Quebec health authorities are lifting capacity restrictions on venues with assigned seating starting Oct. 8 but say it's too soon to permit larger indoor private gatherings.
Health Minister Christian Dubé made the announcement Thursday, saying anyone attending events at those venues will need to show proof of vaccination and wear a mask.
The new rules apply to cinemas, theatres, conferences and graduation ceremonies, and they will also permit Montreal's Bell Centre to be at full capacity for the Canadiens' first NHL home game in October.
Dubé says Quebec has done well during the month of September, but it remains too early to declare victory in the fight against COVID-19 or to lift the 10-person indoor gathering limit inside private homes.
Earlier in the day, Quebec reported 655 new cases of COVID-19 and two more deaths attributed to the novel coronavirus.
Quebec public health says the number of hospitalizations rose by five, to 311, and 91 people were in intensive care, unchanged from the day before.
The province's Ministry of Security says police forces across the province have issued 34 tickets related to the province's vaccine passport system.
Proof of vaccination has been required for a range of non-essential businesses and services in the province since Sept. 1, but fines ranging from $1,000 to $6,000 were not issued during an initial two-week grace period.
Ministry of Security spokesperson Marie-Josée Montminy says 31 tickets were issued between Sept. 20 and Sept. 26, adding that police conducted 1,726 inspections related to the health order.
Quebec's public health institute says 89.4 per cent of residents 12 and over have received at least one dose of the COVID-19 vaccine and 85.4 per cent are considered adequately vaccinated.
MONTREAL -- Quebec will lift capacity restrictions on venues and events with assigned seating, Health Minister Christian Dube said Thursday, but he warned that the situation is still fragile and further relaxations won't come until after October.
The new rules, which start Oct. 8, apply to venues such as cinemas, theatres, arenas and stadiums, and they will permit Montreal's Bell Centre to be at full capacity for the Canadiens' first NHL home game on Oct. 16 against the New York Rangers. The arena had previously been limited to about one-third of its capacity, or 7,500 people.
"Good news for hockey fans, it's good news for the economy, it's good news for culture, I think it's good news for everybody," Dube told reporters. "Quebecers have paid a high price over the last year and a half and we said when you would be vaccinated, you could have some benefits, those are the benefits they were expecting."
Anyone attending events at those venues will have to show proof of vaccination and wear a mask, except when eating or drinking, Dube added.
The change only applies to organized events, and a 10-person indoor gathering limit inside private homes remains in effect. Dube said other restrictions will likely not be lifted unless the COVID-19 situation remains stable after October.
"We can't declare victory, because we have to remain careful, the month of October will also have its challenges,'' Dube said. "On one hand, I'm saying, bravo, very good September, a huge success, but we know there will be more indoor contacts during the month of October.''
Gatherings for Thanksgiving and Halloween parties are part of the "October challenge,'' public health director Dr. Horacio Arruda told reporters.
"We now are going to have inside parties, which were, most of the time, outside during the summer,'' he said. "This could have an impact on transmission, because these will be contacts where there is higher risk of transmission.''
Events such as meetings and graduation ceremonies, which are currently subject to a limit of 250 people, will also be free of capacity restrictions -- if participants are fully vaccinated and wear masks while seated.
Dr. Leighanne Parkes, an infectious disease specialist and microbiologist at Montreal's Jewish General Hospital, said increasing capacity at venues for vaccinated individuals is a ``measured risk.''
"These individuals are very well protected against severe disease, they have a good level of protection even against the most virulent variant we have today, in terms of symptomatic infection,'' she said in an interview Thursday. "And we're going to layer on top of that other types of infection control practices, like masking, like making sure we have assigned seating.''
In addition to limiting contacts, assigned seating makes contact tracing easier, Parkes said.
Meanwhile, Quebec's Public Security Department said police forces across the province have issued 34 tickets related to the province's vaccine passport system. Proof of vaccination has been required to access a range of non-essential businesses and services in the province since Sept. 1, but fines ranging from $1,000 to $6,000 were not issued during an initial two-week grace period.
Quebec reported 655 new cases of COVID-19 and two more deaths attributed to the novel coronavirus Thursday.
Editor’s note: With overwhelming consistency, research has shown vaccinations against COVID-19 are safe and effective. Residents of Canada who are looking to learn more about vaccines, or the country’s pandemic response, can find up-to-date information on Canada’s public health website.
Some family physicians in Alberta say they are dealing with an increasing number of aggressive, misinformed and untrusting patients who want a note exempting them from getting a COVID-19 vaccine.
Two of three Calgary doctors who spoke to The Canadian Press also said some people have yelled racist comments at them after they declined to write a note because the patients did not have health conditions known to cause serious side-effects to a shot.
“They mostly comment on my brown skin and hijab,” said Dr. Sakina Raj. “I’m also Muslim… so they come to religion and they get personal with that.
“It’s really scary because I feel sometimes they were so abusive verbally, that they could harm us.
“But I still am kind to them. I calm them down nicely. I’m too experienced to be stressed by them.”
Raj said since Premier Jason Kenney announced a proof of vaccination program to try to turn back a crippling fourth wave in the province, safety has become such a concern that Sehet Medical Clinic is now dealing with new patients wanting an exemption only on the phone.
Raj and another Calgary physician said more than three patients a day are asking their clinics for an exemption. Dr. Mukarram Zaidi said one patient tried to bribe him with $200.
“He comes and says that he would like to have a note and he will be compensating for that,” Zaidi said.
When Zaidi declined, the patient became aggressive and began talking to him louder about ethics, he said.
Alberta’s vaccine passport system starts amid growing fourth wave
Zaidi said few people are eligible for an exemption. They include anyone diagnosed with myocarditis or pericarditis — inflammation of the heart or its membrane — or someone who has a confirmed anaphylactic allergy to an ingredient in a COVID-19 vaccine.
This particular patient did not meet those criteria.
“I was really upset with it,” Zaidi said.
Raj said she has thought about calling police during a few consultations.
“Before, there were individuals coming in without a mask, kind of arguing, but this vaccine proof has brought it to another level,” Zaidi added.
Zaidi and Raj said racist comments and an aggressive tone are regular occurrences these days, but they don’t want to focus on that. What’s most concerning to them is that misinformed patients are walking into their clinics.
Some patients tell stories about family members in other countries having outlandish reactions to the vaccine. Others say their religious leader has told them not to get a shot. Zaidi said some patients don’t want to hear any scientific information at all.
“What boggles me is that they come in, trust me for everything else besides COVID. They allow me to examine them for everything else.
“It frustrates me to understand the mentality of these individuals.”
If patients are worried about having an allergic reaction, the doctors direct them to take an allergy test, which some patients decline to do.
Dr. Memoona Butt, another Calgary physician, said she gets most frustrated with patients who read information about the virus from unverified sources.
“Some people are saying that they don’t want any foreign particle or any chemical injected into their body. A number of patients are also worried that we are putting some chips in their system,” Butt said.
Engage or ignore? Tim Caulfield on dealing with spreaders of COVID-19 misinformation
Engage or ignore? Tim Caulfield on dealing with spreaders of COVID-19 misinformation – Sep 10, 2021
The three doctors said colleagues across the province have successfully persuaded the vaccine-hesitant to get their shots by walking them through what’s involved and addressing their concerns.
“I also tell them that Canada’s independent drug authorization … has high standards and a rigorous review process,” Butt said.
Raj said she worries about her patients who don’t want to be vaccinated.
“Some of them are smokers, or have underlying lung conditions, or they’re diabetic. If they catch COVID, they might end up in (an intensive care unit).”
She said her clinic has been calling patients to educate them on why they need to get their shots.
Calgary researchers create vaccine hesitancy guide – Aug 17, 2021
“We have seen how interactions with patients on this topic may become emotional and difficult,” the College of Physicians and Surgeons of Alberta wrote in a statement to doctors.
The college, which regulates the practice of medicine in the province, says doctors can ask patients to leave if they become abusive.
“You and your team are not expected to tolerate this type of behaviour,” the statement says.
Raj said the best advice she gives to her patients is to keep an open mind.
Some family physicians in Alberta say they are dealing with an increasing number of aggressive, misinformed and untrusting patients who want a note exempting them from getting a COVID-19 vaccine.
Two of three Calgary doctors who spoke to The Canadian Press also said some people have yelled racist comments at them after they declined to write a note because the patients did not have health conditions known to cause serious side-effects to a shot.
"They mostly comment on my brown skin and hijab," said Dr. Sakina Raj. "I'm also Muslim ... so they come to religion and they get personal with that.
"It's really scary because I feel sometimes they were so abusive verbally, that they could harm us. But I still am kind to them. I calm them down nicely. I'm too experienced to be stressed by them."
Raj said since Premier Jason Kenney announced a proof of vaccination program to try to turn back a crippling fourth wave in the province, safety has become such a concern that Sehet Medical Clinic is now dealing with new patients wanting an exemption only on the phone.
Raj and another Calgary physician said more than three patients a day are asking their clinics for an exemption. Dr. Mukarram Zaidi said one patient tried to bribe him with $200.
"He comes and says that he would like to have a note and he will be compensating for that," Zaidi said.
When Zaidi declined, the patient became aggressive and began talking to him louder about ethics, he said.
Zaidi said few people are eligible for an exemption. They include anyone diagnosed with myocarditis or pericarditis — inflammation of the heart or its membrane — or someone who has a confirmed anaphylactic allergy to an ingredient in a COVID-19 vaccine.
This particular patient did not meet those criteria.
"I was really upset with it," Zaidi said.
Doctor thought about calling police
Raj said she has thought about calling police during a few consultations.
"Before, there were individuals coming in without a mask, kind of arguing, but this vaccine proof has brought it to another level," Zaidi said.
Zaidi and Raj said racist comments and an aggressive tone are regular occurrences these days, but they don't want to focus on that. What's most concerning to them is that misinformed patients are walking into their clinics.
Some patients tell stories about family members in other countries having outlandish reactions to the vaccine. Others say their religious leader has told them not to get a shot. Zaidi said some patients don't want to hear any scientific information at all.
"What boggles me is that they come in, trust me for everything else besides COVID. They allow me to examine them for everything else. It frustrates me to understand the mentality of these individuals."
If patients are worried about having an allergic reaction, the doctors direct them to take an allergy test, which some patients decline to do.
Misinformation frustrating
Dr. Memoona Butt, another Calgary physician, said she gets most frustrated with patients who read information about the virus from unverified sources.
"Some people are saying that they don't want any foreign particle or any chemical injected into their body. A number of patients are also worried that we are putting some chips in their system," Butt said.
The three doctors said colleagues across the province have successfully persuaded the vaccine-hesitant to get their shots by walking them through what's involved and addressing their concerns.
"I also tell them that Canada's independent drug authorization ... has high standards and a rigorous review process," Butt said.
Raj said she worries about her patients who don't want to be vaccinated.
"Some of them are smokers, or have underlying lung conditions, or they're diabetic. If they catch COVID, they might end up in [an intensive care unit]."
She said her clinic has been calling patients to educate them on why they need to get their shots.
"We have seen how interactions with patients on this topic may become emotional and difficult," the College of Physicians and Surgeons of Alberta wrote in a statement to doctors.
The college, which regulates the practice of medicine in the province, says doctors can ask patients to leave if they become abusive.
"You and your team are not expected to tolerate this type of behaviour," the statement says.
Raj said the best advice she gives to her patients is to keep an open mind.
Amid all the focus on COVID-19 vaccinations, U.S. health experts have another plea: Don’t skip your flu shot.
Flu cases have dropped to historically low levels during the pandemic. The U.S. and Europe experienced hardly any flu last winter, and the Southern Hemisphere just ended its second flu season of the coronavirus pandemic with little to report.
But with U.S. schools and businesses reopened, international travel resuming and far less masking this fall, flu could make a comeback. The big question is whether it will trickle in or roar back and put extra pressure on hospitals already struggling with COVID-19 surges.
“People are sick to death of hearing about having to roll on out and get vaccines of any sort,” said flu specialist Richard Webby of St. Jude Children’s Research Hospital in Memphis.
Yet after 18 months of little influenza exposure, “we probably as a population don’t have as much immunity against this virus as we typically might,” Webby said. “It makes absolute sense to go on out and get that vaccine and at least prepare for something that, you know, could be quite severe.”
Here are some things to know:
Q: Who should get a flu vaccine?
A: The Centers for Disease Control and Prevention says just about everybody needs an annual flu vaccination, starting with 6-month-old babies. Influenza is most dangerous for adults over age 65, young children, pregnant women and people with certain health conditions, such as heart or lung disease.
Q: Why do I need one this year, since flu hasn’t been a threat during the pandemic?
A: COVID-19 restrictions including masking and staying home — especially for children, who are flu’s biggest spreaders — clearly had a side benefit of tamping down influenza and other respiratory bugs. But as soon as masks started to come off, the U.S. experienced an unusual summer surge of children hospitalized with a different virus, named RSV, that usually strikes in the winter. That’s a worrying sign of what to expect if flu returns.
Q: What’s the forecast for flu this winter?
A: Flu is notoriously difficult to predict. But there’s a little more circulating in some countries this fall than last, including a recent uptick in China, said Webby, who directs a World Health Organization flu center. And people may be a little more vulnerable: Before the pandemic, 15% to 30% of the population was exposed to flu each year, a missing bump in immunity, he said.
“If flu does at least get a foothold in, it’s going to have more opportunity of spreading this season,” he said.
Q: When should I get a flu vaccine?
A: Now. The CDC encourages people to get their vaccine by the end of October. Doctors' offices, retail pharmacies and local health departments have millions of doses in hand. And most Americans with health insurance can get it with no co-pay.
Q: I already got a COVID-19 vaccine. Do I really need a flu shot, too?
A: COVID-19 vaccines prevent the coronavirus and flu vaccines prevent influenza. They don’t overlap. But you can catch both viruses at the same time, or one after the other.
“Avoid the double whammy” and get both vaccines, advised the American College of Emergency Physicians. For now, COVID-19 vaccines are available for anyone 12 and older.
Flu vaccines aren’t as powerful as vaccines against some other diseases but if people do get influenza anyway, they tend to have a much milder illness.
Q: Can I get a flu vaccine and a COVID-19 vaccine at the same visit?
A: Yes, the CDC says it’s fine to pair a flu vaccine with either a primary COVID-19 shot or a booster dose.
Q: What’s the best flu vaccine to get?
A: Flu constantly evolves, and each year’s vaccine is made to fight the strains that international experts deem most likely to circulate. This year all the flu vaccines offered in the U.S. offer protection against all four of those strains. Options include traditional shots or a nasal spray vaccine. There also are shots specifically designed to rev up seniors’ age-weakened immune systems, either with a higher dose or an added immune booster. There are also options for people allergic to eggs, which are used to make some flu shots.
Q: How much flu vaccine is available?
A: The CDC expects vaccine manufacturers to deliver 188 million to 200 million doses. Nearly 194 million doses were distributed last winter, a record.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
Amid all the focus on COVID-19 vaccinations, U.S. health experts have another plea: Don’t skip your flu shot.
Flu cases have dropped to historically low levels during the pandemic. The U.S. and Europe experienced hardly any flu last winter, and the Southern Hemisphere just ended its second flu season of the coronavirus pandemic with little to report.
But with U.S. schools and businesses reopened, international travel resuming and far less masking this fall, flu could make a comeback. The big question is whether it will trickle in or roar back and put extra pressure on hospitals already struggling with COVID-19 surges.
“People are sick to death of hearing about having to roll on out and get vaccines of any sort,” said flu specialist Richard Webby of St. Jude Children’s Research Hospital in Memphis.
Yet after 18 months of little influenza exposure, “we probably as a population don’t have as much immunity against this virus as we typically might,” Webby said. “It makes absolute sense to go on out and get that vaccine and at least prepare for something that, you know, could be quite severe.”
Here are some things to know:
Q: Who should get a flu vaccine?
A: The Centers for Disease Control and Prevention says just about everybody needs an annual flu vaccination, starting with 6-month-old babies. Influenza is most dangerous for adults over age 65, young children, pregnant women and people with certain health conditions, such as heart or lung disease.
Q: Why do I need one this year, since flu hasn’t been a threat during the pandemic?
A: COVID-19 restrictions including masking and staying home — especially for children, who are flu’s biggest spreaders — clearly had a side benefit of tamping down influenza and other respiratory bugs. But as soon as masks started to come off, the U.S. experienced an unusual summer surge of children hospitalized with a different virus, named RSV, that usually strikes in the winter. That’s a worrying sign of what to expect if flu returns.
Q: What’s the forecast for flu this winter?
A: Flu is notoriously difficult to predict. But there’s a little more circulating in some countries this fall than last, including a recent uptick in China, said Webby, who directs a World Health Organization flu center. And people may be a little more vulnerable: Before the pandemic, 15% to 30% of the population was exposed to flu each year, a missing bump in immunity, he said.
“If flu does at least get a foothold in, it’s going to have more opportunity of spreading this season,” he said.
Q: When should I get a flu vaccine?
A: Now. The CDC encourages people to get their vaccine by the end of October. Doctors' offices, retail pharmacies and local health departments have millions of doses in hand. And most Americans with health insurance can get it with no co-pay.
Q: I already got a COVID-19 vaccine. Do I really need a flu shot, too?
A: COVID-19 vaccines prevent the coronavirus and flu vaccines prevent influenza. They don’t overlap. But you can catch both viruses at the same time, or one after the other.
“Avoid the double whammy” and get both vaccines, advised the American College of Emergency Physicians. For now, COVID-19 vaccines are available for anyone 12 and older.
Flu vaccines aren’t as powerful as vaccines against some other diseases but if people do get influenza anyway, they tend to have a much milder illness.
Q: Can I get a flu vaccine and a COVID-19 vaccine at the same visit?
A: Yes, the CDC says it’s fine to pair a flu vaccine with either a primary COVID-19 shot or a booster dose.
Q: What’s the best flu vaccine to get?
A: Flu constantly evolves, and each year’s vaccine is made to fight the strains that international experts deem most likely to circulate. This year all the flu vaccines offered in the U.S. offer protection against all four of those strains. Options include traditional shots or a nasal spray vaccine. There also are shots specifically designed to rev up seniors’ age-weakened immune systems, either with a higher dose or an added immune booster. There are also options for people allergic to eggs, which are used to make some flu shots.
Q: How much flu vaccine is available?
A: The CDC expects vaccine manufacturers to deliver 188 million to 200 million doses. Nearly 194 million doses were distributed last winter, a record.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
The Ontario government is recommending people aged 18-24 take the Pfizer COVID-19 vaccine instead of Moderna’s. This comes due to an increase in cases of rare heart conditions in young adults.
The Ontario government said the rise of myocarditis and pericarditis has been observed, particularly in the age group and among males.
Health officials say between June and August, the risk of the heart conditions in males in that age groups after two doses of Moderna was 1 in 5,000, but for those who received the Pfizer BioNTech vaccine it was 1 in 28,000.
Ontario’s chief medical officer, Dr. Kieran Moore, said the recommendation is being made out of an abundance of caution.
"I know that this news might make some people nervous and heighten concerns about receiving COVID vaccine, and I can understand that," Kieran said. "But the benefits of vaccination continue to significantly outweigh the risks of COVID-19 illness and related possibly severe consequences."
Meanwhile, new modeling released this week shows the Delta-driven fourth wave of the pandemic is flattening in Ontario. Ontario’s Science Advisory Table still warned there is no wiggle room, adding that there could be an exponential increase in cases if restrictions are lifted prematurely.
The projections suggested a rolling seven-day overage of new cases is on track to hit about 1,000 a day in October, rising to about 1,500 by the beginning of November. Researchers also saidit’s too soon to see the impact of increased contacts with the return to school and workplaces.
Pharmaceutical giant Pfizer and its partner BioNTech have submitted data on the effectiveness of their COVID-19 vaccine in children to U.S. regulators, clearing the way for a possible authorization by Halloween, according to a member of the company's board of directors.
Canadian parents likely will be waiting longer to secure shots for their kids, however, because Pfizer-BioNTech hasn't yet made a similar filing with Health Canada. That could mean pediatric doses won't be available north of the border until the final weeks of the year at the earliest.
And it's not just the regulatory review that could hold up the shots. Canada may also have to buy the pediatric-specific variety Pfizer has in development — which means the vaccine supply chain is still an open question.
The race is on to vaccinate the country's kids at a time when many Canadian schools are dealing with a wave of the highly contagious delta variant. As the health crisis morphs into a pandemic largely for the unvaccinated, kids are uniquely vulnerable because they don't have any access to a vaccine.
A Health Canada spokesperson said Wednesday the department "anticipates vaccine manufacturers to provide data in children in the coming months."
Pfizer said that work is already underway.
"We are continuing our discussions with Health Canada and preparing to make our submission, but I cannot confirm timelines yet. We will provide updates as soon as we have more to share on this subject," Pfizer spokesperson Christina Antoniou said in a statement to CBC News.
In an interview with CBC's Power & Politics, Scott Gottlieb, a former U.S. Food and Drug Administration (FDA) commissioner and a current Pfizer board member, said the company could get the green light for its pediatric shot in the American marketplace "as early as Halloween, or if it's gets pushed a little bit, maybe into mid-November" if the FDA agrees it is safe and effective for use among people 5 to 11 years of age.
"I don't have a sense of the timeline outside the United States," he said.
WATCH: Former FDA commissioner Scott Gottlieb talks about the need for booster shots
Israel data could support booster shots for those over 60 and possibly even 50, says former FDA chief
2 days ago
"I think the data out of Israel could support booster shots for those over the age of 60 and maybe even you could make a case for those as young as 50," says former FDA Commissioner Dr. Scott Gottlieb, "but here in the U.S. we use 65 as a cutoff where people should go get boosters." 10:15
Last year, Pfizer started submitting data on its adult vaccine to Health Canada in October. Two months later, on December 9, Health Canada authorized its use. It's unclear if that two-month timeframe will be repeated with the pediatric product.
'Officials will work as quickly as they can'
A federal official familiar with the Canadian regulatory process told CBC News on background that "nothing is a guarantee at this point. They'll submit it when they submit it."
"Officials will work as quickly as they can but we can't compromise health and safety. We have to manage expectations. Just because they submit their data doesn't mean, two weeks later, that product will be out the door to the provinces and territories," the official said.
Speaking to reporters late last week, Dr. Theresa Tam, Canada's chief public health officer, said regulators have to be sure the product is safe before it can be widely disseminated to the nation's children.
"For the 12 to 17 year olds, so far those programs are going well. There's no specific safety concern. I do think seeing the safety data in the younger children is of paramount importance," she said.
WATCH: Tam talks about vaccines for children
Tam is asked to advise parents considering COVID-19 vaccines for children
6 days ago
A reporter asks Dr. Theresa Tam, Canada's chief public health officer, for her advice to parents considering vaccinating their children once the COVID-19 vaccine becomes available to those younger than 12. 4:01
Another possible roadblock for the Canadian immunization campaign is supply. While the country is still awash in Pfizer shots from earlier procurement efforts, the company is now marketing a separate pediatric version of its product because kids are expected to get a much smaller dose than adolescents and adults receive.
"We are working on a different presentation designed for pediatric use, which will be supplied for commercial use if authorized," the Pfizer spokesperson said.
Canada may have to buy new kids-only Pfizer shots
That means Canada may have to procure a new kids-only supply of shots to vaccinate the nearly six million people in the country under the age of 12.
A federal official said those details will be worked out as part of Health Canada's review process. "I don't suspect it's as easy as taking what we've already got in the warehouse," the official said. "That will come from their submission to the regulator."
Families wait at a vaccine clinic in Los Angeles, Calif. Pfizer's pediatric vaccine could be authorized for use in the U.S. by Halloween, according to a member of the company's board of directors. (Damian Dovargnaes/AP Photo)
The federal government signed a deal in April to get more shots from Pfizer — including, if necessary, the pediatric variety and reformulated booster shots for adults — but deliveries of this new batch aren't expected to start until sometime in the new year.
So even if Health Canada regulators authorize the product for children before Christmas, shots may not be ready for use until 2022.
The kids' product isn't different from what has been used among people age 12 and up for nearly a year — it's the same vaccine with an identical formulation — but children will get a lower dose.
After testing different dosing levels throughout its clinical trial process, Pfizer found it was best to give kids a 10-microgram dose rather than the 30 micrograms used in other groups. This smaller dose still generated a strong antibody response but also produced fewer side effects for young trial participants, compared to what they experienced with the larger dose currently in use.
"You want to find an optimal dose where you have an equivalent amount of antibodies produced but you want to minimize any vaccine side effects, like fevers and injection site reactions," Gottlieb said. "You're trying to test the lowest possible dose that will elicit an appropriate immune response."
Asked why regulators might have to authorize a new kids-specific vaccine product when there's already an existing supply of the Pfizer vaccine, Gottlieb said it's all about preventing possible contamination. It's not as easy as drawing a smaller amount of product from the vials we already have, he said.
"Typically you would want to introduce vials that have lower amounts of vaccine in it so that you're not going into it as much," he said.
"If you have a vial that's used for dispensing 30 micrograms and now you are dispensing 10 micrograms, you're pulling out a smaller amount each time you go in. You are going in and out of a vial with a needle, multiple times, more times, and that introduces the risk that you could introduce bacteria into the vials."
A salon in the Elysian Valley neighborhood of Los Angeles in July. Almost 70 percent of Californians age 12 and older have been fully immunized against the coronavirus.Alex Welsh for The New York Times
The city of Los Angeles appears close to enacting one of the strictest rules in the United States requiring proof of full vaccination against Covid to enter many indoor public spaces.
The ordinance would require people to provide proof to enter sites, including restaurants, gyms, museums, movie theaters and salons. The L.A. City Council debated it on Wednesday night in anticipation of its being approved next week. The ordinance would take effect on Nov. 4.
“We need to both limit the transmission of the virus as well as make it inconvenient for those that are unvaccinated to access indoor public venues, because they’re putting lives in jeopardy,” said Nury Martinez, the council president. “We have spent too much time placing restrictions on people who have done their part.”
The proposal would allow people with medical conditions that do not allow them to be vaccinated, or who have a sincerely held religious belief, to instead show proof of a negative coronavirus test taken within the preceding 72 hours.
In August, New York City became the first city in the nation to require proof that workers and customers at indoor sites for dining, physical fitness and entertainment had received at least one dose of a Covid vaccine. Not long after, some cities and counties in California, including San Francisco, followed suit. In Los Angeles, a growing number of bars and restaurants have voluntarily begun checking that patrons are vaccinated before allowing them indoors.
Some council members expressed concerns about imposing extra burdens on already struggling businesses.
“We say we support our essential workers,” said Joe Buscaino, a council member who moved to slow the passage of the ordinance on Wednesday. “We don’t want them to be on the front lines of enforcing this.”
But while other council members acknowledged the complexity of implementing the measure, they said its approval should not be delayed.
“It is an extreme measure,” said Bob Blumenfield, a council member, “but we are in an extreme crisis.”
Masks are still required in indoor spaces in Los Angeles County, including in the city of Los Angeles, when people are not eating or drinking, and that will continue to be the case until public health officials say otherwise, even with the new vaccination requirements.
Nurses and administrative workers completing paperwork at a vaccine clinic at a school in Cheyenne, Wyo., in August.Rachel Woolf for The New York Times
The coronavirus is raging in the northern states of the Mountain West, especially Wyoming, where the Delta variant is tearing through one of the least vaccinated populations in the country.
Wyoming is tied with its neighbor Idaho for the second-lowest vaccination rate of any U.S. state. Each has fully vaccinated 41 percent of residents, compared with 56 percent nationally. And newly reported virus cases are at their highest levels since November in Wyoming and neighboring Montana.
Covid-19 patients are filling Wyoming’s hospitals and stretching health care workers thin, leading to the cancellation of elective procedures at some hospitals. Some patients are traveling as far away as Texas for care.
Unlike hospitals in many states, most in Wyoming are not requiring their employees to be vaccinated. Some hospital administrators worry that President Biden’s national vaccine mandate for health care workers, which has yet to take effect, could prompt some workers to quit, making staffing shortages more severe.
“We’re near bursting at the seams, and a lot of that has to do not really with the number of beds we have available, but with the staffing for those beds,” said Eric Boley, the president of the Wyoming Hospitals Association, a trade group that represents most of the state’s hospitals.
“I don’t think they realize what a delicate balancing act it is to try to have enough trained staff,” he said of federal officials.
Dr. Mark Dowell, the health officer for Natrona County, said the governor’s approach was out of sync with the reality on the ground.
“It’s become political instead of medical,” said Dr. Dowell, an infectious disease specialist. “There has been basically no major activity at a state level to acknowledge or deal with this — it’s almost as if it doesn’t exist.” He added that because anti-vaccine sentiment was so pervasive in Wyoming, vaccine mandates were needed “simply to save lives.”
Many health care workers do not need the extra push, said Mike McCafferty, the chief executive of Sheridan Memorial Hospital. He said that more than 70 percent of his hospital’s employees had been vaccinated without using an incentive or mandates.
Most health care workers around the country, especially those at large hospital systems, seem to be going along with vaccination requirements. That is true at Wyoming’s largest hospital, the Wyoming Medical Center in Casper, according to Dr. Carol Solie, its chief medical officer.
All of the hospital’s roughly 1,500 workers and contractors must be fully vaccinated by Nov. 1, with exemptions for religious and medical reasons. Dr. Solie said that more than 60 percent were already vaccinated, while “a very small number” had quit over the mandate, which was announced on July 20.
“If you tell a group of professionals that they have to do something to keep their job,” Dr. Solie said, “the majority are going to act on it.”
Protesters opposing a K-12 mask mandate gathered outside the Genesee County Health Department in Flint, Mich., this month.Jake May/The Flint Journal, via Associated Press
Describing a “crisis affecting America’s public schools,” a group representing tens of thousands of school board members urged President Biden on Thursday to take action to protect them from rising threats and violence by members of the public, including opponents of coronavirus mask mandates.
In a letter, the National School Boards Association called for federal law enforcement agencies to investigate and prevent violence, citing numerous instances this year of school board meetings being interrupted by anti-mask protesters or members of extremist groups.
In Mendon, Ill., this month, a 30-year-old man was arrested and charged with battery and disorderly conduct after striking a school board member at a meeting. Two school board meetings in Michigan were disrupted when a person yelled a Nazi salute in protest of mask requirements, the group said.
Arguing that the actions could amount to “a form of domestic terrorism and hate crimes,” the association asked for agencies including the F.B.I. to investigate whether the incidents violated counterterrorism or any other federal laws.
“These threats and acts of violence are affecting our nation’s democracy at the very foundational levels, causing school board members — many who are not paid — to resign immediately and/or discontinue their service after their respective terms,” the group wrote.
Once staid, sparsely attended affairs, school board meetings have turned chaotic across the United States in recent weeks, with demonstrators challenging mask requirements, testing guidelines and other measures imposed by school districts to prevent the spread of the coronavirus as students nationwide return to in-person learning.
The school boards association, which represents more than 90,000 school board members across 14,000 districts, said that threats had also been sent in the mail and via social media platforms. A letter mailed to a school board in Ohio, carrying the return address of a local neighborhood association, warned that “we are coming after you” for imposing a mask requirement “for no reason in this world other than control. And for that you will pay dearly.”
The school boards group asked the U.S. Postal Service to intervene to stop threatening letters and cyberbullying against students, school boards, district officials and other educators. It also asked Mr. Biden to increase collaboration between federal law enforcement agencies and local authorities to more closely monitor such threats.
“As the threats grow and news of extremist hate organizations showing up at school board meetings is being reported,” the association wrote, “this is a critical time for a proactive approach to deal with this difficult issue.”
Tyson said that about 91 percent of its 31,000 unionized employees are now vaccinated, matching the company’s overall rate.John Konstantaras/Associated Press
When Tyson Foods announced on Aug. 3 that it would require coronavirus vaccines for all 120,000 of its U.S. employees, it was notable because it included frontline workers at a time when corporate mandates applied primarily to office workers. At the time, less than half of its work force was inoculated.
Nearly two months later, 91 percent of Tyson’s U.S. work force is fully vaccinated, said Dr. Claudia Coplein, Tyson’s chief medical officer, who spoke to the DealBook newsletter about the results of its policy.
Tyson did not release vaccination rates by type of worker, but “certainly the vaccination rate amongst our frontline workers was lower than our office-based workers at the beginning of this,” Dr. Coplein said.
The United Food and Commercial Workers union, which represents several thousand Tyson workers, endorsed the mandate in return for more benefits, like paid sick leave. Frontline workers have until Nov. 1 to get vaccinated (or request an exemption), while the company’s roughly 6,000 office workers have until Friday to do so.
Tyson said that about 91 percent of its 31,000 unionized employees are now vaccinated, matching the company’s overall rate. Unlike some other big companies, Tyson has not faced any lawsuits over its mandate, but it has lost a handful of employees over its mandate, a number that may increase as the deadline nears.
One of the company’s poultry plants achieved a 100 percent vaccination rate, from 78 percent, after Covid hit close to home. A viral video about Caleb Reeves, a young Arkansas man who died of Covid, helped to highlight the risk of the virus to young people, “and we have many young frontline workers,” Dr. Coplein said. Mr. Reeves’s uncle worked at a Tyson plant, and the video “gave them a personal connection to say, ‘Hey, that could be my family, too,’” Dr. Coplein said.
Tyson executives have visited plants to have small group conversations about the vaccines. “It’s important to recognize that misinformation is out there,” Dr. Coplein said. Some questions she regularly hears are whether vaccination will affect fertility or pregnancy (the evidence suggests not).
“The most powerful conversations have been when I sat down with somebody who was scared or emotional or otherwise hesitant to get the vaccine,” she said, “and they just really needed somebody to listen to them with empathy.”
Fortune 500 companies and the White House’s Covid task force have reached out to Tyson to discuss the company’s experience, particularly after the White House asked the Occupational Safety and Health Administration to order large employers to make vaccination mandatory.
Tyson expects that when OSHA outlines more details and a timeline for mandates, which could take weeks, more companies will announce vaccine requirements. When that happens, the options will be limited for those who quit (or are let go) because of a mandate.
Lining up at a Covid inoculation site in Tokyo in August. Japan, Malaysia and South Korea have pulled ahead of the United States in the number of vaccine doses administered per 100 people.Franck Robichon/EPA, via Shutterstock
As the United States and Europe ramped up Covid-19 vaccinations, countries in the Asia-Pacific region, once lauded for their pandemic response, struggled with their inoculation programs. Now, many of those countries that lagged behind are speeding ahead, lifting hopes of a return to normalcy in an area that had been resigned to repeated lockdowns and onerous restrictions.
Japan, Malaysia and South Korea have even pulled ahead of the United States in the number of vaccine doses administered per 100 people — a pace that seemed unthinkable in the spring. Several have surpassed the United States in the percentage of their populations that are fully vaccinated, or are on track to do so.
In South Korea, the authorities said that vaccines had helped keep most people out of the hospital. In Japan, new cases and hospitalizations have plummeted.
“It’s almost like the tortoise and the hare,” said Jerome Kim, the director general of the International Vaccine Institute, a nonprofit based in Seoul. “Asia was always going to use vaccines when they became available.”
In contrast with the United States, vaccines were never a polarizing issue in the Asia-Pacific region. Although each country has had to contend with its own anti-vaccine movements, the opposition has been relatively small.
Demonstrators in Manhattan on Monday protesting a vaccine mandate.Dave Sanders for The New York Times
New York’s mandate that more than 650,000 hospital and nursing home workers be vaccinated against Covid-19 took effect this week, prompting tens of thousands of holdouts to get their first dose. But the mandate has also prompted lawsuits across the state by nurses and others who are seeking exemptions.
In courtrooms from Manhattan to Utica, judges are weighing whether to carve out exemptions that would cover thousands, or even tens of thousands, of health care workers. If they do, they may leave hospitals and nursing homes more vulnerable to coronavirus outbreaks, health care officials say.
Alternately, if the mandate is upheld and providers fire significant numbers of unvaccinated workers, some institutions could face staff shortages — although so far industry officials say that most seem able to handle limited job losses.
Several suits accuse New York of violating religious freedoms. These have mostly been brought on behalf of Christian health care workers who say their faith-based opposition to abortion requires them to avoid a Covid-19 vaccine. Cell lines derived from fetuses aborted decades ago were used in development, production or testing of vaccines.
The suits include one that is set to be heard on Thursday in State Supreme Court in Albany that challenges the legality of the mandate on procedural grounds, saying that it should have been enacted by the State Legislature, not as an emergency regulation by the executive branch. There are also federal court cases that intersect at certain points of law or involve conflicting decisions made in the state Health Department and then changed.
One issue in the litigation is whether it is lawful for the state to offer medical but not religious exemptions. In U.S. District Court in Utica, 17 plaintiffs including doctors and nurses are asserting that the mandate restricts their First Amendment right to practice their religion and intrudes on federal anti-discrimination law.
A garment factory in Hanoi in January, before the lockdown.Kham/Reuters
The Delta variant of the coronavirus is on a rampage in Vietnam, the second-biggest supplier of apparel and footwear to the United States after China, highlighting the uneven distribution of vaccines globally and the perils that new outbreaks pose to the world’s economy, Sapna Maheshwari and Patricia Cohen report for The New York Times.
With the holiday season fast approaching, many American retailers are anticipating delays and shortages of goods, along with higher prices tied to labor and already skyrocketing shipping costs. Nike cut its sales forecast last week, citing the loss of 10 weeks of production in Vietnam since mid-July and reopenings set to start in phases in October. Everlane said it was facing delays of four to eight weeks.
The densely packed industrial hub of Ho Chi Minh City, the country’s virus epicenter, has experienced a series of increasingly stringent lockdowns, with many factories temporarily closing in July. That paralyzed commercial activity and added stress to a strained global supply chain. Although new cases have started to decline, the government extended the lockdown through the end of September, as it struggles to vaccinate its residents.
American companies are looking outside Vietnam, often returning to Chinese factories that they worked with previously or finding partners in other countries that are not in the middle of a surge.
Whether they will have enough time to shift before the holidays is questionable. “September is a bad time to reposition things,” said Gordon Hanson, an economist and urban policy professor at Harvard Kennedy School.
Retailers are already trying to prepare customers. L.L. Bean is warning about holiday shipping delays and shortages and urging early shopping. READ THE ARTICLE →
The economy has begun to rebound from the coronavirus pandemic, but millions of people still haven’t returned to work. Some are looking but haven’t been able to find jobs. Others can’t work because of child care or other responsibilities. Still others say the pandemic led them to rethink how they prioritize their careers.
What is keeping you on the sidelines right now? How are you getting by financially without a steady paycheck? How has your time away from work changed your life, both now and in the future?
As of Friday, all Saskatchewan residents will need to show proof of vaccination or a negative COVID-19 test result to enter many businesses and organizations, including restaurants, gyms, bars and event venues.
On Wednesday, eHealth Saskatchewan launched two new apps to help with the COVID-19 vaccine verification process and gave a demonstration at Memories Fine Dining in Regina.
One of the apps —SK Vax Verifier—is for businesses to download. It will read customers' QR codes to verify if they're fully vaccinated. The other is an SK Vax Wallet app for residents to keep their personal QR code in for easy access.
"It's very, very easy. I download both of them in an hour," said Thomas Siarkos, owner and operator of Memories Fine Dining. "Simple, very simple."
Davin Church, vice president of programs and technology at eHealth Saskatchewan, demonstrates how the new free SK Vax Verifier app works. (Matthew Howard/CBC)
Siarkos said his restaurant and staff are ready for Friday and that the owner himself will be verifying vaccination at the door.
"Hopefully the customers realize that we have to abide by the government rules and it should be very easy. It shouldn't be no problem whatsoever. Our number one priority is the health and wellbeing of our staff and, of course, the customers."
Siarkos said that while there's always some concern that residents won't comply, he is hopeful the community will work to move forward.
"I hope that my compatriots and my colleagues in the restaurant business realize that these are the new rules and we have done them before. We didn't protest when they were shutting us down or anything like that. So why this would be any different? So let's move on. We need to put our province back on its feet."
Thomas Siarkos is owner and operator of Memories Fine Dining in Regina. He says he hopes everyone will comply with the new rules. (Matthew Howard/CBC)
Fines for businesses that don't comply
Not every business is embracing the new system.
Villains Strength & Conditioning in Regina recently sent an email to its attendees stating, "The vaccination policy is exactly that, a policy. It is in no way a law that is mandatory to follow (at this moment at least), and with that being said, we WILL NOT be requiring a proof of vaccination to workout at the facility."
The province tells CBC that statement is false.
"Public health orders are not policy, they are lawful requirements made under legislative and regulatory authority," the province said in an email.
Villains Strength & Conditioning in Regina says it will not be requiring proof of vaccination to workout at the facility. (Richard Agecoutay/CBC)
The province said that if the gym intends to permit access to their facility without proof of either vaccination or testing, the business will be in violation of the public health order and could be subject to a ticket.
According to the province, the fine will start at $10,000 for corporations.
Will there be QR codes for proof of a negative test?
There are not currently any QR codes available for those who choose not to get vaccinated and instead opt to pay to get tested for COVID-19 and receive a negative result.
"We were beginning to look at the options around that, and the technology can support it. However, we'd be be looking for for guidance and requirements around that," said Davin Church, vice president of programs and technology at eHealth Saskatchewan.
"There's been investigation into kind of the feasibility and how it would be done, but we haven't actually began developing that at this point."
For the time being, those who are unvaccinated but have a negative test result will need to show proof through an online account that has their results, or a printout.
Saskatchewan's vaccine passport system demonstrated
13 hours ago
eHealth has launched two new apps to help with the COVID-19 vaccine verification process. 2:57
How can those without a driver's license get a QR code?
Church said that in lieu of a driver's licence, Saskatchewan residents can use a province-issued ID card to access their online health account.
While there is not currently a free vaccine certificate available to residents, Church said that is in the works.
"There will be another process through eHealth ... to access a proof of vaccine certificate that at this point will have no cost."
Church said access to the certificate will be available within the next few days.
The SK Vax Verifier app will turn green if a patron's QR code indicates they are fully vaccinated. (Matthew Howard/CBC)
Opposition says last minute proof of vaccination roll-out is 'chaotic'
On Wednesday the province's Official Opposition issued a statement calling on the government to create a free phone-based service for people to access their vaccination records.
The NDP called the vaccine passport system "chaotic" and said the current web-based system can be difficult to navigate for those who have difficulty with computers, including seniors.
The Opposition also said the province had months over the summer to develop a proo- of-vaccination strategy, but opted for a "last minute rush."
Official Opposition health critic Vicki Mowat said on Wednesday that the province's roll-out of its vaccine verification strategy has been 'chaotic.' (Adam Hunter/CBC)
eHealth said it had been working with the federal government on the technology over the summer for travel purposes.
The Saskatchewan government did not announce a vaccine mandate until Sept. 17.
"We're hearing from businesses and people who feel they've received little to no direction when it comes to proof of vaccination requirements coming into place on Oct. 1," said Opposition health critic Vicki Mowat.
"Not only that, the government is charging those who can't use the difficult online system, many of them seniors, $20 to receive a printout. We need to make sure we're taking down barriers and making it as easy as possible for everyone to get a copy of their vaccination record."
For now, the original wallet cards that people received when they got their shots will still be accepted as proof of vaccination. But the province is hoping many will get the QR codes.
"Certainly the wallet card and any document has the opportunity to be forged and that has legal ramifications, and that's why we worked toward more secure options," Church said.
The free SK Vax Verifier app is now available in the Apple app store, and will be on the Google Play app store within the next two days.
The SK Vax Wallet app is currently available in the Apple app store and is expected to be in the Google Play store by Monday.
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