Covid-19 News: In-Person School Attendance Inches Up but Roadblocks Remain – The New York Times

Heres what you need to know:Fourth graders at Alvarado Elementary, a school in Long Beach, Calif., were back in the classroom on Monday for their first day of in-person learning in more than a year.Credit...Brittany Murray/MediaNews Group/Long Beach Press-Telegram via Getty Images

Elementary students returned to classrooms in Long Beach, Calif., on Monday and campuses from Los Angeles to Boston prepared for significant expansions of in-person instruction as a majority of the nations districts have now begun to reopen school buildings, many of which have been closed for more than a year.

On Monday, Burbio, which monitors some 1,200 districts including the largest 200 in the country, reported that 53.1 percent of students were in schools offering daily, in-person classes, and that for the first time, the proportion of students attending school virtually or in hybrid classes had dropped.

The change, Burbio officials said, appeared to be driven by the return in elementary and middle schools to in-person classes, and by the new rules from the Centers for Disease Control and Prevention permitting schools to allow three feet of social distance instead of six feet in elementary schools.

But a number of roadblocks to reopening remain. On the West Coast, large urban districts generally have lagged behind their counterparts across the rest of the nation. Surging infections in Southern California after the winter holidays were partly to blame for a slow rebound in the Los Angeles school system.

Part of the slow start can be traced to resistance from teachers, whose unions generally are more powerful in Democratic-led Washington, Oregon and California than in many other states, and who have been wary of returning to what they regard as a hazardous workplace, despite federal guidance that elementary schools in particular are safe when health precautions are followed.

Even some schools where teachers have agreed to return are still experiencing setbacks. Schools in Oakland and San Francisco, for example, are scheduled to reopen next month for elementary and special-needs students. But labor agreements in both of those California cities have allowed substantial numbers of teachers to opt out, leaving some schools without enough teachers to reopen and prompting others to scramble for substitutes.

Public schools in Californias top three districts by enrollment Los Angeles, San Diego and Fresno have said they will begin to allow grade-school students back onto campus later in April, as new coronavirus cases have fallen sharply statewide.

And on Monday, Long Beach the states fourth-largest district, with about 70,000 students began allowing about 14,000 elementary students back into school buildings for about 2 hours each day, five days a week.

The Long Beach school district was able to open earlier than other large California school systems because labor unions there agreed last summer to reopen as soon as health conditions permitted, and because the city was able to start vaccinating teachers earlier than other districts in the state.

Unlike most other cities in Los Angeles County, Long Beach has its own public health department, giving the city its own vaccine supplies and the power to set its own vaccine priorities, at a time when the county as a whole was making teachers wait until after other groups, like residents 65 and older, were vaccinated.

A city with its own health department has the ability to be more nimble, said Jill Baker, the citys schools superintendent, who called the return to classrooms this week exciting and momentous.

The school district is among the citys largest employers, and two-thirds of its students qualify for free or reduced-price lunches, so vaccinating school employees and reopening classrooms was viewed as economically important, Ms. Baker said.

In-person classes for older students are scheduled to resume April 19, with grades 6 to 8 getting the option to return on April 20 and grades 9 to 11 on April 26. The last day of school will be in mid-June.

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When I first started at the C.D.C. about two months ago, I made a promise to you: I would tell you the truth, even if it was not the news we wanted to hear. Now is one of those times when I have to share the truth, and I have to hope and trust you will listen. Im going to pause here. Im going to lose the script. And Im going to reflect on the recurring feeling I have of impending doom. We have so much to look forward to, so much promise and potential of where we are, and so much reason for hope. But right now, Im scared. We have come such a long way: Three historic scientific breakthrough vaccines, and we are rolling them out so very fast. So Im speaking today not necessarily as your C.D.C. director, and not only as your C.D.C. director, but as a wife, as a mother, as a daughter, to ask you to just please hold on a little while longer. I so badly want to be done. I know you all so badly want to be done. We are just almost there, but not quite yet. We can change this trajectory of the pandemic, but it will take all of us recommitting to following the public health prevention strategies consistently while we work to get the American public vaccinated. We do not have the luxury of inaction. For the health of our country, we must work together now to prevent a fourth surge.

President Biden, facing a rise in coronavirus cases around the country, called on Monday for governors and mayors to reinstate mask mandates as the director of the Centers for Disease Control and Prevention warned of impending doom from a potential fourth surge of the pandemic.

The presidents comments came only hours after the C.D.C. director, Dr. Rochelle Walensky, appeared to fight back tears as she pleaded with Americans to hold on a little while longer and continue following public health advice, like wearing masks and social distancing, to curb the viruss spread. The nation has so much reason for hope, she added.

But right now, she said, Im scared.

The back-to-back appeals reflected a growing sense of urgency among top White House officials and government scientists that the chance to conquer the pandemic, now in its second year, may slip through its grasp. According to a New York Times database, the seven-day average of new virus cases as of Sunday was about 63,000, a level comparable with late Octobers average. That was up from 54,000 a day two weeks earlier, an increase of more than 16 percent.

Public health experts say that the nation is in a race between the vaccination campaign and new, worrisome coronavirus variants, including B.1.1.7, a more transmissible and possibly more lethal version of the virus that has been spreading rapidly. While more than one in three American adults have received at least one shot and nearly one-fifth are fully vaccinated, the nation is a long way from reaching so-called herd immunity the tipping point that comes when spread of a virus begins to slow because so many people, estimated at 70 to 90 percent of the population, are immune to it.

The warnings come at the same time as some promising news: A C.D.C. report released Monday confirmed the findings of last years clinical trials that vaccines developed by Moderna and Pfizer were highly effective against Covid-19. The report documented that the vaccines work to prevent both symptomatic and asymptomatic infections in real-world conditions.

The seven-day average of vaccines administered hit 2.76 million on Monday, an increase over the pace the previous week, according to data reported by the C.D.C. On Sunday alone, nearly 3.3 million people were inoculated, said Andy Slavitt, a senior White House pandemic adviser.

Mr. Biden said on Monday that the administration was taking steps to expand vaccine eligibility and access, including opening a dozen new mass vaccination centers. He directed his coronavirus response team to ensure that 90 percent of Americans would be no farther than five miles from a vaccination site by April 19.

The coronavirus vaccines made by Moderna and Pfizer-BioNTech are proving highly effective at preventing symptomatic and asymptomatic infections under real-world conditions, federal health researchers reported on Monday.

Consistent with clinical trial data, a two-dose regimen prevented 90 percent of infections by two weeks after the second shot. One dose prevented 80 percent of infections by two weeks after vaccination.

The news arrives even as the nation rapidly broadens eligibility for vaccines, and the average number of daily shots continues to rise. The seven-day average of vaccines administered hit 2.76 million on Monday, an increase over the pace the previous week, according to the Centers for Disease Control and Prevention.

But the virus may be gaining renewed momentum. According to a New York Times database, the seven-day average of new virus cases as of Sunday was 63,000, an increase of more than 16 percent over the past two weeks.

Similar upticks over the summer and winter led to major surges in the spread of disease, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said at a news briefing on Monday. She said she had a sense of impending doom about a possible fourth surge of the virus.

The nation has so much reason for hope, she said. But right now Im scared.

Scientists have debated whether vaccinated people may still get asymptomatic infections and transmit the virus to others. The new study, by researchers at the C.D.C., suggested that since infections were so rare, transmission was likely rare, too.

There also has been concern that variants may render the vaccines less effective. The studys results do not confirm that fear. Troubling variants were circulating during the time of the study from Dec. 14, 2020, to March 13, 2021 yet the vaccines still provided powerful protection.

The C.D.C. enrolled 3,950 people at high risk of being exposed to the virus because they were health care workers, first responders or others on the front lines. None had previously been infected.

Most participants 62.8 percent received both shots of the vaccine during the study period, and 12.1 percent had one shot. They collected their own nasal swabs each week, which were sent to a central location for P.C.R. testing, the most accurate type of test. The weekly swabs allowed the researchers to detect asymptomatic infections as well as symptomatic ones.

The investigators asked participants about symptoms associated with infection, including fever, chills, cough, shortness of breath, sore throat, diarrhea, muscle aches, or loss of smell or taste. They also analyzed patients medical records to detect illnesses.

Fifty-eight percent of the infections were detected before people had symptoms. Just 10.2 percent of infected people never developed symptoms.

Among those who were fully vaccinated, there were .04 infections per 1,000 person-days, meaning that among 1,000 persons there would be .04 infections in a day.

There were 0.19 infections per 1,000 person-days among those who had had one dose of the vaccine. In contrast, there were 1.38 infections per 1,000 person-days in unvaccinated people.

Dr. Walensky urged Americans to continue taking precautions and to waste no time getting the shots as soon as they are eligible.

I am asking you to just hold on a little longer, to get vaccinated when you can, so that all of those people that we all love will still be here when this pandemic ends, she said.

HOUSTON As Texas joined several other states on Monday in opening eligibility for coronavirus vaccines to millions of healthy adults, anticipation for the shot could be seen in the long line that snaked outside Booker T. Washington High School in Houston.

This is a good sign, said Nelson Garcia, 48, who waited more than two hours with his two young children before he was finally within reach of protection from a disease that could be deadly for people with diabetes like himself. It looks like everyone wants to get vaccinated. I want my children to see that this is a good thing and that the vaccine may finally help us get back to normal.

On Monday, Texas became the largest state to expand vaccination eligibility to anyone 16 or older, or about 22 million people. Long lines were replicated across the state and appointments were difficult to snag online. Vaccination spots at HEB.com, the website for the most popular supermarket chain in Texas, were few and far between.

The spike was expected. Virtually anyone can get a vaccine now, said Representative Sheila Jackson Lee, a Democrat who represents the Houston region.

Five other states, including neighboring Oklahoma and Louisiana, as well as Kansas, Ohio and North Dakota, also opened their doors for all adults on Monday. Several reported increased interest in the vaccine, but the numbers did not overwhelm the system of vaccine providers.

Also on Monday, officials in New York State, once the center of the pandemic with about 31,000 deaths in New York City alone, announced that beginning on Tuesday, all adults 30 and older would be eligible for the vaccine. At least 36 other states have vowed to offer shots to every adult who wants one by mid-April.

Six states Colorado, Connecticut, Indiana, Minnesota, New Hampshire and South Carolina plan to expand eligibility this week, officials in those states said.

The German health authority responsible for vaccine guidelines recommended on Tuesday that the country suspend use of the AstraZeneca vaccine in adults under 60 because of concerns about a possible association with blood clots. The action came a day after Canada suspended its use in people 55 and under.

Earlier in the day, a number of local authorities in Germany including Berlin, Munich and the state of Brandenburg had made similar moves.

A small district in North Rhine-Westphalia banned use of the AstraZeneca vaccine on Monday for all women below the age of 55, after serious episodes last week involving two women who had received the vaccine: one, 47, died of sinus vein thrombosis and another, 28, became seriously ill.

No causative link has been established between the patients conditions and the vaccine.

Chancellor Angela Merkel met Tuesday evening with state governors to discuss the AstraZeneca vaccine, and said that Germany would follow the recommendation and hold off using it to inoculate people under 60 unless they have discussed the risks with their doctor first.

France and several Nordic countries have also taken a precautionary stance on the vaccine, even after the European Unions top drug regulator cleared it as safe this month. Some suspensions in Europe may have been driven as much by political considerations as by science.

In Canada, Dr. Caroline Quach-Thanh, the chairwoman of the National Advisory Committee on Immunization, said at a video news conference on Monday that more study was needed. Given alternative vaccines are available in Canada, N.A.C.I. feels it is very important to study the risks and benefit as a precautionary measure, she noted.

The Canadian decision was made after reviewing evidence emerging from Germany, where the Paul-Ehrlich Institute, the countrys vaccine regulatory body, reported earlier this month that at least seven people who had recently received the AstraZeneca vaccine had developed a very rare, potentially fatal condition involving blood clots that can block the drainage of blood from the brain, associated with low blood platelet counts (thrombocytopenia) and bleeding.

(An earlier version of this item referred incompletely to the condition.)

Statistically, seven cases was significantly higher than normal for the population of 1.6 million adults that had received the vaccine in Germany by March 15, the institute said; by its calculations, just one case would have been expected.

The Canadian health authority continues to recommend the AstraZeneca vaccine for older adults, who are much more susceptible than younger people to serious cases of Covid-19, and have not appeared to develop blood clots in studies conducted in Europe, the committee members said.

We want to prevent hospitalizations and severe disease for those over 55, Dr. Quach-Thanh said.

The AstraZeneca vaccine, created by Oxford University, was approved in late February for use in Canada but has suffered setbacks there and elsewhere. Soon after its approval, N.A.C.I. recommended that it not be administered to people 65 and older, because of a lack of data about that age group; two weeks later, N.A.C.I. waived its initial concerns and approved the vaccine for all adults.

The vaccine was the third approved in the country, after those from Pfizer-BioNTech and Moderna. Just over 300,000, or 6 percent, of the doses administered in Canada so far have been AstraZenecas vaccine. The Biden administration promised this month to loan Canada 1.5 million more doses of the vaccine, which still has not been approved for use in the United States.

New York can begin vaccinating anyone 30 or older on Tuesday and will make all residents 16 or over eligible on April 6, beating President Bidens goal of making every adult eligible for a coronavirus vaccine by May 1, Gov. Andrew M. Cuomo announced on Monday.

New York was one of only a few states that had not yet set a timeline for universal adult eligibility. Five states had already expanded eligibility fully by the end of last week; six did so on Monday; seven more will follow later this week, and another six on April 5. At least 11 states have said they will wait until May 1.

Though Mr. Cuomo has gradually loosened vaccine eligibility criteria over the last month, he expressed reluctance last week to set a specific target date for doing away with the states requirements. The governor said he did not want to outline a timeline for more widespread vaccination until he was more confident that New York would have adequate vaccine supply on hand for its population.

I just want to make sure that the allocation projections that were getting from the feds are right, frankly, Mr. Cuomo said at a news conference last week. I dont want to say, Were going to open up to 30-year-olds in three weeks, and then something happens with the allocation.

Mr. Cuomos announcement comes as New York has been adding new virus cases at one of the highest rates among U.S. states. As of Monday, the state had a seven-day average of 49 new virus cases a day for every 100,000 residents, according to a New York Times database, second only to New Jersey. (The nation as a whole was averaging 19 new cases per 100,000 people.)

Even as the number of new cases continues to mount, the state has not faced anywhere near the level of devastation that it experienced a year ago, when hospitals were overwhelmed with patients and morgues were overflowing.

Eligible only in some counties

Eligible only in some counties

Eligible only in some counties

Buoyed by its vaccination progress, the state has also been gradually reopening businesses in the last several weeks. Mr. Cuomo allowed sporting events and concerts to resume at large venues last month and movie theaters to bring back audiences this month. Restaurants in New York City are now allowed to serve diners indoors at 50 percent capacity, their highest level of indoor dining since Mr. Cuomo closed them last year at the onset of the pandemic.

As of Monday morning, 29.6 percent of people in New York State had received at least one shot of a vaccine, while 16.8 percent were fully vaccinated, according to the states data.

Currently, all people 50 and over are eligible to receive the vaccine in New York, in addition to teachers, some essential workers and people with certain medical conditions that make them more susceptible to serious illness from the virus.

Massachusetts on Monday expanded a new state-financed coronavirus testing program to allow every public school in the state to test all students and staff members weekly for the rest of the school year, using a pooled testing approach that could be a model for school districts nationwide.

More than 1,000 schools in Massachusetts, representing nearly half the districts in the state, are already participating in the program.

Since February, the program has analyzed 22,679 pooled samples from students, teachers and staff members, reporting on Monday a positivity rate of less than 1 percent, considered low. Since the pooled samples typically include swabs from seven different people, state officials said the individual positivity rate is probably much lower.

In a phone interview on Monday, Gov. Charlie Baker said that the state had been able to scale up the program by vetting testing labs and signing contracts with them, instead of leaving each district to do that work on its own. He estimated that the program, which is using federal Covid relief funds to pay for the tests, could cost $30 million to $40 million.

We started doing it on a demonstration basis with a few school districts just to test it and see if the logistics could work, Mr. Baker said. We now have a working model that is operating at a pretty big scale and in a pretty big state.

The pooled testing program collects nasal swabs from students, faculty and staff members and then tests them in batches, a process that saves time and lab resources. Last week, about 63,000 students and staff members were tested.

If a batch tests negative, everyone in the pool is considered to have a negative result. If a batch tests positive, each person in the pool is then tested.

Massachusetts, which had initially planned to pay for the tests for schools until mid-April, now plans to cover the costs through the end of the school year. It is also encouraging other school districts in the state to sign up.

Mr. Baker said he planned to promote the Massachusetts model to other states. Some districts, like Montgomery County Public Schools, Marylands largest system, are planning to introduce pooled testing in April.

Theres enough money in the various federal bills that have been passed, including the most recent one, to make it possible for states or municipalities both to pay for a program like this, Mr. Baker said.

The state of New York must immediately begin to offer Covid-19 vaccines to all incarcerated people in the states prisons and jails, a judge ruled on Monday, making the state one of few in the nation to provide doses to such a broad population behind bars.

The order, the first involving any of the countrys largest correctional systems, comes as the coronavirus continues to roar through facilities in New York. At least 1,100 people living behind prison walls have tested positive for the virus since the start of last month, and five have died.

But even as corrections staff and many other groups, including some who live in close-contact settings like group homes and homeless shelters, have gained access to the vaccines in recent weeks, most incarcerated people in New York have remained ineligible to receive doses.

Justice Alison Y. Tuitt of State Supreme Court in the Bronx wrote in her ruling on Monday afternoon that people in prisons and jails had been arbitrarily left out of the rollout and that doing so was unfair and unjust and an abuse of discretion.

State officials, she said, irrationally distinguished between incarcerated people and people living in every other type of adult congregate facility, at great risk to incarcerated peoples lives during this pandemic.

She added: There is no acceptable excuse for this deliberate exclusion.

Epidemiologists and infectious disease specialists widely agreed, even in the earliest stages of vaccination efforts when supply was more limited, that the roughly 50,000 people in correctional facilities across the state should be made eligible because of their uniquely high risk for contracting and spreading the virus. A disproportionate number of them are also Black and Latino, groups that have been hit hard by the pandemic.

But vaccinating incarcerated people has proved politically fraught across the country, and states grappling with the same ethical, logistical and legal questions have drawn up drastically different timelines for offering doses. In some states, officials have backtracked from plans to vaccinate prisoners because of political headwinds.

In New York, most of those behind bars had been left out, though correctional officers were included and other high-risk groups like restaurant workers, public-facing government employees and essential building service workers have recently become eligible.

State officials announced on Monday that all adult residents would be eligible to receive a coronavirus vaccine by April 6, which might have led more people behind bars to soon be offered doses even had the ruling not been issued.

Vermont is reporting a sharp spike in coronavirus cases, reaching highs that have not been seen since January.

This is a concerning number of new cases and should not be dismissed, Dr. Mark Levine, the states health commissioner, said at a news conference on Friday.

Vermont hit a single-day case record with 283 new confirmed cases on Friday, according to a New York Times database, making it the first state to set a case record since Jan. 18. (Its seven-day average, 154, is still lower than its peak in January.) Half of the cases reported in the past two weeks were in people under the age of 30, officials said.

The renewed surge has been driven by a number of factors, including pandemic fatigue and the spread of worrisome variants, Dr. Levine said in an interview on Monday. As older people get vaccinated and deaths start to drop, younger people have been more willing to gather in groups, he said.

The University of Vermont has reported a significant increase in confirmed cases among students, climbing to 80 last week from 41 two weeks before. The statewide surge, though, does not appear to be driven largely by college students, Dr. Levine said, since there have not been widespread increases on other campuses.

Cases across the United States have started to rise in recent weeks, after infections began to drop following a post-holiday surge. Scientists have warned for weeks about another increase, as more cases of variants are detected and states lift restrictions. Still, the United States remains behind in its attempts to track variants, though the Centers for Disease Control and Preventions efforts to locate them has recently improved and will continue to grow. States in the Northeast have accounted for about 30 percent of the nations new cases over the past two weeks, up from 20 percent in early February.

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Covid-19 News: In-Person School Attendance Inches Up but Roadblocks Remain - The New York Times