British studies warn of Omicron’s speed, and one notes the need for boosters.
The intensive care unit at a hospital in Uniontown, Pa., last year.Credit…Alexandra Wimley/Pittsburgh Post-Gazette, via Associated Press
Across Pennsylvania, a sharp increase in Covid-19 patients has pushed hospitals to capacity, leading to long wait times in emergency rooms and prompting some hospitals to delay elective care and limit hospital visitors.
Hospitalizations nationwide surged over the summer amid the rise of the Delta variant of the coronavirus, before decreasing this fall. Now, they have climbed back up again as the cold has set in, and reached a daily average of more than 65,000 as of Saturday, according to federal data.
Upticks in hospitalizations have been particularly steep in the Midwest and the Northeast.Governors in some states — including Maine and Wisconsin — have requested federal health care workers be sent to assist them.
New coronavirus cases have been increasing across the United States, according to a New York Times database, a similar rise in cases to last year during the cold months. Last year, hospitalizations began increasing in September and peaked in January, when an average of nearly 140,000 people were hospitalized with Covid-19 nationwide.
“The trends this year are very similar to last year,” said Pinar Karaca-Mandic, one of the leaders of the Covid-19 Hospitalization Tracking Project at the University of Minnesota. “There is a seasonality effect going on with the pandemic.”
The strain on hospitals in Pennsylvania, however, has been exacerbated because many of them are now seeing a crush of patients seeking care for conditions other than Covid, said Dr. Jeffrey Jahre, the senior vice president for medical and academic affairs for St. Luke’s University Health Network in Pennsylvania.
“Last year, many people put their care off and did not get the appropriate care that they needed and have more advanced disease and are now suffering the consequences,” he said. The combination of those patients with increasing numbers of Covid patients “represent a major challenge to our hospital,” he added. The hospital system recently limited visitors to two per patient for the duration of hospitalization.
He said the surge is taking a toll on medical workers.
“I’d be lying to you if I didn’t say there was a certain weariness in terms of staff who have now gone through this for more than a year and feel frustrated that we have a weapon that could have prevented a lot of what we’re seeing, if people would only be vaccinated,” he said.
Some hospital administrators fear that the worst is yet to come, as people continue to gather for holidays and spend more time inside during the colder months.
“We’re going to have these kinds of stressors for weeks to months,” said Dr. Donald Yealy, the chief medical officer for the University of Pittsburgh Medical Center. “I’m not sure we’re ever going back to the way we saw health care delivered in 2019.”
Peter Navarro, who served as trade adviser to former President Donald J. Trump and who fought with government scientists while helping to orchestrate the administration’s coronavirus response, is refusing to respond to a congressional subpoena for documents, telling lawmakers he is following a “direct order” from Mr. Trump not to comply.
House Democrats released Mr. Navarro’s written response to their subpoena on Saturday, along with a letter asking him to appear on Wednesday for a deposition before the Select Subcommittee on the Coronavirus Crisis, which is investigating the federal pandemic response, including whether Trump administration officials interfered with scientific decisions.
“Your blanket refusal to comply with the subpoena in its entirety is improper,” Representative Jim Clyburn of South Carolina, the committee chairman and the No. 3 House Democrat, wrote to Mr. Navarro in a letter the committee made public. He added: “It is abundantly clear that you possess information responsive to the subpoena that is not covered by any colorable claims of executive privilege.”
The demand sets up a clash that could result in a move by House Democrats to hold Mr. Navarro in contempt of Congress, if he fails to appear. Last month, another Trump adviser, Stephen K. Bannon, surrendered to authorities after a grand jury indicted him on two counts of contempt of Congress for refusing to provide information to the House committee investigating the Jan. 6 attack on the Capitol.
Mr. Clyburn issued a subpoena to Mr. Navarro in November, calling on him to provide any documents — including a “daily journal” Mr. Navarro has said he kept while working at the White House — related to the pandemic response.
Mr. Navarro wrote back this week, citing a public statement by Mr. Trump, who had said he was instructing Mr. Navarro “to protect executive privilege and not let these unhinged Democrats discredit our great accomplishments.” Mr. Navarro said he construed it as a “direct order” and a “direct, proper and explicit invocation” of executive privilege.
He also said he had no access to communications from his official government account, and objected to the document requests, which he described as “vague.” (He also mistakenly referred to Mr. Clyburn as “Mr. Rayburn” — a likely reference to the Rayburn House Office Building, where the committee’s offices are.)
Mr. Navarro had broad influence over the Trump administration’s response to the pandemic, advising the former president on supply chain issues and how to keep the economy open. He often pushed unproven treatments, including the malaria drug hydroxychloroquine, and he was a staunch and vocal critic of Dr. Anthony S. Fauci, the U.S. government’s top infectious disease expert, whom he described in a USA Today opinion piece last year as being “wrong about everything I have interacted with him on.”
But Mr. Navarro was also prescient about the pandemic, and more forward-thinking than some of his White House colleagues. In late January 2020 — nearly two months before Mr. Trump declared a national emergency — he starkly warned Trump administration officials that the coronavirus crisis could cost the United States trillions of dollars and put millions of Americans at risk of illness or death.
Earlier this year, the panel released emails and other documents showing that Mr. Navarro also sounded an early alarm about supply shortages, and it said a preliminary investigation had found that Mr. Navarro steered coronavirus-related contracts to politically connected companies. In a memo to Mr. Trump dated March 1, 2020, Mr. Navarro complained that he had been pushing the White House to move quickly, “in Trump time,” but said “movement has been slow.”
In a statement to Politico at the time the subpoena was issued, Mr. Navarro called the investigation “a witch hunt” and said he planned to deliver a copy of his new book, “In Trump Time,” which would explain the White House’s decision making. Mr. Clyburn cited the book in his letter, saying Mr. Navarro’s disclosures of “multiple conversations” with the former president and “numerous meetings” with other Trump White House officials effectively waived any claim of privilege.
The first real-world study of how vaccines hold up against the Omicron variant showed a significant drop in protection against symptomatic cases caused by the new and fast-spreading form of the coronavirus.
But the study, published by British government scientists on Friday, also indicated that third vaccine doses provided considerable defense against Omicron.
Government scientists on Friday also offered the most complete look yet at how quickly Omicron was spreading in England’s highly vaccinated population, warning that the variant could overtake Delta by mid-December and, without any precautionary measures, cause Covid-19 cases to soar.
Those warnings were reinforced by a computer modeling study of England released on Saturday suggesting that even in populations with high levels of immunity, Omicron could significantly disrupt life and overwhelm hospitals. Scientists cautioned that those projections could change as they learned more about the severity of Omicron infections.
The vaccine study published Friday indicated reduced levels of protection. Four months after people received a second dose of the Pfizer-BioNTech vaccine, the shots were roughly 35 percent effective in preventing symptomatic infections caused by Omicron, a significant drop-off from their performance against the Delta variant, the scientists found.
A third dose of the Pfizer-BioNTech vaccine, though, lifted the figure to roughly 75 percent.
Two doses of the AstraZeneca vaccine appeared to offer virtually no protection against symptomatic infection caused by Omicron several months after vaccination. But for those recipients, an additional Pfizer-BioNTech dose paid big dividends, boosting effectiveness against the variant to 71 percent.
Still, the study’s authors said they expected that the vaccines would remain a bulwark against hospitalizations and deaths, if not infections, caused by Omicron. And the researchers cautioned that even in a country tracking the variant as closely as Britain is, it was too early to know precisely how well the vaccines would perform.
That study was released alongside new findings about how easily Omicron is managing to spread. Someone infected with the Omicron variant, for example, is roughly three times as likely as a person infected by the Delta variant to pass the virus to other members of his or her household, Britain’s Health Security Agency reported.
And a close contact of an Omicron case is roughly twice as likely as a close contact of someone infected with Delta to catch the virus.
Neil Ferguson, an epidemiologist at Imperial College London, said that Omicron’s ability to evade the body’s immune defenses accounted for most of its advantage over previous variants. But modeling work by his research team also suggested that Omicron was simply more contagious than Delta, by roughly 25 to 50 percent.
“I think that there’s a significant amount of immune escape,” Dr. Ferguson said, referring to the virus’s ability to dodge the body’s defenses. “But it’s also more intrinsically transmissible than Delta.”
He and other scientists have cautioned that evidence was still coming in, and that better surveillance in places where the Omicron wave is most advanced could affect their findings.
The World Health Organization said this week that some evidence had emerged that Omicron was causing milder illness than Delta, but that it was too early to be certain. Still, scientists have warned that if the variant keeps spreading as quickly as it is in England, where cases are doubling every 2.5 days, health systems around the world may be deluged with patients.
Even if Omicron causes severe illness at only half the rate of the Delta variant, Dr. Ferguson said, his computer modeling suggested that 5,000 people could be admitted to hospitals daily in Britain at the peak of its Omicron wave — a figure higher than any seen at any other point in the pandemic.
Scientists said that widespread vaccination in countries like Britain and the United States would keep as many people from dying as have in earlier waves. But the experts also warned that patients with Covid and with other illnesses would suffer if hospitals became too full.
“It only requires a small drop in protection against severe disease for those very large numbers of infections to translate into levels of hospitalization we can’t cope with,” Dr. Ferguson said.
It will take several weeks to understand how the current surge in Omicron infections may translate into people needing hospital care. “I’m concerned that by the time we know about severity,” Dr. Ferguson said, “it may be too late to act.”
The potential for a surge in hospitalizations was thrown into sharp relief by the modeling study released on Saturday, created by a separate group of experts at the London School of Hygiene & Tropical Medicine. For now, those scientists assumed that Omicron would cause disease just as severe as Delta does in unvaccinated people, but also that mounting levels of immunity from vaccinations and previous infections would temper the Omicron wave, as has happened in South Africa.
In the scenario that some outside experts said was most likely — in which Omicron evaded people’s immune defenses to a large degree, but booster doses also proved highly effective — the scientists said that England could be hit hard. Through April, they predicted roughly 300,000 hospitalizations and 47,000 deaths.
That could place a bigger daily burden on English hospitals at the peak of the Omicron wave than was seen at any time earlier in the pandemic.
Crucially, the scientists said that reintroducing certain restrictions could save thousands of lives and spare tens of thousands of people hospital stays.
Outside experts emphasized that Omicron remained poorly understood, that people may be able to fight off severe infections more effectively than the models predicted, and that the arrival of new antiviral pills in the coming months could soften the blow of infections.
Still, scientists urged governments to speed up inoculation campaigns, share doses with less-vaccinated nations and consider measures like more self-testing, if not new restrictions.
“The coronavirus has not finished with us,” said Michael Head, a senior research fellow in global health at the University of Southampton in England.
“A tactic of ‘turning the lights off and pretending we are not in’ is a failed policy.”
La Scala, the famed opera house in Milan, pushed back the premiere of its ballet season after at least 14 cast and crew members tested positive for the coronavirus.
The resident ballet company was scheduled to perform the 19th-century ballet “La Bayadere” to open its season on Wednesday, but the show was postponed until Dec. 21.
Four ballerinas and 10 theater staff members tested positive for the virus, including one person who worked in the hairdressing department, La Scala said in a statement to The Associated Press.
Italian health authorities placed several other people in quarantine because they were in close contact with those who were infected, the theater, officially known as Teatro alla Scala, said.
At least one of the ballerinas who tested positive appeared in the debut of the opera “Macbeth” last Tuesday, which heralded the start of the theater’s opera season. That show opened to a full house, a welcome change from last year when productions had to be televised because of the pandemic.
Virus outbreaks have also forced Broadway to pause several New York City productions in recent months.
“Wicked” canceled two shows in the past week because of “the detection of a limited number of positive Covid test results combined with previously scheduled absences in the company,” the production told BroadwayWorld.com. Performances resumed last Tuesday.
In November, after having to scrap more than a week’s worth of shows after members of its company tested positive for the coronavirus, the producers of the new Broadway play “Chicken & Biscuits” announced that it would end its run on Nov. 28 because of financial difficulties.
And in late September, “Aladdin” canceled performances because of a virus outbreak, a day after it staged its first show since Broadway closed for the pandemic in 2020.
The virus infections have occurred in the theater industry despite a strict vaccination mandate in place that applies to Broadway performers, backstage crew and theater staff, as well as audiences.
Here are the types of documentation that many destinations now require from U.S. travelers. As in prepandemic times, make physical copies of everything and if you have digital versions, organize them in an accessible place on your phone. Keep them handy, too, as you will be asked for your documents multiple times during your journey.
Proof of vaccination
No matter your destination, no matter what requirements it has for proving you are vaccinated against the coronavirus, it’s smart to bring your physical, C.D.C.-issued vaccine card with you, along with digital photos of your card and paper photocopies. You might not need it — be sure to store it safely — but don’t assume that a U.S.-based digital passport or QR code is acceptable.
A completed locator form
Some destinations, including the United Kingdom and certain European Union countries, require travelers to complete a digital passenger locator form before entering the country (you must submit the U.K. form in the 48 hours before you arrive in the country), to help with contact tracing.
Coronavirus test results
More countries now require proof of a negative test, often in addition to proof of vaccination. Depending on where you are going, some countries require P.C.R. tests, while others allow rapid antigen tests. The timing requirement of your test might ask for results between 24 or 72 hours before your arrival, or one to three days.
Mask mandates too vary by country and maybe localities, but you will most certainly need masks in airports, on your flight — and if you are going to most places in Europe and the U.K., for indoor activities like dining. And rather than hoping your cloth mask will have you covered, come prepared with surgical masks and N95s as well.
Proof of insurance
Not only is it a good idea to check your health-insurance policies if you get sick abroad, you should research whether proof of health or travel insurance is needed at your destination.
Test for your return trip
All travelers, vaccinated or not, wishing to fly into the United States from abroad are currently required to show proof of a negative coronavirus test — specifically, a rapid antigen or P.C.R. test — taken within one day of their flight.
The executives had a good feeling about Jan. 10, 2022 — the date when DocuSign’s 7,000 employees worldwide would finally come back to work.
This deadline wouldn’t be like that earlier one in May 2020, which was always a fantasy, or in August 2020, which was a bit ambitious, or in October 2021, a plan derailed by the Delta variant. Fourth time’s the charm.
“Every time we delay this we’re pushing off the inevitable,” said Joan Burke, the chief people officer, in a late November interview. “At some point in time DocuSign is going to be open.”
That some point in time is no longer in January. The Omicron variant interjected. Just as companies from Ford Motor to Lyft have done in the past week, DocuSign postponed again. In place of a new date came the company’s promise to “reassess our plans as 2022 unfolds.”
“Employees understand the evolving nature of what we’re dealing with makes it impossible to predict,” Ms. Burke said this month. “I can’t even remember all the dates we’ve put out there, and I’m the one who put them out there.”
Return-to-office dates used to be like talismans; the chief executives who set them seemed to wield some power over the shape of the months to come. Then the dates were postponed, and postponed again. At some point the spell was broken. For many companies, office reopening plans have lost their fear factor, coming to seem like wishful thinking rather than a sign of futures filled with alarm clocks, commutes and pants that actually button. The R.T.O. date is gone. It’s been replaced with “we’ll get back to you.”
“The only companies being dishonest are the ones giving employees certainty,” said Nicholas Bloom, a Stanford University professor who advises dozens of chief executives. “As a parent you can hide stuff from your kids, but as a C.E.O. you can’t do that to adult employees who read the news.”
Consider the denizens of the office — those figures hunched over their desks typing, pinging, barking into phones, scarfing down salads, sometimes closing the loop, always circling back. They’d love to touch base. They’ll do a deep dive, if it moves the needle.
Office lingo signals affiliation with an in-group. But that isn’t its only function. “Corporate language serves the purpose of papering over the messiness of being a person with emotions and contradictory impulses,” said Aparna Nancherla, a comedian who played a human resources representative on the Comedy Central show “Corporate.”
During the pandemic, Ms. Nancherla noted, as lives and routines were upended, that sleek language didn’t always meet the demands of the moment. “Corporate life is so tied to time and efficiency, and none of that felt like it mattered anymore,” she continued. “It felt like playacting, like keeping up this charade.”
Still, Ms. Nancherla, like millions of other Americans, found herself going through the motions: sending Google calendar invitations, logging onto video calls, adjusting her ring light as the world fell to pieces. New phrases cropped up to label those jarring experiences. There was social distancing, Covidiot, Zoom fatigue. Lexicographers took note of that gloomy vocabulary. In 2020, the digital word of the year was doomscrolling, according to the American Dialect Society. In 2021, burnout made Dictionary.com’s shortlist.
Employers relied on jargon more than ever, according to Andre Spicer, a professor at Bayes Business School, City, University of London, because the usual tools they had for building workplace community had disappeared. That meant inventing fresh terms as well as leaning on the classics, like disruption and road map. Then there were oldies that got an update. “I hope this finds you well” gained the addendum, “in these trying and unprecedented times.”