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Covid-19 Live Updates: Heart Problems After Vaccination Are Exceedingly Rare, Federal Researchers Say

Credit…Hannah Beier/Reuters

The coronavirus vaccines made by Pfizer-BioNTech and Moderna may have caused heart problems in more than 1,200 Americans, including about 500 who were younger than age 30, according to data reported on Wednesday by researchers at the Centers for Disease Control and Prevention.

Still, the benefits of immunization greatly outweigh the risks, advisers to the C.D.C. said. They strongly recommended vaccination for all Americans 12 and older.

The heart problems are myocarditis, inflammation of the heart muscle; and pericarditis, inflammation of the lining around the heart. The risk is higher after the second dose of an mRNA vaccine than the first, and much higher in men than in women. Researchers do not know why.

But the side effect is very uncommon, just 12.6 cases per million second doses administered.

C.D.C. researchers estimated that every million second doses given to boys ages 12 to 17 might cause a maximum of 70 myocarditis cases, but would prevent 5,700 infections, 2,215 hospitalizations and two deaths.

Agency researchers presented the data to members of the Advisory Committee on Immunization Practices, which makes recommendations on vaccine use in the United States. (The scientists grouped together pericarditis and myocarditis for reporting purposes.)

Most cases were mild, with symptoms like fatigue, chest pain and disturbances in heart rhythm that quickly cleared up, the researchers reported. Of the 484 cases reported in Americans under age 30, the C.D.C. has definitively linked 323 cases to vaccination. The rest remain under investigation.

“These events are really very rare, extremely rare,” said Dr. Brian Feingold, an expert on heart inflammation in children at the UPMC Children’s Hospital of Pittsburgh. “That needs to be taken in context with illness and morbidity and mortality related to Covid.”

Separately, more than a dozen federal and professional medical organizations said in a joint statement on Wednesday that myocarditis “is an extremely rare side effect, and only an exceedingly small number of people will experience it after vaccination.”

The C.D.C. advisers met as the Biden administration publicly acknowledged that it expected to fall short of its goal of getting 70 percent of Americans partly vaccinated by July 4. The shortfall, officials said on Tuesday, resulted in part from reluctance among younger Americans to be immunized.

It’s unclear what causes myocarditis, or why it is more common in young men than in women. The first cases linked to coronavirus vaccines were reported in Israel, mostly among young men aged 16 to 19 years. Israel recorded 148 cases between December and May, 95 percent of them mild.

In the United States, too, myocarditis has been more common in men and boys: Up to 80 percent of cases after the second dose were in males. There has also been a clear age difference, with the side effect clustered in individuals in their late teens and early 20s.

The vast majority of patients with myocarditis recovery fully, noted Dr. James de Lemos, a cardiologist at the University of Texas Southwestern Medical Center in Dallas, who reported one of the first cases in January.

Covid-19 itself may cause heart problems in young people. A large study of collegiate athletes showed that 2.3 percent of those who had recovered from Covid-19 had heart abnormalities consistent with myocarditis.

“It’s going to be many-fold more common to get heart muscle inflammation from getting Covid than you would from getting a vaccine, even in young men,” Dr. de Lemos said.

Vaccination is becoming an even more urgent priority, given more contagious variants of the coronavirus now circulating in the United States, Dr. Paul Offit, a pediatrician at the Children’s Hospital of Philadelphia and a member of the Food and Drug Administration’s vaccine safety committee, said in an interview.

“We are not close to being near where we need to be” in terms of the percentage of the population that should be vaccinated, Dr. Offit said. “And you’re going to head into winter when you’re going to have a generally under vaccinated population.”

The Biden administration plans to extend the national moratorium on evictions through July, officials said. Activists in Brooklyn called in May for an extension of New York State’s eviction moratorium.
Credit…Justin Lane/EPA, via Shutterstock

The Biden administration plans to extend the national moratorium on evictions, scheduled to expire on June 30, by one month to buy more time to distribute billions of dollars in federal pandemic housing aid, according to two officials with knowledge of the situation.

The moratorium, instituted by the Centers for Disease Control and Prevention last September to prevent a wave of evictions spurred by the economic downturn associated with the coronavirus pandemic, has significantly limited the economic damage to renters and sharply reduced eviction filings.

Congressional Democrats, local officials and tenant groups have been warning that the expiration of the moratorium at the end of the month, and the lapsing of similar state and local measures, might touch off a new — if somewhat less severe — eviction crisis.

President Biden’s team decided to extend the moratorium by a month after an internal debate at the White House over the weekend. The step is one of a series of actions that the administration plans to take in the next several weeks, involving several federal agencies, the officials said.

Other initiatives include a summit on housing affordability and evictions, to be held at the White House later this month; stepped-up coordination with local officials and legal aid organizations to minimize evictions after July 31; and new guidance from the Treasury Department meant to streamline the sluggish disbursement of the $21.5 billion in emergency aid included in the pandemic relief bill in the spring.

White House officials, requesting anonymity because they were not authorized to discuss the issue publicly, said that the one-month extension, while influenced by concerns over a new wave of evictions, was prompted by the lag in vaccination rates in some parts of the country and by other factors that have extended the coronavirus crisis.

Forty-four House Democrats wrote to Mr. Biden and the C.D.C. director, Dr. Rochelle P. Walensky, on Tuesday, urging them to put off allowing evictions to resume. “By extending the moratorium and incorporating these critical improvements to protect vulnerable renters, we can work to curtail the eviction crisis disproportionately impacting our communities of color,” the lawmakers wrote.

A spokesman for the C.D.C. did not immediately reply to a request for comment.

Many local officials have also pressed to extend the freeze as long as possible, and are bracing for a rise in evictions when the federal moratorium and similar state and city orders expire over the summer.

Gov. Gavin Newsom of California announced on Monday that his state had set aside $5.2 billion from federal aid packages to pay off the back rent of tenants who fell behind during the pandemic, an extraordinary move intended to wipe the slate clean for millions of renters.

Still, groups representing private landlords maintain that the health crisis that justified the freeze has ended, and that continuing the freeze even for an extra four weeks would be an unwarranted government intrusion in the housing market.

“The mounting housing affordability crisis is quickly becoming a housing affordability disaster fueled by flawed eviction moratoriums, which leave renters with insurmountable debt and housing providers holding the bag,” said Bob Pinnegar, president of the National Apartment Association, a trade group representing owners of large residential buildings.

Representative James Clyburn, Democrat of South Carolina, speaking during a hearing about Emergent in Washington in May.
Credit…Pool photo by Susan Walsh

Congressional investigators are expanding their inquiry of Emergent BioSolutions, the operator of a troubled Maryland vaccine-making plant, to encompass the firm’s relationship with the two companies that hired it to produce their shots.

In letters dated Tuesday, two House panels asked the companies, AstraZeneca and Johnson & Johnson, to document their efforts to supervise production of their vaccines at Emergent’s factory and to produce all records related to their decisions to hire Emergent as a subcontractor.

The plant, in southeastern Baltimore, has been forced to throw out the equivalent of 75 million doses of Johnson & Johnson’s coronavirus vaccine because of suspected contamination. Deliveries of more than 100 million other doses of both vaccines have been delayed for weeks while regulators check them. The plant has been closed since mid-April while Emergent tries to meet the regulators’ demands to bring its manufacturing up to standard.

The congressional panels began a joint investigation of Emergent’s operations after The New York Times documented months of problems at the Baltimore plant, including a failure to properly disinfect equipment and to protect against viral and bacterial contamination. Among other matters, Democratic lawmakers are looking into whether the company leveraged its contacts with a top Trump administration official, Dr. Robert Kadlec, to win the business of vaccine production, and whether federal officials failed to oversee the firm’s work.

The investigation is being run by the Committee on Oversight and Reform, headed by Carolyn B. Maloney, a New York Democrat, and the Select Subcommittee on the Coronavirus Crisis, headed by James E. Clyburn, a Democrat from South Carolina.

“We are troubled by the impact Emergent’s manufacturing errors have had on the availability of coronavirus vaccine doses, as well as the potential effect on public perceptions regarding the safety and efficacy of these vaccines,” the lawmakers said in the nearly identical letters to the two vaccine developers. “We are also concerned about the circumstances that led AstraZeneca and Johnson & Johnson to sign contracts with Emergent,” they wrote.

At a congressional hearing last month, Emergent’s founder and executive chairman, Fuad El-Hibri, testified that the Trump administration had been well aware of the risks of relying on the Baltimore plant. “Everyone went into this with their eyes wide open, that this is a facility that had never manufactured a licensed product before,” he said.

Confidential audits obtained by The Times show that both Johnson & Johnson and AstraZeneca — as well as the division of the Department of Health and Human Services that oversees Emergent’s contract — all found deficiencies at the plant last summer. AstraZeneca’s audit said that the firm had not documented that it had mitigated “high risk” hazards of contamination. It also said that Emergent repeatedly loosened monitoring criteria so it appeared to meet them, but even then failed the tests.

Johnson & Johnson’s audit said that the firm’s “contamination control strategy is deficient” and that monitoring reports for bacteria or other contaminants were filed four to six months late. Emergent has said that it takes all such observations seriously and works expeditiously to address them.

The federal government agreed in May 2020 to pay Emergent $628 million, much of that to reserve production capacity at the Baltimore plant. It also signed billion-dollar contracts with Johnson & Johnson and AstraZeneca for the doses that Emergent was supposed to produce, and Emergent signed production contracts with the vaccine developers that were expanded in multiyear agreements in July 2020.

Federal officials have now stripped Emergent of its responsibility to manufacture AstraZeneca’s vaccine, lessening the firm’s payments by at least $18 million a month. The factory is expected to eventually reopen and resume manufacturing Johnson & Johnson’s vaccine.

The main port area in Patmos, Greece in May.
Credit…Byron Smith/Getty Images

Residents of the European Union should be fully vaccinated against the coronavirus as quickly as possible this summer, the European Center for Disease Prevention and Control warned on Wednesday, as concerns grew that the contagious Delta variant would sweep across the bloc.

Andrea Ammon, the agency’s director, said the variant was expected to account for 90 percent of all coronavirus cases in the European Union by the end of August. The variant has already spread to 23 European countries; in some it is linked to a limited share of cases, but it is responsible for more than 66 percent of new cases in Portugal, which has faced a recent surge of infections. In Moscow, 90 percent of new cases are reported to be the Delta variant, according to the local authorities.

“Unfortunately, preliminary data shows that it can also infect individuals that have received only one dose of the currently available vaccines,” Dr. Ammon said. “It is very likely that the Delta variant will circulate extensively during the summer, particularly among younger individuals that are not targeted for vaccination.”

The Delta variant is unlikely to pose much risk to people who have been fully vaccinated, experts said. According to one recent study, the Pfizer-BioNTech vaccine was 88 percent effective at protecting against symptomatic disease caused by Delta, nearly matching its 93 percent effectiveness against the Alpha variant. But a single dose of the vaccine was just 33 percent effective against Delta, the study found.

After a sluggish start, the distribution of vaccines in the European Union has sped up in recent months. Even so, around 30 percent of residents over 80 years old and around 40 percent of those over 60 have yet to be fully vaccinated, according to the center.

Most E.U. countries have not yet fully vaccinated one-third of their total populations: the average is about 27 percent.

Chancellor Angela Merkel of Germany said on Wednesday that her country’s entire population will have been offered at least one dose of a vaccine by Sept. 21 if vaccine deliveries arrive as planned.

Public health officials have said that Delta may be 50 percent more contagious than Alpha, though precise estimates of its infectiousness vary. The European Center for Disease Prevention and Control estimates that Delta is between 40 and 60 percent more transmissible.

The warning on Tuesday brought a feeling of déjà vu: Last summer, a rise of cases among younger populations in some European countries and the United States led to new lockdown measures and a surge of infections among older people. But vaccines are driving down coronavirus case numbers in most of the United States, and it’s unclear whether Delta will reverse that trend.

The Delta variant has been detected in at least 85 countries to date, and public health experts say a surge of new cases in Britain in recent weeks has been driven in part by the variant. Dr. Hans Kluge, the World Health Organization’s regional director for Europe, said this month that the variant was “poised to take hold” in Europe.

The European Union is set to launch a bloc-wide program for proof of vaccination — the so-called digital green certificate — on July 1. Its purpose is to allow residents to travel freely within the bloc if they have been fully vaccinated, have proof of a recent negative test, or have recovered from Covid-19, although individual countries can impose their own restrictions.

Under recommendations issued last week by the European Union, American visitors would be able to travel to countries of the bloc if they can show a proof of vaccination or a recent negative test.

Tumon Bay, near Hagatna, Guam. Tourists who want to visit the island and get their coronavirus shots will need to book a package from a participating government-approved hotel.
Credit…Tassanee Vejpongsa/Associated Press

The U.S. territory of Guam has begun offering Covid vaccinations to travelers from any country in a bid to lift tourism to the island.

On Tuesday, the authorities in Guam announced that a program called Air V&V, which previously allowed U.S. citizens to visit and get vaccinated, would now be open to international tourists age 12 and over.

The program aims mostly at countries in the Asia-Pacific region, where the rollout of vaccines has been relatively slow. The first three tourists will arrive from Taiwan on Wednesday evening, according to the Guam-based Pacific Daily News. Early next month, three more flights from Taiwan are set to bring about 500 passengers, another local news outlet, the Guam Daily Post, reported.

Carl Gutierrez, president of the island’s visitor bureau, said in a statement, “This program captures a unique demographic of travelers around the world that are tired of waiting to get vaccinated in this pandemic.”

Visitors will need to book a package from a participating government-approved hotel, which includes accommodation, meals, transportation to and from the airport, coronavirus tests, health monitoring and two doses of a vaccine. Participants can choose from the vaccines made by Pfizer and Moderna, which require two doses, or the “one and done” shots from Johnson & Johnson.

The travelers are required to present a negative coronavirus test result before departing their home country and must quarantine for seven days upon arrival in Guam. They will receive a first vaccine shot on their second day on the island.

But it is not a cheap vacation for visitors who opt for a vaccine that requires two doses and who remain on the island for three weeks to get both: Hotel rooms are about $150 to $350 a night, while the additional coronavirus measures cost a flat rate of $880 per person.

About 71 percent of Guam’s population of 169,000 has had at least one vaccine dose, while 63 percent are fully inoculated.

A medical staff member holding samples from patients infected by Covid-19 in Wuhan, China, in March 2020.
Credit…Agence France-Presse — Getty Images

About a year ago, genetic sequences from more than 200 virus samples from early cases of Covid-19 in China mysteriously disappeared from an online scientific database.

Now, by rooting through files stored on Google Cloud, a researcher in Seattle reports that he has recovered 13 of those original sequences — intriguing new information for discerning when and how the virus may have spilled over from a bat or another animal into humans.

The new analysis, released on Tuesday, bolsters earlier suggestions that a variety of coronaviruses may have been circulating in Wuhan before the initial human outbreaks linked to animal and seafood markets in December 2019.

As the Biden administration investigates the contested origins of the virus, known as SARS-CoV-2, the new study neither strengthens nor discounts the hypothesis that the pathogen leaked out of a famous Wuhan lab. But it does raise questions about why original sequences were deleted from the open database, which is run by the National Institutes of Health, and suggests that there may be more revelations to recover from the far corners of the internet.

Jesse Bloom, a virologist at the Fred Hutchinson Cancer Research Center who wrote the new report, called the deletion of these sequences suspicious. It “seems likely that the sequences were deleted to obscure their existence,” he wrote in the paper, which has not yet been peer-reviewed or published in a scientific journal.

Dr. Bloom belongs to an outspoken group of scientists who have called for more research into how the pandemic began. In a letter published in May, they complained that there wasn’t enough information to determine whether it was more likely that a lab leak had spread the coronavirus, or that it had leapt to humans from contact with an infected animal outside of a lab.

The genetic sequences of viral samples hold crucial clues about how SARS-CoV-2 shifted to our species from another animal, most likely a bat. Most precious of all are sequences from early in the pandemic, because they take scientists closer to the original spillover event.

Some scientists are skeptical that there is anything sinister behind the removal of the sequences. Dr. Bloom acknowledged that the reasoning is unknown, but he also noted that the Chinese government ordered the destruction of a number of early samples of the virus and barred the publication of papers on the coronavirus without its approval.

Brighton High School seniors during their graduation ceremony at Fenway Park in Boston last week.
Credit…Brian Snyder/Reuters

Nearly 80 percent of American high school juniors and seniors say the coronavirus pandemic has affected their plans after graduation, and 72 percent of 13- to 19-year-olds have struggled with their mental health, a new survey shows.

The survey, conducted by America’s Promise Alliance, a nonprofit group, found that 58 percent of teenagers reported learning entirely or mostly online in the 2020-21 school year, and 22 percent said that they had learned about half online and half in person. Nineteen percent said they had learned mostly through in-person instruction.

The results are from a nationally representative survey of 2,400 high school students conducted in March and April.

Among those who said the pandemic had affected their plans after high school, one-third said they would attend college closer to home; one-quarter said they would attend a two-year college instead of a four-year institution; 17 percent said they would attend college remotely rather than in person; and 16 percent said they would put off attending college. Seven percent said they were no longer planning to attend college.

Nearly half the respondents who changed their plans said they were doing so because of financial pressure, suggesting that the pandemic will probably widen educational inequalities among young adults.

Given the extraordinary swell of racial-justice activism over the past year, the survey also asked students about how their schools had handled race issues. Two-thirds reported that “the history of racism” had been taught at their schools. But Asian, Black, Latino and multiracial students were less likely than white students to say that the curriculum represented their own “racial and ethnic background.”

Most of New York’s remaining pandemic restrictions were relaxed last week.
Credit…Calla Kessler for The New York Times

New York’s state of emergency will end on Thursday, more than a year after Gov. Andrew M. Cuomo imposed it to help quell the coronavirus raging through the state, the governor said on Wednesday.

The governor had already relaxed most of New York’s remaining pandemic restrictions last week. But officially ending the state of emergency is another welcome sign of the state’s steady march back toward normalcy after more than 53,000 deaths linked to the virus, according to a New York Times database.

“The emergency is over,” Mr. Cuomo said at a news conference. “It’s a new chapter.”

Federal guidance advising people to go on wearing masks in many situations if they are unvaccinated, and on public transportation and in settings like homeless shelters even if they are vaccinated, will still be in effect, Mr. Cuomo said. He asked New Yorkers to remain “wary and vigilant” about the virus and noted that many still needed to be vaccinated, especially young people.

New York State’s Liquor Authority said on Twitter that a popular executive order that had allowed bars and restaurants to sell to-go and deliver alcoholic beverages would end after Thursday.

Mr. Cuomo declared the state of emergency on March 7, 2020, as New York City became one of the world’s hardest-hit places. Virus numbers declined in the city by the fall, but the state later experienced a new surge in cases around the holidays, and until relatively recently was still reporting new cases at a high rate. Buffalo and other cities also struggled to tamp down outbreaks.

After some initial snags in the state’s vaccination campaign, more than 70 percent of adults in New York have now received at least one dose of a vaccine. The seven-day average of new reported cases has fallen by about 40 percent, and deaths by 55 percent, over the past two weeks, the Times database said.

As the coronavirus began to wane in the state this year, and as Mr. Cuomo came under several investigations, New York State lawmakers scaled back some of his emergency powers, and later suspended a rule that restricted bars and restaurants to serving alcohol only to customers who also ordered food.

In Tokyo last week. The Olympic organizing committee had said that it was considering sales of alcohol during the Games, which are scheduled to begin in the Japanese capital on July 23.
Credit…Charly Triballeau/Agence France-Presse — Getty Images

Organizers of the Tokyo Olympics said on Wednesday that they would ban alcohol at the Games, bowing to an outcry from a Japanese public that is deeply skeptical of hosting the event and weary of months of pandemic restrictions.

Two days earlier, the organizing committee said that it was considering sales of alcohol during the Games, which are scheduled to begin in Tokyo on July 23. That prompted outrage from many Japanese, with Tokyo and several other areas just emerging from a prolonged state of emergency during which restaurants were prohibited from selling alcohol as a virus control measure.

On Wednesday, the president of Tokyo 2020, Seiko Hashimoto, said that the committee had consulted with experts and decided to ban the sale and consumption of alcohol at Olympic venues “to prevent expansion of infection.”

Asahi Breweries, an official partner and one of the largest beer and spirits producers in Japan, endorsed the ban. “We totally understand the decision by the committee,” said Takayuki Tanaka, a company spokesman. “We will keep supporting the Games’ success.”

The alcohol ban is the latest sign that the Tokyo Games, postponed from 2020 because of the pandemic, will be unlike any other. This week, organizers said that crowds would be limited to 50 percent of a venue’s capacity, up to 10,000 people. Only spectators who live in Japan will be permitted to attend, with the organizers having decided back in March not to allow fans to travel to the Games from overseas.

Organizers are still determining what the crowd guidelines will be for some outdoor events such as marathons and whether viewing events that could attract large groups should be allowed in certain parts of the country.

After a sharp spike in May, coronavirus cases in Japan are receding, with daily totals of new cases nationwide having fallen by 38 percent over the past two weeks. A sluggish vaccination drive is starting to pick up pace, but with only 8 percent of the country fully vaccinated, according to New York Times data, the Olympic events are set to take place in front of crowds that are mostly not immunized.

Medical personnel remove the body of a Covid-19 victim from the coronavirus ward at the Honorio Delgado Hospital in Arequipa, Peru, last week, following an outbreak of cases of the Delta strain in the city.
Credit…Diego Ramos/Agence France-Presse — Getty Images

The super-contagious Delta variant of the coronavirus is now responsible for about one in every five Covid-19 cases in the United States, and its prevalence has doubled in the last two weeks, health officials said on Tuesday.

First identified in India, Delta is one of several “variants of concern,” as designated by the Centers for Disease Control and Prevention and the World Health Organization. It has spread rapidly through India and Britain.

Its appearance in the United States is not surprising. And with vaccinations ticking up and Covid-19 case numbers falling, it’s unclear how much of a problem Delta will cause here. Still, its swift rise has prompted concerns that it might jeopardize the nation’s progress in beating back the pandemic.

“The Delta variant is currently the greatest threat in the U.S. to our attempt to eliminate Covid-19,” Dr. Anthony S. Fauci, the nation’s leading infectious disease expert, said at the briefing. The good news, he said, is that the vaccines authorized in the United States work against the variant. “We have the tools,” he said. “So let’s use them, and crush the outbreak.”

Global Roundup

Chancellor Angela Merkel of Germany at a cabinet meeting in Berlin on Wednesday. Unlike other world leaders, she has refrained from widely publicizing her vaccinations with a selfie photograph or public event.
Credit…Pool photo by Henning Schacht

When Chancellor Angela Merkel of Germany received her second coronavirus vaccination recently, she was given a Moderna shot to follow the AstraZeneca one she received in mid-April, a spokesman confirmed on Tuesday.

Germany has permitted “mix and match” vaccinations for those who received one AstraZeneca dose before the authorities introduced age-specific recommendations for that vaccine at the end of March. Since then, the combination of one AstraZeneca shot followed by either the Pfizer-BioNTech or Moderna vaccine has become standard in Germany for people under 60.

It was not clear why Ms. Merkel, who will turn 67 next month, chose the mixed approach.

Initial studies suggest the combination of the two types of vaccines is effective, but a report published in May in The Lancet, a medical journal, also found that side effects were more common than with uniform first and second shots.

AstraZeneca shots make up only about 17 percent of the doses administered in Germany, while Moderna vaccines account for just 9 percent. The Pfizer-BioNTech vaccine is the most widely used, with nearly 71 percent of doses administered so far (unsurprising, perhaps, as BioNTech is a German company). A relatively small number of Johnson & Johnson vaccine doses have also been administered.

Unlike other world leaders, Ms. Merkel refrained from widely publicizing her vaccinations with a selfie photograph or public event. After her first dose in April, her spokesman merely tweeted a picture of her W.H.O.-issued vaccination booklet. It is not clear exactly when Ms. Merkel received the second dose, but a spokesman confirmed on Tuesday that it had been within the last few days.

Currently, 52 percent of the German population has received at least one dose of a vaccine. Ms. Merkel joined the 32 percent of Germans who are fully vaccinated.

In other news from around the world.

  • The government of New Zealand announced on Wednesday that it would impose social-distancing and mask-wearing requirements until Sunday in the city of Wellington, after a tourist visiting the capital from Sydney, Australia, over the weekend tested positive for the coronavirus. New Zealand began a 72-hour pause on Tuesday for quarantine-free travel from the Australian state of New South Wales, which includes Sydney, after more than 20 cases were reported in the eastern suburbs of the city.

  • The Red Cross has urged residents of the South Pacific island nation of Fiji to get vaccinated after a surge in new coronavirus infections there reached record highs. The health and humanitarian organization said that new infections were doubling every 10 days as the country grappled with the more transmissible Delta variant, adding that “misinformation and rumors” on social media were stoking fear and undermining immunization efforts.

  • The Greek health authorities announced on Wednesday that face masks will. no longer be mandatory in uncrowded outdoor areas starting Thursday. The decision comes amid a significant drop in the rate of daily infections and follows the country‘s official opening to international tourists last month. Masks will continue to be obligatory in all indoor public areas and in outdoor spaces with crowds, officials told a news conference. The officials also announced the revocation, as of next Monday, of a public curfew first imposed last November, which has been gradually shortened in recent weeks.

Festivalgoers at the Download Festival in Donington Park, England, last Friday. The three-day festival is a test event to examine how Covid-19 transmission takes place in crowds, with reduced capacity.
Credit…Joe Giddens/Press Association, via Associated Press

CASTLE DONINGTON, England — At 5 p.m. on Friday, a metal band called Death Blooms walked onstage in a field in Derbyshire, England, and launched into a pummeling track to open Download Festival, Britain’s first large-scale music festival to take place since the pandemic began.

A second later, several hundred rain-soaked fans — including two men dressed as bananas — began careering into one another in front of the stage at Donington Park, arms and legs flailing, smiling ecstatically as they formed the first legal mosh pit in the country in 15 months.

Since the 1970s, music festivals have been a key part of the British summer: events where teenagers get a first taste of parent-free vacations, music fans find community and people generally get very muddy and carefree. But there is widespread concern that few events will go ahead this year despite nearly half of Britain’s population having been fully vaccinated against Covid-19. And organizers say they risk going bankrupt.

Several major festivals were canceled for the second year in a row after Prime Minister Boris Johnson said last week that social-distancing measures would continue in England until at least July 19.

Download, too, was initially canceled in March. Last weekend’s hastily arranged special edition was able to go ahead only because it was part of a government trial to see whether and how cultural life could return safely. Previous pilot events — two 3,000-person club nights and a 5,000-capacity rock concert in Liverpool — led to eight cases of potential coronavirus transmission, according to one of the scientists involved, Iain Buchan.

Download 2021 had a significantly reduced capacity of only 10,000 fans, and the lineup featured only British acts to avoid the risks of international travel and quarantines.

Attendees had to take a coronavirus test before going in, and agree to another one five days after the festival. But once inside in the grounds, masks weren’t required — though head banging, moshing and drunken conversations at the campsite were prevalent.

Federico Ivan Cuadrado (left), Sahar Alfredo (center) and Laura Alfredo waited after receiving vaccinations during the last days of a mass Covid-19 vaccination site at the New Jersey Institute of Technology in Newark last week.
Credit…Bryan Anselm for The New York Times

On Sunday, the last of 39 mass vaccination centers operated by the U.S. government closed in Newark, the end of an effort that administered millions of Covid-19 shots over five months in 27 states. Many state-run sites are also closed or soon will be.

The United States’ shift away from high-volume vaccination centers is an acknowledgment of the harder road ahead. Health officials are pivoting to the “ground game”: a highly targeted push, akin to a get-out-the-vote effort, to persuade the reluctant to get their shots.

President Biden will travel to Raleigh, N.C., on Thursday to spotlight this time-consuming work. It will not be easy — as Dr. Anthony S. Fauci, the president’s coronavirus response coordinator, discovered last weekend, when he went door-knocking in Anacostia, a majority-Black neighborhood in Washington, with Mayor Muriel E. Bowser.

In an interview on Tuesday, Dr. Fauci said he and the mayor spent 90 minutes talking to people on their front porches. He said he persuaded six to 10 people to get their shots, though he did encounter some flat refusals.

“We would say, ‘OK, come on, listen: Get out, walk down the street, a couple of blocks away. We have incentives, a $51 gift certificate, you can put yourself in a raffle, you could win a year’s supplies of groceries, you could win a Jeep,’” Dr. Fauci said. “And several of them said, ‘OK, I’m on my way and I’ll go.’”

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