Tag: Variants

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A vaccination site administering the Sinopharm Covid-19 vaccine in North Macedonia on Thursday.Credit…Ognen Teofilovski/Reuters

The World Health Organization on Friday approved China’s Sinopharm’s Covid-19 vaccine for emergency use, easing the way for poorer nations to get access to another much-needed shot to help end the pandemic.

The approval allows the Sinopharm vaccine to be included in Covax, the World Health Organization’s global initiative that is designed to promote equitable vaccine distribution around the world.

The need is dire.

Rich countries are hoarding doses. India, a major vaccine maker, has stopped exports to address its worsening coronavirus crisis. Questions about safety after exceedingly rare side effects led some countries to briefly pause using AstraZeneca and Johnson & Johnson doses or change their guidance around the use.

Reliable vaccine access could improve further next week when the W.H.O. considers another Chinese shot, made by the company Sinovac.

Andrea Taylor, who analyzes global data on vaccines at the Duke Global Health Institute, called the potential addition of two Chinese vaccines into the Covax program a “game changer.”

“The situation right now is just so desperate for low- and lower-middle-income countries that any doses we can get out are worth mobilizing,” Ms. Taylor said. “Having potentially two options coming from China could really change the landscape of what’s possible over the next few months.”

But the fanfare may be short-lived. While China has claimed it can make up to 5 billion doses by the end of this year, Chinese officials say the country is struggling to manufacture enough doses for its own population and are cautioning a pandemic-weary world to keep expectations in check.

“This should be the golden time for China to practice its vaccine diplomacy. The problem is, at the same time, China itself is facing a shortage,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations. “So in terms of global access to vaccines, I don’t expect the situation to significantly improve in the coming two to three months.”

Still, the approval represents a high point in its vaccine diplomacy efforts and a chance to fill the gap left by Western nations and pharmaceutical companies in low- and middle-income countries. Sinopharm is the first Chinese shot to be classified as safe and effective by the W.H.O., and its approval could ease concerns about the lack of transparency from Chinese vaccine companies.

Regulators from China and other countries have approved the Sinopharm vaccine in recent months, though the company has not released Phase 3 clinical trial data for scientists to independently assess.

The W.H.O. was given access to this data before the announcement, but there is limited data on how well the vaccine will work against the many coronavirus variants cropping up around the world.

United States ›	United StatesOn May 6	14-day change
New cases	47,325	–27%
New deaths	818	–4%

World ›	WorldOn May 6	14-day change
New cases	856,719	Flat
New deaths	13,873	+9%

U.S. vaccinations ›

Ton Tran, 106, receiving his second dose of the Pfizer-BioNTech Covid-19 vaccine at a clinic in San Jose, Calif., on Thursday.Credit…Noah Berger/Associated Press

Pfizer and the German company BioNTech have become the first companies to apply to the U.S. Food and Drug Administration for full approval of their Covid-19 vaccine for use in people 16 and older. The vaccine is currently being administered to adults in America under an emergency use authorization granted in December.

The approval process is likely to take months.

The companies said in a statement on Friday that they had submitted their clinical data, which includes six months of information on the vaccine’s safety and efficacy, to the F.D.A. They plan to submit additional material, including information about the manufacturing of the vaccine, in the coming weeks.

“We are proud of the tremendous progress we’ve made since December in delivering vaccines to millions of Americans, in collaboration with the U.S. government,” Dr. Albert Bourla, Pfizer’s chief executive, said in the statement. “We look forward to working with the F.D.A. to complete this rolling submission and support their review, with the goal of securing full regulatory approval of the vaccine in the coming months.”

As of Thursday, more than 134 million doses of the vaccine had been administered in the United States, according to the Centers for Disease Control and Prevention. Full approval would allow Pfizer and BioNTech to market the vaccine directly to customers.

It could also make it easier for companies, government agencies and schools to require vaccinations. The Equal Employment Opportunity Commission said in December that employers could mandate vaccination, and legal experts have generally agreed.

Many companies have been hesitant to require the vaccines, especially while they have only emergency authorization, which is designed to be temporary. Some institutions, like the University of California and California State University systems, have said that they would do so only after a vaccine has full approval.

Full approval could also prompt the U.S. military, which has had low uptake of Covid-19 vaccines, to mandate vaccinations for service members.

If the F.D.A. grants full approval, it could also help raise confidence in the vaccine. The pace of vaccination has slowed in the United States in recent weeks, and a recent national survey indicated that most people in the country who planned to get the shots had already done so.

The agency is also expected to issue an emergency authorization for use of the Pfizer-BioNTech vaccine in 12- to 15-year-olds next week. The companies have said that they plan to file for emergency authorization for 2- to 11-year-olds in September.

Moderna plans to apply for full approval for its Covid-19 vaccine this month, the company said during its quarterly earnings call on Thursday.

Director of the Center for the National Center for Immunization and Respiratory Diseases Dr. Nancy Messonnier spoke in Washington in January 2020.Credit…Amanda Voisard/Reuters

Dr. Nancy Messonnier, who famously warned the nation early last year that the coronavirus would upend their lives, resigned from her position at the Centers for Disease Control and Protection on Friday.

Dr. Messonnier’s resignation is effective May 14. She is taking on a new role as an executive director at the Skoll Foundation, a philanthropical organization based in Palo Alto, Calif., she told staff in an email on Friday.

Her exit may augur more changes at the agency. Reports have circulated for weeks that the C.D.C.’s new director, Dr. Rochelle Walensky, planned to completely reorganize the division Dr. Messonnier led.

“My family and I have determined that now is the best time for me to transition to a new phase of my career,” Dr. Messonnier wrote in the email to staff.

Dr. Messonnier began her career in public health in 1995 with a stint in the prestigious Epidemic Intelligence Service. She has since held a number of leadership posts in the C.D.C. Since 2016, she has served as director of the National Center for Immunization and Respiratory Diseases, the C.D.C. division responsible for managing influenza and other respiratory threats.

In late 2019, she became the agency’s lead in responding to the coronavirus, and initially shared a stage with President Trump at briefings about the coronavirus.

She fell out of favor with President Trump and sent stocks tumbling after she sounded a dire alarm about the coronavirus, saying it would disrupt the lives of every American.

“It’s not a question of if this will happen but when this will happen and how many people in this country will have severe illnesses,” she said on Feb. 25, just as Mr. Trump was boarding Air Force One in New Delhi for his flight home.

Soon after that, she stopped appearing at briefings of the White House and of the C.D.C.

Patients with Covid-19 in the emergency ward at the Holy Family hospital in New Delhi on Thursday.Credit…Rebecca Conway/Getty Images

India’s worsening coronavirus outbreak has spread far outside its cities to rural areas with poor health care infrastructure and limited testing capacities, doctors and experts say.

One factor behind the surge of cases, they believe, is a series of recent campaign rallies held without social distancing.

The state of West Bengal, where Prime Minister Narendra Modi’s party lost an election last week after more than a month of campaigning to vast crowds, is recording the highest rate of positive coronavirus tests in the country. More than 31 percent of tests in the state are now coming back positive.

“There is a clear pattern here: States that went through elections and where large rallies were held are witnessing a huge rise in cases,” said Dr. Thekkekara Jacob John, a senior virologist in the southern state of Tamil Nadu.

In Uttar Pradesh, India’s most populous state, 1,028 new coronavirus cases and four deaths were recorded on March 26. On April 29, after campaigns for local village council elections were held, there were 35,104 cases and 288 deaths. A teachers’ union in the state said that 577 teachers and support staff members who were on duty as election workers had died of Covid-19.

The country’s cases as a whole have been skyrocketing since late March, from a seven-day average of more than 62,000 on March 31 to more than 385,000, according to the Our World in Data project at the University of Oxford. On Friday, the country reported more than 410,000 new daily infections, a record, and more than 3,900 deaths.

As the outbreak reaches new heights, India’s vaccination campaign has slowed down, marred by supply shortages and competition among states.

The official daily death in the country has stayed over 3,000 over the past 10 days, and experts say the numbers are much higher,.

The true scope of the outbreak remains hard to measure. Nationwide, India conducted about 1.9 million coronavirus tests on Thursday, an increase from about 1.2 million daily tests last month, but hardly enough to keep up with a daily caseload that has almost quadrupled in that time.

West Bengal, a state of 90 million people that has poor health care infrastructure and is under a partial lockdown, has carried out fewer than 60,000 coronavirus tests a day. That is one of the lowest rates in the country, according to data compiled by researchers at the University of Michigan.

Dr. Abhijeet Barua, a physician in Kolkata, the state’s capital, said that cases had exploded in every corner of the city and that infections were spreading quickly in the state’s rural areas. At his 10-bed clinic, two people have died every day over the past 15 days, Dr. Barua said.

“What is making things worse in Kolkata is that over 70 percent of the population lives in close contact,” he said, adding that he was receiving dozens of calls a day from patients seeking help. “You can’t isolate yourself, because it is so congested here.”

Mr. Modi has repeatedly refrained from imposing a nationwide lockdown. Instead nearly a dozen of India’s 28 states have imposed restrictions, though they are less stringent than the nationwide lockdown put in place last year.

Protective masks are worn in March in Tokyo, the host of this summer’s Olympic Games.Credit…Noriko Hayashi for The New York Times

TOKYO — Japan on Friday extended a state of emergency in Tokyo and other regions until the end of May to contain a surge of coronavirus cases, casting further doubt on the country’s ability to safely host the Summer Olympics, which are scheduled to begin in 11 weeks.

Prime Minister Yoshihide Suga made the announcement at a meeting of the government’s coronavirus task force, saying that the measures were necessary because infections remain at a “high level, mainly in large cities.”

The announcement extends emergency measures imposed last month to two more prefectures, covering a total of six prefectures, including Tokyo and Osaka, that are together home to over a third of Japan’s 126 million people. Another eight prefectures will be under slightly looser restrictions.

The existing state of emergency, which were imposed to curb travel during the just-ended Golden Week holiday period and had been set to expire next week, have not slowed Japan’s fourth wave of coronavirus infections. In early March, the country recorded about 1,000 daily new. It is now recording nearly 6,000, according to a New York Times database.

Health officials say that they are seeing a growing number of cases of coronavirus variants spreading in the population, including at least 26 cases of the strain first detected in India. The authorities in Tokyo say that in four out of five cases found in the city, the infected person neither traveled abroad nor had close contact with someone who had.

The outbreak is stretching health care systems even in Japan’s biggest cities. On Thursday, there were 370 people being treated for serious cases of Covid-19 in Osaka, a prefecture of nine million people, more than the number of hospital beds available for seriously ill patients.

Japan, which has recorded more than 620,000 infections and 10,000 deaths since the start of the pandemic, has controlled the virus better than many countries. But the government has faced criticism for the sluggish pace of vaccinations, and for pledging to go ahead with the Tokyo Olympics, scheduled to begin on July 23, despite widespread public opposition.

Toru Hashimoto, a lawyer and a former governor of Osaka prefecture, said on a television show on Friday that Olympic organizers were ignoring the severity of Japan’s outbreak, and that it was inappropriate to continue holding pre-Olympic “test events” during the state of emergency, even though they are taking place without spectators.

“If the government wants to reduce the number of people in the city, it’s not a time when test events can be held,” Mr. Hashimoto said.

The government has imposed two previous states of emergency during the pandemic, although they are looser than the total lockdowns seen in many nations. The measures allow the prefectures to ask businesses to close or to restrict their hours, and to fine those that do not.

Under the extended state of emergency, people are asked not to go out for nonessential matters, especially after 8 p.m., and to refrain from traveling outside their prefectures. Karaoke parlors are asked to close, and restaurants requested not to serve alcohol, with fines of up to 300,000 yen, or $2,750, for noncompliance.

A vaccination center in Johannesburg in March.Credit…Joao Silva/The New York Times

A global debate is heating up over how to get Covid-19 vaccines to the nations most in need.

The United States supports an effort to suspend intellectual property protections on Covid-19 vaccines, and European countries say that richer nations should begin exporting more of their vaccine supply to poorer ones.

The European Union — whose approval is needed for any waiver of vaccine patents — said on Thursday that it would consider the Biden administration’s proposal. But Germany, the bloc’s largest economy, said that pushing pharmaceutical companies to share vaccine patents could have “significant implications” for the production of vaccines. The European Commission signaled it wouldn’t support the U.S. proposal.

“The limiting factor in vaccine manufacturing is production capacity and high-quality standards, not patents,” a spokeswoman for Chancellor Angela Merkel of Germany said in a statement.

Europe’s position emphasized the challenges of winning support for the waivers at the World Trade Organization, where the bloc wields significant influence, and where unanimous approval would be needed for any measure to suspend patents.

Many experts believe that the waivers are needed to expand the manufacturing of vaccines and get them to poorer parts of the world where inoculations have lagged behind those of richer countries.

Until the Biden administration’s announcement this week, the United States had been a major holdout at the W.T.O. over a proposal by India and South Africa to suspend some intellectual property protections. The move could give drugmakers access to the trade secrets of how the vaccines are made.

The pharmaceutical industry has argued that suspending patent protections would undermine risk-taking and innovation.

The debate arises amid a growing divide between wealthy nations that are slowly regaining normal life, and poorer countries that are confronting new and devastating outbreaks.

In India, which is suffering the world’s worst outbreak since the start of the pandemic, only 2.2 percent of the population is fully vaccinated, according to a New York Times database. South Africa has fully vaccinated less than 1 percent of its people. By contrast, vaccinations are slowing down in the United States — where one-third of people are fully inoculated — as they begin to pick up in Europe.

Even if a waiver receives support from the trade body, it alone would not increase the world’s vaccine supply. Large drug manufacturers in India and elsewhere would need extensive technological and other support to produce doses, experts say.

The American jobs engine slowed markedly last month, confounding rosy forecasts of the pace of the recovery and sharpening debates over how best to revive a labor market that was severely weakened by the coronavirus pandemic.

Employers added 266,000 jobs in April, the government reported Friday, far below the vigorous gains registered in March. The jobless rate rose slightly to 6.1 percent, as more people rejoined the labor force.

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“It turns out it’s easier to put an economy into a coma than wake it up,” Diane Swonk, chief economist for the accounting firm Grant Thornton, said of the disappointing report. “It’s understandable, it’s going to take some time, you’re not just going to snap your fingers and get everyone back to work,

Economists had forecast an addition of about a million jobs. The increase for March was revised down to 770,000 from 916,000.

The Alliance for American Manufacturing blamed supply chain problems for the loss of 18,000 jobs in that sector, noting in particular the impact that a shortage of semiconductors has had on the automotive industry.

And many offices are not yet ready to reopen fully. “I just think it takes a while for businesses to figure out how many people they need,” Ms. Swonk said, noting there is still a lot of skittishness on the part of employers and workers. “I don’t view this as terribly troubling or distressing.”

Ben Herzon, executive director of U.S. economics at the financial services company IHS Markit, agreed. “A single report with unexpected weakness in job gains is not a cause for concern,” he said. “Demand is picking up, activity is picking up.”

He noted that labor force participation had been on the upswing for two months in a row, rising to 61.7 percent last month from 61.4 percent in February.

More opportunities are bubbling up as coronavirus infections ebb, vaccinations spread, restrictions lift and businesses reopen. Job postings on the online job site Indeed are 24 percent higher than they were in February last year.

“There’s been a broad-based pickup in demand,” said Nick Bunker, who leads North American economic research at the Indeed Hiring Lab. The supercharged housing market is driving demand for construction workers. There is also an abundance of loading, stocking and other warehousing jobs — a side-effect of the boom in e-commerce.

The economy still has a lot of ground to regain before returning to prepandemic levels. Millions of jobs have vanished since February 2020, and the labor force has shrunk.

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152.5 million jobs in February 2020

As the economy fitfully recovers, there are divergent accounts of what’s going on in the labor market. Employers, particularly in the restaurant and hospitality industry, have reported scant response to help-wanted ads. Several have blamed what they call overly generous government jobless benefits, including a temporary $300-a-week federal stipend that was part of an emergency pandemic relief program.

But there are other forces constraining the return to work. Millions of Americans have said that health concerns and child care responsibilities — with many schools and day care centers not back to normal operations — have prevented them from returning to work. Millions of others who are not actively job hunting are considered on temporary layoff and expect to be hired back by their previous employers once more businesses reopen fully. At the same time, some baby boomers have retired or switched to working part time.

An 18-year-old student received a shot of a coronavirus vaccine in Los Angeles last month.Credit…Etienne Laurent/EPA, via Shutterstock

A series of vaccine developments and the loosening of restrictions amid an improving virus trajectory may foreshadow a welcome return to normalcy for many young Americans, just as summer vacation nears.

By early next week, the Food and Drug Administration is expected to issue an emergency use authorization allowing the Pfizer-BioNTech coronavirus vaccine to be used in children 12 to 15 years old, a major step ahead in the United States’ efforts to tackle Covid-19. Pfizer also expects to seek federal clearance in September to administer the vaccine to children age 2 to 11, the company said on Tuesday.

Vaccinating children is key to raising the level of immunity in the population, experts say, and to bringing down the numbers of hospitalizations and deaths. It could also put school administrators, teachers and parents at ease if millions of adolescent students become eligible for vaccination before the next academic year begins.

The move would be a major leap forward, experts say, and comes as the director of the Centers for Disease Control and Prevention, Dr. Rochelle Walensky, said that vaccinated adolescents would be able to remove their masks outdoors at summer camps.

Yet the eagerness of parents to let their children be vaccinated is limited, according to a new national poll, which found that three in 10 parents surveyed said they would get their children vaccinated right away and 26 percent said they wanted to wait to see how the vaccine was working. About 23 percent said they would definitely not get their children vaccinated, and 18 percent said they would do so only if a child’s school required it. The survey also noted that only 9 percent of respondents said they had not yet gotten a shot but still intended to do so, one more indication that achieving widespread immunity in the United States is becoming increasingly challenging.

As health experts focus on the future of vaccinating children, a growing number of students have returned to in-person learning this school year. In March, 54 percent of K-8 schools were open for full-time in-person learning, and 88 percent were open for either full-time in-person and/or hybrid learning, according to data from a federal government survey released on Thursday. But Black, Hispanic and Asian students are enrolled in full-time in-person learning at much lower rates than white students.

The Biden administration has made an aggressive push for reopening schools in recent months, including an effort to prioritize vaccinations for teachers and employees.

An airplane landing at the airport in Frankfurt, Germany.Credit…Michael Probst/Associated Press

One returning pilot lost control of an aircraft during landing and skidded off the runway into a ditch. Another just returning from furlough forgot to activate a critical anti-icing system designed to prevent hazards in cold weather. Several others flew at the wrong altitudes, which they attributed to distractions and lapses in communication.

In all of these incidents, which were recorded on NASA’s Aviation Safety Reporting System, a database of commercial aviation mistakes that are anonymously reported by pilots and other airline crew, the pilots involved blamed the same thing for their mistakes: a lack of practice flying during the pandemic.

In 2020, global air passenger traffic experienced the largest year-on-year decline in aviation history, falling 65.9 percent compared with 2019, according to the International Air Transport Association. Flights were grounded, schedules reduced and thousands of pilots were laid off or put on furlough for up to 12 months.

As vaccination programs pick up speed across some parts of the world and travel starts to rebound, airlines are beginning to reactivate their fleets and summoning pilots back as they prepare to expand their schedules for the summer. But returning pilots can’t just pick up where they left off.

“It’s not quite like riding a bike,” said Joe Townshend, a former pilot for Titan Airways, a British charter airline, who was laid off when the pandemic hit in March last year.

“You can probably go 10 years without flying a plane and still get it off the ground,” he said, “but what fades is the operational side of things.”

Marc Johnson, a virologist at the University of Missouri, examining samples of wastewater to track the coronavirus.Credit…MichaelB Thomas for The New York Times

Although Covid-19 is primarily a respiratory disease, research conducted early in the pandemic revealed that people infected with the coronavirus often shed it in their stool. This finding, combined with the scale and urgency of the crisis, spurred immediate interest in tracking the virus by sampling wastewater.

In the past year, many scientists have been drawn into the once niche field of wastewater epidemiology. Researchers in 54 countries are tracking the coronavirus in sewage, according to the Covid19Poops Dashboard, a global directory of the projects.

These teams have found that the wastewater data seemed to accurately indicate what was happening in society. When the number of diagnosed Covid-19 cases in an area increased, more coronavirus appeared in the wastewater. Levels of the virus fell when areas instituted lockdowns and surged when they reopened.

Several teams have also confirmed that sewage can serve as an early warning system: Wastewater viral levels often peaked days before doctors saw a peak in official Covid-19 cases.

And wastewater analysis has allowed scientists to detect the arrival of certain variants in a region weeks before they are found in people — and to identify mutations that have not yet been detected in people anywhere.

The surveillance is not a replacement for clinical testing, experts said, but can be an efficient and cost-effective complement. The approach is likely to be especially valuable in low- and middle-income countries, where testing resources are more limited.

“Not every population gets tested, not everyone has access to health care,” said Dr. Marc Johnson, a virologist at the University of Missouri. “If there’s groups of people that are asymptomatic, they probably aren’t getting tested either. So you aren’t really getting the full big picture. Whereas for our testing, everyone poops.”

global roundup

Administering the AstraZeneca vaccine in Nottingham, England, last month.Credit…Oli Scarff/Agence France-Presse — Getty Images

Britain’s vaccines regulator advised on Friday that all adults under 40 in the country should be offered alternatives to AstraZeneca’s Covid-19 vaccine. It factored in concerns over very rare blood clots, the dwindling risk of severe coronavirus infection in younger adults and the availability of alternatives.

The guidance extends earlier advice that people under 30 would be offered alternative doses.

The use of the AstraZeneca vaccine has been marred by uncertainty after reports of a possible link between the doses and very rare blood clots, but public health experts around the world say that the vaccine’s benefits far outweigh the risks for most people.

Britain’s Joint Committee on Vaccination and Immunization stressed that the chances of younger people becoming seriously ill with the coronavirus had grown smaller as infection rates decrease across the country. It said that this new reality paired with the availability of alternative vaccines had factored into the decision.

In other news from around the world:

• Australia will resume repatriation flights for Australian nationals in India after May 15, Prime Minister Scott Morrison said on Friday. The resumption will end a travel ban that made it a criminal offense for citizens and residents of Australia to enter the country from India. No other democratic nation has issued a similar ban on all arrivals.

• Tunisia will enter a weeklong nationwide lockdown starting on Sunday, Prime Minister Hichem Mechichi said on Friday. The country of nearly 12 million people has reported 11,122 deaths and 315,000 cases, according a New York Times database.

Here’s what you need to know:

South African health care workers were given the Johnson & Johnson vaccine at a hospital in Johannesburg in March.Credit…Joao Silva/The New York Times

South Africa will resume the use of the Johnson & Johnson vaccine to inoculate health care workers next week, offering some relief to the country that has suffered a series of blows to its vaccination efforts in recent months, according to South African authorities.

The country suspended an early-access Johnson & Johnson vaccination program last week after health officials in the United States put a pause on the vaccine amid concerns of rare blood clots that emerged in a handful of people who received it.

South Africa’s decision to move forward again was the second green light this week for Johnson & Johnson. On Tuesday, the European Union drug regulator also recommended resuming the rollout of the company’s vaccine.

Now, many eyes are on Washington, where a federal advisory panel is scheduled to meet Friday to discuss whether to lift the pause in the United States.

The blood clots that led to the Johnson & Johnson suspensions were all reported in the United States. In South Africa, officials confirmed Thursday that no cases of clots have been reported among the roughly 290,000 health care workers who have received the vaccine so far.

“The temporary suspension in South Africa was in line with government’s commitment to ensure comprehensive measures are undertaken regarding vaccine rollout,” Khumbudzo Ntshavheni, a cabinet minister, told reporters on Thursday.

Health experts welcomed the resumption of the vaccine campaign in South Africa, which has recorded more coronavirus cases than any other country on the continent and has suffered serious setbacks in its attempt to combat the virus in recent months.

In February, health officials scrapped plans to use the AstraZeneca vaccine after it proved ineffective against a variant of the virus now dominant in South Africa. The decision came a week after a million doses of the vaccine arrived in the country and amid a devastating second wave of virus cases.

Though the Johnson & Johnson vaccine has not yet been approved for general use in South Africa, it has been used as part of a research study offering early access to the vaccine to the country’s 1.2 million health care workers.

South African health officials are gearing up to extend vaccinations to the general public starting in May. In a first step to launching a national rollout, the country last week opened its vaccine registration to people over 60 years old, who will be among the first to be inoculated.

That plan depends on tens of millions of doses of the Pfizer-BioNTech vaccine, which requires two doses and will be used in major cities. The single-shot Johnson & Johnson vaccine, which is easier to store and better for hard-to-reach populations, will be used in the country’s rural areas.

United States ›	United StatesOn Apr. 21	14-day change
New cases	64,853	–4%
New deaths	879	–1%

World ›	WorldOn Apr. 21	14-day change
New cases	952,928	+23%
New deaths	17,951	+14%

U.S. vaccinations ›

People waiting in line to register for a vaccination in Brooklyn earlier this month.Credit…Spencer Platt/Getty Images

Federal health officials appear to be leaning toward lifting their recommended pause on the use of Johnson & Johnson’s coronavirus vaccine after finding only a limited number of additional cases of a rare blood clotting disorder among recipients.

Instead, the Food and Drug Administration is likely to attach a warning to the vaccine’s label to inform health practitioners — and the public — about the exceedingly uncommon, but dangerous possible side effect.

Federal health officials are waiting to act until they hear from a committee of outside experts who advise the C.D.C. The committee is scheduled to meet on Friday to discuss whether to recommend lifting, extending or modifying the pause that was initiated on April 13.

“We know that it’s not a good thing to leave the pause going for any longer than it absolutely has to go for,” Dr. Peter Marks, the Food and Drug Administration’s top vaccine regulator, said Thursday, adding that a protracted pause could contribute to greater vaccine hesitancy. “Once, essentially, the adequate discussion has occurred, we’re prepared to move as quickly as we possibly can.”

When top federal health officials abruptly decided early last week to recommend a temporary halt in the use of the shot, six women had been reported to have suffered from the disorder, a combination of clots in the brain that led to bleeding and low platelets, components of the blood that normally help to heal wounds.

That was fewer than one in a million recipients of Johnson & Johnson’s shot in the United States. But officials worried that more cases were hidden or could develop shortly as the new vaccine rolled out.

That fear has not materialized.

Dr. Marks and Dr. Janet Woodcock, the F.D.A.’s acting commissioner, said the clotting disorder appeared to be nearly as rare as they hoped it would be when they recommended the pause.

“We’ve now received more cases, but it isn’t an avalanche,” Dr. Woodcock said “We’re not seeing a big surge, which is a great relief.”

Even if the C.D.C.’s advisory committee decides Friday that the benefits of Johnson & Johnson’s single-dose vaccine outweigh its risks, the company will still face manufacturing hurdles at a Baltimore plant that regulators have refused so far to certify. That plant was supposed to deliver the bulk of the nearly 100 million doses the firm had promised to have ready by the end of May.

But it would mean a temporary surge of about 10 million shots that were effectively put on hold when the pause was announced.

A man who died of complications from the coronavirus was being cremated in Mumbai on Wednesday.Credit…Atul Loke for The New York Times

India’s rapidly worsening coronavirus outbreak is now expanding on a scale beyond any previously measured in more than a year of the pandemic: The health ministry reported more than 310,000 new infections on Thursday, the most recorded in any country on a single day.

India’s total eclipsed the previous one-day high of 300,669 recorded coronavirus cases, set in the United States on Jan. 8, according to a New York Times database, though differences in testing levels from country to country, and a widespread lack of tests early in the pandemic, make comparisons difficult.

Over the past two months, the outbreak in India has exploded, with reports of superspreader gatherings, oxygen shortages and ambulances lined up outside hospitals because there were no ventilators for new patients.

As cases worldwide reach weekly records, a substantial proportion of the new infections are coming in India, a sobering reminder that the pandemic is far from over, even as infections decline and vaccinations speed ahead in the United States and other wealthy parts of the world. India has surpassed 15.6 million total reported infections so far, second-most after the United States.

The death toll has also begun to climb precipitously.

On Thursday, the Indian government recorded 2,104 deaths, and an average of more than 1,600 people have died of the virus every day for the past week. That is less than the tolls at the worst points of the pandemic in the United States or Brazil, but it is a steep increase from just two months ago, when fewer than 100 people in India were dying daily.

There are signs that the country’s health system, patchy even before the pandemic, is collapsing under the strain. On Tuesday, at least 22 people died in an accident in the central city of Nashik when a leak in a hospital’s main oxygen tank cut the flow of oxygen to Covid-19 patients.

The picture is staggeringly different from early February, when India was recording an average of just 11,000 cases a day, and domestic drug companies were pumping out millions of vaccine doses. More than 132 million Indians have received at least one dose, but supplies are running low and experts warn that the country is unlikely to meet its goal of inoculating 300 million people by the summer.

Critics say Prime Minister Narendra Modi, who imposed a harsh nationwide lockdown in March 2020 in the early stages of the pandemic, failed to prepare for a second wave or to warn Indians to remain vigilant against the virus, especially as more infectious variants began to spread.

Mr. Modi’s Hindu nationalist government has also allowed a massive Hindu festival to take place, drawing millions of pilgrims to the banks of the Ganges River, and his party has held packed political rallies in several states.

“India’s rapid slide into this unprecedented crisis is a direct result of complacency and lack of preparation by the government,” Ramanan Laxminarayan, the director of the Center for Disease Dynamics, Economics and Policy in Washington, wrote in The New York Times on Tuesday.

The hardest-hit region is Maharashtra, a populous western state that includes the financial hub of Mumbai. On Wednesday, the state’s top leader ordered government offices to operate at 15 percent capacity and imposed new restrictions on weddings and private transportation to slow the spread of the virus.

This week, Britain’s prime minister, Boris Johnson, and Japan’s prime minister, Yoshihide Suga, called off plans to visit India. On Thursday, the Australian prime minister, Scott Morrison, said that direct flights from India would be reduced by about 30 percent, and that Australians would be allowed to travel to India only in “very urgent circumstances.” Canada also suspended all direct flights from India and Pakistan starting Thursday night for 30 days.

People relaxed in the Place des Vosges in central Paris on Saturday. Prime Minister Jean Castex said that France will relax many of its coronavirus restrictions in May. Credit…Dmitry Kostyukov for The New York Times

The French government outlined plans on Thursday to gradually reopen the country starting in early May, stoking hopes that life might finally return to something close to normal after more than a year of on-and-off pandemic restrictions.

Prime Minister Jean Castex said at a news conference that primary school students would be allowed to return to classrooms on Monday, followed by middle and high school students the following week. Travel restrictions will be lifted on May 3.

Depending on how things are going at that point, Mr. Castex said, retail stores, outdoor dining, and certain cultural and sporting activities could start to reopen in mid-May.

The pandemic situation appears to be improving in France, with the daily average number of new cases falling to about 32,000 from 42,000 the week before. Hospitalizations seem to have plateaued at nearly 6,000.

“The peak of the third wave seems to be behind us,” Mr. Castex said.

The government is hoping to alleviate the deep sense of pandemic fatigue that has taken root in France. When the country went into its third lockdown at the start of April, once again closing schools and “nonessential” retail stores, the move was met with anger and some pointed protests.

Hundreds of lingerie shops across France, closed under the lockdown order, have been mailing panties to Mr. Castex since the beginning of the week, as part of a campaign called “Action Culottée,” meaning “cheeky action,” which was coordinated on Facebook.

The country’s vaccination campaign, which stumbled for months, has gathered speed recently, and is now administering about 2.5 million doses a week. More than 13 million people have received at least one dose so far, and the country aims to raise the figure to 20 million — 30 percent of the population — by mid-May. Even so, France lags far behind countries like the United States, Britain and Israel in its vaccination efforts.

To limit the spread of highly transmissible virus variants, Mr. Castex said, France will tighten testing and quarantine requirements for travelers arriving from five countries — Brazil, Chile, Argentina, South Africa and India — where the variants are circulating widely.

The Atlantic City boardwalk last July.Credit…Michelle Gustafson for The New York Times

With summer on the horizon, states are beginning to rethink social-distancing measures.

In Rhode Island, Gov. Dan McKee said that starting May 7, the state will stop requiring masks outside, and social gatherings can increase to 25 people indoors and 75 people outdoors. By May 28, the state will lift capacity limits on businesses and houses of worship; the bar areas of restaurants will be able to open; and dance floors can once again be filled.

“It’s a good day for everyone here in the Ocean State,” Mr. McKee said at a news conference Thursday. “It’s a little early to put a ‘Mission Accomplished’ sign up but we’re getting ready to order that sign.”

Mr. McKee attributed the reopening plans to the state’s vaccination rate — 48 percent of residents have received at least one shot and 33 percent are fully vaccinated, according to a New York Times database. But masks will still be required indoors.

Rhode Island is not alone.

On Monday, Gov. Ned Lamont of Connecticut announced that his state would phase out all pandemic restrictions, except the indoor mask mandate, by May 19. And in New Jersey, Gov. Phil Murphy said Wednesday that he would announce “a pretty significant amount of guidance” for summer activities next week.

“We don’t want to lurch, in other words go forward and then have to pull something back,” Mr. Murphy said at his weekly news conference. “And we don’t want to start that now. But we also owe people our best guesses for what it’s going to look like for graduation, summer, the beaches and what not.”

As more people get vaccinated and the outdoors become more appealing with spring weather and sunshine, one question persists: Do we still need to wear masks outside? Science shows that the risk of viral transmission outside is very low. The Times’ Well columnist, Tara Parker-Pope, suggests making sure your activity meets two out of the following three conditions: outdoors, distanced and masked.

Global Roundup

Police officers stood guard in Berlin as Germans demonstrated against coronavirus measures on Wednesday.Credit…Christian Mang/Reuters

BERLIN — State lawmakers in Germany approved a new version of a law on Thursday boosting the federal government’s power to enforce uniform coronavirus lockdown rules. New restrictions are expected in most districts soon after the president signs the bill into law, which could be as early as Thursday afternoon.

The law, which Chancellor Angela Merkel’s cabinet passed last week, is a response to a disjointed virus response by state governments, which previously had the ultimate say in carrying out restrictions. For months, experts have called for a lockdown to control Germany’s surging third wave of coronavirus infections.

Under the law passed by the federal council of states on Thursday, the rules would apply uniformly across the country but would depend on the rate of infection in each district, leading to more severe lockdowns in highly affected areas. There would be a curfew from 10 p.m. to 5 a.m. in districts with more than 100 new infections per 100,000 people in a week. Restaurants would remain closed, and nonessential stores would require an appointment and a negative test result in districts with more than 150 new infections per 100,000 people. Schools would close if 165 new infections per 100,000 were registered.

Germany is currently measuring 161 infections per 100,000 in a week, according to the health authorities, which also counted 29,518 new infections on Wednesday.

As many as 8,000 people, including right-wing extremists and coronavirus deniers, took to the streets in Berlin to protest the measures on Wednesday. Several lawsuits against it have already been announced.

Germany has recorded more than 80,000 deaths so far.

In other developments across the world:

• Japan’s auto industry group canceled the biennial Tokyo Motor Show, scheduled for the fall, because of rising coronavirus cases, the Kyodo News agency reported. It was the first cancellation in the 67-year history of the event, which drew around 1.3 million people in 2019. Akio Toyoda, the chairman of the industry group and president of Toyota Motor Corp., said at a news conference that “it seems difficult to offer main programs in a safe environment.” The cancellation came as Japan reported 5,291 new infections, the highest daily total in three months. And it raised more questions about plans for the Tokyo Olympics, which organizers have insisted will begin in July even as officials plan to impose emergency measures in Tokyo and other municipalities.

• The European Union will not order an extra 100 million vaccines from AstraZeneca foreseen in its contract, a European Commission spokesman said Thursday, underscoring the soured relationship between the pharmaceutical company and the bloc of 27 countries. The bloc could have added 100 million doses of vaccines to its existing order of 300 million from AstraZeneca but the time to do so has passed, Stefan de Keersmaecker, the spokesman, said. The European Union is embroiled in a dispute with the British-Swedish company over its inability to deliver expected doses, which has set the bloc’s vaccination efforts back significantly. They have been in a legal arbitration process for weeks, and the bloc is considering suing.

Megan Fairchild practicing in her parent’s home in Utah.Credit…Kim Raff for The New York Times

At the beginning of the pandemic, one of Megan Fairchild’s former dance teachers gave her some advice: Now would be a really great time to get pregnant. Ms. Fairchild, a principal at New York City Ballet, was aghast.

“I was like, that’s a ridiculous idea and the last thing on my mind right now,” she said. “This is going to last a couple months, and I don’t want to not be there when we get back.”

But when it became clear that her kind of live performance, dancing for thousands at Lincoln Center, would not be resuming anytime soon, the decision to have another child came to her in three words when she was meditating: Do it now.

For much of the pandemic year, Ms. Fairchild, 36, was pregnant with twins. On April 10, she gave birth to two girls.

She’s not the only one to have taken advantage of the theatrical shutdown. The dance world is experiencing a full-blown baby boom.

Federal regulators have found many shortcomings at a plant of Emergent BioSolutions in Baltimore.Credit…Saul Loeb/Agence France-Presse — Getty Images

WASHINGTON — Federal regulators have found serious flaws at the Baltimore plant that had to throw out up to 15 million possibly contaminated doses of Johnson & Johnson’s coronavirus vaccine, casting doubt on further production in the United States of a vaccine that the government once viewed as essential in fighting the pandemic.

The regulators for the Food and Drug Administration said that the company manufacturing the vaccine, Emergent BioSolutions, may have contaminated additional doses at the plant. They said the company failed to fully investigate the contamination, while also finding fault with the plant’s disinfection practices, size and design, handling of raw materials and training of workers.

The F.D.A. has not yet certified the plant, in Baltimore’s Bayview neighborhood, and no doses made there have gone to the public. All the Johnson & Johnson shots that have been administered in the United States have come from overseas.

The report amounted to a harsh rebuke of Emergent, which had long played down setbacks at the factory, and added to problems for Johnson & Johnson, whose vaccine had been seen as a game changer because it requires only one shot, can be produced in mass volume and is easily stored.

The inspection began after routine checks showed that Emergent workers had contaminated at least part of a batch of 13 million to 15 million doses of the Johnson & Johnson vaccine with the harmless virus that is used to make the AstraZeneca shot, which is not yet authorized in the United States.

The F.D.A. findings, based on an inspection that ended on Tuesday, underscore questions raised in reports by The New York Times about why Emergent did not fix problems earlier and why federal officials who oversee its lucrative contracts did not demand better performance.

In statements on Wednesday, the F.D.A., Emergent and Johnson & Johnson all said they were working to resolve the problems at the factory. There was no indication of how long that would take.

Nepal’s dethroned king, Gyanendra Shah, center, at Golden Temple in Amritsar, India, last year.Credit…Sameer Sehgal/Hindustan Times, via Getty Images

KATHMANDU, Nepal — At the beginning of this month, Nepal’s dethroned king, Gyanendra Shah, and his wife, Komal, traveled to northern India for the Kumbh Mela, a Hindu pilgrimage where millions seek a dip in the Ganges River to absolve themselves of their sins.

Gyanendra bathed in the river, and for 10 days, he and his aides mingled in crowds and met ascetics, Hindu leaders and other dignitaries. On April 18, he and Komal flew home to Nepal, where supporters welcomed them at the airport and formed a procession to escort them home, chanting pro-Hindu and pro-monarchy slogans along the way.

Three days later, the couple tested positive for the coronavirus. Now they are in quarantine at their residence in Kathmandu, the capital, while health officials in Nepal try to trace anyone who was in contact with them.

“Both king and queen have isolated themselves from other family members,” said Phani Raj Pathak, an aide to Gyanendra, who was dethroned when Nepal became a republic in 2008 and ended a two-century-old Hindu monarchy. The former ruler, who is in his 70s, retains support among some Hindus in Nepal as well as among critics of the elected government.

The infections have cast a harsh spotlight on the Kumbh Mela, where millions of Hindu pilgrims have gathered for weeks, shoulder to shoulder and often maskless, even as highly infectious variants of the coronavirus surge across South Asia. On Thursday, India reported more than 312,000 new infections, the highest daily total in any country since the pandemic began.

The Indian government has defended the gathering as safe, even as news media report thousands of infections among participants. Organizers say that attendees are required to wear masks and show proof of a negative coronavirus test, but they acknowledge that given the size of the event, many could have flouted the rules.

Now there are fears that the Kumbh Mela will cause the virus to explode in Nepal, which shares a porous border with India.

“The majority of people weren’t wearing face masks,” said Yogini Saritanandi, a pilgrim who returned to Nepal. She said she had seen “nothing other than a sea of humans on the bank of the Ganges.”

She said the authorities in the northern city of Haridwar, where the Kumbh Mela is being observed this year, began to slightly restrict entry after a few ascetics were reportedly infected and after India’s prime minister, Narendra Modi, urged organizers to observe social distancing. But it appeared to be too late.

“People got Covid one after another,” said Ms. Saritanandi, 43. “When I saw this, I thought of my 10-year-old son, and I cut my visit short to return to Nepal earlier.”

As Indian states impose new lockdowns, tens of thousands of Nepali migrant workers have returned from India without undergoing coronavirus tests. After reporting no new infections for much of January, Nepal is now averaging more than 1,100 cases a day, according to a New York Times database.

The government has closed schools and colleges in urban areas and tried to speed up vaccinations, with more than 1.7 million people having received at least one shot. But the inoculation drive was slowed after India restricted exports of vaccines to fight the outbreak at home, leaving Nepal to rely on a donation of shots from China.

A man used a self-administered coronavirus test kit in Durham, N.C., in February.Credit…Pete Kiehart for The New York Times

The health effects of Covid-19 not only can stretch for months, but also appear to increase the risk of death and chronic medical conditions even in people who were never sick enough with Covid to be hospitalized, according to a new study published Thursday in the journal Nature.

Researchers looked at medical records of more than 73,000 people across the United States who were infected with the coronavirus between March and November 2020 and did not require hospitalization. In the period from one to six months after becoming infected, those patients were 20 percent more likely to need outpatient medical care, and 60 percent more likely to die, than people who had not contracted the coronavirus.

The Covid survivors experienced a vast array of long-term medical problems that they had never had before — not just lung issues from the respiratory effects of the virus, but symptoms that could affect virtually any organ system or part of the body, from neurological to cardiovascular to gastrointestinal. They were also at greater risk of mental health problems, including anxiety and sleep disorders.

Some of the patients’ post-Covid medical issues — like diabetes, kidney disease and some heart problems — could become chronic conditions that would require treatment for the rest of their lives.

Most of the nearly 32 million people who have contracted the coronavirus in the United States have not needed hospitalization, so the findings may have wide implications. But the study sample and the control group they were compared with may not be very representative of the general public: They were Veterans Health System patients, overwhelmingly men with a median age over 60.

A pregnant woman receiving the Pfizer vaccine in Schwenksville, Pa., in February.Credit…Hannah Beier/Reuters

In an early analysis of coronavirus vaccine safety data, researchers at the Centers for Disease Control and Prevention have found no evidence that the Pfizer-BioNTech or Moderna vaccines pose serious risks during pregnancy.

The findings are preliminary and cover just the first 11 weeks of the U.S. vaccination program. But the study, which included self-reported data on more than 35,000 people who received one of the vaccines during or shortly before pregnancy, is the largest yet on the safety of the coronavirus vaccines in pregnant people.

During the clinical trials of the vaccines, pregnant women were excluded. That left patients, doctors and experts unsure whether the shots were safe to administer during pregnancy.

“There’s a lot of anxiety about whether it’s safe and whether it would work and what to expect as far as side effects,” said Dr. Stephanie Gaw, a maternal-fetal medicine specialist at the University of California, San Francisco.

The new data, Dr. Gaw said, demonstrate that “a lot of pregnant people are getting the vaccine, there isn’t a significant increase in adverse pregnancy effects at this point, and that side effect profiles are very similar to nonpregnant people.”

“I think that’s all very reassuring,” she said, “and I think it will really help providers and public health officials more strongly recommend getting the vaccine in pregnancy.”

Covid-19 poses serious risks during pregnancy. Pregnant women who develop symptoms of the disease are more likely to become seriously ill, and more likely to die, than nonpregnant women with symptoms.

Because of those risks, the C.D.C. has recommended that coronavirus vaccines be made available to pregnant women, though it also suggests that they consult with their doctors when making a decision about vaccination.

The new study, which was published on Wednesday in The New England Journal of Medicine, is based largely on self-reported data from V-safe, the C.D.C.’s coronavirus vaccine safety monitoring system. Participants in the program use a smartphone app to complete regular surveys about their health, and any side effects they might be experiencing, after receiving a Covid-19 vaccine.

The researchers analyzed the side effects reported by V-safe participants who received either the Pfizer or Moderna vaccine between Dec. 14, 2020, and Feb. 28, 2021. They focused on 35,691 participants who said that they had been pregnant when they received the vaccine or became pregnant shortly thereafter.

After vaccination, pregnant participants reported the same general pattern of side effects that nonpregnant ones did, the researchers found: pain at the injection site, fatigue, headaches and muscle pain.

Women who were pregnant were slightly more likely to report injection site pain than women who were not, but less likely to report the other side effects. They were also slightly more likely to report nausea or vomiting after the second dose.

Pregnant V-safe participants were also given an opportunity to enroll in a special registry that tracked pregnancy and infant outcomes.

By the end of February, 827 of those enrolled in the pregnancy registry had completed their pregnancies, 86 percent of which resulted in a live birth. Rates of miscarriage, prematurity, low birth weight and birth defects were consistent with those reported in pregnant women before the pandemic, the researchers report.

“This study is of critical importance to pregnant individuals,” Dr. Michal Elovitz, a maternal-fetal medicine specialist at the University of Pennsylvania, said in an email. “It is very reassuring that there were no reported acute events in pregnant individuals” over the course of the study, she said.

But the report has several limitations and much more research is needed, experts said. Enrollment in the surveillance programs is voluntary and the data are self-reported.

In addition, because the study period encompassed just the first few months of the U.S. vaccination campaign, the vast majority of those enrolled in the pregnancy registry were health care workers. And there is not yet any data on pregnancy outcomes from people who were vaccinated during the first trimester of pregnancy.

“I think we can feel more confident about recommending the vaccine in pregnancy, and especially with pregnant people that are at risk of Covid,” Dr. Gaw said. “But we do need to wait for more data for complete pregnancy outcomes from vaccines early in pregnancy.”

Jackie Robinson Day at Dodger Stadium earlier this month.Credit…Kirby Lee/USA Today Sports, via Reuters

Fully vaccinated baseball fans will be granted their own section at the Los Angeles Dodgers game this weekend against the San Diego Padres.

The set-aside seats, reported by The Los Angeles Times, are part of the many incentives being offered — from doughnuts to beer — to encourage people to get vaccinated against Covid-19. The Miami Heat and the San Francisco Giants have introduced similar sections at their stadiums.

To prove they are fully vaccinated, fans will have to show government-issued I.D. and documentation like a vaccination card, according to the Dodgers’ website. Everyone 16 years and older will have to show proof that at least two weeks have passed since they were fully vaccinated. Fans younger than 16 will be required to show proof of a negative coronavirus test taken within 72 hours before admission.

Face masks will still be required, but social distancing will not. The team said spectators in the sections for the fully vaccinated will be seated directly next to each other.

The game Saturday won’t mark the first time fans have entered Dodger Stadium since the pandemic began. The team’s home opener on April 9 was attended by fans — just not all that many of them. Attendance was capped at around 11,000, about 20 percent of capacity.

In the past week, there has been an average of more than 2,300 daily coronavirus cases in the state, and Los Angeles County has seen an average of 435 daily cases — a 20 percent drop over the past two weeks, according to a New York Times database.

As of Wednesday, more than 40 percent of Californians had received at least one dose of the vaccine, and more than 20 percent had been fully vaccinated.

On April 15, Gov. Gavin Newsom loosened some restrictions in the state, permitting limited outdoor gatherings and live events, depending on a region’s Covid-19 risk level.

A 5K run organized by New York Road Runners in October.Credit…John Minchillo/Associated Press

New York Road Runners, the club that puts on the New York City Marathon, has announced the return of its first regularly scheduled race since the beginning of the pandemic.

On Thursday, the club said that it would hold the annual New York Mini 10K on June 12. The 10-kilometer, women-only race has been held annually since 1972, with the exception of last year.

“This is our first real table setting,” said Kerin Hempel, the organization’s interim chief executive. “It’s starting to feel like ‘OK, we’re back, we’re coming back.’”

This will not be the first race the club has held since the onset of the pandemic.

The organization has held a series of “return to racing” events as pilots starting last fall, allowing very small fields to run with safety protocols in place. Among other measures, the races had temperature checks, staggered starts and different corralling of runners.

Those events, Ms. Hempel said, have given N.Y.R.R. the confidence to move ahead with its first regularly scheduled race since March 2020.

The Mini 10K field will be smaller than in past years, with a cap of 1,200 runners. The race will also have safety protocols, such as requiring runners to mask up at the start and finish. (They will be strongly encouraged to wear masks during the race, too.)

It will be the first time N.Y.R.R. has welcomed elite athletes since the 2019 New York City Marathon, with 25 elite athletes expected at the starting line. The 2019 Mini 10K champion, Sara Hall, will return to defend her title.

The announcement comes as runners look ahead — with cautious optimism — to the return of major road races. Ms. Hempel anticipated the question on the minds of many: What does this mean for the New York City Marathon?

“We’ve been saying the marathon is going to happen,” she said. “It’s more about what it’s going to look like, and how many people we can accommodate on the course.”