Covid-19 Information: Restaurant Eating and Lack of Masks Mandates Are Every Linked to U.S. Virus Unfold, C.D.C. Says

Gov. Doug Ducey of Arizona signed an executive order on Friday that ends capacity limits on businesses, but he said that they were still required to follow health and safety guidance, including mask use, from the state’s Department of Health.

By ending occupancy restrictions on businesses, Mr. Ducey, a Republican, has joined a growing number of governors who are lifting measures even as the Centers for Disease Control and Prevention continues to warn officials that doing so could be premature.

Also on Friday, Gov. Henry McMaster of South Carolina signed an executive order lifting the state’s mask mandate in government buildings. Mr. McMaster, a Republican, cited vaccines and lower infection rates in the state as reasons to lift the mandate. Mr. McMaster recommended in his order that restaurants and other food establishments continue to require mask use and social distancing.

The California Department of Public Health also loosened some restrictions Friday saying amusement parks and outdoor sports and live events at stadiums can restart on April 1, with reduced capacity and mandatory masks.

Like many states, Arizona has recorded a steep decline in coronavirus cases since they peaked in January, according to a New York Times database. Mr. Ducey’s decision on Friday to ease some restrictions comes after his Republican peers in Texas and Mississippi lifted their state’s mask mandates, despite pleas from the Biden administration that it was critical that people continue wearing masks and as a new report from the C.D.C. found that counties that allowed restaurants to open for in-person dining had a rise in daily infections weeks after. The study also said that counties that issued mask mandates reported a decrease in virus cases and deaths within weeks.

The question of when it’s safe for states to reopen has been complicated by the emergence of more contagious and possibly more lethal variants in the United States, like B.1.1.7, originally identified in Britain. In Carver County, Minn., which has a population of about 91,000, at least 68 cases of the variant have been linked to participants in both school-sponsored and club sports activities, according to the Minnesota Department of Public Health. High schools and middle schools in Minnesota began opening up for some in-person learning in February.

Govs. Kay Ivey of Alabama and Mike DeWine of Ohio, both Republicans, are also taking more measured approaches. Ms. Ivey announced on Thursday that she was extending her state’s mask order until April 9. Mr. DeWine said on the same day that he would lift all public health measures aimed at curbing the virus in Ohio once new cases drop to a certain threshold.

This week, Mr. Ducey also issued an executive order requiring schools to offer in-person learning no later than March 15. According the C.D.C., 12 of Arizona’s 15 counties, including the state’s two largest counties — Maricopa and Pima, are in phases where all schools are safe to reopen.

Over the summer, when Arizona led the nation in the number of cases per person, Mr. Ducey gave city and county officials the green light to order residents to wear masks. It was a reversal for Mr. Ducey, who had been among a cadre of Republican governors who bucked mask-wearing, seeing it as a violation of individual liberties.

At the time, Mr. Ducey also rolled back earlier reopenings, and he directed bars, indoor gyms, water parks and movie theaters to shut down again.

About a month after Mr. Ducey embraced mask use, the number of Arizonans hospitalized with the virus started to decline.

The latest Arizona order states that mayors and local entities cannot put into effect measures that shut down businesses, and that major league sports can start up again if they get approval from the state’s Department of Health Services.

“Today’s announcement is a measured approach; we are not in the clear yet,” Mr. Ducey said in a statement on Friday. “We need to continue practicing personal responsibility. Wear a mask. Social distance. Stay home when you’re sick and wash your hands frequently.”

The teacups could soon be spinning again: Disneyland, which has been closed for a year, is poised to reopen this spring.

California officials announced on Friday that theme parks in the state could reopen on a limited basis as soon as April 1. Eligibility, however, will depend on coronavirus transmission statistics in individual counties.

For instance, theme parks in counties where the virus threat remains the most severe (in the purple tier under the state’s system) must remain closed. But parks in areas where the threat of infection has eased somewhat (red tier) will be allowed to reopen at 15 percent capacity. Even less threat (orange tier) will allow for 25 percent capacity.

Attendance will be limited to in-state visitors.

Disneyland is in Orange County, which is in the purple tier. But if coronavirus cases continue to decline in Southern California at the current pace, the county could fall within the orange tier by late April. The Walt Disney Company said last year that reopening a park at less than 25 percent capacity would not make economic sense. A Disney spokeswoman declined to comment on a specific reopening timeline on Friday.

“We are encouraged that theme parks now have a path toward reopening this spring, getting thousands of people back to work,” Ken Potrock, Disneyland’s president, said in a statement.

Disney has said it would take at least four weeks to rehire employees and train them on new coronavirus safety procedures. Before the pandemic, roughly 32,000 people worked at the 486-acre Disneyland Resort, which includes two separately ticketed theme parks, three Disney-owned hotels and an outdoor shopping mall. Most of the Anaheim complex has been closed for a year.

Disney had hoped to reopen its California attractions in July. But unions representing Disneyland employees criticized that timetable as too fast and pressured Gov. Gavin Newsom to withhold approval. He sided with the unions, prompting fans to attack him online. (“Open Disney, or we are taking away your hair gel.”)

In contrast, Florida allowed Disney to reopen its Orlando parks in July. The company endured withering criticism for doing so, but stringent safety procedures, including mandatory masks, resulted in a safer-than-expected environment.

“It has been a success story,” Julee Jerkovich, a United Food & Commercial Workers official, said in October. “As a union rep, I do not say that lightly.”

In addition to Disneyland, theme parks in California include Universal Studios Hollywood, Six Flags Magic Mountain, Knott’s Berry Farm and the Santa Cruz Boardwalk.

As countries jostle to secure enough vaccine doses to help put an end to the pandemic, a new competition is unfolding: for syringes to administer them with.

There is simply not enough of them.

Officials in the United States and the European Union have said they need more. And in January, Brazil restricted exports of syringes and needles when its vaccination efforts fell short.

Further complicating the challenge, not just any syringe will do the trick.

Japan revealed last month that it might have to discard millions of doses of the Pfizer-BioNTech vaccine if it couldn’t secure enough syringes able to draw out a sixth dose from vials. In January, the Food and Drug Administration advised health care providers in the United States that they could extract more doses from the Pfizer vials after hospitals there discovered that some contained enough for a sixth — or even a seventh — shot.

“A lot of countries were caught flat-footed,” said Ingrid Katz, the associate director of the Harvard Global Health Institute.

The world needs between eight billion and 10 billion syringes for Covid-19 vaccinations alone, experts say.

In previous years, only 5 percent to 10 percent of the estimated 16 billion syringes used worldwide were meant for vaccination and immunization, said Prashant Yadav, a senior fellow at the Center for Global Development, a think tank in Washington, and an expert on health care supply chains.

Wealthier nations like the United States, Britain, France and Germany pumped billions into developing the vaccines, but little public investment has gone into expanding manufacturing for syringes, Mr. Yadav said.

The industry has ramped up to meet demand.

Becton, Dickinson and Company, which is the world’s largest manufacturer of syringes and is based in New Jersey, said it was producing 2,000 each minute to meet orders of more than a billion.

The United States is the world’s largest syringe maker by sales, according to Fitch Solutions, a research firm. The United States and China are neck and neck in exports, with combined annual shipments worth $1.7 billion.

While India is a small player globally, Hindustan Syringes & Medical Devices in Ballabgarh, one of the world’s largest syringe makers, sunk millions of dollars into preparing its syringe factories for the vaccination onslaught.

Rajiv Nath, the company’s managing director, added 500 workers to his production lines, which crank out more than 5,900 syringes per minute at factories spread over 11 acres in a dusty industrial district outside New Delhi. With Sundays and public holidays off, the company churns out nearly 2.5 billion a year, and plans to scale up to three billion by July.

Mr. Nath has sold 50 million to the Japanese government, he said, and over 400 million to India for its Covid-19 vaccination drive, one of the largest in the world.

More are waiting in line, including UNICEF. In November, the United Nations agency for children reached out to say that it was desperately seeking syringes. And not just any would do. They had to be smaller than usual, and break if used a second time, to prevent spreading disease through accidental reuse.

Most important: UNICEF needed them in vast quantities. Now.

“I thought, ‘No issues,’” said Mr. Nath. “We could deliver it possibly faster than anybody else.”

The company is set to begin shipping 3.2 million of those syringes soon, UNICEF said, provided they clear another quality check. And Mr. Nath has offered to produce about 240 million more.

The images above tell a story of disparity of the starkest sort.

“People of color are getting vaccinated at rates below their representation of the general population,” Dr. Marcella Nunez-Smith, the chair of President Biden’s coronavirus equity task force, said at a recent forum on the vaccine. “This narrative can be changed. It must be changed.”

In recent days, The New York Times’s graphics team set out to measure how equitably Covid-19 vaccines were being distributed across the United States.

The data is imperfect. As of March 3, only 38 states publicly shared race and ethnicity data for vaccinated people.

Further complicating the task, different jurisdictions define race and ethnicity categories in slightly different ways — and with different levels of completeness. In some states, as much as a third of vaccinations were missing race and ethnicity data.

But a disturbing portrait nevertheless emerged.

Communities of color, which have borne the brunt of the Covid-19 pandemic in the United States, have also received a smaller share of available vaccines. The vaccination rate for Black Americans is half that of white people, and the gap for Hispanic people is even larger, The Times analysis found.

Scientists in Oregon have identified a homegrown version of a fast-spreading variant of the coronavirus that first surfaced in Britain — but this one has a mutation that may make the variant less susceptible to vaccines.

The researchers have so far found just a single case of this formidable combination, but genetic analysis suggested that the variant had been acquired in the community and did not arise in the patient.

“We didn’t import this from elsewhere in the world — it occurred spontaneously,” said Brian O’Roak, a geneticist at Oregon Health and Science University who led the work. He and his colleagues participate in the Centers for Disease Control and Prevention’s effort to track variants, and they have deposited their results in databases shared by scientists.

The variant originally identified in Britain, called B.1.1.7, has been spreading rapidly across the United States, and accounts for at least 2,500 cases in 46 states. This form of the virus is both more contagious and more deadly than the original version, and is expected to account for most infections in America in a few weeks.

The new version that surfaced in Portland has the same backbone as B.1.1.7, and the mutation it carries — E484K, or “Eek” — is one seen in variants of the virus circulating in South Africa, Brazil and New York City.

Lab studies and clinical trials in South Africa indicate that the Eek mutation renders the current vaccines less effective by blunting the body’s immune response. (The vaccines still work, but the findings are worrying enough that Pfizer-BioNTech and Moderna have begun testing new versions of their vaccines designed to defeat the variant found in South Africa.)

The B.1.1.7 variant with Eek also has emerged in Britain, but the virus identified in Oregon seems to have evolved independently, Dr. O’Roak said.

Dr. O’Roak and his colleagues found the B.1.1.7 variant with Eek among coronavirus samples collected by the Oregon State Public Health Lab from an outbreak in a health care setting. Of the 13 test results they analyzed, 10 turned out to be B.1.1.7 alone, and one the combination.

Experts said the discovery was not surprising, because the Eek mutation has arisen in forms of the virus all over the world. But the mutation’s occurrence in B.1.1.7 is worth watching, they said.

Vaccine hesitancy has been a concern among U.S. public health experts for months now. But evidence increasingly suggests that as vaccination rates increase, many unvaccinated Americans are becoming more comfortable with the idea of receiving the shot themselves.

The proportion of adults in the country who intend to get vaccinated has increased significantly over the last several months, according to a survey released Friday by the Pew Research Center. Sixty-nine percent of the public now plans to get vaccinated — or already has — up from 60 percent who said in November that they intended to pursue it.

The issue has become more partisan over time, however. The new survey finds a 27-percentage point political gap, with 83 percent of Democrats saying they plan to get the vaccine or have already received it, compared to just 56 percent of Republicans.

Despite the divides, the new survey bolsters optimism that overall, Americans are increasingly open to receiving the vaccine. About 54 million people — 16 percent of the population — had received at least one dose of a Covid-19 vaccine as of Thursday, according to the Centers for Disease Control and Prevention.

The survey also notes that 47 percent of Black Americans plan to get vaccinated and 15 percent say they already have been. Taken together, that is a sharp increase from the 42 percent who said in November they intended to be vaccinated.

Black and Latino people in the United States are being vaccinated at lower rates in part because they face obstacles like language barriers and inadequate access to digital technology, medical facilities and transportation. Mistrust in government officials and doctors also plays a role, experts say, and is fed by misinformation that is spread on social media. President Biden has made equity a major focus of his pandemic response, saying he wants pharmacies, mobile vaccination units and community clinics that help underserved communities to help increase the pace of vaccinations.

Overall, those surveyed by Pew who say they do not plan to get the vaccine cite reasons including concerns about side effects and a feeling that the vaccines were developed too quickly. Others say they are waiting for more information about how well they work.

The Pew results echo a survey released last week from the Kaiser Family Foundation that found vaccine hesitancy declining among most demographic groups. That survey also found a significant political gap, but noted that both Democrats and Republicans were significantly more likely to say they intended to get the vaccine now than in December.

Since Johnson & Johnson revealed data showing that its vaccine, while highly protective, had a slightly lower efficacy rate than the ones produced by Moderna and Pfizer-BioNTech, health officials have feared that the new shot might be viewed by some Americans as the inferior choice.

But the early days of its rollout suggest something different: Some people are eager to get it because they want the convenience of a single shot.

And public health officials are enthusiastic about how much faster they can get the single-shot doses distributed, particularly in vulnerable communities that might not otherwise have access to vaccine.

“This is a potential breakthrough,” said Dr. Joseph Kanter, the top health official in Louisiana.

With its first allotted doses, that state is holding a dozen large Johnson & Johnson vaccination events at civic centers and other public places, modeled after what has worked for flu vaccines.

Only four million doses were shipped this week, and the company’s manufacturing lags mean that it will be at least a month before states start receiving significant supplies. But as Johnson & Johnson ramps up production over the next few months, Dr. Kanter said, the vaccine will allow his state to slash costs for staffing and operations related to second doses.

“The J. & J. vaccine brings a lot to the table,” he said.

Judged by how well it prevents severe disease, hospitalization and death, the Johnson & Johnson shot is comparable to those made by Moderna and Pfizer-BioNTech. And although it has a lower overall efficacy rate in the United States — 72 percent, compared with roughly 95 percent for the others — experts say that comparing those numbers is problematic because the companies’ trials were conducted in different places and at different times.

Besides being a single-dose shot, the Johnson & Johnson vaccine offers another benefit: It can be kept at normal refrigeration temperatures for three months. That makes it ideal for distribution at nonmedical sites such as stadiums and convention centers. The vaccine has caused a surge of excitement at small, independent pharmacies, too.

Many state health officials said they were focused on getting the vaccine to people who might be harder to reach for a second dose, such as those who are homeless or on the verge of release from prison.

Patricia Cooper, a teacher in Washington, D.C., said that President Donald J. Trump’s efforts to claim credit for a vaccine last year and the label “emergency use authorization” had suggested to her that the federal government may have rushed its reviews of vaccines. That left her feeling jittery about their safety.

But Ms. Cooper said she was eager to get a shot, especially the Johnson & Johnson one.

“This one is more appealing to me,” she said. “Who likes to get stuck more than once?”

Pope Francis made an audacious return to the world stage in the midst of the pandemic on Friday when he became the first leader of the Roman Catholic church to visit Iraq, seeking to help heal a nation uniquely wounded by violent sectarianism, foreign adventurism and the persecution of minority populations, including his own Christian flock.

“I’m happy to travel again,” Francis, who has been vaccinated against the coronavirus, said after taking off his blue surgical mask to address reporters on the papal plane.

The pope’s trip sent a message that, after a year of being cooped up in Rome and fading from public consciousness, Francis wanted to elevate his profile and spend his time with those who have suffered the most.

The pope’s visit coincided with a recent return of suicide bombings, increased rocket attacks and renewed geopolitical tensions, and some of Francis’ admirers worry that his whirlwind four-day visit will exacerbate a recent spike in the country’s coronavirus cases by drawing crowds.

But his advisers and Iraq’s top prelates insisted social distancing measures would be followed and argued the trip was necessary to show Francis’ closeness to a flock that had suffered terribly. The pope’s predecessors dreamed of visiting, but those aspirations were dashed by tensions and conflict.

The pope called for an equitable distribution of vaccines to countries already scarred by “fragility and instability.” A vaccination program began just this week in Iraq, where social distancing restrictions are largely ignored.

Top aides to Gov. Andrew M. Cuomo were alarmed: A report written by state health officials had just landed, and it included a count of how many nursing home residents in New York had died in the pandemic.

The number — more than 9,000 by that point in June — was not public, and the governor’s most senior aides wanted to keep it that way. They rewrote the report to take it out, according to interviews and documents reviewed by The New York Times.

The extraordinary intervention, which came as Mr. Cuomo was starting to write a book on his pandemic achievements, was the earliest act yet known in what critics have called a monthslong effort by the governor and his aides to obscure the full scope of nursing home deaths in the state. The episode reflects the lengths to which Mr. Cuomo has gone to control data, brush aside public health expertise and bolster his position as a national leader in the fight against the coronavirus.

The details contradict the timeline and motivation Mr. Cuomo offered in recent weeks, when he released the complete data after the state attorney general, Leticia James, revealed that thousands of deaths of nursing home residents had been undercounted, Mr. Cuomo said he had withheld the information out of concern that the Trump administration might pursue a politically motivated inquiry into the state’s handling of the outbreak in nursing homes.

But the rewriting of the report came well before requests for data arrived from federal authorities, and was accompanied by Cuomo aides’ battles with top state health officials, according to documents and interviews with six people with direct knowledge of the discussions, who requested anonymity to describe the closed-door debates.

The aides involved in changing the report included Melissa DeRosa, the governor’s top aide; Linda Lacewell, the head of the state’s Department of Financial Services; and Jim Malatras, a former top adviser to Mr. Cuomo brought back to work on the pandemic. None had public health expertise.

In response to a detailed list of questions from The Times sent on Tuesday, the governor’s office responded with a statement Thursday night from Beth Garvey, a special counsel, who said “the out-of-facility data was omitted after D.O.H. could not confirm it had been adequately verified.” She added that the additional data did not change the conclusion of the report.

Top Democrats reached a deal late Friday to scale back weekly unemployment payments in President Biden’s $1.9 trillion stimulus plan, working to preserve moderate support for the package by dropping their effort to increase those payments to $400 and agreeing on a $300 supplement instead.

The agreement came about nine hours after Senator Joe Manchin III of West Virginia, a centrist Senate Democrat, created an impasse by raising concerns that an overly generous benefit could discourage people from returning to work. The impasse paralyzed efforts to move Mr. Biden’s stimulus bill through the Senate, and the vote dragged on past midnight.

By late Friday, Democrats had reached a compromise that appeared to satisfy Mr. Manchin, a crucial swing vote in an evenly divided Senate. While Mr. Manchin is a Democrat, his state is decidedly not (former President Donald J. Trump won nearly 70 percent of the vote in the 2020 election). As a result, Mr. Manchin is among the most centrist Democrats in the party.

The amendment ultimately passed, 50 to 49, just before 1:30 a.m. Saturday as the Senate barreled through a stretch of amendment votes that would modify the legislation even further. Most of the amendments failed on party lines.

The agreementwould extend the existing $300 jobless benefit through Sept. 6, and make up to $10,200 of unemployment benefits received last year tax-free for households with incomes less than $150,000. It would also extend tax rules regarding excess business loss limitations for one additional year, through 2026.

“The president has made it clear we will have enough vaccines for every American by the end of May, and I am confident the economic recovery will follow,” Mr. Manchin said in a statement. “We have reached a compromise that enables the economy to rebound quickly while also protecting those receiving unemployment benefits” from being hit with unexpected tax bills.

Top Democrats had initially planned to drop their effort to increase the payments to $400 but extend them for an additional month, through Oct. 4. The agreement reached with Mr. Manchin shaves one month off that extension.

The impasse had halted the measure just as the Senate began voting on proposed changes. What was supposed to have been a 15-minute vote on a minimum-wage increase stretched for hours as Democrats stalled for time, huddling on the Senate floor in search of a solution.

The White House declined to say whether Mr. Biden had reached out to Mr. Manchin to try to secure his support.

In a statement, Jen Psaki, the White House spokeswoman, said that Mr. Biden “supports the compromise agreement.”

The proposal was one of dozens that the Senate considered in a marathon session of rapid-fire votes that was delayed by the impasse. The vote-a-rama, as it is known, stretched past midnight and would pave the way for a Senate vote to pass the stimulus plan as early as Saturday.

Democrats are racing against the clock, as some Americans have already begun to file their taxes and unemployment benefits are set to begin lapsing next weekend. Once the legislation clears the Senate, it will have to be approved for a second time in the House before it heads to Mr. Biden’s desk.

The compromise was aimed at appeasing centrist Democrats who might otherwise have been tempted to vote for a Republican amendment by Senator Rob Portman of Ohio to keep the unemployment benefit at $300 per week — extending it until July but omitting any tax sweeteners — thus sapping support for the bill among other Democrats.

Republican efforts to slow action on the Senate floor were expected to have little effect on the final legislation. Another wrinkle arose late Friday when Senator Dan Sullivan, Republican of Alaska, left the Capitol to catch a flight to Fairbanks and attend his father-in-law’s funeral.

A spokesman, Nate Adams, confirmed the senator’s departure and said Mr. Sullivan “intended to vote against final passage of the bill and made his opposition clear” by voting against advancing the measure.

In an evenly divided Senate, Mr. Sullivan’s absence could give Democrats an extra vote of leeway as they haggle over last-minute changes to the $1.9 trillion package.

Each party holds 50 seats in the chamber, giving Democrats a one-vote margin of control thanks to Vice President Kamala Harris’s power to break ties. Senate Democrats, having already made significant revisions to the text the House approved over the weekend, are working to remain united. Republicans are expected to oppose the bill en masse, arguing that it is too costly and not targeted enough.

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Canada’s health regulator on Friday authorized the use of Johnson & Johnson’s single-dose vaccine. The move now gives the country, which has experienced a slow start to vaccinations, four inoculations to choose from.

“This is great news,” Prime Minister Justin Trudeau said at a news conference. He offered no projected date for the first deliveries.

Health Canada officials said that the vaccine has an overall effectiveness of 66.9 percent, much lower than the efficacy rates reached by Pfizer and Moderna vaccines. But it is similar to those vaccines in having a powerful ability to prevent severe disease, hospitalizations and death.

The United States and Bahrain have also authorized the Johnson & Johnson vaccine.

Production delays with the Pfizer and Moderna vaccines, combined with relatively modest initial shipments, have led to frustration among many Canadians — and put political pressure on Mr. Trudeau as Canada’s vaccination rate fell far behind that of the United States, Britain and other countries. As of Friday, 2.86 percent of all Canadians have received at least one dose.

Canada has ordered 10 million doses of the Johnson & Johnson vaccine and has options for another 28 million, a combined number that is slightly higher than the country’s population.

Depending on its arrival and combined with the need to only administer a single shot, the new vaccine may help significantly boost the country’s vaccination rate. The Johnson & Johnson vaccine also does not require extremely low storage temperatures, as the Pfizer vaccine does, making it easier to distribute to remote communities in Canada’s north.

Mr. Trudeau said that Pfizer would send 1.5 million doses, originally scheduled for delivery in the summer, over the next two months. Canada also received its first shipment this week of a version of the AstraZeneca vaccine, developed by the Serum Institute of India.

The Canadian government had initially promised to obtain six million doses of vaccines by the end of March. The new Pfizer schedule combined with AstraZeneca shipments, officials said, will raise that figure to eight million.