Daily Archives: March 31, 2021

Covid-19 deaths in the U.S. are expected to bottom out in the next two weeks and then may inch higher as the nation races to blunt an incipient new wave of cases with its vaccination campaign.

A plateau or small increase -- instead of the hoped-for decline -- could mean tens of thousands of additional fatalities.

The deaths are likely to dip to 6,028 in the week ending April 10 before slightly increasing, according to the Covid-19 Forecast Hub, a project from the University of Massachusetts Amhersts Reich Lab. Its so-called ensemble forecast, which was updated Tuesday, is based on dozens of independent models and projects fatalities four weeks into the future.

Weekly deaths as forecast by Covid-19 Forecast Hub's ensemble model

Source: University of Massachusetts Amherst's Reich Lab,Covid-19 ForecastHub

Confirmed and suspected Covid-19 hospitalizations are rising again in half the country, and the U.S. Centers for Disease Control and Prevention has warned that the country may be entering a fourth wave of the pandemic.

Public-health experts had hoped that vaccinations would mean a steady decline in deaths through the summer, but the best-case scenario isnt coming to pass. A plateau around 1,000 deaths a day translates into some 30,000 deaths a month -- and many more by Independence Day, when President Joe Biden has said the country may return to a semblance of normality.

Still, the targeted vaccination of nearly three-quarters of the 65-and-over community should prevent a death surge of the magnitude the U.S. saw in prior waves. U.S. seniors account for 4 in 5 Covid-19 deaths, and at least 73% of the elderly have had one or more dose.

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U.S. Covid Deaths Expected to Rise Soon With New Wave Emerging - Bloomberg

Mothers and advocates for families cite a long list of policy frustrations. Congress declined to mandate paid leave in the stimulus bill, opting instead to extend a tax credit to employers who voluntarily offer the policy. While the relief bill included money for school reopenings, the support has not been well-targeted and comes toward the end of the school year. And it remains unclear whether the administration will push for the child care tax credit to be made permanent.

Moms are getting screwed on the right or the left. I dont feel like anyone is out there fighting for us, said Reshma Saujani, the founder and chief executive of Girls Who Code, a group that works to attract more young women to become programmers and engineers. There is an enormous amount of populist mom rage and I dont think that moms feel seen. Why arent the schools open now? Every day that goes by, another mother is losing their job. Its not a priority.

Ms. Saujani is the creator of the Marshall Plan for Moms, a package of policies funding paid leave, affordable child care and pay equity aimed at helping mothers who have struggled during the pandemic. While pieces of her plan have been introduced in Congress and were included in the relief bill, and have been embraced by policymakers, celebrities and activists, Ms. Saujani would like to see more attention paid to a situation she views as a national emergency.

Absolutely everything is a struggle right now getting sick days, getting my son to learn, getting help, said Adriana Alvarez, a single mother of a 9-year-old, who works at a McDonalds just outside Chicago and has significantly cut back her hours in the last year. There has to be a solution thats funded by the government to help people like me.

For others who have pushed for these policies for years, the moment seems most ripe: If a pandemic is not enough to persuade lawmakers to pass policies like paid family leave, will anything ever convince them?

Thestimuluspayments would be $1,400 for most recipients. Those who are eligible would also receive an identical payment for each of their children. To qualify for the full $1,400, a single person would need an adjusted gross income of $75,000 or below. For heads of household, adjusted gross income would need to be $112,500 or below, and for married couples filing jointly that number would need to be $150,000 or below. To be eligible for a payment, a person must have a Social Security number. Read more.

Buying insurance through the government program known as COBRA would temporarily become a lot cheaper. COBRA, for the Consolidated Omnibus Budget Reconciliation Act, generally lets someone who loses a job buy coverage via the former employer. But its expensive: Under normal circumstances, a person may have to pay at least 102 percent of the cost of the premium. Under the relief bill, the government would pay the entire COBRA premium from April 1 through Sept. 30. A person who qualified for new, employer-based health insurance someplace else before Sept. 30 would lose eligibility for the no-cost coverage. And someone who left a job voluntarily would not be eligible, either. Read more

This credit, which helps working families offset the cost of care for children under 13 and other dependents, would be significantly expanded for a single year. More people would be eligible, and many recipients would get a bigger break. The bill would also make the credit fully refundable, which means you could collect the money as a refund even if your tax bill was zero. That will be helpful to people at the lower end of the income scale, said Mark Luscombe, principal federal tax analyst at Wolters Kluwer Tax & Accounting. Read more.

There would be a big one for people who already have debt. You wouldnt have to pay income taxes on forgiven debt if you qualify for loan forgiveness or cancellation for example, if youve been in an income-driven repayment plan for the requisite number of years, if your school defrauded you or if Congress or the president wipes away $10,000 of debt for large numbers of people. This would be the case for debt forgiven between Jan. 1, 2021, and the end of 2025. Read more.

The bill would provide billions of dollars in rental and utility assistance to people who are struggling and in danger of being evicted from their homes. About $27 billion would go toward emergency rental assistance. The vast majority of it would replenish the so-called Coronavirus Relief Fund, created by the CARES Act and distributed through state, local and tribal governments,accordingto the National Low Income Housing Coalition. Thats on top of the $25 billion in assistance provided by the relief package passed in December. To receive financial assistance which could be used for rent, utilities and other housing expenses households would have to meet severalconditions. Household income could not exceed 80 percent of the area median income, at least one household member must be at risk of homelessness or housing instability, and individuals would have to qualify for unemployment benefits or have experienced financial hardship (directly or indirectly) because of the pandemic. Assistance could be provided for up to 18 months,accordingto the National Low Income Housing Coalition. Lower-income families that have been unemployed for three months or more would be given priority for assistance. Read more.

Nearly 200 businesses signed on to a letter to congressional leaders last week urging them to include paid family and medical leave in the upcoming infrastructure package, which many believe is the best chance to get the policy approved by Congress. Liberal organizations and caregiver advocacy groups started their own $20 million campaign, called #CareCantWait, that is pushing the administration to expand access to child care, paid family and medical leave, as well as home and community-based services for people with disabilities and aging adults.

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Why Mothers Are Skeptical of Covid-19 Aid Promises - The New York Times

SIOUX FALLS, S.D. (KELO) Two new deaths were reported by theSouth Dakota Department of Healthas hospitalizations increased on Tuesday.

The two deaths reported were women in the 60-69 age range. The death toll is at 1,935.

According to the latest update, 159 new total coronavirus cases were announced bringing the states total case count to 117,495 up from Monday (117,336).

While the difference in the total case count reported Tuesday and Monday equals 159, when you add the PCR, or newly confirmed, cases (118) and antigen, or new probable, cases (47), there were 165 new cases.

There are 95 current hospitalizations as of Tuesday, up from 91 on Monday. Total hospitalizations are at 6,985.

Active cases are now at 2,436, up from Monday (2,393).

Total recovered cases are now at 113,124, up from Monday (113,010).

Total persons negative is now at 326,102, from Monday (325,754).

There were 507 new persons tested in the data reported on Tuesday for a new persons-tested positivity rate of 31.3%.

The latest seven-day all test positivity rate reported by the DOH is 10.1%. The latest one-day PCR test positivity rate is 9.4%.

According to the DOH, 205,269 doses of the Pfizer vaccine have been administered with 8,033 doses of the Janssen vaccine and 190,879 of the Moderna vaccine given out to a total number of 249,042 persons.

There have been 72,683 persons who have completed two doses of Moderna and 82,447 who have received two doses of Pfizer, according to the DOH.

When combining state and federal vaccine distribution, the state estimates 42.26% of the population has received at least one dose and 28.00% have received both doses.

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COVID-19 in South Dakota: 159 new total cases; Death toll increases to 1,935; Active cases at 2,436 - KELOLAND.com

The WHO Strategic Advisory Group of Experts (SAGE) on Immunisation has issued Interim recommendations for the use of the Janssen Ad26.CoV2.S vaccine against COVID-19.

Here is what you need to know.

This article provides a summary of the interim recommendations; the interim recommendations and the background document are also available.

Who should be vaccinated first?

While COVID-19 vaccine supplies are limited, health workers at high risk of exposure and older people should be prioritised for vaccination.

Countries can refer to the WHO Prioritization Roadmap and the WHO Values Framework as guidance for their prioritization of target groups.

Who else can take the vaccine?

The vaccine is safe and effective in people with known medical conditions associated with increased risk of severe disease, such as hypertension, chronic lung disease, significant cardiac disease, obesity, and diabetes.

Persons living with human immunodeficiency virus (HIV) are at higher risk of severe COVID-19 disease. This population group was included in clinical trials and no safety concerns were observed. It is recommended that known HIV-positive vaccine recipients be provided with information and counselling prior to vaccination. Further studies are needed to assess vaccine efficacy for persons with HIV; it is possible that the immune response to the vaccine may be reduced which would lower the vaccines effectiveness.

The J&J vaccine can be offered to people who have had COVID-19 in the past. But individuals may wish to defer their own COVID-19 vaccination for up to six months from the time of SARS-CoV-2 infection, to allow others who may need the vaccine more urgently to go first.

This vaccine can be offered to a breastfeeding woman who is part of a group recommended for the vaccination (e.g. health workers); discontinuing breastfeeding after vaccination is not currently recommended.

Should pregnant women be vaccinated?

While pregnancy puts women at higher risk of severe COVID-19, very little data are available to assess vaccine safety in pregnancy.

Pregnant women may receive the vaccine if the benefit of vaccinating a pregnant woman outweighs the potential vaccine risks.

For this reason, pregnant women at high risk of exposure to SARS-CoV-2 (e.g. health workers) or who have comorbidities which add to their risk of severe disease, may be vaccinated in consultation with their health care provider.

Who is the vaccine not recommended for?

Individuals with a history of anaphylaxis to any component of the vaccine should not take it.

Anyone with a body temperature over 38.5C should postpone vaccination until they no longer have a fever.

The vaccine is not recommended for persons younger than 18 years of age pending the results of further studies in that age group.

Whats the recommended dosage?

SAGE recommends the use of Janssen Ad26.CoV2.S as one dose (0.5 ml) given intramuscularly.

There should be a minimum interval of 14 days between the administration of this vaccine and any other vaccine against other health conditions. This recommendation may be amended as data on co-administration with other vaccines become available.

How does this vaccine compare to the dual dose vaccines already in use?

We cannot compare the vaccines head-to-head due to the different approaches taken in designing the respective studies, but overall, all of the vaccines that have achieved WHO Emergency Use Listing are highly effective in preventing severe disease and hospitalization due to COVID-19.

Is it safe?

SAGE has thoroughly assessed the data on quality, safety and efficacy of the vaccine and has recommended its use for people aged 18 and above.

This vaccine has also undergone review by the European Medicines Agency (EMA) and the U.S. Food and Drug Administration (FDA) and found to be safe for use.

How efficacious is the vaccine?

28 days after inoculation Janssen Ad26.CoV2.S was found to have an efficacy of 85.4% against severe disease and hospitalisation.

A dose of Janssen Ad26.COV2.S was found in clinical trials to have an efficacy of 66.9% against symptomatic moderate and severe SARS-CoV-2 infection.

Does it work against new variants of SARS-CoV-2 virus?

SAGE has reviewed all available data on the performance of the vaccine in the settings of the variants of concern. In clinical trials this vaccine has been tested against a variety of SARS-CoV-2 virus variants, including B1.351 (first identified in South Africa) and P.2 (first identified in Brazil), and found to be effective.

SAGE currently recommends using this vaccine, according to the WHO Prioritization Roadmap, even if variants of concern are present in a country. As new data becomes available, WHO will update recommendations accordingly.

Does it prevent infection and transmission?

There is currently no substantive data available related to the impact of Ad26.COV2.S on transmission of virus that causes COVID-19 disease.

In the meantime, we must maintain and strengthen public health measures that work: masking, physical distancing, handwashing, respiratory and cough hygiene, avoiding crowds and ensuring good ventilation.

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The J&J COVID-19 vaccine: What you need to know - World - ReliefWeb

Heres what you need to know:Fourth graders at Alvarado Elementary, a school in Long Beach, Calif., were back in the classroom on Monday for their first day of in-person learning in more than a year.Credit...Brittany Murray/MediaNews Group/Long Beach Press-Telegram via Getty Images

Elementary students returned to classrooms in Long Beach, Calif., on Monday and campuses from Los Angeles to Boston prepared for significant expansions of in-person instruction as a majority of the nations districts have now begun to reopen school buildings, many of which have been closed for more than a year.

On Monday, Burbio, which monitors some 1,200 districts including the largest 200 in the country, reported that 53.1 percent of students were in schools offering daily, in-person classes, and that for the first time, the proportion of students attending school virtually or in hybrid classes had dropped.

The change, Burbio officials said, appeared to be driven by the return in elementary and middle schools to in-person classes, and by the new rules from the Centers for Disease Control and Prevention permitting schools to allow three feet of social distance instead of six feet in elementary schools.

But a number of roadblocks to reopening remain. On the West Coast, large urban districts generally have lagged behind their counterparts across the rest of the nation. Surging infections in Southern California after the winter holidays were partly to blame for a slow rebound in the Los Angeles school system.

Part of the slow start can be traced to resistance from teachers, whose unions generally are more powerful in Democratic-led Washington, Oregon and California than in many other states, and who have been wary of returning to what they regard as a hazardous workplace, despite federal guidance that elementary schools in particular are safe when health precautions are followed.

Even some schools where teachers have agreed to return are still experiencing setbacks. Schools in Oakland and San Francisco, for example, are scheduled to reopen next month for elementary and special-needs students. But labor agreements in both of those California cities have allowed substantial numbers of teachers to opt out, leaving some schools without enough teachers to reopen and prompting others to scramble for substitutes.

Public schools in Californias top three districts by enrollment Los Angeles, San Diego and Fresno have said they will begin to allow grade-school students back onto campus later in April, as new coronavirus cases have fallen sharply statewide.

And on Monday, Long Beach the states fourth-largest district, with about 70,000 students began allowing about 14,000 elementary students back into school buildings for about 2 hours each day, five days a week.

The Long Beach school district was able to open earlier than other large California school systems because labor unions there agreed last summer to reopen as soon as health conditions permitted, and because the city was able to start vaccinating teachers earlier than other districts in the state.

Unlike most other cities in Los Angeles County, Long Beach has its own public health department, giving the city its own vaccine supplies and the power to set its own vaccine priorities, at a time when the county as a whole was making teachers wait until after other groups, like residents 65 and older, were vaccinated.

A city with its own health department has the ability to be more nimble, said Jill Baker, the citys schools superintendent, who called the return to classrooms this week exciting and momentous.

The school district is among the citys largest employers, and two-thirds of its students qualify for free or reduced-price lunches, so vaccinating school employees and reopening classrooms was viewed as economically important, Ms. Baker said.

In-person classes for older students are scheduled to resume April 19, with grades 6 to 8 getting the option to return on April 20 and grades 9 to 11 on April 26. The last day of school will be in mid-June.

transcript

transcript

When I first started at the C.D.C. about two months ago, I made a promise to you: I would tell you the truth, even if it was not the news we wanted to hear. Now is one of those times when I have to share the truth, and I have to hope and trust you will listen. Im going to pause here. Im going to lose the script. And Im going to reflect on the recurring feeling I have of impending doom. We have so much to look forward to, so much promise and potential of where we are, and so much reason for hope. But right now, Im scared. We have come such a long way: Three historic scientific breakthrough vaccines, and we are rolling them out so very fast. So Im speaking today not necessarily as your C.D.C. director, and not only as your C.D.C. director, but as a wife, as a mother, as a daughter, to ask you to just please hold on a little while longer. I so badly want to be done. I know you all so badly want to be done. We are just almost there, but not quite yet. We can change this trajectory of the pandemic, but it will take all of us recommitting to following the public health prevention strategies consistently while we work to get the American public vaccinated. We do not have the luxury of inaction. For the health of our country, we must work together now to prevent a fourth surge.

President Biden, facing a rise in coronavirus cases around the country, called on Monday for governors and mayors to reinstate mask mandates as the director of the Centers for Disease Control and Prevention warned of impending doom from a potential fourth surge of the pandemic.

The presidents comments came only hours after the C.D.C. director, Dr. Rochelle Walensky, appeared to fight back tears as she pleaded with Americans to hold on a little while longer and continue following public health advice, like wearing masks and social distancing, to curb the viruss spread. The nation has so much reason for hope, she added.

But right now, she said, Im scared.

The back-to-back appeals reflected a growing sense of urgency among top White House officials and government scientists that the chance to conquer the pandemic, now in its second year, may slip through its grasp. According to a New York Times database, the seven-day average of new virus cases as of Sunday was about 63,000, a level comparable with late Octobers average. That was up from 54,000 a day two weeks earlier, an increase of more than 16 percent.

Public health experts say that the nation is in a race between the vaccination campaign and new, worrisome coronavirus variants, including B.1.1.7, a more transmissible and possibly more lethal version of the virus that has been spreading rapidly. While more than one in three American adults have received at least one shot and nearly one-fifth are fully vaccinated, the nation is a long way from reaching so-called herd immunity the tipping point that comes when spread of a virus begins to slow because so many people, estimated at 70 to 90 percent of the population, are immune to it.

The warnings come at the same time as some promising news: A C.D.C. report released Monday confirmed the findings of last years clinical trials that vaccines developed by Moderna and Pfizer were highly effective against Covid-19. The report documented that the vaccines work to prevent both symptomatic and asymptomatic infections in real-world conditions.

The seven-day average of vaccines administered hit 2.76 million on Monday, an increase over the pace the previous week, according to data reported by the C.D.C. On Sunday alone, nearly 3.3 million people were inoculated, said Andy Slavitt, a senior White House pandemic adviser.

Mr. Biden said on Monday that the administration was taking steps to expand vaccine eligibility and access, including opening a dozen new mass vaccination centers. He directed his coronavirus response team to ensure that 90 percent of Americans would be no farther than five miles from a vaccination site by April 19.

The coronavirus vaccines made by Moderna and Pfizer-BioNTech are proving highly effective at preventing symptomatic and asymptomatic infections under real-world conditions, federal health researchers reported on Monday.

Consistent with clinical trial data, a two-dose regimen prevented 90 percent of infections by two weeks after the second shot. One dose prevented 80 percent of infections by two weeks after vaccination.

The news arrives even as the nation rapidly broadens eligibility for vaccines, and the average number of daily shots continues to rise. The seven-day average of vaccines administered hit 2.76 million on Monday, an increase over the pace the previous week, according to the Centers for Disease Control and Prevention.

But the virus may be gaining renewed momentum. According to a New York Times database, the seven-day average of new virus cases as of Sunday was 63,000, an increase of more than 16 percent over the past two weeks.

Similar upticks over the summer and winter led to major surges in the spread of disease, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said at a news briefing on Monday. She said she had a sense of impending doom about a possible fourth surge of the virus.

The nation has so much reason for hope, she said. But right now Im scared.

Scientists have debated whether vaccinated people may still get asymptomatic infections and transmit the virus to others. The new study, by researchers at the C.D.C., suggested that since infections were so rare, transmission was likely rare, too.

There also has been concern that variants may render the vaccines less effective. The studys results do not confirm that fear. Troubling variants were circulating during the time of the study from Dec. 14, 2020, to March 13, 2021 yet the vaccines still provided powerful protection.

The C.D.C. enrolled 3,950 people at high risk of being exposed to the virus because they were health care workers, first responders or others on the front lines. None had previously been infected.

Most participants 62.8 percent received both shots of the vaccine during the study period, and 12.1 percent had one shot. They collected their own nasal swabs each week, which were sent to a central location for P.C.R. testing, the most accurate type of test. The weekly swabs allowed the researchers to detect asymptomatic infections as well as symptomatic ones.

The investigators asked participants about symptoms associated with infection, including fever, chills, cough, shortness of breath, sore throat, diarrhea, muscle aches, or loss of smell or taste. They also analyzed patients medical records to detect illnesses.

Fifty-eight percent of the infections were detected before people had symptoms. Just 10.2 percent of infected people never developed symptoms.

Among those who were fully vaccinated, there were .04 infections per 1,000 person-days, meaning that among 1,000 persons there would be .04 infections in a day.

There were 0.19 infections per 1,000 person-days among those who had had one dose of the vaccine. In contrast, there were 1.38 infections per 1,000 person-days in unvaccinated people.

Dr. Walensky urged Americans to continue taking precautions and to waste no time getting the shots as soon as they are eligible.

I am asking you to just hold on a little longer, to get vaccinated when you can, so that all of those people that we all love will still be here when this pandemic ends, she said.

HOUSTON As Texas joined several other states on Monday in opening eligibility for coronavirus vaccines to millions of healthy adults, anticipation for the shot could be seen in the long line that snaked outside Booker T. Washington High School in Houston.

This is a good sign, said Nelson Garcia, 48, who waited more than two hours with his two young children before he was finally within reach of protection from a disease that could be deadly for people with diabetes like himself. It looks like everyone wants to get vaccinated. I want my children to see that this is a good thing and that the vaccine may finally help us get back to normal.

On Monday, Texas became the largest state to expand vaccination eligibility to anyone 16 or older, or about 22 million people. Long lines were replicated across the state and appointments were difficult to snag online. Vaccination spots at HEB.com, the website for the most popular supermarket chain in Texas, were few and far between.

The spike was expected. Virtually anyone can get a vaccine now, said Representative Sheila Jackson Lee, a Democrat who represents the Houston region.

Five other states, including neighboring Oklahoma and Louisiana, as well as Kansas, Ohio and North Dakota, also opened their doors for all adults on Monday. Several reported increased interest in the vaccine, but the numbers did not overwhelm the system of vaccine providers.

Also on Monday, officials in New York State, once the center of the pandemic with about 31,000 deaths in New York City alone, announced that beginning on Tuesday, all adults 30 and older would be eligible for the vaccine. At least 36 other states have vowed to offer shots to every adult who wants one by mid-April.

Six states Colorado, Connecticut, Indiana, Minnesota, New Hampshire and South Carolina plan to expand eligibility this week, officials in those states said.

The German health authority responsible for vaccine guidelines recommended on Tuesday that the country suspend use of the AstraZeneca vaccine in adults under 60 because of concerns about a possible association with blood clots. The action came a day after Canada suspended its use in people 55 and under.

Earlier in the day, a number of local authorities in Germany including Berlin, Munich and the state of Brandenburg had made similar moves.

A small district in North Rhine-Westphalia banned use of the AstraZeneca vaccine on Monday for all women below the age of 55, after serious episodes last week involving two women who had received the vaccine: one, 47, died of sinus vein thrombosis and another, 28, became seriously ill.

No causative link has been established between the patients conditions and the vaccine.

Chancellor Angela Merkel met Tuesday evening with state governors to discuss the AstraZeneca vaccine, and said that Germany would follow the recommendation and hold off using it to inoculate people under 60 unless they have discussed the risks with their doctor first.

France and several Nordic countries have also taken a precautionary stance on the vaccine, even after the European Unions top drug regulator cleared it as safe this month. Some suspensions in Europe may have been driven as much by political considerations as by science.

In Canada, Dr. Caroline Quach-Thanh, the chairwoman of the National Advisory Committee on Immunization, said at a video news conference on Monday that more study was needed. Given alternative vaccines are available in Canada, N.A.C.I. feels it is very important to study the risks and benefit as a precautionary measure, she noted.

The Canadian decision was made after reviewing evidence emerging from Germany, where the Paul-Ehrlich Institute, the countrys vaccine regulatory body, reported earlier this month that at least seven people who had recently received the AstraZeneca vaccine had developed a very rare, potentially fatal condition involving blood clots that can block the drainage of blood from the brain, associated with low blood platelet counts (thrombocytopenia) and bleeding.

(An earlier version of this item referred incompletely to the condition.)

Statistically, seven cases was significantly higher than normal for the population of 1.6 million adults that had received the vaccine in Germany by March 15, the institute said; by its calculations, just one case would have been expected.

The Canadian health authority continues to recommend the AstraZeneca vaccine for older adults, who are much more susceptible than younger people to serious cases of Covid-19, and have not appeared to develop blood clots in studies conducted in Europe, the committee members said.

We want to prevent hospitalizations and severe disease for those over 55, Dr. Quach-Thanh said.

The AstraZeneca vaccine, created by Oxford University, was approved in late February for use in Canada but has suffered setbacks there and elsewhere. Soon after its approval, N.A.C.I. recommended that it not be administered to people 65 and older, because of a lack of data about that age group; two weeks later, N.A.C.I. waived its initial concerns and approved the vaccine for all adults.

The vaccine was the third approved in the country, after those from Pfizer-BioNTech and Moderna. Just over 300,000, or 6 percent, of the doses administered in Canada so far have been AstraZenecas vaccine. The Biden administration promised this month to loan Canada 1.5 million more doses of the vaccine, which still has not been approved for use in the United States.

New York can begin vaccinating anyone 30 or older on Tuesday and will make all residents 16 or over eligible on April 6, beating President Bidens goal of making every adult eligible for a coronavirus vaccine by May 1, Gov. Andrew M. Cuomo announced on Monday.

New York was one of only a few states that had not yet set a timeline for universal adult eligibility. Five states had already expanded eligibility fully by the end of last week; six did so on Monday; seven more will follow later this week, and another six on April 5. At least 11 states have said they will wait until May 1.

Though Mr. Cuomo has gradually loosened vaccine eligibility criteria over the last month, he expressed reluctance last week to set a specific target date for doing away with the states requirements. The governor said he did not want to outline a timeline for more widespread vaccination until he was more confident that New York would have adequate vaccine supply on hand for its population.

I just want to make sure that the allocation projections that were getting from the feds are right, frankly, Mr. Cuomo said at a news conference last week. I dont want to say, Were going to open up to 30-year-olds in three weeks, and then something happens with the allocation.

Mr. Cuomos announcement comes as New York has been adding new virus cases at one of the highest rates among U.S. states. As of Monday, the state had a seven-day average of 49 new virus cases a day for every 100,000 residents, according to a New York Times database, second only to New Jersey. (The nation as a whole was averaging 19 new cases per 100,000 people.)

Even as the number of new cases continues to mount, the state has not faced anywhere near the level of devastation that it experienced a year ago, when hospitals were overwhelmed with patients and morgues were overflowing.

Eligible only in some counties

Eligible only in some counties

Eligible only in some counties

Buoyed by its vaccination progress, the state has also been gradually reopening businesses in the last several weeks. Mr. Cuomo allowed sporting events and concerts to resume at large venues last month and movie theaters to bring back audiences this month. Restaurants in New York City are now allowed to serve diners indoors at 50 percent capacity, their highest level of indoor dining since Mr. Cuomo closed them last year at the onset of the pandemic.

As of Monday morning, 29.6 percent of people in New York State had received at least one shot of a vaccine, while 16.8 percent were fully vaccinated, according to the states data.

Currently, all people 50 and over are eligible to receive the vaccine in New York, in addition to teachers, some essential workers and people with certain medical conditions that make them more susceptible to serious illness from the virus.

Massachusetts on Monday expanded a new state-financed coronavirus testing program to allow every public school in the state to test all students and staff members weekly for the rest of the school year, using a pooled testing approach that could be a model for school districts nationwide.

More than 1,000 schools in Massachusetts, representing nearly half the districts in the state, are already participating in the program.

Since February, the program has analyzed 22,679 pooled samples from students, teachers and staff members, reporting on Monday a positivity rate of less than 1 percent, considered low. Since the pooled samples typically include swabs from seven different people, state officials said the individual positivity rate is probably much lower.

In a phone interview on Monday, Gov. Charlie Baker said that the state had been able to scale up the program by vetting testing labs and signing contracts with them, instead of leaving each district to do that work on its own. He estimated that the program, which is using federal Covid relief funds to pay for the tests, could cost $30 million to $40 million.

We started doing it on a demonstration basis with a few school districts just to test it and see if the logistics could work, Mr. Baker said. We now have a working model that is operating at a pretty big scale and in a pretty big state.

The pooled testing program collects nasal swabs from students, faculty and staff members and then tests them in batches, a process that saves time and lab resources. Last week, about 63,000 students and staff members were tested.

If a batch tests negative, everyone in the pool is considered to have a negative result. If a batch tests positive, each person in the pool is then tested.

Massachusetts, which had initially planned to pay for the tests for schools until mid-April, now plans to cover the costs through the end of the school year. It is also encouraging other school districts in the state to sign up.

Mr. Baker said he planned to promote the Massachusetts model to other states. Some districts, like Montgomery County Public Schools, Marylands largest system, are planning to introduce pooled testing in April.

Theres enough money in the various federal bills that have been passed, including the most recent one, to make it possible for states or municipalities both to pay for a program like this, Mr. Baker said.

The state of New York must immediately begin to offer Covid-19 vaccines to all incarcerated people in the states prisons and jails, a judge ruled on Monday, making the state one of few in the nation to provide doses to such a broad population behind bars.

The order, the first involving any of the countrys largest correctional systems, comes as the coronavirus continues to roar through facilities in New York. At least 1,100 people living behind prison walls have tested positive for the virus since the start of last month, and five have died.

But even as corrections staff and many other groups, including some who live in close-contact settings like group homes and homeless shelters, have gained access to the vaccines in recent weeks, most incarcerated people in New York have remained ineligible to receive doses.

Justice Alison Y. Tuitt of State Supreme Court in the Bronx wrote in her ruling on Monday afternoon that people in prisons and jails had been arbitrarily left out of the rollout and that doing so was unfair and unjust and an abuse of discretion.

State officials, she said, irrationally distinguished between incarcerated people and people living in every other type of adult congregate facility, at great risk to incarcerated peoples lives during this pandemic.

She added: There is no acceptable excuse for this deliberate exclusion.

Epidemiologists and infectious disease specialists widely agreed, even in the earliest stages of vaccination efforts when supply was more limited, that the roughly 50,000 people in correctional facilities across the state should be made eligible because of their uniquely high risk for contracting and spreading the virus. A disproportionate number of them are also Black and Latino, groups that have been hit hard by the pandemic.

But vaccinating incarcerated people has proved politically fraught across the country, and states grappling with the same ethical, logistical and legal questions have drawn up drastically different timelines for offering doses. In some states, officials have backtracked from plans to vaccinate prisoners because of political headwinds.

In New York, most of those behind bars had been left out, though correctional officers were included and other high-risk groups like restaurant workers, public-facing government employees and essential building service workers have recently become eligible.

State officials announced on Monday that all adult residents would be eligible to receive a coronavirus vaccine by April 6, which might have led more people behind bars to soon be offered doses even had the ruling not been issued.

Vermont is reporting a sharp spike in coronavirus cases, reaching highs that have not been seen since January.

This is a concerning number of new cases and should not be dismissed, Dr. Mark Levine, the states health commissioner, said at a news conference on Friday.

Vermont hit a single-day case record with 283 new confirmed cases on Friday, according to a New York Times database, making it the first state to set a case record since Jan. 18. (Its seven-day average, 154, is still lower than its peak in January.) Half of the cases reported in the past two weeks were in people under the age of 30, officials said.

The renewed surge has been driven by a number of factors, including pandemic fatigue and the spread of worrisome variants, Dr. Levine said in an interview on Monday. As older people get vaccinated and deaths start to drop, younger people have been more willing to gather in groups, he said.

The University of Vermont has reported a significant increase in confirmed cases among students, climbing to 80 last week from 41 two weeks before. The statewide surge, though, does not appear to be driven largely by college students, Dr. Levine said, since there have not been widespread increases on other campuses.

Cases across the United States have started to rise in recent weeks, after infections began to drop following a post-holiday surge. Scientists have warned for weeks about another increase, as more cases of variants are detected and states lift restrictions. Still, the United States remains behind in its attempts to track variants, though the Centers for Disease Control and Preventions efforts to locate them has recently improved and will continue to grow. States in the Northeast have accounted for about 30 percent of the nations new cases over the past two weeks, up from 20 percent in early February.

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Covid-19 News: In-Person School Attendance Inches Up but Roadblocks Remain - The New York Times

Heres what you need to know:Former President Donald J. Trump and former Vice President Mike Pence with Adm. Brett P. Giroir and Dr. Deborah Birx during a news conference at the White House in April 2020.Credit...Doug Mills/The New York Times

In interviews broadcast on CNN Sunday night, former President Donald J. Trumps pandemic officials confirmed in stark and no uncertain terms what was already an open secret in Washington: The administrations pandemic response was riddled with dysfunction, and the discord, untruths and infighting most likely cost many lives.

Dr. Deborah L. Birx, Mr. Trumps coronavirus response coordinator, suggested that hundreds of thousands of Americans may have died needlessly, and Adm. Brett P. Giroir, the testing czar, said the administration had lied to the public about the availability of testing.

The comments were among a string of bombshells that emerged during a CNN special report that featured the doctors who led the governments coronavirus response in 2020.

Dr. Robert R. Redfield, the former director of the Centers for Disease Control and Prevention, accused Mr. Trumps health secretary, Alex M. Azar III, and the secretarys leadership team of pressuring him to revise scientific reports. Now he may deny that, but its true, Dr. Redfield said in an interview with Dr. Sanjay Gupta, CNNs chief medical correspondent. Mr. Azar, in a statement, denied it.

Dr. Stephen K. Hahn, the former commissioner of the Food and Drug Administration, said his relationship with Mr. Azar had grown strained after the health secretary revoked the agencys power to regulate coronavirus tests. That was a line in the sand for me, Dr. Hahn said. When Dr. Gupta asked him if Mr. Azar had screamed at him, Dr. Hahn replied: You should ask him that question.

But it was Dr. Birx, who has been pilloried for praising Mr. Trump as being so attentive to the scientific literature and for not publicly correcting the president as he made outlandish claims about unproven therapies, whose disclosures may have been the most compelling.

As of Sunday, more than 548,000 Americans have died from infection with the coronavirus. I look at it this way, she said. The first time, we have an excuse. There were about 100,000 deaths that came from that original surge.

All of the rest of them, she said, referring to almost 450,000 deaths, in my mind, could have been mitigated or decreased substantially had the administration acted more aggressively.

In what was one of her first televised interviews since leaving the White House in January, she also described a very uncomfortable, very direct and very difficult phone call with Mr. Trump after she spoke out about the dangers of the virus last summer. Everybody in the White House was upset with that interview, she said.

After that, she decided to travel the country to talk to state and local leaders about masks and social distancing and other public health measures that the president didnt want her to explain to the American public from the White House podium.

Dr. Gupta asked if she was being censored. Clearly someone was blocking me from doing it, she said. My understanding was I could not be national because the president might see it.

Several of the officials in the interview, including Dr. Anthony S. Fauci who unlike the others is a career scientist and is now advising President Biden blamed China, where the virus was first detected, for not being open enough with the United States. And several, including Dr. Redfield and Admiral Giroir, said early stumbles with testing and the attitude within the White House that testing made the president look bad by driving up the number of case reports were a serious problem in the administrations response.

And the problems with testing went beyond Mr. Trumps obsession with optics. Admiral Giroir said that the administration simply did not have as many tests as top officials claimed at the time.

When we said there were millions of tests there werent, right? he said. There were components of the test available but not the full deal.

In a lengthy statement Monday evening, Mr. Trump shot back at Dr. Fauci and Dr. Birx, blasting them as two self-promoters trying to reinvent history to cover for their bad instincts and faulty recommendations, while praising his administrations efforts to develop a vaccine.

The former president, who routinely questioned the need for lockdowns and other precautions during his administration, said of Dr. Fauci and Dr. Birx, If it were up to them, wed currently be locked in our basements as our country suffered through a financial depression.

Scientists view Florida the state furthest along in lifting restrictions, reopening society and welcoming tourists as a bellwether for the nation.

If recent trends there are any indication, the rest of the country may be in trouble.

The number of confirmed coronavirus cases in Florida has been steadily rising, though hospitalizations and deaths are still down. Over the past week, the state has averaged nearly 5,000 cases per day, an increase of 8 percent from its average two weeks earlier.

B.1.1.7, the more contagious variant first identified in Britain, is also rising exponentially in Florida, where it accounts for a greater proportion of total cases than in any other state, according to numbers collected by the Centers for Disease Control and Prevention.

Wherever we have exponential growth, we have the expectation of a surge in cases, and a surge in cases will lead to hospitalizations and deaths, said Bill Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health.

Florida has had one of the countrys most confusing and inefficient vaccination campaigns, and has fully vaccinated about 15 percent of its population well below what top states, like New Mexico and South Dakota, have managed. Still, immunization of older people and other high-risk individuals may blunt the number of Floridas deaths somewhat. The state has announced it will start offering the vaccine to anyone over age 18 on April 5.

At least some of the cases in Florida are the result of the states open invitation to tourists. Hordes of students on spring break have descended on the state since mid-February. Rowdy crowds on Miami Beach this month forced officials to impose an 8 p.m. curfew, although many people still flouted the rules.

Miami-Dade County, which includes Miami Beach, has experienced one of the nations worst outbreaks, and continues to record high numbers. The county averaged more than 1,100 cases per day over the past week.

In Orange County, cases are on the rise among young people. People 45 and younger account for one in three hospitalizations for Covid, and the average age for new infections has dropped to 30.

Gov. Ron DeSantis has rejected stringent restrictions from the very start of the pandemic. Florida has never had a mask mandate, and in September Mr. DeSantis banned local governments from enforcing mandates of their own. Among his scientific advisers now are architects of the Great Barrington Declaration, which called for political leaders to allow the coronavirus to spread naturally among young people, while the elderly and those with underlying conditions sheltered in place.

After weeks of decline followed by a steady plateau, coronavirus cases are rising again in the United States. Deaths are still decreasing, but the country averaged 61,545 cases last week, 11 percent more than the average two weeks earlier.

Scientists predicted weeks ago that the number of infections would curve upward again in late March, at least in part because of the rise of variants of the coronavirus across the country. The variant that walloped Britain, called B.1.1.7, has led to a new wave of cases across most of Europe. Some scientists warned that it may lead to a new wave in the United States.

The rise in infections is also a result of state leaders pulling back on mitigation measures, and large social interactions, like spring break gatherings in Florida, Dr. Anthony S. Fauci, the Biden administrations chief science adviser, said on the CBS program Face the Nation on Sunday.

The variants are playing a part, but its not completely the variants, Dr. Fauci said. Most states have lifted restrictions, including on indoor dining, in response to the drop in numbers, actions that Dr. Fauci called premature.

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As of Thursday, there were 8,337 known cases of the B.1.1.7 variant in the country, but the actual number is probably much higher because labs in the country analyze only a very small proportion of the diagnosed cases. Still, the trend is clear: The variant which is more transmissible and possibly more lethal has been rising exponentially in the United States, its growth masked by the overall drop in infections.

It is remarkable how much this recalls the situation last year where we had introductions of virus to different places that scientists warned would be a problem, Bill Hanage, an epidemiologist at the Harvard T.H. School of Public Health, said in an interview on Sunday. People waited for them to be a problem before they took action and then too late, they took action.

Dr. Hanage said he was particularly worried about B.1.1.7 because it is at least 50 percent more transmissible than the original virus. The brisk pace of vaccinations will stem the tide somewhat, but the rising immunity in the population may be more than offset by the variants contagiousness, he added. B.1.1.7 is really scary, he said.

The vaccines in use in the United States made by Pfizer-BioNTech, Moderna and Johnson & Johnson are expected to prevent severe disease and death from any of the variants, although they are slightly less effective against a variant that was identified in South Africa. That variant, known as B.1.351, has not yet spread widely in the United States.

Because many of the highest-risk people have been inoculated, hospitalizations and deaths may not show a steep rise along with infections. But a surge in cases will still lead to some severe cases and deaths, Dr. Hanage said.

How large it will be well need to wait and see, he said. But ideally we would not be waiting to see, ideally wed be taking action.

This time last year, Esti Shushans Passover was ruined. The sudden enforcement of the coronavirus lockdown in Israel forced Ms. Shushan to mark the Jewish festival usually a joyous time of large family gatherings with just her four children and husband.

But this weekend, Ms. Shushan, an entrepreneur and womens rights activist, was able to return to something approaching normality. Israels vaccine program has caused infection rates to plummet, leading to a loosening of restrictions. Ms. Shushan gathered on Saturday night with 40 relatives.

It was a feeling of release, she said. It made us feel free. It allowed us to breathe to experience the springtime around us.

Across Israel, life is opening up. More than half of the Israeli population has received both doses of the Pfizer-BioNTech vaccine, the highest rate in the world.

On Saturday evening, that allowed large groups to celebrate Passover, which marks the escape of Israelites from slavery in Egypt. Then on Sunday morning, Christian worshipers were permitted to gather in large numbers to mark Palm Sunday including at the Church of the Holy Sepulchre, which according to tradition was built on the site in Jerusalem where Jesus Christ was both crucified and buried.

For many Israelis, the emergence from anti-virus restrictions gave added symbolism to a ritual, known in Judaism as Seder, that centers on freedom.

For Jews, Seder is celebrating liberation, said Harry D. Wall, an activist and documentary filmmaker who celebrated the evening in a group of 11 in Jerusalem 10 more than last year when he spent the holiday alone.

And that made the return to in-person gathering, after a year of on-off lockdowns, restrictions, isolation from friends and family to be even more meaningful this year, Mr. Wall added. It felt like a real deliverance.

The atmosphere at the Palm Sunday service at the Church of the Holy Sepulchre where worshipers commemorated Christs entry into Jerusalem, a week before his crucifixion was still subdued compared with the prepandemic era. Most places of worship can still admit only up to 50 percent of their capacity. But it was a happy improvement from last year, said Pierbattista Pizzaballa, the most senior Catholic official in the city.

Last year was a terrible Easter, without people, closed doors, he said in an interview with Reuters after the service. This year is much better the doors are open. We dont have a lot of people, but we feel more hopeful that things will become better.

A few miles to the south in Bethlehem, in the occupied West Bank, Christian Palestinians were also able to gather at the Church of the Nativity, which stands on a site where tradition holds that Christ was born. But the mood in Bethlehem is generally more somber: As in much of the West Bank, the city now shuts down at 7 p.m. to help temper the spread of the virus.

The infection rate is surging in the parts of the occupied territories administered by the Palestinian Authority. The authority has been able to procure only a small fraction of the vaccines it needs to protect the Palestinian population. And Israel has vaccinated predominantly those Palestinians who work in Israel itself or in Jewish settlements in the West Bank, stirring a debate about its responsibility as an occupying power.

Israel argues that Palestinian officials assumed responsibility for vaccinations after the signing of the Oslo accords in the 1990s. But Palestinian advocates argue it is Israels duty to help the Palestinians, citing the Fourth Geneva Convention, an international law that governs occupations.

New York State has introduced a digital app that allows individuals to prove they have been fully vaccinated against the coronavirus or have recently tested negative, as part of an effort to fast-track the reopening of businesses, sports arenas and entertainment venues in the state.

New York is the first state to formally create a digital passport for Covid-19. The free online platform, called Excelsior Pass, was developed with IBM and works like a mobile airline boarding pass. Users are assigned a digital pass with a secure QR code, which they can print out or save to their smartphones. Participating businesses then use a companion app to scan the customers QR code and verify their Covid status. The state said peoples data would be kept secure and confidential.

The question of public health or the economy has always been a false choice the answer must be both, Gov. Andrew M. Cuomo said in a statement. As more New Yorkers get vaccinated each day and as key public health metrics continue to regularly reach their lowest rates in months, the first-in-the-nation Excelsior Pass heralds the next step in our thoughtful, science-based reopening.

The Biden administration has been monitoring private and nonprofit efforts to develop vaccine passports, and is working to ensure that they meet certain standards, including for privacy, Jeffrey D. Zients, the White House coronavirus response coordinator, told reporters this month.

As we increase the number of people vaccinated, we know some people may have a need to demonstrate that they are vaccinated, Mr. Zients said. The private sector and not-for-profit coalitions are already beginning to work on this. Our role is to help ensure that any solutions in this area should be simple, free, open source, accessible to people both digitally and on paper, and designed from the start to protect peoples privacy.

As part of the initial launch, New Yorkers can use the digital pass to verify their Covid-19 status to attend games at stadiums and arenas, wedding receptions or other events above the states social gathering limit.

Major venues, including the 20,000-seat Madison Square Garden in New York City, have announced they plan to use this technology in the coming weeks. Beginning April 2, smaller arts and entertainment venues can also use Excelsior Pass. Interested New Yorkers can sign up for the app here.

The Centers for Disease Control and Prevention recently released its guidance for people in the United States who have been fully vaccinated, which is two weeks after the second dose in the Pfizer-BioNTech or Moderna vaccine or two weeks after the one-dose Johnson & Johnson vaccine.

It allows for the resumption of some activities in private settings between fully vaccinated people in small groups or a fully vaccinated household with one other unvaccinated household. It emphasized how fully vaccinated people should keep following health and safety precautions in public, including wearing a mask.

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Doctors in the Paris region warned Sunday that hospitals there may soon be overwhelmed with coronavirus cases as a third wave of the pandemic sweeps through the country, possibly forcing them to choose which patients they will treat.

In an op-ed article published in the Journal du Dimanche newspaper, 41 doctors said that vaccinations were not being administered fast enough, creating a catastrophic medical situation in which Paris region hospital capacity will be exceeded in the next two weeks.

We have never experienced such a situation, even during the worst attacks in recent years, the doctors wrote, referring to the attacks by Islamic State terrorists in Paris in 2015 that killed 130 people.

We will be forced to triage patients in order to save as many lives as possible, the doctors added, saying that the emergency would lead to non-access of care for some patients.

The warning comes as the number of Covid patients in intensive care in France hit 4,900, nearly the same level as a year ago, when the pandemic first surged into the country. The rise now is linked to the rapid spread of the variant first discovered in Britain. France has lagged behind other European countries in its vaccine rollout.

In an interview published Sunday in the same newspaper, President Emmanuel Macron defended a recent decision not to fully lock down the country despite the alarming surge.

The government recently imposed a nationwide curfew of 7 p.m. and closed nonessential businesses. But on Sunday, a warm sunny afternoon, crowds of people in Paris jammed the quais along the Seine river and thronged to parks, some not wearing masks while drinking and eating, prompting warnings from police officers patrolling the streets.

Mr. Macron, in the newspaper interview, left open the possibility of shifting course should hospitals face the threat of being overwhelmed.

The coming weeks will be difficult, he said. We will take all the necessary measures in due time, and in my view, there is no taboo.

In other news around the world:

In Germany, Chancellor Angela Merkel warned of potential curfews as case rates continue to climb. The countrys vaccination rate 10 percent of the population has received at least a first shot, according to a New York Times database is behind other nations in Europe and around the world.

Britain, where at least 45 percent of the country is partly vaccinated, is set to lift at least two lockdown measures. As of Monday, up to six people, or two households, can gather outside; and outdoor sports sites, like tennis courts and basketball courts, can be used to a limited degree.

In Australia, the city of Brisbane announced a three-day lockdown after seven people were infected with the coronavirus, the first citywide lockdown in the country in more than a month. Starting at 5 p.m. on Monday, residents of Australias third-largest city will be allowed to leave their houses only for essential purposes such as buying groceries, exercising or seeking medical care and masks will be mandatory in public. Tests showed the virus spreading in Brisbane is the highly contagious variant first detected in Britain, officials said.

Chris Adams, 36, has spent the past year of the pandemic living with his grandparents in Wichita, Kan., and being extremely strict about social distancing. I never went out, he said.

But starting Monday, when all adults in Kansas become eligible for the coronavirus vaccine, Mr. Adams plans to find a vaccination site where there is an available appointment. What Im looking forward to is seeing my friends again, he said.

Kansas is one of six states Louisiana, North Dakota, Ohio, Oklahoma and Texas are the others that are expanding eligibility for the vaccine to all adults on Monday. Minnesota will follow on Tuesday, and Indiana and South Carolina on Wednesday.

Gov. Laura Kelly of Kansas urged residents last week to seek out appointments, saying, With the anticipated increase in supply from the federal government, we must get every dose of vaccine into arms quickly.

Even as vaccine eligibility continues to expand across America nearly all states have pledged to make every adult eligible by May 1 the United States has also reported an increase in new cases over the past week. About 75,000 new cases were reported on Friday, a significant increase from the 60,000 added the Friday before.

States in the Northeast have accounted for about 30 percent of the nations new cases over the past two weeks, up from 20 percent in the first couple of weeks in February.

In New York, there has been an average of 8,426 new cases a day, an 18 percent increase from the average two weeks earlier, according to a New York Times database. In New Jersey over the past week, there have been an average of 4,249 new cases reported daily, a 21 percent increase from the average two weeks earlier. And on Friday, Vermont set a single-day case record with 283 new infections; it is the first state to set a case record since Jan. 18.

For many, the vaccine cannot come soon enough.

Nicole Drum, 42, a writer in the Kansas City, Kan., metro area, cried on Friday when she found out that she would be eligible to get the vaccine as early as Monday. She started calling pharmacies and looking online for available appointments within minutes of the news breaking, she said.

Ms. Drum called about 10 places without success. She had more luck on a county website, and booked an appointment for Wednesday.

She said she planned to wear a special T-shirt saying I believe in science to her appointment. I got myself a fun Im-getting-the-vaccine outfit, she said, laughing.

She also plans to take her 4-year-old son with her, because she wants him to see how research and science and people coming together can really help stem these kinds of things, she said.

I want him to know that theres no need to be afraid all the time of big scary things, because there are always helpers trying to figure this out, Ms. Drum said. While the solution might be something thats a jab in the arm that hurts a little bit, its worth it.

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transcript

[music] [applause]

BARCELONA, Spain Mireia Serret, a 21-year old student at the University of Barcelona, said that she was not a big fan of the band that played here on Saturday, nor does she normally like large crowds.

Nevertheless, she snapped up one of the 5,000 tickets to Europes biggest indoor rock concert since the start of the pandemic. It had just been too long since I was last able to dance and have fun at a concert, she said.

Organized by a group of Spanish music promoters as part of an initiative called Festivals for Safe Culture, the concert in the Palau de Sant Jordi was presented as Europes boldest effort to get thousands into an indoor venue, without seating or mandatory social distancing. The sole act was Love of Lesbian, a Spanish indie rock band formed decades ago.

A hospital team helped test the concertgoers for the coronavirus beforehand. Six people tested positive, according to the organizers. The team is relying on public medical records to track whether any concertgoers later test positive.

At a time when countries like France and Italy have recently put their residents back under lockdown to help stop another wave of infection, the people behind the Barcelona event said their goal was to look ahead.

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Covid-19: Birx Lashes Trumps Pandemic Response and Says Deaths Could Have Been Decreased Substantially - The New York Times

Heres what you need to know:A hot dog vendor in Los Angeles reopened on Monday after being closed for two months. The restaurant has been in business since 1939.Credit...Frederic J. Brown/Agence France-Presse Getty Images

Tens of thousands of students walked into classrooms in Chicago public schools on Monday for the first time in nearly a year. Restaurants in Massachusetts were allowed to operate without capacity limits, and venues like roller skating rinks and movie theaters in most of the state opened with fewer restrictions. And South Carolina erased its limits on large gatherings.

Across the country, the first day of March brought a wave of reopenings and liftings of pandemic restrictions, signs that more Americans were tentatively emerging from months of isolation, even if not everyone agrees that the time is ripe.

There are plenty of reasons for optimism: Vaccinations have increased significantly in recent weeks, and daily reports of new coronavirus cases have fallen across the United States from their January peaks.

In Kentucky, all but a handful of school districts are now offering in-person classes, while the state races to vaccinate teachers as quickly as possible. Gov. Andy Beshear told reporters last week that the states falling infection statistics showed that immunizations were beginning to make an impact.

It means vaccinations work, he said. Were already seeing it. Were seeing it in these numbers. Its a really positive sign.

Dr. Anthony S. Fauci, President Bidens chief medical adviser for Covid-19, said at a news briefing on Monday that for small groups of people who have all been fully vaccinated, there was a low risk in gathering together at home. Activities beyond that, he said, would depend on data, modeling and good clinical common sense, adding that the Centers for Disease Control and Prevention would soon have guidance for what vaccinated people could safely do.

The positive signs come with caveats. Though the national statistics have improved drastically since January, they have plateaued in the last week or so, and the United States is still reporting more than 65,000 new cases a day on average comparable to the peak of last summers surge, according to a New York Times database. The country is still averaging about 2,000 deaths per day, though deaths are a lagging indicator because it can take weeks for patients to die.

More contagious variants of the virus are circulating in the country, with the potential to push case counts upward again. Testing has fallen 30 percent in recent weeks, leaving experts worried about how quickly new outbreaks will be known. And millions of Americans are still waiting to be vaccinated.

Given all that, some experts worry that the reopenings are coming a bit too soon.

Were, hopefully, in between what I hope will be the last big wave, and the beginning of the period where I hope Covid will become very uncommon, said Robert Horsburgh, an epidemiologist at the Boston University School of Public Health. But we dont know that. Ive been advocating for us to just hang tight for four to six more weeks.

The director of the C.D.C., Dr. Rochelle Walensky, said at the briefing on Monday that she was really worried about the rollbacks of restrictions in some states. She cautioned that with the decline in cases stalling and with variants spreading, we stand to completely lose the hard-earned ground we have gained.

And the plateauing case levels must be taken extremely seriously, Dr. Walensky warned at a briefing last week. She added: I know people are tired; they want to get back to life, to normal. But were not there yet.

After some counties in Washington State allowed movie theaters to reopen, Nick Butcher, 36, made up for lost time by attending screenings of the Lord of the Rings trilogy for three straight nights. He bought some M&Ms at the concession stand, sat distanced from others in the audience, and said he felt as though things were almost back to normal.

A first dose of the Oxford-AstraZeneca vaccine substantially reduced the risk of older people becoming ill with Covid-19, scientists in Britain reported on Monday, the strongest sign yet that a shot that much of the world is relying on to end the pandemic will protect the elderly.

Four weeks after the first dose, the vaccine was roughly 60 percent effective in preventing Covid-19 among people at least 70 years old in England, the scientists wrote in a paper that was posted online on Monday but not yet published in a journal or vetted by other researchers.

That figure appeared to rise in the following week, though there was a high level of statistical uncertainty in the subsequent number.

For countries across Europe that have been hesitant about authorizing the AstraZeneca vaccine for use in older people, the data could resolve some of those doubts. The early clinical trials of the AstraZeneca vaccine did not enroll as many older people as the trials of other shots, making a number of European countries uneasy about using it in that age group.

But Britain decided to authorize the vaccine for people of all ages, creating a valuable store of data on its effectiveness.

In France, one of the countries that had restricted the AstraZeneca vaccine to younger people, the countrys health minister said people over 65 with pre-existing conditions would be able to receive the vaccine, Reuters reported.

In part because of the age restrictions, countries across Europe have been slow to use their doses of the AstraZeneca vaccine, with some health workers holding out for the Pfizer-BioNTech vaccine instead.

The same study from England showed strong protection from the Pfizer vaccine. Among people at least 70 years old, a first dose was 61 percent effective in preventing Covid-19 up to four weeks after the shot, a figure that then plateaued, the study said.

In people at least 80 years old, a first dose was 70 percent effective at preventing Covid-19 four weeks later, a figure that rose to 89 percent two weeks after the second shot. (Britain has decided to delay second doses of both the Pfizer and AstraZeneca shots up to 12 weeks after the first.)

The results demonstrate that a single dose of either the Pfizer-BioNTech or the Oxford-AstraZeneca vaccine provides a high level of protection against severe disease in the most vulnerable age groups, Azra Ghani, a professor of infectious disease epidemiology at Imperial College London, said of the findings.

Because Britain authorized the AstraZeneca vaccine later than the Pfizer vaccine, there is less data on the effectiveness of a full two-dose course of the AstraZeneca vaccine.

Both vaccines were also highly effective at preventing coronavirus-related hospitalizations in the study from England.

The study was part of a wealth of data that has emerged from Britains mass inoculation program showing that the vaccines were working as intended. No other large nation is inoculating people as quickly as Britain, the first country in the world to authorize and begin using both the Pfizer shot and the one developed by AstraZeneca and the University of Oxford.

California lawmakers and Gov. Gavin Newsom on Monday announced a plan intended to encourage districts to reopen schools, the latest state to take the step that has drawn contentious deliberations across the country.

The agreement includes $2 billion in incentives and fast-tracked vaccinations to lure teachers back for at least some of the remaining school year.

President Biden has pushed for schools to safely reopen, even if that means limited in-person learning, having called for them to be open five days a week, but has been vague about what that would look like. Less than half of students in the United States are attending public schools that offer traditional full-time schedules, frustrating both parents and educators.

In Philadelphia, elected officials, teachers unions and health agencies have urged strict caution, putting most districts on hybrid schedules, while some remain fully remote. In the city itself, the teachers union and district reached a reopening deal to return students in kindergarten through the second grade to classrooms in phases over the month of March. The city is expediting teacher vaccination and purchasing air purifiers, and hopes to return older students to school before the end of the academic year.

The new schools chancellor in New York City, the largest public school district in the country, pledged on Friday to at least partially reopen high schools by the end of the year. While the citys schools were among the first in the country to reopen last fall, the in-person learning has been inconsistent because of the virus, and high schools have been closed since November.

The new measures in California come as the state emerges from a towering post-holiday spike in coronavirus cases. The aim is to restore six to 12 weeks of in-person class for the regular school year, which ends in late June in most of the states districts. Most of Californias six million schoolchildren have been receiving only remote instruction for the past year.

Rather than mandating reopening, the state will make a time-limited offer of grants to help pay for coronavirus testing, upgraded ventilation and other campus safeguards, along with $4.6 billion for extended class time and summer school.

The money is modest by California standards. The state spent nearly $100 billion last year on its public school system, and the $2 billion pot will be open to more than 1,000 school districts. Those with plans to reopen after March 31 will be eligible for less money, with grants shrinking to zero for schools opening after May 15.

And reopenings are likely to be limited, particularly where the virus and its variants are still surging. In counties with the states highest-risk purple designation Los Angeles, for instance schools will only have to offer face-to-face class for high-needs students and children in transitional kindergarten through second grade to be eligible for reopening money.

In lower-risk counties, districts applying for the grants also will have to offer face-to-face class in elementary schools and at least one middle school and one high school grade.

But the incentives, along with the governors promise last week to earmark 10 percent of new first doses of vaccines for school employees, establish Californias clearest blueprint so far for restoring in-person instruction for the bulk of the states six million-plus public school students. And they address key demands of the states powerful teachers unions. Most large districts, including those in Los Angeles, San Diego and San Francisco, have been operating remotely for the vast majority of students for nearly a year.

On Monday, Austin Beutner, the Los Angeles districts superintendent, said Mr. Newsom had procured enough vaccine doses for its schools to inoculate 40,000 teachers, bus drivers, custodians and other school employees within the next two weeks enough to reopen Los Angeles classrooms at least through second grade by mid- to late April if school employee unions comply.

Leaders of United Teachers Los Angeles, which represents educators in the nations second-largest school district, have asked members to vote this week on a proposed endorsement of their conditions for an in-person return, which include teacher vaccines, stringent health measures and a potential sticking point: a rate of community transmission that is significantly lower than present before schools can reopen.

California school districts need agreements with their unions in order to reopen, although most of the states other large districts have already worked out at least a framework for an in-person return.

Long Beach, where city and school district officials have been working together to vaccinate teachers since January, for instance, are on track to resume in-person classes on March 31. And the schools in Elk Grove, near Sacramento, have said elementary students there could be back in classrooms, at least part time, by the middle of this month.

Dana Goldstein contributed reporting.

Extraordinarily high staff turnover at U.S. nursing homes most likely contributed to the shocking number of deaths at the facilities during the pandemic, the authors of a new study suggested.

The study, which was published Monday in Health Affairs, a health policy journal, represents a comprehensive look at the turnover rates in 15,645 nursing homes across the country, accounting for nearly all of the facilities certified by the federal government. The researchers found the average annual rate was 128 percent, with some facilities experiencing turnover that exceeded 300 percent.

Researchers pointed to the findings to urge Medicare to publish the turnover rates at individual nursing home sites, as a way of putting a spotlight on substandard conditions and pressuring owners to make improvements.

Inadequate staffing and low pay have long plagued nursing homes and quality of care for the more than one million residents who live in these facilities. But the pandemic has exposed these issues even more sharply, with investigations underway into some states oversight of the facilities as Covid-19 cases spiraled unchecked and deaths skyrocketed.

The high turnover rate most likely made it harder for nursing homes to put in place strong infection controls during the pandemic, and led to rampant spread of the coronavirus, said Ashvin Gandhi, the lead author and a health economist and assistant professor at the University of California Los Angeles Anderson School of Management.

Nursing-home owners blame inadequate reimbursement from Medicaid, the federal-state program for elderly skilled nursing care.

Workforce recruitment and retention is among the most pressing challenges confronting long-term care providers, and we have been calling for help for years, Dr. David Gifford, the chief medical officer for the American Health Care Association and National Center for Assisted Living, a trade group, said in an emailed statement.

Its high past time that providers receive the proper resources to invest in our frontline caregivers in order to improve quality care, he said.

Nursing home staff members have also shown resistance to getting vaccinated against the coronavirus. If a nurse who was immunized leaves and is replaced, the facility will need to ensure the new employee is also vaccinated, especially given the reluctance of some workers to get a coronavirus shot.

Trying to do a one-shot vaccination push isnt enough, Dr. Gandhi said. You need continued vaccination outreach.

New York City added workers in the food service and hotel industries to the list of people eligible for coronavirus vaccination on Monday, the same day the governors of Florida and Ohio announced expansions for eligibility in their states.

The expansions come as the supply of vaccines being distributed nationally is ramping up, and after a third vaccine, a single-shot dose from Johnson & Johnson, was authorized for emergency use by the Food and Drug Administration over the weekend. The pace of U.S. vaccinations is again accelerating, up to about 1.82 million doses per day on average, according to a New York Times database, above last months peak before snowstorms disrupted distribution.

In New York City, people who work in regional food banks, food pantries and permitted home-delivered meal programs became eligible on Monday to receive a vaccine. Hotel workers who have direct contact with guests also became eligible.

The governor of Florida, Ron DeSantis, said on Monday that people 50 and older who work in K-12 schools, law enforcement or firefighting would become eligible on Wednesday. Florida was one of the first states that decided to vaccinate anyone 65 and older, even before most essential workers, which led to long lines and confusion.

Gov. Mike DeWine of Ohio said on Monday that the state would receive more than 448,000 doses this week, including more than 96,000 doses of the Johnson & Johnson vaccine. He said that in response to this significant increase in the amount of vaccine coming into Ohio, a new group of people would be eligible on Thursday to get a shot.

That group includes people with Type 1 diabetes, pregnant women and certain workers in child care and funeral services, as well as law enforcement and corrections officers.

To stay ahead of more contagious and possibly more deadly virus variants, states have been racing to ramp up vaccinations and expand eligibility. But they have often done so before the supply could increase quickly enough, creating shortages and making it harder for people to get vaccination appointments.

Widespread testing is crucial in controlling the spread of the coronavirus and squashing new outbreaks, experts say. But the amount of testing in the United States has fallen by 30 percent in recent weeks.

From a high of nearly 14 million tests a week in early January, the pace fell to fewer than 10 million a level not seen since October in the week ended Feb. 24, according to the Covid Tracking Project.

Some areas report even sharper declines: Michigan is testing about half as many people now as it was in November, and Delawares state-run sites are testing about one-third as many. Los Angeles Countys sites, which were running flat out last month, tested just 35 percent of their capacity last week.

Experts cited a number of factors that could be contributing to the slump:

Fewer exposures. Since daily tallies of new coronavirus infections have fallen sharply, fewer people may be having contacts that would prompt them to seek a test.

Less travel. The holiday rush is over, reducing the need for people to get tested before or after trips.

Bad weather. The severe storms and Arctic temperatures that battered much of the country, from Texas to the Northeast, caused many testing sites to close temporarily.

The vaccine rollout. Some states have shifted their limited public health resources, and their public messaging, toward vaccination efforts at the expense of testing.

Pandemic fatigue. Some experts worry the decline may be yet another symptom of public exhaustion and frustration with pandemic precautions and safety measures.

All those forces may be at play, said Dr. Jennifer Nuzzo of the Johns Hopkins Bloomberg School of Public Health: My sense is that its probably that there are fewer options for testing, fewer communications about it, people may be perceiving that its less necessary maybe they just dont see the point any more.

The slump in testing, at a time when a clear picture of the pandemic is still badly needed, worries some epidemiologists. Theres nothing about the current situation that has made testing any less necessary, Dr. Nuzzo said.

Among other things, less testing makes it harder to follow the viruss mutations and to get ahead of variants that may be more contagious or deadly, said Dr. Rick Pescatore, the chief physician at the Delaware Division of Public Health. We cant identify variants until we first identify positives.

But the decline in testing may not be a cause for alarm and may even be a good sign if it reflects wider progress in tamping down the pandemic, said Dr. Clemens Hong, who runs Los Angeles Countys testing program.

The biggest reason for the drop in testing demand, I think, is the decrease in infections and spread, Dr. Hong said. Covid-19 is not spreading as quickly right now, which means theres fewer people with symptoms, and also fewer people having contact with people with Covid-19. Thats just the reality.

Across the country, new case reports have dropped sharply since mid-January. At its peak on Jan. 8, the U.S. reported a seven-day average of over 259,000 new cases. Now, the seven-day average is less than 70,000, as of Saturday.

Hospitalizations and deaths have followed suit, and vaccine distribution is rapidly increasing: 15 percent of the U.S. population has now received at least one dose.

Nonetheless, Dr. Hong said, testing remains vital to getting ahead of outbreaks.

Even with all these declines and the rollout of the vaccines, its just not enough, he said. We dont have enough immunity in the community to prevent another surge. We may never see a surge like we saw in December and January again, but well see little pockets and little surges that will try to come to life, and we just need to put them out.

When Johnson & Johnsons coronavirus vaccine won emergency use authorization on Saturday from the Food and Drug Administration, the move augmented the nations vaccination effort with a third major tool one that differs markedly from the first two authorized vaccines, made by Pfizer-BioNTech and Moderna.

Most notably, it is administered in a single dose instead of two, and can be kept unfrozen in an ordinary refrigerator for up to three months features that promise greater flexibility as public health officials try to immunize Americans as quickly as possible.

Much is still to be determined about how this new tool will be used. Here is what we know so far.

Within the next few days. Johnson & Johnson started shipping out doses on Monday, and they can be used as soon as they reach vaccination sites starting on Tuesday.

At first, the increase in availability will be limited. The company had about 3.9 million doses on hand to ship right away, but after that, deliveries could be patchy for a few weeks. (For comparison, the nation is using up that many doses of the Pfizer-BioNTech and Moderna vaccines in a little more than two days.)

By the end of March, Johnson & Johnson says it will ship roughly 16 million more doses. Even so, the Pfizer-BioNTech and Moderna vaccines will continue to make up the majority of the nations supply.

The same way the two earlier vaccines are: in proportion to each state or territorys population.

Thats still under discussion. The Centers for Disease Control and Prevention has said that the vaccine can be given to people 18 and over, and state officials are working out what their policies will be.

Because the new vaccine is given in a single shot and doesnt require cold storage, some experts and officials have suggested directing it toward hard-to-reach segments of the population (like rural residents or homeless people), or to people who might not keep an appointment for a second shot (like college students or those with mobility issues).

But there is concern about appearing to favor or disfavor some groups, and the Biden administration has said it will insist that the new vaccine be distributed equitably.

Thats not clear. Right now, people are getting whichever vaccine the site has on hand when their turn comes, and appointment scheduling systems generally dont tell users beforehand which it will be. Depending on how states decide to deploy the Johnson & Johnson vaccine, though, it may be possible to effectively choose what you get by choosing where you sign up to get it.

Health experts say the best shot is the one you can get the soonest, whichever one it turns out to be. All three authorized vaccines are highly protective, and the differences among them pale in comparison, they say, with the risk you would run by being picky and passing up a chance to get a shot because it was not your top choice.

A Frontier Airlines flight from Miami to La Guardia Airport in New York was canceled on Sunday night after a large group of passengers, including several adults, refused to wear masks, the airline said.

By Monday morning, the airline was facing accusations of anti-Semitism for its treatment of the passengers, who are Hasidic Jews, as well as demands for an investigation from the Anti-Defamation League of New York and other groups. Frontier steadfastly held to its position that the passengers had refused to comply with federal rules requiring them to wear masks.

Several phone videos that have surfaced do not show the confrontation that took place between the passengers and the Frontier crew members, only the aftermath. The video footage from inside the aircraft appeared to show members of the group wearing masks. Some passengers said that the episode escalated because just one member of the group, a 15-month-old child, was not wearing one.

Videos of the passengers exiting the plane amid chaos, captured by other people on the flight, were posted on Twitter by the Orthodox Jewish Public Affairs Council. In one video, a passenger says, This is an anti-Semitic act.

Another video showed a couple holding a maskless baby in a car seat, as children could be heard crying and a woman explained that the young children in their group, sitting in the back of the plane, had taken off their masks to eat.

A Frontier Airlines spokeswoman said in a statement that a large group of passengers repeatedly refused to comply with the U.S. governments federal mask mandate.

GLOBAL ROUNDUP

NEW DELHI Prime Minister Narendra Modi of India was vaccinated against the coronavirus on Monday as the country began the next phase of its inoculation drive, one of the largest in the world.

India has approved two coronavirus vaccines for emergency use: the Oxford-AstraZeneca vaccine, which is produced by the Serum Institute of India, the worlds largest vaccine producer; and Covaxin, which was developed by Bharat Biotech, an Indian pharmaceutical company.

Mr. Modi received the first of two doses of Covaxin, in line with his pitch for a self-reliant India, which he reiterated in his monthly radio address over the weekend. The first condition for self-reliance is to have pride in the things of ones own country, he said.

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