England’s Reopening Could Be Delayed by Weeks

Here’s what you need to know: On the waterfront in Poole, southern England, last month. Under the current rules, pubs and restaurants can operate but with limited capacity.Credit...Suzie Howell for The New York Times LONDON — Concerned by the spread of a new coronavirus variant, Prime Minister Boris Johnson of Britain was preparing on Monday to announce a delay of up to four weeks on the lifting of Covid-19 restrictions in England, effectively postponing a long-awaited moment described in the news media as “freedom day.” In a statement scheduled for Monday afternoon, Mr. Johnson is expected to say that rising cases of the Delta variant, first detected in India, make it impossible to remove the remaining curbs on June 21, as had been envisioned, because a rapid growth in infections would pose a risk to the health service. The decision is a political setback for Mr. Johnson, an instinctive libertarian, who resisted imposing lockdowns in the first place and whose swift vaccination rollout has provided an exit route from the crisis. Under the current rules, pubs and restaurants can operate but with limited capacity, and there are limits on gatherings such as weddings. Indoor live theater venues and nightclubs are closed. Andrew Lloyd Webber, the producer of musicals including Cats, has pledged to reopen his theaters this month “come hell or high water,” telling the Telegraph newspaper that he is willing to be arrested. It was unclear whether Mr. Johnson would allow any of the remaining restrictions to be eased. But, having already been forced to impose three lockdowns, Mr. Johnson now says he wants any moves out of them to be “irreversible.” At the weekend, he all but confirmed the delay when he said that Monday’s decision would be driven by caution. Although Britain is one of the world’s leaders in vaccination, the government’s plans have been thrown off course by the growth in cases of the Delta variant, which British scientists have reported to be even more transmissible than the variant that swept across the country over the winter. Though case numbers are still relatively low — 7,490 new ones were reported on Sunday — they have risen rapidly in recent weeks and the Delta variant now makes up the overwhelming majority of all coronavirus cases in England. Critics who say that the government is being too cautious note that as lockdowns were eased, cases were always going to rise. And as variants continue to spread, they argue, policies need to account for the virus’s becoming endemic in the population, for example by focusing more effort on tackling hot spots. So far, the increase in cases in Britain has not translated into large-scale hospitalizations and deaths. Still, on Sunday, 187 new hospitalizations were reported and the government says that it is not yet clear that the vaccination campaign is far enough along to sever the link between case counts and serious illness. Government officials have argued that a delay in easing all restrictions would provide more time to ramp up vaccinations and deliver the second doses that make the vaccine more effective against the Delta variant. “Clearly, what you’ve got is a race between the vaccines and the virus, and the vaccines are going to win,” Mr. Johnson told the BBC on Sunday. “It’s just a question of pace.” Around 80 percent of adults have received a first dose and more than 55 percent have gotten two shots, according to government data. For days, ministers have been debating whether to opt for a four-week delay or to limit it to two weeks. One alternative is to set out a four-week span but with a review halfway through. Since people can still go to pubs, restaurants and stores, albeit with social-distancing restrictions, the impact of the delay will be somewhat blunted. But for businesses operating at a loss, and those that remain closed, the decision will be another bitter blow after a traumatic year and a half. The Night Time Industries Association called the delay “catastrophic,” noting that businesses such as nightclubs had already spent millions preparing to reopen. Administering a Novavax shot during trials at Howard University Hospital in Washington, D.C., in January.Credit...Kenny Holston for The New York Times Novavax, a small American company buoyed by lavish support from the U.S. government, announced on Monday the results of a clinical trial of its coronavirus vaccine in the United States and Mexico, finding that its two-shot inoculation provided potent protection against the coronavirus. In the 29,960-person trial, the vaccine demonstrated an overall efficacy of 90.4 percent, on par with the vaccines made by Pfizer-BioNTech and Moderna, and higher than the one-shot vaccine from Johnson & Johnson. The Novavax vaccine showed an efficacy of 100 percent at preventing moderate or severe disease. Despite the impressive results, the vaccine’s future in the United States is uncertain and it might be needed more in other countries. N

England’s Reopening Could Be Delayed by Weeks
Here’s what you need to know: On the waterfront in Poole, southern England, last month. Under the current rules, pubs and restaurants can operate but with limited capacity.Credit...Suzie Howell for The New York Times LONDON — Concerned by the spread of a new coronavirus variant, Prime Minister Boris Johnson of Britain was preparing on Monday to announce a delay of up to four weeks on the lifting of Covid-19 restrictions in England, effectively postponing a long-awaited moment described in the news media as “freedom day.” In a statement scheduled for Monday afternoon, Mr. Johnson is expected to say that rising cases of the Delta variant, first detected in India, make it impossible to remove the remaining curbs on June 21, as had been envisioned, because a rapid growth in infections would pose a risk to the health service. The decision is a political setback for Mr. Johnson, an instinctive libertarian, who resisted imposing lockdowns in the first place and whose swift vaccination rollout has provided an exit route from the crisis. Under the current rules, pubs and restaurants can operate but with limited capacity, and there are limits on gatherings such as weddings. Indoor live theater venues and nightclubs are closed. Andrew Lloyd Webber, the producer of musicals including Cats, has pledged to reopen his theaters this month “come hell or high water,” telling the Telegraph newspaper that he is willing to be arrested. It was unclear whether Mr. Johnson would allow any of the remaining restrictions to be eased. But, having already been forced to impose three lockdowns, Mr. Johnson now says he wants any moves out of them to be “irreversible.” At the weekend, he all but confirmed the delay when he said that Monday’s decision would be driven by caution. Although Britain is one of the world’s leaders in vaccination, the government’s plans have been thrown off course by the growth in cases of the Delta variant, which British scientists have reported to be even more transmissible than the variant that swept across the country over the winter. Though case numbers are still relatively low — 7,490 new ones were reported on Sunday — they have risen rapidly in recent weeks and the Delta variant now makes up the overwhelming majority of all coronavirus cases in England. Critics who say that the government is being too cautious note that as lockdowns were eased, cases were always going to rise. And as variants continue to spread, they argue, policies need to account for the virus’s becoming endemic in the population, for example by focusing more effort on tackling hot spots. So far, the increase in cases in Britain has not translated into large-scale hospitalizations and deaths. Still, on Sunday, 187 new hospitalizations were reported and the government says that it is not yet clear that the vaccination campaign is far enough along to sever the link between case counts and serious illness. Government officials have argued that a delay in easing all restrictions would provide more time to ramp up vaccinations and deliver the second doses that make the vaccine more effective against the Delta variant. “Clearly, what you’ve got is a race between the vaccines and the virus, and the vaccines are going to win,” Mr. Johnson told the BBC on Sunday. “It’s just a question of pace.” Around 80 percent of adults have received a first dose and more than 55 percent have gotten two shots, according to government data. For days, ministers have been debating whether to opt for a four-week delay or to limit it to two weeks. One alternative is to set out a four-week span but with a review halfway through. Since people can still go to pubs, restaurants and stores, albeit with social-distancing restrictions, the impact of the delay will be somewhat blunted. But for businesses operating at a loss, and those that remain closed, the decision will be another bitter blow after a traumatic year and a half. The Night Time Industries Association called the delay “catastrophic,” noting that businesses such as nightclubs had already spent millions preparing to reopen. Administering a Novavax shot during trials at Howard University Hospital in Washington, D.C., in January.Credit...Kenny Holston for The New York Times Novavax, a small American company buoyed by lavish support from the U.S. government, announced on Monday the results of a clinical trial of its coronavirus vaccine in the United States and Mexico, finding that its two-shot inoculation provided potent protection against the coronavirus. In the 29,960-person trial, the vaccine demonstrated an overall efficacy of 90.4 percent, on par with the vaccines made by Pfizer-BioNTech and Moderna, and higher than the one-shot vaccine from Johnson & Johnson. The Novavax vaccine showed an efficacy of 100 percent at preventing moderate or severe disease. Despite the impressive results, the vaccine’s future in the United States is uncertain and it might be needed more in other countries. Novavax says it may not seek emergency authorization from the Food and Drug Administration until the end of September. And with a plentiful supply of three other authorized vaccines, it’s possible that the agency may tell Novavax to apply instead for a full license — a process that could require several extra months. The company’s chief executive, Stanley Erck, acknowledged in an interview that Novavax would probably win its first authorization elsewhere. The company is also applying in Britain, the European Union, India and South Korea. “I think the good news is that the data are so compelling that it gives everybody an incentive to pay attention to our filings,” Mr. Erck said. By the time Novavax gets the green light from the U.S. government, it may be too late to contribute to the country’s first wave of vaccinations. But many vaccine experts expect that, with waning immunity and emerging variants, the country will need booster shots at some point. And the protein-based technology used in the Novavax vaccine may do a particularly good job at amplifying protection, even if people have previously been vaccinated with a different formulation. “They may be really the right ones for boosters,” said Dr. Luciana Borio, who was the acting chief scientist at the F.D.A. from 2015 to 2017. Last year, the Trump administration’s Operation Warp Speed program awarded Novavax a $1.6 billion contract for 100 million future doses. The company won this tremendous support despite not having brought a vaccine to market in over three decades. In January, Novavax announced that its 15,000-person trial in Britain found that the vaccine had an efficacy of 96 percent against the original coronavirus. Against Alpha, a virus variant first identified in Britain, the efficacy fell slightly to 86 percent. In South Africa, where the Beta variant was dominant, Novavax ran a smaller trial on 2,900 people and found an efficacy of just 49 percent. But the South Africa trial was complicated by the fact that a number of the volunteers had H.I.V., which is known to hamper vaccines. In addition, the study was so small that it was difficult to estimate how much protection the vaccine provided H.I.V.-negative volunteers. With the support of Operation Warp Speed, Novavax drew up plans for an even larger late-stage trial in the United States and Mexico. But difficulties with manufacturing delayed its start until December. By then, the United States had authorized the Pfizer-BioNTech and Moderna vaccines. In February, with the Novavax trial still underway, the government authorized Johnson & Johnson’s. Receiving the Sinovac vaccine at a center in Bangkok last month. Only about 3 percent of the population of Thailand has been fully inoculated.Credit...Adam Dean for The New York Times BANGKOK — For months, the government of Thailand assured citizens that a plan to dole out free, locally made coronavirus shots would start in early June. About 70 percent of the national population would be inoculated by the end of the year, health officials said. Then the delays began, just as the country was struggling with its worst outbreak of the coronavirus since the start of the pandemic. On Sunday night, nearly a week after the vaccination program was supposed to have kicked into high gear, hospitals in Bangkok announced that previously confirmed appointments had been canceled. There was no word as to why or when they might be rescheduled. The knock-on effect of what appears to be a mass shortage of Thai-made vaccines is also radiating to other parts of the region, where inoculation campaigns are far behind those of many Western countries. The governments of Malaysia, the Philippines and Taiwan have announced that they are scaling back their vaccine rollouts because of lower-than-expected shipments from Thailand. (Thailand disputed the claims that it was to blame.) Last year, Thailand was designated the regional hub for local production of the AstraZeneca shots. A contract was awarded to Siam Bioscience, a pharmaceutical firm with no prior experience in manufacturing vaccines. The company is controlled by the king of Thailand. Prime Minister Prayuth Chan-ocha of Thailand has warned that criticism of the company could be considered a criminal offense under the kingdom’s strict royal defamation laws. An opposition politician who questioned how Siam Bioscience got such a contract was charged with lèse-majesté — wronging the monarch — this year. Although Thailand was the first country to record a coronavirus case outside of China, in January 2020, the country suppressed the virus’ rampant spread for most of that year. Late in 2020, the country had recorded fewer than 5,000 total cases of the coronavirus. But Thailand is now dealing with thousands of new cases each day. As of Monday, only about 3 percent of the population had been fully inoculated. Phatorn Chingduang, a shipping company employee, was supposed to get his first dose of AstraZeneca on June 12, along with about 15 others at his company. The day before the shots were to be administered, he was sent a text canceling the appointment. “I don’t see the government doing enough,” Mr. Phatorn said. “This vaccine drama, it’s so bad.” Recriminations are ricocheting. At least five Bangkok hospitals said on Monday that they did not have enough doses. All vaccines in Thailand are being distributed by the Ministry of Public Health. The ministry countered by saying that it had sent out promised doses to the local authorities, who were responsible for specific hospital allocations. Vaccines for at least 50 million people have already been procured, said Opas Karnkawinpong, the director general of the department of disease control, on Monday. The same day, Aswin Kwanmuang, the governor of Bangkok, alluded to “technical difficulties” and said that mass vaccinations in the capital would be suspended on June 15. “Bangkok will stop the vaccinations and will resume the inoculations as soon as we receive the vaccines,” he said. On Monday, as factories and prisons in the Bangkok area struggled with mounting outbreaks, officials said that parks and museums would reopen in the capital, loosening a monthslong lockdown. Also open for business again? Tattoo parlors and foot massage salons. A market in Saarbrücken, Germany, on Saturday. Jens Spahn, the health minister, said on Monday that states could start setting their own rules on masks in outdoor areas as the average number of cases drops.Credit...Laetitia Vancon for The New York Times In Germany, where infection rates have been steadily falling for weeks, masks are still obligatory nearly everywhere, including on downtown sidewalks and at many outdoor venues, such as farmers’ markets. Depending on the state, the rules are even more stringent for riding public transport, shopping or entering public buildings, with medical-grade face coverings often required. But in an indication that masks may start coming off soon in Germany, the country’s health minister, Jens Spahn, said on Monday that states could start setting their own policies — at least for outdoor areas — as the average number of recorded infections drops under 1,000 per day. “With the falling infection rates, we should proceed in stages: In a first step, the mask requirement outside can be dropped in general,” Mr. Spahn said in an interview with the Funke group of newspapers. Germany has recently reopened restaurant terraces, beer gardens and outdoor dining, and most states have started opening indoor dining — but only for those who can show that they have been vaccinated or tested negative. Museums are also now open to visitors. Although individual states make the final rules, governors look to Berlin — and each other — for guidance on coronavirus restrictions. On Sunday, Germany registered 549 new cases; in December, before the country’s vaccination drive, cases had reached a daily average of more than 30,000. Currently, 48.4 percent of the population has received a first shot, and 26.2 percent are fully vaccinated. In an interview on Sunday, Wolfgang Kubicki, a centrist lawmaker with the opposition Free Democratic Party, called for completely abandoning mask rules in areas where there were fewer than 35 new cases a week per 100,000 people. (Currently, Germany is averaging 16.6 cases per 100,000 in a week — and most regions would fall below the threshold of 35.) But others have expressed more caution, warning that mask rules are still important. “Completely dropping mask requirements just before millions are vaccinated is just one thing: electioneering on the backs of the health of the citizens,” the Social Democratic lawmaker Karl Lauterbach wrote on Twitter. Mr. Lauterbach, whose party is a member of the governing coalition, has a public health degree from Harvard and has become one of the country’s most prominent experts on the pandemic. He added: “Of course, the mask requirement outdoors can be waived almost everywhere. There is no superspreading outdoors.” A protest in Baytown, Texas, last week against Houston Methodist Hospital’s policy of insisting workers get vaccinated.Credit...Yi-Chin Lee/Houston Chronicle, via Associated Press A federal judge in Texas has dismissed a lawsuit brought by employees of Houston Methodist Hospital who had challenged the hospital’s coronavirus vaccination requirement. U.S. District Judge Lynn N. Hughes, in the Southern District of Texas, issued a ruling on Saturday that upheld the hospital’s new policy, announced in April. The judge said that the hospital’s decision to mandate inoculations for its employees was consistent with public policy. And he rejected a claim by Jennifer Bridges, a nurse and the lead plaintiff in the lawsuit, that the vaccines available for use in the United States were experimental and dangerous. “The hospital’s employees are not participants in a human trial,” Judge Hughes wrote. “Methodist is trying to do their business of saving lives without giving them the Covid-19 virus. It is a choice made to keep staff, patients and their families safer.” The judge’s decision appeared to be among the first to rule in favor of employer-mandated vaccinations for workers. Several major hospital systems have begun to require Covid shots, including in Washington, D.C., and Maryland. But many private employers and the federal government have not instituted mandatory immunization as they shift operations back to office settings. This year, the Equal Employment Opportunity Commission issued guidance allowing employers to require vaccines for on-site workers. In Houston, Ms. Bridges was among those who led a walkout on Monday, the hospital’s deadline for getting the vaccine. And on Tuesday, the hospital suspended 178 employees who refused to get a coronavirus shot. Ms. Bridges cited the lack of full Food and Drug Administration approval for the shot as justification for refusing to get vaccinated. But the F.D.A., which has granted emergency use authorizations for three vaccines, says clinical trials and post-market study shows they are safe, as does the Centers for Disease Control and Prevention. The judge also noted that Texas employment law only protects employees from termination for refusing to commit an act that carries criminal penalties. “Bridges can freely choose to accept or refuse a Covid-19 vaccine, however if she refuses, she will simply need to work somewhere else,” he said, also rejecting the argument that employees were being coerced. And the judge called “reprehensible” the lawsuit’s contention that a vaccination requirement was akin to medical experimentation during the Holocaust. In a statement late Saturday, Dr. Marc Boom, chief executive of Houston Methodist, said: “Our employees and physicians made their decisions for our patients, who are always at the center of everything we do.” Houston Methodist said it would begin proceedings to terminate employees who were suspended if they did not get vaccinated by June 21. Jared Woodfill, the employee plaintiffs’ lawyer, also issued a statement on Saturday, according to news reports, that indicated the workers would appeal the ruling. Mayor Lori Lightfoot of Chicago. She has said that her focus is on reducing violence over the summer.Credit...Akilah Townsend for The New York Times Even as the pandemic recedes and cities reopen, local leaders across the United States face another crisis: a crime wave with no signs of ending. Mayors are trying to quell a surge of homicides, assaults and carjackings that began during the pandemic and has cast a chill over the recovery. Homicide rates in large cities were up more than 30 percent on average last year, and up another 24 percent for the beginning of this year, according to criminologists. Some city officials have touted progressive strategies focused on community policing in neighborhoods where trust between officers and residents has frayed. Others have deployed more traditional tactics like increasing surveillance cameras in troubled areas and enforcing curfews in city parks to clear out crowds, as the police did in Washington Square Park in Manhattan in recent days. In Chicago, which fully reopened on Friday, Mayor Lori Lightfoot made clear that her focus was on reducing violence over the summer, and that her administration would focus resources on 15 high-crime pockets of the city as part of that effort. “We owe it to all of our residents, in every neighborhood, to bring peace and vibrancy back,” Ms. Lightfoot said. Homicides in Miami are 30 percent higher this year than the same period in 2020, according to data from the medical examiner’s office. This month, the top prosecutor in Miami-Dade County and local police leaders turned to the issue of public safety, announcing efforts that include additional streetlights and surveillance cameras, prosecutors assigned to “hot spot” areas and a code enforcement crackdown on illegal party venues. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky during a Senate Appropriations Subcommittee hearing in May.Credit...Pool photo by Greg Nash On her first day as director of the Centers for Disease Control and Prevention in January, Dr. Rochelle Walensky ordered a review of all Covid-related guidance on the agency’s website. Some of its advice had been twisted by the Trump administration, and her message was clear: The C.D.C. would no longer bend to political meddling. Four months later, Dr. Walensky announced that vaccinated people could stop wearing masks in most settings. The recommendation startled not just the White House but also state and local leaders, prompting criticism that she had failed to prepare Americans for the agency’s latest about-face during the pandemic. The two announcements captured the challenge that will define Dr. Walensky’s tenure at the C.D.C.: restoring an agency once renowned as the world leader in public health but whose reputation has been battered by political interference, even as the country transitions out of a pandemic that has left nearly 600,000 Americans dead. President Biden had promised that the C.D.C. director he chose would be free to make scientifically grounded decisions without interference from politicians. Dr. Walensky, a widely respected infectious disease expert known for her battles with drug companies over prohibitive prices, seemed ideally suited. Dr. Walensky’s appointment instantly made her one of the most influential women in the nation, and was greeted with enthusiasm by public health experts and C.D.C. staff members. But that enthusiasm has been tempered by occasional missteps in communications, an aspect of the job that is more important and challenging than it has ever been. “Rochelle at baseline is an excellent communicator, but I think in a situation this fraught — politically, operationally and how quickly the science moves — you’re going to make mistakes,” said Dr. Celine Gounder, a former adviser to Mr. Biden’s team on Covid-19. “The question is, how does she acknowledge those and learn from those and move forward from there?”