The number of Americans hospitalized with Covid-19 has surpassed last winter’s peak, underscoring the severity of the threat the virus continues to pose as the extremely contagious Omicron variant tears through the United States.
As of Sunday, 142,388 people with the virus were hospitalized nationwide, according to data from the U.S. Department of Health and Human Services, surpassing the single-day peak of 142,315 reported on Jan. 14 of last year. The seven-day average of daily hospitalizations was 132,086, an increase of 83 percent from two weeks ago.
The Omicron wave has overwhelmed hospitals and depleted staffs that were already worn out by the Delta variant. It has been driven in large part by people younger than 60. Among people older than 60, daily admissions are still lower than last winter.
The hospitalization totals also include people who test positive for the virus incidentally after being admitted for conditions unrelated to Covid-19; there is no national data showing how many people are in that category.
About this dataSources: State and local health agencies (cases, deaths); U.S. Department of Health and Human Services (hospitalizations).
As cases soared over the past few weeks to an average of over 737,000 per day, far higher than last winter’s peak, public health officials have argued that caseloads were of limited significance because Omicron is less virulent than Delta and other variants, and that vaccines, and especially boosters, offered protection against severe illness.
But the surge’s sheer volume has overwhelmed hospitals across the country. And outside cities like New York, where Omicron hit early and has pushed hospitals to the brink, it is unlikely to have peaked.
Current hospitalizations are one of the most reliable measures of the severity of the pandemic over time, because they are not influenced by testing availability or by spikes in minor cases.
Dr. Anthony S. Fauci, the country’s top infectious diseases expert, told ABC News last week that it was “much more relevant to focus on the hospitalizations,” which lag behind cases.
About a quarter of U.S. hospitals are experiencing critical staffing shortages, according to the Department of Health and Human Services. Some states, like Oregon, have deployed the National Guard to help. Others, like Illinois and Massachusetts, are delaying elective surgeries — meaning surgeries that are scheduled, as opposed to an emergency, a category that can include procedures like a mastectomy for a cancer patient. In some cases, employees with asymptomatic or mildly symptomatic coronavirus infections have been working, potentially putting patients at risk.
After nearly two years, “even the most dedicated individuals are going to be tired and worn out, if not burned out and dealing with mental health issues as a consequence,” said Dr. Mahshid Abir, an emergency physician at the University of Michigan who is a researcher at the RAND Corporation.
Data in some of the first cities hit by Omicron also show deaths spiking sharply — not as fast as case rates, but fast enough to warn of more devastation to come.
Doctors, nurses and other medical personnel are also falling ill themselves, and while most are vaccinated and have not needed hospitalization, their illness still keeps them out of work. Now, hospitals overwhelmed by coronavirus patients are ill equipped to handle other emergencies like heart attacks, appendicitis and traumatic injuries.
“The demand is going up and the supply is going down, and that basically doesn’t paint a good picture for people and communities — not just for Covid, but for everything else,” Dr. Abir said.
Mayor Lori Lightfoot announced a deal with the Chicago Teachers Union on Monday that would return students to classrooms on Wednesday after a dispute over coronavirus safeguards canceled a week of classes in the country’s third-largest school district.
“No one is more frustrated than I am,” Ms. Lightfoot said after the deal was reached. She added: “I’m glad that we’re hopefully putting this behind us and looking forward. But there does come a point when enough is enough.”
The deal, which city officials said included provisions for additional testing and metrics that would close schools with major virus outbreaks, was approved by the union’s House of Delegates on Monday night and was expected to be voted on later in the week by rank-and-file teachers.
On Tuesday, Ms. Lightfoot said she had tested positive for the coronavirus after experiencing cold-like symptoms. The mayor, who said she was vaccinated and boosted, said she planned to work from home.
Under the deal, teachers were expected to return to school buildings on Tuesday, with students joining them the next day. Leaders of the union described the agreement as imperfect and were highly critical of Ms. Lightfoot, but they said the deal was needed given the conditions teachers are facing in the pandemic.
“This agreement is the only modicum of safety that is available for anyone that steps foot in the Chicago Public Schools, especially in the places in the city where testing is low and where vaccination rates are low,” said Stacy Davis Gates, the union’s vice president.
School leaders across the United States have scrambled to adjust to the highly infectious Omicron variant, which has pushed the country’s daily case totals to record levels and led to record hospitalizations. Most school districts have forged ahead with in-person instruction, as the Biden administration has urged, sometimes quarantining individual students or classrooms as outbreaks emerge. Some large districts, including in Milwaukee and Cleveland, have moved class online.
But the debate in Chicago proved uniquely bitter and unpredictable, with hundreds of thousands of children pulled out of class two days after winter break when teachers voted to stop reporting to their classrooms. Rather than teach online, as the union proposed, the school district canceled class altogether.
Chicago Public Schools leaders have insisted that virus precautions were in place and that pausing in-person instruction would unfairly burden parents and harm students’ academic and social progress. Union members said that the schools were not safe, that more testing was needed and that classes should be temporarily moved online.
The Chicago area, like much of the country, is averaging far more new cases each day than at any previous point in the pandemic. The Omicron variant is believed to cause less severe illness than prior forms of the virus, with vaccinated people unlikely to face severe outcomes. Still, coronavirus hospitalizations in Illinois have exceeded their peak levels from last winter and continue to rise sharply.
Members of Ms. Lightfoot’s administration have defended the school system’s efforts to make classrooms safe and have emphasized that children rarely face severe outcomes from Covid-19. But their efforts to reassure parents and teachers have sometimes faltered. The district instituted an optional testing plan over winter break, but most of the 150,000 or so mail-in P.C.R. tests given to students were never returned; of the ones that were, a majority produced invalid results.
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Private insurers will have to cover the cost of eight at-home coronavirus tests per member per month starting on Saturday, the Biden administration said Monday.
People who provide their insurance information will be able to get the tests with no out-of-pocket costs at certain pharmacies; in other cases, they will have to file claims to their insurers for reimbursement, according to the Department of Health and Human Services, just as they often do for medical services.
The plan “incentivizes insurers to cover these costs up front and ensures individuals do not need an order from their health care provider to access these tests for free,” the agency said in a statement. Roughly 150 million Americans, or about 45 percent of the population, are privately insured.
Insurers that do not require people to pay the upfront cost for tests at certain retailers will be charged no more than $12 per test, if the test was purchased at an out-of-network site. Otherwise, insurers will be charged the full price of a test.
“Today’s action further removes financial barriers and expands access to Covid-19 tests for millions of people,” Chiquita Brooks-LaSure, the Biden administration’s Medicare and Medicaid chief, said in a statement.
The at-home tests are typically sold in packs of two, and prices have ranged in cost from $14 to $34, which can be prohibitively expensive especially when tests are purchased in bulk. Tests ordered or administered by a health provider would continue to be covered by insurance without co-payment or a deductible, the administration said.
Other countries have spent more heavily on rapid testing. In Britain, citizens can use a government website to order free rapid tests for home use. Germany invested hundreds of millions of dollars to create a network of 15,000 rapid testing sites. The United States has instead focused public purchasing on vaccines and efforts to encourage their uptake.
Some local governments in the United States have invested more heavily in rapid testing to counter this latest wave of cases. Washington, D.C., for example, now allows residents to pick up four free rapid tests daily at eight libraries across the city.
The new U.S. policy does not apply to at-home tests that Americans have already purchased. The Biden administration is also working on other efforts to get tests to people regardless of their insurance status, including a plan to deliver 500 million free rapid tests to the homes of Americans who order them, starting later this month.
Like that plan, the guidelines announced Monday were part of a broader effort the Biden administration has undertaken in recent weeks to catch up to skyrocketing demand for rapid tests, as virus cases have exploded around the nation with the arrival of the highly contagious Omicron variant.
Supplies of the tests at pharmacies and grocery stores quickly diminished last month, and manufacturers are racing to restock shelves, a scramble that has prompted some experts to criticize the administration for being caught flat-footed ahead of a winter surge.
Availability could at first hinder the rollout of the reimbursement policy, said Lindsey Dawson, an associate director at the Kaiser Family Foundation who has researched the availability of rapid tests.
“If reimbursement exists but there aren’t tests to purchase,” she said, “that doesn’t help an individual consumer.”
She added, “The policy could certainly drive demand, and could exacerbate the problem.”
SYDNEY, Australia — Novak Djokovic, the Serbian tennis star, moved one step closer to competing for his record 21st Grand Slam title after an Australian judge ordered his release from immigration detention on Monday, the latest turn in a five-day saga over his refusal to be vaccinated for Covid-19.
The judge, Anthony Kelly, found that Djokovic had been treated unfairly after his arrival at a Melbourne airport for the Australian Open, where he had been cleared to play with a vaccination exemption. After detaining Djokovic, the border authorities promised to let him speak with tournament organizers and his lawyers early Thursday morning, only to cancel his visa before he was given a chance.
Restoring the visa does not, however, guarantee that Djokovic will be able to vie for his 10th Open title when the tournament begins next Monday. In court, the government’s lawyers warned that the immigration minister could still cancel his visa, which would lead to an automatic three-year ban.
Whatever happens next, the drawn-out conflict over the world’s top men’s tennis player seems to have crystallized a moment as the pandemic approaches its third year and the coronavirus is circulating more widely than ever. Hosting international sports events now involves navigating ever-evolving public health and border security rules, including the management of vaccine mandates on athletes who see themselves as high priests of their own bodies and their sports.
The Centers for Disease Control and Prevention on Monday advised Americans to avoid travel to Canada, citing “very high” levels of the coronavirus.
Canada was placed under a Level 4 travel health notice — the highest category — joining several countries, including France, Germany, Britain, Spain, South Africa and others. The Caribbean island of Curaçao was also placed under Level 4 travel notice on Monday.
“Because of the current situation in Canada, even fully vaccinated travelers may be at risk for getting and spreading Covid-19 variants,” the C.D.C. said.
Through Sunday, Canada had reported a daily average of 42,062 new infections, an increase of 169 percent over the past two weeks, according to a New York Times database.
Travel between the two countries has only resumed recently. The U.S. land border reopened to Canadian travelers on Nov. 8. Americans have been allowed to travel to Canada since Aug. 9 as long as they had been fully vaccinated at least two weeks before traveling.
For those who must travel to Canada, the C.D.C. recommends being fully vaccinated. Those who are fully vaccinated are eligible to enter Canada, but must also be tested beforehand.
The Canadian government recently announced that starting on Saturday, certain groups of people, who were previously exempt from entry requirements, will be allowed to travel to the country only if they are fully vaccinated.
They include professional athletes, certain temporary foreign workers and essential service providers, including truck drivers.
The move has raised concerns from certain groups, including the National Propane Gas Association and the Canadian Propane Gas Association, which said in a statement that the mandate may cause “significant logistics disruptions or delays.”
In December, the Canadian government issued its own travel health notice, advising Canadians to avoid nonessential travel out of the country, regardless of their vaccination status.
Tens of thousands of protesters in cities across Germany demonstrated again on Monday to vent their anger at the country’s pandemic restrictions, as reports of rising coronavirus cases worsen frictions between public health officials in Europe and their fatigued and frustrated populations.
The turnout for the protests appeared to be smaller in some cities than on previous Mondays, but it was not clear whether that signaled any waning of anger or had more to do with the demonstrations spreading to more days of the week.
The new German government’s postponement of a parliamentary debate on a proposed national vaccine mandate, a flash point for many protesters, may also have sapped some urgency from the protests, at least for now.
In Rostock, a large port city on the Baltic coast, officers used tear gas to keep a rowdy group of protesters from breaking a police line. But in general, the protests on Monday appeared to come off without violence.
Developments in two nations where cases are rising fast — they have nearly doubled in Germany and more than quadrupled in Italy over the past two weeks — encapsulate the tensions in many European countries where leaders are doubling down on Covid-19 vaccinations and boosters, edging closer to making them all but mandatory.
Almost seven out of 10 people in the European Union have been fully vaccinated, according to official data, and the figures are even higher in Italy (75 percent) and Germany (72 percent).
The authorized vaccines, which have been shown to provide good protection against severe illness and death, are readily available in most of Europe, and governments have increasingly come to see people who still refuse to get vaccinated as an obstacle to their efforts to avoid imposing painful measures like lockdowns to rein in the highly transmissible Omicron variant.
The challenge was expressed in harsh language last week by President Emmanuel Macron of France, who said in a newspaper interview that he wanted to “piss off” the millions of his compatriots who have declined the shots by barring them from public spaces. Thousands of protesters took to the streets in France on Saturday in opposition to proposals that would effectively ban unvaccinated people from public areas.
Protesters also came out in large numbers in Vienna, where vaccination will be mandatory for all adults starting next month.
In Germany, where the strident anti-vaccination movement has ties to far-right political groups, social restrictions and rules that shut the unvaccinated out of much of public life have prompted large protests on Mondays — the same day of the week as the demonstrations that helped bring down the Berlin Wall in 1989 Some protests have turned violent.
Chancellor Olaf Scholz used a New Year’s speech to rebut misinformation that vaccines were unsafe. Some members of his coalition government worry about possible violence when lawmakers begin debating the bill to make vaccination mandatory.
In Italy, where opposition to vaccines is less fierce, a rule took effect Monday requiring all workers who are 50 or older to be vaccinated or to show that they have recently recovered from an infection.
Those who don’t meet the requirement by Feb. 1 could be suspended from their jobs. The measure is among the latest steps by the government of one of Europe’s worst-affected nations to curb a steep rise in infections and mitigate the impact on hospitals.
Italy is focusing the mandate on older workers because they have tended to be more susceptible to serious illness from the virus than younger people have. Until now, those employees could take frequent P.C.R. tests that, if negative, allowed them to enter their workplaces without being vaccinated.
Other new measures taking effect in Italy on Monday bar people who are neither vaccinated nor have recently recovered from infection from using public transportation or entering banks and other offices, restaurants, hotels, ski lifts and many other public places.
Andrés Manuel López Obrador, the president of Mexico, announced on Monday that he has Covid-19, his second bout with the virus in less than a year.
In a post on Twitter on Monday evening, he said that his symptoms were mild, and that he would work virtually while he isolated. President López Obrador’s infection comes almost a year after he announced testing positive for the coronavirus on Jan. 24, 2021.
At a news conference on Monday morning, President López Obrador admitted that he sounded hoarse, and said that he would later seek a coronavirus test.
“I think it is a cold,” he said.
President López Obrador, 68, is fully vaccinated and received a booster shot on Dec. 7 at a news conference along with some members of his cabinet.
At the nearly two-hour-long news conference on Monday, President López Obrador said that those in Mexico with symptoms similar to Covid should assume it is the virus and isolate at home, rather than seek a test. The president also said that the Omicron variant is “a little Covid,” adding that hospitalizations and deaths across Mexico have not risen sharply.
Coronavirus infections have risen in Mexico over the past two weeks, with an increase in cases of 644 percent through Sunday, according to a New York Times database.
President López Obrador is not the first head of state to be reinfected with the coronavirus. Andrzej Duda, the president of Poland, and Arif Alvi, the president of Pakistan, each announced last week that they had tested positive for a second time.
Cities in Italy appeared quiet on Monday morning as the latest restrictions to curb the rise of coronavirus infections took effect.
People could no longer use public transportation without proof of either vaccination or a recovery after a positive test in the past six months, and all passengers were required to wear the more protective FFP2-type masks. Both private and public employees were encouraged to work remotely if possible, and banks, public offices, restaurants, bars, gyms and culture centers required customers to show a health pass to enter.
“The metro ride this morning felt very different from the last few weeks,” said Maria Francesca Rotondaro, a communications specialist who commuted to her office in the city center from her home in the eastern part of Rome. “Everybody wore protective masks and sat at a distance,” she noted. “Before Christmas, it was a mess. Overcrowded buses, and passengers pushing as if it was 2019.”
Italy recorded 101,762 new coronavirus cases on Monday, below the recent 7-day average of about 158,000 new cases a day but still several times higher than the average of two weeks earlier. Deaths rose 44 percent over the same period, to an average of 199 a day; the figure for Monday was 227.
Simone Torvi, an accountant in Rome who often takes the subway, said that most riders seemed to be complying with the new rules. “I didn’t see anybody checking, but people did wear their masks, and I assume they had their passes,” he said.
A spokesman for ATAC, the company that runs most of Rome’s public transportation, said that inspectors could ask passengers at random to show their health passes to help enforce the new measures. Officers caught one man on Monday riding a bus with no health pass and a less protective surgical mask near the Termini railway station.
The rules applied to anyone 12 or older. Some unvaccinated students rode bicycles to school or were driven by their parents instead of using public transportation, while others simply stayed home, further lowering already reduced attendance.
“Schools are decimated anyway,” said Mario Rusconi, president of the principal’s association in the region that includes Rome. “From 5 to 10 percent of teachers in Italy are home sick with Covid or quarantining; many parents of pupils in elementary schools chose not to send them until they are fully vaccinated.”
Only 4 percent of children 5 to 12 years old are vaccinated in Italy, where they became eligible only last month.
Mr. Rusconi was among the principals who asked the Italian Education Ministry to postpone reopening schools after the holiday break to allow more students to get vaccinated and to try and track infections among them. Still, the authorities decided to start classes on Monday everywhere in Italy except the Campania region in the south, where they will reopen Tuesday after a court voided the regional president’s order to keep them closed until February.
Reports of doctors and nurses helping people get false health certificates keep springing up in the Italian news media. A nurse in Ancona was arrested on Monday and accused of helping produce about 45 fake passes by pretending to administer vaccine shots and then discarding them instead.
Pope Francis, in an address to diplomats on Monday, called health care “a moral obligation” and spoke strongly in favor of getting as many people vaccinated as possible, saying it was “the most reasonable solution for the prevention of the disease.”
When China’s leader Xi Jinping inspected the Beijing Winter Olympics venues last week, he laid out his vision for a “green, safe and simple” event.
But diplomatic boycotts and, increasingly, the fast-spreading Omicron variant of the coronavirus may make safety and simplicity near impossible to achieve, at least by Beijing’s stringent “zero Covid” standards.
With less than a month to go until the opening of the Winter Games, Chinese officials are racing to extinguish a spate of coronavirus infections around the country, including several locally transmitted cases of the Omicron variant.
On Monday, officials in Tianjin, a northern Chinese port city of 14 million, reported 21 domestically transmitted cases, according to China’s National Health Commission, bringing the total over the last two days to 40, including at least two cases of the Omicron variant.
The situation has taken on heightened urgency in China given Tianjin’s proximity to Beijing. Many commuters travel daily between the two cities, often using high-speed rail, which takes about 30 minutes.
In response to the threat of rising infection rates, Tianjin officials have quickly moved to enforce lockdowns in several affected neighborhoods. Widespread testing of the entire city was still underway on Monday. The authorities have also tightened travel restrictions into and out of Tianjin, requiring residents to obtain approval from employers or community officials before leaving. And starting Sunday afternoon, train tickets between Tianjin and Beijing were suspended for purchase.
But there were worrying signs that the Omicron variant had already spread beyond Tianjin. The central Chinese city of Anyang, in Henan Province, reported two local Omicron infections on Monday, traced to a student who had traveled from Tianjin on Dec. 28, spurring concerns that the Omicron variant may have already been circulating in Tianjin for nearly two weeks.
Millions of people in the Chinese cities of Xi’an and Yuzhou, in Henan Province, are also currently being confined to their homes following a recent surge in cases of the Delta variant.
The outbreaks have concerned officials in Beijing, who are stepping up measures to ensure that the virus does not penetrate the capital city’s already substantial fortifications ahead of the Games. On Monday, the Beijing Center for Disease Control and Prevention called on residents who had traveled to areas with recent flare-ups to report themselves to the authorities. That would include anyone who has been in or passed through Tianjin since Dec. 9.
On Monday, Beijing officials also urged residents not to leave during the Lunar New Year holiday, which begins on Jan. 31. For many of the city’s millions of migrant workers, it is the third year in a row in which the coronavirus has spoiled the weeklong holiday, which is typically their only chance to return home and see loved ones.
Students and employees in Massachusetts public schools will be required to wear face coverings indoors until at least through February, the state education commissioner, Jeffrey Riley, said on Monday, announcing an extension of a mandate that was set to expire on Jan. 15.
The surge of the Omicron variant in the United States has forced dozens of school districts to start 2022 with remote learning, though most districts have forged ahead with in-person instruction instead, as the Biden administration has urged.
About a dozen states still have statewide school mask mandates in force. The one in Massachusetts will retain an exception, available since Oct. 1, that allows districts to lift indoor mask requirements for a middle or high school if at least 80 percent of all students and staff are vaccinated. Officials have approved requests to do so in about 30 schools.
Unvaccinated people are still required to wear masks indoors in all schools, and the state department of public health issued an advisory on Dec. 21 that recommends, but does not require, that every resident of Massachusetts wear a mask when in indoor public spaces.
Massachusetts is one of the most vaccinated states in the country, but even so, the most recent state data shows more than 50,000 known coronavirus infections in students or school employees in the last two weeks.
“The mask requirement remains an important measure to keep students, teachers and staff in school safely at this time,” state education officials said in a statement, adding that the state would evaluate whether to extend the mandate again, beyond Feb. 28.
The president of the Massachusetts Teachers Association, Merrie Najimy, said last week that she supported a state bill that would require masks in public schools through the end of the academic year.
Some teachers’ unions in other states are going further, pushing for a return to remote instruction. They frequently cite understaffing because of illness, and widespread shortages of rapid tests and medical-grade masks.
In Chicago, where teachers have stopped reporting to work over pandemic safety, Mayor Lori Lightfoot rejected a proposal by the teachers’ union there to return to in-person instruction on Jan. 18 with expanded coronavirus testing. Hundreds of thousands of students in the Chicago school system, the nation’s third-largest, missed three days of class last week, and classes were canceled again on Monday.
As cities struggle to keep school buildings in operation, Boston Public Schools announced on Monday afternoon that it was canceling classes for Tuesday, when bitter cold weather is forecast, with morning temperatures in the low teens.
Some people with a weakened immune system can get a fourth dose of the coronavirus vaccine as early as this coming week, according to recommendations from the Centers for Disease Control and Prevention that were updated last week.
The C.D.C. endorsed a third dose of the Pfizer-BioNTech and Moderna vaccines for moderately or severely immunocompromised people on Aug. 13, but said this would be considered a part of the primary immunization, not a booster shot.
In October, the agency said those immunocompromised people could receive a booster shot — a fourth dose of vaccine, six months after their third dose. These guidelines were consistent with its recommendation for other adults.
Last week, hoping to stem the surge of infections with the highly contagious Omicron variant, the C.D.C. shortened that interval to five months for a booster shot for Pfizer-BioNTech or Moderna recipients.
For immunocompromised people who received a single shot of the coronavirus vaccine made by Johnson & Johnson, the C.D.C. does not recommend additional primary doses, but advises that they get a booster shot of the Moderna or Pfizer-BioNTech vaccines two months after the first dose.
Some people are born with absent or faulty immune systems, and in others, treatments for some diseases like cancer diminish the potency of immune defenses. The C.D.C. estimates there are about seven million immunocompromised individuals in the country.
Many of them produce few to no antibodies in response to a vaccine or an infection, leaving them susceptible to the virus. When they do become infected, they may suffer prolonged illness, with death rates as high as 55 percent.
It is unclear what proportion of those people are protected by additional doses. Still, with the Omicron variant surging in the country, some immunocompromised people sought out fourth or even fifth shots of the vaccines even before the C.D.C. changed its guidelines. While receiving multiple doses of vaccines in a short period is unlikely to be harmful, it may produce diminishing returns, according to some experts.
The C.D.C. has said that any American 12 and older can receive a Pfizer-BioNTech booster — those 18 and older can alternatively receive a Moderna booster — five months after completing their initial shots with those vaccines. Israel has already begun offering fourth doses to high-risk groups including older adults. But the Biden administration has not yet said whether it plans to follow suit.
When asked on Friday about the possibility of a fourth shot for the general population, Dr. Rochelle Walensky, director of the C.D.C., said that focus remained on Americans eligible for their third shots.
She added that U.S. officials remained in close touch with Israel experts about their data. “We will be following our own data carefully as well, to see how these boosters are working in terms of waning effectiveness, not just for infection but, importantly, for severe disease,” she said.
We spoke to experts to better understand what it could mean to test positive for both infections. Here’s what to keep in mind.
Will co-infection make me twice as sick?
A co-infection doesn’t immediately mean that a patient will be doubly sick. A strong immune response may actually help the body fight off pathogens of all types, so one infection could stimulate some additional protection.
“An infection to one might help to aid your immune response to another,” Dr. Grein said, “because it’s activating that same immune response that’s going to be effective in fighting both.”
Still, scientists don’t know for sure yet, because so few people have tested positive for both Covid-19 and influenza. But judging from past trends, doctors are not overly worried.
Who is most susceptible?
Dr. Saad B. Omer, the director of the Yale Institute for Global Health, identified two groups he thought could be most vulnerable to co-infection.
First: unvaccinated adults. “Based on previous work on vaccinations, people who refuse one vaccine might refuse others as well,” he said. He said he expected there to be a “significant overlap between people who refuse both vaccines.”
Second: children, especially those under 5, who are too young to get vaccinated against Covid. Kids are also petri dishes, as any parent will tell you, and have lived through fewer cycles of the flu. So even if a child got a flu shot, Dr. Omer said, “their library of protection is narrow” against the many viral flu strains that can emerge each year.
How can I prevent co-infection?
On this one, the medical advice remains consistent: Get vaccinated for both Covid and flu. And get vaccinated right now.
Both kids and adults can get both vaccines at the same time. Children ages 5 years and older are eligible for a Covid vaccine, and children older than 6 months can get vaccinated against the flu.
In addition, experts agree you should wear masks and maintain social distancing measures when appropriate. Both flu and the coronavirus are airborne viruses, so limiting your exposure cuts down on your chances of getting infected.
Health officials in India have reported an increasing number of people refusing to wear masks, despite rising case numbers fueled by the Omicron variant, with rule breakers’ excuses including seeing masks as a sign of weakness or as simply unhelpful in preventing infection.
“When you hear people offer explanations like that, you want to bang your head against a wall,” said Manish Chakraborty, a health official in the state of West Bengal who is part of a team of officers who impose fines on people for skirting Covid rules.
After the deadly wave of Covid caused by the Delta variant in India last year began to recede, mask wearing also declined. Crowded markets and tourist destinations again filled with people, mostly unmasked and not social distancing. Researchers say mask wearing in public in the country has fallen to the levels last seen in March.
As coronavirus cases started increasing in urban centers, Prime Minister Narendra Modi told residents to be vigilant, and the chief minister of Delhi, Arvind Kejriwal, imposed a curfew, among other measures. But with the opening of election season a month off, both leaders have been seen campaigning in states that are going to the polls, holding rallies that packed in thousands of people, lots of them without masks.
After many Indians took to social media to express their outrage at the apparent double standard, India’s top election body stepped in and banned public campaign rallies until Saturday.
On Monday, the defense minister, Rajnath Singh, announced that he had tested positive for Covid. Mr. Singh, 70, who said on Twitter that he had mild symptoms and was quarantining at home, had addressed a rally in the northern state of Uttarakhand on Thursday.
Over the weekend, a lawyer who was traveling at night by car in eastern Delhi fired five shots from his pistol after a dispute with police officers who had stopped him because he was violating curfew. The officers also asked the lawyer why he was not wearing a mask, as he was not alone in the car.
No one was hurt in the episode, but the police said that they had opened an investigation.
Last week, the police in the western state of Gujarat arrested three men after they were caught violating Covid restrictions while hosting a birthday party for their pet dog.
Siddesh Valvaikar, a volunteer who spent time between Christmas and New Year handing out masks to people on tourist-filled beaches in Goa, said that he often got a cold stare in return.
“When we gave them masks, people just threw them away,” he said.
The Indian Health Ministry reported 179,723 new Covid cases on Monday, the highest number since May, and identified approximately 410 new cases of the Omicron variant. But epidemiologists warn that those numbers most likely exceed what has been reported since most of those infected are asymptomatic or have mild symptoms and did not get tested.
As Hungary tries to combat a Covid death rate that ranks among the top 10 worst in the world, efforts by the country’s medical authorities to increase immunization rates may have been hampered by claims that the national drug regulator rushed the approval process for Chinese and Russian shots.
Vaccine skepticism in Hungary may have already hampered the country’s inoculation campaign, which has lagged the progress made in several other countries in the European Union, particularly in Western Europe.
But that was not always the case. Hungary led the way for inoculations in Europe early last year after procuring the Sputnik shot from Russia and the Sinopharm vaccine from China. The country obtained both after Viktor Orban, the far-right prime minister of Hungary, criticized the European Union’s slow start to its immunization campaign.
“It cannot be that Hungarian people are dying because vaccine procurement in Brussels is slow,” Mr. Orban said in January 2021. “This is simply unacceptable,” he added.
On Friday, Hungary announced that it had received a shipment of the Russian-manufactured Sputnik Light, a one-shot vaccine, for testing.
But Mr. Orban has also struggled to develop public health policies to curb the spread of the coronavirus, and his decision to go all-in with vaccines not approved by E.U. medicine regulators has generated significant criticism at home. Among those concerns were the speed with which the Hungarian authorities approved usage of the Chinese and Russian vaccines, which prompted fears about potential corruption, and doubts about the safety of the shots.
In Hungary, the authorities do not publish data about which vaccines were given to people who have died of Covid. Hospitals and health care workers are also barred from speaking to the news media without prior authorization from the government. And citizens face criminal penalties for spreading false or distorted information that the government says hampers its ability to deal with the public health crisis.
In February 2021, Dr. Gyula Kincses, president of the Hungarian Medical Chamber, called on the National Institute of Pharmacy and Nutrition, the medicines regulator, to make public the documentation relating to the approval of the Sputnik and Sinopharm vaccines. He added that, without the documentation, the chamber could not in good conscience recommend that doctors administer the shots.
Gergely Gulyas, a deputy to Prime Minister Orban, said in April 2021 that Russia’s Sputnik vaccine was among the best, “even better than the Western vaccines,” and that “Sinopharm is better than Pfizer.”
In December, after months of litigation, the institute released redacted documents about the approval process.
Akos Hadhazy, an opposition lawmaker, claimed to have circumvented the redactions. He said the redacted portions showed that Hungarian experts had reported being unable to thoroughly inspect vaccine production sites and laboratory processes and lacked information about “several important tests concerning efficacy and safety.”
Mr. Hadhazy has since filed a criminal complaint claiming that the Hungarian medical authorities had caved to political pressure and violated professional standards during the approval process for the Russian and Chinese vaccines.
Dr. Ferenc Falus, a Hungarian former chief medical officer, said in an interview that the case illustrated how the government “broke the spine” of the National Institute of Pharmacy and Nutrition, allowing political expediency to override the proper medical processes.
Hungary’s high death rate, he said, can be attributed to the lack of political will to introduce stringent public health measures, the “catastrophic” situation in health care that preceded the pandemic and the government’s misleading communication on vaccines.
Uganda reopened its schools on Monday after what is reported to be the longest pandemic-prompted shutdown in the world. Educators and others say that the lengthy closure has taken a lasting toll, eroding decades of classroom gains in the East African nation.
Though efforts were made to provide remote instruction, more than half of Uganda’s students effectively stopped learning when the government ordered classrooms closed in March 2020, a government agency has found.
And the outlook is not optimistic: Up to a third of students, many of whom took jobs during the pandemic to support their struggling families, may not return to the classroom. Thousands of schools, themselves under financial stress, are not expected to reopen their doors. And countless teachers will not come back either, having turned to other work after losing their income during the shutdown.
“The damage is extremely big,” said Mary Goretti Nakabugo, the executive director of Uwezo Uganda, a Uganda-based nonprofit organization that conducts educational research. Unless there are intensive efforts to help students catch up, she said, “we may have lost a generation.”
In other news from around the globe:
Myanmar’s ousted civilian leader, Daw Aung San Suu Kyi, was convicted on Monday and sentenced to four years in prison for possessing walkie-talkies in her home and for violating Covid-19 protocols. Altogether, Ms. Aung San Suu Kyi, 76, has so far been sentenced to a total of six years in prison, with more charges pending against her.
Macau’s ban on all incoming commercial international flight took effect at 11:59 p.m. on Sunday, as the autonomous Chinese region went further than Hong Kong in seeking to keep out the Omicron variant of the coronavirus. Hong Kong temporarily banned flights from eight countries, including the United States. The flight suspensions in Chinese regions will last two weeks. Macau, a popular gambling destination, has recorded fewer than 80 cases of the virus, according to figures from Our World in Data.
Officials in Indonesia gave emergency authorization on Monday for five different vaccines to be used as booster doses for older and medically vulnerable members of the general public, The Associated Press reported. Health workers in the country have had access to boosters since July. The five include the Chinese-developed Sinovac and Zifivax vaccines as well as those from Pfizer-BioNTech, Moderna and AstraZeneca.
Slovakia is easing its coronavirus restrictions. Officials canceled an 8 p.m.-to-5 a.m. curfew starting on Monday, though access to bars, restaurants and other businesses will still generally be limited to vaccinated people and those who have recovered from coronavirus infections, The A.P. reported. The nation also reopened its schools on Monday. Slovakia had a record-setting surge in late fall, driven by the Delta variant, but case and hospitalization numbers have recently been declining and the country has yet to detect a major Omicron outbreak, the news agency said.
Sweden took the opposite tack on Monday, ordering cafes, bars and restaurants to close by 11 p.m. starting on Friday and urging residents to work from home if possible, The A.P. reported. Though millions of Swedes have been vaccinated and the country has tried to avoid imposing restrictions, Prime Minister Magdalena Andersson said, “we believe that the situation requires further measures over a period of time, in order to curb the spread of infection and reduce the burden on health care and care.”
Livia Albeck-Ripka and Richard C. Paddock contributed reporting.
On Dec. 29, The Gateway Pundit, a far-right website that often spreads conspiracy theories, published an article falsely implying that the Centers for Disease Control and Prevention had withdrawn authorization of all P.C.R. tests for detecting the coronavirus. The article collected 22,000 likes, comments and shares on Facebook and Twitter.
On TikTok and Instagram, videos of at-home virus tests displaying positive results after being soaked in drinking water and juice have gone viral in recent weeks, and were used to push the false narrative that coronavirus rapid tests don’t work. Some household liquids can make a test show a positive result, health experts say, but the tests remain accurate when used as directed. One TikTok video showing a home test that came out positive after being placed under running water was shared at least 140,000 times.
And on YouTube, a video titled “Rapid antigen tests debunked” was posted on Jan. 1 by the Canadian far-right website Rebel News. It generated over 40,000 views, and its comments section was a hotbed of misinformation. “The straight up purpose of this test is to keep the case #’s as high as possible to maintain fear & incentive for more restrictions,” said one comment with more than 200 likes. “And of course Profit.”
Misinformation about virus tests has spiked across social media in recent weeks, researchers say, as coronavirus cases have surged again worldwide because of the highly infectious Omicron variant.
The burst of misinformation threatens to further stymie public efforts to keep the health crisis under control. Previous spikes in pandemic-related falsehoods focused on the vaccines, masks and the severity of the virus. The falsehoods help undermine best practices for controlling the spread of the coronavirus, health experts say, noting that misinformation remains a key factor in vaccine hesitancy.
KATHMANDU, Nepal — Top education officials in Nepal decided on Monday to close the country’s schools until the end of January, as part of a package of measures meant to contain a coronavirus surge.
Most schools in Nepal reopened in late September after closing intermittently earlier in the pandemic. Schools in cities like Kathmandu were able to offer remote instruction during closures, but many schools in the countryside could not — nor could many rural families take part even if it was offered.
“No electricity. No internet. We cannot run online classes. Students will be deprived of education again,” said Aruna Budha Chhetri, an elementary-school teacher in Dailekh, a rural district.
The repercussions of school closures in Nepal have been far-reaching, with reports of girls from poor families who could no longer attend school being forced into child marriages and boys leaving their interrupted schooling to earn money for their households.
Even so, Ms. Budha Chhetri said she agreed with the decision to close schools for a while.
“They will learn someday, if they survive the pandemic,” she said of her students.
The country’s health infrastructure is fairly limited, and most school-age children are unvaccinated. Policymakers and parents are grappling with how to protect them from the virus with the least possible disruption to their studies.
Reports of new coronavirus cases are soaring, and there are worries that recent political party meetings in Kathmandu have helped spread the virus to the most remote corners of the country. Former Prime Minister Pushpa Kamal Dahal is recovering after testing positive for the virus.
Along with closing schools, officials have banned gatherings of more than 25 people and have introduced a requirement for proof of vaccination to access public services — a decision that immediately drew complaints on social media, since only about 37 percent of Nepal’s population of 30 million people is fully vaccinated.
Christy Smith has never been tested for the coronavirus. As a blind person, she can’t drive to testing sites near her home in St. Louis, and they are too far away for her to walk. Alternative options — public transportation, ride share apps or having a friend drive her to a test site — would put others at risk for exposure.
The rapid tests that millions of other people are taking at home, which require precisely plunking liquid drops into tiny spaces and have no Braille guides, are also inaccessible to Ms. Smith.
Many people who are blind or have limited vision are not being tested as often as they would like — and some are staying isolated because testing is too difficult.
“Not all of us have access to somebody sighted to help with things on a regular basis,” Ms. Smith said. “It’s kind of a mix of frustration and just feeling a bit helpless,” she added.
When Ms. Smith’s husband, who is also blind, fell sick with a sore throat, stuffy nose and fever last fall, both of them isolated at home until his symptoms disappeared. They never found out what pathogen caused the infection.
Some blind people manage to take at-home tests with the help of video call apps, like Be My Eyes and Aira. These services pair blind individuals with a sighted person who can describe their surroundings and guide them through a test, step by step.
But these interactions are difficult, and not everyone who is blind owns a smartphone or is able to use a smartphone. What’s more, relying on others can erode a blind person’s privacy and independence.
This year’s tax filing season is likely to be another challenging one because of pandemic-related tax changes. But the first step for many taxpayers is simple: Check your mail.
The Internal Revenue Service is sending special statements to the millions of Americans who received monthly payments of the expanded child tax credit last year as part of the pandemic relief program. The agency is also sending letters to the people who got the third stimulus payment last year, reports Ann Carrns for The New York Times.
The advance payments of the child tax credit reflected half of a family’s estimated credit. To claim the other half, people must enter information from the I.R.S. statement on their federal tax return to reconcile the amounts. The document, I.R.S. Letter 6419, details the total amount of advance payments paid last year and how the amount was calculated.
A quick refresher:
Congress expanded the child tax credit for the 2021 tax year, providing as much as $3,600 per child, up from $2,000.
Half of the credit was paid in advance, divided into monthly payments delivered from July through December.
The aid went to families with about 61 million children, according to the Treasury Department.
The I.R.S. is also sending a second letter later this month regarding the third round of stimulus checks. The third batch of checks, of $1,400 per person, was sent beginning in March as part of the pandemic relief effort.
Most eligible people have already received the payments. But if you didn’t, or if you got less than the full amount, the letter — known as Letter 6475, Your Third Economic Impact Statement — will help determine if you can claim the money as a “recovery rebate credit” on your 2021 tax return.
Filing season normally starts in mid- to late January, but the I.R.S. hasn’t yet announced when it will begin accepting returns. READ MORE
With the deadline for 2022 coverage fast approaching, sign-ups for Obamacare health insurance plans continue to break records.
Enrollment in plans that began coverage on Jan. 1 reached 13.8 million, according to the Centers for Medicare and Medicaid Services. The figure is about 20 percent more than at a comparable time last year and a small increase over preliminary figures announced in late December for Jan. 1 policies.
Americans who want health insurance for 2022 under the law have through Saturday to sign up on Healthcare.gov or on a state website, to obtain coverage that will take effect in February.
Several factors are driving the rising enrollment. Increased subsidies passed by Congress last year have lowered the cost of health insurance for almost everyone who buys it directly. The Biden administration has invested heavily in marketing and outreach for the programs. And shifts in employment during the pandemic may be bringing more people into the market who previously received coverage through their jobs.
Chiquita Brooks-LaSure, the administrator of the Centers for Medicare and Medicaid Services, said: “All of the numbers bear out just how important this increase in affordability is for people feeling like it’s worth making the investment in insurance coverage. The second piece is the outreach.”
The agency does not yet have demographic data available on who is newly enrolling. But Ms. Brooks-LaSure said there were indications that the largest gains had been among people of modest incomes, particularly in states that did not expand their Medicaid programs. Many such people can qualify for strong coverage this year without owing any premium.
The enhanced subsidies are set to expire at the end of the year, though, unless Congress extends them. A three-year extension is included in the Democrats’ Build Back Better legislative package that remains stalled in the Senate.
Americans tend to sound cavalier about flu, and falsely comparing Covid-19 to flu was a way of dismissing the coronavirus as no big deal. But deaths from influenza range from 12,000 nationally in an unusually mild year to 60,000 or more in a virulent one.
Flu also sends hundreds of thousands of Americans to the hospital annually, and evidence is emerging of its association with other serious diseases.
Yet vaccination among older Americans, those most apt to accumulate the chronic conditions that can make flu particularly dangerous, has remained stuck at roughly 65 percent in most recent years, leaving millions unprotected.
This year, based on early reporting, the rate appears to be even lower. In October 2019, almost 20 percent of Medicare fee-for-service beneficiaries had been vaccinated, according to the Centers for Disease Control and Prevention; in October 2020, the proportion reached close to 30 percent.
This past October, only 11 percent of seniors had received a shot.
“I think it’s going to be a bad flu year,” said Nathaniel Hupert, a co-director of the Cornell Institute for Disease and Disaster Preparedness. “The trajectory is just like prior bad flu years — 2017, 2019. And for reasons that are unclear, we have this incredibly low rate of vaccination reported among older people.”
California may spend $2.7 billion more on fighting the pandemic, with the bulk of that money aimed at boosting access to testing, according to a budget proposal Gov. Gavin Newsom presented on Monday.
Of the total budget, $1.2 billion would help keep testing sites open longer, and pay for millions of antigen tests for local health departments and schools. Another $614 million will support health care systems, including with extra staffing, and $583 million will propel the state’s efforts to get residents vaccinated, and combat misinformation around the vaccines.
Mr. Newsom asked for the state to spend much of that money on an emergency basis, as California contends with surging coronavirus case numbers driven by the Omicron variant. The state is averaging almost 75,000 new Covid cases per day, according a New York Times database, a 405 percent increase from two weeks ago.
California officials, led by Mr. Newsom, have for nearly two years sought to position the nation’s most populous state as at the vanguard of aggressive, science-driven pandemic response. But the governor has faced frustration with prolonged shutdowns that fueled an unsuccessful bid last year to recall him from office.
Mr. Newsom has noted repeatedly that the state was the first to require health care workers and schoolchildren to be vaccinated. And California sent stimulus checks to residents, on top of funds provided by the federal government. In December, the state reinstated an indoor masking mandate.
But throughout the pandemic, promises to spend big on a robust response have often collided with more difficult realities. For example, even as Mr. Newsom and members of his administration lauded the state’s early vaccine rollout, experts said the campaign was marred by confusing eligibility changes and an expensive and ultimately unnecessary deal with the insurer Blue Shield of California to manage the distribution of doses.
More recently, Mr. Newsom’s vow to get enough rapid tests to screen children before they returned to classrooms after the holidays fell short.
In an interview, the governor said the effort to distribute rapid tests to schools has been dogged by difficulties in obtaining supplies.
“It’s a lot better than it used to be,” he said, “but the testing right now reminds me a little bit of the early days with P.P.E. where we found ourselves, quite literally, competing with the federal government.”
Mr. Newsom added that the budget also calls for spending more money on disease surveillance and reports on best practices to be compiled after the pandemic ends.
“We’re resourcing that to prepare for the next one,” he said. “We’re still flying the plane right now.”
Los Angeles, the second-largest school district in the United States, is forging ahead with plans to open its classrooms for in-person learning on Tuesday.
Like other school districts across the country, Los Angeles Unified is dealing not only with uncertainty over the Omicron variant, but also with politicized tensions over the possibility of a return to remote learning, as well as teacher shortages that have left schools scrambling.
Most students attended classes in person last fall, connecting with their friends and snatching back traces of the normalcy they lost nearly two years ago. Now, school districts across the United States are trying to chart a way forward as coronavirus case numbers break records once again.
Los Angeles public schools had one of the longest shutdowns in the country last school year. The district is ramping up safety measures, but officials there seem determined to keep the children in their classrooms.
“We know there is apprehension, and we’ve added the extra layers of protection for the return to school,” Megan K. Reilly, the interim superintendent, said in a video address on Monday. “There may be a few lines at the start of the school day and longer wait times for buses.”
Nazli Santana, a mother of two middle school students who will return to class on Tuesday, said she wished the district had waited a little longer. “If they could just shut it down for two more weeks, that would have been helpful,” she said.
Last week, the district issued new rules requiring testing as a condition of returning to campus, regardless of vaccination status. Schools have hosted coronavirus testing and vaccination sites for students and distributed at-home tests. Masks are required on campus. A vaccine mandate for students 12 and older was scheduled to take effect this week, but enforcement was delayed to the fall.
District data showed that during the week ending Monday, out of about 458,000 tests of students and staff members, 66,000 had come back positive for the coronavirus, a positivity rate of more than 15 percent — lower than county, state and the country averages, but still high enough to cause alarm.
“I’m worried, like a lot of parents,” said Amanda Santos, whose 7-year-old attends first grade in the district.
For months, Ms. Santos has been keeping her eye on an online dashboard where the district shares data. For much of the fall semester, the weekly report for her son’s elementary school was showing only a couple of positive cases at a time. But over the winter break, she watched that number shoot up into the dozens.
That was worrisome, Ms. Santos said. But she added that schools seemed careful about safety, and good about keeping parents informed. “They’re not letting anybody who has a positive test, or who doesn’t test, on campus,” she said. “So I feel secure about that.”
Cecily Myart-Cruz, the president of the local teachers’ union, said in a statement on Monday that the district was “in a better position than most others in the country” because of the safety measures it has taken.
“This week will be stressful, and there will be disruptions,” she added. “No one has a playbook for this moment.”
The U.S. Supreme Court blocked a requirement that large companies mandate vaccines or weekly testing for workers on Thursday. Parts of the rule, which the Occupational Safety and Health Administration issued in November, had been scheduled to take effect on Monday.
The often fraught choice is now up to employers, who have to decide whether to proceed with planned mandates without cover from the federal government.
The decision may snarl some planned mandates. Employers have been concerned about losing employees to mandates when workers are already scarce.
And some companies with vaccine mandates said keeping those policies might become more difficult in light of the Supreme Court’s ruling.
In a November poll of 543 companies by the consulting firm Willis Towers Watson, 57 percent said they either required or planned to require Covid-19 vaccinations. But that included 32 percent that planned to mandate vaccines only if the OSHA rule takes effect. And only seven percent said they planned to carry it out regardless of the outcome.
Still, companies have been preparing for months for the mandate, and many may still go forward with their policies, said Douglas Brayley, an employment lawyer at Ropes & Gray.
And several major companies — including United Airlines and Tyson Foods — already have vaccine requirements. Firms with mandates say concerns about mass resignations have largely not come to fruition.
In fact, United Airlines said this week that while 3,000 of its employees had Covid-19, none of its vaccinated employees were currently hospitalized. Since its vaccine policy went into effect, the airline said, its employee hospitalization rate had dropped significantly below the rate for the U.S. population.
“This decision will be an excuse for those employers who care less about their employees to return to business as usual,” said David Michaels, an epidemiologist and a professor at George Washington University and a former OSHA administrator.
Sapna Maheshwari contributed reporting.
Like many businesses, health care facilities and cultural organizations, the Met has struggled in recent weeks with employee absences, at times closing multiple galleries to cope with a security staff reduced, on the worst days, by as much as a third because of illness.
On one day in early January, for example, some 80 of the museum’s roughly 430 galleries were closed, including rooms displaying medieval, Egyptian, Chinese, European and American art and objects.
But while the immediate staffing issue is largely related to the surge of the highly contagious Omicron variant, the museum has also had a longer-term problem hiring guards to rebuild its staff after layoffs in 2020 that came in response to the pandemic.
In August 2020, five months after it had closed its doors and as the financial impact of the pandemic deepened, the Met furloughed about 120 guards who worked at the main museum on Fifth Avenue or at two satellites, the Met Cloisters and the Met Breuer. Those guards were later laid off, the museum said.
As the Omicron variant spread in recent weeks, other museums have experienced staff shortages because of illness. Among them is the Smithsonian’s National Air and Space Museum in Washington, which is closed until later this month, and its National Museum of Natural History, which closed briefly amid a shortage of staff but has now reopened.
In New York City, where record numbers of Covid-19 cases have been reported, the Met has reduced its visitor capacity. Anne Canty, a spokeswoman for the American Museum of Natural History, said its galleries had remained open except for the museum’s Butterfly Conservatory, which has been closed for several weeks because of shortages among specialized employees and volunteers.
Amanda Hicks, a spokeswoman for the Museum of Modern Art, said that while some employees had been out because of the impact of Covid, no galleries had closed.