The director of the Centers for Disease Control and Prevention issued a grave warning on Friday that a recent sharp drop in coronavirus cases across the United States “may be stalling” and “leveling off at a very high number” — a worrisome development that comes as more cases of concerning new variants have been found, and could suggest that a return to normalcy is not yet quite as near as many Americans had hoped.
Even as the vaccination campaign continues, the director, Dr. Rochelle Walensky, also warned governors not to roll back mask mandates or other efforts to contain the virus: “Things are tenuous. Now is not the time to relax restrictions.”
According to a New York Times database, virus cases across the United States appear to be leveling off from the steep decline that began in January, with figures comparable to those reported in late October. Cases have slightly increased week over week in recent days, though severe weather limited testing and reporting in Texas and other states the previous week, and not all states reported complete data on the Presidents Day holiday. The seven-day average of new cases was 77,800 as of Thursday.
While deaths tend to fluctuate more than cases and hospital admissions, Dr. Walensky told reporters during a White House briefing on the pandemic, the most recent seven-day average is slightly higher than the average earlier in the week. The seven-day average of newly reported deaths was 2,165, as of Thursday.
“We at C.D.C. consider this a very concerning shift in the trajectory,” she said, adding, “I want to be clear: cases, hospital admissions and deaths — all remain very high and the recent shift in the pandemic must be taken extremely seriously.”
Dr. Walensky said some of the rise may be attributable to new variants of the coronavirus that spread more efficiently and quickly. The so-called B.1.1.7 variant, which first emerged in Britain, now accounts for approximately 10 percent of all cases in the United States, up from one to four percent a few weeks ago, she said. The U.S. ability to track variants is much less robust than Britain’s.
“I know people are tired; they want to get back to life, to normal,” she said. “But we’re not there yet.”
As cases had declined, some governors around the United States have begun to relax pandemic restrictions. States with Republican governors appeared to be more eager to make rollbacks, though New York, which has a Democrat as governor, has also been easing restrictions on a variety of activities. On Thursday, Gov. Greg Abbott of Texas said he was considering lifting a statewide mask mandate in place since July.
In Mississippi, Gov. Tate Reeves said he was also considering pulling back some restrictions, particularly mask mandates for people who have been fully vaccinated. As of Thursday, just over 12 percent of the state’s population has received at least one shot, and 5.5 percent have received two, according to a Times database.
Dr. Anthony S. Fauci, the government’s top infectious disease expert, echoed Dr. Walensky’s warnings that more rollbacks at state or local levels would be unwise, noting that case levels remained at a “very precarious position.”
“We don’t want to be people always looking at the dark side of things, but you want to be realistic,” he said. “So we have to carefully look at what happens over the next week or so with those numbers before you start making the understandable need to relax on certain restrictions.”
The doctors’ comments came as the Biden administration announced an aggressive push to enlist the help of some of the country’s biggest corporations and business lobbying groups, including the U.S. Chamber of Commerce, the Business Roundtable and organizations representing Asian, Black and Latino executives.
The aim is two-fold: to expand the private sector’s contributions beyond the manufacture of vaccines, tests and treatment, and to encourage businesses to give employees time off and the necessary support to get vaccinated, said Andy Slavitt, a senior Biden health adviser.
Mr. Slavitt ticked off a list of companies and groups that have responded to what he described as the administration’s “call to action”: Ford and The Gap intend to donate more than 100 million masks for free distribution. Uber and Lyft are teaming up with pharmacies to offer free or discounted rides to vaccination sties. Best Buy, Dollar General and Target will give workers paid time off to get a shot. He said the initiatives would be coordinated by the companies themselves and the administration did not have a formal role.
Pro sports leagues, Mr. Slavitt said, are helping set aside more than 100 stadiums and arenas to become mass vaccination sites. A few weeks ago, Mr. Biden announced in a C.B.S. interview that the N.F.L. commissioner had offered him the use of stadiums.
“We’ll ask companies to make similar unique commitments that bring their unique skills and resources to the problem of key keeping Americans safe and ending the pandemic as quickly as possible,” Mr. Slavitt said.
The Food and Drug Administration’s vaccine advisory panel is holding an all-day meeting on Friday to consider whether the coronavirus vaccine made by Johnson & Johnson should be authorized by federal regulators.
The panel is expected to endorse the vaccine, meaning that the United States may have a third one authorized as early as Saturday.
Composed of independent infectious disease experts, statisticians and epidemiologists, the panel is hearing presentations from top scientists at Janssen Pharmaceuticals, the drug development arm of Johnson & Johnson. Committee members will then discuss the technical components of the vaccine with them and regulators at the F.D.A.
The committee’s vote is expected to occur late Friday afternoon or early evening.
The meeting participants are equipped with analyses published online this week by the F.D.A. and the company that detail how the vaccine works — its success in preventing moderate and severe cases of Covid-19, hospitalizations and death, as well as the side effects it causes and how its efficacy varied in different regions of the world and among different groups of people.
According to the briefing documents, the vaccine had an overall efficacy rate of 72 percent in the United States and 64 percent in South Africa, where a concerning variant emerged in the fall and has spread to the United States. The vaccine showed 86 percent efficacy against severe forms of Covid-19 in the United States, and 82 percent against severe disease in South Africa.
None of the nearly 22,000 vaccinated people in the trial died of Covid-19.
When the panel met in December to consider the two-dose coronavirus vaccines made by Pfizer-BioNTech and Moderna, the sky-high efficacy rates of those shots led to a consensus and resounding votes to endorse them.
The discussion on Friday could be more complicated.
Johnson & Johnson’s vaccine is a single dose and uses a different kind of technology than the first two authorized vaccines. And the scale and size of the Johnson & Johnson trial was vast, spanning eight countries, three continents and 45,000 participants. That resulted in a large data set that is likely to prompt a more complex — and potentially splintered — discussion.
The F.D.A.’s analysis estimated that the vaccine has an efficacy rate of 74 percent against asymptomatic infections, which suggests that it may help reduce the spread of the virus by vaccinated people. That is likely to be one subject of discussion at the meeting, as the public and health authorities grapple with how vaccination should — or shouldn’t — change behavior when cases remain high.
The federal government has agreed to buy 100,000 doses of a recently authorized Covid-19 treatment from Eli Lilly, increasing the supply of such drugs for patients who are high risk of becoming seriously ill but are not yet hospitalized.
Under the deal, announced on Friday, the government will pay $210 million and Eli Lilly will ship out the doses by the end of March. The government has the option to buy 1.1 million more doses of the treatment through November, but how many of those doses ultimately get ordered will depend in part on the course of the pandemic in the United States.
The treatment is a cocktail of monoclonal antibodies combining the Eli Lilly drug known as bamlanivimab — which was authorized last November and is in use for high-risk Covid-19 patients — with a second drug known as etesevimab. The combination received emergency authorization earlier this month from the Food and Drug Administration. Both drugs consist of artificial copies of the antibodies that are naturally generated when a person’s immune system fights off an infection.
The U.S. government previously agreed to buy nearly 1.5 million doses of bamlanivimab alone. Eli Lilly has delivered more than 1 million doses already, with the remainder to be delivered by the end of March. More than 660,000 doses of bamlanivimab have been shipped out to states and other jurisdictions.
Eli Lilly’s new combination therapy could offer an advantage over bamlanivimab alone if worrisome coronavirus variants — particularly B.1.351, the one first identified in South Africa — take off in the United States. While bamlanivimab alone was found in a lab study to be powerless against the B.1.351 variant, preliminary data suggest that the combination therapy may be better able to fight off variants. That’s because so-called escape mutations in the variants that may enable them to avoid one antibody may not work against the second.
Another monoclonal antibody cocktail, made by Regeneron, is also authorized in the United States. Nearly 100,000 doses of that therapy have been shipped out.
Antibody treatments got a publicity boost last fall when they were given to Donald J. Trump when he was infected in the last months of his presidency, and to other high-profile Republicans, but they were surprisingly underused in many places in their first months of availability. Overwhelmed hospitals did not prioritize the treatments, which are cumbersome and must be given via intravenous infusions. Many patients and doctors did not know to ask for them or how to find them.
In December, the federal government’s early data collected from hospitals suggested that they had given only about 20 percent of their supply to patients. But that picture is changing. Eli Lilly has seen usage of bamlanivimab alone rise to around 40 percent nationwide, with uptake much higher in some places, Janelle Sabo, who leads Eli Lilly’s work on Covid-19 antibodies, said in an interview earlier this week.
For people who have had Covid-19, a single dose of the Pfizer vaccine is enough to provide robust protection from the coronavirus, according to two new studies from Britain that were published late Thursday in The Lancet, a prominent medical journal.
The studies, among the first fully vetted papers to weigh in on how to vaccinate people who have had Covid-19, added strong evidence to the case for inoculating people who already have antibodies against the virus — but only with one dose of the Pfizer vaccine.
One of the studies, led by researchers at University College London and Public Health England, described the benefits of that strategy.
“This could potentially accelerate vaccine rollout,” they said. And that in turn could forestall dangerous new mutations: “Wider coverage without compromising vaccine-induced immunity could help reduce variant emergence,” the paper said.
In recent weeks, several studies on the topic were posted online that were not yet published in scientific journals, showing that one dose of a coronavirus vaccine amplified people’s antibodies from an earlier infection.
People’s immune responses to being infected are highly variable: Most people make considerable and long-lasting antibodies, while others who had milder infections produce relatively few, making it difficult to know how protected they are from the virus.
Vaccines act as a sort of booster for those people’s immune responses, inducing enough antibodies to offer protection. But a single dose, rather than the full two-dose protocol, is enough for those who have been infected, a number of studies have suggested.
Some researchers in the United States are trying to persuade the Centers for Disease Control and Prevention to recommend giving only one dose to people who have recovered from Covid-19. The studies from Britain seem likely to put pressure on health officials there to consider the same approach.
More than 28 million people in the United States and four million people in Britain, along with many others whose illnesses were probably never diagnosed, have been infected so far.
One of the new studies — led by Charlotte Manisty, a professor at University College London, and Ashley D. Otter, a research scientist at Public Health England — tracked 51 health workers in London who have submitted to routine tests for antibodies and infection since March. That gave researchers an unusually detailed picture of any pre-existing protection from the virus.
Roughly half of the health workers had experienced a mild or asymptomatic infection. And a single dose of the Pfizer vaccine increased their antibody levels more than 140-fold from their peak levels before being inoculated, the study said. That appeared to give them better protection against the coronavirus than two doses of the vaccine did in people who had never been infected, the researchers wrote.
The study raised the idea of giving people blood tests in the weeks before they became eligible for a Pfizer vaccine to determine whether they already had antibodies. People’s immune responses to an infection are highly variable, making it difficult to predict without a blood test who can be fully protected with a single dose.
As a further benefit of the single-dose strategy, the researchers wrote that it would spare people who have already been infected from the unpleasant side effects that sometimes follow a booster shot in that group.
The second study, led by scientists at Imperial College London, measured the immune responses of 72 health workers who were vaccinated in late December. A third showed signs of having previously been infected.
For those people, one dose of the Pfizer vaccine stimulated “very strong” antibody responses, the study said, as well as “very strong T-cell responses,” referring to another arm of the immune system.
It is not clear how long the post-vaccine immune response will last in people who have previously been infected compared with those who have not.
Canada’s drug regulator authorized the AstraZeneca vaccine on Friday as well as a version of it developed by the Serum Institute of India. The vaccine, which was developed with Oxford University, has not yet been authorized for use in the United States but has been key to Britain’s rapid vaccination rollout.
The addition of a third vaccine, in addition to the offerings from Moderna and Pfizer-BioNTech, may help Canada alleviate a growing dissatisfaction about the sluggish pace of vaccination in the country.
“Vaccines will keep arriving faster and faster,” Prime Minister Justin Trudeau told a news conference. “We now have a third safe and effective vaccine.”
Mr. Trudeau said that the government expects to receive, within days, about 500,000 doses out of an order of two million doses of the Serum Institute version of the vaccine, known as Covishield. About 20 million doses will start arriving from AstraZeneca in the spring.
The AstraZeneca vaccine, the first virus vector-based inoculation for Covid-19 authorized in Canada, has had some stumbles. It proved ineffective against the coronavirus variant first found in South Africa, and during trials some people reported adverse reactions.
Drug approval officials with Health Canada said on Friday that while some studies suggested that the AstraZeneca vaccine is less effective overall than others, the sample sizes used were not large enough to yield a clear conclusion. But in Germany, many people regard it as “second-class” compared to the vaccine developed by the German company BioNTech and Pfizer, and are avoiding AstraZeneca’s.
Across the United States and the world, the coronavirus seems to be loosening its stranglehold. The curve of cases, hospitalizations and deaths has yo-yoed before, but never has it plunged so steeply and so quickly.
Is this it, then? Is this the beginning of the end?
The road ahead is potholed with unknowns: how well vaccines prevent further spread of the virus, whether emerging variants remain susceptible enough to the vaccines and how quickly the world is immunized, so as to halt further evolution of the virus.
And the greatest ambiguity is human behavior. Will Americans desperate for a return to pre-pandemic lifestyles continue to wear masks and distance themselves from family and friends? How much longer can communities keep businesses, offices and schools closed?
Covid-19 deaths are unlikely to again rise quite as precipitously as in the past, and the worst may be behind us. But if Americans let down their guard too soon and if the variants spread in the United States as they have elsewhere, another spike in cases may well arrive in the coming weeks.
Buoyed by the shrinking rates over all, governors are lifting restrictions across the United States and are under enormous pressure to reopen completely.
“Everybody is tired, and everybody wants things to open up again,” said Ashleigh Tuite, an infectious disease modeler at the University of Toronto. “Bending to political pressure right now, when things are really headed in the right direction, is going to end up costing us in the long term.”
Looking ahead to late March or April, the majority of scientists interviewed by The Times predicted a fourth wave of infections. But they stressed that it is not an inevitable surge if precautions are maintained for a few more weeks.
“Just hang in there a little bit longer,” Dr. Tuite said. “There’s a lot of optimism and hope, but I think we need to be prepared for the fact that the next several months are likely to continue to be difficult.”
BRUSSELS — In vaccine-hungry, cash-rich Europe, the hunt for more doses has nations trading with each other, weighing purchases from Russia and China, and fielding offers from middlemen ranging from real to outright frauds.
Anger has been building over the European Union’s sluggish Covid vaccine rollout, which has left the E.U. member nations far behind several other wealthy countries, and many E.U. states are now looking beyond the bloc’s underwhelming joint purchasing strategy.
An immense black — or at least gray — market has arisen, with pitches from around the world at often exorbitant prices. Sellers have approached E.U. governments claiming to offer 460 million doses of vaccines, according to early results of an investigation by the bloc’s anti-fraud agency that were shared with The New York Times.
While they still plan to get vaccines from the bloc, some nations are also trying to negotiate directly with drug makers and eyeing the murky open market, where they are still unsure of the sellers and the products. Some have also agreed to swap vaccines with each other, deals some of them now have reason to regret.
The European Union last year was slow to make massive advance purchases from drug companies, acting weeks after the United States, Britain and a handful of other countries. This year, the bloc was blindsided by slower-than-expected vaccine production, and individual countries have fumbled the rollout.
About 5 percent of the E.U.’s nearly 450 million people have received at least one dose of a vaccine, versus almost 14 percent in the United States, 27 percent in Britain and 53 percent in Israel, as of earlier this week, according to the Our World in Data database and governments.
The stumbles by the world’s richest bloc of nations have turned vaccine politics toxic. Particularly galling to many Europeans is the sight of a former E.U. member, Britain, forging ahead with its vaccination and reopening plans, while many of their own societies remain under lockdown to contain a new surge of dangerous variants, their economies sinking deeper into recession.
In other international news on the pandemic:
The government in France has announced stricter border checks between Germany and the eastern Moselle region, one of several areas experiencing a spike in coronavirus infections. It is the latest pandemic measure to challenge the E.U.’s open borders. Officials said that starting Monday, those wanting to cross the border would have to present a negative coronavirus test from the past 72 hours. Cross-border workers in the area will be exempt.
President Emmerson Mnangagwa of Zimbabwe threatened this week to punish residents who do not take Covid vaccines. “You are not going to be forced to be vaccinated, but the time shall come when those who are not vaccinated won’t get jobs,” he said on Wednesday. The country of 15 million people received 200,000 donated doses from the Chinese company Sinopharm, and 600,000 more doses are expected in early March. Zimbabwe is also set to receive more than 1.1 million doses as part of the Covax distribution program for poor and middle-income countries.
North Korea’s borders have been closed for a year because of the pandemic, but some Russian diplomats and their families found a way home on a route that included a bus ride and a trip on a hand-pushed railroad trolley. Russia’s Foreign Ministry said on Friday that the journey by trolley was the only possible way for them to cross the border.
The phone and online registration system set up by the District of Columbia for its residents to use to schedule Covid-19 vaccination appointments has been faltering after the city broadened the eligibility of prioritized residents who can make appointments on Thursday.
D.C. widened the criteria from people 65 and older to include residents with certain health conditions and those working jobs that require contact with multiple people.
But many complained on Thursday and Friday that the phone number listed for scheduling a jab was not in service, and that the website was returning error messages. Some people were able to secure an appointment, though it was not immediately clear why they were successful when others were not.
“In short … it did not go well,” one of the city’s council members, Charles Allen, said in an email to constituents on Thursday.
Mayor Muriel Bowser blamed the problems on the “high volume of traffic” on the city’s vaccination site and said in a tweet that the city was trying to fix the problems quickly. The mayor’s office did not immediately respond to a request for comment.
The city’s health department apologized for the problems and said the “technical review failure” on Thursday had been addressed. However, the problems persisted on Friday when the city released another 4,350 vaccine appointments.
As of Thursday, 10.6 percent of D.C. residents had received one dose of a vaccine, and 4.8 percent had received two doses, according to a Times database.
The head of Canada’s largest pension fund stepped down on Thursday evening after news broke that he had flown to the United Arab Emirates to receive a coronavirus vaccine, despite federal rules banning inessential travel and a long line of older and immunocompromised citizens across the country waiting for their shots.
The Canada Pension Plan Investment Board announced in a news release on Friday that it had accepted the resignation of its chief executive, Mark Machin, who had “decided to travel personally to the United Arab Emirates where he arranged to be vaccinated against Covid-19.” The board added: “We take that responsibility of leadership very seriously.”
At about $375 billion, the fund is Canada’s largest, with more than 20 million contributors and beneficiaries.
Mr. Machin, who last year earned about $4.2 million at the helm of the crown corporation, is the latest public figure in the country to be publicly sanctioned for traveling abroad for personal reasons, while much of the country is hunkered down during the pandemic’s second wave.
His trip was perceived as not just selfish, but as queue-jumping by many Canadians, who have grown increasingly impatient with the sluggish rollout of vaccinations across the country. Less than 4 percent of the country’s 38 million people have received a dose — far fewer than most Western nations.
The Canada Pension Plan Investment Board is an independent corporation, but the country’s finance minister appoints its directors. Through her spokeswoman, the deputy prime minister and finance minister, Chrystia Freeland, called Mr. Machin’s decision “very troubling” and said Canadians expect the organization to “be held to a higher standard.”
Mr. Machin’s trip was first reported by The Wall Street Journal on Thursday night. Soon after, he sent an internal memo to staff stating the trip was supposed to be “very private” and that he was disappointed it has become the focus of “expected criticism,” The Globe and Mail reported.
RIO DE JANEIRO — The daily death toll of Covid-19 in Brazil hit a record high of 1,582 on Thursday, according to a news consortium’s survey of local health departments. The painful milestone came as President Jair Bolsonaro railed against face masks, despite compelling scientific evidence that they are effective at preventing infections.
A rise in coronavirus infections in several states in Brazil, which officials say is being driven by more contagious variants, has overwhelmed hospitals across the country.
While epidemiologists and health officials warn of a worsening crisis in the weeks ahead, Mr. Bolsonaro took aim at masks during his weekly address on Facebook Thursday. Citing an unspecified German study, the president said masks were bad for children and that wearing them could lead to headaches, difficulty concentrating and a “decreased perception of happiness.”
Mr. Bolsonaro has been criticized at home and abroad for his cavalier response to the coronavirus pandemic. He has questioned the use of quarantine measures, social distancing and has sowed doubts about vaccines, saying he does not intend to get a shot.
While new cases and deaths are dropping in a number of other countries that were hard hit by the pandemic, including the United States, Brazil is in the grip of a second wave that began in November and shows no sign of easing.
The country began vaccinating medical professionals and older people last month, but the campaign is off to a slow start because the government has struggled to procure enough doses to quickly inoculate its 212 million citizens.
This week, Brazil’s Covid death toll surpassed 250,000, which is second only to the U.S. count of more than 500,000 deaths. The Brazilian health minister, Eduardo Pazuello, said on Thursday that the country had entered a “new stage of the pandemic” as a result of variants that he said are three times more contagious than earlier strains of the virus. “That is the reality we’re living today in Brazil,” he said.
Richard A. Carranza will resign as chancellor of New York City’s public school system, the nation’s largest, in March, city officials announced Friday. The abrupt move comes after disagreements between Mayor Bill de Blasio and Mr. Carranza over school desegregation policy reached a breaking point in recent weeks.
Mr. Carranza, 54, is leaving one of the most influential education jobs in America about three years after he was appointed, and just 10 months before the end of Mr. de Blasio’s second and final term.
He will be replaced by Meisha Porter, a longtime city educator and current Bronx superintendent who will become the first Black woman to lead the sprawling system, which has over 1 million students and 1,800 schools. Ms. Porter, 47, will take over as chancellor on March 15.
“I know the pandemic has not been easy for you, or for any New Yorker,” Mr. Carranza will say to his colleagues at the Board of Education at a news conference on Friday, according to a copy of his prepared remarks. “And I am a New Yorker — a New Yorker who has lost 11 family members and close friends to Covid. A New Yorker who needs to take time to grieve.”
Mr. Carranza’s announcement follows years of tension between the chancellor and the mayor involving who had the final say over major education decisions. The chancellor and other senior education officials sometimes felt that their expertise was overruled or disregarded by Mr. de Blasio, who runs the school district under mayoral control.
The two men repeatedly clashed over school desegregation policy in particular.
Mr. Carranza vowed from his first day as chancellor to tackle entrenched segregation in the city’s schools, while the mayor has largely avoided even using the word. New York is home to one of the most segregated public school districts in the nation, a trend that has worsened over the last few decades as the city has introduced more selective admissions policies for elementary, middle and high school.
It became clear several months into Mr. Carranza’s tenure that the mayor and chancellor had fundamentally different approaches to the problem, particularly when it came to selective admissions policies and gifted and talented programs.
The long-simmering issues came to a head earlier this month, during one heated conversation between Mr. Carranza and Mr. de Blasio over the future of gifted and talented classes, according to several sources with direct knowledge of that conversation. Mr. Carranza drafted a resignation letter after that meeting, but did not immediately quit.