Covid News: F.D.A. Expected to Fully Approve Pfizer Vaccine Next Week

Katie R. Ochoa
Pfizer vaccines were administered at the St. John Chrysostom Catholic Parish in The Bronx on Sunday.
Credit…James Estrin/The New York Times

The Food and Drug Administration is pushing to approve Pfizer-BioNTech’s two-dose Covid-19 vaccine on Monday, further expediting an earlier timeline for licensing the shot, according to people familiar with the agency’s planning.

Regulators were working to finish the process by Friday but were still working through a substantial amount of paperwork and negotiation with the company. The people familiar with the planning, who were not authorized to speak publicly about it, cautioned that the approval might slide beyond Monday if some components of the review need more time.

An F.D.A. spokeswoman declined to comment.

The agency had recently set an unofficial deadline for approval of around Labor Day.

The approval is expected to pave the way for a series of vaccination requirements by public and private organizations who were awaiting final regulatory action before implementing mandates. Federal and state health officials are also hoping that an approved vaccine will draw interest from some Americans who have been hesitant to take one that was only authorized for emergency use, a phenomenon suggested by recent polling.

Some universities and hospitals are expected to mandate inoculation once a vaccine is fully approved. The Pentagon earlier this month said it plans to make Covid vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of next month, or sooner if the F.D.A. acts earlier.

Once it obtains the approval, Pfizer-BioNTech is planning to quickly ask the F.D.A. to approve a third dose as a booster shot. The Biden administration on Wednesday announced that fully vaccinated adults should prepare to get booster shots eight months after they received their second doses, beginning Sept. 20. Pfizer is expected to finish submitting data that it says shows a third shot is safe and effective next week.

The F.D.A. last week updated its authorizations of Pfizer-BioNTech’s and Moderna’s vaccine to allow third doses for some immunocompromised people, a decision backed by the Centers for Disease Control and Prevention.

Regulators are still reviewing Moderna’s application for full approval for its coronavirus vaccine, and a decision could come at least several weeks after the one for Pfizer-BioNTech. Moderna is planning to submit its data in support of a booster shot in September.

A couple walk through sprinklers in the Hunter’s Creek neighborhood in Orlando, Fla.
Credit…Phelan M. Ebenhack/Associated Press

Orlando Mayor Buddy Dyer and utility officials asked residents to conserve water Friday to preserve the city’s supply of liquid oxygen, which is being used to treat a surging number of Covid-19 patients.

During a Friday afternoon news conference, Linda Ferrone of the Orlando Utilities Commission asked residents to refrain from using excess water and to be prepared to do so for at least several weeks.

A Delta variant-driven surge has made Florida one of the nation’s worst-hit states, with new cases recently topping their winter peak. Hospitalizations in Orange County, where Orlando is, are up 58 percent over the past two weeks, according to a New York Times database. Deaths in the Orlando area have overwhelmed crematoriums, which are running out of room to store bodies, local media reported.

The New York Times has previously reported on supply chain issues and oxygen shortages during the pandemic in India, northern Brazil, Mexico and elsewhere.

“It’s critical that we continue to work together and each one of us do our part, as we have done throughout this pandemic, to mitigate the impacts the virus continues to have on our community,” Mayor Dyer said during the news conference. “While this is another new challenge, I know that as a community, working together, we can overcome it with the help of our residents and businesses.”

The leader of the school board of Orange County has said the district should begin mandating masks in its schools.

That would defy the state’s Republican governor, who has refused to budge on his ban on mask mandates, though several school districts have gone ahead with them.

According to documents obtained by Politico, educators in Broward and Alachua counties have received orders from the state to reverse their mask requirements within 48 hours or face losing their salaries. President Biden stated earlier this week that his Education Department may take legal action to deter states from barring universal masking in classrooms.

The Rice University campus in Houston last year. 
Credit…William Widmer for The New York Times

Rice University, a private institution in Houston, has done its best to build a wall against the Delta variant engulfing the state of Texas by imposing stringent requirements for being on campus.

Unlike the state’s public universities, which cannot mandate vaccines or masks, Rice requires student and faculty members to wear masks and has testing protocols for all visitors. And while Rice has not risked running afoul of Texas law by requiring vaccines, it has told students they are expected to be vaccinated.

Still, the virus has surged in Houston, and on Thursday, Rice became the second university in the state to shift classes online, dampening hopes for a return to normal college life this fall. Rice delayed the start of school by two days until Aug. 25 and said that classes would remain online through Sept. 3.

It also said that members of the Rice community had tested positive for Covid despite the high vaccination rates — 98.5 percent — among the student body.

“I’ll be blunt: the level of breakthrough cases (positive testing among vaccinated persons) is much higher than anticipated,” Bridget Gorman, the dean of undergraduates, wrote in a letter to the school’s 8,000 graduate and undergraduate students. The university didn’t specify how many breakthrough cases there were.

More than 12,000 people are hospitalized with the coronavirus in Texas, where officials have prohibited both masks and vaccine mandates, and where Gov. Greg Abbott recently tested positive.

“We’re in a hot spot right now,” said Rice’s president, David Leebron, adding that the decision to move temporarily to remote classes was made to give the university time to assess the results of its recent testing.

“Having new information of concern, as people worry about breakthrough infections, as people with children are worried around those issues, we wanted to have a little bit of time to gather data and look at it more carefully,” he said.

Rice was the second Texas university that has announced a move to remote learning. Last week, the University of Texas at San Antonio said it would begin with mostly remote classes, citing the city’s high infection rate.

Fans stood for the national anthem before a Boston Bruins game at TD Garden in May.
Credit…Adam Glanzman/Getty Images

Face masks will be required in all public indoor spaces in Boston starting Aug. 27, the city’s mayor, Kim Janey, announced on Friday. The measure is intended to impede the spread of the coronavirus’s extremely transmissible Delta variant.

“We know that masks work best when everyone wears one,” Ms. Janey said in a statement. “Requiring masks indoors is a proactive public health measure to limit transmission of the Delta variant, boost the public confidence in our businesses and venues, and protect the residents of our city who are too young for vaccination.”

Boston’s Public Health Commission issued the order not long before more than 50,000 college students return to the area and more than 50,000 public school students start class, the city said in a release.

The seven-day average of new reported cases in Suffolk County, which includes Boston, has been above 140 for more than a week, up from fewer than 10 in late June, and hospitalizations have also increased, according to data compiled by The New York Times — though both numbers are well below their peaks from last winter.

Boston joins San Francisco, Los Angeles County, Chicago and Washington, D.C., on the list of cities that have instituted similar mandates. However, New York City, which has a strict requirement that patrons and employees of indoor establishments provide proof of at least one vaccine shot, has not imposed a mask rule.

And Republican governors in hard-hit states like Florida and Texas have banned mask mandates, though some districts and municipalities have imposed them anyway.

Massachusetts Governor Charlie Baker, also a Republican, has not taken as strong a stance, but he has so far declined to impose a mask mandate for the commonwealth’s public schools, despite a strong push to do so from Massachusetts’s largest teacher’s union.

In a radio interview earlier this month, Mr. Baker said he thought such decisions were better left to localities.

“I’m not going to get into making decisions that I believe in many cases ought to be driven, at the end of the day, by the folks at the local level who know those communities best,” Mr. Baker said.

The Archdiocese of Philadelphia joins a number of other Catholic dioceses that decline parishioners religious exemption for getting vaccinated against Covid-19. Pope Francis released a statement earlier this week in which he called getting vaccinated “an act of love.”
Credit…Riccardo De Luca/Associated Press

The Archdiocese of Philadelphia announced earlier this week that it will not sanction religious exemptions to Covid vaccine mandates, joining a growing chorus of other Catholic dioceses that are declining to give their parishioners an excuse for not getting inoculated.

“Individuals may wish to pursue an exemption from vaccination based on their own reasons of conscience,” Kenneth A. Gavin, the chief of communications for the archdiocese, wrote in a statement. “In such cases, the burden to support such a request is not one for the local Church or its clergy to validate.” Neither the Archdiocese nor its parishes would support exemption requests, he said.

Other dioceses around the country, including those of New York City, San Diego and Honolulu, have made similar statements. Some, like that of El Paso, Texas, have even imposed vaccine requirements for their employees.

The Vatican announced in February a vaccine requirement for its employees in Rome, but quickly reversed the rule after criticism.

The issue has become a matter of contention within the church, as it has within the broader society, with more conservative church leaders supporting people who choose not to get vaccinated while more progressive ones, like Pope Francis, arguing in favor of vaccines.

Earlier this week the Pontiff released a public service advertisement in which he called getting vaccinated against Covid-19 “an act of love.”

But for many Catholics some vaccines are morally questionable, because they can be developed using human cell lines derived from fetuses aborted decades ago, and mandating them is seen by some as an infringement on individual liberties.

Bishops in South Dakota, for instance, have argued in favor of religious exemptions for vaccination.

“A Catholic may, after consideration of relevant information and moral principles, discern it to be right or wrong to receive one of the available Covid-19 vaccines,” two bishops wrote in a public letter earlier this month. “If he or she thus comes to the sure conviction in conscience that they should not receive it, we believe this is a sincere religious belief, as they are bound before God to follow their conscience. We support any Catholic who has come to this conviction in seeking religious exemption from any Covid-19 requirement.”

For his part, Francis said getting vaccinated against the virus was a moral act.

“Getting the vaccines that are authorized by the respective authorities is an act of love, and helping the majority of people to do so is an act of love,” Francis said in the advertisement. “Getting vaccinated is a simple yet profound way to care for one another, especially the most vulnerable.”

Shefali S. Kulkarni contributed reporting.

AstraZeneca’s North America headquarters in Wilmington, Del., in March.
Credit…Rachel Wisniewski/Reuters

An antibody drug developed by AstraZeneca was strongly effective in preventing Covid in a study that mostly enrolled high-risk people, the company announced on Friday.

The findings raise hopes that the drug, which is easier to administer and designed to stay in the body for much longer than the available antibody treatments for Covid, could provide long-lasting protection for people with weakened immune systems who do not respond well to vaccination.

AstraZeneca said it would ask regulators to authorize the therapy, though it is not clear who the company will seek to reach with the drug.

Some people with weakened immune systems became eligible last week to start receiving third doses of the vaccines from Pfizer and Moderna, a decision prompted by data indicating that they were not sufficiently protected by an initial series of shots.

But some immunocompromised people remain ineligible, and even a third shot may not be enough protection for others.

“There are tens of thousands of patients for whom a drug like this is really important,” said Dr. Myron Cohen, a University of North Carolina researcher who has worked on monoclonal studies but was not involved in AstraZeneca’s trial. “I get emails every day from people who say, ‘I cannot respond to a vaccine. What can I do?’ Or, ‘Can you help me?’”

Antibody drugs are becoming an increasingly important tool in the United States as hospitals have been overwhelmed with cases caused by the Delta variant. The treatments, designed to mimic the immune response generated naturally in response to an infection, have almost entirely been used to keep vulnerable people who are already sick with Covid from getting worse.

But AstraZeneca’s drug is the latest to show that the therapies can also help people before they’re infected.

The antibody drug being predominantly used in the United States, from Regeneron, was recently authorized to prevent Covid-19 in a limited number of high-risk patients, including people with certain health conditions who are not vaccinated or may not mount an adequate immune response. Those people are eligible to get the treatment for prevention if they have been exposed to the virus or live in nursing homes or prisons.

AstraZeneca’s trial, which enrolled more than 5,000 people in the United States and Europe, found that people who received the treatment had a 77 percent reduced risk of developing Covid within six months compared to people who got a placebo.

Dr. Rajesh Gandhi, an infectious diseases physician at Massachusetts General Hospital, said that he and other physicians would welcome another treatment option. “With Delta and other variants, the more tools we have, the better,” he said. “And so this in my mind, is potentially another tool, especially if it prevents symptomatic Covid in those at most risk.”

Abbott Laboratories’ factory in Westbrook, Maine, a major supplier of coronavirus tests.
Credit…Ryan David Brown for The New York Times

For weeks in June and July, workers at a Maine factory making one of America’s most popular rapid tests for Covid-19 were given a task that shocked them: take apart millions of the products they had worked so hard to create and stuff them into garbage bags.

Soon afterward, the manufacturer, Abbott Laboratories, announced layoffs, canceled contracts with suppliers and shuttered the only other plant making the test, in Illinois, dismissing a work force of 2,000. “This is all about money,” Andy Wilkinson, a site manager, told the workers in Maine.

As virus cases in the U.S. plummeted this spring, so did Abbott’s Covid-testing sales. But now, amid a new surge in infections, steps the company took to eliminate stock and wind down manufacturing are hobbling efforts to expand screening as the highly contagious Delta strain rages across the country. Demand for its 15-minute antigen test, is soaring again as people return to schools and offices.

Yet Abbott has reportedly told thousands of newly interested companies that it cannot equip their testing programs in the near future. CVS, Rite Aid and Walgreens locations have been selling out of the at-home version, and Amazon shows shipping delays of up to three weeks. Abbott is scrambling to hire back hundreds of workers.

America was notoriously slow in rolling out testing in the early days of the pandemic, and the story of the Abbott tests is a microcosm of the larger challenges of ensuring that the private sector can deliver the tools needed to fight public health crises, both before they happen and during the twists and turns of an actual event.

“Businesses crave certainty, and pandemics don’t lend certainty to demand,” said Stephen S. Tang, chief executive of OraSure Technologies, which in the midst of the testing slump in June received emergency F.D.A. authorization for its own rapid test, InteliSwab, long in development. But the company is not yet supplying retail stores.

Meanwhile, Dr. Sean Parsons, chief executive of Ellume, the Australian manufacturer of a competitor rapid test, said this week that demand was 1,000 times greater than forecast and the company was racing to set up a U.S. plant.

Abbott’s decisions have ramifications even beyond the United States. Employees in Maine, many of them immigrants from African countries, were upset at having to discard what might have been donated. Other countries probably could have used the materials, according to Dr. Sergio Carmona, chief medical officer of FIND, a nonprofit that promotes access to diagnostics.

“This makes me feel sick,” he said of the destruction, noting that more than a dozen African nations have no domestic funds to buy Covid tests.

In an interview, Robert B. Ford, Abbott’s chief executive, argued that the discarded materials — finished test cards — should not be viewed as tests. Kits for sale also include swabs, liquid buffer and instructions.

Emily Anthes contributed reporting.

“Infinite Life,” by the Pulitzer Prize-winning playwright Annie Baker, right, had been set to begin performances at the Signature Theater on Oct. 5.
Credit…Jeenah Moon for The New York Times

Signature Theater, a prominent Off Broadway nonprofit, has postponed its return to the stage over concerns about the persistent coronavirus pandemic, becoming the first major New York theater to take such a step.

The theater’s leadership announced the postponement Friday afternoon, just days before rehearsals were to begin for “Infinite Life,” a new play by the Pulitzer Prize-winning playwright Annie Baker, who was also planning to direct the work. The production was supposed to run from Oct. 5 to Nov. 7.

“Due to ongoing health and safety concerns, Signature Theater and Annie Baker have decided to postpone the upcoming production of ‘Infinite Life,’” the theater said in a statement. “Signature will continue, in discussion with artists, to evaluate on a case-by-case basis how to proceed with other programming planned for this season. The company and artist agree that this is the best choice for this show at this time.”

Around the country, there have been a number of cancellations and postponements of pop music tour dates and festivals because of the rise in coronavirus cases caused by the spread of the Delta variant. There have been several theater postponements in California, including at Berkeley Repertory Theater, which recently cited the Delta variant in delaying until next year a Christina Anderson play that had been scheduled to begin in October.

It is unclear whether the postponement of “Infinite Life” is an outlier or a first indication that the theater industry is getting cold feet about the many reopenings planned this fall, on Broadway and off. Two Broadway shows, “Springsteen on Broadway” and “Pass Over,” are already running, and 15 more plan to start next month; there are also some plays already running in commercial and nonprofit venues around the city, and many of the city’s larger nonprofits plan to resume presenting shows during the fall.

People receiving Covid-19 vaccinations at Pharos Academy Charter School in the Bronx in July.
Credit…James Estrin/The New York Times

New York City’s high school student athletes and coaches participating in high-risk sports will have to be vaccinated in order to play, Mayor Bill de Blasio said on Friday. The announcement represents the first student vaccine mandate in New York City, and could set the stage for broader mandates for the city’s roughly 1 million public school students later this year.

About 20,000 students and staff — about half of the total Public School Athletic League — will have to receive at least one vaccine dose by the first day of competitive play. That means students with fall seasons, including football and volleyball players, will have to be at least partially vaccinated by the first few weeks of school.

But students who play winter and spring sports like basketball, ice hockey and lacrosse, along with wrestlers, have several months before they have to start the vaccination process. And more than 20,000 students and staff who participate in sports considered low-risk, including baseball, soccer, tennis, track and gymnastics, will not have to be vaccinated.

Private schools can determine their own mandates for student athletes.

The first day of school for all students is Sept. 13, which means eligible students who are still unvaccinated will not be fully protected by the start of school, even if they begin their vaccination process immediately. Just under 60 percent of all eligible New Yorkers ages 12 to 17 have received at least one dose, according to the city, but it’s not clear how many of those children are public school students.

The mandate follows guidance by the Centers for Disease Control and Prevention that students playing contact sports should be vaccinated to prevent canceled or virtual sports seasons. Last year, some districts across the country saw higher transmission among high-risk sports teams than in classrooms.

The state of Hawaii has already mandated vaccines for its high school student athletes. But vaccine requirements for eligible public school students remain extremely rare. The Culver City school district in California is believed to be the first district in the country to issue a broad vaccine mandate for all its eligible students.

Renters racked up billions of dollars of rent debt during the pandemic.
Credit…Micah Green for The New York Times

A federal appeals court has allowed the Biden administration’s replacement evictions moratorium to stay in place for now, issuing a swift ruling on Friday in a politically charged case that is speeding its way toward the Supreme Court.

In a one-page, unsigned order, a three-judge panel of the United States Court of Appeals for the District of Columbia Circuit declined to block the government from enforcing the emergency public-health policy while a legal challenge to it brought by landlords, including the Alabama Association of Realtors, plays out.

The Justice Department had no immediate comment. But Patrick Newton, a spokesman for the National Association of Realtors, which is not a party to the case but supports the landlords and has been speaking on their behalf, expressed confidence that the Supreme Court would now move quickly to block the policy.

The Centers for Disease Control and Prevention imposed the evictions moratorium on Aug. 3 in counties where Covid-19 is raging, a category that currently covers about 91 percent of counties in the United States. It replaced an earlier nationwide ban on evictions that had been in effect since September and was extended several times.

The ban ultimately expired in July, a month after the Supreme Court allowed the moratorium to continue but strongly suggested that five justices would block the policy if the government extended it past its scheduled expiration.

President Biden, who initially had no intention of reviving the ban, reversed course in early August after coming under intense pressure to act by Speaker Nancy Pelosi and other Democrats. In the interim, the Delta variant sent new coronavirus cases soaring even as it became clear that most of the $46.5 billion that Congress had appropriated for emergency rental assistance funds had yet to reach tenants.

Deborah Childs, a staff member at Forest Hills Nursing Home, receiving her second dose of Covid vaccine.
Credit…Kenny Holston for The New York Times

Of the 1.5 million nursing home staff members in the United States, some 540,000 are unvaccinated. Their fate could be directly impacted by a policy announced on Wednesday by President Biden requiring all nursing home employees to be vaccinated, with the rules likely to take effect sometime in September. Facilities that fail to meet that target could face fines or lose eligibility to receive federal reimbursement, a vital source of income for many.

The practical effect is that workers will have to be vaccinated or lose their jobs.

Janet Snipes manages Holly Heights Care Center in Denver. She wants to see all nursing home workers vaccinated, but not at the risk of losing employees who won’t comply, in an industry with a high turnover rate and a labor shortage.

Ms. Snipes said several employees had told her that they might leave, including one she described as her best nurse. Getting vaccinated “is the safest thing for our residents and our staff, but we feel strongly he needs to mandate for all health care settings,” Ms. Snipes said of Mr. Biden. “We can’t afford to lose staff to hospitals and assisted living facilities.”

Several major nursing home chains, and some states, have already imposed vaccine mandates. Industry officials said inoculations were strongly advised, but their position on the new policy echoed that of Ms. Snipes.

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

Dr. Lee A. Fleisher, chief medical officer of the Centers for Medicare & Medicaid Services, said recent data indicated a “direct relationship” between rising infections at nursing homes and unvaccinated staff.

Of the 625,000 Covid deaths in the United States to date, nearly one-fifth — 133,700 — have been nursing home residents, according to the Centers for Disease Control and Prevention. The industry is again experiencing rising infection rates and deaths among residents, although none approaching the peak figures of last year.

Global Roundup

Australian armed forces standing by outside a Covid-19 vaccination site in Sydney on Wednesday.
Credit…Saeed Khan/Agence France-Presse — Getty Images

The lockdown in Sydney, Australia’s largest city, has been extended for another month as a Delta outbreak continues to surge.

Sydney has now recorded over 10,000 infections and 65 deaths since the outbreak began in mid-June. This week, daily case numbers jumped from the 400s to the 600s, forcing the state government to extend the lockdown, which began in late June, to Sept. 30. It had previously been scheduled to be lifted later this month.

On Thursday, Australia reported 754 cases, its highest daily number since the start of the pandemic, surpassing the height of the Melbourne outbreak last year. On Friday, New South Wales reported 644 new infections.

From Monday, a 9 p.m. to 5 a.m. curfew will also be imposed on 2 million people in 12 areas with the highest infection rates around Sydney. Those areas are also home to some of the city’s most diverse and impoverished residents.

A total of 7 million Australians are now under curfew, with Melbourne having implemented similar measures earlier this week.

Although evidence of the efficacy of measures like curfews has been “mixed,” state premier Gladys Berejiklian said on Friday that they were part of a “a final list of what we can throw at this, to leave no shadow of a doubt as to how serious we are about getting the rate of growth down, the case numbers down.”

The New South Wales government has come under criticism for not acting quickly enough to contain the current outbreak and for initially trying to avoid going into lockdown.

Other new measures introduced on Friday include mandatory masks outdoors across all of Sydney and a one-hour daily limit on outdoor exercise for residents in the 12 high-risk areas.

On Thursday, the federal government fully opened vaccinations to all Australians age 16 to 39. Previously, Pfizer vaccinations were only available to those age 40 to 60 because of supply issues. Those under 40 had previously been given access only to the AstraZeneca vaccine, which the country’s health experts did not recommend for them because it carries an extremely small risk of blood clots.

As of Thursday, 51 percent of Australians over 16 had received at least one vaccine dose and 29 percent were fully vaccinated, according to government statistics.

In other developments across the world:

  • The Philippines logged its highest single-day tallies of new infections, 17,231, and deaths, 317, while the government of President Rodrigo Duterte extended the lockdown covering metro Manila until the end of the month, albeit with some modifications. Essential workers can continue with their jobs, but al fresco services at restaurants will be forbidden, and salons and barbershops will be closed. Religious gatherings will be allowed only online. About 70 percent of all intensive care unit beds in Manila are already in use, with many hospitals turning away patients. “We will continue to see a dramatic increase in cases in the coming days and this is not the time to be complacent,” said Maria Rosario Vergeire, a health department spokeswoman.

  • New Zealand extended its three-day nationwide lockdown to the end of Tuesday after 31 people across several cities tested positive for the Delta variant. Genomic sequencing has revealed that the outbreak began with a person who had traveled to New Zealand from New South Wales, Australia, earlier this month.

  • Nitzan Horowitz, Israel’s minister of health, announced on Twitter that booster doses of the Pfizer-BioNTech vaccine are now available for people 40 and older, as well as teachers.

Unloading boxes of Moderna’s Covid-19 vaccine in Tangerang, Indonesia, this month.
Credit…Antara Foto, via Reuters

Few places benefited from China’s vaccine diplomacy as much as Southeast Asia, a region of more than 650 million that has struggled to secure doses from Western drugmakers. Several of these countries have recorded some of the fastest-growing numbers of cases in the world, underscoring the desperate need for inoculations.

China, eager to build good will, stepped in, promising to provide more than 255 million doses, according to Bridge Consulting, a Beijing-based research company.

Half a year in, however, that campaign has lost some of its luster. Officials in several countries have raised doubts about the efficacy of Chinese vaccines, especially against the more transmissible Delta variant.

Indonesia, which was early to accept Chinese shots, was recently the epicenter of the virus. Now, officials there are administering the Moderna vaccine as a booster to health care workers who had received two doses of Sinovac.

And in Thailand, residents vaccinated with one dose of China’s Sinovac are now given the AstraZeneca shot three to four weeks later.

The setback to China’s vaccine campaign has created a diplomatic opening for the United States when relations between the two countries are increasingly fraught, in part because of the coronavirus.

Vaccine aid from the United States offers an opportunity to restore relations in a region that American officials have mostly ignored for years while China extended its influence. The Biden administration has dispatched a crowd of senior officials, including Vice President Kamala Harris, who is scheduled to arrive on Sunday to visit Singapore and Vietnam. It has also, at last, made its own vaccine pledges to Southeast Asia, emphasizing that the American contribution of roughly 20 million shots comes with “no strings attached,” an implicit reference to China.

Muktita Suhartono and Vo Kieu Bao Uyen contributed reporting. Claire Fu and Elsie Chen contributed research.

Students and teachers wearing their school-required masks wait for parents to arrive outside Lamar Elementary School in San Antonio, Texas.
Credit…Matthew Busch for The New York Times

The Texas Education Agency said it would temporarily stop enforcing Gov. Greg Abbott’s ban on mask mandates and the State Supreme Court issued a ruling allowing school districts to require face-coverings. Both decisions are temporary.

The agency said in new guidance on Thursday that it would immediately stop enforcing the ban on mask mandates until litigations were resolved.

In a reversal, the agency’s new guidance requires schools to notify their local health department if a student tests positive. The school must also notify students in the same classroom as well as those who share extracurricular activities.

As coronavirus hospitalizations have again surged in the state, nearing last year’s peaks, Mr. Abbott has resisted calls for new mandates and doubled down on his ban.

The governor’s mask mandate ban has been making its way through the courts as school districts and parents have continued to challenge it. Seven counties and 48 school districts have defied the governor by ordering mask mandates, The Associated Press reported. Several large cities, including Dallas, San Antonio and Houston, have bucked the governor’s ban.

School districts say they need mask mandates to combat a spike in pediatric cases, just as they face the monumental task of trying to restore in-person learning and reverse the devastating setbacks experienced by a range of students. A confluence of factors — including the Delta virus variant’s contagiousness and the fact that people under 12 are not yet eligible to be vaccinated — is sending more children to hospitals, especially in areas of the country where the virus is surging, like Texas.

New daily cases in Texas have increased by 37 percent over the past two weeks, approaching the peak levels of winter, according to a New York Times database, as the virus stretches hospitals in hot spots to their limits. According to the most recent data from the Texas Department of State Health Services, 829 students and 872 school staff members had tested positive for the coronavirus as of Aug. 8, The Associated Press reported.

Last week, after Mr. Abbott’s ban suffered at least three legal setbacks, the state attorney general, Ken Paxton, said that he was taking the issue to the State Supreme Court. The setbacks were in areas with Democratic leaders, rampant cases and rising hospitalizations.

The State Supreme Court sided with the governor on Sunday, ruling temporarily that schools could not make masks mandatory.

Thursday’s ruling denied the governor’s request to block a Travis County judge’s temporary restraining order that allowed mask mandates. The court said the attorney general should have taken his case first to an appellate court.

In another legal fight, parents of young children with disabilities filed a federal lawsuit against Governor Abbott on Tuesday over his ban, arguing that it prevents their medically at-risk children from being able to attend school safely.

On Tuesday, Mr. Abbott’s office announced the governor, 63, had tested positive for the coronavirus and had no symptoms, but had begun receiving monoclonal antibody treatment. The governor received his first vaccine dose in December.

Senator Roger Wicker of Mississippi leaving the Senate subway at the Capitol this month.
Credit…Cheriss May for The New York Times

Senators Roger Wicker, Republican of Mississippi, Angus King, independent of Maine, and John Hickenlooper, Democrat of Colorado, said on Thursday that they had tested positive for the coronavirus, adding to the number of breakthrough cases among lawmakers.

“Senator Wicker is fully vaccinated against Covid-19, is in good health and is being treated by his Tupelo-based physician,” his spokesman, Phillip Waller, said in a statement released by his office, adding that the senator was experiencing only mild symptoms.

The announcement from Mr. Wicker came as his home state has shattered previous records for new cases this week, and is now reporting more new cases relative to its population than any other state in the country. Mississippi is averaging 118 new cases a day for every 100,000 people, according to data compiled by The New York Times.

Mr. King’s statement said he was symptomatic but taking recommended precautions.

“While I am not feeling great, I’m definitely feeling much better than I would have without the vaccine,” he said. “I am taking this diagnosis very seriously, quarantining myself at home and telling the few people I’ve been in contact with to get tested in order to limit any further spread.”

Mr. Hickenlooper said on Twitter that he was experiencing limited symptoms and expressed gratitude to scientists who had developed the vaccine. He also encouraged vaccinated people to get booster shots in accordance with a plan that the Centers for Disease Control and Prevention announced this week.

The Senate is in recess this week after adjourning early last Wednesday, leaving it unclear whether any of the men had been in recent contact with other lawmakers, as well as when or where they were first exposed. Their diagnoses bring to 11 the number of senators who have tested positive so far, according to news reports compiled by Ballotpedia, a political data website; more than 50 members of the House have tested positive.

Several other vaccinated politicians have recently announced breakthrough cases of their own, including Senator Lindsey Graham of South Carolina, who said he had tested positive for the virus after attending a gathering hosted by Senator Joe Manchin III of West Virginia.

On Tuesday, Gov. Greg Abbott of Texas tested positive and began receiving an antibody treatment, highlighting both the growing concerns over breakthrough cases in the United States and the political tensions over public health measures that Mr. Abbott has consistently opposed in his home state.

While Mr. Wicker has encouraged his constituents to get vaccinated and has applauded the national vaccination effort in official statements, he has also resisted elements of the Biden administration’s coronavirus response. In June, he introduced a resolution calling on the C.D.C. to end a mask mandate for vaccinated people on public transportation.

As the Delta variant spreads aggressively, infections in vaccinated people have been seen more frequently, though they are still rare. The surge and the rising frequency of breakthrough infections have prompted agencies to extend public health measures. The Transportation Security Administration said on Tuesday that the mask mandate would remain in effect on public transportation through Jan. 18.

Correction: 

Because of an editing error, an earlier version of this item referred incorrectly to John Hickenlooper’s elected office. He is a senator, no longer a governor.

Waiting for shuttle buses to mandatory government-designated quarantine hotels in the arrival hall at the Hong Kong International Airport on Tuesday.
Credit…Jerome Favre/EPA, via Shutterstock

The members of the Bordia family thought they were finally going home.

Priyanka and Ankur Bordia had been trying for almost a year to return to Hong Kong from India, where they traveled in February 2020 as coronavirus cases began to increase in the Chinese territory.

In accordance with Hong Kong’s pandemic border policies, which vary by country, they had to be outside India for at least 21 days before they could return. So they went to the Maldives and then Dubai. From there, they planned to fly to Hong Kong and complete another 21 days of mandatory hotel quarantine, all at their own expense.

But their plans were upended this week when the Hong Kong government, citing concerns about the more contagious Delta variant, abruptly moved 15 additional countries to its “high risk” category, including the United States, France and the United Arab Emirates. The changes extended the quarantine period from 14 to 21 days for vaccinated travelers arriving from those countries, and barred unvaccinated travelers who had been in any of those countries in the previous 21 days.

The changes went into effect on Friday, the day the Bordias were supposed to arrive in Hong Kong. And even though the Bordias were vaccinated in India, Hong Kong does not recognize Indian vaccine certificates, which meant they would be barred from entering. Now stranded in Dubai with their two daughters, ages 1 and 3, they are contemplating starting their 21-day “washout” all over again in a lower-risk country.

“We are drained financially, emotionally, mentally, physically,” said Mrs. Bordia, 37, who has lived in Hong Kong for many years, along with her husband, Ankur, 38, who owns a jewelry business there.

Since the government’s announcement, untold numbers of travelers have canceled trips to and from Hong Kong, while others have found themselves stranded or rushed to get back before the new rules went into effect.

The abrupt rule changes have drawn criticism from businesses and Hong Kong residents. Public ire has been raised further by reports that the actress Nicole Kidman was allowed to skip quarantine altogether when she arrived in Hong Kong last week to film “Expats,” a new Amazon Prime Video series about privileged foreigners living in the global financial hub.

Ms. Kidman was seen boarding a private jet in Sydney, Australia, the center of a Delta-driven outbreak that has sent much of Australia into lockdown. As of Friday, Hong Kong is requiring vaccinated travelers from Australia to quarantine in a hotel for 14 days, up from the previous seven.

Amid the growing anger, Carrie Lam, Hong Kong’s chief executive, apologized to travelers on Tuesday for the disruptions.

“I hope they will understand that everything we are doing is to protect Hong Kong from another major outbreak,” she said.

And without naming any celebrities, the Hong Kong government said in a statement that an unnamed person filming in Hong Kong had been granted a quarantine exemption “for the purpose of performing designated professional work, taking into account that it is conducive to maintaining the necessary operation and development of Hong Kong’s economy.”

Hong Kong’s Covid-zero strategy has been successful in keeping virus cases to a minimum: about 12,000 in a population of seven million. The government says strict quarantines are necessary to protect the local population, with vaccination uptake especially low among older residents.

But the frequent rule changes have made travel risky. The government also said this week that it was suspending an antibody testing program that would have allowed some travelers to reduce their quarantine to seven days, which again sent people scrambling to extend their stays at quarantine hotels that are often booked solid.

Teen twins Kira and Nola Barth receive the coronavirus vaccine in Nashville, Tennessee.
Credit…Brett Carlsen for The New York Times

Vaccination rates among middle and high school students need to rise drastically if the United States is going to achieve what are arguably the two most important goals in addressing the pandemic in the country right now: curbing the spread of the highly infectious Delta variant and safely reopening schools.

President Biden told school districts to organize vaccination clinics, but that is putting superintendents and principals — many of whom are already at the center of furious local battles over masking — in a delicate position.

The Pfizer-BioNTech vaccine is authorized for people 12 and older, but administering it to anyone younger than 18 usually requires parental consent, and getting shots into the arms of teenagers has proved harder than vaccinating adults. Only 33 percent of 12- to 15-year-olds and 43 percent of 16- and 17-year-olds are fully vaccinated, according to federal data, compared with 62 percent of adults. Yet some school districts offering the shots, along with pediatrics practices, appear to be making progress: Over the past month, the average daily number of 12- to 15-year-olds being vaccinated rose 75 percent, according to Biden administration officials.

Nationally, more children are hospitalized with Covid-19 — an average of 276 each day — than at any other point in the pandemic.

Children ages 11 and under are not yet eligible for the vaccine, but if and when it is authorized for them, experts expect it could be harder to persuade their parents than those of older children. A recent survey by the Kaiser Family Foundation found that parents of younger children were “generally more likely to be hesitant to vaccinating,” said Liz Hamel, who directed the research.

Jared Mezzocchi, an advocate for digital experimentation, in the Geffen Playhouse production of “Someone Else’s House.”
Credit…Geffen Playhouse

If you were marshaling evidence that streaming theater can pay off, look no further than the Geffen Playhouse in Los Angeles, which sold 35,000 tickets and grossed over $3 million during the pandemic from magic shows and other performances that could be watched at home.

As quickly as you could say “Pick a card, any card,” that’s changed, reports Matt Shakman, the company’s artistic director. “The ticket desire started to drop precipitously as the country was opening up,” he said recently of the digital initiative.

But theater is not beating a full retreat to the Before Days. Spirited arguments have erupted over the relationship between theater and screens — down to an ongoing debate about what to call the new hybrid forms, if not theater.

Many theaters want to incorporate online strategies into a new way of working.

“Would we want to just be a streaming theater?” asked Martin Miller, executive director of TheaterSquared in Fayetteville, Ark. “No. But it did start to feel additive to us when we started having performances in person again this April, because we were still having people streaming the shows. So it was no longer a question about what was lost but what was gained.”

Hybrid plans are in place at the family-friendly New Victory Theater in New York, which is building up its successful online New Victory Arts Breaks, a series of free interactive artistic activities for kids.

“In a given year, we see 100,000 people live; in a year where we’re remote, we’re going to have served a million people,” said Russell Granet, president and chief executive of the theater’s parent organization, New 42. The New Victory is planning to make all of the new season’s shows available on demand for $25.

“Our business model is forever changed in a good way as a result of this past year,” Granet added.

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Kentucky governor suffers legal defeat in combating Covid surge