Oct. 18, 2021, 5:45 p.m. ET

Daily Covid Briefing

Average daily deaths in the United States surpass 2,000.

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A woman with Covid-19 being transported to a hospital in Houston last week. Credit...John Moore/Getty Images

The average U.S. daily death toll from Covid-19 over the last seven days surpassed 2,000 this weekend, the first time since March 1 that deaths have been so high, according to a New York Times database.

Texas and Florida, two of the hardest-hit states in the country, account for more than 30 percent of those deaths: Florida, where 56 percent of the population is vaccinated, averages about 353 deaths a day, and Texas, where 50 percent of the population is vaccinated, averages about 286 deaths a day. In the United States as a whole, 54 percent of all people are vaccinated.

New reported deaths by day
Feb. 2020
Sept.
Apr. 2021
Nov.
Jun. 2022
Jan. 2023
1,000
2,000
3,000 deaths
7-day average
255

These are days with a reporting anomaly.

Source: State and local health agencies. Daily cases are the number of new cases reported each day. The seven-day average is the average of the most recent seven days of data.

Hot spots continue to speckle the map of the country, many of them in line with low vaccination rates but others in areas where vaccinations are among the highest. Vermont, for example, has a vaccination rate of 69 percent and reported more coronavirus cases in the past week than in any other seven-day period, though it still has the fewest cases per person in the country.

As of Saturday, Guam, where 64 percent are vaccinated, and Idaho, where 41 percent are vaccinated, reported more deaths in the previous week than in any other seven-day period.

These surges, according to public health leaders, are tied to the highly transmissible Delta variant. “The war has changed,” the Centers for Disease Control and Prevention said in July about the variant, comparing its contagiousness to that of chickenpox. And while the vaccines provide strong protection against severe illness from Delta, there are still reports of breakthrough infections, and the variant continues to vex scientists and pandemic strategists.

Other numbers appear to be plateauing, or even inching lower. New hospitalizations and new cases have started to tick slowly downward but remain alarmingly high, intensifying the already fierce debate around booster shots. A key advisory panel to the Food and Drug Administration on Friday recommended that people over 65 or at high risk of developing Covid who had been inoculated with the Pfizer vaccine get a booster dose.

Dr. Anthony S. Fauci, appearing on the Sunday talk shows, tried to give some context for the shifting guidance and cautioned against expecting uniformity. “In real time, more and more data are accumulating,” he said on the ABC program “This Week.” “There will be a continual re-examination of that data, and potential modification of recommendations.”

Fauci urges Americans not to get booster shots until they are eligible.

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Dr. Anthony S. Fauci, the nation’s top infectious disease doctor, during a television interview at the White House last month.Credit...Shawn Thew/EPA, via Shutterstock

Dr. Anthony S. Fauci, the nation’s top infectious disease doctor, defended President Biden’s decision last month to announce the availability of Covid booster shots before regulators had weighed in, and he urged vaccinated Americans to wait until they were eligible for an extra shot before getting one.

Dr. Fauci’s remarks on three Sunday morning news shows followed a vote Friday by an advisory panel to the Food and Drug Administration, which recommended that those who received the Pfizer-BioNTech vaccine get a booster dose if they are over 65 or are at high risk of developing severe Covid-19. The panel’s recommendation, represented a more limited plan than one that Mr. Biden had announced over the summer, in which he said that, beginning Sept. 20, all Americans who had been fully vaccinated would be eligible for booster shots eight months after their last dose.

The panel’s members decided that there was not yet enough evidence to recommend the extra shots for younger, healthier people, given evidence that the vaccine continues to protect against severe disease and deaths in that group.

The F.D.A. is expected to make a decision on boosters in the coming days. It usually follows the recommendation of its advisory committees but is not required to do so.

The debate over boosters has happened during a relentless surge of the extremely transmissible Delta variant, which now accounts for more than 99 percent of cases tracked in the country, according to the data from the Centers for Disease Control and Prevention. While hospitalizations and new cases have started to trend slowly downward, deaths have topped an average of 2,000 per day for the first time since March 1, according to a New York Times database. Vaccinations have been shown to protect against severe illness brought on by Delta.

Mr. Biden’s announcement concerned regulators at the F.D.A., given that it came before the agency had evaluated the data on whether the shots were needed. Two top vaccine officials soon announced that they would depart the agency this fall, in part over the issue.

Speaking on NBC’s “Meet the Press,” Dr. Fauci said Mr. Biden “wasn’t getting ahead of the science,” noting that the president always said the plan was dependent on authorization by the F.D.A.

“I think people are not understanding the difference of planning for something and actually what element of that, what proportion of it, you’re actually going to roll out,” he said. “And that’s exactly what happened.”

Dr. Fauci also asked Americans to be patient and wait until they are eligible for an additional shot, adding that it would be only weeks before data on whether an extra shot of the Moderna and Johnson & Johnson vaccines was needed.

“We’re working on that right now to get the data to the F.D.A., so they can examine it and make a determination about the boosters for those people,” he said. “They’re not being left behind by any means.”

As more information comes in about how the original vaccines are working, Dr. Fauci said he expects to see the plan for boosters change. “In real-time, more and more data are accumulating,” he said on ABC’s “This Week.” “There will be a continual re-examination of that data, and potential modification of recommendations.”

Dr. Francis S. Collins, the director of the National Institutes of Health, echoed those remarks on CBS’s “Face the Nation," saying that the category of who is eligible for an extra shot would likely be expanded in the “coming weeks.”

Dr. Fauci also confirmed that the timeline for the authorization of vaccines for children under 12 continues to be this fall. About 48 million children in the United States are under 12 and therefore still ineligible for a vaccine.

Pfizer has said that it expects to announce the results of its children’s vaccine trial before the end of September. Dr. Fauci said the results from Moderna’s trial will likely come a few weeks later.

“Sometime in the mid to late fall, we will be seeing enough data from the children from 11 down to 5 to be able to make a decision to vaccinate them,” he said.

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Mississippi’s governor plays down state’s high death rate.

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Governor Tate Reeves speaking at a news briefing regarding Mississippi’s Covid-19 response in Jackson, Miss., last month.Credit...Rogelio V. Solis/Associated Press

Gov. Tate Reeves of Mississippi on Sunday downplayed his state’s high Covid death rate, calling it an inadequate benchmark to measure the pandemic’s toll in the state.

The state is among the top three in the nation for recent Covid-19 deaths per capita, behind only Florida and Alabama, according to The New York Times database.

New reported deaths by day
Apr. 2020
Oct.
Apr. 2021
Oct.
Apr. 2022
Oct.
20
40 deaths
7-day average
2

These are days with a reporting anomaly.

Source: State and local health agencies. Daily cases are the number of new cases reported each day. The seven-day average is the average of the most recent seven days of data.

Just 42 percent of Mississippi’s residents are vaccinated, well below the national average of 54 percent, according to The New York Times database. The number of deaths increased by 18 percent in the last 14 days, bringing its total to more than 9,200 reported fatalities.

“Unfortunately, fatalities are a lagging indicator when it comes to the virus,” Mr. Reeves said on CNN’s “State of the Union.” “Timing has as much to do with that statistic as anything else.”

Mr. Reeves attributed the deaths to the presence of the more-contagious Delta variant, suggesting that current conditions in the state are temporary. He also noted that new cases in Mississippi have been falling recently.

Despite continued probing, Mr. Reeves refused to answer whether his state would take any additional measures. Mr. Reeves, who is vaccinated, said that vaccination is “the best thing Americans can do to protect themselves against the virus.”

The governor critiqued the Biden administration’s plans to enforce a vaccine mandate for two-thirds of American workers.

“This is an attack by the president on hard working Americans, and hard working Mississippians, who he wants to choose between getting a jab in their arm — and their ability to feed their families,” Mr. Reeves said.

In addition to challenging the proposed mandate’s constitutionality, Mr. Reeves, who is vaccinated, voiced concerns over the legal precedent it would set.

“This should scare Democrats just as much as it scares Republicans,” he said. “The fact is, if we give unilateral authority by one individual to do anything that he wants to do — whether it’s a jab in the arm or something else — then this country is in deep, deep trouble. That’s not something that I am going to stand by and let him do.”

A correction was made on 
Sept. 20, 2021

An earlier version of this story misstated Mississippi's Covid-19 deaths per capita, due to an editing error. Mississippi has the highest overall Covid-19 deaths per capita, not the third-highest.

How we handle corrections

Chris Rock says he has Covid.

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Chris Rock at a news conference on Covid-19 in Brooklyn last year.Credit...Angela Weiss/Agence France-Presse — Getty Images

Chris Rock told his social media followers on Sunday that he is sick with Covid-19 after a breakthrough infection, and the comedian urged people to get vaccinated.

In May, the 56-year-old comic and actor appeared on “The Tonight Show” and told the show’s host Jimmy Fallon that he couldn’t wait to get vaccinated. “I’m two-shots Rock, that’s what they call me,” he said before clarifying that he received the Johnson & Johnson vaccine, which is a single dose.

He joked that he would have pushed aside his fellow actors to receive the vaccine. “I used my celebrity, Jimmy,” Mr. Rock said. “I didn’t care. I was like, ‘Hey, step aside, Betty White.’”

Mr. Rock didn’t elaborate on his symptoms, but his infection was a breakthrough case, meaning he got Covid despite being fully vaccinated.

There is still a lot that is not known about breakthrough infections. But with the extremely transmissible Delta variant now representing more than 99 percent of all coronavirus cases in the United States, rising numbers of breakthrough cases are being reported. Still, they rarely result in hospitalization or death because vaccines have been shown to protect against severe illness.

A recent analysis of state-reported data from the Kaiser Family Foundation found that more than nine in 10 Covid-19 cases that resulted in hospitalization and death occurred among people who were not fully vaccinated.

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Madrid is set to remove most of its restrictions on Monday.

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A restaurant terrace in Barcelona in July.Credit...Albert Gea/Reuters

Madrid will remove most of its pandemic restrictions on Monday amid a general easing of lockdown rules in Spain after the country’s coronavirus infection rate fell to its lowest level in more than a year.

Restaurants and bars in Spain’s capital region will be allowed to stay open as late as their licenses allow, while shopping malls, cinemas and theaters will no longer have to apply capacity limits. Only a few restrictions will remain in Madrid, including limits on party sizes at restaurants — 10 per outdoor table, up from eight — and a 75 percent capacity limit at nightclubs.

New reported cases by day
Feb. 2020
Sept.
Apr. 2021
Nov.
Jun. 2022
Jan. 2023
50,000
100,000 cases
7-day average
1,013
Source: Data for Spain comes from the Center for Systems Science and Engineering at Johns Hopkins University. Population data from the National Statistics Institute of Spain. The daily average is calculated with data that was reported in the last seven days.  ∙  Because of a change in reporting methods in March 2022, case data for Spain now only includes reported cases in people 60 years old and older.

This past week, Spain’s 14-day infection rate fell below 100 registered cases per 100,000 inhabitants, the lowest since August 2020. The latest figures come after the infection rate reached almost 700 in July, before falling to 400 last month.

Most experts attribute the improvement to the speeding up of Spain’s vaccination campaign, which allowed the government to reach its goal of fully vaccinating 70 percent of the population by the end of August. As of Friday, 35.8 million residents, more than 75 percent of the population, had been fully vaccinated, giving Spain one of the largest vaccinated populations in Europe.

Tourism in Spain, which has maintained only limited travel restrictions over the summer, is also expected to increase after London’s decision this past week to stop forcing vaccinated visitors to test for Covid-19 before returning to Britain. The switch, which comes into force on Oct. 4, also benefits some other European countries that are heavily dependent on British tourists, such as France, Italy and Portugal.

Retail landscape changes in pandemic-battered Manhattan.

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Many ground-floor storefronts in Midtown are vacant, including 1500 Broadway, where the Philippines-based chicken chain Jollibee plans to open a flagship restaurant.Credit...Hilary Swift for The New York Times

While the Delta variant of the coronavirus has delayed plans by many U.S. companies to bring employees back to offices en masse, New York City workers who have been trickling into Midtown Manhattan are discovering that many of their favorite haunts for a quick cup of coffee and a muffin in the morning or sandwich or salad at lunchtime have disappeared. A number of those that are open are operating at reduced hours or with limited menus.

By the end of 2020, the number of chain stores in Manhattan — everything from drugstores to clothing retailers to restaurants — had fallen by more than 17 percent from 2019, according to the Center for an Urban Future, a nonprofit research and policy organization.

Across Manhattan, the number of available ground-floor stores, normally the domain of busy restaurants and clothing stores, has soared. A quarter of the ground-floor storefronts in Lower Manhattan are available for rent, while about a third are available in Herald Square, according to a report by the real-estate firm Cushman & Wakefield.

Starbucks has permanently closed 44 outlets in Manhattan since March of last year. Pret a Manger has reopened only half of the 60 locations it had in New York City before the pandemic. Numerous delicatessens, independent restaurants and smaller local chains have gone dark.

But in a city where one person’s downturn is someone else’s opportunity, some restaurant chains are taking advantage of the record-low retail rents to set up shop or expand their presence in New York City.

In the second quarter, food and beverage companies signed 23 new leases in Manhattan, leading apparel retailers, which signed 10 new leases, according to the commercial real estate services firm CBRE.

Shake Shack and Popeyes Louisiana Kitchen were among those signing new rental agreements this year. The burger chain Sonic signed a lease for its first New York City outpost. The Philippines-based chicken joint Jollibee, which enjoys a committed following, plans to open a huge flagship restaurant in Times Square.

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John Nkengasong, the first director of Africa’s C.D.C., is launching the continent’s public health revolution.

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John Nkengasong, director of the Africa Centers for Disease Control, in Addis Ababa, Ethiopia, last year.Credit...Tiksa Negeri/Reuters

When Dr. John Nkengasong took the job as the first head of Africa’s new Centers for Disease Control in 2017, part of the continent had just emerged from a devastating Ebola outbreak. Less than three years later, Covid-19 hit.

Dr. Nkengasong is now trying to bring together the governments of a vast, diverse continent to anticipate and fight public health threats and make them less reliant on international institutions like the World Health Organization or the Red Cross. He has helped Africa speak with a unified voice, particularly about what he calls “vaccine famine,” with rich countries buying up millions of doses they do not need while Africa goes wanting.

Perhaps Ebola was a signal that something bigger was looming, he says, and that something turned out to be Covid-19. He also thinks Covid-19 could be a harbinger of something worse to come — a virus as contagious as the Delta variant, but with the high fatality rate of Ebola.

The Africa C.D.C. was started in response to the Ebola outbreak, with funding from the African Union and some other donors. When Dr. Nkengasong arrived, for months there was no office, no staff and even at one point no internet; the Ethiopian government had shut it down to prevent people from cheating on university entrance exams.

But, he says: “We can do public health under the tree. It doesn’t really matter. The thing is the concepts. Are you committed to solving problems of inequity and health security?”

A new coronavirus testing model aims to spare students from quarantine.

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Mondo Donovan, left, Natalia Cifuentes, Hadja Bah and Jessica Allen administering Covid tests in Marietta, Ga., as part of its school system’s test-to-stay program.Credit...Nicole Craine for The New York Times

An increasing number of school districts are turning to testing to keep more children in the classroom and avoid disrupting the work lives of their parents. The resource-intensive approach — sometimes known as “test to stay” or modified quarantine — allows students who have been exposed to the virus to stay in school as long as they take frequent Covid tests, which are typically provided by the school, and adhere to other precautions.

Experts agree that children who are infected with the virus should isolate at home, but the question of what to do about their classmates poses a dilemma.

Allowing children who have been exposed to the virus to remain in school does pose a potential transmission risk, and the Centers for Disease Control and Prevention says that it “does not have enough evidence” to support the approach. Instead, it recommends that close contacts who have not been fully vaccinated quarantine for as long as 14 days. (Vaccinated close contacts can remain in the classroom as long as they are asymptomatic and wear a mask, according to the agency’s school guidance.)

“At this time, we do not recommend or endorse a test-to-stay program,” the C.D.C. said in a statement to The New York Times. The agency added, “However, we are working with multiple jurisdictions who have chosen to use these approaches to gather more information.”

The C.D.C. guidelines mean that in some cases, especially in classrooms where students are not vaccinated, masked or socially distanced, a single case of Covid can force a dozen or more students out of school. New York City’s school guidelines are even more stringent, stipulating that all unvaccinated students must quarantine for seven to 10 days if one of their classmates contracts the virus.

With the academic year barely underway, some districts in Florida, Louisiana, Missouri and other Covid hot spots have already had to quarantine hundreds or even thousands of students. In mid-August, Mississippi had nearly 30,000 students in quarantine, according to data reported to the state.

A new study, which was published last week in The Lancet, suggests that the test-to-stay approach can be safe.

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When Covid-19 stole their sense of smell, these experts lost much more.

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For an oenologist, losing the sense of smell can be devastating. “It’s like taking a bricklayer’s trowel away,” Ms. Barre said. “Very frustrating. And nerve-racking.”Credit...Dmitry Kostyukov for The New York Times

PARIS — Hélène Barre, 35, lost her sense of smell when she fell ill with Covid-19 in November, a condition known as anosmia. Her slow recovery was plagued by disturbing distortions: Peanuts smelled like shrimp, raw ham like butter, rice like Nutella. The phantom scent of something burning still bothers her for hours at a time.

Those symptoms would be troubling enough for anyone. But Ms. Barre is an oenologist, an expert on wines and winemaking. Her career, her livelihood, her passion — they all depend on one thing: her ability to smell.

“It’s our work tool, our way of detecting problems,” said Ms. Barre, who works at a wine cooperative in Limoux, a town in southwestern France not far from Carcassonne. “We use it to describe the wine, but also to analyze and criticize it.”

“It’s like taking a bricklayer’s trowel away,” she said. “Very frustrating. And nerve-racking.”

For millions worldwide, anosmia has become a telltale sign of Covid-19, often accompanied by the inability to taste anything more than basic characteristics like sweetness or saltiness. Compared with the disease’s more serious symptoms, though, and the risk of drawn-out illness or death, it is often experienced as a minor, if jarring, inconvenience.

But for professionals like Ms. Barre, smell is not a lesser sense — especially in France, with its celebrated cuisine, wines and perfumes. For sommeliers, perfumers, oenologists and others, smell is a skill honed over many years of identifying things like subtle notes of citrus in a perfume, or parsing the bouquet of a mature Bordeaux.

The Covid crisis is now a garbage crisis, too.

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A recycling center in Sao Paulo, Brazil, in June.Credit...Sebastiao Moreira/EPA, via Shutterstock

Across Brazil, recycling plants stopped running for months. In Uganda, a junkyard is short on reusable plastics. And in Indonesia’s capital, disposable gloves and face shields are piling up at the mouth of a river.

Surging consumption of plastics and packaging during the pandemic has produced mountains of waste. But because fears of Covid-19 have led to work stoppages at recycling facilities, some reusable material has been junked or burned instead.

At the same time, high volumes of personal protective equipment have been misclassified as hazardous, solid waste experts say. That material often isn’t allowed into the normal trash, so a lot of it is dumped in burn pits or as litter.

Experts say a problem in both cases is that an early fear — that the coronavirus could spread easily through surfaces — has created a hard-to-shake stigma around handling perfectly safe trash. Many scientists and government agencies have since found that the fear of surface transmission was wildly overblown. But old habits die hard, especially in countries where waste-disposal guidelines haven’t been updated and officials are still preoccupied with fighting fresh outbreaks.

“Because there isn’t a route of transmission through recycling, say, we are still finding things being burned rather than recycled because people are scared” of surface transmission, said Anne Woolridge, who leads a working group on health care waste for the International Solid Waste Association. “You try to educate the entire world’s population in less than a year. It’s impossible.”

As for personal protective equipment, Dr. Woolridge said, the sight of gloves and masks littering the world would have been unthinkable before the pandemic. “But because everybody’s saying anything to do with the pandemic is a medical waste, it’s put pressure on the system,” she added.

Recycling rates dropped sharply around the world last year, in part because demand from manufacturers fell. In many countries where the recycling industry is still driven by hand sorting, rather than machines, in-person work was suspended out of virus-related fears.

In Brazil, for example, the generation of recyclable material in cities rose 25 percent in 2020, primarily because of a spike in online shopping, according to Abrelpe, a national association of sanitation companies. But recycling programs in several cities suspended operations for several months anyway, citing fears of surface transmission.

Recycling rates are now inching back to pre-Covid levels in developed economies, said James D. Michelsen, a solid waste expert at the International Finance Corporation.

But in countries where recycling is driven by informal collectors, he added, lockdowns and outbreaks are still creating major disruptions.

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A new school year begins with a new challenge: staffing shortages.

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Melissa Minter drives her daughter Taylor Minter, 16, to school in San Antonio, Texas.Credit...Matthew Busch for The New York Times

In Massachusetts, Gov. Charlie Baker is activating the National Guard to help with the shortage in bus drivers. In North Carolina, legislators are hoping to ease a cafeteria worker shortage by giving districts federal funding to cover signing bonuses for new hires. And some Missouri districts are wiping away some of the requirements to become a substitute teacher to attract more applicants.

Across the country, school districts are desperate to fill jobs.

Some are struggling to retain counselors, teachers and principals, but a more urgent need seems to be for employees who have traditionally operated behind the scenes — cafeteria workers, bus drivers and substitute teachers — according to Chip Slaven, interim director for the National School Boards Association.

The shortages have affected families who are already under stress.

Melissa Minter has driven her three children every morning to middle school and high school in the Northside Independent School District in San Antonio. A severe staffing shortage has forced bus drivers to make multiple trips, turning what should be a 15-minute bus ride into an hour-and-a-half odyssey.

“My children are begging me to start picking them up in the afternoon, too,” Ms. Minter said. “My husband and I have talked about it — but we don’t know if there’s enough in our budget for more gas.”

There are hundreds of unfilled positions in the district, according to Brian Woods, Northside’s superintendent — more than he’s ever seen in his career.

The district is using funds from recent federal stimulus bills to hire more personnel. For a long time schools were unfunded, he said. “But now you have this federal funding. We have plenty of money. But the human capital is not there.”

Against official advice, rich people are counting their antibodies ‘like calories.’

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Credit...Julia Dufosse

Before Juhi Singh, 46, who owns a high-end wellness center on Manhattan’s Upper East Side, jetted off to the Amalfi Coast last month, her personal driver took her to Sollis Healthcare, a concierge medical service in Manhattan, to measure her antibodies for the coronavirus.

“I wouldn’t go on a trip without my antibodies,” Ms. Singh said. “It’s nerve-racking, but my numbers have been good.”

Ms. Singh received the Johnson & Johnson vaccine in February, and wanted to see if her immunity was still robust before joining friends at a five-star resort overlooking the Tyrrhenian Sea.

Although medical experts warn that an antibody count cannot tell if somebody is protected against the virus, patients have been reading into the numbers anyway.

Antibody testing on a monthly or regular basis has become a common practice among certain members of the nervous affluent class. “It’s the Upper East Side, the Hamptons circles,” Ms. Singh said. “It’s like dinner conversation at this point. It almost feels like counting calories.”

Current tests only look for antibodies for SARS-CoV-2, the virus that causes Covid-19, and not for T cells, which plays an important role in the body’s immune response.

It is also not clear what the antibody count means.

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Covid requirements add another number to define small businesses.

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Credit...Tom Grillo

When the Biden administration announced a mandate that employees be vaccinated or tested regularly at companies with 100 or more employees, business leaders responded with a barrage of questions. Among smaller companies, one loomed especially large: Why 100?

It’s an appealingly round, easy-to-remember number, and it captures a broad section of the American work force. President Biden estimated that his order would apply to 80 million employees and cover two-thirds of all workers.

But as a dividing line between a “big” business and a “small” one, it’s a threshold not found in any other major federal or state law. There was no explanation for how or why the number was chosen. And for entrepreneurs who employ a smattering of workers, that’s an increasingly common challenge: Every time lawmakers invent a new regulation, they also make up a new definition of which businesses count as small.

The Affordable Care Act set 50 as the number of workers after which employers would be required to offer health insurance. That edict, which took full effect in 2016, led to an intense, vocal backlash from owners who feared that the requirement would bankrupt them, with some even paring back their business to keep their employee roster under the limit.

The mandate’s actual costs turned out to be fairly muted for most — the law helped stabilize insurance prices in the notoriously erratic market for small-group plans — and, after surviving many legal and political efforts to dismantle it, the health care law has become a bedrock piece of federal policy. So why not use 50 employees as the boundary for the vaccination mandate?

The White House isn’t saying; officials did not respond to repeated questions about the 100-person criterion. The Labor Department’s Occupational Safety and Health Administration, which is responsible for drawing up the rules, has not yet explained how and when the mandate will be enforced.

Biden will push a global plan to send more vaccines to needy countries.

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Boxes of Moderna vaccines distributed through Covax, the United Nations-backed vaccine program, arriving in Nairobi, Kenya, this month.Credit...Brian Inganga/Associated Press

At a virtual summit on Wednesday, while the annual United Nations General Assembly meeting is underway, President Biden will urge other vaccine-producing countries to balance their domestic needs with a renewed focus on manufacturing and distributing doses to poor nations in desperate need of them.

The push, which White House officials say seeks to inject urgency into vaccine diplomacy, will test Mr. Biden’s doctrine of furthering American interests by building global coalitions. Covax, the United Nations-backed vaccine program, is so far behind schedule that not even 10 percent of the population in poor nations is fully vaccinated, experts said. And the landscape is even more challenging now than when Covax was created in April 2020.

Some nations in Asia have imposed tariffs and other trade restrictions on Covid-19 vaccines, slowing their delivery. India, home to the world’s largest vaccine maker, banned coronavirus vaccine exports in April, but announced on Monday that it would resume shipments next month. And an F.D.A. panel on Friday recommended Pfizer booster shots for those over 65 or at high risk of severe Covid, meaning that vaccine doses that could have gone to low and lower-middle income countries would remain in the United States.

Officials said Wednesday’s summit would be the largest gathering of heads of state to address the coronavirus crisis. It aims to encourage pharmaceutical makers, philanthropists and nongovernmental organizations to work together toward vaccinating 70 percent of the world’s population by the time the U.N. General Assembly meets in September 2022, according to a draft document the White House sent to the summit participants.

Experts estimate that 11 billion doses are necessary to achieve widespread global immunity. The United States has pledged to donate more than 600 million — more than any other nation — and the Biden administration has taken steps to expand vaccine manufacturing in the United States, India and South Africa. The 27-nation European Union aims to export 700 million doses by the end of the year.

But on the heels of the United States’ calamitous withdrawal from Afghanistan last month that drew condemnation from allies and adversaries alike, the effort to rally world leaders will be closely watched by public health experts and advocates who say Mr. Biden is not living up to his pledges to make the United States the “arsenal of vaccines” for the world.

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