CoronavirusCovid News: Omicron Causes Fewer and Shorter Hospitalizations, Study Shows

California hospitals find that Omicron causes fewer hospitalizations and shorter stays.

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A nurse talking with a Covid-19 patient at Providence Holy Cross Medical Center in Los Angeles in December.Credit...Jae C. Hong/Associated Press

A new study of nearly 70,000 Covid patients in California demonstrates that Omicron causes less severe disease than other coronavirus variants, results that align with similar findings from South Africa, Britain and Denmark, as well as a host of experiments on animals.

Compared with Delta, Omicron infections were half as likely to send people to the hospital. Out of more than 52,000 Omicron patients identified from electronic medical records of Kaiser Permanente of Southern California, a large health system, the researchers found that not a single patient went on a ventilator during that time.

“It’s truly a viral factor that accounts for reduced severity,” said Dr. Lewnard, an epidemiologist at the University of California, Berkeley who was an author of the study, which was posted online on Tuesday and has not yet been published in a scientific journal.

Despite the less severe virulence of Omicron, U.S. hospitals are buckling under an influx of coronavirus cases. Dr. Lewnard said that this was the result of the variant spreading like wildfire. On average, more than 730,000 people are testing positive every day in the United States, almost three times the previous peak last winter.

“Since it’s more transmissible, there will just at some point be a lot of hospitalizations that inevitably occur,” Dr. Lewnard said.

In recent weeks, Britain and several other countries have reported that Omicron has a lower risk of hospitalizations. When the variant hit the United States last month, Dr. Lewnard and his colleagues began analyzing electronic health care records maintained by Kaiser Permanente of Southern California, which serves 4.7 million people.

They analyzed 69,279 symptomatic patients who tested positive for the coronavirus from Nov. 30 to Jan. 1. Three-quarters of the positive samples contained the Omicron variant, and the rest were Delta.

The researchers then followed the people who tested positive to see whether they ended up in the hospital. They excluded the so-called incidental Covid patients who showed up at hospitals for other complaints and tested positive for the coronavirus after arriving.

Compared with Delta, Omicron cut the risk of hospitalization in half, the study found, and the people who came to the hospital with Omicron stayed for a shorter period. The variant cut hospital stays by more than three days, a reduction of 70 percent compared with Delta.

Fourteen of the Delta-infected patients died, while only one Omicron patient did.

As scientists have gathered evidence that Omicron is less severe, they have struggled to understand why. One reason is that the people infected with Omicron have more immune defenses than in previous waves.

In other countries, researchers have found that earlier infections with other variants reduce the chances that people end up severely ill with Omicron. Vaccination also offers protection.

“Vaccines are quite helpful,” Dr. Lewnard said. He and his colleagues found that Californians who were vaccinated were 64 to 73 percent less likely to be hospitalized than unvaccinated people.

Even among unvaccinated people, however, Omicron was less likely to lead to hospitalizations than Delta.

Dr. Lewnard said that this extra analysis showed that Omicron was fundamentally less severe. Studies on animals suggest that Omicron readily infects cells in the upper airway but works poorly in the lungs, which could explain its milder effects.

Facing harsh criticism from senators, U.S. health officials defend the Biden administration’s Omicron response.

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Fauci and Walensky Back the C.D.C.’s New Covid-19 Guidelines

Dr. Anthony S. Fauci, White House Covid-19 adviser, and Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, responded to criticism about scarce coronavirus tests and confusing guidance.

“Today, we are faced with a different challenge, a new variant called Omicron that has rapidly spread throughout the world, including a massive, unprecedented surge in the United States. This is an extraordinary virus, the likes of which we have not seen even close to in well over 100 years. It is a very wily virus. It has fooled everybody all the time, from the time it first came in, to Delta, to now Omicron — very unpredictable, and we’re doing the best we possibly can.” “I have heard from so many people who find the latest C.D.C. isolation and quarantine guidance confusing and hard to interpret. If someone is exposed to or has Covid-19 and they’re vaccinated, what do they do?” “If they are exposed to Covid-19 and they are completely boosted, they should — they do not need to stay home, but they should get a test on Day 5. If they have Covid, our guidance does not distinguish between your vaccination status. So by five days after your symptoms, if you’re feeling better, if your fever is better, if your cough and sore throat are better, then on Day 6 you can go out, but you have to wear a mask.”

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Dr. Anthony S. Fauci, White House Covid-19 adviser, and Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, responded to criticism about scarce coronavirus tests and confusing guidance.CreditCredit...Pool photo by Shawn Thew/EPA, via Shutterstock

Top federal health officials on Tuesday defended the Biden administration’s efforts to protect Americans from the highly contagious Omicron variant, facing withering accusations from senators about the scarcity of coronavirus tests and confusing guidance on how soon people who test positive for the virus can return to normal life.

In a nearly four-hour hearing, lawmakers charged that the administration remained woefully unable to meet the demand for at-home tests, noting that the White House would fulfill its pledge to send 500 million of them to American households for free only after the current surge had peaked.

The health officials testified before the Senate Committee on Health, Education, Labor and Pensions during one of the most trying weeks yet in the administration’s struggle with the pandemic. Infection rates are skyrocketing nationwide, and hospitals set a single-day record on Sunday for the number of patients with the virus, surpassing last winter’s peak.

While Democratic senators offered only gentle criticism, Republicans were unsparing, claiming that President Biden and his pandemic response team had mangled public health strategy and messaging.

“Most Americans can’t make heads or tails of anything coming out of this administration,” said Senator Tommy Tuberville, Republican of Alabama.

The officials who testified said they had mounted an all-out effort to test, treat and vaccinate Americans in the middle of a shape-shifting pandemic.

“It’s hard to process what’s actually happening right now, which is, most people are going to get Covid,” said Dr. Janet Woodcock, the acting commissioner of the Food and Drug Administration, offering one of the federal government’s most pointed acknowledgments of Omicron’s effect since the variant arrived in the United States.

Dr. Anthony S. Fauci, Mr. Biden’s chief medical adviser, said the virus had “fooled everybody all the time, from the time it first came in, to Delta, to now Omicron,” adding, “We’re doing the best we possibly can.”

Covid patients in hospitals and I.C.U.s
Early data may be incomplete.
Feb. 2020
Sept.
Apr. 2021
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50,000
100,000
150,000 hospitalized
Hospitalized
In I.C.U.s
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Source: U.S. Department of Health and Human Services. The seven-day average is the average of a day and the previous six days of data. Currently hospitalized is the most recent number of patients with Covid-19 reported by hospitals in the state for the four days prior. Dips and spikes could be due to inconsistent reporting by hospitals. Hospitalization numbers early in the pandemic are undercounts due to incomplete reporting by hospitals to the federal government.

The hearing came as the Omicron variant, coupled with the Delta variant, has strained hospital systems and caused businesses to struggle to stay open because of staff shortages. An average of more than 735,000 infections are being reported in the United States each day, according to a New York Times database.

On average over the past seven days, more than 135,000 people were hospitalized with the virus, an 83 percent increase from two weeks ago.

Modeling scenarios cited in an internal government document dated Jan. 5 and obtained by The New York Times suggested there would be more than a million confirmed infections per day by the end of the month. That number is widely viewed as a vast undercount because of the scarcity of tests and the widespread failure of people to report positive results from at-home tests to government authorities.

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As Covid sweeps Europe, the W.H.O. warns of ‘a closing window to act now.’

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Covid Cases in Europe More Than Doubled in Two Weeks, W.H.O. Says

The World Health Organization warned that more than half of people in Europe could be infected with the Omicron coronavirus variant in the next six to eight weeks.

The region saw over seven million newly reported cases of Covid-19 in the first week of 2022, more than doubling over a two-week period. The Institute for Health Metrics and Evaluation forecasts that more than 50 percent of the population in the region will be infected with Omicron in the next six to eight weeks. The currently approved vaccines do continue to provide good protection against severe disease and death, including for Omicron. But because of the unprecedented scale of transmission, we are now seeing rising Covid-19 hospitalizations. It is challenging health systems and service delivery in many countries where Omicron has spread at speed, and threatens to overwhelm in many more. I am also deeply concerned that as the variant moves east, we have yet to see its full impact in countries where levels of vaccination uptake are lower, and where we will see more severe disease in the unvaccinated. For countries not yet hit by the Omicron surge, there is a closing window of opportunity to act now and plan for contingencies.

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The World Health Organization warned that more than half of people in Europe could be infected with the Omicron coronavirus variant in the next six to eight weeks.CreditCredit...Francois Mori/Associated Press

More than half of people in Europe could be infected with the Omicron variant of the coronavirus in the next six to eight weeks, the World Health Organization warned on Tuesday, amid “a new west-to-east tidal wave sweeping across the region.”

“The region saw over seven million cases of Covid-19 in the first week of 2022, more than doubling over a two-week period,” Dr. Hans Kluge, the agency’s regional director for Europe, said at a news conference.

While coronavirus vaccines remain remarkably effective at preventing severe illness and death, the agency cautioned against treating the virus like the seasonal flu, since much remains unknown — particularly regarding the severity of the disease in areas with lower vaccination rates, such as Eastern Europe.

The W.H.O. has cautioned for months that booster shots could worsen vaccine inequality around the world, but Dr. Kluge said on Tuesday that they would play an essential role in protecting the most vulnerable people from severe disease and should also be used to protect health workers and other essential employees, including teachers.

Since Omicron was first detected in late November, it has torn across the planet at a pace unseen during two years of the pandemic. As friends, co-workers and family members test positive, the reality that the virus is moving quickly and widely has been a defining feature of this wave of infection.

Global coronavirus cases by region

This chart shows how reported cases per capita have changed in different parts of the world.

  • Africa
  • Asia-Pacific
  • Europe
  • Latin America
  • Middle East
  • U.S. and Canada
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Jun. 2022
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100 cases
200 cases per 100,000
Sources: Center for Systems Science and Engineering at Johns Hopkins University and state and local health agencies (cases); World Bank and U.S. Census Bureau (population data).

But the steep rise that Dr. Kluge cited, based on forecasts by the Institute for Health Metrics and Evaluation, is a stark paradigm shift. Although the institute’s models have frequently been criticized by experts, it is clear that the virus is spreading quickly. Even if many people avoid severe illness, the virus promises to cause societal disruption across the continent.

While much of the public discussion has revolved around whether this was the moment when governments should shift policies and restrictions to treat the coronavirus as an endemic disease — removing most restrictions and allowing people to manage risk in a way similar to the way they do with influenza — the W.H.O. said it was too early to call this virus endemic.

Catherine Smallwood, a W.H.O. senior emergencies officer, said that one of the key factors in declaring the virus to be endemic was some sense of predictability.

“We are still ways off,” she said. “We still have a huge amount of uncertainty.”

Dr. Kluge added that there were simply too many unknown factors, including exactly how severe Omicron is for unvaccinated people and how high the risk is of infection leading to “long Covid” symptoms.

“I am also deeply concerned that as the variant moves east, we have yet to see its full impact in countries where levels of vaccination uptake are lower, and where we will see more severe disease in the unvaccinated,” he said.

Nations in the Balkans and Eastern Europe, where Omicron is just starting to spread widely, have much lower rates of vaccination than nations in Western Europe.

“For countries not yet hit with the omicron surge, there is a closing window to act now and plan for contingencies,” he said.

One of the central struggles of governments across Europe has been trying to keep schools open, and Dr. Kluge described those efforts as essential.

“Schools should be the last places to close and the first to reopen,” he said, although he added that “the numbers of infected people are going to be so high in many places that schools in many countries are going to be unable to keep all classes open” because of illness and staff shortages.

The F.D.A. extends the shelf life of up to a million expired tests in Florida.

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Employees of the Miami-Dade Public Library System distributing rapid test kits for coronavirus in Miami on Saturday.Credit...Chandan Khanna/Agence France-Presse — Getty Images

MIAMI — The Food and Drug Administration has extended the shelf life of up to one million rapid coronavirus tests that had expired in Florida, the state’s Division of Emergency Management said on Tuesday.

The extension will allow the tests to be used over the next three months, the division said in a statement. It provided a copy of a letter from the F.D.A. dated Jan. 7 that granted Florida’s request to lengthen the tests’ shelf life to 15 months, meaning March of this year.

Floridians have experienced long lines at testing sites and a shortage of at-home tests amid a surge of the Omicron variant. The confirmation by state officials last week that so many tests were sitting unused prompted harsh criticism of the administration of Gov. Ron DeSantis, a Republican.

New reported cases by day
Mar. 2020
Oct.
May 2021
Dec.
Jul. 2022
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20,000
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844

These are days with a reporting anomaly.

Source: State and local health agencies. Daily cases are the number of new cases reported each day. The seven-day average is the average of the most recent seven days of data.

Mr. DeSantis said that demand for the tests had plummeted in the fall, in the lull of infections between the wave caused by the Delta variant and the arrival of Omicron in December. (The stockpiled tests were not of the at-home variety, but rather require a trained professional to administer them.)

Now that the F.D.A. has deemed the tests usable for three more months, the Florida Department of Health will “continue to push out test kits to county emergency management offices, county health departments, public safety agencies, hospitals, and long-term care facilities,” the statement said.

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New York City sees ‘a glimmer of hope’ as virus cases level off, but they are still rising upstate.

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Governor Kathy Hochul of New York said case numbers in New York City had begun to plateau, but hospitalizations continued to grow.CreditCredit...Dave Sanders for The New York Times

A month into the Omicron surge, Gov. Kathy Hochul of New York said on Tuesday that there was a sign of hope on the horizon as the rate of new coronavirus cases in New York City had begun to plateau.

Still, she said, with case counts continuing to increase elsewhere in the state and a growing number of hospitals forced to limit elective procedures as a result, it would be premature to declare victory over the current virus wave.

“Looks like we may be cresting over that peak,” Ms. Hochul said at her daily news briefing, before clarifying: “Cases are slowing down, the rate of increase is slowing down, but they are still high.”

According to data compiled by The New York Times, the seven-day average of new cases in New York City dipped to 40,150 on Monday from 40,526 on Sunday; statewide, the average fell to 73,815 from 74,182 a day earlier.

“We’re not at the end,” Ms. Hochul said, while calling the latest figures “a glimmer of hope in a time when we desperately need that.”

Other data provided a potentially sobering counterpoint to Ms. Hochul’s optimism. Nearly one in five reported virus tests in New York continue to come back positive, according to state records. Case numbers keep climbing in some neighboring states, including Massachusetts and Connecticut, according a New York Times database.

And even as case numbers in New Jersey show signs of leveling off, Gov. Phil Murphy on Tuesday extended a state of emergency declaration that allows state officials to, among other things, continue to to require that masks be worn in schools and at day care centers. (Ms. Hochul previously extended through the end of January New York’s requirement that masks be worn in all public places that do not require vaccination.)

Ms. Hochul also acknowledged that a large swath of New York was not faring as well as New York City. Across the state, 12,540 people were hospitalized with Covid-19 on Monday and 160 died. By comparison, on Friday 11,548 people were hospitalized and 155 died.

“Upstate is continuing to go up, without a doubt,” Ms. Hochul said of the case numbers, adding: “Upstate is about two weeks behind downstate.”

The surge has prompted hospitals across the Finger Lakes, Mohawk Valley and Central New York regions to call off elective surgical procedures — a measure that Ms. Hochul said would remain in effect for the next two weeks.

In another acknowledgment of how fast the Omicron variant continues to spread, the state health commissioner, Dr. Mary T. Bassett, said at the Tuesday briefing that New York would no longer require local health departments to conduct contact tracing on virus cases.

“Omicron is very contagious and has a very short incubation period,” Dr. Bassett said. Because of that, she added, there was “a very short window for intervention to disrupt transmission, which is the purpose of contact tracing.”

The move will allow the state to redirect resources to testing and vaccination efforts, which will do more to fight the virus’s spread, officials said.

Some health departments, like Rockland County’s, had already stopped their tracing efforts as a result of the Omicron-driven spike.

“Due to the recent surge, the Health Department will not be able to reach every Covid-19 positive resident through contact tracing,” Dr. Patricia Schnabel Ruppert, the county’s health commissioner, said in a statement last week. She encouraged residents instead to use self-service forms online and to contact a doctor if they needed medical attention.

Ms. Hochul said individual counties could still conduct contact tracing if they wanted to but they would no longer be obligated to do so. Instead, the state plans to create a website offering guidance to New Yorkers on how to isolate themselves.

“If you’re not feeling well please stay home,” Ms. Hochul said. “Watch some football, watch some whatever you want to watch, but just — just be safe.”

Asked at the briefing whether she would consider a remote option for state workers, the governor said that all employees should stay home if they felt ill but that she did not think a broad return to remote work was necessary given the widespread availability of testing.

Lisa Waananen and Sharon Otterman contributed reporting.

A popular at-home test detects most infectious Omicron cases, a study suggests.

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Americans have struggled to get tested amid the Omicron wave.Credit...Patrick T. Fallon/Agence France-Presse — Getty Images

The Abbott BinaxNOW, a widely used at-home coronavirus test, can detect most people who are infected with the new Omicron variant and are carrying high levels of the virus, according to a new, real-world study of more than 700 people who visited a walk-up testing site in San Francisco.

Like all rapid antigen tests, BinaxNOW is less sensitive than P.C.R. tests, which can find even very small traces of the virus, and federal health officials have recently sent mixed messages about the usefulness of such antigen tests. But they have generally been good at catching people who have high viral loads and are most likely to be infectious.

The new study, which has not yet been reviewed by experts, found that overall the BinaxNOW detected 65 percent of the infections identified via P.C.R. testing, but 95 percent of people who had the highest viral loads. Among those with high levels of the virus, the tests caught 98 percent of those with symptoms and 90 percent of those without symptoms, the researchers found.

The test’s performance was roughly on par with what the scientists had observed in real-world studies before Omicron emerged, they said.

“It’s working as it was designed,” said Joseph DeRisi, a biochemist at the University of California, San Francisco, who is a president of the Chan Zuckerberg Biohub and an author of the paper. “There does not seem to be any performance deficit with Omicron.”

The findings come after some preliminary studies raised questions about whether rapid antigen tests might be less sensitive for Omicron than for other variants — and whether saliva samples might be a better way to detect the variant than the nasal swabs currently used in antigen tests.

At a Senate hearing on the federal coronavirus response on Tuesday, Dr. Janet Woodcock, the acting commissioner of the Food and Drug Administration, said that scientists were still trying to determine how well the currently authorized at-home tests work for the new variant.

“We believe all of them detect Omicron,” she said. “We simply feel they are somewhat less sensitive than they were to some of the previous variants.”

The new research, which relied on nasal swabs, does not address how early in the course of an infection the antigen tests can detect the variant, as one small previous study did, or whether the tests would perform better with saliva samples. And the results cannot be extrapolated to other antigen tests, which must be evaluated individually, the researchers cautioned.

But they suggest that BinaxNOW should still be able to pick up most infectious Omicron cases.

“This tool continues to be very important,” said Dr. Diane Havlir, an infectious disease physician specialist at the University of California, San Francisco, and an author of the paper.

The new study, conducted on Jan. 3 and 4, was performed independently of Abbott, she noted, although the company did provide BinaxNOW test kits for a prior study, in 2020. The test kits for the new study were provided by the health department, she said.

Because the tests may not catch people who have been infected very recently, the researchers recommend that people who are exposed to the virus then test more than once over a period of a few days.

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Australia is investigating whether Novak Djokovic violated travel rules.

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Novak Djokovic at a practice session in Melbourne, Australia, on Tuesday.Credit...Pool photo by Kelly Defina

The immigration authorities in Australia said on Tuesday that they were investigating whether Novak Djokovic could be charged with making a false statement on his visa entry form as the controversy over the Serbian tennis star’s Covid vaccination exemption continued.

Mr. Djokovic, who had to gain an exemption to enter Australia because he has shunned Covid vaccines, stated on his entry form that he had not traveled internationally in the 14 days before his flight on Jan. 4 from Spain, via Dubai, to Australia, where he plans to compete in the Australian Open starting on Monday.

That appeared to be contradicted by social media posts that showed him in Serbia on Christmas Day, hitting tennis balls in the streets of Belgrade in one video, and posing with handball player Petar Djordjic, in a picture posted to Twitter by José Morgado, a Portuguese sports journalist.

Mr. Djokovic was detained upon arrival at the airport in Melbourne last week, questioned over his exemption and had his visa canceled. The nine-time Australian Open champion spent four nights in immigration detention until a judge ruled on Monday that he had been treated unfairly and reinstated his visa, allowing him to enter the country.

But Alex Hawke, Australia’s immigration minister, said on Monday that he was still considering whether to rescind the tennis star’s visa for a second time.

Australia, which is in the grip of a large coronavirus surge, and where 78 percent of people are fully vaccinated, requires all visitors to be fully inoculated against Covid-19. Immigration laws also allow the government to deport Mr. Djokovic or any other visa holder for even the smallest of violations: a slight risk to public health, an incorrect statement on immigration forms or a perceived deficit of character.

The controversy over Mr. Djokovic, one of many sports figures increasingly scorned for vaccine skepticism, has created a political headache for Australia’s prime minister, Scott Morrison. A proponent of tough border enforcement, Mr. Morrison is facing questions over whether his government has tried to make an example of Mr. Djokovic, who entered the country with documents proving that he had obtained an exemption based on a recent coronavirus infection.

The exemption had been endorsed by a doctor and an independent panel from the state of Victoria, where the Australian Open is held.

On Tuesday, Mr. Morrison’s office said that he had spoken by phone with Prime Minister Ana Brnabic of Serbia to discuss Australia’s border policies. Serbian officials have previously accused Australia of trying to humiliate Mr. Djokovic, who is revered in his home country.

Fauci accuses Senator Paul of fueling threats against him in the latest exchange.

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Fauci Accuses Senator Paul of Attacking Him for ‘Political Gain’

Dr. Anthony S. Fauci refuted claims by Senator Rand Paul, Republican of Kentucky, that he was undermining scientists with opposing views.

“Do you really think it’s appropriate to use your $420,000 salary to attack scientists that disagree with you?” “I think in usual fashion, senator, you are distorting everything about me.” “Did you ever object to Dr. Collins’ characterization of them as fringe? Did you write back to Dr. Collins saying, ‘No, they’re not fringe, they’re esteemed scientists, and it would be beneath me to do that.’” “I did not —” “This happens all the time. You personally attack me with absolutely not a shred of evidence of anything you say. The last time we had a committee, or the time before, he was accusing me of being responsible for the death of five, four to five million people. What happens when he gets out and accuses me of things that are completely untrue is that all of a sudden that kindles the crazies out there and I have life — threats upon my life, harassment of my family. So I ask myself, why would senator want to do this? So go to Rand Paul website, and you see ‘Fire Dr. Fauci’ with a little box that says, ‘Contribute here.’ You can do $5, $10, $20, $100. So you are making a catastrophic epidemic for your political gain.”

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Dr. Anthony S. Fauci refuted claims by Senator Rand Paul, Republican of Kentucky, that he was undermining scientists with opposing views.CreditCredit...Pool photo by Greg Nash/Getty Images

A Senate hearing on the federal government’s Covid response briefly turned into a fierce back-and-forth between Senator Rand Paul of Kentucky and Dr. Anthony Fauci on Tuesday, the latest in a series of heated exchanges between the two men stretching back to the early days of the pandemic.

Mr. Paul accused Dr. Fauci of plotting with colleagues to undermine scientists with opposing views on the virus, something Dr. Fauci denied doing.

The senator cited an email exchange between Dr. Fauci and Francis Collins, a former director of the National Institutes of Health.

“In usual fashion, you are distorting everything about me,’’ Dr. Fauci responded. The two then spoke over each other, disputing the contents of the email chain.

Later in the hearing, Dr. Fauci said Mr. Paul was partly responsible for a surge in threats against Dr. Fauci and his family.

He said personal attacks from Republicans had put his safety and that of his family at risk. He cited reports that an armed man in Iowa had been arrested in connection with plans to kill him and other officials in Washington. Dr. Fauci also displayed a fund-raising webpage for Mr. Paul that included a “Fire Dr. Fauci” graphic.

“You are making a catastrophic epidemic for your political gain,” Dr. Fauci said to Mr. Paul.

Since the early days of the pandemic in 2020, Dr. Fauci has often clashed with Mr. Paul, an ophthalmologist who is not currently practicing. Their exchanges have become a common scene at Senate testimony. Mr. Paul has accused Dr. Fauci of manipulating research and of lying to the public about the origins of the virus to protect China. Dr. Fauci has denied these claims, dismissed many of Mr. Paul’s assertions as falsehoods, and has stated in a hearing that Mr. Paul did not know what he was talking about.

Mr. Paul was one of the first senators to be infected with the coronavirus in 2020, and has often criticized pandemic precautions like wearing masks. YouTube has twice suspended him from posting on their service for spreading misinformation.

Noah Weiland contributed reporting.

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The Met will pay its guards more to address Covid-related shortages.

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At times, the Metropolitan Museum of Art has had to close multiple galleries to deal with staff shortages.Credit...Timothy A. Clary/Agence France-Presse — Getty Images

The Metropolitan Museum of Art has agreed to increase the salaries of its security guards, part of an effort to ease staffing shortages because of the coronavirus pandemic.

Like many businesses, health care facilities and cultural organizations, the Met has struggled in recent weeks with employee absences, at times closing multiple galleries to cope with a security staff reduced, on the worst days, by as much as a third because of illness.

On one day in early January, for example, some 80 of the museum’s roughly 430 galleries were closed, including rooms displaying medieval, Egyptian, Chinese, European and American art and objects.

But while the immediate staffing issue is largely related to the surge of the highly contagious Omicron variant, the museum has also had a longer-term problem hiring guards to rebuild its staff after layoffs in 2020 that came in response to the pandemic.

In August 2020, five months after it had closed its doors and as the financial impact of the pandemic deepened, the Met furloughed about 120 guards who worked at the main museum on Fifth Avenue or at two satellites, the Met Cloisters and the Met Breuer. Those guards were later laid off, the museum said.

As the Omicron variant spread in recent weeks, other museums have experienced staff shortages because of illness. Among them is the Smithsonian’s National Air and Space Museum in Washington, which is closed until later this month, and its National Museum of Natural History, which closed briefly amid a shortage of staff but has now reopened.

In New York City, where record numbers of Covid-19 cases have been reported, the Met has reduced its visitor capacity. Anne Canty, a spokeswoman for the American Museum of Natural History, said its galleries had remained open except for the museum’s Butterfly Conservatory, which has been closed for several weeks because of shortages among specialized employees and volunteers.

Amanda Hicks, a spokeswoman for the Museum of Modern Art, said that while some employees had been out because of the impact of Covid, no galleries had closed.

Chicago schools will reopen as teachers and the city reach a deal over virus safeguards.

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Chicago Schools to Reopen After Reaching Deal With Teachers’ Union

The city of Chicago and the Chicago Teachers Union agreed to return to in-person learning in a deal that would include additional testing and metrics to close schools with major virus outbreaks.

“I’m pleased to report that the Chicago Teachers Union House of Delegates voted to end their work stoppage. That means teachers will be back in classes tomorrow, and all students should return on Wednesday. We know that this has been very difficult for students and families. Our goal throughout this entire process was to both get our students back to in-person learning as quickly as possible, and prevent work disruptions for the rest of the school year. Switching completely back to remote learning again without a public health reason to do so would have created and amplified the social, emotional and economic turmoil that far too many of our families are facing.” “This agreement is the only modicum of safety that is available for anyone that steps foot in a Chicago public school, especially in the places in this city where testing is low, and where vaccination rates are low.”

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The city of Chicago and the Chicago Teachers Union agreed to return to in-person learning in a deal that would include additional testing and metrics to close schools with major virus outbreaks.CreditCredit...Charles Rex Arbogast/Associated Press

Mayor Lori Lightfoot announced a deal with the Chicago Teachers Union on Monday that would return students to classrooms on Wednesday after a dispute over coronavirus safeguards canceled a week of classes in the country’s third-largest school district.

“No one is more frustrated than I am,” Ms. Lightfoot said after the deal was reached. She added: “I’m glad that we’re hopefully putting this behind us and looking forward. But there does come a point when enough is enough.”

The deal, which city officials said included provisions for additional testing and metrics that would close schools with major virus outbreaks, was approved by the union’s House of Delegates on Monday night and was expected to be voted on later in the week by rank-and-file teachers.

On Tuesday, Ms. Lightfoot said she had tested positive for the coronavirus after experiencing cold-like symptoms. The mayor, who said she was vaccinated and boosted, said she planned to work from home.

Under the deal, teachers were expected to return to school buildings on Tuesday, with students joining them the next day. Leaders of the union described the agreement as imperfect and were highly critical of Ms. Lightfoot, but they said the deal was needed given the conditions teachers are facing in the pandemic.

“This agreement is the only modicum of safety that is available for anyone that steps foot in the Chicago Public Schools, especially in the places in the city where testing is low and where vaccination rates are low,” said Stacy Davis Gates, the union’s vice president.

School leaders across the United States have scrambled to adjust to the highly infectious Omicron variant, which has pushed the country’s daily case totals to record levels and led to record hospitalizations. Most school districts have forged ahead with in-person instruction, as the Biden administration has urged, sometimes quarantining individual students or classrooms as outbreaks emerge. Some large districts, including in Milwaukee and Cleveland, have moved class online.

But the debate in Chicago proved uniquely bitter and unpredictable, with hundreds of thousands of children pulled out of class two days after winter break when teachers voted to stop reporting to their classrooms. Rather than teach online, as the union proposed, the school district canceled class altogether.

Chicago Public Schools leaders have insisted that virus precautions were in place and that pausing in-person instruction would unfairly burden parents and harm students’ academic and social progress. Union members said that the schools were not safe, that more testing was needed and that classes should be temporarily moved online.

The Chicago area, like much of the country, is averaging far more new cases each day than at any previous point in the pandemic. The Omicron variant is believed to cause less severe illness than prior forms of the virus, with vaccinated people unlikely to face severe outcomes. Still, coronavirus hospitalizations in Illinois have exceeded their peak levels from last winter and continue to rise sharply.

Members of Ms. Lightfoot’s administration have defended the school system’s efforts to make classrooms safe and have emphasized that children rarely face severe outcomes from Covid-19. But their efforts to reassure parents and teachers have sometimes faltered. The district instituted an optional testing plan over winter break, but most of the 150,000 or so mail-in P.C.R. tests given to students were never returned; of the ones that were, a majority produced invalid results.

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Bungled execution. Not enough resources. Virus testing falls short in U.S. schools.

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A student showed her negative Covid test result to enter Olive Vista Middle School in Sylmar, Calif., on Tuesday, the first day back following the winter break in Los Angeles County.Credit...Frederic J. Brown/Agence France-Presse — Getty Images

As millions of American students head back to their desks, the coronavirus testing that was supposed to help keep classrooms open safely is itself being tested. In much of the country, things are not going well.

Slammed by the ultra-contagious Omicron variant, pressured by political factions, baffled by conflicting federal guidance and hamstrung by a national shortage of rapid-test kits, many districts have struggled to ramp up or effectively implement testing programs. In many areas, schools have already had to close in recent weeks because flawed screenings have allowed infected children and teachers to return to class, putting others at risk.

A vast majority of schools nationally have managed so far to continue in-person instruction, and in many areas, transmission in classrooms has been kept lower than in the broader community. But parents’ anxiety and confrontations with teachers’ unions partly over the availability of tests are jeopardizing the Biden administration’s efforts to prevent a return to remote instruction. And even for districts that have working testing programs, high costs are raising questions about their sustainability.

Data from Burbio, a company that audits how schools have operated through the pandemic, shows that more than 5,400 schools have reverted to virtual learning since Jan. 3. The issue, epidemiologists say, is not that testing does not work — particularly in combination with vaccination, face masks and other precautions. Rather, they say, many districts are bungling the execution or failing to muster the resources necessary to test properly.

“A lot of schools are just testing parts of their population once a week, or not using the tests strategically, or confusing surveillance with testing to suppress outbreaks,” said Dr. Michael J. Mina, a former Harvard University epidemiologist and a leading expert on rapid testing who is now the chief science officer for eMed, which authenticates at-home test results.

The result, he said, has been the equivalent of an army going to battle without knowing how to use its weapons or understanding its objectives.

“You can throw all the guns and military personnel you want into a war zone, but if you don’t go in with strategy you’re never going to win,” Dr. Mina said.

Boris Johnson is back under pressure over another Downing Street party.

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Prime Minister Boris Johnson of Britain leaving 10 Downing Street in London last month.Credit...Dylan Martinez/Reuters

Prime Minister Boris Johnson of Britain confronted a fresh blizzard of questions on Tuesday about a garden party at 10 Downing Street in May 2020 that violated his government’s lockdown regulations, the latest in a skein of scandals that are sowing doubts about his long-term political survival.

The British news media reported that as many as 100 staff members were invited to a “bring your own booze” party in the backyard of Mr. Johnson’s residence, at a time when the government was instructing people not to socialize with more than a single person outside their families, to curb the spread of the coronavirus.

Mr. Johnson has not denied that he and his wife, Carrie, attended the gathering, which drew about 30 guests. If true, that would belie his statement in Parliament last year that he was told there were no Downing Street parties that broke social-distancing rules. The Metropolitan Police have indicated that they may investigate.

For Mr. Johnson, who had hoped to put a turbulent period of political setbacks and ethical questions behind him, the latest furor all but guarantees that the politically damaging issue of parties will continue to haunt him in 2022.

New reported cases by day
Feb. 2020
Sept.
Apr. 2021
Nov.
Jun. 2022
Jan. 2023
50,000
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150,000 cases
7-day average
4,111
Source: Data for the United Kingdom comes from the Department for Health and Social Care, Public Health England, Public Health Scotland, Public Health Wales, Public Health Agency of Northern Ireland and the Chief Medical Officer Directorate. Population data from U.K. Data Service Census Support. The Office for National Statistics also produces a weekly report on the number of deaths that mention Covid-19 on a death certificate. This figure, which includes deaths outside of hospitals, is many thousands of deaths higher than the reported daily death toll. The daily average is calculated with data that was reported in the last seven days.

In December, nearly 100 lawmakers of his Conservative Party rebelled over new Covid restrictions, fueling speculation that his leadership was in danger. But that crisis ebbed somewhat over Christmas, and last week many Conservative lawmakers praised Mr. Johnson for resisting calls for tighter curbs.

Analysts concluded that he had bought himself breathing space until local elections in May, which will be a big test of how much the outcry over the parties and other ethical issues has damaged electoral support for the Conservatives.

The accusations are being investigated by Sue Gray, a senior civil servant, who replaced the cabinet secretary, Simon Case, after he was forced to step aside following claims that he had breached the rules himself.

Even before Ms. Gray wraps up her report, however, the public seems to have made up its mind. Opinion polls indicate that the stream of disclosures about Downing Street parties during the lockdown have drained support for the Conservative Party, and for Mr. Johnson in particular.

“Hardly anybody believes what Boris Johnson has to say on the matter,” Chris Curtis, the head of political polling at Opinium Research, wrote on Twitter. “In fact, more people think the moon landings were faked than think the prime minister is telling the truth.”

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Despite Omicron, Los Angeles students are going back to class.

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Students were provided with Covid-19 at-home self-tests at the Johnnie L. Cochran Jr. Middle School in Los Angeles on Friday before returning to classes on Tuesday.Credit...Etienne Laurent/EPA, via Shutterstock

Los Angeles, the second-largest school district in the United States, is forging ahead with plans to open its classrooms for in-person learning on Tuesday.

Like other school districts across the country, Los Angeles Unified is dealing not only with uncertainty over the Omicron variant, but also with politicized tensions over the possibility of a return to remote learning, as well as teacher shortages that have left schools scrambling.

Most students attended classes in person last fall, connecting with their friends and snatching back traces of the normalcy they lost nearly two years ago. Now, school districts across the United States are trying to chart a way forward as coronavirus case numbers break records once again.

Los Angeles public schools had one of the longest shutdowns in the country last school year. The district is ramping up safety measures, but officials there seem determined to keep the children in their classrooms.

“We know there is apprehension, and we’ve added the extra layers of protection for the return to school,” Megan K. Reilly, the interim superintendent, said in a video address on Monday. “There may be a few lines at the start of the school day and longer wait times for buses.”

Nazli Santana, a mother of two middle school students who will return to class on Tuesday, said she wished the district had waited a little longer. “If they could just shut it down for two more weeks, that would have been helpful,” she said.

Last week, the district issued new rules requiring testing as a condition of returning to campus, regardless of vaccination status. Schools have hosted coronavirus testing and vaccination sites for students and distributed at-home tests. Masks are required on campus. A vaccine mandate for students 12 and older was scheduled to take effect this week, but enforcement was delayed to the fall.

District data showed that during the week ending Monday, out of about 458,000 tests of students and staff members, 66,000 had come back positive for the coronavirus, a positivity rate of more than 15 percent — lower than county, state and the country averages, but still high enough to cause alarm.

“I’m worried, like a lot of parents,” said Amanda Santos, whose 7-year-old attends first grade in the district.

For months, Ms. Santos has been keeping her eye on an online dashboard where the district shares data. For much of the fall semester, the weekly report for her son’s elementary school was showing only a couple of positive cases at a time. But over the winter break, she watched that number shoot up into the dozens.

That was worrisome, Ms. Santos said. But she added that schools seemed careful about safety, and good about keeping parents informed. “They’re not letting anybody who has a positive test, or who doesn’t test, on campus,” she said. “So I feel secure about that.”

Cecily Myart-Cruz, the president of the local teachers’ union, said in a statement on Monday that the district was “in a better position than most others in the country” because of the safety measures it has taken.

“This week will be stressful, and there will be disruptions,” she added. “No one has a playbook for this moment.”

The World Bank warns that the pandemic will slow economic growth in 2022.

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Construction at the Route 50 interchange with I-66 in Fairfax, Va. The World Bank said that the recently passed infrastructure law would do little to buttress growth in the United States in the near term.Credit...Jim Lo Scalzo/EPA, via Shutterstock

WASHINGTON — The World Bank said on Tuesday that the pace of global economic growth was expected to slow in 2022, as new waves of the pandemic collide with rising prices and snarled supply chains, blunting the momentum of last year’s recovery.

This projection underscores the stubborn nature of the public health crisis, which is widening inequality around the world. The pandemic is taking an especially brutal toll on developing countries, largely owing to rickety health care infrastructure and low vaccination rates.

“The Covid-19 crisis wiped out years of progress in poverty reduction,” David Malpass, the World Bank president, wrote in an introduction to the report. “As government’s fiscal space has narrowed, many households in developing countries have suffered severe employment and earning losses — with women, the unskilled and informal workers hit the hardest.”

Global growth is expected to slow to 4.1 percent this year, from 5.5 percent in 2021, according to the World Bank. Output is expected to be weaker, and inflation is likely to be hotter than previously thought.

The World Bank said growth rates in most emerging markets and developing economies outside East Asia and the Pacific would return to their prepandemic levels, still falling short of what would be needed to recoup losses during the pandemic’s first two years. The slowdown in these regions will be more abrupt than what advanced economies will experience, leading to what the World Bank describes as “substantial scarring” to output.

Income inequality is widening both within and between countries, the World Bank said, and could become entrenched if disruptions to education systems persist and if high national debt hinders the ability of nations to support their low-income populations. Globally, the prospect of higher interest rates and withdrawal of fiscal support could take a toll on low-income countries while they are already vulnerable.

Growth in the world’s two largest economies, the United States and China, is poised to moderate considerably. The World Bank said that the recently passed infrastructure law would do little to buttress growth in the United States in the near term and that pandemic restrictions were curbing consumer spending and residential investment in China.

The World Bank is recommending stronger debt relief initiatives to help poor countries as well as urging support for policies that will strengthen their financial systems and improve local infrastructure in ways that will spur growth. Easing global supply chain bottlenecks, particularly for Covid vaccine doses, will be crucial.

“At the start of 2022 the supply of vaccines is increasing appreciably, but new variants and vaccine deployment bottlenecks remain major obstacles,” Mr. Malpass said.

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Global Roundup

Hong Kong closes kindergarten and elementary schools, and begins vaccinating 5- to 11-year-olds.

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Students were back in class at Chiu Sheung School in Hong Kong in September, but kindergarten and elementary classes will be suspended until after the Lunar New Year next month because of coronavirus concerns.Credit...Anthony Kwan for The New York Times

Hong Kong will suspend in-person teaching for kindergarten and elementary schools from the end of the week until the end of Lunar New Year holiday in early February as the city tries to control the spread of the Omicron variant.

The city will also begin vaccinating children ages 5 to 11 with the Chinese-made Sinovac doses.

New reported cases by day
Feb. 2020
Sept.
Apr. 2021
Nov.
Jun. 2022
Jan. 2023
20,000
40,000
60,000 cases
7-day average
0
Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

Carrie Lam, Hong Kong’s chief executive, said that she was reluctant to close schools because of the harm to child development, but that concerns about the hidden transmission of the coronavirus made it necessary. Online learning will continue, she said.

Face-to-face classes will continue for older schoolchildren, as they are better able to take protective measures, Mrs. Lam said.

In other news from around the globe:

  • China locked down a third city — Anyang, with a population of 5.5 million — because of a coronavirus outbreak, according to news reports. A notice said that officials would conduct mass testing in the city. About 13 million people are also locked down in the city of Xi’an and 1.1 million in Yuzhou, raising the number of Chinese residents confined to their homes to about 20 million.

  • Japan will maintain its ban on nonresident foreigners entering the country until the end of February to help curb the spread of the Omicron variant, Prime Minister Fumio Kishida said on Tuesday, though some exceptions for humanitarian reasons may be considered. Cases of the virus in the country have increased by more than 2,000 percent in the past two weeks, according to data from The New York Times. But they remain far below the country’s peak in August. That trend, Mr. Kishida told reporters, was “thanks to the toughest border control measures among G7 countries.”

  • Starting Wednesday, lawmakers in Germany who wish to take their regular seats in the Bundestag will have to be vaccinated against the coronavirus or to have recovered from a recent infection. Lawmakers who do not comply will be given seats in what used to be the visitor’s balcony. Wherever they sit, lawmakers will still have to be tested daily and show a negative result to enter the building, unless they have received a booster shot of vaccine.

Listen to ‘The Daily’ about why this virus surge feels different from earlier ones.

Image
A medical worker waving to a colleague with a Covid-19 patient in the intensive-care unit of UMass Memorial Medical Center in Worcester, Mass., this month.Credit...Joseph Prezioso/Agence France-Presse — Getty Images

The Omicron variant of the coronavirus has a reputation for causing mild illness, yet it is fueling a staggering rise in hospitalizations across the United States.

In some of the early hot spots for the variant, such as New York and New Jersey, emergency rooms are filling up and hospitals are being flooded with more new patients than they have staff to care for.

This episode of “The Daily” explores why the Omicron surge is leading to hospitalizations. It also hears from doctors on the front lines about what they are seeing and why this surge feels different from the ones that came before.

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Listen to ‘The Daily’: Omicron Surges, Hospitals Struggle

Why doctors and nurses inside hospitals inundated with Covid patients say this phase of the pandemic feels so different.
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transcript

Listen to ‘The Daily’: Omicron Surges, Hospitals Struggle

Why doctors and nurses inside hospitals inundated with Covid patients say this phase of the pandemic feels so different.

annie correal

From The New York Times, I’m Annie Correal, in for Michael Barbaro. This is The Daily.

Today: Despite its reputation for mild illness, the Omicron variant is fueling a staggering rise in hospitalizations around the country. I spoke with my colleague, Emily Anthes, about why doctors and nurses inside those hospitals say that this phase of the pandemic feels so different. It’s Tuesday, January 11.

So Emily, you’ve been reporting on hospitals across the U.S. and the challenge that they’re facing at this particular moment in the pandemic. Can you tell us about what you’ve been hearing?

emily anthes

Absolutely. So cases have been skyrocketing in recent weeks. If you look at graphs of cases, they’re basically vertical, and the highest case numbers we’ve seen at any point in the pandemic. And hospitalizations, which tend to lag behind cases, have started to rise, too.

And in some of the early Omicron hotspots — New York, New Jersey, Massachusetts, elsewhere — hospitals are being flooded with new patients. They’re just being inundated. Emergency rooms are filling up. There aren’t enough staff to care for all these patients. And that might seem like a bit of a paradox because we, ourselves, have covered a bit about how evidence is emerging that this variant, Omicron, might be a bit milder than Delta, which caused some of the previous surges.

So we wanted to try to figure out what was at the heart of this tension. If this variant was causing milder illness and so many Americans are vaccinated now, why are hospitals filling up?

speaker

This is [INAUDIBLE]

emily anthes

Hi, this is Emily Anthes, calling from The New York Times. How are you?

speaker

Good, good. Can you hear me OK?

emily anthes

I can.

emily anthes

So several of my colleagues and I —

azeen ghorayshi

— are trying our best to talk to as many hospitals —

emily anthes

— including my colleague, Azeen Ghorayshi —

azeen ghorayshi

— to sort of find out what’s happening on the ground —

emily anthes

— started calling doctors and hospitals —

speaker

Hold on. Let me get Dr. Mays on the line.

emily anthes

— all over the country.

speaker

Here in Miami-Dade, our vaccination rate is high.

emily anthes

Florida —

speaker

We are the main university hospital in Winston-Salem, North Carolina.

emily anthes

— North Carolina.

speaker

— the state of Georgia and others.

emily anthes

— California, Maryland, Texas, Rhode Island.

speaker

Yes, I am hanging in there.

emily anthes

And we asked them —

azeen ghorayshi

Can you just describe a little bit more just how this does feel different? I mean —

emily anthes

What are you seeing and how is this surge different?

speaker 1

Our hospitalizations are nowhere near what they were at the height of the epidemic. But they are higher than they were in the summer when we had a bump up with Delta.

speaker 2

Very early in the pandemic, the thing that health systems everywhere were worried about were running out of ventilators. And now the real limitations are obviously physical bed space.

speaker 3

I mean, it’s now to the point where it’s just kind of crazy. It’s crazy.

annie correal

So what did doctors say about why the hospital system is under such strain at this moment?

emily anthes

Well, there are two big reasons. And the first is just that Omicron moves really, really fast. Several weeks ago, I talked to some forecasters and some modelers who were trying to predict how this would all unfold here. And at the time, they were saying this surge would probably peak in mid to late January with something like 400,000 new cases per day in the U.S.

Well, here we are in early January, and we are already at nearly 700,000 cases a day. We just blew past that forecast. And this thing has moved so much faster than even the experts predicted.

annie correal

So even if Omicron is half as severe, if it’s causing twice as many infections, you’re sending the same number of people to the hospital.

speaker 1

The last two weeks have really, really picked up.

speaker 2

It’s very hard. It’s very concerning. We have more patients in the hospital than we’ve ever had before with Covid.

emily anthes

So hospitals just aren’t used to the volume.

speaker

We’re overwhelmed. We’re overwhelmed with Covid and other diseases, right? I mean, in the first Covid wave, all of the patients stopped coming to the hospital. Right now, we’re seeing everybody else plus the Covid patients.

azeen ghorayshi

Right.

speaker

You know, we were at a low point. And then all of a sudden, in comes the Omicron 800-pound spreading gorilla to Houston. And lo and behold, we’re off with a case-doubling time of roughly, once again, rounding to two days — very, very traumatic.

emily anthes

And what doctors are telling us is that this variant is so infectious that they’re finding it in a lot of patients that aren’t even coming in for Covid.

speaker

People who are admitted for something else who incidentally have Covid, that’s a change.

emily anthes

Yeah.

emily anthes

They’re coming in to give birth. They’re coming in because they broke a bone. They’re coming in because they had scheduled a hip replacement a month ago. And when they get tested for the virus, they’re turning out to be positive.

speaker

About a third to a half of the people coming in these days have Covid.

emily anthes

Mm-hmm.

speaker

It’s an amazing number, right?

emily anthes

Uh-huh.

emily anthes

So these incidental infections are part of what hospitals are seeing now. There isn’t really good data on this, especially nationally. But there’s a significant share of patients in hospitals right now who have these incidental infections. So estimates we got ranged from 20 percent to 65 percent at one New York hospital. So these are patients that are coming in for other reasons and upon being admitted to the hospital, turned out to have the virus.

And we wouldn’t have even found a lot of these cases, if not for the fact that a lot of hospitals have started testing all of their patients for the virus. So this thing is everywhere.

annie correal

Right. But just to make sure I understand, these people who come in for other things, they would have come to the hospital regardless. So how is that an added strain on hospitals?

emily anthes

Well, it is true that a lot of them probably would have been coming into the hospital anyway. And the good news is that a lot of people with these incidental infections may not get very sick from Covid. But they can still pose an added strain on hospitals.

speaker

Even though they’re not sick with Covid, they still have Covid and they’re still infectious. So you still need to put them in isolation. You still need to treat them as patients who have potentially transmitted Covid in the hospital, right?

azeen ghorayshi

Right. Which takes more space and more staff.

speaker

Correct, correct.

emily anthes

And part of that is because they need to be isolated while they’re in the hospital to prevent them from passing the virus onto others. And that requires resources and staffing. And, in some cases, having one of these incidental infections can worsen their own outcomes that can interact with whatever reason it is there in the hospital. And these patients may fare more poorly than they otherwise would have.

annie correal

OK so more patients are coming in with Covid than ever before. And that’s overwhelming hospital systems. What’s the second reason that hospitals are facing a bigger burden today than during previous surges?

speaker

Well, you have to understand that the major concern right now is staff.

emily anthes

This was a very clear answer from every doctor we talked to.

speaker

Staffing limitations.

emily anthes

A huge concern —

speaker

There’s a shortage of staff.

emily anthes

— staffing.

speaker

Frankly, today I’m more worried about staffing than I am being overwhelmed by patients.

emily anthes

Many hospitals were already really struggling with staffing shortages, even before this surge. Over the course of the last two years and the pandemic, a lot of health care professionals and hospital staff have left their positions.

speaker

If we were to compare it to a year ago when we thought this was the worst, the difference now is our staff are tired. Our staff are getting sick and calling off work. And we entered it with fewer staff than we ever had before.

emily anthes

Due to stress, burnout.

speaker

Choosing to either pursue other careers or different pathways.

emily anthes

So even before this surge started, hospitals were really strapped for staff.

speaker

So we’re entering with higher numbers than we saw a year ago, with fewer people to care for those patients. We can take up to about 140 patients normally. Right now, we’ve reduced that, though, because we don’t have enough staff to care for patients.

emily anthes

And then you layer on top of that the fact that we’re dealing with this highly contagious variant, and lots of hospital personnel are catching it. And that is further depleting the ranks of hospital staff.

You know, it’s not just doctors and nurses.

speaker

We have a reduced number of certified nursing assistants.

emily anthes

But they’re also short on behavioral therapists —

speaker

— radiology techs —

emily anthes

— and pharmacists.

speaker

— cafeteria staff —

emily anthes

— and custodial staff. Everyone that it takes to sort of make a hospital run smoothly and run well, the entire operation is struggling under the weight of this surge.

annie correal

I heard that they had, in some places, called in the National Guard to assist, to help people because of that shortage in staff?

emily anthes

That’s right. And some of the doctors I talked to said that was actually really welcome and exactly what they needed, were more hands right now. Obviously, that’s not a long term solution for staff shortages. But right now, it’s really all-hands-on-deck. And they are happy to have whoever they can get.

annie correal

So to recap, what we’re looking at is an enormous surge in cases driven by this highly infectious and fast-moving variant, combined with extreme staffing issues. We’ve got all this attrition, people quitting after two years of the pandemic, and doctors and nurses and janitors out sick.

So what is the impact of that on patients?

emily anthes

The impact is enormous.

speaker

I can’t speak for each and every Maryland hospital, but several of our hospitals in Maryland have declared they need to go on crisis standards of care.

emily anthes

A lot of the doctors we talked to said that they had already stopped doing or were considering stopping doing any sort of non-emergency procedure — all these elective surgeries.

speaker

So our hospitals, we’ve curtailed surgeries. And the important surgeries — like we think of them as elective. But if you have breast cancer and you need an operation, I don’t think anybody really thinks that’s elective.

emily anthes

Really, they can be for quite serious conditions. These might include things like cancer surgeries, transplants, heart surgeries. And they’re being canceled or postponed because hospitals just don’t have the staff and the bandwidth right now.

speaker

You know, here’s a scenario. Here’s a perfect example. You have an aneurysm. It’s not going to hurt you right now. It doesn’t look like it’s getting bigger. But we should probably operate.

So now I come home from that doctor’s appointment and I tell my family, my God, I got this thing in my head. If it bursts, right, that’s like having a stroke, that’s awful. Like, this could be a big deal. And then their doctor calls them and says, you know what? We’re going to wait another week or two. Like, there’s not a single scenario I can run through my head where a human being can feel calm and collected about that.

emily anthes

Another doctor we talked to said that some of these surgeries are essentially canceling themselves because people are coming in for surgeries they’ve scheduled and testing positive for the virus, which means that the surgeries then have to be postponed and care is delayed.

annie correal

So when hospitals get overwhelmed and staff get stretched really thin —

speaker

There’s shortages of ambulances.

annie correal

— everybody’s care suffers.

speaker

— people with heart attacks might not get to the hospital as much. The E.D.s are absolutely full and crushed with patients, a huge set of safety issues.

annie correal

We’ll be right back.

So Emily, you’ve explained how hospitals can be under such stress at this moment, even though Omicron seems to be presenting as a milder version of the virus. Do you have a sense from your reporting how long this will last? Is there a world in which this is just a short-term hit on the health care system?

emily anthes

Well, in South Africa it took about three to four weeks for cases to peak. And then they started declining. It’s not clear yet if the same pattern will hold here in the U.S. But even if it does, we know that hospitalizations tend to lag about two weeks behind cases. And deaths tend to lag about three weeks behind cases.

And here in the U.S. right now, our cases are still rising. It doesn’t look like we’ve hit that peak yet. So most doctors we talked to unfortunately think that it’s going to get worse before it gets better.

annie correal

Hmm.

emily anthes

And even if the immediate crisis is short-term, it could have lasting consequences. Delaying these elective or non-emergency procedures could cause them to pile up, could cause patients to worsen. So when they do eventually get medical care, they are sicker and have worse outcomes. And they could further worsen the staff shortages that already exist by driving more people out of the health care field.

The other reason to be concerned here in the U.S. is that we still have a lot of people in this country who are unvaccinated. And Omicron is not necessarily mild for them.

annie correal

So then are places where more people are vaccinated more likely to fare better with this most recent surge?

emily anthes

So it’s a little bit hard to draw any conclusions about that right now. And part of that is because of the patterns of when and where Omicron arrived first. As it happens, some of the areas of the country that got hit first, and hardest, and fastest with Omicron are areas that have pretty high vaccination rates.

They are places like New York City, New Jersey, Massachusetts, which are highly vaccinated areas. So these are the places that are really seeing hospitalizations surge right now, while some of the less vaccinated places in the country are a little bit behind. So we have to wait for more time and more data to make those kinds of community-level comparisons.

But what we do know is that the overwhelming majority of patients who are getting severely ill and ending up in I.C.U.s are the unvaccinated. Omicron can be quite serious for these patients. And doctors told us over and over again that these are the patients who are on ventilators, these are the patients they worry about, these are the patients who are dying.

dr. ryan maves

Hey, how are you doing?

emily anthes

Good, how are you?

dr. ryan maves

Gainfully employed.

emily anthes

Yeah, well thank you so much for making time —

emily anthes

So I talked to a critical care doctor in North Carolina, Dr. Ryan Maves. And he’s a former Navy captain who was deployed to Afghanistan.

dr. ryan maves

And I’ve just — over these last two years, I’ve never seen deaths like this before. Right? You know, and I’ve been to war. And this last week was a particularly poignant reminder of that.

emily anthes

And he said that what he saw recently in the hospital and especially in the I.C.U. was among the worst weeks of his career. And it actually reminded him of being back at war.

dr. ryan maves

And I’ll say, every vaccinated patient whom I’ve cared for in the I.C.U., they are people with kidney transplants. They are people with leukemia, lymphoma, people with cancer, people for whom immunization is protective, but they’re less likely to benefit from it, right? But yeah, it’s overwhelmingly unvaccinated people. And it is skewing younger than it used to.

emily anthes

Mm-hmm.

dr. ryan maves

You know, many more people in their 40s and 50s and many of them dying. And it’s a grim feeling, watching people who are your own age and maybe not that much older than you dying of an entirely preventable illness.

emily anthes

And I think there’s a lot of frustration that America’s not more vaccinated at this point, which could have fended off the worst of this surge.

dr. ryan maves

It’s a few things. It’s all at the same time. It’s sad. It’s infuriating. And it is, a lot of times, very difficult to be empathetic.

emily anthes

There’s a doctor in the suburbs of Chicago, Dr. Bob Manam, who said this really explicitly.

dr. bob maman

So this is something that we’re constantly getting emails from the hospital saying, you’ve got to keep your empathy up. You have to — and when you read the chart before you go into the room, you’re, like, just shaking your head. But then when you go in there and you talk to the individual, you do definitely feel very sorry. But it didn’t — it’s like it is a 100-car wreck on the road. And this is the 101st car. Everybody’s been saying slow down, the streets are icy, be careful. Wouldn’t you want to take some sort of precaution?

annie correal

So where does that leave doctors and hospitals in this moment?

emily anthes

It leaves them in trouble. I think a lot of us think that we’ll probably pull through this Omicron wave just fine. And most of us, especially those of us who are vaccinated and boosted, probably will. But I don’t think we can forget the toll that this is taking on health care workers who have already been pushed to the limit and who are now being pushed even further by this surge.

speaker

To me, that’s the main story, how bad and how big this really is.

emily anthes

You know, my colleague Azeen talked to a doctor in Maryland, Dr. Gabe Kelen, who said he’s not even sure that Americans really know how crushed hospitals are right now. But just because they don’t know doesn’t mean it’s not happening.

dr. gabe kelen

The last time, in the first really big crush, I think we reached a peak of about 1,500 hospital beds for Covid patients. This morning, we’re at 2,700. I mean, with an acceleration of 200-300 a day. You know, it’s like going down Great Six Rapids. You just can’t ever quite catch your breath.

And the public just doesn’t know. And maybe they’re just too tired at this point as well, to care.

annie correal

Thank you, Emily, very much.

emily anthes

Thanks for having me.

annie correal

The number of Americans hospitalized with Covid-19 has now surpassed last winter’s peak, according to the U.S. Department of Health. As of Sunday, 142,388 people had been hospitalized, surpassing the previous record set in January of last year.

[music]

We’ll be right back.

Here’s what else you need to know today. The Biden administration said on Monday that private insurers will soon be required to cover the cost of eight at-home coronavirus tests a month. The requirement is designed to address the high cost of at-home tests, which has discouraged many Americans from using them. Under the plan, people will be able to buy the tests at no cost from pharmacies approved by their insurance, or buy them elsewhere and file for reimbursement.

Today’s episode was produced by Daniel Guillemette and Asthaa Chaturvedi, with help from Mooj Zadie. It was edited by Mark George and Lisa Chow, features original music by Marion Lozano and Dan Powell, and was engineered by Marian Lozano. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly.

That’s it for The Daily. I’m Annie Correal. See you tomorrow.

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For retail workers, Omicron disruptions aren’t just about health.

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An Apple Store in Miami that was closed due to coronavirus cases last month.Credit...Saul Martinez for The New York Times

A weary retail work force is experiencing the fallout from the latest wave of the pandemic, with a rapidly spreading variant cutting into staffing.

While data show that people infected with the Omicron variant are far less likely to be hospitalized than those with the Delta variant, especially if they are vaccinated, many store workers are dealing with a new jump in illness and exposures, grappling with shifting guidelines around isolation and juggling child care.

At the same time, retailers are generally not extending hazard pay as they did earlier in the pandemic and have been loath to adopt vaccine or testing mandates.

Macy’s said last week that it would shorten store hours nationally on Mondays through Thursdays for the rest of the month. At least 20 Apple Stores have had to close in recent weeks because so many employees had contracted Covid-19 or been exposed to someone who had.

Store workers are navigating the changing nature of the virus and trying their best to gauge new risks. Many say that with vaccinations and boosters, they are less fearful for their lives than they were in 2020, but they remain nervous about catching and spreading the virus.

Shifting guidelines around isolation are also causing confusion at many stores. Macy’s said in a memo to employees last week that it would adopt new guidance from the Centers for Disease Control and Prevention that recommended shortening isolation for infected people to five days from 10 if they are asymptomatic or their symptoms are resolving.

But even if retailers shorten isolation periods, schools and day-care facilities may have longer quarantine periods for exposed families, putting working parents in a bind.

Seattle’s maestro resigns after the pandemic strained relations with orchestra management.

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Thomas Dausgaard leading the Seattle Symphony in February 2020. His abrupt resignation last week blindsided the orchestra.Credit...James Holt

On Christmas morning, at his seaside home near Copenhagen, the Danish conductor Thomas Dausgaard made a difficult decision: He would step down as the music director of the Seattle Symphony, effective immediately, more than a year before the end of his contract.

He pressed send on a resignation email on Jan. 3 — blindsiding an orchestra that was expecting his arrival a few weeks later to lead a world premiere and a Tchaikovsky symphony, and forcing the organization to scramble to find replacements for his remaining dates this season.

Dausgaard, 58, had seemed a good fit for his position, which he had held just since fall 2019. But he was separated from the acclaimed orchestra for much of 2020 and 2021 because of pandemic-related travel restrictions. And he had grown increasingly frustrated by what he described in an interview as a strained relationship with the orchestra’s managers, accusing the administration of repeatedly trying to silence and intimidate him. (The Seattle Symphony denies his allegations.)

“I felt personally not safe,” Dausgaard said, providing few specifics as he offered his first public comments on his abrupt resignation, which the orchestra announced on Friday. “I felt threatened.”

Jon Rosen, the chairman of the orchestra’s board, said in an interview, “There’s no accuracy to any allegations that there was a hostile environment or that he was, in fact, unsafe.”

By the time he returned to Europe, after finally making it to Seattle for a stint this fall, the board had grown increasingly disenchanted with Dausgaard. In late November the board privately decided not to renew his contract, which was to have ended after the 2022-23 season, according to two people briefed on the decision who were granted anonymity to discuss personnel matters.

It is an unusually bitter, and open, rupture. Fraught relations between artists and administrators are hardly uncommon in classical music, which teems with big personalities. But the problems rarely break into view, or result in the immediate departure of music directors, who are often the public faces of their organizations.

The situation also highlights the strain the pandemic has placed on ensembles across the country. Many are grappling with waves of cancellations, visa delays and financial woes, among other problems.

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Quebec introduces a financial penalty for the unvaccinated.

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People wait for Covid-19 vaccinations at a clinic in Montreal last week.Credit...Paul Chiasson/The Canadian Press, via Associated Press

As hospitals across the world struggle to cope under the strain of surging Covid-19 cases, Quebec has come up with a novel coping mechanism: a fine for the unvaccinated.

The province of 8.6 million people has been trying to shield its overstretched health care system by introducing tough restrictions, including a nighttime curfew that came into force on New Year’s Eve and vaccine passports to enter liquor and cannabis stores.

Now it is reaching for a new policy weapon — untested in Canada — by forcing unvaccinated people to pay a financial penalty, regardless of whether they use hospital services.

Premier François Legault, who has come under criticism for inconsistency during the pandemic, said at a news conference on Tuesday that “those who refuse to receive their first dose in the coming weeks will have to pay a new health contribution.”

He did not specify the amount of the levy on unvaccinated residents but said it would be “significant,” adding that a fee of 100 Canadian dollars, or about $80, wouldn’t be enough of a deterrent.

The government has not yet determined how the penalty will be calculated or paid, or whether it will come in the form of a tax. People with valid medical exemptions from the Covid vaccine will not incur the fee.

New reported cases by day
Feb. 2020
Sept.
Apr. 2021
Nov.
Jun. 2022
Jan. 2023
10,000
20,000
30,000
40,000 cases
7-day average
1,234
Source: Data for Canada comes from the Center for Systems Science and Engineering at Johns Hopkins University. Population data from Statistics Canada. The daily average is calculated with data that was reported in the last seven days.

The announcement generated mixed reactions. Supporters of the policy said it was high time that the unvaccinated paid a price for putting strain on the health care system. But some critics said the levy unfairly penalized the unvaccinated and breached their civil liberties.

Quebec is Canada’s second most populous province after Ontario and had the highest rate of Covid-19 cases in the last 14 days, according to the federal public health data. Nearly 80 percent of Quebec’s population is fully vaccinated, and 84 percent have received at least one dose.

Yet half of the people in intensive care with Covid-19 are unvaccinated, the province’s health minister said at a news conference last week.

The unvaccinated “put a very important burden on our health care network,” Mr. Legault said. “I think it’s normal that the majority of the population is asking that there be a consequence.”

Quebec, a majority French-speaking province, also leads Canada with the greatest number of deaths linked to Covid-19, according to Public Health Agency of Canada data.

Flu vaccination rates are low, especially among older Americans.

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Preparing Covid vaccines at a nursing home in Manhattan last year. According to the federal government, only 11 percent of seniors had received a flu shot by last October.Credit...Yuki Iwamura/Associated Press

Americans tend to sound cavalier about flu, and falsely comparing Covid-19 to flu was a way of dismissing the coronavirus as no big deal. But deaths from influenza range from 12,000 nationally in an unusually mild year to 60,000 or more in a virulent one.

Flu also sends hundreds of thousands of Americans to the hospital annually, and evidence is emerging of its association with other serious diseases.

Yet vaccination among older Americans, those most apt to accumulate the chronic conditions that can make flu particularly dangerous, has remained stuck at roughly 65 percent in most recent years, leaving millions unprotected.

This year, based on early reporting, the rate appears to be even lower. In October 2019, almost 20 percent of Medicare fee-for-service beneficiaries had been vaccinated, according to the Centers for Disease Control and Prevention; in October 2020, the proportion reached close to 30 percent.

This past October, only 11 percent of seniors had received a shot.

“I think it’s going to be a bad flu year,” said Nathaniel Hupert, a co-director of the Cornell Institute for Disease and Disaster Preparedness. “The trajectory is just like prior bad flu years — 2017, 2019. And for reasons that are unclear, we have this incredibly low rate of vaccination reported among older people.”

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A dissident poet, jailed by Iran for his writing, dies of Covid.

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Baktash Abtin during his detention in Iran, in a widely shared photo.Credit...Center for Human Rights in Iran

He was a renowned poet. A documentary filmmaker. A prisoner. Baktash Abtin was serving a six-year prison sentence in Iran, on national security and propaganda charges, when he died on Saturday of Covid-19 complications.

Mr. Abtin, who was about 47 years old, had contracted Covid once before in prison and was hospitalized, but then was returned to the feared Evin prison. He was infected again and fell ill last month, hospitalized again, and placed in an induced coma in early January as his health deteriorated.

Human rights organizations, which have said that Mr. Abtin was imprisoned for nothing more than speaking out, announced his death and blamed Iran’s government. They accused prison authorities of denying him a medical leave despite his vulnerable condition, and of delaying his medical care once he got sick.

“Covid is a natural killer, but Abtin’s death was aided and abetted by the Iranian government every step of the way,” the rights group PEN America, which advocates for writers and free expression, wrote on Twitter.

Iran’s prisons directorate denied in a statement that it had delayed Mr. Abtin’s medical care. It said Mr. Abtin was treated at the prison’s clinic for a sinus infection and was transported to a government hospital when he showed symptoms of Covid. From there, his family transferred him to a private hospital, where he died after 35 days, the statement said.

New reported cases by day
Mar. 2020
Oct.
May 2021
Dec.
Jul. 2022
Feb. 2023
10,000
20,000
30,000 cases
7-day average
436
Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

Human Rights Watch said in a statement that Mr. Abtin’s death was “emblematic of the dire situation Iranian authorities have created for imprisoned critics of the government.”

Many Iranians on social media criticized the government for jailing a poet who posed no violent threat to anyone. They slammed the government’s claims that Mr. Abtin’s words and deeds posed a national security threat.

Iranians have a long history of revering poets and celebrating them as national icons. The tombs of the medieval poets Hafez and Saadi, for example, are treated like religious shrines where pilgrims gather daily to pay respects.

The Iranian Writers Association, where Mr. Abtin was a board member, said in a statement that “Baktash Abtin is alive, because the spirit of freedom-seeking and the fight against tyranny and injustice is alive.”

A photo taken last year and shared widely on social media summed up his saga: It showed him shackled at the ankles while lying on a hospital bed in a blue striped prison uniform, reading a book.

New York State is dropping contact tracing requirements, but New York City will keep trying.

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Maryama Diaw preparing for a shift as a contact tracer with New York City’s public hospital system at her home in New York in August 2020.Credit...John Minchillo/Associated Press

New York officials say the state will no longer require local health departments to trace the contacts of new coronavirus cases, a practice that was once considered vital to slowing the spread of the virus but that has become increasingly difficult to sustain as the highly contagious Omicron variant fuels a deluge of cases. But officials in New York City, home to more than two-fifths of the state’s population, said they weren’t ready to give up trying.

Gov. Kathy Hochul said at a news conference on Tuesday that a sharp increase in cases across the state in the past few weeks had made it “almost impossible to do contact tracing the way we have been in the past.” And Dr. Mary Bassett, the state’s acting health commissioner, said the variant’s contagiousness and its short incubation period left “a very short window for intervention to disrupt transmission.”

“The big change for New Yorkers is that if you test positive, you should no longer expect a call from your health department,” Dr. Bassett said at the news conference.

During the process, people who have tested positive receive a call from their local health department to determine who they may have exposed so those people can also seek a test.

New York is not the first state to cut back on such efforts. Last week, Arkansas said that its health department would no longer trace contacts for adults, and would instead focus on children. Georgia said that contact tracing in schools would be optional. Massachusetts ended its contact-tracing program last month.

In South Africa, one of the first countries to identify Omicron, the government dropped contact tracing after cases skyrocketed, and said it would focus on vaccinations instead.

Dr. Gigi Gronvall, a senior associate at the Johns Hopkins Center for Health Security, said that for health departments struggling to balance resources, vaccinations must be the priority. “The end game has to be vaccination and boosters for people who are already vaccinated,” Dr. Gronvall said, adding that to improve contact tracing, “you have to narrow the scope,” for example by focusing on groups that are most at risk.

Dr. Bill Hanage, an associate professor focusing on pathogen evolution at the Harvard T.H. Chan School of Public Health, said that New York’s announcement on Tuesday was a reaction to “the sheer number of cases.”

“At some point, because the numbers of contacts are also growing exponentially along with the cases, it becomes a waste of resources,” he said of contact tracing. “Given the properties of Omicron, I am surprised they didn’t stop it already.”

Ms. Hochul said local health departments were free to continue contact tracing on their own, and in New York City, Dr. Ted Long, the executive director of the city’s contact-tracing program, said the effort would continue.

“Our mission ends when the pandemic does,” Dr. Long said in a statement on Tuesday night.

Dr. Dave Chokshi, the city’s health commissioner, noted in a statement on Tuesday that the city’s program helps New Yorkers who test positive to connect with isolation hotels and get access to meals and care packages. Through Tuesday, the program had delivered nearly 1.8 million meals to more than 200,000 residents who have had to quarantine with the virus, according to the city.

Dr. Gronvall said that in some cases, people who test positive may need to notify friends and co-workers themselves. “It may be an awkward conversation to do your own contact tracing and tell your friends,” she said. “But it’s more awkward to not have that conversation.”

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