Covid Live Updates: First U.S. Omicron Case Found in California

ImageA view of San Francisco in late October.
Credit…Carlos Barria/Reuters

The first case of infection with the Omicron variant of the coronavirus has been reported in the United States, the Centers for Disease Control and Prevention announced on Wednesday.

The patient, a traveler who returned to California from South Africa on Nov. 22, is in isolation and aggressive contact tracing is underway. The individual was fully vaccinated and had mild symptoms that are improving.

The World Health Organization has warned that the risk posed by the variant, a new iteration of the coronavirus that was first identified in southern Africa, is “very high.” More than a dozen countries across four continents have detected the variant since it was first identified in southern Africa. Experts have said it was only a matter of time before the variant showed up in the United States.

Omicron carries more than 50 genetic mutations that in theory may make it both more contagious and less vulnerable to the body’s immune defenses than previous variants. More than 30 of the mutations are in the virus’ spike, a protein on its surface. Vaccines train the body’s immune defenses to target and attack these spikes.

Available vaccines may still offer substantial protection against severe illness and death following infection with the variant, and federal officials are calling on vaccinated people to get booster shots. The makers of the two most effective vaccines, Pfizer-BioNTech and Moderna, are preparing to reformulate their shots if necessary, but that will take time.

Following news of the variant’s spread in South Africa, countries around the world curtailed air travel to and from southern Africa, measures that officials there described as unduly punitive, especially in light of the fact that Western countries have failed to deliver sufficient vaccines and logistical support to the continent.

Dutch officials said on Tuesday that they identified cases of the variant a week before Friday, when 13 passengers who arrived on flights from South Africa tested positive for it, signaling that the variant was already present.

In South Africa, the variant accounts for most of the new daily cases reported in the nation’s most populous province, Gauteng, which is home to some 15 million people and the cities of Johannesburg and Pretoria.

The W.H.O. says the emergence of Omicron resulted from vaccine inequity in poor countries. Even so, some nations, including Britain and the United States, have renewed efforts to persuade citizens to get vaccine booster shots as quickly as possible.

In New York, Gov. Kathy Hochul has declared a state of emergency, slated to go into effect on Friday, that will allow the state to acquire supplies, take steps to reduce staffing shortages at hospitals, and limit elective procedures.

New York City on Monday imposed an updated mask advisory urging people to wear them inside public spaces, regardless of vaccination status. The measure stops short of being a requirement.

This developing story will be updated shortly.

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Federal health officials have directed airlines to provide the Centers for Disease Control and Prevention with the names and contact information of all passengers who boarded flights bound for the United States since Nov. 29 and who had been in southern Africa during the prior two weeks.

The directive, issued Wednesday, applies to passengers who spent time in Botswana, the Kingdoms of Eswatini and Lesotho, Malawi, Mozambique, Namibia and South Africa in the two weeks before flying to the United States. The airlines were directed to provide their names, addresses while in the United States, phone numbers, email addresses, dates of birth and flight information, including seat numbers.

“C.D.C. is issuing this directive to prevent the importation and spread of a communicable disease of public health importance,” a statement from the agency said, an apparent reference to the new Omicron variant of the virus that causes Covid.

Last week, the White House announced a ban on travel from eight countries in southern Africa. And late Tuesday night, the C.D.C. said it planned to toughen virus testing and screening of people flying to the United States by requiring all international passengers to provide a negative result from a test taken within 24 hours of departure.

The new directive was issued under an Oct. 25 order that instructed airlines and aircraft operators to collect specific information from all passengers before boarding, retain the information for 30 days, and transmit it to C.D.C. within 24 hours if requested to do so.

The C.D.C. can share the information with state and local health departments at passengers’ destinations, enabling local health authorities to monitor travelers for Covid, identify symptomatic individuals, notify their contacts, and direct those who are infected to isolate and their contacts to quarantine to avoid further disease spread. They can also use the information to ensure infected individuals get appropriate care.

The order applies to flights that have departed for the United States since Monday morning. Two flights left Johannesburg for the United States that day: a Delta Air Lines flight with more than 300 seats that was headed for Atlanta, and a United Airlines flight with more than 250 seats that was headed for Newark, N.J.

Both flights landed in the United States on Tuesday morning, according to schedules from Cirium, an aviation data provider. Two more United flights are scheduled to leave South Africa for Newark on Wednesday, one from Cape Town and one from Johannesburg.

Delta and United are currently the only two carriers that offer direct or single-layover flights between the countries covered by the C.D.C. order and the United States, according to Cirium schedule data. Delta operates three weekly flights between Johannesburg and Atlanta. United operates five flights a week between Johannesburg and Newark. It also plans to restart seasonal flights between Cape Town and Newark on Wednesday.

Both airlines have said that they are not planning to adjust their flight schedules in response to the administration’s ban on travelers from the region, which took effect on Monday and does not apply to American citizens or lawful permanent residents. The airlines also said that they plan to comply with the C.D.C. order.

Sixty-one people who arrived in the Netherlands on Friday aboard two flights that departed from South Africa tested positive for the virus that causes Covid, including over a dozen who were carrying the new Omicron variant. The number of overall positive cases represented more than 10 percent of the 600 passengers tested.

Credit…Bryan Anselm for The New York Times

Travelers reacted with dismay and confusion on Wednesday after the Centers for Disease Control and Prevention said that it plans to toughen coronavirus testing requirements and screening of international fliers bound for the United States because of concern about the Omicron variant.

The agency is considering requiring travelers to provide a negative result from a test taken within 24 hours before departure, among other steps, a spokesman said Tuesday night.

Though the C.D.C. has yet to officially announce any changes, the prospect of them sent travelers searching for updates, booking pre-emptive tests where they could, and scouring airline websites for reservation changes, as the pandemic threatened to upend another December travel season.

“It’s a shame, because travel just opened up again,” said Giritharan Sripathy, who was scheduled to fly to New York from London on Thursday. Mr. Sripathy, who had already taken a P.C.R. test three days before his flight, as required, said he had scheduled a new rapid test for Wednesday as a precaution, “in case they change the rules tomorrow.”

Mr. Sripathy, a Singaporean film producer, said he was concerned that the United States might close off entry to people who are not American citizens or permanent residents. Last year, restrictions like that kept him from returning to the United States, where he works, from a holiday in Singapore for eight months.

“I don’t want a repeat of that,” he said.

The plans to tighten testing requirements reflect growing concern about Omicron, a highly mutated form of the virus that was first documented by researchers in southern Africa and has since been detected in more than a dozen countries around the world, including Britain. Experts say it may be weeks before they will know enough about it to assess how readily it spreads or whether it can evade existing vaccines. In the meantime, countries around the world have imposed travel restrictions, and stock markets have tumbled.

The C.D.C. spokesman, Jason McDonald, said that requiring a negative test within a day of departure, instead of three days, would strengthen the United States’ “already robust protocols” for international travelers, including a requirement that they be fully vaccinated. It was unclear whether the new 24-hour rule would require a particular type of rapid test.

President Biden has said he would announce plans on Thursday for stepping up the fight against the pandemic. It was not clear whether his announcement would include the tighter testing requirements for international travelers, which were first reported by The Washington Post. Mr. McDonald offered no timeline for the C.D.C.’s action.

Mr. McDonald said the C.D.C. continues to recommend that all travelers get a coronavirus test three to five days after arrival in the United States. Unvaccinated travelers should self-isolate and quarantine for seven days after arrival, even if they test negative, the agency says.

Natalie Quillian, the deputy coordinator for the Covid response at the White House, said in an interview on Monday that the administration was “assessing all of our tests to make sure they’re effective in picking up” the Omicron variant, and would remove from the accepted list any tests that were not.

Some travelers said a 24-hour testing rule could make visiting the United States difficult. Paula Tolton, 23, a student in Taipei, Taiwan, who plans to visit relatives in Florida in January, said that she found even the current 72-hour rule nerve-racking because of delays in test processing.

“I’ve had that stress before, when a P.C.R. test didn’t come back when I was supposed to fly here in April,” she said. “I was freaking out.”

Carlos Valencia, a dual Spanish and American citizen whose Seville-based company runs a study-abroad program for American students, said he would put a planned January trip to return to the United States on hold until “there is at least some clarity about whether the new rules make a trip feasible.”

He said shifting rules had driven students in his program “completely crazy” and hampered his business, especially “when you know that variants are going to keep coming.”

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The Omicron variant has become by far the most prevalent version of the coronavirus spreading in South Africa, replacing the fading Delta variant, health officials said on Wednesday.

Nearly three-quarters of all samples from positive tests in the country that were checked genetically in November were found to involve the Omicron variant, the National Institute for Communicable Diseases announced.

New cases are rising sharply in South Africa, after having dropped to low levels in recent months. The institute said that there were 8,651 new cases reported on Wednesday, almost twice as many as the day before; as recently as early November, the country was averaging fewer than 300 new cases a day. The share of tests that are coming back positive rose to 16.5 percent, from 10.2 percent on Tuesday, the institute said.

The first Omicron case detected in the United States was announced on Wednesday. The World Health Organization said that at least 23 other countries around the world have reported cases of Omicron, and that it expects that number to grow as scientists around the world sequence more test samples.

In a virtual news conference, W.H.O. experts said that “it is early days” in determining whether the mutations seen in the new variant made it more transmissible or better able to evade vaccine protection, as some experts fear. Dr. Maria Van Kerkhove, the technical lead of the W.H.O.’s coronavirus response, said she expected more information on those issues “within days,” but she emphasized that so far, “there is no evidence to suggest that the vaccines don’t work” against Omicron.

“Vaccines are saving lives,” she said.

Many questions remain about whether this variant causes more severe illness than others, she said, adding that officials in South Africa had seen reports of Omicron cases with symptoms that ranged from “mild disease all the way to severe disease.” To date they had seen no deaths associated with the variant.

Tulio de Oliveira, director of the KwaZulu-Natal Research and Innovation Sequencing Platform, said that the Omicron variant “seems to cause much more breakthrough infections than the previous ones.” He said that he was concerned about the threat of such infections among health workers, which would sap the country’s ability to cope with a surge in cases.

But Mr. de Oliveira cautioned against reading too much into head-to-head comparisons between Omicron and Delta. Omicron might swiftly supplant Delta in countries like South Africa where the older variant was fading, but perhaps not as readily where Delta is still spreading actively, he noted.

The W.H.O. panel emphasized the need for countries to speed up vaccination efforts as much as possible, particularly for vulnerable populations.

The panel also called on health authorities to strengthen sequencing, surveillance and field investigations, including community testing.

The agency strongly advised against imposing “blanket travel bans,” calling instead for “a tailored approach” to travel restrictions that could include quarantine and testing requirements for arrivals.

“Our concern here is that we apply public health principles, not political principles, to select the measures that are used,” said Dr. Michael Ryan, the head of the emergencies program at the W.H.O.

Credit…Pool photo by Fabrice Coffrini

The World Health Organization’s member states on Wednesday took the first step toward what many governments hope will be a legally binding treaty aimed at strengthening global defenses against pandemics.

A rare special session of the W.H.O.’s governing body agreed to set up an intergovernmental negotiating body that is to meet no later than March to begin negotiating an international agreement intended to ensure a more coherent and equitable response to future pandemics. But the United States and other countries have pushed for a weaker mechanism that would not carry legal obligations for member states.

The W.H.O. director-general, Dr. Tedros Adhanom Ghebreyesus, a strong advocate of a legally binding treaty, hailed the decision as historic, calling it “a once-in-a-generation opportunity to strengthen the global health architecture to protect and promote the well-being of all people.”

The decision marked only the beginning of what promises to be arduous negotiations to try to achieve consensus among the W.H.O.’s 194 member countries. The agreement calls for negotiators to deliver the result of their deliberations in May 2024.

The European Union and Britain have pushed for months for an ambitious treaty or convention that carries legal force. The discovery of the Omicron variant, which has prompted a new wave of travel rules and border closures, primarily targeted at southern African nations where the variant was first identified, has renewed criticism that countries worldwide are acting in a patchwork and discriminatory fashion.

“No better response to the emergence of the Omicron variant than this coming together of the international community behind the effort to strengthen the legal framework underpinning our collective response to pandemics,” Simon Manley, Britain’s ambassador in Geneva, said on Twitter.

The United States described the initiative in a statement as “a momentous step” but, with support from Brazil and other countries, it refused to commit to anything that is legally binding, and kept open the possibility of a weaker instrument.

The international agreement is intended to avoid any repetition of the “fragmented and splintered” steps by nations that Dr. Tedros has said weakened the global response to Covid-19. Proponents of a treaty want commitments to share data, virus samples and technology, and to ensure an equitable distribution of vaccines.

Those issues raise politically sensitive questions of national sovereignty over access to the sites of outbreaks, and potential investigations into origins of diseases — a source of tension between Western governments and China, which has resisted calls for an independent inquiry into the emergence of Covid-19 in the Chinese city of Wuhan in early 2020.

China said this week that it agreed “in principle with the ideas of further strengthening compliance, financing, sharing and information management.” But Beijing appeared wary of a new treaty and cautioned against “politicization, stigmatization and instrumentalization.”

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A federal judge issued a preliminary injunction on Tuesday to halt the start of President Biden’s national vaccine mandate for health care workers, which had been set to begin next week.

The injunction, written by Judge Terry A. Doughty, effectively expanded a separate order issued on Monday by a federal court in Missouri. The earlier one had applied only to 10 states that joined in a lawsuit against the president’s decision to require all health workers in hospitals and nursing homes to receive at least their first shot by Dec. 6 and to be fully vaccinated by Jan. 4.

“There is no question that mandating a vaccine to 10.3 million health care workers is something that should be done by Congress, not a government agency,” Judge Doughty, of U.S. District Court for the Western District of Louisiana, wrote. He added: “It is not clear that even an act of Congress mandating a vaccine would be constitutional.”

The judge, who was nominated to the court by former President Donald J. Trump, also wrote that the plaintiffs had an “interest in protecting its citizens from being required to submit to vaccinations” and to prevent the loss of jobs and tax revenue that may result from the mandate.

Several cities and states had already imposed their own vaccine mandates for health care workers, in an effort to contain outbreaks that were often passed from communities into medical settings like nursing homes. The momentum for vaccine mandates gained steam during the summer as the Delta variant swept through nursing homes, causing spikes in staff and resident infections, as well as overwhelming hospitals in many states with another Covid surge.

Some of the larger hospital chains and several big nursing home operators also began requiring staff vaccinations, before the president began calling for nationwide compliance. Vaccinations among health care employees have increased since the summer, although cases among residents and staff remain in the thousands reported each week. Nationwide, the immunization rate among nursing home staffs is more than 74 percent, although much lower rates still exist in some regions.

In leading a 14-state lawsuit against the mandate, Attorney General Jeff Landry of Louisiana said the federal mandate would blow holes in state budgets and exacerbate shortages in health care facilities.

The Biden administration tied compliance with the vaccine mandate to federal funding, requiring immunizations of millions of workers at hospitals, nursing homes or other health facilities that heavily rely on the Medicare or Medicaid programs. But many health care providers — especially nursing home and rural hospital operators — complained that staff members who were hesitant to be immunized would leave, aggravating employee shortages that plagued the industry long before the pandemic.

Those complaints helped swell opposition in many states, like Texas and Florida, that have been vehemently against dictates on vaccines, mask-wearing and other federal policies at the heart of public health advice during the pandemic.

More than a dozen states and some employers joined forces to fight a broader mandate that would require private employers of 100 or more workers to impose companywide immunization. An appeals court has temporarily blocked that mandate as well, as the challengers to the policy pursue their arguments that the Occupational Safety and Health Administration overstepped its authority.

In response to recent court decisions, the Centers for Medicare & Medicaid said in a statement, “While we cannot comment on the litigation, CMS has remained committed to protecting the health and safety of beneficiaries and health care workers. The vaccine requirement for health care workers addresses the risk of unvaccinated health care staff to patient safety and provides stability and uniformity across the nation’s health care system.”

The injunction issued on Tuesday is a first step in the lawsuits against the vaccine mandate. The cases still have to be argued before a judge, and any lower-court ruling will likely be appealed.

Credit…Joao Silva/The New York Times

The detection of the Omicron variant in southern Africa signals the next stage of the battle against Covid-19: getting many more people inoculated in poorer nations where vaccines have been scarcest in order to deter new mutations from developing.

But while world leaders sometimes talk about this as if it is largely a matter of delivering doses overseas, the experience of South Africa, at least, hints at a far more complex set of challenges.

Like many poor countries, South Africa was made to wait months for vaccines as wealthier countries monopolized them. Many countries still do not have anywhere near enough vaccines to inoculate their populations.

The problems have not ended as shots began arriving in greater numbers.

Neglected and underfunded public health infrastructure has slowed their delivery, especially to rural areas, where storage and staffing problems are common.

And now, there are growing signs in parts of Africa, as well as South Asia, that skepticism or outright hostility toward the Covid vaccines may run deeper than expected.

Deep distrust of governments and medical authorities, especially among rural and marginalized communities, may already be stalling out vaccination drives. The legacy of Western exploitation and medical abuses during and after colonialism is weighing heavily, too.

Misinformation circulating on social media often fills the vacuum, some of it floating in from the United States and Europe, where vaccine refusal has also been an issue.

“There’s no doubt that vaccine hesitancy is a factor in the rollout of vaccines,” said Dr. Matshidiso Moeti, the Africa director of the World Health Organization. News or rumors of potential side effects, she said, “gets picked out and talked about, and some people become afraid.”

Just days before the Omicron variant was first detected, health officials in South Africa turned away shipments of doses from Pfizer-BioNTech and Johnson & Johnson, worried that their stockpile of 16 million shots might spoil amid insufficient demand.

Though only 36 percent of South African adults are fully vaccinated, daily vaccinations have already been flatlining, according to government statistics.

Namibia, Zimbabwe, Mozambique and Malawi have also asked vaccine manufacturers and donors to hold off on sending more shots because they can’t use the supplies they have, according to several health officials involved in the effort to distribute vaccines to developing nations.

Credit…Lynsey Addario for The New York Times

The head of the United Nations-backed global vaccine distribution program said on Tuesday that it had shipped more than 11 million doses in the last 24 hours, its busiest day of deliveries ever.

The leader, Seth Berkley, said the program had been asking donors and vaccine manufacturers for months “to give us better-quality donations” and more information on when doses would arrive. That message, he wrote on Twitter, “is just starting to be heard.”

Covax, a multibillion-dollar alliance between international health bodies and nonprofits, was supposed to ensure that poor countries got access to coronavirus vaccines and that rich countries did not hoard them. It has struggled in that mission and had to scale back its goals.

The new Omicron variant has prompted rich, highly vaccinated countries like the United States, Britain and Japan to expand their booster programs, while poorer, less vaccinated countries like South Africa are still trying to get first doses to residents.

Only about 5 percent of people living in low-income countries have received even one vaccine dose, according to the Kaiser Family Foundation, a health organization that is tracking coronavirus infections and vaccine distribution.

“Getting doses to countries is the easy part,” Mr. Berkley wrote on Twitter. Making the doses readily available “is harder & requires active collaboration” among manufacturers, shipping companies and officials in those countries.

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The Japanese government said on Wednesday that it had asked airlines to stop taking new bookings for all flights into the country for the rest of the year, extending one of the world’s most far-reaching border closures in response to the Omicron variant.

Existing bookings would not be affected, officials said.

On Monday, Japan barred all nonresident foreigners from entering the country, and on Tuesday it closed its borders to all non-Japanese travelers, including permanent residents of Japan, from 10 southern African countries.

Japan confirmed its second Omicron case, in a traveler from Peru, on Wednesday. Its first case, confirmed on Tuesday, involved a traveler from Namibia.

Japan had only tentatively opened last month to business travelers and students, despite recording the highest vaccination rate among the world’s wealthy democracies — and after seeing its coronavirus caseloads plunge by 99 percent since August.

In South Korea, five cases of the Omicron variant were confirmed on Wednesday among inbound travelers, according to health officials. Officials said they would require all international arrivals from Dec. 3 to Dec. 16 to quarantine for 10 days, with only rare exemptions, such as for those attending funerals.

South Korea will also conduct genomic sequencing on all imported coronavirus cases conducted to check for the Omicron variant, the health officials said.

Credit…Ruth Fremson/The New York Times

President Donald J. Trump tested positive for coronavirus three days before his first debate with Joseph R. Biden Jr. in 2020, two former administration officials said Wednesday.

The White House did not announce the positive test at the time, and the president received a negative result shortly afterward and carried on with a campaign rally and the debate, the officials said. The account was first reported by The Guardian, which cited a forthcoming book by Mr. Trump’s chief of staff, Mark Meadows.

The two former officials, who spoke on condition of anonymity because they were not authorized to discuss the matter publicly, confirmed the timeline on Mr. Trump’s test results contained in “The Chief’s Chief,” by Mr. Meadows, Mr. Trump’s fourth and final White House chief of staff.

The revelation came nearly a year after widespread speculation that Mr. Trump was sick when he first shared a stage with Mr. Biden for their first presidential debate on Sept. 29, months into the pandemic.

The White House declined repeatedly at the time to give a precise chronology of when precisely Mr. Trump first received a positive coronavirus test result. The administration first told the public in the early hours of Oct. 2 that Mr. Trump had tested positive. Mr. Trump was hospitalized later that same day.

Credit…Sebastian Kahnert/DPA, via Associated Press

Olaf Scholz, who is designated to replace Angela Merkel as Germany’s chancellor next week, wants to see Covid vaccinations become mandatory, possibly by the end of February, he said in news media interviews on Tuesday.

While Mr. Scholz and other mainstream politicians in Germany have long dismissed the idea of forcing people to take the shot, he told the tabloid newspaper Bild that the country’s high infection rates warranted the move.

“You can’t callously watch the situation as it is right now,” he was quoted as saying. “If we had a higher vaccination rate, we would have a different situation.”

Mr. Scholz said that he would free lawmakers in his coalition from having to vote with their parties when a bill on the question came to the German Parliament, allowing them to vote their conscience on such an important issue.

On Tuesday, the country’s highest court ruled that the government had acted in accordance with the Constitution when ordering lockdowns and school closures earlier this year. The ruling that was seen as instrumental in allowing the government to impose more restrictions on public life as it tries to battle a surge in case.

As Europe confronts a sharp rise in coronavirus, Austria last month became the first European nation, and the first Western democracy, to require Covid vaccinations for all adults. Although recent polls have shown Germans coming around to the idea of a national vaccine mandate, in a poll in late October, 65 percent of unvaccinated respondents said that they would not get the shots under any circumstances.

Germany is registering a daily average of nearly 60,000 new reported cases, a 42 percent increase over two weeks ago, according to the Center for Systems Science and Engineering at Johns Hopkins University. Almost 300 people a day are dying of the disease, a 54 percent increase from two weeks ago.

More than 68 percent of Germany’s population is fully vaccinated, higher than the European Union average, but lower than some major European nations like France, Britain and Spain, according to the European Centre for Disease Prevention and Control. New laws restricting access to public transportation and other venues for unvaccinated people has drawn more to get shots — last week, nearly 900,000 doses were administered in a single day, the most since July.

Chancellor Angela Merkel and Mr. Scholz had agreed on Tuesday that under a new national vaccine drive, 30 million additional doses would be administered by Christmas.

On Wednesday, Pfizer and BioNTech announced that their vaccine for younger children would be delivered to European Union customers starting on Dec. 13. The E.U. drug regulator approved the lower-dose vaccine last week for use in children ages 5 to 11.

Credit…Peter Byrne/Press Association, via Associated Press

England’s return to some Covid restrictions on Tuesday provoked a range of emotions: anger, dismay, weariness, and, for some, indifference. From London, festooned with Christmas lights, to Bradford, in northern England, the feeling on the streets was, above all, one of weary resignation.

“I expected it, because the British took so long,” said Ali Hasan, 31, a medical consultant at a hospital in Bradford, referring to the nation’s first lockdown, in March 2020, which he said should have been imposed sooner, were it not for what he described as the “laziness” of the country’s political parties.

The British government ended virtually all restrictions in England over the summer, and has seen a high but relatively stable coronavirus caseload in recent weeks. Even now, it is stopping short of the health pass systems, vaccine mandates and lockdown measures that have been implemented to stem surges elsewhere in Europe.

But it has responded to news of the Omicron variant by severely restricting travel from 10 African countries, reinstating testing and self-isolation requirements for other arrivals, and making face masks compulsory on public transportation and in shops.

Many in England had been anticipating restrictions for a while, and some had started to take matters into their own hands. Though masks are not mandatory in restaurants or cafes, Audrey Mekki, 35, a waitress at Pera, a Mediterranean restaurant in North London, makes a point of wearing one throughout her shift.

“I’m wearing it for my safety, and also for the customers,” she said. “Most don’t mind, but some may not feel comfortable if the waitresses serving their food are not masked.”

Helen Daly, 62, who was in London on a holiday from Cork, Ireland, said she had been surprised by the lax British attitude.

“There’s very little mask-wearing here,” she said. “We were at the theater last night. There were four of us, and we were the only four wearing masks.”

For Matthew Leonard, 22, however, the change on the subway was sudden and visible. He said he arrived in London the night before the new regulations took effect. “It was pretty much how it was before, sort of 50-50,” Mr. Leonard said, “but then this morning I noticed almost all people wearing masks.”

At schools, students age 11 and older are now advised to wear masks in communal spaces. Lucy Long, 41, who has a 10-year-old-daughter, explained that the school drop-off had also changed; parents no longer gather for a conversation at the gates. She supports requiring children to wear masks.

“We don’t know what’s going to happen to these children in 20 years’ time after any infection,” she said.

In Bradford, where Ursula Sutcliffe runs a small plant shop and cafe, she said the successive lockdowns had taken a toll — to say nothing of Brexit, which drove up the cost of her plants, which are imported from the Netherlands.

“We’ve just been in an uphill battle,” Ms. Sutcliffe said. Referring to Britain’s prime minister, she added: “Boris Johnson should never have stopped wearing face masks in the first place. If we’d just kept face masks on, we probably could have just gone about our lives. But he is so eager to say, ‘Yay, we’re back to normal.’ We’re not!”

Credit…Gbemiga Olamikan/Associated Press

Nigeria’s public health institute said on Wednesday that it had identified the variant in three travelers who arrived from South Africa in the last week, Dr. Ifedayo Adetifa, its director general, said in a statement.

The institute, the Nigeria Center for Disease Control, had said earlier on Wednesday that it had also detected the Omicron variant in a sample from October, but then retracted that announcement. The earlier sample was of the Delta variant, according to a message shared on WhatsApp by the institute’s spokesman, Emeka Oguanuo.

Referring to the three Omicron cases, Dr. Adetifa said in the statement: “Follow up to ensure isolation, linkage to clinical care, contact tracing and other relevant response activities have commenced.”

Nigeria is the third country in mainland Africa — besides South Africa and Botswana — to report the variant, which is now known to have reached every continent except Antarctica. But scientists say it could be weeks before more is known about how transmissible the variant is, the severity of illness it causes and how much protection the current vaccines offer against it.

Still, governments have reacted with alarm and markets have tumbled in recent days, as the W.H.O. rated the global risk from the variant “very high.”

On Wednesday, Nigerian health officials urged state governments to make testing easily accessible, vaccinate many more people and ensure the public was adhering to public health measures including masking and social distancing. Nigeria has so far reported 214,113 positive cases and 2,976 deaths from the coronavirus.

With more than 200 million people, Nigeria has administered just over 9.8 million vaccine doses, according to the World Health Organization. Starting Wednesday, federal government workers were expected to either be vaccinated or show a negative Covid-19 certificate. Travelers into the country are expected to arrive with a negative Covid test and to take two more tests on the second and seventh day following arrival.

Credit…Jeremie Souteyrat for The New York Times

Since England’s theaters reopened without restrictions in July, one thing has been as notable as the action onstage: the lack of masks in the audience.

Unlike in Broadway theaters, patrons here have not been required to wear face coverings, and many attendees have chosen to ignore preshow announcements encouraging them to mask up.

Several visiting theater critics have been left aghast. Laura Collins-Hughes, writing in The New York Times in September, said that at “nearly every production I saw, there were loads — sometimes a majority — of barefaced people in the crowd, which felt reckless and delusional.”

Peter Marks, writing in The Washington Post in November, called London’s theaters “consistently shocking these days.” That had nothing to do with the action onstage, he added; it was entirely down to the absence of masks.

Now, that image may be about to change. On Saturday, Prime Minister Boris Johnson made masks mandatory in stores and on public transportation in England, responding to the newly discovered Omicron variant of the coronavirus.

He did not make them mandatory in theaters, but several venues have now done so voluntarily. On Monday, the Royal Shakespeare Company said face coverings would be required at its theaters in Stratford-upon-Avon, England, unless an attendee is under age 12 or has a medical exemption.

“We want to do all we can to ensure that we do not have to cancel performances and disappoint our audiences,” the company’s executive director, Catherine Mallyon, said in a news release.

Other theaters quickly followed. On Monday, Andrew Lloyd Webber, the composer and theater impresario, quietly strengthened rules for the six theaters he owns in the West End. His company website was updated to say, “All audience members must wear a face covering throughout their visit, except when eating and drinking, or if they are medically exempt.” Previously, those theaters requested masks, but did not require them.

On Tuesday, the National Theater, the Royal Opera House, the English National Opera and the Old Vic also said they would make masks mandatory.

The rules might only last a few weeks. The National Theater’s website says the measure will be in place until Dec. 19, “when the next government review of Covid measures is due.”

So far, there appears to be little resistance to the changes. Kate Evans, a spokeswoman for the Royal Shakespeare Company, said 30 people had asked for refunds or to exchange their tickets for vouchers to see a future show since the mandate was announced, out of 6,000 who had booked to see its current show, “The Magician’s Elephant.”

“The majority of feedback we’ve received around the decision has been very positive,” she said.


Because of an editing error, an earlier version of this article misstated the number of theatergoers who requested refunds or ticket exchange vouchers from the Royal Shakespeare Company after its mask mandate announcement. It was 30, not 45.

Credit…EPA, via Shutterstock

A federal advisory committee on Tuesday voted to recommend that the government for the first time authorize the use of an antiviral pill to combat the worst effects of Covid-19.

The advisory committee, in a surprisingly narrow 13-to-10 vote, endorsed the pill from Merck, while public health officials worldwide raced to buttress their defenses against the newly emerging Omicron variant of the coronavirus.

The Merck treatment, known as molnupiravir, has been shown to modestly reduce the risk of hospitalization and death from Covid. The pill could be authorized for use in the United States within days and available to patients within weeks.

In the coming weeks, the F.D.A. may also authorize a similar pill from Pfizer that appears to be significantly more effective than Merck’s. Together, the arrival of the two easy-to-use treatments could provide a cushion against a resurgent virus.

The F.D.A. advisory panel, a group of experts on antimicrobial drugs, recommended that Merck’s treatment be authorized for people with Covid who are at high risk of becoming severely ill. That would most likely cover tens of millions of Americans who are older or have medical conditions such as obesity, diabetes or heart disease.

But the committee’s close vote reflected doubts about the pill’s effectiveness and concerns that it could cause reproductive harm.

“The efficacy of this product is not overwhelmingly good,” said Dr. David Hardy, an infectious-disease physician in Los Angeles. Still, he voted to recommend the drug, saying “there is a need for something like this.”

Other members of the committee who voted against authorization said more research was needed about the drug’s safety. “The risk of widespread effects on potential birth defects, especially delayed effects on the male, has not been adequately studied,” said Dr. Sankar Swaminathan, an infectious disease specialist at the University of Utah.

The pills, which doctors will prescribe and will be dispensed at pharmacies, are much more convenient and are expected to reach many more people than the monoclonal antibody treatments that have typically been used to aid high-risk Covid patients. The antibody treatments are expensive and typically given intravenously at hospitals or clinics.

The Biden administration has been hoping that the emergence of the antiviral pills from Merck and Pfizer will help end the most acute phase of the pandemic. The U.S. government has spent billions of dollars to secure millions of treatment courses of the new pills.

Merck’s clinical trials primarily enrolled people who were infected with the Delta, Mu and Gamma variants of the coronavirus. Scientists have yet to run experiments to see how well the pills block Omicron viruses from replicating. But there are reasons to think they would remain effective even if the variant can sometimes evade vaccines, as well as monoclonal antibodies.

Credit…Remko De Waal/EPA, via Shutterstock

The hundreds of passengers traveling from South Africa to Amsterdam on Friday, on flight KL592, came armed with paperwork proving their eligibility to fly. Check-in agents sifted through a bewildering assortment of requirements determined by final destination.

But while the flight was en route, and the passengers slept or watched their screens, everything changed on the ground.

Panic about the new Omicron variant that had been discovered in southern Africa prompted countries to close their borders. The arrivals descended into a new post-Omicron reality, and it was a hellish one, with hours spent breathing stale air as their planes sat on the tarmac, then fighting exhaustion in crammed waiting rooms, awaiting swab results in close quarters with fellow travelers who would turn out to be infected with the new and possibly more dangerous variant.

“We were in the same place, the same room,” said one passenger, Jan Mezek, 39, a laboratory technician whose company services swab-test machines and who was returning from a two-week work trip to his home in Prague. “I felt like a pig in a pen,” he said, adding: “They were completely spreading the virus around us.”

Of the more than 60 people on that and another KLM flight from South Africa who tested positive for the virus, at least 14 had Omicron, according to Dutch officials. The Dutch authorities have quarantined them while requiring the hundreds who showed negative results from the PCR test administered at the airport to go home or board connecting flights to their final destinations.

“They went around the world, who knows where,” said Fabrizio Pregliasco, a prominent Italian virologist at the University of Milan. He said that all the passengers should have been quarantined or isolated and monitored closely for seven to 10 days, especially because they could have caught the virus on the flight and tested negative as it incubated.

“If this variant is very contagious, this flight is an explosive bomb,” Dr. Pregliasco said.

Credit…Ringo H.W. Chiu/Associated Press

Los Angeles Lakers star forward LeBron James has entered the N.B.A.’s coronavirus health and safety protocols, the team announced Tuesday.

James missed the team’s game Tuesday night against the Sacramento Kings and would likely miss at least 10 days if he is in the protocols because he tested positive for the coronavirus. The Lakers have yet to confirm that James has tested positive, but after the game James’s teammate Anthony Davis made comments that indicated that was the case.

“He said he’s good,” Davis told reporters. “I think he’s asymptomatic which is a good sign. We want to make sure that he gets back. Health is most important. It’s bigger than basketball.”

Lakers Coach Frank Vogel told reporters before the game that he found out Tuesday morning that James had entered the health and safety protocols. Vogel said the team arranged for James to get “back to L.A. safely.”

James, 36, said before the season that he had been vaccinated against Covid-19.

Typically, players who are vaccinated face less stringent requirements than unvaccinated players. After Thanksgiving, though, the league implemented enhanced testing requirements even for vaccinated players, according to documents sent by league officials to each of the 30 teams. They did so with the expectation that the holiday would increase players’ potential exposure to the virus.

Under the current guidelines, James would be forced to sit out for at least 10 days unless he was able to return multiple negative results for the virus.

“We just want the best for him right now,” Vogel said. “That’s where our thoughts are. We have a next man up mind-set. It’s an 82-game season. You got to deal with guys being in and out of the lineup. We’ve been without him some already this season.”

Tuesday’s game was the 12th James has missed this season. He missed 10 because of ankle and abdominal injuries. He also missed the Lakers’ game against the Knicks earlier this month after being suspended for the first time in his 19-season career.

Credit…The New York Times

Among the many unknowns surrounding the new coronavirus variant called Omicron, named after the 15th letter of the Greek alphabet, one has stood out to many English speakers: How is it pronounced?

There is no single, agreed-on English pronunciation, experts say.

One pronunciation, according to Merriam Webster, is “OH-muh-kraan,” with a stress on the first syllable.

A World Health Organization official, Dr. Maria Van Kerkhove, recently said it that way when announcing that the variant was of concern.

Pronouncing ‘Omicron’

There are several widely accepted ways in English to pronounce “Omicron,” a variant of the coronavirus named after the 15th letter of the Greek alphabet.

In the United States, it is often pronounced “AH-muh-kraan,” Merriam Webster says. Less common are “OH-mee-kraan,” as Prime Minister Boris Johnson of Britain pronounced it this week, or “OH-my-kraan.”

On the New York Times podcast “The Daily,” Apoorva Mandavilli, who reports on the coronavirus and its variants, said she was going with “AH-muh-kraan.”

“I don’t think it really matters that much, honestly,” she said.

The New Oxford English Dictionary gives a pronunciation that differs from those in Merriam-Webster, according to Dr. Andreas Willi, a comparative linguistics professor at Oxford University. “Namely rather like an English phrase ‘o-MIKE-Ron,’” he said.

The word is a compound from the Greek “o mikron,” meaning “small o.” In classical Greek, the word was pronounced with the second syllable sounding like an English “me,” Dr. Willi said.

Peter Sokolowski, editor at large at Merriam Webster, said that because the Greek word is transliterated for pronunciation into English, sounding much as the word “omnipotent” is different from its Latin “omni-potent” origin, then the “AH-muh-kraan” pronunciation “makes perfect sense.”

But, he added, “There isn’t a wrong answer.”

“The question of British versus American pronunciation of the first syllable isn’t really specific to this particular word,” Dr. Willi said. “Compare the British versus American pronunciation of ‘god.’”

The divergences are to do with the name having been adopted as a loanword and used by English speakers in different places at different times, Dr. Willi said.

“When we speak of ‘Paris’ in English, that is also very different from the ‘proper’ French way of pronouncing the same name,” he said. “But it is hardly wrong in a strict sense.”


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