Back in the spring, Pauline Criel and her cousins talked about reuniting for Thanksgiving at her home near Detroit after many painful months of seclusion because of the covid-19 pandemic.
But the virus had a different plan. Michigan is now the nation's hot spot. Hospitals there are teeming with patients, and schools are scaling back in-person learning. A resurgent virus has pushed new infections in the U.S. to 95,000 daily; hospitals in Minnesota, Colorado and Arizona are also under pressure; and health officials are pleading with unvaccinated people not to travel.
Criel's big family feast was put on hold. She roasted a turkey and whipped together a pistachio fluff salad -- an annual tradition -- but only for her, her husband and two grown boys.
"I'm going to wear my stretchy pants and eat too much -- and no one's going to care," she said Thursday.
Her story reflected the Thanksgiving dilemma that families across America faced as the gatherings became burdened with the same political and coronavirus debates consuming other arenas.
"I know that it might be overkill that we're not sharing Thanksgiving here with my cousins, but better be safe than sorry, right?" said Criel, a 58-year-old data administrator for a finance company.
As cases surged, the European Union warned member countries Thursday that they risk undermining the 27-nation bloc's covid-19 travel and access certificate system with new restrictions that some are putting in place.
At the same time, the EU's executive branch, the European Commission, recommended that a covid safe-country list with about 20 countries outside Europe currently on it should be dropped from March and that all travelers with World Health Organization endorsed shots be allowed in.
The European Medicines Agency approved Thursday the use of the Pfizer-BioNTech coronavirus vaccine for children ages 5 to 11, bringing European governments one step closer to inoculating young children.
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The recommendation of the European Union's drug regulator will now be sent to the European Commission, the bloc's administrative arm, for final approval, which it is expected to do swiftly. It will then be up to the national health authorities to decide if and when they will start inoculating young children.
The decision comes amid a covid spike across the bloc. The European Center for Disease Prevention and Control said Wednesday that European governments should accelerate their vaccination rates, consider booster shots for adults and tighten restrictions in order to avoid a "very high burden" on national health care systems. Approximately 66% of the European Union's total population has been fully inoculated, according to European Center for Disease Prevention and Control data.
The regulator approved the Pfizer-BioNTech vaccine for children ages 12 to 15 in May, in what the agency called "an important step forward in the fight against the pandemic."
All 27 member nations are now inoculating adolescents, according to the European Center for Disease Prevention and Control.
The World Health Organization says coronavirus infections jumped 11% in Europe in the past week, the only region in the world where covid-19 continues to rise. The WHO's Europe director, Dr. Hans Kluge, warned that without urgent measures, the continent could see another 700,000 deaths by the spring.
Many countries have begun tightening rules on people who are not vaccinated to try to encourage them to get shots to better halt the spread of the virus. Austria even plans to make vaccines obligatory from next February.
As winter closes in and coronavirus restrictions are ramped up, tens of thousands of people have rallied around Europe in recent weeks in protest against the tightening of measures and against the requirement for covid-19 certificates.
The EU's covid pass contains proof that the holder has either been vaccinated, has in the past recovered from the disease, or has recently tested negative.
But some German states are now demanding proof of vaccination and daily negative tests. From next month, Italy will require proof of vaccination or having recovered to access a host of free-time activities over the holiday season. Tests will no longer be enough.
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"Holders of [an] EU certificate should, in principle, not be subject to additional restrictions, wherever they come from in the European Union. Restrictions such as additional tests or quarantine, for instance," Didier Reynders of Belgium, the European justice commissioner, told reporters.
The commission says scientific evidence shows that vaccine immunity begins to diminish after about six months. But it's recommending that certificates should continue to be accepted as valid for nine months after the first shot.
Some countries want booster shots to be mandatory for the certificates to be valid. France, for example, wants to require them on certificates for people over 65, while neighboring Belgium does not think it's necessary yet.
"The commission is not proposing any period of validity for boosters at the moment," Reynders said.
Brussels also wants to end the EU's safe-country list for nonessential travel. Like other countries, the United States has been on and off it as the pandemic spread in waves. That is set to change from March 1, if the 27 member countries agree.
"Now we are moving away from this country-based approach to an individual approach," EU Home Affairs Commissioner Ylva Johansson said. "All people that are vaccinated can come into the European Union."
Travelers who have had EU-approved vaccines would simply be able to enter, while those with other WHO-endorsed shots would also have to submit a negative PCR test as well. But certificates that these travelers present must not be more than 9 months old.
Africa is seeing a rise in deliveries of vaccine doses to the continent, but only one in four of its health workers has been fully vaccinated against covid-19, the World Health Organization regional office said Thursday.
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WORRY IN AFRICA
The most common reasons for the low vaccination rate among health workers on the African continent of about 1.3 billion people include vaccine hesitancy and the unavailability of vaccine services, especially in rural areas, Matshidiso Moeti, WHO's Africa director, told an press news briefing.
It's a striking contrast to the more developed countries where more than 80% of health care workers in 22 mostly high-income countries have been fully vaccinated, according to a recent WHO study.
The low vaccination rate among health workers in Africa "puts at risk not only their own health and well-being but also that of the patients that they look after," Moeti warned, calling on African countries to "urgently speed up the rollout of vaccines to those on the front lines."
Africa has an acute shortage of health workers, with only one country in the region having the recommended number of health workers to provide essential health services.
"Any loss of these essential workers to covid-19 due to illness or death therefore heavily impacts on service provision capacity," WHO's Nigeria office said in a statement.
Many of Africa's health workers, including those working in rural communities, still have "concerns over vaccine safety and adverse side effects," Moeti said.
In Nigeria, Africa's most populous country, only 300,000 -- or 18% -- of its 1.6 million health workers have been fully vaccinated.
A recent study also found that only 40% of health workers in Nigeria intended to receive the vaccine while less than 50% hope to get their shot in Ethiopia, the WHO said.
To increase the vaccination rate among health workers in Nigeria, nurses and midwives need to be more involved in the vaccination process, according to the president of the National Association of Nigeria Nurses and Midwives. With that and through health education, "many people will be convinced" to take the vaccine, Michael Nnachi said. "When the nurses are directly involved, we can achieve more."
Just about 7% of Africa's population has been fully vaccinated, mainly because of delays in vaccine supplies and vaccine hesitancy, Moeti said. But after challenging months in getting needed supplies, Africa is now seeing "an acceleration in the availability of vaccines."
As more doses are arriving on the continent, more countries are introducing mandates -- often targeting government workers and public places -- to increase the vaccination rate.
"It will be good to balance the approaches of persuasion, information sharing, expansion of capacity to deliver, intensification of the campaigns as well as using that additional tool of further motivating people to be vaccinated because they need to get services that they need," Moeti said.
Mayors across Brazil are divided on whether to maintain end of year festivities and February's Carnival, traditionally celebrated lavishly in all four corners of the vast nation, with some fearing that now-low covid-19 infection rates could roar back.
RIO'S CELEBRATIONS A GO
Rio de Janeiro is moving forward with both New Year's Eve and its legendary Carnival, each likely to attract millions of revelers. But others have opted for a more conservative approach: Several municipalities in Sao Paulo, Minas Gerais and other states canceled Carnival altogether, including the street parties known as "blocos".
The number of daily deaths and new infections from the virus are currently low and vaccination coverage is higher than in many countries -- including the U.S. -- but officials fear bringing large crowds together could reignite a disease that has already killed more than 600,000 in Brazil alone.
Officials in favor of maintaining events stress the importance of Carnival for local economies that deeply suffered during the pandemic.
Brazil's Tourism Minister Gilson Machado Neto declined to take sides Thursday, saying that legally, the decision lies with states and municipalities.
Brazil's National Council of Health Secretaries told The Associated Press that decisions should be made based on scientific studies and on the state of the pandemic in each municipality.
In the absence of national guidelines, many mayors are still undecided, especially since cases and hospitalizations are rise in countries with similar vaccination coverage to Brazil's, such as Germany.
In Belo Horizonte, capital of Minas Gerais state, the mayor said last week that he could not force people to stay home, but that the city would not "sponsor" Carnival.
The mixed message brought criticism from state officials, who called for mayors not to shirk responsibilities. "The worst thing a city can do, is not to interfere in anything," Minas Gerais Gov. Romeu Zema said Tuesday.
The position was echoed by his health secretary, Fabio Baccheretti: "Carnival will happen, we cannot close our eyes. The parties are happening, the events are happening. And if we don't give guidance, Carnival will happen in a disorganized way, with greater risk for the population."
Information for this article was contributed by Bobby Caina Calvan, Thomas Peipert, Lorne Cook, Frank Jordans, Colleen Barry, Olga R. Rodriguez, Chinedu Asadu and Diane Jeantet of The Associated Press and by Monika Pronczuk of The New York Times.