People over 65, who are much more likely than younger people to become seriously ill from Covid, have been a high priority since the U.S. vaccination campaign began. 
Credit…Christopher Capozziello for The New York Times

More than 70 percent of Americans who are 65 or older are fully vaccinated, and 84 percent have received at least one dose, a much higher proportion than for younger Americans, according to federal data. The numbers have surpassed President Biden’s goal of at least partly vaccinating 70 percent of the nation’s adults by July 4.

Some counties have blown far past that threshold, getting shots into more than 90 percent of residents 65 and older and offering an example for other areas where vaccine campaigns have lagged.

Two of the most populous 90-percent-plus counties are Jo Daviess County, Ill., across the Mississippi River from Dubuque, Iowa, and Dane County, Wis., which includes Madison, the state capital.

Elected and health officials in both counties suggested that some of the measures that they have adopted locally, such as expanding access and relying on trusted medical figures to share information about vaccines, were also reflected in the federal government’s strategy to reach those who have not received shots yet after the pace of vaccination has lagged in recent weeks.

President Biden has pushed for tens of thousands of pharmacies to allow people to walk in for their vaccinations, and ordered up pop-up and mobile clinics, especially in rural areas. The administration is also enlisting the help of family doctors and other trusted messengers to build up confidence in the vaccines.

On Thursday, Mr. Biden praised another incentive: The recommendation from the Centers for Disease Control and Prevention that people who have been fully vaccinated can go without masks in most situations.

In Dane County, Joe Parisi, the county executive, said this week that a number of efforts contributed to his county’s success in at least partly vaccinating most of the nearly 78,000 people 65 or over who live in the county. Over 90 percent of that group had been completely vaccinated as of Friday, according to local and federal data.

Officials strove to maximize access to the vaccine. They set up a mass vaccination site in December at the Alliant Energy Center, an arena and exhibition complex in Madison, and have distributed vaccines at health centers, pharmacies and mobile vaccination clinics, according to Morgan Finke, a spokeswoman for the county public health department.

Mr. Parisi said that the county worked with local hospital systems, health care providers, senior care centers and nursing homes to locate homebound people and help them get shots.

They did not encounter much hesitancy. “People wanted the vaccine,” Mr. Parisi said, “that certainly wasn’t the problem with that age group.”

Even so, he said, fostering trust and answering people’s questions are very important, especially now that the most eager recipients are already done. Mr. Parisi said the county partnered with trusted local doctors to spread the word about the vaccines through local news media outlets.

“We tried to share as much information as possible,” Mr. Parisi said, by “providing those voices that are nonjudgmental and can answer questions.”

In Jo Daviess County in the northwestern corner of Illinois, communication and community partnerships also played a major role, Lori Stangl, the county’s director of clinical services, wrote in an email.

Of the roughly 6,000 seniors in the county, 96.7 percent are fully vaccinated as of Friday, according to the C.D.C. Ms. Stangl credited extensive collaboration both within the county and with neighboring counties and states.

“Since Jo Daviess County borders Iowa and Wisconsin, many of our residents were able to receive vaccines there as well,” Ms. Stangl wrote, “especially early on, when our allocations were low.”

Though county leaders celebrate their success with seniors, she wrote, they are mindful that they still have many younger people left to reach. As of Friday, 54.9 percent of the county’s total population had been fully vaccinated, according to the C.D.C.

At the Public Garden in Boston on Friday.
Credit…Katherine Taylor for The New York Times

Advice from federal health officials that fully vaccinated people could drop their masks in most settings came as a surprise to Americans, from state officials to scientific experts. Even the White House got less than a day’s notice from the Centers for Disease Control and Prevention, the press secretary, Jen Psaki, said at a news briefing on Friday.

“The C.D.C., the doctors and medical experts there, are the ones who determined what this guidance would be based on their own data, and what the timeline would be,” Ms. Psaki said. “That was not a decision directed by or made by the White House.”

For months, federal officials have vigorously warned that wearing masks and social distancing were necessary to contain the pandemic. So what changed?

Introducing the new recommendations on Thursday, Dr. Rochelle P. Walensky, the C.D.C. director, cited two recent scientific findings as significant factors: Few vaccinated people become infected with the virus, and transmission seems rarer still; and the vaccines appear to be effective against all known variants of the coronavirus.

There is no doubt at this point that the vaccines are powerful. On Friday, the C.D.C. released results from another large study showing that the vaccines made by Pfizer-BioNTech and Moderna are 94 percent effective in preventing symptomatic illness in those who were fully vaccinated, and 82 percent effective even in those only partly vaccinated.

“The science is quite clear on this,” said Zoë McLaren, a health policy expert at the University of Maryland, Baltimore County. Mounting evidence indicates that people who are vaccinated are highly unlikely to catch or transmit the virus, she noted.

The risk “is definitely not zero, but it’s clear that it’s very low,” she said.

One of the lingering concerns among scientists had been that even a vaccinated person might carry the virus — perhaps briefly, without symptoms — and spread it to others. But C.D.C. research, including the new study, has consistently found few infections among those who received the Pfizer-BioNTech and Moderna vaccines.

“This study, added to the many studies that preceded it, was pivotal to C.D.C. changing its recommendations for those who are fully vaccinated against Covid-19,” Dr. Walensky said in a statement on Friday.

Other recent studies confirm that people who are infected after vaccination carry too little virus to infect others, said Florian Krammer, a virologist at the Icahn School of Medicine at Mount Sinai.

“It’s really hard to even sequence the virus sometimes because there’s very little virus, and it’s there for a short period of time,” he said.

Still, most of the data has been gathered on the Pfizer-BioNTech and Moderna vaccines, Dr. Krammer cautioned. Because Johnson & Johnson’s vaccine was authorized later, there are fewer studies assessing its effectiveness.

A vaccination center in London in April. The British authorities are considering reintroducing local lockdowns to stem the spread of a coronavirus variant first detected in India.
Credit…Justin Tallis/Agence France-Presse — Getty Images

LONDON — Prime Minister Boris Johnson of Britain said on Friday that vaccination protocols would be changed to swiftly deliver second doses to people over 50-years-old to combat the spread of a coronavirus variant first detected in India, a warning sign for countries that are easing restrictions even though their own vaccination campaigns are incomplete.

“We believe this variant is more transmissible than the previous ones,” Mr. Johnson said. What remained unclear, he said, was by how much. The infectiousness of the variant first detected in India remains the subject of intense study and some leading experts have said it is too early to assess its transmissibility.

If it proves significantly more transmissible, he said, “we face some hard choices.” He added that there was no evidence that the variant was more likely to cause serious illness and death, and there was no evidence to suggest vaccines were less effective against the variant in preventing serious illness and death.

While he said the country would not delay plans to ease restrictions on Monday, he warned that the spread of the variant could force the government to change course.

“This new variant could pose a serious disruption to our progress,” he said at a news conference on Friday.

The numbers of cases involving the variant, known as B.1.617, rose from 520 last week to 1,313 cases this week in Britain, according to official statistics.

The extent to which the variant has spread globally is unclear, because most countries lack the genomic surveillance capabilities employed in England.

That surveillance capability has allowed health officials in Britain to spot the rise of concerning variants more quickly than other nations, offering an early warning system of sorts as a variant seen in one nation almost invariably pops up in others.

Most cases detected in Britain are in northwestern England. The focus has been on Bolton, a town of nearly 200,000 that has one of the country’s highest rates of infection and where health officials have warned of widespread community transmission of the B.1.617 variant. Some cases have also been reported in London. The rapid spread of the variant has led officials to debate speeding up dosing schedules and opening up access to shots in hot spots to younger age groups.

National restrictions in England are scheduled to be eased on Monday, with indoor dining and entertainment returning, before a full reopening in June. But officials have cautioned that those plans might be in danger.

In Scotland, First Minister Nicola Sturgeon said on Friday that plans to ease restrictions in Glasgow would be delayed at least a week out of concern about an uptick in cases that officials said may be being driven by the variant.

Much is unknown about the new variant, but scientists fear it may have driven the rise of cases in India and could fuel outbreaks in neighboring countries.

Dr. Maria Van Kerkhove, the technical lead of the World Health Organization’s coronavirus response, said a study of a limited number of patients, which had not yet been peer-reviewed, suggested that antibodies from vaccines or infections with other variants might not be quite as effective against B.1.617. The agency said, however, that vaccines were likely to remain potent enough to provide protection from serious illness and death.

British officials have said the variant appears to be more contagious than the B.1.1.7 variant, which was detected last year in Kent, southeast of London and swept across Britain in the winter, forcing the country into one of the world’s longest national lockdowns. The B.1.1.7 variant has now been found in countries around the world.

In the United States, the B.1.1.7 variant did become the predominant version of the virus, now accounting for nearly three-quarters of all cases. But the U.S. surge experts had feared ended up a mere blip in most of the country. The nationwide total of daily new cases began falling in April and has now dropped more than 85 percent from the horrific highs of January.

The B.1.617 variant has been found in virus samples from 44 countries and was designated a variant of concern by the W.H.O. this week, which means there is some evidence that it could have an impact on diagnostics, treatments or vaccines and needs to be closely monitored.

Christina Pagel, a member of a group of scientists advising the government, known as SAGE, said postponing next week’s reopening would avoid “risking more uncertainty, more damaging closures and longer recovery from a worse situation.”

“We need to learn from previous experience,” Dr. Pagel, the director of the Clinical Operational Research Unit at University College London, said on Twitter.

Britain briefly reopened its economy at the end of last year, only to abruptly impose new restrictions that remained in place for months as it fought a deadly wave of infections.

In an attempt to offer at least partial protection to as many people as quickly as possible, Britain spaced injections between doses for two-stage coronavirus vaccines up to 12 weeks after the first vaccines were approved in December. That was far longer than the three- or four-week interval employed by most other countries.

Mr. Johnson said that those older than 50 will now be able to get second doses after eight weeks.

“It is more important than ever that people get the additional protection of a second dose,” he said.

The speedy rollout saved at least 11,700 lives and prevented 33,000 people from becoming seriously ill in England, according to research released by Public Health England on Friday.

Infections, serious illness and deaths have plummeted across Britain. Only 17 deaths were reported on Friday.

But the vaccination campaign has slowed down since last month because of supply shortages and the need to start distributing second doses. The number of daily first doses on average last month was 113,000, far below the average of 350,000 daily doses administered in March.

Only those over 38-years-old are currently eligible for vaccination.

It remains unclear whether the country has the vaccine supplies on hand to move rapidly to surge more into communities around the country to speed up vaccinating younger age groups.

Correction: 

An earlier version of this item misstated the affiliation of Christina Pagel, a science adviser. Ms. Pagel is a member of Independent SAGE, a group of expert advisers unaffiliated with the government. She is not a member of SAGE, a panel of government advisers.

global roundup

Disinfecting seats at a Covid-19 testing site in Taipei on Saturday.
Credit…Ritchie B Tongo/EPA, via Shutterstock

Taiwan, which has had remarkable success in containing the coronavirus, raised restrictions for its main city to their highest level since the start of the pandemic on Saturday, after reporting a daily record of 180 new locally transmitted infections.

Taiwan’s current outbreak — its worst yet by far — began in late April with a cluster in airline workers. Saturday’s caseload represented more than half of the 344 locally transmitted cases that the self-governing island has recorded during the entire pandemic.

The Taiwanese premier, Su Tseng-chang, and other officials told reporters on Saturday that masks and other medical supplies to fight the outbreak were plentiful. Mr. Su urged Taiwanese to be “obedient, helpful and protect yourselves, your families, all of society and our country.”

The government raised the restrictions in the city of Taipei to Level 3 out of 4, still short of a full lockdown. Even so, the announcements sent a shiver of anxiety through Taipei, and some residents filed into supermarkets to stock up on food, toilet paper and other essentials.

“I felt a bit panicky in recent days because of the surge of cases,” said Chen Mei-ling, 58, a retired high school teacher who stood in a long line at a Taipei supermarket. “It seems that the pandemic will last for a while and we can’t expect a virus-free environment in the near future.”

The restrictions in Taipei and adjoining New Taipei include a ban on indoor gatherings of more than five people and require the use of protective masks outdoors. Many public venues across the island will be closed, except for essential facilities like hospitals and police stations.

Taiwan has for decades been at loggerheads with China, which considers the island democracy to be a breakaway region that must accept eventual reunification. The Taiwanese government took swift measures to prevent the spread of the coronavirus from China early last year, even before the Chinese authorities confirmed that it was highly infectious.

In other news:

  • Japan said that as of Sunday, three more prefectures — Hokkaido, Okayama and Hiroshima — would be included in a state of emergency declaration that was already in force in Tokyo and five other prefectures, and which is scheduled to last until at least the end of May. The designation, under which people are asked to stay home except to run essential errands, was implemented to control a fourth wave of coronavirus infections and has cast further doubt on Japan’s ability to safely host the Tokyo Summer Olympics in July. Only about three percent of Japan’s 126 million people have received a first shot of a coronavirus vaccine. Taro Kono, the cabinet minister in charge of vaccinations, this week blamed the slow pace in part on the country’s strict drug approval system.

  • China’s sports administration is putting an end to attempts to climb Mount Everest from its north face this spring, citing concern about the coronavirus, the official Xinhua news agency reported on Saturday. The agency said there was a need to “ensure absolutely no missteps,” apparently reflecting worries that climbers in Nepal, where infections are surging, could bring the virus to the top of the world’s highest mountain from the other side. The announcement came a few days after the authorities in Tibet, a region of China, said they would enforce a “zero contact strategy” to ensure there were no transmissions from climbers on the Nepal side of the mountain, which is called Chomolungma in Tibetan. Xinhua said 21 Chinese climbers had previously been given permission to try for the peak this season.

A man in Los Angeles being vaccinated in March. The C.D.C. released a study on Friday providing more evidence that the vaccines are working well in real world settings.
Credit…Allison Zaucha for The New York Times

The Pfizer-BioNTech and Moderna coronavirus vaccines are 94 percent effective at preventing symptomatic Covid-19 illness, according to a new study of more than 1,800 health care workers in the United States.

The research, which the Centers for Disease Control and Prevention released on Friday, provides yet more evidence that the vaccines are working well even outside controlled clinical trials.

“This report provided the most compelling information to date that Covid-19 vaccines were performing as expected in the real world,” Dr. Rochelle Walensky, the C.D.C. director, said in a statement on Friday.

“This study, added to the many studies that preceded it, was pivotal to C.D.C. changing its recommendations for those who are fully vaccinated against Covid-19.”

The findings are based on an ongoing study of health care workers in 25 states. This interim analysis included data on 1,843 health care workers who were routinely tested for infection with the coronavirus. More than 80 percent of participants were female.

Some 623 workers tested positive between January and mid-March. Those who were fully vaccinated were 94 percent less likely to develop symptomatic coronavirus infections than their unvaccinated peers, the researchers found. The figures are consistent with the efficacy estimates from the clinical trials.

The scientists also found that a single dose of the two-shot regimen was 82 percent effective at preventing symptomatic infection. That figure is higher than has been reported in other studies and may be a result of the relative youth of the study participants, who had a median age of 37 to 38. Fewer than 2 percent were 65 or older.

C.D.C. scientists had previously found that fully vaccinated health care, frontline and essential workers were 90 percent less likely to contract the coronavirus. Those findings helped allay fears that vaccinated people might still be likely to carry the virus, even asymptomatically, and spread it to others.

The concern was one of the main rationales for asking vaccinated Americans to continue to wear masks, a recommendation that the C.D.C. lifted on Thursday.

Times Square, where three people, including a toddler out toy shopping, were shot last Saturday.
Credit…Dakota Santiago for The New York Times

As of the second weekend in May, New York City had recorded 505 shooting victims, the most through that point of any year in the last decade.

The rise began in 2020, and experts say the economic and physical strain of the virus, which disproportionately took lives and jobs from neighborhoods already struggling with such violence, most likely drove the increase.

Those factors are not likely to subside soon, criminologists warn. Fears are growing that gun violence will slow the city’s ability to bounce back from its long lockdown.

Restaurants, stores, offices and theaters will be allowed to open fully May 19. But the cycles of violent retaliation fueled by individual shootings in recent months will be hard to break, said Jeffrey Butts, the director of the research and evaluation center at the John Jay College of Criminal Justice.

“This could be a generation that we have screwed up for some time,” Dr. Butts said.

Other large cities, including Los Angeles and Philadelphia, also reported jumps in gun violence during the pandemic. Chicago, with about a third of the population of New York City, saw 865 shootings by the first weekend of this month, compared with about 550 in 2019 and 650 in 2020.





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