Covid-19 Latest Updates: Biden Administration Opens Nursing Home Doors

The Biden administration on Wednesday published revised guidelines for nursing home visits during the pandemic, allowing guests the freedom to go inside to see residents regardless of whether the visitors or the residents have been vaccinated.

The new recommendations, released by the Centers for Medicare & Medicaid Services with input from the Centers for Disease Control and Prevention, are the first revision to the federal government’s nursing home guidance since September. And they arrived as more than three million vaccine doses have been administered in nursing homes, the agency said.

The guidance was also the latest indication that the pandemic in the United States was easing, with Covid-19 cases continuing to decrease across the nation, though the seven-day average remains at more than 58,000. The C.D.C. on Monday released long-awaited guidance for Americans who have been fully vaccinated, telling them that it is safe to gather in small groups at home without masks or social distancing.

About 62.5 million people have received at least one dose of a Covid-19 vaccine, including about 32.9 million people who have been fully vaccinated with Johnson & Johnson’s single-dose vaccine or the two-dose series made by Pfizer-BioNTech and Moderna.

In a statement of the reasoning behind the updated recommendations, Dr. Lee Fleisher, the chief medical officer at C.M.S., cited the millions of vaccines administered to nursing home residents and staff and a decline in infections in nursing homes.

“C.M.S. recognizes the psychological, emotional and physical toll that prolonged isolation and separation from family have taken on nursing home residents, and their families,” Dr. Fleisher said.

Earlier in the pandemic, the coronavirus raced through tens of thousands of long-term care facilities in the United States, killing more than 150,000 residents and employees and accounting for more than a third of all virus deaths since the late spring. But since the arrival of vaccines, new cases and deaths in nursing homes have fallen steeply, outpacing national declines, according to a New York Times analysis of federal data.

The eight pages of recommendations, which are not legally binding, did come with suggested limits, saying that “responsible indoor visitation” should be allowed at all times unless a guest is visiting an unvaccinated resident in a county where the Covid-19 positivity rate is higher than 10 percent and less than 70 percent of residents in the nursing home have been fully vaccinated. The guidance also says to limit visits if residents have Covid-19 or are in quarantine.

Federal officials said in the new guidance that outdoor visits were still preferable because of a lower risk of transmission, even when the residents and guests have been fully vaccinated.

So-called “compassionate care” visits — when a resident’s health has severely deteriorated — should be allowed regardless of vaccination status or the county’s positivity rate, the guidance said.

Across Maryland on Wednesday, mayors, county executives, business owners and public health officials were parsing Gov. Larry Hogan’s surprise Tuesday announcement that he was loosening statewide Covid restrictions.

The order allows bars, restaurants, churches and gyms to open back up to full capacity starting Friday evening, though with certain social distancing regulations still in place. It also allows larger venues like banquet halls, theaters and sports stadiums to open to the public at 50 percent of capacity. The statewide mask mandate remains in effect.

“With the pace of vaccinations rapidly rising and our health metrics steadily improving, the lifting of these restrictions is a prudent, positive step in the right direction and an important part of our economic recovery,” Mr. Hogan said. He was joined at his announcement by Dr. Robert R. Redfield, a former director the Centers for Disease Control and Prevention, who is now a senior adviser to the governor.

Some business owners applauded the announcement as a sign that they may be able to begin crawling out of an economically punishing year. Public health experts were less welcoming.

“I was shocked, I thought it was a joke,” said Dr. Leana Wen, a public health professor at George Washington University and former Baltimore health commissioner.

City and state officials were surprised by the order, but they were particularly taken aback by one part of it, which seemed to say that starting Friday, the ability of local governments to make rules that are more restrictive than the state’s — a flexibility they have had throughout the pandemic — would be “null and void.”

That language seemed to conflict with Mr. Hogan’s remarks at the announcement, when he said that though he discouraged deviations, state law gave local jurisdictions “some powers to take actions that were more restrictive.” The governor’s spokesman said in a tweet that county “emergency powers and authorities” established during the pandemic were unaffected.

County and city officials spent Wednesday reading their local charters and talking with their lawyers about the situation.

In an emailed statement, Baltimore County Executive John A. Olszewski, Jr., said, “leaders across Maryland have been forced to scramble to meet with our legal teams, health officials, and neighboring jurisdictions to understand how this impacts our own executive orders and to determine if and how to use our own local authority moving forward.”

Maryland ranks in the middle of states in the percentage of its people who have been given at least one vaccine dose, according to a New York Times database, and somewhat above average in the number of new cases it has been reporting lately relative to its population — 13 per 100,000 residents. All three of the variants of the virus that are being tracked by the C.D.C. have been reported there, but only one in significant numbers: B.1.1.7, which was first identified in Britain and is more transmissible and possibly more lethal than earlier versions of the virus.

In the early days of the pandemic, Governor Hogan drew bipartisan praise for his aggressive response. He was among the first governors in the country to order schools closed, and he publicly criticized President Trump, a fellow Republican, for leaving states unprepared to deal with the pandemic. “I think a lot of us locally and around the country would have rated him very highly,” Dr. Wen, former Baltimore health commissioner, said.

Her estimation has fallen considerably since then. While she said she was pleased that Mr. Hogan did not lift his statewide mask order, as fellow Republican governors in Texas and Mississippi did last week, she called the broad lifting of capacity restrictions a dangerous gamble.

“It’s really disappointing, because we’ve come so far,” she said. “Why are we letting down our guard down when we’re so close?”

About 300,000 people are expected to descend on Daytona Beach, Fla., this week for an annual motorcycle rally despite the pandemic and a lack of restrictions to slow the spread of the coronavirus.

Excitement about the event has been tempered by some motorcycle enthusiasts in a Facebook group dedicated to the rally who worry it could turn into a superspreader event.

Last August, the Sturgis motorcycle rally in South Dakota drew more than 450,000 bikers, most of whom did not wear masks or appear to follow social-distancing guidelines. That rally was later blamed for outbreaks in other states.

Daytona Beach’s Bike Week typically draws almost half a million people, though because of the pandemic, numbers are estimated to be closer to 300,000 people this year, said Janet Kersey, the executive vice president and chief operating officer of the Daytona Regional Chamber of Commerce.

“We know because of continued Covid concerns and the loss of income many have had over this past year it will be less,” Ms. Kersey said. Good weather and the accelerating pace of vaccinations might increase attendance, she said.

At least 125 new coronavirus deaths and 4,426 new cases were reported in Florida on Tuesday, according to a New York Times database. Over the past week, there has been an average of 4,948 cases per day in the state, a decrease of 16 percent from the average two weeks earlier.

A more contagious and possibly more lethal variant of the coronavirus, known as B.1.1.7, which was first spotted in Britain, is spreading more widely in Florida as a share of total cases than in any other state, according to an analysis of data from Helix, a lab testing company.

Officials urged people attending Bike Week to exercise care.

“While our community is working hard to follow C.D.C. safety guidelines,” Ms. Kersey said, “the support of the visitors and participants is important in these efforts, as well, for everyone’s safety.”

Bike Week events include races, bike exhibitions, concerts and giveaways in and around Daytona Beach. Ms. Kersey said that officials had considered canceling the gathering but that the Daytona Beach City Council was “very meticulous in its decision to move forward.”

HOUSTON — The plexiglass was down. The tables were crammed back into bars and restaurants. The masks were off.

There had been plenty of resistance to masks in Texas, even if many started to begrudgingly wear them. But now it is official: The state is no longer legally requiring people to cover their faces.

It is just one of the rules loosened by state officials eager to declare the pandemic over, even if the case numbers say otherwise.

“It is now time to open Texas 100 percent,” Gov. Greg Abbott declared in announcing the changes last week. And so on Wednesday, the signs reminding people about the mask mandate came down. So did barriers intended to curb the spread of the coronavirus.

On South Padre Island, it was like prepandemic times, with spring breakers drinking and dancing at a beachside bar. And the Texas Rangers announced that when the baseball season starts next month, they would allow the stadium — 40,518 seats — to be filled to capacity.

Not everyone was celebrating.

At Barflys in San Antonio, the “MASKS REQUIRED UPON ENTRY” sign outside may have been gone, but Britt Harasmisz’s face covering remained firmly in place as she tended customers at the patio bar.

“A lot of people have been vaccinated — Governor Abbott was vaccinated,” said Ms. Harasmisz, 24. “But a lot of us on the front lines have not.”

Texas has not rolled the calendar back entirely.

Businesses are still allowed to require employees and customers to cover their faces and limit capacity. Cities can choose to keep limits in place in municipal facilities, and masks remain required on federal property.

Hours before restrictions were lifted across the state, city officials in Austin announced they planned to defy the governor’s new orders and impose a citywide mask mandate. That puts this Democratic-led city on yet another likely collision course with the Republican-led state Legislature after years of clashes on a range of issues.

A City Council member, Greg Casar, said city officials believed their stance is “legal and it’s right.”

“If the state chooses to sue us, then it’s basically them going out of their way to undermine the health of Texas,” he said. “My hope is that they focus on vaccine distribution rather than messing with Austin and putting more lives at risk.”

Others welcomed the new rules.

On the smoky back patio of Barflys, Sophie Bojorquez, 47, sat at a table with friends. She is a vaccinated nurse and a self-proclaimed anti-masker.

“I’m happy about the governor’s decision. The masks impeded the herd immunity we need. Now they want to vax so fast,” she said, shaking her head.

The move to open Texas has faced intense resistance.

The governor’s medical advisers have said that they were not involved in the decision. And federal health officials and some experts are concerned that the moves, especially repealing the mask mandate, could intensify the spread of the virus during the vaccination process.

Texas, which is averaging about 5,500 new cases a day, has one of the lowest vaccination rates in the country.

Lina Hidalgo, the county judge in Harris County, which includes Houston, argued that lifting the mask mandate puts the burden on workers to enforce rules in retail establishments and restaurants.

“We know better than to let our guard down simply because a level of government selected an arbitrary date to issue an all-clear,” Ms. Hidalgo, a Democrat and a persistent critic of Mr. Abbott, said in an op-ed column published this week by Time magazine. “I am working to clearly explain to the residents of my county that we will spare ourselves unnecessary death and suffering if we just stick with it for a little bit longer.”

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Biden Orders 100 Million More Johnson & Johnson Vaccine Doses

President Biden announced on Wednesday that the government would secure another 100 million doses of the Johnson & Johnson vaccine and touted a joint production deal between the company and the pharmaceutical giant Merck.

Today, we’re seeing two health companies, competitors, each with over 130 years of experience, coming together to help write a more hopeful chapter in our battle against Covid-19. During World War II, one of the country’s slogans was, “We are all in this together.” We are all in this together. And the companies took that slogan to heart. For example, one automaker didn’t have the capacity to build enough Jeeps. The competitors stepped in to help. The result is that we’re now on track to have enough vaccine supply for every American adult by the end of May, months earlier than anyone expected. And today, I’m directing Jeff and my H.H.S. team to produce another 100 million doses and purchase another 100 million doses of the Johnson & Johnson vaccine. On Saturday, we hit a record of 2.9 million vaccinations in one day in America. And beyond the numbers are the stories. A father says he no longer fears for his daughter when she leaves to go to work at the hospital. The children are now able to hug their grandparents. The vaccines bring hope and healing in so many ways. There is light at the end of this dark tunnel of the past year, but we cannot let our guard down now or assume the victory is inevitable. Together, we’re going to get through this pandemic, and usher in a healthier and more hopeful future.”

President Biden said on Wednesday that he was directing the federal government to secure an additional 100 million doses of Johnson & Johnson’s Covid-19 single-shot vaccine, a move the White House said could help the country vaccinate children and, if necessary, administer booster doses or reformulate the vaccine to combat emerging variants of the virus.

Mr. Biden made the announcement during an afternoon event at the White House with executives from Johnson & Johnson and the pharmaceutical giant Merck, where he praised them for partnering to ramp up production of the Johnson & Johnson vaccine — a deal brokered by the White House.

“During World War II, one of the country’s slogans was, ‘We are all in this together,’” Mr. Biden said. “And the companies took that slogan to heart.”

In announcing the agreement between Merck and Johnson & Johnson last week, Mr. Biden said that the United States would now have enough vaccine available by the end of May to vaccinate every American adult — roughly 260 million people. But Jen Psaki, the White House press secretary, said on Wednesday that the administration was trying to prepare for unpredictable challenges, from the emergence of dangerous virus variants to manufacturing breakdowns that could disrupt vaccine production.

“We still don’t know which vaccine will be most effective on kids,” she said at the White House’s daily briefing. “We still don’t know the impact of variants, the need for booster shots and these doses can be used for booster shots, as well.” She said the decision to purchase a surplus of the Johnson & Johnson vaccine was driven by a desire for “maximum flexibility.”

“It’s a one-shot vaccine,” she said. “It can be stored in the fridge and not a freezer. It’s highly effective as the others are as well against hospitalization and death.”

Mr. Biden said on Wednesday he was directing the White House’s pandemic response team and the Department of Health and Human Services to finalize the supply increase.

The White House had initially intended to hold Wednesday’s event at the Baltimore manufacturing facility of Emergent BioSolutions, another company that partners with Johnson & Johnson to make coronavirus vaccine. But Mr. Biden canceled his trip after The New York Times published an investigation into how Emergent used its Washington connections to gain outsize influence over the Strategic National Stockpile, the nation’s emergency repository of drugs and medical supplies.

Ms. Psaki has since said that the administration will conduct a comprehensive audit of the stockpile.

Emergent officials did not attend Wednesday’s session. In explaining the change in plans, Ms. Psaki said that the administration thought the White House was a “more appropriate place to have the meeting,” which it is billing as a celebration of what Mr. Biden has called the “historic” partnership between Johnson & Johnson and Merck.

Last August, Johnson & Johnson signed an agreement with the government to deliver 100 million doses of its coronavirus, and in an emailed statement on Wednesday the company said it is “on track to meet that commitment.” The government has the option to purchase additional doses under a subsequent agreement.

The administration says the collaboration with Merck will increase manufacture of the vaccine itself, and will also bolster Johnson & Johnson’s packaging capacity, known in the vaccine industry as “fill-finish” — two big manufacturing bottlenecks that had put the company behind schedule.

Wednesday’s announcement is in keeping with Mr. Biden’s aggressive efforts to acquire as much vaccine supply as possible, as quickly as possible. Before Mr. Biden took office, he pledged to get “100 million shots into the arms” of the American people by his 100th day in office — a timetable that seemed aggressive at the time, but more recently has looked tame. He has been trying to speed it up ever since.

At the time, two vaccines — one made by Moderna and the other by Pfizer-BioNTech — had been authorized by the Food and Drug Administration for emergency use. In January, Mr. Biden said the administration would have enough vaccine to cover every American by the end of summer. Last month, the president announced his administration had secured enough doses from those two companies to have enough to cover every American by the end of July.

The recent addition of the Johnson & Johnson vaccine, which received emergency authorization in late February, opened a path for the administration to move up the timetable yet again. But Johnson & Johnson and its other partners, including Emergent, were behind schedule, which prompted the administration to reach out to Merck.

Noah Weiland and Annie Karni contributed reporting.

Black and Hispanic communities are confronting vaccine conspiracy theories, rumors and misleading news reports on social media.

The misinformation includes false claims that vaccines can alter DNA or don’t work, and efforts by states to reach out to Black and Hispanic residents have become the basis for new false narratives.

“What might look like, on the surface, as doctors prioritizing communities of color is being read by some people online as ‘Oh, those doctors want us to go first, to be the guinea pigs,’” said Kolina Koltai, a researcher at the University of Washington who studies online conspiracy theories.

Research conducted by the nonprofit Kaiser Family Foundation in mid-February showed a striking disparity between racial groups receiving the vaccine in 34 states that reported the data.

State figures vary widely. In Texas, where people who identify as Hispanic make up 42 percent of the population, only 20 percent of the vaccinations had gone to that group. In Mississippi, Black people received 22 percent of vaccinations but make up 38 percent of the population. According to an analysis by The New York Times, the vaccination rate for Black Americans is half that of white people, and the gap for Hispanics is even larger.

The belief that doctors are interested in experimenting on certain communities has deep roots among some groups, Ms. Koltai said. Anti-vaccine activists have drawn on historical examples, including Nazi doctors who ran experiments in concentration camps, and the Baltimore hospital where, 70 years ago, cancer cells were collected from a Black mother of five without her consent.

An experiment begun in the 1930s (not conducted in 1943, as an earlier version of this item reported) on nearly 400 Black men in Tuskegee, Ala., is one of the most researched examples of medical mistreatment of the Black community. Over four decades, scientists observed the men, whom they knew were infected with syphilis, but didn’t offer treatments so that they could study the disease’s progression.

Researchers who study disinformation followed mentions of Tuskegee on social media over the last year. The final week of November, when the pharmaceutical companies Moderna and Pfizer announced promising results in their final studies on the safety of their Covid-19 vaccines, mentions of Tuskegee climbed to 7,000 a week.

New York City’s public schools have seen remarkably low virus transmission compared with the citywide rate of positive test results in the months since the nation’s largest school system reopened for thousands of students, according to a major new peer-reviewed study in the medical journal Pediatrics.

Of over 200,000 people who were tested in city school buildings from October to December, only .4 percent of tests came back positive for the coronavirus. That was during a period when virus cases were spiking in the community.

And even when cases were detected, relatively few close contacts in the school ended up testing positive for the virus during the same period: .5 percent of school-based contacts who quarantined contracted the virus.

“In-person learning in New York City public schools was not associated with increased prevalence or incidence overall of Covid-19 infection compared with the general community,” the study’s authors wrote. The study was led by Dr. Jay Varma, Mayor Bill de Blasio’s senior health adviser.

Still, school-based testing has been random and therefore focused more on identifying asymptomatic cases, while many New Yorkers who got tested outside schools had symptoms or had been exposed to the virus.

Mr. de Blasio reopened classrooms last September, months before many other large districts, particularly in the Northeast and on the West Coast. The city closed schools in November as virus cases surged, and has gradually reopened throughout the winter and spring. Still, the vast majority of city school students, roughly 700,000 children, have elected to learn from home for the rest of the school year.

The mayor faced significant criticism for his push to reopen schools, and there was widespread fear among families and educators that it was not yet safe to return to school buildings. But the strict safety measures the city put in place, including required masking, social distancing between students and teachers, and weekly random testing seem to have helped keep positivity rates in schools extremely low, the study said.

“We’ve said that our public school buildings are some of the safest places in New York City — and we’ve got the numbers to back it up,” Mr. de Blasio said in a statement on Wednesday.

The European Union exported 25 million doses of vaccines produced in its territory last month to 31 countries around the world, with Britain and Canada the top destinations, just as the bloc saw its own supply cut drastically by pharmaceutical companies, slowing down vaccination efforts and stoking a major political crisis at home.

The European Union — whose 27 nations are home to 450 million people — came under criticism last week, when Italy used an export-control mechanism to block a small shipment of vaccines to Australia. The move was criticized as protectionist and in sharp contrast to the bloc’s mantra of free markets and global solidarity in the face of the coronavirus pandemic.

The issue of vaccine production and exports has also created a bitter dispute between the European Union and Britain, which recently departed the bloc, prompting accusations that Brussels wants to deprive London of doses out of spite, in part because Britain is doing so much better with its rollout.

The tensions culminated in a diplomatic spat on Wednesday, after a top E.U. official accused the United States and Britain of implementing an “export ban” — a charge the British government vehemently denied.

Practically speaking, ban or no ban, Britain is not exporting vaccines authorized for use at home. The country has said that it would be prepared to give excess shots to neighboring Ireland but only after it was done with its own vaccination efforts.

The United States has also been hoarding doses, in part through a wartime mechanism known as the Defense Production Act which permits the federal government greater control over industrial production. President Biden last week promised each adult American at least one vaccine dose would be offered to them by May.

But information made public for the first time, recorded in detailed internal documents seen by The New York Times, shows that the European Union, far from being protectionist, is in fact a vaccine exporting powerhouse.

Of the nearly 25 million total vaccines made in the European Union that were exported from Feb. 1 — when the export mechanism came into force — to March 1, about a third, more than eight million doses, went to Britain.

And while the United States kept doses for itself, the European Union shipped 651,000 vaccines to the country last month, and made vaccines for others across the Atlantic: The country that received the second-largest number of shots made in the European Union was Canada, with more than three million doses last month, while Mexico received nearly 2.5 million.

GLOBAL ROUNDUP

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Chaos in the Streets: Protests Turn Violent in Athens

Around 6,000 people gathered to protest against police violence and officers’ coronavirus lockdown tactics in Athens on Tuesday night. Police said 10 officers were wounded and 16 people were arrested.

[shots fired] [explosions] [explosion]

A protest in Greece turned violent on Tuesday night as anger grew about tactics used by police officers who were enforcing coronavirus lockdown restrictions.

The clashes came on the same day that Greece said it was aiming to open to vacationers in mid-May. Later, the country reported 3,215 new infections, its highest daily tally since mid-November.

The protest on Tuesday was provoked after a video emerged two days earlier seeming to show an officer beating a man with a baton in the Athens suburb of Nea Smyrni. The man was apparently among several who had expressed objections to officers issuing fines to people in the square. The officer has since been suspended, the police said on Wednesday.

Around 6,000 people gathered in the normally quiet suburb on Tuesday evening to protest against police violence. The demonstration began peacefully but spiraled into violence after about 500 people appeared to pelt officers with firebombs. The police said that 10 officers were wounded, one seriously after he was dragged off a motorcycle and set upon. Sixteen people were arrested and were to face a prosecutor on Wednesday on charges including attempted homicide, possession of explosives and arson.

Prime Minister Kyriakos Mitsotakis appeared on television on Tuesday night, calling for calm and restraint. The violent turn of the protest has fueled debate in the Greek media about police tactics in enforcing the lockdown.

The Greek ombudsman said on Tuesday that reports of police violence had increased by 75 percent over the past year. Alexis Tsipras, leader of the leftist opposition party Syriza, referred on Monday to a “crescendo of police violence on the pretext of enforcing health measures.” Mr. Mitsotakis countered by calling Mr. Tsipras’s support for large rallies at the peak of a pandemic “the height of irresponsibility.”

The conservative government of Mr. Mitsotakis has urged Greeks to be patient for a little longer so that it can start gradually reopening the country’s battered economy without provoking a new surge in infections. However, public tolerance appears to be waning as government officials have been accused of flouting restrictions that thousands of ordinary Greeks have been fined for violating.

Mr. Mitsotakis himself came under fire last month for apparently disregarding his own government’s restrictions for the second time in two months, violating limits on public gatherings by attending a lunch at a politician’s home on an Aegean island.

In other news from around the world:

• Mauritius went into a two-week nationwide lockdown on Wednesday, Agence France-Presse reported, the second time that the Indian Ocean archipelago nation has imposed such a restriction since the pandemic began. “We had no other choice but total containment in order to prevent the spread of the virus and protect the population,” Prime Minister Pravind Kumar Jugnauth announced Tuesday evening in a televised address. Only essential services will be operational from Wednesday, including hospital services and emergency relief. As of Thursday, supermarkets, bakeries, petrol stations and pharmacies will have limited accessibility. The country, which has a population of about 1.4 million, has reported 641 cases of the virus and 10 deaths.

• Kenya and Morocco have approved the Russian Sputnik V vaccine, according to RDIF, a Russian sovereign wealth fund, Reuters reported. The fund, which is promoting the vaccine globally, said that 48 countries had now approved Sputnik V.

Across the United States, thousands of actors, musicians, dancers and other entertainment industry workers are losing their health insurance or being saddled with higher costs in the midst of the pandemic. Some were simply unable to work enough hours last year to qualify for coverage. Others were in plans that made it harder to qualify for coverage.

The insurance woes came as performers faced record unemployment. Several provisions in President Biden’s $1.9 trillion coronavirus relief plan, which passed the Senate on Saturday and is expected to pass the House on Wednesday, offer the promise of relief. One would make it a lot cheaper for people to take advantage of the federal government program known as COBRA, which allows people to continue to buy the health coverage they have lost. Another would lower the cost of buying coverage on government exchanges.

Many of the more than two dozen performers interviewed by The New York Times said that they had felt abandoned for much of the year — both by their unions and by what many described as America’s broken health care system.

“You never think it’s going to be you,” said Robbie Fairchild, a former dancer at New York City Ballet who was nominated for a Tony Award in 2015 for his star turn in “An American in Paris” on Broadway and who later appeared in the film adaptation of “Cats.”

Unlike other workers who simply sign up for a health plan when they start a new job, the people who power film, television and theater often work on multiple shows for many different employers, cobbling together enough hours, days and earnings until they reach the threshold that qualifies them for health insurance. Even as work grew scarce last year, several plans raised that threshold.

Musicians are struggling, too. Officials at Local 802 of the American Federation of Musicians, the New York local that is the largest in the nation, estimate that when changes to its plan take effect this month, roughly one in three musicians will have lost coverage.

Insurance plan officials say they were left with no choice but to make painful changes to ensure their funds survive because health care costs have been rising at rates that have outpaced contributions.

The delivery of restaurant orders and other goods has become a bigger part of daily life across the United States since the pandemic forced millions of people indoors. And in New York City — where the disease has taken nearly 30,000 lives — delivery workers have become a lifeline for people working from home and for vulnerable residents who have been warned against going outside.

On any given day, thousands of men, and a growing number of women, can be seen crisscrossing city arteries, transporting meals, groceries and medicine in plastic bags on top of their well-worn bikes.

But their visibility has also made them targets for criminals looking for a quick profit through robbery. The unemployment rate has surged into double digits and economic desperation has grown in the city’s less affluent neighborhoods, which had already been pummeled by the pandemic.

Stolen electric bikes can be easily sold on the streets for cash or dismantled for their parts, the police and workers say. The bikes can cost thousands of dollars and are vital tools for the workers, who often make less than $60 a day. Many have come to rely on the bikes, despite the steep price tag, because they can go about 20 miles per hour, enabling workers to travel farther and make more trips to increase their slim bottom lines.

The theft of electric bikes doubled during the first year of the pandemic, rising to 328 in 2020 compared with 166 the year before, according to police data obtained by The New York Times.

Investigators said robbers often use fraudulent credit cards to call in bogus orders and lure delivery workers to secluded locations. The delivery workers then are faced with two dire options: let go of the expensive bikes they need to remain employed, or risk injury and even death.

Ligia Guallpa, director of the Worker’s Justice Project, a nonprofit that represents immigrants working in low-wage jobs, said that many delivery workers did not report robberies and assaults. A large percentage of them lack the documentation to work in the country legally and don’t speak English fluently. Many fear filing a police report could lead to deportation.

An Indian-made Covid-19 vaccine that was rolled out in an ambitious inoculation campaign even before some questions about it had been fully answered appears to be safe to use, a leading British medical journal reports.

Writing in The Lancet, researchers said the vaccine, Covaxin, did not produce any serious side effects in trials.

But the researchers said they were not yet able to say how well the vaccine works.

Covaxin was developed by Bharat Biotech and was authorized for use by India’s top drug regulators in January. That was done before it had been publicly established whether the vaccine was either safe or effective, prompting many people in India, including some front-line health care workers, to voice concerns.

Bharat Biotech said last week that initial results from its clinical trials indicated that the vaccine was both safe and effective, but many public health officials prefer to rely on independent assessments like that published in The Lancet, rather than a company’s own announcements.

Around the time that the Indian government green-lit Covaxin, it also authorized the use of the Oxford-AstraZeneca vaccine, which is known in India as Covishield and is manufactured there, among other places.

India has set out on one of the most ambitious and complex nationwide health campaigns in its history: immunizing 1.3 billion people against the coronavirus. It has also bet heavily on its growing pharmaceutical industry, which produces drugs and vaccines for export around the world as well as domestic use.

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Variants Comprise About Half of N.Y.C. Virus Cases, Officials Say

New York City health officials said genetic analysis suggested that 51 percent of the city’s coronavirus cases were now caused by two new variants, but emphasized that vaccines remained effective.

“Unfortunately we have found that the new variants of Covid-19 are continuing to spread. And when you combine the variant of concern, B.1.1.7., the one first reported in the U.K., and the new variant of interest, B.1.5.2.6., that was first reported here in New York, together these new variants account for 51 percent of all cases that we have in the city right now. So for the variant of interest, B.1.5.2.6., that was reported here first in New York, our preliminary analysis indicates that it is probably more infectious than older strains of the virus. You know, what I referred last week to ‘Covid Classic.’ It may be similar in infectiousness to the B.1.1.7., the U.K. strain, but we’re not certain about this yet. We need to understand and study it more. Very important: Our preliminary analysis does not show that this new strain, B.1.5.2.6., causes more severe illness or reduces the effectiveness of vaccines.” “The B.1.5.2.6. variant, in particular, is increasing in prevalence across New York City, representing about 39 percent of all samples sequenced by the pandemic response lab during the most recent week with full data, compared to 31 percent the week prior. The B.1.1.7. strain, sometimes known as the U.K. variant, which also spreads more easily, has increased to 12 percent of samples analyzed in the most recent week, up from 8 percent the prior week. We know the virus is a formidable foe, but we also know what has worked to curb its spread. And that’s true for the new variants too. It’s the Safe 6: masking, distancing, handwashing, getting tested, staying home if you’re feeling ill and getting vaccinated when it’s your turn.”

Genetic analysis suggests that roughly half of coronavirus cases in New York City now are caused by two new forms of the pathogen, city officials reported on Wednesday.

One of the so-called variants, first detected in the city, now accounts for nearly 40 percent of all cases analyzed in local laboratories. The increase in the variant, B.1.526, was so striking that officials said they believed it was more infectious than the original form of the coronavirus.

Another more contagious variant, B.1.1.7, first discovered in Britain, also is spreading steadily in the city, accounting for 12 percent of cases analyzed in the last week of February, up from 8 percent the prior week. B.1.1.7 may be more lethal than earlier versions of the virus.

Rather than sound an alarm, officials said that they believed continued health practices — from masking to getting vaccinated — were sufficient to control the virus. Vaccines remain effective against these variants, as well as the original coronavirus.

So far, deaths and serious hospitalizations continued on a downswing in the city, the officials noted. “So far, thank God, what we’re finding is the variants are not posing the worse kind of problems that we might fear,” Mayor Bill de Blasio said at a news briefing on Wednesday.

Dr. David Chokshi, the city health commissioner, said that the B.1.526 variant had been detected in samples across the city, and not just in one community. The variant first appeared in samples in November, particularly those from Washington Heights in Manhattan, and was first described in academic papers released in late February.

The variant was detected in about one-quarter of samples analyzed by the two academic groups in mid-February, one led by a group at Caltech, the other by researchers at Columbia University.

But the city’s own analysis found that the prevalence of the B.1.526 variant was even higher, at 31 percent in the third week of February, and 39 percent by the end of the month, Dr. Chokshi said.

Dr. Anthony West, a computational biologist at Caltech, said in an interview on Wednesday that his ongoing research also showed that the B.1.526 variant was “increasing at a considerable pace in New York City” but that it remained “fairly localized” in the area.

He and his colleagues have found two subtypes of the B.1.526 variant: one with the E484K mutation seen in South Africa and Brazil, which is thought to help the virus partially dodge the vaccines; and another with a mutation called S477N, which may affect how tightly the virus binds to human cells.

Epidemiologists have expressed concern about the variant, but city officials said that despite the E484K mutation, they still had no evidence that the B.1.526 variant was partially evading vaccine protection. “Our preliminary analysis does not show that this new strain causes more severe illness or reduces the effectiveness of vaccines,” said Dr. Jay Varma, an adviser to Mr. de Blasio.

Earlier this year, experts had said the city’s capacity for genetic analysis was inadequate to understand the dynamics of New York’s outbreak. The United States’ overall ability to track variants is much less robust than in Britain, and federal health officials have expressed significant concern that variants may spread here undetected. New York has been increasing the number of samples it analyzes in recent weeks.

Nationally, epidemiologists have been sounding alarms about B.1.1.7, which is on track to be the dominant form of the virus in this country by the end of March. That variant is believed to have contributed to steep case increases and full hospitals in Britain and elsewhere.

“What we’ve seen in Europe when we hit that 50 percent mark, you’ll see cases surge,” said Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, on NBC’s “Meet the Press” on Sunday. He urged the public not to let up on health measures and to get vaccinated as quickly as possible.

Dr. Denis Nash, an epidemiologist at the City University of New York, said Wednesday that while he was worried about the new variants, more questions than answers remain about how they will impact the spread of the virus in New York City.

“It’s anybody’s guess, given the vaccine, the competition among the variants and everything we are trying to do to keep the virus low,” he said.

“The same things we always do have the ability to reduce the impact of the virus,” he added, urging continued vigilance and precautions. “If there is an exposure that gets past those defenses, there is potential that it could more easily take hold, or last longer. But if we keep doing everything we have been doing to prevent spread, we should be able to manage the variants too.”

Apoorva Mandavilli contributed reporting.

Some of Spain’s largest regions are pressing the central government to speed up the country’s Covid-19 vaccination program, in particular by increasing access for older people to the vaccine developed by AstraZeneca and Oxford University.

When the vaccine was first approved in Europe in February, a number of countries — including Spain — set an age limit for its use, because there was relatively little data available then on its safety in older people. Spain set its age ceiling at 55.

Those limits have since been relaxed in countries like Germany and France, and on Wednesday, Spain’s neighbor Portugal announced that it would start allowing the Oxford-AstraZeneca vaccine to be given to people over 65.

That added to mounting pressure on the Spanish government to do the same.

The health minister of Catalonia, the northeastern region that includes Barcelona, issued an ultimatum on Wednesday, saying that if national officials did not soon follow Portugal’s example, Catalonia would do so unilaterally.

Isabel Díaz Ayuso, the leader of Spain’s capital region, has also been asking the central government to raise the age ceiling to at least 65.

Spain’s vaccination rollout has also come in for criticism from members of the main association of doctors, who have complain about red tape slowing the process and about people like teachers and police officers starting to get shots while some health care workers have not yet had a chance.

As of the start of this week, the health ministry said, some 3.4 million people in Spain, or about 7 percent of the population, had received at least one dose of vaccine. The Spanish government has pledged to vaccinate 70 percent of the population by the end of summer.