The White House on Wednesday is set to announce a billion-dollar investment in at-home rapid coronavirus tests that it says will help quadruple their availability by later this year, according to a White House official.
By December, 200 million rapid tests will be available to Americans each month, with tens of millions more arriving on the market in the coming weeks, the official said. The White House is also set to announce that it will double the number of sites in the federal government’s free pharmacy testing program, to 20,000.
The changes reflect the administration’s growing emphasis on at-home testing as a tool for slowing the spread of Covid-19. President Biden in September said that he would use the Defense Production Act to increase the production of rapid testing kits and would work with retailers, including Amazon and Walmart, to expand their availability. He pledged $2 billion to the effort, or roughly 280 million tests.
The Biden administration’s efforts to expand testing access also received a significant boost on Monday, when the Food and Drug Administration authorized Acon Laboratories’ at-home test. Dr. Jeffrey E. Shuren, the director of the agency’s medical devices center, said the move could double at-home testing capacity in the coming weeks.
“By year’s end, the manufacturer plans to produce more than 100 million tests per month, and this number will rise to 200 million per month by February 2022,” he said. Like tests already available from Abbott, Quidel, Becton Dickinson and other makers, Acon’s test is made to detect proteins from the virus on a nasal swab, and produces results in 15 minutes.
Rapid tests can cost as little as $10, which public health experts say can still be prohibitively expensive for some people, and are not as sensitive as P.C.R. tests. Experts have said they are still accurate in detecting the virus in someone who is in the first week of displaying symptoms, when the viral load is likely to be highest.
Some pharmacies and retailers have recently struggled to keep tests in stock, or have had to place limits on how many customers can purchase. Demand has increased with the school year underway and employees returning to many workplaces.
Last week, Ellume, an Australian company that makes a widely available at-home coronavirus test, recalled nearly 200,000 test kits because of concerns about a higher-than-expected rate of false positives. The recall did not affect most of the 3.5 million test kits Ellume has shipped to the United States.
New coronavirus cases, hospitalizations and deaths are falling as the United States begins to recover from a persistent summer surge that strained hospitals across the country and killed over 100,000 Americans in just three and a half months.
As of Tuesday night, virus cases in the United States had averaged more than 101,000 a day for the past week, a 24 percent decrease from two weeks ago. Reported new deaths are down 12 percent, to 1,829 a day. Hospitalizations have decreased 20 percent and are averaging below 75,000 a day for the first time since early August, according to a New York Times database.
Public health officials, however, said the pandemic remained a potent threat. Most of the Covid deaths in that span were people who were unvaccinated, and about 68 million eligible Americans have yet to be inoculated. That leaves the country vulnerable to continued surges.
“We’re not out of danger,” Ali Mokdad, a University of Washington epidemiologist who is a former Centers for Disease Control and Prevention scientist, said in an interview this week. “This virus is too opportunistic and has taught us one lesson after another.”
He worries about people dropping their use of masks and traveling more, as they have after earlier drops in new cases — actions that could help fuel a fresh surge in December and January.
The number of new daily cases in the United States has fallen 35 percent since Sept. 1, according to a New York Times database. The drop was especially stark in Southern states that had the highest infection rates during the Delta variant surge that started in June.
Florida, which averaged more than 20,000 new cases a day during much of August, is reporting fewer than 6,000 infections a day. Louisiana, which weeks ago was averaging more than 5,000 cases daily, has about 1,000 cases each day.
“This wave is petering out,” Edwin Michael, a professor of epidemiology at the University of South Florida, in Tampa, said in an interview. “If there were waning immunity, then we should be at the beginning of another wave now.”
Only 57 percent of Floridians are fully vaccinated, and Dr. Michael said his biggest worry was the greater chance for the virus to genetically mutate while people remain unvaccinated across the country. Still, he said, “this might be the last wave, pending any new variants that arrive, and the boosters will help with that.”
While there are about 20,000 fewer Covid patients hospitalized nationwide than at the start of September, many hospitals in hard-hit parts of the country remain overstretched. That is especially true in Alaska, which leads the country by a wide margin in recent cases per person. The threat of flu season could worsen matters.
Newly reported cases in Montana and Wyoming, which had reported some of the worst outbreaks in recent weeks, appear to have stabilized. In both states, less than 50 percent of the population is inoculated against the coronavirus. Montana is at 49 percent fully vaccinated, and Wyoming 42 percent. Only West Virginia, at 40 percent, has a lower rate.
Nearly 2,000 Covid-related deaths are being reported nationally each day, and the United States surpassed 700,000 deaths on Friday. About 65 percent of the eligible U.S. population is fully vaccinated against the virus.
Tracking community transmission is at the heart of efforts to stop the spread of the coronavirus, scientists say, and in most states the daily dashboards showing new cases have been a critical tool for public health officials trying to track the trajectory of the virus, which has killed 700,000 Americans.
Yet for three crucial months this summer, Nebraska did not report any county-level information to the public. State officials stopped sharing counts of new coronavirus cases by county with the public on June 30, just as the Delta variant began surging in the United States.
That was by design. Gov. Pete Ricketts, a Republican who opposes both mask and vaccine mandates, allowed his emergency order to expire in June, and the state’s unusually strict privacy laws were reinstated, which he said prohibited the continued release of the data.
At the time, the number of new cases in Nebraska had reached a low in the state, and Test Nebraska, which gave free virus tests to hundreds of thousands of residents, ended its operations shortly after the emergency ended.
The virus continued to spread in the state, however, driven by the highly contagious Delta variant. Hospitalizations increased tenfold from the end of June through mid-September. New cases rose sharply in August. Deaths increased as well.
On Sept. 20, after coronavirus hospitalizations surpassed 10 percent of the state’s capacity of staffed hospital beds, Mr. Ricketts announced that county-level case data would once again be made public on a new “hospital capacity” state dashboard.
But he said the data will disappear again if the number drops below 10 percent on a 7-day rolling average. And the state is still not reporting county-level deaths.
Public health experts in Nebraska were dismayed all summer about the decision to delete the dashboard, and state legislators wrote a letter requesting that it be restored.
A handful of the state’s 93 counties continued to provide daily data on their websites throughout the pandemic because they have more than 20,000 residents.
That meant that the only real-time data on the virus across the state that doctors like Dr. David Brett-Major, an infectious disease specialist, had during July and August was watching sick people stream into the emergency department of the University of Nebraska Medical Center in Omaha.
“If the tests are only happening when the cases are more severe, then you’re not getting a broad look,” he said in a recent interview.
Susan Bockrath, the executive director of the Nebraska Association of Local Health Directors, said her group brought up the missing dashboard repeatedly with state officials, pointing out it was also a necessary tool in the campaign against pandemic misinformation.
The dashboard was removed just as Stephanie Summers, board of education president in David City, was trying to determine the best policy for students and families in her rural community one hour west of Omaha. Mr. Ricketts has told Nebraskans to get vaccinated, but declined to require masks, despite pleas from some public health officials.
“The state cannot insist on an individual’s freedom to choose to wear, or not wear, a mask, or whether or not to get vaccinated, and then also withhold the data needed for citizens to make informed decisions,” she said, adding that she fully agreed with state leaders in emphasizing those individual freedoms.
While the dashboard has mostly been restored, some doctors doubt the current testing system is capturing the reality on the ground. Two dozen doctors sent a letter in early September to Mr. Ricketts asking for the return of Test Nebraska.
“Our access to testing is so bad right now, and the turnaround so bad, that these numbers are probably vast underestimates, and not accurate just because there is not enough testing,” said Dr. Bob Rauner, chief medical officer of OneHealth Nebraska, a group of 65 locally owned medical clinics across the state.
The governor and his aides have defended their decision to stop the flow of data on privacy grounds, saying publishing county-level data could violate the state’s version of HIPAA, which prevents the release of patients’ personal health information without their consent.
Experts say privacy becomes a concern in releasing data from counties with only a handful of cases, and for that reason, states generally suppress information in jurisdictions with fewer than five cases or deaths.
Covid-19 vaccinations helped prevent tens of thousands of hospitalizations and deaths among older people in the United States in the first five months of this year, according to a new federal study of Medicare recipients.
The study, published by the Department of Health and Human Services on Tuesday, indicated that Covid-19 vaccinations were associated with 39,000 fewer deaths and 107,000 fewer hospitalizations among Medicare recipients nationwide from January through May.
Reductions in deaths were observed in all 48 states included in the study sample, and among members of all racial and ethnic groups, although the greatest reductions appeared to be among American Indians and Alaska Natives, groups that were hit particularly hard by the pandemic.
In counties with average to above-average vaccination rates, the study found that deaths and hospitalizations fell more sharply than in areas where uptake of vaccines was lower.
The study used county vaccination statistics and a sample of 25.3 million Medicare beneficiaries to estimate the impact of Covid vaccines on the entire population of Medicare recipients, about 62.7 million people. The authors found that a 10 percent increase in a county’s vaccination rate was correlated with an 11 to 12 percent decrease in Covid-19 hospitalizations and a similar decrease in infections among Medicare recipients.
New Zealand hopes to vaccinate as many as 350,000 people in a single day next week, the country’s largest Covid inoculation effort to date, as it pushes closer to reopening its economy.
Vaccination clinics will be open all day on Saturday, Oct. 16, said Chris Hipkins, the minister leading New Zealand’s Covid-19 response. The facilities will be able to vaccinate 350,000 people — about 8.3 percent of the eligible population of people 12 and older, he said.
“Like on Election Day, we’ll be asking all of our civic and political leaders to contribute to our efforts to turn people out,” Mr. Hipkins said.
New Zealand has had one of the most successful responses to the pandemic, recording just 28 deaths from the virus. And though it was late to begin its vaccination campaign, the country is now on pace to fully vaccinate about 90 percent of its eligible population by the end of November.
New Zealand is the latest country to focus its intense vaccination efforts into a single day. In August, Tunisia vaccinated more than 500,000 people in one day, and this month India said it had given 25 million shots on a single day to mark Prime Minister Narendra Modi’s birthday.
As of Wednesday, 50 percent of New Zealand’s eligible population had received two doses of the Pfizer-BioNTech shot, the only vaccine the country is using, while 80 percent had received a single dose.
New Zealand is also cutting the time between receiving a first and second dose, to three weeks, from six — a shift that means “more people can be fully vaccinated sooner, increasing our community immunity,” a health ministry official said in a statement.
The country is currently administering about 17,000 first doses and about 46,000 second doses a day, according to the most recent data. Its rate of first vaccination doses has been dwindling, down more than three-fourths from an August high of about 67,000 doses a day.
New Zealand has not set a vaccine target or a date at which to ease restrictions, although Prime Minister Jacinda Ardern said on Tuesday that the country would introduce a national vaccine certificate that would be required for entry into “high-risk settings” like summer music festivals.
A Colorado health system told a prospective kidney transplant recipient that she would not receive an organ donation if she remained unvaccinated against the coronavirus, a state lawmaker said this week.
Representative Tim Geitner, a Republican, said in a Facebook Live post on Tuesday that a local resident had received a letter from the service, UCHealth, stating that her status on the transplant waiting list had been changed to inactive.
“Unfortunately and sadly, UCHealth has said that unless and until this individual is willing to take a Covid vaccine, that they will not be able to perform this lifesaving surgery,” Mr. Geitner said.
Posting on Twitter, Mr. Geitner shared a letter from UCHealth to the patient that cited “noncompliance.” The letter, dated Sept. 28, advised the patient that she had 30 days to “begin the vaccination series” and that she would be removed from the list if she did not.
UCHealth did not immediately respond to a request for comment on Wednesday. But the health system told 9 News, a local television station, on Tuesday that organ transplant recipients and living donors were required to be vaccinated against Covid-19 “in almost all situations.”
Mr. Geitner said that the patient had about 12 percent of her kidney function left and that she had found a donor.
UCHealth told the TV station that studies had shown that transplant recipients who later tested positive for Covid-19 had a significantly higher mortality rate, of 18 to 32 percent, compared with 1.6 percent among those in the general population who tested positive.
The health system said its policy stemmed from that mortality rate and from concern that living donors could pass on the virus.
A hospital spokesman told The Denver Post that transplant patients were generally required to meet similar requirements before and after surgery, even before the pandemic. “Patients may be required to receive vaccinations including hepatitis B, MMR and others,” the spokesman told the paper in an email. “Patients may also be required to avoid alcohol, stop smoking, or prove they will be able to continue taking their anti-rejection medications long after their transplant surgery.”
The patient, Leilani Lutali, told the TV station that she had learned of the hospital’s policy as her donor was undergoing required testing. She said that she worried about how the vaccines might affect her health in the future, and that she and her donor had declined them for religious reasons.
“I’m being coerced into making a decision that is one I’m not comfortable making right now in order to live,” Ms. Lutali said.
The California National Guard has been deployed to four hospitals in Northern and Central California, where some areas with relatively low vaccination rates have struggled to handle an influx of Covid patients.
Teams of up to 17 National Guard troops were sent over the past week to staff the hospitals in two counties: Mercy Medical Center Redding, in Shasta County in the northern part of the state; and Adventist Health Bakersfield, Bakersfield Memorial Hospital and Mercy Hospital Southwest - Bakersfield, in Kern County in Central California, according to a statement from the California National Guard.
The rate of recent daily cases per person in California overall is very low, second only to Connecticut in the mainland United States, according to a New York Times database. But hospitals in some parts of the state have been overwhelmed by a Delta variant-driven surge of Covid patients.
New cases and hospitalizations all reached or exceeded peak levels in mid-September in Shasta County and have been trending back down. In the more populous Kern County, hospitalizations jumped at the beginning of last month but have been falling ever since.
The amount of fully vaccinated people in both counties — 42 percent of the population — is far below the statewide rate of 59 percent.
The National Guard’s deployment in California coincides with a mandate that took effect last week that requires all of the state’s health care workers to be vaccinated. Major health systems then reported that the mandate had helped boost their vaccination rates to 90 percent or higher. There have been no reports of mass firings of health care workers in the state.
Each National Guard medical team includes a physician assistant or registered nurse who leads a group of medical and administrative assistants, Lt. Col. Jonathan M. Shiroma, a spokesman for the state National Guard, said in the statement.
The situation at Mercy Medical Center Redding was further complicated by the Fawn Fire, which left about 30 staff members unable to work toward the end of the month, the Record Searchlight in Redding reported. A spokeswoman for the hospital did not respond to requests for comment on Tuesday night.
Several states have called on the National Guard to ease the strain on hospitals during the pandemic. Gov. Kate Brown of Oregon asked in August for at least 500 of the state’s National Guard troops to help staff hospitals. Idaho’s governor, Brad Little, also deployed his state’s National Guard troops this summer.
The pandemic has led to a surge of inexperienced hikers venturing into the outdoors, and that in turn has increased the pressure on search-and-rescue teams, as well as the costs.
Increasingly, U.S. states are looking for ways to penalize people who take unnecessary risks. But some question whether these laws might also discourage people from seeking help soon enough after putting their lives at risk because of an honest mistake.
New Hampshire passed a law in 2008 that allowed it to seek reimbursement if state officials deemed that a rescued person had been negligent.
“We don’t do it very often,” said Col. Kevin Jordan of the New Hampshire Fish and Game Department. “It’s got to be something that’s pretty wild, pretty out-there. But one thing I am pretty strict on is being unprepared, because those are literally the things that cost lives.”
Five other states — Hawaii, Idaho, Maine, Vermont and Oregon — have similar laws allowing them to bill people for the cost of rescues in certain situations.
Hawaii has two bills pending that would allow search and rescue operators to seek reimbursement from people who stray from hiking trails or intentionally disregarded a warning or notice and then need to be rescued.
And South Dakota passed a law to help offset search and rescue costs. In March 2020, Gov. Kristi Noem signed Senate Bill 56, allowing rescue agencies to charge each person as much as $1,000.
LONDON — England took a high-stakes gamble when it sent millions of students back to school last month with neither vaccines nor a requirement to wear face masks, even as the coronavirus continued to course through the population.
On Tuesday, the country’s Education Department issued its latest report card on how the plan is working: About 186,000 students were absent from school on Sept. 30 with confirmed or suspected virus infections, 78 percent more than the number reported two weeks earlier, and the highest number since the pandemic began.
Yet to hear many parents tell it, the bigger risk would have been to force the students to keep wearing masks or, worse, to keep them home.
“It’s important for kids,” said Morgane Kargadouris, who was picking up her daughter recently at Notting Hill Preparatory School in northwest London, where none of the children wear masks. “So much of what they learn is through expressions and through contact they have with people.”
Such sentiments are not unusual in a country that has shrugged off social-distancing rules and made an aggressive rollout of vaccines and a swift return to normalcy the twin cornerstones of its pandemic response. But they are striking in a debate as parents across the globe struggle to balance the risks of a potentially deadly disease with the costs of keeping children at home or in classrooms where protective measures are required.
Across New York City, many tenants who lost their jobs after the city went into lockdown are facing millions of dollars in unpaid rent. They’ve been kept in their homes by government aid programs and a state eviction moratorium that expires in January.
But the pandemic has also mobilized some tenants to take on landlords who have done little to improve their living conditions and pushed them into a new kind of activism.
At 1616 President St. in the Crown Heights section of Brooklyn, Patricia Edwards is one of a dozen residents — about half of the building’s tenants — who are withholding rent until the landlord forgives the debt owed by residents affected by the pandemic and makes repairs to a building that they say has long been neglected.
It has been years since Ms. Edwards’s top-floor apartment has felt like an acceptable home. When it rains, water leaks into the kitchen and living room. It also pours through a crack in the bathroom ceiling so big that Ms. Edwards needs an umbrella just to use the toilet.
But when the pandemic hit last year, leaving many of her neighbors struggling financially, Ms. Edwards, a retired bank employee, decided to do something she had never done: She refused to pay.
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