Editor’s note: This is a live account of COVID-19 updates from Monday, October 4, 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 It is no longer being updated.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.

Last week, the U.S. reached another pandemic milestone, surpassing 700,000 deaths from COVID-19. The record came just as hospitalizations started to dip slightly.

In schools, the debate over vaccine mandates continues. Supreme Court Justice Sonia Sotomayor denied an emergency appeal to block New York City’s COVID-19 vaccine mandate for public school teachers and staff. Those who have not gotten at least their first shot face suspension without pay on Monday.

Meanwhile, California is poised to enact the first coronavirus vaccine mandate for schoolchildren once the government has fully vetted the vaccine for two age groups — 12 to 15 and 5 to 11.

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.

US unveils guidance for federal vaccine mandate, exemptions

With just weeks remaining before federal workers must be vaccinated against COVID-19, the federal government on Monday outlined procedures for employees to request medical or religious exemptions from President Joe Biden’s mandate.

The Office of Management and Budget released the new guidance Monday afternoon ahead of the Nov. 22 deadline for workers to be fully vaccinated, outlining specific medical conditions that would warrant an exemption. Under the guidelines, agencies are to direct workers to get their first shot within two weeks of an exemption request being denied, or the resolution of a medical condition. They also make clear that federal agencies may deny medical or religious exemptions if they determine that no other safety protocol is adequate.

The Biden administration is drawing on Centers for Disease Control and Prevention guidance to determine approved medical exemptions, including a history of allergic reaction to the vaccines. Other conditions, including being treated with monoclonal antibodies or having a history of multisystem inflammatory syndrome, warrant a 90-day delay in vaccination, in accordance with CDC advice.

While the CDC recommends that women who are pregnant or are planning to become pregnant get vaccinated against COVID-19, the federal government will consider requests to delay vaccination while pregnant depending on the worker’s particular medical circumstances.

Read the full story here.

—Zeke Miller, The Associated Press

Non-bargaining, exempt Washington state workers get more time to get COVID-19 shots under Inslee mandate

OLYMPIA — Gov. Jay Inslee’s administration has extended some union provisions to nonrepresented and exempt Washington state workers that gives them a little more time to get vaccinated before losing their jobs.

Those provisions will allow workers who sought exemptions or accommodations from the vaccinate mandate more time to get their shots before losing their jobs. Others who started their vaccination process late can also get extra time.

The move comes as Washington’s agencies work to verify how many of the 63,000 state workers subject to Inslee’s mandate were vaccinated as of Monday.

Monday was the last day for state workers to get a shot to meet Inslee’s Oct. 18 deadline. That’s because full vaccination isn’t achieved until two weeks after the final shot.

Read the full story here.

—Joseph O'Sullivan

UNICEF: Battered by pandemic, kids need mental health help

Governments must pour more money and resources into preserving the mental well-being of children and adolescents, the U.N.’s child protection agency urged in a report Tuesday that sounded alarms about blows to mental health from the COVID-19 pandemic that hit poor and vulnerable children particularly hard.

The United Nations Children’s Fund said its “State of the World’s Children” study is its most comprehensive look so far this century at the mental health of children and adolescents globally. The coronavirus crisis, forcing school closures that upended the lives of children and adolescents, has thrust the issue of their mental well-being to the fore.

UNICEF said it may take years to fully measure the extent of the pandemic’s impact on young people’s mental health. Psychiatrists quickly saw signs of distress, with children and adolescents seeking help for suicidal thoughts, anxiety, eating disorders and other difficulties as lockdowns and switching to remote learning severed them from friends and routines and as COVID-19 killed parents and grandparents.

“With nationwide lockdowns and pandemic-related movement restrictions, children have spent indelible years of their lives away from family, friends, classrooms, play — key elements of childhood itself,” said UNICEF’s executive director, Henrietta Fore.

Read the full story here.

—John Leicester, The Associated Press

Seattle-area hospitals fear exodus of unvaccinated health care workers as deadline approaches

Washington state hospital leaders urged people to stay as healthy as possible as the state’s COVID-19 vaccination deadline approaches in two weeks. They say workers who are not vaccinated and won’t be allowed to work could further strain staffing.

Monday is the last day most unvaccinated health care workers can get a COVID-19 vaccine, the single-dose Johnson & Johnson shot, to comply with the mandate.

Several health care systems reported a high level of vaccination among their staffs but worry understaffed hospitals could be further burdened amid patients sick with COVID-19 and those sick with seasonal respiratory illnesses, like the flu.

The immunization rate among health care workers in Washington is fairly high, said Taya Briley, executive vice president of the Washington State Hospital Association, during a Monday morning news briefing.

Read the full story here.

—Elise Takahama

With most pregnant women unvaccinated, doctors worry about virus’s toll

Kyndal Nipper started the morning with a sense of relief.

To the eight-months pregnant 29-year-old from Columbus, it seemed that her bout with COVID-19 had ended and she had made it through the illness with only mild symptoms: a low-grade fever, fatigue and a loss of taste and smell. She felt better than she had in days as she resumed her normal routine.

But, as morning gave way to afternoon, she noticed that her baby wasn’t moving as much he usually did. Maybe not at all. She ate a snack and drank a caffeinated beverage to stimulate movement. Still nothing.

Out of an abundance of caution, she headed to Piedmont Columbus Regional Hospital, where her husband, Thomas, and Dr. Timothy Villegas later joined her. A series of tests revealed the unthinkable: The baby had died.

The Nippers were devastated and filled with questions.

Read the full story here.

—Helena Oliviero, The Atlanta Journal-Constitution

FIFA urges players to get vaccinated, EPL lags on take-up

FIFA offered direct encouragement for footballers to get vaccinated on Sunday.

The first clear statement of its kind from world football’s governing body came as players were flying to countries for men’s World Cup qualifiers.

“We encourage COVID-19 vaccinations,” FIFA said, “and endorse the World Health Organization’s position: safe, fair, and equitable access is critical in all countries. Players should not receive priority access to vaccines.”

The British government last week agreed to ease strict quarantine requirements to allow fully vaccinated players to train and feature in matches on their return to England from red-list countries, which includes all of South America. Those players who don’t want to be vaccinated would still be sent to spend 10 days in government hotel quarantine when flying back to England.

“We acknowledge this decision does not help every player,” FIFA said, “and we remain committed to further improving the situation for upcoming windows and joining discussions to explain more about the many measures we are putting in place to reduce the risks of COVID transmission into the community as a result of player travel.”

Many Premier League clubs blocked players from going to red-list countries during the international window last month. Players who did go missed games for their clubs as a result.

Read the story here.

—Rob Harris, The Associated Press

State health officials confirm 1,873 new coronavirus cases

The state Department of Health (DOH) reported 1,873 new coronavirus cases and 42 new deaths on Monday.

The update brings the state's totals to 667,834 cases and 7,807 deaths, meaning that 1.2% of people diagnosed in Washington have died, according to the DOH. The data is as of 11:59 p.m. Sunday. Tallies may be higher earlier in the week because new state data isn’t reported on weekends.

In addition, 37,129 people have been hospitalized in the state due to the virus — 375 new hospitalizations. In King County, the state's most populous, state health officials have confirmed a total of 153,430 COVID-19 diagnoses and 1,881 deaths.

Since vaccinations began in mid-December, the state and health care providers have administered 9,154,939 doses and 58.3% 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 15,583 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.


Seattle tour operators that have survived COVID-19 tell how they made it — and what they make of travel’s future

Travel workers have had a particularly rough go of things during the coronavirus pandemic.

Practically overnight, their livelihoods went from being rooted in a lucrative, global industry to a grounded one. The travel industry has continued to have stops and starts as waves of this pandemic have come and gone; the promise of vaccines and summer activities led to a hopeful moment, but then came the surge of the delta variant.

Caught in the middle were tour operators and guides. We spoke with three creative operators with Seattle ties to find out how they survived the last 18 months, and how they’re thinking of their businesses — and travel as a whole — going forward.

Read the story here.

—Colleen Stinchcombe, Special to The Seattle Times

Mormon president thanks those who've followed church guidance in getting vaxxed

The president of The Church of Jesus Christ of Latter-day Saints urged members Saturday to listen to the faith’s leaders when they seek “pure truth” and expressed gratitude for those who have followed church guidance during the pandemic, which has been to get vaccinated against the coronavirus.

President Russell M. Nelson acknowledged at a church conference that the world is “still dealing with the ravages of COVID-19 and its variants.” And while he didn’t mention vaccines specifically, he thanked members for following the advice of church leaders, medical experts and government officials.

The Utah-based faith has repeatedly encouraged its 16 million members worldwide to limit the spread by getting vaccines and wearing masks.

“Contrary to the doubts of some, there really is such a thing as right and wrong. There really is absolute truth — eternal truth,” said Nelson, speaking from inside a mostly empty conference center in Salt Lake City. 

Read the story here.

—Brady McCombs, The Associated Press

Russia hits record number of daily COVID-19 deaths

Russia on Sunday reported a record daily death toll from COVID-19, the fifth time in a week that deaths have hit a new high.

The national coronavirus task force said 890 deaths were recorded over the past day, exceeding the 887 reported on Friday. The task force also said the number of new infections in the past day was the second-highest of the year at 25,769.

Overall, Russia, a nation of 146 million people, has Europe’s highest death toll from the pandemic, nearly 210,000 people.

Yet despite the country’s persistent rise in daily deaths and new cases, Russian officials say there are no plans to impose a lockdown. Mask-wearing regulations are in place but are loosely enforced.

Even though Russia boasted of creating the world’s first coronavirus vaccine, Sputnik V, only 32.5% of its people have gotten at least one vaccine shot and only 28% are fully vaccinated.

Read the story here.

—The Associated Press

Trying to make sense of COVID’s mysterious 2-month cycle

COVID-19 is once again in retreat.

The reasons remain somewhat unclear, and there is no guarantee that the decline in caseloads will continue. But the turnaround is now large enough — and been going on long enough — to deserve attention.

The number of new daily cases in the United States has fallen 35% since Sept. 1. Worldwide, cases have also dropped more than 30% since late August. “This is as good as the world has looked in many months,” Dr. Eric Topol of Scripps Research wrote last week.

The most encouraging news is that the most serious forms of COVID are also declining. The number of Americans hospitalized with COVID has fallen about 25% since Sept. 1. Daily deaths — which typically change direction a few weeks after cases and hospitalizations — have fallen 10% since Sept. 20. It is the first sustained decline in deaths since early summer.

These declines are consistent with a pattern that readers will recognize: COVID’s mysterious two-month cycle. Since the COVID virus began spreading in late 2019, cases have often surged for about two months — sometimes because of a variant, such as delta — and then declined for about two months.

Public health researchers do not understand why. Many popular explanations — such as seasonality or the ebbs and flows of mask wearing and social distancing — are clearly insufficient, if not wrong. The two-month cycle has occurred during different seasons of the year and occurred even when human behavior was not changing in obvious ways.

Read the story here.

—David Leonhardt, The New York Times

3 Swiss Guards who refused vaccination return to Switzerland

Three Vatican Swiss Guards who have refused to be vaccinated against COVID-19 upon Holy See orders have voluntarily left the storied corps to return to Switzerland, a Swiss Guard official said Sunday.

Lt. Urs Breitenmoser told The Associated Press that all Swiss Guards had been asked to be vaccinated “to protect their health and that of the others they come into contact with as part of their service.”

Three other guardsmen are temporarily suspended from duty while they await vaccination, he said.

The prime duty of the all-male corps, with its colorful uniforms and plumed helmets, is to protect the pontiff. During the pandemic, the guardsmen on duty don protective surgical masks.

Pope Francis, who has been vaccinated against COVID-19, has repeatedly stressed the altruistic and health value of receiving the shots during the pandemic.

Read the story here.

—The Associated Press

EU regulator OKs Pfizer vaccine booster for 18 and older

The European Union’s drug regulator gave its backing Monday to administering booster shots of the Pfizer-BioNTech COVID-19 vaccine for people 18 and older.

The European Medicines Agency said the booster doses “may be considered at least 6 months after the second dose for people aged 18 years and older.”

The agency’s human medicines committee issued the recommendation after studying data for the Pfizer vaccine that showed a rise in antibody levels following boosters given around 6 months after the second dose in people from 18 to 55 years old.

The agency also said it supports giving a third dose of either the Pfizer-BioNTech or the Moderna vaccine to people with severely weakened immune systems at least 28 days after their second shot.

Read the story here.

—The Associated Press

COVID vaccine mandate takes effect for NYC teachers, staff

A COVID-19 vaccination requirement for teachers and other staff members took effect in New York City’s sprawling public school system Monday in a key test of the employee vaccination mandates now being rolled out across the country.

Mayor Bill de Blasio said 95% of the city’s roughly 148,000 public school staffers had received at least one vaccine dose as of Monday morning, including 96% of teachers and 99% of principals.

Some 43,000 employees have gotten the shots since the mandate was announced Aug. 23, de Blasio said. The mayor had warned that unvaccinated school employees would be placed on unpaid leave and not be allowed to work this week. The city planned to bring in substitutes where needed.

Read the story here.

—Karen Matthews, The Associated Press

Johnson & Johnson to seek FDA authorization for booster shot

Johnson & Johnson is planning to ask federal regulators early this week to authorize a booster shot of its coronavirus vaccine, according to officials familiar with the company’s plans. The firm is the last of the three federally authorized vaccine providers to call for extra injections, amid mounting evidence that at least the elderly and other high-risk groups need more protection.

Federal officials have become increasingly worried that the more than 15 million Americans who received the Johnson & Johnson vaccine face too much risk of severe COVID-19. The Food and Drug Administration on Friday scheduled a meeting on Oct. 15 of its expert advisory committee to discuss whether to grant emergency use authorization of a booster shot of Johnson & Johnson’s vaccine.

That is part of a broader effort by the government to shore up the protection provided by all three vaccines. Regulators last month authorized a booster shot for many recipients of Pfizer-BioNTech’s vaccine and are contemplating doing the same this month for recipients of Moderna’s.

Read the story here.

—The New York Times

VA hospital nurse charged with stealing and selling COVID vaccination cards: ‘I charge $150 for these’

When a person messaged Bethann Kierczak requesting coronavirus vaccine cards earlier this spring, the registered nurse promised she would do her best, court records state.

Kierczak, a nurse at a Michigan Veterans Affairs hospital, had access to immunization records since she was responsible for administering the doses. But the requester, who is not identified in court records, needed 10 vaccine cards.

According to investigators, Kierczak explained that the request could take time because “this pharmacist seems to be a little protective of the cards, lol ... But if I can’t today I will have more chances through next week,” Kierczak allegedly said.

Federal authorities have since charged Kierczak with stealing authentic coronavirus vaccination cards from the VA hospital – along with vaccine lot numbers required to make the cards appear legitimate – and later reselling those cards for $150-$200.

She is among the latest people charged with selling coronavirus vaccine cards as some attempt to evade immunization requirements. Federal authorities have also seized thousands of fake vaccination cards destined for locations across the U.S.

Read the story here.

—Andrea Salcedo, The Washington Post

Virus surge hits New England despite high vaccination rates

Despite having the highest vaccination rates in the country, there are constant reminders for most New England states of just how vicious the delta variant of COVID-19 is.

Hospitals across the region are seeing full intensive care units and staff shortages are starting to affect care. Public officials are pleading with the unvaccinated to get the shots. Health care workers are coping with pent-up demand for other kinds of care that had been delayed by the pandemic.

The head of UMass Memorial Health, the largest health system in central Massachusetts, said recently that regional hospitals were seeing nearly 20 times more COVID-19 patients than in June and there isn’t an ICU bed to spare.

Read the story here.

—Wilson Ring, The Associated Press

Doctors grow frustrated over COVID-19 denial, misinformation

The COVID-19 patient’s health was deteriorating quickly at a Michigan hospital, but he was having none of the doctor’s diagnosis. Despite dangerously low oxygen levels, the unvaccinated man didn’t think he was that sick and got so irate over a hospital policy forbidding his wife from being at his bedside that he threatened to walk out of the building.

Dr. Matthew Trunsky didn’t hold back in his response: “You are welcome to leave, but you will be dead before you get to your car,’” he said.

Such exchanges have become all-too-common for medical workers who are growing weary of COVID-19 denial and misinformation that have made it exasperating to treat unvaccinated patients during the delta-driven surge.

The Associated Press asked six doctors from across the country to describe the types of misinformation and denial they see on a daily basis and how they respond to it.

They describe being aggravated at the constant requests to be prescribed the veterinary parasite drug Ivermectin, with patients lashing out at doctors when they are told that it’s not a safe coronavirus treatment. An Illinois family practice doctor has patients tell him that microchips are embedded in vaccines as part of a ploy to take over people’s DNA. A Louisiana doctor has resorted to showing patients a list of ingredients in Twinkies, reminding those who are skeptical about the makeup of vaccines that everyday products have lots of safe additives that no one really understands.

Read the story here.

—Heather Hollingsworth, The Associated Press

Israel tightens COVID ‘green pass’ rules, sparking protest

Israel restricted its COVID Green Pass on Sunday to allow only those who have received a vaccine booster dose or recently recuperated from coronavirus to enter indoor venues. The new criteria mean that nearly 2 million people will lose their vaccination passport in the coming days.

Israel is the first country to make a booster shot a requirement for its digital vaccination passport. The move is widely seen as a step to encourage booster vaccination among those who have yet to receive a third dose.

Scores of Israelis staged demonstrations around the country in protest of the green pass system, with convoys of cars clogging morning commutes as many Israelis returned to work Sunday after September’s Jewish High Holidays. Opponents of the system said it is a form of forced vaccination.

Read the story here.

—The Associated Press

New Zealand admits it can no longer get rid of coronavirus

New Zealand’s government acknowledged Monday what most other countries did long ago: It can no longer completely get rid of the coronavirus.

Prime Minister Jacinda Ardern announced a cautious plan to ease lockdown restrictions in Auckland, despite an outbreak there that continues to simmer.

Since early in the pandemic, New Zealand had pursued an unusual zero-tolerance approach to the virus through strict lockdowns and aggressive contact tracing. Until recently, that elimination strategy had worked remarkably well for the country of 5 million, which has reported just 27 virus deaths.

But that changed when the more contagious delta variant somehow escaped from a quarantine facility in August after it was brought into the country from a traveler returning from Australia.

Read the story here.

—Nick Perry, The Associated Press

Catch up on the past 24 hours

Kristina Bowman thought her Mukilteo family was doing all the right things to avoid COVID-19, then everyone fell ill. Soon after that, pediatric cases in Washington began climbing, eventually hitting a new peak. Doctors are urging vaccines for every family member who can get them, and early testing even if symptoms seem like just a cold. 

Today is the last day many Washington state employees, educators and health care workers can get vaccines to meet their deadline, and some workers who haven't shown proof are already getting separation notices. A possible preview for Washington: New York City, where school staffers must be vaccinated when the bell rings today. Here's how the day is going.

Make unvaccinated people pay? They've already cost up to $850 million in Washington state, columnist Danny Westneat writes.

Dr. Anthony Fauci says U.S. is "turning the corner" on the latest COVID-19 surge. It doesn't look like that yet in Alaska, where doctors at one hospital found themselves locked in an agonizing debate over who should get the final bed.

"Wow, this sounds like a great trip," J.R. Kroll thought when his wife gave him a birthday vacation to Iceland. They packed their proof of vaccination and negative COVID tests — but Kroll's dream trip turned into 10 days quarantined alone in a "cruddy" hotel room.

—Kris Higginson