Covid: Missouri Seeks Help From White House to Battle Outbreaks Driven by Delta Variant

WASHINGTON — Federal regulators on Friday cleared a batch of vaccine that could furnish up to 15 million doses of Johnson & Johnson’s one-shot coronavirus vaccine, deciding they can be safely distributed despite production failures at the vaccine-making factory that ruined 75 million other doses.

The move brings the total number of Johnson & Johnson doses made at the Baltimore facility and cleared by the Food and Drug Administration for distribution in the United States to roughly 40 million. But Johnson & Johnson remains far from its goal of delivering 100 million doses to the federal government by the end of June. European Union officials have said the firm is missing its delivery targets there, as well.

The vaccine cleared on Friday is not yet bottled, and the Biden administration’s plans for it remain unclear. But with the pandemic abating and the country awash in vaccines from the two other authorized manufacturers, any new Johnson & Johnson doses produced in the United States are likely destined mostly for export.

Johnson & Johnson has been unable to produce much vaccine since regulators shut down the Baltimore factory, operated by Emergent BioSolutions, nearly three months ago because of major production errors. Johnson & Johnson had been relying on Emergent, its subcontractor, to produce vaccine for use in the United States as well as to meet its commitments overseas while it expanded its own plant in Leiden, the Netherlands.

Even with the newly cleared batch, Johnson & Johnson remains nearly 40 million doses short of its 100-million-dose pledge for U.S. use. The F.D.A. did not disclose the precise number of doses cleared Friday, but multiple people familiar with Emergent’s operation said the batch amounted to as many as 15 million doses.

Also on Friday, European regulators approved the reopening of Johnson & Johnson’s Dutch plant, a piece of good news for the firm amid its supply woes. “Today’s approval represents progress in expanding our global manufacturing network to supply our Covid-19 vaccine worldwide,” the company said in a statement.

And on Thursday, Johnson & Johnson reported that early results of unpublished studies showed that its vaccine is effective against the highly contagious Delta variant, even eight months after inoculation. That was a reassuring finding for those who have gotten the company’s shot.

The Baltimore factory is expected to remain shuttered for several more weeks while Emergent tries to bring it up to standard, according to people familiar with its operation who spoke on condition of anonymity. The F.D.A. said in a statement Friday that it was not yet ready to certify that the plant was following good manufacturing practices.

The highly contagious Delta variant has gained ground in New York City in recent weeks, though overall case counts remain low, according to a recent analysis by the city’s Health Department.

Since mid-June, there has been a steady daily average of about 200 new Covid-19 cases detected in New York City, the lowest since the early days of the pandemic and an indication that there is relatively little virus circulating there.

“The stability in terms of the daily numbers of cases is quite reassuring,” said Dr. Wafaa El-Sadr, an epidemiology professor at Columbia University’s Mailman School of Public Health.

The city’s daily Covid deaths are usually in the single digits now, and the number of new hospitalizations has been relatively steady for a couple of weeks — about 171 Covid patients were in area hospitals at the start of July.

In England, where the Delta variant now accounts for most cases, epidemiological data released on Thursday showed that it was not driving any surge in the rate of hospitalizations.

Dr. Torian Easterling, the first deputy commissioner of the New York City Department of Health and Mental Hygiene, said that “young adults” made up most of the new cases involving the Delta variant.

For now, Delta’s growing presence has not prompted any dramatic shifts in Covid-19 guidance from City Hall, and more and more people are shedding their masks.

The variant was first identified in India and is now causing a new surge of cases in many places around the world, including a handful of places in the United States. It was detected in New York in March. At that point, the city’s vaccination campaign was gaining momentum, but the long second wave that began last fall had yet to recede. Research shows that a full regimen of the vaccines in use in New York offer a high degree of protection against the Delta variant.

By the end of May, the city’s genome sequencing program suggested that the Delta variant made up about 8 percent of overall new cases in the city, even as case counts were plummeting. New data released on Thursday, based on genome sequencing of just 54 case samples, suggested that by mid-June, Delta could have accounted for 44.4 percent of new cases. (The data is reflected in a chart near the bottom of this page on the Department of Health’s website.)

The city’s sequencing program has been robust in recent months, with more than 10 percent of confirmed cases tested for variants in some weeks. The latest sample of cases to be sequenced was unusually small, involving only about 5 percent of confirmed cases.

Public health experts have said Delta’s gains should motivate New Yorkers to get vaccinated. About 49 percent of the city’s population has not been fully vaccinated — about four million people, including children not yet eligible.

And vaccination rates are uneven across the city, leaving pockets at risk. Vaccinations are lagging generally among Black New Yorkers, and, geographically, in northern Manhattan, the Bronx, and parts of Brooklyn and Queens.

“We need to always emphasize the fact that even though the percentage of Delta cases is going up, the total number of people getting Covid continues to go down and the vaccines continue to be very effective,” Dr. Jay Varma, a senior adviser for public health to Mayor Bill de Blasio, said at a news conference earlier this week.

GLOBAL ROUNDUP

In a bid to provide effective coverage against the Delta variant, German health authorities broadened their recommendation that those who received a first shot of the AstraZeneca vaccine get a second dose with either the Pfizer-BioNTech or Moderna vaccines.

This “is one of the best available vaccine combinations currently available,” Jens Spahn, the country’s health minister, said on Friday, after agreeing to formally adopt a recommendation from the country’s vaccination expert panel with state lawmakers.

Studies have shown that while mixing vaccines may increase the odds of mild and moderate side effects, including fever, fatigue and headache, the protection is at least on par with two jabs of the mRNA vaccines from Pfizer and Moderna.

Germany had already been advising people under 60 to take the mixed regimen after worries about rare but severe side effects were observed in younger women receiving AstraZeneca shots. Chancellor Angela Merkel, who is 66, was inoculated with a Moderna vaccine last month after receiving an AstraZeneca shot earlier this year.

Now, authorities believe the combination can help protect all vaccine recipients in the fight against the Delta virus, which is currently estimated to make up 50 percent of new cases across the country.

Mr. Spahn also said that doctors and nurses could give the second shot just four weeks after the first, significantly shortening the period between shots that was initially recommended for a full AstraZeneca treatment, when the wait between shots could be as long as 12 weeks.

“The more vaccinations in the summer, the better the autumn,” said Mr. Spahn.

Currently 56 percent of Germans have received at least one dose and 38 percent are fully vaccinated. Nearly 17 percent of all vaccines delivered to Germany come from AstraZeneca, which for a while was the jab of choice for people who were not high on any priority list.

Despite the spread of the Delta variant, the number of new cases is at the lowest level in about a year.

Here’s what’s happening around the world:

• Portugal is imposing a curfew from 11 p.m. to 5 a.m. in Lisbon, Porto and other popular tourism spots to fight a Delta-driven surge, reversing course after it had reopened its economy to prepare for summer travelers. The measure is designed to discourage gatherings of younger people at night, said Mariana Vieira da Silva, a cabinet minister. The country reported almost 2,500 new cases on Thursday, the highest daily rise since mid-February, although cases have remained far below its January peak of more 16,000 per day.

• France warned on Friday that the Delta variant now accounted for a third of all new cases. Olivier Véran, France’s health minister, said that while the virus was under control, the decline in new cases has slowed, and that the variant was a “real threat” that could “ruin” summer holidays. Mr. Véran said authorities would not make vaccination mandatory for the general population but were debating doing so for health workers.

• Three guests and one firefighter died in a blaze at a quarantine hotel in Taiwan, and more than 20 people were injured. Some guests had worried that leaving their rooms would violate Covid rules, and the owner at first thought it was a false alarm and urged people to stay in their rooms. The fire renewed debate over the use of hotels as quarantine facilities.

With just a few days to go, there is no longer much doubt that the United States will fall just short of President Biden’s goal to have 70 percent of adults at least partly vaccinated against the coronavirus by Independence Day.

It was always more of a rhetorical deadline than a practical one: It doesn’t make much difference exactly what the national figure will be on July 4 (probably 67 or 68 percent) or which day the national odometer will roll past 70 percent (perhaps around mid-month). The point was to give the public something to shoot for, to keep up the pace of progress.

That progress has hardly been uniform. Some parts of the country have embraced vaccination avidly, others diffidently and some grudgingly — just as happened with precautions like mask-wearing, social distancing, and school and business closures.

Here is a rundown of which states have led the way and which have lagged, according to Centers for Disease Control and Prevention data tracked by The New York Times:

Over the goal line

Twenty states, Washington, D.C., and two territories exceeded the 70 percent threshold by Thursday, three days ahead of Mr. Biden’s target date.

Twelve are in the Northeast and Mid-Atlantic region, including Vermont, the national leader, Delaware, Maryland, New Jersey, New York, Pennsylvania and Virginia.

California, Oregon and Washington have surpassed 70 percent, as has Hawaii.

The other four states that have cleared 70 percent are Colorado, Illinois, Minnesota and New Mexico, along with the territories of Puerto Rico and Guam.

Close but not quite

Fourteen states, mainly in the Midwest and Southwest, were between 60 and 65 percent on Thursday. Two of the nation’s most populous states are in this group: Florida at 65 percent and Texas at 61 percent.

The remaining 16 states, including nearly the whole South, were below 60 percent, with Mississippi in last at 46 percent.

Denis McDonough, the secretary of veterans affairs, said this week that he was considering a move to compel workers at V.A. hospitals to get vaccinated against the coronavirus, fearing that centers with low inoculation rates were risking the health of veterans seeking care.

The military is struggling to fully vaccinate more troops across all service branches. While the Army and Navy are outpacing the civilian population in vaccine uptake, the Air Force and the Marine Corps have faced greater challenges. About 68 percent of active-duty members have had at least one dose of a vaccine, officials said.

President Biden could legally require members of the military to get vaccinated, but he has declined to exercise that power even as the highly contagious Delta variant has become an increasing threat to unvaccinated Americans.

The military has worked hard to combat vaccine misinformation in its ranks since the shots first became available. More than 80 percent of active-duty service members are under 35, a group that often views itself as impervious to coronavirus infections. Many worry that the vaccines are unsafe, were developed too quickly or will affect fertility.

A lack of vaccine acceptance among hospital workers who care for veterans could be more worrisome; because of their average age and service-related injuries and illnesses, veterans can be more vulnerable to infection. Nearly 12,500 veterans have died from coronavirus-related complications since the pandemic began.

President Biden’s plan to celebrate “independence from the virus” on the Fourth of July is running into an unpleasant reality: Less than half the country is fully vaccinated against the coronavirus, and the highly contagious Delta variant is threatening new outbreaks.

Mr. Biden will visit Traverse City, Mich., on Saturday as part of what the White House calls the “America’s Back Together” celebration. On Sunday, he and Jill Biden, the first lady, have invited 1,000 military personnel and essential workers to an Independence Day bash on the South Lawn of the White House.

But public health experts fear that scenes of celebrations will send the wrong message when wide swaths of the population remain vulnerable and true independence from the worst public health crisis in a century may be a long way off.

On Friday, Mr. Biden urged those who have yet to get vaccinated to “think about their family” and get a shot as the Delta variant spreads. At a news conference mainly focused on the strong jobs report from the Labor Department, he said he wasn’t worried about another major coronavirus outbreak, but instead wanted to make sure next year’s July 4 holiday was even better than this year’s.

“I am concerned that people who have not gotten vaccinated have the capacity to catch the variant and spread the variant to other people who have not been vaccinated,” he said. “To those of you who haven’t been vaccinated, it doesn’t hurt. It’s accessible. It is free. Don’t just think about yourself. Think about your family.”

Dr. Thomas Frieden, a former director of the Centers for Disease Control and Prevention, and other experts said they feared that if the Delta variant continued to circulate, it would mutate in a way that left even the vaccinated vulnerable. That already seems to be happening elsewhere in the world; South Korea and Israel, where the virus seemed to be in check, have new clusters of disease.

“Compared to many other countries, we are in a much more secure situation,” said Dr. Jennifer Nuzzo, an epidemiologist at Johns Hopkins University. But, she added, “I really do worry that as America enjoys its freedoms, we forget about the rest of the world, and that could come back to bite us.”

SYDNEY, Australia — Three days after the emergence of a rare Covid case in Sydney, around 40 friends gathered for a birthday party. Along with cake and laughter, there was a hidden threat: One of the guests had unknowingly crossed paths with that single Covid case.

Two weeks later, 27 people from the party have tested positive, along with 14 close contacts. And the seven people at the gathering who were not infected? They were all vaccinated.

For Australia and every other nation pursuing a so-called “Covid zero” approach, including China and New Zealand, the gathering in western Sydney amounts to a warning: Absent blanket vaccinations, the fortress cannot hold without ever more painful restrictions.

The Delta mutation has already raced from Sydney across Australia. Half of the country’s 25 million people have been ordered to stay home as the caseload, now at around 200, grows every day. State borders are closed, and exasperation is intensifying.

It’s a sudden turn in a country that has spent most of the past year celebrating a remarkable achievement. With closed borders, widespread testing and efficient tracing, Australia has quashed every previous outbreak, even as almost every other country has lived with the virus’s unceasing presence, often catastrophically.

In Australia, no one has died from Covid-19 in all of 2021. While New York and London sheltered last year from a viral onslaught, Sydney and most of the country enjoyed full stadiums, restaurants, classrooms and theaters with “Hamilton.”

That experience of normalcy — diminished only by a lack of overseas travel, occasional mask mandates and snap lockdowns — is what Australian politicians are so desperate to defend. To them, keeping Covid out, whatever it takes, remains a winning policy.

On Friday, Australia doubled down on this approach, announcing that the trickle of a few thousand international arrivals allowed each week (and quarantined) would be cut by half.