Piazza San Marco in Venice in July. Italy has reintroduced some restrictions for U.S. travelers.
Credit…Giulia Marchi for The New York Times

Italy now requires travelers from the United States to take a test before arrival, and unvaccinated American visitors must isolate for five days. Sweden is barring all nonessential U.S. visitors. The Netherlands says vaccinated travelers must isolate after arriving from the United States — and unvaccinated ones are not welcome.

In removing the United States from a safe list of countries whose residents can travel without coronavirus testing or quarantine requirements, the European Union last week opened the door to myriad rules, restrictions and hurdles for travelers, with the bloc’s member countries implementing different measures.

The surge of coronavirus deaths and hospitalizations in the United States has led some countries — including Bulgaria, Italy, the Netherlands and Sweden — to enforce new obstacles, and the list could grow.

The E.U. suggestion to reimpose restrictions on unvaccinated U.S. travelers is not binding, however, and many European governments have yet to act on it. Some may even choose to ignore it entirely, creating confusion for travelers.

For questions about requirements in a given European Union member state, the best answers can usually be found on the website of its U.S. Embassy. Most, including France, Spain and Germany, still welcome travelers from the United States without much hassle.

It is different for a few others, and that’s where the confusion starts.

For instance, any traveler from the United States, no matter their nationality, is prohibited from entering Bulgaria “unless they meet an exception,” according to the U.S. Embassy in Sofia. Those exceptions include students with a visa, citizens from an E.U. country, and foreign officials or medical professionals.

In Italy, meanwhile, the U.S. Embassy in Rome states that vaccinated travelers must take a virus test 72 hours before arrival, and that unvaccinated ones must isolate for five days. France has no travel restrictions on American visitors, but a “health pass,” based on testing or proof of vaccination, is needed to access cultural venues, restaurants or bars, among other places.

These varying measures, which can appear dizzying to non-Europeans, reflect a reality that the pandemic has only amplified: As much as the European Union strives to present a unified front on many issues, the bloc is made of 27 member countries with diverging — sometimes competing — interests, and facing different epidemiological situations.

After the European Union closed its external borders in March last year, it urged member states to reopen to U.S. travelers and some others in June, hoping that a revival of tourism would boost E.U. economies.

Yet some countries had already moved ahead, while others waited for the recommendations from E.U. officials. A similar scenario is at play with the new travel guidelines. And the hurdles don’t only affect travelers from the United States or other non-European countries; some member states have implemented new measures for travelers coming from other E.U. countries, too.

Overall, the European Union has fared better than the United States in vaccinations: 70 percent of the E.U. adult population has been fully inoculated, compared with 64 percent in the United States.

And while the more transmissible Delta variant of the virus is becoming dominant in Europe, case numbers across most of the continent have not yet resurged to the levels seen in the United States.

Yet just as the virus’ spread varies across U.S. states, E.U. member countries are seeing divergent outbreaks. More than 83 percent of Belgium’s adult population has been fully vaccinated against the coronavirus, for instance, but only 20 percent have been inoculated in Bulgaria, which has one of the highest death rates in the world and has lately faced a surge of hospitalizations and deaths.

A Covid-19 testing site in Seoul last week. The metropolitan area has more than half South Korea’s population, and 75 percent of its recent virus cases.
Credit…Ahn Young-Joon/Associated Press

South Korean health authorities urged caution on Wednesday as they reported more than 2,000 new Covid-19 cases in one day, nearing last month’s record.

“We’re taking this as a very dangerous sign,” said Park Hyang, a senior health official, at a news conference in the capital, Seoul. “We urge residents of the Seoul metropolitan area to be especially careful. The virus is spreading on a large scale and infections are appearing anytime and anywhere.”

Cases have remained stubbornly high even as the pace of vaccinations has quickened. While social distancing restrictions have remained in place, the government has eased some rules on private gatherings. The health officials also said that people aren’t adhering to them as much as pandemic fatigue accumulates.

That’s a concern ahead of Chuseok, a three-day national holiday later this month when families will be able to travel to see one another. As of Tuesday, about 61 percent of South Koreans had received at least one vaccine dose and more than 36 percent were fully vaccinated, the health authorities said.

At the current pace, the health authorities said they expect to fully vaccinate 70 percent of the population by the end of October. That would allow the country to return to a more normal way of life in November, they said. But, they added, for the country to open up, cases must go down.

The country recorded 2,050 daily new cases on Wednesday, of which about 75 percent were found in the Seoul metropolitan area. More than half of South Korea’s population lives in Seoul.

The Delta variant made up an estimated 97 percent of the cases from the past week, said Bang Dae-bon, the head epidemiologist of the government’s Central Disease Control Headquarters, at a news conference on Tuesday.

Ms. Park, the senior health official, said more people had been traveling in the past two weeks, and traffic on highways was rising.

A vaccination center in Melbourne in May. So far, less than a third of Australians are fully vaccinated.
Credit…Darrian Traynor/Getty Images

The Australian government’s approach to securing Covid vaccines has come under scrutiny again after it released documents detailing the early stages of talks with the drug maker Pfizer.

Internal government emails, released in response to a Freedom of Information request by an opposition party politician, show that a Pfizer Australia representative wrote to the Australian minister of health, Greg Hunt, in late June last year to request a meeting. The Pfizer representative wrote that the pharmaceutical giant had “the potential to supply millions of vaccine doses by the end of 2020.”

The request was passed to a senior official, a first assistant secretary of the health department, who met with Pfizer the following month. Subsequent emails show that Pfizer had asked the Australian government to sign a confidential disclosure agreement, which the official said was “not usual practice” for the government.

The exchange occurred around the same time that the U.S. and British governments were finalizing multibillion-dollar deals with Pfizer to secure access to large numbers of vaccine doses. That month, Britain bought 30 million doses and the United States 100 million.

The released documents do not include information about costs, or about the scope of the confidentiality agreement.

Opposition politicians including Ged Kearney, the lawmaker who filed the Freedom of Information request, have used the documents to amplify criticism that Prime Minister Scott Morrison’s government bungled the vaccine rollout, which has been slowed in part by a tight supply of Pfizer doses. Opposition leaders criticized the government for a slow response to Pfizer’s offer, which they said put Australia “months behind other countries.”

Mr. Hunt’s office rejected suggestions that the government had been slow to act. A spokesperson for the Department of Health said that the government had “constant informal engagements” with Pfizer before the email, on June 30, but were told that the company was not ready to begin formal talks.

After Pfizer wrote to Australia on June 30, the government “moved immediately to formal negotiations,” including negotiating a confidentiality agreement, the spokesperson added. In August 2020, Mr. Hunt’s office met with Pfizer’s leadership to discuss issues such as supply chains and costs for the first time, the released documents show.

Last November, Australia signed a deal with Pfizer to procure 10 million doses, the first of which arrived in February, about two months after the United States received its initial supplies. Australia has since purchased another 30 million doses from the company.

So far, just 52 percent of Australians have received at least one vaccine dose and 31 percent are fully vaccinated, compared with 62 percent with at least one dose and 53 percent fully vaccinated in the United States. More than half of Australia’s population of 25 million is in lockdown as outbreaks of the Delta variant surge.

This is not the first time that the Australian government has faced scrutiny over its approach to Pfizer. In July, Kevin Rudd, a former prime minister, claimed that he had personally appealed to Pfizer’s chief executive, Albert Bourla, to speed up vaccine deliveries to Australia after Mr. Morrison had failed to speak to him. Mr. Morrison’s government denied that account and said that it was in regular contact with Pfizer’s leadership in Australia.

Receiving a vaccine in Bethlehem in August.
Credit…Samar Hazboun for The New York Times

The Palestinian Authority has banned weddings, mourning tents and other gatherings, taking measures to stem the most significant outbreak of the coronavirus in the occupied West Bank in months.

An average of 1,074 infections have been recorded daily over the past week by the Health Ministry, the highest seven-day average in the territory since at least April. Serious cases of the virus have also jumped, with the number of hospitalized people increasing more than sevenfold in the past month, according to ministry data.

The ban on gatherings is scheduled to come into effect on Monday. Officials had originally said it would begin this week, but elected to postpone the date to allow people who had already reserved wedding halls this weekend to celebrate, said Ghassan Nimr, a spokesman for the Interior Ministry.

Wedding hall owners, who have closed their businesses for much of the pandemic, expressed frustration that they would need to close once again.

“I have 20 employees: What am I supposed to tell them?” said Hanna Abu Alees, the owner of the Golden Roof Hall in Bethlehem. “Should I say go home and good luck finding a way to feed your families?”

Mr. Abu Alees, 73, said he had been trying to limit the spread of the virus at his facility by distributing masks and hand sanitizer during events and capping attendance at 300 to 400 people, less than the 1,000 it can hold.

Health Minister Mai al-Kaila suggested on Tuesday that the authority could enact even more restrictive measures if the virus continues to spread widely.

“As the health minister, I can’t hold on to a mask for everyone and give a mask to everyone,” Ms. al-Kaila told government-run television. “In order to not close the country, let us follow the guidelines,” she said, adding that vaccinations and social distancing are not “a big deal and it should be a matter of personal responsibility.”

While many Palestinians have expressed skepticism about getting vaccinated, the number of people in the West Bank receiving inoculations has risen in recent weeks since the government announced that public sector employees who did not get the shots would be placed on unpaid leave until the end of the pandemic. The Transportation Ministry has also said that people must present vaccination certificates to receive services like renewing licenses or vehicle registration.

More than 820,000 people in the West Bank, whose population is estimated to be about 2.75 million, have received at least one dose, according to Health Ministry statistics.

Parents in Mexico are fighting a government program that restricts vaccination to people over the age of 18, though regulators have approved shots for use in children as young as 12.
Credit…Joebeth Terriquez/EPA, via Shutterstock

Hundreds of parents in Mexico are asking for court injunctions to have their children vaccinated against Covid-19 before they return to school, because the government is yet to offer a shot to people ages 12 to 18 even though they are authorized to receive it.

The legal battle is taking place as the more transmissible Delta variant has pummeled Mexico, where only 28 percent of the population is fully vaccinated. The country is recording some of its highest daily caseloads of the pandemic, according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University.

President Andrés Manuel López Obrador’s administration wants all students to return to school for in-person classes, which have been suspended for almost a year and a half. The Pfizer vaccine was approved in Mexico for use in children age 12 and above in June, but so far only those age 18 and above have been able to get shots.

In the United States and various Latin American countries, vaccinations for children age 12 and above are well underway. But Mexican officials have downplayed the risk of the virus for minors, saying older people still waiting for their doses should be given priority.

Alma Franco, a lawyer from the southern region of Oaxaca, was one of the first parents to sue and win an injunction. When she was granted the vaccine for her 12-year-old son, she tweeted a photo of the constitutional appeal, or “amparo,” a legal process used in Mexico. In her appeal arguing that her son should be entitled to vaccination, Ms. Franco cited both the Health Department’s approval for the Pfizer vaccine and Mexico’s laws around equal medical care.

Since then, she said, about 1,000 parents from around the country have emailed her asking how they can do the same.

“Most of the parents who have asked me for the amparo are just worried about what’s happening at a global level, and particularly in Mexico,” Ms. Franco said.

Hugo López-Gatell Ramírez, the deputy health minister who is running Mexico’s response to the coronavirus, said at a news conference on Tuesday that 262 legal appeals have been filed by parents since August, with the number rapidly increasing. He said that although he understood why parents want to ensure their children are vaccinated, every dose given to a student because of judicial action would otherwise have gone to someone with a higher risk of dying from Covid-19.

“Scientific evidence is abundantly clear and consistent that those who have the highest risk of severe Covid, hospitalization, intubation and death are older people,” Mr. López-Gatell said. “There is a scale where the risk is progressively decreasing for younger ages.”

The new school year in Mexico began on Aug. 30, and the Mexican department of public education released a statement on Tuesday saying that 12 million students 18 and under were attending classes in over 135,000 schools. Entering the second week of the academic year, 88 schools have had coronavirus cases, and 39 had closed “as a preventive measure,” Delfina Gómez Álvarez, the secretary of education, said in the statement.

A woman waiting for a malaria test in La Paz, Colombia. The pandemic has made treatment for illnesses such as malaria, TB and H.I.V. harder to come by.
Credit…Federico Rios for The New York Times

The Covid-19 pandemic has severely set back the fight against other global scourges like H.I.V., tuberculosis and malaria, according to a sobering new report released on Tuesday.

Before the pandemic, the world had been making strides against these illnesses. Overall, deaths from them had dropped by about half since 2004.

But the pandemic has flooded hospitals and disrupted supply chains for tests and treatments. In many poor countries, the coronavirus diverted limited public health resources from treatment and prevention of these diseases.

Many fewer people sought diagnosis or medication, because they were afraid of catching the coronavirus at clinics.

Unless comprehensive efforts to beat back the illnesses resume, “we’ll continue to play emergency response and global health Whac-a-Mole,” said Mitchell Warren, executive director of AVAC, a nonprofit organization promoting H.I.V. treatment worldwide.

The report was compiled by the Global Fund, an advocacy group that funds campaigns against H.I.V., malaria and tuberculosis.

Before the arrival of the coronavirus, TB was the biggest infectious-disease killer worldwide, claiming more than a million lives each year. The pandemic has exacerbated the damage.

In 2020, about a million fewer people were tested and treated for TB, compared with 2019 — a drop of about 18 percent, according to the new report.

Compared with 2019, the number of people who sought testing for H.I.V. last year declined by 22 percent, and those who opted for H.I.V. prevention services by 12 percent. Medical male circumcision, thought to slow the spread of the virus, decreased by 27 percent.

However, there were some hopeful developments: The crisis forced health agencies and ministries in many poor countries to adopt innovations that may outlast the pandemic. Among them: dispensing several months’ supplies to patients of TB and H.I.V. drugs, or condoms, lubricants and needles; using digital tools to monitor TB treatment; and testing simultaneously for H.I.V., TB and Covid-19.

The Food and Drug Administration has warned Covid-19 patients against taking the anti-parasitic drug ivermectin, especially in concentrated doses intended for large livestock.
Credit…Rolex Dela Pena/EPA, via Shutterstock

An Ohio judge on Monday reversed an earlier decision requiring a hospital to administer ivermectin, an anti-parasitic drug that is primarily used as a veterinary deworming agent, to a patient as a treatment for Covid-19.

The judge, Michael A. Oster Jr., wrote that “there can be no doubt that the medical and scientific communities do not support the use of ivermectin as a treatment for Covid-19” and that the plaintiff had failed to provide convincing evidence to show that it was effective.

The Food and Drug Administration has warned Covid-19 patients against taking ivermectin. Concentrated doses intended for horses and other large livestock can be toxic in humans, the agency has said.

However, the drug has become a popular subject among conservative talk show hosts. Physicians and toxicologists have raised alarms about people obtaining ivermectin from livestock supply centers amid a surge in calls to poison control centers about overdoses and adverse reactions to the drug.

The Ohio lawsuit was filed by Julie Smith, who was acting as the guardian for her husband, Jeffrey Smith. A different judge granted a 14-day injunction last month, ordering West Chester Hospital north of Cincinnati to administer the drug to Mr. Smith.

Mr. Smith, 51, tested positive for the virus on July 9 and the following week was admitted to West Chester Hospital’s intensive care unit, according to court documents. On Aug. 1, he was sedated, intubated and placed on a ventilator.

Ivermectin was prescribed by Mr. Smith’s physician, who does not have privileges at West Chester Hospital and did not see Mr. Smith before approving the treatment, court records show.

“While the court is sympathetic to the plaintiff and understands the idea of wanting to do anything to help her loved one, public policy should not and does not support allowing a physician to try ‘any’ type of treatment on human beings,” Judge Oster wrote.

In May, Prague Castle held a memorial for Czech victims of the coronavirus, with nearly 30,000 candles set out in its plazas. The Czech Republic, Hungary, Poland, Romania and Bulgaria have had some of the European Union’s highest excess mortality rates during the pandemic.
Credit…David W Cerny/Reuters

BRUSSELS — More than 70 percent of the European Union’s adult population has been fully vaccinated, making it one of the world’s vaccination leaders. But vaccination rates in Eastern and Central Europe are all below that average, exposing the bloc to new waves of infections and creating a divide that E.U. officials and experts say could hamper recovery efforts.

While 80 percent of the adult populations in countries like Belgium, Denmark and Portugal have been fully vaccinated, European data shows that the figure plunges to about 32 percent in Romania and about 20 percent in Bulgaria, where deaths have been surging.

Those countries, along with the Czech Republic, Hungary and Poland, have had some of the highest excess mortality rates across the European Union during the pandemic. And inoculation rates have fallen broadly in recent weeks, particularly in countries like Poland and Slovakia.

“We cannot afford to have parts of Europe less protected, this makes us all more vulnerable,” Stella Kyriakides, the European Union’s health commissioner, said.

The high vaccination rates in Western European countries are an achievement that few would have believed possible earlier this year, when E.U. member countries were embroiled in sluggish rollouts that probably caused thousands of additional deaths and quarreling with bloc officials and vaccine makers over delivery issues.

But they made a strong comeback, and countries like France and Germany are about to vaccinate millions with booster shots. Spain is aiming to inoculate 90 percent of its total population soon. And Italy is considering making vaccinations mandatory. In contrast, large swaths of the populations of Eastern European nations have yet to receive a single dose.

“The story we hear about the pandemic in France, Germany or the Netherlands is very different than the one we hear in Bulgaria or Poland,” said Ivan Krastev, a Bulgarian political scientist and the co-author of a report on the perceptions of the pandemic in 12 E.U. countries.

The scarcity of doses that dogged early vaccination campaigns across the bloc is no longer an issue. Instead, misinformation, distrust of the authorities, and ignorance about the benefits of inoculation seem to be behind the low uptake in Central and Eastern Europe.

The World Health Organization warned last month that 230,000 people in Europe could die of the coronavirus by December, citing slowing vaccination rates and the lack of restrictive measures to combat the spread.

Credit…Cooper Neill for The New York Times

Three Vermont state troopers accused of being involved in a fake Covid-19 vaccination card scheme have resigned amid a federal investigation, the authorities said.

The troopers, Shawn Sommers, Raymond Witkowski and David Pfindel, were suspected of having “varying roles” in the production of fraudulent coronavirus vaccine cards, the Vermont State Police said in a news release on Tuesday.

Mr. Sommers and Mr. Witkowski resigned on Aug. 10, a day after another trooper raised concerns with supervisors about their conduct, the police said. Mr. Pfindel resigned on Sept. 3 after an investigation by the state’s Department of Public Safety.

The Vermont Troopers’ Association, an organization that represents troopers, detectives and sergeants of the Vermont State Police, did not immediately respond for comment on Wednesday morning.

“The accusations in this case involve an extraordinary level of misconduct — a criminal violation of the law — and I could not be more upset and disappointed,” Col. Matthew T. Birmingham, the director of the Vermont State Police, said in a news release.

In August, Gov. Phil Scott of Vermont announced that some state employees who work with vulnerable populations would be required to get vaccinated against Covid-19. About 77 percent of people ages 12 and older have been fully vaccinated, according to a Times database.

As businesses and states reopen amid rising cases of the virus, many have required vaccination cards as proof that someone has been inoculated against Covid-19. Instead of getting vaccinated, some people have turned to faking that proof. In March, the federal Department of Health and Human Services’ Office of Inspector General and the F.B.I. issued a public service announcement to warn the public that selling fake vaccination cards with a government logo on them is a crime.

In July, a homeopathic doctor in California became the first person to face federal charges for selling fake Covid-19 vaccination cards. And in May, the owner of a bar in California was arrested on charges that he had sold fake Covid-19 vaccination cards.

The authorities in Greece are investigating 10 vaccination centers across the country on suspicion of issuing fake vaccination certificates for Covid after dozens of forged documents were linked to health centers and hospitals.

There is a high rate of vaccine hesitancy in Greece, even as experts warn of infection rates rising following the return to the cities after summer holidays on the islands.

At one health center in the small town of Palamas in central Greece, 44 fake certificates were issued in August alone and have been traced to an administrative employee who is being sought by the authorities. Five employees of a hospital in Thessaloniki, Greece’s second city, were suspended after using fake certificates to dodge vaccination which is obligatory for health workers. And a doctor in Messolongi in western Greece, is under scrutiny after using a sample from a patient with Covid to issue an antibody certificate to a colleague, according to local news media reports.

Ιt is thought that the real number of fake certificates is much higher, and Greece’s national transparency authority is seeking to determine whether they are the work of nationwide forgery rackets similar to rings under investigation in France and elsewhere.

The Greek government passed a law this week imposing a 5,000-euro ($5,900) fine for each instance of fraud. The same fine applies to individuals caught using fake certificates to go to work or gain entrance to cafes or leisure venues only serving the vaccinated.

“We won’t allow anyone to defraud the system and put public health at risk,” Greece’s health minister Thanos Plevris said on Monday.

About 54 percent of the population of 10 million has been fully vaccinated, compared with an average of 69.4 percent in the 27-nation European Union. More than 6,000 Greek health workers have been suspended without pay in the past week after refusing to get the jab in contravention of a new law obliging them to get the vaccine.

— Niki Kitsantonis

The Macy’s Thanksgiving Day Parade in 2019.
Credit…Brittainy Newman/The New York Times

Participants in the Macy’s Thanksgiving Day Parade must be masked and vaccinated, with a few exceptions, the company said on Wednesday, as the annual tradition plans a return to a version of its old self this November after a muted performance last year.

The announcement is the latest sign that New York is determined to resume some semblance of normalcy even as it grapples with the spread of the highly contagious Delta variant of the coronavirus.

Macy’s said that its 95th celebration will travel a longer route than the one block it was confined to in 2020 and bring in marching bands and other groups that were unable to perform last year. It will allow 80 to 100 handlers for its giant character balloons after reducing the number last year.

The company said it anticipated thousands of participants again, though less than its typical 8,000, and said that all volunteer participants and staff must be fully vaccinated. They must also wear face coverings, with some exceptions for performers, and maintain social distancing throughout much of the event.

The pandemic upended traditions including festivals and Santa Claus meetings last year, and the parade became largely a television event as many spectators were told to stay home and the parade route shrank from its usual two-mile stretch. Some balloons even had flights that were pretaped for broadcast. A representative for Macy’s said that the company was still determining this year’s route but expected that it would be closer to two miles.

“We applaud Macy’s work to creatively continue this beloved tradition last year and look forward to welcoming back parade watchers to experience it safely, live and in person this November,” Mayor Bill de Blasio said in a statement.

The Supreme Court in Washington.
Credit…Stefani Reynolds for The New York Times

WASHINGTON — The Supreme Court will resume hearing arguments in person when its new term starts in October, after a break of more than a year in response to the coronavirus pandemic, the court announced on Wednesday.

But the effects of the pandemic will continue to alter the court’s practices, the announcement said. The courtroom will not be open to the public, and the court will provide a live audio feed. The new arrangement is an interim measure that will remain in place for arguments in October, November and December.

“Courtroom access will be limited to the justices, essential court personnel, counsel in the scheduled cases and journalists with full-time press credentials issued by the Supreme Court,” the announcement said. “The court will continue to closely monitor public health guidance in determining plans.”

The court last heard in-person arguments in March 2020. The court’s initial reaction to the pandemic was to postpone some 20 arguments that had been scheduled for that spring. In the end, it heard 10 of them that May and deferred the rest to its next term, which started last October.

Since then, arguments have taken place by telephone. Though the court had long resisted live audio coverage, it provided a live feed of the telephone arguments, an innovation that now seems here to stay.

The telephonic argument received mixed reviews. They were orderly, with the justices asking questions one at a time in order of seniority. Justice Clarence Thomas, who seldom asks questions from the bench, was a full participant.

But the telephone arguments lacked the dynamic quality of the free-for-all that characterizes arguments in the courtroom. The static forced-march nature of the questioning diminished the ability of the justices to use their questions to talk to one another by jumping in to build on or respond to their colleagues’ concerns.





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