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Health

Mississippi seeks docs, nurses, ventilators as Covid sufferers pack ICU beds

A prisoner at the Bolivar County Correctional Facility receives a Covid-19 vaccination administered by medical workers with Delta Health Center on April 28, 2021 in Cleveland, Mississippi.

Spencer Platt | Getty Images

Mississippi Gov. Tate Reeves pleaded Friday with residents to get vaccinated as the state scrambles to hire hundreds of temporary doctors, nurses and EMTs.

He’s also requested ventilators from the Strategic National Stockpile as the spread of the delta variant fills hospitals in the state with mostly unvaccinated patients. The state even asked federal officials to send a medical U.S. Navy ship but was turned down, he said.

“When you look across the country, to a certain extent, this current wave is the pandemic of the unvaccinated,” Reeves said at a press conference, adding that the state was headed toward a new peak of the Covid-19 pandemic. “We continue to see more and more data, and the data is becoming more and more clear. Those who received the vaccine are significantly less likely to contract the virus.”

For the few breakthrough cases in fully vaccinated people the state has seen so far, “they’re much less likely to spread the virus and it is highly unlikely that if you have the vaccine that you end up in the hospital or that you end up in an ICU bed,” he said.

Mississippi extended a state-of-emergency order on Thursday that was set to expire this week after the state hit a record of more than 5,000 new Covid cases in one day, said Reeves, a Republican. The spike in cases will likely be followed by an increase in hospitalizations and deaths.

The state requested 65 physicians, 920 nurses, 41 nursing aides, 59 advanced practice nurses, 34 physician assistants, 239 respiratory technicians and 20 EMTs, according to Reeves. The extra help would open up 771 medical surgery beds and 235 ICU beds, he said.

About 97% of people currently hospitalized for Covid in the state are unvaccinated, a trend seen throughout the country. This week, Mississippi’s daily hospitalization rate reached numbers higher than any the state has seen throughout the pandemic.

In the last four days, “we’ve lost four healthy people in their 20s, two of whom were pregnant, zero vaccinated,” Mississippi state health officer Dr. Thomas Dobbs said during the briefing. “In the past four days, we’ve lost 10 people in their 30s, and these aren’t people who are chronically ill cancer patients.” None in their 30s who died were vaccinated.

In other age groups, the number of deaths in unvaccinated people continued to overwhelmingly eclipse the number of deaths in vaccinated people.

“I mean, there’s a pattern here … by and large the vaccines have been incredibly protective and helpful and especially for people who are under 50,” Dobbs said.

The state has one of the lowest vaccination rates per capita in the United States, but daily vaccination rates have tripled over the past month amid the spread of the dominant delta variant, according to state health officials.

The governor said he has no intention of mandating masks or vaccines for state employees “or for anyone else” and emphasized that he believes those things are personal choices.

“I have no intention based upon the data that I have seen of issuing a statewide mask mandate,” Reeves said in a press briefing on Friday.

Reeves said he does not plan to impose mask mandates on schools either, saying that school districts “have every right” to encourage mask use if they deem it necessary.

More than 5,000 children are currently quarantining after positive cases were detected in just the first couple of weeks of schools reopening, some without mask mandates.

In total, Mississippi has recorded 381,147 Covid cases and 7,761 deaths since the beginning of the pandemic, according to the Mississippi State Department of Health.

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Health

‘We’re stretched to breaking level,’ says Mississippi pulmonologist

The pulmonologist Dr. Ijlal Babar warned of the poor state of health systems and providers in Mississippi.

“I want the country to know we are tense to the breaking point, that we need help,” said Babar, director of intensive care at Singing River Health in Mississippi.

“We’re busy right now, our beds in the intensive care unit are full, we have a significant number of patients to be admitted to the emergency room.”

In Mississippi, several schools have already been forced to move to distance learning as Covid cases and hospitalizations rise across the state. Average daily cases have increased 45% over the past week, according to Johns Hopkins, while hospital admissions increased 40% over the same period, according to the Department of Health. State officials asked the Biden government to send a military hospital ship to relieve the overburdened health system.

Babar told The News with Shepard Smith that he is seeing more younger patients compared to the surge in cases over the past year.

“The average age is under 50 and their lungs are just as sick or sicker as they were on the previous climbs,” said Babar. “So last year we saw people’s kidneys and livers collapse, and we don’t see that this time, but the lungs are terrible.”

35.4% of Mississippi’s people are fully vaccinated, the second lowest rate in the country, according to the Centers for Disease Control and Prevention. Babar said he advises patients to get vaccinated but has received a rebound.

“I was told by a patient, a very young patient, that she would rather die than get the vaccine, so let’s see that.”

Babar added that of the few patients with Covid he has seen who have been vaccinated, “no one has been put on a ventilator and almost everyone is discharged.”

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Health

Covid vaccinations greater than double in Arkansas, Mississippi, Louisiana, Alabama

A man will be vaccinated against COVID-19 at a vaccination festival in New Orleans, New Orleans, Louisiana, United States, on May 28, 2021.

Lan Wei | Xinhua News Agency | Getty Images

More and more people who were once hesitant in several southern states are now getting their first vaccinations as the Delta-Covid variant is tearing through areas of the United States with low vaccination rates.

Arkansas, Mississippi, Louisiana, and Alabama have more than doubled the seven-day average of daily first-doses reported since early July, data from the Centers for Disease Control and Prevention shows, as the outbreak worsened nationwide.

Over the same period, the average daily caseload increased from about 13,000 per day across the country to about 94,000 per day on Aug. 4, according to data compiled by Johns Hopkins University, with the overwhelming majority of new infections below those who are unvaccinated .

“Americans are clearly seeing the effects of not being vaccinated and unprotected, and they are responding by doing their part, rolling up their sleeves and getting vaccinated,” White House Covid Tsar Jeff Zients said Thursday to reporters.

In Arkansas, which has the third worst outbreak in the country, based on new cases per capita every day, vaccinations nearly tripled. On July 1, the state administered a seven-day average of 2,893 first doses in the arms, which, according to a CNBC analysis of CDC data, represented new people receiving their first shots. By August 4, that number had increased to a seven-day average of 8,585 first doses per day.

Mississippi, which saw the fourth worst outbreak in the country, saw its first doses given since early July increased 178% through August 4. Louisiana saw a 128% increase and Alabama, which hosted the fifth worst outbreak nationwide, saw a 109% increase.

Louisiana is experiencing the worst per capita outbreak of new Covid cases in the country, recording hospital admissions after the Delta variant targeted the state’s mostly unvaccinated population.

The state governor has reintroduced a mask mandate until at least September 1 to slow down the transmission. Despite the recent surge in vaccinations, Louisiana still ranks fifth in the country for fully vaccinated residents at 37.2%.

“The COVID-19 vaccination rate in Louisiana is not where we need it and that, when combined with the Delta variant, has resulted in the perfect storm we’re seeing right now,” said Mindy Faciane, Public Information Officer at the Department of Health Louisiana across from CNBC.

Behind Louisiana is Arkansas with 37% of the fully vaccinated population, Wyoming with 36.7%, Mississippi with 34.8% and Alabama with 34.6%, according to CDC data.

Covid cases with serious consequences are also increasing, according to US officials. The seven-day average of daily hospital admissions is up 41% from a week, with the average daily death toll up 39%, said CDC director Dr. Rochelle Walensky on Thursday.

Studies have shown that the Delta variant is much more transmissible than the original Covid strain and, unlike the original, requires two doses of vaccine so that the body has a chance to fight against infection and severe symptoms.

“Even if someone decided to get the vaccine today, it will be some time before their body and immune system are able to cope with it,” said Gigi Gronvall, immunologist and senior scientist at the Johns Hopkins Center for Health Safety. said CNBC. “You want to make sure you aren’t exposed before your body has a chance to turn the virus off.”

Still, residents in severely affected states who start vaccinating will help slow the spread of the virus sooner rather than later and could prevent future hospitalizations and deaths.

“People are seeing how this is affecting their communities and they are actively changing their minds to get the vaccine,” Faciane said. “Our vaccination rate is going through the roof right now.”

Patients of different ages hospitalized with Covid in states like Missouri, Florida, Arkansas, and Louisiana regret having refused the vaccination initially and are asking their communities to get vaccinated.

Overall, the US reported an average of about 677,000 daily vaccinations last week (as of August 4), up 11% from a week.

The number of first vaccine doses increases faster than the overall rate. According to the CDC, an average of about 446,000 first doses were given daily for the past seven days, 17% more than the week before.

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Health

Mississippi and Louisiana have a number of the worst vaccine charges and highest Covid hospitalizations in U.S.

Covid cases are doubling across several states and hospitals are starting to fill up again, especially in states with lower vaccination rates as the highly contagious delta variant rips across the country.

Two of the states hit hardest last week — Mississippi and Louisiana and — have the nation’s worst and fourth-worst vaccination rates and rapidly climbing Covid hospitalizations.

Louisiana Health Officer Dr. Joseph Kanter, said Friday the state was in the middle of “a very dangerous surge.” Gov. John Bel Edwards said the outbreak there was so bad, the White House designated Louisiana as a “state of concern.” He and Kanter urged everyone, including fully vaccinated people, to wear masks indoors and work from home when possible.

“To ensure their own safety people in Louisiana should take precautions immediately. Masking and testing will limit death and suffering until we make it through this,” he said in a press release. New Orleans officials issued a citywide indoor mask advisory earlier in the week.

The surge in average new cases, which have jumped by more than 105% over the past week to a seven-day average of 7,592, has some Louisiana residents rushing to get vaccinated, state officials said. Just 41.2% of the state’s residents have had at least one Covid shot, according to CDC data, but many are rushing to get them as evidence mounts that the delta variant is attacking mostly unvaccinated people, state officials said. More than 58,000 Louisianans received their first vaccine doses last week, a 153% increase from the previous week, according to data compiled by the Centers for Disease Control and Prevention.

Medical workers with Delta Health Center wait to vaccinate people at a pop-up Covid-19 vaccination clinic in this rural Delta community on April 27, 2021 in Hollandale, Mississippi.

Spencer Platt | Getty Images

Neighboring Mississippi also saw vaccinations jump last week as average daily cases climbed by more than 132% a seven-day average of 910 new cases per day as of Sunday, according to a CNBC analysis of data compiled by Johns Hopkins University. The state’s administered at least one shot to just 38.6% of its population — ranking it last in the country.

In Mississippi, the state’s given almost 27,000 first doses administered over the seven days through Sunday, 42% more than the prior week.

“Y’all, we’re going to have a rough few weeks,” State Health Officer Dr. Thomas Dobbs, the state’s former top epidemiologist, told reporters at a press conference last week. “Delta is hitting us very strongly. We anticipate that we’re going to continue to put additional pressure on the healthcare system.”

Across the nation, roughly 73% of available hospital beds are currently in use, about 4.5% are taken up by Covid patients, according to CDC data. But they account for a greater share of available ICU beds, comprising about 11.9% of all intensive care patients.

In Louisiana, Covid patients are using 8.4% of all available beds and about 16.8% of ICU beds, according to the CDC. Covid patients in Mississippi are taking up 7.2% of all hospital beds and 23% of ICU beds.

Dobbs said there are currently 13 hospitals across Mississippi that have “zero ICU beds and a significantly higher number than that have less than 10% availability.” He said 93% of the state’s Covid cases and 89% of the deaths in the past month are among unvaccinated individuals.

Vaccination rates there are also climbing. The the state administered almost 27,000 first doses over the seven days through Sunday, a 42% jump from the prior week. Vaccine reluctance is high across the state, officials said, adding that they are trying to convince residents one person at a time to get the shots. State officials pleaded with elderly and vulnerable residents earlier this month to avoid large indoor events.

“We hear it all, from the microchip insertion to the depopulation plan using the vaccine to the magnetizing people. I mean you name it, we’ve heard it,” state health department Chief Medical Officer Dr. Dan Edney told reporters last week.

Hospitals, in the meantime, are keeping a close watch on their ventilator supplies.

“Our number of cases is increasing rapidly,” Dobbs said. “Our ICU utilization is starting to rise to levels not seen since last summer, and we’re also seeing an increase in the utilization of our mechanical ventilators.”

CNBC’s Nate Rattner contributed to this reporting.

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Health

Mississippi well being officers plead with aged to keep away from mass indoor gatherings as delta Covid variant rips by state

Medical workers with Delta Health Center wait to vaccinate people at a pop-up Covid-19 vaccination clinic in this rural Delta community on April 27, 2021 in Hollandale, Mississippi.

Spencer Platt | Getty Images

Mississippi state health officials issued new guidance on Friday that calls for state residents over the age of 65 and immunocompromised residents, vaccinated or unvaccinated, to avoid any indoor mass gatherings for the next two weeks amid “significant transmission” of the delta variant over the coming weeks.

The new guidance is in place until July 26 and is not mandatory. The guidance should instead be considered a recommendation.

“We’re not recommending any mandates. What we’re doing is we’re providing personal recommendations for individuals who are at high risk for severe outcomes,” Mississippi State Health Officer Dr. Thomas Dobbs said during a press briefing Friday. “We don’t want anybody to die needlessly.”

Dobbs said he currently “does not anticipate” the guidance being expanded to other age groups in the future.

Officials said they are starting to see significant transmission of the delta variant that is very reminiscent of what was seen in the early days of the pandemic. Mississippi state health epidemiologist Dr. Paul Byers specifically highlighted church groups, school and summer programs, funeral gatherings and workplaces as well as long-term care facilities as areas where officials are already seeing spikes in infections.

“We have directly identified that they are the result of the delta variant, and the transmission … has been pretty significant,” Byers said at the press briefing Friday.

The state is second to last to Alabama out of all states when it comes to the percentage of the population that is fully vaccinated with two doses. About 25% of Mississippians over age 65 are still unvaccinated, and make up the majority of Covid deaths in the state. State health officials also said they are seeing deaths in vaccinated residents as well, “because we are exposing them over and over again,” Dobbs said, though it is a miniscule percentage.

Zoom In IconArrows pointing outwards

Graph shows cases, hospitalizations and deaths among vaccinated vs unvaccinated in Mississippi from June 3 to July 1, 2021.

Mississippi State Health Department

Mississippi is ranked last in the country in its share of adults with at least one Covid shot and the state is also ranked last in the country in the percentage of residents age 12 and older with at least one shot.

“I don’t think that we’re going to have some miraculous increase in our vaccination rate over the next few weeks, so people are going to die needlessly,” Dobbs warned.

State health officials asked vaccinated residents to speak with others about their experience with the vaccine in an effort to raise awareness about the safety and efficacy of the shots.

“Let people, let your family know, let your neighbors know, let your friends know,” Dobbs said. “There’s no more powerful message than trust and faith for people to know how widely utilized the vaccine has been, and understand that people are safe and excited to be protected.”

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Politics

Supreme Court docket to listen to Mississippi abortion case difficult Roe v. Wade

The Supreme Court on Monday agreed to hear arguments in a major Mississippi abortion case that pushes the limits of abortion laws set by the landmark reproductive rights case, Roe v. Calf, which were cemented, could reset.

The case will be the first major abortion dispute in which all three people appointed by former President Donald Trump will be considered in the Supreme Court, including the newest member, Justice Amy Coney Barrett.

The Supreme Court announced in an order that it would hear the dispute, Dobbs v Jackson Women’s Health Organization, 19-1392. The court will hear the case during its term in office from October. A decision is expected to be made in June 2022.

The case concerns a 2018 Mississippi abortion law that bans abortions after 15 weeks with limited exceptions. The law was blocked by the 5th US Circuit Court of Appeals. Under the existing Supreme Court precedent, states cannot prohibit abortions that occur before the fetus is viable, typically about 22 weeks or later.

In this case, Mississippi is asking the judges to re-examine that viability standard. The state argued that the viability rule prevents states from adequately defending maternal health and potential life.

“It is long time the court reassessed the wisdom of the profitability rule,” Mississippi Attorney General Lynn Fitch wrote in a brief report filed with the judges.

The Mississippi abortion clinic that challenged the law, the Jackson Women’s Health Organization, called on the Supreme Court not to take the case.

“In an uninterrupted series of decisions over the past fifty years, this court has ruled that the constitution guarantees everyone the right to choose whether to continue a pregnancy before viability,” wrote Hillary Schneller, an attorney who runs the clinic represents, in a file.

Schneller said Mississippi’s argument was based “on a misunderstanding of the core principle” of previous Supreme Court rulings.

She wrote, “While the state has interests throughout pregnancy.”[b]Prior to viability, state interests are not strong enough to support an abortion ban. “

Conservatives passed a number of bills that challenged Roe and were passed in 1973 in hopes of getting the court to reconsider its previous precedents. With the people appointed by Trump, the nation’s Supreme Court now has a Conservative majority of 6-3.

The struggle for abortion revitalized the confirmation hearings for Barrett, a devout Catholic who, after the death of the liberal judiciary, was the favorite among anti-abortion groups to seek the success of Justice Ruth Bader Ginsburg.

While Barrett has not made her exact legal views on abortion clear from the bank, the Democrats have taken up her earlier comments identifying aborted fetuses as “unborn victims” among other potential harbingers of their views.

The other two Trump nominees on the bench, Justices Neil Gorsuch and Brett Kavanaugh, voted last June to allow a restrictive abortion law to come into effect for Louisiana in the first major reproductive rights case before them. Chief Justice John Roberts, a Conservative, sided with the Liberals in the 5-4 decision that blocked the law.

In a statement, Center for Reproductive Rights President Nancy Northup said: “Alarm bells are ringing loudly about the threat to reproductive rights.”

The Center for Reproductive Rights represented the abortion clinic alongside the Paul Weiss law firm and the Mississippi Center for Justice.

“The consequences of a Roe reversal would be devastating. Over 20 states would directly ban abortion. Eleven states – including Mississippi – currently have trigger bans on the books that would immediately ban abortion if Roe is overturned,” Northup said.

Diane Derzis, owner of the Jackson Women’s Health Organization, said in a statement, “As the only abortion clinic in Mississippi, we see patients who spent weeks saving the money to travel here and pay for childcare for shelter.” and everything else. “

“If this ban went into effect, we would be forced to turn many of these patients away and they would lose their right to abortion in that condition,” Derzis said.

Fitch, the Mississippi attorney general, said the state legislature “enacted this law in accordance with the will of its constituents to promote the health of women and preserve the dignity and sanctity of life.”

“I continue to advocate for women and defend Mississippi’s legal right to protect the unborn,” she said.

Anti-abortion groups welcomed the Supreme Court move. Susan B. Anthony List President Marjorie Dannenfelser said the court’s decision to hear the case was a “landmark opportunity,” citing the enormous number of bills recently passed to improve access to abortion to restrict.

“Across the country, state lawmakers acting according to the will of the people have introduced 536 pro-life bills aimed at humanizing our laws and challenging the radical status quo imposed by Roe,” she said.

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Health

Vaccine Slots Go Unused in Mississippi and Different States

When it comes to getting the coronavirus vaccine, Mississippi residents have a wealth of options. There were more than 73,000 slots on the state’s scheduling website on Thursday, up from 68,000 on Tuesday.

In a way, the growing number of appointments in Mississippi is cause for celebration: it reflects the increasing supply that has led states across the country to open up eligibility to anyone over the age of 16.

However, public health experts say the pile of unclaimed appointments in Mississippi exposes something more worrying: the large number of people who are reluctant to get vaccinated.

“It is time to do the heavy lifting that is required to overcome the hesitation we encounter,” said Dr. Obie McNair, an internist in Jackson, the state capital, whose office has plenty of vaccines but not enough buyers.

Though access remains an issue in rural Mississippi, experts say the state – one of the first to open the permit to all adults three weeks ago – could be a harbinger of how much of the country is in the Will Face Coming Weeks When Growing Supply Allows Most Americans Who Would Like The Vaccine To Have Appointments Easily.

The hesitation has national implications. Experts say that between 70 and 90 percent of Americans must be vaccinated for the country to achieve herd immunity. At this point the virus can no longer spread through the population.

In terms of vaccination rates, Mississippi still has a long way to go: only a quarter of all residents have received at least one dose, according to the state, compared to the statewide average of 33 percent. Other southern states, including Tennessee, Arkansas, Alabama, and Georgia, have similarly low vaccination rates.

A closer look at Mississippi’s demographics explains why hesitation can be particularly pronounced. The state reliably elects Republicans, a group that remains very skeptical about the coronavirus vaccine. Almost half of all Republican men, and a total of 40 percent of Republicans, said they did not plan to vaccinate, according to several recent surveys. These numbers have changed little in the months since vaccines first became available. In contrast, only 4 percent of Democrats said they won’t get the vaccine.

Another contributing factor to the state’s low vaccination rate could be Mississippi’s large black community, which makes up 38 percent of the state’s population but accounts for 31 percent of the doses administered, according to the state. Reluctance to vaccinate remains somewhat high among African Americans, although doubts and suspicions – largely due to previous government abuses such as the infamous Tuskegee syphilis experiments – have declined significantly in recent months.

According to a survey by the Kaiser Family Foundation published last week, about 55 percent of black adults said they had been vaccinated or were planning to vaccinate soon. That’s an increase of 14 percentage points from February, which is a rate of 61 percent versus Hispanics at 64 percent.

A number of other heavily republican states are also facing an abundance of doses. On Thursday, Oklahoma officials who have provided 34 percent of its residents with at least one dose announced they would open the license to non-state residents, and in recent weeks Republican governors in Ohio and Georgia have raised concerns about lackluster vaccine demand among their residents.

Tim Callaghan, assistant professor at Texas A&M University School of Public Health and an expert on vaccine skepticism, said more research was needed to determine the reasons behind the declining vaccine demand in Mississippi. The Americans were probably the first to face the problem. “If you want to see vaccine hesitate, it will be in red states like Mississippi,” he said.

Updated

April 9, 2021, 5:04 p.m. ET

Mississippi officials are aware of the challenge. On Tuesday, Governor Tate Reeves held a press conference with a group of medical experts who tried to dispel some of the misinformation related to the vaccines. They tried to explain the vaccine development process, refuted claims that the vaccine can cause miscarriages, and shared their own personal experiences after receiving the shot.

“I had about 18 hours of turbulence,” said Governor Reeves, describing the mild, flulike symptoms he felt after his second injection. “But I could go on and go on and work and I feel a lot better every day knowing I have been vaccinated.”

Access remains a challenge in parts of rural Mississippi, especially among African Americans who live far from drive-through vaccination centers in urban areas, which account for roughly half of the doses administered by the state. The scheduling system has also proven frustrating for the poor and elderly, who often lack internet access to book appointments or take them to remote vaccination sites.

“We need to get the vaccines to the people, to pop-up locations that don’t require internet or advance registration,” said Pam Chatman, the founder of Boss Lady Workforce Transportation, a system of minivans that drove ferries Mississippi Delta residents to mass vaccination sites.

Demand among African Americans is still robust, she said, noting long lines that formed outside a tent in Indianola, a small town in the Delta this week, that was selling the Johnson & Johnson single-dose vaccine. (The tents with the Pfizer and Moderna vaccines, which require two doses, were almost empty.)

But hesitation is common. Dr. Vernon Rayford, an internist in Tupelo, said he was frustrated with patients who gave various reasons for rejecting the vaccine. They claim it will give them Covid-19 or make them sterile and they worry about unknown effects that could appear decades later. “I’ve heard some really crazy theories,” he said.

Dr. Rayford, who sees patients of all races, said he has noted subtle differences in skepticism: African Americans express suspicion of the health care system while whites express a more amorphous distrust of the government. “It’s like that line from ‘Anna Karenina’,” he said. ‘All happy families are equal; Every unhappy family is unhappy in its own way. ‘“

Dr. Brian Castrucci, President of the de Beaumont Foundation, which focuses on public health, has worked to allay such fears. Dr. Castrucci, an epidemiologist, is particularly concerned about young Conservatives, ages 18 to 34; He cited a recent poll that found that 55 percent of Republican women with college degrees under the age of 49 would not be vaccinated.

“His polls like this one keep me up at night,” he said.

The biggest barriers to greater vaccine adoption are the misinformation that thrives on social media and the mixed news from Republican governors confusing people.

“By easing Covid restrictions, elected leaders are pushing coronavirus narratives in states like Florida, Mississippi, Texas and Georgia that work against a narrative that promotes the urgency of vaccinations,” he said. “And unfortunately, our vaccination campaigns are being rolled back late at night on Facebook, Twitter and Instagram.”

So far, Mississippi health officials have focused much of their vaccine delay efforts on African American and Hispanic residents through partnerships with churches and health clinics. Governor Reeves, a Republican, has so far refused to highlight the skepticism among white conservatives in the state, but health officials said they planned to address the issue through Facebook and Zoom meetings with local organizations.

Public health experts say that well-crafted messages are needed from doctors, religious leaders, and other individuals trusted by a particular community. Dr. Thomas Friedan, a former director of the Centers for Disease Control and Prevention who participated in a focus group of vaccine-reluctant Trump voters organized by the de Beaumont Foundation last month, said participants wanted their fears to be recognized and they longed for factual information without being instructed or belittled. “There’s no real way to communicate about vaccines, but you need multiple messages with multiple messengers,” said Dr. Friedan, who leads the Resolve to Save Lives health advocacy group. “And people don’t want to hear from politicians.”

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Health

Mississippi Will Take away ‘Deceptive’ Language About Covid-19 Vaccine

Bobby Wayne, a retired minister with prostate cancer and leukemia, had called health officials in his Mississippi county for a week to find out where to get the Covid-19 vaccine.

But when Mr. Wayne, 64, called the state helpline on Monday, he said an operator whose job it was to help residents schedule vaccination appointments had given him annoying and inaccurate information.

“That’s how she told me: They had no documentation that the vaccine was effective,” Wayne said. “And then she asked me if I still wanted to take it.”

When he said “yes” to her, the operator replied that there were no appointments available and that he should call again the next morning.

Recognition…Elizabeth Wayne

The confusion was the result of “miscommunication” about a misleading script that the hotline operators had received, according to the Ministry of Health.

The script referred to pregnant women, breastfeeding women and people with weakened immune systems.

It was asked, “Still want to be vaccinated with the understanding that no data are currently available on the safety or effectiveness of Covid-19 vaccines, including the Moderna Covid-19 vaccine, in pregnant women, breastfeeding women or the immunocompromised?”

Most experts agree that the risks to pregnant women from Covid-19 are far greater than any theoretical harm from the vaccines. Doctors have said they believe the vaccines are safe for people with autoimmune diseases.

Liz Sharlot, a spokeswoman for the Mississippi Department of Health, said the script could be confusing “if read out of context.”

Updated

March 24, 2021, 9:11 p.m. ET

“We are replacing this confusing and misleading language,” she said in a statement

However, Ms. Sharlot said operators were never told that there was no documented evidence that the Moderna vaccine, or any other vaccine approved by the Food and Drug Administration, worked.

“Just the opposite is the case,” she said. “Both Moderna and Pfizer have high rates of effectiveness.”

Ms. Sharlot added, “I think the Lord misunderstood this.”

Mr. Wayne said he understood perfectly.

“I’m not confused at all,” he said. “I’m maybe 64 years old and disabled, but my brain is still working and so are my ears.”

Mr. Wayne said it was worrying to think that people asking for information about the vaccination might be discouraged by the very people who are supposed to help them get a shot.

“I wouldn’t want anyone else to go through this,” he said.

According to a New York Times database, Mississippi has given 22 percent of its population at least one dose of a Covid-19 vaccine. Just over 12 percent of citizens are fully vaccinated.

Mr. Wayne’s daughter, Elizabeth Wayne, an assistant professor of biomedical engineering at Carnegie Mellon University, complained on Twitter about her father’s conversation with the state operator, calling it “violence.”

“It’s dangerous,” said Dr. Wayne. “There is therapy. There is a way to treat something and you make it harder for them to get access to that treatment, making it more likely that they will get sick. “

The Mississippi Free Press covered the story after Dr. Wayne wrote on Twitter about her father’s experience.

Dr. Thomas E. Dobbs III, the state health commissioner, responded to her post on Twitter and shared a link to a study in the New England Journal of Medicine that showed the Moderna vaccine, Covid-19, was 94.1 percent effective prevented and that “No safety concerns were identified. “

Dr. Wayne said she was pleased that the health department appeared to be taking her and her father’s concerns seriously.

“I think it was a really good example of the State Health Department trying to contact because they actually want to restore confidence,” she said.

Mr. Wayne said he got his shot Wednesday morning.

“I feel a lot better,” he said.

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World News

Covid-19 Vaccine Stay Updates: Mississippi Opens Eligibility, Italy Lockdown and Extra

Here’s what you need to know:

Credit…Rory Doyle for The New York Times

Mississippi will become the second state to open Covid-19 vaccinations to all of its adult residents, following a call from President Biden for all states to do so by May 1.

Alaska opened its vaccination doors last week to anybody 16 or older who lives or works in the state. The change in Mississippi takes effect Tuesday.

“Get your shots, friends,” Gov. Tate Reeves announced on Twitter. “And let’s get back to normal!”

The pace of vaccinations in the United States has steadily increased as production has ramped up, from well under one million shots per day on Jan. 20, when Mr. Biden took office, to about 2.4 million doses per day on average, according to a New York Times database.

Mr. Biden’s team has made key decisions that quickened the manufacturing and distribution of vaccines, but now the country faces the challenge of getting all those shots into arms. Mass vaccination sites across the country are opening up or increasing their capacity, in part to respond to the influx of doses from the single-shot Johnson & Johnson vaccine.

But more challenges remain, including improving access in communities of color and convincing Americans wary for a variety of reasons that getting vaccinated is safe and effective.

Although Mississippi lags most states in the share of its population that has been vaccinated, it is doing better than all of its neighbors except Louisiana, according to a New York Times tracker. As of Sunday, about 20 percent of Mississippians have received at least one shot, and 11 percent have been fully vaccinated.

The state had already opened eligibility further than most states, to cover everyone 50 or over. Governor Reeves urged older residents to book appointments as soon as possible.

Gov. Gretchen Whitmer of Michigan has said that her state will drop its restrictions on eligibility by April 5, about a month before Mr. Biden’s deadline. Gov. Ned Lamont of Connecticut said his state would as well, tentatively opening vaccine eligibility to all adults on April 5.

“It’s still going to take some time to get the vaccine to everyone who wants it, and I urge patience to the greatest extent possible,” Mr. Lamont said in a news release.

Officials in Washington, D.C., said on Monday that they would do the same by May 1, allowing anyone 16 or older who lives in the city to be inoculated.

In New York, where the minimum age was recently lowered to 60, the state will open three new mass vaccination sites on Long Island at the end of the week, Gov. Andrew M. Cuomo said on Monday at a news conference. The sites will be on college campuses in Old Westbury, Brentwood and Southampton.

More categories of public-facing workers will become eligible in New York on Wednesday, including government employees, building services workers and employees of nonprofit groups. Mr. Cuomo has yet to announce how or when the state would open eligibility to all adults.

About 92.6 million vaccine doses have been administered since Mr. Biden’s inauguration, according to data released on Monday by the Centers for Disease Control and Prevention. At the current pace, the country will pass 100 million doses under Mr. Biden before the end of the week.

United States › United StatesOn March 14 14-day change
New cases 38,034 –19%
New deaths 572 –31%
World › WorldOn March 14 14-day change
New cases 369,370 +11%
New deaths 5,360 –6%

U.S. vaccinations ›

Where states are reporting vaccines given

Peter Krage, 54, a gerontological nurse, getting his first dose of the AstraZeneca vaccine in Rostock, Germany, last month.Credit…Lena Mucha for The New York Times

As a third wave of the pandemic crashes over Europe, questions about the safety of one of the continent’s most commonly available vaccines led Germany, France, Italy and Spain to temporarily halt its use on Monday. The suspensions created further chaos in inoculation rollouts even as new coronavirus variants continue to spread.

The decisions followed reports that a handful of people who had received the vaccine, made by AstraZeneca, had developed fatal brain hemorrhages and blood clots.

The company has strongly defended its vaccine, saying that there is “no evidence” of increased risk of blood clots or hemorrhages among the more than 17 million people who have received the shot in the European Union and the United Kingdom.

“The safety of all is our first priority,” AstraZeneca said in a statement Monday. “We are working with national health authorities and European officials and look forward to their assessment later this week.”

The timing of the pause in inoculations by some of Europe’s largest countries — which followed a flurry of similar actions by Denmark, Norway and several others — could not have been worse.

Europe’s vaccine rollouts already lag far behind those in Britain and the United States, and there is dawning realization that much of the continent is suffering a third wave of infections. Leading immunologists fretted on Monday that the decision by several of Europe’s leading nations to suspend the use of AstraZeneca would make vaccination efforts even harder by emboldening vaccine skeptics in countries where they are particularly entrenched.

The European Medicines Agency and the World Health Organization warned against an exodus from vaccines that would undermine rollout efforts at a pivotal moment.

VideoVideo player loadingItaly began to enter strict regional lockdowns on Monday, as the government moved to halt an increase in coronavirus infections just one year after the country became the first in Europe to impose a national lockdown.CreditCredit…Alessandro Grassani for The New York Times

A year after Italy became the first European country to impose a national lockdown to contain the spread of the coronavirus, the nation has fallen eerily quiet once again, with new restrictions imposed on Monday in an effort to stop a third wave of infections that is threatening to wash over Europe and overwhelm its halting mass inoculation program.

As he explained the measures on Friday, Prime Minister Mario Draghi warned that Italy was facing a “new wave of contagion,” driven by more infectious variants of the coronavirus.

Just as before, Italy was not alone.

“We have clear signs: The third wave in Germany has already begun,” Lothar Wieler, head of the Robert Koch Institute for Infectious Diseases, said during a news conference on Friday. Prime Minister Viktor Orban of Hungary predicted that this week would be the most difficult since the start of the pandemic in terms of allocating hospital beds and breathing machines, as well as mobilizing nurses and doctors. Hospitalizations in France are at their highest levels since November, prompting the authorities to consider a third national lockdown.

Officials in the United States are watching those developments with wary eyes. At a White House news briefing on Monday, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, pleaded with Americans not to let their guard down as case numbers have dropped from their peak. She pointed to images of young people crowded onto Florida beaches, though generally people are safer outside than inside, and to European nations as a warning.

“Each of these countries has had nadirs like we are having now, and each took an upward trend after they disregarded no mitigation strategies,” she said. “They simply took their eye off the ball. I’m pleading with you for the sake of our nation’s health. These should be warning signs for all of us.”

The U.S. death rate remains at nearly 1,400 people every day. That number still exceeds the summer peak, when patients filled Sun Belt hospitals and outbreaks in states that reopened early drove record numbers of cases, though daily deaths nationwide remained lower than the first surge last spring. The average number of new reported cases per day remains comparable to the figures reported in mid-October.

Across Europe, cases are spiking. Supply shortages and vaccine skepticism, as well as bureaucracy and logistical obstacles, have slowed the pace of inoculations. Governments are putting exhausted populations under lockdown. Street protests are turning violent. A year after the virus began spreading in Europe, things feel unnervingly the same.

In Rome, the empty streets, closed schools, shuttered restaurants and canceled Easter holidays came as a relief to some residents after months of climbing infections, choked hospitals and deaths.

“It’s a liberation to return to lockdown, because for months, after everything that happened, people of every age were going out acting like there was no problem,” said Annarita Santini, 57, as she rode her bike in front of the Trevi Fountain, a popular site that had no visitors except for three police officers. “At least like this,” she added, “the air can be cleared and people will be scared again.”

For months, Italy had relied on a color-coded system of restrictions that, unlike the blanket lockdown of last year, sought to surgically smother emerging outbreaks in order to keep much of the country open and running. It does not seem to have worked.

“History repeats itself,” Massimo Galli, one of Italy’s top virologists, told the daily Corriere della Sera on Monday. “The third wave started, and the variants are running.”

“Unfortunately we all got the illusion that the arrival of the vaccines would reduce the necessity of more drastic closures,” he said. “But the vaccines did not arrive in sufficient quantities.”

Sheryl Gay Stolberg Lauren Leatherby and Mitch Smith contributed reporting.

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Biden: ‘Shots in Arms and Money in Pockets’

President Biden declared on Monday that within 10 days the U.S. would achieve his goal of administering 100 million vaccination shots and delivering 100 million stimulus checks to Americans.

Over the next 10 days, we’ll reach two goals, two giant goals. The first is 100 million shots in people’s arms will have been completed within the next 10 days and 100 million checks in people’s pockets in the next 100 days. Shots in arms and money in pockets. That’s important. The American Rescue Plan is already doing what it was designed to do, make a difference in people’s everyday lives. And we’re just getting started. By the time all the money is distributed, 85 percent of American households will have gotten their $1,400 rescue checks. I’m pleased to announce and introduce another gifted manager to coordinate our implementation of the American Rescue Plan, Gene Sperling. Gene will be on the phone with mayors and governors, red states, blue states, the source of constant communication, a source of guidance and support, and above all, a source of accountability for all of us to get the job done. And together, we’re going to make sure that the benefits of the American Rescue Plan go out quickly and directly to the American people where they belong. Help is here and hope is here in real and tangible ways. We’re just days away from 100 million shots and millions — in the arms of millions of Americans. That’s the way, that’s the way on the way to get every single American access to the vaccine.

Video player loadingPresident Biden declared on Monday that within 10 days the U.S. would achieve his goal of administering 100 million vaccination shots and delivering 100 million stimulus checks to Americans.CreditCredit…Doug Mills/The New York Times

President Biden said Monday that his administration was on pace to achieve two key goals by March 25: the distribution of 100 million shots of Covid-19 vaccines since his inauguration and 100 million checks and electronic deposits of stimulus payments under his economic relief bill.

“Shots in arms and money in pockets. That’s important,” Mr. Biden said in a brief address from the White House.

The president also introduced Gene Sperling, a longtime Democratic policy aide, as his pick to oversee implementation of the $1.9 trillion economic relief package that he signed into law late last week.

“The American Rescue Plan is already doing what it was designed to do,” Mr. Biden said. “Make a difference in people’s everyday lives.”

The United States has administered 92.6 million vaccine doses since Jan. 20, when Mr. Biden took office, according to data released on Monday by the Centers for Disease Control and Prevention. At the current pace of vaccinations, the country will pass 100 million doses under Mr. Biden before the end of the week.

Answering a question from a reporter after the speech, Mr. Biden brushed aside calls for his administration to enlist former President Donald J. Trump’s help in appealing to Republicans who have resisted getting vaccinated.

“I discussed it with my team,” Mr. Biden said, “And they say the thing that has more impact than anything Trump would say to the MAGA folks is what the local doctor, what the local preachers, the local people in the community would say. So I urge, I urge all local docs, and ministers, and priests, to talk about why — why it’s important to get that vaccine.”

Mr. Biden’s remarks came as his team launched a week of sales pitches for the relief bill. The president and several members of his administration will travel the country to promote the plan that contains direct $1,400-per-person payments to low- and middle-income Americans, new monthly checks for parents and additional relief for the unemployed, among other particulars.

Mr. Biden will visit Delaware County, Pa., on Tuesday and will appear with Vice President Kamala Harris on Friday in Atlanta, which helped deliver Democrats the Senate majority that made the stimulus law possible.

A group of other administration representatives and officials, including the first lady, Jill Biden, and Ms. Harris’s husband, Doug Emhoff, will also make trips. Ms. Harris and her husband landed in Las Vegas for an event on Monday afternoon, while Dr. Biden finished an event in New Jersey.

The road show is an effort to avoid the messaging mistakes of President Barack Obama’s administration, which Democrats now believe failed to continue vocally building support for his $780 billion stimulus act after it passed in 2009. The challenge will be to highlight less obvious provisions, including the largest federal infusion of aid to the poor in generations, a substantial expansion of the child tax credit and increased subsidies for health insurance.

Mr. Sperling’s challenge with the rescue plan will be different than the one Mr. Biden faced in 2009, because the relief bill differs starkly from Mr. Obama’s signature stimulus plan. The Biden plan is more than twice as large as Mr. Obama’s. It includes money meant to hasten the end of the pandemic, including billions for vaccine deployment and coronavirus testing.

Oversight of the $1.9 trillion relief legislation is currently expected to rely on the Government Accountability Office and the Pandemic Response Accountability Committee, a panel of inspectors general from across the federal government. A Treasury official said that the department would set up a process to monitor the use of funds that are being sent to states to ensure that they are used according to the eligibility requirements in the law.

A rally in San Francisco on Saturday in support of a five-day in-person learning schedule at the city’s public schools.Credit…John G Mabanglo/EPA, via Shutterstock

Parents of schoolchildren protested in several cities around the United States over the weekend, frustrated by the off-again-on-again reopening policies in some school districts and blanket closures in others a full year after the pandemic began, despite growing scientific evidence that schools can reopen safely if they follow basic procedures.

Several hundred people rallied in downtown Naperville, Ill., on Sunday to urge officials to give students the option of returning to the classroom five days a week. Wielding signs with messages like “Get our kids back in school” and “Flip the school board,” demonstrators chanted, “Five days a week,” The Naperville Sun reported.

In San Francisco, hundreds of parents and children marched on Saturday in support of a five-day in-person learning schedule, arguing that a partial reopening falls short, The San Francisco Chronicle reported. Similarly, parents demonstrated at Pan Pacific Park in Los Angeles on Saturday, according to a local news station, saying a tentative agreement with teachers for a partial reopening in April was not enough.

Parents pressing for in-person classes say that remote learning leaves students feeling emotionally and socially drained at home.

They have the Biden administration on their side. Jill Biden and members of her husband’s administration have been traveling the country in a campaign aimed at reopening schools. And the Centers for Disease Control and Prevention released guidelines last month saying it was safe for schools to reopen if they could ensure measures like proper masking, physical distancing and hygiene were taken. The recommendations called for every elementary school to open in some fashion.

In early February, The New York Times surveyed 175 experts — mostly pediatricians focused on public health — who largely agreed that it was safe enough for schools to be open to elementary students for full-time, in-person instruction. Some said that was true even in communities where coronavirus cases were widespread, with proper safety precautions, including adequate ventilation and avoidance of large group activities.

Heather Kilpatrick used to work in hospitality before the pandemic, but she now stays home with her 3-year-old daughter, Vivienne. Credit…Tony Luong for The New York Times

In the year since the pandemic upended the U.S. economy, more than four million people have quit the labor force, leaving a gaping hole in the job market that cuts across age and circumstances.

An exceptionally high number have been sidelined because of child care and other family responsibilities or health concerns. Others gave up looking because they were discouraged by the lack of opportunities. And some older workers have called it quits earlier than they had planned.

These labor-force dropouts are not counted in the most commonly cited unemployment rate, which was 6.2 percent in February, making the group something of a hidden casualty of the pandemic.

Now, as the labor market begins to emerge from the pandemic’s vise, whether those who have left the labor force return to work — and if so, how quickly — is one of the big questions about the shape of the recovery.

There is some reason for optimism. Economists expect that many who have left the labor force in the past year will return to work once health concerns and child care issues are alleviated. And they are optimistic that as the labor market heats up, it will draw in workers who grew disenchanted with the job search.

Moreover, after the last recession, many economists said those who left the labor force were unlikely to come back, whether because of disabilities, the opioid crisis, a loss of skills or other reasons. Yet labor force participation, adjusted for demographic shifts, eventually returned to its previous level.

But the speed with which the pandemic has driven workers from the labor force could leave lasting damage.

Many Facebook and Instagram users are already using the apps to share their vaccination status.Credit…Marcio Jose Sanchez/Associated Press

Facebook said on Monday that it planned to expand its efforts to help get people vaccinated against the coronavirus.

The social network said it would roll out a new location-based tool to direct people to the clinics nearest to them that offer vaccinations, which users can find inside Facebook’s main app.

The company will also have an information center for Covid-19-related questions and data inside its Instagram photo-sharing app, building on a similar effort that Facebook introduced last year. And it will keep adding automated chat bots to WhatsApp, which can text users information on where to get vaccinated.

“By working closely with national and global health authorities and using our scale to reach people quickly, we’re doing our part to help people get credible information, get vaccinated and come back together safely,” Mark Zuckerberg, the chief executive of Facebook, said in a company blog post.

While Facebook previously allowed anti-vaccination groups on its platform to flourish, last year it pledged to remove Covid-related misinformation from its site. It also labeled posts related to the coronavirus with links to its official information center so it could direct people to sources like the World Health Organization.

But critics have said that false or misleading data about vaccines and the virus continues to be visible in private groups and pages on Facebook.

At North Dakota State University in October. Several studies have shown that the pandemic has disproportionately affected the mental health of young people.Credit…Bing Guan/Reuters

Young people’s reports of poor well-being during the pandemic have fueled a global crisis that needs immediate attention, according to a nonprofit organization that surveyed nearly 50,000 people in eight countries, providing a comprehensive overview of the pandemic’s impact on mental health.

More than one in four respondents reported facing or being at risk of clinical disorders, a number that rose to nearly one in two for those ages 18 to 24, according to the report, which was released by group, Sapien Labs, a U.S. nonprofit group dedicated to understanding the human mind.

The report, based on data collected from an online, anonymous survey whose findings were published on Monday, focused on Australia, Britain, Canada, India, New Zealand, Singapore, South Africa and the United States. It found that 40 percent of respondents ages 18 to 24 reported feeling sadness, distress or hopelessness, as well as unwanted, strange and obsessive thoughts.

“The coronavirus pandemic has exacerbated trends that were already there, and made them worse,” said Dr. Tara Thiagarajan, the founder and chief scientist of Sapien Labs. “Particularly, social isolation has had a larger impact on young people, and it’s pushed many of them over the edge.”

Other studies have shown that the pandemic has disproportionately affected the mental health of young people, women and people of color.

Mental health experts have also warned against the long-term effects of the pandemic, which are likely to include an economic recession and the psychological fallout of long-term social isolation.

The report’s authors, Dr. Thiagarajan and Jennifer Newson, urged governments to focus on population-wide policies targeting mental health, instead of individual approaches that are often favored.

“While much of the focus in the mental health arena has been on self-care through apps, therapy and other programs, social and economic policy and institutional culture may have a large role to play in the mitigation of our present mental health crisis and prevention of future crises,” they wrote.

Anallely Falcon receiving her second dose on in Central Falls, R.I., last month.Credit…David Degner for The New York Times

Nearly nine in 10 Americans who received the first dose of a two-dose Covid-19 vaccine went on to complete the regimen, and most people who received two doses got them within the recommended time frames, federal health officials reported on Monday.

The analyses, by investigators with the Centers for Disease Control and Prevention, included data on tens of millions of Americans who received the Moderna or Pfizer-BioNTech vaccines between mid-December and mid-February.

The percentage of people completing the regimens varied markedly by jurisdiction and between demographic groups, however. Federal health officials urged local vaccinators to take steps to ensure that everyone comes back, including scheduling a return appointment when giving the first shot, sending reminders, and rescheduling missed or canceled appointments.

While the data were “reassuring” over all, C.D.C. researchers said, the first groups receiving the vaccine in the United States — health care workers and long-term care facility residents — had easy access to the second dose, since they were likely to have been vaccinated at their workplace or place of residence.

As vaccines are offered to broader groups of people, the scientists warned, the percentage getting fully vaccinated may drop.

People are not considered fully vaccinated against the coronavirus until two weeks after they receive the second shot of the two-dose regimen (or two weeks after receiving the single-dose vaccine made by Johnson & Johnson).

C.D.C. researchers looked at some 40.5 million Americans who were vaccinated between Dec. 14, 2020 and Feb. 14, 2021.

In one analysis, they reviewed the records of 12.4 million people who had received the first dose of a two-dose vaccine regimen and had enough time to get the second dose. Some 88 percent had completed the series, while 8.6 percent were still within the allowable interval — 42 days — to receive the second dose. But 3.4 percent had missed that window. (The recommended interval between doses is 21 days for the Pfizer-BioNTech vaccine and 28 days for Moderna).

Americans most likely to have missed the second dose varied by locality. Among vaccine recipients for whom information on race and ethnicity were known, the lowest completion rates were among Native American or Alaska Native individuals.

A second analysis of 14.2 million people who completed the full regimen found that 95.6 percent received the second dose within the recommended period, though again the figures varied by community.

The authors of the study urged providers and public health workers to encourage Americans to come back for second doses and to emphasize the importance of full vaccination. C.D.C. officials also asked that vaccinators work to understand what keeps people from completing the series, and whether access or lack of confidence in the vaccines are playing a role.

GLOBAL ROUNDUP

With the borders closed, Russian tourists are discovering domestic destinations, like Lake Baikal.Credit…Sergey Ponomarev for The New York Times

Usually, it is foreigners who flock to Lake Baikal in Siberia this time of year to skate, bike, hike, run, drive, hover and ski over a stark expanse of ice and snow, while Russians escape the cold to Turkey or Thailand.

But Russia’s borders are still closed because of the pandemic, and to the surprise of locals, crowds of Russian tourists have traded tropical beaches for the icicle-draped shores of Baikal, the world’s deepest lake. The tour guides are calling it Russian Season.

If you catch a moment of stillness on the crescent-shaped, 400-mile-long, mile-deep lake, the assault on the senses is otherworldly. You stand on three feet of ice so solid it is crossed safely by heavy trucks, but you feel fragile, fleeting and small.

Yet stillness is hard to come by.

Western governments have been discouraging travel during the pandemic, but in Russia, as is so often the case, things are different. The Kremlin has turned coronavirus-related border closures into an opportunity to get Russians — who have spent the last 30 years exploring the world beyond the former Iron Curtain — hooked on vacationing at home.

A state-funded program that began last August offers $270 refunds on domestic leisure trips, including flights and hotel stays. It is one example of how Russia, which had one of the world’s highest coronavirus death tolls last year, has often prioritized the economy over public health during the pandemic.

“Our people are used to traveling abroad to a significant degree,” President Vladimir V. Putin said in December. “Developing domestic tourism is no less important.”

In other news from around the world:

  • The government of Hong Kong said on Monday that vaccine eligibility would be expanded to include everyone age 30 and older regardless of occupation, as the Chinese territory tries to increase vaccine uptake. About 200,000 of Hong Kong’s 7.5 million residents have received a first dose of either the BioNTech or Sinovac vaccines since the inoculation drive began late last month. But the proportion of people who show up for their appointments has fallen amid reports that six people have died after receiving the vaccine developed by Sinovac, a private Chinese company. Officials say that two of the deaths are not directly related to the vaccine and that the others are under investigation. The vaccine announcement came as Hong Kong is trying to contain a cluster of cases that began at a gym and has grown to 122 people, with more than 850 close contacts sent to government quarantine facilities and multiple residential buildings locked down overnight for mandatory testing. Also on Monday, the U.S. Consulate in Hong Kong said it was closing for deep cleaning after two employees tested positive for the virus.

The pandemic became real for Clary Montgomery when she introduced her daughter, Paloma, who was born March 11, 2020, to family members via video.

“When my toddler grandson tried to feed me a blueberry through the cellphone screen.”

That was the answer from Alice Gilgoff, 74, of Rosendale, N.Y., when The New York Times asked readers: When did the coronavirus pandemic become real for you? Nearly 2,000 people responded, and we have compiled many of their thoughts.

Across the United States and around the globe, nearly everyone experienced a moment when the pandemic truly hit home. And one year later, as the pandemic carries on, having claimed more than 2.6 million lives worldwide, it has been with us long enough to have its own history.

The answers from readers to that question are a journey through time. It has been a year of trauma and resilience. No one has been spared, yet some have borne burdens far more profound than others.

Still, our stories connect us: each of us human, each of us just trying to survive a pandemic that changed us and the world.

Denise Saylor photographed herself as Lara Comstack injected her with  vaccine in January at the Callen-Lorde Community Health Center in Manhattan.Credit…James Estrin/The New York Times

Most people aren’t particularly fond of needles.

For a significant number of people, though, fear of needles goes beyond anxiety into a more dangerous area, and prevents them from seeking out needed medical care.

As the world’s hopes of returning to a post-pandemic normal rest largely on people’s willingness to take a Covid-19 vaccine, experts and health care professionals are assuring those people that there are ways to overcome this problem.

“It would be heartbreaking to me if a fear of needles held someone back from getting this vaccine, because there are things we can do to alleviate that,” said Dr. Nipunie S. Rajapakse, an infectious diseases expert at the Mayo Clinic in Minnesota.

A study from the University of Michigan found that 16 percent of adults in several countries avoided annual flu vaccinations because of a fear of needles, and 20 percent avoided tetanus shots.

Whether fear is keeping you from being vaccinated at all or is causing you distress about doing so, there are some steps that the experts suggest:

  • Seek professional help. A therapist can help people with the most severe fear, especially if the fear is interfering with getting appropriate medical care.

  • Tell the nurse about your fear before getting the shot. There may be techniques the nurse can use, or products may be available, to reduce the pain of the injection or to put you at ease.

  • Distract yourself. It could be a YouTube video or your favorite song playing on your phone. You could practice deep-breathing or meditation techniques, or wiggle your toes, or look around and count all of the blue items you can see in the room.

  • Focus on the benefits. Think about the summer barbecues, family gatherings and economic recovery the vaccines will help usher in, and you might be feeling more optimistic and excited than nervous.

The apparent assault on an Uber driver, Subhakar Khadka, is the latest incident involving confrontations around coronavirus protections.Credit…Jason Henry for The New York Times

Two arrests have been made after scenes from a viral video that circulated showed passengers taunting and deliberately coughing on an Uber driver.

In the dashcam video, the driver, who had a hand on his head, looked exasperated. A woman in the passenger’s seat uttered an expletive about a mask and then coughed on the driver, while using racial slurs. Another passenger joined in, pulling down her mask and laughing. “And I got corona,” she said.

The driver refused to continue the ride, and the situation escalated. The passenger who had initially coughed on the driver grabbed his phone and tore off his mask, breaking the strap. The women continued screaming profanities.

The San Francisco Police Department said in a statement last Thursday that the driver, identified by KGO-TV as Subhakar Khadka, had picked up three passengers in the early afternoon on March 7, but when he saw that one of the women was not wearing a mask, he told them he would not continue unless they all wore masks.

In a video that was posted on Instagram and has since been removed, one passenger said that the driver was trying to make them exit the car in the middle of the freeway.

Soon, “an altercation ensued,” the police said.

One woman grabbed the driver’s cellphone, which Mr. Khadka eventually retrieved, and another passenger sprayed “what is believed to be pepper spray” into the car through an open window after they exited the vehicle, according to the police.

The flare-up is the latest high-profile example of mask conflicts, which have sometimes taken violent turns. Last year, prosecutors in Chicago said two sisters attacked a store security guard with a garbage can. One of the women stabbed the guard repeatedly with a small knife after he tried to insist that they wear masks and use the store’s hand sanitizer on entry.

In another case last year, an 80-year-old man in upstate New York was killed after he asked a bar patron to wear a mask; the patron shoved the man to the ground, causing him to hit his head.

Mr. Khadka, an Uber driver from Nepal who came to the United States eight years ago, said in an interview with KPIX that he never said anything “bad” to the women, and that they had refused to leave his car. Mr. Khadka said he believed he was singled out for their ire because he is South Asian. “If I was of another complexion, I would have not gotten that treatment from them,” he said. “The moment I opened my mouth to speak, they realized I’m not among one of them. It’s easy for them to intimidate me.”

One of the passengers was arrested in Las Vegas on Thursday, the Las Vegas Police Department said. The passenger, Malaysia King, 24, was taken into custody on a warrant for assault with a caustic chemical, assault and battery, conspiracy and violation of a health and safety code, the police said.

A second passenger, Arna Kimiai, 24, turned herself in on Sunday, the San Francisco Police Department announced. Ms. Kimiai was booked on charges of robbery, assault and battery, conspiracy, and violation of a health and safety code.

“The behavior captured on video in this incident showed a callous disregard for the safety and well-being of an essential service worker in the midst of a deadly pandemic,” said Lt. Tracy McCray, who heads the San Francisco Police Department’s robbery detail.

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Texas, Mississippi elevate Covid restrictions, regardless of CDC warnings

Texas Governor Greg Abbott speaks during an Operation Warp Speed ​​Vaccination Summit at the White House in Washington, DC on Tuesday, December 8, 2020.

Al Drago | Bloomberg | Getty Images

Texas and Mississippi governors both announced Tuesday that they were lifting the statewide mask mandates and allowing companies to reopen at full capacity even as the decline in daily Covid-19 cases slows and federal officials urge states to exercise caution.

Texas governor Greg Abbott said at a press conference at Montelongo’s Mexican restaurant in Lubbock that he would issue a new executive order lifting most of his previous Covid-19 restrictions, including a statewide mask mandate. He added that effective March 10th, all companies should open “100 percent”.

“Removing statewide mandates does not end personal responsibility,” Abbott said in a crowded dining room where many did not wear masks. “It’s just that government mandates are no longer needed.”

“It is now time to open 100 percent Texas,” he added.

Around the same time as Abbott’s remarks, Mississippi Governor Tate Reeves announced at a separate press conference that he was lifting all county mask mandates and lifting statewide restrictions on almost all businesses.

“I’m replacing our current orders with referrals,” Reeves said. “The only rules that stay in this order are a 50% capacity limit for indoor arenas and those governing K-12 schools.”

Both announcements come shortly after federal officials including the director of the Centers for Disease Control and Prevention Dr. Rochelle Walensky, who warned state officials not to be too quick to lift public health restrictions.

Walensky said Monday at a Covid-19 briefing at the White House that while daily incidence has declined rapidly since the peak in January, the decline appears to be leveling off with a worryingly high infection rate. She added that the spread of new, more contagious variants of the coronavirus poses a new threat that could reverse the nation’s progress, even if vaccines are introduced.

“At this level of cases where variants spread, we will completely lose the hard-earned ground we gained,” she said. “With these statistics, I’m really concerned that more states are rolling back the exact public health measures we have recommended to protect people from Covid-19.”

“Please listen to me clearly: at this level of cases with spreading variant, we are going to completely lose the hard-earned ground we have gained,” she said.

– CNBC’s Berkeley Lovelace Jr. contributed to this report.

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