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The fight over requiring vaccinations for travel is heating up.

Norwegian Cruise Line Holdings sued Florida’s surgeon general on Tuesday, accusing the state of preventing it from “safely and soundly” resuming trips by barring it from requiring customers to be vaccinated against the coronavirus.

The filing represents the latest twist in a monthslong fight over the resumption of cruises from Florida, a hub for the industry. Under Gov. Ron DeSantis, the state has fought vaccine requirements by cruises and other businesses, claiming that such policies are discriminatory. Supporters of vaccine requirements have argued that requiring vaccines is necessary to protect public health.

Under a state law approved in May, businesses that force customers to provide proof of vaccination could face fines of up to $5,000 per violation. In its lawsuit, filed in the U.S. District Court for the Southern District of Florida, Norwegian said it was forced to sue Scott Rivkees, the state’s surgeon general, “as a last resort.”

“One anomalous, misguided intrusion threatens to spoil N.C.L.H.’s careful planning and force it to cancel or hobble upcoming cruises, thereby imperiling and impairing passengers’ experiences and inflicting irreparable harm of vast dimensions,” the company said in the lawsuit.

Norwegian is claiming that Florida’s ban is not valid because it pre-empts federal law and violates various provisions of the Constitution, including the First Amendment. Neither Norwegian nor the Florida Department of Health immediately responded to requests for comment.

After banning cruises nearly a year and a half ago, the Centers for Disease Control and Prevention said in the fall that it would allow cruises to set sail again. The agency later developed a set of stringent conditions that cruise lines are required to follow.

Florida sued the C.D.C., arguing that the health agency had overstepped its authority in setting those standards. In June, a federal judge temporarily blocked the agency from enforcing the rules in the state while the case proceeds. Later that month, Celebrity Cruises, a subsidiary of Royal Caribbean Group, began the first major cruise from a U.S. port since the pandemic began, sailing from Fort Lauderdale, Fla. Norwegian hopes to restart cruises from Miami on Aug. 15.

The industry was devastated by the pandemic, with ridership falling 80 percent last year compared with 2019. The three major cruise companies — Carnival Corp., Royal Caribbean and Norwegian — have lost a combined $900 million each month since March 2020, according to a recent report by Moody’s, the credit rating firm.





Scotland Cautiously Eases Virus Restrictions

On Tuesday, Scotland’s First Minister, Nicola Sturgeon, outlined a careful plan to ease coronavirus restrictions, saying that some rules such as face mask mandates will remain in place.

Scotland will move to level zero from next Monday. We will do so with certain modifications to our original indicative plans. This is intended to ensure that our pace of easing restrictions is sensible in light of the challenge we continue to face from the Delta variant. And I will also confirm that certain mitigations such as the mandatory wearing of face coverings will remain in place not just now, but in all likelihood for some time to come. We had indicated that a gradual return to the office could begin from level zero. But given the current situation, we intend to postpone this until we move beyond level zero, which we still hope will be on the 9th of August. And on the issue of mandating mitigations like face coverings, let me just say this. It is my view that if government believes measures like this matter, and this government does, we should say so, we should do what is necessary to ensure compliance and we should be prepared to take any resulting flak from those who disagree. We shouldn’t lift important restrictions to make our lives easier and then expect the public to take responsibility for doing the right thing in anyway.

On Tuesday, Scotland’s First Minister, Nicola Sturgeon, outlined a careful plan to ease coronavirus restrictions, saying that some rules such as face mask mandates will remain in place.CreditCredit…Andrew Milligan/Reuters

LONDON — The day after Prime Minister Boris Johnson set England on course for “freedom day” next week, Scotland’s First Minister, Nicola Sturgeon, on Tuesday outlined more cautious plans to relax coronavirus rules and said face masks would still be required for “some time to come.”

While England embarks on a wholesale lifting of its remaining restrictions on Monday, people in Scotland will still be urged to work from home, face restrictions on the size of gatherings and be obliged to wear face coverings in indoor spaces, including public transportation.

Throughout the pandemic Ms. Sturgeon has taken a more cautious approach than Mr. Johnson, prioritizing heath over the economy and invariably adopting tougher restrictions, and her announcement on Tuesday was no exception.

“A gradual approach stands the best chance of minimizing further health harm and loss of life,” Ms. Sturgeon told a virtual meeting of the Scottish Parliament, adding that “because a gradual approach stands the best chance of being a sustainable approach it will be better in the long term for the economy as well.”

The difference was most stark on the issue of face coverings which, she said, would remain mandatory in Scotland “not just now, but in all likelihood, for some time to come.”

On Monday Mr. Johnson said that rules requiring masks would be scrapped in England, but that the government would recommend their use in crowded indoor places such as public transportation. Even that was a change in tone from Mr. Johnson and some of his ministers who had previously appeared more enthusiastic about ending the use of face coverings. And tabloid newspapers have campaigned for the end of restrictions, a moment they have anticipated as “freedom day.”

In a thinly veiled attack on Mr. Johnson’s policy on masks, Ms. Sturgeon said that “if a government believes that measures like this matter — and this government does — we should say so, we should do what is necessary to ensure compliance and we should be prepared to take any resulting flak.”

She added, pointedly: “We shouldn’t lift important restrictions to make our lives easier and then expect the public to take responsibility for doing the right thing anyway.”

Despite the caveats, Ms. Sturgeon said that infections in Scotland were falling sufficiently to allow all Scottish regions to move to the lowest tier of restrictions, known as Level 0, from Monday. This means that all shops, pubs, restaurants and other venues can open, except for nightclubs and adult entertainment. However, some social distancing rules will remain and hospitality venues will have to close at midnight.

If the data continues to improve, a further relaxation of restrictions will be made in August.

Scotland recorded 2,529 daily cases according to the latest figures, a reduction in the numbers after a rapid rise at the beginning of the month.

Mr. Johnson believes the vaccine rollout is weakening the link between infections and hospital admissions, and Ms. Sturgeon expressed some relief that the National Health Service seemed to be under less strain than at other points during the pandemic. Still, she said that the system could face pressure if the case numbers were to rise. In Scotland, virtually all those over 60 years old have been fully vaccinated, including 96 percent of those aged 55 to 59, she said.

“Lifting all restrictions and mitigations right now would put all of us at greater risk,” Ms. Sturgeon added, “but in particular it would make it much more difficult for the most clinically vulnerable to go about their normal life.”

However Douglas Ross, leader of the Scottish Conservatives, Scotland’s opposition party, said that the sacrifices made by the public were not being fully rewarded and that “the balance has to tilt further in favor of moving forward.”

California will require students to wear masks for the upcoming school year, while leaving enforcement up to individual schools.Credit…Jae C. Hong/Associated Press

The Centers for Disease Control and Prevention issued new school guidance on Friday, calling for a full return to classrooms in the fall and recommending that masks be optional for fully vaccinated students and staff.

But the guidance left a lot of details up to state and local governments, advising districts to use local coronavirus data to guide decisions about when to tighten or relax prevention measures like masking and physical distancing. It also recommended that unvaccinated students and staff members keep wearing masks.

In New York City, the nation’s largest public school district, Mayor Bill de Blasio said on Monday that masks will still be required for everyone in the upcoming school year, though he added that officials would continue to evaluate the decision.

“For now, assume we’re wearing masks, but that could change as we get closer,” Mr. de Blasio said at a news conference. “But we’ll be driven by, you know, the data we see and, and the science as always.”

California also announced that it will continue requiring masks in public schools, a policy that has been in place since February and was reiterated in newly issued guidance released on Monday for K-12 public schools.

But on Monday, California officials briefly went a step further when it was announced that “schools must exclude students from campus if they are not exempt from wearing a face covering under California Dept. of Public Health guidelines and refuse to wear one provided by the school.”

The announcement created confusion about whether it marked a change in how mask rules would be enforced in schools and what the state’s role might be in that enforcement, the state’s health and human services secretary, Mark Ghaly, said in an interview.

Within hours, that language was removed, and updated guidelines were released again, omitting the reference that schools “must exclude” students who refuse to wear masks.

Mr. Ghaly said masks will continue to be required in school settings, but how that mandate will be enforced will be up to schools’ own discretion, a continuation of a policy from the previous academic year.

“I think the most important thing to say is that California is starting the school year with all of our students masked,” Mr. Ghaly said.

Health officials will continue to monitor data and revisit whether to ease or maintain its mask mandate in schools no later than Nov. 1, he said.

The topic of school closures and reopenings has been particularly contentious since the onset of the pandemic, and advising districts has been a pervasive challenge for the C.D.C.

On Friday, the C.D.C. issued guidance urging schools to fully reopen in the fall and called on local districts to use local coronavirus data as guidance for public health measures.

The agency continues to recommend three feet of social distancing in classrooms, but in a departure from previous guidance, it says that schools can also combine other strategies, like indoor masking, testing and enhanced ventilation, if such spacing would prevent schools from fully reopening.

In another shift, masks are not mandatory for those who are fully vaccinated, according to the new guidelines. The C.D.C. continues to recommend masks for those who are not vaccinated, mirroring guidance for the general public.

In California and in New York City, average daily cases have increased in recent weeks, driven largely by the Delta variant, now the dominant strain in the country. But the overall number of cases remains low, and epidemiologists have said it was unlikely that the Delta variant would prove anywhere near as devastating as the past two waves of Covid-19.

Immigrants arriving at the border in May. Fewer than 20 percent of detainees passing through ICE facilities have received at least one dose of vaccine while in custody.Credit…Ringo Chiu/Agence France-Presse — Getty Images

In an effort to increase vaccination rates at detention centers, the Department of Homeland Security has begun administering Johnson & Johnson vaccines to people being held in Immigration and Customs Enforcement lockups.

The department said it has received 10,000 doses of the Covid vaccine, with more expected in the future.

“DHS remains committed to a public health-guided, evidence-based approach to vaccine education that ensures those in our care and custody can make an informed choice during this global pandemic,” the agency said in a statement.

The new push to scale up vaccine distribution comes after the agency has drawn criticism for its previous efforts. As of May, according to ICE’s latest available data, only about 20 percent of detainees passing through its facilities had received at least one dose of vaccine while in custody.

Since testing for the virus began at ICE facilities in 2020, more than 19,000 detainees have tested positive, according to the agency.

On July 11, there were 906 detained immigrants at ICE facilities who had tested positive for the coronavirus and were being monitored or under isolation. Those positive cases were out of about 27,000 detainees, according to ICE.

Lagging vaccination rates have been an issue not only at ICE facilities, but also at prisons, jails and detention centers across the United States, which have seen some of the worst outbreaks in the country.

Throughout the pandemic, prison inmates have been more than three times as likely as other Americans to become infected, according to a New York Times database, which indicates that the virus has killed prisoners at higher rates than the general population.

In May, the American Civil Liberties Union wrote to the homeland security secretary, Alejandro Mayorkas, calling for detained immigrants to have access to Covid vaccines.

“ICE’s failure to ensure a coordinated strategy for vaccination continues to endanger people in detention nationwide,” the A.C.L.U. said in its letter.

VideoVideo player loadingAt least 64 people were killed when the new coronavirus isolation ward at al-Hussein Teaching Hospital in Nasiriya, Iraq, caught fire. It was not immediately clear what had caused the fire.CreditCredit…Khalid Mohammed/Associated Press

BAGHDAD — The death toll at a southern Iraqi hospital treating Covid patients rose to at least 92 people on Tuesday, as witnesses described chaotic scenes of volunteers desperately trying to pry open a padlocked front door, malfunctioning fire extinguishers, and fire trucks running out of water as the ward burned.

The fast-spreading blaze tore through the new isolation ward at the Imam Hussein Teaching Hospital in the city of Nasiriya late Monday night into early Tuesday. It was the second such tragedy in the country in less than three months, after a similar fire broke out in April in a Baghdad coronavirus hospital and killed at least 82 people.

“Most of the patients were breathing through ventilators and unable to move,” said Dr. Aws Adel, a health official for the province of Dhi Qar which includes Nasiriya. “Most of the hospital staff were able to escape.”

The lack of precautions at the hospital, the speed at which the fire spread, and the feeble ability to fight it reflected a country in deep crisis after years of corruption and government mismanagement have left basic government services barely functioning.

The fire was sparked by an electrical short in a ventilator that resulted in oxygen canisters exploding, said Brig. Gen. Fouad Kareem Abdullah, a provincial police spokesman.

The Iraqi civil defense chief, Maj. Gen. Kathem Bohan, said the building that housed the three-month-old coronavirus isolation ward next to the main hospital had been constructed from flammable materials. The roof appeared to have melted along with sandwich board panels with foam cores that made up much of the construction. Other officials have said oxygen is stored haphazardly at almost all Iraqi hospitals.

Provincial health officials said that around 70 patients and at least as many of their relatives were in the ward when the fire broke out. While normal coronavirus precautions ban visitors from isolation wards, a lack of nursing and other hospital staff in Iraq mean that patients rely on family members to take care of them.

Iraq is in the midst of a third wave of coronavirus infections. Last week, the country reached a high of 9,000 new cases a day with more than 17,000 dead since the pandemic began, according to the Health Ministry. The infection and death rates are believed to be significantly undercounted because many people believe it is safer to be treated at home.

People wait in line to receive a Covid-19 vaccine in Springfield, Mo.Credit…Nathan Papes/The Springfield News-Leader, via Associated Press

A rise in the coronavirus cases has prompted the city of Springfield, Mo., to cancel this year’s Birthplace of Route 66 Festival, which features musical acts, car shows and other exhibitions.

The two-day festival, which was scheduled for Aug. 13-14, drew 65,000 attendees in 2019 and was expected to draw more than 75,000 this year, said Cora Scott, the city of Springfield’s director of public information and civic engagement.

“Obviously, we are very disappointed. After having to cancel the 2020 festival, we were so looking forward to 2021,” Ms. Scott said in a statement. “With our region’s low vaccination rate against Covid-19, the resulting surge of infections are overwhelming our hospitals and making our community sick. We feel it is just not safe to bring tens of thousands of people from all over the world to this community for any reason.”

The cancellation of the festival comes after Mercy Hospital in Springfield ran out of ventilators earlier this month as a rise in cases drove an increase in hospitalizations.

About 46 percent of Missourians have received at least one Covid vaccine dose, and 40 percent are fully inoculated, according to New York Times data. The state’s vaccination rates lag behind the national average of 56 percent of Americans who have received at least one shot, and 48 percent who are fully vaccinated.

In some parts of Missouri, vaccination rates are even further behind. In Greene County, which includes Springfield, only about 35 percent of residents have been fully vaccinated.

The cancellation of the festival is a blow to Springfield, which like other Missouri cities counts on tourism dollars.

Cases are also up in other tourist cities such as Branson, Mo., which is home to attractions such as Dolly Parton’s Stampede dinner show and the Titanic Museum Attraction.

Infections also appeared to be rising in the counties around the Lake of the Ozarks area, a popular vacation destination. Over Memorial Day weekend 2020, videos of large crowds in the lake region spead on social media and drew sharp criticism from state officials, who urged people who had been in the area to get tested for the virus or quarantine for two weeks.

Low vaccination rates and the spread of the Delta variant have helped fuel the rise in cases and hospitalizations in Missouri. The raised cases prompted the federal government to send a “surge response team” to the state earlier this month.

Under new coronavirus regulations in Seoul, the music played at gyms must be no faster than 120 beats per minute.Credit…Jung Yeon-Je/Agence France-Presse — Getty Images

As South Korea endures its worst wave of the coronavirus yet, government officials rolled out a plan for Seoul on Monday that would limit social gatherings and close nightclubs, some of the routine steps that health officials around the world have taken to limit the spread of the virus.

It also included some not-so-routine restrictions.

Under the regulations, which are in effect through July 25, gyms can remain open, but the treadmills must run no higher than 3.7 miles per hour. And the music played at the gyms must be no faster than 120 beats per minute, roughly the speed of “Call Me Maybe” by Carly Rae Jepsen.

Health officials said the measures were to prevent people from breathing too hard or sweating on other people. But gym-goers, epidemiologists and other observers were confused by the specific guidelines.

Dr. Kim Woo-joo, an infectious disease specialist at Korea University Guro Hospital in Seoul, said the gym policies were “absurd” and “ineffective.”

“I wish people would listen to the experts,” Dr. Kim said.

Other songs around 120 beats per minute include “Born in the U.S.A.” by Bruce Springsteen, “Bad Romance” by Lady Gaga, “Respect” by Aretha Franklin and, appropriately, “The New Workout Plan” by Kanye West. (In K-pop terms, “Boombayah” by Blackpink comes in just over the line at 123 beats per minute, while the BTS hit “Boy With Luv” is barely permissible at 120.)

A standard walking pace is a bit more than three miles per hour, putting 3.7 at roughly the speed one might move if someone else were holding a door open ahead.

The restrictions are meant to battle a wave of virus cases that has alarmed many in South Korea, which had succeeded at maintaining low levels of infections throughout the pandemic but is now contending with the Delta variant and a flagging vaccination drive. Just 11 percent of the population is fully vaccinated, with 30 percent having had one dose, and appointments have been halted because of a lack of vaccine supply.

Dr. Michelle Fiscus, Tennessee’s medical director for immunization programs, was fired for suggesting some teenagers might be eligible for vaccinations without their parents’ consent.Credit…William DeShazer for The New York Times

First came public service ads alerting teenagers in Tennessee that they were eligible to get vaccinated for Covid-19. Then, the state’s top immunization leader, Dr. Michelle Fiscus, distributed a memo that suggested some teenagers might be eligible for vaccinations without their parents’ consent.

By this week, Dr. Fiscus said she was fired — a circumstance she attributed to pushback among Republican lawmakers in the state, who have complained that the Tennessee Department of Health had gone too far in its efforts to raise awareness of the shot among young people.

Dr. Fiscus, the health department’s medical director for vaccine-preventable diseases and immunization programs, is one of scores of public health officials across the United States who have quit or been forced from their jobs in a pandemic that was unlike anything they had tackled before and in a political climate that has grown increasingly split over the coronavirus and the vaccines.

A review published in December by Kaiser Health News and The Associated Press found that at least 181 state and local public health leaders in 38 states had resigned, retired or been fired since April 1, 2020.

“It’s just a huge symptom of just how toxic the whole political landscape has become,” Dr. Fiscus said in an interview on Tuesday. “This virus is apolitical — it doesn’t care who you are or where you live or which president you preferred.”

The Tennessean, the Nashville newspaper that earlier reported Dr. Fiscus’s dismissal, also reported on Tuesday that the health department was pulling back its vaccination outreach efforts to children for all diseases — not just the coronavirus — amid the backlash from lawmakers.

The tumult comes as virus cases are rising in Tennessee, as vaccinations have slowed, and as concerns about the Delta variant are emerging in parts of the country.

Campaigns to raise awareness about the vaccines have not resonated in parts of Tennessee, where a hesitance has hardened especially among white, rural conservatives, Dr. Fiscus said. “It seems like there’s nothing that we can do to to get the message through,” she said.

Jan Hoffman contributed reporting.

The pandemic and a hiring freeze have led to a shortage of train operators, conductors and workers in New York City, forcing thousands of subway trips to be canceled.Credit…Gabriela Bhaskar/The New York Times

Thousands of subway trips in New York City have been canceled in recent weeks because the pandemic and a related hiring freeze have battered the work force and left a shortage of train operators, conductors and workers.

And with fewer trains, many passengers on the largest transit system in North America have seen their commutes become less reliable and take noticeably longer. Nearly 11,000 trips were eliminated last month alone.

The Metropolitan Transportation Authority, which operates the city’s subway and buses, expanded an existing hiring freeze in the early days of the pandemic to include operations workers like train operators. The agency made the move as it faced financial calamity, after more than 90 percent of subway riders disappeared and critical revenue vanished.

It was the first time the agency had included such workers in a hiring freeze. Since then, the work force has been whittled down by scores of retirements prompted in part by worries over the coronavirus, job changes and the deadly outbreak, which has killed at least 168 workers.

Though the hiring freeze was lifted for operations workers in February, after $14.5 billion in expected federal pandemic relief stabilized the agency’s finances, officials said it would take time to hire and train new workers, including up to nine months for train operators.

Until then, canceled train trips will likely continue. That will mean longer waits for trains for months to come, even as public schools fully reopen after Labor Day and many companies welcome back office workers for the first time since the pandemic shut down the city last March.

Jill Biden will travel to Japan for the opening ceremony of the Summer Olympics, which will be her first solo trip abroad as first lady.Credit…Scott McIntyre for The New York Times

Jill Biden, the first lady, will travel to Japan next week to attend the opening ceremony of the Summer Olympics in Tokyo, scheduled for July 23, her office said on Tuesday.

It will be the first solo trip abroad for Dr. Biden, whose traveling schedule currently outpaces her husband’s. Dr. Biden has been a frequent traveler in service of promoting the Biden administration’s coronavirus vaccine efforts domestically, and her appearance in Tokyo comes as the host city extended a state of emergency in response to a spike in coronavirus cases.

Officials have barred spectators from most of the events and urged residents to watch the proceedings on television at home. The declaration of the state of emergency disrupted carefully laid plans to revive the Games, which have already been delayed a year because of the pandemic.

Mr. Biden will not attend the Games, but he has voiced his support for them to the country’s prime minister, Yoshihide Suga. During an April visit to the White House, Mr. Suga told reporters that Mr. Biden “once again expressed his support” to host the events.

Jen Psaki, the White House press secretary, told reporters last month that the White House would send a delegation from the United States, “but we will continue to also convey the public health guidelines and guidance that we’ve been delivering out there about only essential travel.”

The first lady will not have to quarantine in order to attend the games, according to Michael LaRosa, her press secretary.

“She will not be quarantining before the games as there are very specific entry and movement rules, testing, and procedures for the delegation which the government of Japan and organizers have laid out in order to ensure the protection of everyone involved,” he said in an email. “She is following White House and C.D.C. guidance upon return, which as you know, does not include quarantine for vaccinated individuals.”

The East Wing did not have further information about what the first lady would be doing while in Tokyo, and administration officials said the White House was still in negotiations with the Japanese over how much access she and her delegation would have to the Games.

global roundup

A vaccination site in Lyon, France, last week. The Delta variant of the coronavirus now accounts for half of new infections in the country.Credit…Laurent Cipriani/Associated Press

More than 1.3 million people in France were reported to have booked appointments for coronavirus shots within hours of President Emmanuel Macron’s announcement of new vaccination requirements as the authorities scrambled to fend off a rise in infections driven by the Delta variant.

The surge in registrations, reflected in data provided by Doctolib, a widely-used private online booking platform, represents nearly 2 percent of France’s population. It comes after Mr. Macron said on Monday that inoculation would be made mandatory for health care workers and that proof of immunization or a recent negative test would soon be required to enter restaurants and cultural venues.

With the fast-spreading Delta variant taking hold, however, it was uncertain whether the measures would be enough to avoid a fourth wave of the virus in France. Delta already accounts for about half of new infections in the country.

Mr. Macron’s announcement came just three days after nightclubs reopened for the first time in 16 months, which many believed had symbolically signaled the completion of France’s protracted efforts to emerge from the pandemic. But the new measures dashed hopes of a return to a prepandemic normal and of a smooth summer vacation season.

In his televised address, Mr. Macron spoke of “a strong resurgence of the epidemic” that would require France to redouble use of “a key asset”: vaccines.

He announced that he wanted to pass a law that would require all health workers to get vaccinated by Sept. 15 and that the goal was now to “put restrictions on the unvaccinated rather than on everyone.”

The law is likely to pass this summer as most political parties are in favor of mandatory vaccinations for health care workers.

The government aims to get two-thirds of people fully protected by the end of August, but public demand has dwindled in recent weeks because of vaccine hesitancy and a growing sense among many people that the virus is no longer a threat.

On Monday, Mr. Macron stopped short of making vaccinations obligatory but added that such an option may be considered, “depending on the evolution of the situation.”

In other news from around the world:

  • Doctors in Britain have warned that Prime Minister Boris Johnson’s plan to lift almost all of England’s coronavirus-related restrictions starting July 19 could have “potentially devastating consequences” as the Delta variant spreads. Dr. Chaand Nagpaul, a senior figure in the British Medical Association, said that the government’s decision was “irresponsible” and would lead to increased infection rates and hospitalizations. And a special envoy on Covid-19 for the World Health Organization, Dr. David Nabarro, told the BBC on Tuesday that the pandemic was “advancing ferociously around the world” and that it was “too early to be talking about massive relaxation or freedom.”

Léontine Gallois contributed reporting.