WASHINGTON — The Centers for Disease Control and Prevention plans to toughen coronavirus testing and screening of international fliers to the United States by requiring them to provide a negative result from a test taken within 24 hours of departure, a spokesman for the agency said Tuesday night.
The move to strengthen the testing regime reflects growing concern about the Omicron variant, a highly mutated form of the virus that was first documented by researchers in South Africa and detected in more than a dozen countries around the world.
“C.D.C. is working to modify the current global testing order for travel as we learn more about the Omicron variant; a revised order would shorten the timeline for required testing for all international air travelers to one day before departure to the United States,” said the spokesman, Jason McDonald.
“This strengthens already robust protocols in place for international travel, including requirements for foreign travelers to be fully vaccinated,” he added.
Earlier Tuesday, a senior administration official, who spoke on the condition of anonymity because no final decisions had been made, said health officials were examining whether current testing — which allows fully vaccinated people to take a P.C.R. test up to three days before departing on a flight to the United States — was stringent enough. It was unclear whether the new 24-hour rule would require a rapid P.C.R. or antigen test.
President Biden has said he will announce on Thursday his plans for enhancing the fight against the pandemic. It is not clear whether he will announce tougher testing requirements for international travelers, which were first reported by The Washington Post, during Thursday’s speech. Mr. McDonald offered no timeline for the C.D.C.’s action.
In the meantime, Mr. McDonald said, the C.D.C. continues to recommend that all travelers get a coronavirus test three to five days after arrival in the United States. Unvaccinated travelers should self-isolate and quarantine for seven days after arrival, even if they test negative.
Natalie Quillian, the deputy coordinator for the Covid response at the White House, said in an interview on Monday that the Omicron variant had prompted the administration to re-evaluate its efforts to ensure that people entering the country were not carrying the virus.
“We’re constantly looking at what can we do to make that travel system even stronger,” she said. “For example, right now we’re assessing all of our tests to make sure they’re effective in picking up this variant.”
She added: “If we found that a test was not effective at picking up the variant, we would remove that from the list that is accepted to enter the country.”
A 24-hour testing rule could make visiting the United States difficult, some travelers said. Paula Tolton, 23, a student in Taipei, Taiwan, said the plan made her worry about missing the flight she planned to take next month to visit her family in Jacksonville, Fla.
Even the current 72-hour rule is nerve-racking, she said. “I’ve had that stress before when a P.C.R. test didn’t come back when I was supposed to fly here in April,” she said. “I was freaking out.” Finding a clinic that could meet the 24-hour mark would make traveling home much harder, she added.
A federal judge issued a preliminary injunction on Tuesday to halt the start of President Biden’s national vaccine mandate for health care workers, which had been set to begin next week.
The injunction, written by Judge Terry A. Doughty, effectively expanded a separate order issued on Monday by a federal court in Missouri. The earlier one had applied only to 10 states that joined in a lawsuit against the president’s decision to require all health workers in hospitals and nursing homes to receive at least their first shot by Dec. 6 and to be fully vaccinated by Jan. 4.
“There is no question that mandating a vaccine to 10.3 million health care workers is something that should be done by Congress, not a government agency,” Judge Doughty, of U.S. District Court for the Western District of Louisiana, wrote. He added: “It is not clear that even an act of Congress mandating a vaccine would be constitutional.”
The judge, who was nominated to the court by former President Donald J. Trump, also wrote that the plaintiffs had an “interest in protecting its citizens from being required to submit to vaccinations” and to prevent the loss of jobs and tax revenue that may result from the mandate.
Several cities and states had already imposed their own vaccine mandates for health care workers, in an effort to contain outbreaks that were often passed from communities into medical settings like nursing homes. The momentum for vaccine mandates gained steam during the summer as the Delta variant swept through nursing homes, causing spikes in staff and resident infections, as well as overwhelming hospitals in many states with another Covid surge.
Some of the larger hospital chains and several big nursing home operators also began requiring staff vaccinations, before the president began calling for nationwide compliance. Vaccinations among health care employees have increased since the summer, although cases among residents and staff remain in the thousands reported each week. Nationwide, the immunization rate among nursing home staffs is more than 74 percent, although much lower rates still exist in some regions.
In leading a 14-state lawsuit against the mandate, Attorney General Jeff Landry of Louisiana said the federal mandate would blow holes in state budgets and exacerbate shortages in health care facilities.
The Biden administration tied compliance with the vaccine mandate to federal funding, requiring immunizations of millions of workers at hospitals, nursing homes or other health facilities that heavily rely on the Medicare or Medicaid programs. But many health care providers — especially nursing home and rural hospital operators — complained that staff members who were hesitant to be immunized would leave, aggravating employee shortages that plagued the industry long before the pandemic.
Those complaints helped swell opposition in many states, like Texas and Florida, that have been vehemently against dictates on vaccines, mask-wearing and other federal policies at the heart of public health advice during the pandemic.
More than a dozen states and some employers joined forces to fight a broader mandate that would require private employers of 100 or more workers to impose companywide immunization. An appeals court has temporarily blocked that mandate as well, as the challengers to the policy pursue their arguments that the Occupational Safety and Health Administration overstepped its authority.
In response to recent court decisions, the Centers for Medicare & Medicaid said in a statement, “While we cannot comment on the litigation, CMS has remained committed to protecting the health and safety of beneficiaries and health care workers. The vaccine requirement for health care workers addresses the risk of unvaccinated health care staff to patient safety and provides stability and uniformity across the nation’s health care system.”
The injunction issued on Tuesday is a first step in the lawsuits against the vaccine mandate. The cases still have to be argued before a judge, and any lower-court ruling will likely be appealed.
The head of the United Nations-backed global vaccine distribution program said on Tuesday that it had shipped more than 11 million doses in the last 24 hours, its busiest day of deliveries ever.
The leader, Seth Berkley, said the program had been asking donors and vaccine manufacturers for months “to give us better-quality donations” and more information on when doses would arrive. That message, he wrote on Twitter, “is just starting to be heard.”
Covax, a multibillion-dollar alliance between international health bodies and nonprofits, was supposed to ensure that poor countries got access to coronavirus vaccines and that rich countries did not hoard them. It has struggled in that mission and had to scale back its goals.
The new Omicron variant has prompted rich, highly vaccinated countries like the United States, Britain and Japan to expand their booster programs, while poorer, less vaccinated countries like South Africa are still trying to get first doses to residents.
Only about 5 percent of people living in low-income countries have received even one vaccine dose, according to the Kaiser Family Foundation, a health organization that is tracking coronavirus infections and vaccine distribution.
“Getting doses to countries is the easy part,” Mr. Berkley wrote on Twitter. Making the doses readily available “is harder & requires active collaboration” among manufacturers, shipping companies and officials in those countries.
The Japanese government said on Wednesday that it had asked airlines to stop taking new bookings for all flights into the country for the rest of the year, extending one of the world’s most far-reaching border closures in response to the Omicron variant.
Existing bookings would not be affected, officials said.
On Monday, Japan barred all nonresident foreigners from entering the country, and on Tuesday it closed its borders to all non-Japanese travelers, including permanent residents of Japan, from 10 southern African countries.
Japan confirmed its second Omicron case, in a traveler from Peru, on Wednesday. Its first case, confirmed on Tuesday, involved a traveler from Namibia.
Japan had only tentatively opened last month to business travelers and students, despite recording the highest vaccination rate among the world’s wealthy democracies — and after seeing its coronavirus caseloads plunge by 99 percent since August.
In South Korea, five cases of the Omicron variant were confirmed on Wednesday among inbound travelers, according to health officials. The Korea Medical Association recommended pausing quarantine exemptions for arriving travelers.
The government is also considering expanding genomic sequencing for more inbound travelers, a South Korean Health Ministry spokesman, Son Young-rae, said at a news conference on Wednesday.
England’s return to some Covid restrictions on Tuesday provoked a range of emotions: anger, dismay, weariness, and, for some, indifference. From London, festooned with Christmas lights, to Bradford, in northern England, the feeling on the streets was, above all, one of weary resignation.
“I expected it, because the British took so long,” said Ali Hasan, 31, a medical consultant at a hospital in Bradford, referring to the nation’s first lockdown, in March 2020, which he said should have been imposed sooner, were it not for what he described as the “laziness” of the country’s political parties.
The British government ended virtually all restrictions in England over the summer, and has seen a high but relatively stable coronavirus caseload in recent weeks. Even now, it is stopping short of the health pass systems, vaccine mandates and lockdown measures that have been implemented to stem surges elsewhere in Europe.
But it has responded to news of the Omicron variant by severely restricting travel from 10 African countries, reinstating testing and self-isolation requirements for other arrivals, and making face masks compulsory on public transportation and in shops.
Many in England had been anticipating restrictions for a while, and some had started to take matters into their own hands. Though masks are not mandatory in restaurants or cafes, Audrey Mekki, 35, a waitress at Pera, a Mediterranean restaurant in North London, makes a point of wearing one throughout her shift.
“I’m wearing it for my safety, and also for the customers,” she said. “Most don’t mind, but some may not feel comfortable if the waitresses serving their food are not masked.”
Helen Daly, 62, who was in London on a holiday from Cork, Ireland, said she had been surprised by the lax British attitude.
“There’s very little mask-wearing here,” she said. “We were at the theater last night. There were four of us, and we were the only four wearing masks.”
For Matthew Leonard, 22, however, the change on the subway was sudden and visible. He said he arrived in London the night before the new regulations took effect. “It was pretty much how it was before, sort of 50-50,” Mr. Leonard said, “but then this morning I noticed almost all people wearing masks.”
At schools, students age 11 and older are now advised to wear masks in communal spaces. Lucy Long, 41, who has a 10-year-old-daughter, explained that the school drop-off had also changed; parents no longer gather for a conversation at the gates. She supports requiring children to wear masks.
“We don’t know what’s going to happen to these children in 20 years’ time after any infection,” she said.
In Bradford, where Ursula Sutcliffe runs a small plant shop and cafe, she said the successive lockdowns had taken a toll — to say nothing of Brexit, which drove up the cost of her plants, which are imported from the Netherlands.
“We’ve just been in an uphill battle,” Ms. Sutcliffe said. Referring to Britain’s prime minister, she added: “Boris Johnson should never have stopped wearing face masks in the first place. If we’d just kept face masks on, we probably could have just gone about our lives. But he is so eager to say, ‘Yay, we’re back to normal.’ We’re not!”
Nigeria’s public health institute said on Wednesday that it had identified the variant in three travelers who arrived from South Africa in the last week, Dr. Ifedayo Adetifa, its director general, said in a statement.
The institute, the Nigeria Center for Disease Control, had said earlier on Wednesday that it had also detected the Omicron variant in a sample from October, but then retracted that announcement. The earlier sample was of the Delta variant, according to a message shared on WhatsApp by the institute’s spokesman, Emeka Oguanuo.
Referring to the three Omicron cases, Dr. Adetifa said in the statement: “Follow up to ensure isolation, linkage to clinical care, contact tracing and other relevant response activities have commenced.”
Nigeria is the third country in mainland Africa — besides South Africa and Botswana — to report the variant, which is now known to have reached every continent except Antarctica. But scientists say it could be weeks before more is known about how transmissible the variant is, the severity of illness it causes and how much protection the current vaccines offer against it.
Still, governments have reacted with alarm and markets have tumbled in recent days, as the W.H.O. rated the global risk from the variant “very high.”
On Wednesday, Nigerian health officials urged state governments to make testing easily accessible, vaccinate many more people and ensure the public was adhering to public health measures including masking and social distancing. Nigeria has so far reported 214,113 positive cases and 2,976 deaths from the coronavirus.
With more than 200 million people, Nigeria has administered just over 9.8 million vaccine doses, according to the World Health Organization. Starting Wednesday, federal government workers were expected to either be vaccinated or show a negative Covid-19 certificate. Travelers into the country are expected to arrive with a negative Covid test and to take two more tests on the second and seventh day following arrival.
Since England’s theaters reopened without restrictions in July, one thing has been as notable as the action onstage: the lack of masks in the audience.
Unlike in Broadway theaters, patrons here have not been required to wear face coverings, and many attendees have chosen to ignore preshow announcements encouraging them to mask up.
Several visiting theater critics have been left aghast. Laura Collins-Hughes, writing in The New York Times in September, said that at “nearly every production I saw, there were loads — sometimes a majority — of barefaced people in the crowd, which felt reckless and delusional.”
Peter Marks, writing in The Washington Post in November, called London’s theaters “consistently shocking these days.” That had nothing to do with the action onstage, he added; it was entirely down to the absence of masks.
Now, that image may be about to change. On Saturday, Prime Minister Boris Johnson made masks mandatory in stores and on public transportation in England, responding to the newly discovered Omicron variant of the coronavirus.
He did not make them mandatory in theaters, but several venues have now done so voluntarily. On Monday, the Royal Shakespeare Company said face coverings would be required at its theaters in Stratford-upon-Avon, England, unless an attendee is under age 12 or has a medical exemption.
“We want to do all we can to ensure that we do not have to cancel performances and disappoint our audiences,” the company’s executive director, Catherine Mallyon, said in a news release.
Other theaters quickly followed. On Monday, Andrew Lloyd Webber, the composer and theater impresario, quietly strengthened rules for the six theaters he owns in the West End. His company website was updated to say, “All audience members must wear a face covering throughout their visit, except when eating and drinking, or if they are medically exempt.” Previously, those theaters requested masks, but did not require them.
The rules might only last a few weeks. The National Theater’s website says the measure will be in place until Dec. 19, “when the next government review of Covid measures is due.”
So far, there appears to be little resistance to the changes. Kate Evans, a spokeswoman for the Royal Shakespeare Company, said 30 people had asked for refunds or to exchange their tickets for vouchers to see a future show since the mandate was announced, out of 6,000 who had booked to see its current show, “The Magician’s Elephant.”
“The majority of feedback we’ve received around the decision has been very positive,” she said.
Because of an editing error, an earlier version of this article misstated the number of theatergoers who requested refunds or ticket exchange vouchers from the Royal Shakespeare Company after its mask mandate announcement. It was 30, not 45.
A federal advisory committee on Tuesday voted to recommend that the government for the first time authorize the use of an antiviral pill to combat the worst effects of Covid-19.
The advisory committee, in a surprisingly narrow 13-to-10 vote, endorsed the pill from Merck, while public health officials worldwide raced to buttress their defenses against the newly emerging Omicron variant of the coronavirus.
The Merck treatment, known as molnupiravir, has been shown to modestly reduce the risk of hospitalization and death from Covid. The pill could be authorized for use in the United States within days and available to patients within weeks.
In the coming weeks, the F.D.A. may also authorize a similar pill from Pfizer that appears to be significantly more effective than Merck’s. Together, the arrival of the two easy-to-use treatments could provide a cushion against a resurgent virus.
The F.D.A. advisory panel, a group of experts on antimicrobial drugs, recommended that Merck’s treatment be authorized for people with Covid who are at high risk of becoming severely ill. That would most likely cover tens of millions of Americans who are older or have medical conditions such as obesity, diabetes or heart disease.
But the committee’s close vote reflected doubts about the pill’s effectiveness and concerns that it could cause reproductive harm.
“The efficacy of this product is not overwhelmingly good,” said Dr. David Hardy, an infectious-disease physician in Los Angeles. Still, he voted to recommend the drug, saying “there is a need for something like this.”
Other members of the committee who voted against authorization said more research was needed about the drug’s safety. “The risk of widespread effects on potential birth defects, especially delayed effects on the male, has not been adequately studied,” said Dr. Sankar Swaminathan, an infectious disease specialist at the University of Utah.
The pills, which doctors will prescribe and will be dispensed at pharmacies, are much more convenient and are expected to reach many more people than the monoclonal antibody treatments that have typically been used to aid high-risk Covid patients. The antibody treatments are expensive and typically given intravenously at hospitals or clinics.
The Biden administration has been hoping that the emergence of the antiviral pills from Merck and Pfizer will help end the most acute phase of the pandemic. The U.S. government has spent billions of dollars to secure millions of treatment courses of the new pills.
Merck’s clinical trials primarily enrolled people who were infected with the Delta, Mu and Gamma variants of the coronavirus. Scientists have yet to run experiments to see how well the pills block Omicron viruses from replicating. But there are reasons to think they would remain effective even if the variant can sometimes evade vaccines, as well as monoclonal antibodies.
The hundreds of passengers traveling from South Africa to Amsterdam on Friday, on flight KL592, came armed with paperwork proving their eligibility to fly. Check-in agents sifted through a bewildering assortment of requirements determined by final destination.
But while the flight was en route, and the passengers slept or watched their screens, everything changed on the ground.
Panic about the new Omicron variant that had been discovered in southern Africa prompted countries to close their borders. The arrivals descended into a new post-Omicron reality, and it was a hellish one, with hours spent breathing stale air as their planes sat on the tarmac, then fighting exhaustion in crammed waiting rooms, awaiting swab results in close quarters with fellow travelers who would turn out to be infected with the new and possibly more dangerous variant.
“We were in the same place, the same room,” said one passenger, Jan Mezek, 39, a laboratory technician whose company services swab-test machines and who was returning from a two-week work trip to his home in Prague. “I felt like a pig in a pen,” he said, adding: “They were completely spreading the virus around us.”
Of the more than 60 people on that and another KLM flight from South Africa who tested positive for the virus, at least 14 had Omicron, according to Dutch officials. The Dutch authorities have quarantined them while requiring the hundreds who showed negative results from the PCR test administered at the airport to go home or board connecting flights to their final destinations.
“They went around the world, who knows where,” said Fabrizio Pregliasco, a prominent Italian virologist at the University of Milan. He said that all the passengers should have been quarantined or isolated and monitored closely for seven to 10 days, especially because they could have caught the virus on the flight and tested negative as it incubated.
“If this variant is very contagious, this flight is an explosive bomb,” Dr. Pregliasco said.
Los Angeles Lakers star forward LeBron James has entered the N.B.A.’s coronavirus health and safety protocols, the team announced Tuesday.
James missed the team’s game Tuesday night against the Sacramento Kings. It is unclear when he will be able to play again, and it is also unclear whether James has tested positive for the coronavirus or has come into close contact with someone who tested positive.
Lakers Coach Frank Vogel told reporters before the game that he found out Tuesday morning that James had entered the health and safety protocols. Vogel said the team arranged for James to get “back to L.A. safely.”
Players who test positive for the coronavirus must miss at least 10 days before they can return. All players who enter the protocol must return two negative tests on separate days before being allowed to play again.
James, 36, said before the season that he had been vaccinated against Covid-19.
Typically, players who are vaccinated face less stringent requirements than unvaccinated players. After Thanksgiving, though, the league implemented enhanced testing requirements even for vaccinated players, according to documents sent by league officials to each of the 30 teams. They did so with the expectation that the holiday would increase players’ potential exposure to the virus.
“We just want the best for him right now,” Vogel said. “That’s where our thoughts are. We have a next man up mind-set. It’s an 82-game season. You got to deal with guys being in and out of the lineup. We’ve been without him some already this season.”
This will be the 12th game James has missed this season. He missed 10 because of ankle and abdominal injuries. He also missed the Lakers’ game against the Knicks earlier this month after being suspended for the first time in his 19-season career.
Among the many unknowns surrounding the new coronavirus variant called Omicron, named after the 15th letter of the Greek alphabet, one has stood out to many English speakers: How is it pronounced?
There is no single, agreed-on English pronunciation, experts say.
One pronunciation, according to Merriam Webster, is “OH-muh-kraan,” with a stress on the first syllable.
A World Health Organization official, Dr. Maria Van Kerkhove, recently said it that way when announcing that the variant was of concern.
In the United States, it is often pronounced “AH-muh-kraan,” Merriam Webster says. Less common are “OH-mee-kraan,” as Prime Minister Boris Johnson of Britain pronounced it this week, or “OH-my-kraan.”
On the New York Times podcast “The Daily,” Apoorva Mandavilli, who reports on the coronavirus and its variants, said she was going with “AH-muh-kraan.”
“I don’t think it really matters that much, honestly,” she said.
The New Oxford English Dictionary gives a pronunciation that differs from those in Merriam-Webster, according to Dr. Andreas Willi, a comparative linguistics professor at Oxford University. “Namely rather like an English phrase ‘o-MIKE-Ron,’” he said.
The word is a compound from the Greek “o mikron,” meaning “small o.” In classical Greek, the word was pronounced with the second syllable sounding like an English “me,” Dr. Willi said.
Peter Sokolowski, editor at large at Merriam Webster, said that because the Greek word is transliterated for pronunciation into English, sounding much as the word “omnipotent” is different from its Latin “omni-potent” origin, then the “AH-muh-kraan” pronunciation “makes perfect sense.”
But, he added, “There isn’t a wrong answer.”
“The question of British versus American pronunciation of the first syllable isn’t really specific to this particular word,” Dr. Willi said. “Compare the British versus American pronunciation of ‘god.’”
The divergences are to do with the name having been adopted as a loanword and used by English speakers in different places at different times, Dr. Willi said.
“When we speak of ‘Paris’ in English, that is also very different from the ‘proper’ French way of pronouncing the same name,” he said. “But it is hardly wrong in a strict sense.”
The New York Times – [source]