Covid Live Updates: News On Boosters And The Omicron Subvariant – The New York Times

President Biden stepped up pressure on Congress to approve billions of dollars in emergency coronavirus relief aid, using a speech at the White House on Wednesday to warn that U.S. progress against Covid-19 would be at severe risk if Congress failed to act right away.

“This isn’t partisan. It’s medicine,” Mr. Biden said, adding, “Americans are back to living their lives again; we can’t surrender that now. Congress, please act. You have to act immediately.”

On Capitol Hill, senators of both parties said they hoped a deal could be struck before Congress leaves next week for a two-week April recess. Such a deal would likely be $15.6 billion, matching the size of the smaller package that Democrats abruptly removed from a catchall spending bill earlier this month when rank-and-file lawmakers and governors objected to clawing back state aid to help pay for the deal.

It remains unclear how the package will be paid for — a Republican demand that has delayed passage.

“It’s totally up to Democrats,” said Senator John Thune of South Dakota, the No. 2 Republican. “This can get done, but it’s in their court, and it just requires them to be willing to repurpose some existing funds, which they’re reluctant to do.”

Mr. Biden’s speech on Wednesday was his first dedicated entirely to the pandemic since before his State of the Union address on March 1. It came just one day after federal regulators cleared additional boosters of the Pfizer and Moderna vaccines for Americans older than 50 and many immunocompromised people, four months after their first booster dose.

At the end of his remarks, the president, 79, rolled up his sleeve to get his second Pfizer-BioNTech booster shot.

Mr. Biden also used his remarks to spotlight a new one-stop-shopping coronavirus website, covid.gov, aimed at helping Americans navigate access to testing, treatment, vaccines and masks, and to assess the risk of Covid-19 in their neighborhoods. The site went live Wednesday morning.

The website, and Mr. Biden’s speech, are part of a broader effort to ease the nation out of pandemic crisis mode and usher in what experts are calling the “next normal” — a phase in which Americans will learn to live with the risk of Covid-19 and to adjust behavior like wearing masks based on whether cases and hospitalizations are rising or falling.

That strategy depends on the availability of vaccines and therapeutics, though, and the administration says it is out of money for both. The White House has been pleading with Republicans in Congress to approve the emergency aid to purchase new vaccines and therapeutics, and to reimburse doctors who care for uninsured Covid-19 patients.

While new coronavirus case have been falling in the United States, a highly transmissible Omicron subvariant known as BA.2 has driven a surge in cases in Europe, and many experts expect that the United States may soon see the same. Should that occur, it will be the first major test of the country’s new strategy of living with the virus while limiting its impact.

The Biden administration is expected to lift a pandemic-related public health order this week that has restricted immigration for the past two years, a change that could more than double what is already a historic number of migrants surging into the United States from Mexico.

The change is to take effect in late May, according to people familiar with the planning, and should restore the right of migrants to request asylum once they are in the United States, just as they did before the pandemic.

Even with the rule in place, the administration has struggled to manage a record spike in illegal migration along the border with Mexico, which Republicans have cast as out of control since President Biden took office. In recent days, border officials have encountered about 7,000 migrants daily. An even bigger surge — Homeland Security officials said on Tuesday they were preparing for as many as 18,000 migrants a day — could pose a serious political problem for Democrats ahead of the midterm elections this fall.

The public health order has given border officials the authority to quickly expel undocumented migrants, even those seeking asylum, to help prevent the spread of the coronavirus at border facilities and in border communities. In all, there have been 1.7 million expulsions under the order, which was issued by the Centers for Disease Control and Prevention and is known as Title 42.

It was not immediately clear whether the C.D.C. would lift the order in phases or all at once. The move will likely draw court challenges from Republican-led states, as have most of the Biden administration’s actions on immigration.

The C.D.C. issued the order in March 2020 and is responsible for deciding when “the danger of further introduction of Covid-19 into the United States” has receded enough that the order is no longer necessary. It has been questioned by public health experts and others who saw it more as an immigration control measure than a legitimate means of protecting Americans’ health.

WASHINGTON — President Biden received a second Pfizer-BioNTech booster shot against the coronavirus on Wednesday afternoon, a day after federal health officials cleared an additional booster dose of Pfizer or Moderna vaccines for people over 50 and for many of those who have compromised immune systems.

Officials said that people in those two categories could get another shot at least four months after they received their first booster. Mr. Biden, now 79, received a Pfizer booster in late September.

“We know boosters are critical to providing an additional level of protection,” Mr. Biden said on Wednesday, explaining why he was getting his second booster then. He got his shot after making remarks about the status of the fight against the pandemic, in which he highlighted a new website.

“It didn’t hurt a bit,” he said afterward.

Mr. Biden and his top public health advisers have repeatedly urged people to get fully vaccinated with the initial two-shot regimen required with either the Pfizer or Moderna vaccine. And they have said that everyone should get boosted because the initial vaccination’s effectiveness against infection from the virus diminishes over time.

In taking the shot, the president is hoping to encourage a population that is already weary of the fight against Covid-19 and over the vaccines. Officials said far fewer people have received booster shots than original vaccinations.

“If you haven’t gotten your first booster, please don’t wait,” Mr. Biden said on Wednesday.

Lawmakers and their staffs on Capitol Hill were informed on Wednesday that they too were now allowed to receive a second booster dose, if they are older than 50 or meet other criteria.

Zachary Montague contributed reporting.

In yet another twist to the debate over how best to protect children against the coronavirus, researchers reported on Wednesday that Covid vaccines conferred diminished protection against hospitalization among children 12 and older during the latest Omicron surge.

Vaccine effectiveness against hospitalization held steady in children aged 5 to 11 years, however, and among adolescents ages 12 to 18 years, two doses of the vaccine remained highly protective against critical illness requiring life support.

But effectiveness against hospitalization for less severe illness dropped to just 20 percent among these children. The findings were published in the The New England Journal of Medicine.

The data are broadly consistent with studies showing that, across all age groups, the vaccines lost much of their power against infection with the Omicron variant but still prevented severe illness and death.

Among adolescents in the study who were critically ill, 93 percent were unvaccinated, and most had at least one underlying condition, Dr. Patel noted. “I think the big take-home message is that with the simple act of vaccination, you can prevent most critical illness in most children,” he said.

As of March 23, only about one in four children ages 5 to 11, and just over half of adolescents 12 to 17, were fully vaccinated in the United States. Those percentages have barely budged in the past few months.

Because relatively few children are hospitalized for Covid, the researchers were able to identify only 1,185 children, comparing them with 1,627 others who did not have Covid. Among those hospitalized for Covid, 291 received life support and 14 died.

The study included data from 31 hospitals in 23 states, and spanned July 1 to Dec. 18, 2021, when the Delta variant was circulating, and Dec. 19 to Feb. 17, when the Omicron variant was dominant. During the Delta period, effectiveness against hospitalization was more than 90 percent among the adolescents up to 44 weeks after immunization.

When the researchers parsed the data by severity of illness, they found that vaccine effectiveness against critical illness among hospitalized adolescents remained high, at 79 percent, but had fallen to 20 percent for less severe illness.

The new study is among the first to look at vaccine effectiveness in relation to severity of illness among hospitalized patients. It’s possible that this trend would appear among adult patients, too, if they were analyzed similarly, said Eli Rosenberg, deputy director for science at the New York State Department of Health.

“This split along critical, noncritical is interesting,” he said. “This definitely adds a new layer.”

About 78 percent of all hospitalized adolescents in the study, and 82 percent of younger children, had one or more underlying medical conditions, like obesity, autoimmune diseases or respiratory problems, including asthma.

The study suggests that the vaccine protected a majority of these children from the worst outcomes, said Dr. Luciana Borio, a former acting chief scientist at the Food and Drug Administration.

The next wave of the coronavirus is coming, and in some parts of the United States, it’s already here. The culprit this time is the highly contagious Omicron subvariant BA.2, which has already led to a surge of cases in Europe and is now the dominant version of the virus in the United States and around the world.

American health officials have said they are hopeful that BA.2 won’t cause another major surge, in part because so many people were infected by the original Omicron wave this winter and most likely have at least some natural or vaccine immunity to protect them against severe illness and hospitalization.

But other variables could make the BA.2 wave more damaging. Less than 70 percent of Americans over 65 have had a first booster shot, leaving a large group vulnerable, said Dr. Eric Topol, a professor of molecular medicine at Scripps Research in La Jolla, Calif. And for many people who got their booster shots in the fall, immune protection may be waning. Unvaccinated people who are counting on natural immunity from a previous infection by a different variant should know that BA.2 can easily sidestep those fading immune defenses.

And then there’s the question of whether pandemic fatigue will prevent some people from taking reasonable precautions, like wearing masks and social distancing, when case numbers start to rise in their area.

While the virus is unpredictable, there are clear ways to protect yourself. Here’s what you can do to prepare:

• Pay attention to Covid indicators in your community.

• Have high-quality masks on hand.

• Order home coronavirus tests sooner rather than later.

• Get a booster (when you’re eligible).

• Get a pulse oximeter.

• Make a plan for antiviral drug treatment.

• Have backup plans for social events and travel.

As Americans shed masks and return to offices and restaurants, officials in states across the country are scaling back the most visible public health efforts to address the coronavirus pandemic: free state-run testing and vaccination sites.

States like Arizona, Nevada, Hawaii and Ohio have also stopped releasing daily data on virus hospitalizations, infections and deaths.

The cutbacks are coming at a time when the virus appears, at least for now, to be in retreat in the United States as a whole, with cases falling swiftly in recent weeks. But the more transmissible version of the Omicron variant, known as BA.2, is already surging in Europe and Asia and has become the dominant cause of new cases in the United States, and the statistics have started to edge upward once again in several states, including New York.

And Americans still lag behind many other countries in vaccination. Only about 65 percent of Americans have completed an initial vaccination so far, and less than one-third have had a first booster shot. With protection waning over time, federal authorities announced on Tuesday that people 50 or older could get a second booster shot.

If the United States is in for another surge, public health officials said, it could be difficult to quickly restore the vaccination and testing sites and other measures that are now being shut down. But may local officials say they cost too much to keep open when demand is low, and federal support is drying up.

“If people aren’t walking in the door, it burns a lot of cash to have a fully staffed testing center,” said Andrew Noymer, a public health professor at the University of California, Irvine. “So I can understand why states and localities are closing them. We’re going to have to find a way to be flexible.”

Maintaining that flexibility may prove challenging.

“I’m concerned about what’s next,” said Robert Spencer, chief executive of Kintegra Health, which operates health centers across central North Carolina. Noting that Kintegra’s mobile testing and vaccination clinics have relied on federal reimbursement that is longer available, he said, “When I shut it down, and all these people go find other jobs, and the next variant comes along, will I be ready?”

In a move celebrated by many cruise operators, the Centers for Disease Control and Prevention ended on Wednesday the tiered system that it has used for two years to publicly rate the pandemic risk of taking a cruise.

“While cruising will always pose some risk of Covid-19 transmission, travelers will make their own risk assessment when choosing to travel on a cruise ship, much like they do in all other travel settings,” a C.D.C. spokesman said in a statement.

Virgin Voyages, a cruise company owned by the British billionaire Richard Branson, applauded the agency’s decision.

“While we feel this was a long time coming, we recognize this move as a demonstration of all of the hard work this industry has done to ensure that we’re offering the safest way to travel,” Tom McAlpin, the chief executive of Virgin Voyages, said in a statement.

When the C.D.C. published its final rating under the old system on Tuesday, the agency rated cruise travel overall in the Level 2 orange or moderate-risk category. That meant that in the agency’s view, cruise travel was relatively safe for most travelers but should be avoided by unvaccinated travelers, who are at increased risk for severe illness.

From late December through February, when the Omicron surge was at its most severe in the United States, the agency rated cruise travel in its highest-risk category, Level 4, and warned all travelers, vaccinated or not, to avoid cruise ships.

The ratings have been closely watched over the past two years both by travelers who were impatient for a safe vacation and by ship operators who were desperate to make up the gargantuan losses they suffered in the long periods when they could not sail at all.

Cruise ships have been the sites of some of the most alarming and highly publicized coronavirus outbreaks, with infection spreading rapidly among guests and employees.

One early example was the Diamond Princess. One infected passenger boarded the ship in January 2020, and a month later there were more than 700 positive cases among the 3,711 passengers and crew members, with many falling seriously ill.

As horror stories spread about some people quarantining for weeks in small, windowless staterooms on the Diamond Princess and other afflicted ships, some of which were denied port entry, the future of the cruise industry seemed uncertain.

Then, as the first waves of the pandemic subsided and cruise operators sought to resume sailing, safety precautions like requiring proof of vaccination to board became political bones of contention, especially in Florida.

The C.D.C. said that while it was ending its industrywide rating for cruise travel, it would continue to publish a color-coded rating for conditions on some individual ships, based on the percentage of passengers who are vaccinated and the number of coronavirus cases reported on board.

Global Roundup

Hong Kong is scrambling to import more coffins as the Chinese territory struggles to handle the surge in deaths during the latest wave of the pandemic.

More than 90 percent of all the deaths linked to the virus since the pandemic started happened in the past 30 days, putting a strain on mortuaries, funeral homes and the local government. The number of bodies at public mortuaries has risen “exponentially,” said Carrie Lam, the chief executive, this week. Hong Kong has recorded about 7,400 deaths tied to the virus since 2020.

Hong Kong officials have already brought in 2,170 coffins from mainland China and have ordered at least 1,000 more that were expected to arrive this week, the city’s Food and Environmental Hygiene Department said.

The pandemic’s death toll in Hong Kong has also put the city’s crematories under pressure. Daily cremation sessions have more than doubled to 300 this month, the department said last week.

While funeral and cremation services have been overwhelmed, it appears that worst is behind Hong Kong. Cases and deaths are declining. The average number of new daily cases in the past week has dropped 85 percent from the peak earlier this month. And deaths have declined 34 percent from the seven-day average two weeks ago.

Still, about 186 people have died from the virus each day on average in the past seven days. There are about 7.5 million residents in Hong Kong.

To speed up the process of identifying bodies and helping families claim them, the city has deployed civil servants and retired medical staff to public mortuaries, Mrs. Lam said on Sunday.

In other global news:

• Starting Sunday, Macau, the Chinese territory west of Hong Kong, will require people ages 18 and up arriving from outside the region, including mainland China, Hong Kong and Taiwan, to have received a third dose of the coronavirus vaccine before entry if their second dose was administered more than seven months ago.

• After opening up its borders to business travelers earlier this month, Taiwan will require customers entering places like bars and nightclubs to show proof of three vaccinations. The new rules start on Friday and will last through the end of April. Staff members at those facilities will be required to undergo rapid tests every week.

Jin Yu Young contributed reporting.

Jilin, an industrial province in northeastern China, is at the front line of the country’s latest coronavirus outbreak, leaving medical workers and migrant laborers there struggling to cope with restrictions.

Shanghai, which imposed a lockdown to stanch a coronavirus surge, has won more attention in China and abroad in part because it had appeared to be a well-run bastion against infections, and it has a large and vocal-middle class. But statistics of illness and resident accounts suggest that Jilin has been hit harder.

China is trying to follow a restrictive policy, but is now reporting nearly 9,000 cases a day, most of them in people showing no symptoms. More than 2,000 new cases were detected in Jilin on Tuesday, most of them light or asymptomatic, according to China’s National Health Commission.

While the numbers are relatively few compared with those in many countries, especially when it comes to serious illness and death, China’s stringent lockdown and quarantine policies have put a strain on local governments as cases rise and residents require hospital beds, medicine and food deliveries. All 1,150 symptomatic cases in Jilin recorded on Tuesday have been put into medical isolation, according to local health officials.

In recent days, messages have spread on China’s internet describing rural migrant workers in Jilin who have tested positive for the coronavirus and then come under quarantine. Some have complained of lack of medical treatment and economic support. They included laborers who, in a twist of irony, said they had helped build the makeshift hospitals to treat Covid patients there.

“Everyone’s panicking and they don’t know where to go,” said one of the calls for help. “Over 40 have tested positive. Where do we get treatment? Afterward who’s going to set things right with us?”

One infected worker who posted the plea online said in a telephone interview that he had been locked up in the same hospital he had just built as a day laborer, along with dozens of other infected workers. He said he had a fever and sometimes could not get medicine while medical staff members struggled to tend to 300 patients. He said that he was not being paid for his time in quarantine and would miss the spring planting season on his farm.

On Monday, officials in Hebei Province, near Beijing, confirmed that two workers who had traveled to Jilin to help build the Covid hospitals had returned home infected with the coronavirus.

At a news conference on Monday, an official from the Jilin city government — the city is a namesake of the province — acknowledged that workers on a building site for a Covid hospital there had been infected. The official said that the spread had been stopped and “the workers’ rights have been effectively protected and assured.”

Calls to Jilin province government’s press office went unanswered, and an official at the province’s health department said he did not know about the workers’ complaints.

This week, Sun Chunlan, the Chinese vice premier in charge of pandemic measures, visited Jilin. She told officials to stick to the government’s “dynamic zero” goal of minimizing infections.

“Apply rigorous measures to continue getting to grips with every task in pandemic prevention and control,” she said, according to the Jilin government website.

Keith Bradsher contributed reporting and Liu Yi contributed research.

The anti-parasitic drug ivermectin, which has surged in popularity as an alternative treatment for Covid-19 despite a lack of strong research to back it up, showed no sign of alleviating the disease, according to results of a large clinical trial published on Wednesday.

The study, which compared more than 1,300 people infected with the coronavirus in Brazil who received either ivermectin or a placebo, effectively ruled out the drug as a treatment for Covid, the study’s authors said.

The researchers shared a summary of these results in August during an online presentation hosted by the National Institutes of Health, but the full data set had not been published until now in The New England Journal of Medicine.

“Now that people can dive into the details and the data, hopefully that will steer the majority of doctors away from ivermectin towards other therapies,” Dr. David Boulware, an infectious-disease expert at the University of Minnesota, said.

For decades, ivermectin has been widely used to treat parasitic infections. Early in the pandemic, when researchers were trying thousands of old drugs against Covid-19, laboratory experiments on cells suggested that ivermectin might block the coronavirus despite evidence that it would work and the drug being toxic to humans.

But no large study had been able to disprove that ivermectin did not work against Covid-19 until now.

Researchers in Brazil provided the drug to 679 patients over the course of three days between March and August 2021 in a double-blinded treatment, meaning that neither the patients nor their medical staff knew whether they received a Covid treatment drug or a placebo.

The results were clear: Taking ivermectin did not reduce a Covid patient’s risk of ending up in the hospital.

The researchers zeroed in on different groups of volunteers to see if they experienced benefits that others didn’t. For example, it might be possible that ivermectin only worked if taken early in an infection. But volunteers who took ivermectin in the first three days after a positive coronavirus test turned out to have worse outcomes than did those in the placebo group.

There are other ongoing randomized trials of ivermectin, with thousands of volunteers, that have yet to share their results. The National Center for Advancing Translational Sciences, which is part of the N.I.H., has for more than a year been running one closely watched trial of ivermectin and several other drugs for Covid patients. But it has yet to release results.