Reversing a decision made just two months ago, the Centers for Disease Control and Prevention is expected to recommend on Tuesday that people vaccinated for the coronavirus resume wearing masks indoors in certain areas of the country.
The change follows reports of rising breakthrough infections with the Delta variant of the virus in people who were fully immunized, and case surges in regions with low vaccination rates. The vaccines remain effective against the worst outcomes of infection with the virus, including those involving the Delta variant.
But the new guidance, the details of which are expected later Tuesday, would mark a sharp turnabout from the agency’s position since May that vaccinated people do not need to wear masks in most indoor spaces.
As recently as last week, an agency spokesman said that the C.D.C. had no plans to change its guidance, unless there were a significant change in the science. Federal officials met on Sunday night to review new evidence that may have prompted the reversal, CNN reported on Tuesday.
“I think that’s great,” said Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center in New York. Based on what scientists are learning about the Delta variant’s ability to cause breakthrough infections, she said, “this is a move in the right direction.”
Jen Psaki, the White House press secretary, said at a news conference on Tuesday that changing the guidance was crucial to “battling an ever-evolving virus” and that the C.D.C. was right to do it. The agency is expected to hold a news briefing at 3 p.m. Eastern.
“Their job is to look at evolving information, evolving data, an evolving historic pandemic, and provide guidance to the American public,” Ms. Psaki said. “That’s exactly what they will do, and what they will provide specific details on later this afternoon.”
The C.D.C.’s initial guidance in May said people fully protected from the coronavirus could go mask-free indoors in most scenarios, but recommended that unvaccinated people still wear masks. Those recommendations drew sharp criticism from some experts, who said it was premature given the vast swaths of unvaccinated people in the country.
Dr. Rochelle Walensky, the C.D.C.’s director, at the time pointed to two scientific findings as significant factors. Few vaccinated people become infected with the virus, and transmission seems rarer still, she noted; and the vaccines appear to be effective against all known variants of the coronavirus.
A day after the announcement, the agency released results from a large study showing that the mRNA vaccines made by Pfizer-BioNTech and Moderna were 94 percent effective in preventing symptomatic illness in those who got two doses, and 82 percent effective in those who had received one dose.
But those data, and the C.D.C.’s decision, were based on infections of previous versions of the virus before the Delta variant began sweeping through the country. Reports of clusters of infections among fully immunized people have suggested that the variant may be able to break through the vaccine barrier more often than previous iterations of the virus.
On Sunday, Dr. Anthony S. Fauci, President Biden’s chief medical adviser, warned in an interview on the CNN program “State of the Union” that the pandemic was “going in the wrong direction” because too many Americans were not getting vaccinated. Slightly less than half of the population had been fully vaccinated, as of Monday, according to federal data.
Dr. Fauci said that mask use by vaccinated people was “under active consideration” by federal health authorities, adding that it was prudent for vaccinated people to wear masks indoors in areas with “a lot of dynamics of infection.”
Daniel E. Slotnik contributed reporting.
As coronavirus infections rise in the United States, concern is mounting among officials and health experts that a surge of cases could devastate unvaccinated populations and push some communities back into the types of lockdowns imposed at the peaks of the pandemic.
Although case numbers are still a fraction of what they were in the worst months, Dr. Anthony Fauci, the nation’s top infectious disease expert, told CNN on Sunday that the country was “going in the wrong direction.” And it is not just Dr. Fauci. Gov. Kay Ivey of Alabama, a Republican, told reporters last week that unvaccinated Americans “are letting us down.”
On Monday, U.S. officials matched the growing concern with steps aimed at controlling travel to and from the United States to stem the spread of the highly contagious Delta variant.
The Biden administration said it would continue to restrict the entry of Europeans and others into the country, citing concerns that infected travelers could contribute to Delta’s spread. And the Centers for Disease Control and Prevention urged Americans to avoid traveling to Spain and Portugal, saying that as cases rise in both countries, “even fully vaccinated travelers may be at risk for getting and spreading Covid-19 variants.”
Spain and Portugal reopened their borders to American tourists in June. But over the past two weeks, there has been a 74 percent increase in new cases in Spain and an 18 percent rise in Portugal, according to New York Times data.
Last week, the C.D.C. put out a similar Level 4 travel notice — the highest warning it issues — for Britain. Almost all Covid restrictions have been lifted in England, and case numbers have been high.
Restrictions on travel from Europe and other parts of the world to the United States will remain in place, Jen Psaki, the White House press secretary, said on Monday afternoon, adding that she had no information on when the travel bans would be lifted.
“I don’t have a timeline to predict for you, because it’s all about what success we have at getting more people vaccinated, getting more vaccines out to the world and fighting the virus,” she said.
The U.S. government began restricting travel from foreigners in January 2020, when President Donald J. Trump blocked some travel from China in the hopes of preventing the spread of the virus. That effort largely failed. But health officials pressed the Trump administration to expand travel bans to much of Europe during the first surge of the pandemic in the spring of 2020, and more countries have been added to the ban as the virus and variants have spread.
Controlling travel in and out of the country is proving to be less daunting for U.S. officials than other problems in the pandemic. Misinformation continues to undermine efforts to persuade people that the vaccines are safe, with wildly inaccurate claims of the health risks thriving in some corners of the internet.
In Louisiana, where the vaccination rate is just over 45 percent, according to New York Times data — among the lowest in the United States — public health workers are going door-to-door to counter the claims. As mass vaccination sites have closed, health workers are trying to persuade people who are hesitant, and people who outright refuse, to get the shots.
Some jurisdictions are adopting more aggressive tactics, such as insisting that employees be vaccinated. U.S. officials said on Monday that the Department of Veterans Affairs would require 115,000 of its frontline health care workers to be vaccinated against the coronavirus in the next two months, making it the first federal agency to issue such a mandate.
In New York City, all municipal employees, including police officers and teachers, will have to be vaccinated or face at least weekly testing. Similar rules will apply to state employees and on-site public and private health care workers in California.
Such steps could become more prevalent if the virus continues to spread through unvaccinated populations. Dr. Joseph Kanter, the top health official in Louisiana, lamented that his state had become “the leading edge of the Delta surge,” adding: “We lost all the progress we had made.”
Ethan Hauser and
TIJUANA — On a recent morning, hundreds of Mexican workers from the factories here, known as maquiladoras, were waved across the border into San Diego, without visas or passports, and rolled up their sleeves to be vaccinated against Covid-19. An hour later, they were back on production lines in Tijuana.
The goal was to protect not just the workers, but also the intertwined U.S. and Mexican economies.
“If the maquiladoras can’t operate, then we don’t get our Coca-Cola,” said Lydia Ikeda, the senior director of Covid operations at the University California San Diego Health, which is helping run the program. “We cannot be isolated.”
The cross-border vaccination effort is meant to remedy the kind of disparity in access to the vaccine that economists have warned could keep a robust global economic rebound out of reach.
The Biden administration has pledged to send 80 million doses to other nations, including four million for Mexico, and to distribute 500 million doses of Pfizer-BioNTech’s vaccine among 100 countries over the next year.
Along the U.S.-Mexico border, however, a pandemic border closure and a dearth of vaccines in Mexico have threatened to keep local economic recovery at bay. And officials from both nations have found a way to share surplus vaccines from Texas and California with Mexicans on the other side.
“We are divided by a virtual line,” Dr. Ikeda said, gesturing to the border. “To get them vaccinated is the only way for us to get out of the pandemic.”
The idea of vaccinating workers just across the border occurred to Carlos González Gutiérrez, Mexico’s consul general in San Diego, when he watched as college students and undocumented workers plucking berries in California’s fields received the vaccines with relative ease while Mexico struggled to provide them for its older people.
Mr. González reached out to San Diego County officials, who had seen the closure of the border in March 2020 damage the region’s once-thriving economy, with a proposal: Why not give excess vaccines nearing expiration to the thousands of Mexicans factory workers just across the border?
Soon, Mexican and U.S. officials agreed that San Diego’s excess vaccines, all Johnson & Johnson, would be sold to American companies with factories in Mexico. By May, San Diego County had received permission from the federal government — which owns the vaccines — to sell the shots, and worked with the Department of Homeland Security to allow Mexicans without visas to cross the border to receive them.
New coronavirus cases have declined for six days in a row in Britain, a shift that is baffling scientists, many of whom predicted a powerful surge in cases after the government relaxed all but a handful of restrictions in England last week.
Few experts are willing to draw definitive conclusions from the downward trend, which could reflect transient factors like the school summer break, the end of the European soccer championships or fewer people getting tested for the virus.
But if sustained, the case numbers raise a tantalizing prospect that Prime Minister Boris Johnson bet correctly that the country could withstand a return to normalcy, even with the rapidly transmissible Delta variant widely circulating in the population. Even his own health secretary, Sajid Javid, predicted that cases could skyrocket to 100,000 a day before the country’s third wave of the pandemic ebbed.
The government has been careful not to declare victory too soon. Mr. Johnson emerged from self-isolation himself on Tuesday, after being in close contact with Mr. Javid, who tested positive for the virus on July 17.
“It is very, very important that we don’t allow ourselves to run away with premature conclusions about this,” the prime minister told reporters on Tuesday during a visit to a police station in Surrey, southwest of London. “People have got to remain very cautious, and that remains the approach of the government.”
On Monday, the government reported 24,950 new cases, down from a high of 54,674 on July 17. Hospital admissions and deaths are still up compared with a week ago, though both are typically lagging indicators. The Daily Telegraph reported, based on leaked data, that roughly half of all new Covid cases in people admitted to hospitals were in patients seeking care for other illnesses and found to be infected through routine testing.
That would be another encouraging sign, experts said, since it would suggest that many such people do not even realize that they have Covid — confirmation that the vaccines have weakened the link between infection and serious illness. Just over 70 percent of adults in Britain have received both doses of a vaccine.
In addition to the threat of soaring cases, Britain has also struggled with a cascade of people being notified, or “pinged,” by the National Health Service and told that they had been exposed to the virus and should quarantine themselves.
Scientists said it would take several more days to form definitive conclusions about the declining case numbers.
Elementary school students in the United States ended the 2020-21 school year four to five months behind where they normally would have been in academic achievement, according to a report by the consulting firm McKinsey & Co. that was released Tuesday. It found that many of the most vulnerable students experienced the steepest setbacks.
The new report — based on assessments taken by more than 1.6 million elementary school students who had returned to the classroom in the spring — is the latest indication that students who were already experiencing educational inequities were also hit hardest by the crisis.
For example, students attending schools whose student bodies were mainly Black or Hispanic ended the school year six months behind where they normally would have been in math, compared with four months behind for students in mainly white schools.
Similarly, students who attended a school where the average household income was less than $25,000 a year were seven months behind in math by the end of the term, compared with four months behind for schools where the average income was greater than $75,000.
“The pandemic hit everyone, but it hit kids who were already vulnerable hardest,” said Emma Dorn, an associate partner at McKinsey and the lead author of the report.
“That really widens some of the pre-existing opportunity and achievement gaps we were already facing in our country,” Ms. Dorn said.
Researchers used data provided by Curriculum Associates, an assessment company, and compared student performance this spring to the performance of demographically similar groups in the springs of 2017, 2018 and 2019.
The disparities probably reflect a number of factors, including less access to technology, higher rates of Covid-19 and higher unemployment in low-income communities and communities of color, and the fact that schools in major cities tended to stay longer with remote instruction. The report found that students in more urban schools experienced greater setbacks than those at rural schools, which generally returned to in-person learning sooner.
“You can’t look at the results in a vacuum,” said Pedro Noguera, dean of the University of Southern California Rossier School of Education, who called on schools to use federal funding to hire additional employees and devise individualized recovery plans for every student.
“If you have one teacher with 33 kids, that is not going to be a recipe for addressing this problem,” he said.
As coronavirus cases surge again across the United States, many inoculated people are losing patience with vaccine holdouts who they say are neglecting a civic duty or clinging to misinformation even as new patients arrive in emergency rooms and the nation renews mask advisories.
Barely a month ago, the country seemed to be exiting the pandemic, and a sense of celebration was palpable. Now, many vaccinated people fear for their unvaccinated children and worry that they themselves are still at risk of infection. Rising case rates are upending plans for school and workplace reopenings, and threatening another wave of infections that may overwhelm hospitals.
The mounting anger is contributing to political support for more coercive measures. Scientists, business leaders and government officials are calling for vaccine mandates — if not by the federal government, then by local jurisdictions, schools, employers and businesses.
And frustration is straining relations even within closely knit families.
Josh Perldeiner, 36, a public defender in Connecticut who has a 2-year-old son, was fully vaccinated by mid-May. But a close relative, who visits frequently, has refused to get the shots, although he and other family members have urged her to do so.
She recently tested positive for the virus after traveling to Florida, where hospitals are filling with Covid-19 patients. Now Mr. Perldeiner worries that his son may have been exposed.
“It goes beyond just putting us at risk,” he said. As infections rise, he added, “I feel like we’re at that same precipice as just a year ago, where people don’t care if more people die.”
Two Australian states will come out of lockdown on Wednesday night, as the authorities believe they have suppressed clusters of the infectious Delta variant. But in Sydney, the country’s biggest city, an outbreak that has swelled to 2,000 cases shows no signs of abating.
Starting on Thursday, shops and other businesses will be allowed to reopen in Victoria State, which includes Melbourne, although masks will still be required indoors and outdoors and a ban on at-home visitors will remain in place. A two-week lockdown, which aimed to contain a cluster that grew to 200 cases, had followed a similar lockdown in May.
The state’s premier, Daniel Andrews, celebrated the news on Tuesday, saying: “We have seen off two Delta outbreaks. I don’t think there’s a jurisdiction in the world that has been able to achieve that, and every Victorian should be proud of that.”
Restrictions were also set to be lifted in South Australia, which locked down a week ago after a handful of cases.
Case numbers continue to surge in New South Wales, which is in a fifth week of lockdown as officials struggle to battle an outbreak centered in the Sydney area that has led to 10 deaths. On Tuesday, the state reported 172 new cases, the most in a day since the outbreak began.
The state’s premier, Gladys Berejiklian, expressed concern that the measures were not enough to halt the spread of the virus, which was still being transmitted among essential workers and within households. She said that further measures to reduce transmission could be announced this week, and that officials would redouble efforts to get more people vaccinated. Only 13 percent of Australia’s population has received both doses of a Covid vaccine, according to New York Times data.
The authorities were also bracing for more infections after large anti-lockdown protests over the weekend in several cities, where photos showed many demonstrators not wearing masks. Prime Minister Scott Morrison called the protesters “selfish” and “self-defeating.”
In Sydney, where a protest drew about 3,500 people, the police made 63 arrests and issued more than 100 fines. The authorities warned that a protest reportedly planned for next weekend “won’t be tolerated again.”
Less than two weeks ago, a charter flight carrying half a million doses of Moderna’s Covid-19 vaccine took off from Kentucky and touched down at the international airport in Bhutan. By Monday, most adults in the remote Himalayan kingdom had been fully vaccinated against the coronavirus, all through donated shots.
The July 12 flight was the culmination of a weekslong diplomatic scramble in which Bhutan’s government asked 28 countries to supply doses for its second round of vaccinations, according to Will Parks, the country representative for the United Nations’ children’s agency.
The plane carried doses donated by the United States and distributed through Covax, a global vaccine-sharing partnership. Separately, Denmark sent 250,000 AstraZeneca doses directly; Bulgaria, Croatia and other nations sent another 100,000; and China sent 50,000 doses of its Sinopharm vaccine. Most of Bhutan’s second-round shots were administered over the past week, including to yak herders at high altitudes.
Bhutan’s success is notable because the campaign to vaccinate the world’s poorer nations is mostly floundering as wealthy nations delay shipments of doses, exacerbating inequalities in the pandemic response that analysts see as both a moral and epidemiological failure.
“I hope that this piece of good news functions as a prompt for the international community to do more to also reach other countries in need of vaccines,” said Lisa Herzog, a professor of philosophy at the University of Groningen in the Netherlands who has studied the ethics of the Covax distribution model.
Back in March, Bhutan pulled off a remarkable feat: vaccinating more than 93 percent of eligible adults with first doses in a country where some villages are accessible only by helicopter or on foot. But the success of that undertaking meant that the government needed to complete a second round of vaccinations within the recommended window of 12 to 16 weeks.
The first round — 550,000 doses of the AstraZeneca vaccine — had been donated by the government of India, where the drug is known as Covishield and manufactured by the Serum Institute of India, the world’s largest vaccine producer. But India later cut back on vaccine exports as its own outbreak surged.
“Bhutan had that kind of circumstantial imperative to chase, chase and chase vaccines in sufficient quantity to arrive en masse in a limited time, to be used in a mass vaccination for the second round,” said Dr. Parks, the UNICEF representative. “Other countries have not had that kind of circumstance, where they’ve done a massive first round. It’s been a trickle effect.”
Tashi Yangchen, a representative from Bhutan’s Health Ministry, said the second round of mass vaccination had ended on Monday with 90.2 percent of eligible adults fully vaccinated. Dr. Parks said the official figure would inch up a bit further in the coming days as people in hard-to-reach groups, such as nomadic tribes, received second shots.
Dr. Parks credited leadership from Bhutan’s government and royal palace, plus low levels of vaccine hesitancy and a robust cold-chain infrastructure.
Another reason, he said, was that the success of the first round of shots helped prove to donors that the country of fewer than 800,000 people could roll out a second round efficiently and effectively.
“Some of the other countries — which were struggling with using vaccines that they had available — couldn’t really fall back on that demonstration that ‘if you give, we will use,’” he said.
New York City resumed the process of transferring thousands of homeless people from pandemic hotel rooms back to barracks-style group shelters on Monday, two weeks after a judge halted the moves on the grounds that the city was not giving adequate consideration to people’s health.
The transfers, which caused confusion outside at least two hotels in Midtown Manhattan, came amid growing concern over the recent quadrupling in coronavirus cases citywide and over the objections of advocates for homeless people, who said that the city was flouting the judge’s orders.
As three school buses and several vans waited outside the Hotel at Fifth Avenue near the Empire State Building, Dianne Marks, said she had been told that she was being transferred to a group shelter uptown, even though she had applied for a disability exemption because of health issues including respiratory problems.
“I have no idea what is going on,” said Ms. Marks, 57, as hotel residents milled around with their possessions packed into city-issued trash bags.
The transfers resumed on the same day that Mayor Bill de Blasio ordered that city workers get vaccinated or tested weekly because “the Delta variant is deadly,” and his former health commissioner was quoted as saying that the transfer of homeless people to group shelters endangered “the entire city.”
In such shelters, 20 people sometimes sleep in a single room and share a bathroom, and city officials do not know how many homeless people have been vaccinated against Covid-19. They say that 7,300 out of 20,000 adults in the main shelter system have been inoculated at sites run by the Department of Homeless Services and that an undetermined number have been vaccinated elsewhere.
With coronavirus case counts rising, officials are imposing vaccine mandates on government workers in hopes that the private sector will follow suit. “We’re leading by example,” Mayor Bill de Blasio of New York said Monday, in announcing the city is mandating vaccines or testing for all municipal employees. “A lot of times, private sector employers say that’s what they need.”
The Centers for Disease Control and Prevention is expected on Tuesday to recommend that vaccinated people begin wearing masks indoors again in certain areas of the country, a reversal from its earlier guidance.
Some major New York employers, notably Morgan Stanley, have already moved toward mandating vaccination for workers returning to its offices in the city. Many others haven’t taken that step, even after the mayor’s urging.
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Facebook, which has 4,000 employees at its New York office, said Monday that it would continue to encourage, rather than require, coronavirus vaccines for workers. “We understand that some people may not or cannot get the Covid-19 vaccine for a variety of reasons, so the vaccine is not required to work from a Facebook office, though we encourage employees to get the vaccine to protect themselves and the communities we live in,” said Jamila Reeves, a Facebook spokeswoman.
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Goldman Sachs declined to comment. The New York Times reported in June that the bank, which has roughly 10,000 New York employees, was requiring its bankers to log their vaccination status before being allowed in the office. It has been requiring regular testing for unvaccinated employees.
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JPMorgan Chase, which employs about 20,100 people in New York, declined to comment. The bank has so far only strongly encouraged vaccinations, but its chief executive, Jamie Dimon, warned employees in a memo last month the bank “may mandate that all employees receive a Covid-19 vaccination consistent with legal requirements and medical or religious accommodations.”
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Citigroup, which has 7,000 New York-area employees, is requiring unvaccinated employees to use an at-home rapid test three times a week and to wear masks in the office. Those who show proof of vaccination can bypass those requirements.
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Pfizer, which employs roughly 2,700 employees and contractors in its Manhattan headquarters, does not generally require vaccinations as condition to enter its offices. “There may be certain circumstances in the future in which we impose a vaccination requirement in the interest of colleague health and wellness,” said Faith Salamon, a Pfizer spokeswoman.
As the world’s top athletes compete in near-empty Olympic venues cordoned off from the public, the coronavirus is racing through the rest of Tokyo: The city recorded a record number of new infections on Tuesday, suggesting that the measures that have kept the pandemic in check in Japan over the last year are beginning to lose their effectiveness just as the Summer Games have begun.
Tokyo officials said that 2,848 people had tested positive for the virus, the highest daily count since the pandemic began. The test positivity rate was 14.5 percent, according to government data, suggesting that many cases may be going undiagnosed.
Tokyo entered its fourth state of emergency this month as the city prepared to host the Olympics, which were delayed for a year because of the pandemic. Unlike some other countries, Japan has never entered a hard lockdown, instead relying on softer measures like mask-wearing and asking restaurants and bars to close early. But experts fear that those steps are becoming less effective as the more contagious Delta variant accounts for a larger proportion of new cases.
Japan’s vaccination program got off to a slow start, and three-quarters of the population has not been fully inoculated against Covid-19, according to New York Times data. At the same time, the public’s tolerance for even the soft limits placed on their daily lives has sharply diminished and life in Tokyo has, in many respects, returned to its prepandemic rhythms. That has raised concern among Japan’s medical community that stricter measures may be required to curb this and future outbreaks.
The Olympics has been a source of anxiety for many in the country, who feared that it could become a superspreader event. But so far there is little evidence that the surge in cases is linked to the Games. Olympic organizers have barred spectators from nearly all venues and instituted other measures, including frequent testing.
As of Tuesday, 160 people connected to the Games, including 21 athletes, had tested positive for the coronavirus, according to Olympic organizers and Times reporting. Although several athletes have had to withdraw from competition because of positive tests — including golfers Bryson DeChambeau of the United States and Jon Rahm of Spain — the Games have so far avoided a spike in infections that many had feared.
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