June 10, 2022, 11:15 a.m. ET

Daily Covid Briefing

The milestone, according to a New York Times database, comes while there is no national, permanent memorial to the country’s loss. The deaths of so many people also leaves a crater of grief.

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Credit...Dave Sanders for The New York Times

The U.S. surpasses 1 million Covid deaths, the world’s highest known total.

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Credit...M. Scott Brauer for The New York Times

The United States has officially surpassed one million known deaths from Covid-19, according to a New York Times database, a cataclysmic outcome that only hints at the suffering of millions more Americans who are mourning their spouses, parents, children, siblings, friends and colleagues.

The milestone has been anticipated and talked about for weeks, and a the Times database of Covid deaths surpassed one million deaths late Thursday, marking the somber moment.

“Hopefully, the enormity of that number would spur us on to do whatever we can to make sure that we don’t have as bad a time in the coming months and years that we’ve had over the past two years,” Dr. Anthony Fauci, the chief medical adviser to the president, told a Boston public radio station, WGBH, earlier this month.

Some initial forecasts put the number of Americans likely to die from the virus between 100,000 and 240,000, although officials warned that the death toll could climb if protective measures weren’t taken. The United States reached 100,000 in May 2020, and 200,000 a few months later, in September.

The United States has a higher rate of infection than many other wealthy countries do, and the pathogen has continued to spread in a population afflicted by inequity, political divisions, a sometimes overwhelmed public health system, and an inconsistent array of policies and responses.

While Covid stole lives from all strata of society, it magnified disparities, and some groups have been more vulnerable than others to infection, based on factors like sex, age, health care access, income and housing.

The virus arrived in the United States by early 2020, setting off five distinct waves of new cases over the 26 months that followed. An unexpected early wave in the spring of 2020 was followed by another wave in the winter, when access to vaccines was still very limited; more Americans died in that wave than in any other period.

New reported cases by day
Feb. 2020
Jul.
Dec.
May 2021
Oct.
Mar. 2022
1,000
2,000
3,000 deaths
7–day average
387
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.

In January 2021, the country’s daily death toll peaked, with more than 3,300 deaths recorded each day in the United States. And then came new waves: Delta in the summer of 2021 and Omicron in the late fall and winter. Omicron caused illness that was milder for some, though not for all; even so, it spread so swiftly and so widely that U.S. deaths surged again, and peaked in the first week of February, when more than 2,500 Americans a day were dying.

Now, Americans are still dyingmore than 300 a day on average, as of Thursday. Vaccines are readily available to nearly everyone other than young children, but even so, about a third of people across the country have not been fully inoculated against the virus, and about 70 percent have received no booster, despite the vaccines’ effectiveness at preventing severe disease and death.

“It’s reaching a point now with Covid, where some very obvious scientific truths based on clear-cut, very visible data are rejected by people,” Dr. Fauci said on WGBH. “When it gets in the way of the proper and appropriate response to a deadly outbreak, it becomes even more tragic.”

As of Tuesday, the average of new confirmed coronavirus cases surpassed 100,000 a day again, as Omicron subvariants have spread across the country. And those figures are thought to be undercounts, especially given that at-home test results often go unreported. Hospitalizations are on the rise, mostly on the East Coast; on average as of Thursday, more than 23,800 Americans were in hospitals with the coronavirus on a given day, 31 percent more than two weeks ago.

While each of the one million victims has a unique story, they leave behind a shared feeling among their loved ones, who say the lives of the dead have been pushed to the side in a country eager to get on with post-pandemic life. As it is, there is no national memorial to the people who have died, no shared remembrance, no communal place to gather, or to receive a nation’s sympathy. There is only a number.

Amy Harmon, Danielle Ivory, Albert Sun, Lauren Leatherby, Sarah Almukhtar and Jeremy White contributed reporting.

Tracking the Coronavirus ›

Here’s how The Times and others count the unfathomable number of a million U.S. virus deaths.

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Credit...Stefani Reynolds for The New York Times

It’s difficult to comprehend and convey the toll of the coronavirus pandemic, so it may not be surprising that there’s no single way that federal agencies, newsrooms or universities have arrived at such an immense number as one million known U.S. coronavirus deaths.

Even the White House has acknowledged that there was no consensus method for tallying coronavirus data.

When Jen Psaki, then Biden’s press secretary, was asked last week how the administration would recognize the milestone, she said in part that “We look at the C.D.C. data and the Johns Hopkins data, and different news organizations evaluate it differently.”

Two days later, President Biden anticipated the moment at his second Covid-19 summit.

“We mark a tragic milestone here in the United States: one million Covid deaths, one million empty chairs around the family dinner table — each irreplaceable,” Mr. Biden told the summit, which was held virtually. That came more than a week after NBC News said the mark had been reached, but before some other tallies had crossed the threshold, including that of The New York Times, which did so on Thursday.

The number is based on death certificates and other official records. But given how many diagnoses were probably missed in the spring of 2020, when testing was in short supply, and a lack of official guidance about reporting these records, that is certainly an undercount, experts say.

Just more than 300 known daily deaths, on average as of Thursday, are now being reported in the U.S., according to data collected by The Times. At the height of the winter Omicron surge, there were more than 2,600 deaths a day in the United States, according to The Times’s data, and in January 2021, the daily toll reached a U.S. peak of more than 3,300 a day.

Since the beginning of the pandemic, The Times has had a team of journalists who are dedicated to collecting and publishing national coronavirus data. The Times developed a system that combines computer software and manual reporting to compile a unique data set which sometimes yields figures that vary slightly from those compiled by others.

The crucial difference is in the combination of sources. Some news outlets draw their data exclusively from the Centers for Disease Control and Prevention or from Johns Hopkins University. But The Times uses a broad variety of data sets — from the federal government, state governments, and many local and regional health departments. These sources can vary in their counts of cases and deaths for particular areas at particular times. For example, the state of California releases new data in the morning, but Los Angeles County typically updates its data late in the day.

The Times’s system of data collection also enables the newsroom to set aside figures that appear to be unreliable. That policy helps explain why The Times’s national death count may differ from others.

A crucial consideration for counting deaths by county is how a death’s location is recorded. For example, several states such as Georgia and Tennessee include deaths of nonresidents in their state totals. The Times omits these deaths when possible to avoid double-counting deaths that occur away from the victim’s home county and might be reported in both places.

The Times considers that precaution an essential characteristic of its data set. But it means that some deaths may be omitted if their counties of residence are not clearly indicated, and as a result, the Times’s count may differ from others’ totals.

By any reckoning, though, the scale of the nation’s loss to the virus has been immense. In marking it last week, Mr. Biden said in a statement that the nation “must not grow numb to such sorrow.”

Lisa Waananen contributed reporting.

The C.D.C. recommends Pfizer-BioNTech boosters for children 5 to 11.

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Credit...Jim Wilson/The New York Times

The Centers for Disease Control and Prevention on Thursday recommended a booster dose of the Pfizer-BioNTech vaccine for children ages 5 to 11. Children in this age group who received their last dose at least five months earlier are eligible to receive the additional doses immediately.

“Vaccination with a primary series among this age group has lagged behind other age groups, leaving them vulnerable to serious illness,” Dr. Rochelle Walensky, director of the C.D.C., said.

“With over 18 million doses administered in this age group, we know that these vaccines are safe, and we must continue to increase the number of children who are protected.”

The booster shot would be the third dose available for most children and the fourth dose for some immunocompromised children.

A booster dose will offer children an extra layer of protection at a time when infections and hospitalizations are once again rising nationally, scientific advisers to the agency concluded at a meeting on Thursday.

“It is sobering that we have experienced over a million deaths in the U.S. as a consequence of Covid infection,” Dr. Grace Lee, a pediatrician at Stanford University and chair of the Advisory Committee on Immunization Practices, which sets recommendations for the use of vaccines, told other panel members.

In November, the committee recommended booster shots for adults and in January did so for children 12 and older.

Pfizer and BioNTech reported in April that in children aged 5 to 11, a third dose generated antibodies against both the Omicron variant and the original version of the coronavirus. In the trial, the children received 10 micrograms of vaccine — one-third of the dose given to adolescents and adults — in each shot.

As with the first two doses, the booster appeared safe, the companies reported. The most commonly reported side effects were pain, redness and swelling at the injection site as well as aches, chills and fever.

Based on these data, the Food and Drug Administration authorized the boosters for children aged 5 to 11 on Tuesday.

About 70 percent of children in this age group have evidence of prior infection and may have some immunity as a result, Dr. Sara Oliver, a C.D.C. scientist, noted at the science advisers meeting.

But some evidence suggests that compared with vaccination, protection following an Omicron infection may be weaker and may not last as long.

“Prior infection can result in protection against reinfection for a time period, but it’s not 100 percent and likely decreases over time,” Dr. Oliver said.

The rise in pediatric hospitalizations during the Omicron surge suggests that immunity gained from infection is “not sufficient to provide a broad population-level protection,” she added.

The committee members debated whether to recommend that all children aged 5 to 11 “should” receive a booster or only that they “may” do so if their parents or health care providers deem it to be necessary.

Ultimately, the experts voted for the stronger recommendation, after several committee members argued that there was enough evidence suggesting that a booster dose was broadly beneficial in all age groups. Dr. Walensky endorsed the recommendation later in the day.

The extra dose may boost immunity to the current Omicron variants in young children. Studies have shown that two doses of the vaccine offer virtually no barrier against infection with the Omicron variant in children aged 5 to 11, although protection against severe disease remains strong.

In adolescents aged 12 to 17, two doses offered little protection even against hospitalization, but a booster significantly improved effectiveness of the vaccines.

Many parents have hesitated to immunize their children, in part because they are at much lower risk of severe disease than adults. Fewer than one-third of 5- to 11-year-olds in the United States have received two doses. The rates were lower among children from communities of color and low-income families and those living in rural areas.

But record numbers of children were hospitalized during the Omicron surge this winter. Nearly 4,000 children aged 5 to 11 have been diagnosed with a Covid-related condition called multisystem inflammatory syndrome during the pandemic. And some studies find that even children who have a mild illness may experience symptoms for months.

Covid-19 has been responsible for more deaths in children aged 5 to 11 than many other vaccine-preventible diseases, noted Dr. Matthew Daley, a senior investigator at Kaiser Permanente Colorado who heads the C.D.C.’s Covid-19 vaccine working group.

“Most parents accept vaccination for hepatitis A, meningococcal, varicella, rubella and rotavirus, even though deaths from these diseases are relatively rare,” he said.

At the science advisers meeting, Dr. Doran Fink, a deputy director for the F.D.A.’s vaccine division, acknowledged the “continued intense interest in the availability of Covid vaccines” for children younger than age 5.

He said that agency scientists were working to quickly review data on the Moderna vaccine’s effects in the youngest children and were awaiting an application from Pfizer and BioNTech for their vaccine’s use in this age group.

Correction: 
May 19, 2022

An earlier version of this article incorrectly referred to the numbers of children aged 5 to 11 with multisystem inflammatory syndrome. About 4,000 have been diagnosed, not died, with the syndrome.

Boris Johnson won’t face further fines over lockdown parties, as the U.K. police end their investigation.

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Credit...Niklas Halle'N/Agence France-Presse — Getty Images

Follow the latest on Prime Minister Boris Johnson and Sue Gray’s lockdown report.

LONDON — Prime Minister Boris Johnson of Britain has escaped without further penalties in a long-simmering scandal that threatened his grip on power, after the Metropolitan Police announced on Thursday they had ended an investigation into lockdown-breaking parties in Downing Street.

The decision lifts much of the cloud that had hung over Mr. Johnson since the reports of illicit parties first erupted in November last year. With public anger over the issue rising, he had faced a potential leadership challenge from rebellious members of his Conservative Party. But that danger appears to have receded.

The police said they had imposed 126 fines, relating to eight social gatherings in and around Downing Street and Whitehall, several of which Mr. Johnson attended. The lack of additional penalties for him surprised many observers, burnishing his reputation as a politician known for his Houdini-like escapes.

Adding to the reversal of fortune, the spotlight has now swung to the leader of the opposition Labour Party, Keir Starmer, who is under pressure for taking part in a beer-and-Indian-food gathering with members of his party during a lockdown. Police in Durham are investigating whether he breached the rules.

Mr. Starmer has said that if he receives a fine, he will step down as party leader — a move calculated to draw a contrast with Mr. Johnson, who vowed to stay in office, regardless of whether he was found to have broken the law.

Mr. Johnson had already paid one fine for taking part in a rule-breaking office birthday celebration for him. But the damaging effect of that was mitigated somewhat because the police also fined one of his internal rivals — the chancellor of the Exchequer, Rishi Sunak — for attending the same party.

Still, Mr. Johnson faces other hurdles, including the publication of an internal report on the scandal, as well as an investigation by a House of Commons committee, which will address the question of whether he misled fellow lawmakers when he denied that any illegal parties had taken place.

Moreover, Mr. Johnson’s government faces a deteriorating economic situation, with soaring food and fuel prices, the specter of a recession, and growing disarray within his cabinet about what to do about all of it.

Tim Bale, a professor of politics at Queen Mary, University of London, said it now appeared that the party scandal “is not going to be the thing that brings him down. But it could still be one of the things that brings him down, given how many problems this government has, most notably on the economy.”

Labour Party officials seized on the occasion to renew calls for Mr. Johnson to resign. Angela Rayner, the deputy leader, said, “Industrial scale rule breaking has taken place at the heart of Boris Johnson’s Downing Street.” But Ms. Rayner is also under pressure: She was alongside Mr. Starmer at the gathering in Durham.

In London, the police said that 53 of the fines went to men and 73 to women. Some people received more than one. In addition to Mr. Johnson, his wife, Carrie Johnson, was informed that she would not face a penalty.

One of the parties that drew the most scrutiny was held in the couple’s Downing Street apartment after the ouster of Mr. Johnson’s disaffected chief adviser, Dominic Cummings. Witnesses reported hearing “The Winner Takes it All” by the Swedish pop group Abba blasting from the windows.

“Our investigation was thorough and impartial and was completed as quickly as we could, given the amount of information that needed to be reviewed and the importance of ensuring we had strong evidence,” the police said in a statement.

The police said 12 detectives worked on the case, code-named Operation Hillman. They reviewed 345 documents, 510 photographs and surveillance footage, as well as collecting 204 questionnaires.

But the police department’s role has been sharply criticized. For months, it declined to investigate reports of illicit parties, which emerged in a drip of news media reports, only to reverse course and open an investigation in late January, just as the internal government report on the parties was about to be released.

That report, by a senior civil servant, Sue Gray, was published only in highly redacted form. With the police investigation completed, the government has pledged to release the full report, likely next week. It is expected to cast a harsh light on the alcohol-fueled culture in Downing Street under Mr. Johnson’s leadership.

“We don’t understand the basis on which they’ve exonerated the prime minister for events in which other people who attended were fined,” said Jill Rutter, a former civil servant who is now a senior research fellow at the U.K. in a Changing Europe, a think tank in London. “There’ll be some questions about that.”

The police’s imposition of dozens of fines, many on younger aides who took part in gatherings, will also raise questions of fairness, given that they largely spared Mr. Johnson, as well as the Cabinet secretary at the time, Simon Case. That could pose a threat of further embarrassing leaks from disgruntled staffers.

“The temptation for anyone who has an embarrassing photo on their phone, is angry about what happened, and no longer works there, is now inordinate,” Ms. Rutter said.

Although Mr. Johnson may have navigated the most dangerous stretch of the scandal, it has taken a toll on his popularity, and that of the Conservative Party. The party lost about 500 seats in local elections two weeks ago, a setback that was fueled at least in part by popular anger over the parties scandal.

With the likelihood of more economic bad news on the horizon, political analysts did not discount the chance that he could still face a confidence vote in his party.

Mr. Johnson’s skill in extracting himself from scrapes once led one of his predecessors, David Cameron, to describe him as the “greased piglet” of British politics. But while he has survived again, he has not done so unscathed.

“Some of the grease has come off,” Mr. Bale said. “He’s just a piglet now.”

Biden’s health officials warn of a substantial increase in coronavirus cases.

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Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, urged Americans to consider returning to mitigation measures like wearing masks in indoor public settings.CreditCredit...Shawn Thew/EPA, via Shutterstock

WASHINGTON — Federal health officials warned on Wednesday that a third of Americans live in areas where the threat of Covid-19 is now so high that they should consider wearing a mask in indoor public settings. They cited new data showing a substantial jump in both the spread of the coronavirus and hospitalizations over the past week.

Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said that the seven-day average of hospital admissions from Covid rose 19 percent over the previous week. About 3,000 people a day were being admitted with Covid, she said, although death rates, a lagging indicator, remained low.

More than 32 percent of Americans now live in counties with medium to high levels of virus transmission, compared with about 24 percent the previous week. Dr. Walensky said that local leaders and individuals in those regions should adopt — or at least consider — prevention strategies, such as masking in indoor public settings and more frequent testing.

The warnings from Dr. Walensky and other federal health officials seemed somewhat at odds with President Biden’s own stance. The attitude in the West Wing more closely mirrors that of most Americans, who have eagerly moved away from mask-wearing and other strategies to prevent infection.

Mr. Biden no longer wears a mask in most settings, and is once again participating in Washington’s political and social scenes. The White House still takes precautions, regularly testing the president and those in close contact with him, and aides say Mr. Biden adheres to C.D.C. guidelines.

But he no longer treats the pandemic as his chief concern among many. Wednesday’s Covid briefing at the White House was the first in six weeks. While he has spoken about the pandemic’s enduring threat and toll, Mr. Biden has given far more speeches recently on Russia’s invasion of Ukraine and on inflation.

At the same time, a string of people in the president’s circle have been infected with the virus. On Wednesday, officials announced that Xavier Becerra, the health and human services secretary, had tested positive, as did Ashley Biden, the president’s daughter.

Mr. Biden says the shift in his tone is the result of the country’s success. Many people are vaccinated, a fair number are boosted, and those doses, plus new antiviral treatments, have been warding off severe disease, officials say. But the new approach is also a recognition of the political reality. Many Americans have decided to accept the risk of infection to resume their normal routines.

Andy Slavitt, a former senior adviser to the Biden White House on the pandemic, said the nation’s attention had shifted. The president “is managing a war overseas, the economy, inflation, infant formula and as these things go, the pandemic is now seen by the public as one more thing,” he said. “Of all the things going on, most people don’t perceive this to be the problem that it probably is.”

The president’s stance could backfire if the virus’s latest surge continues to build, evading the vaccines and making more people seriously ill. Should that happen, it could look like a repeat of last summer, when the president declared “independence” from the virus ahead of the July 4 holiday, only to see massive waves of illness and death once the Delta and Omicron variants hit.

Experts say that administration officials — including the president — should also be doing a better job of preparing the public for a reinvigorated virus in the fall and winter, when people spend more time indoors. If people become complacent now, they say, forgoing booster doses or failing to vaccinate their children, they could pay a price then.

“The attitude is, ‘We’ve got this, we’re over it.’” said Dr. Eric Topol, a professor of molecular medicine at Scripps Research in San Diego. “People should be gearing up, they should be getting booster shots. But there is no awareness.”

If the pandemic appears to be a lesser concern, that also makes it harder for the White House to make the case that it needs tens of billions in new funding from Congress to replenish its supply of tests, treatments and vaccines in time for the fall. The administration has said it wants to launch a booster campaign at that point, hopefully with vaccines retooled to work better against the latest version of the virus.

At the White House briefing, Dr. Ashish Jha, the new White House coordinator of the pandemic response, warned that if Congress failed to grant the administration’s request for $22 billion in new Covid funding, Americans would suffer come the fall.

He did not repeat an earlier administration claim that the nation could face 100 million infections next fall and winter. Instead, he said that projections from biostatisticians varied greatly, depending on estimates of how much of the population has developed immunity and other complex factors.

But he said that a scenario in which the nation had to face the virus without enough doses of vaccines and treatments would be “terrible,” adding: “I think we would see a lot of unnecessary loss of life.”

Dr. Jha said the current incidence of severe disease would be worse if not for Paxlovid, an oral treatment developed by Pfizer that helps prevent severe illness if taken soon after symptoms develop. Doctors are prescribing Paxlovid pills to about 20,000 patients a day, he said. That may help explain why the rates of hospitalization and intensive care patients are low relative to the jump in infections, he added.

Officials also warned at the briefing that far too many Americans are failing to take advantage of booster shots to bolster waning protection against infection, leaving themselves vulnerable to the coronavirus’s ever more contagious incarnations. Dr. Walensky said 62 percent of those aged 50 to 64 have not received a booster in the past six months, nor have 57 percent of those 65 or older.

Despite the nation’s weariness with mitigation measures, she said that in areas with high levels of transmission, mostly in the Northeast, “we urge local leaders to encourage the use of prevention strategies like masking in public indoor settings and increasing access to testing and treatment for individuals.”

In areas with medium levels of transmission, including counties in nearly every state, people should consider wearing a mask in indoor public settings, avoiding crowds and testing themselves more often, especially before gathering with others indoors, she said.

Whether local leaders will heed C.D.C. recommendations is another matter. New York City is now experiencing a high level of transmissions, but Eric Adams, the city’s mayor, said on Wednesday that he had no plans to bring back mask requirements.

“If every variant that comes, we move into shutdown thoughts, we move into panicking, we’re not going to function as a city,” Mr. Adams said at a news conference. He said the city was settling into a “new norm” instead, recognizing that the virus would keep on mutating.

In an implicit recognition that the pandemic is not over, the administration on Monday quietly let pass a deadline for lifting the public health emergency, which has allowed the government to take steps like offering Americans free coronavirus vaccines, tests and treatments; barring states from canceling people’s Medicaid coverage; and expanding access to telehealth appointments. It has also allowed hospitals to get paid more for treating Medicare patients who have Covid.

As of Tuesday, the average of new, confirmed coronavirus cases in the United States surpassed 100,000 a day for the first time since Feb. 20, according to a New York Times database. That figure is up 61 percent from two weeks ago. Public health experts believe the true number is far higher, because many people are not reporting the results of at-home tests.

The big unanswered question, experts say, is whether the rise in cases that is already well underway will be followed by a commensurate rise in hospitalizations and deaths. While hospitalizations are rising, deaths have remained low. About 275 deaths have been recorded each day on a seven-day average, according to the C.D.C. director, but the number has actually dipped slightly in recent weeks.

“We could be entering a period where we have an increased number of cases but a substantially decreased severity of illness, so that we see fewer hospitalizations and many fewer deaths,” said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “But as absolutely uncomfortable and unsatisfactory as this is, we just don’t know what this virus is going to throw at us in the next 90 days.”

That poses a messaging challenge for the White House, he said: “What we need to do is not whipsaw from, ‘We’re over,’ to ‘Oh my God, how bad it could be.’ ”

Dr. Ezekiel Emanuel, an oncologist, medical ethicist and University of Pennsylvania professor who led an effort to draft a new pandemic strategy called “The Next Normal,” was more blunt in calling for the White House to improve its Covid communications strategy: “They need to step up their game.”

Emma G. Fitzsimmons and Isabella Grullón Paz contributed reporting from New York.

What are the coronavirus testing requirements for travel to the U.S.?

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Credit...Frank Augstein/Associated Press

[Update: The United States will lift the virus testing mandate for international air travelers on June 12. Read more here.]

As countries, including Canada and Britain, have lifted their Covid testing requirements for vaccinated visitors in recent months, some Americans are irate that they still have to show a negative test to board a flight back to the United States.

Jason Miller, a 37-year-old software engineer who lives in Texas, is so frustrated with the rule that he recently sent letters to the White House and several lawmakers and began encouraging others to do the same. “I support the C.D.C., still wear a N95 mask when in crowds and when I travel,” he said. But, he no longer feels that the rule provides value, in large part because “the testing has not stopped variants from entering the country.”

Other travelers have posted similar comments on social media, and a good portion of the travel industry in the United States has made clear it feels the same way.

But they have gotten little satisfaction from the Biden administration and public health officials.

On May 6, Jen Psaki, then the White House press secretary, said she was “not aware of a timeline” for ending the testing requirement and that the administration would base its decision on a Centers for Disease Control and Prevention recommendation. As to what, specifically, the C.D.C. is using to determine whether testing is still necessary, an agency spokeswoman offered the vague explanation that it “is looking at different indicators” and “evaluating all guidance and orders based on the latest science and state of the pandemic.”

The obligatory test has not just created logistical hassles, it has fundamentally shifted the experience of traveling internationally, travelers say.

“It was always in the forefront of my mind,” said Danielle Bradbury, 42, who recently spent 12 days in Israel for her job developing medical devices while her husband cared for their two children back in Boston. “Every time I left the hotel, I asked myself, how much risk of not being able to get home am I putting myself in?”

Why was testing started in the first place?

In January 2021, when the C.D.C. first instituted the rule that all U.S.-bound travelers 2 years and older had to show a negative test or proof of recovery before boarding a flight, the United States joined a sea of countries experimenting with different ways to slow the virus’s spread across borders. A statement from the State Department announcing the requirement played up the difficulty in getting a test abroad, suggesting that the rule also aimed to discourage Americans from traveling internationally. At that point fewer than 10 percent of Americans were vaccinated and case counts were rising, hitting a record of more than 300,000 new cases on Jan. 8.

Testing was not the first travel limitation the United States had deployed. In the winter of 2020, President Trump banned visitors from China, much of Europe, Brazil and Iran. When President Biden took office he layered the testing requirement on top of the travel bans. (He also expanded the ban to India.)

In late 2021, the United States pivoted away from country-specific bans and doubled down on testing, shortening the window from within three days of travel to one day, even for vaccinated Americans. By then it had become clear that vaccinated people could also spread the coronavirus. (Most unvaccinated visitors from abroad were prohibited from entering the country, even with testing.)

How effective has the policy been?

It depends how you define success, said Jeremy Goldhaber-Fiebert, a professor of health policy at Stanford University. If success was reducing the number of infected people who flew to the United States, he said, the testing requirement achieved that.

“It certainly prevented people who tested positive from getting on planes and it almost certainly prevented some amount of transmission on aircraft and in airports,” he said.

The exact number of infected people who were prevented from boarding planes is unknown, however, because no one tracks whether a passenger cancels a flight because of Covid. Most of the evidence is anecdotal; lots of people have stories about testing positive before flying home.

If success means keeping new variants out of the country, then it failed, said Dr. William Morice, the chair of lab medicine and pathology at the Mayo Clinic.

“The reality is that none of these measures have prevented the rapid global spread of any variant of concern,” he said.

But if success was not preventing the arrival of new variants, but instead delaying their arrival so that hospitals and authorities could be more prepared, then it may have worked. Mark Jit, a professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine, who has studied the effectiveness of travel requirements, said that this is what testing does well.

“Testing can prevent the peak from being reached so quickly,” he said.

Still, once a variant is already widespread in a country, he found, a travel test has little effect.

Why are many countries getting rid of testing requirements now?

Explanations from authorities include readiness to enter a new phase of the pandemic, high vaccination rates and a determination that new variants are manageable.

“The current variant is making people less ill and the number of people being admitted to intensive care is limited,” the Netherlands government said in a typical statement in March, as it ended travel testing, among other Covid-related recommendations.

What’s the argument for getting rid of the U.S. requirement?

The primary argument is that it’s not doing enough good to rationalize the hassle.

Dr. Tom Frieden, who was the C.D.C. director during the Ebola outbreak of 2014, was among those who made this point. “Between super-effective vaccinations that we have and Paxlovid, which is a super-effective treatment, Omicron is less deadly than flu most years and we don’t require people to test for flu before they get on a plane,” he said. “If a more dangerous variant emerges,” he noted, “that’s a very different situation.”

Others argue that it doesn’t make sense to inconvenience so many people for a system that’s full of holes. Antigen tests — one option for travelers to the United States — are notoriously unreliable in the early stage of infection, said Anne Wyllie, a microbiologist at the Yale School of Public Health. For this reason she called the requirement “hygiene theater.”

The testing requirement is not just annoying for travelers, it’s economically damaging, according to the U.S. Travel Association, a trade group. In a recent letter to Dr. Ashish K. Jha, the White House Covid coordinator, signed by more than 260 businesses, including airlines, cruise operators, casinos, tourism boards, Disney Parks and a zoo, the group said “the economic costs associated with maintaining the measure are significant.”

“Given the slow economic recovery of the business and international travel sectors, and in light of medical advancements and the improved public health metrics in the U.S., we encourage you to immediately remove the inbound testing requirement for vaccinated air travelers,” the group wrote.

A survey commissioned by the group found that 46 percent of international travelers would be more likely to visit the United States without the requirement. A similar survey by the Points Guy, a site that specializes in traveling with credit card points and miles, found that more than half of its participating readers would be more likely to travel abroad without the requirement.

What’s the argument for keeping the policy?

Meegan Zickus, who runs a Facebook group for people with weakened immune systems, said that testing has become more important since the mask requirement went away. Without a testing requirement, most travelers are not going to bother to test or stay home, even if they suspect that they are infected, she said.

“Judging by the past two years, the only way to protect others is some type of enforced testing,” she said, because “the moral compass points directly to self.”

Dr. Seema Yasmin, a public health doctor and the director of the Stanford Health Communication Initiative, echoed this point. “I would say that it can give a high level of reassurance when 75 percent of people are not wearing a mask and might even be coughing and sneezing loudly,” Dr. Yasmin said.

(Though airplane ventilation systems appear to significantly mitigate spread of the coronavirus, research suggests that people sitting within a few rows still pose a risk to one another.)

“Some testing is better than none,” said Nathaniel Hafer, a molecular biologist at the UMass Chan Medical School.

Many countries also use testing to incentivize vaccination by waiving the requirement for vaccinated people, said Meghan Benton, a research director at the Migration Policy Institute, which tracks travel requirements. The United States encourages vaccination in its own way by prohibiting most unvaccinated visitors from abroad from entering.

Could a lawsuit end testing the way it did the mask mandate?

Given that there are currently at least four pending lawsuits that challenge the international testing requirement, some wonder whether it might be struck down by a judge’s decision, as the requirement to wear a mask on airplanes and other forms of transport was in April.

Lawrence O. Gostin, a professor of global health law at Georgetown Law, does not think so. The C.D.C. can require testing from visitors entering the country from abroad because of the Public Health Service Act, which was explicitly created to prevent the introduction of dangerous infectious diseases in the United States, he said.

The rule, he said, “would be exceedingly difficult to successfully challenge in the courts, even for the most conservative judges.”

Follow New York Times Travel on Instagram, Twitter and Facebook. And sign up for our weekly Travel Dispatch newsletter to receive expert tips on traveling smarter and inspiration for your next vacation. Dreaming up a future getaway or just armchair traveling? Check out our 52 Places for a Changed World for 2022.

Correction: 
May 20, 2022

An earlier version of this article misspelled the surname of the chair of lab medicine and pathology at the Mayo Clinic. It is Dr. William Morice, not Omrice.

Here’s how Title 42, used as a pandemic restriction, has affected migrants at the southern U.S. border.

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Credit...Adriana Zehbrauskas for The New York Times

NOGALES, Mexico — Guadalupe Garcia crossed the border into Arizona with her 11-year-old daughter early this year, saying she was fleeing the brutal beatings she was suffering at the hands of her husband in Guatemala. The Border Patrol informed her that the United States was not open for asylum, and quickly put the pair on a bus back to Mexico.

Five months later, Ms. Garcia and her daughter are still in the Mexican border city of Nogales, where she has found work at a restaurant. “We are waiting patiently for the U.S. to open,” she said on a recent day while filling orders for breaded chicken, enchiladas and tacos. Isilda was in a side room, making collages from magazine cutouts while her mother worked.

San Juan Bosco, a shelter in Nogales, where the two are staying, has hosted many migrants for “five, six, even 10 months,” said Maria Antonia Diaz, a longtime volunteer. They are among tens of thousands of migrants lingering now in Mexican outposts — some who have taken jobs and rented apartments — waiting for the day, expected soon, when the United States fully opens its doors again to asylum seekers.

The situation on the southern border is reaching a critical stage, according to federal and state officials who must accommodate the incoming migrants. Even before the scheduled lifting next week of the Title 42 public health rule, which has allowed the government to swiftly expel nearly two million migrants over the past two years, U.S. Border Patrol agents are encountering near-record numbers of people who either crossed on their own or were allowed to enter under various Title 42 exemptions.

A total of 234,088 migrants crossed the southern border in April, topping March’s 22-year high of 221,444, including a record 34,821 from Cuba and 20,118 from Ukraine. Lifting Title 42 could send an even bigger surge of up to 18,000 migrants a day, administration officials say.

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Credit...Adriana Zehbrauskas for The New York Times
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Credit...Adriana Zehbrauskas for The New York Times

Though a federal court could temporarily halt the lifting of the public health order — postponing the day of reckoning — the key challenge for the Biden administration in the coming months is finding a way to deter the thousands of migrants who head for the United States not because of imminent threats of violence or persecution — threats which the United States is legally and morally obligated to address — but in search of jobs and a better future.

The official intent of Title 42, originally put in place under the Trump administration, was to slow the transmission of the coronavirus across the border. But it quickly became a powerful tool to slow immigration.

“There has never been a public health justification for using Title 42 authority in the battle to contain Covid-19,” said Wayne Cornelius, director emeritus of the Center for Comparative Immigration Studies at the University of California, San Diego.

“It was an obscure rule,” he said, “part of a multipronged effort to curb immigration to the U.S.”

The Biden administration has faced pressure from progressives to halt the expulsions and offer refuge to migrants who have legitimate claims of persecution in their home countries. It announced in April that the order would be lifted on May 23, with stepped-up plans to handle the new arrivals. But the large number of migrants predicted to cross in the weeks after the order is lifted has given pause, with even some Democrats advocating a go-slow approach.

Whether the policy is terminated next week or not, the United States is likely to see large numbers of people at the border for the foreseeable future. Turmoil around the globe is pushing migrants from Venezuela to Colombia; from Nicaragua to Costa Rica; and from everywhere near and far to the United States, where jobs are plentiful and prosperity and security seem within reach.

“Despite who is in charge and what policies are in place, there are global and regional forces that are going to lead to a continuation of migration,” said Eileen Díaz McConnell, professor of global migration at Arizona State University. These forces, she said, include climate change, economic and political upheaval, organized crime and domestic abuse, as well as the fallout from the global health crisis.

To handle the expected surge, the Homeland Security Department has unveiled a plan to focus new resources on the border, and Alejandro N. Mayorkas, the agency’s chief, has vowed that people without a legal basis for entering the country will face detention, deportation and other consequences that have been frozen during Title 42.

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Credit...Tamir Kalifa for The New York Times
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Credit...Tamir Kalifa for The New York Times

A new program to adjudicate border asylum cases within one year, rather than through the backlogged immigration courts that often take six to eight years, aims to discourage families with weak claims from journeying north.

“We are elevating the enforcement consequences we bring to bear on individuals who don’t qualify” to remain in the United States under the law, Mr. Mayorkas said during a visit to the Rio Grande Valley in Texas on Tuesday.

Any U.S. effort to prevent an overwhelming influx will depend on how well countries throughout the region, especially Mexico and Guatemala, manage their borders. Migrants from around the world travel through those countries en route to the United States. Mexico also plays a crucial role in deciding which migrants it takes back after their expulsion from the United States.

In April, more than four out of 10 border encounters by agents were with migrants from countries beyond Mexico and Central America’s Northern Triangle, an unprecedented share. And many have been allowed to enter the United States despite Title 42, which has excluded about 60 percent of the migrants who crossed the border since it took effect in 2020.

On a recent day, three busloads packed with male migrants, mainly from India, Senegal and Georgia, arrived at Casa Alitas shelter in Tucson within a three-hour span. Most of them had spent a few days in detention and then had been released with ankle monitors and orders to report to court later for deportation hearings.

Among those standing in line for assistance booking tickets to destinations across the country was Bassir, 30. He had flown from Senegal to Brazil, where he began a trek over land to reach the Mexico-Arizona border, he said. As he traversed the Darien Gap, a lawless stretch of jungle near the border of Colombia and Panama, bandits put a pistol to his head, and stole his watch and $350. But after being intercepted by border agents and spending a few days in detention, he was finally looking at a chance to get a job in the United States, only wondering aloud, “How long will they keep this thing on my foot?”

A 20-year-old man named Preet Singh, headed for Los Angeles, said that his parents in India had paid $16,000 to guides who ferried him through Europe and Mexico to the United States.

The numbers at the U.S. border reflect an escalating range of global tumult that increasingly has ended up at America’s door, said Adam Isacson, a scholar at the Washington Office on Latin America, who started studying the border in 2000.

“The world cratered during the pandemic,” Mr. Isacson said, “and this internationalization of crossers intensified.”

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Credit...Tamir Kalifa for The New York Times
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Credit...Adriana Zehbrauskas for The New York Times

It is a trend unlikely to reverse. “There is little reason to think the world will become more stable, peaceful and prosperous in the next 10 years,” he said.

Because the rapid expulsions under Title 42 have enabled many single adults to make repeated tries until they succeed in eluding U.S. border authorities, administration officials have predicted that the total number of encounters by agents could decline after Title 42 is rescinded, despite the expected arrival of thousands of new asylum seekers who have been waiting on the other side.

But deterring large numbers of people from arriving with dubious asylum claims will be one of the central challenges in the months after Title 42 is lifted. Even if many claims are quickly rejected under the administration’s new fast-track policies, it will take time for word to get back that people are being denied protection and deported. And any messaging by the U.S. government will compete with that of a sophisticated smuggling industry that adapts quickly to shifting policies.

“It’s not just individual migrants; there is a system that responds to policy changes,” said Professor Díaz McConnell of Arizona State.

The only certainty is that the longer it takes for Title 42 to be lifted, the more migrants will amass on the Mexican side, creating a bottleneck that raises the potential for overcrowding and disruption when it ultimately ends.

A Mexican woman named Betzaida and her three children are among hundreds or more displaced families from Guerrero, a Mexican state convulsed by cartel violence, who have been waiting in Nogales for Title 42 to end. The family is renting an apartment and receiving assistance from the Kino Border Initiative, a nonprofit that provides meals, clothes and legal services to migrants.

“We never considered leaving Mexico. We had a stable life,” said Betzaida, who did not want her last name published out of fears for her safety. That changed, she said, when gang members, determined to seize their property, kidnapped and beat her husband unconscious. “All we want to do is disappear from Mexico so that they can’t find us,” she said.

Similar scenes are playing out in Mexican border towns from the Pacific Coast to the Gulf of Mexico.

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Credit...Tamir Kalifa for The New York Times
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Credit...Tamir Kalifa for The New York Times

Magdala Jean, 33, and her husband came from Haiti. They have been waiting with thousands of other migrants in the cartel-controlled border city of Reynosa, across from McAllen, Texas.

In Port-au-Prince, they said, they felt unsafe amid a spate of shootouts by gangs that now control broad swaths of the capital. They also could not find jobs. Camping out in Mexico has been their best option, she said.

“We want to wait, so that we’re not turned back,” she said.

About 280 miles away, in the small town of Piedras Negras, Mexico, men, women and children in tattered clothes trickled into Primera Iglesia Bautista, a shelter in a nondescript building a block from the international bridge leading to Eagle Pass, Texas. They said that there were many people behind them.

Israel Rodriguez, the pastor at the shelter, said that not only have more people been arriving in the past few weeks, but also they are coming from different countries than in the past.

“People will continue coming. It’s the oldest story,” he said. “They have crossed mountains, lakes and rivers and they are not going to turn back because a law is lifted or added. Nothing stops them.”

Eileen Sullivan and Edgar Sandoval contributed reporting.

The world is as vulnerable as ever to pandemics, an expert panel concludes.

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Credit...Atul Loke for The New York Times

Governments around the world are no better prepared today to address a new global disease threat than they were just before the coronavirus outbreak began in late 2019, a World Health Organization panel concluded in a report released on Wednesday.

The Independent Panel for Pandemic Preparedness and Response has sought an overhaul of the world’s approach to outbreaks, which it considers outdated and inadequate. The group, established in July 2020, made recommendations last year for improving political leadership, financing and surveillance systems. But it appears that little has changed since then.

“One year on, and political focus to prepare for more waves is flagging,” wrote the authors, led by Helen Clark, the former New Zealand prime minister; and Ellen Johnson Sirleaf, the former president of Liberia. “Work has begun to prevent the next pandemic, but at the current pace, the transformative change required will take years to complete.”

The report was released ahead of the World Health Organization’s annual policymaking forum, the World Health Assembly, which is starting next week in Geneva. It echoes a report released late last year that said the world remained “dangerously unprepared” for the next major disease outbreak.

The authors of the new report zeroed in on the uneven distribution of vaccines around the world as one of the major hurdles to overcome. The issue is highlighted by the unfolding coronavirus crisis in North Korea, one of two countries — the other is Eritrea — that have not yet begun vaccinating their residents. North Korea said the number of suspected coronavirus infections had neared 1.5 million on Tuesday.

W.H.O. officials in Geneva told reporters on Tuesday that uncontrolled transmission of the virus could allow new variants to arise, a point that was reiterated by the panel’s new report.

“Variants may still emerge that our vaccines cannot manage,” the panel wrote. “The more quickly we vaccinate now, the less likelihood there is of ever more variants emerging.”

The panel is pushing to expand the development and supply of therapeutics and diagnostic tests.

It noted that all told, high-income countries had obtained enough Covid vaccine doses to vaccinate their entire populations twice over, through direct deals with vaccine manufacturers to buy existing supplies and future output. That left many low- and middle-income countries without adequate vaccine supplies.

Fewer than 13 percent of people in low-income countries are considered fully vaccinated against Covid-19, the report said.

Germany announced plans on Wednesday to spend another $870 million to buy more vaccines to prepare for possible new variants this fall. About 80 percent of Germans are vaccinated, according to the Our World in Data project at the University of Oxford.

Vaccine production is now at its limit, the panel said, adding that new manufacturing capacity for mRNA and other vaccines must urgently be built in Africa, Latin America and other low- and middle-income regions. “Boosting production takes time, so enabling it must begin now,” the report said.

The panel applauded President Biden’s second Covid-19 summit, held virtually last week. But it said that “a ‘charity’ approach is not serving the interests of ending this pandemic or tackling future pandemic threats.”

A man in Japan gambled away his town’s Covid relief fund.

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Credit...Kyodo News, via Getty Images

TOKYO — Residents of a rural Japanese town were each looking forward to receiving a $775 payment last month as part of a coronavirus pandemic stimulus program.

But a municipal official mistakenly wired the town of Abu’s entire Covid relief budget, nearly $360,000, to a single recipient on the list of low-income households eligible to receive the money. After promising to return the accidental payment, the police said, the man gambled it away.

The man, Sho Taguchi, 24, told the police that he had lost the money in online casinos, a police official in Yamaguchi Prefecture said by phone on Thursday. The day before, the authorities arrested Mr. Taguchi, the official said. The charge: fraud.

Japan is not the only country where coronavirus relief money has been misappropriated. The fraud has been so widespread in the United States that the Justice Department recently appointed a prosecutor to go after it. People have been accused of buying a Pokémon card, a Lamborghini and other luxuries.

But Abu, population 2,952, may be the only town on earth where an entire Covid stimulus fund has vanished at the hands of an online gambler who received it through administrative error. The details of the case, and the rare attention from Japan’s national news media, have come as a shock to residents of the seaside town.

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By The New York Times

“I was surprised to hear the news and also amazed at how he spent the money,” said Yuriko Suekawa, 72, who has lived in Abu since she was born. “It’s truly unbelievable.”

The tale began on April 8, when an official in Abu mistakenly asked a local bank to wire Mr. Taguchi 46.3 million yen, or about $358,000, said Atsushi Nohara, a town official. Mr. Taguchi’s name had been at the top of the list of 463 households that were each eligible for 100,000 yen as part of a national stimulus package.

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Credit...Kyodo News, via Getty Images

After Abu officials realized the mistake, they immediately visited Mr. Taguchi and asked for the money back, the town’s mayor, Norihiko Hanada, said in an address on the town’s YouTube channel.

Mr. Taguchi agreed to travel with the officials to his bank in a government car, but he refused to enter the building and later said that he planned to consult a lawyer, according to the public broadcaster NHK. Mr. Taguchi met with Abu’s deputy mayor on April 14, NHK reported, and his lawyer told the town the next day that his client would return the money.

“But he ultimately did not do so,” Mr. Hanada said on YouTube. He said Mr. Taguchi eventually told town officials that he had spent the 46.3 million yen, would not run away and planned to “atone for the sin.”

Mr. Hanada has apologized to residents on behalf of the town for losing “such a precious and a large amount of public funds.”

“The arrest will help us to get closer to knowing the truth,” he said on Thursday. “His testimony will give us a steppingstone to retrieving the money.”

Masaki Kamei, a prosecutor in the city of Osaka, said that Abu officials were to blame for allowing Mr. Taguchi to drain the town’s Covid relief fund.

“The town’s approach was not strict enough, and it allowed the case to develop to this point,” Mr. Kamei said. “Maybe their approach was based on a view of human nature as fundamentally good.”

Abu sits about 100 miles north of the nearest major city, Fukuoka, in an area of Yamaguchi Prefecture where agriculture, fishing and forestry drive the economy. Mr. Taguchi moved there about a year and a half ago as part of a program in which the local government offers subsidies to outsiders who move in and rent unoccupied homes, said Mr. Nohara, the town official.

After the error, town officials sent Covid relief payments to the local households, Mr. Nohara said, adding that the money had come from another municipal source. He did not elaborate.

Ms. Suekawa, the Abu resident, said the episode was a misfortune for a town that had successfully weathered the pandemic and hoped to attract visitors to its newly built seaside campground.

“I hope this negative image of the town will ease and that it will once again become a sunny and quiet place,” she said. “Anyone makes a mistake, so I don’t blame this man for that, but I would like him to admit his crime and give us our money back.”

In any event, Mr. Nohara said, Abu sued Mr. Taguchi last week for about 51 million yen, including legal fees.

Hisako Ueno reported from Tokyo, and Mike Ives from Seoul.

Health officials in parts of the U.S. see signals in wastewater data hinting at a worsening virus wave.

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Credit...Michael B. Thomas for The New York Times

Health officials in several parts of the United States are seeing worrisome signals in wastewater surveillance data that the coronavirus may be spreading more widely than recent tallies of new cases would indicate, and that a steeper wave may be coming.

Wastewater surveillance provides only a broad-brush picture of virus prevalence in a particular community, but the readings it gives are close to real-time and do not depend on people seeking tests and reporting results. So health officials are looking to wastewater data for early warning of trends. And in some places, those warnings are flashing red.

The data has been like a “canary in a coal mine” for New Orleans, said Dr. Jennifer Avegno, the head of the city’s health department.

Case counts are a “gross underrepresentation,” as many people are opting to take at-home tests instead of going to hospitals or doctors’ offices. Dr. Avegno said the rising prevalence of virus seen in wastewater testing has prompted the city to begin mobilizing resources to prepare for another spike.

Although the city is not considering reinstating mandates, it is preparing in other ways. City officials have begun planning mask giveaways and are stepping up their campaign to encourage residents to get vaccinated and boosted.

New-case counts in the city are averaging 155 a day, five times the rate of a month ago, and wastewater tests show increased coronavirus concentrations in both residential and tourist areas.

“It looks like a surge in slow motion,” Dr. Avegno said. “It’s not the sharp increase we saw with Delta and definitely not with Omicron,” she added.

Houston is another city where wastewater data has been showing ominous signs of increasing infections.

“I don’t know if it’s going to be the magnitude that we saw in the previous surge, but I definitely think we’re starting to see more community infections,” Lauren Stadler, who manages wastewater collection and analysis at Rice University, said in an interview on Thursday.

Harris County, where the city of Houston is, has seen a 175 percent increases in cases in the last two weeks, according to a New York Times database.

Dr. Stadler said that health officials in the city are trying to use the wastewater data to decide what a surge looks like these days.

“I definitely think the wastewater is telling us it’s spreading in the community. But does that mean we’re going to see a surge in hospitals? What does that mean in terms of, like, severity of disease,” Dr. Stadler said. She added that wastewater collection also makes it hard to know who exactly is getting infected, since the data is less individualized.

Scott W. Long, medical director of diagnostic microbiology at Houston Methodist Hospital, said he hoped that people would begin to take more precautions to lessen the severity of the surge in Houston.

“In my personal day-to-day, I know I’ll be masking more outside of work and while traveling,” he said.

In Maine, state health officials have been seeing a surge “for a while,” Mike Abbott, a lead analysts on wastewater screening for the Maine Center for Disease Control and Prevention, said on Thursday. He noted that the increase in cases began in mid-April, with the incline getting steeper in May.

A New York Times database shows that the Maine recorded a sharp upward trend in cases the last week of April and into May that reached levels the state saw during the Delta surge at the end of August.

“We’ve been riding that surge,” Mr. Abbott said. “Now, as far as what’s going to happen next and what we’re worried about, I mean, certainly we’re hoping this isn’t the beginning of a surge similar to what we saw in January with the original variant.”

Experts maintain that the best way to combat surges and protect yourself against the virus is to to be vaccinated.

“My take home advice for people is vaccines are still our best defense. Get boosted if you’re due for one,” Dr. Long said.

Correction: 
May 20, 2022

An earlier version of this article misspelled the surname of the head of the New Orleans health department. She is Jennifer Avegno, not Avengo. Also, an earlier version of a picture caption with the article misstated the year the picture was taken. It was May 2021, not May 2022.

Here’s why Adams is rejecting mask mandates as coronavirus cases rise in New York City.

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Credit...Amir Hamja for The New York Times

In what was a typically busy week for Mayor Eric Adams, he met with the model Gigi Hadid at Netflix’s studio in Brooklyn. He visited a college to promote a new degree in video game design. And he visited the State Capitol in Albany to push for the renewal of mayoral control of schools.

But as New York City entered the high risk level for the coronavirus, Mr. Adams did not hold any public events to warn residents about the surge in cases.

Mr. Adams has insisted that he would not bring back mask and vaccine mandates and would instead focus on antiviral treatments and at-home testing.

While many American cities long ago jettisoned public health precautions, New York City and other Democrat-led cities like Los Angeles and Philadelphia had taken a more cautious approach to combating waves of the virus. Now, even as cases and hospitalizations rise again, those cities may resemble the rest of the nation by focusing on a return to normalcy and personal responsibility.

In New York, rather than raising alarm about the city’s heightened risk level, Mr. Adams has repeatedly emphasized that his infection in April was mild, in part because he took the antiviral Paxlovid.

“I think that the reason we are here and we are not seeing drastic actions is because we’ve done an amazing job of telling people — vaccines, boosters,” Mr. Adams said at a recent news conference. “When I was hit with Covid, it was just a tickle in my throat. I was still able to exercise, didn’t have any breathing issues, no pain.”

Mr. Adams, a Democrat who took office in January, appears to be weighing several factors: He has not called for mandates because hospitalizations and deaths have risen more slowly than in previous waves, because of a possible political cost to embracing restrictions that have fatigued the public, and because he is concerned about the impact on restaurants, tourism and the city’s economic comeback.

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Credit...David Dee Delgado/Getty Images

But some health experts have criticized the mayor’s approach and fear that letting the virus spread broadly could hurt the city’s most vulnerable residents. They believe the city should bring back mask and vaccine mandates, but acknowledge that it would be politically difficult to do so.

The city is now logging more than 4,000 cases per day, a figure that is likely much higher because most home tests are not counted in the official tally. As of Tuesday, more than 770 people in the city were hospitalized with Covid and 84 were in I.C.U.s.

Mr. Adams said this week that he did not plan to bring back mandates unless the hospital system was reaching a “state of emergency,” or trending in that direction. The new alert system Mr. Adams approved in March recommends instituting a mask mandate for public indoor settings at the current risk level.

Health experts have argued that waiting until hospitals and health workers are overwhelmed would be too late. Some elected officials like Mark Levine, the Manhattan borough president, support bringing back a mask mandate for most public indoor settings.

“I want this to be a city that can turn on and off protective measures when we hit a surge,” Mr. Levine said. “I would like to see us do more and push harder right now.”

On a call on Thursday with Anne Williams-Isom, one of Mr. Adams’s deputy mayors, community groups and disability advocates expressed strong support for a mask mandate for indoor spaces, according to someone who participated in the call. Ms. Williams-Isom said she would convey their message to the mayor.

Mr. Adams’s approach mirrors the tone of other leaders like Gov. Kathy Hochul and President Biden who are eager to move past the pandemic and to focus on economic recovery. Gov. Philip D. Murphy in New Jersey has also resisted bringing back mandates and removed a mask mandate on New Jersey Transit trains that travel into the city.

Ms. Hochul, who recently tested positive for the virus, has kept a mask mandate on public transit in place, but she has not set broader restrictions despite a major surge in upstate New York. Ms. Hochul faces an additional political calculation — she is in the middle of her campaign for a full term as governor and needs support from more conservative corners of the state.

Many business leaders support the mayor’s approach, including Kathryn Wylde, president of the Partnership for New York City, an influential business group.

“New Yorkers have demonstrated that they have the good sense to follow safety protocols, including masks where it’s appropriate,” she said. “To reverse progress made on reopening the city would be a blow to the recovery but also seems unnecessary at this point.”

The city’s health commissioner, Dr. Ashwin Vasan, issued an order on Monday strongly recommending that all residents wear medical-grade masks in offices, grocery stores, schools and other public indoor settings citywide. A day later, he announced that the city had hit the high alert level, which was triggered by rising hospital admissions.

Mr. Adams said the city was settling into a “new norm” as variants arrive.

“If every variant that comes, we move into shutdown thoughts, we move into panicking, we’re not going to function as a city,” Mr. Adams said on Wednesday.

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But former Mayor Bill de Blasio and his health commissioner, Dr. Dave Chokshi, who stayed on during the first months of the Adams administration and crafted the new alert system in March, have made public comments encouraging Mr. Adams to be prepared to return to mandates.

“I’d say this as a friendly reminder to keep those strong tools available,” Mr. de Blasio said in a radio interview last week. “You may need them real soon.”

Mr. de Blasio, who oversaw the city’s response during the worst waves of the virus, held near-daily virtual virus briefings, sometimes inviting outside health experts like Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at the Columbia Mailman School of Public Health, and Dr. Celine Gounder, an infectious disease expert at New York University. He rolled out some of the most aggressive health measures in the country, including a vaccine mandate for city workers and private employers that is still in effect.

Mr. Adams has relied on a handful of key advisers to form his virus response: Dr. Vasan, an epidemiologist who formerly led a mental health nonprofit; Dr. Mitchell Katz, the head of the city’s hospital system; Ms. Williams-Isom, deputy mayor for health and human services; Dan Weisberg, first deputy schools chancellor; and Dr. Ted Long, executive director of the city’s test and trace corps. The group meets nearly every morning on a virtual call to discuss the latest data.

Mr. Adams said that the message from hospital and school leaders was clear: “They’re all saying the same thing. They say, ‘Listen, we got this. We’re not overwhelmed.’”

But Dr. Chokshi, the former health commissioner, said in a recent interview that during each new wave of cases in the city, elected officials and New Yorkers often had “collective amnesia” about how to respond.

“People would say, ‘Well, it’s only cases increasing, let’s see what happens to hospitalizations,’” he said. “To me, as someone who’s steeped in this, and particularly to understand the epidemiology, it’s hard not to have your head explode when you feel the public, and in many cases, the political conversation, go in those circles. And you’re like, ‘Wow, when are we going to learn.’”

Some health experts agreed that it would be difficult at this point in the pandemic to reinstate broad mandates unless the health system became seriously overtaxed. At the same time, having an alert system but not following through on its recommendations can confuse the public and weaken trust, particularly if the change is not carefully explained.

“It absolutely makes sense to pick a set of indicators and use that to decide what steps you’ll take,” said Dr. Jay Varma, who served as a senior health adviser to Mr. de Blasio. “There is value to putting out a weather report, but you have to be clear about how you’re using it.”

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Credit...Dave Sanders for The New York Times

Short of mandates, several experts said, the Adams administration should be doing more to convince people of the gravity of the current moment, even among those vaccinated and not personally afraid of dying from the virus. For example, a refreshed public health campaign could focus on the importance of wearing masks to protect the vulnerable, the risks of long Covid or the increased risk of cardiovascular disease after Covid-19.

Mr. Adams has focused on offering free home delivery of antiviral medications like Paxlovid and distributing millions of home tests to public school students and at libraries and museums. His administration says it has distributed 35,000 antiviral treatments, which have prevented nearly 2,000 hospitalizations.

The city has led the nation in vaccination rates, but booster rates have stalled. An estimated 88 percent of adults in the city are fully vaccinated; only 46 percent have received a booster dose.

New Yorkers who have disabilities and weakened immune systems worry that the city’s new approach is not keeping them safe. Emily Ladau, a disability rights advocate who lives on Long Island and frequently visits the city, said that few people are wearing masks because the mayor had not clearly delivered the message that they are important.

“There’s a huge difference between masking and a lockdown,” she said. “I don’t think it should be that hard to put a mask on and protect the people around you.”

Joseph Goldstein, Sharon Otterman and Dana Rubinstein contributed reporting.