For the second year in a row, enormous wildfires are creating clouds of smoke big enough to generate their own weather, blanket entire continents, and turn faraway skies orange or grey.

Smoke is billowing from blazes in the western US, Canada, Greece, Turkey, Italy, Spain, Algeria, and Siberia — so much, in fact, that astronauts on the space station can see it. The wildfires in California and Oregon have darkened skies and led to air-quality warnings in New York City and Boston, as they did last summer. The Siberian fires, meanwhile, have sent clouds of smoke and ash to the North Pole, nearly 2,000 miles away, then down to Canada and Greenland.

Each time a big fire burns, its smoke can rise high in the atmosphere, where winds can catch it and carry it for thousands of miles until it hits a weather system that pushes it back towards the ground. That's when it poses a health risk. Many people see wildfires as a local problem — a danger to people in Greece or California, say, but not for them personally. That's incorrect, according to environmental epidemiologist Jesse Berman.

"Every one of these wildfire events is an opportunity for that smoke to travel long distances and affect not only the people nearby, but also those very far away," Berman told Insider. "People who live in areas that have relatively good air quality are going to be all of a sudden subjected to levels of pollution that are many times higher than what's normally seen, and at levels that are very harmful to health."

These mega-clouds of world-traveling smoke may become a regular, annual occurrence, according to Berman — "if not multiple times every single year," he said.

Climate change is expected to lead to more frequent, larger, more intense wildfires in the coming decades. A new report from the UN's Intergovernmental Panel on Climate Change warns that "fire weather" will probably increase through 2050 in North America, Central America, parts of South America, the Mediterranean, southern Africa, north Asia, Australia, and New Zealand. That means more days where conditions are warm, dry, and windy enough to trigger and sustain wildfires.

The amount of fuel available to burn in those places — dry vegetation — is also likely to increase as rising temperatures cause the air to absorb more moisture and bring about more droughts.

"When these events cover hundreds or thousands of miles, everybody is at risk," Berman said. "It doesn't matter where you're living. You can be affected by these events the same as anyone else."

Particles in wildfire smoke can strain your lungs, heart, and immune system

Wherever it goes, wildfire smoke fills the air with microscopic particles from the material that has burned and the resulting chemical reactions.

Known as PM2.5, these particles measure no more than 2.5 micrometers across (that's about 30 times smaller than a human hair), allowing them to penetrate deep into your lungs and enter your bloodstream. When you inhale these particles — as millions of people have in the last year — they can damage the lining of your lungs and cause inflammation.

The Centers for Disease Control and Prevention warns that smoke can "make you more prone to lung infections" including COVID-19, since any breach in the lungs' lining offers more opportunities for a virus to infiltrate.

Indeed, a recent study linked about 19,000 cases of COVID-19 on the West Coast to wildfire smoke last summer. The paper, published last week, found a correlation between high levels of PM2.5 pollution and spikes in coronavirus cases in counties across California, Oregon, and Washington.

Experts suspected as much. Previous research had already shown that wildfire smoke leaves people more vulnerable to disease. In the short term, smoke can irritate the eyes and lungs and cause wheezing, coughs, or difficulty breathing, even in healthy people. Longer-term studies have connected PM2.5 pollution to an increased risk of heart attack, stroke, heart failure, and premature death. PM2.5 particles can also impair the immune system, possibly by disabling immune cells in the lungs.

Wildfire smoke can have the most severe effects on people who are already highly vulnerable to COVID-19: the elderly, children (many of whom are unvaccinated against the coronavirus), and people with asthma or chronic lung disease.

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The Delta variant has thrown a wrench in the US's pandemic exit plan. Delta now accounts for more than 90% of cases in the US after spurring a dramatic surge in infections and hospitalizations over the last two months. A growing number of breakthrough cases has led to questions about how well COVID-19 vaccines hold up against the variant. 

Some research shows that the Delta variant can partially evade vaccine-induced antibodies, which means vaccinated people have lower levels of antibodies that can protect against Delta compared to other variants.

So Insider reviewed more than a dozen studies and releases from vaccine makers, public-health organizations, and researchers across several countries to parse out how well the vaccines from Pfizer, Moderna, Johnson & Johnson, and AstraZeneca work against Delta.

The results are promising. While vaccine effectiveness against infection is declining over time, protection against severe disease, hospitalization, and death remains high.

"We have been fortunate to have safe and effective vaccines that offer outstanding protection against the worst outcomes of this virus — severe disease, hospitalization, and death," Vivek Murthy, the US Surgeon General, said in a White House briefing on Wednesday. 

The chart below summarizes what we know so far.

Vaccines prevent hospitalization and death

Our understanding of how well shots stack up against Delta is changing with time, which is why the chart above lists large ranges for some types of protection. Research completed in the spring suggested a higher level of vaccine protection against Delta than the data from the last few months.

More comprehensive data is available for Pfizer and AstraZeneca, because public-health agencies in Israel and the UK — where these shots dominate — are constantly surveilling clinical outcomes among their populations.

A May analysis from Public Health England found that Pfizer's and AstraZeneca's vaccines were 88% and 60% effective in preventing symptomatic COVID-19, respectively. However, a study from Israel using data collected in June and July found that two Pfizer doses were only 64% effective at preventing infection and symptomatic illness.

Both of these studies, though, found that the vaccines were more than 90% effective in preventing hospitalization. And the Israeli data found Pfizer's shot to be 93% effective against severe disease.

The vaccines from Moderna and Johnson & Johnson showed similarly strong performance against the worst outcomes associated with Delta, though the shots are less studied thus far. 

One Canadian study, which has not been peer-reviewed, suggested Moderna's vaccine is 72% effective against a symptomatic Delta infection after just one dose. Johnson & Johnson's shot, meanwhile, is 71% effective against hospitalization from Delta, and up to 95% effective in preventing death, Yale Medicine reported. 

According to the Centers for Disease Control and Prevention, unvaccinated people are about twice as likely to be hospitalized with COVID-19 than vaccinated people. The unvaccinated have accounted for about 97% of hospitalizations in the US in this recent surge. More than 1,900 children — many of whom are too young to be vaccinated — have been hospitalized with COVID-19. 

In the last month, the average number of new daily cases in the US has more than quadrupled, from about 32,300 on July 18 to 140,900 on Wednesday. About 99.5% of new cases are among the unvaccinated.

Vaccine effectiveness is waning over time, which is why the US plans to roll out boosters

The Delta variant isn't the only reason vaccine protection seems a little weaker than it was a few months ago, though.

CDC director Rochelle Walensky said on Wednesday that rising rates of breakthrough cases are " likely due to both waning immunity and the strength of the widespread Delta variant." 

Think of it as a one-two punch.

Indeed, researchers have found that protection against a mild or moderate coronavirus infection decreases over time. For example, data from the Israeli Health Ministry showed that Pfizer's vaccine was 75% effective against infection in people who'd gotten their shots in April, whereas that protection dropped to 16% in those who got the vaccine in January.

A University of Oxford study published Thursday looked at people who had breakthrough infections with high viral loads — meaning more virus in their test samples, a metric linked to higher infectiousness. The results showed Pfizer's shot was 92% effective in preventing infection with a high viral load two weeks after the second dose, but 78% at the three-month mark. AstraZeneca's effectiveness fell from 69% to 61% during the same time frame.

Such findings, coupled with recent data from Pfizer suggesting a third dose of its COVID-19 vaccine boosts protection against the Delta variant, informed the Biden administration's decision to recommend booster shots after eight months. The Pfizer data showed that a third shot produced five to eight times more antibodies against the Delta variant.

If the Food and Drug Administration authorizes booster shots in the coming weeks, the US booster campaign will begin September 20 for people who received Moderna or Pfizer vaccines. People who got the J&J shot will probably need boosters too, but officials are still evaluating data for that vaccine.

Andrew Dunn contributed reporting. 

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Starlink satellites will ultimately be involved in 9 in 10 near misses between spacecraft that are orbiting Earth, a scientist and space debris expert has predicted.

Once the "megaconstellation" of Starlink satellites has reached its intended size of 12,000, it will be responsible for 90% of these close encounters, research by Hugh Lewis, of the University of Southampton, published by Space.com, suggests.

Starlink, which is owned by Elon Musk's SpaceX, aims to create "the world's most advanced broadband internet system." It has already launched around 1,700 satellites into Earth orbit, which are responsible for about half of all near misses presently, Professor Lewis' research suggests.

Near misses in Earth orbit occur when two spacecraft pass within 1 kilometer (0.6 miles) of each other. With a rapidly growing number of satellites being sent into orbit, scientists are concerned about the increased likelihood of collisions, and the potential for a chain reaction that leads to multiple collisions.

Lewis examined data from the Satellite Orbital Conjunction Reports Assessing Threatening Encounters in Space (Socrates) database, which tracks satellite orbits and models their trajectory to assess collision risk. He looked at data back to May 2019, when Starlink launched its first batch of satellites.

Lewis said that Starlink satellites were responsible for 1,600 close encounters between two spacecraft a week. Excluding near misses involving two Starlink satellites, the figure was 500, he said.

He told Space.com that the number of encounters picked up by the Socrates database "has more than doubled and now we are in a situation where Starlink accounts for half of all encounters."

OneWeb, a Starlink competitor, has 250 satellites in orbit, which are involved in 80 near misses with other operators' satellites each week, according to data that Lewis provided to Space.com.

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Following is a transcript of the video.

The United States has countless accents. But, where did they all come from? American accents have been evolving for hundreds of years. And while Americans sound very different today, here's where some of those iconic accents got their start.

New England

Let's start with New England, which was one of the first US regions to develop its own American English accent. Today, a speaker from New England might say, "Were you gonna plagiarize the whole thing for us? You have any thoughts of your own on this matter? Is that your thing; you come into a bar and read some obscure passage and pretend...you pawn it off as your own?"

New York

For such a geographically small area, New York City certainly has a bunch of distinctive accents. But in general, its accents evolved from a mixture of its Dutch and English roots and numerous waves of immigration.

A modern speaker from New York probably won't sound like what you hear in movies like "Hey, I'm walking here! I'm walking here!"

They're more likely to say "Deep dish pizza is not not only better than New York pizza, it's not pizza."

Delaware River Valley

New York's New Jersian and Pennsylvanian neighbors sounded quite different.

Nowadays, someone from Philly might say "We're a regular family. We watch Philly jawn on TV. We go down to the Jersey Shore. But when we want great hoagies, discount prices on beer, and a great atmosphere we go to Lee's Hoagies in Horsham, PA."

Southern Coast

Let's take a look at what went on down south.

The southern coast of the United States has a variety of different accents. One example is Southern coastal white. "What concerns me about the American press is this endless...endless attempt to label the guy some kind of kook."

African American

Other southern dialects preserved some of the original remnants to this day. "They come over here and get oysters and clam and go fishing because they're right down the road. They're right in Brunswick or Savannah or Jacksonville.

Much later, a wave of African Americans migrated from the American South to urban centers in the North, mixing their accents together. "Being a kid from New York City, I mean from Brooklyn. And my aunt — God bless her soul — she used to always take me to The Rockettes — you know, the Easter show and the Christmas show."

Appalachians

The Ulster-Scots had a significant influence on many American dialects in the South and West. Most of the original accent has disappeared, and today, an American from Tennessee might sound like this. "Now, I am just who I am. I'm not always nice. I choose to be good. I choose to have a good attitude because I want people to know. I am a girl with many colors."

Midwest

As the Appalachian settlers headed west, their accents joined with speech patterns from the North.

The Midwest has many diverse accents. Today, a speaker from the Great Lakes might say "I was born in the middle of the century in the middle of the country; a classic baby boomer."

Or more famously, "We got a full tank of gas, half a pack of cigarettes, it's dark, and we're wearing sunglasses."

While another from Wisconsin/Minnesota/the Dakotas might say "If either of these men draw, I'm gonna be forced to shoot some people, and I don't want to do that."

Texas

Down in Texas, a very distinct accent developed. The famous Texan accent we know from movies like "They shot and killed a state senator named Bibs in Waco, Texas." has started to level out. Visitors to big cities like Houston might be surprised to hear something more like "Thank you to everyone who worked so hard to beautifully capture the profundity of deep southern culture."

California

Last but not least is the West Coast, which had a very different mix of immigrants compared to the East Coast. California doesn't come close to having one, distinct accent. A modern-day speaker might sound like "We woke up the next morning on his actual birthday. And I told him I wanted to take him somewhere to lunch for his birthday." or "What's so powerful about this novel is everyone has their own interpretation to these characters."

These are just a handful of American accents...and they're still evolving as we speak. We'll have to check back in a century or so from now to see what happens next.

EDITOR'S NOTE: This video was originally published on June 18, 2018.

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President Joe Biden told ABC News in a one-on-one interview that he and first lady Jill Biden plan on getting COVID-19 booster shots once they're available.

"We're gonna get the booster shots," Biden told George Stephanopoulos in an interview that aired Thursday morning. "And it's something that I think — you know, because we got our shots all the way back in December. So I think it's past time."

Biden received his second dose on January 11.

On Wednesday, the Biden administration announced that booster shots will be available starting in September for those who were vaccinated at least eight months prior.

CDC officials said on Wednesday that while the vaccines have proven effective against severe illness and death caused by COVID-19, the immunity they provide wanes over time.

Amid the surging Delta variant — which now accounts for more than 90% of cases in the United States and has brought several states with low vaccination rates over their previous peaks for hospitalizations — booster shots could ensure that fully-vaccinated Americans maintain their immunity as the hypertransmissible variant continues to spread.

The booster news applies to those, like the Bidens, who took a two-dose regimen for the jabs.

If the Food and Drug Administration authorizes booster shots in the coming weeks, the US booster campaign will begin on September 20 for people who received Moderna or Pfizer-BioNTech vaccines, government officials announced. Those who took the single-dose Johnson & Johnson vaccine will likely need boosters as well, though officials are still evaluating data on that vaccine.

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The federal government has recommended COVID-19 booster shots for all.

In a statement on Wednesday, US health officials said all Americans who received an mRNA vaccine from Pfizer or Moderna may get a boost eight months after their second shot. A booster is not yet recommended for people who received a J&J vaccine, which uses different vaccine technology.

"The current protection against severe disease, hospitalization, and death could diminish in the months ahead," the officials said, "especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout."

Experts in the field weren't particularly surprised at the announcement. The Centers for Disease Control and Prevention, the Food and Drug Administration, and pharmaceutical companies have anticipated that COVID-19 booster doses will eventually be necessary.

But there is some debate about the new plan — including whether it is the right approach to contain the pandemic at this juncture, and who really needs boosters.

John Moore, an immunologist from Weill Cornell Medical College, said he trusted that the Biden administration's recommendation was "science-driven." But like others interviewed for this story, he questioned how much boosting people who are already well protected from disease and death — i.e., fully vaccinated people under 60 who aren't immunocompromised — would affect the pandemic. 

"The unvaccinated are the drivers of this pandemic," he said. "If we didn't have 100 million unvaccinated people, we wouldn't be having this kind of conversation because the pandemic would have been squelched in America several months ago." 

Why US officials recommend boosters at 8 months

In announcing the new recommendations on Wednesday, the CDC shared a few data sets that influenced its decision.

CDC Director Rochelle Walensky referenced data from Israel and New York, as well as a preprint from the Mayo Clinic, that showed protection from the vaccines waned slightly over time. One study found that the Pfizer and Moderna mRNA vaccines were 75% effective at preventing infection in nursing homes in the spring, but by summer, with Delta spreading, they were 53% effective. Another study found that the two vaccines protected very well against severe COVID-19 and hospitalization for up to six months. 

Pfizer's research, meanwhile, suggested that its vaccine was highly protective (91.3% efficacy) against symptomatic COVID-19 for six months after the second dose. On Monday, Pfizer submitted data to the FDA recommending boosters six to 12 months after the second dose. The people in its study received boosters eight to nine months out.

Taken together, these findings suggest vaccine effectiveness does wane over time, especially in the face of the Delta variant. But it's not clear when the optimal time is for a booster shot.

"There's no question that a third dose does increase antibody response," Moore said. "The debate has been whether and when it was necessary to do this."

Walensky said staying ahead of the virus was the biggest motivation driving the eight-month booster recommendation. And vaccines have proved to be our best tool: The US-authorized shots, which were rolled out eight months ago, have protected Americans from symptomatic infection and severe illness and saved hundreds of thousands of lives.

"You don't want to find yourself behind, playing catch up," Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said in a press conference on Wednesday.

Boosters seem to protect vaccinated people from mild illness

Studies have shown that COVID-19 booster doses increase the antibody levels in vaccinated people's blood. Higher antibody levels in general are associated with greater immune protection.

Dr. Robert Atmar, who's leading a booster trial at Baylor College of Medicine, said he suspected boosters could even prevent some cases of long COVID-19 by protecting vaccinated people from mild illness.

"That's always a good thing," Atmar said. But "it may be a little bit of extrapolation to suggest that a booster is warranted," he added. 

What is surely warranted right now, Atmar said, is curbing the soaring rate of hospitalizations among the 50% of Americans who remain unvaccinated or partially vaccinated. Boosters might not do much to address that. 

"Will it keep more people out of the hospital? Maybe, but I don't know that," he said, adding: "Targeting the unvaccinated would have a greater effect, from a public-health standpoint, if those individuals could be persuaded to accept the vaccine."

Boosters do not solve the real problem: keeping unvaccinated people out of the hospital

Dr. Paul Offit, a pediatrician at the Children's Hospital of Philadelphia and coinventor of the rotavirus vaccine, said the goal of these boosters should be the same as any vaccination: to eliminate "the worst things the virus can do."

Offit, like Moore and Atmar, said that aim would be better achieved by first vaccinating more people who haven't got their first dose, rather than bolstering protection for those who have.

"The real problem in this country is not that we need to boost the vaccinated — it's that we need to vaccinate the unvaccinated," Offit said. "That's the problem. Until we do that, we're going to suffer in this country." 

Moore put it even more starkly: "There are 100,000 to 200,000 people walking around America today who will be dead by the end of the year, and mostly self-inflicted, by refusing vaccination," he said. "That's the bigger issue."

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A Chinese satellite mysteriously broke apart in March, scattering into dozens of pieces. Now, a Harvard astronomer has discovered what likely happened: It seems to have collided with a chunk of a Russian rocket.

"This looks to be the first major confirmed orbital collision in a decade," Jonathan McDowell, who spotted the probable crash in a data log from the US Space Force, said on Twitter.

Space Force sensors detected new debris from the breakup of the Chinese satellite, called Yunhai 1-02, in mid-March. Yunhai 1-02 launched in 2019, so it was relatively young and should have been in good enough shape to not fall apart on its own. No verdict about the cause was ever announced.

But the Space Force did quietly update its space-debris catalogue with a new hint on Saturday. Object 48078, a piece of a Russian Zenit-2 rocket that launched in 1996, is now listed with a peculiar note: "collided with satellite."

McDowell spotted that new listing and shared it on Twitter. He went back through the orbital data and found that the Russian rocket chunk and the Yunhai satellite passed within 0.6 miles (1 kilometer) of each other at the exact time and day that Yunhai broke apart.

That passing distance is within the margin of error. Both objects would have been zipping around Earth faster than a bullet, so any contact would result in an explosion of debris. The crash created 37 known bits of debris, according to McDowell, though he added that there are probably more uncatalogued pieces.

It doesn't look like the collision was "catastrophic," McDowell said, since the Yunhai satellite has made several orbital adjustments since March, indicating that China can still control it.

"It's a moderately big deal," McDowell told Insider. "It shows that these smaller non-catastrophic collisions are becoming a thing — we will see more and more of them."

The dangers of space debris

The last time two large objects orbiting Earth crashed into each other was in 2009, when a defunct Russian military satellite careened into an active Iridium communications satellite above Siberia. That collision, along with a prior one in 2007, increased the amount of large debris in low-Earth orbit by about 70%.

There have been several false alarms and close calls since then. A dead Soviet satellite and a discarded Chinese rocket body sped past each other in space in October, after orbital models suggested they were at "very high risk" of colliding. In January 2020, a dead space telescope and an old US Air Force satellite beat alarming odds of crashing over Pittsburgh, Pennsylvania. In both incidents, nobody could control the satellites to avoid collision.

Already, nearly 130 million bits of space junk surround Earth — from abandoned satellites, spacecraft that broke apart, and other missions. That debris travels at roughly 10 times the speed of a bullet, which is fast enough to inflict disastrous damage to vital equipment, no matter how small the pieces. Such a hit could kill astronauts on a spacecraft.

Every time objects in orbit collide, they can explode into new clouds of tiny chunks of high-speed debris. In fact, the piece of debris that hit the Chinese satellite may have broken off of the original Russian rocket in an earlier collision.

"That's all very worrying and is an additional reason why you want to remove these big objects from orbit," McDowell told Space.com, which first reported his discovery. "They can generate this other debris that's smaller."

Experts expect more near-collisions like this if nobody removes dead satellites and old rocket bodies from space.

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For years, Apple has insisted that your iPhone is good for the planet. 

"We build them with the environment in mind," the company proclaims, and it builds the ubiquitous devices "to last." Gone are the days when the phones' glass was laced with mercury and arsenic. Now, the iPhone is green.

But the truth is that smartphones have a serious environmental toll. iPhones, like most smartphones, run on lithium ion batteries — manufactured with precious metals mined from Tibetan grasslands, the salt flats of Chile, and, soon, the Salton Sea in California. The waste from these mines is poisonous and leaches into surrounding communities. Lithium extraction requires enormous quantities of water and eats up local water supply.

And every day, instead of repairing their broken phones, consumers discard hundreds of thousands of smartphones, which then join the billions of tons of electronic waste that is flowing into landfills, into the ocean, and into city streets. 

The old smartphones are replaced with more, newer smartphones, adding to the tech industry's carbon footprint. Apple's own environmental reports, in fact, show that lifetime carbon emissions of newer iPhone models are higher than older models, and are growing — directly contradicting their claims of a greener phone. For the iPhone 12, more than 80% of those emissions occurred during production. The demand for lithium and copper is, subsequently, on the rise. Our single-use model for technology is unsustainable.

The material that I find most representative of the problem at hand is not a precious metal, however. It is glue. Consumer tech manufacturers have, gradually, replaced screws with adhesives — which make your smartphone more intimidating to repair.

In the newest iPhone models, for example, glue ensures that the glass on the back of the devices is nearly impossible to replace — although one resourceful repair shop suggests that a laser machine could do the job. Not only are our smartphones full of destructive rare earth metals, they are glued together, full of speciality screws that make them difficult to open, and hostile software that flashes warnings when parts are replaced.

These features have ensured that tech is difficult to fix, for both independent repair shops and DIY tinkerers. They have also kept the tech industry booming. Consumers, meanwhile, are forced to give money to the manufacturer for repairs — or, more often, to just buy a new phone. Our irreparable tech is thus heading to the landfill at a rapid pace. To fight against mass waste, consumers not only need the right to repair our devices — we need to value technology that lasts.

The 'right to repair' movement

It was last spring, at the onset of the pandemic, that the question of repairability — often a more niche movement — began to take on a new urgency. As the pandemic filled emergency rooms, ventilators began to break. And hospitals were not able to fix them: They were constrained by the whims of medical tech manufacturers, which frequently keep repair instructions from the public, forcing hospitals to consult "authorized" repair technicians, even when on-site staff were qualified to do so.

The needlessly broken ventilator was a powerful image. Biomedical technicians were forced to hack into ventilators, amounting to, as Democratic Sen. Ron Wyden of Oregon wrote in Slate, "denying sick people access to life-saving equipment over a repair manual." It became a metaphor for the ways that consumers are being held hostage by technology companies, all for the sake of revenue. 

Still, the fight for consumers — and independent repair shops — to be able to fix their own goods has a longer history. In the early 2010s, the automobile industry lobbied hard against proposed legislation to ensure that independent repair shops had access to the same repair information as dealers. It was a lone Massachusetts law that forced the industry to craft nationwide standards around repair rights — although car manufacturers are still lobbying against them. This was the first major victory of "Right to Repair" — a longstanding movement to give consumers the right to repair their own devices. In most other industries, however, there is no such agreement.

Increasingly computerized 

Take the agricultural sector, for instance. For years, farmers have warred with John Deere, a tractor and machinery manufacturer, to allow them to fix their equipment without heading to the dealer. John Deere has been unrelenting. Three years after the company had promised to provide tools and parts to independent shops, farmers still have no access to those resources. 

Part of the issue with John Deere is that tractors, like cars, are increasingly computerized — requiring the work of software engineers, instead of mechanics, when problems emerge. Like John Deere's tractors, our cars, our tools, and our household appliances, too, are becoming more alien — wired with impenetrable software that consumers are prevented from fixing.

The use of software might make the machines more modern, but it also renders them more controllable by the manufacturer. John Deere argues that relinquishing control of its software would pose a security risk: "It's a 40,000-pound tractor going down the road at 20 miles an hour," CTO Jahmy Hindman told Verge. "Do you really want to expose untested, unplanned, unknown introductions of software into a product like that?" It's a fragile argument, however: What's the difference between making a software modification and installing an engine modification? 

Change on the horizon

Last month, President Biden signed an executive order that announced his support for better consumer protections for repairs, directing the Federal Trade Commission (FTC) to consider new enforcement on the issue. And a few weeks ago, the FTC voted unanimously to better enforce laws around the right to repair. It was, as Nathan Proctor, a repair advocate with the US Public Interest Research Group, wrote: "a big day for the right to fix our stuff." It was a big day, too, for the fight for a greener economy.

This rhetorical support is, of course, not yet translated into actual enforcement. The US's formidable intellectual property regime poses a real threat to a robust legal right to repair. And, for years, manufacturers have gotten away with crafting illegal warranties that prevented consumers from seeking out third-parties repairs. The FTC itself concluded, in a report issued earlier this year, that there were "serious concerns" around manufacturers' compliance with such laws. But the urgency is justified. Unnecessary waste from electronics is a major threat to the environment — the "fastest-growing waste stream in the world," according to the UN — and is aggravating the encroaching climate catastrophe.

The FTC's announcement signals an important first step: enforcing laws like the Magnuson-Moss Warranty Act, which already gives consumers the right to third-party repairs without breaking a warranty. But much more is needed to reduce the extraordinary waste produced by flimsy, single-use consumer tech. 

Biden's executive order, and the FTC's actions, focus on competition in the marketplace — on cutting back the aftermarket monopolies that manufacturers have created by limiting repairs on their products. But they fail to address the underlying culture that the tech industry has created: As one study found, consumers are often eager to upgrade their iPhones, even if nothing is wrong with them, buying into the wasteful aesthetics marketed by Apple and other companies. To fight back against the ever-growing pile of e-waste, consumers must, instead, want their technology to last.

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Americans who have been fully vaccinated with Pfizer or Moderna should get a booster shot eight months after their second dose, US health authorities announced Wednesday. 

The Biden administration had already recommended boosters for some immunocompromised people, including those who have received an organ transplant or have an advanced HIV infection. The decision to expand that recommendation to all Americans is based on new data indicating that vaccine protection wanes over time — particularly in the face of the Delta variant.

A new CDC study found that the Pfizer and Moderna vaccines lowered the risk of a coronavirus infection by 75% in nursing homes from March to May, before the Delta variant became dominant in the US. But from June to August, after the variant had spread widely, those vaccines only lowered the risk of infection by 53%.

Additionally, a recent study from the Mayo Clinic, which is still awaiting peer review, identified a similar pattern in Minnesota. During the first half of 2021, Pfizer's vaccine lowered the risk of a coronavirus infection by 76%, it found. But in July, when Delta represented the majority of Minnesota's COVID-19 cases, that protection went down to 42%. Moderna's effectiveness also dropped to 76% in July, down from 86% during the first half of the year.

In New York, meanwhile, vaccines were found to be 92% effective at preventing COVID-19 as of May 3 — but by July 25, that effectiveness had gone down to 80%, according to a CDC study released Wednesday.

Other factors are at play in these declines in addition to efficacy drops, though. The researchers suggested that the Delta variant may evade vaccine protection better than its predecessors, and it's also possible that early reports inflated how well the vaccines protected against COVID-19, since Americans were more diligent about masks and social distancing then. 

However, vaccines remained just as effective at preventing hospitalizations in New York from May through July: They lowered the risk of hospitalization by 92% to 95% during that time.

"Based on our latest assessment, the current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout," US health authorities said in a joint statement on Wednesday. "For that reason, we conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability."

Boosters seem to offer more immune protection

Data from Israel, too, suggests that vaccine effectiveness may fall over time. There, Pfizer's vaccine now seems to lower the risk of severe disease and hospitalization by less than 55% among Israelis ages 65 and older who got the shot in January. (Clinical trials previously suggested that Pfizer's shot lowered the risk of severe disease by at least 95% up to six months after the second dose.)

Those findings, however, may be skewed by the fact that older people are more likely to be vaccinated and generally more prone to severe disease. In general, most breakthrough cases in Israel remain mild.

New data from the CDC shows that vaccines are still highly effective against severe disease for up to six months: Pfizer's and Moderna's shots lowered the risk of hospitalization in the US by 84% around three to six months after the second dose, a recent study found.

"While protection against infection may decrease over time, protection against severe disease and hospitalization is currently holding up pretty well," CDC Director Rochelle Walensky said at a White House briefing on Wednesday.

Still, Pfizer's data indicates that a third dose of its vaccine may help maintain a high level of protection against COVID-19 when given 6 to 12 months after the second shot. A study that's still awaiting peer review found that boosters could provide high levels of immune protection against the current variants for at least another six months.

But before booster shots can be rolled out to the public, the FDA still has to authorize them. Assuming that happens, the Biden administration plans to start distributing boosters the week of September 20.

By that point, the first people to get vaccinated in the US – healthcare workers, nursing home residents, and other elderly residents — will have gotten their second dose roughly eight months prior. US health authorities said they would start delivering boosters to residents of long-term care facilities first.

Health officials and other disease experts continue to emphasize, though, that the only way the pandemic will end is for more people to get their first shots.

"The real problem in this country is not that we need to boost the vaccinated — it's that we need to vaccinate the un-vaccinated," Dr. Paul Offit, who sits on the FDA's vaccine advisory committee, told Insider. "That's the problem. Until we do that, we're going to suffer in this country."

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The Biden administration rolled out its plan Wednesday for giving booster shots of the COVID-19 vaccine, saying most people in the US will be offered another dose about eight months after their initial vaccination to bolster their protection.

The decision comes as the Delta variant fuels a coronavirus surge in the US, with the daily average of new cases over the past week hovering around 140,000 — the highest levels since February. Hospitalizations and deaths have also increased, especially in the South, though the vast majority are occurring among people who aren't vaccinated.

The booster-shot campaign will begin September 20 for people who received Moderna or Pfizer-BioNTech vaccines, government officials said. People who got the single-dose Johnson & Johnson vaccine will probably need boosters as well, though officials are still evaluating data on that vaccine.

The US Food and Drug Administration needs to authorize booster shots from each vaccine-maker before they can be rolled out. People will likely be eligible for boosters eight months after they received their second dose of the two-dose immunizations.

Booster shots will be free to individuals, and available at about 80,000 locations including pharmacies, Jeff Zients, the White House's COVID-19 response coordinator, said during a press conference. He said the US has enough vaccines to give everyone an extra dose.

US health officials leading agencies including the FDA, the Centers for Disease Control and Prevention, and the National Institutes of Health released a statement Wednesday saying the data is "very clear that protection against SARS-CoV-2 infection begins to decrease over time following the initial doses of vaccination."

"Based on our latest assessment, the current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout," the public-health leaders said in the statement. "For that reason, we conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability.

Health officials said Wednesday the latest study results show waning effectiveness from the vaccines, particularly in preventing symptomatic illness. One new CDC study, for instance, found the Pfizer and Moderna vaccines lowered the risk of a coronavirus infection by 75% in nursing homes from March to May, before the Delta variant became dominant in the US. But from June to August, after the variant had spread widely, those vaccines only lowered the risk of infection by 53%.

While Moderna and Pfizer are both working on newer versions of their vaccines tailored to protect against Delta and other variant, these booster shots are expected to be similar to the shots that people are already receiving.

Both drugmakers have recently presented data showing that booster shots can increase the immune system's ability to fend off the Delta variant.

The decision comes amid an ongoing debate over whether or not booster shots are needed. Some vaccine experts  have said there isn't enough data to justify giving boosters now, and the vaccines are still highly effective at preventing hospitalizations and deaths. They also contend that the goal should be to get initial vaccine doses to more people, both in the US and around the world.

On the other side, executives at vaccine-makers Pfizer and Moderna have argued it's best to be proactive. As Moderna CEO Stéphane Bancel has repeatedly put it, he'd rather have the US offer boosters two months too early than two months too late. 

Health workers and vulnerable people to get boosters first

By tethering booster shots to the time of initial vaccination, the booster campaign will follow a similar sequence to the initial rollout of shots: healthcare workers, as well as the elderly and other vulnerable people first, followed by younger and healthier populations.

It's unclear how many vaccinated people will decide to get a booster; Michael Yee, a biotech analyst at Jefferies, estimated in an August 10 research note that about 30% of immunized people would get a booster. 

The US has already started offering booster shots to a small group of people with weakened immune systems. Those shots are only available to people who were initially vaccinated with shots from Pfizer-BioNTech or Moderna.

About nine in 10 fully vaccinated Americans received two doses of either the Moderna or Pfizer-BioNTech vaccines, which both use a similar technology. 

Nearly 14 million people in the US received the single-dose J&J vaccine. The health officials said they expect data that will help them decide on a booster-shot plan for people who received that vaccine in the next few weeks.

To date, the US has administered more than 357 million doses of COVID-19 vaccines. About 169 million people in the US are fully vaccinated, or just over half of the nation's population. Children younger than 12 still aren't eligible to get coronavirus vaccines.

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Some hospitals across the country are reporting severe staff shortages as a surge of COVID-19 patients overwhelms them, with some saying they have to leave patient beds unused as a result.

"We're really struggling," Dr. Dale Bratzler, Oklahoma University's Chief COVID Officer, told Insider. "We don't have the nursing capacity now ... that we did in January." 

Hospitalizations are on the rise in the US, with almost 73,000 COVID-19 patients in hospitals across the country as of August 15, up from about 17,000 a month before.

Patient beds are being left unused, even as demand is high

States with low vaccination rates have been hit hard: Louisiana is approaching a "major failure" of its health system, Gov. John Bel Edwards said last week.  Oklahoma is sending patients out of state, KFOR reported. Tennessee is rolling out the National Guard to fill staff shortages in hospitals. And Alabama has no ICU beds available left, according to a hospital chief.

Yet Bratzler said some beds in his hospital have been left unused due to the staffing shortage.

"We just opened 144 new patient beds in our university hospital. But parts of the floors are not open yet because we don't have the staffing," he said.

Austin Public Health also has more beds than it could use, the Austin American-Statesman reported.

"In theory, there are more ICU beds available, but there is not enough staff to provide service for all those ICU beds," said spokesperson Matt Lara.

All states are reporting some level of staffing shortage, Dr. Jorge Caballero, an anesthesiologist and data engineer, told Marketplace.

In fact, more than one in five hospitals in states in the South and Southwest — such as Alabama, Arizona, Louisiana, and Missouri — have reported "critical staffing shortages," he said.

"It's a real dire situation," said Joe Kanter, Louisiana's chief public health officer, per the Associated Press. "There's just not enough qualified staff in the state right now to care for all these patients."

A survey found that 75% of Florida hospitals were likely to hit critical staffing shortages within the next week, according to Becker's Hospital Review.

Tennessee hospitals are operating with about 1,000 fewer staff than at the beginning of the pandemic, the Tennessean reported. 

Texas has set out to recruit 2,500 out-of-state nurses, a number that falls "woefully short" of demand, said Darrell Pile, CEO of the Southeast Texas Regional Advisory Council, the Houston Chronicle reported. 

Pandemic fatigue

Nurses have been driven out due to pandemic fatigue and burnout, Bratzler said.

"We do have more people on quarantine right now than we did before. But by and large, we lost a lot of nursing staff during the peak of the pandemic," he said.

Nurses went to work in other positions that didn't require them to give inpatient care, he said. 

More staff could be driven out by the ongoing COVID-19 wave. This wave has been particularly hard on the medical staff because patients are so young, Dr. Cam Patterson, the Chancellor of the University of Arkansas for Medical Sciences, told Vice News.

"You see people, young people, healthy people who are dying. And they have babies, the babies are dying," he told Vice, adding: "At some point, that's not just burnout; it becomes acute mental trauma." 

Exhausted nurses have walked out in the middle of their shifts, he said. 

"It's really hard to come to work all the time and just see such sick young patients," Alyssa Kirkpatrick, a critical care nurse, told Vice.

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At least two US officials in Germany have developed symptoms of "Havana Syndrome," The Wall Street Journal reported.

US diplomats told The Journal that they sought treatment after developing symptoms including nausea, fatigue, and headaches, over the last few months.

More than 130 US personnel across the world have reported similar symptoms, as Insider's Aylin Woodward previously reported. Locations have included in Cuba, China, Russia, and the US.

These latest cases are the first reported in a NATO country that hosts US troops and nuclear weapons, The Journal reported.

Theories behind the mysterious illness have included pesticides and a microwave weapon.

The White House has ordered studies into its origin.

It is known as Havana Syndrome, as that is where cases first started showing up in 2016.

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Alabama has more patients needing ICU beds than are available as COVID-19 cases max out the state's intensive care capacity, the head of the state's hospitals association said Tuesday. 

"We've never been here before," Alabama Hospital Association President Dr. Don Williamson told WSFA. "We are truly now in uncharted territory in terms of our ICU bed capacity."

As of Tuesday, there were 1,568 patients needing intensive care, but only 1,557 designated ICU beds, Williamson told WSFA. 

In total, there are 2,700 people being treated for COVID-19 in the state, of whom 41 are children, he said, according to WFSA. New cases in Alabama reached 4,023 on Tuesday, one of the highest days since the pandemic began, according to The New York Times' cases tracker. 

Patients are still receiving ICU-level care in other units, and the ventilator supply has held up, Williamson told WSFA. But the issue of ICU space is critical.

"We've got patients in some hospitals on gurneys, receiving ICU care in the hallway," Williamson told WSFA. 

The situation is having a knock-on effect on patients with other ailments as staff and space are reallocated to COVID-19 patients, he said, according to WSFA. Most worrying, he said, was that he didn't believe the crisis has reached its peak yet. 

A crisis of vaccine hesitancy

"This could have been prevented had we gotten vaccination numbers to higher levels," Williamson told WSFA. 

Alabama is one of the least vaccinated states in the country, with just 35% of the state's population fully vaccinated, according to CDC data.

Only 12% of those hospitalized with COVID-19 in the state are fully vaccinated, Williamson told WSFA. Vaccine hesitancy is so rife that by early August, 65,000 doses of vaccine had expired unused, WSFA earlier reported. 

As of early August, 11,600 Alabama patients had died with the virus since the pandemic began. Of those, only 26 were fully vaccinated.  

The situation is prompting increasingly tough measures to promote vaccination. In early August, two major hospitals in Mobile and the Birmingham area took the decision to require all staff and volunteers to get vaccinated, AL.com reported. 

Dr. Jason Valentine, a physician in Mobile, posted to Facebook to say that, as of October, he would no longer treat unvaccinated patients, AL.com reported.

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Four US states have set records for new COVID-19 infections and hospitalizations over the past few days, data from Johns Hopkins University shows.

Florida recorded more than 151,000 new cases on Friday, and Hawaii reached 1,167 new infections — both the highest since the start of the pandemic in those states. On Monday, Mississippi recorded a peak of 7,839 cases, and Oregon 4,380, which are the highest in the states since the pandemic began, according to Johns Hopkins University. The Mississippi Department of Health reported 7,839 as a 3-day total.

The daily number of hospitalizations is also at an all-time high in these four states, the data showed 

But of the four states, those with higher vaccination rates — Oregon and Hawaii — have more room left in the state's intensive-care units, suggesting vaccines are reducing severe infections.

Peter Chin-Hong, a professor of medicine at University of California, San Francisco, told CNBC that Oregon and Hawaii were "hurting with explosive case rates, but with high vaccination and masking rates, may not ever be in the same precarious position" as Florida or Mississippi.

Florida and Mississippi's ICUs are at more than 90% capacity and are mostly full of COVID-19 patients, the Johns Hopkins University data showed. Oregon and Hawaii's ICUs are more than 73% full, with mostly non-COVID-19 patients.

Oregon and Hawaii have mask mandates in place, while Florida and Mississippi don't. 

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Hawaii and Oregon have fully vaccinated 61.3%, and 58% of their population respectively, according to Johns Hopkins University — well above the 50.8% national tally.

Meanwhile, 51.8% of Floridians are fully vaccinated and Mississippi's vaccination rate is much lower, at 36.1%, the same data shows.

Mississippi Gov. Tate Reeves said at a news conference on Friday that "when you look across the country, to a certain extent, this current wave is the pandemic of the unvaccinated."

"Those who received the vaccine are significantly less likely to contract the virus," he said.

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Eight months after vaccines became available, Louisiana faces its most dire coronavirus surge yet. 

Around 3,000 people in the state were in the hospital with COVID-19 as of Sunday — a five-fold increase over the last month. The state's record before vaccines came out was around 2,000 COVID-19 hospitalizations at one time. 

"We are rapidly getting to the point where we could have a major failure of our healthcare delivery system," Gov. John Bel Edwards said at a Friday press briefing. "There's some people out there whose care is being delayed to the point where, for them, it's already failed."

When hospitals reach capacity, doctors have to start turning away patients — in some cases determining who lives and who dies. Already, many large hospitals in Louisiana are delaying non-emergency surgeries and denying patient transfers, and some patients have had to wait several hours for emergency room beds.

"We're putting off cases that we would consider to be urgent," Dr. Catherine O'Neal, chief medical officer at Our Lady of the Lake hospital in Baton Rouge, told Insider. "People who have cancer, for instance — we would never put you off. You have to get your cancer diagnosed. You have to get your cancer taken out. But this week we saw that we were making those decisions because we just didn't have room to admit that patient and have them take up an ICU bed."

The situation inside hospitals is far worse than anything Louisiana saw in the pandemic before now, she added.

"There's no photo or image or even video scene that captures the unrelenting pace," O'Neal said. "It's like taking a picture of a marathon runner."

The chart below shows how Louisiana's hospitalization surge compares to last winter:

This surge is fueled by the Delta variant, which may be two to three times as contagious as the original version of the virus, according to one estimate.

Louisiana's low vaccination rate is also a major factor. Less than 39% of the state's residents are fully vaccinated, and unvaccinated people account for 90% of its COVID-19 hospitalizations right now, according to data from Louisiana's health department.

'This is not something that's happened before'

At the moment, four hospital regions in Louisiana — South Central Louisiana, Acadiana, Southwest Louisiana, and Central Louisiana — have just a handful of available ICU beds each. In eight out of nine regions, hospital beds are at least 70% full. And in South Central Louisiana, where hospitals have reached 83% capacity, just 100 hospital beds are currently available. 

"This is not something that's happened before," Louisiana's state health officer, Dr. Joe Kanter, said in the Friday briefing. "We've never been to a place where not one hospital, but almost every hospital in the state, is at a point where they simply can't meet the demand that comes in."

He added that 58 hospitals have reached out to the state asking for additional doctors and nurses. 

O'Neal said ambulances are also facing abnormally long wait times outside her hospital in Baton Rouge, which can further jeopardize a patient's health.

"Usually an ambulance comes in, drops off, and leaves and you would never stack up more than two or three," she said. "But now it's not uncommon to see five to seven out there waiting."

The state is still trying to avoid a lockdown

Gov. Edwards temporarily reinstated Louisiana's indoor mask mandate on August 4, as COVID-19 hospitalizations hit record highs. But the mandate is set to end in early September, and Louisiana hasn't put any capacity caps on businesses or gatherings. Louisiana's school districts all resumed in-person leaning for the new school year.

Rather than implement any new policies or mandates, the state has focused on boosting vaccination rates.

Louisiana has seen a three-fold increase in its vaccination rate over the last month. The state is now administering 18,600 daily doses, on average — up from 6,100 daily doses in mid-July. But 67% of people ages 18 to 29 in Louisiana have yet to receive their first shot. So Edwards announced Monday that Louisiana will give $100 debit cards to the first 75,000 college students who get vaccinated.

Healthcare workers are also pleading with residents to get vaccinated.

"The majority of COVID patients that we've seen who are unvaccinated have regret," O'Neal said. "There's so much misinformation and they're sort of surprised that they're in this situation because the reason that they didn't get vaccinated, for the most part, was because they thought they would be OK."

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Health officials in Central Florida say that the high levels of COVID-19 RNA concentration found in the region's wastewater are "very concerning."

The concentration has risen 600% since sampling began in mid-May, Director of Orange County Utilities Ed Torres told reporters, according to FOX 13 News. The wastewater levels — which public health officials have used as a tool to measure COVID-19 infections — indicate that the surge that is overwhelming Florida hospitals is not slowing down.

"The results of the virus RNA that we measure in wastewater indicate that we will see continued clinical cases and hospitalizations this week, even beyond what was reported this weekend," Torres said. "Please, we urge you to get vaccinated and continue to take the proper precautions." 

Orange County started surveilling Atwater in May in partnership with the Centers for Disease Control and Prevention.

Florida is seeing a surge of COVID-19 cases because of the Delta variant. The state recorded more than 151,000 new cases last week — a record high — and more than 1,070 deaths, according to data from Johns Hopkins.

In recent weeks,hospitals across the state are facing long wait times and limited oxygen.

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A generation of leaders is creating a new future for the healthcare industry. 

In 2021, they've navigated the impacts of a pandemic to their businesses and to their lives as the US gets vaccinated and faces a swell of COVID-19 cases. 

For their work, we've named an impressive group of young leaders to Insider's annual list of the 30 people under 40 who are transforming healthcare.

The 30 people were selected from hundreds of nominations, based on their potential to improve healthcare.

They include young leaders within Amazon and Google, doctors doubling as company founders, leaders within healthcare companies big and small, and scientists trying to crack the code on cancer-detecting blood tests and new ways to tackle infectious diseases like malaria.

Subscribe to Insider to read the full list of 30 leaders under 40:

Meet the 30 young leaders forging a new future for the healthcare industry in 2021

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New Zealand is back in strict national lockdown after one 58 year-old-man tested positive for COVID-19, with no immediate evidence that he'd traveled abroad.

Officials assume that the infection was caused by the highly-infectious Delta coronavirus variant.

National statistics suggest that all of New Zealand's cases since February have been detected at its border, rather than in the community. The country, of nearly 5 million people, has recorded just 26 COVID-19 deaths since the start of the pandemic, and has favored strict lockdowns.

Prime Minister Jacinda Arden said in a briefing on Tuesday that Delta, which had caused all but one of New Zealand's COVID-19 infections since late June, was a "game changer."

"It means we need to again go hard and early to stop the spread. We have seen what can happen elsewhere if we fail to go on top of it. We only get one chance," she said. 

Arden said that the decision was made on the basis it was "better to start high and go down levels" of lockdown.

"We've seen the dire consequences of taking too long to act in other countries," she said.

From midnight on Tuesday, New Zealanders can only leave the house for exercise, supermarket shopping, essential medical care including pharmacy visits, and for getting a test, Arden said. They must wear a mask.

This is New Zealand's second "Level 4" lockdown, the nation's strictest level.

Arden said that it would last three days for most of the country except Auckland, New Zealand's largest city, where the man lived, and the Coromandel, where the man traveled to over the weekend. 

Arden also suspended the nation's vaccine rollout, which already lags behind most other countries, for 48 hours, while measures were put in place to continue it safely.

New Zealand has fully-vaccinated 18.6% of its population, according to Johns Hopkins University. The world average is 23.6%.

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Dr. Ashley Broomfield, chief executive of the Ministry of Health, said in a briefing that the man, who was unvaccinated, developed symptoms on Saturday when on a weekend trip to the Coromandel on the east coast of New Zealand's North Island, and was tested by his family doctor in Auckland on Monday.

He was now self-isolating, Broomfield said. The man's wife, who was vaccinated, had tested negative.

Health officials said the man had no obvious travel history or contact with anyone who had traveled. They were trying to establish how he got infected, they said.

The country first went into Level 4 lockdown on March 26, 2020, when it had recorded fewer than 300 cases, and no deaths. The country has recorded 2,927 COVID-19 cases and 26 deaths since the start of the pandemic, according to Johns Hopkins University.

There are currently 43 New Zealanders with COVID-19, and an average of 1.07 daily new confirmed COVID-19 cases per million people, as of Monday, according to Oxford University's Our World in Data's most recent stats. For comparison, on the same date, the US had an average of 394.89 daily new confirmed cases per million and the UK had 418.85 new cases per million.

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