Will Omicron Bring Pandemic’s End? It’s Too Soon to Know, Fauci Says.

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Even if enough people build natural immunity to Covid-19 by catching the highly contagious Omicron variant, Dr. Anthony S. Fauci said it is too soon to say if this will spell an end to the pandemic.

On Monday, Dr. Fauci, President Biden’s top medical adviser for Covid, was asked at the online World Economic Forum if this may be the year that the virus becomes endemic, meaning it is still circulating but does not disrupt society.

While Omicron seems to cause less severe disease than other variants, Dr. Fauci said the sheer volume of cases could have a meaningful effect on collective immunity, but added, “it is an open question as to whether or not Omicron is going to be the live virus vaccination that everyone is hoping for, because you have such a great deal of variability with new variants emerging.”

“I would hope that that’s the case,” he said, “but that would only be the case if we don’t get another variant that eludes the immune response.”

Dr. Fauci said the evolution of the pandemic is still an open question. “The answer is: We do not know,” he said.

While cases seem to be leveling off in New York and other parts of the Northeast, they remain extremely high across the United States, averaging nearly 802,000 per day, an increase of 98 percent over the past two weeks. An average of nearly 156,000 people with the virus are hospitalized nationwide, a record. Deaths now exceed 1,900 per day, up 57 percent over two weeks.

Dr. Fauci also said that the world is still in the first of what he considered to be the five phases of the pandemic. The first is the “truly pandemic” phase, “where the whole world is really very negatively impacted,” followed by deceleration, control, elimination and eradication.

He said that only one infectious human disease has ever been eradicated: smallpox.

“That’s not going to happen with this virus,” he said.

However, once countries reach the “control” phase, when the virus becomes a “non-disruptive presence,” then the virus will be considered endemic, he said. The rhinovirus and some upper respiratory infections are examples of endemic diseases.

As Omicron continues to spread at a breakneck speed, some governments seem resigned to the idea that Covid is already a fixture of daily life. In some European countries, the authorities are pushing a “learn to live with it” approach that includes shorter isolation periods and the elimination of pre-departure tests for travel.

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Canada approved on Monday the nation’s first antiviral pill to be used at home to fight Covid-19 infections, although global supply shortages may impact how quickly the drug can be distributed to those who need it.

In December, Canada ordered one million treatment courses of Paxlovid, manufactured by Pfizer, and has received a shipment of more than 30,000 treatment courses, said Jean-Yves Duclos, minister of health. He said another 120,000 Paxlovid courses were expected to arrive in February and March.

The United States approved the use of Paxlovid in December, and then doubled its order for the drug earlier this month, requesting enough supply for 20 million treatments.

Health Canada, the agency responsible for drug authorization in the country, is still considering the approval of Merck’s antiviral pill, molnupiravir. In December, Canada ordered up to one million treatment courses of molnupiravir and made a deal to manufacture it at a Whitby, Ontario facility for local and international distribution.

Paxlovid has been shown to reduce the risk of hospitalization and death by Covid-19 by 85 percent when taken within five days of symptoms, when compared with having no treatment. Those findings were based on data from a clinical trial in unvaccinated, high-risk adults with Covid-19 who were not hospitalized, and submitted by Pfizer on Dec. 1 to Health Canada as part of the agency’s expedited review, officials said in a technical briefing on Monday.

The data also confirmed the medication’s effectiveness against the Omicron variant.

One treatment course lasts five days and is a combination of two antiviral drugs, nirmatrelvir and ritonavir, taken twice per day, said Dr. Supriya Sharma, chief medical adviser at Health Canada.

Paxlovid is intended to be used following a positive test result for the coronavirus and within five days of first symptoms.

“I would like to provide a reminder that no drug, including Paxlovid, is a substitute for vaccination or public health measures,” said Dr. Theresa Tam, chief public health officer of Canada. “This is another tool in the tool kit to fight the pandemic.”

Health Canada will be sending Paxlovid pills to provinces, based on population and health equity factors. Priority targets for the medication include people who are moderately to severely immunocompromised, regardless of vaccination status; those 80 years and older whose vaccinations are not up-to-date; and those 60 years or older living in remote regions, long-term care facilities, or Indigenous communities.

A surge of virus cases in Canada is expected to ramp up hospital admissions to levels not yet seen during the pandemic. The national seven-day positivity rate is close to 24 percent as of Monday, according to data from the Public Health Agency of Canada. This rate undercounts active cases, as many provinces turn to rapid antigen testing to offset the burden on P.C.R. test resources for the most severe cases.

About 77 percent of Canadians are fully vaccinated, and 28 percent have also received a booster shot.

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Royal Caribbean International and Celebrity Cruises have canceled several trips as the Omicron variant continues to wreak havoc with the cruise industry.

In recent weeks, hundreds of passengers have contracted the coronavirus onboard ships, with many falling ill and spending days in quarantine.

On Friday, Royal Caribbean canceled a sailing on the ship Independence of the Seas, in response to “COVID-related circumstances around the world,” the company said on its website.

Earlier this month, the company said it had called off planned trips on three ships — Serenade of the Seas, Symphony of the Seas and Jewel of the Seas — and delayed the return to cruising of another, Vision of the Seas, to March.

In a statement on Monday, Celebrity Cruises said it had postponed service on its Celebrity Eclipse ship. The ship was scheduled to make four trips in March and April.

The cruise industry has been battered by the pandemic. It was all but shuttered for nearly 18 months before making a comeback this past summer, but the industry has recently faced mounting criticism about its safety protocols.

Last month, the Centers for Disease Control and Prevention urged travelers to avoid cruises, even if they had been vaccinated. The agency raised its Covid-19 warning level for cruise ships to 4, the highest level.

The move came as the number of outbreaks on ships has grown, causing some ports to turn away ships. In December, clusters broke out aboard two Royal Caribbean cruises after they left port in Florida, and more than a dozen people tested positive on a Norwegian Cruise Line vessel after it returned to New Orleans.

Royal Caribbean and Celebrity Cruises require passengers who are eligible for inoculations to receive them. Younger passengers who are not eligible must test negative before sailing.

Ceylan Yeginsu contributed reporting.

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China had already barred foreign spectators from attending the Winter Games that begin in Beijing in less than a month. On Monday, it announced that most Chinese people won’t be able to attend either.

Citing the evolving threat from the coronavirus pandemic, the Beijing 2022 organizing committee announced that it was ending ticket sales to the events “to ensure the safety of all participants and spectators.”

The decision came less than two days after health authorities reported Beijing’s first case of the Omicron variant and ordered an immediate lockdown and mass testing in one of the capital’s neighborhoods.

The outbreak, though so far limited, pierced the extraordinary efforts to isolate Beijing, including a ban on travel into the city, in part to assure that the Olympics would be affected as little as possible.

The organizers committee said they had created an “adapted program” to allow some spectators, suggesting that groups that had been sufficiently screened and quarantined would be invited to attend.

Those could involve government workers, sponsors or government officials, but the committee did not elaborate except to make clear that the public would not be able to buy tickets, which had not yet gone on sale.

7–day average

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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.

The International Olympic Committee later released a statement that largely echoed Beijing’s.

“The organizers expect that these spectators will strictly abide by the Covid-19 countermeasures before, during and after each event so as to help create an absolutely safe environment for the athletes,” the international committee’s statement said.

The Winter Games, which begin on Feb. 4, will now unfold like those in Tokyo, which also barred most spectators before last year’s Summer Games. The authorities in China, who had pressed ahead defiantly to fill the venues with spectators, have now had to bow to the grim realities of the pandemic.

Even before Monday’s end of ticket sales, organizers had already drafted health protocols that far exceeded those in Tokyo. They have created a “closed loop” system that will isolate athletes, spectators, journalists and Olympic workers within the three clusters of venues where the events will take place.

Until Monday, the organizers had hoped to be able to allow vaccinated and tested spectators to buy tickets to enter the three “bubbles,” which include the main Olympic Village in Beijing, the site of the Summer Games in 2008; and the two mountain clusters north of the capital, Zhangjiakou and Yanqing.

Anyone from China who had entered would have still been expected to quarantine for 21 days after leaving, an effort to protect the broader population from exposure from the foreign visitors.

Even with such extraordinary measures, the organizers no longer felt they could risk the interaction between the population outside the event and the international crowd that is beginning to arrive.

China has in recent weeks aggressively sought to stamp out a series of concurrent outbreaks as part of the government’s policy of “zero tolerance” for the coronavirus. By last week, more than 20 million people were confined in their homes in cities around China, including Tianjin, a port city just 70 miles east of Beijing.

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Two members of the Joint Chiefs of Staff, including the chairman, have tested positive for the coronavirus, Pentagon officials said on Monday.

Gen. Mark A. Milley, the chairman of the Joint Chiefs, who is vaccinated and boosted, tested positive on Sunday and is isolating, said his spokesman, Col. Dave Butler. “He is experiencing very minor symptoms and can perform all of his duties from the remote location,” Colonel Butler said.

Gen. David H. Berger, the commandant of the Marine Corps, who is also vaccinated, is following a similar protocol after his positive test on Sunday. “The performance of his duties will remain unaffected,” Maj. Eric D. Flanagan, a spokesman, said on Monday.

General Milley and President Biden came into contact on Wednesday at a funeral for Raymond T. Odierno, a four-star Army general, Colonel Butler said. But the Joint Chiefs chairman tested negative in the days before and after the funeral, until Sunday. All the other chiefs tested negative on Sunday.

The Joint Chiefs of Staff comprises eight members: the chairman, the vice chairman, the Army chief of staff, the naval operations chief, the Air Force chief of staff, the Marine Corps commandant, the National Guard Bureau chief and the space operations chief.

Defense Secretary Lloyd J. Austin III also tested positive for the virus this month. He experienced mild symptoms and attended key meetings from home. Mr. Austin attributed his less severe case to being vaccinated and boosted.

“I am grateful,” he said at the time, adding that vaccines are a requirement for the military. “The vaccines work.”

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As the anniversary of President Biden’s inauguration approaches this week, American opinion of his efforts to contain the pandemic is lower than ever, according to a CBS News/YouGov poll.

The poll, released on Sunday, found just 36 percent of respondents believed U.S. efforts to deal with the coronavirus were “going well.” Just 49 percent of Americans approved of the president’s management of the pandemic, compared to 66 percent of Americans who gave the same response in July, in a previous version of the poll.

Seventy-eight percent of those who approved of the president’s handling of the pandemic identified as liberal, and 83 percent who disapproved identified as conservative.

The president’s first year in office included widespread distribution of coronavirus vaccines, the rise of the aggressive Delta variant and, most recently, the record-breaking surge of Omicron overwhelming hospitals across the country. The federal government faced a significant setback in its efforts to curb the spread of the virus when the Supreme Court rejected a vaccine-or-testing mandate for private employers that would have affected more than 80 million workers. But the court allowed a more limited mandate that requires health care workers at facilities that receive federal money to be vaccinated.

The poll, of 2,094 adult respondents surveyed between Jan. 12 to 14, found that 35 percent of Americans believed the administration’s policies were improving the pandemic, compared to 40 percent who believed the policies made the situation worse. Among the respondents who believed Biden’s policies improved the pandemic, 61 percent identified as liberal; among the respondents who said Biden’s policies made the pandemic worse, 68 percent identified as conservative.

While new cases seem to be peaking in New York and some other Northeastern states, they remain extremely high there and at record levels elsewhere. Nationally, the United States is averaging nearly 802,000 daily cases, a near doubling over the past two weeks. More than 156,000 people with the virus are hospitalized, a record and an increase of 61 percent over two weeks. Average deaths exceed 1,900 a day, up 57 percent.

Dissatisfaction with the administration’s policies had little to do with vaccine availability, according to the survey. Of those who said the federal government was doing a bad job handling the coronavirus, 70 percent of respondents said information had been confusing.

The Centers for Disease Control and Prevention weathered its share of messaging debacles after issuing isolation guidelines that changed so rapidly they spawned a meme. The agency’s director, Dr. Rochelle P. Walensky, has also faced criticism after issuing recommendations that baffled or surprised state health experts.

Others in the poll criticized the administration for promoting vaccine mandates, not adequately preparing for the Omicron variant and failing to make testing easily available.

The respondents who believed Mr. Biden was doing a good job handling the pandemic praised his encouragement of vaccination, promotion of vaccine mandates and distribution of economic aid to those affected by the virus.

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Companies are bracing for another round of potentially debilitating supply chain disruptions as China, home to about a third of global manufacturing, imposes sweeping lockdowns in an attempt to keep the Omicron variant at bay.

The measures have already confined tens of millions of people to their homes in several Chinese cities and contributed to a suspension of connecting flights through Hong Kong from much of the world for the next month. At least 20 million people, or about 1.5 percent of China’s population, are in lockdown, mostly in the city of Xi’an in western China and in Henan Province in north-central China.

The country’s zero-tolerance policy has manufacturers — already on edge from spending the past two years dealing with crippling supply chain woes — worried about another round of shutdowns at Chinese factories and ports. Additional disruptions to the global supply chain would come at a particularly fraught moment for companies, which are struggling with rising prices for raw materials and shipping along with extended delivery times and worker shortages.

China used lockdowns, contact tracing and quarantines to halt the spread of the coronavirus nearly two years ago after its initial emergence in Wuhan. These tactics have been highly effective, but the extreme transmissibility of the Omicron variant poses the biggest test yet of China’s system.

Analysts warn that many industries could face disruptions in the flow of goods as China tries to stamp out any coronavirus infections ahead of the Winter Olympics, which will be held in Beijing next month. On Saturday, Beijing officials reported the city’s first case of the Omicron variant, prompting the authorities to lock down the infected person’s residential compound and workplace.

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BELGRADE, Serbia — Novak Djokovic, undone in his quest for a 10th Australian Open tennis championship by his decision to remain unvaccinated against Covid-19, returned on Monday to the warm embrace of his home nation of Serbia even as his future in the sport was shrouded in uncertainty.

He landed in Belgrade a day after being deported from Australia following a decision by the Australian government to revoke his visa out of concern that he might inspire anti-vaccination sentiment.

As he slipped out a private exit at Nikola Tesla International Airport in Belgrade to avoid a crowd of waiting reporters, nearly two weeks of legal wrangling, political posturing and intense media focus came to a rather subdued end.

7–day average

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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.

The few dozen supporters who made their way to the airport waved flags, chanted their support for Mr. Djokovic and complained that their hero had been mistreated.

One of them, Simon Avramov, came with his wife and two small children.

“The world could not let someone from this small country be a champion,” he said.

But if Mr. Djokovic chooses to remain unvaccinated, it will not just be Australia where he might have trouble playing. His quest to win a record 21st Grand Slam title could be in jeopardy, as other nations also have rules on allowing in travelers who are unvaccinated.

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For months, former President Donald J. Trump has been grumbling quietly to friends and visitors to his Palm Beach mansion about a rival Republican power center in another Florida mansion, some 400 miles to the north.

Gov. Ron DeSantis, a man Mr. Trump believes he put on the map, has been acting far less like an acolyte and more like a future competitor, Mr. Trump complains. With his stock rising fast in the party, the governor has conspicuously refrained from saying he would stand aside if Mr. Trump runs for the Republican nomination for president in 2024.

“The magic words,” Trump has said to several associates and advisers.

That long-stewing resentment burst into public view recently in a dispute over a seemingly unrelated topic: Covid policies. After Mr. DeSantis refused to reveal his full Covid vaccination history, the former president publicly acknowledged he had received a booster. Last week, he seemed to swipe at Mr. DeSantis by blasting as “gutless” politicians who dodge the question out of fear of blowback from vaccine skeptics.

Mr. DeSantis shot back on Friday, criticizing Mr. Trump’s early handling of the pandemic and saying he regretted not being more vocal in his complaints.

The back and forth exposed how far Republicans have shifted to the right on coronavirus politics. The doubts Mr. Trump amplified about public health expertise have only spiraled since he left office. Now his defense of the vaccines — even if often subdued and almost always with the caveat in the same breath that he opposes mandates — has put him uncharacteristically out of step with the hard-line elements of his party’s base and provided an opening for a rival.

Global roundup

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Australia said on Monday that it would recognize a two-dose course of Russia’s Sputnik V vaccine for incoming travelers, in a move that officials said would “expand options” for the return of international students, workers and elite sports players.

The agency that regulates vaccines accepted in Australia said in a statement that it had made the decision based on information received last week “demonstrating this vaccine provides protection and potentially reduces the likelihood that an incoming traveler would transmit Covid-19 infection to others while in Australia or become acutely unwell due to Covid-19.”

Studies showed that two doses of the Russian vaccine were on average 89 percent effective against symptomatic infection and on average at least 98 percent effective against hospitalization and death, according to the agency, the Therapeutic Goods Administration. The studies were conducted before the emergence of the Omicron variant, the agency noted.

Sputnik V was the world’s first registered vaccine for the coronavirus, but neither the United States nor the European Union has authorized it for use. In September, the United States, announcing that it would reopen its doors to vaccinated foreign travelers, excluded those who had received the Russian vaccine.

In other global news:

  • China and North Korea will restart trade by cross-border rail after train shipments between the two countries were frozen for more than a year because of coronavirus fears, the Chinese government said on Monday. Despite its heavy dependence on China for food, fertilizer and other basic goods, North Korea closed off rail shipments to prevent the spread of the virus. Some trade by ship had continued. On Sunday, a train from North Korea crossed the Yalu River railway bridge and pulled into the Chinese border town of Dandong. Zhao Lijian, a spokesman for the Chinese Foreign Ministry, said the two neighbors had reopened their rail trade link “on the basis of ensuring pandemic prevention and security.” North Korea has not officially reported any Covid-19 cases since the pandemic began.

  • The European Union recommended on Monday that member states should restrict travel from Argentina, Australia and Canada because of a deteriorating Covid-19 situation in those countries. The bloc maintains a “safe list” of destinations from which it recommends accepting tourists and other nonessential travelers without pandemic restrictions; Australia and Canada were among a handful of countries on its first such list in June 2020. Though the “safe list” still excludes the vast majority of countries worldwide, E.U. states now generally impose vaccination, testing or quarantine requirements rather than simply barring nonessential travel from countries outside the bloc or the list.

  • Greece will start enforcing a national vaccine mandate beginning Monday for citizens age 60 and over, with monthly fines for those who refuse. Greeks over 60 who have yet to receive a Covid shot or book an appointment for one will have to pay 50 euros — around $57 — in January and €100 in each subsequent month. Officials say the measure has prompted more than 200,000 vaccination appointments since it was announced in November, with more than 90 percent of those over 60 either vaccinated or booked for a shot. Around 67 percent of Greeks overall are fully vaccinated, according to Our World in Data. The move follows one by Italy, which introduced a national vaccine mandate this month for those over 50. Austria plans to enforce a mandate covering all residents eligible for vaccination from next month, a policy that has inspired street protests.

  • The Philippines is grappling with a Covid-19 surge that has accelerated at a pace not seen since the start of the pandemic. But fewer people are severely ill than in previous waves. The government said this week there was a “very high” likelihood that the Omicron variant had fueled the latest outbreak, which began after the Christmas and New Year holiday period, though sequencing results have also shown that the Delta variant is still spreading in the country.

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Detainees at an Arkansas jail who had Covid-19 were unknowingly treated by the detention center’s doctor with ivermectin, a drug not approved for Covid treatment, according to a federal lawsuit filed by the American Civil Liberties Union on behalf of four detainees.

The four men — Dayman Blackburn, Julio Gonzales, Jeremiah Little and Edrick Floreal-Wooten — say in the lawsuit that after testing positive for the coronavirus in August, they were taken to the “quarantine block” of the Washington County Detention Center and given a “cocktail of drugs” twice a day by Dr. Robert Karas, who runs Karas Correctional Health, the jail’s health provider.

Health officials have continually said that ivermectin, an antiparasitic drug commonly used for livestock, is dangerous and should not be taken for Covid.

The American Civil Liberties Union said in a statement that the jail had been giving ivermectin to detainees as early as November 2020. In August 2021, amid surging demand for the drug, the Centers for Disease Control and Prevention warned that ivermectin was “not authorized or approved” for any type of Covid treatment.

Misinformation that ivermectin is effective at treating or preventing coronavirus infection has run rampant across social media during the pandemic, and the inaccuracies have led some people to overdose on certain formulations of the drug, according to the Food and Drug Administration.

The lawsuit says the men “ingested incredibly high doses” of the drug while sick with Covid, causing some to experience diarrhea, bloody stools, stomach cramps and issues with their vision.