Editor’s note: This is a live account of COVID-19 updates from September 23, 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 It is no longer being updated.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.

After weeks of debate, the Food and Drug Administration has authorized booster shots for adults over 65 who received their second Pfizer-BioNTech coronavirus vaccine dose at least six months ago. 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 decision sets up the beginning of another logistics operation to deliver vaccines to the most vulnerable Americans.

King County announced that the county has reached a deal with unions representing most of its employees, extending the deadline to be fully vaccinated against COVID-19 to Dec. 2.

The new agreement gives some leeway for workers who have been hesitant. They won’t be fired from county employment “provided they have begun the process for being fully vaccinated and can complete that process by Dec. 2,” Constantine’s office said in a news release.

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.

Gov. Jay Inslee has set a press conference today at 3 p.m. to discuss the state’s ongoing response to the COVID-19 pandemic.

Is your mask good enough to face COVID’s delta variant?

In recent months, some European airlines have banned the use of cloth face coverings to control the spread of the coronavirus during air travel, instead favoring surgical masks — sometimes referred to as medical or disposable — and N95 respirators.

It’s another salvo in the debate over the effectiveness of the ubiquitous cloth mask, which sprang into fashion when surgical masks and N95s were harder to find in the pandemic’s early days. The Centers for Disease Control and Prevention still promotes cloth face coverings in its guidance about masks.

And masks remain a critical mitigation tool because people primarily become infected with SARS-CoV-2, the virus that causes COVID-19, by inhaling small aerosol particles that linger in the air or large respiratory droplets produced in coughs and sneezes.

But the science is changing. Delta, currently the primary variant in the United States, is far more contagious than the original coronavirus, so the density of virus in the air is greater.

Read the full story here.

—Amanda Michelle Gomez, Kaiser Health News

Many unvaccinated people are not opposed to getting a shot. The challenge is trying to get it to them

Yolanda Orosco-Arellano decided she would get the coronavirus vaccine long before it became available. But securing an appointment for it was less straightforward.

The hotel housekeeper and mother of four worried about her anemia, a risk factor for severe illness from the virus. But Orosco-Arellano doesn’t have a car and needed a vaccination slot scheduled around her shifts at the hotel.

Barriers to getting the shot and information about the vaccines have hindered the “unvaccinated but willing,” who account for about 10% of the American population, according to a report last month by the Department of Health and Human Services. Unlike those who have declined vaccines, some vocally, because of their politics or ideology, a quieter share — about 44% of unvaccinated people — were willing to get a shot in late June and early July, including those who said they would definitely or probably get a shot and those who are unsure, HHS estimated. Those who remain on the fence for certain reasons, like Orosco-Arellano, lack transportation or other means, while others wish to wait and see or don’t know coronavirus vaccines are free.

Immunizing that population could be critical to attaining herd immunity and protecting those disproportionately affected by the pandemic. But public health officials have, so far, struggled to reach young adults, Black people, Hispanic people and uninsured people, groups who are unvaccinated but willing at higher rates.

Read the full story here.

—Meryl Kornfield, The Washington Post

As we enter cold and flu season, here’s how to tell if you have COVID or a cold

As we lurch into fall and then winter, we also say hello to flu season, which starts in early to mid-September.

But we are also in the throes of a pandemic, and when we come down with sore throats and runny noses, how do we tell if it’s COVID-19 or something else?

The short answer is that there’s no rule, according to Dr. Mary Hayden, a professor at Rush University and head of the university’s Division of Infectious Diseases. The symptoms are so similar that “there’s really nothing that clearly differentiates one illness from the other,” making it nearly impossible to reliably self-diagnose.

Read the full story here.

—Jade Yan, Chicago Tribune

Washington state analyzed two COVID scenarios for fall. One is much worse than the other.

COVID-19 hospitalization and transmission rates are likely to remain at high levels through the fall, despite slight declines since peaks in August, according to new projections by the state Department of Health.

Washingtonians are at a critical moment in terms of how our actions can shape infection, hospitalization and death rates in the coming months, DOH’s latest COVID-19 modeling and surveillance situation report says.

The report found that COVID-19 prevalence — the percent of residents with an active virus infection — is at a new high at 0.94%, or about one in every 106 people in the state. The previous reported high was 0.64% this past August.

Transmission remains high but also has slowed, according to the state’s projections. At the beginning of this month, the effective reproductive number — or Re, which shows how many additional people each positive person will infect — was 1.14, compared to 1.49 at the start of August. A reproductive number above 1 means cases will continue to increase. To decline, the number must stay “well below” 1 for a “substantial amount of time,” the report says.

Read the full story here.

—Elise Takahama

Nobel Prize ceremonies to be curtailed again due to pandemic

The Nobel Prize ceremonies will be reined in and scaled-down for the second year in a row due to the coronavirus pandemic, the foundation behind the coveted prizes said Thursday.

The winners of this year’s prizes in chemistry, literature, physics, medicine and economics, as well as the Nobel Peace Prize, are set to be announced between Oct. 4 and Oct. 11.

The laureates will receive their Nobel Prize medals and diplomas in their home countries, the foundation said. It said the presentation events will be woven together with an awards ceremony at Stockholm City Hall on Dec. 10, which is the anniversary of the death of prize founder Albert Nobel. The peace prize is awarded in Oslo, Norway, because Nobel wanted it that way for reasons he kept to himself.

Read the story here.

—The Associated Press

U.S. had its slowest week of first-dose vaccinations since July, worrying health experts ahead of flu season

The number of Americans receiving their first dose of a coronavirus vaccine has dropped significantly in recent days, according to Centers for Disease Control data released late Wednesday, worrying health officials as flu season approaches.

The seven-day moving average of daily first doses was about 272,000 by the end of last week, according to the CDC, making it the slowest week of first-dose immunizations since mid-July. On Tuesday, fewer than 21,000 individuals were injected with their first shot, tentative figures from the CDC show, potentially making it the slowest day since Christmas 2020.

This slowdown is partly because millions of Americans have already been either fully or partially vaccinated. About 55% of Americans are fully vaccinated, while about 64% have received at least one dose of a coronavirus vaccine. But it also comes amid an unwelcome comeback of infections and deaths across the country, and as the United States falls behind in overall vaccination rates globally, despite having had a months-long head start in immunizing its population.

Read the story here.

—Andrew Jeong, The Washington Post

State health officials confirm 4,154 new coronavirus cases

he state Department of Health (DOH) reported 4,154 new coronavirus cases and 61 new deaths on Thursday.

The update brings the state's totals to 637,367 cases and 7,434 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. Wednesday.

In addition, 35,689 people have been hospitalized in the state due to the virus — 175 new hospitalizations. In King County, the state's most populous, state health officials have confirmed a total of 148,167 COVID-19 diagnoses and 1,839 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.


US sets the stage for COVID booster shots for millions

The U.S. vaccination drive against COVID-19 stood on the verge of a major new phase as government advisers Thursday recommended booster doses of Pfizer’s vaccine for millions of older or otherwise vulnerable Americans — despite doubts the extra shots will do much to slow the pandemic.

Advisers to the Centers for Disease Control and Prevention said boosters should be offered to people 65 and older, nursing home residents and those ages 50 to 64 who have risky underlying health problems. The extra dose would be given once they are at least six months past their last Pfizer shot.

Deciding who else might get one was far tougher. While there is little evidence that younger people are in danger of waning immunity, the panel offered the option of a booster for those 18 to 49 who have chronic health problems and want one.

But the advisers refused to go further and open boosters to otherwise healthy front-line health care workers who aren’t at risk of severe illness but want to avoid even a mild infection.

Read the story here.

—The Associated Press

Panama plans to vaccinate tourists as it nears herd immunity

Panama will offer vaccines to foreign visitors in the near future now that most of its own citizens are fully inoculated, the nation’s trade and industry minister said.

“Next month we’re going to have more than 70% of our population with two vaccines and that’s been one of the keys of our economic plan for recovery,” Trade and Industry Minister Ramon Martinez told Bloomberg Television’s Shery Ahn in an interview in New York.

“We’re going to open for tourists to visit Panama and get vaccinated, and allow them to see the other wonders that Panama has.”

Read the story here.

—Michael McDonald, Bloomberg

African leaders highlight vaccine inequity in UN speeches

The inequity of COVID-19 vaccine distribution came into sharper focus Thursday as many of the African countries whose populations have little to no access to the life-saving shots stepped to the podium to speak at the U.N.’s annual meeting of world leaders.

Already, the struggle to contain the coronavirus pandemic has featured prominently in leaders’ speeches over the past few days — many of them delivered remotely exactly because of the virus. Country after country acknowledged the wide disparity in accessing the vaccine, painting a picture so bleak that a solution has at times seemed impossibly out of reach.

South Africa’s president Cyril Ramaphosa pointed to vaccines as “the greatest defense that humanity has against the ravages of this pandemic.”

“It is therefore a great concern that the global community has not sustained the principles of solidarity and cooperation in securing equitable access to COVID-19 vaccines,” he said. “It is an indictment on humanity that more than 82% of the world’s vaccine doses have been acquired by wealthy countries, while less than 1% has gone to low-income countries.”

Read the story here.

—Pia Sarkar, The Associated Press

COVID-19 creates dire US shortage of teachers, school staff

One desperate California school district is sending flyers home in students’ lunchboxes, telling parents it’s “now hiring.” Elsewhere, principals are filling in as crossing guards, teachers are being offered signing bonuses and schools are moving back to online learning.

Now that schools have welcomed students back to classrooms, they face a new challenge: a shortage of teachers and staff the likes of which some districts say they have never seen.

Public schools have struggled for years with teacher shortages, particularly in math, science, special education and languages. But the coronavirus pandemic has exacerbated the problem. The stress of teaching in the COVID-19 era has triggered a spike in retirements and resignations. Nationwide, some schools have had to shut classrooms because of a lack of teachers.

Read the story here.

—Jocelyn Gecker, The Associated Press

Decision fatigue: Why it’s so hard to make up your mind these days, and how to make it easier

From the moment we wake up each day, we’re faced with a continuous stream of choices. Many are minor, others are major and they all add up. When there are too many options, we tend to feel overwhelmed, anxious, stressed or otherwise out of sorts. This is decision fatigue, a state of mental overload that can impede our ability to make additional decisions.

Even if you’ve never heard of decision fatigue, you have probably experienced it, especially during the pandemic, which has added a new layer of complexity to the everyday choices we face. “There’s no aspect of the pandemic that has not thrown decisions at us that we haven’t had to make before,” says psychologist Barry Schwartz, a visiting professor at the Haas School of Business at the University of California, Berkeley and author of “The Paradox of Choice.” “Things that used to require no thought or effort now require a lot of planning. In the COVID world so much is uncertain — we haven’t had practice making decisions under these circumstances.”

Furthermore, the information we need to make decisions keeps changing.

Decision-making is challenging under any circumstances, because there are a lot of moving pieces to the process. “People have to consider their preferences and how they’re linked to their goals and values, they commit themselves to a course of action, and there are evaluative steps including cost-benefit calculations,” explains consumer psychologist Kathleen Vohs, a professor of marketing at the Carlson School of Management at the University of Minnesota. “In combination, this makes it a very taxing psychological experience.”

Read the story here.

—Stacey Colino, The Washington Post

Unruly airplane behavior prompted harsher penalties and more enforcement. It’s not working, lawmakers say.

Flight attendants, airline officials and airport representatives are scheduled to testify Thursday before a House subcommittee as lawmakers consider whether harsher penalties are needed to deter bad behavior on airplanes.

The Federal Aviation Administration said this week it has received 4,385 reports of unruly passenger incidents, most of which involve masks. The increase comes despite stepped-up efforts to punish those who act out in the skies.

The FAA instituted a zero-tolerance policy in January. Earlier this month, the Transportation Security Administration – which enforces a mask mandate in transportation settings – doubled fines for those who refuse to comply. Thursday’s hearing before the subcommittee on aviation is more evidence of the growing concern that those measures haven’t stopped passengers from assaulting crew members and fellow passengers, or flouting requirements that they wear masks on commercial airplanes.

Read the story here.

—Lori Aratani, The Washington Post

Ravaged by war, Syrian rebel area struggles with virus surge

Coronavirus cases are surging to the worst levels of the pandemic in a rebel stronghold in Syria — a particularly devastating development in a region where scores of hospitals have been bombed and that doctors and nurses have fled in droves during a decade of war.

The total number of cases seen in Idlib province — an overcrowded enclave with a population of 4 million, many of them internally displaced — has more than doubled since the beginning of August to more than 61,000. In recent weeks, daily new infections have repeatedly shot past 1,500, and authorities reported 34 deaths on Sunday alone — figures that are still believed to be undercounts because many infected people don’t report to authorities.

The situation has become so dire in the northwestern province that rescue workers known as the White Helmets who became famous for digging through the rubble of bombings to find victims now mostly ferry coronavirus patients to the hospital or the dead to burials.

Read the story here.

—Bassem Mroue, The Associated Press

CDC advisers try to work out the details on booster shots

With booster doses of Pfizer’s COVID-19 vaccine now authorized in the U.S., government advisers reconvened on Thursday to tackle the most contentious question yet: Exactly who should roll up their sleeves right away?

Late Wednesday, the Food and Drug Administration signed off on extra shots of the Pfizer formula for a broad swath of Americans: those 65 and older, people at high risk of severe illness, and health care workers and others in danger of becoming infected on the job.

But that was not the last hurdle. The Centers for Disease Control and Prevention sets final U.S. policy on who qualifies for the extra shot. The CDC’s advisers were set to vote Thursday on how many of the roughly 26 million Americans who had their last Pfizer shot at least six months ago should go ahead and get that third dose.

Read the story here.

—Lauran Neergaard and Mike Stobbe, The Associated Press

Jackson released from Chicago facility after COVID recovery

The Rev. Jesse Jackson was released Wednesday from a Chicago facility a month after he was hospitalized for a breakthrough COVID-19 infection and intensive physical therapy for Parkinson’s disease.

The civil rights leader and his wife, Jacqueline, were first hospitalized at Northwestern Memorial Hospital last month. Jesse Jackson, 79, was vaccinated for COVID-19, but his 77-year-old wife was not. She required oxygen and a brief intensive care unit stay before she was released this month.

The reverend’s case was less severe, and about a week after he was first hospitalized for COVID-19 treatment, he was transferred to a physical therapy hospital.

Read the story here.

—Sophia Tareen, The Associated Press

Self-storage industry roars back, boosted by pandemic changes

Early in the pandemic, Katharine Lau, a commercial real estate professional, turned her focus to decluttering, and as she stared at a pile of unneeded things, she wondered how she could save them despite her lack of space.

“It was the first time I thought about self-storage as a business, which I always thought was so unsexy and so uncool that I didn’t want to get involved,” she said. “But I began to think about whether I could monetize underutilized pieces of existing commercial real estate and pair it with technology.”

The company she created, Stuf Storage, sets out to do just that. With $1.8 million in seed funding announced in December, Stuf joins a big, disaggregated industry.

More than 30,000 owners operate roughly 55,000 self-storage facilities nationwide, according to statistics from the Self Storage Association, a trade group. 

The industry is booming now, but some experts are unsure how post-pandemic behavior will affect the industry. For instance, what happens when storage renters leave their parents’ homes or do not need to use their second bedroom as a makeshift office?

Read the story here.

—Ellen Rosen, The New York Times

High school goes remote again, blames student misbehavior

A Connecticut high school that recently resumed full in-person learning for the first time since the onset of the pandemic sent students home temporarily for remote learning — not because of the virus, but rather issues with misbehavior.

New Britain High School, in suburban Hartford, is “hitting the refresh button” and will restart the school year, Principal Damon Pearce wrote in a letter late Tuesday to students and families.

As students return to schools after a year and a half of learning disrupted by the pandemic, many districts have reported issues with behavior, including fighting and the kind of vandalism that was promoted by a viral TikTok challenge.

Read the story here.

—Michael Melia, The Associated Press

Some Argentines turn to unusual pandemic pets for comfort

Millions of people have found solace during the pandemic in cuddling a dog or cat. For a few, comfort comes in other forms — those of a horse or a pig, perhaps a possum-like sugar glider or even a tarantula.

As the new coronavirus began to circulate last year, Luciana Benetti found her plans for a big traditional 15th birthday party scrapped so her parents gave her a pig who turned out to be a loyal and loving companion — racing to her side when she fainted

Then there's Lorena Álvarez, whose Buenos Aires apartment is also home to 28 pocket-sized marsupials commonly known as sugar gliders.

“They create pure love for me,” she said. “Do you know what it is to lay down … and they smother you with kisses?”

Álvarez, who teaches statistics at a university — online these days — lives otherwise alone, but said the pets have helped her feel like she has company — sometimes popping up atop her head during Zoom calls.

Read the story here.

—Almudena Calatrava and Natacha Pisarenko, The Associated Press

Judge gives Dutch boy OK for vaccine amid parental dispute

A 12-year-old boy has gone to court in the Netherlands to get permission to receive a COVID-19 vaccine so he can visit his grandmother who is battling lung cancer, according to a written court ruling published Thursday.

The boy, whose identity was not released, “is afraid that he could infect his grandmother, and he is convinced that if she is infected, it could immediately be life-threatening for her,” the Dutch court’s written ruling said.

A judge who heard the case earlier this week gave the boy permission to get a vaccine shot.

Children ages 12-17 years can get vaccinated in the Netherlands with parental approval. If parents do not consent, “then you can ultimately decide for yourself to get vaccinated,” the Dutch government says in a message to children on its website outlining their right to vaccination.

The 12-year-old secondary school student went to court because his parents, who are separated, could not agree on the issue; his mother gave him permission, but his father would not, citing concern about short-term and long-term side effects.

The judge at the Northern Netherlands Court in Groningen said the father’s concerns about short-term side effects were “understandable” but added that the side effects he cited are very rare and treatable and were taken into consideration by Dutch health authorities when they approved COVID-19 vaccines for children.

Read the story here.

—The Associated Press

Catch up on the past 24 hours

Most employees of King County will have more time to get vaccinated. The county last night announced a deal with unions to delay the shot requirement for roughly 10,000 workers.

Is your mask good enough to beat the delta variant? It may be time for an upgrade. When one researcher saw the results of his recent study on masks, "I threw away my cloth mask," he says. He's among experts who have revised their guidance on what's best. If you want to keep wearing your cloth mask, proceed with caution and try two tests to gauge its effectiveness.

Moderna vs. Pfizer: Both vaccines are knockouts, but one seems to have the edge, multiple studies indicate. This is playing into the debate over booster shots. The FDA yesterday authorized Pfizer boosters for older Americans, people with underlying health conditions and high-risk workers. But more hurdles lie ahead before the dispensing of boosters can begin. 

Ahh-chooo! Is that COVID-19 or a cold? As we enter cold and flu season, here’s how you might be able to tell, and how to choose the right test.

Three Seattle scientists are getting millions to chase their "wildest scientific ideas" about viral outbreaks including the coronavirus.

Alaska is staggering under the nation's highest COVID-19 case rate per capita. In Idaho, so many people are dying that funeral homes are "bursting at the seams." Both states have activated "crisis standards of care" for deciding which patients to treat; here's how that looks.

—Kris Higginson