The daily average for hospitalized Covid-19 patients in the United States is now more than 100,000 over the last week. That average is higher than in any previous surge except last winter’s, before most Americans were eligible to get vaccinated.
The influx of patients is straining hospitals and pushing health care workers to the brink as deaths have risen to an average of more than 1,000 a day for the first time since March. The seven-day average of Covid hospitalizations peaked in mid-January with nearly 140,000 people hospitalized.
Hospitalizations nationwide have increased by nearly 500 percent in the past two months, particularly across Southern states, where I.C.U. beds are filling up, a crisis fueled by some of the country’s lowest vaccination rates and widespread political opposition to public health measures like mask requirements.
In Florida, 16,457 people are hospitalized, the most of any state, followed by Texas, according to data from the U.S. Department of Health and Human Services.
With the surge pummeling the nation and overwhelming hospitals, a shortage of bedside nurses has complicated efforts to treat hospitalized coronavirus patients, leading to longer emergency room waiting times and rushed or inadequate care.
This month, one in five American I.C.U.s had reached or exceeded 95 percent of beds full. Alabama was one of the first states to run out, and the crisis is concentrated in the South, with small pockets of high occupancy elsewhere in the country. As cases and hospitalizations surged, the University of Tennessee Medical Center in Knoxville on Thursday requested assistance from the National Guard.
“I’ve never seen anything quite like it,” said Dr. Shannon Byrd, a pulmonologist in Knoxville, who described local hospitals filled to capacity, noting that the vast majority of I.C.U. patients in the region were unvaccinated. “It’s bringing whole families down and tearing families apart. They’re dying in droves and leaving surviving loved ones with a lot of funerals to go to.”
As in previous surges, hospitals have been forced to expand capacity by creating makeshift I.C.U.s in areas typically reserved for other types of care, and even in hallways or spare rooms. Experts say maintaining existing standards of care for the sickest patients may be difficult or impossible at hospitals with more than 95 percent I.C.U. occupancy.
Hard-hit communities in Oregon and elsewhere are asking for mobile morgues to store the dead.
Dr. Ijlal Babar, the director of pulmonary critical care for the Singing River Health System in coastal Mississippi, said the influx of mostly unvaccinated, younger Covid-19 patients was hampering care across the system’s hospitals.
“Because a lot of these patients are lingering on, the ventilators are occupied, the beds are occupied,” he said. “And a lot of other patients who need health care, we can’t do those things, because we don’t have the I.C.U. beds, we don’t have the nurses, we don’t have the ventilators.”
Like many health care workers, Dr. Babar voiced frustration at the refusal of many residents to get inoculated, even after they had lost an unvaccinated family member to the virus.
“The families, you don’t see them going out and talking about the benefits of vaccine,” he said. “Nobody brings it up, nobody expresses any remorse. It’s just something that they absolutely do not believe in.”
GENEVA — The coronavirus has caused “the most catastrophic disruption of education in history,” and it is vital for children’s learning and mental health that schools take the necessary measures to open and to continue classroom-based lessons, the World Health Organization’s top European official said on Monday.
“We encourage all countries to keep schools open and urge all schools to put in place measures to minimize the risk of Covid-19 and the spread of different variants,” the official, Hans Kluge, said in a statement released jointly with the United Nations children’s agency, UNICEF.
The statement came as millions of children prepare for the start of a new school year against a backdrop of concern over the spread of the Delta variant.
Children have suffered greatly over the past 20 months, particularly those who were already vulnerable or could not participate in digital learning, Dr. Kluge, the W.H.O.’s European director, said at a news briefing on Monday.
But, he said, “Unlike a year ago, we are in a position to keep them safe,” referring to a range of measures that could minimize the risk of infection.
Dr. Kluge recommended actions such as vaccinating teachers, other school staff and children over the age of 12, and regular testing. He also urged schools to keep classrooms clean, improve ventilation, reduce class sizes where possible and maintain social distancing. Mask wearing would depend on the local risk assessment, he added.
But Dr. Kluge also warned that the Delta variant, together with the “exaggerated easing” of public health measures and increased travel in the summer months had led to a worrying rise in Covid-19 cases, particularly in the Balkans, the Caucasus region and Central Asia.
One reliable projection pointed to 236,000 more deaths in the European region alone by Christmas, he added.
Vaccine skepticism is stalling progress in stabilizing the pandemic, Dr. Kluge said, noting that the numbers of people receiving shots had slowed in recent weeks.
“Vaccination is a right, but it’s also a responsibility,” he said, adding that vaccine skepticism and denial of science “serves no purpose and is good for no one.”
Prescriptions for ivermectin, a drug typically used to treat parasitic worms that has repeatedly failed in clinical trials to help people infected with the coronavirus, have risen sharply in recent weeks, jumping to more than 88,000 per week in mid-August from a prepandemic average of 3,600 per week, according to the Centers for Disease Control and Prevention.
Ivermectin was introduced as a veterinary drug in the late 1970s, and the discovery of its effectiveness in combating certain parasitic diseases in humans won the 2015 Nobel Prize for medicine.
Though it has not been shown to be effective in treating Covid-19, people are now clamoring to get the drug, trading tips in Facebook groups and on Reddit. Some physicians have compared the phenomenon to last year’s surge of interest in hydroxychloroquine, though there are more clinical trials evaluating ivermectin.
While sometimes given to humans in small doses for head lice, scabies and other parasites, ivermectin is more commonly used in animals. Physicians are raising alarms about a growing number of people getting the drug from livestock supply centers, where it can come in highly concentrated paste or liquid forms.
Calls to poison control centers about ivermectin exposures have risen significantly, jumping fivefold over their baseline in July, according to C.D.C. researchers, who cited data from the American Association of Poison Control Centers. Mississippi’s health department said this month that 70 percent of recent calls to the state poison control center had come from people who ingested ivermectin from livestock supply stores.
BATON ROUGE, La. — After a powerful storm blows through Baton Rouge, the emergency room at Our Lady of the Lake Regional Medical Center generally fills with patients suffering from burns and injuries from falls and power tool accidents.
But as Hurricane Ida strafed Baton Rouge, hospital officials were grappling with an extra challenge. They were bracing for an influx of patients at a time when they are already strained by the coronavirus pandemic, which has swept across Louisiana with a renewed fury in recent weeks. On Saturday, for example, nine patients in the hospital died, and eight of those were Covid-19 patients.
Some patients were being kept on stretchers, and the ratio of nurses to patients has expanded.
“Our people are stretched, our devices are stretched,” said Catherine O’Neal, the hospital’s chief medical officer. “It’s not the level of care that we expect from our team or this hospital, but it is the level of care that we have been presented with and we’ll do our best.”
The hospital has received reinforcements from the state and from the U.S. Department of Defense, all supplementing a staff that has been worn thin as the pandemic flared.
Hospital officials are expecting patients to be brought in from other facilities in the region that have been severely damaged by the storm. “We can take on more, we will take on more,” said Stephanie Manson, the hospital’s chief operating officer.
Conditions may be less than perfect, she said, but “it’s still a much better situation than where they were.”
Public health officials are also worried about how the hurricane will ultimately affect the pandemic in Louisiana, as people fleeing their homes pack in with relatives or into shelters with conditions conducive to the spread of the virus. Dr. O’Neal said that similar concerns were raised last year after Hurricane Laura hit Southwest Louisiana, but those fears were not realized. “We were on the downswing when it hit,” she said, “and there was a great deal of testing that went on in those shelters.”
But the outcome might be different this time. “We know that Delta is different and it’s far more contagious,” Dr. O’Neal said. “But we have learned to be patient.”
The Australian state of New South Wales on Monday reported its highest daily number of coronavirus cases since the pandemic began, as infections driven by the Delta variant continued to surge and millions remained in lockdown.
New South Wales, the country’s most populous state, reported 1,290 cases, and the authorities said that they expected infections and intensive-care hospitalizations to continue to rise until peaking in October.
“Our hospital system is under pressure,” Gladys Berejiklian, the premier of New South Wales, told reporters in Sydney, the state capital and a city of more than five million people. “We will need to manage things differently.”
Ms. Berejiklian added that vaccination was the key to increasing freedoms and reducing the spread of the virus.
Victoria, the country’s second-most populous state, reported 73 new cases of the virus. Melbourne, the state capital, is now in its sixth lockdown, making it among the most locked-down places in the world. Combined, the lockdowns have lasted more than 200 days.
“We’re in a very challenging position right now,” Victoria’s chief health officer, Brett Sutton, told reporters in Melbourne on Monday.
As the outbreak has grown, so, too, have concerns that Australia’s vulnerable Indigenous population could be disproportionately affected.
An Aboriginal man in his 50s became the first Indigenous person to die of Covid-19, in Western New South Wales, a spokeswoman for the local health district confirmed on Monday.
Though Australia is battling its most severe outbreak so far, daily cases are still relatively low compared with those in many other countries. Four people per 100,000 are becoming sickened per day with the coronavirus in Australia. In the United States, that figure is 47, according to data from Johns Hopkins University.
For now, international borders and some state borders in Australia remain closed, but some airlines have begun preparing to reopen. On Monday, Virgin Australia announced that it planned to require all its staff to be vaccinated by March.
In other developments around the globe:
The Zhangjiajie Hehua International Airport, in Hunan Province, China, resumed flights on Monday after being shut down for a month to contain an outbreak of the Delta variant. As cases spread over the country in the past two months, the authorities locked down several cities, requiring several million residents to stay home and participate in rounds of testing.
The government of South Korea announced on Monday plans to hand out a fifth round of Covid-19 emergency relief funds, this time to people in the bottom 88 percent of the nation’s income bracket. The packages of up to $215 per person will be distributed starting early next week and must be used by the end of this year. Recipients can use the money for food or other necessities, but not at department stores or entertainment facilities or on delivery apps.
The authorities in New Zealand reported what could be the country’s first Pfizer vaccine-related death: A woman died of myocarditis, an inflammation in the heart muscle, shortly after receiving her shot. According to New Zealand’s Covid-19 Vaccine Independent Safety Monitoring Board, myocarditis is a rare side effect of the Pfizer vaccine. Although the cause of death has not been confirmed by the coroner, a news release by officials stated that this “is the first case in New Zealand where a death in the days following vaccination has been linked to the Pfizer Covid-19 vaccine.”
The health authorities in Denmark recommended on Monday that people with severe immune deficiency get a booster dose of a coronavirus vaccine. The authorities have also announced that, because of the high rate of inoculation in the country, the digital Covid pass that is currently required to enter places such as restaurants will be phased out, starting on Sept. 10. More than 80 percent of people over the age of 12 in Denmark are fully vaccinated, and the country aims to reach 90 percent by Oct. 1.
The Czech Republic will offer a booster Covid-19 vaccine shot from Sept. 20 to any previously vaccinated person, the country’s health minister, Adam Vojtech, said on Monday, according to Reuters. The country of 10.7 million, has been one of the countries worst hit by the pandemic as measured by deaths per population, with over 30,400 victims. Nearly 1.68 million Czechs have contracted the virus, and many more are estimated to have caught it without being tested.
Tiffany Mayand Jin Yu Young contributed reporting.
BERLIN — In an effort to convince holdouts to get inoculated against the coronavirus, a train of the S-Bahn, the iconic red-and-orange line in Berlin, was converted into a mobile vaccination center on Monday.
“I think it’s really super,” said Max Kietzmann, 18, who was one of the first to get a shot — the one-and-done Johnson & Johnson vaccine — on the train on Monday morning. “It’s so easy — it literally comes to you,” he added.
The German authorities are working to persuade unvaccinated residents to get the shots to try to flatten a fourth wave of the pandemic. Despite a relatively successful vaccination campaign in the early summer months, when daily inoculations reached more than a million, the number of new vaccinations has flattened in Germany recently. About 60 percent of the population is now fully vaccinated, according to the Our World in Data project at the University of Oxford.
Politicians and public figures have made direct appeals, and a system of free testing will be abandoned next month, meaning that people will have to pay to obtain proof of a negative result, which is needed for certain activities, such as indoor dining or visiting a hair salon. State and city officials are also trying to make it easier to get a shot, for example by setting up vaccination posts at dance clubs or malls.
In the case of the S-Bahn train, the mobile vaccination center traced a normal one-hour route around the city, with passengers seeking a shot allowed to board at four major stops. The initiative, which was scheduled for Monday only but may be repeated if demand proves high, was aimed at catching commuters who had simply not found the time to get inoculated since doses were made available to all in Germany in July.
Appropriately, Dr. Christian Gravert, the physician onboard, started his medical career on a ship. He noted that the train ride was relatively smooth. “I have performed an appendectomy on the high seas, I trust myself to inject here,” he said.
The Delta variant of the coronavirus has disrupted back-to-office plans for some companies, while others are still expecting employees to be at their desks in September or sooner. And at some, like Goldman Sachs and JPMorgan Chase, employees are already back at their desks.
The Times has compiled the latest information on when companies plan to return to the office, and whether they’ll require vaccines when they do.
The European Union is set to advise member states that they should reintroduce travel restrictions for visitors from the United States, three E.U. officials said on Sunday, as coronavirus infections and hospitalizations have surged in the U.S. in recent weeks.
Starting Monday, the officials said, the United States will be removed from a “safe list” of countries whose residents can travel to the 27-nation bloc without additional restrictions, such as quarantine and testing requirements. The suggested restrictions, made by the European Council, will not be mandatory for member countries, and it will remain up to those countries to decide whether or not to impose them.
Most European countries reopened their borders to Americans in June, more than a year after imposing a travel ban, hoping that Americans would visit this summer and help an ailing tourism industry bounce back.
In essence, the European Union gave the United States a summertime pass to encourage tourism, despite the relatively high infection rates in parts of the country.
The threshold for being on the E.U. “safe travel” list is having fewer than 75 new Covid-19 cases daily per 100,000 people over the previous 14 days. The United States has an infection rate well above that threshold, and Covid hospitalizations in the country climbed above 100,000 last week for the first time since January.
Yet while American tourists were able to travel to Europe this summer, the United States has remained closed to Europeans, drawing anger from Europeans and their leaders, who have expressed frustration at the lack of reciprocity.
Travelers from countries on the safe list can usually visit E.U. countries without quarantining by showing a proof of vaccination or a negative test, while those from countries not on that list are barred from visiting for nonessential reasons and can be subject to further testing and quarantine requirements.
Most European countries reopened their economies this summer after vaccination campaigns picked up speed in recent months. Countries like France and Italy, among others, have required proof of vaccination or a negative coronavirus test result for people to dine in restaurants, visit museums or attend concerts, making Covid passes a fixture of daily life.
The decision to urge the reimposition of travel restrictions on U.S. travelers was first reported by Reuters. European officials who outlined the plan did so under condition of anonymity because they were not authorized to discuss the matter publicly ahead of an announcement planned for Monday.
AstraZeneca has mandated that its U.S.-based employees be vaccinated against the coronavirus if they are returning to the workplace or visiting customers, the company confirmed on Monday.
The drug maker, which has headquarters in Cambridge, England, said the mandate also applied to employees of its Alexion Pharmaceuticals subsidiary, which is based in Boston. Workers can request exemptions for medical, religious or other reasons but will be required to take weekly coronavirus tests.
“To safeguard the health and well-being of our employees and communities, we must follow the science,” an AstraZeneca spokesman said in a statement.
AstraZeneca’s coronavirus vaccine has been authorized for use in 87 countries, according to the company’s website, and 913 million doses have been shipped. The vaccine has not been authorized for use in the United States.
Pfizer, an American competitor based in New York, is requiring all of its U.S. employees and contractors to be vaccinated or participate in weekly Covid-19 testing. Johnson & Johnson and Moderna, both of which have vaccines that are authorized for use in the United States, did not immediately respond to requests for comment.