Covid Updates: C.D.C. Says Cloth Masks Are Not as Effective as Others

The Biden administration said its website would begin taking orders for free tests on Jan. 19. Hospitals are filling up in two dozen U.S. states.

Follow our latest coverage of the coronavirus pandemic.

The C.D.C. concedes that cloth masks do not protect against the virus as effectively as other masks.

ImageLinsey Jones, a medical assistant at a drive-up Covid-19 testing clinic in Puyallup, Wash., equipped with a N95 mask.
Credit...Ted S. Warren/Associated Press

The Centers for Disease Control and Prevention on Friday clarified its stance on various kinds of masks, acknowledging that the cloth masks frequently worn by Americans do not offer as much protection as surgical masks or respirators.

While this disparity is widely known to the general public, the update marks the first time the C.D.C. has explicitly addressed the differences. The agency’s website also no longer refers to a shortage of respirators.

The change comes as infections with the highly contagious Omicron variant continue to soar. Some experts have said that cloth masks are inadequate to protect from the variant, and have urged the C.D.C. to recommend respirators for ordinary citizens.

The agency did not go that far. Its updated language now says that “a respirator may be considered in certain situations and by certain people when greater protection is needed or desired.”

The previous version of the recommendations said individuals may choose to use a disposable N95 respirator instead of a mask “when supplies are available.”

N95 respirators, so named because they can filter out 95 percent of all airborne particles when used correctly, were in short supply early in the pandemic. At the time, the C.D.C. and the World Health Organization both repeatedly said that ordinary citizens did not need to wear masks unless they were sick and coughing.

The C.D.C. also said regular surgical masks were “an acceptable alternative” for doctors and nurses when interacting with a patient infected with the coronavirus — a move that angered medical personnel.

Critics charged that the recommendations were based not on what would best protect Americans, and were instead prompted by a shortage of N95 respirators.

When the C.D.C. finally recommended masks for ordinary Americans, it emphasized cloth face coverings. It took months more for the C.D.C. and the W.H.O. to concede that the coronavirus can be carried by tiny droplets called aerosols, which can linger indoors for hours.

According to the C.D.C.’s new description of masks, loosely woven cloth products provide the least protection and layered finely woven products offer more. Well-fitting disposable surgical masks and KN95s — another type of respirator mask — are more protective than all cloth masks, and well-fitting respirators, including N95s, offer the highest level of protection.

The agency urged Americans to “wear the most protective mask you can that fits well and that you will wear consistently.”

Tracking the Coronavirus ›

Shipments of free coronavirus tests will take at least a week, U.S. officials say.

Image
Credit...Michael Reynolds/EPA, via Shutterstock

WASHINGTON — Americans will be able to request free rapid coronavirus tests from the federal government beginning on Wednesday, but the tests will take seven to 12 days to arrive, senior Biden administration officials said on Friday.

The administration’s website to process the requests, covidtests.gov, was up and running on Friday, the latest sign of its efforts to ramp up access to testing since the fast-spreading Omicron variant sent coronavirus case counts soaring.

But the delay in accepting orders and the lag in shipping mean that people are unlikely to receive the free tests until the end of January at the earliest. In some parts of the country, that may be after the peak of the current surge of cases.

President Biden said last month that his administration would purchase 500 million rapid at-home coronavirus tests and distribute them to Americans free of charge. On Thursday, he announced plans to buy an additional 500 million tests, bringing the total to one billion. The administration has already contracted for 420 million tests.

Each household will be limited to four free tests. The Postal Service will handle shipping and delivery through first-class mail, the officials said. Free tests will also be available at some community health centers, rural clinics and federal testing sites.

Separately, people with private insurance should be able to start seeking reimbursement for tests they purchase themselves beginning on Saturday, less than a week after the administration announced the new rule. Insurers will be required to cover eight at-home tests per person per month.

The administration is also creating incentives to encourage insurers to work with pharmacies and other retailers so people can be reimbursed at the time of purchase, as is often the case with prescription drugs. But some insurers say it will probably take weeks to fully set up the system the White House envisions.

Testing has been a challenge for the federal government since the earliest days of the pandemic. Supply chain shortages made them hard to come by, and overloaded laboratories took days to process them. Mr. Biden, who came into office promising to ramp up testing, has made some progress in expanding the supply of rapid at-home tests. There were none available to American consumers when he took office.

But the Omicron wave has put intense pressure on the nation’s testing capacity. At-home tests began flying off pharmacy shelves and are now scarce in many parts of the country. At the same time, some consumers are confused about how to use them.

Administration officials sought to clear up some of that confusion on Friday, specifying three reasons people should use at-home tests: They begin to have symptoms of Covid-19; they were exposed to someone who tested positive for the virus five or more days earlier; or they are planning to gather indoors with someone at risk of Covid-19, and want to assure themselves they are negative.

Amtrak temporarily reduces train service amid Omicron surge within its ranks.

Image
Credit...Robert F. Bukaty/Associated Press

Amtrak said on Friday that it will temporarily reduce service on some trains because of staffing challenges stemming from a surge in cases of the Omicron variant among workers.

While nearly 97 percent of Amtrak workers are fully vaccinated, several hundred employees — including service personnel, conductors, engineers and mechanical crew members — have been sidelined because of Covid-19 infections or exposures, officials said. The agency will suspend 8 percent of its train departures over the next 10 weeks.

“These Covid-related absences, when combined with the general skilled work force shortage Amtrak and other transportation companies are facing, have reduced our ability to consistently deliver our current schedules and impacted the pace of hiring and training efforts,” Jason Abrams, an Amtrak spokesman, said in a statement.

The reductions will affect the Northeast Regional route, where 8 percent of weekly departures will be suspended between Jan. 24 and March 27. Amtrak will also reduce some of its long-distance service and suspend 6 percent of its weekly departures along state-supported routes from Jan. 18 to March 27.

Coronavirus cases in the United States by region

This chart shows how reported cases per capita have changed in different parts of the country.

Amtrak said it is working to resolve the issue, including trying to hire more workers and train new staff members to “avoid staffing shortfalls due to unplanned absences,” according to the statement.

Riders impacted by service reductions will be offered same-day travel alternatives and customers will be notified about changes, according to the statement.

The suspensions come on the heels of previous service reductions, both weather and Covid-related, which Amtrak instituted between New Year’s Eve and Jan. 6 . Last month, officials struck an optimistic tone and said they would likely be able to avoid cuts to service after dropping a mandate for all employees to be vaccinated against Covid-19. The agency had dropped the mandate after a federal court decision halted the enforcement of the executive order for federal contractors.

Jim Mathews, the president and chief executive officer of the Rail Passengers Association, said the agency’s decision to reduce service reflected how the virus was continuing to disrupt daily life and travel plans for Americans.

“This is a nationwide problem, not just an Amtrak problem, and we’re encouraged to see Amtrak trying to make the smallest possible cuts to carry the railroad through,” Mr. Mathews said.

Some experts call for a switch from nasal swabs to saliva-based tests, to better detect Omicron.

Image
Credit...Jenn Ackerman for The New York Times

Diagnosing a coronavirus infection has often required probing the nose. But the rapid spread of the Omicron variant, and questions about the sensitivity of at-home tests, have rekindled a debate over whether the best way to detect the virus is to sample a different site: the mouth.

“The virus shows up first in your mouth and throat,” said Dr. Donald Milton, an expert on respiratory viruses at the University of Maryland. “That means that the approach we’re taking to testing has problems.”

The science is still evolving, and the data paint a complex picture, suggesting that saliva-based tests have limitations of their own. Many labs are not currently set up to process saliva, nor are the at-home antigen tests available in the United States authorized for it.

If test manufacturers want to add saliva samples or throat swabs, they will need to validate their tests with those samples and submit the data to regulators. At a Senate hearing on Tuesday, Dr. Janet Woodcock, the acting commissioner of the F.D.A., noted that manufacturers might also have to reconfigure their tests to accommodate the larger swabs that are designed for the throat.

It’s not yet clear whether any of the major at-home testing companies have plans to do so. “We continue to monitor and evaluate,” said John M. Koval, a spokesman for Abbott Laboratories, which makes rapid antigen tests. “Our test is currently indicated for nasal use only.”

Even scientists who were convinced of saliva’s potential were reluctant to recommend that people swab their mouths or throats with tests that are not authorized for that purpose. (The F.D.A. has also warned against this.) The biochemistry of the mouth is different than that of the nose and may affect the test results, potentially yielding false positives, scientists said.

“It’s not as easy as just saying, ‘Hey, just use a rapid antigen for saliva,’” said Glen Hansen of the clinical microbiology and molecular diagnostics laboratory at Hennepin County Medical Center in Minnesota.

But experts said they hoped that laboratories, test manufacturers and regulators would move swiftly to evaluate whether any currently available tests might perform better on other sample types.

The Treasury Department threatens to keep relief funds from Arizona for using it to fight school mask rules.

Image
Credit...Ross D. Franklin/Associated Press

WASHINGTON — The Treasury Department told Arizona officials on Friday that it could claw back some of the state’s pandemic aid and withhold future payments if the state did not halt or redesign programs that use the money to undercut mask requirements in schools.

The warning was the latest development in a dispute between Gov. Doug Ducey, a Republican, and the Biden administration over how the $4.2 billion that was awarded to the state as part of the relief package that Congress passed last year can be used. Republican governors in several states have been trying to use the money for unauthorized purposes, such as cutting taxes or enacting immigration policies that are unrelated to the pandemic.

The Treasury Department first raised concerns about Arizona’s education policies last October, but the state declined to make changes.

Mr. Ducey announced last year that he was rolling out two education programs intended to undercut school mask requirements that some school districts in the state put in place.

A $163 million program using the federal relief money provides up to $1,800 in additional funding per pupil in public and charter schools. However, these schools must be “following all state laws” and open for in-person instruction. Schools that required masks would not be eligible.

A separate $10 million program funds vouchers worth up to $7,000 to help poor families leave districts that require face coverings or impose other Covid-related “constraints.”

In the letter, the Treasury Department said that if Arizona does not cease or change the programs within 60 days, it could start a process to recoup the money that is being misused. It also said that it could hold back the second installment of relief money that Arizona is scheduled to receive this year.

Arizona has so far received about $2.1 billion of the $4.2 billion that it was awarded through the $1.9 trillion relief package.

Djokovic continues his fight to stay in Australia despite being unvaccinated.

Image
Credit...Diego Fedele/EPA, via Shutterstock

A day after Novak Djokovic’s visa was revoked a second time, his lawyers went to court on Saturday morning to challenge the Australian government’s decision in a last-ditch attempt to save his chances to compete in the Australian Open.

The hearing was the latest twist in a dizzying drama over Djokovic’s refusal to be vaccinated against Covid-19.

During a brief hearing Saturday, Justice David O’Callaghan said a full hearing on Djokovic’s appeal would be held on Sunday morning at 9:30 a.m. and told both sides to submit legal papers laying out their arguments to the court later in the day.

Djokovic was taken into custody on Saturday and was expected to be held by immigration officials until the hearing on Sunday.

Later Saturday, Justice O’Callaghan granted the Djokovic legal team’s request that a full panel of judges hear the case rather than a single judge, which means the court’s decision on the matter cannot be appealed. A lawyer for the immigration minister had opposed that request.

50,000
100,000 cases
Feb. 2020
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb. 2021
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
7–day average
107,666
Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

On Friday, a different judge, Anthony Kelly of the Federal Circuit and Family Court, ordered the government not to deport Djokovic while his appeal is being heard. Hours earlier, the immigration minister, Alex Hawke, had revoked Djokovic’s visa on the grounds of “health and good order,” adding that the move was in the public interest.

Time is running short to resolve the dispute. The tournament starts on Monday morning and Djokovic has won its men’s singles title a record nine times.

Djokovic’s lawyers are arguing that Hawke did not act rationally when he said that Djokovic’s refusal to be vaccinated against Covid-19 posed a public health risk and could “excite anti-vaccination sentiment” in Australia. Nicholas Wood, one of Djokovic’s lawyers, said the minister did not take into account the impact of forcing the player out of the country.

Djokovic’s lawyers asked for a speedy schedule so that he could potentially be cleared to play.

The lawyers criticized the immigration minister for taking four days since an earlier court ruling to decide to rescind the visa, and for announcing it at 6 p.m. on Friday. “We are where we are because of the time the minister has taken,” Wood said. “We are moving as fast as we can.”

Omicron pushes hospitals to the brink in two dozen U.S. states.

Image
Credit...Etienne Laurent/EPA, via Shutterstock

The extremely contagious Omicron variant is fueling an enormous coronavirus wave that is pushing hospitals close to their capacity limits in about two dozen states, according to data posted by the U.S. Department of Health and Human Services.

At least 80 percent of staffed hospital beds were occupied in 24 states on Thursday, including Georgia, Maryland and Massachusetts, the figures show.

More troubling, the data showed that in 18 states and Washington, D.C., at least 85 percent of beds in adult intensive care units were full, with the most acute scarcity of beds in Alabama, Missouri, New Mexico, Rhode Island and Texas.

The pressure on I.C.U. capacity comes as the Omicron variant has touched off a nearly vertical rise in infections and hospitalizations. The country as a whole and 26 states have reported more coronavirus cases in the past week than in any other seven-day period.

50,000
100,000
150,000 hospitalized
Feb. 2020
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb. 2021
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
7–day average
154,452
Source: U.S. Department of Health and Human Services. The seven-day average is the average of a day and the previous six days of data. Currently hospitalized is the most recent number of patients with Covid-19 reported by hospitals in the state for the four days prior. Dips and spikes could be due to inconsistent reporting by hospitals. Hospitalization numbers early in the pandemic are undercounts due to incomplete reporting by hospitals to the federal government.  ∙  Holiday interruptions to testing and data reporting may affect case and death trends.

In that time, an average of more than 803,000 coronavirus cases have been reported each day in the United States, an increase of 133 percent from two weeks ago, according to a New York Times database, and 25 states and territories have reported their highest weekly caseloads yet. Deaths are up 53 percent to an average of roughly 1,871 a day.

That has helped push the country’s average rate of hospitalizations above last winter’s peak. Hospitalizations of people testing positive for coronavirus over that week are up to more than 148,000 a day, a record. The numbers are rising fastest in Alabama, Florida, Louisiana, Puerto Rico and the U.S. Virgin Islands, according to the Times database.

(The hospitalization figures include people who test positive for the virus after being admitted for conditions unrelated to Covid-19, but there is no national data showing how many people are in that category.)

Since Thanksgiving, the White House has sent more than 350 military doctors, nurses, medics and other personnel to 24 states to help hospitals with staffing challenges, President Biden said this week, and plans to send an additional 1,000 service members to six hard-hit states. That is in addition to the more than 14,000 National Guard members deployed in 49 states to help staff hospitals and other medical facilities, he and other officials said.

On Wednesday, Gov. Tim Walz of Minnesota said the state would spend $40 million in federal funds to hire more staff to help hospitals there for the next 60 days because “we know we’re going to continue to see a sharp rise in cases from the Omicron variant.” Minnesota’s hospitals have been struggling to keep up since the fall, when the National Guard was called in to help with a flood of patients infected by the deadlier Delta variant.

Also Wednesday, Gov. Kate Brown of Oregon said she was sending an additional 700 members of the state’s National Guard — bringing the total deployed to 1,200 members — to help hospitals deal with a rise in coronavirus patients. “Our hospitals are under extreme pressure,” she wrote on Twitter.

One day earlier Gov. Janet Mills of Maine said she was activating 169 members of the National Guard to help with capacity constraints at hospitals, joining more than 200 members already deployed in the state.

“I wish we did not have to take this step,” Ms. Mills said in a statement, “but the rise in hospitalizations — caused primarily by those who are not vaccinated — is stretching the capacity of our health care system thin, jeopardizing care for Maine people, and putting increased strain on our already exhausted health care workers.”

Many fellow Serbians share Djokovic’s hesitation about the coronavirus vaccine.

Image
Credit...Oliver Bunic/Agence France-Presse — Getty Images

Novak Djokovic has said little publicly about why he has declined to be vaccinated against Covid, a decision at the heart of the Australian government’s decision to revoke his visa, now for a second time.

But while his views are out of step with most people in Australia — where roughly 80 percent of the population is vaccinated — in his homeland of Serbia, skepticism of vaccination runs deep. Serbia has one of the lowest vaccination rates in Europe, with less than 50 percent of people having received two shots, according to the Our World in Data project at Oxford University.

Serbians can choose from a virtual vaccine bazaar, including Sinopharm from China, Sputnik from Russia and the AstraZeneca shot, developed in partnership with Britain’s Oxford University and the U.S. drug company Pfizer, which is referred to in Serbia as the American vaccine.

But as cases rise, getting vaccinated is an increasingly hard sell.

5,000
10,000 cases
Apr. 2020
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb.
Mar.
Apr. 2021
May
Jun.
Jul.
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
7–day average
11,786
Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.