JERUSALEM — Israel on Sunday introduced new rules for determining coronavirus vaccination status, making a booster shot a requirement for full inoculation and vaccination passports.
After pioneering booster shots for everyone 12 and older, Israel is believed to be the first country to condition the validity of vaccination passports on having received a booster.
The country said it would soon cancel the vaccination passports of more than a million people, mainly those who are eligible for, but have not yet received, a third vaccination shot.
To be considered fully vaccinated in Israel people must meet one of the following criteria: be 12 or older and have received a booster shot at least a week ago; be within six months of having received a second vaccination shot; or be within six months of having tested positive for Covid-19.
The booster shots are Pfizer vaccinations, by far the most commonly administered in Israel.
In Israel, a Green Pass — a digital or paper vaccination certificate — is required for entry to public spaces, including restaurants, hotels, clubs, cultural venues and large private gatherings. Unvaccinated people can only gain entry with a proof of a negative rapid test carried out at an authorized test station, which is valid for 24 hours, or a negative PCR test valid for 72 hours.
The change in policy came after Israeli health officials and experts identified a significant waning of immunity in people five or six months after their second Pfizer dose and after studies indicated the effectiveness of the booster shot in preventing severe disease as Israel battled a fourth wave brought on by the highly infectious Delta variant this summer.
There are signs that the fourth wave is being contained. The daily average of infections has dropped by about 54 percent over the last two weeks and the number of severe cases among the hospitalized is decreasing.
“Now is the time to be strict about the Green Pass, be cautious and not become complacent,” Prime Minister Naftali Bennett of Israel said late Saturday. An early advocate of the third dose, Mr. Bennett said it saved lives and allowed the economy to remain open.
Israel initially led the world with its rapid vaccine rollout and, with a population of just over 9 million, is one of the most vaccinated societies. Since the government made boosters available in August, starting with older age groups, and quickly expanding to the younger ones, more than 3.4 million people have received a third dose. People who recovered from Covid-19 more than six months ago are now required to get at least one shot.
Demand for a third dose increased in recent days as the deadline for the validity of people’s vaccination passports approached. A rush of people trying to download a new Green Pass caused the Health Ministry’s phone application to crash temporarily on Sunday, so the ministry announced that expired Green Passes would remain valid for a few more days.
Singapore has vaccinated the majority of its population, yet in recent days it has still experienced a record surge in new Covid-19 cases.
Coronavirus infections in the Southeast Asian city-state rose to new highs in the past week, with 2,909 new infections reported on Friday, the largest number of daily cases since the pandemic began, the Ministry of Health said in a statement Saturday.
But officials urged residents to remain calm, because more than 98 percent of the newly reported cases have been mild or asymptomatic and can therefore be treated at home. One reason for the mild cases is that Singapore has vaccinated 82 percent of its eligible population, dramatically reducing instances of severe illness, officials said.
“We have already said because of our high vaccination rate we are no longer focusing solely on headline numbers,” the minister of finance, Lawrence Wong, said at the news conference on Saturday morning with other officials. “Our focus is on the people who are seriously ill and to make sure that our health care system is able to take care of them.”
About 2 percent of the new cases have required hospitalization, the Health Ministry said. On Friday, there were 1,356 people being treated in hospitals. Of those, 222 required oxygen and 34 were in intensive care.
Officials offered no explanation for what was driving the surge, which has cases doubling every 10 days. Singaporeans and migrant workers in the country are subjected to routine testing, which catches many asymptomatic cases. It remained unclear how many of the newly reported cases were breakthrough infections in vaccinated people.
Health officials estimated that the city-state will surpass 3,200 daily cases soon and may even start to see as many as 5,000 cases a day around mid-October.
In migrant dormitories, once a hot spot for Singapore’s previous surges, an average of 500 positive cases a day have been reported recently, said Tan See Leng, the minister of manpower. A great share of those cases have been asymptomatic, however, and 90 percent of the workers in dormitories have been vaccinated.
Still, Kenneth Mak, the director of medical services at the Ministry of Health, predicted that hospitals are likely to be overwhelmed this month, primarily by unvaccinated patients over 60. He said the unvaccinated population is 14 times more likely to have severe symptoms from Covid-19.
To curb the rise in new cases, the Ministry of Health has implemented tighter restrictions on social distancing and social gatherings. The new rules limit gatherings to two people and include a default policy of working from home.
Singapore will also continue to impose severe restrictions on hundreds of thousands of migrant workers, who have been forced to live in isolation when not working since the pandemic began.
Other new protocols being implemented are aimed at adding resources and staffing at hospitals. The health minister, Ong Ye Kung, said the country faces a shortage of hospital beds because doctors too often admit patients for close observation even though they do not require serious care.
Mr. Kung said the Health Ministry will increase to 3,700 the total number of beds for coronavirus patients at hospitals and so-called Covid Treatment Facilities. The ministry is also looking to open up more such treatment facilities and has recommended that vaccinated citizens with Covid-19 take care of themselves at home to unburden hospitals.
As the United States passed the milestone of 700,000 Covid-19 deaths on Friday, it was not lost on public health officials that many of the recent deaths could have been avoided had more Americans chosen to be vaccinated.
The majority of 100,000 Americans who died in the last three and a half months were unvaccinated even though vaccines were plentiful and available to all adults. The three vaccines in use in the United States have been shown to reduce the risk of hospitalization and death. On Saturday, President Biden issued a statement saying “the astonishing death toll is yet another reminder of just how important it is to get vaccinated.”
“Hundreds of thousands of families have been spared the unbearable loss that too many Americans have already endured during this pandemic,” Mr. Biden said. “If you haven’t already, please get vaccinated. It can save your life and the lives of those you love. It will help us beat Covid-19 and move forward, together, as one nation.”
About 76 percent of people in the United States who are eligible to be vaccinated have gotten at least one dose and 65 percent are fully vaccinated, according to The New York Times. The C.D.C. also reported that about 4.7 million fully vaccinated people have received an additional vaccine dose since Aug. 13, the day after the F.D.A. opened up eligibility for third shots for some people with weakened immune systems.
Nearly all of United Airlines’ 67,000 employees in the U.S. have been vaccinated against Covid-19 after one of the largest and most significant corporate inoculation campaigns in the United States.
The push came out of sheer frustration with the deadly consequences of the disease, Scott Kirby, chief executive of United Airlines, told The Times on Thursday.
Mr. Kirby said he reached a breaking point over the summer, after finding out that a 57-year-old United pilot had died after contracting the coronavirus. “We concluded enough is enough,” he said. “People are dying, and we can do something to stop that with United Airlines.”
At the time, Mr. Kirby estimated that about 70 percent of the airline’s workers were vaccinated. To raise that level, the company announced a vaccine mandate in early August and offered incentives, like extra pay or vacation days for compliance. United also reached out to the labor unions representing its workers. Still, some employees have resisted, and the company is weighing stricter measures.
About 2,000 employees have applied for medical or religious exemptions, though their fate remains unclear as United fights a lawsuit over its plan to place them on temporary leave. A few hundred more failed to comply with the mandate and could be fired in coming weeks.
The airline earned praise from President Biden, who in early September announced that all U.S. businesses with 100 or more workers would have to require vaccinations or weekly testing.
American Airlines, Alaska Airlines and JetBlue have since issued vaccine mandates, citing the requirements from the Biden administration. In late August, Delta said it would charge its unvaccinated employees an additional $200 per month for health insurance.
Alaska is confronting the nation’s worst outbreak of the coronavirus, with new infections coming off a recent peak and hospitalizations still surging upward, even though the state’s natural isolation had largely shielded its population through previous waves.
Nearly two years after the virus began circulating in the United States, the country’s northernmost state is now coping with a crisis that brings to mind the darkest early day of the pandemic, with testing supplies depleted, patients treated in hallways and doctors rationing oxygen. With emergency rooms overwhelmed, the governor has asked hundreds of medical workers to fly in from around the country to help.
“We are taxed to a point of making decisions of who will and who will not live,” said Dr. Steven Floerchinger, a doctor at Providence Alaska Medical Center in Anchorage, the state’s largest hospital.
Even so, political opposition to measures aimed at curbing the virus remains strong, and some pockets of the state are wary of getting vaccinated.
Gov. Mike Dunleavy, a Republican, has avoided endorsing a mask mandate or other restrictions to curtail the virus. Doctors and nurses who spoke before the Anchorage Assembly, as it considered a mask mandate this week, were jeered and badgered by opponents of pandemic restrictions. The debate was scheduled to continue for a fourth day on Monday.
While much of the nation’s hospital system is stressed, it’s easier in the lower 48 contiguous states to transfer patients to medical facilities in neighboring cities or across state lines.
Some hospitals in Alaska are operating under “crisis standards of care” that allow them to ration health care to attend to the neediest patients or share limited resources among those in their hospital beds.
That means doctors in some places have had to make difficult triage decisions. When Providence Alaska Medical Center was hit with a deluge of coronavirus patients on a recent night, doctors had to decide whether the last spot in the intensive care unit should go to one of the Covid patients in the emergency room or to someone from an isolated town who needed to be flown in for emergency surgery.
Dr. Floerchinger gathered with his colleagues for an agonizing discussion. They had a better chance of saving one of the patients in the emergency room, they determined. The other person would have to wait.
That patient died. “This is gut-wrenching, and I never thought I’d see it,” Dr. Floerchinger said.