A Florida court on Friday rejected an effort by Gov. Ron DeSantis and other state officials to prevent mask mandates in schools during the state’s worst Covid-19 outbreak yet.
Judge John C. Cooper of the state’s Second Judicial Circuit said that Florida’s school districts may impose strict mask mandates on students to curb the spread of the coronavirus, handing a defeat to Governor DeSantis, whose administration has vehemently insisted on leaving masking decisions to children’s parents.
In a lengthy ruling from the bench, Judge Cooper sided with parents of students in various school districts who had argued that Florida’s Constitution requires keeping schoolchildren safe and secure, and masks would help accomplish that in a pandemic. Florida had previously indicated that it would appeal any adverse ruling to a more conservative appellate court.
Lawyers for Mr. DeSantis, a Republican, and the Florida Department of Education had countered that a “parents’ bill of rights” enacted by state lawmakers earlier this year gave parents the right to decide if their child should wear a mask. Judge Cooper disagreed, saying the new law “doesn’t ban mask mandates” and in fact gives school districts the discretion to impose them.
“I’m a parent — parents’ rights are very important,” Judge Cooper said. “But they’re not without some reasonable limitation, depending upon safety, reasonableness and a compelling state need.”
In a statement, the Department of Education said it would appeal.
“We are immensely disappointed that the ruling issued today by the Second Judicial Circuit discards the rule of law,” said Jared M. Ochs, a spokesman. “This decision conflicts with basic and established rights of parents to make private health care and education decisions for children.”
The ruling, delivered over nearly two hours on Friday, came after a high-profile trial was held via Zoom over the course of four days this week. At one point, more than 2,000 people watched Judge Cooper deliver his ruling in a livestream on YouTube.
Judge Cooper granted an injunction against the Department of Education — but not the governor — blocking it from punishing local school boards. Florida had threatened to withhold funding from two school districts, Alachua and Broward, which were the first to impose strict mask mandates, in an amount equal to school board members’ monthly salaries.
Other Republican governors who have banned school mask mandates, including Gov. Greg Abbott of Texas and Gov. Doug Ducey of Arizona, are also facing legal challenges.
Florida is experiencing its worst moment of the pandemic after a brutal summer surge fueled by the Delta variant that has left more people testing positive for, hospitalized with and dying from the virus than ever before. More children in the state are hospitalized with Covid-19 than at any other point. This week in Orange County, where Orlando is, children between the ages of 5 and 14 made up about 20 percent of new virus cases.
Classes have started over the past few weeks, prompting 10 of the state’s 67 countywide school districts, covering about half of the state’s 2.8 million students, to defy the state and require masks with limited medical exemptions. Other districts made masks voluntary or allowed parents to opt out for any reason.
Florida has allowed parents to apply for private school vouchers if they consider mask mandates to be “harassment” of their children.
Half of the 12 to 17 year olds in the United States have gotten at least one dose of a coronavirus vaccine, the White House’s Covid-19 response coordinator said on Friday.
“We have now hit a major milestone in our effort to vaccinate adolescents,” Jeff Zients, the response coordinator, said at a news conference with the White House Covid-19 Response Team.
The pace of vaccinations has picked up in recent weeks after the extremely contagious Delta variant drove a surge in cases, hospitalizations and deaths around the country, all of which have reached levels not seen since last winter.
“This is critical progress as millions of kids head back to school, and in fact the vaccination rate among adolescents is growing faster than any other age group,” Mr. Zients said. “And we will continue to do everything we can to get this group of adolescents vaccinated.”
Vaccinating adolescents is particularly important now that schools are reopening, since children younger than 12 are not yet authorized to receive any of the vaccines and inoculating as many people around them as possible will help keep them safe, said Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention.
“It’s human nature to protect our children above all else, and the best way to protect them is to get everyone who is eligible vaccinated and surround children who are not yet vaccine eligible with people who are vaccinated to effectively shield them from Covid harm,” Dr. Walensky said, adding that widespread vaccination, coupled with measures like masking and social distancing, would help keep children safe in a school setting.
The Food and Drug Administration first expanded its emergency use authorization for the Pfizer-BioNTech vaccine to include adolescents in May, so there has not been as much time for them to get inoculated.
Earlier this week the F.D.A. granted full approval to Pfizer’s vaccine for people 16 and older, but it is not yet clear when such an approval, which can make it easier to impose vaccine mandates, might be granted for adolescents and younger children.
India has given at least one Covid-19 vaccine shot to more than half of the eligible population, a milestone in a country that initially struggled to roll out enough doses for its 1.4 billion people.
The country’s health ministry said it was ramping up its vaccination drive and working with regional governments to accelerate the pace of inoculation as they race to stave off another wave of infections.
India is still recording about 33,000 cases a day. With more than 32 million total Covid-19 cases, the country is second only to the United States in terms of number of cases and the third to record more than 400,000 total deaths. Scientists widely believe the official figures vastly undercount the toll.
So far, the country has fully vaccinated around 15 percent of the eligible population since the beginning of the drive in January. Health officials said they have given more than 610 million doses of three approved vaccines.
India’s vaccine supplies will get a major lift when the country begins using Zydus Cadila’s DNA-based vaccine beginning in the first week of October. Health ministry officials say over 473 million people have received the first dose and another 138 million have received both shots. That covers just over 50 percent of India’s adult population based on the country’s projected midyear count for 2020.
The country’s daily vaccination drive also ramped up in August with over 5.2 million administered, compared with 4.3 million shots administered in July.
Government officials have said they are aiming to vaccinate all Indians by the end of this year. But some Indian states are still struggling with the vaccination drive because of the resource disparities and the sheer size of the population.
Officials are cautioning against relaxing attitudes, one reason behind the devastating second wave of the coronavirus that struck earlier this year.
Balram Bhargava, the director general of the Indian Council of Medical Research, a top government science body, said on Thursday that although vaccines reduce the severity and reduce chances of hospitalization, people should continue with wearing masks. Relaxed attitudes, he said, could have disastrous consequences.
“Only fully vaccinated people should attend social gatherings,” he said. “The second wave is still on in India. In some states, an upsurge is being observed in a few districts.”
global roundup
Since May, a third wave of the pandemic has ripped through countries in southern and eastern Africa. One country in North Africa — Tunisia — is experiencing its fourth wave.
The continent, with a population of 1.3 billion people, has recorded almost 7.6 million cases and at least 191,000 Africans have died. A brutal wave of infections driven by the Delta variant has strained health systems in countries from South Africa to Tunisia, and from Zambia and Senegal, where vaccination rates are far lower than in Europe and North America.
But the World Health Organization said on Thursday that coronavirus infections in the continent had stabilized and the once slow vaccination rate has picked up pace.
Dr. Matshidiso Moeti, the W.H.O. regional director for Africa, told an online news conference that nearly 248,000 new cases had been reported in the past week, down from 282,000 in mid-July. At the same time, the number of vaccinations in the continent had tripled to 13 million.
“The third wave appears to be stabilizing but cases are still very high,” she said.
Many of the administered vaccine doses arrived as donations and sharing arrangements through the Covax program. Originally, the program hoped to vaccinate 20 percent of the African population this year. But Covax, co-led by the W.H.O. to provide vaccines to poorer countries, has been plagued by delays.
The W.H.O. now aims to vaccinate 10 percent of people in Africa by the end of September, according to Dr. Moeti. “117 million doses are due to arrive in the coming month and up to 34 million additional doses will be needed to reach that target,” she said.
Dr. Moeti called the goal a very daunting task and urged countries to continue sharing supplies. “With international solidarity we can protect those at highest risk of Covid-19 in all countries in the world,” she said.
In other developments around the world:
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As of Friday, 33 American service members on the Osan Air Base in Pyeongtaek, South Korea, tested positive for the coronavirus, according to military and health officials. The cluster infection broke out after a “no-mask party” last Saturday in a club on the base, according to reports from state media. South Korea is experiencing its worst wave of the pandemic, with much of the country under its strictest social distancing regulations. The cluster of infections came as joint military drills wrapped up between South Korea and the United States. South Korean military officials have conducted pre-emptive tests on 800 people: No Korean military personnel have tested positive.
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Thailand will lift most coronavirus restrictions on retail and dining beginning in September and permit gatherings of up to 25 people in Bangkok and other high-risk areas, Reuters reported. The country’s Covid-19 task force said on Friday that the changes were necessary to revive the Thai economy safely. But the country is battling its worst coronavirus outbreak and struggling to ramp up vaccinations, with only one in 10 people inoculated so far.
Jin Yu Young contributed reporting.
The largest published study to date of certain post-vaccine side effects found that people were at slightly higher than normal risk of blood clots after receiving an AstraZeneca or Pfizer-BioNTech shot. But the same clotting conditions were substantially more likely to occur — and over longer periods — among people infected with the coronavirus, the study found.
Coupled with another study this week from Israel, the data, published on Thursday night in The British Medical Journal, added to the growing evidence that though the coronavirus vaccines are associated with certain rare side effects, those risks are dwarfed by the risks from Covid-19.
The study was based on the electronic health records of more than 29 million people in England. It went beyond previous analyses in finding a link not only between very rare clotting conditions and the AstraZeneca vaccine, but also between those conditions and the Pfizer vaccine. Earlier studies had detected increased clotting risks after the AstraZeneca vaccine, but not after the Pfizer shot.
In interviews, the new paper’s co-authors said that the numbers of those cases they detected — involving clots blocking a vein that drains blood from the brain — were small enough that further studies were needed. Even the increased risk of those clots was far outweighed by people’s chances of developing them after contracting the virus itself, the study said.
“Although there are some risks, clearly the risks of these events are very rare,” said Aziz Sheikh, a co-author of the study and a professor of primary care research at the University of Edinburgh in Scotland. “And the biggest point is that the risks associated with Covid-19 are orders of magnitude higher, really.”
The study examined the electronic health records of people given a first dose of a coronavirus vaccine during the first five months of England’s inoculation campaign. Of those 29 million people, nearly 1.8 million people also tested positive for the coronavirus before or after being vaccinated. The study compared the risk of blood clots shortly after vaccination to the risk during other periods, as well as to the weeks after someone developed Covid-19.
After a first shot of the AstraZeneca vaccine, people were at slightly increased risk of certain blood clots, as well as a condition characterized by a low level of platelets that can leave them prone to abnormal bleeding. A first shot of the Pfizer vaccine appeared to put people at slightly elevated risk of strokes caused by blockages within a blood vessel.
And both vaccines were linked, though at low numbers, to the very rare clots that prevent blood from draining out of the brain.
Even so, those risks were far smaller than those linked to developing Covid-19. For example, the authors said, for every 10 million people given a first dose of the AstraZeneca vaccine, about 66 more people than normal would develop clots starting in a vein. But among the same number infected with the virus itself, 12,614 more people than normal would develop those clots.
In the United States, 300,000 to 600,000 people a year develop blood clots in their lungs or in leg veins or other parts of the body, according to the C.D.C. With nearly a million people a day now getting vaccinated, some of those clots will occur in those receiving the shots just by coincidence, unrelated to the vaccine.
Some countries restricted use of the AstraZeneca vaccine after a small number of people in Europe who had received a shot were seriously sickened or killed by a very rare condition characterized by both clotting and abnormal bleeding.
Carol Coupland, a co-author on the latest study and a professor of medical statistics affiliated with both the University of Oxford and the University of Nottingham, said that the study could not evaluate that precise condition because the researchers did not have detailed enough readings of patients’ platelet counts.
The finding of a slightly elevated clotting risk after the Pfizer vaccine conflicted with other analyses, including the article from Israel published in the New England Journal of Medicine this week. The study from England included far more people, allowing it to home in on rarer categories of clots. It was also designed differently: It studied the same people over time, whereas the Israeli study compared risks in vaccinated and unvaccinated people over the same period.
Ben Reis, a co-author of the Israeli study and the director of the predictive medicine group at the Boston Children’s Hospital Computational Health Informatics Program, said that both studies were a testament to the way electronic health records allowed researchers to rapidly pick up on even very rare safety signals and compare the risks to those following a coronavirus infection.
“The vaccination decision shouldn’t be made in a vacuum,” he said. “The alternative outcome is the very real risk of being exposed to the virus without vaccination. Those are the two scenarios that should be compared.”
As children’s hospitals in many parts of the United States admit more Covid-19 patients, a result of the highly contagious Delta variant, federal and state health officials are grappling with a sharp new concern: Children not yet eligible for vaccination in places with substantial viral spread are now at higher risk of being infected than at any other time in the pandemic.
Nowhere is that worry greater than in Louisiana, which has among the highest new daily case rates in the country and only 40 percent of people are fully vaccinated, putting children at particular risk as they return to school.
Most children with Covid-19 have only mild symptoms, and there is not enough evidence to conclude that Delta makes some of them sicker than other variants do, scientists say. Doctors and nurses at Children’s Hospital New Orleans agreed with that assessment.
“So many days are filled with this puzzle of: We don’t have enough beds for this patient who wants to come, so how are we going to shuffle our children around to accommodate one more?” said Devon H. Relle, a pediatric nurse practitioner at Children’s Hospital, where she worked the front desk of the 17-bed I.C.U. The hospital was also seeing an early, worrisome wave of respiratory syncytial virus, known as R.S.V., which can cause some of the same symptoms and was contributing to the overflow conditions.
The crush of Covid-19 at Children’s Hospital grew so intense this month that the state called in a federal “surge team” of emergency responders from the Department of Health and Human Services’ National Disaster Medical System. The group of about 14 included a physician, a nurse practitioner, nurses, paramedics, a respiratory therapist and a pharmacist.
The team was the first assigned to a children’s hospital during the pandemic.
“Covid-19 right now down here is so endemic that you don’t have to have a specific exposure, because it’s just out there,” said Anne Barylick, a nurse practitioner on the surge team who handled patient intake in the emergency department and Covid-19 units. “Statistically, you’re going to run into it.”
Denmark, whose health minister said on Thursday that the country had fully vaccinated 80 percent of residents over age 12, will no longer consider Covid-19 a “socially critical disease.” It will drop all Covid restrictions as of Sept. 10.
The heath minister, Magnus Heunicke, made the announcement on Twitter on Friday. The socially critical designation is a political one, which allowed officials to implement measures such as national closures and requirements for coronavirus passes.
Denmark has reported a total of 342,866 virus cases and 2,575 deaths since the pandemic began, according to the Center for Systems Science and Engineering at Johns Hopkins University. The country has been averaging just under 1,000 new cases a day in recent weeks.
Mr. Heunicke said that as of Sept. 10, the country would phase out the last of its “important restrictions,” including having to show coronavirus passes at nightclubs and sporting events, according to Jyllands-Posten, the Danish newspaper.
He said if the situation changed, the government would not hesitate to intervene, and he urged vigilance.
But he said, “It is the good Danish epidemic management that makes this possible, and I want to say thank you to everyone involved for a gigantic job.”
As schools return to in-person learning with masks and social distancing, some districts are facing another challenge: getting students to class.
Thousands of school bus drivers were furloughed, fell ill or quit as classes moved online last year because of the coronavirus pandemic, school and union officials said. Now districts across the country are trying to lure them back, offering signing bonuses and juggling schedules and bus routes to make up for the shortfall. One school in Delaware is even paying parents to drive their children to school.
“There are reports of shortages across the country,” said Joanna McFarland, the chief executive of HopSkipDrive, which works with districts on transportation solutions. “It is the worst that we have seen in a very long time, if not ever.”
Driver shortages have been an issue for years, but the pandemic made things worse. Many school bus drivers retired or quit out of fear of becoming exposed to the virus in an enclosed space, a risk some new drivers were also reluctant to take. Some quit over mask mandates, while others were furloughed or got sick, further diminishing the pool.
As the start of the 2021-22 academic year approached, officials sounded the alarm. HopSkipDrive, which conducted a national survey of 1,186 transportation and district officials, said that efforts to prepare for the coming school year would be hobbled by the shortages. The National School Transportation Association, which represents bus companies, warned this year that new drivers would not be able to fill the shortfall caused by furloughs and the loss of drivers from the work force.
The training of replacements is not keeping pace. It can take up to eight weeks for a driver to get a commercial license, the association said. Additional training is required for drivers who transport children with special needs and behavioral issues.
From late spring into early summer, Britain’s elementary and secondary schools were open during an alarming wave of Delta infections.
And they handled the Delta spike in ways that might surprise American parents, educators and lawmakers: Masking was a limited part of the strategy. In fact, for the most part, elementary school students and their teachers did not wear them in classrooms at all.
Instead, the British government focused on other safety measures, widespread quarantining and rapid testing.
“The U.K. has always, from the beginning, emphasized they do not see a place for face coverings for children if it’s avoidable,” said Dr. Shamez Ladhani, a pediatric infectious-disease specialist at St. George’s Hospital in London and an author of several government studies on the virus and schools.
The potential harms exceed the potential benefits, he said, because seeing faces is “important for the social development and interaction between people.”
The British school system is different than the American one. But with school systems all over the United States debating whether to require masking, Britain’s experience during the Delta surge does show what happened in a country that relied on another safety measure — quarantining — rather than face coverings for young children.
Rohingya in Myanmar will be vaccinated against the coronavirus, Gen. Zaw Min Tun, the spokesman for Myanmar’s military junta, said at a news conference on Friday.
In 2017, a military crackdown in Myanmar against the Rohingya drove hundreds of thousands of men, women and children from their homes.
Vaccinations are set to begin on Saturday, people in the camps said. Abhishek Kumar Singh, a Rohingya man who is a leader in Thet Kal Pyin camp, confirmed that the Rohingya would receive 20,000 vaccine doses, sponsored by the U.N. Commission on Human Rights, according to documents seen by The New York Times. There are a total of 13 camps in Sittwe, the capital of Rakhine State, with a population of about 200,000 Rohingya. The first priority will be people 65 and older.
“The Bengalis in Rakhine State, including Buthidaung and Maungdaw, will be vaccinated with Covid-19. All of them are our people,” Gen. Zaw Min Tun said, while using terminology that implies the Rohingya, members of a Muslim ethnic group that has been living in Myanmar’s Rakhine State for generations, belong in neighboring Bangladesh.
Rohingya in Bangladesh have begun receiving vaccinations. But no attempt has been made until now to vaccinate the Rohingya in Myanmar, and some are skeptical that the vaccines will come through.
“The military is pretending to the international community to get a good political image. I never trust them,” said Mr. Singh, who lives in the Rohingya camp in Sittwe.
A military coup in February ousted the government led by Daw Aung San Suu Kyi, and Myanmar’s vaccination program has been in turmoil. Like many others, the country experienced a surge over the summer.
Myanmar has recorded 383,514 total cases of the virus and 14,850 deaths, according to the Center for Systems Science and Engineering at Johns Hopkins University.
One year after becoming ill with the coronavirus, nearly half of patients in a large new study were still experiencing at least one lingering health symptom, adding to evidence that recovery from Covid-19 can be arduous and that the multifaceted condition known as “long Covid” can last for months.
The study, published Thursday in the journal The Lancet, is believed to be the largest to date in which patients were evaluated one year after being hospitalized for Covid. It involved 1,276 patients admitted to Jin Yin-tan Hospital in Wuhan, China, who were discharged between Jan. 7 and May 29, 2020.
The researchers, who also evaluated the patients six months after hospitalization, found that while many symptoms improved over time and many of the 479 people who had been employed when they got Covid had returned to their original job, 49 percent of patients still had at least one health problem.
And shortness of breath and mental health issues such as anxiety or depression were slightly more prevalent 12 months later than at the six-month mark, the researchers reported, saying the reasons for that “worrying” increase were unclear.
The researchers also compared the patients in the study with people in the community who had not had Covid but had similar pre-existing health conditions and other characteristics. After 12 months, Covid survivors had worse overall health than people who had not been infected. They were also much more likely to be experiencing pain or discomfort, anxiety or depression, and mobility problems than those who had not had the disease.
The patients, whose median age was 57, were given physical exams, lab tests and a standard measure of endurance and aerobic capacity called a six-minute walk test. They were also interviewed about their health.
The study involved patients who were sick enough to be hospitalized, but who were generally not the most severely debilitated. About 75 percent required supplemental oxygen when they were hospitalized, but most did not need intensive care, ventilators or even high-flow nasal oxygen, a noninvasive method.
Women were more likely than men to have some lingering symptoms, including mental health issues and lung function problems. One of the most common symptoms was fatigue or muscle weakness, reported by 20 percent of patients. But that represented a significant decrease from the 52 percent who reported such symptoms six months after hospitalization.
Some issues, like shortness of breath, were more common in people who had been more severely ill. But some issues did not correlate to severity of the initial illness. For example, 244 patients underwent a lung function test, which found that from six months to one year after hospitalization, there was no decrease in the proportion of patients with reduced flow of oxygen from their lungs to their bloodstream — regardless of how ill the patients had been initially.
“The need to understand and respond to long Covid is increasingly pressing,” said an editorial The Lancet published about the study. “Symptoms such as persistent fatigue, breathlessness, brain fog, and depression could debilitate many millions of people globally.”
It added: “Long Covid is a modern medical challenge of the first order.”
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