Covid-19 Live Updates: C.D.C. Eases Mask Advice for Vaccinated People

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Masked and maskless pedestrians at the Long Beach boardwalk in New York this month.
Credit…Johnny Milano for The New York Times

Americans who are fully vaccinated against the coronavirus no longer need to wear masks outdoors if they’re walking, running, hiking or biking alone, with members of their household, or if they attend small outdoor gatherings, federal health officials announced on Tuesday.

The Centers for Disease Control and Prevention stopped short of telling those people that they could shed their masks altogether in outdoor settings — citing the worrying risk that remains for transmitting the coronavirus, unknown vaccination levels among people in crowds and the still high-caseloads in some regions of the country.

Federal health officials and President Biden were announcing the updated advice on Tuesday, linking the news with the administration’s public campaign to get most American adults vaccinated by summer and trying to offer reassurances that some semblance of normal life can return.

But the C.D.C. is maintaining advice on other safety measures, saying vaccinated adults should continue wearing masks and staying six feet apart in large public spaces, like outdoor performance or sports events, indoor shopping malls and movie theaters, where the vaccination and health status of others would be unknown. And they still should avoid medium and large gatherings, crowds and poorly ventilated spaces, officials said.

“I welcome less restrictive guidelines about masking outdoors,” said Linsey Marr, an aerosol scientist at Virginia Tech. “We know that transmission outdoors is much less likely to occur than indoors, because the virus cannot accumulate in the air outdoors. It’ll become rapidly diluted.”

But the guidelines themselves, which outline different masking recommendations for a variety of scenarios, seem overly complex, she said. “I can’t remember this. I would have to carry around a sheet of paper — a cheat sheet with all these different stipulations.” She added: “I worry that this is not as helpful as it could be.”

Americans have been whipsawed on the issue of mask-wearing advice since the beginning of the pandemic, when top health officials said people did not need them — in part because of severe shortages of protective gear for health care workers on the front lines.

And mask restrictions since then have been a patchwork from state to state, despite growing evidence of a mask’s protection for individuals and those around them. Many states have already lifted restrictions they had put in place for indoor and outdoor activities. Others like New York, however, have maintained mask-wearing requirements even for outdoor spaces, citing the threat of potentially more contagious variants.

But the pace of vaccinations has helped influence some easing of those limits. So far, about 42 percent of Americans have received at least one dose of a Covid-19 vaccine, and 29 percent have received both doses of the two vaccines requiring double shots.

Credit…Centers for Disease Control and Prevention

The vaccines are highly effective at preventing people from becoming seriously ill from the coronavirus.

“Scientifically the vaccines are good enough that it’s highly unlikely that someone who’s vaccinated is going to be exposed to enough virus outdoors to have a breakthrough infection,” Dr. Marr said.

Early evidence also suggests that vaccinated people may be significantly less likely to transmit the virus, but the exact risks are not yet known.

Some experts also wondered if the new directives were confusing, by establishing different standards for those who are vaccinated and those who are not, even though it is impossible to know who is who.

“It’s not like you can go up to someone in public and say, ‘You don’t have a mask on – are you vaccinated?’” said Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco. “Those who aren’t vaccinated will promptly take their mask off outdoors because no one can check.”

But, she said, that is probably fine, since the risk of transmission in outdoor settings is very low, absent close or prolonged contact with someone.

Dr. Mercedes Carnethon, an epidemiologist at Northwestern University, said the relaxed guidelines signal that “if you’re outside in a group of individuals who you know well, then it is safe to be without a mask if you were vaccinated. I don’t think that it goes so far as to change what our behavior needs to be in outdoor settings where we don’t know people, and we can’t distance.”

Masking and distancing are still generally recommended when gathering with unvaccinated people from more than one other household or with an unvaccinated person who is at high risk of severe illness from Covid, or who lives with a vulnerable person.

And there are scenarios in which wearing a mask outdoors can still be an important social signal, Dr. Carnethon said. For instance, no vaccine has yet been authorized for children under 16. “And when we’re going to require children to wear masks, at school and on the playground when they’re at school,” she said, “I think that it is responsible for the adults in the situation to model that behavior and normalize mask wearing even when outside.”

A growing body of research indicates that the risk of spreading the virus is far lower outdoors than indoors. Viral particles disperse quickly outdoors, experts say, meaning brief encounters with a passing walker or jogger pose very little risk of transmission.

But most if not all of the research about viral transmission outside was done before the vaccine was available.

A recent systematic review of studies that examined the transmission of the coronavirus and other respiratory viruses among unvaccinated individuals concluded that fewer than 10 percent of infections occurred outdoors and that the odds for indoor transmission were 18.7 times higher than outdoors. (The odds of super-spreading events were 33 times higher indoors.)

Coronavirus patients in New Delhi waited on the street on Sunday to receive oxygen from a Sikh house of worship.
Credit…Atul Loke for The New York Times

As a second wave of the pandemic rages in India, which logged more than 300,000 new coronavirus cases for the sixth consecutive day on Tuesday, countries around the world are trying to help. But their efforts to send oxygen and other critical aid are unlikely to plug enough holes in India’s sinking health care system to end its deadly catastrophe.

The Indian health ministry reported more than 320,000 new cases and 2,771 deaths on Tuesday. Both figures represented slight declines from the previous day’s record highs, but experts said this was not a sign that the outbreak was easing. With enormous funeral pyres spilling into parking lots and city parks, there are signs that India’s reported overall toll of nearly 198,000 deaths could be a vast undercount.

Australia and the Philippines said on Tuesday they would pause commercial flights from India, joining Britain, Canada, Singapore and several other nations that have restricted travel from the country. Australia’s prime minister, Scott Morrison, said his government would donate ventilators and protective equipment to help India contain the outbreak.

The emergency in India, where a worrying virus variant is spreading rapidly, is driving a new global surge in the pandemic. It also carries implications for countries relying on India for the AstraZeneca vaccine, millions of doses of which are manufactured there.

“It’s a desperate situation out there,” said Ramanan Laxminarayan, the founder and director of the Center for Disease Dynamics, Economics & Policy, adding that donations would be welcome but might make only a “dent on the problem.”

Scientists fear that part of the problem is the emergence of a virus variant known as the “double mutant,” B.1.617, because it contains genetic mutations found in two other difficult-to-control versions of the coronavirus. One of the mutations is present in the highly contagious variant that ripped through California earlier this year. The other is similar to one found in the variant dominant in South Africa and is believed to make the virus more resistant to vaccines.

Still, scientists caution that it is too early to know with certainty how pernicious the variant emerging in India is.

Earlier this year, the government of Prime Minister Narendra Modi acted as if the coronavirus battle had been won, holding huge campaign rallies and permitting thousands to gather for a Hindu religious festival.

Now, Mr. Modi is striking a far more sober tone. He said in a nationwide radio address on Sunday that India has been “shaken” by a “storm.” And countries, companies and powerful members of the diaspora have pledged to pitch in.

Patients are suffocating in the capital, New Delhi, and other cities because hospitals’ oxygen supplies have run out. Frantic relatives have appealed on social media for leads on intensive-care-unit beds and experimental drugs. The government has extended New Delhi’s lockdown by another week.

India’s Supreme Court last week ordered the government to come up with a “national plan” for distributing oxygen supplies.

Mr. Modi appears to be looking to the rest of the world to help India quell the wave. Britain, Germany, France, Saudi Arabia and the United Arab Emirates have promised oxygen generators or ventilators. The United States has pledged raw material for coronavirus vaccines and intends to share up to 60 million doses of the AstraZeneca vaccine with other nations, so long as the doses clear a safety review conducted by the Food and Drug Administration, officials said Monday. Indian-American businessmen have pledged millions in cash from the companies they lead.

At a news conference on Monday, Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, called the situation in India “beyond heartbreaking.” He said the organization had deployed 2,600 staff members to India to provide vaccination help.

The world’s seven-day average of new cases has remained well above 750,000 for the past week, according to a New York Times database, higher than the peak average during the last global surge in January. Despite more than one billion shots having been administered globally, far too small a percentage of the world’s nearly eight billion people has been vaccinated to slow the virus’s spread.

A Sputnik V vaccine production line in Saint Petersburg, Russia in February.
Credit…Emile Ducke for The New York Times

RIO DE JANEIRO — Brazil’s health authority said late Monday that it would not recommend importing Sputnik V, the Covid-19 vaccine developed by Russia.

The need for vaccines is urgent in Brazil: The country has been battered by one of the world’s worst outbreaks, driven by the highly contagious P. 1 virus variant.

But the health authority, Anvisa, said that questions remained about the Russian vaccine’s development, safety and manufacturing. All five of Anvisa’s directors voted against importing the vaccine.

Data about Sputnik V’s efficacy was “uncertain,” Gustavo Mendes Lima Santos, Anvisa’s manager of medicine and biological products, said in a lengthy late-night presentation. He noted that “crucial questions” had gone unanswered, including those about potential adverse events.

Russia is using Sputnik V in its own mass vaccination campaign, and the vaccine has been approved for emergency use in dozens of countries. A peer-reviewed study published in The Lancet in February said the vaccine had an efficacy rate of 91.6 percent.

Brazil’s decision prompted a response at the highest level of the Russian government, which has been energetically promoting Sputnik V in Latin America at a time when the United States has limited its vaccine exports to reserve doses for its own citizens.

The Kremlin spokesman, Dmitri S. Peskov, said on Tuesday that the Russian government would try to win over the Brazilian regulators’ minds about the vaccine’s safety. “Contacts will continue,” Mr. Peskov said on a conference call with journalists. “If data is missing, it will be provided. There should be no doubt in this.”

The official Sputnik V Twitter account have also pushed back, with a post in Portuguese on Monday saying that the vaccine’s developers had shared “all the necessary information and documentation” with Anvisa. In another tweet, it said Anvisa’s decision “was of a political nature” and had “nothing to do with access to information or science.” It alleged that the United States had persuaded Brazil to deny approval.

Anvisa officials were under immense pressure to deliver a decision on Sputnik V, because Brazilian states had contracts to buy almost 30 million doses. The Supreme Court ordered Anvisa to make a decision.

“The days of yes to the vaccine and to treatments are celebrated,” Alex Machado, an Anvisa director, said. “There will inevitably be days of no.”

Gov. Camilo Santana of Ceará, one of the states with a Sputnik V contract, said on Twitter that he respected Anvisa’s decision but found it strange, given that Sputnik V is being used in other countries. “I will keep fighting for this authorization, in a safe manner, following all the rules,” he said.

The Gamaleya Research Institute, part of Russia’s Ministry of Health, developed the vaccine, also known as Gam-Covid-Vac. The shot has been entangled in politics and propaganda, with President Vladimir V. Putin announcing its approval even before late-stage trials had begun.

Ana Carolina Moreira Marino Araújo, the general manager of the Anvisa department that inspects vaccine development, said at the meeting that Brazilian officials could not perform a full inspection of the Russian facilities.

She said officials who were in Russia last week were denied access to the Gamaleya Institute and inspected only two factories, finding problems in one of them. She also said Russian officials had tried to cancel the agency’s visit.

“At this moment, the inherent risk in manufacturing couldn’t be overcome,” Ms. Araújo concluded.

Thailand’s prime minister Prayuth Chan-ocha arriving at the Government House in Bangkok last month.
Credit…Athit Perawongmetha/Reuters

With Thailand struggling to bring its worst coronavirus outbreak under control, Bangkok made it compulsory for residents to wear masks in public beginning on Monday. One of the first to break the new rule?

The country’s prime minister, Prayuth Chan-ocha, who was seen maskless at a government meeting in a photo published on his official Facebook page.

As a first-time offender, he agreed to pay a fine of about $190. Bangkok’s governor, Aswin Kwanmuang, came around with top police officials on Monday to help collect it.

“I informed the prime minister this was a violation of the rules,” the governor wrote on Facebook. The photograph was removed from the prime minister’s Facebook page.

For Mr. Prayuth, the gaffe is the least of his pandemic problems. His government has struggled to curb transmissions and been slow to obtain vaccines. As infections ticked upward earlier this month, he decided to let Thais continue to travel widely during a major holiday.

“Whatever will be will be,” he said then. “The government will have to try to cope with that later.”

Now, his government is scrambling to procure vaccines from a stretched global supply and rushing to set up field hospitals at sports stadiums and other locations as many hospitals report being near capacity. Only 0.3 percent of the population has been fully vaccinated, according to a New York Times database.

On Tuesday, the government reported 15 deaths, its highest daily total since the pandemic began, and more than 2,000 new cases for the fifth day in a row. That brings Thailand’s total for the pandemic to nearly 60,000 cases and 163 deaths, according to the government.

The numbers are low by global standards; Thailand was among the world’s leaders in containing the virus last year. Nearly 90 percent of its cases have come since Jan. 1.

Many provinces have imposed their own restrictions, including Bangkok, which has ordered the closure of more than 30 types of businesses, such as fitness centers, cinemas, bars and massage parlors. Restaurants, malls and department stores can continue operating but with restrictions.

Nearly two-thirds of Thailand’s provinces have imposed fines for failing to wear a mask in public. The maximum penalty is about $635.

Global Roundup

Walking near the Acropolis in Athens last month.
Credit…Byron Smith for The New York Times

Greece lifted quarantine requirements on Monday for arrivals from seven more countries, including Russia and Australia, continuing an easing of rules for foreign visitors before a formal reopening to tourists on May 15.

Last week, Greece ended quarantine restrictions for visitors from European Union member states as well as the United States, Britain, Serbia and the United Arab Emirates. The steps were similar to those put in place in March for arrivals from Israel, which has been far ahead of most of the world in vaccinations.

Greece is also stopping restrictions this week for visitors from New Zealand, South Korea, Thailand, Rwanda and Singapore.

Greece had previously required arrivals to quarantine themselves for seven days. It is waiving that rule for passengers from the listed countries as long as they produce a vaccination certificate or the results of a negative PCR test conducted within 72 hours of their arrival.

After heavy economic losses in 2020, the Greek authorities are determined to save this year’s summer tourist season despite experiencing a severe third wave of coronavirus infections. Health officials have said the infection rate is stabilizing, though slowly. Greek health officials have reported more than 334,000 infections and more than 10,000 deaths from the virus, according to a New York Times database.

A new concern is the appearance of the coronavirus variant that is believed to be fueling the worsening outbreak in India. On Sunday, health officials recorded the second case of that variant in Greece, found in a 33-year-old foreign woman who had traveled to Dubai in early April.

Greece’s high infection rate remains a worry for some governments. The U.S. State Department has advised against travel to Greece, citing a “very high level” of coronavirus cases. Greek health officials have expanded testing in recent weeks as they gradually lift lockdown restrictions, with bars and restaurants scheduled to reopen on May 3 after a six-month hiatus.

In other updates from around the world:

  • New Zealand said it would allow quarantine-free travel from Western Australia to resume on Wednesday, after a three-day pause prompted by two coronavirus cases in the Australian city of Perth. Travelers who have been identified as contacts of the infected Australians — a man believed to have been infected in hotel quarantine, and a woman he later stayed with — will have to self-isolate and test negative for the virus before departure, according to New Zealand’s Covid-19 response minister, Chris Hipkins.

  • The authorities in Portugal said they might lift a state of emergency as early as the end of this month after reporting zero deaths from the virus on Monday. It was the first such day since August. The infection rate in Portugal has recently fallen to one of the lowest levels in Europe. Portugal’s president, Marcelo Rebelo de Sousa, is giving a televised address on the subject Tuesday evening.

  • At first, getting the vaccine itself was the prize for older people in Russia seeking protection from the coronavirus. But with vaccinations slowing in Moscow, the city government began a program on Tuesday to encourage turnout with gift certificates. Residents over 60 will receive a voucher for 1,000 rubles, or about $13, redeemable at stores and restaurants. The Russian government has blamed widespread vaccine hesitancy for a slow start to its campaign. A shortage has also slowed the effort, with Russia exporting some of its doses. About 5 percent of Russians are now fully vaccinated; in the United States, it’s 27 percent.

The entrance of the Hilton Times Square. A new proposal would give the City Council the ability to approve all new hotel development in New York City.
Credit…Chang W. Lee/The New York Times

New York City leaders, led by Mayor Bill de Blasio, are closing in on a plan to drastically restrict hotel development, a move that the mayor’s own experts fear could endanger the city’s post-pandemic recovery.

It came days after the mayor announced a $30 million advertising campaign to draw tourists to the city again.

Before the pandemic, in 2019, 67 million tourists flocked to the city. About 23 million visited last year, and much of the city’s recovery hinges on bringing those visitors back.

But building hotels would become more challenging under the special approval process envisioned by Mr. de Blasio, said Moses Gates, vice president of housing and neighborhood planning at the Regional Plan Association, an influential nonprofit planning group.

Before the pandemic decimated the hotel sector, there were nearly 128,000 hotel rooms in New York City, and hotels had annual occupancy rates that averaged between 85 and 90 percent, which the city says “were among the highest of any urban market in the United States.”

Now, roughly 30 percent of those rooms have closed. New York City’s occupancy rate this month stood at 53 percent, excluding the closed hotels, according to STR, which tracks the hospitality industry.

Having a drink or two after the shot will not make any of the vaccines less effective.
Credit…Tony Cenicola/The New York Times

After a long year and a lot of anticipation, getting the vaccine can be cause for celebration, which for some might mean pouring a drink and toasting to their new immunity. But can alcohol interfere with your immune response?

The short answer is that it depends on how much you drink.

There is no evidence that having a drink or two can render any of the current Covid vaccines less effective. Some studies have even found that over the longer term, small or moderate amounts of alcohol might actually benefit the immune system by reducing inflammation.

Heavy alcohol consumption, on the other hand, particularly over the long term, can suppress the immune system and potentially interfere with your vaccine response, experts say. Since it can take weeks after a Covid shot for the body to generate protective levels of antibodies against the novel coronavirus, anything that interferes with the immune response would be cause for concern.

Health care workers prepared doses of a Covid-19 vaccine in Buffalo, W.Va., last month. Gov. Jim Justice announced a plan to give savings bonds to young people who get vaccinated.
Credit…Stephen Zenner/Getty Images

West Virginia will give $100 savings bonds to 16- to 35-year-olds who get a Covid-19 vaccine, Gov. Jim Justice said on Monday.

There are roughly 380,000 West Virginians in that age group, many of whom have already gotten at least one shot, but Mr. Justice said he hoped the money would motivate the rest to get inoculated, as “they’re not taking the vaccines as fast as we’d like them to take them.”

The state will use federal funds from the CARES Act to pay for the bonds, Mr. Justice, a Republican, said at a news conference, adding that he had “vetted this every way that we possibly can” to ensure that the unconventional use of the funds was allowed.

The bonds will be also be available to anyone in that age group who has already been vaccinated, Mr. Justice said.

West Virginia has the 16th highest rate of new coronavirus cases per person among U.S. states and ranks 12th in hospitalizations, according to a New York Times database.

Mr. Justice said the state needed to stop the virus “dead in its tracks,” and that if it did, “these masks go away, the hospitalizations go away, the death toll and the body bags start to absolutely become minimal.”

Earlier this year, at the start of the country’s vaccination effort, West Virginia had stood out for its success in vaccinating its residents. At one point, it had administered second doses to more of its population than any other state; it was also behind only Alaska for the percent of its residents that had received a first dose.

But now West Virginia is fallen behind, ahead of only nine states for the portion of its residents that have had a first dose, according to a New York Times database tracking vaccines.

Mr. Justice said that young West Virginians could “always stand an extra dose of patriotism.” He urged them to “accept that wonderful savings bond” — which will allow the recipient to retrieve the $100, plus interest, at a later date — adding, “I hope that you keep it for a long, long, long time.”





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