Here’s what we know about the delta-plus variant

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The Seattle Times 03 August, 2021 - 02:52pm 102 views

Thursday’s Tokyo Olympics men’s volleyball semifinals are set:

ROC (Russia) plays Brazil — both won in three — and Argentina plays France — both won in five.

Now the the women take the court at Ariake Arena with Wednesday’s quarterfinals and that includes the USA, minus two starters with ankle injuries, playing the Dominican Republic. That match starts at 1 p.m. local time, midnight Eastern on Tuesday in America.

According to the Olympics.com and NBC brackets, the winner of that match plays the winner of the match between Serbia and Italy. However, in the USA Volleyball story, it has the USA winner playing the Korea vs. Turkey winner.

After Serbia faces Italy, Brazil, the only undefeated team in the tournament, plays ROC.

The USA is without opposite Jordan Thompson, who was leading the team in kills before going down with a sprained ankle against ROC on Saturday. Then in the next match, in which the Americans ralled to beat Italy in five, setter Jordyn Poulter sprained her ankle the same way, stepping on a teammate.

In their places Annie Drews has taken over at opposite and been outstanding, while Micha Hancock came in at setter. 

Just in case, is there a backup setter? 

Libero Justine Wong-Orantes was a setter through high school and club (she won a national championship) before becoming a libero at Nebraska.

Thompson is still the sixth-leading attacker in the tournament with 66 kills. Her next closest teammate is Michelle Bartsch-Hackley, who has 49. Jordan Larson has 48.

The Dominican team includes Bethania De La Cruz, one of the stars of last winter’s Athletes Unlimited Volleyball conducted in Dallas. Jordan Larson was the AU MVP.

In pool play, the USA won Pool B as it swept Argentina and China, beat Turkey five, was swept by ROC, and beat Italy in five.

The DR was swept by Serbia, lost in five to Brazil, lost in five to Korea, swept Kenya, and beat Japan in four to win fourth place in Pool A. 

Tuesday’s men’s action started out predictably enough as ROC swept Canada and Brazil swept Japan.

But then Argentina went five to knock out Italy to get back into the Olympics semifinals for the first time since 1988,

And then France stunned Poland in five. 

ROC beat Canada 25-21, 30-28, 25-22. ROC (5-1) got 12 kills each from Dmitry Volkov and Maxim Mkihaylov and nine from Egor Kliuka.

“Serving well was a big key for us,” said ROC coach Tuomas Sammelvuo, whose team had eight aces. 

“We waited for our chance to close the second set. We lost our game plan on block and defence in the middle of the third, but we made few mistakes on the attack. We showed strong teamwork on our side out.”

Ryan Sclater led Canada (2-4) with 12 kills and Nicholas Hoag had nine.

Brazil (5-1) beat Japan (3-3) 25-20, 25-22, 25-20. Brazil got 15 kills from Yoandy Hildago and 12 from Ricardo Souza.

Argentina (4-2) beat Italy (4-2), the 2016 silver medalists in Rio, 21-25, 25-23, 25-22, 14-25, 15-12. Facuno Conte led a balanced Argentine attack with 17 kills and two blocks. Ezequiel Palacios had 14 kills, two blocks, and two aces, and Bruno Lima had 12 kills and two aces. Italy’s Osmany Juantorena had 19 kills and two blocks, and Alessandro Michieletto had 17 kills, two blocks, and two aces.

France, which opened the tournament by losing to the USA, improved to 3-3 with its 21-25, 25-22, 21-25, 25-21, 15-9 victory over Pool A winner Poland (4-2). Jean Patry led with 19 kills and two blocks. Earvin Ngapeth had 16 kills and a block, and Trevor Clevnot had 14 kills and two blocks. Antoine Brizard had four blocks and a kill. 

Poland got a combined 53 kills from Wilfredo Leon Venero and Bartosz Kurek. Venero had 28 kills and an ace, while Kurek had 25 kills and a block.

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US COVID hospitalizations surge as Delta variant spreads

Al Jazeera English 04 August, 2021 - 08:30am

I went to a party with 14 other vaccinated people; 11 of us got COVID | COMMENTARY

Baltimore Sun 03 August, 2021 - 09:37am

Given the way that I felt, it was what I expected. But it wasn’t supposed to happen: I’ve been fully vaccinated for months.

Five days earlier, I had gone to a house party in Montgomery County. There were 15 adults there, all of us fully vaccinated. The next day, our host started to feel sick. The day after that, she tested positive for COVID-19. She let all of us know right away. I wasn’t too worried. It was bad luck for my friend, but surely she wasn’t that contagious. Surely all of us were immune. I’d been sitting across the room from her. I figured I’d stay home and isolate from my family for a few days, and that would be that. And even that seemed like overkill.

The official Centers for Disease Control and Prevention guideline stated that, since I was fully vaccinated, I didn’t need to do anything different unless I started developing symptoms. I’m an epidemiologist at a major medical research university, which has a dedicated COVID exposure hotline for staff. I called it, and workers said I didn’t need to do anything.

Then, I started to hear that a few other people who had been at the party were getting sick. Then a few more. At this point, 11 of the 15 have tested positive for COVID.

Fortunately, none of us seems to be seriously ill. When fully vaccinated people experience so-called “breakthrough” infection, they tend not to progress to serious disease requiring hospitalization, and I expect that will be the case for us. But I can tell you that even a “mild” case of COVID-19 is pretty miserable. I’ve had fever, chills and muscle aches, and I’ve been weak enough that I can barely get out of bed. I don’t wish this on anybody.

Our research group at work has shown that the COVID vaccine isn’t always fully effective in transplant recipients. I’m proud of the work we’ve done. But once I got the vaccine, I figured the COVID battle was over for me. Out of an abundance of caution I took an antibody test shortly after my second vaccine dose. It was off the charts.

As much as I hate me and my fully-vaccinated friends being sick, I’ve been thinking about what our little outbreak among means for the rest of us. Here’s what I’ve concluded:

State and local health departments, and the CDC, need to do a better job collecting and reporting data on breakthrough infections. The CDC announced in May that it was only going to collect data on breakthrough infections that led to hospitalization or death, which are fortunately rare. But that means that outbreaks like ours will fly under the radar. Any of us could infect others, apparently including other vaccinated people. It’s not clear if our group got sick because of a particularly virulent variant, because the vaccine is wearing off or for some other reason. Without good data, we’ll never know.

Fully vaccinated people exposed to COVID need to isolate at home and get tested. I thought I might be overreacting by leaving work in the middle of the day and immediately moving to our basement at home. Now I’m glad I did.

Governments and businesses should consider bringing back masking requirements, even for vaccinated people. We’re still at risk of getting sick, and we’re still at risk of infecting others. The CDC recently recommended masks for vaccinated people in areas with over 50 new infections per 100,000 people per week. In the seven days before my exposure, Montgomery County had 19.4 new infections per 100,000 people.

Pharmaceutical companies, research institutions and governments should prioritize research into booster vaccines. At one point it seemed like two mRNA doses or a single Janssen dose might be the answer. But apparently, whether because of variants or fading immunity, being “fully vaccinated” doesn’t necessarily mean you’re immune.

COVID-19 vaccines do an enormous amount of good. I expect a milder course of disease since I’m vaccinated. But COVID-19 isn’t over, even for the vaccinated. As the pandemic continues to evolve, we need to evolve with it.

Copyright © 2021, Baltimore Sun

Biden calls Delta Variant a ‘Largely Preventable Tragedy That Will Get Worse Before It Gets Better.’

The New York Times 03 August, 2021 - 03:59am

Follow our latest coverage of the coronavirus pandemic.

Mr. Biden singled out Florida and Texas, where cases have risen sharply, criticizing the pandemic response by the governors in those states.

“We need leadership from everyone,” he said. “Some governors aren’t willing to do the right things to make this happen. I say to these governors, please, if you aren’t going to help, at least get out of the way for people who are doing the right thing.”

Mr. Biden has been under pressure to redirect the American public’s focus after days of policy whiplash, shifting directives on mask usage, and roiling debates about requiring workers to receive the vaccine.

Mr. Biden’s speech reflected in blunt terms what his top advisers have been saying, with varying degrees of success, for days: that the people who get sickest from the Delta variant are unvaccinated, and that his administration is working to make vaccines available to every person who needs one. Fully vaccinated people are protected against the worst outcomes of Covid-19 caused by the Delta variant.

On Tuesday, Mr. Biden was plainspoken and direct in his remarks, calling the rise of the Delta variant a “largely preventable tragedy that will get worse before it gets better.” He also tackled a criticism directed at his White House in recent days: that his administration had not done enough to synthesize information in a way that Americans could understand.

“I know there’s a lot of misinformation out there, so here are the facts,” Mr. Biden said. “If you are vaccinated, you are highly unlikely to get Covid-19. and even if you do, the chances are you won’t show any symptoms. And if you do, they’ll most likely be very mild. Vaccinated people are almost never hospitalized.”

Mr. Biden reiterated his earlier mandate that all federal workers must be vaccinated or subject to strict requirements.

“If you want to do business with the federal government,” he said, “get your workers vaccinated.”

He added that the private sector, including companies like Wal-Mart, Google and Tyson Foods, were taking similar steps. “Even Fox has vaccination requirements,” he quipped.

Mr. Biden had said earlier this year that he wanted to see 70 percent of eligible Americans at least partly vaccinated by July 4. The country hit that goal on Monday, about a month late and only after the Delta variant began disrupting the progress touted by the president and public health officials.

There was no celebration of reaching the delayed milestone. Instead, the Biden administration has been in a race to encourage vaccine-reluctant and vaccine-refusing Americans to receive shots as caseloads rise in states with high unvaccinated populations.

“The vaccines are doing exactly what they are supposed to do when it comes to keeping you out of the hospital, out of serious disease, and certainly, preventing your death,” Dr. Anthony Fauci, the nation’s top disease expert, told reporters.

The White House has also struggled to put into context the threat of the Delta variant to those who are vaccinated. Experts say that infections in vaccinated people — so called breakthrough infections — are still relatively uncommon, and that even in those cases, the vaccines appear to protect against severe illness and death.

Nationally, new cases have reached an average of about 86,000 a day as of Monday, a dramatic jump from about 13,000 daily cases a month ago but still far fewer than in January. Hospitalizations have risen as well, but hospitalizations and deaths remain a fraction of their devastating winter peaks.

Mr. Biden’s pledge to donate 500 million Pfizer-BioNTech doses is by far the largest yet by a single country, but it would fully inoculate only about 3 percent of the world’s population. The United States will pay $3.5 billion for the Pfizer-BioNTech shots, about $7 apiece, which Pfizer described as a “not for profit” price — much less than the $20 it has paid for domestic use.

In a fact sheet released on Tuesday, the administration said that it would work with programs focused on the equitable distribution of vaccines, including Covax, to ensure that the doses arrive in the countries that are in the most need. But health officials in countries that have received some of the doses have already warned that additional funding is needed to train people to administer the shots and fuel vehicles that transport the vaccines to clinics in remote areas.

Mr. Biden also announced during a speech at the White House on Tuesday that the United States has donated more than 110 million vaccine doses globally, a down payment on a pledge he made to send half a billion doses of vaccine to poorer countries over the next year.

Mr. Biden, who for months was under pressure to share doses of the vaccine, is now seeking to position his administration as a global leader in inoculating the rest of the world amid the spread of highly contagious variants of the virus.

“The virus knows no boundaries,” Mr. Biden said. “There’s no wall high enough or ocean wide enough to keep us safe” from the virus in other countries.

The findings suggest that what has sometimes been called “long Covid” may be less common in children than adults. In a previous study, some of the same researchers found that 13.3 percent of adults with Covid-19 had symptoms that lasted at least four weeks and 4.5 percent had symptoms that lasted at least eight weeks.

“It is reassuring that the number of children experiencing long-lasting symptoms of Covid-19,” is low, Dr. Emma Duncan, an endocrinologist at King’s College London and lead author of the study, said in a statement. “Nevertheless, a small number of children do experience long illness with Covid-19, and our study validates the experiences of these children and their families.”

The study, published on Tuesday in the journal The Lancet Child & Adolescent Health, is based on an analysis of data collected by the Covid Symptom Study smartphone app. The paper focuses on 1,734 children between the ages of 5 and 17 who tested positive for the virus and developed symptoms between Sept. 1 and Jan. 24. Parents or caregivers reported the children’s symptoms in the app.

In most cases, the illness was mild and short. Children were sick for six days, on average, and experienced an average of three symptoms. The most common symptoms were headache and fatigue.

But a small subset of children experienced lingering symptoms, including fatigue, headache and a loss of smell. Children between 12 and 17 were sicker for longer than younger children and more likely to experience symptoms that lasted at least four weeks.

“We hope our results will be useful and timely for doctors, parents and schools caring for these children — and of course the affected children themselves,” Dr. Duncan said.

The researchers also compared children who tested positive for the coronavirus with those who reported symptoms in the app but tested negative for the virus. Children who tested negative — and may have had other illnesses, such as colds or the flu — recovered more quickly and were less likely to have lingering symptoms than those with Covid. They were ill for three days, on average, and just 0.9 percent of children had symptoms that lasted at least four weeks.

Many of the patients with Covid-19 now arriving at the hospital are not just unvaccinated — they are much younger than 50, a stark departure from the frail, older patients seen when the pandemic first surged last year.

In Baton Rouge, La., young adults with none of the usual risk factors for severe forms of the disease — such as obesity or diabetes — are also arriving in E.R.s, desperately ill. It isn’t clear why they are so sick.

Physicians working in Covid hot spots across the nation say that the patients in their hospitals are not like the patients they saw last year. Almost always unvaccinated, the new arrivals tend to be younger, many in their 20s or 30s. And they seem sicker than younger patients were last year, deteriorating more rapidly.

Doctors have coined a new phrase to describe them: “younger, sicker, quicker.” Many physicians treating them suspect that the Delta variant of the coronavirus, which now accounts for more than 80 percent of new infections nationwide, is playing a role.

Studies done in a handful of other countries suggest that the variant may cause more severe disease, but there is no definitive data showing that the new variant is somehow worse for young adults.

Some experts believe the shift in patient demographics is strictly a result of lower vaccination rates in this group.

As of Sunday, more than 80 percent of Americans ages 65 to 74 were fully vaccinated, compared with fewer than half of those ages 18 to 39, according to figures from the Centers for Disease Control and Prevention.

The vaccines are powerfully effective against severe illness and death after infection with any variant of the virus, including Delta. A vast majority of hospitalized patients nationwide — roughly 97 percent — are unvaccinated.

“I don’t think there’s good evidence yet about whether it causes more severe disease,” Dr. Adam Ratner, associate professor of pediatrics and microbiology at the New York University Grossman School of Medicine, said of the Delta variant.

President Biden said last week that he expected a fully approved vaccine in early fall. But the F.D.A.’s unofficial deadline is Labor Day or sooner, according to multiple people familiar with the plan. The agency said in a statement that its leaders recognized that approval might inspire more public confidence and had “taken an all-hands-on-deck approach” to the work.

Giving final approval to the Pfizer vaccine — rather than relying on the emergency authorization granted late last year by the F.D.A. — could help increase inoculation rates at a moment when the highly transmissible Delta variant of the virus is sharply driving up the number of new cases.

A number of universities and hospitals, the Defense Department and at least one major city, San Francisco, are expected to mandate inoculation once a vaccine is fully approved. Final approval could also help mute misinformation about the safety of vaccines and clarify legal issues about mandates.

Federal regulators have been under growing public pressure to fully approve Pfizer’s vaccine ever since the company filed its application on May 7. “I just have not sensed a sense of urgency from the F.D.A. on full approval,” Dr. Ashish K. Jha, the dean of the Brown University School of Public Health, said in an interview on Tuesday. “And I find it baffling, given where we are as a country in terms of infections, hospitalizations and deaths.”

Although 192 million Americans — 58 percent of the total population and 70 percent of the nation’s adults — have received at least one vaccine shot, many remain vulnerable to the ultracontagious, dominant Delta variant. The country is averaging nearly 86,000 new infections a day, an increase of 142 percent in just two weeks, according to a New York Times database.

Recent polls by the Kaiser Family Foundation, which has been tracking public attitudes during the pandemic, have found that three of every 10 unvaccinated people said that they would be more likely to get a shot with a fully approved vaccine. But the pollsters warned that many respondents did not understand the regulatory process and might have been looking for a “proxy” justification not to get a shot.

“Simply put, we need more Idahoans to choose to receive the vaccine,” Mr. Little said, adding that the vaccinations are needed if schoolchildren are going to “have a chance at a normal school year, one that is entirely in person without outbreaks and quarantine.”

Speaking on a call with reporters, he added, “If you are among the folks ‘waiting to see’ about the vaccine, please consider talking to a doctor about it. Not only for your sake, but to ensure our kids are safe and back in school.”

A telephone message left at the governor’s office on Tuesday night was not immediately returned.

In March 2020, as the pandemic was raging across the country, schools in Idaho closed their doors to in-person learning. According to Mr. Little’s comments, the plan to conduct the upcoming school year in person could be in jeopardy.

In Idaho, 37 percent of all people are fully vaccinated, far below the national average of nearly 50 percent, according to data collected by The New York Times. As of Tuesday, the seven-day average of new cases in Idaho is 290, the highest it has been since April, according to The Times’s data.

The effort to vaccinate more people has grown increasingly polarized in recent months. On Tuesday, President Biden, a Democrat, singled out governors in Texas and Florida, where cases are rising. “If you aren’t going to help, at least get out of the way of the people who are trying to do the right thing,” he said.

Unlike those governors, Mr. Little, a conservative Republican in his first term, has taken a relatively moderate approach to the pandemic.

He resisted enacting a mask mandate for the state, but in May he repealed an executive order issued by his lieutenant governor while he was out of state on business, barring localities from issuing them, KTVB 7 reported.

Earlier this year, he signed an executive order preventing state agencies, but not private companies, from requiring vaccines, Idaho News 6 reported.

In Arkansas, Gov. Asa Hutchinson, a Republican, let a statewide mask mandate expire in March. Now, coronavirus cases fueled by the highly contagious Delta variant have skyrocketed in Arkansas, and Mr. Hutchinson is trying to partly reverse course. He is urging state lawmakers to allow schools to require students to wear masks.

So today, I announce a new approach, which we’re calling the Key to N.Y.C. Pass, the key to New York City. When you hear those words, I want you to imagine the notion that because someone’s vaccinated, they can do all the amazing things that are available in this city. This is a miraculous place, literally full of wonders. And if you’re vaccinated, all that’s going to open up to you. You’ll have the key. You can open the door. But if you’re unvaccinated, unfortunately, you will not be able to participate in many things. That’s the point we’re trying to get across. The Key to N.Y.C. Pass will be a first-in-the-nation approach. It will require vaccination for workers and customers in indoor dining and indoor fitness facilities, indoor entertainment facilities. This is going to be a requirement. The only way to patronize these establishments indoors will be if you’re vaccinated — at least one dose. The same for folks in terms of work, they’ll need at least one dose. This new policy will be phased in over the coming weeks. So we’ve been working with the business community, getting input. We’re going to do more over the next few weeks. The final details of the policy will be announced and implemented in the week of Aug. 16.

New York City will become the first U.S. city to require proof of at least one dose of a coronavirus vaccine for a variety of activities for workers and customers — indoor dining, gyms and performances — to put pressure on people to get vaccinated, Mayor Bill de Blasio announced Tuesday morning.

The program, similar to mandates issued in France and Italy last month, will start on Aug. 16, and after a transition period, enforcement will begin on Sept. 13, when schools are expected to reopen and more workers could return to offices in Manhattan. Mr. de Blasio has been moving aggressively to get more New Yorkers vaccinated to curtail a third wave of coronavirus cases amid concern about the spread of the Delta variant. He is also requiring city workers to get vaccinated or to face weekly testing, and he has offered a $100 incentive for the public.

“If you want to participate in our society fully, you’ve got to get vaccinated,” he said at a news conference. “It’s time.”

“This is going to be a requirement,” he added. “The only way to patronize these establishments is if you are vaccinated, at least one dose. The same for folks in terms of work, they will need at least one dose,” he said, holding up a single finger.

On Monday Mr. de Blasio stopped short of reinstating an indoor mask mandate even as large urban areas, including Los Angeles County, San Francisco and Washington, and at least one state did so. He said he wanted to focus on increasing vaccination rates, and was concerned that requiring everyone to wear masks would remove an incentive for those who are considering getting vaccinated now.

Nationally, new cases have reached an average of about 86,000 a day as of Monday, a dramatic jump from about 13,000 daily cases a month ago but still far fewer than in January. Hospitalizations have risen as well, but hospitalizations and deaths remain a fraction of their devastating winter peaks.

About 66 percent of adults in the city are fully vaccinated, according to city data, although pockets of the city have lower rates. The federal government has authorized three vaccines for emergency use in the United States: The Pfizer-BioNTech and Moderna vaccines both take two doses while Johnson & Johnson uses a single dose. Individuals are not considered to be fully vaccinated until two weeks after their final dose.

Fully vaccinated people are protected against the worst outcomes of Covid-19 caused by the Delta variant, but there’s a sharp drop in the efficacy if an individual has only had one dose of a two-dose vaccine.

The new program, dubbed “Key to NYC Pass,” is not a particular document, but rather the strategy of requiring proof of vaccination for workers and customers at indoor dining, gyms, entertainment and performances, including Broadway, the mayor said.

Indoor movies and concerts will also require people to show proof of vaccination to enter. People will be able to continue to dine outdoors without showing proof of vaccination.

To enter indoor venues, patrons must use the city’s new app, the state’s Excelsior app or a paper card to show proof of vaccination. The mayor did not say how the city will handle vaccinations like AstraZeneca or Sinovac that may be common among international tourists.

Children younger than age 12 will not be excluded from venues because they are not eligible to be vaccinated, he said. But the details of those plans remain to be worked out. “We have to figure out how to do things in a safe manner,” the mayor said.

The city will issue a health commissioner’s order and a mayoral executive order to put the vaccine mandate in place. The six weeks before enforcement begins on Sept. 13 will be spent educating businesses and doing outreach, he said.

The mayor said the city consulted with the U.S. Department of Justice and got a “very clear message” that it was legal to move forward with these mandates, even without full F.D.A. approval.

Only people fully vaccinated in the state of New York can get an Excelsior pass, which confirms vaccination against city and state records. Everyone, however, can use the city’s new app, NYC Covid Safe, because it is simply a digital photo album that stores a picture that a person takes of their own vaccination card and does not double check it against any registry. A paper card from the Centers for Disease Control and Prevention must always be accepted, too.

The new requirements could have been rolled out sooner, some health experts said, and vaccination and mask requirements could be further expanded.

Still, the new restrictions got a positive response from one important trade group, the N.Y.C. Hospitality Alliance, which represents restaurants and bars, a sector still recovering from months of limited capacity and other restrictions.

Andrew Rigie, the trade group’s executive director, said that the new restrictions could avert another broad lockdown. The rules “may prove an essential move to protecting public health and ensuring that New York City does not revert to restrictions and shut down orders,” he said in a statement.

At the White House, the press secretary Jen Psaki said the Biden administration supported local efforts to control the virus.

“Different communities and states are going to take steps to protect the people living in their states, and also incentivize, whether it’s through carrots and sticks, more people getting vaccinated,” Ms. Psaki said at a news conference. The federal government, she said, has no plans to issue similar guidance on a national level.

Later in the afternoon, President Biden reiterated the point, saying he thought that more cities and states should announce rules like New York City’s.

Mr. de Blasio said the program will start on Aug. 16, and that enforcement will begin on Sept. 13, when schools are expected to open and more workers could return to the office.

Dr. Wafaa El-Sadr, an epidemiology professor at Columbia University, said that she wished the mayor had imposed the restrictions earlier and that she did not see the point in further delaying them.

“Once vaccination was widely available to people, which was weeks ago, I think requiring vaccination for access to such venues would have been appropriate,” Dr. El-Sadr said.

The city’s vaccination program has slowed in recent months, despite efforts like a $100 payment to people who get vaccinated and inoculating people at home.

Fully vaccinated people are protected against the worst outcomes of Covid-19 caused by the Delta variant, but there’s a sharp drop in the efficacy if an individual has only had one dose of a two-dose vaccine.

Dr. Celine Gounder, an epidemiologist at New York University’s Grossman School of Medicine and an adviser to city officials, also recommended that city officials expand their message about the importance of masking and testing, even for vaccinated people, noting that “we can walk and chew gum at the same time.”

About a week ago, the federal government updated its health guidance, recommending that people wear masks indoors in virus hot spots even if they are vaccinated.

Mr. de Blasio said on Monday that he strongly recommended that people wear masks indoors, but that he would not immediately impose a requirement in the city, as many municipalities have.

The city, the first to show the world the damage the virus could wreak, had not recorded any local cases since May of last year, after a harsh two-and-a-half month lockdown helped eradicate the virus there. But city officials said they had detected three symptomatic local cases in the previous 24 hours, as well as five asymptomatic ones.

Wuhan had some of China’s strictest measures to stop the spread of the virus, and many residents continued to wear masks even as people elsewhere relaxed as the country brought the outbreak under control. But China is battling several new flare-ups as the Delta variant makes inroads, including in the cities of Nanjing and Zhangjiajie, and several more in the country’s south. The authorities in Zhangjiajie also barred residents and tourists from leaving the city, imposing a de facto lockdown.

Wuhan had previously tested all its residents in two weeks last spring, mobilizing the Chinese Communist Party’s vast network of local officials in a feat unprecedented at the time. Since then, the country has carried out several mass testing campaigns.

Officials said that Wuhan was a major transportation hub and that it was crucial to cut off any further transmission there. Liu Dongru, a provincial health official, said at a news conference on Tuesday that the authorities would “firmly protect the hard-won results against the epidemic.”

Officials also announced on Tuesday that large-scale gatherings would be prohibited. They encouraged residents not to leave Wuhan and suspended offline classes.

Ransomware attacks, in which criminals break into a computer system, encrypt the data it contains and demand money to release it, have struck health care systems in many countries, paralyzing hospitals, clinics and testing centers from California to Ireland and New Zealand. The attack in Italy is one of the largest to affect a vaccination campaign, raising alarms about its potential impact.

“It’s hitting one of the things that in 2021 are fundamental,” said Stefano Zanero, a professor of cybersecurity at the Polytechnic University of Milan.

The attack against the regional information technology services began at midnight on Saturday. It came at a fraught time, as the Italian authorities are grappling with vaccine skepticism and the spread of the Delta variant, which is dominant in the country.

Italy’s postal police, who have jurisdiction over cyberattacks, are still investigating the identity of the attackers, but the president of the Lazio region, Nicola Zingaretti, said on Monday that the police knew it had come from abroad. He called the attack “very powerful and very invasive.”

A ransomware attack in May on the Colonial Pipeline, which transports fuel from Texas across the southeastern United States as far as New Jersey, caused a shutdown that lasted several days and prompted panic buying of gasoline in the United States. In Ireland, an attack paralyzed the health services’ digital systems for more than a week in June, delaying Covid-19 testing and medical appointments.

Regional governments have extensive powers over vaccinations in Italy, and the Lazio region, home to nearly 6 million people, prided itself on an efficient campaign. About 70 percent of the region’s adult population is fully vaccinated, the highest figure in the country; for Italy as a whole, the figure as of Tuesday was 53 percent, according to a New York Times tracker.

Vaccinations are going ahead in Lazio, and the 500,000 people who had booked appointments before the cyberattack will still receive their shots, the authorities said. After Aug. 13, though, the region’s vaccination schedule is empty. Alessio D’Amato, the region’s top health care official, said that bookings would become available again by the end of the week.

Several other public services have also been affected by the attack, including health care appointments, but the authorities said personal health and financial information had not been breached or stolen. Residents can still download the health pass that will be required for many social activities starting Friday.

Some vaccination sites in the region are offering shots without appointments, including one at the Rome-Fiumicino International Airport, and officials are sending vans to distribute shots in remote villages. But their capacity is limited.

The pace of Italy’s vaccination campaign has slackened in recent weeks, and many Italians over the age of 60 have not yet completed their vaccinations. “I make an appeal to all the workers and the citizens,” Mr. Zingaretti said, “Let’s go ahead and not slow down.”

Mr. Zanero, the professor of cybersecurity, said that he thought the attack was financially motivated rather than a political or terrorist attack. He expressed hope that the attack would prompt more investment in cybersecurity. “This could be an impulse in that direction,” he said.

Jeremy R. Root resigned his position as chairman of the Shiawassee County Board of Commissioners, according to a resignation letter read at a public meeting on Sunday. Mr. Root, who did not attend the meeting, said in the letter that he would retain his position as a commissioner, representing the southeast part of the county, about 26 miles west of Flint.

Telephone and email messages sent to Mr. Root on Monday evening were not returned.

The plan to use the federal funds for “Covid hazard pay for county employees” was approved by all six Republican commissioners that were present at the board’s July 15 meeting, according to a draft of the minutes.

The bonuses included $25,000 for Mr. Root, $10,000 each for two other commissioners, and $5,000 each for four other commissioners, MLive-The Flint Journal reported. After a public backlash, the commissioners reversed course a week later, and a judge later ordered them to give back the money, The Associated Press reported.

An average of six coronavirus cases per day are being reported in the county, according to data collected by The New York Times. Since the beginning of the pandemic, at least one in 10 county residents has been infected, totaling more than 6,500 cases.

At Sunday’s board meeting, a commissioner read two sentences from Mr. Root’s resignation letter. In a video from the meeting, cheers could be heard after the first sentence was read aloud, announcing Mr. Root’s resignation as chairman “effective immediately.”

But when Mr. Root’s letter went on to say that he “will retain my position as a commissioner,” the cheers turned to boos.

The action was also intended to quell a rebellion among angry Democrats who blamed the White House for allowing a previous eviction ban to expire on Saturday — after the Democratic-controlled House was unable to muster enough votes to extend that moratorium.

Any call for a moratorium based on the Supreme Court recent decision is likely to face obstacles. I’ve indicated to the C.D.C. I’d like them to look at other alternatives than the one that is in power, in existence, which the court has declared they’re not going to allow to continue. And the C.D.C. will have something to announce to you in the next hour to two hours. The court’s made it clear that the existing moratorium was not constitutional. It wouldn’t stand. And they made that clear back in, I guess, July 15th or July 18th. In the meantime, what I’ve been pushing for and calling for is we have billions of dollars given to states to provide for rent and utilities for those people who can’t afford to stay in their homes because they can’t, in an apartment, they can’t pay their rent. And so we’re urging them to distribute those funds to the landlords. I believe that would take care of the vast majority. of what needs to be done to keep people in their apartments now. And so that’s what we’re working on. Some states have done it, and some communities have, but they have not. The money is there, it’s not, we don’t have to send it out. It’s been sent out to the states and counties, billions of dollars for the express purpose of providing for back rent and rent the people who are in the middle of this crisis. And that’s there, that’s what we’re pushing now. And we’ve been pushing that.

President Biden has been under intense pressure from activists and allies for the last week to protect people at risk of being driven from their homes for failing to pay their rent during the economic crisis brought on by the pandemic. The previous nationwide moratorium on evictions, which went into effect in September, expired on Saturday after the Supreme Court warned that an extension would require congressional action.

The end of the rental protections has prompted a flurry of recriminations in Washington and a furious effort by the White House to find a solution that prevents working-class and impoverished Americans from being evicted from their homes on Mr. Biden’s watch as billions in aid allocated by Congress goes untapped.

The Centers for Disease Control and Prevention late Tuesday announced the new order barring people from being driven out of their homes in many parts of the country, saying that “the evictions of tenants for failure to make rent or housing payments could be detrimental to public health control measures” aimed at slowing Covid-19.

The order will expire on Oct. 3, the C.D.C. said, and applies to areas of the country “experiencing substantial and high levels of community transmission” of the virus. Mr. Biden, in remarks ahead of the official order, said the moratorium was expected to reach 90 percent of Americans who are renters.

“This moratorium is the right thing to do to keep people in their homes and out of congregate settings where Covid-19 spreads,” Dr. Rochelle P. Walensky, the director of the C.D.C., said in a statement. “Such mass evictions and the attendant public health consequences would be very difficult to reverse.”

The decision to impose a new and targeted moratorium, rather than extending the previous national ban, is aimed at sidestepping a Supreme Court ruling from late June that seemed to limit the administration’s ability to enact such policies. While the court upheld the C.D.C.’s moratorium, Justice Brett M. Kavanaugh issued a brief concurring opinion explaining that he had cast his vote reluctantly and believed the C.D.C. had “exceeded its existing statutory authority by issuing a nationwide eviction moratorium.”

Mr. Biden conceded on Tuesday that the new approach might be struck down by the courts as executive overreach. But he suggested the move could help buy the administration time as it tried to get states to disburse billions of dollars of aid to help renters meet their obligations to landlords.

Congress previously allocated $46.5 billion in rental assistance in two coronavirus relief packages, but only about $3 billion had been delivered to eligible households through June, according to Treasury Department data.

“Whether that option will pass constitutional measure with this administration, I can’t tell you. I don’t know,” Mr. Biden said of a new moratorium. “There are a few scholars who say it will and others who say it’s not likely to. But at a minimum, by the time it gets litigated, we’ll probably give some additional time while we’re getting that $45 billion out to people who are in fact behind in rent and don’t have the money.”

For days, some of Mr. Biden’s closest allies on Capitol Hill, including some of the most progressive Democrats in Congress, have been publicly and privately assailing his lack of action to help renters, accusing the president and his aides of failing to find a replacement for the eviction moratorium until it was too late.

Just days before Saturday’s expiration of the ban, Mr. Biden called on Congress to pass legislation to extend it. But with the House about to leave town for a seven-week vacation and Republicans solidly opposed to an extension, progressive Democrats described the White House call as a cynical attempt to shift blame to lawmakers. The administration, for its part, feared that any unilateral move would open the White House to legal challenges that could ultimately erode Mr. Biden’s presidential powers.

The expiration presented the president with a thorny choice: Side with the C.D.C. and his own lawyers, who saw an extension as a dangerous step that could limit executive authority during health crises, or heed the demands of his party’s progressive wing to take immediate action to halt what they saw as a preventable housing crisis.

Under intense pressure from Speaker Nancy Pelosi and other Democrats, Mr. Biden’s team opted for an approach that would give them a chance to satisfy both camps, creating a new moratorium, based on a recent rise in infections from the Delta variant, that cited the risks associated with the movement of displaced tenants in areas where the virus is raging.

But ultimately it came down to a simpler calculation: Mr. Biden could not ignore the call, led by Black Democrats, to reverse course.

“Every single day that we wait, thousands of people are receiving eviction notices, and some of them are being put out on the street,” said Representative Cori Bush, Democrat of Missouri, who has been sleeping on the steps of the Capitol since the moratorium expired in a bid to pressure her party’s leadership. “People started sending me pictures of dockets, court dockets, that were all evictions. We cannot continue to sit back. We need this done today.”

Ms. Pelosi and Senator Chuck Schumer, Democrat of New York and the majority leader, were briefed on Tuesday on the C.D.C.’s plan by Dr. Walensky, the agency’s director, and Xavier Becerra, the secretary of health and human services, according to a person familiar with the call. Ms. Pelosi hailed the idea of a new eviction moratorium as a victory for many Americans who were struggling because of the pandemic.

“Today is a day of extraordinary relief,” she said in a statement. “Thanks to the leadership of President Biden, the imminent fear of eviction and being put out on the street has been lifted for countless families across America. Help is here!”

Yet for two days it was unclear how — or whether — any help would arrive as landlords prepared to turn to housing courts to evict tenants who were behind on their rent.

At a White House meeting with Mr. Biden on Friday, Ms. Pelosi and Mr. Schumer bluntly informed Mr. Biden they did not have the votes to pass an extension — and pressed him to take whatever action he could using his executive power, according to two Democratic congressional aides briefed on the meeting.

On Tuesday, House Democrats summoned Treasury Secretary Janet L. Yellen to explain what the agency was doing to help struggling renters. In a private call between Democrats and Ms. Yellen, the Treasury secretary insisted that her team was using all available tools to get rental assistance money to states and to help governments distribute those funds to landlords and renters.

“I thoroughly agree we need to bring every resource to bear,” Ms. Yellen said, according to a person who was on the call.

The White House had been scrambling to figure out exactly what its legal options were for continuing the moratorium. On Monday, Jen Psaki, the White House press secretary, said that Mr. Biden had asked the C.D.C. on Sunday to consider extending the moratorium for 30 days, even just to high-risk states, but that the C.D.C. had “been unable to find legal authority for a new, targeted eviction moratorium.”

A day later, however, the administration appeared ready to barrel through legal challenges and embrace a solution that did just that.

The extension is likely to intensify a legal fight with landlord groups that have argued that the eviction ban has saddled them with debt.

The National Apartment Association, which filed a lawsuit last week seeking to recoup lost rent, said the moratorium was jeopardizing the viability of the housing market. The group estimates that the apartment industry is shouldering $26.6 billion in debt as a result of the eviction ban.

“The government has intruded into private property and constitutional freedoms, and we are proudly fighting to make owners whole and ensure residents’ debt is wiped from their record,” said Robert Pinnegar, the chief executive of the association.

Legal experts said it was likely that the administration would face a new wave of lawsuits if the justification and structure of a new moratorium was similar to the one that had been in place.

“The only logic by which this could be justified is a logic that would enable them to be able to suppress virtually any activity of any kind that they can claim might spread contagious disease,” said Ilya Somin, a law professor at George Mason University.

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