AUCKLAND, New Zealand — Rawiri Jansen, a Maori doctor, had an urgent message for the 150 people, mostly patch-wearing members of New Zealand’s plentiful street gangs and their families, who sat before him on a bright Saturday afternoon.
Covid is coming for them, he said. Cases in New Zealand’s hospitals are rising rapidly. Soon, dozens of new infections a day might be hundreds or even a thousand. People will die. And vaccination is the only defense. “When your doctors are scared, you should be scared,” he said.
By the end of the day, after an exhaustive question-and-answer session with other health professionals, roughly a third of those present chose to receive a dose then and there.
Having abandoned its highly successful “Covid-zero” elimination strategy in response to an outbreak of the Delta variant, New Zealand is now undergoing a difficult transition to trying to keep coronavirus cases as low as possible. On Friday, the country set a target of getting at least 90 percent of the eligible population fully vaccinated — a goal, the highest in the developed world, whose success hinges on persuading people like those who gathered to hear Dr. Jansen.
intensely criticized, including by police leaders.
Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines. Pfizer and Moderna recipients who are eligible for a booster include people 65 and older, and younger adults at high risk of severe Covid-19 because of medical conditions or where they work. Eligible Pfizer and Moderna recipients can get a booster at least six months after their second dose. All Johnson & Johnson recipients will be eligible for a second shot at least two months after the first.
Yes. The F.D.A. has updated its authorizations to allow medical providers to boost people with a different vaccine than the one they initially received, a strategy known as “mix and match.” Whether you received Moderna, Johnson & Johnson or Pfizer-BioNTech, you may receive a booster of any other vaccine. Regulators have not recommended any one vaccine over another as a booster. They have also remained silent on whether it is preferable to stick with the same vaccine when possible.
The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.
The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.
Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.
Chris Hipkins, the minister responsible for New Zealand’s Covid-19 response, acknowledged earlier this month that the decision to enlist gang leaders was an unusual one.
“Our No. 1 priority here is to stop Covid-19 in its tracks, and that means doing what we need to do to get in front of the virus,” he said. “Where we have been able to enlist gang leaders to help with that, and where they have been willing to do so, we have done that.”
Some gang leaders have acted independently to help the vaccination effort. They have connected members of their community to health officials, organized events with health professionals like Dr. Jansen, and streamed events on Facebook Live to allow an open forum for questions about rare health risks. In some cases, they have taken vaccines to communities themselves.
“Our community is probably less well informed; they’re probably not as health literate,” said Mr. Tam, the Mongrel Mob member, who is a former civil servant and who received the border exemption. Constant media criticism has turned them off from reading traditional news outlets, he added.
“They then resort to social media, because they have much greater control,” he said. “It’s also a space that perpetuates conspiracy theories and false information and all the rest of it.” Health advice has to come from trusted individuals and leaders in the community, he said.
In the past week, Mr. Tam has traveled almost the length of the country organizing pop-up vaccination events for members and their communities, as well as coordinating with other chapter leaders to get their members vaccinated, he said.
It was difficult work that put him at personal risk, he said, and that invited intense skepticism from people who thought of gangs only as violent or connected to organized crime.
“Why do we bother?” Mr. Tam said. “We bother because we care about those people that others don’t care about, as simple as that. They can talk about my gang affiliation, all the rest of it. But it’s that affiliation that allows me to have that penetration, that foot in the door. I can do the stuff that they can’t do.”
OTTAWA — At times it was the Royal Canadian Mounted Police who came for them. Other times, it was a school van. However it happened, for generations, Indigenous families in Canada had no choice but to send their children to church-run residential schools established by the government to erode their culture and languages, and to assimilate them.
A national Truth and Reconciliation Commission declared in 2015 that the schools, which operated from 1883 to 1996, were a form of “cultural genocide.”
But the profound damage inflicted by the schools didn’t stop there. The commission cataloged extensive physical, sexual and emotional abuse at the schools, which were often overcrowded, understaffed and underfunded. Disease, fire and malnourishment all brought death and suffering.
Now, the national shame of the schools is again dominating the conversation in Canada.
Since May, new technology has enabled the discovery of human remains, mostly of children, in many hundreds of unmarked graves on the grounds of three former schools in Canada — two in British Columbia and one in Saskatchewan. Who they were, how they died or even when they died may never be fully known.
were forced to attend residential schools in a forced assimilation program. Most of these schools were operated by churches, and all of them banned the use of Indigenous languages and Indigenous cultural practices, often through violence. Disease, as well as sexual, physical and emotional abuse were widespread. An estimated 150,000 children passed through the schools between their opening and their closing in 1996.
The Missing Children: A National Truth and Reconciliation Commission, set up as part of a government apology and settlement over the schools, concluded that at least 4,100 students died while attending them, many from mistreatment or neglect, others from disease or accident. In many cases, families never learned the fate of their offspring, who are now known as “the missing children.”
The Discoveries: In May, members of the Tk’emlups te Secwepemc First Nation found 215 bodies at the Kamloops school — which was operated by the Roman Catholic Church until 1969 — after bringing in ground-penetrating radar. In June, an Indigenous group said the remains of as many as 751 people, mainly children, had been found in unmarked graves on the site of a former boarding school in Saskatchewan.
Cultural Genocide’: In a 2015 report, the commission concluded that the system was a form of “cultural genocide.” Murray Sinclair, a former judge and senator who headed the commission, recently said he now believed the number of disappeared children was “well beyond 10,000.”
Apologies and Next Steps: The commission called for an apology from the pope for the Roman Catholic church’s role. Pope Francis stopped short of one, but the archbishop of Vancouver apologized on behalf of his archdiocese. Canada has formally apologized and offered financial and other search support, but Indigenous leaders believe the government still has a long way to go.
“Something good has to come out of this,” Joey Desjarlais, 73, said outside the ruins of the Muskowekwan Indian Residential School in Saskatchewan, which he was forced to attend, as were his parents, grandparents and great-grandparents. “Our children need to learn about the residential school, what we went through and what went on in there but also to learn their culture, so at least they’ll get it back.”
The image below shows girls working in the kitchen at the Bishop Horden Memorial School in Moose Factory, Ontario, around 1940.
Boys at the Shingwauk Indian Residential School playing with handmade bows, and a game of table hockey, in the 1960s.
Boys say their prayers in the dormitory at the Bishop Horden Memorial School in Moose Factory, Ontario, in 1950.
Girls at a residential school in Fort Resolution, Northwest Territories, around 1936. It is estimated that roughly one-third of all Indigenous children were enrolled in the schools by the 1930s.
Boys and girls, in their first communion outfits, posing at Spanish Indian Residential School in Spanish, Ontario, in the 1960s.
LONDON — He suggested that a doctor inject him with the coronavirus live on television to play down the dangers to a nervous public. He modeled himself after the small-town mayor in the movie “Jaws,” who ignored warnings to close the beaches even though there was a marauding shark offshore. As the pandemic closed in on Britain, he was distracted by an unflattering story about his fiancée and her dog.
That was the portrait of Prime Minister Boris Johnson painted by his disaffected former chief adviser, Dominic Cummings, in parliamentary testimony on Wednesday. While Mr. Johnson flatly rejected several of the assertions in his own appearance in Parliament on Wednesday, they nevertheless landed with a thud in a country still struggling to understand how the early days of the pandemic were botched so badly.
“When the public needed us most, the government failed,” said Mr. Cummings, the political strategist who masterminded Britain’s campaign to leave the European Union and engineered Mr. Johnson’s rise to power before falling out bitterly with his boss and emerging as a self-styled whistle-blower.
a much-criticized road trip he made with his family that breached lockdown rules, saying he had fled London because of threats against his family. And he apologized for his failure to act sooner when he realized that Britain’s delay in imposing a lockdown last March was courting disaster.
“It’s true that I hit the panic button and said we’ve got to ditch the official plan,” Mr. Cummings said. “I think it’s a disaster that I acted too late. The fundamental reason was that I was really frightened of acting.”
testing 100,000 people a day. Mr. Cummings said he told Mr. Johnson to dismiss Mr. Hancock, as did the then-cabinet secretary, Mark Sedwill.
move patients from hospitals to nursing homes without testing them.
“Hancock told us that people were going to be tested before they went back to care homes, what the hell happened?” he said. “Quite the opposite of putting a shield round them, we sent people with Covid back to the care homes.”
A spokesman for Downing Street said on Wednesday that Mr. Johnson did not believe Mr. Hancock had lied to him.
reported by the BBC but denied by Downing Street.
Asked if Mr. Johnson was the right person to guide the country through the pandemic, Mr. Cummings responded simply: “No.”
This morning, I am going to tell you another story about the C.D.C. and its approach to Covid-19 behavioral guidelines. It’s a story that highlights the costs of extreme caution.
When Dr. Rochelle Walensky, the C.D.C. director, appeared before a Senate committee this month and defended the agency’s description of how often Covid-19 is transmitted outdoors, she cited a single academic study.
She was responding to a question from Senator Susan Collins of Maine, who had asked why some C.D.C. guidelines seemed inconsistent with the available data. Collins quoted from that day’s edition of this newsletter and argued that the C.D.C. was exaggerating the risk of outdoor activities by claiming that “less than 10 percent” of Covid transmission occurred outside.
Anything close to 10 percent would mean that outdoor infections were a huge problem. Yet the true share appears to be closer to 0.1 percent.
a study published in The Journal of Infectious Diseases. The study was “a meta-analysis,” she explained, which means it synthesized data from other studies. “The topline result of all studies that were included in the systematic review said less than 10 percent of cases were transmitted outdoors,” she said.
Her answer made the study sound definitive. Walensky did not mention any other studies or offer any logical argument for why she believed outdoor transmission was a significant risk. She implied that the C.D.C. was simply listening to The Journal of Infectious Diseases, which, as she noted, is a top journal.
Later that day, one of the study’s authors posted several messages on Twitter, and the story got more complicated.
‘An amazing resource’
The tweets came from Dr. Nooshin Razani, an epidemiologist at the University of California, San Francisco. In them, she emphasized that the study’s results suggested that the share of Covid occurring outdoors was “much lower than 10 percent.” The central message of the paper, Razani wrote, was the relative safety of the outdoors:
in her testimony, had used the two terms interchangeably.)
Singapore construction workers who probably transmitted it in enclosed spaces.)
The actual share occurring outdoors is “probably substantially less than 1 percent,” Razani told me. “The outdoors is an amazing resource,” she added. “What we really should be focused on is how to transition more activities to be outdoors.”
Masks for all campers
Yet the C.D.C.’s guidance continues to treat outdoor activities as a major risk — as if the truth were closer to 10 percent than 0.1 percent.
The agency advises unvaccinated people to wear masks outdoors much of the time, and many communities still impose strict guidelines on outdoor activities. The C.D.C. has also directed virtually everyone attending summer camp this year — counselor or camper, vaccinated or not — to wear a mask at almost all times. The camp guidelines use the word “universal.”
It’s true that for many people, masks are a minor nuisance. For others, though, masks bring real costs. Some children find it harder to breathe while wearing one during, say, a game of soccer or tag. Many adults and children find it more difficult to communicate. That’s especially true for people without perfect hearing and for young children, both of whom rely heavily on facial movements to understand others.
has written, is often “like talking on your phone in a zone with weak cell service.”
No free lunch
For unvaccinated adults indoors or in close conversation outdoors, the costs of a mask are vastly lower than the risks from Covid. But the trade-offs are different in most outdoor settings, and they are different for children. The Covid risks for children are similar to those from a normal flu (as these charts show).
There does not appear to be much scientific reason that campers and counselors, or most other people, should wear a mask outdoors all summer. Telling them to do so is an example of extreme caution — like staying out of the ocean to avoid sharks — that seems to have a greater cost than benefit.
The C.D.C., as I’ve written before, is an agency full of dedicated people trying their best to keep Americans healthy. Walensky, a widely admired infectious-diseases expert, is one of them. Yet more than once during this pandemic, C.D.C. officials have acted as if extreme caution has no downsides.
Everything has downsides. And it is the job of scientific experts and public-health officials to help the rest of us think clearly about the benefits and costs of our choices.
THE LATEST NEWS
They’re on the menu.
Like a boss: Meet Beyoncé’s go-to stylist.
Not who she says: A scholar faked her Cherokee ancestry. Her career has thrived.
A Times classic: See how climate change is weakening the Gulf Stream.
Lives Lived: As a performer, writer and director, Robbie McCauley often put race at the center of her works. “Our nation is starving for the kinds of courageous conversation that Robbie and her work engendered,” a fellow artist said. McCauley died at 78.
ARTS AND IDEAS
baked feta pasta and dalgona coffee — as well as a new generation of cooking stars who are largely self-taught, preparing meals in their home kitchens.
Within 24 hours of posting his first TikTok in 2019, Eitan Bernath, now 19, had tens of thousands of followers. His upbeat and approachable food videos have since earned him over a million more, and he has three full-time employees, as well as a gig as a resident culinary expert on “The Drew Barrymore Show.”
Other up-and-coming food creators are making six figures through the app and sponsorships, often using TikTok fame to launch cookware lines, cookbooks and more.
Read Taylor Lorenz’s full story. — Sanam Yar, a Morning writer
In late 1910, a deadly plague started spreading in the northeast reaches of China, reaching the large city of Harbin. Tens of thousands of people coughed up blood; their skin pruned and turned purple. They all died.
This outbreak sent the Qing government into a tailspin: They didn’t know what illness was causing these deaths, let alone how to control it. So they brought in one of the best trained doctors in Asia at the time, Dr. Wu Lien-Teh. After performing autopsies, Dr. Wu found Yersinia pestis, a bacterium similar to the one that had caused bubonic plague in the West. He recognized Manchuria’s plague as a respiratory disease and urged everyone, especially health care professionals and law enforcement, to wear masks.
Chinese authorities, heeding his call, coupled masking with stringent lockdowns enforced by the police. Four months after the doctor was summoned, the plague ended. Although often overlooked in Western countries, Dr. Wu is recognized in world history as a pioneer of public health, helping to change the course of a respiratory disease spread by droplets that could have devastated China in the early 20th century, and perhaps spread far beyond its borders.
While the Chinese of that era complied with these strategies, public health professionals in the United States and other Western countries have struggled to get people to listen to themduring the Covid-19 pandemic. China, too, ran into challenges early on, but the country’s institutional memory from previous viral outbreaks helped turn the tide. And as many Americans abandon masking, push to restore normality in places where risks of infection remain high and hesitate to get vaccinated, some public health experts have looked to Dr. Wu’s success, seeking lessons on handling not only Covid, but also future epidemics.
masks became a political flash point in the United States and elsewhere during the Spanish flu pandemic, the idea of using them persisted in China, and gauze masks became an important tool in the political agenda of the Nationalist Party when it took over in 1928. Public health officials recommended all citizens wear gauze masks in public spaces during outbreaks of meningitis or cholera.
Kyle Legleiter, the senior director of policy advocacy at The Colorado Health Foundation.
Another factor that might have contributed to Dr. Wu’s success in China would be the reverence residents and officials had for him as a figure of authority, Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, said.
In some ways, Dr. Anthony Fauci, the chief medical adviser on Covid to President Biden and a prominent public health figure since the 1980s, served in a role similar to the one Dr. Wu played in China, Dr. Huang said. But, his message perhaps didn’t always get through because Americans are more polarized in their political identities and beliefs.
Dr. Legleiter added that public health messaging only penetrates if the public identifies with or trusts that figure of authority.
“An individual person is a stand-in for a broader set of institutions or systems that they’re speaking on the behalf of,” Dr. Legleiter said. Those who lean conservative, for instance, may put Dr. Fauci and other scientists in the category of “the elites.” As such, they’re more likely to flout public health policies that such authority figures promote, and comply with proclamations from individuals they identify with the most.
Others say that public health is intrinsically tied to the legitimacy of the state promoting it. At the turn of the 20th century, China was in distress, Dr. Hanson said. Dr. Wu helped bring China out of a tumultuous period, and the enforcement of public health measures gave the country more legitimacy.
Similarly, because the current pandemic has laid bare shortcomings in the public health systems in the United States, Britain and other Western countries, some experts believe it can be a catalyst for change.
“Since the mid-19th century, the West has generally seen its ability to control infectious disease as a marker of their civilizational superiority over much of the rest of the world,” Dr. White said. While China was seen as the sick man of the world then, some commentators in China now attempt to brand the United States with that label.
Ruth Rogaski, a medical historian at Vanderbilt University who specializes in studying the Qing dynasty and modern China, believes that the coronavirus crisis similarly offers an opportunity for reflection, which can be very motivating.
“Epidemics can serve as inflection points,” Dr. Rogaski said. “Opportunities to rethink, retool and even revolutionize approaches to health.”
These are some of the hardest cases, because children under 12 seem to be months away from being vaccinated.
There are a few reassuring facts for these families. First, in many of the places where children spend time, Covid transmission is uncommon. It is extremely rare outdoors, and springtime is a good time to be outdoors. The number of outbreaks in schools has also been quite low worldwide, perhaps because children may be less likely to infect others even when they have Covid.
Most reassuring is the fact that Covid is no more serious for children on average than the flu. I have written an article, with charts, that goes into more detail. As I explain, some parents may still choose to be extremely cautious, while others will be more comfortable with normalcy. Both decisions are defensible. Here’s an interview from that article:
Jennifer Nuzzo, an epidemiologist at Johns Hopkins, told me that she viewed decisions about children’s activities as a matter of personal choice that different parents would make differently. In her family, she said she was worried about how a year of pandemic life had hurt her children, by making them less comfortable in social situations. Once all the adults are vaccinated, she plans to restart more activities.
“I can accept the risks of my kids getting Covid, in part because I compare it to the risk of them getting other infectious diseases and the risk seems very, very small,” Dr. Nuzzo said. “I feel that if my kids were to get Covid, they would be OK. I also see the direct harms of their not having a normal life.”
4. The unvaccinated
About 40 percent of U.S. adults have not yet received a vaccine shot. For the country to reduce that number as rapidly as possible, it’s important to acknowledge reality: The vast majority are unvaccinated by choice.
They do not have health problems that prevent them from getting a shot, and they have not been stymied by the logistics of getting a shot. Yes, there are people in both of those groups, and they will need special help as society begins to reopen. Among other things, the Biden administration, state officials and employers will need to keep pushing to make vaccination even more convenient.
But the much larger issue is vaccine skepticism.
In the most recent poll by the Kaiser Family Foundation, 15 percent of adults said they did not want to get a shot until they knew more about how it affected other people. Another 6 percent said they would get a shot only if required (say, by their employer), and an additional 13 percent said they would definitely not get a shot. Put those three numbers together, and you get 34 percent — which, again, accounts for most of the unvaccinated 40 percent.
Unvaccinated people do face some additional risk from the hypothetical example that many people have been talking about since the C.D.C. changed its guidelines: the unvaccinated person who was wearing a mask in stores and avoiding restaurants until last week but no longer will.
“I don’t know if it’ll solve it in the long run,” said Mr. Gigante of Proskauer Rose. “But I do think that’s what we’re talking to people about and talking to clients about.”
Requiring tests before an employee can come to work doesn’t fully protect other employees from contracting the disease. Tests vary in accuracy, and results refer only to the moment tests were administered. The more frequent the tests, the more informative they are. Mr. Gigante said he most commonly hears of companies mandating tests twice a week, though some situations, like a movie set or a courtroom, may require daily testing.
Some companies may not want to deal with considerations that come with such a program — like the cost, the need to figure out where and how to administer the tests, and the headache of keeping track of the results.
“Logistics and costs were making it less likely to be relied on by employers as an avenue, but as tests are becoming more available and less expensive, employers are looking at testing as a good layer of protection,” said David Schwartz, who runs the labor group at the law firm Skadden, Arps, Slate, Meagher & Flom.
Can employee wellness programs reward vaccinations?
Laura Godfrey in Saugatuck, Mich., is curious about the relationship between vaccinations and employee health care plans. “Companies have been focused on wellness to a determined level,” she writes. “So to ask for a vaccine seems reasonable.”
“It’s definitely something that’s on a lot of employers’ minds,” said Emily Zimmer, a partner who specializes in employee benefits at the law firm Troutman Pepper.
That’s particularly the case for companies with established wellness programs, she said. For example, if a company already rewards employees who receive annual flu shots, it would be easier to do the same for employees who receive the Covid-19 vaccine.
The world’s first mass coronavirus inoculation campaign for children kicked off in earnest in the United States on Thursday after the federal government recommended making the Pfizer-BioNTech vaccine available to those aged 12 to 15.
Even as the decision was embraced by millions of parents wearied by pandemic restrictions and desperate to get their children back into classrooms, states, counties and school districts around the country were trying to figure out the most reassuring and expedient ways to offer the shots.
The various authorities were making plans to offer vaccines not only in schools, but also at pediatricians’ offices, day camps, parks and even beaches.
President Biden, who hailed the vaccine as “safe, effective, easy, fast and free,” said that as many as 20,000 pharmacies stood ready to start giving shots on Thursday.
recommend use of the vaccine.
Some states, including Delaware, Georgia and Maine, had already started to offer doses to children after the authorization of the vaccine by the Food and Drug Administration on Monday.
But the ruling by the C.D.C. was the final step in the federal process that allows for widespread inoculations of the roughly 17 million children in the United States ages 12-15.
For many parents, it could not come too soon. About one-third of eighth graders, usually 13 or 14 years old, are still in remote learning.
But the authorities must also overcome a significant amount of hesitancy. A recent survey by the Kaiser Family Foundation found that many parents — even some who eagerly got their own coronavirus shots — were reluctant to vaccinate pubescent children.
health authorities require anyone younger than 18 to be accompanied by a parent, guardian or responsible adult and to present photo identification and verification of age, county officials said.
In Maine, a parent does not need to be with the child as long as the adult provides permission over the phone or signs a form beforehand.
Federal and local officials said that there should be no problem with supply meeting demand. The expansion of the U.S. vaccination effort underscored the widening gulf in the world’s inoculation campaigns even as the pandemic gathers force in several regions.
Referring to the global situation, Dr. Oliver Morgan, director of the risk assessment department at the W.H.O., said on Wednesday, “Throughout the month of March and April, there has been a steady increase in the number of cases each week and the weekly number of cases is now higher than any time in the pandemic.”
At the same time, many of the countries being walloped by the virus — and those where the threat of new outbreaks is growing — have not been able to secure vaccines to inoculate even health workers or those most at risk of serious illness and death.
Research shows that children are mostly spared severe disease and are not significant drivers of coronavirus spread, as they are for influenza, for example.
Young children are thought to spread the virus less often than adults do, but their ability to transmit increases with age. Teenagers may transmit the virus as readily as adults.
Vaccinating children is viewed as an important increase to the level of immunity in a population, driving down the number of cases broadly, while offering protection to more people.
While risk of severe illness in youngsters is low compared with that in adults, the coronavirus has infected more than 1.5 million children and sent more than 13,000 to hospitals, more than are hospitalized for flu in an average year, according to data collected by the C.D.C.
Once Americans return to crowded offices, schools, buses and trains, so too will their sneezes and sniffles.
Having been introduced to the idea of wearing masks to protect themselves and others, some Americans are now considering a behavior scarcely seen in the United States but long a fixture in other cultures: routinely wearing a mask when displaying symptoms of a common cold or the flu, even in a future in which Covid-19 isn’t a primary concern.
“I will still feel a responsibility to protect others from my illness when I have a cold or bronchitis or something along those lines,” said Gwydion Suilebhan, a writer and arts administrator in Washington who said he also plans to continue wearing masks in situations like flying on airplanes. “It’s a responsible part of being a human in a civil society to care for the people around you.”
Such routine use of masks has been common for decades in other countries, primarily in East Asia, as protection against allergies or pollution, or as a common courtesy to protect nearby people.
Meet the Press.”
Other leading American health officials, however, have not encouraged the behavior. The Centers for Disease Control and Prevention — which at the beginning of the pandemic advised against wearing masks, and only changed its guidance a couple of months later — does not advise people with flu symptoms to wear masks, and says they “may not effectively limit transmission in the community.”
That’s partly because there’s no tidy scientific consensus on the effect of masks on influenza virus transmission, according to experts who have studied it.
Nancy Leung, an epidemiologist at the University of Hong Kong, said that the science exploring possible links between masking and the emission or transmission of influenza viruses was nuanced — and that the nuances were often lost on the general public.
randomized controlled trials — the gold standard in scientific research — that masking reduced transmission of influenza viruses in a community.
There was some evidence from observational studies that masks reduced community transmission of influenza viruses, she added, but that research had a caveat: Observational studies cannot isolate masking from other possible factors, such as hand hygiene or social distancing.
“You can’t really decipher whether that observed reduction in transmission is due to face masks alone or not,” Dr. Leung said.
For similar reasons, the fact that the flu all but vanished in the United States during the coronavirus pandemic — and that many Americans anecdotally reported that they caught fewer colds than usual in 2020 — is not evidence alone that masks were responsible.
In East Asia, the historical use of masks is based on more than just medical research, and the steps that led each country to adopt them vary widely.
Please sneeze into your elbow, not your hand.)
Others pointed to institutional differences, including a history of anti-masking laws in the United States that were implemented during periods of social unrest in order to discourage violence.
New York State, for example, passed an anti-masking law in 1845 to prevent tenants from demanding land reform, according to research by Sharrona Pearl, a professor of medical ethics at Drexel University in Philadelphia. And from the 1920s to 1950s, several states passed similar laws in response to violence by the Ku Klux Klan.
Several East Asian scholars said in interviews that the region’s mask-wearing customs varied widely because people in each country had responded over the years to different epidemiological or environmental threats.
Jaehwan Hyun, a professor of history of Pusan National University in South Korea, said that ignoring the nuances could be dangerous.
seasonal dust storms that sweep into the country from Mongolia and northern China.
“Generally speaking, Koreans until recently believed that mask wearing was a sort of ‘Japanese practice,’ not ours,” he said.
In Hong Kong, where 299 people died during the SARS epidemic of 2002-3, the experience of universal masking against that coronavirus helped create a “cultural familiarity” with a practice that was also common during episodes of severe air pollution, Mr. De Kai said.
“It was a big reminder to people that masks are important not only to protect yourself from the pollution but also to avoid infecting those around you,” he said.
In Taiwan, SARS and recent air pollution were the two main factors that prompted people there to develop the habit of mask wearing, said Yeh Ming-Jui, a professor of public health at National Taiwan University in Taipei.
Professor Yeh said he believed mask wearing was not more widespread in the West because people there had no immediate memories of a severe pandemic — at least until now.
“The experience and health practices of past generations have been gradually forgotten,” he said.
Amy Chang Chien contributed reporting from Taipei.
The federal government on Wednesday took a final step toward making the Pfizer-BioNTech coronavirus vaccine available to adolescents in the United States, removing an obstacle to school reopenings and cheering millions of families weary of pandemic restrictions.
An advisory committee to the Centers for Disease Control and Prevention votedto recommend the vaccine for use in children ages 12 to 15. The C.D.C. director, Dr. Rochelle Walensky, is expected to review the recommendations and approve them later on Wednesday.
“Approving Covid-19 vaccines for children 12 to 15 years of age is an important step in removing barriers for vaccinating children of all ages,” said Dr. Yvonne Maldonado, who represents the American Academy of Pediatrics on the federal Advisory Committee on Immunization Practices.
Many parents are eagerly anticipating the availability of vaccines for children, at least in part to speed their return to schools. Roughly one-third of eighth graders, usually 13 or 14 years old, are still learning fully remotely.
at least as effective in 12- to 15-year-olds as it has been in older teenagers and adults. Apart from a slight increase in the frequency of fevers, the shots also seemed to have comparable, mostly negligible side effects.
The company plans to continue monitoring trial participants for two years after the second dose to assess the vaccine’s long-term safety and efficacy.
The Food and Drug Administration reviewed the clinical data and on Monday authorized the Pfizer vaccine for use in these children, capping weeks of anticipation from parents and children about a swifter return to normalcy.
“While it’s true that children are generally spared from severe disease, the fact that they’ve been unable to be vaccinated has caused major disruptions in their lives that have real developmental consequences,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “Vaccination of this age cohort will allow these children to more fully return to their normal lives.”
about 20,000 pharmacies nationwide are expected to offer the vaccine for free to these children.
survey by the Kaiser Family Foundation.
Some of those parents may change their minds, as other children safely receive vaccines and resume in-person schooling, or rejoin team sports like football and basketball that involve close contact, the researchers suggested.
Others may wait until they must comply with school requirements. Public schools in all 50 states require certain vaccines, but officials may not be able to enforce compliance until the Pfizer-BioNTech vaccine gains the F.D.A.’s full approval.
The vaccine has emergency authorization now. Pfizer has applied to the F.D.A. for full approval, but that process is expected to take several months. Even after approval, students may still opt out by citing medical reasons or religious beliefs.
State and local leaders will need to make particular efforts to reach children in low-income families or in communities of color. Black and Hispanic adults have among the lowest rates of vaccination: As of May 3, just 25 percent of Black people and 27 percent of Hispanic people had been inoculated, compared with 39 percent of white people.
Making the vaccine accessible to these communities will require easier transportation and storage of doses. The Pfizer-BioNTech vaccine can be stored for only five days in standard refrigerators. The companies are planning to ship smaller packs for use in doctors’ offices, and are developing a formulation that can be refrigerated for up to 10 weeks.
Pfizer and BioNTech plan in September to submit requests for authorization of the vaccine in children ages 2 to 11.