Burden on U.S. Hospitals Eases as Covid-19 Cases Decline
The United States reached a staggering milestone on Monday, surpassing 500,000 known coronavirus-related deaths in a pandemic that has lasted almost a year. The nation’s total virus toll is higher than in any other country in the world. It has far surpassed early predictions of loss by some federal experts. And it means that more Americans have died from Covid-19 than did on the battlefields of World War I, World War II and the Vietnam War combined.
“The magnitude of it is just horrifying,” said Jeffrey Shaman, a professor of environmental health sciences at Columbia University who has modeled the virus’s spread and says that the scale of loss was not inevitable, but a result of the failure to control the virus’s spread in the United States.
The United States accounts for about 20 percent of the world’s known coronavirus-related deaths, but makes up just 4.25 percent of the global population.
About one in 670 Americans has died of Covid-19, which has become a leading cause of death in the country, along with heart disease and cancer, and has driven down life expectancy more sharply than in decades. The losses have been searingly personal for the relatives and friends of the 500,000.
“It never goes away,” the Rev. Ezra Jones of Chicago said of his grief for his uncle, Moses Jones, who died of the coronavirus in April.
The harrowing milestone comes amid hopeful news: New virus cases and deaths have slowed dramatically, and vaccine distribution has gradually picked up pace. But uncertainty remains about emerging virus variants, some more contagious and possibly more lethal, so it may be months before the pandemic is contained. Scientists say the trajectory of the U.S. death toll will depend on the speed of vaccinations, the effects of the variants and how closely people stick to guidelines like mask-wearing and social distancing.
Last March, in the early days of the pandemic, Dr. Anthony S. Fauci, the nation’s top infectious disease expert, and Dr. Deborah L. Birx, the official coordinating the coronavirus response at the time, projected that even with strict stay-at-home orders, the virus might kill as many as 240,000 Americans — a number that seemed unimaginable at the time.
“As sobering a number as that is, we should be prepared for it,” Dr. Fauci said at the time.
Less than a year later, the virus has killed more than twice that number.
U.S. deaths from Covid-19 came faster as the pandemic wore on. The country’s first known Covid-19 death occurred in Santa Clara County, Calif., on Feb. 6, 2020, and by the end of May, 100,000 people had died. It took four months for the nation to log another 100,000 deaths; the next, about three months; the next, just five weeks.
The virus has reached every corner of America, devastating dense cities and rural counties alike through surges that barreled through one region and then another.
In New York City, more than 28,000 people have died of the virus — or roughly one in 295 people. In Los Angeles County, the toll is about one in 500 people. In Lamb County, Texas, where 13,000 people live scattered on a sprawling expanse of 1,000 square miles, the loss is one in 163 people.
The virus has torn through nursing homes and other long-term care facilities, spreading easily among vulnerable residents: They account for more than 163,000 deaths, about one-third of the country’s total.
Virus deaths also have disproportionately affected Americans along racial lines. Over all, the death rate for Black Americans with Covid-19 has been almost two times higher than for white Americans, according to the Centers for Disease Control and Prevention; the death rate for Hispanics was 2.3 times higher than for white Americans. And for Native Americans, it was 2.4 times higher.
By Monday, about 1,900 Covid deaths were being reported, on average, most days — down from more than 3,300 at peak points in January. The slowing came as a relief, but scientists said variants made it difficult to project the future of the pandemic, and historians cautioned against turning away from the scale of the country’s losses.
“There will be a real drive to say, ‘Look how well we’re doing,’” said Nancy Bristow, chair of the history department at the University of Puget Sound in Tacoma, Wash., and author of “American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic.” But she warned against inclinations now to “rewrite this story into another story of American triumph.”
President Biden and Vice President Kamala Harris, surrounded by candles going up to a balcony on the White House South Lawn, bowed their heads in a moment of silence, as the U.S. Covid-19 death toll topped 500,000 Monday evening.
In the ceremony to remember those who died of the coronavirus — the second memorial service Mr. Biden has held — he urged Americans to remember everyone who died and he instilled hope toward healing.
“We often hear people described as ordinary Americans,” Mr. Biden said in a televised address before the ceremony. “There’s nothing ordinary about them. The people we lost were extraordinary, they span generations, born in America and immigrated to America. But just like that, so many of them took their final breath alone in America.”
Mr. Biden also called for lowering federal flags to half-staff for the next five days, to mark the somber milestone, which he compared with the number of Americans who died in both world wars and the Vietnam War combined.
Mr. Biden often talks about his grief and has been known to bond with people over the losses he has endured. His son Beau died in May 2015 at the age of 46, and his first wife and baby daughter died in a car accident in 1972.
On the eve of Mr. Biden’s inauguration, he held a national mourning ceremony at the Reflecting Pool by the Lincoln Memorial for the 400,000 people who had then died from the virus. The pool was surrounded by a symbolic 400 lights.
Even as the number of deaths each day remains high, there are signs of improvement across the country. Since mid-January, the number of U.S. hospitalizations has steadily and swiftly declined. And the number of new cases has decreased more than 40 percent over the past two weeks and is down 70 percent since its high point on Jan. 8, according to a New York Times database.
Experts credit the declines, in part, to widespread mask wearing, social distancing and vaccinations. About 12 percent of people in the country have received at least one vaccine dose, and about 5 percent are fully vaccinated.
At a news briefing before the memorial ceremony, Andy Slavitt, a White House pandemic adviser, said the grim milestone makes the administration “more determined to turn the tide on Covid-19 so the losses can subside and the healing can begin.”
“As a nation, we can’t accept such a cruel fate,” Mr. Biden said in his speech before the moment of silence among the candles.
“This nation will smile again,” he added. “This nation will know sunny days again. This nation will know joy again. And as we do, we’ll remember each person we lost, the lives they lived and the loved ones they’ve left behind. We will get through this. I promise you.”
The enormous scale of illness and death wrought by the coronavirus is traced in figures that have grown so far beyond the familiar yardsticks of daily life that they can sometimes be difficult to get a handle on.
The news on Monday that the United States had recorded 500,000 Covid-19-related deaths in just a year is just the latest example.
One way to put that in context is to compare it to other major causes of death in 2019, the year before the pandemic took hold in the country.
500,000 deaths is …
Three times the number of people who died in the U.S. in any kind of accident, including highway accidents, in 2019 (167,127).
More than eight times the number of deaths from influenza and pneumonia (59,120).
More than 10 times the number of suicides (48,344).
More than the number of deaths from strokes, diabetes, kidney disease, Alzheimer’s and related causes, combined (406,161).
Only heart disease (655,381) and cancer (599,274) caused more deaths.
When full data for 2020 is available from the Centers for Disease Control and Prevention, Covid-19 will certainly be one of the leading killers. But trying to project where it will rank may be complicated. A very large share of deaths from Covid-19 have been people who were medically vulnerable because of other significant health problems like cancer, lung or heart disease. Some number of them would probably have succumbed to those causes, and been counted in those categories, if their deaths had not been hastened by Covid-19.
LONDON — Prime Minister Boris Johnson of Britain said Monday that schools in England would reopen on March 8 and that people would be allowed to socialize outdoors starting on March 29, the tentative first steps in a long-awaited plan to ease a nationwide lockdown prompted by a highly contagious variant of the coronavirus.
Mr. Johnson’s “road map” was intended to give an exhausted country a path back to normalcy after a dire period in which infections skyrocketed and hospitals overflowed with patients. At the same time, Britain rolled out a remarkably successful vaccination program, injecting 17 million people with their first doses.
That milestone, combined with a decline in new cases and hospital admissions, paved the way for Mr. Johnson’s announcement. But the prime minister emphasized repeatedly that he planned to move slowly in reopening the economy, saying that he wanted this lockdown to be the last the nation had to endure.
Under the government’s plan, pubs, restaurants, retail shops and gyms in England will stay closed for at least another month — meaning that, as a practical matter, daily life will not change much for millions of people until the spring.
“We’re setting out on what I hope is a one-way journey to freedom,” Mr. Johnson said in a statement to the House of Commons. “This journey is made possible by the success of the vaccine program.”
The specific timetable, Mr. Johnson said, will hinge on four factors: the continued success of the vaccine rollout; evidence that vaccines are reducing hospital admissions and deaths; no new surge in cases that would tax the health service; and no sudden risk from new variants of the virus.
“At every stage,” the prime minister said, “our decisions will led by data, not dates.”
Mr. Johnson was scheduled to present the plan to the nation in an evening news conference, along with data that he said showed that the two main vaccines — from Pfizer and AstraZeneca — both reduced severe illness.
Mr. Johnson’s appearance in Parliament ended days of speculation about the government’s timetable. But it is likely to kindle a new round of debate about whether Mr. Johnson is easing restrictions fast enough.
With pubs and restaurants not allowed to offer indoor service until May, some members of Mr. Johnson’s Conservative Party are likely to revive their pressure campaign to lift the measures more quickly.
Mr. Johnson, however, appears determined to avoid a repeat of his messy reopening of the economy last May after the first phase of the pandemic.
Then, the government’s message was muddled — workers were urged to go back to their offices but avoid using public transportation — and some initiatives, like subsidizing restaurant meals to bolster the hospitality industry, looked reckless in hindsight.
Under Mr. Johnson’s plan, the current coronavirus restrictions would be lifted in four steps, with a gap of five weeks between steps. That way, the government would have four weeks to analyze the impact of each relaxation and another week’s notice of the changes to the public and businesses.
All the moves would be made throughout England, with no return to the regional differences in rules that applied last year, depending on local infection rates. The government warned that the dates specified are the earliest at which the restrictions would be lifted, and that the steps may happen later.
When students go back to school, they will be regularly tested for the virus while older pupils will be required to wear face masks. Those living in nursing homes will be allowed one regular visitor, but few other restrictions will be lifted.
Starting on March 29, up to six people would be allowed to meet outdoors, including in gardens. Outdoor sports will be permitted and though people will be urged to stay in their areas, they will not be urged to remain in their homes.
Then, no earlier than April 12, retail shops will reopen, along with hairdressers, beauty salons, gyms, museums and libraries, while people will be able to eat and drink outside in pub and restaurant gardens in small groups.
Starting on May 17, up to six people, and groups drawn from two households, will be able to meet indoors, including in pubs and restaurants. Hotels will also be able to reopen and spectators will be allowed into sporting events in limited numbers.
Restrictions on foreign travel could also be eased, though that will be addressed by one of several policy reviews being launched by the government. These will also focus on the possible use of vaccine passports to help open up the economy, and on guidance and rules on social distancing measures such as the use of face masks.
A White House official said Monday that it expects all doses of the vaccine delayed by recent extreme weather to be delivered by the middle of this week.
“Today alone, we plan to deliver seven million doses,” Andy Slavitt, a White House pandemic adviser, said at a news briefing on Monday afternoon. That number is a combination of normal distribution and backlogged doses delayed by weather last week. On Friday, the White House said that six million doses had been held up because of winter storms across the country.
Among other efforts, Mr. Slavitt cited expanded weekend hours at McKesson, the medical distribution company that has contracted with the federal government to deliver vaccination supplies.
Winter storms delayed efforts to maintain and increase the pace of vaccinations. About 1.52 million vaccine doses were being administered per day last week, according to a New York Times database. Although that is still above President Biden’s target, it was the lowest rate since Feb. 8.
Shipping delays last week left New York City with fewer than 1,000 first doses of a coronavirus vaccine on hand, but the city expects to get a new shipment on Monday, Mayor Bill de Blasio said at a midmorning news conference. All the doses the city had been expecting last week should arrive by Wednesday, officials said.
The stall in deliveries interrupted the city’s vaccination effort, with officials halting the scheduling of appointments as they awaited fresh supplies.
“We basically lost a full week in our vaccination efforts,” Mr. de Blasio said.
Texas, where the frigid storm left millions without power and water for a time, has reopened some inoculation sites. The state has been assigned almost 600,000 first doses of the vaccine for the coming week, according to the state health department, up from about 400,000 first doses for the week of Feb. 15.
The White House praised the efforts to ramp up distribution to make up for time lost to the elements. “Progress began as soon as the weather began to improve,” Mr. Slavitt said at the news briefing. “We encourage vaccination sites to follow that same lead of those who are working extended hours to catch up on deliveries by scheduling more appointments to vaccinate the anxious public as quickly as possible.”
Movie theaters in New York City will be permitted to open for the first time in nearly a year on March 5, Gov. Andrew M. Cuomo announced at a news conference on Monday.
The theaters will only be permitted to operate at 25 percent of their maximum capacity, with no more than 50 people per screening. Masks will be mandatory, and theaters must assign seating to patrons to guarantee proper social distancing. Tests for the virus will not be required.
Movie theaters were permitted to open with similar limits in the rest of the state in late October, but New York City was excluded out of concern that the city’s density would hasten the spread of the virus there.
The virus has battered the movie theater industry. In October, the owner of Regal Cinemas, the second-largest cinema chain in the United States, temporarily closed its theaters as Hollywood studios kept postponing releases and cautious audiences were hesitant to return to screenings. AMC Entertainment, the world’s largest movie theater chain, has increasingly edged toward bankruptcy.
The economic effects of the pandemic have been particularly felt in New York City, one of the biggest movie markets in the United States. Theaters in the city closed in mid-March, as the region was becoming an epicenter of the pandemic in the country.
While other indoor businesses, including restaurants, bowling alleys and museums, had been allowed to open in the city, Mr. Cuomo had kept movie theaters closed out of concern that people would be sitting indoors in poorly ventilated theaters for hours, risking the further spread of the virus.
Theaters that open will be required to have enhanced air filtration systems. Public health experts say when considering indoor gatherings, the quality of ventilation is key because the virus is known to spread more easily indoors.
Mr. Cuomo’s announcement was applauded by the National Association of Theater Owners.
“New York City is a major market for moviegoing in the U.S.; reopening there gives confidence to film distributors in setting and holding their theatrical release dates, and is an important step in the recovery of the entire industry,” the association said in a statement.
In a statement, AMC’s chief executive, Adam Aron, said the company would open all 13 of its New York City theaters on March 5.
The move came just days after Mr. Cuomo said that indoor family entertainment centers and places of amusement could reopen statewide, at 25 percent maximum capacity, on March 26. Outdoor amusement parks will be allowed to open with a 33 percent capacity limit in April.
The governor also said that the state was working on guidelines to allow pool and billiards halls to reopen after the state lost a lawsuit from pool hall operators. Those establishments will be allowed to reopen at 50 percent capacity with masks required, he said.
Cases in New York remain high despite climbing down from their January peak. Over the last seven days, the state averaged 38 cases per 100,000 residents each day, as of Sunday. That is the second-highest rate per capita of new cases in the last week in the country, after South Carolina.
The Food and Drug Administration said on Monday that vaccine developers would not need to conduct lengthy randomized controlled trials to evaluate vaccines that have been adapted to target concerning coronavirus variants.
The recommendations, which call for small trials more like what is required for annual flu vaccines, would greatly accelerate the review process at a time when scientists are increasingly anxious about how the variants might slow or reverse progress made against the virus.
The guidance was part of a slate of new documents the agency released on Monday, including others addressing how antibody treatments and diagnostic tests might need to be retooled to respond to the virus variants. Together, they amounted to the federal government’s most detailed acknowledgment of the threat the variants pose to existing vaccines, treatments and tests for the coronavirus and come weeks after the F.D.A.’s acting commissioner, Dr. Janet Woodcock, said the agency was developing a plan.
“We want the American public to know that we are using every tool in our toolbox to fight this pandemic, including pivoting as the virus adapts,” Dr. Woodcock said in a statement Monday.
Most of the vaccine manufacturers with authorized vaccines or candidates in late-stage trials have already announced plans to adjust their products to address the vaccine variants. The Moderna and Pfizer-BioNTech vaccines use mRNA technology that the companies have said can be used to alter the existing vaccines within six weeks, although testing and manufacturing would take longer.
Moderna has already begun developing a new version of its vaccine that could be used as a booster shot against a virus variant that originated in South Africa, known as B.1.351, which seems to dampen the effectiveness of the existing vaccines.
A fast-spreading coronavirus variant first observed in Britain has also gained a worrisome mutation that could make it harder to control with vaccines. That variant with the mutation was found in the United States last week.
Still, the guidance did not appear to be written with the assumption that new vaccines were imminent, or would be needed at all. Despite the recent indications that some variants — and particularly B.1.351 — make the currently authorized vaccines less effective, the shots still offer protection and appear to greatly reduce the severity of the disease, preventing hospitalizations and death.
An updated Covid-19 vaccine can skip the monthslong process of a randomized clinical trial that would compare it with a placebo, the agency said. But a tweaked vaccine will still need to go undergo some testing. In trials proposed by the F.D.A., researchers will draw blood from a relatively small group of volunteers who have been given the adapted vaccine. Scientists will then observe what percentage of volunteers’ samples produce an immune response to the variants in the lab, and how large that response is. The vaccines will be judged acceptable if they produce an immune response that is relatively close to what is prompted by the original vaccines.
The volunteers will also be monitored carefully for side effects. The agency said the testing can be done in a single age group and then extrapolated to other age groups.
The guidance also encouraged the use of animal studies to support the case for modified vaccines, in case immune response studies come up with ambiguous conclusions.
The F.D.A. acknowledged that many questions remain unanswered, such as what type of data would trigger the need for an adapted vaccine and who would make that decision. The agency also noted that scientists have not yet determined what level of antibodies in a vaccinated person’s blood would protect someone from the virus.
Some other vaccines are regularly updated in a similar way. Because the influenza virus evolves rapidly from one year to the next, vaccine developers have to come up with new recipes annually.
The newly tweaked Covid-19 vaccines would be authorized under an amendment to the emergency authorization granted to the original vaccine, regulators said.
Dr. Anthony S. Fauci, looking ahead to the next phase of the fight against the coronavirus, said Monday that the United States must mobilize to develop “potent antivirals” to fight Covid-19, just as the federal government and private industry once developed highly specialized drugs to combat two other viruses: H.I.V. and hepatitis C.
So far, just one antiviral medication, remdesivir, has been approved by the Food and Drug Administration to treat Covid-19. Speaking to reporters during Monday’s White House coronavirus briefing, Dr. Fauci said the effect of that drug is “clear, but modest.” Other treatments, including the steroid dexamethasone and monoclonal antibodies, are also in use.
What is needed now, he said, are drugs that are specifically designed to attack “vulnerable targets” in the replication cycle of the virus.
“Looking forward, and the clear need in this is the development of potent antivirals directly acting on SARS-CoV-2 very similar to what was done with the highly successful drug development program for H.I.V., as well as for hepatitis C,” Dr. Fauci said, adding, “This is going to be the direction of the future.”
Dr. Fauci’s comments, coming at a time when the Biden administration is almost singularly focused on its vaccination campaign, suggest that he expects Covid-19 to be a sustained and lasting threat. They were also a tacit admission that, while the government spent billions developing vaccines, the effort to find therapeutics has been neglected.
While therapies like remdesivir have improved the care of Covid patients, the drugs are hardly cure-alls and they are not for everyone. Efforts to repurpose other drugs, or discover new ones, have not had much success.
The Trump administration poured $18.5 billion into vaccines, a strategy that resulted in two vaccines that now have emergency use authorization from the Food and Drug Administration, with others on the way. But its investment in drugs, under a public-private partnership known as Accelerating COVID-19 Therapeutic Interventions and Vaccines — ACTIV for short — was far smaller, about $8.2 billion, most of which went to just a few candidates, like monoclonal antibodies.
At the same time, the government poured money into testing drugs that did not work against Covid-19 but were pet projects of former President Donald J. Trump, including the malaria drugs hydroxychloroquine and chloroquine. The Trump administration also funneled tens of millions of dollars into an expanded access program for convalescent plasma, infusing almost 100,000 Covid patients before there was any robust evidence that it worked.
The first studies of Britain’s mass inoculation program showed strong evidence on Monday that the coronavirus vaccines were working as intended, offering among the clearest signs yet that the vaccines slash the rate of Covid-19 hospital admissions and may be reducing transmission of the virus.
A single dose of either the AstraZeneca vaccine or the one made by Pfizer could avert most coronavirus-related hospitalizations, the British studies found, though researchers said it was too early to give precise estimates of the effect.
The findings on the AstraZeneca shot, the first to emerge outside of clinical trials, represented the strongest signal yet of the effectiveness of a vaccine that much of the world is relying on to end the pandemic.
And separate studies of the Pfizer vaccine offered tantalizing new evidence that a single shot may be reducing the spread of the virus, showing that it prevents not only symptomatic cases of Covid-19 but also asymptomatic infections.
The findings reinforced and went beyond studies out of Israel, which has also reported that the vaccine developed by Pfizer and BioNTech offered significant protection from the virus in real-world settings, and not only in the clinical trials held last year. No other large nation is inoculating people as quickly as Britain, and it was the first country in the world to authorize and begin using both the Pfizer shot and the one developed by AstraZeneca and the University of Oxford.
The studies released on Monday — two on the Pfizer shot and one on it and the AstraZeneca injection — showed both vaccines were effective against the more infectious coronavirus variant that has taken hold in Britain and spread around the world.
“Both of these are working spectacularly well,” said Aziz Sheikh, a professor at the University of Edinburgh who helped run a study of Scottish vaccinations.
Still, the findings contained some cautionary signs. And even as British lawmakers cited the strength of the vaccines in announcing a gradual loosening of lockdown restrictions, government scientists warned that many more people needed to be injected to prevent cases from spreading into vulnerable, vaccinated groups and occasionally causing serious disease and death.
The U.S. economy remains mired in a pandemic winter of shuttered storefronts, high unemployment and sluggish job growth. But attention is shifting to a potential post-Covid boom.
Forecasters have always expected the pandemic to be followed by a period of strong growth as businesses reopen and Americans resume their normal activities. But in recent weeks, economists have begun to talk of something stronger: a supercharged rebound that brings down unemployment, drives up wages and may foster years of stronger growth.
There are hints that the economy has turned a corner: Retail sales jumped last month as the latest round of government aid began showing up in consumers’ bank accounts. New unemployment claims have declined from early January, though they remain high. And measures of business investment have picked up.
Economists surveyed by the Federal Reserve Bank of Philadelphia this month predicted that U.S. output would increase 4.5 percent this year, which would make it the best year since 1999. Some expect an even stronger bounce: Economists at Goldman Sachs forecast that the economy would grow 6.8 percent this year and that the unemployment rate would drop to 4.1 percent by December, a level that took eight years to achieve after the last recession.
“We’re extremely likely to get a very high growth rate,” said Jan Hatzius, Goldman’s chief economist. “Whether it’s a boom or not, I do think it’s a V-shaped recovery,” he added, referring to a steep drop followed by a sharp rebound.
The growing optimism stems from several factors. Coronavirus cases are falling in the United States. The vaccine rollout is gaining steam. And largely because of trillions of dollars in federal help, the economy appears to have made it through last year with less structural damage than many people feared last spring.
Consumers are also sitting on a trillion-dollar mountain of cash, a result of months of lockdown-induced saving and rounds of stimulus payments.
“There will be this big boom as pent-up demand comes through and the economy is opening,” said Ellen Zentner, chief U.S. economist for Morgan Stanley. “There is an awful lot of buying power that we’ve transferred to households to fuel that pent-up demand.”
Even if there is a strong rebound, however, economists warn that not everyone will benefit.
Standard economic statistics like the unemployment rate and gross domestic product could mask persistent challenges facing many families, particularly the Black and Hispanic workers who have borne the brunt of the pandemic’s economic pain. That could lead Congress to pull back on aid when it is still needed.
Officially, Tanzania has not reported a single coronavirus case since April 2020. According to government data, the country has had only 509 positive cases and 21 deaths since the start of the pandemic.
Almost no one believes those numbers to be credible. But they fit with President John Magufuli’s declaration that the pandemic was “finished.”
Now, facing criticism from the World Health Organization and skepticism from the public as Tanzanians take to social media to voice concern about a growing number of “pneumonia” cases, Mr. Magufuli is changing course and asking people to take precautions against the coronavirus and wear masks.
Speaking during a church service in the port city of Dar es Salaam, the president asked congregants to continue praying for the disease to go away but also urged them to follow “advice from health experts.”
In a statement released by his office, Mr. Magufuli said his government had never barred people from wearing masks but urged them to use only those made in Tanzania.
“The masks imported from outside the country are suspected of being unsafe,” the statement said.
Mr. Magufuli’s comments come a day after the director general of the World Health Organization urged the country to start reporting coronavirus cases and share data.
Mr. Magufuli, 61, who was re-elected last October, has derided social distancing, publicized unproven treatments as a cure for the virus, questioned the efficacy of coronavirus testing kits supplied by the Africa Centers for Disease Control and Prevention and said that “vaccines don’t work.”
Yet health experts, religious entities and foreign embassies have issued warnings about the rising number of cases — and as deaths follow, the reality is harder to dismiss.
The vice president of the semiautonomous island of Zanzibar, Seif Sharif Hamad, died last week after contracting the virus, according to his political party. The United States Embassy in Tanzania also said in a statement it was “aware of a significant increase in the number of Covid-19 cases” since January.
Lawmakers are increasingly asking the health authorities to explain why so many people are dying from respiratory problems.
Speaking on Friday at the funeral of a government official, however, Mr. Magufuli said that citizens should put God first and not be instilled with fear about the virus.
“It is possible that we wronged God somewhere,” he said. “So let’s stand with God, my fellow Tanzanians.”
In his statement, the W.H.O. chief, Dr. Tedros Adhanom Ghebreyesus, said he had spoken to “several authorities” in the country about their plans to mitigate the spread of the coronavirus but had yet to receive any response.
“This situation remains very concerning,” he said.
In other news from around the world:
The French Riviera, the famed strip along the Mediterranean coast that includes jet-setting hot spots like Saint-Tropez and Cannes, will be locked down over the next two weekends in an attempt to fight back a spike in coronavirus infections. Infection rates surged as many French people flocked to the coast to escape gloomy cities like Paris.
Hong Kong’s chief executive, Carrie Lam, and other top officials received the Sinovac coronavirus vaccine on Monday as the semiautonomous Chinese territory prepares to begin its mass inoculation campaign. Widespread vaccinations are set to begin on Friday, with health care workers, people over 60, and nursing home residents and staff members receiving them first.
In an effort to speed up vaccinations in Bulgaria, Prime Minister Boiko Borisov called for “green corridors” allowing anyone who wanted a vaccination to get one. The reaction appears to be better than expected: The lines evoked the period of communist rule, when people would spend hours waiting to get basic supplies like oil or meat.
Spain reported on Monday its lowest positivity rate of the year. The country has also given out over three million doses of vaccine since late December, when its vaccination rollout began. Over the weekend, there were 20,849 new confirmed cases, down from over 30,000 the previous weekend, according to Spain’s health ministry. Still, Fernando Simón, the head of Spain’s health emergency center, told a news conference on Monday evening that the encouraging trendline should not lead regional authorities to push for “an excessive relaxation” of lockdown measures.
New Jersey, home to several major league sports teams, will allow a limited number of fans to attend sports and entertainment events at venues with 5,000 or more seats as soon as next week, Gov. Philip D. Murphy said on Monday.
Indoor venues will be limited to 10 percent of their seating capacity, while outdoor venues will be limited to 15 percent capacity, Mr. Murphy said in a radio interview on WFAN. The events can begin next Monday at 6 a.m.
Mr. Murphy’s announcement comes two weeks after a similar decision by New York’s governor, Andrew M. Cuomo, whose plan allowed fans at venues with 10,000 or more seats starting this week, provided that seating is limited to 10 percent of the venue’s capacity.
Mr. Cuomo’s announcement covered several New York City-area sports franchises, like the Nets, Knicks, Rangers and Islanders, which can begin to have fans in the stands as soon as Tuesday. Attendees in New York have to show proof of a negative P.C.R. test for the coronavirus taken within 72 hours of the event.
Mr. Murphy said that New Jersey would not require test results, but people at the venues will be required to wear face coverings at games and remain socially distanced. Public health experts say when considering indoor gatherings, the quality of ventilation is key because the virus is known to spread more easily indoors.
Cases in New Jersey, while still high, are now on the decline, nearing levels reported in early November. Over the last seven days the state averaged 33 cases per 100,000 residents each day, as of Sunday. That was the third-highest rate per capita of new cases in the last week, after New York and South Carolina.
The governor’s announcement will allow his state’s pro hockey team, the Devils, to play home games starting next Tuesday, the team’s first home game after the change takes effect.
“This is a day toward which our entire staff has been planning, working, and looking forward to for the past 11 months,” said the team’s president, Jake Reynolds, in a statement.
The state also has two pro football teams, the Giants and the Jets; a Major League Soccer team, the Red Bulls; and a National Women’s Soccer League franchise, Sky Blue F.C. Mr. Murphy said he hoped those teams would still be able to have fans when their seasons began later this year.
“I’ll be shocked if we’re not at a higher level of capacity for Jets, Giants, Rutgers football, you name it, as we get into the summer and fall,” Mr. Murphy said.
Several other states have already permitted sports fans inside venues during the pandemic, especially at outdoor stadiums for football and baseball. But Mr. Cuomo and Mr. Murphy had resisted until December, when Mr. Cuomo worked with the N.F.L. to allow a limited number of fans at a Buffalo Bills playoff game in their open-air stadium.
Mr. Murphy also said that New Jersey would start to allow parents and guardians to watch their children play both indoor and outdoor college sports, provided venues meet capacity limits, on Monday. The state reopened high school sports to parents earlier this month, with indoor attendance limited to 35 percent or 150 people.
New Jersey will also allow houses of worship and religious services to operate at 50 percent capacity effective Monday, the governor said. The limit is an increase from the previous cap of 35 percent maximum capacity up to 150 people.
Alison Saldanha contributed reporting.
The number of Americans hospitalized for Covid-19 is at its lowest since early November, just before the surge that went on to ravage the country for months.
There were 56,159 people hospitalized as of Feb. 21, according to the Covid Tracking Project. That’s the lowest since Nov. 7. It’s a striking decline for a nation that is approaching 500,000 total deaths and once had some of the world’s worst coronavirus hot spots.
While deaths remain high, because it can take weeks for patients to die from Covid-19, the number of U.S. hospitalizations has steadily and rapidly declined since mid-January, when the seven-day average reached about 130,000, according to a New York Times database. Experts attributed that peak to crowds gathering indoors in colder weather, especially during the holidays, when more people traveled than at any other time during the pandemic.
Experts have pointed to a variety of explanations for why the country’s coronavirus metrics have been improving over the past few months: more widespread mask use and social distancing after people saw friends and relatives die, better knowledge about which restrictions work, more effective public health messaging, and, more recently, a growing number of people who have been vaccinated. The most vulnerable, like residents of nursing homes and other elderly people, were among the first to receive the vaccine.
While scientists hope the worst is behind us, some warn of another spike in cases in the coming weeks, or a “fourth wave,” if people become complacent about masks and distancing, states lift restrictions too quickly or the more contagious variants become dominant and are able to evade vaccines.
The change can be felt most tangibly in intensive care units: Heading into her night shift in the I.C.U. at Presbyterian Rust Medical Center in Rio Rancho, N.M., Dr. Denise A. Gonzales, the medical director, said she had seen a difference in her staff.
“People are smiling. They are optimistic,” she said. “They’re making plans for the future.” During the worst of the crisis, “working in such a highly intense environment where people are so sick and are on so much support and knowing that statistically very few are going to get better — that’s overwhelming.”
Though the winter wave that hit her hospital system was “twice as bad” as the summer surge, she said it seemed more manageable because hospitals had prepared to move patients around, staff had more knowledge about P.P.E. and treatment therapies, and facilities had better airflow.
At the CoxHealth hospital system in Springfield, Mo., there was a “moment of celebration” as staff emptied the emergency Covid-19 I.C.U. wing built last spring. “We have not defeated this disease,” said Steve Edwards, the system’s chief executive. “But the closing of this unit, at least for now, is a tremendous symbolic victory.”
Staff members wearing biohazard suits and heavy-duty masks were pictured in a rare occasion of relief and joy that Mr. Edwards shared on Twitter.
Dr. Kyan C. Safavi, the medical director of a group that tracks Covid-19 hospitalizations at Massachusetts General Hospital in Boston, said the number of newly admitted patients has dropped sharply. The hospital is admitting about 10 to 15 new patients daily, a decline of about 50 percent from early January, Dr. Safavi said.
“Everybody’s physically exhausted — and probably a little bit mentally exhausted — but incredibly hopeful,” Dr. Safavi said.
Around the United States, the vaccine rollout has reflected the same troubling inequalities as the pandemic’s death toll, leaving Black, Latino and poorer people at a disadvantage. In New York City, home to more than three million immigrants from all over the world, data released last week suggests that vaccination rates in immigrant enclaves scattered across the five boroughs are among the city’s lowest.
This month, The New York Times interviewed 115 people living in predominantly immigrant neighborhoods about the rollout and their attitudes toward the vaccines.
Only eight people said they had received a shot. The interviews revealed language and technology roadblocks: Some believed there were no vaccine sites nearby. Others described mistrust in government officials and the health care system. Many expressed fears about vaccine safety fomented by news reports and social media.
The broader public may find it difficult to understand why people in communities ravaged by the coronavirus would be reluctant to line up to get vaccinated, said Marcella J. Tillett, the vice president of programs and partnerships at the Brooklyn Community Foundation.
“This is where there has been a lot of illness and death,” said Ms. Tillett, whose foundation is distributing funds to social service organizations for vaccine education and outreach. “The idea that people are just going to step out and trust a system that has harmed them is nonsensical.”
To be sure, thousands of immigrant New Yorkers have gotten vaccinated, navigating the system with patience, if not ease. Others have relied on social service organizations. BronxWorks recently held a five-day vaccine pop-up on the Grand Concourse in the Bronx, administering hundreds of shots each day.
To increase participation in immigrant enclaves and communities of color, the city has opened vaccine mega-sites at Yankee Stadium in the Bronx and Citi Field in Queens, which offer vaccinations to eligible residents of each borough. (There have been reports of suburbanites coming in to claim doses.)
On Monday, Gov. Andrew M. Cuomo said that the Metropolitan Transportation Authority would boost bus service to the two new vaccine sites from public housing projects and community centers in Brooklyn and Queens to better serve Black, Latino and poorer New Yorkers who are most vulnerable to the virus.
Still, obstacles remain.
Coronavirus clusters at six elementary schools in Georgia resulted from poor social distancing and, to a lesser extent, inadequate mask use by students, public health officials reported on Monday.
Teachers played a role in transmitting the virus in all but one of the clusters, and two of the clusters probably involved teacher-to-teacher transmission that was followed by teacher-to-student transmission, the study found.
Researchers from the Centers for Disease Control and Prevention examined nine clusters of three or more linked infections involving teachers and students in Cobb County, Ga., between Dec. 1 and Jan. 22, a period when the county, in suburban Atlanta, was experiencing a surge in cases.
Some 2,600 elementary school students — about 80 percent of the district’s total — were going to school in person at the time, and some 700 staff members were working in person.
The researchers identified transmission clusters involving 13 educators and 32 students at six schools in the county; some schools had more than one cluster.
In four of the nine clusters, an educator was identified as the index patient, or original source of infection. One cluster had a student as the index patient, and the researchers could not determine who the index patient was in the rest.
The study was limited in many ways, the investigators conceded. They said it was “challenging” to try to distinguish between infections acquired at school and those that were acquired in the community.
Some clusters may have been missed, they said, because almost half the people who were identified through contact tracing as having possibly been exposed refused to be tested.
Because infected adults are more likely to have symptoms and be tested, teachers may have been identified more frequently than students as index cases, the researchers said, while instances of student-to-student or student-to-teacher transmission may have gone undetected.
Even so, the authors said, their findings were consistent with studies in other countries. One in Britain found that transmission at schools happened most often from teacher to teacher; a German study found that in-school transmission rates were three times as high when the cluster began with an educator, rather than a student.
The C.D.C. investigators urged teachers to follow precautions to prevent coronavirus infection when they are not in school, and to limit their interactions with colleagues at meetings and over lunch.
They also called for teachers to be vaccinated. “Although not a requirement for reopening schools, adding Covid-19 vaccination for educators as an additional mitigation measure, when available, might serve several important functions, including protecting educators at risk for severe Covid-19 associated illness, potentially reducing in-school SARS-CoV-2 transmission and minimizing interruption to in-person learning,” the researchers said.
A coronavirus testing campaign in San Francisco has found more evidence that a variant first observed in California may be more contagious.
Looking at more than 600 cases in one of the city’s predominantly Latino communities, scientists found that the proportion of virus samples carrying this variant greatly increased from late November to late January.
Although the study was relatively small, and no one knows whether the variant affects the effectiveness of vaccines, “this is not the time to let down the guard,” said Joe DeRisi, the co-president of the Chan Zuckerberg Biohub and one of the scientists involved in the new study. A more contagious variant could threaten to reverse the decline in cases seen over the past couple of months in California and elsewhere.
The results were announced on Monday by the University of California at San Francisco, which carried out the research in collaboration with the Chan Zuckerberg Biohub, the Chan Zuckerberg Initiative, and the Latino Task Force for Covid-19. The data have not yet been published.
The variant first came to light on Jan. 17, when the California Department of Public Health reported that it had become noticeably common in several communities across the state. The variant, which has gone by several names, is now known as B.1.429.
The variant might have become common in one of two ways. It might be more contagious, or it might simply have gone through a superspreading event, fueling its spread. “Just by random chance, a bad wedding or choir practice can create a large frequency difference,” Dr. DeRisi said.
Soon after the announcement, researchers at the Cedars-Sinai Medical Center in Los Angeles reported that B.1.429 was rapidly becoming more common around that city. But those findings were based on a limited sample of just 185 coronavirus genomes that had been fully sequenced.
To get more samples, Dr. DeRisi and his colleagues focused their efforts on the predominantly Latino community in the Mission District neighborhood. There they have been running a community testing program since last April, called Unidos en Salud.
Looking at their samples from late November, the researchers found that 16 percent of the coronaviruses belonged to B.1.429. By January, after sequencing 630 genomes, the team found 53 percent were B.1.429.
Because the researchers were running their tests in a community, they could investigate how the B.1.429 variant spread from person to person. In some cases, entire families came to get tested. In other cases, the researchers followed up on positive tests to ask if they could test other people in the same household. The researchers studied the spread of B.1.429 and other variants in 326 households.
The researchers found that B.1.429 was more likely to spread among people living in the same house than other variants were. People had a 35 percent chance of getting infected if someone else in their home was infected with the B.1.429 variant. If the person was infected with another variant, the rate was only 26 percent.
“What we see is a modest, but meaningful difference,” Dr. DeRisi said.
As coronavirus cases decline across the United States, the East Coast has emerged as a lingering hot spot — at least in relative terms.
Eight of the 10 states with the highest rates of recent cases border the Atlantic Ocean. New York and New Jersey are adding cases at rates higher than every state except South Carolina, with Rhode Island close behind. Massachusetts, Connecticut and New Hampshire are all in the top 15.
“It’s whack-a-mole,” said Leana Wen, an emergency physician and public health professor at George Washington University. “One part of the country sees a surge, and then another, and then it declines.” Several months ago, the Upper Midwest was outpacing other regions in new infections. Before that, the Sunbelt surged.
Those waves of regional outbreaks could help explain why the East Coast is struggling compared with other parts of the country, said Ashish K. Jha, the dean of the Brown University School of Public Health. Although the Upper Midwest has similarly frosty winters — keeping people indoors, where the virus can spread more easily — that region’s previous outbreak meant it achieved “not quite herd immunity but pretty close,” said Dr. Jha, “unfortunately in all the wrong ways.”
Even the states seeing the most new cases are seeing steady improvement, however. Over the last two weeks, New York has seen a 14 percent decline in new cases and a 24 percent decline in coronavirus-related deaths. South Carolina’s declines are even more dramatic.
“We’re moving in the right direction, just not as fast as other places,” said Simone Wildes, an infectious disease expert at South Shore Health in Weymouth, Mass., referring to the East Coast. She wondered if the regional lag could be attributed in part to lower vaccination rates among Black Americans, with high populations in East Coast urban centers. “As more vaccines become available, we want to make sure this particular group gets all the information they need,” she said.