dade holds one of the highest vaccination rates among the nation’s large, socially vulnerable counties, those characterized by high poverty rates, crowded housing and poor access to transportation.

County health care workers going  door to door to promote Covid-19 vaccines in Springfield, Mo., earlier this month.
Jill Toyoshiba/The Kansas City Star, via Associated Press

The Covid-19 vaccination effort has become so polarized in Missouri that some people are responding to the state’s Delta-driven surge by trying to get shots in secret, a doctor there said.

In a video circulated by her employer, Dr. Priscilla A. Frase, a hospitalist and the chief medical information officer at Ozarks Healthcare in West Plains, Mo., said this month that several people had pleaded for anonymity when they came in to be vaccinated, and that some appeared to have made an effort to disguise themselves.

“I work closely with our pharmacists who are leading our vaccine efforts through our organization,” she said, “and one of them told me the other day that they had several people come in to get vaccinated who have tried to sort of disguise their appearance and even went so far as to say, ‘Please, please please, don’t let anyone know that I got this vaccine.’”

It was not clear how many people had tried to alter their appearance to avoid recognition, or how they had done so. Dr. Frase, who wore a mask in the video, did not immediately respond to a request for comment.

Some people, she said in the video, are “very concerned about how their people that they love, within their family and within their friendship circles and their work circles, are going to react if they found out that they got the vaccine.”

“Nobody should have to feel that kind of pressure to get something that they want, you know,” she added. “We should all be able to be free to do what we want to do, and that includes people who don’t want to get the vaccine as well as people who do want to get the vaccine. But we’ve got to stop ridiculing people that do or don’t want to get the vaccine.”

Missouri’s vaccination rate is lagging. According to a New York Times database, 41 percent of Missouri residents have been fully vaccinated, compared with more than 49 percent nationwide. In Howell County, Mo., where Ozarks Healthcare and Dr. Frase are based, only 20 percent of residents are fully vaccinated.

On Thursday, Missouri reached a seven-day average of nearly 2,500 new cases of Covid-19 — an increase of 39 percent over the previous two weeks. Hospitalizations were up 38 percent over the same period.

Roselyn Estampador, 65, who lost her son to Covid-19 in January, visits his room with her daughter, Jeneffer Haynes, 37.
Rosem Morton for The New York Times

The coronavirus pandemic, which brought social-distancing measures that included restrictions on gatherings, had left millions of bereaved Americans unable to grieve with others for those they’ve lost — as of July, over 600,000 Americans have died from Covid.

Sheltering at home during the pandemic meant many went without a communal release of grief. Others felt cheated by online ceremonies devoid of touch, embraces and social connection. Postponed funerals, memorials and celebrations of life are now being held, with hopes that the gatherings will ease feelings of guilt and, at last, open a path for solace.

For Jeneffer Haynes of Gaithersburg, Md., losing her 30-year-old brother, John Estampador, to Covid-19 in January and having to be alone with her grief was “absolutely indescribable,” she said.

At the funeral in June, she had been asked to stand 10 feet away from his coffin and not embrace the few people there, including her mother, who cried: “Bye, John John. Bye, John John.”

Barbara Sabat said she needed to have a ceremony for her mother, Meryl, this summer in Bensalem, Pa., because if she did not, her feelings of regret would never subside. “I’m in grief purgatory,” she said.

And the country’s Delta-driven surge has raised the prospect of further postponements. Those who lost someone to Covid-19 are at an increased risk of developing prolonged grief disorder, in which a person’s bereavement is so intense that it disrupts day-to-day activities, experts said. The disorder, they added, affects about 10 percent of people who lose someone close to them.

Because the pandemic disproportionately killed Black people, Indigenous people and other people of color, prolonged grief disorder is likely to become more prevalent in those communities, which already lack adequate mental health resources, experts said.

“When you don’t have that process of a funeral, it can stunt your grieving,” said Kenneth Fowler, a traumatologist based in Tallahassee, Fla.

At least 26 Olympic athletes, including six from the United States, have tested positive for the coronavirus.
Hiroko Masuike/The New York Times

A cluster of coronavirus cases has emerged among police officers providing security at the Tokyo Games, sending 50 officers into quarantine as the Olympics reach their midway point and the city grapples with a surge of infections.

Kazuhiro Kimura, a spokesman for the Tokyo Metropolitan Police Department, said that 14 officers who were assigned to guard Olympic competition venues had become infected and were in quarantine. Another 36 officers were identified as close contacts and also quarantined.

According to the police, four officers developed symptoms on July 23, the day of the opening ceremony. Officials did not disclose which venues the officers had been assigned to, but said that they wore masks while on duty and did not have contact with members of the public.

Tokyo 2020 organizers on Saturday reported 21 new infections among people credentialed for the Games, bringing the total number of reported cases connected to the Olympics to 246, including 26 athletes.

Athletes who have tested positive for the coronavirus

Scientists say that positive tests are expected with daily testing programs, even among the vaccinated. Little information on severity has been released, though public reports suggest that cases among athletes have generally been mild or asymptomatic. Some athletes who have tested positive have not been publicly identified.

July 30

Paula Reto

South Africa

Golf

South Africa

July 29

Germán Chiaraviglio

Track and field

Argentina

Sam Kendricks

United States

Track and field

United States

July 28

Bruno Rosetti

Rowing

Italy

July 27

Evangelia Platanioti

Artistic swimming

Greece

July 26

Jean-Julien Rojer

Netherlands

Tennis

Netherlands

July 25

Jon Rahm

Golf

Spain

July 24

Bryson DeChambeau

United States

Golf

United States

July 23

Finn Florijn

Netherlands

Rowing

Netherlands

Jelle Geens

Triathlon

Belgium

Tokyo and the rest of Japan are experiencing the worst surge of the pandemic. On Saturday, officials in Tokyo reported more than 4,000 new infections, the first time the city’s daily count had surpassed that figure.

Prime Minister Yoshihide Suga announced on Friday that the government would expand a state of emergency to four areas besides Tokyo, and that the restrictions in the capital would be extended until the end of August — past the conclusion of the Olympics and into the start of the Paralympic Games.

With only 28 percent of the population fully vaccinated, the highly contagious Delta variant has taken root in Japan. More than three-quarters of cases in Tokyo are now being caused by the variant, according to the health ministry.

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Prime Minister Yoshihide Suga of Japan announced that the government would expand a state of emergency to other areas besides Tokyo, and that the restrictions in the capital would be extended until the end of August after the Olympics concludes.

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