Covid-19 Live Updates: F.D.A., J&J Vaccine Booster News

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Rapid at-home Covid-19 testing is about to become much more widely available in the United States, the Food and Drug Administration says, following authorization of a mass-produced testing kit.

Competing at-home tests have been on the market for months, but Acon Laboratories’ test, authorized by the agency on Monday, “is expected to double rapid at-home testing capacity in the U.S. over the next several weeks,” Dr. Jeffrey E. Shuren, director of the F.D.A.’s Center for Devices and Radiological Health, said in a statement.

“By year’s end, the manufacturer plans to produce more than 100 million tests per month, and this number will rise to 200 million per month by February 2022,” he said.

Like tests already available from Abbott, Quidel, Becton Dickinson and other makers, Acon’s test is made to detect antigens, proteins from the coronavirus, on a nasal swab, and produces results in 15 minutes.

Such tests, which cost as little as $10, are not as sensitive as P.C.R. tests, which replicate the virus’s genetic material and are performed in labs. As a result, experts recommend that users carefully follow instructions and test themselves more than once, rather than trust what might be a false negative result.

But antigen tests are highly accurate in detecting infection in someone who is suffering symptoms in the first week after they appear, when the viral load is likely to be highest.

Despite their limitations, “we believe at-home diagnostic tests play a critical role in the fight against Covid-19,” Dr. Shuren said.

Demand for at-home tests has grown sharply as workplaces and schools have reopened, the highly contagious Delta variant has spread, and many people have returned to in-person gatherings and travel. At times they have been hard for consumers to find.

Federal regulators have approved hundreds of lab tests for the coronavirus, and some kits for taking samples at home and sending them to labs, but only a handful of at-home tests.

Credit…Bess Adler for The New York Times

Johnson & Johnson on Tuesday morning asked federal regulators to authorize a booster shot for adults, becoming the third coronavirus vaccine manufacturer to do so.

The company said that a second shot of its vaccine about two months after the first significantly boosts protection, to 94 percent, against moderate to severe disease. Other coronavirus vaccines have been given in two doses, but Johnson & Johnson’s is a single dose.

The Food and Drug Administration last month authorized boosters for many recipients of Pfizer-BioNTech’s vaccine, and Moderna is seeking authorization for boosters of its inoculation. Regulators could decide on both Moderna’s and Johnson & Johnson’s applications as early as this month.

Senior federal health officials have been privately convinced for some time about the need to offer a booster shot to recipients of Johnson & Johnson’s vaccine.

A recent study by the Centers for Disease Control and Prevention found that Johnson & Johnson’s single-dose vaccine was 71 percent effective against hospitalization from Covid-19, compared with 88 percent for Pfizer-BioNTech’s and 93 percent for Moderna’s two-dose vaccines. Other research found that Johnson & Johnson recipients were more likely to suffer breakthrough infections or symptomatic Covid-19 than recipients of the other two vaccines.

Johnson & Johnson’s own study cited better results, finding its vaccine was 81 percent effective against hospitalization and 79 percent effective against infection. The company has said that its study also found that the protection its vaccine provides does not wane over time as does protection from Pfizer-BioNTech’s vaccine.

Nearly 15 million Americans have been inoculated with Johnson & Johnson’s vaccine, compared with 102 million fully vaccinated with the Pfizer-BioNTech vaccine and nearly 69 million with Moderna’s.

On Tuesday afternoon, Dr. Peter Marks, the F.D.A.’s top vaccine regulator, suggested that federal officials favor extra shots for all three vaccines. “The data seem to demonstrate that booster shoots seem necessary,” he said.

Speaking at a virtual town hall held by the Covid-19 Vaccine Education and Equity Project advocacy group, he added: “I think the maturing data will make it clear that a larger group of people, perhaps in the individuals 18 and older, will be eligible for booster shots. But we’ll have to see what our advisers say.”

It is unclear to some scientists whether it would be better to give a booster shot of Johnson & Johnson after about two months or six months. Johnson & Johnson’s submission to the F.D.A. shows that when a booster shot was given six months after the initial injection, antibody levels increased ninefold within a week and 12-fold within a month.

Some research from the National Institutes of Health also indicates that Moderna’s vaccine may work even better as a booster for Johnson & Johnson’s shot.

“We look forward to our discussions with the F.D.A. and other health authorities to support their decisions regarding boosters,” said Dr. Mathai Mammen, a key research and development leader within Johnson & Johnson. “At the same time, we continue to recognize that a single-shot Covid-19 vaccine that provides strong and long-lasting protection remains a crucial component to vaccinating the global population.”

The F.D.A. and the Centers for Disease Control have been grappling with whether to shore up vaccine effectiveness with booster shots for weeks. After fraught debates with experts on outside advisory panels, the agencies decided late last month to offer a booster shot to a broad swath of adult recipients of the Pfizer-BioNTech vaccine.

The eligible include those 65 and older and those who live in long-term care facilities, who have underlying medical conditions or who are at higher risk of exposure to the virus because of their jobs or institutional settings.

Federal officials are expected to push this month for the same eligibility categories for booster shots of the other two vaccines. There is also a push to include middle-aged people among those generally eligible. The F.D.A.’s advisory panel is scheduled to take up the issue of a third shot of Moderna’s vaccine on Oct. 14, one day before it is to consider Johnson & Johnson’s request.

“Our goal at the end of that is to hopefully have a harmonized approach to boosters for the three different vaccines,” Dr. Marks said at the town hall. His remarks were reported by CBS News and other media organizations.

On Monday, federal regulators for the European Union went farther than U.S. regulators, authorizing booster shots for all Pfizer-BioNTech recipients 18 or older.

Credit…Darren England/EPA/Shutterstock

Ellume, an Australian company that makes a widely available at-home coronavirus test, has recalled nearly 200,000 test kits because of concerns about a higher-than-expected rate of false positives. That represents about 5.6 percent of the approximately 3.5 million test kits Ellume has shipped to the United States.

The company, which detected the problem in mid-September, traced the issue to variations in the quality of one of the raw materials used in the test kit, Dr. Sean Parsons, Ellume’s chief executive, said in a phone interview. He declined to specify the material in question, citing a desire not to publicly disclose precisely how the test kits work.

About 427,000 test kits, including some provided to the U.S. Department of Defense, were affected by the problem, Dr. Parsons said. Roughly half have already been used, he said, yielding about 42,000 positive results. As many as a quarter of those positives may have been inaccurate, Dr. Parsons said, although he stressed that it would be difficult to determine exactly how many.

“I’m very sorry that this has happened,” Dr. Parsons said. “We’re all about chasing accuracy, and to have these false positives is disappointing.”

The issue did not affect all Ellume test kits or the reliability of negative results, the company said.

Ellume’s test is a rapid antigen test, designed to detect pieces of the virus in the nose. Users swab their nostrils, insert the swab into a dropper of fluid and then add the fluid to a Bluetooth-connected analyzer. Results are transmitted to a smart phone app in 15 minutes. Last December, it became the first over-the-counter, completely at-home test to receive an emergency use authorization from the U.S. Food and Drug Administration.

The company has asked retailers to remove the tests from shelves and is in the process of notifying consumers, Dr. Parsons said.

Consumers who have one of the affected tests can request a replacement online. People who try to use one of the affected test kits will be notified in the app that the test has been recalled. “It really won’t be possible to use any of those tests now,” Dr. Parsons said.

He added that the company had put “extra controls” in place to prevent the same problem from cropping up again in the future.

“We are doing everything possible to get known, good product into the hands of consumers in the U.S.,” Dr. Parsons said.

The recall comes as demand for testing has soared, and consumers have complained that at-home test kits are hard to find.

On Monday, the F.D.A. authorized a new at-home antigen test, ACON Laboratories’ Flowflex. The authorization “is expected to double rapid at-home testing capacity in the U.S. over the next several weeks,” Dr. Jeffrey E. Shuren, who directs the F.D.A.’s Center for Devices and Radiological Health, said in a statement. “By year’s end, the manufacturer plans to produce more than 100 million tests per month, and this number will rise to 200 million per month by February 2022.”

Credit…County Of Los Angeles/Via Reuters

The California National Guard has been deployed to four hospitals in Northern and Central California, where some areas with relatively low vaccination rates have struggled to handle an influx of Covid patients.

Teams of up to 17 National Guard troops were sent over the past week to staff the hospitals in two counties: Mercy Medical Center Redding, in Shasta County in the northern part of the state; and Adventist Health Bakersfield, Bakersfield Memorial Hospital and Mercy Hospital Southwest – Bakersfield, in Kern County in Central California, according to a statement from the California National Guard.

The rate of recent daily cases per person in California overall is very low, second only to Connecticut in the mainland United States, according to a New York Times database.

But hospitals in some parts of the state have been overwhelmed by a Delta variant–driven surge of Covid patients. New cases and hospitalizations all reached or exceeded peak levels in mid-September in Shasta County, and have been trending back down. In the more populous Kern County, hospitalizations jumped at the beginning of last month but have been falling ever since.

The amount of fully vaccinated people in both counties — 42 percent of the population — is far below the statewide rate of 59 percent.

The National Guard’s deployment in California coincides with a mandate that took effect last week that requires all of the state’s health care workers to be vaccinated. Major health systems then reported that the mandate had helped boost their vaccination rates to 90 percent or higher. There have been no reports of mass firings of health care workers in the state yet.

Each National Guard medical team includes a physician assistant or registered nurse who leads a group of medical and administrative assistants, Lt. Col. Jonathan M. Shiroma, a spokesman for the state National Guard, said in the statement.

The situation at Mercy Medical Center Redding was further complicated by the Fawn Fire, which left about 30 staff members unable to work toward the end of the month, the Record Searchlight in Redding reported. A spokeswoman for the hospital did not respond to requests for comment on Tuesday night.

Several states have called on the National Guard to ease the strain on hospitals during the pandemic. Gov. Kate Brown of Oregon asked in August for at least 500 of the state’s National Guard troops to help staff hospitals. Idaho’s governor, Brad Little, also deployed his state’s National Guard troops this summer.

Credit…Ross D. Franklin/AP Pool Photo

The Biden administration warned Arizona on Tuesday that it could lose some of its state and local recovery funds because it has been using money meant to combat the pandemic to undercut mask requirements in schools.

In a letter to Arizona’s Republican governor, Doug Ducey, the Treasury Department said the state was misusing the money, which was intended to help local governments bolster public health measures. As part of the $1.9 trillion pandemic aid package that Congress passed earlier this year, states and cities were awarded $350 billion of relief money that they could use for a wide variety of purposes.

However, the funds cannot be used to impose conditions “that would undermine efforts to stop the spread of Covid-19 or discourage compliance with evidence-based solutions for stopping the spread of Covid-19,” Wally Adeyemo, the deputy Treasury secretary, wrote.

Arizona was awarded $4.2 billion from the fund and has received about half of that so far.

Arizona’s Republican-controlled legislature banned school mask mandates earlier this year, but some school districts imposed them anyway. In August, Mr. Ducey announced that he was rolling out two education programs intended to undercut such requirements.

The letter to Mr. Ducey was the first warning that the Treasury Department has sent to a state over what it views as misuse of funds.

Credit…Kristian Thacker for The New York Times

Even in its first months, the U.S. coronavirus vaccination campaign saved the lives of tens of thousands of older people, according to a federal government report released on Tuesday.

From January through May, vaccination prevented about 265,000 cases, 107,000 hospitalizations and 39,000 deaths among Medicare recipients, who are either over age 65 or are disabled, the Department of Health and Human Services analysis said.

That includes a period of time when relatively few people had received the shots. Vaccination began in the United States in mid-December, and at first was generally limited to the elderly and people with serious underlying conditions.

But the rollout was uneven, and vaccine production and distribution were still ramping up. In mid-February, only 4 percent of the U.S. population had been fully vaccinated, but by the end of May, the figure was 41 percent, and about 80 percent for people over 65.

The H.H.S. study did not look at deaths since May, when the percentage of people vaccinated continued to grow, but the efficacy of early vaccines might have waned.

The analysis found that for each increase of 10 percentage points in a county’s vaccination rate, the number of Covid hospitalizations and deaths among Medicare recipients fell 11 to 12 percent.

Covid-19 deaths reported by local and state authorities peaked in January at about 4,000 per day, plunged to as low as 200 to 300 per day in July, and since have rebounded to about 2,000 per day. But experts view those figures as undercounts.

Credit…Emily Kask for The New York Times

The arrival of vaccines and declining Covid-19 cases in the first half of 2021 coincided with an easing of symptoms of anxiety and depression across the United States, according to survey data released on Tuesday by the Centers for Disease Control and Prevention.

But symptoms remained much more common in June 2021, the end of the survey period, than before the pandemic, and could be on the rise again because of the summer surge in cases of the Delta variant, C.D.C. scientists said.

The agency relied on a biweekly online survey conducted from August 2020 to June 2021. Researchers analyzed 1.5 million responses over that period about the severity of symptoms of anxiety or depression.

From August to December 2020, symptoms of anxiety rose by 13 percent and symptoms of depression by 15 percent, the surveys found. But from December to June 2021, that trend reversed: Symptoms of anxiety decreased by 27 percent and of depression by 25 percent.

The C.D.C. said that there was a strong correlation between the average number of daily Covid-19 cases and the severity of respondents’ anxiety and depression.

Noting that some parts of the population had been harder hit by the virus than others, the agency said those same groups may be at higher risk for psychological ill effects from Covid-19 and that good access to mental health services was critical. Other research has indicated that people with low incomes were at higher risk of depression during the pandemic.

The national trends were mirrored in most states, with anxiety and depression peaking in December 2020 or January 2021, when U.S. cases, hospitalizations and deaths all peaked. States that experienced steeper increases in symptoms last year also showed larger reductions in the first half of 2021.

Mississippi was among the states with the largest increases in anxiety and depression scores by percentage in the second half of 2020. New York, on the other hand, experienced both the smallest rise in anxiety scores in late 2020 and the smallest drop in the first half of this year.

Credit…Ting Shen for The New York Times

AstraZeneca said on Tuesday that it had asked the Food and Drug Administration to grant emergency authorization for a long-acting antibody treatment to prevent Covid-19 in people who are at high risk of the disease. If authorized, it would become the first such preventive treatment to be available in the United States, the company said.

The company said in a statement that the treatment had reduced the risk of symptomatic Covid-19 by 77 percent in a trial in which most participants either had other medical conditions that placed them at greater risk of severe illness or were not producing sufficient antibodies after vaccination.

It said the treatment could be used in conjunction with vaccines in people with weaker immune systems. Other antibody treatments in use in the United States, including one developed by the drug maker Regeneron, have mainly been used to treat people who are already infected with the coronavirus. The AstraZeneca treatment is designed to stay in the body for much longer than the available antibody treatments for Covid, the company has said.

“Vulnerable populations such as the immunocompromised often aren’t able to mount a protective response following vaccination and continue to be at risk of developing Covid-19,” Mene Pangalos, an executive vice president at AstraZeneca, said in a statement. “With this first global regulatory filing, we are one step closer to providing an additional option to help protect against Covid-19 alongside vaccines.”

An F.D.A. authorization would raise the fortunes of AstraZeneca, whose coronavirus vaccine, which is in use in numerous countries, has not been authorized in the United States.

Antibody treatments have gained greater attention in recent months as an alternative, if expensive, tool against Covid-19 in the United States, particularly by some who have shunned vaccines. The Biden administration has emphasized that vaccinations are the best way to prevent the spread of the coronavirus, but has urged state and local health officials to make antibody therapy — which the federal government covers at a per-dose cost of roughly $2,100 — more widely available.

The AstraZeneca treatment is one of several in a class of therapies known as monoclonal antibodies, which introduce lab-made, disease-fighting proteins into the bodies of patients, usually through an infusion.

Last month, a World Health Organization panel endorsed the use of Regeneron’s antibody treatment in high-risk Covid-19 patients, while the health agency urged the company and its partner, the Swiss manufacturer Roche, to lower the cost of the therapy and make it more widely available.

Correction: 

The photo caption in an earlier version of this report misidentified the pictured building. It is AstraZeneca’s research and development center, not the company’s U.S. headquarters, which are in Delaware. 

Credit…T.J. Kirkpatrick for The New York Times

A Facebook whistle-blower told lawmakers at a hearing on Tuesday that the company can effectively police at most about a fifth of the vaccine misinformation that appears on its platform.

Frances Haugen, a former Facebook product manager for the company’s civic misinformation team who released a trove of internal documents demonstrating the social media company’s negative impacts, testified on Capitol Hill about a wide range of issues, briefly touching on the problem of virus misinformation.

Facebook and other online platforms like YouTube and Twitter have helped turbocharge the spread of false information about the coronavirus, vaccines and supposed cures, like the livestock deworming drug Ivermectin. The company said in February that it planned to remove posts that contained inaccurate statements about vaccines from its platform and has since last year been vocal about removing coronavirus misinformation.

But posts and groups spreading false information related to the coronavirus continued to appear. In July President Biden said Facebook was “killing people” through the inaccurate information it spread, though he walked the comment back after the company objected.

On Tuesday, Senator Amy Klobuchar of Minnesota asked Ms. Haugen whether Facebook had dedicated enough resources to removing coronavirus falsehoods, noting that YouTube said last week that it would ban all anti-vaccine misinformation.

“I do not believe Facebook, as currently structured, has the capability to stop vaccine misinformation,” Ms. Haugen said.

She added that Facebook said that its efforts were only likely to remove “10 to 20 percent of content.”

Facebook did not immediately respond to requests for comment.

Credit…Anna Moneymaker for The New York Times

Dr. Francis S. Collins, the National Institutes of Health director who has led the agency for more than a decade and through three presidential administrations, said on Tuesday that he would step down from his post by the end of the year.

President Biden is expected to nominate a replacement, who will have to be confirmed in an evenly divided Senate, to manage a budget of over $40 billion.

“No single person should serve in the position too long,” Dr. Collins said in a statement. “It’s time to bring in a new scientist to lead the N.I.H. into the future.”

Dr. Collins, 71, was appointed in 2009 by President Barack Obama after more than a decade leading the National Human Genome Research Institute, which is part of the N.I.H.

Mr. Biden on Tuesday lavished praise on Dr. Collins, whom he called “one of the most important scientists of our time.”

“After I was elected president, Dr. Collins was one of the first people I asked to stay in his role with the nation facing one of the worst public health crises in our history,” Mr. Biden said. “Millions of people will never know Dr. Collins saved their lives. Countless researchers will aspire to follow in his footsteps. And I will miss the counsel, expertise and good humor of a brilliant mind and dear friend.”

On Tuesday, the N.I.H. said that Dr. Collins would return to his laboratory there, which is studying the causes of and prevention for Type 2 diabetes and new therapies for Hutchinson-Gilford Progeria Syndrome, a form of premature aging.

Credit…Atul Loke for The New York Times

NEW DELHI — India’s coronavirus death toll could now amount to a government payout of hundreds of millions of dollars.

The country’s Supreme Court has ordered India’s disaster management agency to pay 50,000 rupees, about $671, to families of people who have died from Covid. The country’s official death toll from the pandemic is 449,260, although experts estimate that the true number of Covid deaths is several times higher. Even that smaller number would suggest payouts amounting to about $300 million.

About this data

Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

The number of families applying for compensation could quickly balloon, because the government has expanded the definition of what qualifies as a Covid-19 death to anyone who died within 30 days of a positive RT-PCR test or clinical examination confirming the infection.

“This is a herculean task for the government,” said Gaurav Kumar Bansal, the lawyer who brought the litigation to India’s top court.

India’s National Disaster Management Act stipulates that government compensation of 400,000 rupees, about $5,400, should be given to families who lose relatives in typhoons, floods and other disasters.

Millions of India’s 1.4 billion people live below the poverty line, and the Supreme Court order, issued on Monday, came in response to public interest litigation, a type of case in India that is brought on behalf of the public at large rather than by any specific plaintiff.

Prime Minister Narendra Modi’s government declared the pandemic a disaster in March 2020, a move that gave it power to impose a strict nationwide lockdown.

Mr. Bansal said the disaster declaration should also have led to compensation payments being made.

“We challenged them to pick and choose,” he said. “If it is notified as a disaster, then all provisions of the Disaster Management Act will apply.”

The government offered $671 per death. The Supreme Court, which factored in the agency’s other costs, agreed.

Anirudh Singh Rathore, 60, a garment trader in the capital, New Delhi, lost his wife to India’s ferocious second wave last spring. He has applied online for compensation through the Delhi government, but he is doubtful that the money will arrive.

“Such compensation is not easy to take from the government,” he said. “It is very easy to announce but difficult to get.”

Credit…Lukas Coch/EPA, via Shutterstock

Australia and New Zealand moved closer on Tuesday to fully reopening their economies in the coming months, with leaders in both countries outlining steps to allow people vaccinated against the coronavirus to move more freely.

Prime Minister Scott Morrison said that Australia could allow vaccinated foreign tourists to enter the country in 2022 at the earliest, even as it prioritizes travel by its own inoculated citizens and permanent residents.

Skilled migrants and students who are vaccinated would then be allowed in, he said in an interview on Channel Seven, reaffirming plans announced in recent days.

“We will get to international visitors as well — I believe next year,” Mr. Morrison said. “The priority is Australians.”

The prime minister’s comments were the firmest assurances of when the island nation may reopen to the world, having closed its borders in March 2020. Millions of Australians have since endured lengthy lockdowns and strict border policies during the course of the pandemic.

Mr. Morrison said on Friday that an international travel ban would be lifted by mid-November as national vaccination rates continue to rise. As of Tuesday, 67 percent of Australians had received a first vaccine dose and 46 percent were fully vaccinated, according to figures compiled from government sources by the Our World in Data project at the University of Oxford.

In neighboring New Zealand, Prime Minister Jacinda Ardern said on Tuesday that people would be required to use a national vaccine certificate to get into “high-risk settings” like summer music festivals.

The certificate, which is expected to be introduced in November, will be a document that people can show in a digital form or download and print out.

New Zealand’s government is still finalizing where certificates will be used beyond large-scale events, though restaurants and bars are one possibility, Ms. Ardern said at a news conference. They will not be required for shopping in supermarkets or receiving health care, she added.

Ms. Ardern urged people in the country to get vaccinated before the passes became a requirement. “It’s one of the best ways we can ensure that summer plans can go ahead uninterrupted,” she said. “It will help us to keep people safe.”

“To be fully vaccinated and fully protected and enjoy the things you love,” she added, “you need to be vaccinated — this month, not in December.”

The plan follows in the footsteps of countries like France and Israel, which have used similar passes to manage access to cafes, restaurants and other services.

New Zealand also said this week that because of an outbreak of the Delta variant in Auckland that has proved impossible to suppress, the country would move away from a zero-Covid plan that has allowed residents to live with few restrictions throughout the pandemic.

As of Monday, nearly 80 percent of people age 12 and up in New Zealand had received one Covid vaccine dose and about 48 percent had received two doses.

Credit…Stefani Reynolds for The New York Times

Southwest Airlines said on Monday that it would require all of its more than 54,000 employees to be fully vaccinated against the coronavirus by the first week in December to remain employed.

Gary Kelly, the company’s chief executive, said that the budget carrier needed to follow competitors, including United Airlines, Alaska Airlines and Jet Blue, in requiring shots for its employees. The company has contracts with the federal government, which now requires all employees at federal contractors be vaccinated.

The airline industry was hard hit during the pandemic as borders closed, tourism evaporated and remote working kept business travelers at home. In recent months, it has seen an uptick in business as more people get vaccinated and travel restrictions are relaxed around the globe.

United Airlines mandated vaccines for its 67,000 U.S.-based employees in August. American Airlines, Alaska Airlines and JetBlue have since made similar announcements.

Southwest employees must be fully vaccinated by Dec. 8 or “be approved for a religious, medical or disability accommodation,” the company said.

Credit…Sonny Tumbelaka/Agence France-Presse — Getty Images

Indonesia will allow international flights to begin landing at the airport on Bali island next week as it weighs reopening the country to foreign tourists for the first time in more than 18 months.

International carriers from countries including China, Japan, New Zealand, South Korea and the United Arab Emirates could resume flights to Bali on Oct. 14, Luhut Pandjaitan, a top minister in the cabinet of President Joko Widodo, said on Monday.

Under the current rules, eligible passengers would include Indonesian citizens as well as foreigners with a work permit or business visa. They would be subject to eight days quarantine at a hotel at their own expense.

Bali is Indonesia’s most important tourist destination, and closing the island to foreign tourists has devastated the tourism industry, leading to tens of thousands of people losing their jobs. Indonesia has been the Southeast Asian nation hit hardest by Covid, with nearly 143,000 deaths. It reached a peak of nearly 57,000 cases a day in July, though the number of infections has dropped sharply since then.

Foreign tourists have been barred from entering Indonesia since April of last year, and international flights have been allowed to land only in Jakarta, the capital, and the city of Manado on Sulawesi island.

Indonesia’s tourism minister, Sandiaga Uno, told reporters that reopening Bali’s airport to overseas flights would serve as a “trial opening of Bali for foreign tourists,” though he did not provide a timetable for their return. Domestic tourists are already allowed to visit.

Earlier he said that Indonesia was studying the example of Thailand’s “Phuket Sandbox,” which allows vaccinated foreign tourists who test negative for Covid-19 to roam freely on Phuket island.

Taufan Yudhistira, a spokesman for Bali’s Ngurah Rai International Airport, said the airport had not received specific instructions for the reopening but had begun readying the international terminal and preparing health protocols.

Credit…Jon Super/Associated Press

LONDON — England took a high-stakes gamble when it sent millions of students back to school last month with neither vaccines nor a requirement to wear face masks, even as the coronavirus continued to course through the population.

On Tuesday, the country’s Education Department issued its latest report card on how the plan is working: 186,000 students were absent from school on Sept. 30 with confirmed or suspected virus infections, 78 percent more than the number reported on Sept. 16, and the highest number since the pandemic began.

Yet to hear many parents tell it, the bigger risk would have been to force the students to keep wearing masks or, worse, to keep them home.

About this data

Source: Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. The daily average is calculated with data that was reported in the last seven days.

“It’s important for kids,” said Morgane Kargadouris, who was picking up her daughter recently at Notting Hill Preparatory School in northwest London, where none of the children wear masks. “So much of what they learn is through expressions and through contact they have with people.”

Such sentiments are not unusual in a country that has shrugged off social-distancing rules and made an aggressive rollout of vaccines and a swift return to normalcy the twin cornerstones of its pandemic response. But they are striking in a debate that has played out differently across the globe, as parents struggle to balance the risks of a potentially deadly disease with the costs of keeping children at home or in classrooms where masks and other protective measures are required.

Defenders of England’s laissez-faire approach say it has allowed a large majority of students to return to a normal school experience; critics warn that the children are being exposed to unacceptable risks. With cases rising fastest among those 10 to 19, the English instinct to just “get on with it” is being put to the test.

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