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.
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.”
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 shape public health measures.
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 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 press 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.
Earlier this month, the C.D.C. issued guidance urging schools to fully re-open 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 re-opening.
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.
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.
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.
NASHVILLE — Across the United States, public health officials have left their jobs, strained by a pandemic unlike anything they had confronted before, then tested further as the coronavirus and vaccines became entangled in politics and disinformation.
In Tennessee, the state’s top immunization official, Michelle Fiscus, said this week that she was forced from her job after writing a memo describing a 34-year-old legal doctrine that suggested that some teenagers might get vaccines without their parents’ permission. Dr. Fiscus’s memo came as conservative lawmakers in the state were lashing out at efforts by her agency to raise awareness of vaccines among teenagers.
One Republican lawmaker, Scott Cepicky, accused the agency of employing “peer pressure” to prod young people into getting immunized.
In a lengthy and searing statement describing her departure, Dr. Fiscus said that the actions of lawmakers have gravely endangered the public by undermining confidence in the vaccines even as virus cases are rising in Tennessee and as concerns about the Delta variant are emerging in parts of the country.
“I am not a political operative, I am a physician who was, until today, charged with protecting the people of Tennessee, including its children, against preventable diseases like Covid-19,” Dr. Fiscus wrote. Her firing was reported by The Tennessean.
A spokesman for the Tennessee Department of Health declined on Tuesday to comment on the dismissal of Dr. Fiscus, the agency’s medical director for vaccine-preventable diseases and immunization programs, saying the agency could not discuss personnel matters.
Tennessee is among the states where the virus has gained ground as vaccination efforts have sputtered, leaving public health officials to grapple with the political resistance and false information about the safety of the shots.
In her statement, Dr. Fiscus, who had been a pediatrician with a practice in the Nashville suburbs before joining the health department, said that her dismissal reflected the challenging climate for public health officials, who typically had low profiles before the pandemic but were suddenly thrust into the spotlight of a complicated and politically rancorous situation.
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, 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 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.
Last summer, as Major League Baseball reeled from coronavirus outbreaks and canceled games, its analog in South Korea became a poster child of how to successfully hold spectator sports in a pandemic.
Now the roles are reversed. As M.L.B. prepared to hold its All-Star Game, canceled last year, in front of a capacity crowd in Denver, the Korea Baseball Organization suspended its season on Monday after five players tested positive for the coronavirus.
The news from South Korea is another sign of backsliding in the Asia Pacific region, where vaccination rates are relatively low, the Delta variant is surging and several countries are reimposing lockdowns.
A year ago, American baseball fans and broadcasters looked to Asia, where the virus was largely under control, to fill a programming void. As dozens of M.L.B. players and staff members were infected and its season delayed by nearly four months, K.B.O. opened its season last May, with live coverage on ESPN, cardboard cutouts in the stands and actual cheerleaders dancing to K-pop anthems. Pro baseball leagues in Taiwan and Japan also started their seasons.
K.B.O. teams played most of last season in empty stadiums, but this year they have been allowed to welcome back some fans. In and around Seoul, the percentage of fans allowed back started at 10 percent and rose to 30 percent last month.
As late as November, no major outbreaks had been traced to K.B.O. stadiums in South Korea, the league’s secretary general, Ryu Dae Hwan, told Bloomberg News at the time. But the league would be vulnerable, he warned, if the national caseload rose.
Now, cases in South Korea have surged to their highest levels of the pandemic. On Tuesday, the country recorded more than 1,000 new infections for the seventh straight day. More than 40 percent of them were in the Seoul area, and health officials estimated that about a quarter were driven by the Delta variant.
Health officials have warned that, by mid-August, the daily infection rate could double from its current level. The rate — 2.1 infections per 100,000 people — is about a third of what the United States is recording, according to a New York Times database. But because only about 11 percent of South Korea’s population has been fully vaccinated, compared with 48 percent in the U.S., people there are more vulnerable to severe infection and hospitalization.
The rise in cases has prompted a scramble for shots. On Tuesday, the Korea Disease Control and Prevention Agency said that it had paused vaccination appointments for more than 1.6 million people ages 55 to 59 for one week because available doses had been exhausted, Reuters reported.
After calling off two games last week, K.B.O. suspended its season indefinitely on Monday, just as the government tightened movement and gathering restrictions in Seoul and nearby regions to their severest levels yet. The season will be on hold until at least Aug. 9. Only a week of games has been officially canceled so far because the league had always planned to take a three-week break for the Summer Olympics.
Fans in South Korea expressed exasperation with the league’s decision. Others criticized the two teams that reported the infections, the NC Dinos of Changwon and the Doosan Bears of Seoul. (The former beat the latter last fall, live on ESPN, to win last year’s K.B.O. championship.)
The league has a 44-page manual of Covid protocols, including requirements that players must sanitize their hands before and after taking the field or entering a locker room. They are also advised to sit in a zigzag pattern if they eat at restaurants as a way of limiting airborne transmission of the virus.
In a statement, the Doosan Bears apologized to its fans and league officials for the cases among its players, and promised to be “even more thorough in the future.”
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.
After Mr. Macron’s announcement, the French health minister, Olivier Véran, said on television, “Starting Sept. 15, if you are a health care worker and you’re not vaccinated, you won’t be able to work and you won’t be paid.”
Starting July 21, anyone entering a cultural venue or an amusement park will also need to show proof of vaccination or a recent negative test for the virus. The requirement will be extended in August to restaurants, shopping centers, hospitals, retirement homes and long-distance transportation.
France will also start charging money for some virus tests, which until now were free, “to encourage vaccination rather than increased testing,” Mr. Macron said.
The new restrictions could tarnish vacation plans for teenagers who have only been eligible for vaccination since mid-June, but who will also be subjected to the new rules in restaurants and other venues. Gabriel Attal, the government’s spokesman said the authorities would seek to make the restrictions flexible. “It is out of the question to impose a hellish summer” on young people, he said on Tuesday.
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.
Australians have lashed out at the government after the release of a graphic advertising video that depicts a woman with severe symptoms of Covid-19, arguing that it unfairly blames younger people, most of whom are ineligible for vaccination.
The campaign, released on Sunday and aimed at encouraging Australians to get vaccinated, depicts a sweating woman lying in a hospital bed gasping for air. Her eyes are desperate. She claws at the breathing tube in her nose. “Covid-19 can affect anyone,” reads the text that follows. “Stay home. Get tested. Book your vaccination.”
The advertisement first aired in Sydney, a city of more than five million people that is battling a ballooning outbreak of the Delta variant of the coronavirus. On Tuesday, the authorities reported 89 new cases and Australia’s second death from the virus this year as concerns continue over a slow vaccine rollout.
Only about 9 percent of Australia’s population is fully inoculated, according to New York Times data, and those younger than 40 can only receive the AstraZeneca shot after getting clearance from a doctor. The majority are not eligible for the Pfizer vaccine, the only other vaccine authorized for use in Australia.
“Is the new Covid ad satire?” tweeted Emma Husar, a former member of Australia’s opposition Labor party, adding that the government had given Australians conflicted advice and failed to order sufficient doses.
Dan Ilic, an Australian comedian, parodied the ad by adding a voice-over suggesting that the woman in the video was 39, and therefore months away from being eligible for a Pfizer vaccine. “Turn 40 sooner,” he said.
Australian officials defended the campaign, which they said was intended to be shocking. “It is quite graphic, and it’s meant to be graphic,” the country’s chief medical officer, Paul Kelly, told reporters on Sunday.
“It is meant to really push that message home that this is important.”