Editor’s note: This is a live account of COVID-19 updates from Thursday, May 20, as the day unfolded. It is no longer being updated. Click here to see all the most recent news about the pandemic, and click here to find additional resources.

Tension over conflicting mask guidelines continues throughout the country, hitting the House chamber this week as Republicans rebelled against the requirement that they wear masks on the House floor.

In Washington, state health officials haven’t yet offered much clarity since new federal guidance was announced last week, and instead are advising residents to respect each other, avoid shaming people who want to keep their masks and not to game the system amid this moment of transition. Further guidelines should be released by the end of the week, state Secretary of Health Dr. Umair Shah said Wednesday.

Meanwhile, many Seattle businesses are keeping their mask requirements in place until they’ve been given more guidance.

We’re updating this page with the latest news about the COVID-19 pandemic and its effects on the Seattle area, the U.S. and the world. Click here to see the previous days’ live updates and all our other coronavirus coverage, and here, to see how we track the daily spread across Washington and the world.

‘Like hell:’ As Olympics loom, Japan health care in turmoil

TOKYO — As she struggled to breathe, Shizue Akita had to wait more than six hours while paramedics searched for a hospital in Osaka that would treat her worsening COVID-19.

When she finally got to one that wasn’t overwhelmed with other patients, doctors diagnosed severe pneumonia and organ failure and sedated her. Akita, 87, was dead two weeks later.

“Osaka’s medical systems have collapsed,” said her son, Kazuyuki Akita. He has watched from his home north of Tokyo as three other family members in Osaka have dealt with the virus, and with inadequate health care. “It’s like hell.”

Hospitals in Osaka, Japan’s third-biggest city and only 2 1/2 hours by bullet train from Summer Olympics host Tokyo, are overflowing with coronavirus patients. About 35,000 people nationwide — twice the number of those in hospitals — must stay at home with the disease, often becoming seriously ill and sometimes dying before they can get medical care.

As cases surge in Osaka, medical workers say that every corner of the system has been slowed, stretched and burdened. And it’s happening in other parts of the country, too.

—Associated Press

Artist publishes 100 drawings from Peru’s COVID-19 pandemic

LIMA, Peru — With a pencil and a notebook, artist Edilberto Jiménez walks the streets of Lima and cities in the Andes mountains collecting stories and images about the coronavirus health crisis that has devastated Peru.

Later, in his workshop, he completes the scenes while reading newspapers or watching television news about the pandemic that has killed tens of thousands of people in his South American homeland.

“It’s like a war with an invisible enemy,” Jiménez says of COVID-19.

“Each drawing tells a story that had an impact on me,” says the artist, who drew 750 sketches and selected 100 of them for a book called “New Coronavirus and Good Government.”

His title plays off that of another book — “New Chronicle and Good Government,” a 1615 work by Felipe Guamán Poma de Ayala containing 400 drawings and 1,200 pages recounting the suffering of Indigenous peoples at the hands of the Spaniards.

The 56-year-old artist in 2005 published another book of drawings and testimonies of the survivors of the internal war between Shining Path rebels and Peruvian security forces in Oreja de Perro, an area in Ayacucho province at the heart of a conflict that killed almost 70,000 people.

—Associated Press

Tokyo organizers say Olympics are ‘safe’ — public disagrees

TOKYO — The IOC wraps up its final planning sessions on Friday with Tokyo Olympic organizers, just two months before the games are to open. Much of the focus is on persuading a skeptical public and medical community that the games should go ahead.

“We have much to do over the next three days,” IOC Vice President John Coates said on Wednesday as the sessions began.

The core problem is that 60 to 80% of people in Japan, depending how the question is asked in public opinion polls, don’t want the postponed Olympics to open in the middle of a pandemic despite repeated assurances from organizers that games will be “safe and secure.”

There is no indication so far the games will be canceled. The International Olympic Committee has repeatedly said they are going ahead.

But the IOC’s most senior member Richard Pound, in an interview with Japan’s JiJi Press, said that the final deadline to call it off was still a month away.

—Associated Press

EU agrees on COVID-19 certificates to sweep away barriers on travel among countries

BRUSSELS — European policymakers struck a deal Thursday to sweep away travel barriers among European countries through a digital certificate system, another step toward normalizing global movement after more than a year in which the modern, interconnected world has seemed on pause because of the pandemic.

The agreement seeks to eliminate quarantine requirements for people who can prove they are at low risk of having COVID-19 because they are vaccinated, have recently tested negative for the coronavirus, or have already recovered from the disease. The plan will set up a digital certificate system that policymakers hope will make it easy for travelers to prove their status. It will go into effect July 1, although EU countries will have another six weeks to implement it if they are not ready by then.

The deal — which is primarily focused on travel inside Europe — is separate from an agreement reached Wednesday to reopen Europe’s borders to travelers from outside the bloc. But the goal is to allow all travelers, not just European residents, to connect to the system. The timing of the new system means that vaccinated Americans and others who want to travel to the EU before July 1 may still face quarantine requirements, depending on their destination, even though the official ban on travel from outside the bloc is expected to end Saturday, after it received final approval earlier Thursday.

“This will mark summer 2021. It will make all the difference, and we won’t be repeating the nightmare of summer 2020,” said Juan Fernando López Aguilar, a Spanish lawmaker who helped lead negotiations on behalf of the European Parliament.

—The Washington Post

Ready to fly again? Airfares are rising, middle seats are full and change fees are back

To lure hesitant fliers back onto planes during much of the COVID-19 pandemic, the nation’s struggling airlines waived change fees, freed up middle seats to promote social distancing, extended expiration dates on loyalty reward points and cut airfares.

Now that new U.S. coronavirus cases are dropping and travel restrictions are being lifted, the country’s airlines are starting to act like, well, airlines again.

Air carriers have reintroduced change fees for the least expensive tickets, returned to filling the middle seats and once again imposed expiration dates for many loyalty reward programs. On average, domestic airfares are up 12% from full-year 2020 prices, according to industry data, and are expected to climb by the end of the year to 28% above the full-year 2020 prices.

“During the pandemic, we saw airlines pulling out all the stops to incentivize people to travel,” said Adit Damodaran, an economist at Hopper, an airline and hotel data analysis company. “But I think the times are changing, and we are turning the corner here.”

—Los Angeles Times

Washington state to close 2 mass-vaccination sites for more focused approach

The Washington State Department of Health will be closing two mass-vaccination sites next week in favor of a more targeted approach to vaccinate harder-to-reach populations.

This new phase of vaccine outreach, announced Thursday, is intended to help people across Washington who have faced barriers to the vaccine by expanding the state’s mobile clinics.

“This transition isn’t closing a door to vaccine opportunity but opening several new ones that will allow for more equitable vaccine access in the future,” Secretary of Health Umair Shah said in a news release.

The Ridgefield, Clark County, and Kennewick mass-vaccination sites will close May 28, and the department will transition management of the Wenatchee site to the Chelan-Douglas Health District, DOH said. The Spokane site remains in operation.

Updated information on mass-vaccination sites can be found on the DOH website. Vaccines also can be found through the Vaccine Locator tool.

Read the full story here.

—Amanda Zhou

Washington state health officials confirm 940 new coronavirus cases

The state Department of Health (DOH) reported 940 new coronavirus cases and 17 new deaths on Thursday.

The update brings the state's totals to 425,848 cases and 5,690 deaths, meaning that 1.3% of people diagnosed in Washington have died, according to the DOH. The data is as of 11:59 p.m. Wednesday.

In addition, 23,478 people have been hospitalized in the state due to the virus — 50 new hospitalizations. In King County, the state's most populous, state health officials have confirmed a total of 107,845 COVID-19 diagnoses and 1,555 deaths.

Since vaccinations began in mid-December, the state and health care providers have administered, 6,424,110 doses and 38.23% of Washingtonians have been fully vaccinated against COVID-19, according to vaccination data, which the state updates on Mondays, Wednesdays and Fridays. Providers are currently giving an average of about 46,410 vaccine shots per day.

The DOH says its daily case reports may also include duplicate test results, results assigned to the wrong county, results that are reported for today but are actually from a previous day, occasional false positive tests and other data discrepancies. Because of this, the previous day’s total number of cases plus the number of new daily cases does not add up to the new day’s total number of cases. State health officials recommend reviewing the dashboard's epidemiologic curves tab for the most accurate representation of the state's COVID-19 spread.


Why many Latino men haven’t gotten vaccinated yet

Nationally, a third of unvaccinated Latinos say they want to get the COVID-19 vaccine as soon as possible — a much higher share than unvaccinated Black or white people, according to a survey by the Kaiser Family Foundation.

But many are concerned about missing work because of side effects, have transportation difficulties or mistakenly believe they might have to pay for the vaccine, the Kaiser survey showed.

Vaccination rates are especially low among Latino men. In L.A. County, 39% had gotten at least one shot, compared to 59% of white men, as of May 9. Across demographics, women are more likely to get vaccinated than men, with about 46% of Latina women having gotten a shot.

Health care advocates are zeroing in on the issues that prevent Latino men from getting vaccinated, which range from misinformation to busy schedules, lack of familiarity with the health care system and fear of side effects.

Read the story here.

—Alejandra Reyes-Velarde, Los Angeles Times

Michigan nonprofit helps vaccinate those with disabilities

LaQuae Lebon wants her 16-year-old son to get the COVID-19 vaccine. Making it happen, though, is a different story.

Lebon brought Noah, who is non-verbal, to a vaccine clinic on Thursday hosted by JARC, a suburban Detroit nonprofit dedicated to assisting those with developmental disabilities.

JARC has hosted a dozen community vaccine clinics at its offices since March, partnering with Oakland County to provide a comfortable and supportive environment designed to put those with disabilities — or any vaccine recipient — at ease.

“The only way to make sure that we reach those milestones is to get the vaccines to every person possible where they need it and in the manner in which they need it,” said Shaindle Braunstein, the CEO of JARC.

Read the story here.

—Mike Householder, The Associated Press

Seattle-Alaska cruises to resume in July, says Holland America

Holland America Line said Thursday it will restart cruising to Alaska in July with roundtrips from Seattle aboard its 2,100-passenger ship Nieuw Amsterdam. The trips, without stopping in Canada as the cruises previously did, are made possible by the recent passage of the Alaska Tourism Restoration Act.

Holland America said bookings are open for the 10 Saturday departures that will operate from July 24 through Oct. 2.

The company said plans for these cruises to fulfill Holland America Line’s obligations under the Passenger Vessel Services Act (PVSA) are expected to be approved, as are final instructions from the Centers for Disease Control and Prevention. The company said it is beginning the return-to-cruising preparation process effective immediately.

Read the story here.

—Seattle Times business staff

UN refugee agency calls on US to end asylum restrictions

The U.N. refugee agency made an unusual plea Thursday for the Biden administration to lift pandemic-related restrictions on people seeking asylum in the United States.

U.N. High Commissioner for Refugees Filippo Grandi asked for an end to so-called Title 42 authority, named for a section of an obscure 1944 U.S. public health law that former President Donald Trump used in March 2020 to effectively end asylum at the U.S.-Mexico border. President Joe Biden has kept the policy in place, though he has exempted children who are traveling alone.

Under the practice, people from Mexico, Guatemala, Honduras and El Salvador are quickly expelled from the U.S. to Mexico without a chance to seek humanitarian protection.

Read the story here.

—The Associated Press

Businesses should continue indoor masking policies in King County, health officials say

Vaccinated or not, everyone should wear a mask when indoors and in a public space.

That’s the message from Public Health — Seattle & King County, which issued a new directive Thursday from health officer Dr. Jeff Duchin.

The directive applies to public indoor spaces unless they have implemented a state-approved means of checking everyone’s vaccination status upon entry, the directive says.

It will apply until at least 70% of the county’s population 16 years and older are fully vaccinated.

The directive also encourages businesses to continue policies that encourage customers and employees to wear masks indoors. It does not apply to outdoor spaces.

Read the story here.

—Evan Bush

China, in global campaign, vaccinates its people in Thailand

Chinese citizens living in Thailand began being vaccinated on Thursday as part of China’s global campaign to inoculate its nationals living and working abroad.

China recently donated 500,000 vaccine doses, and Thailand agreed in turn to inoculate Chinese nationals as it slowly rolls out shots for its own citizens to contain a coronavirus surge that has sickened tens of thousands in the past two months.

Yang Xin, minister counsellor at the Chinese Embassy, said Beijing’s “Spring Sprout” program would benefit tens of thousands of Chinese in the country. An estimated 150,000 Chinese citizens live in Thailand.

Read the story here.

—Patrick Quinn and Fu Ting, The Associated Press

China says providing vaccines to almost 40 African nations

China said Thursday it is providing COVID-19 vaccines to nearly 40 African countries, describing its actions as purely altruistic in an apparent intensification of what has been described as “vaccine diplomacy.”

The vaccines were donated or sold at “favorable prices,” Foreign Ministry official Wu Peng told reporters.

Wu compared China’s outreach to the actions of “some countries that have said they have to wait for their own people to finish the vaccination before they could supply the vaccines to foreign countries,” in an apparent dig at the United States.

Read the story here.

—The Associated Press

Italy’s vaccine drive runs up against a sacred institution: summer vacation

As Dr. Mario Sorlini sits patients down in a vaccination center near the badly affected Italian town of Bergamo, he explains a potential complication of the coronavirus vaccine.

The second dose, he tells patients with terror-stricken faces, will fall on a date during the summer holidays.

For months, Italians have hungered for the vaccines that would give them safety, freedom from lockdown and a taste of normal life. After initial pitfalls and hurdles, the vaccination campaign is finally speeding up, but it is heading smack into the summer holidays that are sacred for many Italians and prompting fears among officials that a significant number would rather get away than get vaccinated.

Read the story here.

—Jason Horowitz, The New York Times

New York offers $5M lottery for newly vaccinated

Anyone who gets vaccinated at a state-run vaccination site in New York next week will receive a lottery scratch ticket with prizes potentially worth millions, as Gov. Andrew Cuomo tries to boost slowing vaccination rates.

The pilot program will offer prizes from $20 up to $5 million and run from Monday, May 24 to Friday, May 28 at the 10 state-run sites, Cuomo said Thursday.

The governor said there’s a one in nine chance of winning a scratch ticket prize in New York, which is joining other states, including Ohio, with similar lottery incentives.

Read the story here.

—Marina Villeneuve, The Associated Press

Austrian authorities seize weapons in raids on opponents of COVID-19 restrictions

Austrian authorities said Thursday they seized weapons and ammunition in raids on radical opponents of coronavirus restrictions.

The interior ministry said that the investigation stemmed from a Telegram chat group in which people discussed things such as building Molotov cocktails and bombs or buying weapons, the Austria Press Agency reported. They allegedly talked about using firebombs against police officers.

The posts talked of violence planned for a protest in Vienna on May 15, and authorities carried out searches the previous day in various part of the country. They found weapons, including two handguns, and large quantities of ammunition as well as two swords, protective vests, helmets and radio devices.

Read the story here.

—The Associated Press

Big gaps in vaccine rates across the US worry health experts

A month after every adult in the U.S. became eligible for the vaccine, a distinct geographic pattern has emerged: The highest vaccination rates are concentrated in the Northeast, while the lowest ones are mostly in the South.

Experts say the gap reflects a multitude of factors, including political leanings, religious beliefs, and education and income levels.

Closing the gaps is vital to controlling the virus that has killed 588,000 people in the U.S., health experts say. The vaccination drive has helped drive U.S. cases down to their lowest level since last June, at around 30,000 a day on average, and reduced deaths to about 570 a day, a level not seen since last July.

Read the story here.

—Jay Reeves, John Seewer and Collin Binkley, The Associated Press

Skagit Transit to return to full service next month

Buses will begin running on their regular schedules in Skagit County starting June 14, after a vote Wednesday by the Skagit Transit Board of Directors. Executive Director Dale O’Brien said riders have been requesting a return to regular bus schedules, as the current hours of 8 a.m. to 6 p.m. aren’t accommodating all bus users.

No Skagit Transit drivers have tested positive for COVID-19, and O’Brien said he has heard of no riders testing positive as a result of a bus ride. Masks will be required, and passengers will be asked to keep 3 feet away from others. This essentially means every other seat will be available, O’Brien said.

Read the story here.

—Brandon Stone, Skagit Valley Herald

Nervous workers struggle to adjust to new mask policies

An abrupt relaxation of mask policies has left workers at some retail and grocery stores reeling as they try to sort out what the new environment means for their own safety and relationship with customers.

Kroger, the country’s largest grocery chain, became one of the latest to announce that, starting Thursday, workers and customers can stop wearing masks in states where mandates are no longer in effect. Other companies that have adopted similar changes include Amazon, Walmart, Best Buy, Macy’s, Costco, Home Depot, Trader Joe’s and Target, following updated guidance from the Centers for Disease Control.

Some workers have taken to social media to cheer, but many others protested. Some don’t trust customers — or their co-workers — to be truthful about their vaccination status since most companies are not requiring proof. Others fear they will be judged if they leave their own masks on, even though their reasons for doing so are varied.

—Alexandra Olson, Joseph Pisani and Anne D'Innocenzio, The Associated Press

Court says Romania’s lockdown didn’t amount to house arrest

The European Court of Human Rights on Thursday ruled against a member of the European Union parliament who claimed that a lockdown to curb COVID-19 infections in his native Romania last year deprived him of liberty.

Cristian Terhes, a member of the European Parliament since 2019, had filed a case with the court arguing that Romania’s March 24-May 14 national lockdown amounted to “administrative detention.”

A panel of seven judges at the ECHR unanimously rejected Terhes’ claims, ruling them “inadmissible.” The court said the lockdown could not be equated with house arrest.

“He had not been subject to individual surveillance by the authorities and did not claim to have been forced to live in a cramped space, nor had he been deprived of all social contact,” the court said in a news release explaining the ruling.

Read the story here.

—Stephen McGrath, The Associated Press

Japan gives preliminary OK to 2 more COVID-19 vaccines

A Japanese health ministry drug safety panel on Thursday gave preliminary approval to coronavirus vaccines developed by Moderna and AstraZeneca ahead of an expansion next week of the country’s slow-paced immunization program before the Tokyo Olympics.

The only COVID-19 vaccine currently approved for emergency use in Japan is developed by Pfizer Inc.

Formal approval of the two additional vaccines is expected Friday by a broader vaccine policy panel, officials said.

Health Minister Norihisa Tamura said approval of the additional vaccines will help speed up inoculations. Japan has administered one or more vaccine doses to roughly 5 million people, or just 4% of the population.

Read the story here.

—Kantaro Komiya, The Associated Press

EU signs new deal with Pfizer-BioNTech, Hungary opts out


The European Union’s executive arm on Thursday finalized a third vaccine contract with Pfizer and BioNTech through 2023 for an additional 1.8 billion doses of their COVID-19 shot to share between the bloc’s countries except for Hungary, which opted out of the deal.

The European commission said the contract, which was agreed to on behalf of all 27 EU countries earlier this month, will allow the purchase of 900 million doses of the current shots and a serum adapted to the virus’ variants, with an option to purchase an extra 900 million shots.

Although EU nations agreed to keep on with their strategy of buying doses collectively, Hungary decided not to be part of the new purchase agreement that followed previous agreements with the two companies for 600 million shots.

Read the story here.

—Samuel Petrequin, The Associated Press

Prince William receives first dose of COVID-19 vaccine

Prince William said Thursday he has received his first dose of COVID-19 vaccine as Britain’s National Health Service expands its inoculation program to younger people.

William, 38, received his shot at London’s Science Museum, one of the large-scale vaccination centers opened around the country. A photo of the prince receiving his shot was posted on his social media account.

“On Tuesday, I received my first dose of the COVID-19 vaccine,’’ he wrote. “To all those working on the vaccine rollout — thank you for everything you’ve done and continue to do.”

Read the story here.

—The Associated Press

Catch up on the past 24 hours

Pints for pokes, vinos for vaccines: Washington state breweries and wineries are joining the crush of vaccine incentive programs, with some hosting pop-up clinics and others providing free drinks. Several restaurants are getting into the act, too.

Where you do and don't need mask up in the Seattle area: The shifting guidance has many stores and other businesses keeping everyone's faces covered, although some of the region's biggest names have lifted restrictions. Clearer guidelines are coming this week, but meanwhile, state officials say, "respect the rules of the room you're in" and don't go shaming people.

For one family, the real nightmare began eight weeks after COVID-19 hit. The long-haul symptoms that have stricken many adults are now hitting kids, plunging families into a terrifying maze of symptoms that come and go with no knowable end.

—Kris Higginson