U.S. health officials have expressed concern over a simultaneous rise in Delta infections and cases of respiratory syncytial virus, a highly contagious seasonal flulike illness that is more likely to affect children and older adults.
Cases of R.S.V. have risen gradually since early June, with an even greater spike in the past month, according to data from the Centers for Disease Control and Prevention. The illness, which can cause symptoms that include a runny nose, coughing, sneezing and fever, normally begins to spread in the fall, making this summer spike unusual.
In a series of posts on Twitter, Dr. Heather Haq, a pediatrician at Texas Children’s Hospital in Houston, described an increase in both coronavirus and R.S.V. hospitalizations.
“After many months of zero or few pediatric Covid cases, we are seeing infants, children and teens with Covid pouring back into the hospital, more and more each day,” she wrote, adding that patients have ranged in age from 2 weeks to 17 years old, including some with Covid pneumonias.
“We are on the front end of a huge Covid surge,” wrote Dr. Haq, who could not be reached for comment on Sunday. “We are now having winter-level patient volumes of acutely ill infants/toddlers with R.S.V., and I worry that we will run out of beds and staff to handle the surge upon surge.”
R.S.V. cases in Texas began to increase in early June and appeared to peak in mid-July, according to data from the state’s health department.
There has been a similar spike in Florida, where infections “were above those seen at this time in past years,” according to a surveillance report.
In Louisiana, where cases have jumped 244 percent in the past two weeks, Our Lady of the Lake Children’s Hospital in Baton Rouge was nearing its capacity on Friday, CNN reported.
“You start with the pandemic for the last 18 months, and then R.S.V. for the last couple of months,” Dr. Trey Dunbar, the hospital’s president, told the network. “It just seems to be one thing after another that’s keeping our teams very busy.”
In Oklahoma, which has also had a spike in R.S.V. cases, beds are becoming scarce at hospitals.
Dr. Cameron Mantor, the chief medical officer for Oklahoma Children’s Hospital at OU Health, told The Oklahoman that in the past two months R.S.V. cases in the state had been “exponentially off the charts.”
“R.S.V. is a real issue right now,” he told the newspaper. “What is going to happen if we do have a surge in pediatric Covid cases?”
The rise comes as new coronavirus infections have risen 148 percent in the United States in the past two weeks and hospitalizations have increased 73 percent, according to New York Times data. The surge of coronavirus infections has been largely attributed to the highly contagious Delta variant and to low vaccination rates in some states.
“I worry as kids go back to school with the Delta circulating, we will see huge school outbreaks that we didn’t see in prior waves, disproportionately affecting kids,” Dr. Haq wrote. “I’ve cared for hospitalized pediatric patients with Covid throughout the pandemic, but this time with unvaccinated, susceptible children plus Delta variant, we will see more pediatric Covid admissions.”
Gov. Greg Abbott of Texas has prohibited local governments and state agencies from mandating Covid vaccines and barred local officials from requiring face masks.
Florida could face similar challenges with viruses when the school year begins. Gov. Ron DeSantis has spoken out against new masking recommendations from the C.D.C., with his office saying in a statement last week that “parents know what’s best for their children.”
Surges in R.S.V. infections have also been reported in places like New Zealand, where it is currently winter. Experts there say that children may be more vulnerable than usual to seasonal viruses and infections because they were underexposed to germs during lockdowns early in the pandemic.
Deaths from Covid-19 were surging across Africa in June when 100,000 doses of the Pfizer-BioNTech vaccine arrived in Chad. The delivery seemed proof that Covax, the United Nations-backed program to immunize the world, could get the most desirable vaccines to the least developed countries.
Yet five weeks later, Chad’s health minister said, 94,000 doses remained unused.
Nearby in Benin, only 267 shots were being given each day, a pace so slow that 110,000 of the program’s AstraZeneca doses expired. Across Africa, confidential documents from July indicated, the program was monitoring at least nine countries where it said doses intended for the poor were at risk of spoiling this summer.
The vaccine pileup illustrates one of the most serious unrecognized problems facing the immunization program: difficulty getting doses from airport tarmacs into people’s arms.
Covax was supposed to be a global powerhouse, a multibillion-dollar alliance of international health bodies and nonprofits that would ensure that poor countries received vaccines as quickly as the rich. Instead, it has struggled to acquire doses: It stands half a billion short of its goal.
Driven by a nonprofit funded by the Gates Foundation, Covax has gotten vaccines to poorer countries faster than was previously typical. It also developed a system to compensate people for serious post-vaccine reactions and protect vaccine makers from legal liability.
Still, the 163 million doses it has delivered — most free to poorer nations, with the rest to countries like Canada that paid their way — are a far cry from plans to have at least 640 million doses available by now.
Now, poor countries are dangerously unprotected as the Delta variant of the virus runs rampant, the very scenario that Covax was created to prevent. And the longer the virus circulates, the more dangerous it can become, even for wealthy countries.
As New York City strives to lure back tourists and office workers, it has undertaken an aggressive campaign to push homeless people off the streets of Manhattan.
City workers used to tear down one or two encampments a day. Now, they sometimes clear dozens. Since late May, teams that include sanitation workers in garbage trucks, police officers and outreach workers have cruised Manhattan around the clock, hitting the same spots over and over.
The sweeps are part of a broader effort by Mayor Bill de Blasio that includes transferring more than 8,000 people from hotels, where they had been placed to stem the spread of the coronavirus, to barracks-style group shelters.
The transfers are continuing despite the recent surge in the Delta variant, though the city told a judge that it would delay the moves on Monday to address concerns that it was not adequately considering people’s health problems and disabilities.
The city is also responding to months of complaints about homeless people blocking public spaces, menacing passers-by and committing assaults. On Wednesday, Gov. Andrew M. Cuomo, whose administration has slashed aid for addressing homelessness, cited the problem as one of the main hurdles to the city’s recovery.
The debate over how to tackle homelessness in New York City, where more than 2,000 people live on the streets and the subway, comes as cities across the country grapple with growing encampments.
On Wednesday, the Los Angeles City Council outlawed camping near parks, libraries and schools. On Saturday, a national eviction moratorium expired, spurring fears of a new surge in homelessness, though in New York the moratorium continues through Aug. 31.
By the Fourth of July, the tourist season in Provincetown, Mass., had built to a prepandemic thrum. Restaurants were booked solid, and snaking lines formed outside dance clubs. There were conga lines, drag brunches and a pervasive, joyous sense of relief.
“We really thought we had beat Covid,” said Alex Morse, who arrived this spring as town manager.
Mr. Morse didn’t think much of it, five days after the holiday, when the town’s Board of Health logged two new cases of coronavirus. A week later, though, the cluster of cases associated with gatherings in Provincetown was growing by 50 to 100 cases per day. Alongside the numbers was an unsettling fact: Most of the people testing positive were vaccinated.
Provincetown, a quirky beach community at the tip of Cape Cod, has provided a sobering case study for the country, abruptly tugging Americans back to the caution of winter and spring.
The Centers for Disease Control and Prevention cited the cluster on Friday as key to its decision to issue new indoor mask guidance, saying viral loads among the vaccinated people there were found to be as high as among the unvaccinated.
The good news is that people infected in Provincetown were for the most part not seriously ill. The bad news is that the variant is extraordinarily contagious — as contagious as chickenpox, the C.D.C. said — and people with breakthrough infections may spread the virus to others.
As a wave of major U.S. employers said last week that unvaccinated workers would need to submit to regular coronavirus testing, it raised a thorny question: Who pays for those tests?
Doctors typically charge about $50 to $100 for the tests, so the costs of weekly testing could add up quickly. Federal law requires insurers to fully cover the tests when ordered by a health care provider, but routine workplace tests are exempt from that provision.
“It’s really up to the employer,” said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms. “They can require employees to pick up the tab.”
Employers have taken a range of approaches, from fully covering the costs to having unvaccinated workers pay full freight.
The U.S. government will pay for its unvaccinated workers’ coronavirus testing, Karine Jean-Pierre, the deputy White House press secretary, said at a news briefing on Friday. Each federal agency will come up with a plan for testing its unvaccinated work force, she said, adding that the costs and procedures of each agency’s testing protocols will depend on the number of unvaccinated people they need to monitor.
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