Nursing homes will have to vaccinate staff to get federal funds.,


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Senators Roger Wicker, Angus King, and John Hickenlooper have tested positive for the coronavirus. All are fully vaccinated.

The Africa director of the W.H.O. said booster shots “make a mockery of vaccine equity.

More than 90,000 coronavirus patients were in U.S. hospitals earlier this week.

Get the latest updates here, as well as maps and a vaccine tracker.

Nursing homes at a crossroads

On Wednesday, President Biden said that all nursing home employees must be vaccinated by Sept. 30. Any facilities that don’t comply will not receive federal Medicare or Medicaid funds.

The practical effect of the mandate, nursing home operators said, is that workers will have to be vaccinated or lose their jobs. Only about 60 percent of the nation’s nearly 1.5 million nursing home employees are vaccinated, far below the industry’s goal of having 75 percent vaccinated by the end of June.

Some administrators are thrilled. “It’s great,” said Marita Smith, who runs a nursing home in Seattle. She called the new policy a “pretty big deal” that would “flush out health care professionals who shouldn’t be in health care.” If individuals don’t want to be vaccinated, she said, they put nursing home residents at risk and need to go.

But some prominent officials in the industry argue that the move will exacerbate staffing shortages, which they say could pose a bigger threat than having unvaccinated staff.

“We will lose tens of thousands, maybe hundred thousands, of workers,” said Mark Parkinson, president and chief executive of the American Health Care Association, the main nursing home industry group.

The blanket mandate means unvaccinated workers cannot simply take another nursing home job, but they can apply for jobs at hospitals or assisted living facilities. Parkinson’s group wants a mandate that will eventually apply across all health care settings, so that nursing home employees recognize that there is nowhere else to go.

More than 80 percent of nursing home residents nationwide are vaccinated, but they now face another frightening surge. Of the 625,000 Covid deaths in the U.S. to date, nearly one-fifth — 133,700 — have been nursing home residents, according to the C.D.C.

As we reported yesterday, a C.D.C. study found that effectiveness of the Pfizer and Moderna vaccines at preventing infections among nursing home residents dropped to 53 percent from about 75 percent after the rise of the Delta variant.

Last week, there were 354 deaths of nursing home residents with Covid-19, the highest figure since mid-March.

Plastic barriers: worse than nothing?

Clear barriers have sprung up at restaurants, nail salons and school classrooms since the pandemic began. But most of the time, they do little to stop the spread of the coronavirus, my colleague Tara Parker-Pope reports.

Scientists who study aerosols, air flow and ventilation say the barriers often don’t help. They probably give people a false sense of security. And sometimes, they can even make things worse.

That’s not intuitive, and there are some situations in which the clear barriers might be protective. For instance, they can stop big droplets ejected during coughs and sneezes, which is why they’re used for buffets and salad bars.

But Covid-19 spreads largely through much smaller aerosol particles. And although the research is limited, scientists have found that rows of clear plastic shields can impede normal air flow and ventilation.

That can create “dead zones,” where viral aerosol particles can build up and become highly concentrated.

Understand the State of Vaccine and Mask Mandates in the U.S.

Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.Vaccine rules . . . and businesses. Private companies are increasingly mandating coronavirus vaccines for employees, with varying approaches. Such mandates are legally allowed and have been upheld in court challenges.College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.Schools. On Aug. 11, California announced that it would require teachers and staff of both public and private schools to be vaccinated or face regular testing, the first state in the nation to do so. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots. Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.New York. On Aug. 3, Mayor Bill de Blasio of New York announced that proof of vaccination would be required of workers and customers for indoor dining, gyms, performances and other indoor situations, becoming the first U.S. city to require vaccines for a broad range of activities. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.

A study published in June showed that desk screens used in classrooms were associated with an increased risk of coronavirus infection.

“One way to think about plastic barriers is that they are good for blocking things like spitballs but ineffective for things like cigarette smoke,” said Linsey Marr, a professor of civil and environmental engineering at Virginia Tech and one of the world’s leading experts on viral transmission.

“The smoke simply drifts around them, so they will give the person on the other side a little more time before being exposed to the smoke,” she continued. “Meanwhile, people on the same side with the smoker will be exposed to more smoke, since the barriers trap it on that side until it has a chance to mix throughout the space.”

What else we’re following

Washington State will require all teachers and school personnel to be fully vaccinated by Oct. 18.

In defiance of a state mandate, Florida school officials in Miami-Dade, Hillsborough and Palm Beach Counties approved strict mask mandates on Wednesday.

New York’s digital vaccine app, the Excelsior Pass, will likely cost about $27 million — far more than originally expected.

The New York Police Department, which appears to have one of the lowest vaccination rates among city agencies, will discipline unvaccinated officers who flout mask mandates.

Cuba’s health care system, long a source of national pride, is in acute distress as the Delta variant fuels a surge in cases.

Five days before the Paralympics are set to open, officials in Tokyo have reported the first confirmed case in the Olympic Village.

If you got the Johnson & Johnson vaccine, here’s what you should know about the booster shots.

What you’re doing

For the past 17 months, I’ve been able to keep my babies safe (I have a 2-year-old, a 5 -year-old and a 9 y-year-old) by keeping them away from public spaces. They all returned to school. Less than 10 days later, my 5-year-old has been infected with Covid, as their schools didn’t require masks. Now, all of my babies are suffering. I’m exhausted and I wouldn’t wish this on anyone. — Alquita Sherraine Dent, Augusta, Ga.

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