Health officials in Colorado are warning about another wave of infections as new coronavirus cases in the state jump to levels not seen since January and as counties start to loosen virus restrictions.
The state is reporting an average of 1,661 new cases a day, up by 18 percent in the past two weeks, according to a New York Times database. Hospitalizations have climbed by 19 percent in the same time period. Deaths from the virus, which tend to lag behind infections for several weeks, have slightly increased.
“We are seeing what appears to be the beginning of a fourth wave of Covid-19 in Colorado,” Scott Bookman, the state’s Covid-19 incident commander, said at a news briefing on Thursday. He urged people to remain vigilant about getting tested as more of the state’s population becomes vaccinated.
As in many parts of the country seeing caseloads rise, health officials say the increase has been fueled in part by the spread of more contagious variants of the virus, particularly the B.1.1.7 variant first found in Britain. That variant is estimated to be about 60 percent more contagious and 67 percent more deadly than the original version. B.1.1.7 is now the most common source of new coronavirus cases in the United States, and tracking by the Centers for Disease Control and Prevention suggests that “variants of concern,” including B.1.1.7 and a variant that emerged in California, CAL.20C, now make up more than half of all new coronavirus cases in Colorado.
Even as cases mount, the state on Friday ended its “dial system” that required counties to place capacity limits on restaurants, offices and gyms, depending on case counts, positive test percentages and hospitalizations in those areas. That change shifted control of pandemic regulations to local counties, prompting concerns from some public health experts that the move could result in cases and hospitalizations continuing to rise. Several counties experiencing an increase in cases and hospitalizations, like El Paso and Douglas Counties, have said they do not plan to impose restrictions beyond those mandated by the state.
The state still requires counties to comply with its mask mandate — which will stay in place through May 2 — and with limits on indoor mass gatherings.
“I am concerned that without policies and behaviors to slow transmission,” said Elizabeth Carlton, an associate professor at the Colorado School of Public Health, “we will continue to see increases in Covid-19 hospitalizations among those who are not yet vaccinated.”
“It worries me,” Dr. Bill Burman, director of Denver Public Health, said about counties that were choosing to be more lax with restrictions. Denver eased some regulations on Friday but kept in place certain restrictions, like capacity limits on bars, offices and retail stores.
An analysis published this month and led by researchers at the Colorado School of Public Health found that delaying policy changes, at the state or local level, until mid-May would “prevent large numbers of deaths and hospitalizations.” According to the report, mobility in the state is also reaching its highest levels since the start of the pandemic.
State officials defended the change last week, pointing to the relatively low number of hospitalizations and deaths compared with the peaks seen in December. Gov. Jared Polis, a Democrat, said at a news briefing on Tuesday that he was confident that counties could take on greater responsibility, but he urged people to remain cautious.
“I think that the number of cases and hospitalizations will sadly continue to go up before it goes down,” Mr. Polis said, adding that he hoped it would be a short peak as more people get vaccinated.
About 41 percent of the state’s population has received at least one shot of a Covid-19 vaccine, and 25 percent have been fully vaccinated, according to data from the Centers for Disease Control and Prevention.
State officials said they would continue to monitor hospitalization levels. Under the governor’s public health order, the state could require counties to put in place additional restrictions if their resident hospitalizations threatened to exceed 85 percent of hospital capacity.
To some, Alaska’s announcement that it would try to entice travelers by offering Covid-19 vaccinations at its airports might signal the state’s plucky resolve and determination to revive a tourism industry that has been devastated by the pandemic.
To others, it’s a sign of everything that is wrong with the way that the United States is distributing its vaccines, as calls for more doses in surge-stricken Michigan are rebuffed.
“It’s hard for me to believe that we’ve so maldistributed a vaccine as to make this necessary,” said Dr. Larry Brilliant, an epidemiologist who was part of the effort to eradicate smallpox in the 1970s. “You don’t want to exchange a bad carbon footprint for a vaccination.”
Starting on June 1, any tourist traveling to Alaska will be able to receive a Pfizer or Moderna vaccine at the Anchorage, Fairbanks, Juneau or Ketchikan airports. It’s part of a larger multimillion-dollar marketing campaign, funded by federal stimulus money, to attract tourists back to the state, Gov. Mike Dunleavy of Alaska, a Republican, announced.
“We believe there’s a real opportunity to get folks to come to Alaska again,” Mr. Dunleavy said at a news conference on Friday.
Alaska is the latest state to announce plans to extend vaccine eligibility to nonresidents as production and distribution have increased around the country. Twenty-one other states do not have residency requirements for vaccination, according to the Kaiser Family Foundation.
Some U.S. experts have worried for months about the growth in “vaccine tourism” — Americans crossing state lines to get a vaccine where there are excess doses. Virologists like Dr. Brilliant say that rather than incentivizing people to fly to Alaska to get a shot from the state’s abundant vaccine supply, doses should be redistributed to states most in need and no longer be allocated strictly by population.
Alaska is not lacking vaccines, said Heidi Hedberg, the state’s director of public health. Health administrators will begin the airport vaccine program for tourists at the Ted Stevens Anchorage International Airport, with a five-day trial at the end of April to gauge interest. Some visitors may have to get their second dose of mRNA vaccines in their home states, depending on how long they remain in Alaska.
Almost 40 percent of Alaskans have received at least one dose of a coronavirus vaccine, according to a New York Times database. Thirty-two percent of the state’s population is fully vaccinated. The state has used 68 percent of its doses.
Alaska was the first state to open up vaccine eligibility to anyone 16 or older living or working in the state, on March 9. At the time of the announcement, Alaska had the highest vaccination rate in the country.
The United States has continued to speed up vaccination efforts, and is now averaging 3.2 million doses a day, up from roughly two million a day in early March. The Centers for Disease Control and Prevention said on Saturday that about 129.5 million people had received at least one dose of a Covid-19 vaccine.
Dr. Brilliant said states like Michigan, the center of the country’s worst surge, should be receiving larger allocations of doses.
The Biden administration and Gov. Gretchen Whitmer of Michigan, a Democrat, have been at odds over her calls for an increase in her state’s vaccine supply. But the Biden administration held fast to distributing vaccines by state population, not by triage.
“The vaccine should go where it will do the most good,” Dr. Brilliant said. “Given the scarcity of vaccine in the world, every dose should be given in a way that is most effective at stopping this pandemic.”
But the issue could be moot by the time that Alaska’s tourist vaccination program begins in earnest on June 1: most Americans who want to be vaccinated might already have received at least one dose by then, said Dr. Peter Hotez, a vaccine scientist at the National School of Tropical Medicine at Baylor College of Medicine in Houston.
“We’re going to reach a point where people don’t need to fly to Alaska to get vaccinated,” he said. “I think it’s going to be more of the case that, here’s an opportunity to visit Alaska and it’s convenient to get vaccinated.”
French authorities will tightly restrict who can travel to France from Brazil, Argentina, Chile and South Africa, and will impose a 10-day quarantine on those who do, in the hope of staving off worrisome coronavirus variants circulating in those countries, the government announced on Saturday.
The announcement adds to a shifting patchwork of international restrictions that have complicated travel around the world.
Prime Minister Jean Castex announced late on Saturday that, starting April 24, travelers arriving from any of the four countries will have to quarantine for 10 days. Police officers will check on them to ensure that they comply.
Entry from the four countries will be limited almost exclusively to French citizens and their families, citizens of other European Union countries, and foreigners with permanent homes in France. Travelers must have tested negative for the virus within a shorter time before takeoff, and will be given antigenic tests on arrival.
“These are the countries that are most dangerous,” Jean-Yves Le Drian, France’s foreign minister, cxstold France 3 television on Sunday.
Nearly all flights between France and Brazil will remain suspended at least until the new rules take effect and possibly longer, the government said.
The tightened restrictions were necessary because of the “uncontrolled spread of the virus in certain countries,” including widespread transmission of virus variants like those first identified in Brazil and South Africa that appear to be more resistant to some current Covid-19 vaccines, Mr. Castex said in his statement.
France’s decision adds to a complex tangle of rules and policies about international travel that can vary widely from country to country and month to month.
Germany loosened some of its travel restrictions this week, removing Britain, Ireland, Finland and Barbados from its list of at-risk areas, meaning that travelers from those countries no longer need to quarantine upon arrival.
But Prime Minister Scott Morrison of Australia said that his country was in “no hurry” to reopen its borders, which have largely been closed to anyone other than returning Australian citizens.
“I will not be putting at risk the way we are living in this country, which is so different to the rest of the world today,” Mr. Morrison told reporters on Sunday.
Unlike the many European countries that have kept restaurants closed, travel restricted and face-masks mandatory to combat a new wave of infections, Australia has its coronavirus epidemic largely under control and residents are mostly free to travel domestically and dine out.
More people are flying every day, as Covid restrictions ease and vaccinations accelerate. But dangerous variants have led to new outbreaks, raising fears of a deadly prolonging of the pandemic.
To understand how safe it is to fly now, The Times enlisted researchers to simulate how air particles flow within the cabin of an airplane, and how potential viral elements may pose a risk.
For instance, when a passenger sneezes, air blown from the sides pushes particles toward the aisle, where they combine with air from the opposite row. Not all particles are the same size, and most don’t contain infectious viral matter. But if passengers nearby weren’t wearing masks, even briefly to eat a snack, the sneezed air could increase their chances of inhaling viral particles.
How air flows in planes is not the only part of the safety equation, according to infectious-disease experts. The potential for exposure may be just as high, if not higher, when people are in the terminal, sitting in airport restaurants and bars or going through the security line.
“The challenge isn’t just on a plane,” said Saskia Popescu, an epidemiologist specializing in infection prevention. “Consider the airport and the whole journey.”
A decision about whether to resume administering the Johnson & Johnson coronavirus vaccine should come this Friday, when an expert panel that is advising the Centers for Disease Control and Prevention is scheduled to meet, according to Dr. Anthony S. Fauci, the nation’s leading infectious disease expert.
“I think by that time we’re going to have a decision,” Dr. Fauci said on Sunday on the CNN program “State of the Union.”
“I don’t want to get ahead of the C.D.C. and the F.D.A. and the advisory committee,” he added, but said he expected experts to recommend “some sort of either warning or restriction” on the use of the vaccine.
Federal health agencies recommended putting injections of the vaccine on pause on Tuesday while they investigated whether it was linked to a rare blood-clotting disorder. All 50 states, in addition to Washington, D.C., and Puerto Rico, have stopped administering the vaccine.
The unusual disorder includes blood clots in the brain combined with low levels of platelets, blood cells that typically promote clotting. The combination, which can cause clotting and bleeding at the same time, was initially documented in six women between the ages of 18 and 48 who had received the vaccine one to three weeks prior. One of the women died, and another was hospitalized in critical condition.
This pattern has prompted questions about whether vaccinations could resume in men or in older people. But because women fill more of the health care jobs for which vaccinations have been prioritized, it is not clear how much the problem might affect men, too. On Wednesday, two more cases of the clotting disorder were identified, including one in a man who had received the vaccine in a clinical trial.
Of the 131.2 million people who have received at least one dose of a Covid-19 vaccine in the United States, more than seven million have received Johnson & Johnson’s. If there is a link between the vaccine and the clotting disorder, the risk remains extremely low, experts say.
“It’s an extraordinarily rare event,” Dr. Fauci said on the ABC program “This Week.” The pause was intended to give experts time to gather more information and to warn physicians about the clotting disorder so that they can make more informed treatment decisions, said Dr. Fauci, who appeared on four TV news programs on Sunday morning.
European regulators have been investigating similar cases of the unusual clotting disorder in people who have received the AstraZeneca vaccine. Some European countries have since stopped administering that vaccine altogether, while others have restricted its use in younger people.
Dr. Fauci also expressed frustration that “a disturbingly large proportion of Republicans,” who have been critical of many coronavirus restrictions, have expressed a reluctance to be vaccinated. “It’s almost paradoxical,” he said. “On the one hand they want to be relieved of the restrictions, but on the other hand, they don’t want to get vaccinated. It just almost doesn’t make any sense.”
The New York Times examined survey and vaccine administration data for nearly every U.S. county and found that both willingness to receive a vaccine and actual vaccination rates to date were lower, on average, in counties where a majority of residents voted to re-elect former President Donald J. Trump in 2020.
Dr. Fauci said that he expected all high school students to become eligible for vaccination before school begins in the fall, with younger children eligible no later than the first quarter of 2022.
An 18-year-old woman was stricken with severe headaches, vomiting, seizures, confusion and weakness in one arm early this month, strokelike symptoms that doctors at a Nevada hospital were shocked to see in someone so young.
Scans found several large blood clots blocking veins that drain blood from the brain, a condition that can disable or kill a patient.
Doctors performed a procedure to suction huge clots from her brain, only to find that new ones had formed.
The patient is one of six women ages 18 to 48 who developed clots in the brain within two weeks of receiving the Johnson & Johnson Covid-19 vaccine. One died, and their devastating cases led U.S. health officials to recommend on Tuesday that use of the vaccine be paused.
The National Institutes of Health is investing $33 million in research projects run by institutions around the country that could help officials safely reopen schools serving vulnerable students and under-resourced rural, urban and Native American communities.
The projects focus on expanding coronavirus testing for children of color, children from low-income families and children with developmental disabilities or complex medical conditions. The projects are part of an N.I.H. program called Rapid Acceleration of Diagnostics Underserved Populations, or RADx-UP, and include initiatives among Native American communities.
“Establishing frequent Covid-19 testing protocols for schools in vulnerable and underserved communities is essential to the safe-return-to-school effort, and these projects will inform decision makers on the best strategies to accomplish this,” Dr. Eliseo J. Pérez-Stable, director of N.I.H.’s National Institute on Minority Health and Health Disparities and co-chair of the RADx-UP program, said in the announcement on Thursday.
Although remote schooling has been a challenge for many families, certain vulnerable populations have faced additional obstacles. Low-income families, for instance, may not have access to computers or high-speed internet connections, while children with developmental disabilities may miss out on speech therapy, occupational therapy and other services that are typically tied to in-person schooling.
The new research projects encompass a wide variety of schools, ranging in size from 50 to 3,500 students.
One study, led by researchers at Washington University in St. Louis, will survey parents of children with disabilities to identify the best communication strategies for promoting in-person learning and examine ways to boost participation in a weekly coronavirus testing program. Another will assess the feasibility of at-home and school-based coronavirus testing programs for children with complex medical needs.
A project based at Duke University will explore whether rapid coronavirus tests can reduce the spread of the virus in schools and help build trust with Black and Latino families, encouraging them to send their children back into the classroom.
The RADx-UP program plans to distribute more funding, and expand its efforts to more locations, in the months ahead, the N.I.H. said.
JERUSALEM — Buoyed by its recent success in combating the coronavirus, Israel lifted its outdoor mask mandate on Sunday, while schools fully reopened for the first time since September.
The country has been taking rapid steps back to normalcy in the wake of its world-leading vaccination campaign and plummeting infection rates. About 56 percent of the Israeli population has been fully vaccinated, according to a New York Times database.
“Finally, I can breathe again!” Eli Bliach, 35, an entrepreneur, said while walking mask-free in downtown Jerusalem on Sunday morning.
With the sun out and temperatures rising, some people joked about avoiding mask tan lines.
But other Israelis were hesitant to remove the layer of protection that had felt so alien at first, but that many have since gotten used to.
“I am not confident that the pandemic is over,” said Ilana Danino, 59, a cosmetician and caregiver who was still wearing a mask while walking down an almost empty street in the city center. “It is still out there all over the world.”
Besides, she said, “I feel good with this on,” gesturing to the air around her and explaining that springtime could still bring allergies and the spread of other viruses.
Israel’s health minister, Yuli Edelstein, urged people to continue carrying masks with them for entry into indoor public spaces, where they are still required.
Daily new coronavirus infections in Israel have fallen from a peak of 10,000 in January to around 100 on some recent days. Prof. Eran Segal of the Weizmann Institute of Science said on Twitter last week that with 85 percent of people 16 and older in Israel either vaccinated or recovered from the virus, “Life is close to pre-Covid.”
As part of the transition, Israel has introduced a “green pass” system allowing people who are vaccinated or recovered to dine indoors in restaurants, stay in hotels and attend large cultural, sports and religious gatherings.
But there is some new concern after several cases of a virus variant with a double mutation first detected in India, B.1.617, were identified in Israel last week. Prof. Nachman Ash, Israel’s coronavirus czar, told the Hebrew news site Ynet on Sunday that the variant might have some characteristics that could make those who have been vaccinated vulnerable to infection.
Israel is working to prevent any further entry of the variant, he said, while trying to learn more about it and how it is behaving in other parts of the world.
Mayor Bill de Blasio of New York City announced on Saturday that New Yorkers who are 50 or older could now walk in and receive the coronavirus vaccine at more than 30 city-operated sites.
“No appointment necessary,” the mayor said on Twitter. One person accompanying the over-50 walk-in candidate can also receive the shot. Mr. de Blasio’s aim is to fully vaccinate five million of the city’s eight million residents by June.
Before Saturday, the city allowed walk-in vaccinations only for people 75 and over.
The city listed 31 locations across the five boroughs where walk-ins would be accepted, including three that usually operate 24 hours a day, seven days a week: Brooklyn Army Terminal, Bathgate Contract Postal Station in the Bronx and Citi Field in Queens. That list of locations will be updated weekly.
Brian Lehrer, a radio host on WNYC, asked the mayor on Friday whether he thought that the growing availability of appointments indicated that vaccine hesitancy was becoming a bigger problem than supply.
“We are filling the appointments,” Mr. de Blasio said, adding that he thought increased availability encouraged more people to get vaccinated.
Mr. de Blasio also noted on Friday that he thought the supply disruptions caused by the pause in use of the Johnson & Johnson vaccine, so that researchers could examine a rare, serious blood-clotting disorder that has emerged in a handful of recipients, would be relatively minimal. But he acknowledged that the disruption had impeded the city’s efforts to vaccinate homebound people.
On Saturday the mayor wrote on Twitter that the city had distributed 106,527 doses of the vaccine on Friday, breaking a record set about a week ago.
A New York Times database indicated that the risk of infection in New York City is still very high, but the numbers of cases, hospitalizations and deaths have declined in recent days.
Several troubling variants of the coronavirus, some of which are more infectious , are a growing proportion among cases in the city that are genetically sequenced, and the test positivity rate remains high, which suggests that cases may be undercounted.
Pope Francis spoke to the faithful from his study overlooking St. Peter’s Square on Sunday, the first time he had done so in just over a month.
“I’ll tell you something: I miss the square when I have to recite the Angelus in the library,’ Francis said, referring to the prayer that he leads the faithful in praying on most Sundays. Throughout the pandemic, the pope has often delivered the weekly address, prayer and blessing from the apostolic library, with no public in attendance.
“I am happy, thanks be to God! And thank you for your presence,” the pope said Sunday, smiling.
The pope identified several flags among the several hundred faithful in the square, “Brazilians, Poles, Spanish people,” Francis said, offering a “warm greeting” also to the “people of Rome and pilgrims.”
Italy suffered one of the earliest and most severe outbreaks of the coronavirus in Europe. During the first lockdown, in 2020, pilgrims were not allowed to gather in St. Peter’s Square from March 8 to May 24. A huge surge over the winter brought back new restrictions, and another that peaked last month prompted another tight lockdown. That has succeeded in lowering infections, and many restrictions are expected to be eased beginning on April 26.
Francis has often used Sunday address to comment on current global affairs. This Sunday, he said he was particularly concerned about growing tensions and an “increase of military activities” in eastern Ukraine, “where in recent months violations of the cease-fire have multiplied.”
For weeks, Russia has been moving military equipment and massing troops along its border with Ukraine, setting off alarms in Europe and Washington, the largest build up since the conflict in the contested region began seven years ago.
“Please, I firmly hope that the increase of tensions may be avoided and, on the contrary, gestures may be made that are capable of promoting mutual trust and fostering reconciliation and peace, both so necessary and so desired,” Francis said.
ISTANBUL — Turkey hit another record high in new cases of Covid-19, reporting more than 62,000 new infections and 288 deaths in a single day, according to figures released by the Health Ministry on Saturday.
President Recep Tayyip Erdogan announced new restrictions last week for the two first weeks of Ramadan, the Muslim month of fasting, in recognition of the serious spike in new infections. He extended a nightly curfew and ordered early closing of shops.
The spike is being driven partly by more transmissible variants of the virus, Health Minister Fahrettin Koca said recently. The variant first identified in Britain is now present in all of Turkey’s provinces, officials said, and those identified in South Africa and Brazil are present in a few provinces as well.
Yet doctors say the government is to blame for failing to impose a stricter lockdown from the beginning of the pandemic, and for failing to act sooner to curb the latest wave with tighter regulations.
“We need a full lockdown that would be economically and socially supported,” said Dr. Kayihan Pala, a public health official and member of the Turkish Medical Association. He said it was not sufficient to rely on vaccinations, which have not reached enough of the population to stem the surge.
Medical workers are overstretched in Istanbul, where the largest number of cases have been identified, he said, and the availability of hospital beds was become an issue.
The Health Ministry data released Saturday showed that just under 70 percent of intensive care beds across the country were filled. The ministry did not release a figure specifically for Istanbul.
Throughout the pandemic, Mr. Erdogan has resisted calls for a total lockdown, and has insisted on allowing private industry and large businesses to keep operating, in order to sustain an economy that was already in recession before the pandemic. Turkey has continued to welcome foreign tourists, and allows them to ignore weekend lockdown rules.
Residents of Istanbul have increasingly flouted restrictions, many of them by exercising outdoors on weekends despite the threat of fines. The interior minister, Suleyman Soylu, warned foreign residents in comments published Sunday that he would confiscate their residency permits if they were found breaking the weekend lockdown rules.
The health minister, Mr. Koca, has resorted to gentle pleading. “Let’s not leave all the work to the vaccine,” he tweeted last week. “Let’s reduce cases until vaccination. Partial closure is an opportunity.”
THIMPHU, Bhutan — There’s a quiet vaccine success story in one of Asia’s poorest countries. As of Saturday, Bhutan, a Buddhist kingdom that has emphasized its citizens’ well-being over national prosperity, had administered a first vaccine dose to more than 478,000 people — over 60 percent of its population. The Health Ministry said this month that more than 93 percent of eligible adults had received their first shots.
A vast majority of Bhutan’s first doses were administered at about 1,200 vaccination centers over a weeklong period in late March and early April. As of Saturday, the country’s vaccination rate of 63 doses per 100 people was the sixth highest in the world, according to a New York Times database.
That rate was ahead of those of Britain and the United States, more than seven times that of neighboring India and nearly six times the global average. Bhutan is also ahead of several other geographically isolated countries with small populations, including Iceland and the Maldives.
A year ago, the United States government made a big bet on plasma.
The Trump administration, buoyed by proponents at elite medical institutions, seized on it as a good-news story at a time when there weren’t many others. It awarded more than $800 million to entities involved in its collection and administration, and put Dr. Anthony S. Fauci’s face on billboards promoting the treatment. Companies and nonprofit groups, with celebrity help, urged people who had recovered from Covid-19 to donate, and volunteers, some dressed in superhero capes, showed up to blood banks in droves.
No one knew if the treatment would work, but it seemed biologically plausible and safe, and there wasn’t much else to try.
But by the end of the year, good evidence for convalescent plasma had not materialized, prompting many prestigious medical centers to quietly abandon it. By February, with cases and hospitalizations dropping, demand dipped below what blood banks had stockpiled.
All told, more than 722,000 units of plasma were distributed to hospitals thanks to the federal program, which ends this month.
Because the government gave plasma to so many patients outside of a controlled clinical trial, it took a long time to measure its effectiveness. Eventually, studies did emerge to suggest that under the right conditions, plasma might help. But enough evidence has now accumulated to show that the country’s broad, costly plasma campaign has had little effect, especially in people whose disease is advanced enough to land them in the hospital.
The government’s bet did not result in a blockbuster treatment, or even a decent one, for Covid-19. But it did give the country a real-time education in the pitfalls of testing a medical treatment in the middle of an emergency. Medical science is messy and slow. And when a treatment fails, which is often, it can be difficult for its strongest proponents to let it go.