Covid News: Over 200 Million Americans Are Fully Vaccinated – The New York Times

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More than 200 million Americans — over 60 percent of the population — have been fully vaccinated against the coronavirus.

The United States crossed that milestone as the threat of the Omicron variant spurred a flurry of jabs in recent days, though the daily rate remains far below its peak in April. And the United States lags significantly behind several other countries, which have inoculated over 80 percent of their populations.

Providers are administering about 1.78 million doses per day on average, including first, second and additional doses, about a 47 percent decrease from the peak of 3.38 million reported on April 13, according to federal data. The Centers for Disease Control and Prevention reported on Nov. 30 that booster doses are sometimes misclassified as first doses, which may overestimate first dose coverage among adults.

The United States remains far behind not only developed countries like Singapore and Portugal, which will soon have vaccinated 90 percent of their populations, but developing nations like Cambodia (over 80 percent), according to the Our World in Data project at the University of Oxford.

Even before the arrival of Omicron, cases and hospitalizations were on the rise in the U.S. as the weather grew colder in much of the country and the highly contagious Delta variant remained a threat. Daily cases are averaging over 120,000 and more than 55,000 patients are hospitalized nationwide, far fewer than in September but an increase of more than 15 percent over the last two weeks. Hospitals have been overstretched from upstate New York to New Mexico.

The United States has been ahead of other countries in booster shots, which it authorized in September and October for many Americans. Then on Oct. 29, the Food and Drug Administration cleared the Pfizer vaccine for children ages 5 to 11.

The daily rate of Americans getting their shots had been steadily climbing since the government widened eligibility and has soared since Thanksgiving, when the Omicron variant was discovered. Data reporting is often disrupted during the holidays, often leading to higher numbers than usual once reporting resumes after the holidays.

With dozens of mutations never before seen, Omicron was named a variant of concern by the World Health Organization.

Scientists have feared that the fast-spreading variant could evade the protection of vaccines. But on Wednesday, Pfizer and BioNTech said laboratory tests suggested that three doses of their coronavirus vaccine offered significant protection against Omicron. The lab experiments don’t indicate with any certainty how the vaccines will perform in the real world, and scientists say it could take a month or more to understand the new variant’s threat.

Many questions remain about Omicron.

There are early signs that it may cause only mild illness, though that observation was based mainly on cases in South Africa among young people, who are generally less likely to become severely ill from Covid. Dr. Rochelle Walensky, director of the C.D.C., told The Associated Press on Wednesday that while the data is very limited, “the disease is mild” in almost all of the U.S. cases recorded so far. Reported symptoms have mainly been cough, congestion and fatigue and some cases have grown more severe over time, she said.

Scientists are also waiting to see whether cases lead to more hospitalizations and deaths; both lag surges in infections by days or weeks.

Broad mandates by President Biden that had helped boost vaccination rates have been put on hold by courts.

Americans who have resisted getting vaccinated can be grouped into two categories, as a New York Times report showed in July.

In one are those who are adamant in their refusal; they include a mix of people but tend to be disproportionately white, rural, evangelical Christian and politically conservative, surveys show.

In the other are those who are persuadable, but say they have been putting off vaccination or want to wait and see before making a decision; they are a broad range of people, but tend to be a more diverse and urban group, including many younger people, Black and Latino Americans and Democrats.

It’s this second group that health officials have made progress in inoculating, but surveys suggest they account for less than half of all unvaccinated adults in the United States.

— Ron DePasquale

Pfizer and BioNTech said Wednesday that laboratory tests suggest a booster shot of their coronavirus vaccine offers significant protection against the fast-spreading Omicron variant of the virus.

The companies said that tests of blood from people who had received only two doses found much lower levels of antibodies protecting against Omicron than against an earlier version of the virus. That suggests that two doses “may not be sufficient to protect against infection” by the new variant, the companies said.

While limited in scope — to get fast results, the companies examined only about 39 samples — the findings provided a bit of hopeful news at a time of renewed uncertainty. Health departments are identifying close to 100,000 cases a day, hospitalizations are ticking up and deaths are again on the rise in the United States, almost all due to the Delta variant.

The companies summarized their findings in a news release and did not release any data. Their study came on the heels of a preliminary report on laboratory experiments in South Africa that also found Omicron seemed to dull the power of two doses of the Pfizer vaccine.

The Omicron variant has been detected in about 20 American states so far, with cases rising much faster in parts of South Africa and Europe. Early modeling and analysis suggest that it may move twice as fast as Delta.

In South Africa, where Omicron already appears to be dominant, two large hospitals are reporting more children testing positive for the coronavirus after being admitted for other reasons, suggesting increased community transmission there. Around the world, cities are canceling Christmas and New Year’s Eve events amid unresolved questions about the transmissibility and virulence of the new variant.

President Biden went out of his way to draw attention to Pfizer-BioNTech’s findings on Wednesday, calling them “very, very encouraging” and saying they showed that the vaccines remain a bulwark against the virus.

“If you get the booster, you’re really in good shape,” Mr. Biden said. According to federal data, the United States has more than 200 million fully vaccinated people, but only about 50 million have gotten a booster dose.

Noah Weiland, Carl Zimmer and Benjamin Mueller contributed reporting.

The Food and Drug Administration on Wednesday authorized the first drug for widespread use in preventing Covid in Americans with weakened immune systems who have not been adequately protected by vaccines.

The antibody treatment, which was developed by AstraZeneca and will be sold under the brand name Evusheld, is engineered to be “long-acting,” meaning the body metabolizes it more slowly so that it can stay active for months. That is expected to offer longer-lasting protection — perhaps for half a year — compared to the monoclonal antibody treatments that are given to high-risk people already sick with Covid.

The F.D.A. authorized AstraZeneca’s treatment for people with immune problems, a group that includes blood cancer patients, transplant recipients and people taking drugs that suppress the immune system. The authorization also included the very small number of people for whom vaccines are not recommended because they are allergic to Covid vaccines or their ingredients.

The United States has contracted with AstraZeneca to buy up to 700,000 doses of the treatment. A Biden administration health official said the doses will be allocated proportionally to states and that the first doses will begin to be distributed at no cost within the next few weeks.

“People who are immunocompromised have spent the last year not celebrating the vaccine but instead being more and more afraid of getting Covid and the implications of getting Covid,” said Dr. Dorry Segev, a transplant surgeon at Johns Hopkins University. “The immunocompromised population has been waiting for this for months and begging for this for months.”

Scientists are scrambling to run lab experiments to see how well Evusheld and other antibody treatments hold up to the Omicron variant, which has caused alarm because it contains mutations in the spike protein that is the target of some Covid drugs. AstraZeneca said that the mutations relevant to its treatment that have been tested so far in experiments do not suggest that the drug’s effectiveness will be significantly weakened against the variant.

AstraZeneca’s treatment is given via an intramuscular injection, like vaccines. It was shown to be strongly effective at preventing Covid in a clinical trial, reducing the risk of developing a symptomatic infection by 83 percent. That study mostly enrolled people who were at high risk of getting Covid, but the company has not broken out the results for people with immune problems.

A growing body of research has shown that many people with weak immune systems do not respond well to Covid vaccines, leaving them vulnerable to infection. The F.D.A. authorized third shots for such people long before they were recommended for the general population, but even three shots may not be enough for some.

An estimated 5 percent of the population is considered to be immunocompromised. Dr. Segev estimated that that has translated into millions of Americans who are not sufficiently protected by vaccines. AstraZeneca estimated that about five million people in the United States may benefit from its drug.

The F.D.A. said that Evusheld may be effective at preventing Covid for six months. That is thought to be longer than the protection provided by another antibody drug, from Regeneron, that the F.D.A. authorized over the summer to prevent Covid-19 in a limited number of patients with compromised immune systems who had not yet been exposed to the virus. They were at high risk of exposure as a result of living in nursing homes, prisons, or under similar conditions.

The vast majority of people with immune-system problems have become eligible for monoclonal antibody treatments, which are typically infused at a hospital or clinic, only after they had already been exposed to the virus or gotten sick.

UNICEF, perhaps the most recognized arm of the United Nations, is commemorating its birthday with the most sobering of messages: The pandemic is the worst threat to gains made for children since the agency was created to help them 75 years ago.

The United Nations Children’s Fund, as UNICEF is formally known, said in a report released Wednesday evening that because of the coronavirus, the number of children who are hungry, out of school, abused, impoverished and forced into marriage is rising. At the same time, the number with access to health care, vaccines, enough food and essential services is falling.

Even in the best-case projection, the report said, it would take seven to eight years just to return to pre-Covid poverty levels for children.

Henrietta Fore, UNICEF’s executive director, said in the report that the basic improvements in children’s lives accomplished since the agency’s formation in the ashes of World War II “are now at risk” from the ravages of Covid-19.

The report cites, for example, evidence that 100 million children have fallen into poverty since the pandemic began, more than 23 million missed getting basic vaccines, and more than eight million have been forced into labor.

“In a year in which we should be looking forward, we are going backward,” Ms. Fore said. She called the pandemic “the biggest threat to progress for children in our 75-year history.”

Originally known as the United Nations International Children’s Emergency Fund, UNICEF was officially created by a General Assembly resolution on Dec. 11, 1946, as a temporary way to help alleviate the postwar suffering of millions of children.

In 1953, its status was extended indefinitely, and the agency was given what became its own iconic logo, depicting a child drinking milk. The logo evolved further in the 1960s as UNICEF’s work expanded, showing a mother lifting a child.

The agency is one of the world’s leading humanitarian providers, with annual expenditures exceeding $6.5 billion and a staff of more than 15,000 in more than 190 countries.

Nearly two years into the Covid-19 pandemic, the world remains “dangerously unprepared” for the next major outbreak, according to a new report.

The 2021 Global Health Security Index, released on Wednesday, ranks 195 countries according to their capacity to respond to epidemics and pandemics. The inaugural version of the index, published just months before the first Covid-19 cases were detected, concluded that no nation was ready for such a crisis.

Overall, the world is not any better prepared today, according to the 2021 index, which was created by the Nuclear Threat Initiative, a global security nonprofit group, and the Johns Hopkins Center for Health Security at the Johns Hopkins University Bloomberg School of Public Health.

More than 90 percent of countries have no plan for distributing vaccines or medications during an emergency, while 70 percent lack sufficient capacity in hospitals, clinics and health centers, the report found. Political and security risks have risen worldwide, and public confidence in government is declining.

Although many nations have funneled resources into addressing the acute Covid-19 crisis, few have made dedicated investments in improving overall emergency preparedness, the report found.

“We documented the places where improvements for Covid were made,” said Jennifer Nuzzo, an epidemiologist at the Bloomberg School and one of the two lead authors of the report.

But, she said, unless political leaders “act to ensure that what we’ve worked hard to develop in the midst of Covid doesn’t just erode after the event is over, we could find ourselves back where we started, or worse.”

It is called “Plan B,” and for many Britons, it is about to make pandemic life a little more complicated.

The British authorities announced Wednesday that they were imposing major new restrictions to curb the spread of the coronavirus, urging people to work from home and introducing a vaccine passport for some indoor venues.

Citing the spread of the Omicron variant, Prime Minister Boris Johnson called the decision a “proportionate and responsible” response.

But it is called Plan B for a reason.

Britain has now put in place a contingency plan that was intended to be used only if new coronavirus case numbers rose to such an extent that the health system could be under threat. And Mr. Johnson’s government had made no secret of its opposition to some of it central provisions.

But on Wednesday, the prime minister said there was little choice.

“I know this will be hard for many people,” he said at an evening news conference, “but by reducing your contacts in the workplace, you will help slow transmission.”

Under the measures, proof of vaccination will be needed to enter some venues in England, among them nightclubs, and mask mandates in public spaces will be extended. Similar “vaccine passport” systems are already either in place or planned in Northern Ireland, Scotland and Wales.

The announcement comes at an awkward time for Mr. Johnson.

In recent days, Mr. Johnson has come under mounting political pressure over reports that his staff breached lockdown rules last Christmas by holding a party in Downing Street. Earlier Wednesday, a spokeswoman, Allegra Stratton, resigned after a video emerged from last year of her and other aides joking about whether the illicit party had been held.

The Senate on Wednesday voted narrowly to roll back President Biden’s vaccine and testing mandate for large private-sector employers, taking mostly symbolic action as Republicans escalate their protest of the administration’s push to immunize Americans against a deadly pandemic.

Two centrist Democrats — Senators Joe Manchin III of West Virginia and Jon Tester of Montana — joined all 50 Republicans in voting 52-48 to pass a bill to overturn the regulation, which has already been blocked in the courts. The House is not expected to take up the measure, and administration officials said Mr. Biden would veto it should it reach his desk.

For the Republicans who forced the action, it was an opportunity to paint the administration’s efforts to increase vaccinations as federal overreach. It was also an unusual successful vote for the minority party.

“The federal government, elites in Washington, cannot micromanage citizens’ personal choices without a legitimate basis in the law and the Constitution,” said Senator Mitch McConnell of Kentucky, the minority leader who has been an outspoken proponent of coronavirus vaccines. “And that goes double for presidents going far beyond the bounds of their office and their authority.”

A majority of Democrats denounced the Republican effort as one to undercut the inoculation of Americans with vaccines that have proved to be safe and effective in stemming the spread of the coronavirus. Senator Elizabeth Warren, Democrat of Massachusetts, said that “taking tools out of the toolbox is just plain dumb.”

The vote is likely to further politicize the pandemic response, particularly as Republican leaders have struggled to quell vaccine misinformation and skepticism in their ranks make clear they opposed the mandates, not the vaccines. Republicans, who conceded that without veto-proof majorities they would be unable to overturn the rule, said they would weaponize the mandate as further evidence of what they call the administration’s heavy-handed approach to governance.

JOHANNESBURG — The children had gone to the hospital for various reasons: One had jaundice, another malaria. A third had a broken bone. But once they were admitted, they all tested positive for the coronavirus, a worrying trend in South African hospitals that hints at how transmissible the new variant, Omicron, may be.

The doctors in the children’s wards of two large hospitals in Johannesburg say they have not seen a spike in admissions, and they still do not know whether the children have Omicron. But the increase in the number of those who test positive after coming in may provide a glimpse into the behavior of the heavily mutated variant that was discovered just last month, and about which little is known.

“Our suspicion is that Covid positivity rates in the community setting are very, very high at the moment and increasing,” said Dr. Gary Reubenson, a pediatrician at the Rahima Moosa Mother and Child Hospital in Johannesburg.

Young children under 12 are not yet eligible for Covid-19 vaccines in South Africa, which also leaves them more vulnerable.

While it is still too soon to draw any conclusions about the severity of the illness caused by Omicron, early modeling and analysis suggest that it may move twice as fast as the Delta variant.

“What is scary now is the proportion of patients who are positive among those who are admitted is very high,” said Dr. Sithembiso Velaphi, who works at the Chris Hani Baragwanath Hospital in Soweto. “The number of admissions overall has not increased.”

And although the number of young patients is relatively small, doctors noted that few of the children so far have needed oxygen.

The number of coronavirus cases in South Africa continues to rise exponentially in a fourth wave of infections that epidemiologists believe is driven by Omicron. Since the variant was first sequenced and announced by South African doctors on Nov. 25, it has become the dominant version among samples tested in the country.

— Lynsey Chutel

A year after her mother died from Covid, Fiana Garza Tulip held a small memorial service on a Texas beach that her family had visited countless times when she was a child. As she and her brother dropped a wreath of yellow roses into the waves, she expected to cry. But the tears did not come. She felt only guilt for appearing to be unmoved, heartless even.

Ms. Garza Tulip, 41, had endured so many losses — two miscarriages, and the virus taking her mother, uncle and great-aunt. It also debilitated her father. “I think the one thing I miss the most is feeling anything,” she said recently of life after the series of tragedies.

She had thought the lack of emotion meant she was not grieving, unaware that numbness can be a symptom of grief. When a therapist diagnosed her with prolonged grief disorder, or P.G.D., a newly recognized condition, Ms. Garza Tulip, who lives in New Jersey, was relieved that her suffering had a name.

Recently added to the upcoming revision of the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., prolonged grief disorder leaves people feeling stuck in an endless cycle of mourning that can last for years or even decades, severely impairing daily life, relationships and job performance.

“This is about a lost relationship that was central to who you are,” said Holly Prigerson, co-director of the Center for Research on End-of-Life Care at Weill Cornell Medicine in New York. “Now this person is gone, it’s ‘I don’t know who I am anymore.’”

Symptoms can include emotional numbness; intense loneliness; avoidance of reminders the person is not there; feelings that life is meaningless; difficulty with reintegration into life; extreme emotional pain, sorrow or anger; disbelief about the death; and a feeling that a part of oneself has died. In the immediate aftermath of a death, such feelings are considered normal, but when several symptoms persist nearly daily for a year, it can be a sign of prolonged grief disorder.

The disorder isn’t new, but until now it was considered a condition for further study. Preliminary research suggests it may affect around 7 percent of those in mourning. With the coronavirus having claimed nearly 800,000 lives in the United States alone, and each death projected to leave a ring of nine bereaved people, that’s roughly seven million grieving parents, children, siblings, grandparents and spouses. And that’s only the beginning.

— Dawn MacKeen

As many as six countries in the Americas are struggling so much with coronavirus vaccinations that they may fall short of a global target of having 40 percent of their populations protected by the end of the year, the Pan American Health Organization warned on Wednesday.

The organization’s parent agency, the World Health Organization, set the goal, but for many poorer countries it has been difficult to attain because of inequities in global vaccine distribution.

Dr. Carissa F. Etienne, director of the Pan American Health Organization, told reporters on Wednesday that overall, 55 percent of people in Latin America and the Caribbean had been fully inoculated so far, but that 20 countries in the region had not yet reached the 40 percent threshold. The agency expects many of them to get there by Dec. 31, Dr. Etienne said, but six countries remain “far behind.”

Dr. Jarbas Barbosa, assistant director of the Pan American Health Organization, identified those countries as Haiti, Jamaica, St. Vincent and the Grenadines, Guatemala, St. Lucia and Grenada. He said the agency was working with each of them to try to improve vaccination rates.

“The most concerning situation is Haiti,” Dr. Barbosa said, citing the earthquake that struck there in August and the political crisis touched off in July by the assassination of Haiti’s prime minister. Those events have contributed to keeping vaccine coverage in Haiti “very low,” he said.

Dr. Etienne said the organization is doing everything possible to speed up vaccinations in Latin America and the Caribbean. “This week, more than 1.6 million doses are being delivered to countries in our region, completing a total of 72 million doses so far,” she said. “And we expect more doses to arrive in the coming days.”

— Todd Gregory

Students and parents in South Korea who have been hesitant about coronavirus vaccinations are protesting the government’s plan to shut unvaccinated students out of cram schools, libraries and study rooms as officials seek to raise inoculation rates amid the latest virus surge.

With daily cases at a national record, surpassing 7,000 for the first time on Wednesday, officials this week began requiring vaccine passes, or digital proof of vaccination, for entry into facilities like restaurants, cafes, libraries and private cram schools, known as hagwon in Korean.

The vaccine pass rules took effect on Monday for people 18 and older; starting in February they will apply to everyone age 12 and up. About 33 percent of people ages 12 to 17 have been fully vaccinated, the health officials said, far lower than the 92 percent among people ages 18 and over. South Korea began vaccinating all adults in August, and children 12 and up in October.

Several groups representing parents, teachers and students held protests this week criticizing the policy, saying that requiring vaccinations at facilities like hagwon and libraries was essentially forcing children to get vaccinated.

“The vaccine passes are effectively a vaccine mandate for children,” Park Jae-chan, the president of Seoul Parents Association, said at a news conference on Tuesday. “The choice should be left to student and parents.”

Health officials said the measure was necessary to keep schools open, as large clusters have emerged in educational facilities. About 80 percent of cluster outbreaks among students are currently associated with schools and hagwon, said Son Young-rae, a spokesman for the Health Ministry, in a news conference on Tuesday.

But the announcement has faced a backlash, with some worried about the vaccine’s possible side effects for children.

“The vaccination of children and adolescents should be carried out more cautiously than ever when adverse reactions such as mild headache, muscle pain and myocarditis are happening,” the Korea Teachers and Education Workers’ Union said in a statement on Monday, adding that the government should reconsider requiring vaccine passes for children.

Some directly affected by the measure also spoke out. One 18-year-old student in Daegu started an online petition against vaccine passes, receiving more than 320,000 endorsements as of Wednesday.

The country’s effort to bring coronavirus infections under control has collided with the priority it places on education, the Korea Association of Hagwon said. A statement from the group last week said that preventing unvaccinated students from attending hagwon was “an infringement of the constitutional right to education.”

As the government tightens curbs on educational facilities, Son Young-rae, a spokesman for the Health Ministry, said in a news conference on Tuesday that officials were also considering introducing restrictions on religious institutions, which have been the center of several major outbreaks in South Korea.

That includes Soong-eui Church, in the city of Incheon, which apologized on Tuesday for its latest cluster of the Omicron variant. The Korea Disease Control and Prevention Agency said it had confirmed 20 Omicron cases associated with that church as of Wednesday.

LONDON — For a week, Prime Minister Boris Johnson of Britain has denied damaging claims that his staff broke lockdown rules by holding a party last Christmas when such festivities were banned under government-imposed coronavirus restrictions.

Late Tuesday, the government’s story weakened when a video surfaced of senior staff members joking about just such a party four days after they had reportedly gathered to eat snacks, drink wine and play party games in Downing Street.

The revelations have shaken Mr. Johnson’s government, coming just as Britain and the rest of the world enter a second holiday season battered by the emergence of a new variant and faced by anger and frustration from exhausted citizens.

The furor claimed its first casualty on Wednesday when Allegra Stratton, a senior aide, resigned. Ms. Stratton acknowledged that remarks she made in the video, at a time when she was Mr. Johnson’s spokesperson, seemed to make light of “rules that people were doing everything to obey.”

Most recently, Ms. Stratton had been spokesperson for the British government on the United Nations global climate summit in Glasgow known as COP26.

Later on Wednesday, Mr. Johnson of Britain announced major new restrictions to curb the spread of the coronavirus, urging people to work from home and introducing a vaccine passport for some indoor venues, measures that his government had long resisted.

Critics have accused Mr. Johnson of lying and trying to cover up the event in Downing Street last Christmas. There has also been anger from some Britons who, at the time, were prevented by lockdown rules even from saying farewell to dying relatives.

Downing Street has denied that a Christmas party took place but has not denied that there was an event of some kind. Mr. Johnson has said that any gathering that occurred followed Covid protocols.

At his weekly question-and-answer session at Parliament Wednesday, Mr. Johnson apologized for the video and said he was “sickened and furious” about it. But he said he was repeatedly assured that no party took place. He said the cabinet secretary, Simon Case, who is head of the civil service, would investigate and that if there were breaches of lockdown rules there would be disciplinary action.

Amid growing pressure on the prime minister, even some of his own lawmakers appealed publicly for him to get his story straight. On Tuesday night, the Metropolitan Police, the force that covers London, said it was reviewing the video.

The reports about the Downing Street party, which first appeared in the Daily Mirror, did not suggest that Mr. Johnson himself had attended any festivities. Nor does the video released by ITV, which shows staff members conducting a mock news conference with questions about the implications of holding such a party, completely confirm that an event occurred.

But the video shows that senior staff members were aware of the risk that they might be asked about a party in Downing Street and had no credible response. The video shows Allegra Stratton, who was then Mr. Johnson’s press secretary, at a rehearsal for a news conference, with a Downing Street colleague playing a journalist. At the time, Ms. Stratton was preparing to give White House style news conferences, though that idea was eventually abandoned.

When asked about reports of a Downing Street Christmas party, she laughed and replied: “I went home,” before asking, “What’s the answer?”

“Is cheese and wine all right? It was a business meeting,” Ms. Stratton can be heard saying. “This fictional party was a business meeting,” she continued, before laughing and adding: “And it was not socially distanced.”

Opponents have seized on the video as more evidence of a familiar and damaging critique: that the Conservative-led government applies one set of rules to itself and another to the rest of the population. That was deeply damaging early in the pandemic when faith in the government was seriously undermined after Mr. Johnson’s former chief adviser, Dominic Cummings, traveled hundreds of miles to his parents’ home during a lockdown.

In response to the video, the leader of the opposition Labour Party, Keir Starmer, accused the government of misleading the public. “People across the country followed the rules even when that meant being separated from their families, locked down and — tragically for many — unable to say goodbye to their loved ones,” he said.

“They had a right to expect that the government was doing the same,” he added. “To lie and to laugh about those lies is shameful.”No timescale has yet been given for the inquiry to be conducted by Mr. Case, the cabinet secretary. Nor does his remit extend to investigating reports about other parties in Downing Street including one that the Daily Mirror claims Mr. Johnson himself spoke at.

Holiday travel suddenly feels more fraught as the world waits for emerging information on the transmissibility and virulence of the new coronavirus variant. Scientists are racing to see if the current vaccines offer protection against Omicron, but many families and other travelers may need to consider a variety of factors now before embarking to see relatives or to experience a change of scenery.

“Once again they will have to make informed decisions,” said Kathy Risse, a pediatrician in Seattle. But unlike last year’s holiday period, Dr. Risse said, “we know so much more about stopping transmission, and widespread testing is up and running.”

For those planning to travel, some basics for protection — vaccinations, masks, social distancing — will help make the trip safer. Take along some at-home test kits. Hunker down between when you get your tests and when you travel. And keep in mind that requirements vary from country to country, state to state, and city to city, so check your destination’s local health websites and C.D.C. guidelines before you embark.

— Julie Weed

With the Omicron virus variant sowing a new wave of uncertainty, leaders around the world are opting to have 2021 rung out the way it was rung in, with only muted public celebrations or none at all.

From Brazil to Germany to the United States and beyond, local officials have canceled Christmas and New Year’s Eve events. The beaches of Copacabana will be empty because officials in Rio de Janeiro have canceled the city’s famous New Year’s Eve celebration. Mayor Eduardo Paes, Rio’s mayor, said on Twitter on Saturday that the event would not take place because, “We respect science.”

“I make the decision with sadness, but we cannot organize the celebration without the guarantee of all the health authorities,” he added.

In Germany, the popular Christmas markets in Munich, Dresden and other cities did not open this year. Officials in Baltimore called off a New Year’s Eve fireworks show and said in a statement to WBAL-TV that the city hoped to bring the event back next year.

The state of Odisha in eastern India issued an order last week banning New Year’s Eve and New Year’s Day celebrations because of the “large potential for spread of Covid-19 infections.”

Taking a different tack, New York City plans to allow fully vaccinated people to throng Times Square in traditional fashion to watch the ball drop on New Year’s Eve, Mayor Bill de Blasio said last month.

The rapid spread of the Omicron variant has dampened hopes that the dawn of 2022 would mark the start of a better era in the world’s fight against the coronavirus.

Many questions remain about the Omicron variant. There are early indications that it may cause only mild illness, though that observation was based mainly on cases in South Africa among young people, who are generally less likely to become severely ill from Covid. Scientists are also waiting to see whether cases lead to substantial hospitalizations and deaths; both often lag surges in infections by days or weeks.

Available vaccines may still offer substantial protection against severe illness and death from the variant, and U.S. officials are calling on vaccinated people to get booster shots.

Perhaps the most immediate task facing Germany’s new leaders: tackling a fourth wave of the coronavirus.

After announcing tough restrictions for unvaccinated people and an intention to make vaccinations mandatory, the incoming chancellor, Olaf Scholz, took the popular step this week of tapping Karl Lauterbach, a Harvard-trained public health expert and medical doctor, to run the health ministry.

Mr. Lauterbach, often in a bow tie, has been a fixture on television debate shows and in newspaper interviews since the pandemic began. His Twitter account, where he comments on scientific studies, gives advice and makes predictions, has over 700,000 followers.

“We’ve been at this for so long now to try to get a handle on viral infections,” Mr. Scholz said in making the cabinet announcement on Monday. He added, “I’m sure most of the people of this country wished that the next minister of health would be an expert in the field — would be really good at this — and that his name would be Karl Lauterbach.”

The latest coronavirus wave has led to a record infection rate in the country, overcrowded intensive-care units, the reintroduction of restrictions on public life, a financial hit to shops, restaurants and other businesses reeling from 20 months of lockdown politics, and the risk of further dividing society.

The new coalition initially stumbled in the weeks after the election, letting lapse a state of emergency that had given the central government powers to set national pandemic policies. But it soon found its footing, passing new restrictions in Parliament, appointing a general to guide a national vaccine drive and announcing a general inoculation requirement that politicians of all stripes had promised for months would never come.

Mr. Lauterbach’s nomination is part of this more aggressive stance on Covid.

The public health expert, who says he reads scientific developments on the new Omicron variant on “an hourly basis,” has publicly argued for restrictions and warned that the fourth wave must be broken before Omicron can send the numbers spiraling even higher.

About 69 percent of people in Germany are fully vaccinated against the virus, and the number of people getting the jab has increased since infections started increasing last month and restrictions for unvaccinated people were announced recently. On two days last week, doctors and nurses in the country administered more than a million jabs a day, a number not seen since July.

On Tuesday, the authorities registered nearly 70,000 new cases and more than 500 deaths. While that’s only a slight increase over two weeks ago, it’s more than double the peak of early pandemic waves.

Mr. Scholz is expected to meet the country’s state governors on Thursday, and he has not excluded the possibility of further restrictions.

The National Guard has been asked to help staff hospitals in at least four states as another virus surge is overstretching healthcare systems and straining overtaxed workers.

On Thursday, the largest hospital network in Indiana announced that it had asked the Guard for assistance for most of its hospitals. Hospitalizations in the state have increased 49 percent over the past two weeks, according to data from The New York Times.

Six-person teams with both medical support and non-clinical members will deploy to Indiana University Health across the state in two-week increments. All Guard members are fully vaccinated, the statement said.

“The demand and strain on IU Health’s team members, nurses and providers has never been greater,” the hospital system said in a statement.

New Hampshire and Maine took similar measures on Wednesday.

In New Hampshire, 70 National Guard members will be deployed the next few weeks to help hospitals with nonmedical functions like food service and clerical work. On top of that, Gov. Chris Sununu said at a news conference, the Federal Emergency Management Agency was dispatching a team of 24 people to assist the hardest-hit facilities.

More than 55,000 coronavirus patients are hospitalized nationwide, far fewer than in September, but an increase of more than 20 percent over the past two weeks, according to a New York Times database.

The United States is averaging over 121,300 cases a day, an increase of about 27 percent from two weeks ago. Reported deaths are up 12 percent, to an average of about 1,275 per day.

Last week, New York State also turned to National Guard troops to reinforce overburdened nursing homes. Gov. Kathy Hochul issued “a pre-emptive strike,” ordering that roughly 30 hospitals nearing their capacity stop performing elective surgeries.

Hospitalizations in the state remained much lower than the highs of last winter or spring. The new restrictions will mostly impact hospitals upstate.

“We continue to see an uptick in hospitalizations,” Ms. Hochul said at a news conference on Thursday. “This is what keeps me up at night.”

Gov. Charlie Baker of Massachusetts signaled that he could take similar measures on Thursday.

Kentucky has yet to enlist the National Guard, but long-term staff shortages plague health care facilities there.

On Thursday, Gov. Andy Beshear declared that the state’s chronic nursing shortage was an emergency, with shortages of up to 20 percent. Mr. Beshear said he would sign an executive order aimed at boosting enrollment in training programs for nurses.

Even states that rank among the highest in vaccination rates are struggling, like Maine, where about 73 percent of the population is fully vaccinated, behind only Vermont and Rhode Island, according to a New York Times database. Cases in Maine recently reached their pandemic peak.

Gov. Janet Mills of Maine activated as many as 75 state Guard members to help hospitals there. She said they would support nursing facilities and administer monoclonal antibodies, which help prevent serious illness.

Maine Medical Center, the state’s largest hospital, said in a statement on Wednesday that there had been times this week “when there were no critical care beds available,” forcing hospital leaders to postpone surgeries.

“We are caring for an unprecedented number of patients,” the hospital said.

Officials are bracing for the Omicron variant, but the Delta variant remains the more imminent threat. Health care workers staff shortages brought on by burnout, illnesses and resistance to vaccine mandates have made the situation even more dire.

In Missouri, where 52 percent of the population is fully vaccinated, hospitalizations are up 43 percent in the past two weeks, data shows. More than 1,680 people were hospitalized with Covid as of Wednesday, compared with about 980 on Nov. 8.

Grace Ashford contributed reporting.