Covid-19: Fauci Warns Americans Might Need to Wear Masks for Another Year

Dr. Anthony S. Fauci, President Biden’s chief medical adviser for Covid-19, said on Sunday that Americans may still be wearing masks outside their homes a year from now, even as he predicted the country would return to “a significant degree of normality” by fall.

“I want it to keep going down to a baseline that’s so low there is virtually no threat,” Dr. Fauci said on the CNN program “State of the Union,” referring to the number of cases nationally that would make him comfortable enough to stop recommending universal masking. “If you combine getting most of the people in the country vaccinated with getting the level of virus in the community very, very low, then I believe you’re going to be able to say, for the most part, we don’t necessarily have to wear masks.”

Dr. Fauci appeared on a series of TV news programs on Sunday morning, where he was quizzed on the dangers of variants of the coronavirus, the schedule of the nation’s vaccine rollout and when vaccination would allow more students to return to schools.

On this last question, Dr. Fauci said on “Fox News Sunday” that he hoped high school students, far fewer of whom have gone back to classrooms compared with younger children, would be eligible for vaccination in the fall.

“That’s why we are pushing on those studies, to get them vaccinated,” he said of teenagers, who are currently the subject of clinical trials by Pfizer and Moderna. “That will likely occur in the fall; I can’t say it’s going to be on day one of when school starts in the fall term.”

Vaccinations for younger children, however, “likely will not be before the beginning of the first quarter of 2022,” Dr. Fauci said.

On the hotly debated question of whether people should wait longer than the recommended three or four weeks to get a booster vaccine, or even skip the second dose, Dr. Fauci said on NBC News’s “Meet the Press” that it was prudent for people to stick to the prescribed schedule.

“There are enough unknowns in that, particularly the durability of the protection,” he said.

He added that while new data suggesting people who have had Covid could get enough protection from one dose was “really quite impressive,” it might be complicated to document who has had the virus.

He also addressed the subject of the mutated variant of the coronavirus identified in South Africa. In clinical trials involving the AstraZeneca-Oxford vaccine in that country, patients who were inoculated were not protected from mild or moderate illness caused by the variant, known as B.1.351. Dr. Fauci said on “Fox News Sunday” that while it is still rare in the United States, “if it becomes more dominant, we may need a version of the vaccine that’s effective specifically against” it.

With the United States expected to surpass 500,000 deaths from Covid-19 in the coming days, Dr. Fauci told Chuck Todd on “Meet the Press” that “we haven’t seen anything even close to this for well over 100 years,” since the 1918 influenza pandemic, adding, “People will be talking about this decades and decades and decades from now.”

The chief executive of the Indian pharmaceutical giant that dozens of countries are counting on to supply them with Covid-19 vaccines said on Sunday that their deliveries might be delayed because it had been “directed” to fill domestic needs ahead of export orders.

“Dear countries & governments,” the executive, Adar Poonawalla of the Serum Institute of India, wrote in a tweet in which he warned of delays. “I humbly request you to please be patient,” he wrote, adding that his company had been directed to prioritize “the huge needs of India and along with that balance the needs of the rest of the world. We are trying our best.”

He did not say who had issued the directive, and the Serum Institute did not immediately return requests for comment.

India produces three-fifths of the world’s supply of all kinds of vaccines, and the country’s prime minister, Narendra Modi, has launched one of the world’s largest and most ambitious vaccination campaigns, aiming to inoculated India’s 1.3 billion people.

But even though the country already operates a huge immunization program, administering about 390 million shots against ailments like measles and tuberculosis in an average year, India is struggling to get Covid inoculations to the population. Less than 1 percent of Indians have been inoculated since mid-January. The pandemic has caused at least 10.9 million known coronavirus infections in India so far, more than in any other country except the United States.

The country’s regulators have approved two vaccines: one developed by AstraZeneca and Oxford University and produced by the Serum Institute, and another — still in trials — developed by the National Institute of Virology with Bharat Biotech, a local pharmaceutical company that will make the doses.

The Serum Institute will also make doses of a vaccine developed by Novovax once it is approved.

Besides helping supply India and other clients, the company is expected to produce hundreds of millions of doses of the AstraZeneca vaccine and more than a billion Novovax vaccines to be distributed through the global vaccination initiative Covax, which aims to ensure that 92 low- and middle-income countries receive vaccines at the same time as the world’s 98 richer countries. Covax did not immediately respond to requests for comment about Mr. Poonawalla’s alert that foreign countries would have to wait for vaccines.

Many developing countries want the AstraZeneca vaccine because it is much less expensive and much easier to store and transport than other Covid vaccines now in use. That also makes it suitable for India’s vast vaccination campaign, which must reach from the towering Himalayan mountains to South India’s dense jungles.

The Indian government has increasingly used the country’s vaccine manufacturing capacity as a currency for its international diplomacy, in competition with China, which has made doling out shots a central plank of its foreign relations. Last week, for example, India promised to donate 200,000 vaccine doses for United Nations peacekeepers around the world.

One year ago, when the coronavirus spread to the United States, few public health experts predicted its death toll would climb to such a terrible height.

At a White House briefing on March 31, Dr. Anthony S. Fauci, the top infectious-disease expert in the country, and Dr. Deborah L. Birx, who was coordinating the coronavirus response at the time, announced a stunning projection: Even with strict stay-at-home orders, the virus might kill as many as 240,000 Americans.

Less than a year later, the virus has killed more than twice that number. A nation numbed by misery and loss is confronting a number that still has the power to shock: 500,000.

No other country has counted so many deaths during the pandemic. More Americans have perished from Covid-19 than they did on the battlefields of World War I, World War II and the Vietnam War combined.

The milestone comes at a hopeful moment: New virus cases are down sharply, deaths are slowing and vaccines are steadily being administered.

But there is concern that new, more contagious variants of the virus could quickly undo the nation’s progress and lead to another spike. It will still take months to vaccinate the American public, and it may be months before the pandemic is contained.

The virus has reached every corner of America, devastating dense cities and rural counties alike. By now, about one in 670 Americans has died of it.

In New York City, more than 28,000 people have died of the virus — or one in 295 people. In Los Angeles County, which has lost nearly 20,000 people to Covid-19, about one in 500 people has died of the virus. In Lamb County, Texas, where 13,000 people live scattered on a sprawling expanse of 1,000 square miles, one in 163 people has died of the virus.

As the United States approaches the loss of half a million people to Covid-19, there are few events in history that adequately compare.

The 1918 influenza pandemic is estimated to have killed about 675,000 Americans, according to the Centers for Disease Control and Prevention, when the country’s population was a third of what it is now. But it also happened at a time when influenza vaccines, antibiotics, mechanical ventilation and other medical tools did not exist yet.

Deaths from Covid-19 in the United States came faster as the pandemic went on. The first known death occurred in February, and by May 27, 100,000 people had died. It took four months for the nation to log another 100,000 deaths; the next, about three months; the next, just five weeks.

Though daily deaths are now slowing, about 1,900 deaths in America are being reported each day. As of Saturday evening, the toll had reached 497,221.

The Institute for Health Metrics and Evaluation, an independent global health research center at the University of Washington, has projected that the nation could reach more than 614,000 deaths by June 1. Factors like how well people adhere to guidelines like mask-wearing and social distancing, plus the speed of vaccinations, could affect that estimate.

WASHINGTON — President Biden’s national security adviser on Sunday urged the World Health Organization to dig deeper and China to release raw data on the origins of the Covid-19 virus, casting doubt on a completeness of coming report from the health organization.

“The only way to have a scientifically based investigation is to have access to all the data,” Jake Sullivan, the national security adviser, said on “Face the Nation” on CBS, calling for “a credible, open, transparent international investigation led by the World Health Organization.”

The W.H.O. sent a team of investigators, mostly scientists, to China for four weeks over January and February to investigate the origins of the virus. The team said after returning to the United States that Chinese scientists refused to give them access to patient records and other critical data. The investigators are already working on a preliminary report, but Mr. Sullivan said more research was needed. “The W.H.O. still has more work to do to get to the bottom of exactly where this virus emerged,” he said.

Toward the end of the show on which Mr. Sullivan aired his concerns, Matthew Pottinger, President Trump’s former deputy national security adviser, made an appearance in which he continued to advance a discredited theory promoted by the previous administration and challenged by many scientists: that Covid-19 was the product of secret Chinese military experimentation in a lab in Wuhan, China.

While acknowledging some of the Trump administration’s “grave missteps,” such as not advising the America public soon enough to wear masks and not doing enough collection and analysis about the how the virus was spreading and evolving genetically, Mr. Pottinger said China misled U.S. public health experts by not disclosing that the virus could spread silently, carried by people who did not show symptoms.

“We were waiting to be fed information when the nature of that regime meant that we were not going to get that information,” Mr. Pottinger said. “They had a strong incentive to mislead their own public and the rest of the world about the nature of this virus.”

During his appearance, Mr. Sullivan lamented a decision by the Trump administration to dismantle a special White House office that the Obama administration set up inside the National Security Council to detect and address pandemics. And Mr. Pottinger said that, based on the Covid-19 experience, the Centers for Disease Control should establish “a new super body for pandemic preparedness and response,” with the person in charge attached to the White House.

Both men said that the U.S. intelligence community should have played a greater role in addressing the Covid-19 pandemic. Mr. Sullivan said the Biden administration would be increasing “its tools, its resources, its practices to focus on detecting, preventing and responding to pandemics.”

Mr. Pottinger, a former Marine intelligence officer who resigned from the Trump administration after Trump supporters invaded the Capitol on Jan. 6, said, “I don’t think that the intelligence community is going to be able to do more than that critical role of collecting and analyzing the information.”

As new variants of the coronavirus spread rapidly, a number of European countries are moving to reintroduce border controls, chipping away at what was once the world’s largest area of free movement.

Fearing the highly contagious and possibly more lethal new variants first identified in Britain and South Africa, both Germany and Belgium introduced new border restrictions this week, adding to steps taken by other countries.

The European Union sees free movement as a fundamental pillar of the continent’s deepening integration, but after a decade in which first terrorism and then the migration crisis tested that commitment, countries’ easy resort to border controls is placing it under new pressure.

The European Commission, the E.U. executive branch, has tried to pull countries back from limiting free movement since last March, after most imposed restrictions at the onset of the crisis.

“Last spring we had 17 different member states that had introduced border measures and the lessons we learned at the time is that it did not stop the virus but it disrupted incredibly the single market and caused enormous problems,” the commission’s president, Ursula von der Leyen, told the news media last week. “The virus taught us that closing borders does not stop it.”

But Ms. von der Leyen’s remarks triggered a pushback from Germany.

“We are fighting the mutated virus on the border with the Czech Republic and Austria,” the German interior minister, Horst Seehofer, told the tabloid newspaper Bild. The commission “should support us and not put spokespeople in our wheels with cheap advice,” he snapped.

One factor that may help keep borders open is the vast and instant economic impact now felt from even minor closures.

Since Sunday, the only people allowed to enter Germany from the Czech Republic or the Tyrol region of Austria, where instances of the coronavirus variant that originated in Britain are rising, are those who are German, living in Germany, carrying freight or working in essential jobs in Germany. All have to register and show a negative coronavirus test result before entry.

But thousands of people in Austria and the Czech Republic commute daily to jobs in Germany, and after the new checks came into force, long lines began to form. By the end of the week, business groups were writing desperate letters asking Germany to ease or lift the restrictions.

From afar, the graphic on the front page of Sunday’s New York Times looks like a blur of gray, a cloudy gradient that slowly descends into a block of solid ink. Up close, it shows something much darker: close to 500,000 individual dots, each representing a life lost in the United States to the coronavirus.

Half of the front page was dedicated to the graphic. The prominent real estate conveyed the significance of this moment in the pandemic and the totality of the devastation.

Lazaro Gamio and Lauren Leatherby, both graphics editors at The Times, plotted out the points so they stretched chronologically down a long scroll, from the first reported U.S. death nearly a year ago to the current toll of often thousands of casualties per day.

The front page has been used to visualize the breadth of the pandemic before. When Covid deaths in the United States reached 100,000 last May, the page was filled with names of those who died. And as that number approached 200,000, the lead photograph on the page showed the yard of an artist in Texas, who filled his lawn with a small flag for every life lost to the virus in his state.

But unlike the previous approaches, Sunday’s graphic depicts all of the fatalities. “I think part of this technique, which is good, is that it overwhelms you — because it should,” Mr. Gamio said.

Since the onset of the pandemic, the Graphics desk has been working on what editors internally call “the State of the Virus,” an effort to provide visuals that capture the defining moments of this story. The goal of this particular visualization was to add context to a fluctuating death count: April 2020 felt like “the sky was falling,” Mr. Gamio said, but this winter has been markedly worse.

“There is just a certain numbness, I think, that is normal human nature when this has been going on for so long, but we’ve tried to just keep reminding people of what’s still going on,” Ms. Leatherby said. “And I think something striking about this particular piece that we were trying to drive home is just the sheer speed at which it was all happening.”

The House version of President Biden’s coronavirus relief plan would add $1.9 trillion to the federal budget deficit over the next decade, the Congressional Budget Office estimated this weekend.

That figure is in line with Mr. Biden’s calls for a $1.9 trillion package, and it reflects Democrats’ determination to hold the line on the president’s calls to “go big” on stimulus despite pressure from Republicans and some liberal economists to scale back the plan, warning of possible inflation stemming from increased federal borrowing.

The legislation would fund measures to combat the pandemic, provide billions of dollars for schools and small businesses, temporarily bolster unemployment benefits, aid state and local governments, and deliver a round of $1,400 direct payments to individuals.

Most of the money is projected to hit the economy over the next year. The budget office estimated that about $1.6 trillion in new spending would occur this fiscal year, which ends Sept. 30, and in the 2022 fiscal year, which begins in October.

The rest of the money will be spent more gradually, the budget office said. Much of the delayed spending comes in the category of education.

Canadians might be known internationally as nice, apologetic and fair-minded. But a very different Canadian persona has been exposed by a year of pandemic: one that shames people for contracting and potentially spreading the virus.

People are calling out not just authority figures like politicians and doctors for breaking the rules, but also their own relatives and neighbors.

Snitch lines set up across Canada have been flooded with tips about people suspected of breaking quarantine, businesses flouting public health restrictions, and out-of-towners siders with unfamiliar license plates who are seen in town and might be bringing the virus with them.

Facebook groups are full of stories of people being labeled potential vectors and are then refused service, disinvited from family gatherings, and reported to the police and public health authorities.

Experts worry that fear of being treated that way may be driving cases underground, delaying reports of Covid-19 symptoms and making people avoid getting tested.

“This is impacting our ability to contain the virus,” said Dr. Ryan Sommers, one of eight public health doctors in Nova Scotia who published a letter beseeching residents in the small Atlantic province to stop shaming one another.

Nova Scotia has one of the lowest coronavirus rates in the country, with just 12 active cases as of Feb. 16. But Dr. Sommers said vigilance has turned into hypervigilance. .

“We want to create a social norm where people will be supportive and caring and compassionate,” Dr. Sommers said. “Social media can be more virulent than the virus itself.”

In the country’s four eastern provinces, which have enforced self-isolation rules for anyone entering the region, the shaming is not just online, said Robert Huish, an associate professor at Dalhousie University in Halifax, who is conducting a study of coronavirus stigma. It’s intimate, particularly in small communities, where “community cohesion quickly flips to become community surveillance.”

Some say the fear of stigma has become worse than the fear of contracting the virus.

Historically, stigma and shaming have faithfully trailed pandemics, said David Barnes, an associate professor at the University of Pennsylvania who studies the history of infectious diseases and epidemics. During the plague years in Europe, Jewish people were made into convenient scapegoats. When cholera afflicted Britain in the 19th century, working-class Irish people were blamed, Mr. Barnes said.

Most recently, gay men and Haitians were stigmatized during the AIDS epidemic in the United States.

“We make ourselves feel safer and superior by associating disease with people who are not like us, do things we don’t do or come from places unlike our place,” Mr. Barnes said. “We shouldn’t be surprised.”

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Australia Begins Covid-19 Vaccination Campaign

Australia began vaccinating its population against Covid-19 on Sunday. Jane Malysiak, 84, a resident of a nursing home in Sydney, and Prime Minister Scott Morrison were among the first to receive a vaccine.

[laughing] “Twenty-five years.” “Oh.” “There you go.” [speaking quietly] “There we go.” [clapping] “What we’re demonstrating today is our confidence. I am supremely confident in the expert process that has been led to get us to this day. So from tomorrow, tens of thousands of Australians over the course of the next week can confidently come forward from those key priority groups that have been defined, to ensure that we move into this next phase of how we’ve been preparing and dealing with Covid-19.” “Well done, P.M.” “Put that there, thank you. Well done.” “Just roll up your —.” “Thank you.” “Great, that‘s all done.” “Thank you.” “Thank you.” “He’s doing the same.” “That was excellent, you had a good nail.” “Oh, good.” “Terrific. All done.” “Terrific.”

Australia began vaccinating its population against the coronavirus on Sunday, with Prime Minister Scott Morrison and 19 other people getting shots a day after hundreds gathered nationwide to protest the vaccine rollout.

The first Australian to be vaccinated was Jane Malysiak, 84, who lives in a Sydney nursing home. She was followed by a number of quarantine and health care workers; the country’s chief health officer, Paul Kelly; and Mr. Morrison.

When asked by the person administering his vaccine whether he had any questions, Mr. Morrison replied, “No, I’m ready to go, just like the country.”

Australia, a country of about 25 million, aims to have four million people vaccinated by the end of next month. Prioritized groups are receiving the Pfizer-BioNTech vaccine, though Australia has also approved the vaccine from Oxford University-AstraZeneca, which is being manufactured domestically. The vaccines are being distributed for free and taking them is not compulsory, although employers in some high-risk industries may be able to compel workers to vaccinate.

The event in Sydney was intended to build confidence ahead of the country’s official vaccine rollout on Monday, and it came a day after anti-vaccine protests took place in most major Australian cities.

In Melbourne, the police clashed with protesters and used pepper spray, according to the local news media. The police said they had arrested 20 people on charges including breaching public health orders and resisting arrest. The Australian Broadcasting Corporation estimated that the protest drew about 500 people.

Protests in other cities were largely peaceful. In Sydney, the police said more than 400 people protested, while in Brisbane, the ABC estimated there were over 1,000. Protesters chanted “Freedom!” and “My body, my choice.”

New Zealand officially began its own vaccine rollout over the weekend, also using the Pfizer-BioNTech vaccine. Both countries have recorded relatively few coronavirus cases and deaths, reporting zero locally acquired infections in the 24 hours before vaccinations began.

Weddings have always been emotional, but adding personal boundaries around safety and health, confusing government guidelines and the finer points of air filtration systems to the mix has pushed families and wedding planners to the edge.

Adept at negotiating fraught moments and achieving the impossible, wedding professionals are now also acting as health, infrastructure and grief experts. They face states, counties and cities with shifting and often senseless hodgepodges of guidelines and restrictions, or, sometimes, no rules at all.

“Everybody in the wedding industry is more confused than ever,” said Sonal Shah, who owns an event consulting company in New York. “One person in our office is dedicated to researching C.D.C. guidelines.”

In Texas, now gripped by a severe storm that forced power outages and water shortages, all venues can currently be filled to 75 percent capacity — but, as with a number of states, churches are exempt from that rule.

In North Dakota, an executive order ended capacity limits on weddings in mid-January, but state guidelines still offer numerous suggestions, such as limiting guest lists to 1,000 people in venues that can hold 2,000.

In New York, for now, weddings are capped at 50 people — indoors or outdoors. Religious ceremonies have to limit attendees to 50 percent of the venue’s capacity.

The Michigan guidelines are nearly impenetrable, but seem to indicate that no more than 10 people from no more than two households can gather indoors, and 25 people can gather outside, as long as there are no more than 20 people within 1,000 square feet — unless there is fixed seating, in which case a maximum of 25 people can gather, as long as attendance is limited to 20 percent of seating capacity of the outdoor area. Got that?

Regulations can also change unexpectedly, a challenge for events that are planned months in advance. Dr. Anthony S. Fauci, the government’s top infectious disease expert, suggested in December that weddings be pushed to June or July of 2021 at the earliest.

But as vaccinations and hope spread across the United States, the race to schedule weddings is back on.

An industry market report — which vividly showed the suffering finances of the wedding industry in 2020 — predicts that there will be a significant increase in wedding revenue this year.