New Daily Cases Ebb in Some Upper Midwest States

Here’s what you need to know: An inoculation at a union hall in Chicago on April 6. Coronavirus cases in Illinois are starting to recede.Credit...Kamil Krzaczynski/Agence France-Presse — Getty Images For weeks, Illinois, like much of the Upper Midwest, has been troubled by a stubbornly high daily load of reported coronavirus cases, leading to climbing numbers of hospitalizations and deaths. But new data is signaling that the virus might be on the verge of retreating. Illinois is reporting an average of about 2,840 new cases a day, down nearly 16 percent from April 17. Central Illinois, which saw major growth in cases earlier this month, is now improving, according to a New York Times database — especially in Peoria, one of the metropolitan areas where the virus had been spreading the fastest. “It is great we have seen some abatement in local hot spots,” said Dr. Emily Landon, the chief epidemiologist at the University of Chicago, who has been advising Gov. J.B. Pritzker, a Democrat, on the state’s pandemic response. Dr. Landon cautioned, though, that other pockets of the state, especially those with low vaccination rates, remained ripe for “a fiery outbreak.” “I wouldn’t say everybody is out of the woods,” she said. Indeed, hospitalizations remain high in Illinois and other Great Lakes states like Michigan and Minnesota, putting mounting pressure on health care systems. Hospitalizations in Illinois are up by about 25 percent over the past two weeks, as are hospitalizations in Michigan and Minnesota. In the past two weeks, deaths have risen by 20 percent in Illinois and 48 percent in Michigan. The surge grew particularly worrisome in Michigan, which continues to lead the nation in daily cases per person but has recorded a 27 percent decline over the past two weeks. Minnesota has recorded an 8 percent drop in daily new cases in the past two weeks, but a 25 percent increase in hospitalizations. The case counts surged as variants were starting to spread widely, and states have been racing to vaccinate as many people as possible. More than a quarter of Illinois’s population is now fully vaccinated, and 44 percent of people have received at least one shot. Officials said the recent surge might be burning itself out in part because of the growing number of people who are protected. “We have seen a beginning of, maybe, a lessening of the rise of cases,” Mr. Pritzker said last week. “I don’t want to predict anything, because this virus is unpredictable. But I think at least in the short term, that seems to be good news.” Officials in Illinois said that when vaccinations first became widely available, people started taking fewer precautions, even though highly contagious variants were spreading. “It led to the perfect storm,” said Monica Hendrickson, public health administrator for the Peoria City/County Health Department, who noted that recent cases had been highest among young people, the last to become eligible for the vaccine. In Michigan, where 40 percent of adults have received at least one vaccine dose, Gov. Gretchen Whitmer, a Democrat, has asked the Biden administration for extra doses, but the administration has so far held to its policy of distributing doses by population and not demand. The director of the Centers for Disease Control and Prevention, Dr. Rochelle P. Walensky, said at a White House news conference last week that securing extra doses was not the most immediate or practical solution. She said that Michigan — whose metro areas include 15 of the 17 worst outbreaks in the nation — needed to enact shutdown measures to quickly slow the virus’s spread. The situation in Illinois remains dire. Dr. Michael Cruz, chief operating officer at OSF HealthCare, said on Thursday that about a half-dozen of the hospital system’s medical centers in Illinois were at more than 90 percent of capacity. He said it was too early to say whether the recent decline in new case reports was a “true inflection point.” In Michigan, 24 hospitals hit 90 percent of capacity last week. “The virus does what the virus does,” Dr. Cruz said. “Let it hang around long enough, it will start mutating.” Terry Scoggin receiving the Moderna vaccine at Titus Regional Medical Center in Mount Pleasant, Texas, in December.Credit...Cooper Neill for The New York Times With the decision by the Food and Drug Administration on Friday to lift its recommended pause on administration of the Johnson & Johnson vaccine, many states are likely to start using it again in short order. Several states, including Texas, Arizona, Alabama, Utah and Wisconsin, had said they expected to follow the recommendations of the F.D.A. and the Centers for Disease Control and Prevention once the decision was made. (The F.D.A. issued its new guidance after advisers to the C.D.C. voted to lift the pause.) Other states, including Washington State, had said they would wait until the conclusion of the C.D.C. meeting and then formulate their plans. Dr. Karen

New Daily Cases Ebb in Some Upper Midwest States
Here’s what you need to know: An inoculation at a union hall in Chicago on April 6. Coronavirus cases in Illinois are starting to recede.Credit...Kamil Krzaczynski/Agence France-Presse — Getty Images For weeks, Illinois, like much of the Upper Midwest, has been troubled by a stubbornly high daily load of reported coronavirus cases, leading to climbing numbers of hospitalizations and deaths. But new data is signaling that the virus might be on the verge of retreating. Illinois is reporting an average of about 2,840 new cases a day, down nearly 16 percent from April 17. Central Illinois, which saw major growth in cases earlier this month, is now improving, according to a New York Times database — especially in Peoria, one of the metropolitan areas where the virus had been spreading the fastest. “It is great we have seen some abatement in local hot spots,” said Dr. Emily Landon, the chief epidemiologist at the University of Chicago, who has been advising Gov. J.B. Pritzker, a Democrat, on the state’s pandemic response. Dr. Landon cautioned, though, that other pockets of the state, especially those with low vaccination rates, remained ripe for “a fiery outbreak.” “I wouldn’t say everybody is out of the woods,” she said. Indeed, hospitalizations remain high in Illinois and other Great Lakes states like Michigan and Minnesota, putting mounting pressure on health care systems. Hospitalizations in Illinois are up by about 25 percent over the past two weeks, as are hospitalizations in Michigan and Minnesota. In the past two weeks, deaths have risen by 20 percent in Illinois and 48 percent in Michigan. The surge grew particularly worrisome in Michigan, which continues to lead the nation in daily cases per person but has recorded a 27 percent decline over the past two weeks. Minnesota has recorded an 8 percent drop in daily new cases in the past two weeks, but a 25 percent increase in hospitalizations. The case counts surged as variants were starting to spread widely, and states have been racing to vaccinate as many people as possible. More than a quarter of Illinois’s population is now fully vaccinated, and 44 percent of people have received at least one shot. Officials said the recent surge might be burning itself out in part because of the growing number of people who are protected. “We have seen a beginning of, maybe, a lessening of the rise of cases,” Mr. Pritzker said last week. “I don’t want to predict anything, because this virus is unpredictable. But I think at least in the short term, that seems to be good news.” Officials in Illinois said that when vaccinations first became widely available, people started taking fewer precautions, even though highly contagious variants were spreading. “It led to the perfect storm,” said Monica Hendrickson, public health administrator for the Peoria City/County Health Department, who noted that recent cases had been highest among young people, the last to become eligible for the vaccine. In Michigan, where 40 percent of adults have received at least one vaccine dose, Gov. Gretchen Whitmer, a Democrat, has asked the Biden administration for extra doses, but the administration has so far held to its policy of distributing doses by population and not demand. The director of the Centers for Disease Control and Prevention, Dr. Rochelle P. Walensky, said at a White House news conference last week that securing extra doses was not the most immediate or practical solution. She said that Michigan — whose metro areas include 15 of the 17 worst outbreaks in the nation — needed to enact shutdown measures to quickly slow the virus’s spread. The situation in Illinois remains dire. Dr. Michael Cruz, chief operating officer at OSF HealthCare, said on Thursday that about a half-dozen of the hospital system’s medical centers in Illinois were at more than 90 percent of capacity. He said it was too early to say whether the recent decline in new case reports was a “true inflection point.” In Michigan, 24 hospitals hit 90 percent of capacity last week. “The virus does what the virus does,” Dr. Cruz said. “Let it hang around long enough, it will start mutating.” Terry Scoggin receiving the Moderna vaccine at Titus Regional Medical Center in Mount Pleasant, Texas, in December.Credit...Cooper Neill for The New York Times With the decision by the Food and Drug Administration on Friday to lift its recommended pause on administration of the Johnson & Johnson vaccine, many states are likely to start using it again in short order. Several states, including Texas, Arizona, Alabama, Utah and Wisconsin, had said they expected to follow the recommendations of the F.D.A. and the Centers for Disease Control and Prevention once the decision was made. (The F.D.A. issued its new guidance after advisers to the C.D.C. voted to lift the pause.) Other states, including Washington State, had said they would wait until the conclusion of the C.D.C. meeting and then formulate their plans. Dr. Karen Landers of the Alabama Department of Public Health said the state would “follow the guidance of the committee and C.D.C. if there is guidance to resume use of Johnson & Johnson.” Shelby Anderson, a spokeswoman for the Washington State Department of Health, said the Western States Scientific Safety Review Workgroup was scheduled to convene after the C.D.C. meeting. “Right now, it’s too soon to say when a decision could be made,” she said. Elizabeth Goodsitt, a spokeswoman for the Wisconsin Department of Health Services, said that the state would follow the federal recommendation, and that its plan was to allocate doses of the Johnson & Johnson vaccine primarily “to local health departments, as well as smaller providers, to offset the hub deliveries and storage challenges of Pfizer.” In a statement, the Minnesota Department of Health said the vote “underscores the importance that is placed on vaccine safety.” Just before the rollout was halted last week, Minnesota had distributed 9,600 Johnson & Johnson doses to providers, officials said, adding, “Those doses have been stored by the providers who received them, and we expect them to be available in the coming days along with any updated information to provide to those getting the vaccine.” Performing last rites for a Covid-19 victim at a mass crematorium ground in East Delhi, India, on Friday.Credit...Atul Loke for The New York Times NEW DELHI — Twenty patients in critical condition at a Covid-19 hospital in New Delhi died overnight when oxygen supplies ran low, doctors said on Saturday — the third hospital tragedy this week in a country that is reeling from an enormous second wave of infections. Deep Kumar Baluja, the medical director of the facility, Jaipur Golden Hospital in New Delhi, said that a scheduled delivery of oxygen supplies was seven hours late on Friday. That left the hospital’s reserves nearly depleted and led to lowered pressure in the oxygen lines that were keeping patients alive. Around midnight, Dr. Baluja said, the patients began to succumb. “A little after that, the patients died. Almost at midnight,” he said in a telephone interview. “One after the other.” Despite numerous calls to Delhi government officials late Friday, the hospital had received only half of the oxygen it needed. Hospitals across India are desperately short of oxygen as new coronavirus patients flood in, prompting many big hospitals to appeal on social media for emergency supplies — or to announce that they cannot take new patients. The Indian government reported more than 344,000 new infections on Saturday, setting a new global record for the third consecutive day, and more than 2,600 deaths from the virus. Yet experts say that those numbers, however staggering, are just a fraction of the real toll. Millions refuse to even step outside for fear of catching the virus. Accounts from around the country tell of the sick being left to gasp for air as they wait at chaotic hospitals that seem to be buckling under the stress. On Wednesday, at least 22 coronavirus patients died at a hospital in Maharashtra State when a leak cut off their oxygen supply. Two days later, a fire at another hospital in the state left at least 13 Covid-19 patients dead. The sudden coronavirus surge in India in recent weeks, with an insidious newer variant possibly playing a role, is casting increasing doubt on the country’s official Covid-19 death toll of nearly 200,000. Interviews from cremation grounds across the country, where the fires never stop, portray an extensive pattern of deaths far exceeding the official figures. Nervous politicians and hospital administrators may be undercounting or overlooking large numbers of dead, analysts say. And grieving families may be hiding Covid connections, adding to the confusion in the enormous nation of 1.4 billion. “It’s a complete massacre of data,” said Bhramar Mukherjee, an epidemiologist at the University of Michigan who has been following India closely. “From all the modeling we’ve done, we believe the true number of deaths is two to five times what is being reported.” Months ago, India seemed to be doing remarkably well with the pandemic. After a harsh initial lockdown early last year was eased, the country continued to avoid the frightening case and death counts that sent other big countries into crisis mode, and officials began talking expansively about its success. Now, countless Indians are turning to social media to send out heartbreaking S.O.S. messages for hospital beds, medicine and oxygen. At the same time, India’s vaccination campaign is struggling. Less than 10 percent of the population has received even one dose, despite India’s status as the world’s leading vaccine manufacturer. The situation will have ripple effects across the world, especially for poorer countries: India had planned to ship out millions of doses, but now, given the country’s stark shortfall, exports have essentially been shut down. Arriving for a Super Rugby match in Perth, Australia, on Friday before a three-day lockdown.Credit...Will Russell/Getty Images Perth, Australia’s fourth largest city, began a three-day lockdown on Saturday after a coronavirus case was discovered outside quarantine. Health officials believe that the virus passed from a man who left a two-week hotel quarantine on April 17 to a woman he later stayed with in Perth. The man tested positive on Friday after flying to Melbourne, officials said. The lockdown bars the city’s two million residents from leaving their homes except to buy groceries, exercise, work or seek medical care. It has also forced the cancellation of public events in Perth on Sunday for Anzac Day, which celebrates military veterans of Australia and New Zealand. New Zealand, which days ago opened a long-awaited travel bubble with Australia, said it had paused flights to and from Western Australia State, of which Perth is the capital. New Zealand’s government said in a statement that the pause was “an example of the type of scenario both countries have planned for.” Australia has all but eliminated local transmission of the virus, in part by imposing swift, short-term lockdowns anytime new infections are found. In February, when one coronavirus case was detected outside quarantine for the first time in 10 months, Perth was locked down for five days. The premier of Western Australia, Mark McGowan, said that more than 2,500 people underwent coronavirus tests at public clinics on Friday, and that more than 300 people who are believed to have come into contact with the infected man had been placed into quarantine and were being tested. No additional infections have been found, Mr. McGowan said, but he urged residents to get tested if they believe they could be at risk. “We need many more tests to be done,” Mr. McGowan told a news conference on Saturday. “This is crucial to get us the data and certainty to look beyond this lockdown.” The Daniel Patrick Moynihan  Courthouse of the Federal District Court in Manhattan in January. Credit...Jefferson Siegel for The New York Times In Manhattan’s Federal District Court, witnesses now testify from Plexiglas booths. New handsets let defendants communicate with lawyers confidentially, but at a distance. Jurors are sit spaced apart on elevated platforms, and deliberate and eat lunch in a separate courtroom. As New York reopens, the sprawling federal and state court systems have transformed the way they operate in order to bring people back into buildings safely and clear case backlogs. Nowhere have the changes been more visible than in jury trials. The court spent $1 million reconfiguring 11 courtrooms and stocking courthouses with sanitizer, gloves, masks and antimicrobial pens. To get the system moving again, the court decided that criminal trials generally would be given precedence. And since trials had begun again, the court was having no difficulty attracting juries — since, for some, jury duty was preferable to staying at home. A mobile Covid-19 walk-up testing site in Los Angeles. A new study says that many adults who have mild cases of Covid-19 can, months later, receive diagnoses of new ailments. Credit...Philip Cheung for The New York Times Most adults who test positive for the coronavirus don’t require hospitalization but tend to seek medical care in subsequent months, and two-thirds of those who do are told they have a health condition they did not have before.. These are the findings of a study conducted by investigators from the Centers for Disease Control and Prevention and Kaiser Permanente, which included some 3,171 members of the Kaiser Permanente Georgia integrated health care system. More than half were Black. The message for patients is that even for those who have had only mild Covid-19, “it’s possible you may experience new or persistent symptoms months after the initial diagnosis,” said Dr. Alfonso C. Hernandez-Romieu, an infectious disease specialist with the C.D.C., and the study’s lead author. “And it’s important for people to make sure they’re going to their clinicians,” he said, to express their concerns. “It’s equally important,” he added, “for clinicians to acknowledge that there may be these long-term effects and to really make sure they’re validating patients, treating them with empathy and trying to help them in the best way possible.” Clinicians need to monitor patients for Covid-19-related complications that are potentially very serious, like blood clots, he said. The study did not compare patients who tested positive for the coronavirus to patients who did not, so the authors were unable to say whether people who had recovered from mild Covid-19 cases made more doctors’ visits than those who never had the virus. But two-thirds of the patients who had mild disease sought medical care one to six months after their Covid-19 diagnoses, and about two-thirds of those who sought care were found to have an entirely new condition. The new diagnoses included cough, shortness of breath, heart rate abnormalities, chest or throat pain, and fatigue, “which likely represent ongoing Covid-19 symptoms,” the study said. Among those more likely to seek medical care were adults 50 and older, women and those with underlying health conditions. Black adults were also slightly more likely than others to seek care. But over all, the authors noted, the number of visits declined over time. The potential for long-term complications, even after a mild course of disease, underscores the need for prevention measures and vaccination, Dr. Hernandez-Romieu said. “There is a lot we don’t know about post-Covid conditions,” he said. “Even though a majority of people don’t end up with severe Covid, or end up in the hospital, the potential for long-term health effects is really important.” In Venice Beach, Calif., in December.Credit...Jessica Pons for The New York Times After a year in which many people have learned to dutifully wear masks and look askance at anyone who does not, it’s understandable that people remain fearful when they cross paths with the unmasked. So how to decide about when to wear a mask outside? Many experts in viruses and public health say the guidance hasn’t changed: Spending time with others outside during the pandemic has always been safer than indoors. But whether a mask is needed outdoors depends on the circumstances, including local public health rules and whether people are vaccinated. On Thursday, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said on the “Today” show that the agency is considering revising its mask guidance for outdoor activities as more and more people get vaccinated against the coronavirus. “We will be looking at the outdoor masking question,” she said. “But it’s also in the context of the fact that we still have people who are dying of Covid.” She added that if “we can get our caseloads down, then we’ll be in really good shape in the country.” While new cases, hospitalizations and new deaths have declined from their peaks in January, they have stayed at a relatively stagnant level in recent weeks, according to a New York Times database. The average of new cases is more than 61,000 a day, as of Thursday, with high concentrations in Michigan and the Northeast. And new deaths remain near an average of more than 715 a day. Currently, the C.D.C. says masks “may not be necessary” when you are outside by yourself away from others, or with people in your household, but it does not explicitly say there is no longer a need to mask up while outdoors. Brief encounters with an unmasked person on a sidewalk or a hiking trail are very low risk, said Linsey Marr, a professor of civil and environmental engineering at Virginia Tech who is one of the world’s leading experts on viral transmission. Even if a person coughs or sneezes outside, the odds of someone nearby getting a large enough dose of virus to become infected remain low, she said. Dr. Marr uses a two-out-of-three rule for deciding when to wear a mask in public spaces or when she doesn’t know others’ vaccination status. In these situations, she makes sure to meet two out of three conditions: outdoors, distanced and masked. “If you’re outdoors, you either need to be distanced or masked,” she said. “If you’re not outdoors, you need to be distanced and masked. This is how I’ve been living for the past year.”