More than 1.1 million Americans have died of Covid. An official end to the health emergency has landed in complicated ways for those affected most acutely.Shannon Cummings, 53, has tried to push forward after her husband, Larry, a college professor, died of Covid-19 in March 2020.She flew from her home in Michigan to Southern California to attend a Harry Styles concert with family members and friends. Twice a week, she meets with her group therapy classes. She started going out to lunch in public again, a step that took her years.“We lost over a million people in the pandemic,” she said. “It doesn’t honor any of them to not live my life.”Yet she is still grappling with the milestone the nation will mark on Thursday: something of an official end of the pandemic, as the Biden administration will allow the three-year-old coronavirus public health emergency — and a separate declaration of a national emergency — to expire.“I feel like some people never really embraced that there was an emergency going on,” Ms. Cummings said. “It’s really hurtful to those of us who have actually experienced a loss from this.”Shannon Cummings at her home in Petoskey, Mich., in 2021.Lyndon French for The New York TimesThe end of the coronavirus public health emergency in the United States comes at a point when vaccines are effective and widely available, testing is easily accessible and treatments have vastly improved since the beginning of the pandemic.More than 1.1 million Americans have died of Covid, and the rate of death has markedly slowed in recent months. In 2020 and 2021, it was the third most common cause of death; by this point in 2023, preliminary data show, it has dropped to seventh.But the move by the Biden administration that takes effect on Thursday has landed with mixed emotions for many Americans who have lost family members and friends to the pandemic.For some people, it has brought worries that the pandemic is being politicized once again.“What’s triggering is when people say, ‘Now we know we didn’t have to shut things down or wear masks,’” said Kori Lusignan, a resident of Florida whose father, Roger Andreoli, died of Covid in 2020. “I got an intimate, up-close look at the suffering. And it led me to believe that we didn’t make hasty or inconsequential decisions. Those were choices we had to make, and there were good reasons for them.”For others, it is a welcome acknowledgment from Mr. Biden that the country is in a different place from where it was before.The surgical intensive care unit at the Brooklyn Hospital Center, which was inundated with Covid-19 patients during the pandemic.Victor J. Blue for The New York Times“I don’t think it’s premature, and I don’t have any hard feelings that he’s going to do this,” said Vincent Tunstall, who lives in Chicago and lost his brother, Marvin, to the virus in November 2020.Mr. Tunstall said that he was still being more cautious about Covid than many people, wearing a mask when he is in an indoor public space and on his daily commute on the train. Any mention of Covid reminds him of his brother, a lingering pain known only to those who have lost people in the pandemic.“Unfortunately, when I think about Covid and the pandemic, thoughts of him are intertwined with both of those,” he said.Pamela Addison, a Covid widow, mother of two and advocate for survivors, said the administration’s decision to allow the emergency to expire was a reminder that the federal government could do more for children who have lost parents and caregivers.“The kids are overlooked constantly,” she said. “We don’t want to talk about them. It’s like we don’t want to talk about the fact that they exist.”The end of the emergency declaration could result in new costs for coronavirus testing, because after Thursday, private insurers will no longer be required to cover up to eight at-home tests per month.Laura Jackson’s husband, Charlie, died of Covid-19 shortly after his 50th birthday. The Jacksons were together for 28 years and had three children.Mike Belleme for The New York TimesLaura Jackson, who lost her husband, Charlie, to the coronavirus, questioned the necessity of the move. Leaving Americans with out-of-pocket costs related to the virus is the equivalent of “dumping this back” on the public, she said, while the country remains unprepared for a future pandemic.“There’s so much more work that needs to be done,” she said, noting that there were still questions about the origin of the virus in China. “We shouldn’t be turning off resources.”For Ms. Jackson, who lives in Charlotte, N.C., the end on Thursday of the pandemic’s classification as a public health emergency has nearly coincided with the anniversary of her husband’s death on May 17, 2020. Both days, she said, have filled her with dread.She still encounters people on a regular basis who deny that Covid is real, or who imply that her husband died because of his pre-existing conditions, a comment that stings.“I never felt like we acknowledged those who we lost,” Ms. Jackson said. “I feel like we’ve always been in a hurry to move on from it. But it’s still so real.”

The potent opioid increasingly is afflicting people of color in American cities. “I’ve seen a lot of terrible drugs,” said a veteran drug counselor. “This is the worst.”MILWAUKEE — Glenda O. Hampton doesn’t need to look far to witness the devastation of the fentanyl epidemic in her neighborhood on Milwaukee’s north side.She has found men lying on the curb, barely conscious, their legs splaying into the street as cars whiz by. She can count at least three people in recent months who sought treatment at the storefront rehabilitation center she runs, then relapsed and died from using fentanyl.“I’ve seen a lot of terrible drugs,” said Ms. Hampton, 68, a tiny figure seated behind her crowded desk, as a group counseling session was underway down the hall. “This is the worst.”The synthetic opioid fentanyl has swept across the United States in recent years, the latest wave of a drug crisis that began with opioid painkillers and was followed by heroin. Fentanyl is a startlingly potent drug, 100 times more powerful than morphine, that was linked to the deaths of more than 70,000 Americans in 2021. They included first-time users who ingested more fentanyl than their bodies could handle, unsuspecting college students taking party drugs like cocaine that were laced with fentanyl, and people with longstanding addictions searching for cheap and plentiful highs.Desilynn Smith, left, an addiction counselor, leading a group session at Gateway to Change in Milwaukee. Milwaukee is seeing a surge in deaths from fentanyl, especially in Black and Latino communities.Todd Heisler/The New York TimesIn cities like Milwaukee, fentanyl is increasingly a crisis in heavily Black and Latino neighborhoods. It is spreading within communities that are already straining under the weight of poverty, disinvestment and violent crime, and are now struggling to control a drug whose reach grows every year.A federal report released in July said that drug overdose deaths in the United States — which are largely driven by fentanyl — hit people of color the hardest, with rates among young Black people during the coronavirus pandemic rising the most sharply. Data from Milwaukee County showed that from 2020 to 2021, fatal overdoses increased by 6 percent among white people, but 55 percent among Black people.In 2021, more than 500 drug-related deaths in Milwaukee County were tied to fentanyl, officials said, and this year’s death toll is expected to be even higher.“Unfortunately, this epidemic is affecting communities of color really hard,” Cavalier Johnson, the mayor of Milwaukee, said in an interview. “The number of fentanyl-related deaths has continued to grow, and so too has the share of people of color who have succumbed to fentanyl-related deaths.”Mayor Johnson, a native of the predominantly Black north side of Milwaukee, has faced a cascade of crises since becoming mayor in 2021. The city budget is strained, with rising pension costs leading officials to consider cuts to libraries, the city’s police force and fire departments. The number of homicides in Milwaukee, a city with a population of 577,000, nearly doubled from 2019 to 2021.Fentanyl Overdoses: What to KnowCard 1 of 5Devastating losses.

Mayor Lori Lightfoot of Chicago said on Wednesday that all city employees will have to be fully vaccinated by Oct. 15. The action by the city, the second-largest in the United States to impose such a requirement, came as coronavirus infections continue to spread rapidly across the country.The policy will apply to more than 30,000 employees, including teachers, police officers, firefighters and sanitation workers. Employees may apply for a medical or religious exemption.“As cases of Covid-19 continue to rise, we must take every step necessary and at our disposal to keep everyone in our city safe and healthy,” Ms. Lightfoot said in a statement. “Getting vaccinated has been proven to be the best way to achieve that and make it possible to recover from this devastating pandemic. And so, we have decided to join other municipalities and government agencies across the nation, including the U.S. military, who are making this decision to protect the people who are keeping our cities and country moving.”The Los Angeles City Council passed a similar vaccine mandate last week for the city’s nearly 60,000 municipal workers (the public schools there are not part of the city government). Los Angeles County and the city of Seattle have also adopted mandates.In New York City, Mayor Bill de Blasio has announced that teachers and other school employees will be required to be vaccinated, and other city employees must either be vaccinated or submit to weekly coronavirus tests.The Food and Drug Administration granted full approval on Monday to Pfizer-BioNTech’s coronavirus vaccine for people 16 and older, making the vaccine the first to move beyond emergency-use status in the United States.Ms. Lightfoot, whose administration has had a rocky relationship with major labor unions, is expected to face resistance from their members, particularly in the union representing police officers. She said on Wednesday that her administration was in conversations with labor unions to “create a vaccination policy that is workable, fair and effective.”The Fraternal Order of Police in Chicago said earlier this week that it opposed a mandate and was awaiting more information from the mayor’s office.Bob Reiter, the president of the Chicago Federation of Labor, which represents union members in Chicago and Cook County, said that while unions believe in the benefits of vaccination, “we do not believe punitive mandates are the right path to significantly increase vaccine uptake.”“We believe this announcement may harden opposition to the vaccine, instead of protecting the workers who have sacrificed so much over the past 18 months,” Mr. Reiter said in an email.Nearly 64 percent of Chicago residents age 12 and older have been fully vaccinated; nationwide, 60 percent of Americans 12 and older have been fully vaccinated.

CHICAGO — They acknowledged that they could have showed up months ago. Many were satisfied that they were finally doing the right thing. A few grumbled that they had little choice.On a single day this past week, more than half a million people across the United States trickled into high school gymnasiums, pharmacies and buses converted into mobile clinics. Then they pushed up their sleeves and got their coronavirus vaccines.These are the Americans who are being vaccinated at this moment in the pandemic: the reluctant, the anxious, the procrastinating.In dozens of interviews on Thursday in eight states, at vaccination clinics, drugstores and pop-up mobile sites, Americans who had finally arrived for their shots offered a snapshot of a nation at a crossroads — confronting a new surge of the virus but only slowly embracing the vaccines that could stop it.Duncan Beauchamp, 17, was vaccinated at Lyman Orchards in Middlefield, Conn. His father had been concerned by how quickly the vaccines were rolled out.Christopher Capozziello for The New York TimesEver Diaz, 42, was vaccinated at the Polk County Health Department in Des Moines. He said it had been hard to get a vaccine because of his job in construction.Kathryn Gamble for The New York TimesThe people being vaccinated now are not members of the eager crowds who rushed to early appointments. But they are not in the group firmly opposed to vaccinations, either.Instead, they occupy a middle ground: For months, they have been unwilling to receive a coronavirus vaccine, until something or someone — a persistent family member, a work requirement, a growing sense that the shot was safe — convinced them otherwise.How many people ultimately join this group, and how quickly, could determine the course of the coronavirus in the United States.Some of the newly vaccinated said they made the decision abruptly, even casually, after months of inaction. One woman in Portland, Ore., was waiting for an incentive before she got her shot, and when she heard that a pop-up clinic at a farmers’ market was distributing $150 gift cards, she decided it was time. A 60-year-old man in Los Angeles spontaneously stopped in for a vaccine because he noticed that for once, there was no line at a clinic. A construction worker said his job schedule had made it difficult to get the shot.Ronald Gilbert, 60, was vaccinated at a light rail station in Hawthorne, Calif. He said he didn’t really believe in the vaccines, but that with an uptick in cases it was “better to be safe than sorry.”Rozette Rago for The New York TimesCliberman Centeno, 36, was vaccinated in Los Angeles. He said he was tired of wearing a mask.Rozette Rago for The New York TimesMany people said they had arrived for a vaccine after intense pressure from family or friends.“‘You’re going to die. Get the Covid vaccine,’” Grace Carper, 15, recently told her mother, Nikki White, of Urbandale, Iowa, as they debated when they would get their shots. Ms. White, 38, woke up on Thursday and said she would do it. “If you want to go get your vaccine, get up,” Ms. White told her daughter, who was eager for the shot, and the pair went together to a Hy-Vee supermarket.Others were moved by practical considerations: plans to attend a college that is requiring students to be vaccinated, a desire to spend time socializing with high school classmates, or a job where unvaccinated employees were told to wear masks. Their answers suggest that the mandates or greater restrictions on the unvaccinated that are increasingly a matter of debate by employers and government officials could make a significant difference.Audrey Sliker, 18, of Southington, Conn., said she got a shot because New York’s governor announced that it was required of all students attending State University of New York schools. She plans to be a freshman at SUNY Cobleskill this fall.“I just don’t like needles, in general,” she said, leaving a white tent that housed a mobile vaccination site in Middlefield, Conn. “So it’s more like, ‘Do I need to get it?’”Lisa Thomas, 45, was vaccinated at the People’s Market in Portland, Ore. She first wanted to see how the vaccines affected Americans. “I do know people who have gotten it and they haven’t gotten sick, so that’s why,” Ms. Thomas said.Tojo Andrianarivo for The New York TimesPatricia White, 46, took her son Tariq, 17, right, to be vaccinated at Michele Clark Academic Preparatory Magnet High School in Chicago. Her grandson Diaunta is too young to be vaccinated.Taylor Glascock for The New York TimesMany people interviewed described their choices in personal, somewhat complicated terms.Willie Pullen, 71, snacked on a bag of popcorn as he left a vaccination site in Chicago, one of the few people who showed up there that day. He was not opposed to the vaccines, exactly. Nearly everyone in his life was already vaccinated, he said, and though he is at greater risk because of his age, he said he believed he was healthy and strong enough to be able to think on it for a while.What pushed him toward a high school on the West Side of Chicago, where free vaccines were being administered, was the illness of the aging mother of a friend. Mr. Pullen wanted to visit her. He felt it would be irresponsible to do so unvaccinated.“I was holding out,” Mr. Pullen said. “I had reservations about the safety of the vaccine and the government doing it. I just wanted to wait and see.”‘I’m still not sure if it’s safe’The campaign to broadly vaccinate Americans against the coronavirus began in a roaring, highly energetic push early this year, when millions were inoculated each day and coveted vaccine appointments were celebrated with joyful selfies on social media. The effort peaked on April 13, when an average of 3.38 million doses were being administered in the United States. The Biden administration set a goal to have 70 percent of American adults at least partly vaccinated by July 4.But since mid-April, vaccinations have steadily decreased, and in recent weeks, plateaued. Weeks after the July 4 benchmark has passed, the effort has now dwindled, distributing about 537,000 doses each day on average — about an 84 percent decrease from the peak.About 68.7 percent of American adults have received at least one shot. Conservative commentators and politicians have questioned the safety of the three vaccines that the Food and Drug Administration has approved for emergency use, and in some parts of the country, opposition to inoculation is tied to politics. An analysis by The New York Times of vaccine records and voter records in every county in the United States found that both willingness to receive a coronavirus vaccine and actual vaccination rates were lower, on average, in counties where a majority of residents voted to re-elect Donald J. Trump.Barnet Gaston, 14, was vaccinated at Michele Clark Academic Preparatory Magnet High School in Chicago. He wanted to get vaccinated so he could spend more time hanging out with his friends, most of whom were vaccinated.Taylor Glascock for The New York TimesAnastiacia Rincon, 15, was vaccinated at the Polk County Health Department in Des Moines. She says that she got vaccinated “to protect myself and others, and I have asthma.”Kathryn Gamble for The New York TimesDespite the lagging vaccination effort, there are signs that alarming headlines about a new surge in coronavirus cases and the highly infectious Delta variant could be pushing more Americans to consider vaccination. On Friday, Jen Psaki, the White House press secretary, said there had been “encouraging data” showing that the five states with the highest case rates — Arkansas, Florida, Louisiana, Missouri and Nevada — were also seeing higher vaccination numbers.In Florida, a clinic in Sarasota County was quiet, a brightly lit waiting area full of mostly empty chairs. Several people wandered in, often no more than one or two in an hour. Lately, they are vaccinating fewer than 30 people there a day.Elysia Emanuele, 42, a paralegal, came for a shot. One factor in her decision had been the rising case numbers in the state, which she had been watching with worry.“If everything had gone smoothly, if we had shut down immediately and did what we needed to do and it was seemingly wiped out,” she said, “I think I would have been less likely to get the vaccine.”In the shade of a freeway underpass in South Los Angeles, volunteers and would-be vaccine patients tried to talk over the roar of passing cars.Charlene Bradley, 71, was vaccinated at the People’s Market in Portland, Ore. “I was kind of against it, but I promised my son I would do it,” she said. “It just took a while.”Tojo Andrianarivo for The New York TimesCindy Adams, 52, was vaccinated at the Polk County Health Department in Des Moines. It was her workplace’s requirement to wear a mask as an unvaccinated person that changed her mind.Kathryn Gamble for The New York TimesRonald Gilbert, 60, said he did not really believe in the vaccines and has never been a fan of needles, but with an uptick in cases he reasoned that it was “better to be safe than sorry.”.css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-9s9ecg{margin-bottom:15px;}.css-uf1ume{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;}.css-wxi1cx{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;-webkit-align-self:flex-end;-ms-flex-item-align:end;align-self:flex-end;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:’See more’;}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 auto;overflow:hidden;}.css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}“I feel better having this now, seriously I do,” he said. “I’m going to be walking like a rooster, chest up, like ‘You got the vaccine? I got the vaccine.’”News of the Delta variant also changed the mind of Josue Lopez, 33, who had not planned on getting a vaccine after his whole family tested positive for the coronavirus in December.“I thought I was immune, but with this variant, if it’s more dangerous, maybe it’s not enough,” he said. “Even now, I’m still not sure if it’s safe.”‘We have to fight for every one of them’At a vaccination site at Malcolm X College in Chicago, Sabina Richter, one of the workers there, said it used to be easy to find people to get shots. More recently, they had to offer incentives: passes to an amusement park in the north suburbs and Lollapalooza.“Some people come in and they’re still hesitant,” she said. “We have to fight for every one of them.”Otchere Darko, 44, was vaccinated at Westchester Community College in Ossining, N.Y. He waited until he felt the vaccines had proven to be safe.Christopher Capozziello for The New York TimesFrederique Moretto, 59, was vaccinated at a Florida Department of Health site in Sarasota, Fla. She got vaccinated to visit her daughter, who is going to a school in Washington in the fall.Octavio Jones for The New York TimesCherie Lockhart, an employee at a care facility in Milwaukee for older and disabled people, said she was worried about the vaccines because she did not trust a medical system that she felt had always treated Black people differently.She was not anti-vaccine, she said, just stalling until something could help her be sure. Her mother ultimately convinced her.“My mom has never steered me wrong,” Ms. Lockhart, 35, said. “She said, ‘I feel this is right in my heart of hearts.’ So I prayed about it. And, ultimately, I went with my guiding light.”Many of the people who newly sought shots said they had wanted to see how the vaccines affected Americans who rushed to get them early.“I do know people who have gotten it and they haven’t gotten sick, so that’s why,” said Lisa Thomas, 45, a home health care worker from Portland, Ore. “I haven’t heard of any cases of anyone hurting from it, and there’s a lot to benefit from it.”Leslie Vences-Avena, 14, was vaccinated at a Florida Department of Health site in Sarasota, Fla. The F.D.A. approved vaccinations for children age 12 and older in May.Octavio Jones for The New York TimesCherie Lockhart, 35, was vaccinated in Shorewood, Wis. Her mother convinced her to get the vaccine.Marla Bergh for The New York TimesFor Cindy Adams, who works for a Des Moines insurance company, it was her job’s requirement to wear a mask as an unvaccinated person that pushed her into the Polk County Health Department drive-up clinic for her first dose of the Pfizer-BioNTech vaccine.Ms. Adams, 52, said she had been concerned about possible long-term effects of the vaccines. But now her husband, children and most of her extended family have been vaccinated, as have most of her co-workers.“I just honestly got sick of wearing the mask,” Ms. Adams said. “We had an event yesterday, and I had to wear it for five hours because I was around a lot of people. And I was sick of it.“Everyone else is healthy and hasn’t had any side effects, gravely, yet, so I decided I might as well join the crowd.”Julie Bosman