Travel

Covid-19: More U.S. States Expand Vaccine Eligibility as Pace of Inoculations Accelerates – The New York Times

Dr. Scott Harris, Alabama’s state health officer, receiving his second shot of a Covid-19 vaccine at Baptist Medical Center South in Montgomery, Ala., in January.
Credit…Mickey Welsh/The Montgomery Advertiser, via Associated Press

Alabama will allow everyone ages 16 or older to sign up for a Covid-19 vaccine on Monday, joining more than 40 states that have already broadened access in an effort to make all adults eligible by the end of the month.

“This vaccine is our ticket back to normal life,” Gov. Kay Ivey, a Republican, said in a statement on her website. “We are so close to getting Covid-19 in the rearview, and until then, we should all keep wearing our masks, get vaccinated and use the common sense the good Lord gave us.”

While states are moving to vaccinate people faster, they are also easing restrictions aimed at curbing the spread of the coronavirus as Americans tire of the constraints more than a year into the pandemic.

On Friday, the Centers for Disease Control and Prevention announced that about 101.8 million people — nearly one-third of the total U.S. population — had received at least one dose of a Covid-19 vaccine. Yet cases are increasing significantly in many states as new variants of the coronavirus spread through the country, and new deaths on average have only just dipped below 900 a day.

Health officials say that new infections are still at a level that is too high. Earlier this week, Dr. Rochelle Walensky, the C.D.C. director, said that the recent case increases had left her with a recurring sense of “impending doom.”

And although the agency said Friday that fully vaccinated Americans could start traveling — not that they should, only that they could — scientists are not yet certain whether, or how often, vaccinated people may become infected, even briefly, and transmit the virus to others.

Travel has already been increasing nationwide, as the weather warms and people grow tired of pandemic restrictions. Last Sunday was the busiest day at domestic airports since the pandemic began. According to the Transportation Security Administration, nearly 1.6 million people passed through the security checkpoints at American airports.

President Biden warned on Friday that the virus was still not under control and said that measures like mask wearing needed to stay in place.

“I ask, I plead with you, don’t give up the progress we have all fought so hard to achieve,” Mr. Biden said at the White House.

Alabama’s current set of restrictions, including a requirement to wear masks in public, expires on April 9, adding tension to a continuing battle between governors anxious to get their states open again, and the C.D.C. and Biden administration who continue to ask for patience. Several states have already dropped mask mandates.

“Please, this is not politics — reinstate the mandate,” Mr. Biden said Monday about the easing of restrictions nationwide, adding, “The failure to take this virus seriously is precisely what got us into this mess in the first place.”

Almost three million people are being vaccinated across the country per day, according to the seven-day average released by the C.D.C. on Friday. But only about 25 percent of Alabama’s total population has received one shot of a vaccine, below the national average of 31 percent, according to the agency.

Alabama, Georgia and Mississippi are tied as the states with the smallest percentage of people who have received at least one shot.

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Vaccinated Americans Are at Low Risk While Traveling, C.D.C. Says

Dr. Rochelle Walensky, director of Centers for Disease Control and Prevention, said on Friday that Americans who were fully vaccinated against Covid-19 could travel “at low risk to themselves,” but should still wear masks.

Fully vaccinated people can resume travel to low, at low risk to themselves. For domestic travel, fully vaccinated people do not need to get a Covid-19 test before or after travel, and do not need to self-quarantine after travel. For example, fully vaccinated. grandparents can fly to visit their healthy grandkids without getting a Covid-19 test or self-quarantining, provided they follow the other recommended prevention measures while traveling. For international travel, fully vaccinated people do not need to get a Covid-19 test before they leave the United States, unless it is required by their international destination. However, fully vaccinated people should get tested and have a negative test result before they board an international flight back into the United States. But they do not need to quarantine when they arrive here. However, fully vaccinated people who do international travel should still be tested three to five days after arrival in the United States on an international flight. Our guidance reiterates that all travelers, regardless of vaccination status, should continue to wear masks on planes, buses, trains and other forms of public transportation while traveling.

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Dr. Rochelle Walensky, director of Centers for Disease Control and Prevention, said on Friday that Americans who were fully vaccinated against Covid-19 could travel “at low risk to themselves,” but should still wear masks.CreditCredit…Erin Schaff/The New York Times

Americans who are fully vaccinated against the coronavirus can travel “at low risk to themselves,” both within the United States and internationally, but they must continue to take precautions like wearing a mask in public to avoid possibly spreading the virus to others, federal health officials said on Friday.

The new recommendations are a modest departure from previous advice. Federal health officials have been urging Americans not to travel at all, unless they absolutely must. That recommendation still applies, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, told reporters at a White House news conference on Friday.

New virus cases, hospitalizations and new deaths have declined significantly since their January peaks, but new infections have remained at a level that health officials say is too high. New deaths on average have only just dipped below 900 a day, according to a New York Times database, and hospitalization numbers have started to level off.

With the case increases in recent weeks, federal health officials are concerned about the potential impact of easing restrictions. Scientists are not yet certain whether, or how often, vaccinated people may become infected, even briefly, and transmit the virus to others. A recent C.D.C. study suggested that it may be a rare event, and the agency said on Friday that about 101.8 million people — nearly one-third of the total U.S. population — had received at least one dose of a Covid-19 vaccine.

Until that question is resolved, many public health officials feel it is unwise to tell vaccinated Americans simply to do as they please. Yet at the same time, Dr. Walensky said on Friday, the agency wished to acknowledge a growing body of evidence suggesting that the risk to vaccinated travelers themselves is comparatively low.

“On the one hand, we are telling you we are worried about rising cases, to wear a mask, and to avoid travel,” Dr. Walensky said. “Yet on the other hand we are saying that if you are vaccinated, evolving data suggests that traveling is likely lower risk.”

Travel has been increasing nationwide as the weather warms and Americans grow fatigued with pandemic restrictions. Last Sunday, for example, was the busiest day at domestic airports since the pandemic began. Several states have lifted restrictions and mask mandates, beckoning tourists despite rising caseloads in some regions.

If an individual is fully vaccinated, the C.D.C. says the person can travel freely within the United States and that the person does not need to get tested, or self-quarantine, before or after traveling. But some states and local governments may choose to keep travel restrictions in place, including testing, quarantine and stay-at-home orders

Earlier this week, Dr. Walensky warned that the increases left her with a recurring sense of “impending doom.” Some scientists predicted weeks ago that the number of infections could curve upward again in late March, at least in part because of the rise of virus variants across the country.

President Biden, who previously urged states to maintain or reimpose mask mandates, pleaded with Americans on Friday to continue to follow guidelines from health experts and get vaccinated as soon as they can. Most states have accelerated their timelines for opening vaccinations to all adults, as the pace of vaccinations has increased. As of Friday, an average of nearly three million shots a day were being administered, according to data reported by the C.D.C.

“Too many Americans are acting as if this fight is over,” Mr. Biden said. “But this is still April, not July, we are not there yet.”

People are considered fully vaccinated two weeks after receiving the single-dose Johnson & Johnson vaccine, or two weeks after receiving the second dose of the two-dose regimen from Pfizer-BioNTech or Moderna.

Fully vaccinated Americans who are traveling domestically do not need to be tested and do not need to follow quarantine procedures at the destination or on return home, the C.D.C. now advises.

Vaccinated Americans do not need to get a coronavirus test before international travel, unless required to do so by the authorities at the destination. Some destinations also may require that vaccinated travelers quarantine after arrival. Vaccinated travelers do not need to quarantine after returning unless required to do so by local officials, the C.D.C. said.

But the C.D.C. says vaccinated Americans traveling internationally are required to have a negative coronavirus test before boarding a flight back to the United States, and they should get tested again three to five days after their return home.

The recommendation is predicated on the idea that vaccinated people may still become infected with the virus. The C.D.C. also cited a lack of vaccine coverage in other countries, and concern about the potential introduction and spread of new variants of the virus that are more prevalent overseas.

The new advice adds to C.D.C. recommendations issued in early March saying that fully vaccinated people may gather in small groups in private settings without masks or social distancing, and may visit with unvaccinated individuals from a single household as long as they are at low risk for developing severe disease if infected.

The travel recommendations issued Friday do not alter C.D.C. guidelines for the unvaccinated. The agency continues to discourage nonessential domestic travel by those who are not fully immunized, saying that if they must travel, they should be tested for infection one to three days before their trip and again three to five days after concluding their trip.

Unvaccinated travelers should also stay home and self-quarantine for seven days after a trip if they get tested, and quarantine for 10 days if they do not get tested after a trip, the agency said. Both vaccinated and unvaccinated individuals should monitor themselves for symptoms after a trip, and all must wear masks and take other precautions in public.

Many countries, including those in the European Union, still block most Americans from coming. Some are starting to make exceptions for those who are vaccinated. As of March 26, fully vaccinated Americans who can present proof of vaccination can visit Iceland, for example, and avoid such restrictions as testing and quarantine, the country’s government said.

A Covid-19 vaccine card given out in College Park, Ga., last month.
Credit…Erik S Lesser/EPA, via Shutterstock

Florida has banned state and local government agencies and businesses from requiring so-called vaccine passports, or documentation proving that someone has been vaccinated against Covid-19.

Gov. Ron DeSantis, a Republican, issued an executive order on Friday prohibiting businesses from requiring patrons or customers to show vaccine documentation, or risk losing grants or contracts funded by the state. It was not immediately clear how the order applied to state and local government agencies.

Requiring proof of vaccination, the order says, would “reduce individual freedom” and “harm patient privacy,” as well as “create two classes of citizens based on vaccination.”

There has been much discussion about vaccine passports, a way to show proof that someone has been vaccinated against the coronavirus, though the passports raise daunting political, ethical and privilege questions. The Biden administration has made clear that it will neither issue nor require the passports, but Republicans have seized on the issue as an example of government overreach.

Mr. DeSantis is seizing on this theme, as the Biden administration tries to set standards for the many private companies that are developing apps and other means of digital verification of coronavirus vaccination. One of Mr. Biden’s executive orders aimed at curbing the virus crisis called for government agencies to “assess the feasibility of linking Covid-19 vaccination to International Certificates of Vaccination or Prophylaxis” and creating electronic versions of them. A wide range of businesses, especially cruise lines and airlines, are eager to have a way for their customers to show proof of vaccination, especially as the number of new virus cases rises across the country.

The Centers for Disease Control and Prevention said on Friday that about 101.8 million people — nearly one-third of the total U.S. population — had received at least one dose of a Covid-19 vaccine. As of Friday, an average of nearly three million shots a day were being administered, according to data reported by the C.D.C.

“It’s completely unacceptable for either the government or the private sector to impose upon you the requirement that you show proof of vaccine to just simply be able to participate in normal society,” Mr. DeSantis said at a news conference on Monday.

Some other Republican governors have also come out against the passport concept. Gov. Pete Ricketts of Nebraska issued a statement Wednesday saying that the state would not participate in any vaccine passport program, and Gov. Mike Parson of Missouri told reporters Thursday that he would not require vaccine passports in the state but was also not opposed to private companies adopting them.

The C.D.C. has issued guidance for fully vaccinated people that allows for the resumption of some activities in private settings. And on Friday, the agency said fully vaccinated Americans can travel “at low risk to themselves,” though federal health officials have urged people not to travel at all, unless they absolutely must.

In New York, however, the state recently introduced a digital tool to allow people to easily show that they have either tested negative for the coronavirus or have been vaccinated in order to gain entry into some events and venues.

Walmart, last month, joined an international effort to provide standardized digital vaccination credentials to people. The company joins a push already backed by major health centers and tech companies including Microsoft, Oracle, Salesforce, Cerner, Epic Systems, the Mitre Corporation and the Mayo Clinic.

Some colleges and universities have also begun setting vaccine requirements for the next school year. Cornell University issued a statement on Friday saying that vaccinations would be required for in-person attendance in the fall, and Rutgers University in New Jersey said last week that all students would need to be fully vaccinated to be allowed to return to campus in the fall, baring religious or medical reasons.

Mr. DeSantis’s order is likely to draw legal challenges, raising questions about the impact of two Supreme Court decisions. In Jacobson v. Massachusetts, the high court in 1905 upheld the authority of states to enforce compulsory vaccination laws. That ruling for more than a century has let public schools require proof of vaccinations of its students, with some exceptions for religious objections.

In 2018, the Supreme Court ruled in favor of a Colorado baker who had refused to create a wedding cake for a gay couple on narrow grounds, and other courts have struggled with how to balance state laws barring discrimination against constitutional rights like free speech and the free exercise of religion. It is not clear that Florida businesses could invoke a constitutional right to refuse to comply with the new measure.

Some venues and events in Florida had already made plans to require vaccinations. The Miami Heat basketball team said it would give prime seating to vaccinated fans. The South Beach Wine & Food Festival said it would require proof of vaccination or a negative coronavirus test to attend. Nova Southeastern University said it would mandate vaccinations for all faculty and staff members as of Aug. 1 to participate in on-campus learning.

It was not immediately clear on Friday what those businesses would do in response to the governor’s order.

Reagan National Airport in Arlington, Va., in February. Air travel has been rebounding in the United States. 
Credit…Erin Schaff/The New York Times

The travel industry on Friday applauded new guidance from the Centers for Disease Control and Prevention that said Americans who are fully vaccinated against Covid-19 could travel at low risk to themselves as likely to help ailing businesses and encourage more Americans to board flights, cruises, buses and trains.

“The C.D.C.’s new travel guidance is a major step in the right direction that is supported by the science and will take the brakes off the industry that has been hardest hit by the fallout of Covid by far,” Roger Dow, the chief executive of U.S. Travel Association, an industry group, said in a statement. “As travel comes back, U.S. jobs come back.”

But while the news may be a boon to the industry, its concerns are far from over. Federal health officials have urged people not to travel at all, unless they absolutely must, a recommendation that still applies, the agency’s director said Friday.

And if an individual is fully vaccinated, the C.D.C. says the person can travel freely within the United States and that the person does not need to get tested, or self-quarantine, before or after traveling. But some states and local governments may choose to keep travel restrictions in place, including testing, quarantine and stay-at-home orders.

Most airlines, hotels and tourist destinations have suffered mounting losses for more than a year as Americans largely stayed home. Travel is beginning to recover, but many of these businesses won’t see meaningful profits for months, at least.

More generally, the pandemic has also shown businesses large and small that their employees can often be just as productive working remotely as in face-to-face meetings. As a result, the airline and hotel industries expect it will be years before lucrative corporate travel returns to pre-pandemic levels, leaving a gaping hole in revenues.

And while leisure travel within the United States may be recovering steadily, airlines expect it will still take until 2023 or 2024 for passenger volumes to return to 2019 levels, according to Airlines for America, a trade association and lobbying group. The industry lost more than $35 billion last year and continues to lose tens of millions of dollars by the day, the group said.

“U.S. airlines share the administration’s commitment to restoring service in a manner that prioritizes the safety and well-being of passengers and employees, and we are encouraged that science continues to confirm there is a very low risk of virus transmission within the air travel environment,” Airlines for America said in a statement.

Still, a rebound appears to be underway. On Thursday, the Transportation Security Administration reported more than 1.5 million travelers going through security checkpoints at airports, with the number of travelers increasing since early-to-mid March.

While that is a significant increase compared with 124,000 travelers a year ago, it is still 35 percent less than it was in 2019.

Many airlines have added flights to the beach and mountain destinations that have been popular throughout the pandemic. This week, Delta Air Lines also said it would start selling middle seats again, United Airlines said it would resume pilot hiring after freezing it last year and Frontier Airlines began an initial public offering.

“The time is now,” Barry Biffle, Frontier’s president and chief executive, said in an interview. “If you look, the vaccine is unlocking the demand, and you’re seeing it everywhere. You’re seeing it in restaurants, you’re seeing it in hotels.”

A vaccination center in Munich last week. So far, only about 11 percent of the European Union’s population has received at least one shot.
Credit…Laetitia Vancon for The New York Times

For decades, the European Union has sold itself not just as the best antidote to another European war, but as “the Europe that protects,” arguing that by its collective size and shared sovereignty, it will deliver a better, longer and more prosperous life to all. With its vaccine rollout in chaos, that promise now looks hollow, and risks undermining the bloc’s credibility when it comes to major challenges.

In Belgium, Alain Walravens, 63, is waiting to be invited for a first coronavirus vaccination. So are Marion Pochet, 71, a retired translator, and her husband, Jean-Marc. At least, Ms. Pochet said, they both have had Covid-19, “so we have some immunity, at least for the moment.”

All three are sharply critical of the European Union, which took control of vaccine procurement and distribution and is widely considered to have done worse than its main partners, the United States and Britain, let alone Israel, which have all gotten vaccines into a much larger percentage of their populations than Europe has.

So far, only about 11 percent of the bloc’s population has received at least one vaccine shot, compared with 47 percent in Britain and 30 percent in the United States.

As European countries lock down again in a new wave of the virus, the reputation and credibility of the European Union and its executive arm, the European Commission, are much in play.

“This is the fault of the European Union,” said Mr. Walravens, an events organizer.

“In other countries where the vaccination is going faster, there are real results,” he added. “The number of cases is going down. Here in Belgium, the hospitals are getting saturated.”

Brussels has always taken pride in its technocratic rule setting for the world, but it has just lost Britain, the world’s fifth-largest economy, and even before the pandemic, it was suffering from low growth and a shrinking share of global trade.

After every crisis, whether it was Kosovo or the euro debt disaster, the usual answer is “more Europe.” But unless Brussels can turn matters around quickly, its vaccine crisis may cause member states to resist granting further authority to the European Commission.

“This has been catastrophic for the reputation of the European Union,” said Mark Leonard, the director of the European Council on Foreign Relations.

Even Guy Verhofstadt, a European Parliament member and fierce European federalist, called the Commission’s performance “a fiasco.”

At the start of the crisis, as nations erected borders and hoarded protective equipment, masks and gowns, there was a huge desire for European cooperation, he said, “not because people liked the E.U. or its institutions, but because they were so absent.”

But the question now, he said, is buyer’s remorse. “The E.U. waded into an area with no expertise and competence and put a spotlight on itself,” he said. “In the minds of many who look at the U.K. and U.S. and Israel, they think we’re doing badly because of European cooperation, and that will have a corrosive impact in other areas.”

People waited outside Gare de Lyon station in Paris on Friday.
Credit…Andrea Mantovani for The New York Times

France headed into its third national lockdown on Saturday as the nation approaches painful milestones a year into the pandemic and struggles to vaccinate its population.

The latest restrictions will severely limit travel across France, confine people’s movements in their communities and shut down schools. Even though President Emmanuel Macron pledged that this would be France’s last national lockdown before life returns to normal, there was no clear light at the end of the tunnel. Infections are soaring as France’s total deaths from the epidemic nears 100,000, and, like in the rest of the European Union, progress on the vaccination campaign remains painfully slow.

“There is a bit of weariness,” said Muriel Sallandre, who was catching a train in Paris on Friday to visit her parents in western France but was planning to return in a few days. “The absence of perspective, being dependent on the government’s messages — all that is ultimately a little depressing.”

Mr. Macron announced the lockdown after months of resisting advice from epidemiologists and pressure from political rivals. He had bet unsuccessfully that, despite rising infections and new powerful variants, a national lockdown could be avoided if enough people got vaccinated at a steady pace.

In other virus news around the world:

  • Britain said it would ban international arrivals from four more countries — Bangladesh, Kenya, Pakistan and the Philippines — amid concerns over virus variants. The move, which takes effect on April 9, will bring the number of countries on Britain’s travel “red list” to 39.

  • San Marino, a microstate surrounded by Italy, feared being left behind in Europe’s inoculation campaign. Now it has jumped ahead, with the Sputnik vaccine sent by an unlikely, faraway friend.

  • Turkey began administering Pfizer-BioNTech shots. With coronavirus infections surging and Ramadan approaching, the government also recently moved to reimpose strict social distancing measures, including a prohibition on the large gatherings for meals before sunrise and after sunset that are traditional during the Muslim holy month.

Administering AstraZeneca doses in January at a vaccination center set up at a racecourse in Epsom, England.
Credit…Pool photo by Dominic Lipinski

Britain reported 30 cases of extremely rare blood clots in people who had received the AstraZeneca-Oxford vaccine, the same sort of events that have prompted some European countries to restrict use of the shot in certain at-risk age groups.

The reports represented 25 more cases than Britain’s medicines regulator had previously received, going some way toward addressing a mystery that has hung over safety concerns about the vaccine: why Britain had not observed the same phenomenon that has been seen in continental Europe, driving countries including France, Germany and Sweden to stop giving the shot to younger people, who are believed to be at higher risk from the rare clotting events.

Britain’s medicines regulator said that it had received reports of no such clotting cases in people who had received the Pfizer-BioNTech vaccine.

The clotting cases have generated concern because, scientists said, they were somewhat unusual. They involve blood clots combined with unusually low levels of platelets, a disorder that can lead to heavy bleeding.

The clotting events that have drawn the most concern, known as cerebral venous sinus thrombosis, entail clots in the veins that drain blood from the brain, a condition that can lead to a rare type of stroke. Those represented 22 of the 30 clotting cases that Britain reported this week.

But it is not clear whether any of the cases are linked to the vaccine. And even if they are, British and European regulators have said they were so rare that the vaccine should continue to be used.

Australia’s health authorities are examining a probable case of the same clotting disorder in a 44-year-old man who received the AstraZeneca vaccine around March 22. He has been hospitalized in Melbourne.

On Thursday, Germany’s immunization commission, the STIKO, recommended that anyone younger than 60 who received an initial vaccination with AstraZeneca be given either Pfizer-BioNTech or Moderna shots as their second vaccine doses. And the Netherlands said on Friday that it had temporarily suspended use of the vaccine in people under 60 after the death of a woman there who had been given the shot.

In reporting its updated case count, Britain’s medicines regulator said that “the benefits of the vaccines against Covid-19 continue to outweigh any risks, and you should continue to get your vaccine when invited to do so.” The European Union’s medicines regulator has also recommended that countries continue to use the AstraZeneca vaccine. Both agencies are continuing to investigate.

Scientists said on Friday that the overall risk of the particular clotting events that have drawn concern was extremely low: roughly one case in 600,000 recipients of the AstraZeneca vaccine in Britain. And it is difficult to know how common the cases are in the general population, given that it can be hard to diagnose. Scientists have said that case counts would inevitably rise among vaccinated people as doctors began looking more closely for the condition.

David Werring, a professor at University College London’s Institute of Neurology, said that the unusual presentation of the cases in vaccinated people was creating concern about possible links with the shot.

But, he said, “The key thing to remember is how rare these brain clots are, and how powerful the proven benefit of vaccination is against Covid.” He added that doctors and people who had received the AstraZeneca vaccine should be on the lookout for symptoms of the clotting events, like severe headaches or signs of a stroke.

“More research is urgently needed,” he said.

Melissa Eddy contributed reporting.

Carolina Rodriguez, 26, receives the Johnson & Johnson Covid-19 vaccine at Booker T. Washington High School in Houston, Texas, on Monday.
Credit…Go Nakamura for The New York Times

Johnson & Johnson on Friday became the third company to enter the race to expand the use of its coronavirus vaccine to adolescents. Researchers have begun testing the drug maker’s vaccine in adolescents 12 to 17 years old, the company announced.

Johnson & Johnson has been lagging its competitors. Pfizer and BioNTech announced on Wednesday that their coronavirus vaccine is extremely effective in young adolescents, perhaps even more so than in adults. Results from a similar trial of Moderna’s vaccine are expected in the next few weeks.

Pfizer, BioNTech and Moderna are also testing their vaccines in children younger than 12. Johnson & Johnson has said it would wait for results from trials in older children before following suit.

A single-shot version of Johnson & Johnson’s vaccine was authorized in February by the Food and Drug Administration for use in adults, and is now being tested on adolescent subjects. Made by Janssen Pharmaceuticals, a subsidiary, the vaccine is authorized in Canada and many other countries. But a mix-up in ingredients at a Baltimore factory may delay future shipments of doses in the United States while the Food and Drug Administration investigates what occurred.

Since September, Johnson & Johnson has also been assessing the safety and efficacy of a two-dose regimen in adults 18 and over. That study now also includes adolescents, the company said.

“The Covid-19 pandemic has had a profound impact on adolescents, not just with the complications of the disease, but with their education, mental health, and well being,” Dr. Paul Stoffels, Johnson & Johnson’s chief scientific officer, said in a statement. “It is vital that we develop vaccines for everyone, everywhere, to help combat the spread of the virus with the goal to return to everyday life.”

As of Thursday, almost 31 percent of all Americans had received at least one dose of a coronavirus vaccine, and 17.5 percent had been fully inoculated, according to data collected by the Centers for Disease Control and Prevention.

But children under 18 account for about 23 percent of the population in the United States, and the country cannot hope to reach herd immunity — the point at which the virus begins to run out of vulnerable hosts — without protecting them, some experts have said.

Members of the New York Mets on the field in Washington on Thursday. Their three-game weekend series was postponed because of an outbreak on the Nationals team. 
Credit…Doug Mills/The New York Times

A day after pushing back the Mets’ season-opening game in Washington because of a coronavirus outbreak on the Nationals, Major League Baseball postponed the teams’ three-game weekend series on Friday. The league said it needed more time for follow-up testing and contact tracing after four Nationals players tested positive this week.

The Mets now will play their first game of the season on Monday in Philadelphia, several hours after the Nationals are scheduled to host the Atlanta Braves. Baseball officials are hopeful that the Nationals will be cleared to play by then, as long as their players continue to test negative during the layoff.

If the Nationals do start on Monday, their roster will be significantly compromised. The players who tested positive cannot return until at least 10 days from their positive tests, and those in close contact must miss at least seven days. The Nationals could fill those roster spots with players from their minor-league system.

For M.L.B., last summer’s outbreaks on the Miami Marlins and the St. Louis Cardinals highlighted the importance of contact tracing to containing the spread of the virus. Players are given wearable devices now to help identify close contacts.

Baseball officials said on Friday that the league had conducted 14,354 tests in the past week, with only four positives — three Nationals players and one staff member who is not with the Nationals — through Thursday. A fourth Washington player tested positive on Friday.

Since the start of spring training, M.L.B. said that it has administered 92,896 tests — counting monitoring and intake testing — and found 38 total positives (28 players and 10 staff members), for a positive rate of .04 percent.

Dining at the Union Square Café in March. It had been closed for months.
Credit…Amr Alfiky/The New York Times

Shoots of budding optimism pop up almost daily in New York City after one of the hardest years in its history.

The Mandarin Oriental Hotel overlooking Central Park called back workers for a reopening this week. Union Square Café, a popular Manhattan restaurant that had been closed for months, is feeding diners again. When the Yankees opened their season in the Bronx on Thursday, fans were back in the stands, though limited to one-fifth of the seats.

It may take some time, said Mark Zandi, chief economist at Moody’s Analytics. but “the city is going to see a big revival.”

It will not be easy.

By many measures, the most populous city in the United States suffered some of the greatest losses in the Covid-19 pandemic, and it faces one of the longest and steepest climbs back. Shows will not return to Broadway stages until after Labor Day. Many workers will not begin commuting to the office and buying lunch at the corner deli for months — if they return at all.

But for the first time since the city went into lockdown late last March, there are palpable signs of rebirth, fueled by a growing supply of coronavirus vaccines and an impending gusher of federal aid to City Hall, the schools, the transit system, restaurants and theaters.

In Manhattan, a year after Covid-19 cratered the sales market, the borough appears poised for a recovery, thanks to price cuts, renewed confidence in the city and a surge of first-time home buyers.

“Yes, the market is recovering,” said Jonathan J. Miller, the president of the appraisal firm Miller Samuel. “But we can’t oversell and say it’s some sort of boom — it’s just dramatically better than it was a quarter or two ago.”

The city’s outlook has improved as a result of the latest stimulus bill, financial analysts say, which included about $6 billion in direct aid to the city government, $6.5 billion to the Metropolitan Transportation Authority and $4 billion to the city’s public schools.

The federal aid will help address some of the city’s biggest short-term problems, including huge drops in revenue from property and sales taxes and fares that the M.T.A., which runs the subway, buses and two commuter rails, is heavily dependent on.

Still, the road to full recovery is strewn with challenges, business leaders and analysts say.

Entire industries, including the arts and the hotel and restaurant sectors, were decimated, with thousands of businesses closing for good. Tourism, a pillar of the economy, is years away from rebounding, according to forecasts. And many companies are making at least some remote work a permanent feature, raising questions about the future of Manhattan without legions of office workers.

“The city still has a ways to go,” said Ana Champeny, director of city studies for the Citizens Budget Commission. “You’ve got to get commuters back in Midtown and downtown, the business district. You’ve got to get restaurants and theaters reopened.”

The New York metropolitan area lost more than one million jobs in 2020, close to double the Los Angeles area’s loss and triple the Chicago area’s, according to the federal Bureau of Labor Statistics. Low-paying jobs that cannot be done from home accounted for most of the losses, and many may not come back for years, if ever, economists said.

New York’s economy was especially vulnerable to the pandemic because of its heavy reliance on tourists and business travelers to fill hotel beds and seats in restaurants, theaters and stadiums. The number of foreign visitors to New York is not expected to reach its 2019 level before 2025, according to the city’s tourism promotion agency.

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The police used water cannons and pepper spray to disperse a crowd of hundreds that had gathered in a park for a hoax April Fool’s Day music festival on Thursday, defying Covid-19 restrictions.CreditCredit…Stephanie Lecocq/EPA, via Shutterstock

BRUSSELS — In an April Fool’s Day joke that went wrong, a fake announcement of a music festival contributed to thousands gathering in a major park in Brussels on Thursday in defiance of Covid-19 restrictions. As the police confronted the crowd, several officers and participants were wounded, and four people were arrested.

The unusually warm weather in the city would most likely have drawn people to the park in higher numbers, but the prank added to the density. The level of frustration, particularly among younger people, is high in Belgium, as new Covid-19 cases are increasing and hospitals become saturated despite months of restrictions.

The hoax festival, announced on Facebook and called “La Boum,” a slang word in French for a party, promised the appearance of famous DJs, including David Guetta, and claimed that no coronavirus rules would be followed.

The organizers noted that the festival was a hoax, but, according to the police, 1,500 to 2,000 people still gathered in the park, Bois de la Cambre, on Thursday afternoon, after tens of thousands registered on Facebook their interest in the event. Despite several warnings, the police said, the attendees refused to leave, and some chanted “Freedom!” and threw bottles. The police used water cannons and sent in mounted officers to disperse the crowd.

Belgium has been in a semi-lockdown since October, with restaurants and bars closed, and rules requiring residents to work from home and limiting social contacts to one person per household. Up to four people are allowed to meet outside, as long as they wear face masks and respect social-distancing rules. Last week, in response to an increasing number of new cases and a rise in the number of hospitalized patients, the Belgian authorities tightened the rules, ordering hairdressers and beauty salons to close and allowing nonessential stores to serve customers by appointment only.

Prime Minister Alexander De Croo posted on Twitter that the gathering in Brussels was “totally unacceptable.”

“All support to the injured police officers,” he added. “I understand everyone is tired of corona. But the rules are there for a reason, and they are binding for everyone. Hospitals are filling up. Solidarity now is the key to freedom tomorrow.”

Annelies Verlinden, the Belgian interior minister, acknowledged that “for many people, especially the young ones, the Covid crisis is now lasting a very long time.” But she said that the gathering in Brussels was “a slap in the face for all those who are doing their best to respect the coronavirus measures.”

On Wednesday, a Brussels court ordered the Belgian government to lift all Covid-19 restrictions, ruling that the measures did not have a legal basis because they had been instituted by ministerial decrees. But the court gave the government 30 days to remedy the situation, and a special pandemic law is currently being debated in Parliament.

Kingsford Smith Airport, which serves Sydney, Australia, last month. As part of strict border closures, the country imposed a cap on the number of passengers who can fly in from overseas, a limit that extends to citizens.
Credit…Loren Elliott/Reuters

Stranded overseas for months because of travel restrictions, three Australians have filed a complaint with the United Nations Human Rights Committee, arguing that the Australian government is violating their right to return home.

Australia’s strict border closures have helped keep the coronavirus largely off its shores, in part by imposing a cap on the number of passengers who can fly in from overseas. That limit extends to citizens, meaning that tens of thousands of Australians remain unable to travel home. And after Prime Minister Scott Morrison failed to make good on a pledge to get “as many people home, if not all of them,” by last Christmas, anger is mounting among those who feel abandoned by their government.

“By going to the U.N., we hope to highlight what an unfeeling government Mr. Morrison heads,” said Deborah Tellis, spokeswoman for the petitioners.

The petition filed on Monday argues that by limiting the number of passengers who are allowed into Australia to about 6,000 per week, the government is violating the United Nations’ International Covenant on Civil and Political Rights, which states that a person cannot be “arbitrarily deprived of the right to enter his or her own country.”

Australia is one of the few countries in the world that have imposed such pandemic restrictions on their own citizens. The government has framed its hard-line approach as necessary because of limited quarantine facilities, and said it has been critical to avoiding the large-scale coronavirus outbreaks seen in other countries.

It’s not clear what effect the petition will have. Some legal experts say that the U.N. committee cannot compel Australia to bring people home, and that the passenger limits do not represent an outright ban on citizens from returning.

But Australians stranded overseas lack other avenues for recourse, Ms. Tellis said.

The petitioners are being advised by international human rights lawyer Geoffrey Robertson, who is also known for being WikiLeaks founder Julian Assange’s lawyer.

Ms. Tellis said she had been working as a teacher in India last June when she and her daughter packed up and prepared to return to Australia. Their plans were scuppered at the last minute when her daughter became infected with the coronavirus. For nine months, they made airline bookings only to be bumped off again and again when flights were canceled or the caps were changed. They alternated between couch surfing with friends and living in Airbnbs.

“It was horrible, living in limbo,” Ms. Tellis said. “Finally, I just went into a bit of a, not a mental breakdown, but I was crippled with anxiety and having to see a psychologist.”

They were finally able to secure a flight back last month. She estimates the ordeal cost her 20,000 Australian dollars, or about $15,000.

As of last week, more than 36,000 Australians overseas had registered with the Department of Foreign Affairs and Trade saying they wanted to come home. But advocates for those stranded say that the real number is most likely higher. Some, like Josh Simons, have declined to register because, to do so, they must sign a waiver that prevents them from taking legal action against the government.

“Going on that list means you’re basically agreeing that Australia has done everything it can to do right by you, which I can say as a stranded Aussie is just not the case,” he said.

Mr. Simons, chief executive of the tech start-up Vampr, was in Australia at the start of the pandemic. But when his wife living in New Jersey lost her two jobs, he flew to the U.S. to support her. They’ve been trying to return to Australia ever since.

Mr. Simons stressed that he was proud of the way Australia had been able to contain the virus. But intertwined with that is a creeping sense that his citizenship doesn’t guarantee him the right to return to his country.

“I never thought the possibility of feeling like citizenship had zero value would happen in my lifetime,” he said. “I wouldn’t have dreamt in my wildest of dreams that I couldn’t come home.”

A volunteer in the Johnson & Johnson vaccine trial received a shot in the Desmond Tutu H.I.V. Foundation Youth Center in Masiphumelele Township, South Africa, in December.
Credit…Joao Silva/The New York Times

JOHANNESBURG — Regulators in South Africa, which has been struggling with a highly transmissible variant of the coronavirus, approved the Johnson & Johnson vaccine on Thursday, a welcome boost to the country’s stop-start inoculation campaign.

The decision paves the way for the distribution of 31 million doses, which the South African government has already secured, President Cyril Ramaphosa said this week.

The approval is based on a “rolling submission” of data on the vaccine’s performance from Dec. 11 to March 17, the South African Health Products Regulatory Authority said in a statement. The single-dose vaccine has been administered to over 269,000 health workers since February as part of the implementation phase of Johnson & Johnson’s trial in South Africa.

The South African authorities turned to the Johnson & Johnson vaccine after the country halted plans to roll out the AstraZeneca-Oxford vaccine, of which it had already acquired a million doses. In February, evidence emerged that the vaccine did not protect clinical-trial participants from mild or moderate illness caused by the more contagious virus variant that was first seen in the country. On Friday, the South African health minister, Dr. Zweli Mkhize, announced that the government had sold the AstraZeneca doses to the African Union, which will distribute them among 18 countries, including Liberia, Nigeria, and Zimbabwe.

The Johnson & Johnson vaccine showed a 64 percent efficacy rate in South Africa, where the variant known as B.1.351 has fueled a wave of infections that saw the country’s death toll rise to nearly 53,000, with over 1.5 million cases. The February results were an improvement of seven percentage points high than earlier data from South Africa released by the company.

The shots will be manufactured by the pharmaceutical company Aspen Pharma as part of a deal that will see 220 million doses produced in the coastal South African city of Gqeberha (formerly known as Port Elizabeth) and supplied to the rest of Africa via the African Vaccine Acquisition Trust, an African Union organization. The organization will also have the option to order an additional 180 million doses for a combined total of up to 400 million doses through 2022.

In February, Mr. Ramaphosa announced that his government had also secured 20 million doses of the Pfizer-BioNTech vaccine. With formal approval still underway, the health products regulator granted emergency use of the vaccine on a case-by-case basis.

South Africans have expressed increased frustration with the slow rollout of the Covid-19 vaccine, their anxieties heightened by fears of a third wave of infections as fall temperatures cool amid increased travel and mass religious gatherings over the Easter period.

A 24-hour vaccination event just outside New Orleans. In states that are doing relatively little testing, it’s possible that their daily case counts are low in part because asymptomatic or mild-symptom cases are going undetected.
Credit…Gerald Herbert/Associated Press

Declines in coronavirus testing in many states in the South and the Great Plains are making it harder to know just how widely the virus may be spreading in those states, even as restrictions are lifted and residents ease back into daily life, experts say.

States in both regions are reporting few new cases relative to their population, compared with harder-hit states like Michigan or New York. But they are also testing far fewer people.

Kansas, for example, is now testing about 60 people a day for every 100,000 in population, according to data compiled by Johns Hopkins University, and Alabama only a bit more. The picture is similar in Iowa, Mississippi and elsewhere.

By contrast, New York is averaging 1,200 tests a day per 100,000, and Rhode Island 1,677 per 100,000.

Testing has been falling in Kansas since Jan. 1, even though hospitalizations were at their highest level of the pandemic then, according to Tami Gurley, co-chair of the virus task force at the University of Kansas Medical Center. The state is now doing fewer tests relative to its population than any state except Idaho.

The tests they are doing in these low-rate states are finding virus.

Twelve percent of Kansas’ coronavirus tests are coming back positive. Alabama’s positivity rate is 12.8 percent. The rate in Idaho is 27.3 percent, the highest in the country. In New York, it’s just 3.5 percent.

So in the states that are doing relatively little testing, it’s possible that their daily case counts are low in part because asymptomatic or mild-symptom cases are going undetected.

Dr. Gurley says she is closely following hospitalizations, as a better indicator of the spread of the virus than new-case reports.

“We think that people are more focused on getting vaccines than getting tested,” she said. “It certainly makes it harder to figure out where we are going. We feel like we are at the point of another uptick in cases.”

Many states in the South and Midwest have relaxed their restrictions, including mask mandates, even though the national data signals that another surge in cases may be coming, according to Edward Trapido, an epidemiologist and associate dean for research at the Louisiana State University School of Public Health.

And many states are shifting resources away from testing to bolster vaccination efforts and meet President Biden’s goal of making all adult Americans eligible for a shot by May 1.

As a result, Dr. Trapido said, in many places these days, only the sickest patients are seeking out a coronavirus test.

“As vaccines have become widespread, people are becoming comfortable about not being tested,” he said. “There is a natural experiment going on. It’s a battle between getting people vaccinated and keeping the percent positive low. When I see a slight change in the curve upward, I get alarmed.”

Dr. Gurley said the shift in emphasis away from testing and toward vaccination may stem in part from widespread public fatigue with pandemic precautions and the political imperative in many states to reopen swiftly.

If all you want to do is prevent deaths from the virus, that may make sense, she said, but “if your end goal is to prevent spread, then we need more testing.”

A health worker prepared a Sinopharm coronavirus vaccine dose in Peshawar, Pakistan, in March. The country’s sluggish public vaccination program has drawn criticism. 
Credit…Muhammad Sajjad/Associated Press

ISLAMABAD — Pakistan said on Thursday that it would allow Covid-19 vaccine doses to be sold commercially to patients, starting with the vaccine developed in China by CanSino Biologics. The Russian Sputnik V vaccine will also be sold, officials said.

The policy will allow affluent Pakistanis to pay to get the shots at large private hospitals whenever they want, while most people wait their turn for a state-supplied vaccination.

“The government will provide free vaccine to 98 percent of the people,” Fawad Chaudhry, the federal minister for science and technology, said on Thursday after a meeting of the federal cabinet in Islamabad. “But 2 percent of the people who don’t want to wait in a line, we have decided to allow the sale of private vaccine.”

The CanSino Biologics vaccine, which is administered in a single shot, will be sold for around $28 a dose, Mr. Chaudhry said.

The pricing for Sputnik V, a two-shot vaccine, is under dispute between the private company that plans to import it and the national drug regulator. Mr. Chaudhry said the company, Ali Gohar Pharmaceutical, wanted a free hand in pricing but the government could not allow that. The company has taken the matter to court in the southern province of Sindh.

On Thursday, Nadeem Akhtar, a judge of the Sindh high court, said in an interim order that “any restriction relating to the sale of the Covid-19 vaccine at this stage would be against the public interest because of the undisputed urgent need due to the crisis currently being faced by the country.” The next hearing of the case is scheduled for April 12.

Pakistan, with a population of more than 220 million, has reported more than 623,000 coronavirus cases and more than 14,000 deaths, according to a New York Times database. Officials said there were 53,127 active Covid cases as of Thursday, and that 98 people had died in the last 24 hours, 29 of whom were on ventilators.

President Arif Alvi; his wife, Samina Alvi; and Pervez Khattak, the defense minister, all tested positive for the virus last week. Prime Minister Imran Khan and his wife, Bushra Bibi, tested positive in March; Mr. Khan has since recovered and resumed his official duties.

The country’s public vaccination program is off to a slow start, in part because the government has not been able to secure large supplies. Officials have said they expect three million doses of the CanSino vaccine to be delivered in the next few weeks.

The government is currently giving doses of another Chinese vaccine, developed by Sinopharm, to people over the age of 60, and began registering people 50 or older for vaccination this week. But according to a major Pakistani news outlet, only about 560,000 people have been inoculated so far, out of the 17 million who are now eligible.

Critics have assailed the slow pace of the free vaccination program, and many opposition politicians and health officials have questioned the government’s decision to allow private sale of the vaccine, raising concerns about affordability and potential corruption.

“The governments all over the world are subsidizing the vaccine for their citizens,” said Faisal Karim Kundi, a spokesman for the opposition Pakistan People’s Party. “The majority of the population is poor in the country. How will the poor afford private vaccination?”