New York City’s classrooms reopened on Monday to roughly a million children, most of whom were returning for the first time since the United States’ largest school system closed in March 2020.
While the city reopened schools last fall for part-time learning, the vast majority of students chose to keep learning remotely. But with no remote option now available to almost all parents, classrooms will be full for the first time in a year and a half.
For months, Mayor Bill de Blasio had forecast the first day of school to be a triumphant coda in New York City’s long recovery from the pandemic. But the spread of the highly contagious Delta variant has complicated the city’s push to fully reopen schools and left many families and educators anxious about what the next few months will hold.
At a news conference on Monday morning, Mr. de Blasio asked parents to put aside their worries and focus on reorienting their children to in-person learning. “I‘m appealing to all parents right now,” he said. “Work past the fear, help your kids move forward.”
Earlier in the day, Tiffany Smith, 37, was on the subway, taking her 8-year-old daughter, Neriyah, and 4-year-old son,Khyree, to their school and daycare center in East New York, Brooklyn, for the first time in 18 months.
Ms. Smith said both had had a hard time focusing when they could not be around their teachers and classmates. “When they’re interacting in person it helps them with their communication skills,” she said.
She said that she had trained her children to keep their masks on that she felt confident in the school’s social-distancing measures. “They have a lot of safety protocols,” Ms. Smith said.
Across the city in Queens, incoming freshmen lined up outside Bayside High School to get a first glimpse inside their new school.
Nate Hernandez, 14, a freshman from Jamaica, Queens, boarded the Q31 bus at 6 a.m. on Monday with his mother to make sure he wouldn’t be late. Nate, who learned fully remotely during his last year of middle school, said online classes made him feel “a little sad and kind of lonely as well,” he said of learning remotely. “It was hard to get to know people.”
He hopes that the new school will offer a fresh start.
“I can’t believe I made it to ninth grade, to high school,” he said. “I’m like, ‘I’m going to high school now.’ It’s crazy.”
The first day of school in a system as large as New York’s can be chaotic even during normal times. This year is anything but. Even before schools opened their doors on Monday morning, the city was scrambling to fix the first problem of the new school year: The online health screenings that families are required to fill out each morning had crashed by about 8 a.m., as hundreds of thousands of parents attempted to log on at the same time.
That led to long lines outside some schools, as educators were forced to complete their own screenings of how each child was feeling that morning.
Monday’s reopening capped months of planning and anticipation for the third consecutive school year disrupted by the pandemic.
In May, amid a brisk vaccine rollout and rapidly declining virus case counts, Mr. de Blasio announced that the city would no longer offer remote instruction to most students. (A few thousand children whom the city considers medically vulnerable will still be able to learn from home.) His announcement triggered little political resistance in the spring, but his administration has faced growing pressure from parents and politicians to reconsider.
About 600,000 families, most of them Black and Latino, kept their children learning from home last year. This year, while parents are much more receptive to reopening schools, some say they would like to wait at least until their young children are eligible for the vaccine. Only children 12 and older are currently eligible, and younger children may not be until later in the year, at the earliest.
Mr. de Blasio has acknowledged that he does not expect all children to return this week, since some parents have informed their principals that they want to wait a few days or even weeks to see how reopening goes.
Emma Goldberg and Chelsia Rose Marcius contributed reporting.
Mayor Bill de Blasio of New York has remained resolute that the school year will proceed normally, albeit with safety measures in place. But it is still possible that significant in-school transmission this fall could force many school buildings — or even the entire system, if virus case numbers rise substantially — to shut down temporarily.
City schools saw remarkably low virus transmission in their buildings last year, but most schools were at significantly reduced capacity. Even with a transmission rate of 0.03 percent as of the end of last year, quarantines were still a regular occurrence.
This year, at least some level of disruption is inevitable, with the city’s newly announced quarantine policy almost certain to lead to frequent short-term classroom closures.
In elementary schools, where children are still too young to be vaccinated, one positive case in a classroom will prompt a 10-day quarantine, and a switch to remote learning, for that entire classroom.
In middle and high schools, only unvaccinated students will have to quarantine if exposed to someone with the virus, meaning that unvaccinated students could have a much different school year than their vaccinated classmates. More than 60 percent of New York City children eligible for the vaccine have received at least one dose, but the city does not know how many of those children attend its public schools.
While the city’s quarantine protocol is more conservative than the Centers for Disease Control and Prevention recommends, New York’s school testing plan is more modest than the C.D.C. calls for, alarming some parents and public health experts.
A random sample of 10 percent of unvaccinated students will be tested in each school every other week; the city was testing 20 percent of people in all school buildings weekly by the end of last year. Experts have said that the city’s current testing plan will almost certainly be too small in scope to stop many outbreaks before they start.
New York has gone further than most districts in the country by implementing a full vaccine mandate for all its educators, along with all adults who work in school buildings. The mayor has said he believes that the mandate, along with increasing vaccination rates for eligible students, will help keep schools as safe this year as they were last year.
For schools to stay open and safe, President Biden said last Thursday, they need to require universal masking, vaccinations for teachers and staff and regular tests for unvaccinated people. So far, the largest U.S. districts are succeeding at masking, but only a minority are implementing the others.
Out of 100 large districts, including the biggest urban districts in every state, nine in 10 are requiring students to wear masks, according to the Center on Reinventing Public Education at the University of Washington. Just one-quarter are requiring teachers to be vaccinated. Fifteen are regularly testing students. And student quarantine policies are generally much less strict than they were last spring.
New York City public schools, which start Monday, are an anomaly on several measures, including the absence of a remote option and a more strict approach with quarantines.
So far this school year, none of the 100 districts have stopped offering full-time, in-person school for Covid-19 reasons. But many plans were hastily revised as school neared and as the Delta variant spread.
The biggest change has been offering a remote option to families not ready for a return to school. Ninety-four of the 100 large districts now have that option — all but those in New York City; Newark; El Paso; Bridgeport, Conn.; Dayton, Ohio; and Manchester, N.H. In more than half of those, it’s available to all students.
Another change has been in mask rules. Eighty-nine of the 100 large districts now require masks, up from half in mid-August.
Twenty-seven of the districts require staff to be vaccinated, up from four in mid-August. Just one, Los Angeles, is requiring vaccines for eligible students, as of last week. Fifteen are testing students regularly, up from seven in mid-August.
Quarantine policies are perhaps the biggest change from last year. Now in many instances, students who share a classroom with an infected person will not have to stay home to quarantine — and their families will not be informed that a classmate was infected.
That’s because many districts are following guidance from the Centers for Disease Control and Prevention, which is more lenient on who needs to quarantine in K-12 schools than in other settings.
Health officials in the United Kingdom on Monday authorized a mass Covid vaccination program for 12- to 15-year-olds, amid widespread concerns that Covid-19 cases could spike with the return to school after the summer vacation.
The authorization, announced by the chief medical officers of England, Wales, Scotland and Northern Ireland, ended weeks of uncertainty and came despite some medical experts’ reservations over whether vaccinations would significantly benefit the age group. The four countries’ governments are now expected to put in place campaigns that will offer the Pfizer-BioNTech vaccine.
The campaigns are expected to be part of an address that the British prime minister, Boris Johnson, is scheduled to give on Tuesday, in which he will outline a strategy to prevent any new surge in Covid infections from overwhelming the national health service over a winter during which seasonal flu could add further strains. His focus is on protecting the country without resorting to the kind of severe lockdown restrictions imposed during earlier phases of the pandemic.
Those 16 and up are already eligible for vaccination, and so are younger children who have health conditions that put them at high risk. But otherwise healthy young people generally face only a small risk of suffering serious illness from the coronavirus, and that has prompted a debate over the ethics of vaccinating children to contain a virus that is mainly a threat to adults.
As a result — and to the frustration of government ministers — Britain has lagged behind some other countries, including the United States, in vaccinating those between the ages of 12 and 15.
The authorizations announced on Monday were presented largely as intended to minimize the disruption caused by outbreaks in schools. Chris Whitty, the chief medical officer for England, said school closings and remote learning had been “extraordinarily difficult for children and had a big impact on health,” including mental health. He acknowledged, however, that the decision to vaccinate children was a closer call than for older people.
The debate over extending vaccines to 12- to 15-year-olds exposed divisions within Britain’s medical and scientific community. Earlier this month, Britain’s Joint Committee on Vaccination and Immunization said that those in the age group would get only marginal benefits from a mass vaccination campaign. It noted concerns over a rare side effect of the Pfizer and Moderna vaccines that has occasionally caused heart inflammations and led to palpitations and chest pains.
“The margin of benefit, based primarily on a health perspective, is considered too small to support advice on a universal program of vaccination of otherwise healthy 12- to 15-year-old children at this time,” the committee concluded.
However, the health ministers of the four U.K. nations reacted by seeking advice from their chief medical officers that took into account “educational impacts” as well as health concerns.
Britain has recently been averaging around 35,000 new coronavirus cases a day — among the highest rates in Europe relative to its population. Two-thirds of the population is fully vaccinated. Government ministers are bracing for the possibility of a further surge in cases after schools reopen and the weather worsens in the fall and winter.
None of the data on coronavirus vaccines so far provides credible evidence in support of boosters for the general population, according to a review published on Monday by an international group of scientists, including some at the Food and Drug Administration and the World Health Organization.
The 18 authors include Dr. Philip Krause and Dr. Marion Gruber, F.D.A. scientists who announced last month that they will be leaving the agency, at least in part because they disagreed with the Biden administration’s push for boosters before federal scientists could review the evidence and make recommendations.
The Biden administration has proposed administering vaccine boosters eight months after the initial shots. But many scientists have opposed the plan, saying the vaccines continue to be powerfully protective against severe illness and hospitalization. A committee of advisers to the F.D.A. is scheduled to meet on Friday to review the data.
In the new review, published in The Lancet, experts said that whatever advantage boosters provide would not outweigh the benefit of using those doses to protect the billions of people who remain unvaccinated worldwide. Boosters may be useful in some people with weak immune systems, they said, but are not yet needed for the general population.
Several studies published by the Centers for Disease Control and Prevention, including three on Friday, suggest that while efficacy against infection with the Delta variant seems to wane slightly over time, the vaccines hold steady against severe illness in all age groups. Only in older adults over 75 do the vaccines show some weakening in protection against hospitalization.
Immunity conferred by vaccines relies on protection both from antibodies and from immune cells. Although the levels of antibodies may wane over time — and raise the risk of infection — the body’s memory of the virus is long-lived.
The vaccines are slightly less effective against infection with the Delta variant than with the Alpha variant, but the virus has not yet evolved to evade the sustained responses from immune cells, the experts said. Boosters may eventually be needed even for the general population if a variant emerges that sidesteps the immune response.
The experts cautioned that promoting boosters before they are needed, as well as any reports of side effects from booster shots such as heart problems or Guillain-Barre syndrome, may undermine confidence in the primary vaccination.
Data from Israel suggest that booster doses enhance protection against infection. But that evidence was collected just a week or so after the third dose and may not hold up over time, the experts said.
China has logged its highest number of coronavirus cases in nearly a month, prompting one county to shut down public transportation and test hundreds of thousands of people.
On Sunday, the Chinese authorities reported 22 new locally transmitted infections, all in the southern province of Fujian and caused by the Delta variant. The number was the highest since Aug. 14, when 24 cases were recorded.
China does not release enough data to make clear how prevalent Delta is there, but last month, the country stamped out multiple Delta outbreaks that swept across half the country through mass testing, contact tracing, and targeted lockdowns. Health experts have warned that such measures come at a punishing economic and social cost and may deepen pandemic fatigue among the public.
The outbreak over the weekend bucked a downward trend of cases, which had fallen for more than a month since Aug. 9, when China reported 109 infections. While Sunday’s case count is far below many other countries, the number reflects what health experts have long warned: that it is probably nearly impossible to completely eradicate the Delta variant, and that Beijing needs to rethink its zero-Covid strategy.
The government said that the Fujian outbreak started on Sept. 10 in a primary school in the county of Xianyou, and local authorities said that most of the cases involved young children. An initial analysis showed that the initial carrier was an adult who had arrived from Singapore.
The authorities in Fujian have ordered mass testing of all students and teachers to be completed within a week. The city of Xiamen has closed off two districts and a hospital after identifying Covid patients. In Xianyou, buses and taxi services have been suspended. More than 900,000 residents in the county have been called up for testing, with threats of criminal punishment for anyone who does not cooperate.
A team from the National Health Commission that has been sent to Fujian said that it would probably detect more cases, but added that the outbreak could be controlled before the weeklong National Day holiday at the start of October, according to CCTV, the state broadcaster.
Beijing is likely to be nervous about large numbers of people traveling and gathering during that holiday, as well as during the three-day Mid-Autumn Festival, which begins on Sunday.
A small hospital in upstate New York is planning to suspend delivering babies starting in a few weeks because some of its labor and delivery nurses resigned rather than comply with the state’s Covid vaccine mandate.
“The math is just not working,” said Gerald Cayer, chief executive officer of Lewis County Health System, at a news conference on Friday. “The number of resignations received leaves us no choice but to pause delivering babies.”
Six out of the 18 staff members in the maternity department at Lewis County General Hospital have resigned, and seven have not indicated whether they will get their shots, Mr. Cayer said in an interview on Monday. The hospital, located in Lowville, the county seat, had expected to deliver about 200 babies this year, he added.
At least 30 employees in the health system have resigned since former Gov. Andrew Cuomo mandated vaccinations by Sept. 27 for New York State’s health care workers, Mr. Cayer said. Of those who have resigned, 21 worked in clinical areas.
The maternity department at Lewis County General will pause deliveries on Sept. 25, Mr. Cayer said, and other units could be affected if more workers resign. Prospective parents in the area will have other options: There are hospitals with maternity departments in Carthage, about 15 miles from Lowville, and in Watertown, about 27 miles away.
The vast majority of workers in his health system have complied with the mandate. Mr. Cayer said that 464 employees, or 73 percent, have been fully vaccinated, and that he he hoped that the staff members who quit would reconsider and take the shots before the deadline. “Anyone who has resigned who changes their mind will be welcomed back,” he said.
The resignations have taken place in a region with a dire staffing shortage. There has been a lack of experienced maternity nursing staff throughout upstate New York, said Dr. Sean Harney, the hospital’s medical director. Thousands of open nursing positions remain, Mr. Cayer said.
Lewis County, with about 27,000 residents, is among the least populous and most politically conservative counties in the state, and has one of the lowest Covid vaccination rates: 44 percent of residents were fully vaccinated as of Friday, compared with 61 percent statewide, according to data from the Centers for Disease Control and Prevention.
Reports of new cases more than doubled in Lewis County, and hospitalizations rose 35 percent in the past 14 days, according to a New York Times database.
Late last month, the N.B.A. sent out a short news release announcing an agreement with the union representing the league’s referees to mandate Covid-19 vaccines. It stipulated that all referees must to be fully vaccinated to work games, including “recommended boosters.”
The agreement stands out in the sports world, where Covid vaccinations remain largely a point of contention. And it is unusual even for pro basketball itself: No such mandate exists with N.B.A. players, creating a potentially awkward situation where some league employees are mandated to take the vaccine and others aren’t.
Marc Davis, the union’s president and a referee himself for more than two decades, said in an interview that the agreement was born of a strong relationship with the N.B.A., and that the referees were broadly in favor of the mandate.
“When you have a collaborative environment between management and labor, I think you’re constantly always working through issues and there’s a constant dialogue back and forth,” Davis said.
“It’s a shared view of vaccines that they are probably one of the top three inventions in the history of humankind. And to have this access to this innovative vaccine and allow us to continue to work, to do our business and to continue to work collaboratively, it’s not that difficult of a conversation to begin and to work through.”
South Africa is easing some of its coronavirus restrictions, with new infections dropping across all provinces, President Cyril Ramaphosa said on Sunday.
“While the third wave is not yet over, we have seen a sustained decline in infections across the country over the last few weeks,” Mr. Ramaphosa said. The seven-day average of daily new cases has decreased by 48 percent in the past 14 days, according to the Center for Systems Science and Engineering at Johns Hopkins University.
When the latest wave of cases surged in June, South Africa introduced some tough restrictions, then relaxed them as cases fell in July. For about a month, restaurants could only sell food by takeout or delivery, alcohol sales were banned and schools were closed.
New rules introduced on Monday further eased those restrictions. The nationwide curfew has been shortened by an hour, operating hours at restaurants, bars and fitness centers have been expanded and hours of alcohol sales have been extended. As many as 250 people may now meet indoors, and as many as 500 outdoors — changes that are expected to make political campaigning easier ahead of local elections in November.
While the easing of restrictions in other parts of the world has been driven by the accelerating pace of vaccinations, South Africa’s vaccination drive has been slow. But the government has secured enough doses to vaccinate the entire adult population, Mr. Ramaphosa said. About 18 percent of the country’s population has been partially vaccinated and 12 percent has been fully vaccinated, according to figures from Our World in Data.
Across Africa, new cases are falling. The continent recently recorded the sharpest seven-day decline in two months, the World Health Organization said this month. But the shortage of doses has left the continent vulnerable to surges, especially of more contagious variants.
Earlier this year, as Covid-19 vaccines became more widely available, some women and girls went on social media to describe changes in their menstrual cycles after receiving the shots, including irregular cycles, painful periods and heavy bleeding.
Some postmenopausal women shared stories about getting their periods for the first time in years. Many wondered whether the vaccines might be the reason.
Now researchers at five institutions, backed by funding from the National Institutes of Health, will be conducting yearlong studies to examine any possible connections between vaccination and irregular menstruation, and to help allay concerns that might prevent women from getting their shots.
The evidence around abnormal periods is so far purely anecdotal. There is no known link between vaccination and changes in menstruation, and public health experts reiterate that vaccines are safe, effective and necessary to end the pandemic.
But the stories underpin a persistent data gap about reproductive health and women’s menstrual cycles that is not collected during clinical trials, including during trials of the Covid vaccines. There have also been no scientific studies published examining a potential relationship between the two.
“This is an important, overlooked issue,” said Dr. Hugh Taylor, chair of the department of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, who added that he has heard from his own patients about differences in their periods after receiving the vaccine.
“A lot of people have irregular menstruation for all sorts of reasons, so is this really different in people with the vaccine, or is it just that when people have it, they are linking it to the vaccine?”
The research will be undertaken by teams at Boston University, Harvard Medical School, Johns Hopkins University, Michigan State University and Oregon Health and Science University. The studies will include participants of all ages and backgrounds who have not yet been vaccinated, including those who plan to get the shots and those who do not, in order to study their menstrual cycles before and afterward.
Menstrual health can be a reflection of women’s overall health, doctors say. But they point out that a number of different factors can temporarily affect a woman’s period, including stress, illness or lifestyle changes. Periods, including length and flow of a menstrual cycle, also vary widely from person to person.
In Idaho, where unchecked virus transmission has pushed hospitals beyond their breaking point, the state is sending some Covid-19 patients to neighboring Washington State.
But Washington hospitals are struggling with their own high caseloads, and some leaders in the state see Idaho’s outsourcing of Covid patients as a troubling example of how the failure to aggressively confront the virus in one state can deepen a crisis in another.
On the Washington side of the border, residents must wear masks when gathering indoors, students who are exposed to Covid face quarantine requirements, and many workers are under vaccination orders. On the Idaho side, none of those precautions are in place.
Last week, Idaho took the extraordinary step of moving its hospitals in the northern part of the state to crisis standards of care — the threshold at which facilities facing overwhelming caseloads are authorized to ration their resources.
Idaho now has more than 600 patients hospitalized with Covid-19, about 20 percent higher than a previous peak in December. Only 40 percent of the state’s residents are fully vaccinated, one of the lowest rates in the nation, compared with 61 percent in Washington State, one of the highest.
The strain on health care facilities is particularly evident in northern Idaho, where the vaccination rate is even lower. The area just hosted the North Idaho State Fair, and in a region where there is deep wariness of government, no mask orders or other strategies were adopted to halt the spread of the virus.
With the Delta strain of the virus sweeping the nation, Washington State has faced its own challenges and record hospitalizations, especially in areas on the eastern side of the state where vaccination rates are lower. This week, that state, too, began talking openly about the possibility that crisis standards of care could become necessary.
A trade group representing some 2,000 consumer brands sent a letter to President Biden on Monday asking for clarification about his announcement last week that all companies with more than 100 employees will soon need to require vaccination or weekly testing.
Mr. Biden said last week that the Department of Labor and its Occupational Safety and Health Administration would draft the rules, which would affect some 80 million workers.
But the mandate has raised vexing issues for employers as they deal with the practicalities of vaccination policies, said Geoff Freeman, the president of the trade group, the Consumer Brands Association.
On Monday, Mr. Freeman called on Mr. Biden to “create immediate clarity” about how private businesses should carry out aspects of the White House’s plan to achieve “our shared goal of increased vaccination rates.”
He shared 19 questions that represented a “small sampling” of those raised by the trade group’s members. Among them:
What proof-of-vaccination documentation will the companies need to collect, and will booster shots also be required?
Must employees be fully vaccinated?
Will workers who have had the coronavirus still have to be vaccinated or get tested?
Will the requirements apply only to vaccines that are fully approved by the Food and Drug Administration? (The Pfizer-BioNTech vaccine is currently the only shot with full approval.)
Who is responsible for vaccination tracking — the government or the individual businesses?
What are the consequences of falsifying a vaccination status?
Other questions, on testing and other policy details, covered similar ground, touching on how federal guidelines interact with state-level initiatives, who will be responsible for paying for testing and whether waivers would be allowed if employee absences or attrition resulted in supply chain disruptions.
Also of concern, Mr. Freeman said in an interview, is the slow pace at which government tends to move, compared with the quick decisions that private businesses are used to making. This has been a problem during the pandemic, he said.
“For 19 months, we’ve been working with either the Trump administration or the Biden administration and all of the agencies involved in this,” he said. “And the simple truth is that they have been slow to keep up with the pace of change.”
He added: “All of us want to get to the other side of this thing as quickly as possible. It’s not going to work in this scenario unless an entity like OSHA can move at the pace of the business environment.”
Major business trade groups have generally been supportive of the mandate, which gives otherwise wary businesses the cover to require inoculation.
The U.S. Chamber of Commerce, the nation’s largest business lobbying group, has said it “will work to ensure that employers have the resources, guidance and flexibility necessary to ensure the safety of their employees and customers and comply with public health requirements.” Another major business advocacy group, the Business Roundtable, has said it “welcomes” the Biden administration’s actions.
But they have also been racing to understand the details and implications, which can vary depending on a company’s size. Does a company’s worker count include part-time employees? What is the deadline for compliance? Will potential lawsuits slow the process down?
The White House has said it will provide more guidance by Sept. 24.
At this point, “there are more questions than answers,” said Ian Schaefer, a partner at the law firm Loeb & Loeb who specializes in labor issues.
Even as companies are calling their lobbyists and lawyers for more insight, many are discussing at a senior level the realities of putting a mandate in place, despite not yet knowing exactly what that might entail, he said.
“In the absence of actionable intelligence that gives a little bit more guidance and direction, I think they’re sort of controlling for what they can control, which is a lot of internal politics at this point,” Mr. Schaefer said.