In U.S., Virus Cases Have Recently Dropped in Over Half of States

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Skiers at Breckenridge Ski Resort in Breckenridge, Colo., on Sunday.
Credit…Stephen Speranza for The New York Times

More than half of U.S. states have seen a significant decline in new coronavirus cases over the past two weeks, as federal health officials have begun to suggest that the virus’s trajectory is improving. Still, the uneven levels of vaccination across the country point to the challenge of reaching those people who have not gotten shots.

As of Wednesday, the United States was averaging about 52,600 new cases a day, a 26 percent decline from two weeks ago, and a number comparable to the level of cases reported in mid-October before the deadly winter surge, according to a New York Times database. Since peaking in January, cases, hospitalizations and deaths nationwide have drastically declined.

While addressing a joint session of Congress on Wednesday night, President Biden touted the nation’s progress on vaccinations since he took office, calling it one of the country’s “greatest logistical achievements.” He also highlighted the passage of the American Rescue Plan, an ambitious relief package to address the economic toll of the pandemic.

Despite the successes, Mr. Biden implored the public to remain on guard.

Over the past two weeks, case numbers have fallen by 15 percent or more in 28 states, the District of Columbia and Puerto Rico, with drops of 30 percent or more in 14 states and the District of Columbia. As of Wednesday, Vermont reported a 54 percent decline in the average number of new cases a day, while Michigan, which had one of the nation’s most severe recent outbreaks, is now seeing rapid improvement with cases there down 40 percent.

In New York City, which had seen stubbornly high caseloads for months, the second wave is receding a half-year after it started, the city’s health commissioner said.

Federal health officials have taken note. After expressing a recurring sense of “impending doom” last month, Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said on Wednesday that she was beginning to see signs of progress.

“Cases are starting to come down. We think that this is related to increased vaccination, increased people taking caution, and so I’m cautiously optimistic that we’re turning the corner,” she said on “Good Morning America.”

But she warned that “the virus is an opportunist” and could strike in communities with low vaccination rates. Persistent vaccine hesitancy remains a challenge, and the pace of vaccination will ebb, officials have acknowledged, amid issues of supply and demand.

About 43 percent of people have received at least one dose of a Covid-19 vaccine, and 30 percent have been fully vaccinated. Providers are administering about 2.67 million doses per day on average, as of Wednesday, about a 21 percent decrease from the peak of 3.38 million reported on April 13.

The C.D.C.’s move to relax mask guidance outdoors this week is a reflection of the rise in the total number of vaccinations — and an incentive to get a shot, experts said.

“It’s another demonstration of what science has been telling us over the last many months, which is that vaccines are effective in preventing the Covid-19 virus from infecting us. And the more people who get vaccinated, the more quickly we can resume our activities,” Dr. Vivek Murthy, the surgeon general, said in a Tuesday interview on CNN.

Mr. Biden has set a target date of July 4 for the country “to get life in America closer to normal.” But public health experts have emphasized that the experience of the pandemic across the world is not universal. India, for example, is experiencing a catastrophic second wave that could have global implications.

“Pandemics require global cooperation and mutual support,” Dr. Murthy said. “When there’s uncontrolled spread of the virus in any part of the world, that means that variants can arise, variants which may over time become resistant to the protection that we get from vaccines, which could mean a real problem for us here in the United States.”

Allyson Waller and Kevin Draper contributed reporting.

A patient receives oxygen inside a car in Delhi.
Credit…Atul Loke for The New York Times

As supplies run dangerously low and hospitals in India are forced to turn away the sick, scientists are trying to determine what role variants of the coronavirus might be playing.

Doctors, the public and the media are citing anecdotal — but inconclusive — evidence to suggest that a homegrown variant called B.1.617 is driving the country’s worsening outbreak. But researchers outside of India say the limited data so far suggests instead that a better-known variant, B.1.1.7., that walloped Britain late last year may be a more considerable factor.

Authorities in India reported nearly 3,300 daily deaths on Wednesday. That brings the official total to nearly 201,200 people lost, though experts believe the true figure is much higher. Daily new infections also surged to nearly 357,700, another record.

The presence of the variant could complicate the taming of India’s Covid-19 disaster. A number of doctors point to anecdotal evidence that people who have been fully vaccinated are getting sick.

“The current wave of Covid has a different clinical behavior,” said Dr. Sujay Shad, a senior cardiac surgeon at Sir Ganga Ram Hospital, where two of the doctors needed supplemental oxygen to recover. “It’s affecting young adults. It’s affecting families. It’s a new thing altogether. Two-month-old babies are getting infected.”

Scientists say that different variants seem to dominate specific parts of India. For instance, the B.1.617 variant has been detected in a large number of samples from the central state of Maharashtra while the B.1.1.7 variant is rising quickly in New Delhi.

“There are variants that are more transmissible than what we all coped with a year ago,” said Dr. Jeffrey Barrett, director of the Covid-19 genomics initiative at the Wellcome Sanger Institute in Britain. “Things can change really quickly, so if a country doesn’t react quickly enough, things can go from bad to very bad very quickly.”

Beyond the variants, scientists believe there are other, possibly more obvious factors that could be powering India’s deadly second wave.

India has just scraped the surface in terms of vaccinating its population, with less than 2 percent fully vaccinated. Experts also blame lax public behavior after last year’s first wave and missteps by Prime Minister Narendra Modi. And they note that India’s schools had started reopening in recent months — a possible factor behind rising infections among young people.

A broad lack of data plagues the scientific chase for variants and whether they are contributing to the severity of India’s crisis. Fast-moving mutations complicate the picture because it isn’t immediately clear how quickly they spread or how they respond to vaccines.

In India, the health care system wasn’t on alert for the impact of variants at home, even as they began to spread globally, said Dr. Thekkekara Jacob John, a senior virologist in the southern state of Tamil Nadu.

“We were not looking for variants at all,” he said. “In other words, we missed the boat.”

A staff member at a vaccination center prepares a vial of the Moderna Covid-19 vaccine.
Credit…Dmitry Kostyukov for The New York Times

The Pfizer-BioNTech and Moderna coronavirus vaccines are 94 percent effective at preventing hospitalization in fully vaccinated adults 65 or older, according to a small study released by the Centers for Disease Control and Prevention on Wednesday.

The findings, which are consistent with the clinical trial results, are the first real-world evidence from the United States that the vaccines protect against severe Covid-19. Older adults are at the highest risk of hospitalization and death from the disease. More than 573,000 people have died across the country related to the virus, according to a New York Times database, and as of Wednesday, 142.7 million people have received at least one dose of one of three federally authorized vaccines, including about 98 million people who have been fully vaccinated.

“These findings are encouraging and welcome news for the two-thirds of people aged 65 and up who are already fully vaccinated,” Dr. Rochelle Walensky, the C.D.C. director, said in a statement. “Covid-19 vaccines are highly effective and these real-world findings confirm the benefits seen in clinical trials, preventing hospitalizations among those most vulnerable.”

The study is based on data from 417 patients who were admitted to 24 hospitals in 14 states between January 1 and March 26. Approximately half were 75 or older.

Both the Pfizer and Moderna vaccines require two shots, spaced three to four weeks apart. Older adults who were partially vaccinated — that is, they had received one dose of the vaccine more than two weeks prior — were 64 percent less likely to be hospitalized with the coronavirus than unvaccinated seniors, the researchers reported.

The vaccines did not reduce hospitalization rates in people who had received their first dose less than two weeks prior. The body requires time to mount an effective immune response, and people are considered fully vaccinated two weeks after the last dose in the series.

“This also highlights the continued risk for severe illness shortly after vaccination, before a protective immune response has been achieved and reinforces the need for vaccinated adults to continue physical distancing and prevention behaviors,” the scientists wrote.

Police officers carrying off a demonstrator who was protesting coronavirus restrictions at a rally in Berlin on April 21.
Credit…Filip Singer/EPA, via Shutterstock

Germany’s domestic intelligence service said on Wednesday that it would surveil members of the increasingly aggressive coronavirus denier movement because they posed a risk of undermining the state.

The movement — fueled in part by wild conspiracy theories — has grown from criticizing coronavirus lockdown measures and hygiene rules to targeting the state itself, its leaders, businesses, the press and globalism, to name a few.

“Our basic democratic order, as well as state institutions such as parliaments and governments, have faced multiple attacks since the beginning of the measures to contain the Covid-19 pandemic,” the Interior Ministry said in a statement confirming that parts of the denier movement were under observation. The Interior Ministry oversees the intelligence agency, the Office for the Protection of the Constitution.

In announcing the decision to keep tabs on conspiracy theorists, intelligence officials noted the movement’s close ties to extremist groups like the Reichsbürger, who refuse to accept the legitimacy of the modern German state.

The news comes days after Germany instituted new virus rules that apply nationwide and allow the federal government to enforce lockdowns. (Such regulation had previously been in the hands of the country’s 16 states.) It also suggests that the authorities believe coronavirus denier groups could continue to flourish and pose a threat after the pandemic ends.

The movement, called Querdenken, German for lateral thinking, communicates and recruits over social media and has a large presence on the encrypted chat service Telegram, where its main channel has 65,000 subscribers.

A week ago, when Parliament passed the law giving the government powers to impose the latest lockdown, about 8,000 of the movement’s activists took to the streets in Berlin before being dispersed by the police for ignoring mask and distancing rules. Germany has seen a persistently high number of new daily cases recently, averaging about 19,000, up from about 8,000 two months ago.

Pia Lamberty, a psychologist and expert in the German conspiracy scene, warned of connections between the deniers and far-right extremists. “The danger of Querdenken,” she said, “has long been underestimated.”

The seven-day citywide positive test rate has been falling since a peak in January and is now between 3 and 4 percent.
Credit…Jeenah Moon for The New York Times

After months of persistently high coronavirus caseloads, New York City appears to have finally reached a turning point. The city’s second wave is ebbing, a half-year after it began, New York City’s health commissioner, Dr. Dave Chokshi, said.

Throughout April, virus cases, hospitalizations and deaths have all been declining, which epidemiologists attribute to the climbing rate of vaccination as well as the arrival of warm weather, drawing people outdoors.

From a second-wave peak of nearly 8,000 cases in a single day in January, New York City, as of last week, was averaging about 2,000 virus cases per day. The seven-day positive test rate has fallen, too, and is now between 3 and 4 percent, according to the city’s data, the lowest it has been since the fall — but still a lot higher than its low of 1 percent last summer.

Public health officials say that by July, if the city stays on its current trajectory, that number could drop to below 600 cases a day, perhaps lower.

But epidemiologists and city officials warn that the epidemic is not close to over in New York, even though there are promising signs.

Hospitalizations have dropped faster for people over 65 — a group prioritized for vaccinations early on — than for other groups. Yet more than 1,500 Covid-19 patients remain hospitalized in New York City, and the death toll on some days is still around 40.

While some neighborhoods now have positivity rates of under 1 percent, in others that rate is six or seven times higher. Officials also worry that uneven vaccination coverage could lead to a situation where the virus persists in some corners of the city, but not others. Manhattan, the borough with the highest median household income, is far more vaccinated than the Bronx, the poorest, reflecting vaccine hesitancy in some parts of the city and underscoring the longstanding inequalities in health care that the virus has laid bare.

And there are signs that the pace of vaccinations is slowing. So far 52 percent of adults across the city have received at least one dose.

“I feel good that we are beginning to see a vaccine effect on transmission here,” said Dr. Denis Nash, an epidemiologist at the City University of New York’s School of Public Health. “But we still have a long way to go, and there are so many New Yorkers and so many neighborhoods that are more affected by this pandemic that are being left behind.”

U.S. Round up

Customers dined outdoors at Good Bar in Brooklyn earlier this month.
Credit…Gabby Jones for The New York Times

New York will end a longstanding curfew next month that forced bars and restaurants to close early in a bid to fight the spread of the coronavirus, Gov. Andrew M. Cuomo said on Wednesday.

The announcement came as state lawmakers voted to suspend an unpopular directive that required customers to order food when purchasing alcohol at bars and restaurants.

The curfew, which currently requires establishments to stop serving customers at midnight, will end statewide on May 17 for outdoor dining areas and May 31 for indoor dining.

Mr. Cuomo, a third-term Democrat, first ordered the restriction last November as the state tried to stave off a second surge of the virus, saying at the time that indoor dining at restaurants was a likely cause of the spread. He loosened the curfew in recent months as cases have fallen, moving it from 10 p.m. to midnight.

The hospitality industry and some state lawmakers have long criticized the curfew as arbitrary, pointing to a lack of evidence that late-night dining was contributing in any meaningful way to the virus’s spread.

The state will also allow people in New York City to sit at bars starting on Monday, for the first time since Mr. Cuomo implemented a statewide shutdown last March. Even as establishments have been allowed to welcome customers indoors, patrons were required to be seated at tables.

The restaurant industry welcomed the news.

“It’s great news that the state will finally undo the bar stool ban and lift the arbitrary midnight curfew,” said Andrew Rigie, the executive director of the New York City Hospitality Alliance, an industry group. “These outdated policies made it too difficult for too many small business owners and workers to support themselves and their families, and were a grave inconvenience to customers.”

The state will also loosen restrictions on catered events at residences. Beginning on Monday, they can have more than 10 people indoors and 25 people outdoors, provided events follow any necessary mask and social-distancing directives. Curfews on all catered events will also be lifted next month.

Officials in the state have gradually taken steps to roll back virus-related restrictions as more New York residents were vaccinated and cases of the virus fell.

The city’s second wave is finally ebbing, a half-year after it began, with virus rates and hospitalizations plunging, though city officials warn that the epidemic is not close to being over in the city.

On Monday, Mr. Cuomo said that next month the state would raise the capacity limits on offices statewide to 75 percent from 50 percent and on gyms outside New York City to 50 percent from 33 percent.

Last month he raised the maximum capacity for indoor dining at restaurants in New York City to 50 percent, up from 35 percent. Restaurants in the remainder of the state are allowed to serve customers at 75 percent occupancy.

Luis Ferré-Sadurní contributed reporting.

In other news from around the United States:

  • Gov. Larry Hogan of Maryland announced Wednesday he would lift the state of Maryland’s outdoor mask mandate, effective immediately, citing recent guidance from the Centers for Disease Control and Prevention. Starting May 1, restrictions surrounding outdoor dining, including capacity limits and social distancing, will also be lifted. Coronavirus cases in Maryland have dropped 29 percent in the past two weeks, according to a New York Times database.

  • In Atlanta, certain sports venues are making a return to 100 percent capacity. On Wednesday, the home stadium of the Atlanta Braves, Truist Park, announced it would allow 100 percent capacity at games starting May 7. Capacity at the Mercedes-Benz Stadium, home of the Atlanta Falcons and Atlanta United, will also move up to 100 percent capacity, AMB Sports and Entertainment, the company that owns the two professional teams, said in a statement on Wednesday. The change in restrictions for the Mercedes-Benz Stadium will start May 15.

A candlelight vigil on March 25 for nursing home residents who died of the coronavirus.
Credit…Eduardo Munoz/Reuters

The effort by Gov. Andrew M. Cuomo’s office to obscure the pandemic death toll in nursing homes in New York State was far greater than previously known, with aides repeatedly overruling state health officials over a span of at least five months, according to interviews and newly unearthed documents.

Mr. Cuomo’s most senior aides engaged in a sustained effort to prevent the state’s own health officials, including Howard Zucker, the health commissioner, from releasing the true death toll to the public or sharing it with state lawmakers, these interviews and documents showed.

A scientific paper, which incorporated the data, was never published. An audit of the numbers by a top Cuomo aide was finished months before it became publicly known. Two letters, drafted by the Health Department and meant for state legislators, were never sent.

The number of nursing home residents who died in first wave of the pandemic has been a particularly sensitive question for the Cuomo administration, which initially put the number at around 6,000.

The full data on nursing home deaths was not released until this year, after a report by the state attorney general in late January found that the official tally might have undercounted the true toll by as much as 50 percent. That was something Mr. Cuomo’s aides had known since the previous spring, The New York Times found.

Watching the Stockyards Championship Rodeo in Fort Worth, Texas, where mask mandates have been lifted.
Credit…Shelby Tauber for The New York Times

The Centers for Disease Control and Prevention recommends that fully vaccinated Americans can, in most cases, avoid wearing masks outdoors. But this group of nearly 100 million, scattered across the country, remains for now under the authority of a patchwork of mask mandates, varying by state and sometimes by county, dictating when and where face coverings should be worn.

Some states, like Arizona and Texas, have already lifted mask mandates. But most indoor mask mandates could be eased or eliminated by the summer, said Dr. Arthur Reingold, chair of the epidemiology division at the School of Public Health at the University of California, Berkeley — as long as people continue to get vaccinated, and as long as the United States avoids the troubling waves it has endured over the past year.

About 2.7 million Covid-19 vaccine doses are being administered nationally each day on average — a drop from the peak of more than 3.3 million this month, when those who were most eager and able to get shots were getting them quickly.

By summer, Dr. Reingold said, “there won’t be big regional differences” in mask wearing as there are now. Strict outdoor masking has been standard behavior in urban centers like New York City and San Francisco, but less common in other parts of the country.

The C.D.C. on Tuesday advised that Americans who are fully vaccinated against the coronavirus no longer need to wear masks outdoors, except in some cases, like during large gatherings.

Gov. Andrew M. Cuomo said that New York would adopt the C.D.C.’s guidance on outdoor mask wearing for vaccinated people, and Gov. Gavin Newsom of California said, “If you’re fully vaccinated, outdoors and not in a large crowd — you do not need to wear a mask.”

A federal mask policy “was always going to be somewhere between difficult and impossible to achieve” in the United States, Dr. Reingold said. Still, outside of places like airports and stores — where strictly enforced mask requirements have sometimes led to heated confrontations — mask wearing has often been an individual choice, as local government mask mandates have rarely led to fines or punishment.

The C.D.C. is maintaining its advice on other safety measures, saying that all adults should wear masks and stay six feet apart at outdoor performance and sporting events and in indoor shopping malls and movie theaters.

President Biden said on Tuesday at an outdoor news conference that the updated guidance was a step toward getting “life in America closer to normal.”

Xavier Becerra, the secretary of health and human services, said on “CBS This Morning” on Tuesday, “The message is clear: You’re vaccinated? Guess what, you get to return to a more normal lifestyle.”

Migrants were met by members of the Border Patrol after crossing from Mexico into the United States by inflatable raft at a short stretch of the Rio Grande.
Credit…Peter van Agtmael for The New York Times

As the United States vaccinates more people and several states begin to reopen, public health officials warn that the failure of U.S. authorities to test adult migrants for the coronavirus in jam-packed border processing centers is creating a potential for new transmissions — even among migrants who may have arrived healthy at America’s door.

More than 170,000 migrants crossed the border in March, many coming from countries still grappling with high infection rates. The government says it has insufficient time and space to test them upon their arrival, so testing is being postponed until the newcomers are released to local community groups, cities and counties.

But that is usually after they have spent days confined in tight spaces with scores of strangers, often sleeping shoulder-to-shoulder on mats on the floor.

There have been no reported instances of mass spread at U.S. border facilities, and overall numbers of cases are relatively low, according to the Department of Homeland Security. But local officials and shelter operators say they fear the true number of cases could be much higher.

Reuben and Estafania Alarcon’s son Eric, who has autism, has been disadvantaged by virtual learning.
Credit…Bryan Anselm for The New York Times

Perhaps no one feels the strain of remote learning more acutely than the youngest, highest-need students, whose ability to access in-person early intervention classes, targeted behavior analysis and speech therapy is considered key to their academic success.

In New Jersey, school districts in two towns five miles apart — with similar population sizes and similarly high rates of coronavirus cases — made radically different choices about whether and how to reopen schools during the pandemic.

In Rutherford, where schools have been mostly open, young children with autism have spent more than 700 hours in class since September. In Secaucus, the number of hours is closer to just 100.

Reuben Alarcon, part of a group of parents who have criticized the Secaucus Public School District’s reopening policies, said he was worried that the educational opportunities his son Eric, who will be 4 next month, lost during a crucial year of brain development would cause lifelong harm.

“He will sometimes use one or two words to ask for something. Sometimes he surprises us and he blurts out a sentence,” Mr. Alarcon said. “He would be so much more ahead had he had the full-time class.”

A staff member distributes the second version of the Tokyo 2020 playbook before a press briefing earlier today.
Credit…Pool photo by Franck Robichon

Organizers of the rescheduled Summer Olympics released a second round of so-called playbooks on Wednesday, with updated protocols for those taking part in the world’s largest sporting event this July.

Among the new rules: Athletes will be tested daily, but they will not need to quarantine. Visitors will be asked to stay off public transit. And members of the news media, along with other officials, will be urged to eat takeout meals alone.

Thomas Bach, the International Olympic Committee president, said the revised protocols were “based on the best scientific and medical expertise” and the experience of hundreds of sports events over the last year, involving thousands of athletes.

Organizers have not mandated that Olympians be vaccinated, and will not address whether domestic spectators will be allowed into Olympic stadiums and arena until June. Overseas spectators are barred from the Games, but tens of thousands of people will enter Japan this summer after nearly a year in which the country’s borders have been mostly closed to nonresidents.

Many in Japan are jittery that the Games could turn into a Covid superspreader event. In several public polls, a majority said they would prefer the Olympics be postponed again or canceled altogether, and some public health experts have questioned whether the Games are safe to stage under current pandemic conditions.

Like many other television shows, “Law & Order: SVU” had to adjust to resume production during the pandemic. The actors Ice-T and Jamie Gray Hyder shot a recent episode.
Credit…Virginia Sherwood/NBC

The unions representing television actors and crews are in talks with the major studios about extending — and possibly changing — the pandemic safety protocols they agreed on last year, like frequent testing and letting some employees record from inside closets.

The economic effects of the pandemic on the entertainment industry have been felt most acutely in the cities like Los Angeles and New York, where, at least in prepandemic times, roughly two thirds of the country’s film, television and theatrical jobs were located. In New York City, for instance, officials have estimated that employment in the arts, entertainment and recreation sector fell by 66 percent from December 2019 to December 2020.

Aiming to revive the industry during the pandemic, television producers said that they have had to test several times each week, hire orange-vested “Covid officers” and bring on extra cleaning companies — all of which have ballooned budgets by as much as 15 percent.

But unions have sometimes struggled to find a balance between keeping workers safe and helping them earn a living: some members have complained that one union’s safety rules have made it too hard to find work.

With vaccinations rising, television executives are now having to decide which innovations of the pandemic are worth holding onto, like whether to permit voice actors to keep working from home or holding virtual auditions.

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