Variants and Eased Restrictions Push US Coronavirus Cases Up Again

After weeks of decline followed by a steady plateau, coronavirus cases are rising again in the United States. Deaths are still decreasing, but the country averaged 61,545 cases last week, 11 percent more than the average two weeks earlier.

Scientists predicted weeks ago that the number of infections would curve upward again in late March, at least in part because of the rise of variants of the coronavirus across the country. The variant that walloped Britain, called B.1.1.7, has led to a new wave of cases across most of Europe. Some scientists warned that it may lead to a new wave in the United States.

The rise in infections is also a result of state leaders pulling back on mitigation measures, and large social interactions, like spring break gatherings in Florida, Dr. Anthony S. Fauci, the Biden administration’s chief science adviser, said on the CBS program “Face the Nation” on Sunday.

“The variants are playing a part, but it’s not completely the variants,” Dr. Fauci said. Most states have lifted restrictions, including on indoor dining, in response to the drop in numbers, actions that Dr. Fauci called “premature.”

8,337 known cases of the B.1.1.7 variant in the country, but the actual number is probably much higher because labs in the country analyze only a very small proportion of the diagnosed cases. Still, the trend is clear: The variant — which is more transmissible and possibly more lethal — has been rising exponentially in the United States, its growth masked by the overall drop in infections.

“It is remarkable how much this recalls the situation last year where we had introductions of virus to different places that scientists warned would be a problem,” said Bill Hanage, an epidemiologist at the Harvard T.H. School of Public Health, said in an interview on Sunday. “People waited for them to be a problem before they took action — and then too late, they took action.”

Dr. Hanage said he was particularly worried about B.1.1.7 because it is at least 50 percent more transmissible than the original virus. The brisk pace of vaccinations will stem the tide somewhat, but the rising immunity in the population may be more than offset by the variant’s contagiousness, he added. “B.1.1.7 is really scary,” he said.

The vaccines in use in the United States — made by Pfizer-BioNTech, Moderna, and Johnson & Johnson — are expected to prevent severe disease and death from any of the variants, although they are slightly less effective against a variant that was identified in South Africa. That variant, known as B.1.351, has not yet spread widely in the United States.

Because many of the highest risk people have been inoculated, hospitalizations and deaths may not show a steep rise along with infections. But a surge in cases will still lead to some severe cases and deaths, Dr. Hanage said.

“How large it will be we’ll need to wait and see,” he said. “But ideally we would not be waiting to see, ideally we’d be taking action.”

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AstraZeneca’s Latest Stumble Again Clouds European Vaccinations

LONDON — The announcement this week that the AstraZeneca shot, the workhorse of global vaccine rollouts, had achieved nearly 80 percent efficacy in a gold-standard American trial was met with relief by the many countries relying on it.

“When you get the call, get the jab,” the British health secretary, Matt Hancock, urged, part of a campaign by European lawmakers to calm people’s nerves after a recent safety scare with the shot.

But by Tuesday, that campaign had, once again, been thrown off course, at least for the moment. For AstraZeneca, it was seemingly another episode of public relations whiplash, part of a series of recent miscues and communication blunders by the company that scientists said had undercut the effort to sell one of the most potent and indispensable vaccines against the coronavirus.

In a highly unusual move, American health officials said on Tuesday that the company’s account of its U.S. trial findings had not been entirely accurate, suggesting that AstraZeneca had used only the most favorable data to generate apparently spectacular efficacy results.

developed unusual blood clots.

In France, Germany, Italy and Spain, more people now believe that the vaccine is unsafe than that safe, polling has shown, a blow to a shot that remains the continent’s best hope for saving people’s lives during a mounting surge of new infections. Millions of doses are sitting unused in refrigerators across the continent, with doctors reporting some people canceling injections over fears about side effects.

driving down hospitalizations and helping the country to emerge from a dreadful wintertime wave of infections.

Nevertheless, AstraZeneca’s U.S. trial was hotly anticipated. The largest of its kind for the shot, it had been expected to provide the cleanest, most complete picture of the vaccine’s efficacy. American officials saw it as an incontrovertible test of the vaccine’s performance.

And health officials around the world were looking to it as a crucial guide to their own rollouts: It would supply crucial data on older people, who had not been as well represented in earlier trials, and a more precise read on the vaccine’s overall efficacy, which had appeared from earlier trials to be lower than that of other leading shots.

As soon as AstraZeneca announced its results on Monday, saying that the vaccine had 79 percent efficacy in preventing symptomatic Covid-19, lawmakers began citing it as part of their fledgling efforts to shore up public confidence in the vaccine.

communications problems that have dogged the company since last year, delaying the regulatory process in some regions and creating hesitation among some recipients.

So far, only 55 percent of the AstraZeneca doses delivered to the European Union have been put into people’s arms, according to the bloc’s figures, markedly lower than the usage rate for other vaccines. Some seven million doses are still sitting in refrigerators.

public confusion about a vaccine that appears to be highly effective.

In early September, the company quietly halted its global trials after a participant in Britain fell ill. But American regulators did not find out until the story broke publicly. Subsequently, the company’s slowness to provide the F.D.A. with evidence that its vaccine was not linked to any illnesses kept it grounded for nearly seven weeks. AstraZeneca has said it shared data in a timely manner.

By late November, the company was again riding high: It released results from early clinical trials, including in Britain, showing that the vaccine was up to 90 percent effective.

But those results, too, were quickly clouded by uncertainty. AstraZeneca later acknowledged that there had initially been confusion over the vaccine dosage received by some study participants, making it more difficult to interpret the findings.

Britain, which has long championed the homegrown vaccine, authorized the shot in late December, relying on the earlier clinical trial results. The European Union’s medicine regulator did the same, but a month later.

E.U. officials said that the delay had partly resulted from a back-and-forth between the regulators and AstraZeneca over the quality of the data.

And even after the vaccine was authorized, a number of European countries initially restricted it to younger people, citing a lack of sufficient data about its efficacy in older people. That problem was supposed to be resolved by the American trial, in which older people were better represented.

Neither European nor British regulators gave any indication on Tuesday that the problems with AstraZeneca’s American data would have any impact on rollouts there. Those agencies relied on a separate set of data from non-American trials to authorize the vaccine.

“We are in contact with the company regarding this further information,” the European Medicines Agency said in a statement on Tuesday, “and E.M.A. will assess the data concerned as soon as the company submits it to us.”

Matina Stevis-Gridneff contributed reporting from Brussels.

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U.S. Risks a ‘Fourth Wave’ Fueled by Variants and Eased Restrictions, Fauci Warns

The Centers for Disease Control and Prevention has been warning about it since January: A more contagious and possibly deadlier variant of the coronavirus, first found in Britain, is likely to become predominant in the United States, perhaps leading to a wrenching surge in cases and deaths.

The first part of that warning seems to be coming true: The variant, known as B.1.1.7, is doubling its share of all new U.S. cases about every 10 days.

But the second part is harder to make out, at least so far. The steep fall in new cases from the January peak halted in mid-February, but the trend since then has been roughly steady or only slightly downward, rather than a feared “fourth wave.”

Experts are not sure why. The accelerating pace of vaccinations and the remaining virus-control measures in much of the country might be balancing out the spread of the more contagious variant, so that total cases neither rise nor fall very much. But it is difficult to know how long that equilibrium might last, or whether the next clear turn in the trend will be upward or downward.

New York Times database. That is the lowest seven-day average since October and about 10 percent below the average on Feb. 21, when the steep decline slowed. Still, the figure is close to the peak level of the surge last summer. Death reports are also falling but remain high, regularly topping 2,000 a day.

In an interview Sunday on the CBS program “Face the Nation,” Dr. Fauci said that over the past week and a half, the decline in cases had stalled. “We’re plateauing at quite a high level — 60 to 70,000 new infections per day is quite high,” he said.

This trend is particularly worrisome, he said, because in the United States over the past year, when the daily level of new infections plateaued at a high level, surges in cases followed. And recently in Europe, infection levels were declining, then plateaued and “over the last week or so, they’ve had about a 9 percent increase in cases,” Dr. Fauci said.

Experts say they need more data to understand why the United States has not yet seen a surge in cases as the fearsome B.1.1.7 variant has spread so rapidly, already accounting for more than one-fifth of new cases.

William Hanage, a Harvard epidemiologist, said there could be several reasons B.1.1.7 has not started ravaging the United States the way it consumed Britain, including more widespread vaccination, improving weather and the patchwork of pandemic restrictions across the states.

Florida, Mr. Hanage and other experts say, is an interesting example, because infections have not surged even though restrictions are looser than in other states and the variant makes up at least an estimated 30 percent of cases, the highest proportion in the nation.

Dr. Fauci said on Sunday that a variant first identified in New York is “not widespread yet, but it seems to be spreading pretty efficiently through the New York City metropolitan area and beyond.”

He said there is evidence that the variant may partly elude protection conferred by vaccines and monoclonal antibody treatments, although the variant does not evade vaccines and treatments as much as one first identified in South Africa.

The best way to prevent further spread is to “get people vaccinated as quickly and as expeditiously as possible and, above all, maintain the public health measures that we talk about so often: the masking, the physical distancing, and the avoiding of congregate settings, particularly indoors.” Dr. Fauci said. “That’s what you can do to prevent the spread of a worrisome variant.”

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Fauci Warns Coronavirus Cases Could Spike as States Ease Restrictions

The B.1.1.7 variant, first identified in Britain, is spreading so rapidly in the United States that data analysis suggest that, as of this week, it has most likely grown to account for 20 percent of new U.S. cases. And scientists in Oregon have identified a single case of a homegrown variant with the same spine as B.1.1.7 that carries a mutation that could blunt the effectiveness of vaccines.

Earlier this week, Texas and Mississippi, both Republican-led states, lifted mask mandates. President Biden denounced those moves as “a big mistake” that reflected “Neanderthal thinking,” saying it was critical for public officials to follow the guidance of doctors and public health leaders as the coronavirus vaccination campaign gains momentum.

Other Republicans have been more cautious. Gov. Mike DeWine of Ohio said he would lift all public health measures aimed at curbing the virus crisis, but only once new cases there drop under a certain threshold. In Alabama, Gov. Kay Ivey said she would extend the state’s mask mandate through April 9.

In Arizona, Gov. Doug Ducey has taken what he calls a “measured approach” requiring schools to offer in-person learning no later than March 15, barring local leaders from enacting measures that shut down businesses and allowing major league sports to restart if they receive approval from the state’s Department of Health Services.

Among Democrats, Gov. Gretchen Whitmer of Michigan said on Tuesday that she was easing restrictions on businesses and would allow family members who had tested negative for the coronavirus to visit nursing home residents. In California, the state’s public health department also loosened some restrictions Friday, saying that amusement parks could reopen on a limited basis as soon as April 1.

In New York City, limited indoor dining has returned. And on Thursday, Connecticut’s governor said the state would end capacity limits later this month on restaurants, gyms and offices. Masks remain required in both places.

Dr. Rochelle P. Walensky, the director of the Centers for Disease and Prevention, has implored states not to relax their restrictions yet. A new report from the C.D.C. found that counties that allowed restaurants to open for in-person dining in the United States had a rise in daily infections weeks after. The study also said that counties that issued mask mandates reported a decrease in virus cases and deaths within weeks.

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