Editor’s note: This is a live account of COVID-19 updates from November 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 It is no longer being updated.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.

All adults age 18 and over are now eligible to receive COVID-19 booster shots, U.S. health agencies announced Friday. The decision was made in an effort to stay ahead of a possible surge in cases caused by holiday travel and the approaching winter months. The Centers for Disease and Control and Prevention urged people over age 50 to get booster shots.

Across the northern border, Canada authorized Pfizer’s kid-size COVID-19 shots for children ages 5 to 11. While U.S. children receive two low doses three weeks apart, Canada’s National Advisory Committee on Immunization recommended the two doses be given at least eight weeks apart.

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 previous days’ live updates and all our other coronavirus coverage, and here to see how we track the daily spread across Washington.


Navigating the pandemic
(Jennifer Luxton / The Seattle Times)

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COVID-19 Vaccine gets muted welcome in land awash in bigger problems

The vaccination campaign team from UNICEF arrived in a small motorboat last month in the flooded village of Wernyol, not far from the capital of South Sudan, and met with elders under a tree on a small patch of dry land.

The team ran point by point through a briefing sheet of facts about coronavirus and the vaccine, hoping to preempt what they assumed would be a flurry of questions from the elders about the shot and its side effects.

But first and foremost, what the elders wanted to know was: When will the rains stop?

In recent years, it has sometimes felt as if rain is the only thing some South Sudanese have ever known. The result is the worst flooding in parts of South Sudan in six decades, affecting about one-third of the country.

For most of the 11 million people in this landlocked nation in east central Africa, one of the poorest countries on Earth, the coronavirus pandemic is not at the top of the list of problems.

Many people have fled Wernyol and other villages in the state of Jonglei, while those who remain have lost their crops, their livestock and their homes. With fish almost the only food available, malnutrition is rampant, as is disease.

In Pawel, another submerged village a few hours down a river that only a few years ago was a road, the village leader, James Kuir Bior, 50, was a little skeptical with the U.N. representatives about how the coronavirus vaccine stacked up against all the village’s other needs.

“We need medicines and nets,” Bior said as a thin covering of clouds overhead hinted at still more rain. “Now all we can think about is how to get out of this flooding.”

Villagers recognize the pandemic as a threat. Just perhaps not a very pressing one.

Read the full story here.

—Lynsey Addario, The New York Times
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Iran says 44 million fully vaccinated, half its population

TEHRAN, Iran (AP) — Iran announced Saturday it has now fully vaccinated 44 million people, more than half of its population of 85 million. The country has been hit the worst by the pandemic in the Middle East.

The health ministry said the 44 million received two doses of the vaccine. Iran has recorded at least 128,000 deaths since the start of the coronavirus pandemic. The ministry also announced that there have been more than 3,500 new cases of infections in the past 24 hours, as well as 118 deaths.

The government also noted that the daily death toll numbers have been decreasing in recent months, something Iranian experts attribute to vaccination. The highest single daily death toll was on Aug. 24, with 709 fatalities.

Authorities have been warning that more surges of the virus are expected; the latest came in August, fueled by the contagious delta variant. Less than half the population in Iran follows measures such as wearing face masks and social distancing.

Due to the positive trends, President Ebrahim Raisi on Saturday lifted nighttime traffic restrictions on private cars, which were previously banned from the streets from 9 p.m. to 4 a.m.

Iran generally uses the China-made Sinopharm vaccine, though the Russian Sputnik-V and the vaccine made by the British-Swedish pharmaceutical company AstraZeneca are also in use.

In June, Iran also officially started using its domestically produced COVIran Barekat vaccine, without publishing data on its safety or efficacy. Iran’s Supreme Leader Ayatollah Ali Khamenei, who previously warned against the import of American and British vaccines amid deep-rooted distrust of the West, received the homemade vaccine on state TV and encouraged the public to follow suit.

— The Associated Press

https://www.seattletimes.com/nation-world/across-europe-protests-swell-against-coronavirus-restrictions/

BRUSSELS — Protests against coronavirus restrictions erupted across Europe — including clashes in Rotterdam and massive rallies in Vienna — as authorities announced more-stringent measures in an attempt to control rising cases ahead of the winter holidays.

At least seven people were injured and more than 50 arrested after protests in Rotterdam turned violent late Friday, with protesters throwing stones and police firing shots, according to Dutch police. Demonstrators decried a proposed law that would ban unvaccinated people from entering businesses even if they provide a negative test. They also protested a partial lockdown that went into effect last week and will last until at least Dec. 4, forcing restaurants and other establishments to close at 8 p.m.

In Vienna, tens of thousands of people took the streets Saturday after the country’s decision to mandate vaccines for everyone starting in February and impose new lockdowns beginning Monday.

In Italy, weekly protests against the coronavirus showed no signs of easing, with demonstrations in Rome including at the ancient Circus Maximus grounds. On social media, users posted videos from protests in other countries including France and Switzerland.

Ferd Grapperhaus, the Netherlands’ minister of security and justice, called for a “vigorous debate” over pandemic measures, but said “harassment and violence do not belong” there.

Rotterdam Mayor Ahmed Aboutaleb described the clashes as “an orgy of violence” and said “police felt it necessary to draw their weapons to defend themselves.”

One police officer was hospitalized with a leg injury and two protesters were struck by bullets. Officials are investigating whether they were hit with police gunfire, according to The Associated Press.

Europe is the world’s only region with coronavirus deaths on the rise, jumping by 5% since earlier this month, according to the World Health Organization. In response, authorities are tightening rules for those unvaccinated.

Read the full story here.

—PERRY STEIN, The Washington Post

Must the swab go that far up your nose to test for COVID?

One Canadian said it felt like a painful poke to his brain. An American heard crunching sounds in her head. A Frenchwoman suffered a severe nosebleed. Others got headaches, cried or were left in shock.

They were all tested for COVID-19 with deep nasal swabs. While many people have no complaints about their experience, for some, the swab test — a vital tool in the global battle against the coronavirus — engenders visceral dislike, severe squirming or buckled knees.

“It felt like someone was going right into the reset button of my brain to switch something over,” Paul Chin, a music producer and DJ in Toronto, said of his nasal swab test. “There’s truly nothing like it.”

“Oh, my goodness,” he added, “the swab just going farther back into my nose than I’d ever imagined or would have guessed. It’s such a long and sharp and pointy kind of thing.”

Since the coronavirus emerged, millions of swabs have been stuck into millions of noses to test for a pernicious virus that has killed millions across the planet. One of the ways to fight the virus, officials say, is to test widely and to test often. The imperative has been to use a test that people are willing to take repeatedly.

The swab generally fits the bill.

In some parts of the United States, health workers hand people the swab to test themselves, assuring a level of personal comfort. To many South Africans, the only COVID-19 test is a painful one — you see stars or gag because a swab goes down your throat.

The range of swabbing raises questions: Who is doing it right? How deeply should the swab slide into your nostril? How long should it spend up there? Does an accurate test have to be uncomfortable? Unfairly or not, some countries have reputations for brutal tests.

Read the full story here.

—LIVIA ALBECK-RIPKA and John Yoon, The New York Times
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When can the COVID-19 masks finally come off?

Amid the turmoil of the past two years — a period that included a deadly pandemic, mass layoffs, an ugly presidential election and an attack on the U.S. Capitol — some of the fiercest political debates in America have been waged over a nearly weightless piece of fabric: the face mask.

U.S. officials were slow to embrace face masks as a strategy for slowing the spread of the coronavirus. When they finally did, masks became a potent symbol of the pandemic — a common-sense public health measure turned political flashpoint and a visible reminder that life was anything but normal.

Now, with the summer’s delta surge in the rearview mirror and the vaccination of school-age children underway, many Americans are wondering when the masks might finally come off.

“The best science does support mask-wearing as a valid strategy to reduce COVID-19,” said Dr. Stephen Luby, an infectious disease expert and epidemiologist at Stanford University. “The issue is: Well, how long do we do this, and in how many contexts?” He added, “Do we all wear masks the rest of our lives?”

Some public officials are already mapping out an endgame. On Tuesday, Mayor Muriel Bowser of Washington, D.C., announced that indoor mask requirements would be loosened. The next day, Florida lawmakers passed a bill banning school mask mandates, which some districts had already abandoned.

Eric Adams, New York City’s mayor-elect, “wants to drop the mask mandate in schools when health officials determine it’s safe,” his spokesperson said in an email.

That time has not yet come, experts said.

Read the full story here.

—EMILY ANTHES, The New York Times

Russia hits record coronavirus deaths for 2nd straight day

MOSCOW (AP) — Russia’s record high coronavirus death toll persisted for a second straight day on Saturday, as the number of new infections declined.

The state coronavirus task force reported 1,254 COVID-19 deaths, matching Friday’s tally.

The task force also reported 37,120 new confirmed cases. The daily new infections in recent weeks appear to have a downward trend but still remain higher than during previous surges of the virus.

The latest surge in deaths comes amid low vaccination rates and lax public attitudes in Russia toward taking precautions. About 40% of Russia’s nearly 146 million people have been fully vaccinated, even though the country approved a domestically developed COVID-19 vaccine — Sputnik V — months before most of the world.

In total, Russia’s coronavirus task force has reported nearly 9.3 million confirmed infections and 262,843 COVID-19 deaths, by far the highest death toll in Europe.

Some experts believe the true figure is even higher. Reports by Russia’s statistical service, Rosstat, that tally coronavirus-linked deaths retroactively reveal much higher mortality. They say 462,000 people with COVID-19 died between April 2020 and September of this year.

Russian officials have said the task force only includes deaths for which COVID-19 was the main cause, and uses data from medical facilities. Rosstat uses wider criteria for counting virus-related deaths and takes its numbers from civil registry offices where registering a death is finalized.

Read the full story here.

—The Associated Press

Philadelphia announces COVID-19 vaccine mandate for all city workers

PHILADELPHIA — Philadelphia will require all of its more than 25,000 city employees to get a coronavirus vaccine by mid-January or risk losing their jobs, officials announced Friday.

With the new policy, Philadelphia joined a number of other cities with vaccine mandates and reversed a prior stance that unvaccinated workers simply had to wear two masks while at work.

“We bear a responsibility to mitigate the harm that would result from inadvertent transmission of COVID-19 to our colleagues and the public and to set an example for other organizations and companies,” Mayor Jim Kenney said in a statement announcing the policy. “We owe it to our city — and to ourselves — to do all we can to keep us all safe.”

While the city recently mandated that non-union employees must be fully vaccinated by Dec. 1, the new policy will also apply to workers who are represented by the city’s four labor unions as well as city contractors.

Starting Jan. 14, the policy will allow for 15 days of unpaid leave for unvaccinated employees, and they will be terminated by the end of that leave if they have not yet gotten vaccinated. The city will offer religious and medical exemptions, but employees won’t be permitted to simply opt out of vaccinations.

But not all city employees are pleased; the Fraternal Order of Police Lodge 5, which represents city police officers, threatened legal action Friday over the mandate. John McNesby, the union’s president, said any mandate is subject to collective bargaining, and he said he’d take the issue before the contract arbitration panel.

Read the full story here.

—Laura McCrystal, The Philadelphia Inquirer
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COVID-19 cases now rising faster in Connecticut than in any other state

HARTFORD, Conn. — COVID-19 cases are increasingly more rapidly in Connecticut than in any other U.S. state, according to numbers released Friday.

Connecticut has now averaged 738 daily COVID-19 cases over the past seven days, up 116% from two weeks prior. No other state has experienced such a rapid increase, per data aggregated by the New York Times.

Because Connecticut started from a low rate of transmission, it still has fewer COVID-19 cases than many other states, including all of its neighbors. But with the trends heading in the wrong direction heading into the holidays, experts urge caution — and vaccination.

“We need to embrace normalcy at this point, but we need to be smart about it,” Dr. Ulysses Wu, an infectious disease specialist at Hartford HealthCare, said Friday. “Who are the people you are going to be hanging out with, how many people are going to be coming, and what is their vaccination status?”

After a summer in which COVID-19 transmission was highest in the southern half of the United States, the northern part of the country, including the Northeast, is having an increasingly difficult fall. Of the five states with the sharpest recent increase in cases, according to the New York Times, four are in New England.

Dr. Manisha Juthani, who in addition to being Connecticut’s public health commissioner is also an infectious disease specialist, said Thursday that she doesn’t expect the state’s current uptick to be as severe as last winter’s surge but that residents should be prepared for the numbers to continue rising.

Read the full story here.

— Ales Putterman, Hartford Courant

New hurdle for COVID-19 home testing — the holiday season

WASHINGTON (AP) — Millions more home tests for COVID-19 are hitting store shelves, but will there be enough for Americans hoping to screen themselves before holiday gatherings?

Gone are last year’s long lines to get tested, thanks to nearly a year of vaccinations, increased testing supplies and quicker options. But with many Americans unvaccinated and reports of infections among those who’ve gotten the shots, some are looking to home tests for an extra layer of protection ahead of this year’s festivities.

Janis Alpine of Seattle is getting together with seven relatives for Thanksgiving, including her 97-year-old father. While everyone is vaccinated, she plans to bring enough Abbott rapid tests for them to use.

“I’m just used to testing now,” said Alpine, who is retired. “Even though he’s vaccinated, just getting a little bit sick is probably not the best thing for a 97-year-old.”

She began testing herself regularly in September after flights to Las Vegas and the East Coast for vacation. Because local pharmacies sometimes sell out of tests, she usually buys five packs at a time when she finds them.

After weeks of shortages, chains like CVS and Walgreens now say they have ample supplies and recently lifted limits on how many can be purchased at one time. The shift comes after test makers ramped up production, spurred by more than $3 billion in new purchasing contracts and assistance from the government. Home tests are typically more than $10 each and take about 15 minutes.

Read the full story here.

—MATTHEW PERRONE, The Associated Press

Alaska medical board gets 600-plus comments on request to investigate doctors spreading COVID-19 misinformation

A request that Alaska’s State Medical Board investigate physicians who prescribe unproven COVID-19 treatments or spread misinformation garnered hundreds of comments ahead of a meeting Friday.

But state officials say the law precludes the board from basing decisions on public opinion and it’s unlikely the board will take any action Friday beyond listening to testimony anyway.

Nearly 150 Alaska physicians signed a letter asking the board to investigate the conduct of local doctors who have publicly advocated for the use of COVID-19 treatments such as ivermectin during the latest and deadliest virus surge that’s only now beginning to subside.

Anchorage psychiatrist Merijeanne Moore drafted the letter because of concerns over an event about COVID-19 early treatments featuring prominent vaccine skeptics in Anchorage late last month. Two local doctors — Illona Farr and John Nolte — spoke at the summit, organized by a group calling itself Alaska Covid Alliance.

Once Moore’s letter surfaced, early treatment event organizers mounted their own campaign asking supporters to support the doctors and treatments like ivermectin in comments to the medical board.

The board received more than 600 written comments by a Wednesday afternoon deadline, according to Sara Chambers, director of the state Division of Corporations, Business and Professional Licensing, which provides staffing for the medical board.

Read the full story here.

—Zaz Hollander and Annie Berman, Anchorage Daily News
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Texas court says hospital can’t be forced to offer ivermectin to COVID patient on ventilator

A Texas appeals court ruled Thursday that a hospital can’t be forced to treat a COVID-19 patient in its care with ivermectin, a drug normally used to eliminate parasitic worms, after the wife of a patient sued a hospital to demand the treatment.

Jason Jones, a 48-year-old law enforcement official, was hospitalized at the Texas Health Huguley Hospital in Fort Worth in late September after testing positive for the coronavirus. He was put in a medically induced coma and a ventilator on Oct. 7, according to court documents. Erin Jones, his wife, asked Huguley to give her husband ivermectin, after consulting with Mary Talley Bowden, a physician not affiliated with the hospital.

Bowden, who recently lost physician privileges at another hospital after it said she spread “misinformation” about the coronavirus, prescribed the drug. But Huguley staff refused to administer it and Erin Jones filed suit. The Food and Drug Administration has not approved or authorized ivermectin for COVID treatment, though there is widespread interest in the drug on the fringes of the Internet and among some right-wing circles.

Thursday’s ruling overturns a trial court decision that gave Bowden temporary privileges at Huguley.

“Judges are not doctors. We are not empowered to decide whether a particular medication should be administered,” wrote Bonnie Sudderth, chief justice of the Texas appellate court. “Although we may empathize with a wife’s desire to try anything and everything to save her husband, we are bound by the law, and the law in this case does not allow judicial intervention.”

Read the full story here.

— Andrew Jeong, The Washington Post

Cuomo misrepresented COVID-19 nursing home toll, report says

ALBANY, N.Y. (AP) — The New York Assembly’s investigation into former Gov. Andrew Cuomo’s conduct in office concluded the Democrat’s administration misrepresented how many nursing home residents died of COVID-19, according to a lawmaker who reviewed the committee’s still-secret report.

Assembly Member Phil Steck was among the Assembly Judiciary Committee members who were able to review a copy of the approximately 45-page report Thursday and Friday in advance of its public release, possibly as soon as next week.

The report, compiled by the New York City law firm Davis Polk & Wardwell, covers a wide array of allegations of misconduct by Cuomo, including sexual harassment claims and the participation of his staff in writing his book on the coronavirus pandemic.

Other topics include the Cuomo administration’s manipulation of data on COVID-19 deaths as presented to the public.

The Associated Press and other news organizations reported on gaps in the state’s statistical accounting of fatalities, including the administration’s decision to exclude from its nursing home death totals thousands of patients who died after being transferred to hospitals.

The Davis Polk investigators confirmed press reports that the state Department of Health wanted to include those hospital deaths in the state’s nursing home fatality count.

Read the full story here.

—Marina Villeneuve, The Associated Press

Thousands protest virus restrictions in Vienna, Zurich

VIENNA (AP) — Tens of thousands of protesters, many from far-right groups, marched through Vienna on Saturday after the Austrian government announced a nationwide lockdown beginning Monday to contain the country’s skyrocketing coronavirus infections.

Among those protesting were members of far-right and extreme-right parties and groups, including the far-right Freedom Party, the anti-vaccine MFG party and the extreme-right Identitarians.

Demonstrations against virus restrictions were also taking place Saturday in Switzerland, Croatia and Italy. On Friday night, Dutch police opened fire on protesters and seven people were injured in rioting that erupted in Rotterdam against COVID-19 restrictions.

The Austrian lockdown will start Monday. Initially it will last for 10 days but it could go up to 20 days, officials said. Most stores will close and cultural events will be canceled. People will be able to leave their homes only for specific reasons, including buying groceries, going to the doctor or exercising.

The Austrian government also said starting Feb. 1, it will make vaccinations mandatory.

Read the full story here.

—KIRSTEN GRIESHABER and Emily Schultheis, The Associated Press
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Europe’s COVID crisis pits vaccinated against unvaccinated

BRUSSELS (AP) — This was supposed to be the Christmas in Europe where family and friends could once again embrace holiday festivities and one another. Instead, the continent is the global epicenter of the COVID-19 pandemic as cases soar to record levels in many countries.

With infections spiking again despite nearly two years of restrictions, the health crisis increasingly is pitting citizen against citizen — the vaccinated against the unvaccinated.

Governments desperate to shield overburdened healthcare systems are imposing rules that limit choices for the unvaccinated in the hope that doing so will drive up rates of vaccinations.

Austria on Friday went a step further, making vaccinations mandatory as of Feb. 1.

“For a long time, maybe too long, I and others thought that it must be possible to convince people in Austria, to convince them to get vaccinated voluntarily,” Austrian Chancellor Alexander Schallenberg said.

He called the move “our only way to break out of this vicious cycle of viral waves and lockdown discussions for good.”

Read the full story here.

—RAF CASERT and KAREL JANICEK The Associated Press