California plans to lift all its coronavirus restrictions on June 15, provided there are enough Covid-19 vaccines available for anyone age 16 or older and hospitalizations remain low and stable, state officials announced on Tuesday.
The move in June will allow Californians to return to restaurants, bars, movie theaters, houses of worship and concerts without strict capacity limits for the first time in well more than a year. President Biden has said there will be enough vaccines available for all adults by the end of May.
Other states have already eased health restrictions at a time when the Biden administration is pleading with them not make those changes just yet. The country is facing a fourth possible surge of the virus, and there are concerns about the spread of worrisome virus variants. In many states, coronavirus case counts have been climbing.
“I think if everyone continues down the road we’re on now, it will be behind us, but it’s not over yet,” Mr. Biden said on Tuesday during a visit to a vaccination site in Alexandria, Va.
But in California, cases have been declining since hitting a peak early this year, with the state now averaging around 2,700 new cases a day, the lowest figure since last June.
And according to data from the Centers for Disease Control and Prevention, as of Monday, 34 percent of the state’s total population has received at least one vaccine shot, and 18 percent are fully vaccinated.
“With more than 20 million vaccines administered across the state, it is time to turn the page on our tier system and begin looking to fully reopen California’s economy,” Gov. Gavin Newsom said in a statement. “We can now begin planning for our lives post-pandemic.”
The state will, however, keep in place a mask mandate for the foreseeable future, and there will be some limits on large indoor events or conventions of more than 5,000 people at least until fall.
California was the first state to implement a stay-at-home order last year, on March 19, plunging the state’s 40 million residents into the nation’s largest experiment in preventing transmission of what was then a mystery-shrouded virus.
Since then, California has toggled among various levels of restriction as new cases have surged, receded and then surged again, overwhelming hospitals in the winter, even as other states have allowed full reopenings.
Mr. Newsom was widely criticized last year when he attended a dinner for a lobbyist friend’s birthday at one of Napa Valley’s most exclusive restaurants, the French Laundry, after imploring Californians to be vigilant and to refrain from seeing their relatives during the holidays.
His administration’s ever-changing reopening strategies, which have been implemented piecemeal across the state’s 58 counties, have also come under fire.
The latest announcement will lift what state leaders have referred to as California’s “Blueprint for a Safer Economy,” which laid out a system of color-coded tiers of restrictions. As individual counties reached certain case thresholds, they were allowed to move through the tiers, a system first introduced in August when the state was grappling with an alarming rise in new cases.
Mr. Newsom and other state leaders emphasized that the state needed to have the ability to quickly reimpose emergency measures if hospitals started to fill up.
Around Thanksgiving, there were signs that public health officials’ worst fears would be realized. By December, hospitals — especially in hard hit areas, like Los Angeles — were overwhelmed with patients, and the state ordered Californians to stay at home again.
Now, as the focus has turned to the state’s vaccine rollout,Californians have been frustrated with what they have seen as a confusing and chaotic effort.
When state officials recently announced that the state would expand vaccine eligibility to anyone 16 or older starting April 15, Dr. Christopher Longhurst, U.C. San Diego Health’s chief information officer, predicted “continued frustration as more people become eligible but supply is not available to meet demand.”
Experts have also criticized the process for allowing poorer and harder-hit communities to be bypassed, even though state officials have repeatedly said equity was a “North Star” for their efforts.
Leaders in California are painfully aware of the divide between the state’s wealthiest and often whitest communities, on the one hand, and its poorest communities, often home to predominantly Latino essential workers, on the other, and so advocates for equity have said that speed and precision should both be priorities in the distribution of vaccines.
“Equity and scale are possible for the wealthiest states in the nation,” Jacqueline Martinez Garcel, chief executive of the Latino Community Foundation, said recently.
State officials said on Tuesday that they were confident in the state’s ability to inoculate millions more Californians, including particularly vulnerable workers, over the next couple of months.
“We’ve been very thoughtful and measured with who’s eligible to be vaccinated,” said Dr. Mark Ghaly, the state’s secretary of health and human services.
President Biden plans to say on Tuesday that he is speeding up the deadline for states to make all adults eligible for a coronavirus vaccine — to April 19, his press secretary said.
The announcement will come as nearly every state in the nation has already heeded earlier calls by the president to accelerate the timelines for when all adult residents will be eligible to be vaccinated — a vast majority now meeting or coming ahead of the April 19 target. On Tuesday, Oregon said those who are 16 or older will be eligible for vaccination on April 19.
“That doesn’t mean they will get it that day,” Jen Psaki, the White House press secretary, said Tuesday ahead of Mr. Biden’s planned remarks. “That means they can join the line that day, if they have not already.”
Mr. Biden’s most recent target comes almost a month after he set an original deadline of May 1 for every state, and a week after he said that by April 19, 90 percent of adults would be eligible for a shot and will be able to get one within five miles of their home.
A White House official said last week that Mr. Biden revised the timeline because states, encouraged by increases in shipments, were ramping up their vaccination programs more rapidly than expected.
Mr. Biden visited a vaccination site at Virginia Theological Seminary in Alexandria, Va., on Tuesday. While he was there, he said that if Americans, including those who are fully vaccinated, continue wearing masks and taking health precautions, progress would continue.
“I think if everyone continues down the road we’re on now, it will be behind us, but it’s not over yet,” he said.
The U.S. vaccination campaign has steadily picked up pace: More than three million doses are being given on average each day, compared with well under one million when Mr. Biden took office in January, according to the Centers for Disease Control and Prevention.
Every state has now given at least one dose to a quarter or more of its population. About 62.4 million people — 19 percent of Americans — have been fully vaccinated. And the White House on Tuesday told governors that over 28 million more doses of vaccines will go out to states, jurisdictions and other programs this week.
Mr. Biden has said he hopes for 200 million doses to be administered by his 100th day in office, a goal that the nation is on pace to meet. As of Monday, more than 150 million shots have been administered beginning on Jan. 20, according to data reported by the C.D.C. The federal government has delivered a total of about 207.9 million doses to states, territories and federal agencies since last year.
The recent burst in supply has prompted governors to move up eligibility timelines on their own weeks ahead of Mr. Biden’s original May 1 marker.
“Today, we are pleased to announce another acceleration of the vaccine eligibility phases to earlier than anticipated,” Gov. Larry Hogan of Maryland said on Monday, announcing that all Maryland residents age 16 or older would be eligible starting on Tuesday for a vaccine at the state’s mass vaccination sites, and from April 19 at any vaccine provider in the state.
Also on Monday, Gov. Philip D. Murphy of New Jersey said residents 16 or older in his state would be eligible on April 19. Mayor Muriel Bowser of Washington said later on Monday that city residents 16 or older would also be eligible on April 19.
In Hawaii, Lt. Gov. Josh Green said on Monday that the state was hoping to open up vaccinations to people 16 years or older on the island of Oahu in two weeks, according to a local television news outlet. The rest of the state has already done so.
Public health experts have said that the vaccines are in a race against worrisome coronavirus variants that were first identified in Britain, South Africa and Brazil. New mutations have continued to pop up in the United States, from California to New York to Oregon.
The shots will eventually win, scientists say, but because each infection gives the coronavirus a chance to evolve further, vaccinations must proceed as fast as possible.
As that race continues, the optimism sown by the steady pace of vaccinations may be threatening to undermine the progress the nation has made. Scientists also fear Americans could let their guard down too soon as warmer weather draws them outside and case levels drop far below the devastating surge this winter.
Cases are now rising sharply in parts of the country, with some states offering a stark reminder that the pandemic is far from over: New cases in Michigan have increased by 112 percent and hospitalizations have increased by 108 percent over the past two weeks, according to a New York Times database.
The United States is averaging more than 64,000 new cases each day, a 20 percent increase from two weeks earlier. That’s well below the peak of more than 250,000 new cases daily in January, but on par with last summer’s surge after reopenings in some states, like Arizona, where patrons packed into clubs as hospital beds filled up. The United States is averaging more than 800 Covid-19 deaths each day, the lowest level since November.
Under a new executive order issued by Gov. Greg Abbott of Texas this week, government agencies, private businesses and institutions that receive state funding cannot require people to show proof that they have been vaccinated against the coronavirus.
Mr. Abbott said that vaccination status is private health information, and that no one should have to disclose it as a condition of engaging in normal activities. His order includes an exception allowing nursing homes and similar care facilities to require documentation of vaccination status for their residents.
A wide range of businesses, including cruise lines, airlines, sports stadiums and theaters, are eager for people to be issued some kind of credential, often called a vaccine passport, that they can present to show they are immunized so that the businesses can more safely reopen, especially as the number of new virus cases rises across the country.
But a growing number of Republicans are politicizing the issue and framing proof-of-vaccination requirements and vaccine passports as government overreach. Last year, many Republican governors rejected mask mandates for similar reasons, often calling the requirement to wear masks in public settings a violation of a citizen’s personal liberties, despite overwhelming evidence that masks stem the spread of the virus.
On Sunday, Gov. Tate Reeves of Mississippi said he opposes the idea of vaccine passports, and last week, Gov. Ron DeSantis of Florida issued an executive order banning policies that would require customers to provide any proof of vaccination. Gov. Pete Ricketts of Nebraska has said his state would not participate in any vaccine passport program. Gov. Mike Parson of Missouri has said he would not require vaccine passports in the state but was also not opposed to private companies adopting them.
Vaccine passports, including digital ones, raise daunting political, ethical and privilege questions. The Biden administration has made clear that it will neither issue nor require them.
“Let me be very clear on this,” Jen Psaki, the White House press secretary said on Tuesday, “the government is not now — nor will we be — supporting a system that requires Americans to carry a credential.”
Ms. Psaki said there would not be a federal vaccine database, either. “As these tools are being considered by the private and nonprofit sectors, our interest is very simple — from the federal government — which is Americans’ privacy and rights should be protected so that these systems are not used against people unfairly.”
She said the Biden administration would provide some guidance — probably in the form of questions and answers — about privacy, security and discrimination concerns.
Legal experts said there might be questions, depending on state law, about whether governors were authorized to bar requests for vaccination status by executive decree. But they said State Legislatures were most likely free to enact statutes to do so.
In 1905, the Supreme Court ruled that states can enforce compulsory vaccination laws. For more than a century, that ruling has allowed public schools to require proof of vaccinations of its students, with some exceptions for religious objections.
Private companies, moreover, are free to refuse to employ or do business with whomever they want, subject to just a few exceptions that do not include vaccination status. But states can probably override that freedom by enacting a law barring discrimination based on vaccination status.
Adam Liptak and Sheryl Gay Stolberg contributed reporting.
In Beijing, the vaccinated qualify for buy-one-get-one-free ice cream cones. In the northern province of Gansu, a county government published a 20-stanza poem extolling the virtues of the jab. In the southern town of Wancheng, officials warned parents that if they refused to get vaccinated, their children’s schooling and future employment and housing were all at risk.
China is deploying a medley of tactics, some tantalizing and some threatening, to achieve mass vaccination on a staggering scale: a goal of 560 million people, or 40 percent of its population, by the end of June.
China has already proven how effectively it can mobilize against the coronavirus. And other countries have achieved widespread vaccination, albeit in much smaller populations.
But China faces a number of challenges. The country’s near-total control over the coronavirus has left many residents feeling little urgency to get vaccinated. Some are wary of China’s history of vaccine-related scandals, a fear that the lack of transparency around Chinese coronavirus vaccines has done little to assuage. Then there is the sheer size of the population to be inoculated.
To get it done, the government has turned to a familiar tool kit: a sprawling, quickly mobilized bureaucracy and its sometimes heavy-handed approach. This top-down, all-out response helped tame the virus early on, and now the authorities hope to replicate that success with vaccinations.
Already, uptake has skyrocketed. Over the past week, China has administered an average of about 4.8 million doses a day, up from about one million a day for much of last month. Experts have said they hope to reach 10 million a day to meet the June goal.
“They say it’s voluntary, but if you don’t get the vaccine, they’ll just keep calling you,” said Annie Chen, a university student in Beijing who received two such entreaties from a school counselor in about a week.
A top vaccines official at the European Medicines Agency said on Tuesday that AstraZeneca’s vaccine was linked to blood clots in a small number of recipients, the first indication from a leading regulatory body that the clots may be a real, if extremely rare, side effect of the shot.
The agency itself has not formally changed its guidance, issued last week, that the benefits of the AstraZeneca vaccine outweigh the risks. It said on Tuesday that its review was ongoing and that it would announce its findings this week. But any further ruling from regulators would be a setback for a shot that Europe and much of the world are relying on to save lives amid a global surge in coronavirus cases.
The medicines agency said last week that no causal link between the vaccine and rare blood clots had been proven. Only a few dozen cases of blood clots have been recorded among the many millions of people who have received the vaccine across Europe.
But the vaccines official, Marco Cavaleri, told an Italian newspaper that “it is clear there is an association with the vaccine.” He said that it would likely remain up to individual countries to decide how to respond, given the variation in supply of Covid-19 vaccines and in the state of the virus.
Those comments represented the first indication from a member of a leading regulatory body that the blood clots could be a genuine, if extremely rare, side effect of the AstraZeneca vaccine. Previously, health officials in several European countries temporarily restricted the use of the shot in certain age groups, despite the European Medicines Agency’s recommendation to keep administering it.
Regulators in Britain and at the World Health Organization have also said that, while they were investigating any rare side effects, the shot was safe to use and would save many lives.
Mr. Cavaleri told the Italian newspaper Il Messaggero that European regulators had not determined why the vaccine might be causing the rare blood clots, which generated concern because the cases were so unusual. They involved blood clots combined with unusually low levels of platelets, a disorder that can lead to heavy bleeding.
The most worrisome of the conditions, known as cerebral venous sinus thrombosis, involves clots in the veins that drain blood from the brain, a condition that can lead to a rare type of stroke.
The clots are, by all accounts, extremely rare. European regulators were analyzing 44 cases of cerebral venous sinus thrombosis, 14 of them fatal, among 9.2 million people who received the AstraZeneca vaccine across the continent. Emer Cooke, the European Medicines Agency’s director, said that the clotting cases in younger people translated to a risk for one in every 100,000 people under 60 given the vaccine. Younger people, and especially younger women, are at higher risk from the brain clots, scientists have said.
In Britain, regulators last week reported 30 cases of the rare blood clots combined with low platelets among 18 million people given the AstraZeneca vaccine, which was developed with the University of Oxford. No such cases were reported in people who had received the Pfizer-BioNTech vaccine in Britain.
Regulators in Britain have said that people should get the vaccine “when invited to do so.” But British news reports indicated Monday night that regulators were considering updating that guidance for certain age groups.
Monika Pronczuk and Emma Bubola contributed reporting.
Students in New York City’s public school system, the largest district in the United States, will be able to take standardized tests this year, a process that has been drastically disrupted because of the pandemic. For the first time, New York City will ask families to opt in to state math and English exams, which all students in grades three through eight are typically asked to take during the spring. Last year, those exams were canceled altogether when city schools were shuttered as New York became a global center of the pandemic.
Though some city and state education officials have sought a waiver from the federal government to cancel the exams again this year, President Biden’s administration is requiring states to offer testing. New York’s solution — asking parents to opt their children in to take the test — will no doubt mean that smaller numbers of students will sit for the exams this year compared with numbers of previous years.
The smaller test score data will significantly disrupt at least two years of state testing, which will make it difficult to track student progress over time on those exams. It is not clear whether eighth graders applying to academically selective high schools will need test scores for admission.
A relatively small percentage of city students refuse the exams each year, as part of a national test refusal movement known as opt out. Students learning in-person and remotely who choose to participate in standardized testing will report to their school buildings during their scheduled exam over a range of dates in April and May.
WASHINGTON — More than eight years ago, the federal government invested in an insurance policy against vaccine shortages during a pandemic. It paid Emergent BioSolutions, a Maryland biotech firm known for producing anthrax vaccines, to have a factory in Baltimore always at the ready.
When the coronavirus pandemic arrived, the factory became the main U.S. location for manufacturing Covid-19 vaccines developed by Johnson & Johnson and AstraZeneca, churning out about 150 million doses as of last week.
But so far, not a single dose has been usable because regulators have not yet certified the factory to allow the vaccines to be distributed to the public. Last week, Emergent said it would destroy up to 15 million doses’ worth of the Johnson & Johnson vaccine after contamination with the AstraZeneca vaccine was discovered.
Emergent and government health officials have long promoted their partnership as a success, but an examination by The New York Times of manufacturing practices at the Baltimore factory found serious problems, including a corporate culture that often ignored or deflected missteps and a government sponsor, the Biomedical Advanced Research and Development Authority, that acted more as a partner than a policeman.
Previously undisclosed internal documents and interviews with current and former federal officials and former company employees depict a factory operation that was ill-equipped to take on such a mammoth manufacturing task, despite Emergent’s having received a $163 million federal contract to improve the center and prepare it for high-volume production.
The loss of the Johnson & Johnson doses was not the first time that the company threw out coronavirus vaccine for fear of contamination. Between early October and January, Emergent discarded five lots of AstraZeneca vaccine — each the equivalent of two million to three million doses — because of contamination or suspected contamination, according to internal logs, a government official and a former company supervisor.
Audits and investigations — including ones conducted in 2020 by Johnson & Johnson, AstraZeneca, two federal agencies and Emergent’s own quality evaluators — found that Emergent had not followed some basic industry standards at the Baltimore plant, and identified repeated shortcomings in efforts to disinfect and prevent contamination.
Although audits always find problems, federal officials and outside experts said that the pattern of lapses suggested deeper quality issues at the factory in Baltimore.
Garment workers in factories producing clothes and shoes for companies like Nike, Walmart and Benetton have seen their jobs disappear in the past 12 months, as major brands in the United States and Europe canceled or refused to pay for orders after the pandemic took hold and suppliers resorted to mass layoffs or closures.
Most garment workers earn chronically low wages, and few have any savings. Which means the only thing standing between them and dire poverty are legally mandated severance benefits that are often owed upon termination, wherever the workers are in the world.
According to a new report from the Worker Rights Consortium, however, garment workers are being denied some or all of these wages.
The study identified 31 export garment factories in nine countries where, the authors concluded, a total of 37,637 workers who were laid off did not receive the full severance pay they legally earned, a collective $39.8 million.
According to Scott Nova, the group’s executive director, the report covers only about 10 percent of global garment factory closures with mass layoffs in the last year. The group is investigating an additional 210 factories in 18 countries, leading the authors to estimate that the final data set will detail 213 factories with severance pay violations affecting more than 160,000 workers owed $171.5 million.
“Severance wage theft has been a longstanding problem in the garment industry, but the scope has dramatically increased in the last year,” Mr. Nova said. He added that the figures were likely to rise as economic aftershocks related to the pandemic continued to unfold across the retail industry. He believes the lost earnings could total between $500 million and $850 million.
The report’s authors say the only realistic solution to the crisis would be the creation of a so-called severance guarantee fund. The initiative, devised in conjunction with 220 unions and other labor rights organizations, would be financed by mandatory payments from signatory brands that could then be leveraged in cases of large-scale nonpayment of severance by a factory or supplier.
Several household names implicated in the report made money during the pandemic. Amazon, for example, reported an increase in net profit of 84 percent in 2020, while Inditex, the parent company of Zara, made 11.4 billion euros, about $13.4 billion, in gross profit. Nike, Next and Walmart all also had healthy earnings.
Some industry experts believe the purchasing practices of the industry’s power players are a major contributor to the severance pay crisis. The overwhelming majority of fashion retailers do not own their own production facilities, instead contracting with factories in countries where labor is cheap. The brands dictate prices, often squeezing suppliers to offer more for less, and can shift sourcing locations at will. Factory owners in developing countries say they are forced to operate on minimal margins, with few able to afford better worker wages or investments in safety and severance.
“The onus falls on the supplier,” said Genevieve LeBaron, a professor at the University of Sheffield in England who focuses on international labor standards. “But there is a reason the spotlight keeps falling on larger actors further up the supply chain. Their behavior can impact the ability of factories to deliver on their responsibilities.”
Saudi Arabia says it will restrict access to the Grand Mosque in Mecca during the Muslim holy month of Ramadan to people who have been vaccinated against the coronavirus or who have recovered from the disease.
The new restrictions, announced on Monday by the state-run Saudi Press Agency, are intended to prevent Mecca from becoming a hub for virus transmission during the most sacred month of the Islamic calendar.
In a typical year, millions of Muslims travel to Mecca from around the world to perform both the hajj pilgrimage, which is undertaken at a specific time of the year, and the lesser umrah pilgrimage, which can be done at any time.
The kingdom has not yet announced restrictions for the hajj, which will take place in July this year and which all Muslims who are financially and physically able must perform at least once in their lives.
Both the annual observance of Ramadan, when most Muslims fast from dawn to dusk, and the hajj are among the five pillars of Islam. The hajj and umrah pilgrimages are important economic drivers in Saudi Arabia, bringing billions of dollars into the kingdom in normal years.
Last June, as the coronavirus spread globally, the Saudi authorities drastically cut participation in the hajj by foreign visitors, limiting it to a few thousand pilgrims who were already in the kingdom — a tiny fraction of the 2.5 million people who had come for the hajj the year before.
The new measures, which will take effect when Ramadan begins around April 14, do not specify how many people will be allowed into the Grand Mosque or nearby sites at any one time. Pilgrims will need to book their visits to the shrine on a government app to prevent crowding.
Visitors will be required to prove that they are fully vaccinated, or had received the first dose of a two-dose vaccination more than 14 days before visiting. Alternatively, they can provide proof that they recovered from Covid-19.
Saudi Arabia imposed lockdowns and restricted international air travel earlier in the pandemic to try to limit coronavirus cases inside the kingdom, but the stringent limits on international flights were eased last month, reopening the possibility for Muslims abroad to reach the holy sites.
Minority communities in Britain have long felt estranged from the government and medical establishment, but their sense of alienation is suddenly proving more costly than ever amid a coronavirus vaccination campaign that depends heavily on trust.
With Britons enjoying one of the fastest vaccination rollouts in the world, skepticism about the shots remains high in many of the communities where Covid-19 has taken the heaviest toll.
“The government’s response to the Black, Asian and minority ethnic communities has been rather limited,” said Dr. Raja Amjid Riaz, 52, a surgeon who is also a leader at the Central Mosque of Brent, an ethnically diverse area of North London. “Those people have not been catered for.”
As a result, communities like Brent offer fertile ground for the most outlandish of vaccine rumors, from unfounded claims that they affect fertility to the outright fabrication that shots are being used to inject microchips.
With the government seen as still disengaged in Black, Asian and other ethnic minority communities even as they have been hit disproportionately hard both by the virus itself and by the lockdowns imposed to stop its spread, many local leaders like Dr. Riaz have taken it upon themselves to act.
Some are well-known and trusted figures like religious leaders. Others are local health care workers. And still others are ordinary community members like Umit Jani, a 46-year-old Brent resident.
Mr. Jani’s face is one of many featured on 150 posters across the borough encouraging residents to get tested for the virus and vaccinated, part of a local government initiative.
The goal is to reframe the community’s relationship with the power structure, and perhaps establish some trust.
“In Brent, things have been done to communities and not in partnership,” said Mr. Jani, who said he had seen the toll the virus has taken on the area’s Gujarati and Somali communities.
For most Americans, the third stimulus payment, like the first two, arrived as if by magic, landing unprompted in the bank or in the mail.
But it’s not as straightforward for people without a bank account or a mailing address. Or a phone. Or identification.
Just about anyone with a Social Security number who is not someone else’s dependent and who earns less than $75,000 is entitled to the stimulus. But some of the people who would benefit most from the money are having the hardest time getting their hands on it.
“There’s this great intention to lift people out of poverty more and give them support, and all of that’s wonderful,” said Beth Hofmeister, a lawyer for the Legal Aid Society’s Homeless Rights Project. “But the way people have to access it doesn’t really fit with how most really low-income people are interacting with the government.”
Interviews with homeless people in New York City over the last couple of weeks found that some mistakenly assumed they were ineligible for the stimulus. Others said that bureaucratic hurdles, complicated by limited phone or internet access, were insurmountable.
Paradoxically, the very poor are the most likely to pump stimulus money right back into devastated local economies, rather than sock it away in the bank or use it to play the stock market.
“I’d find a permanent place to stay, some food, clothing, a nice shower, a nice bed,” said Richard Rodriguez, 43, waiting for lunch outside the Bowery Mission last month. “I haven’t had a nice bed for a year.”
Mr. Rodriguez said he had made several attempts to file taxes — a necessary step for those not yet in the system — but had given up.
“I went to H&R Block and I told them I was homeless,” he said. “They said they couldn’t help me.”
U.S. coronavirus cases have increased again after hitting a low late last month, and some of the states driving the upward trend have also been hit hardest by variants, according to an analysis of data from Helix, a lab testing company.
The country’s vaccine rollout has sped up since the first doses were administered in December, recently reaching a rolling average of more than three million doses per day. And new U.S. cases trended steeply downward in the first quarter of the year, falling almost 80 percent from mid-January through the end of March.
But during that period, states also rolled back virus control measures, and now mobility data shows a rise in people socializing and traveling. Amid all this, more contagious variants have been gaining a foothold, and new cases are almost 20 percent higher than they were at the lowest point in March.
“It is a pretty complex situation, because behavior is changing, but you’ve also got this change in the virus itself at the same time,” said Emily Martin, an epidemiologist at the University of Michigan School of Public Health.
Michigan has seen the sharpest rise in cases in the last few weeks. B.1.1.7 — the more transmissible and more deadly variant of the coronavirus that was first discovered in Britain — may now make up around 70 percent of all of the state’s new cases, according to the Helix data.
Higher vaccination rates among the country’s older adults — those prioritized first in the vaccination rollout — mean that some of those at highest risk of complications are protected as cases rise again.
But almost 70 percent of the U.S. population has still not received a first dose, and only about half of those ages 65 and older are fully vaccinated. And in many states, those with high-risk conditions or in their 50s and 60s had not yet or had only just become eligible for the vaccine when cases began to rise again, leaving them vulnerable.
The tiny German state of Saarland, home to around 990,000 people, is making a cautious return to a new kind of normal in a pilot project that state officials hope could show how to keep the local economy open while controlling infections. From Tuesday, residents who test negative for the coronavirus will be able to use outdoor dining areas, gyms and movie theaters and even attend live theater performances.
Even as cases have continued to rise in Germany, prompting calls for a harsher national lockdown to halt a third wave of the pandemic — which has already shut down many of its European neighbors.
“More vaccinating, more testing, more mindfulness, more options: That’s the formula we want to use as Saarland break new ground in the fight against the coronavirus pandemic,” Tobias Hans, the governor of the state in southwestern Germany, said last week as he announced the reopening plans.
Under the guidelines, as many as 10 people can meet outdoors, and anyone with a negative test result within the previous 24 hours can visit stores, gyms, theaters and beer gardens — places that have largely been closed across Germany since the country announced a “lockdown light” in November.
(Many stores have been open since March, when a court overturned the rules.)
The Saarland project begins the same day that new regulations require travelers from the Netherlands to present a negative coronavirus test to cross the border into Germany. Travelers from the Czech Republic, France and Poland face similar measures.
In other news from around the world:
The new leader of Tanzania said she would set up a committee to look into the coronavirus pandemic in the country — a sharp departure from her predecessor’s stance. “We cannot isolate ourselves as an island,” President Samia Suluhu Hassan said in a speech on Tuesday in the port city of Dar es Salaam. Tanzania has not shared data on the coronavirus with the World Health Organization since April, and it has reported just 509 cases and 21 deaths, figures that have been widely viewed with skepticism. President John Magufuli, who died last month, had scoffed at masks and social distancing measures, argued that “vaccines don’t work,” and said that God had helped the country eliminate the virus.
The World Health Organization does not support requiring vaccination passports for travel, a spokeswoman said on Tuesday during at a news briefing in Geneva, Switzerland.
“At this stage we would not like to see the vaccination passport as a requirement for entry or exit because we are not certain at this stage that the vaccine prevents transmission,” the spokeswoman, Margaret Harris, said, according to Reuters. She also cited concerns over the “question of discrimination against the people who are not able to have the vaccine for one reason or another.”
Many children and teenagers who developed the mysterious inflammatory syndrome that can emerge several weeks after contracting the coronavirus never had classic Covid-19 symptoms at the time of their infection, according to the largest study so far of cases in the United States.
The study, led by researchers from the Centers for Disease Control and Prevention, found that in over 1,000 cases in which information about whether they got sick from their initial Covid-19 illness was available, 75 percent of the patients did not experience such symptoms. But two to five weeks later, they became sick enough to be hospitalized for the condition, called Multisystem Inflammatory Syndrome in Children (MIS-C), which can affect multiple organs, especially the heart.
Published on Tuesday in JAMA Pediatrics, the study said that “most MIS-C illnesses are believed to result from asymptomatic or mild Covid-19” followed by a hyper-inflammatory response that appears to occur when the patients’ bodies have produced their maximum level of antibodies to the virus. Experts do not yet know why some young people, and a smaller number of adults, respond this way.
“It means primary-care pediatricians need to have a high index of suspicion for this because Covid is so prevalent in the society and children often have asymptomatic disease as their initial Covid infection,” said Dr. Jennifer Blumenthal, a pediatric intensivist and pediatric infectious disease specialist at Boston Children’s Hospital, who was not involved in the study.
The researchers evaluated 1,733 of the 2,090 cases of the syndrome in people age 20 and younger that had been reported to the C.D.C. as of January.
The findings show that although the syndrome is rare, it can be serious. The C.D.C’s data only included patients who were hospitalized. More than 90 percent of those young people experienced symptoms involving at least four organ systems and 58 percent needed treatment in intensive care units.
The United States reached a milestone on Saturday, topping 3 million average daily vaccinations for the first time. But speed isn’t the only priority for the country’s vaccination campaign. The Biden administration has also committed to distributing shots equitably to the communities most affected by the pandemic.
Yet more than three months into the rollout, the most socially vulnerable counties in the U.S. have a lower vaccination rate on average than the nation’s least vulnerable. The majority of the most disadvantaged counties with the fewest fully vaccinated people are in the South, while the most vaccinated, least vulnerable counties are in the Midwest.
Counties are ranked according to the Social Vulnerability Index, an indicator from the Centers for Disease Control and Prevention that is used in public health crises and is based on socioeconomic status, housing, transportation, race, ethnicity and language. Each county’s vaccination rate is its share of all residents that have been fully vaccinated, a figure that does not reflect those who have only received one dose of a two-shot vaccine.
A handful of the most vulnerable counties do have some of the top vaccination rates in the country — in places like Apache, Ariz., and Nome Census Area, Alaska — reflecting the work that states, community organizations and federal agencies, such as the Indian Health Service, have done to target at-risk populations. The C.D.C. found similar results in its own analysis, noting that many states have more work to do to reduce vaccination inequities.
In early March, a New York Times analysis of state-reported race and ethnicity information showed that the vaccination rates for Black and Hispanic people in the United States were far outpaced by that of white people. Public health experts have said that obstacles to vaccine access, such as flexible work schedules and access to dependable transportation, deserve much of the blame for these vaccination disparities.
A recent survey conducted by the Kaiser Family Foundation found that the number of Americans, particularly Black adults, who want to get vaccinated has continued to increase. But it also found that vaccine skepticism remains stubbornly persistent, particularly among Republicans and white evangelical Christians.