Nursing home residents, considered among the most vulnerable to Covid-19, appear to receive significant protection from vaccination, according to new research published Wednesday in the New England Journal of Medicine.
In a letter to the editor, the researchers said that the use of vaccinations also appeared to protect nursing home residents who did not get the immunization. That finding suggests, researchers said, that unvaccinated residents benefit when others around them receive the shot.
“These findings show the real world effectiveness” of the Pfizer-BioNTech and Moderna vaccines “in a vulnerable nursing home population,” the researchers wrote.
The findings conform to recent guidance from the Centers for Disease Control and Prevention about the protective benefit of vaccination. The federal agency, in hoping to encourage widespread immunizations, has said that those who get inoculated face sharply reduced risk, but considerable risk remains for those who do not.
The nursing home population has been one of the hardest hit during the pandemic; residents faced significant threat because of the ease of spread in close quarters among people with weakened immune systems. Since the pandemic began in the United States, more than 132,000 residents have died, representing about one-third of all the country’s deaths from Covid-19.
The study published Wednesday drew from more than 20,000 residents of 280 nursing homes in 21 states. Of those, almost 4,000 were unvaccinated and the rest received either the Pfizer or Moderna vaccines. About 70 percent had received two doses.
The study looked at residents of nursing home that had received at least one dose as of Feb. 15 and anyone at the facilities present on the first day of their vaccination clinic who had not yet been vaccinated as of March 31.
After receiving a first dose, 4.5 percent of residents still contracted the virus, although most cases were asymptomatic, researchers wrote. Of those receiving the second dose, only 0.3 percent got the virus after 14 days.
The benefit carried over to those in the same nursing homes who did not get vaccinated. Their rate of infection dropped to 0.3 percent from 4.3 percent. For all groups, most infections were asymptomatic; and the rate of both symptomatic and asymptomatic infections decreased over time.
“Robust vaccine coverage among residents and staff, together with the continued use of face masks and other infection-control measures, is likely to afford protection for a small number of unvaccinated residents,” the researchers wrote.
New York City’s reopening — a milestone longed for over the last 14 months — arrived at last on Wednesday. It was less a grand gala than a soft opening, a finish line at the end of a long race that no one wanted to be the first to cross.
Four hundred and twenty three days since the city shut down, on a Sunday in March 2020, when it accounted for half the nation’s coronavirus cases, its first day fully back in business was messy and inconsistent and confusing. In short, it was New York City, and a single set of new rules statewide was widely superseded by the personal comfort levels of the city’s millions of residents.
Although masks are no longer required in most situations for those who have been vaccinated, the majority of people, whether in the big-box stores and tiny boutiques of Manhattan or the shaded paths of Prospect Park in Brooklyn, seemed to have kept them firmly in place.
“It’s still store policy,” said Raj Lalbatchan, 23, a worker at Victoria, a store selling clothing in the Bronx. Nearby, Elisabeth Ocasio, 51, a server at the restaurant La Isla, said it is standing firm with the status quo. “We don’t know who’s vaccinated and who’s not,” she said. “We’re doing everything the same here.”
Across the United States, other states were also moving to reopen amid a drastic drop in new cases and expanded vaccine eligibility to those 12 and older. But the pace of average vaccinations has declined precipitously since mid-April and even some inoculated Americans have shown some skepticism of the new federal guidance allowing for fully vaccinated people to go without a mask in most circumstances. As of Wednesday, 48 percent of people have received at least one shot, according to federal data.
Outside the U.S., France loosened its rules on Wednesday, and the European Union agreed to reopen its borders to visitors who have been fully vaccinated with an approved shot, just in time for summer tourists. And yet, the virus continued to ravage India, which recorded 4,529 Covid-19 deaths on Tuesday, the pandemic’s highest single known daily death toll in any country so far.
As the virus was crushing New York City last year, testing was limited, hospitals were full and hundreds were dying every day. The living retreated to their apartments and the city, almost overnight, transformed into a shadow of itself. The city’s known death toll sits at more than 33,000 people.
But on Wednesday, scenes of joy alongside those of caution played out throughout the city. The owner of du Pont dry cleaners on Amsterdam Avenue in the Upper West Side, Byong Min, 64, spent 90 days in a hospital suffering from Covid last year, the scar from his tracheotomy visible above his collar. On Wednesday morning, a customer arrived and asked tentatively: Could she enter without a mask?
He said yes. But he regretted it moments later.
“She told me she was vaccinated and I am vaccinated, but wow, maybe I should be more careful,” he said. “I wasn’t really thinking. I just said OK.”
In Red Hook in Brooklyn, the Chelsea Garden Center, a bustling nursery, considered removing its 2-customer indoor limit, but stopped short. “It’s a little scary to change things,” said Bethany Perkins, an employee. “We’re so used to the rules right now.”
Mayor Bill de Blasio said on Wednesday morning that he planned to keep mask rules in place at city offices because there would be a mix of vaccinated and unvaccinated people there, and that he planned to wear a mask in most cases out of an abundance of caution.
“When you’re not sure, my personal advice is wear a mask,” the mayor said, adding “we’ve done it, for god’s sakes, for a year, we can do it a little bit longer to finish the job.”
Adeel Hassan and Daniel E. Slotnik contributed reporting.
The chief executive of Emergent BioSolutions, whose Baltimore plant ruined millions of coronavirus vaccine doses, disclosed for the first time on Wednesday that more than 100 million doses of Johnson & Johnson’s vaccine are now on hold as regulators check them for possible contamination.
In more than three hours of testimony before a House subcommittee, the chief executive, Robert G. Kramer, calmly acknowledged unsanitary conditions, including mold and peeling paint, at the Baltimore plant. He conceded that Johnson & Johnson — not Emergent — had discovered contaminated doses, and he fended off aggressive questions from Democrats about his stock sales and hundreds of thousands of dollars in bonuses for top company executives.
Emergent’s Bayview Baltimore plant was forced to halt operations a month ago after contamination spoiled the equivalent of 15 million doses, but Mr. Kramer told lawmakers that he expected the facility to resume production “in a matter of days.” He said he took “very seriously” a report by federal regulators that revealed manufacturing deficiencies and accepted “full responsibility.”
“No one is more disappointed than we are that we had to suspend our 24/7 manufacturing of new vaccine,” Mr. Kramer told the panel, adding, “I apologize for the failure of our controls.”
Mr. Kramer’s appearance before the House Select Subcommittee on the Coronavirus Crisis, which has opened a broad inquiry into his company, offered the public its first glimpse of the men who run Emergent, a politically connected federal contractor that dominates a niche market in biodefense preparedness, with the U.S. government as its prime customer.
Testifying virtually, Mr. Kramer was joined by the firm’s founder and executive chairman, Fuad El-Hibri, who over the past two decades has expanded Emergent from a small biotech outfit into a company with $1.5 billion in annual revenues. Executive compensation documents made public by the subcommittee show that the company’s board praised Mr. El-Hibri, who cashed in stock shares and options worth more than $42 million last year, for “leveraging his critical relationships with key customers, Congress and other stakeholders.”
Among those members of Congress is Representative Steve Scalise of Louisiana, the No. 2 House Republican and the top Republican on the House subcommittee. Federal campaign records show that since 2018, Mr. El-Hibri and his wife have donated more than $150,000 to groups affiliated with Mr. Scalise. The company’s political action committee has given about $1.4 million over the past 10 years to members of both parties.
Mr. El-Hibri expressed contrition on Wednesday. “The cross-contamination incident is unacceptable,” he said, “period.”
Mr. Kramer’s estimate of 100 million doses on hold added 30 million to the number of Johnson & Johnson doses that are effectively quarantined because of regulatory concerns about contamination. Federal officials had previously estimated that the equivalent of about 70 million doses — most of that destined for domestic use — could not be released, pending tests for purity.
BRUSSELS — The European Union agreed on Wednesday to reopen its borders to visitors who have been fully vaccinated with an approved shot and to those coming from a list of countries considered safe from a coronavirus perspective, permitting broader travel just in time for the summer tourism season.
Ambassadors from the 27 member states of the European Union endorsed a plan that would allow visits from tourists and other nonessential travelers, who have been mostly barred from entering the bloc for more than a year.
The move has been seen as an economic imperative for tourism-dependent countries such as Greece and Spain, and it has been months in the works. Other E.U. nations that are less reliant on tourists for jobs and income, particularly in northern Europe, had been eager to maintain higher barriers for nonessential visitors to keep the coronavirus at bay. But they relented as vaccinations advanced and after they were promised the ability to reverse course if cases surge again.
The new rules are set to become formal policy next week after clearing some bureaucratic hurdles, and, depending on how well each country has prepared to welcome tourists, could be implemented immediately. Some countries, like Greece, have already said that they will remove testing and quarantine requirements for vaccinated visitors. But most countries are likely to implement such changes more slowly and conservatively.
Some experts recently cautioned that restarting international tourism could be premature.
Dr. Sarah Fortune, the chair of the Department of Immunology and Infectious Diseases at the Harvard T.H. Chan School of Public Health, said that reopening areas to vaccinated tourists was a calculated risk.
“My doomsday scenario,” she said, “is a mixing of vaccinated and unvaccinated populations in a setting where there is high viral load and high viral transmission.”
Countries like Greece, Iceland and Croatia had opened to tourists from the United States and other countries before the bloc’s announcement.
Greece, where hospitality and tourism make up a large portion of the economy, was especially intent on reopening. Incoming tourists have to be vaccinated or present a negative PCR test taken up to 72 hours before their arrival, but they do not have to quarantine.
“Unfortunately, after more than 10 years of economic hardship, tourism and food is our only industry,” said Kostas Tzilialis, a co-owner and co-worker at a cafe and bookshop in Athens. “We don’t produce cars or machines. So we have to open our industry right now. Let’s hope that people will be careful and the vaccines will protect us.”
European Union member states will retain the freedom to tweak these measures if they want to take a more conservative approach, meaning that some European countries could retain demands for negative PCR tests or quarantines for certain visitors.
The bloc will also maintain an emergency-brake option, a legal tool that will allow it to quickly snap back to more restrictive travel conditions if a threatening new variant or other Covid emergency emerges.
Paige McClanahan and Stephen Hiltner contributed reporting.
New York State is taking its biggest step yet toward normalcy, or a new version of it.
Starting Wednesday, 14 months after pandemic restrictions began, most businesses can return to 100 percent capacity if customers maintain six feet of distance. The biggest change will be seeing the faces of New Yorkers again: Vaccinated people in most cases no longer have to wear masks, indoors or outdoors, unless businesses mandate them.
Theaters and other large venues, including ballparks, can return to full capacity, up from one-third, if they require patrons to show proof of vaccination. House parties will be allowed: Up to 50 people can gather indoors in private homes.
“This is an exciting moment; this has been a dark, dark hellish year,” Gov. Andrew M. Cuomo said on Monday, after announcing the end of the mask mandate. “But that was yesterday, and we are looking at a different tomorrow.”
But the reopening won’t be a sudden return to prepandemic life. Many New Yorkers will prefer to keep wearing masks. And some restaurant owners, like Annie Shi of King, a small restaurant in the West Village, said that with distancing requirements, “75 percent or 100 percent doesn’t mean a whole lot.”
Sal Rao, the owner of Mama Rao’s in Borough Park, Brooklyn, said that he and his staff — who all got vaccinated on one day, closing the restaurant to do it — will remain masked, but they will let patrons take off their masks on the honor system.
“We are going to let them come in and enjoy some of the privileges of being human again,” Mr. Rao said.
Masks, following new federal guidance, will continue to be mandatory on public transit and in schools from prekindergarten to 12th grade, in homeless shelters, correctional facilities, nursing homes and health care settings.
Mayor Bill de Blasio of New York City said on Wednesday morning that he planned to keep mask rules in place at city offices because there would be a mix of vaccinated and unvaccinated people there, and that he planned to wear a mask in most cases out of an abundance of caution.
“When you’re not sure, my personal advice is wear a mask,” the mayor said, adding “we’ve done it, for god’s sakes, for a year, we can do it a little bit longer to finish the job.”
In the coming weeks, major venues like Radio City Music Hall and Madison Square Garden will be opening or raising capacity at indoor concerts, shows and sporting events. Patrons will have to show either a paper vaccination card, the New York State digital Excelsior Pass or another digital form to enter or, in venues that allow unvaccinated attendees who test negative for the virus, to sit in vaccinated sections.
Restaurants will be allowed to place tables closer together to reach 100 percent capacity if five-foot-tall solid partitions are placed between them, Mr. Cuomo said. But some restaurants feel that using partitions compromises the dining experience, and Plexiglas can be expensive.
Mia Jacobs, a 23-year-old who lives in Crown Heights, Brooklyn, said the reopening feels “hopeful.” She works in social media in the restaurant and hospitality industry, and said she hopes that with the lifting of restrictions, “people will feel more encouraged to go to the restaurants they’ve been wanting to go to for an entire year.”
Even though she is fully vaccinated, Ms. Jacobs said she would probably continue to wear a mask, and that it would take time for her to get reacquainted with being surrounded by many people.
Mr. Cuomo said Wednesday that effective immediately that child care programs, and day and overnight camps, must conduct daily health screenings for all staff and visitors, including daily temperature checks. Unvaccinated people 2 and older must wear face masks unless they are eating, showering, swimming or sleeping, he said. Staff members who have not been vaccinated should stay six feet away from vaccinated staff, and each program or camp should have a capacity limit specific to their property that allows people to stay socially distanced.
Still, the lifting of restrictions meant to curb the spread of a virus that devastated the city comes as a welcome sign of New York’s progress. Cases are plummeting as more New Yorkers get shots — about 43 percent of people in New York State are fully vaccinated, according to C.D.C. data. Nationally, about 38 percent of Americans are fully vaccinated, as of Wednesday.
Mr. Rao, the restaurant owner, said “it was tough” doing temperature checks and contact tracing throughout the pandemic. “I think we are over that now,” he said. “I hope to God this is over.”
The vaccination woes of some of the world’s poorest nations will continue as the Serum Institute of India, a crucial manufacturing pillar in the plan to supply two billion doses of Covid-19 vaccines to low-income countries, signaled that it would not be able to provide vaccines beyond India before the year’s end.
The revelation, tucked into a statement by the vaccine manufacturing giant that attempted to deflect mounting criticism, was another setback for Covax, the global vaccine partnership for the poor. It is already more than 140 million doses behind schedule, and the Serum Institute’s announcement suggested it was all but impossible to meet the goal of two billion doses by the end of the year.
The announcement once again underscored the glaring contrast of inequality: As some of the richer nations tout levels of vaccinations that allow them to reopen their society, most of the poorer nations have barely gotten a start.
“We continue to scale up manufacturing and prioritize India,” the Serum Institute of India said in the statement on Tuesday. “We also hope to start delivering to Covax and other countries by the end of this year.”
The Serum Institute’s manufacturing capacity is at the heart of Covax, run by a global alliance that includes the World Health Organization. The institute received hundreds of millions of dollars to expand its facilities and manufacture the Oxford-AstraZeneca vaccine, licensed to it with the commitment that a large share would go to poor nations.
As part of its plan to have two billion doses by the end of the year, Covax has been counting on hundreds of millions of the Oxford-AstraZeneca vaccine produced by Serum Institute, as well as hundreds of millions of a second vaccine called Novavax that the company is developing.
After India’s devastating second wave of coronavirus infections, the institute diverted all its manufacturing powers to domestic needs, falling behind on commitments to the Covax partnership as well as on bilateral commercial deals with many countries. The institute played down each delay as temporary. But Tuesday’s statement makes clear it is unlikely to meet commitments before the end of the year.
So far, the Covax alliance has supplied only 65 million vaccines, spread across 124 countries, according to the World Health Organization. The W.H.O. said the global alliance was already 140 million doses behind and likely to miss another 50 million doses in June.
“Once the devastating outbreak in India recedes, we also need the Serum Institute of India to get back on track and catch up on its delivery commitments to Covax,” said Dr. Tedros Adhanom Ghebreyesus, the chief of W.H.O.
For its part, the Serum Institute has said its failure in international commitments has been due to the scale of the demand in India.
But India’s vaccination drive has been slow and is facing shortages despite all of Serum’s production capacity. Vaccinating a nation of 1.4 billion was always going to be a mammoth task that has been made more difficult by the government’s mismanagement of the crisis.
India has administered about 180 million doses of vaccines, or only about 5 percent of the country’s adult population. The vaccination rate has fallen to about 1.8 million doses a day, which means it would take the country more than three years to vaccinate 80 percent of its population.
While many cultural attractions in France were reopening on Wednesday as coronavirus restrictions were partially lifted, about a hundred state-funded theaters around the country remained under occupation by protesters, most of them actors, theater workers and students, forcing some institutions to cancel shows and raising worries of a prolonged crisis.
When the demonstrators first occupied theaters in Paris, Strasbourg and elsewhere several months ago, reopening theaters was one of their main demands, but now the protests may be keeping them closed. The anger has since coalesced around larger complaints that have pitted cultural workers against the French government, especially over an unpopular overhaul of unemployment benefits. The protesters, who worry that they will lose leverage and visibility if they move out, have vowed to continue their occupations.
The Odéon Theater in Paris, one of the main protest points, said this week that it had no choice but to cancel performances of “The Glass Menagerie” by Tennessee Williams, featuring Isabelle Huppert, as long as the 40 or so protesters continued to occupy the space day and night.
Stéphane Braunschweig, the director of the theater, said in a statement on Tuesday that it was impossible to stage evening shows with adequate safety and sanitary conditions if the occupation continued, and that his offer to let the protesters occupy the theater during the daytime only had been rejected.
Last week, after the government announced new subsidies and measures to support cultural workers, Mr. Braunschweig and the directors of other large state-funded theaters in Lyon, Nice and in Marseille, where shows were canceled at the Criée Theater this week, had called for the occupations to end.
“The social struggle, whatever its legitimacy, cannot for us prevent the resumption of cultural life,” they wrote in a joint statement.
Protesters at the Odéon accused the director of refusing to consider solutions that would let the occupation continue side-by-side with performances by splitting use of the space.
“Management is trying to place the blame of the cancellation on us even though we are asking exactly the opposite,” Denis Gravouil, a representative for the C.G.T. union, told reporters in front of the theater on Wednesday.
Mr. Gravouil noted that theaters are opening at below half capacity because of coronavirus restrictions, meaning that many actors and technicians still can’t resume their jobs, and he said the government still hadn’t fully addressed the pandemic-related loss of income for many of them.
“We don’t want to block shows, we want everyone to work,” he said.
New York City businesses, and the workers who make them run, have had to navigate shifting regulations from the city and state since the start of the pandemic. For many of those businesses, the struggle for safety was paired with the struggle for solvency.
Most of those regulations came to an end on Wednesday, when the state removed most capacity restrictions from businesses statewide and adopted federal guidelines that allow people who have been vaccinated to largely eschew masks, indoors and out, in most situations.
The reaction from many city dwellers was cautious, after more than a year in which the city’s known virus death toll climbed to more than 33,000 people. Workers at many businesses around the five boroughs expressed similar reluctance to leap back into normal behavior.
Chris Polanco, 32, a clerk at Melrose Hardware in the Bronx, said he will keep his mask and the plastic curtain in front of the cash register, and would continue asking people to mask up in his store, offering masks to people who do not have them.
“You never know if they’re vaccinated or not, unless they have their papers, and there are forgeries,” Mr. Polanco said.
Caution also prevailed in much of the Corona neighborhood of Queens, one of the hardest-hit areas in the country.
Irene DeBenedittis owns Leo’s Latticini, an Italian deli there. She said that even though she and her staff had been vaccinated she planned to keep requiring masks, as a courtesy and a precaution.
“I am a bit confused about the rules, and also concerned about the customer,” Ms. DeBenedittis said. “For now, we are keeping the mask on so we feel safe and our customers feel safe too.”
Representatives for far larger groups of workers also said they planned to move slowly.
Robert W. Newell Jr., the president of a union that represents 17,000 workers, mainly in supermarkets and food production, said, “I’ve asked everyone to keep their masks on, at least for another couple of weeks.”
One of the city’s largest employers, its municipal government, will also keep masks for now, Mayor Bill de Blasio said on Wednesday morning.
Of course it is difficult to distinguish who has and has not been vaccinated. “Vaccine passports” like New York State’s Excelsior Pass are not widely in use, and many consider a vaccine honor code flimsy. Even if proof of vaccination is bolstered somehow, it may be harder for individual business owners to enforce mask rules when they are no longer universal.
Rebecca Robertson, executive director of the Park Avenue Armory, said the indoor performance venue would retain its strict masking policy for Wednesday’s opening night performance of “Afterwardsness,” a modern dance piece in which patrons sit nine feet apart.
The venue plans to continue to require all audience members to wear masks for the foreseeable future.
Ms. Robertson noted that the state continues to strongly recommend masking when a mix of vaccinated and unvaccinated people are together indoors, which to her is just a shade below a requirement.
“If the government says to you it is strongly recommended, for us it’s like a mandate,” Ms. Robertson said.
Not all businesses were so hesitant — some have spurned the rules for much of the pandemic.
One of them is Mac’s Public House, a Staten Island tavern that became a symbol of much of the borough’s defiance to virus regulations when it refused to follow the governor’s curfew and indoor dining bans last year.
The bar lost its liquor license and was told to close, but kept serving customers indoors, channeling the defiance that many Staten Islanders held for the regulations. Danny Presti, Mac’s manager, was arrested twice, and the bar was finally closed down.
On Wednesday Mr. Presti seethed as nearby restaurants and bars reopened while Mac’s remained padlocked.
“It’s frustrating,” Mr. Presti said. “It’s not like I was this lifelong criminal, it was all for businesses, bringing attention to the situation.”
Nate Schweber, Sharon Otterman, Kimiko de Freytas-Tamura and Sadef Ali Kully contributed reporting.