Editor’s note: This is a live account of COVID-19 updates from Wednesday, September 22, 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 It is no longer being updated.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.

With Idaho’s hospitals operating under “crisis standards of care,” Washington Gov. Jay Inslee put pressure on Idaho’s political leaders to take action to stem COVID-19 cases.

“Today in my state, Washington citizens in many cases cannot get heart surgery, cannot get cancer surgery that they need, because we are having to take too many people of unvaccinated nature and unmasked, many of whom come from Idaho, and that’s just maddening frankly,” Inslee said on MSNBC on Friday.

While Washington has enacted mask and vaccine mandates, Idaho’s governor has not issued any such orders.

Meanwhile, Seattle Mayor Jenny Durkan announced on Tuesday that she will extend the city’s eviction moratorium until Jan. 15. The moratorium was set to expire at the end of September.

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.

U.S. will double Pfizer doses it donates abroad, Biden says

President Joe Biden announced Wednesday that the United States will double the number of Pfizer coronavirus vaccine doses it is donating to other countries, a step toward the goal of immunizing 70% of the world’s 8 billion people within the next year.

Biden made the pledge as he convened a virtual global summit of world leaders amid criticism that his administration has done too little to help nations with fewer resources.

Organizers said the conference would explore ways that all nations can cooperate to blunt a pandemic that has killed an estimated 4.5 million people and stunted economic growth around the globe.

Read the full story here.

—Anne Gearan, The Washington Post

King County extends COVID vaccination deadline to Dec. 2 in agreement with unions

King County has reached a deal with unions representing most of its employees that extends the deadline to be fully vaccinated for COVID-19 to Dec. 2.

The agreement — which covers roughly 10,000 workers — was announced Wednesday by King County Executive Dow Constantine.

The county, like the state and city of Seattle, had previously announced a deadline of Oct. 18 for employees be fully vaccinated, with those who don’t comply facing termination.

Already, 87% of county workers have received at least one vaccine dose and 80% have been fully vaccinated, according to Constantine’s office.

Read the full story here.

—Jim Brunner

FDA authorizes Pfizer booster shots for older and at-risk U.S. residents

After weeks of internal strife at the Food and Drug Administration, the agency on Wednesday authorized people over 65 who had received Pfizer-BioNTech’s coronavirus vaccine to get a booster shot at least six months after their second injection.

The FDA also authorized booster shots for adult Pfizer-BioNTech recipients who are at high risk of becoming severely ill with COVID-19 or are at risk of serious complications from the disease because of frequent exposure to the coronavirus at their jobs.

The authorization sets up what is likely to be a staggered campaign to deliver the shots, starting with the most vulnerable Americans. It opens the way for possibly tens of millions of vaccinated people to receive boosters at pharmacies, health clinics, doctors’ offices and elsewhere.

Roughly 22 million Americans are at least six months past their second dose of the Pfizer-BioNTech vaccine, according to the Centers for Disease Control and Prevention. About half of them are 65 and older. Millions of Americans who received the Moderna and Johnson & Johnson vaccines are still waiting to learn whether they, too, can get boosters.

Read the full story here.

—Sharon LaFranier and Noah Weiland, The New York Times

Hospitals overwhelmed by COVID-19 are turning to ‘crisis standards of care.’ What does that mean?

Long-feared rationing of medical care has become a reality in some parts of the United States as the delta variant drives a new wave of coronavirus cases, pushing hospitals to the brink.

Idaho last week activated statewide crisis standards of care, in which health systems can prioritize patients for scarce resources — based largely on their likelihood of survival — and even deny treatment. The decisions affect COVID and non-COVID patients. Some hospitals in Montana and Alaska have turned to crisis standards as well, while Hawaii’s governor this month released health workers from liability if they have to ration care.

Some states have no crisis standards of care plans, while others just created them during the pandemic. The common goal: Give health care workers last-resort guidance to make potentially wrenching decisions. But people disagree on the best calculus.

Read the story here.

—Hannah Sampson, The Washington Post

State health officials confirm 2,324 new coronavirus cases

The state Department of Health (DOH) reported 2,324 new coronavirus cases and 58 new deaths on Wednesday.

The update brings the state's totals to 633,278 cases and 7,373 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. Tuesday.

In addition, 35,514 people have been hospitalized in the state due to the virus — 132 new hospitalizations. In King County, the state's most populous, state health officials have confirmed a total of 147,402 COVID-19 diagnoses and 1,837 deaths.

Since vaccinations began in mid-December, the state and health care providers have administered 8,905,889 doses and 57% 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 16,091 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.

Florida makes quarantine optional for exposed students

A day after assuming his job, Florida’s newly appointed surgeon general on Wednesday signed new protocols allowing parents to decide whether their children should quarantine or stay in school if they are asymptomatic after being exposed to someone who has tested positive for COVID-19.

Ladapo eliminated previous mandates requiring students to quarantine for at least four days off campus if they’ve been exposed. Under the new guidelines, students who have been exposed can continue going to campus, “without restrictions or disparate treatment,” provided they are asymptomatic. They can also quarantine, but no longer than seven days, provided they do not get sick.

The U.S. Centers for Disease Control and Prevention says people who get infected can spread the virus starting from two days before they have any symptoms. The CDC recommends that a student should quarantine for 14 days if they are unvaccinated.

Read the story here.

—Mike Schneider, The Associated Press

COVID hospitalizations at Central Washington Hospital drop, but ICU reaches highest count during the pandemic

COVID-19 hospitalizations at Central Washington Hospital have declined this week but remain very high. And the COVID-19 patient count in the intensive care unit reached 15 Tuesday, the most since the beginning of the pandemic.

The total COVID-19 count has dropped, going from 56 patients Friday to 51 on Tuesday, according to the Confluence Health COVID-19 webpage. Seven of the 51 hospitalized patients were fully vaccinated.

“We are seeing some people with the vaccine hospitalized, but they’re usually stabilized fairly quickly and then sent home after that if they don’t have other comorbidities or complicated issues that are keeping them in the hospital,” Luke Davies, Chelan-Douglas Health administrator, said Monday at the monthly board of health meeting.

“The delta variant is still very active within our two-county area,” Davies said at the board meeting. “When we look at all of North-Central Washington, including Okanogan and Grant counties, you can see there’s still a significant increase. We’re not necessarily seeing relief yet for our health care workers.”

Read the story here.

—Oscar Rodriguez, The Wenatchee World, Wash.

Moderna vs. Pfizer: Both knockouts, but one seems to have the edge

It was a constant refrain from federal health officials after the coronavirus vaccines were authorized: These shots are all equally effective.

That has turned out not to be true.

Roughly 221 million doses of the Pfizer-BioNTech vaccine have been dispensed thus far in the United States, compared with about 150 million doses of Moderna’s vaccine. In a half-dozen studies published over the past few weeks, Moderna’s vaccine appeared to be more protective than the Pfizer-BioNTech vaccine in the months after immunization.

Research published on Friday by the Centers for Disease Control and Prevention found that the efficacy of the Pfizer-BioNTech vaccine against hospitalization fell from 91% to 77% after a four-month period following the second shot. The Moderna vaccine showed no decline over the same period.

If the efficacy gap continues to widen, it may have implications for the debate on booster shots. Federal agencies this week are evaluating the need for a third shot of the Pfizer-BioNTech vaccine for some high-risk groups, including older adults.

Scientists who were initially skeptical of the reported differences between the Moderna and Pfizer-BioNTech vaccines have slowly become convinced that the disparity is small but real.

Read the story here.

—Apoorva Mandavilli, The New York Times

CDC panel tackles who needs booster shot of COVID vaccine

An influential panel of advisers to the Centers for the Disease Control and Prevention convened on Wednesday to debate which Americans should get COVID-19 booster shots and when — a question that has proved more contentious than the Biden administration apparently expected.

The meeting came days after a different advisory group — this one serving the Food and Drug Administration — overwhelmingly rejected a sweeping White House plan to dispense third shots to nearly everyone. Instead, that panel endorsed booster doses of the Pfizer vaccine only for senior citizens and those at high risk from the virus.

If the FDA itself agrees with its advisers’ recommendation and authorizes Pfizer boosters, then the CDC must decide who should get the extra shots after hearing from its own Advisory Committee on Immunization Practices.

Read the story here.

—Lauran Neergaard and Mike Stobbe, The Associated Press

San Francisco mandates vaccines for all airport workers

San Francisco is requiring all workers at San Francisco International Airport to get vaccinated against COVID-19 or undergo weekly testing if employees are exempt.

The mandate announced Tuesday applies to all on-site personnel, of which there are about 46,000. The mandate, which goes into effect immediately, is the first for a U.S. airport.

Some airline companies have already announced vaccination mandates for employees. San Francisco also requires municipal workers to be inoculated.

Read the story here.

—The Associated Press

International travel is about to get more complicated for unvaccinated Americans

The number of countries allowing unvaccinated American travelers to visit has been dwindling in recent weeks. Now those globe-trotters will find it more complicated to return to the United States after going abroad.

Starting in early November, Americans who have not been vaccinated against the coronavirus will have to test negative within a day of leaving on a return flight to the United States. That is a shift from the current rule that mandates travelers test negative within 72 hours of departure.

In a new requirement altogether, those fliers will also have to show proof that they have bought a viral test to take after they return to the country.

Read the story here.

—Hannah Sampson, The Washington Post

German official slams online ‘incitement’ after mask killing

Germany’s health minister on Wednesday partly blamed “incitement” against the government’s pandemic rules on social media for the killing of a gas station clerk by a man who refused to wear a face mask.

A 49-year-old German man was arrested Sunday over the the fatal shooting a day earlier in the western town of Idar-Oberstein. Authorities said the suspect told officers he rejected the measures against the coronavirus.”

“It was a cold-blooded murder,” Health Minister Jens Spahn told reporters in Berlin, noting that the suspect had initially gone home after being refused service for failing to wear a mask, only to return later and shoot the clerk in the head.

“The question is, what is the environment, what are the circumstances in which such a crime can occur?” he asked. “This has a lot to do with the incitement, the hatred, that is posted on social media.”

Read the story here.

—Frank Jordans, The Associated Press

Mormon church to require masks in temples amid COVID surge

The Church of Jesus Christ of Latter-day Saints announced Wednesday that masks will be required inside temples to limit the spread of COVID-19.

Church leaders said in a statement that masks will be required temporarily in an effort to keep temples open. The message was the latest in a series of statements from church leaders encouraging masking and vaccination efforts against COVID-19.

“As cases of COVID-19 increase in many areas, we want to do everything possible to allow temples to remain open,” the church said in a statement. “Therefore, effective immediately, all temple patrons and workers are asked to wear face masks at all times while in the temple.”

In Utah, where the church is based, a summer surge of the virus among unvaccinated residents has continued to grow while vaccination rates have slightly increased.

Read the story here.

—The Associated Press

This widow didn’t qualify for COVID housing aid, so newspaper readers paid off her home

Colandra Boyd-Hopson was panicked earlier this year, worried she was close to losing her family’s home after her husband died from COVID-19 and she fell behind on her monthly payments.

To make things worse, she didn’t qualify for pandemic aid because she was buying her house through a land contract, a nontraditional option to purchase the home over time directly from the owner because the buyer doesn’t qualify for a traditional mortgage.

Then Boyd-Hopson got welcome news.

After the 51-year-old was featured in a February Detroit Free Press article, an anonymous metro Detroit couple donated $16,500 this spring to a local nonprofit specifically so she could pay off her land contract and own her home debt-free.

“It is a very good feeling,” said Boyd-Hopson, who received the final paperwork to clear her housing debt this month. “I am really grateful that someone found it in their heart to help us because it would have been really, really bad if we had not received that help.”

Read the story here.

—Christine MacDonald, Detroit Free Press

Oregon gives some state employees more time to get COVID vaccine

More than half of Oregon’s state employees have an extra six weeks to get fully vaccinated against COVID-19 as a deadline has been pushed back to Nov. 30 from October 18.

The Oregonian/OregonLive reports the change affects about 24,000 state employees represented by the Service Employees International Union 503, out of about 42,000 state executive branch employees.

Union members now have more time to complete shots but no more leeway in getting vaccinated than they did before.

Read the story here.

—The Associated Press

Oregon county commissioner draws condemnation for comparing Holocaust, vaccine requirements

A Clackamas County commissioner who has previously been called on to resign over racist comments has drawn condemnation for an incendiary post on social media.

Commissioner Mark Shull shared a meme on Facebook appearing to compare vaccine requirements to Nazi Germany and the Holocaust, Oregon Public Broadcasting reported on Tuesday. Shull has since removed the post.

Screenshots show the meme mentions Nazi soldiers requiring Jewish people in Germany during World War II to wear a yellow star on their clothes when outdoors, and asks “Anyone see the parallel?”

The rest of the Clackamas County board released a statement slamming Shull.

In June, Shull introduced a resolution comparing vaccine documents to Jim Crow laws, drawing swift opposition and leading the county chair, Republican Tootie Smith, to strip Shull of his committee assignments.

Read the story here.

—The Associated Press

Idaho adds 1,829 COVID-19 cases, 13 deaths; governor allots more relief funding

With some state hospitals on the brink of having to ration care because of an influx of COVID-19 patients, as they observe crisis standards of care protocols, Idaho added 1,829 new cases on Tuesday and 13 deaths, according to data from the Department of Health and Welfare.

Hospital beds and intensive care units are filling with unvaccinated patients in a state where essentially half the eligible population continues to shun vaccines. On Friday, there were 686 patients hospitalized with COVID-19 and 180 patients in an intensive care unit, according to Health and Welfare data. Last winter, the peak figures were 496 patients hospitalized and 122 in intensive care.

In response to the crisis, Gov. Brad Little, who has refused to implement mask mandates, limits on large gatherings, vaccination requirements or other health-safety measures, allocated an additional $10 million in relief funding to Idaho hospitals and urgent care clinics.

Read the story here.

—Ian Max Stevenson, Idaho Statesman

Vaccinated pregnant women’s protection passes to babies, new study finds

Pregnant people who get mRNA vaccines pass high levels of antibodies to their babies, according to a study published in American Journal of Obstetrics & Gynecology — Maternal Fetal Medicine on Wednesday.

The study — one of the first to measure antibody levels in umbilical cord blood to distinguish whether immunity is from infection or vaccines — found that 36 newborns tested at birth all had antibodies to protect against COVID-19 after their mothers were vaccinated with shots from Pfizer-BioNTech or Moderna.

“We didn’t anticipate that. We expected to see more variability,” said Ashley Roman, an obstetrician at NYU Langone Health System and co-author of the study.

The data could help encourage more people to get vaccinated during their pregnancies. Only 30% of pregnant women ages 18 to 49 are vaccinated, according to Centers for Disease Control and Prevention data from Sept. 11, despite growing evidence of prenatal vaccine safety. Given the study’s small sample size, the team is now looking at results from a larger group, as well as how long immunization lasts for infants after birth.

“We pushed this data out relatively early because it’s a unique finding and it has important implications for care,” Roman said. “Right now we’re recommending all pregnant women receive the vaccine for maternal benefit.”

Read the story here.

—Anushree Dave, Bloomberg

‘Don’t get vaccinated,’ say ads for fake funeral home in elaborate campaign to promote COVID vaccines

The black truck turned heads as it looped around Bank of America Stadium in Charlotte, during Sunday’s Carolina Panthers game.

“Don’t get vaccinated,” read digital billboards on the vehicle’s side and rear panels. Underneath, the name and website of a business purporting to be a funeral home were spelled out in white lettering, along with a 10-digit phone number.

It turned out to be an elaborate and highly unorthodox campaign to promote the coronavirus vaccines — one that drew applause from local hospital leaders and social media users as it went viral on Twitter, while leaving some experts in vaccine marketing questioning whether any holdouts would be swayed by the stark message.

The web address for the nonexistent Wilmore Funeral Home took users to a landing page that said simply: “Get vaccinated now. If not, see you soon.” It linked to the vaccine registration site for StarMed, a health-care provider in the area.

For more than a day, the people behind the stunt remained a mystery, even to officials at StarMed. The website’s creator was hidden, and the number on the side of the truck led to a third party whose voicemail was, unsurprisingly, full.

On Tuesday morning, a local advertising agency revealed the sign and website were its idea. “It was us. Get vaccinated,” the firm, BooneOakley, wrote in a tweet.

Read the story here.

—Derek Hawkins, The Washington Post

Asthma group warns against social media trend of inhaling disinfectant to treat coronavirus

A leading asthma patient group has issued a warning against a supposed coronavirus treatment circulating on social media that is leading some people to post videos of themselves breathing in hydrogen peroxide through a nebulizer.

The Asthma and Allergy Foundation of America called the practice “concerning and dangerous” in a Tuesday blog post, emphasizing that it will neither treat nor prevent the virus and is harmful to the lungs.

It’s the latest case in which the medical community has grappled with unsubstantiated and potentially dangerous at-home coronavirus treatments, many of which are driven by various forms of online misinformation.

Read the story here.

—Aaron Gregg, The Washington Post

The days of full COVID coverage are over. Insurers are restoring deductibles and copays, leaving patients with big bills

Jamie Azar left a rehab hospital in Tennessee last week with the help of a walker after spending the entire month of August in the ICU and on a ventilator. She had received a shot of the Johnson & Johnson vaccine in mid-July but tested positive for the coronavirus within 11 days and nearly died.

Now Azar, who earns about $36,000 a year as the director of a preschool at a Baptist church in Georgia, is facing thousands of dollars in medical expenses that she can’t afford.

In 2020, as the pandemic took hold, U.S. health insurance companies declared they would cover 100% of the costs for COVID treatment, waiving copays and expensive deductibles for hospital stays that frequently range into the hundreds of thousands of dollars.

But this year, most insurers have reinstated copays and deductibles for COVID patients, in many cases even before vaccines became widely available. The companies imposed the costs as industry profits remained strong or grew in 2020, with insurers paying out less to cover elective procedures that hospitals suspended during the crisis.

Now the financial burden of COVID is falling unevenly on patients across the country, varying widely by health-care plan and geography, according to a survey of the two largest health plans in every state by the nonprofit and nonpartisan Kaiser Family Foundation.

Read the story here.

—Christopher Rowland, The Washington Post

How the end of the international travel ban may affect your vacation — even for domestic trips

The travel industry, Americans waiting for far-off loved ones and global tourists who want to return to the United States got the news they had been waiting for Monday — the White House announced the end of the international travel ban that has been in place since early last year.

Beginning in early November, the ban, which primarily impacted nonessential travel from 33 countries, will be replaced with a rule that requires foreign nationals flying to the United States to be fully vaccinated and test negative for the coronavirus within three days of their trip. Unvaccinated American travelers will have to test within a day before their trip, as well as after arriving in the U.S.

In 2019, the country saw 79.3 million international arrivals, according to the National Travel and Tourism Office. That number dropped to 19.4 million last year.

After more than 550 days largely without international visitors, domestic travelers will again have some company from the rest of the world. What could that mean for Americans’ future vacation plans, travel prices, crowding and available inventory? 

Read the story here.

—Hannah Sampson and Natalie B. Compton, The Washington Post

Catch up on the past 24 hours

"Stop clogging up my hospitals," Gov. Jay Inslee fired at leaders in Idaho, where infections are hitting new highs as unused vaccines expire. Inslee called on Idaho to act amid the "maddening" toll on Washington residents. Meanwhile, an Idaho ICU doctor's touching message to his exhausted co-workers has gone viral, bringing health-care workers across the nation to tears. 

The U.S. is doubling its purchase of Pfizer’s COVID-19 shots to share with the world, President Joe Biden will announce today as he pushes other wealthy nations at the U.N. General Assembly to help vaccinate 70% of the world within the next year. Other leaders are already saying the American efforts aren't enough.

Seattle renters will be protected longer, but landlords are fuming after Mayor Jenny Durkan extended the city's eviction ban, which was due to expire this month. Rent and mortgage debts are creating conundrums nationwide: In Detroit, one woman lost her husband to COVID-19 and didn't qualify for pandemic housing aid. Then newspaper readers paid off her home.

When will kids under 12 be approved for vaccines? The timing will likely be different for three age groups. Here's what parents should know about the steps ahead.

A couple wore masks in a Texas restaurant to protect their newborn, who has cystic fibrosis. The owner kicked them out.

—Kris Higginson