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Credit…Alex Welsh for The New York Times

The city of Los Angeles appears close to enacting one of the strictest rules in the United States requiring proof of full vaccination against Covid to enter many indoor public spaces.

The ordinance would require people to provide proof to enter sites, including restaurants, gyms, museums, movie theaters and salons. The L.A. City Council debated it on Wednesday night in anticipation of its being approved next week. The ordinance would take effect on Nov. 4.

“We need to both limit the transmission of the virus as well as make it inconvenient for those that are unvaccinated to access indoor public venues, because they’re putting lives in jeopardy,” said Nury Martinez, the council president. “We have spent too much time placing restrictions on people who have done their part.”

The proposal would allow people with medical conditions that do not allow them to be vaccinated, or who have a sincerely held religious belief, to instead show proof of a negative coronavirus test taken within the preceding 72 hours.

In August, New York City became the first city in the nation to require proof that workers and customers at indoor sites for dining, physical fitness and entertainment had received at least one dose of a Covid vaccine. Not long after, some cities and counties in California, including San Francisco, followed suit. In Los Angeles, a growing number of bars and restaurants have voluntarily begun checking that patrons are vaccinated before allowing them indoors.

California now has one of the lowest rates for new cases in the United States. Almost 70 percent of Californians age 12 and older have been fully vaccinated. But public health officials in many parts of the state remain worried about the possibility of another surge of infections.

Some council members expressed concerns about imposing extra burdens on already struggling businesses.

“We say we support our essential workers,” said Joe Buscaino, a council member who moved to slow the passage of the ordinance on Wednesday. “We don’t want them to be on the front lines of enforcing this.”

But while other council members acknowledged the complexity of implementing the measure, they said its approval should not be delayed.

“It is an extreme measure,” said Bob Blumenfield, a council member, “but we are in an extreme crisis.”

Masks are still required in indoor spaces in Los Angeles County, including in the city of Los Angeles, when people are not eating or drinking, and that will continue to be the case until public health officials say otherwise, even with the new vaccination requirements.

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The Pan American Health Organization has struck a deal with the Chinese manufacturer Sinovac to buy millions of Covid-19 vaccines for countries in Latin America and the Caribbean as part of an effort to make more shots available in a region where access has been highly unequal.

The agency, part of the World Health Organization, is negotiating with two other manufacturers and expecting to announce new deals soon, Dr. Jarbas Barbosa, its assistant director, said at a news conference on Wednesday.

Sinovac has offered to sell 8.5 million doses this year and an additional 80 million next year, he said. Countries in the region that want the vaccine will have to buy it from the health organization.

“This is a purchase — it isn’t a donation,” Dr. Barbosa said, noting that the Inter-American Development Bank was offering loans to countries that needed them.

The direct purchases begin at a time when, on average, only 35 percent of people in Latin America and the Caribbean have been fully vaccinated against Covid-19, said Dr. Carissa F. Etienne, the agency’s director.

And that coverage has been unequal. While some countries, including Chile and Uruguay, have fully vaccinated over 70 percent of their populations, she said, others have yet to reach the 20 percent mark. Countries on the lower end of inoculation rates include the Bahamas, Grenada, Guatemala, Haiti, Honduras, Jamaica, Nicaragua, St. Lucia, St. Vincent and the Grenadines, and Venezuela. Haiti is a particularly dire case, she said, with less than 1 percent of the population fully vaccinated.

The health organization, which is also working to expand vaccine manufacturing in the region, announced last week that a site in Brazil and another in Argentina would receive technical support to begin production of messenger RNA vaccines, the type used in the Pfizer-BioNTech and Moderna shots.

But for the time being, Dr. Etienne said, “vaccine donations remain the fastest way to support countries in our region.”

Credit…Tingshu Wang/Reuters

A preliminary set of health protocols for next February’s Winter Games in Beijing, released by the International Olympic Committee on Wednesday, suggest that the next Olympics could be the most extraordinarily restricted large-scale sporting event since the start of the pandemic.

The Beijing Olympic and Paralympic Games will take place in what organizers described as a “closed-loop management system” — a bubblelike environment in which athletes, officials, broadcasters, journalists and a large Games work force will have to eat, sleep, work and compete without leaving, from the day they arrive to the moment they depart.

Anyone, including athletes, intending to enter this bubble has two choices: arrive in China fully vaccinated, or prepare to spend the first 21 days in Beijing in solitary quarantine.

And while spectators will be allowed to return to competition venues after being largely barred from the recent Summer Games in Tokyo, entry will be limited to people who live in mainland China.

The Summer Olympics in Tokyo featured a far more porous health protocol. Participants were not required to be vaccinated and did not have to sequester if they were not. And while they were asked to try to remain within Games-affiliated venues, they still had plenty of opportunities to interact with the outside world, including at convenience stores and restaurants for takeout meals.

Members of the local news media and the venue work forces in Tokyo were allowed to commute to Olympic venues from their homes. And after a 14-day period of more harsh restrictions, all Games visitors were allowed to move about the city as they wished.

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C.D.C. Urges Vaccinations for Pregnant or Breastfeeding Americans

Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said data showed that vaccines were safe and effective for any American who is pregnant, planning to become pregnant or currently breastfeeding.

We now have data that demonstrates that the vaccines, in whatever time in pregnancy or lactating that they’re given, are actually safe and effective and have no adverse events to mom or to baby. And we’ve actually seen that, in fact, some antibody from the vaccine traverses to the baby and, in fact, could potentially protect the baby. I think what’s really important here to emphasize is we know that about 30 percent of women who are pregnant right now are vaccinated, an extraordinarily low number, and about 15 percent of African-American women who are pregnant are vaccinated, and this puts them at severe risk of severe disease from Covid-19. In August this year, we lost 21 pregnant women to Covid-19, so we absolutely have the data that demonstrates the overwhelming benefit of vaccine and really very little safety concerns at all.

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Dr. Rochelle P. Walensky, director of the Centers for Disease Control and Prevention, said data showed that vaccines were safe and effective for any American who is pregnant, planning to become pregnant or currently breastfeeding.CreditCredit…Hannah Beier/Reuters

In an urgent plea, federal health officials are asking that any American who is pregnant, planning to become pregnant or currently breastfeeding get vaccinated against the coronavirus as soon as possible.

Covid-19 poses a severe risk during pregnancy, when a person’s immune system is tamped down, and raises the risk of stillbirth or another poor outcome, according to the Centers for Disease Control and Prevention. Twenty-two pregnant people in the United States died of Covid in August, the highest number in a single month since the pandemic started.

About 125,000 pregnant people have tested positive for the virus; 22,000 have been hospitalized, and 161 have died. Hospital data indicates that 97 percent of those who were infected with the virus when they were hospitalized — for illness, or for labor and delivery — were not vaccinated.

Vaccination rates among pregnant people are lower than among the general population. Fewer than one-third were vaccinated before or during their pregnancy, the agency said.

The rates vary widely by race and ethnicity, with the highest — nearly 50 percent — among pregnant Asian American people, and the lowest rates among pregnant Black people, at 15 percent.

Pregnancy is on the C.D.C.’s list of health conditions that increase the risk of severe Covid. Though the absolute risk of severe disease is low, pregnant patients who are symptomatic are more than twice as likely as other symptomatic patients to require admission to intensive care or interventions like mechanical ventilation, and may be more likely to die.

Some data also suggest that pregnant people with Covid-19 are more likely to experience conditions that complicate pregnancy — such as a kind of high blood pressure called pre-eclampsia — compared with pregnant people who don’t have Covid. Pregnant people with the disease are also at increased risk for poor birth outcomes, like preterm birth.

Clinical trials have a long history of excluding pregnant people from participation, and pregnant people were not included in the coronavirus vaccine trials. As a result, data on the safety and effectiveness of vaccines is limited in this group.

Studies conducted since the vaccines were authorized, however, have shown that the vaccines do not increase the risk of a miscarriage. Both the Pfizer-BioNTech and Moderna vaccines produced robust immune responses in pregnant people and did not damage the placenta, researchers have found.

“Pregnancy can be both a special time and also a stressful time, and pregnancy during a pandemic is an added concern for family,” said Dr. Rochelle Walensky, the C.D.C.’s director.

She encouraged pregnant people and those who may become pregnant “to talk with their health care provider about the protective benefits of the Covid-19 vaccine to keep their babies and themselves safe.”

Credit…Chris Lee/Chelsea FC, via Getty Images

Concerned that a significant number of its players remained unvaccinated, the Premier League, the top tier of English soccer, is offering its 20 clubs an unspecified “reward” for getting more of their rosters immunized.

Only seven of the league’s teams have full vaccination rates of over 50 percent among their players, according to a letter sent last week that outlined the proposal. That figure has alarmed officials of a league that features players from all over the world who regularly cross national borders for competitions.

“It is increasingly clear that full vaccination will be the key criteria for government and health authorities, in terms of international travel and potential Covid certification at large-scale events,” the letter said.

The efforts of the Premier League, the world’s most popular domestic soccer league, to push for greater vaccine uptake mirror the challenges faced by other sports leagues, including the N.B.A. The N.B.A. players’ union has strongly opposed mandatory vaccinations, and unvaccinated players must submit to daily Covid testing.

The Premier League’s letter did not outline what type of reward teams with high vaccination rates could expect. Officials briefed on the matter said the rewards were likely to be a loosening of the stringent coronavirus protocols that have been in place since the league resumed play last year after being suspended because of the pandemic.

“We are considering if and how best we can ‘reward’ those squads/players who are most Covid-compliant,” the league told the clubs.

Many Premier League players also compete on national teams, whose next round of games begins in October. Some league clubs have refused to release players selected by national teams in South America, despite the threat of penalties from the sport’s governing body, because of concerns that when the players returned to Britain they would be subjected to quarantine, as other travelers are when arriving from that continent.

Premier League teams are tested regularly, and coronavirus cases have continued to occur. N’Golo Kanté, a star midfielder for Chelsea who is also on the French national team, tested positive for the virus this week, ruling him out of Chelsea’s Champions League match with Juventus of Italy on Wednesday. He will also miss a coming league game in England and a French national team match next week.

Thomas Tuchel, Chelsea’s coach, told reporters on Tuesday that he did not know how many of the players on his roster were vaccinated.

“We are a reflection of society, the players are adults and they have a free choice,” he said, adding, “I know the situation is far from over. It makes you very aware it is not over.”

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