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Covid Updates: C.D.C. Says Cloth Masks Are Not as Effective as Others

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Linsey Jones, a medical assistant at a drive-up Covid-19 testing clinic in Puyallup, Wash., equipped with a N95 mask.Credit...Ted S. Warren/Associated Press

The Centers for Disease Control and Prevention on Friday clarified its stance on various kinds of masks, acknowledging that the cloth masks frequently worn by Americans do not offer as much protection as surgical masks or respirators.

While this disparity is widely known to the general public, the update marks the first time the C.D.C. has explicitly addressed the differences. The agency's website also no longer refers to a shortage of respirators.

The change comes as infections with the highly contagious Omicron variant continue to soar. Some experts have said that cloth masks are inadequate to protect from the variant, and have urged the C.D.C. to recommend respirators for ordinary citizens.

The agency did not go that far. Its updated language now says that "a respirator may be considered in certain situations and by certain people when greater protection is needed or desired."

The previous version of the recommendations said individuals may choose to use a disposable N95 respirator instead of a mask "when supplies are available."

N95 respirators, so named because they can filter out 95 percent of all airborne particles when used correctly, were in short supply early in the pandemic. At the time, the C.D.C. and the World Health Organization both repeatedly said that ordinary citizens did not need to wear masks unless they were sick and coughing.

The C.D.C. also said regular surgical masks were "an acceptable alternative" for doctors and nurses when interacting with a patient infected with the coronavirus — a move that angered medical personnel.

Critics charged that the recommendations were based not on what would best protect Americans, and were instead prompted by a shortage of N95 respirators.

When the C.D.C. finally recommended masks for ordinary Americans, it emphasized cloth face coverings. It took months more for the C.D.C. and the W.H.O. to concede that the coronavirus can be carried by tiny droplets called aerosols, which can linger indoors for hours.

According to the C.D.C.'s new description of masks, loosely woven cloth products provide the least protection and layered finely woven products offer more. Well-fitting disposable surgical masks and KN95s — another type of respirator mask — are more protective than all cloth masks, and well-fitting respirators, including N95s, offer the highest level of protection.

The agency urged Americans to "wear the most protective mask you can that fits well and that you will wear consistently."

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Free at-home coronavirus rapid tests were distributed at a library in Silver Spring, Md., on Friday. The federal government's website to order free tests will begin taking orders on Wednesday, U.S. officials say.Credit...Michael Reynolds/EPA, via Shutterstock

WASHINGTON — Americans will be able to request free rapid coronavirus tests from the federal government beginning on Wednesday, but the tests will take seven to 12 days to arrive, senior Biden administration officials said on Friday.

The administration's website to process the requests, covidtests.gov, was up and running on Friday, the latest sign of its efforts to ramp up access to testing since the fast-spreading Omicron variant sent coronavirus case counts soaring.

But the delay in accepting orders and the lag in shipping mean that people are unlikely to receive the free tests until the end of January at the earliest. In some parts of the country, that may be after the peak of the current surge of cases.

President Biden said last month that his administration would purchase 500 million rapid at-home coronavirus tests and distribute them to Americans free of charge. On Thursday, he announced plans to buy an additional 500 million tests, bringing the total to one billion. The administration has already contracted for 420 million tests.

Each household will be limited to four free tests. The Postal Service will handle shipping and delivery through first-class mail, the officials said. Free tests will also be available at some community health centers, rural clinics and federal testing sites.

Separately, people with private insurance should be able to start seeking reimbursement for tests they purchase themselves beginning on Saturday, less than a week after the administration announced the new rule. Insurers will be required to cover eight at-home tests per person per month.

The administration is also creating incentives to encourage insurers to work with pharmacies and other retailers so people can be reimbursed at the time of purchase, as is often the case with prescription drugs. But some insurers say it will probably take weeks to fully set up the system the White House envisions.

Testing has been a challenge for the federal government since the earliest days of the pandemic. Supply chain shortages made them hard to come by, and overloaded laboratories took days to process them. Mr. Biden, who came into office promising to ramp up testing, has made some progress in expanding the supply of rapid at-home tests. There were none available to American consumers when he took office.

But the Omicron wave has put intense pressure on the nation's testing capacity. At-home tests began flying off pharmacy shelves and are now scarce in many parts of the country. At the same time, some consumers are confused about how to use them.

Administration officials sought to clear up some of that confusion on Friday, specifying three reasons people should use at-home tests: They begin to have symptoms of Covid-19; they were exposed to someone who tested positive for the virus five or more days earlier; or they are planning to gather indoors with someone at risk of Covid-19, and want to assure themselves they are negative.

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Boarding an Amtrak train in Freeport, Maine, in December.Credit...Robert F. Bukaty/Associated Press

Amtrak said on Friday that it will temporarily reduce service on some trains because of staffing challenges stemming from a surge in cases of the Omicron variant among workers.

While nearly 97 percent of Amtrak workers are fully vaccinated, several hundred employees — including service personnel, conductors, engineers and mechanical crew members — have been sidelined because of Covid-19 infections or exposures, officials said. The agency will suspend 8 percent of its train departures over the next 10 weeks.

"These Covid-related absences, when combined with the general skilled work force shortage Amtrak and other transportation companies are facing, have reduced our ability to consistently deliver our current schedules and impacted the pace of hiring and training efforts," Jason Abrams, an Amtrak spokesman, said in a statement.

The reductions will affect the Northeast Regional route, where 8 percent of weekly departures will be suspended between Jan. 24 and March 27. Amtrak will also reduce some of its long-distance service and suspend 6 percent of its weekly departures along state-supported routes from Jan. 18 to March 27.

Amtrak said it is working to resolve the issue, including trying to hire more workers and train new staff members to "avoid staffing shortfalls due to unplanned absences," according to the statement.

Riders impacted by service reductions will be offered same-day travel alternatives and customers will be notified about changes, according to the statement.

The suspensions come on the heels of previous service reductions, both weather and Covid-related, which Amtrak instituted between New Year's Eve and Jan. 6 . Last month, officials struck an optimistic tone and said they would likely be able to avoid cuts to service after dropping a mandate for all employees to be vaccinated against Covid-19. The agency had dropped the mandate after a federal court decision halted the enforcement of the executive order for federal contractors.

Jim Mathews, the president and chief executive officer of the Rail Passengers Association, said the agency's decision to reduce service reflected how the virus was continuing to disrupt daily life and travel plans for Americans.

"This is a nationwide problem, not just an Amtrak problem, and we're encouraged to see Amtrak trying to make the smallest possible cuts to carry the railroad through," Mr. Mathews said.

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Christy Atkinson, a fourth-year medical student, volunteering in November at a saliva testing site at the University of Minnesota in Minneapolis.Credit...Jenn Ackerman for The New York Times

Diagnosing a coronavirus infection has often required probing the nose. But the rapid spread of the Omicron variant, and questions about the sensitivity of at-home tests, have rekindled a debate over whether the best way to detect the virus is to sample a different site: the mouth.

"The virus shows up first in your mouth and throat," said Dr. Donald Milton, an expert on respiratory viruses at the University of Maryland. "That means that the approach we're taking to testing has problems."

The science is still evolving, and the data paint a complex picture, suggesting that saliva-based tests have limitations of their own. Many labs are not currently set up to process saliva, nor are the at-home antigen tests available in the United States authorized for it.

If test manufacturers want to add saliva samples or throat swabs, they will need to validate their tests with those samples and submit the data to regulators. At a Senate hearing on Tuesday, Dr. Janet Woodcock, the acting commissioner of the F.D.A., noted that manufacturers might also have to reconfigure their tests to accommodate the larger swabs that are designed for the throat.

It's not yet clear whether any of the major at-home testing companies have plans to do so. "We continue to monitor and evaluate," said John M. Koval, a spokesman for Abbott Laboratories, which makes rapid antigen tests. "Our test is currently indicated for nasal use only."

Even scientists who were convinced of saliva's potential were reluctant to recommend that people swab their mouths or throats with tests that are not authorized for that purpose. (The F.D.A. has also warned against this.) The biochemistry of the mouth is different than that of the nose and may affect the test results, potentially yielding false positives, scientists said.

"It's not as easy as just saying, 'Hey, just use a rapid antigen for saliva,'" said Glen Hansen of the clinical microbiology and molecular diagnostics laboratory at Hennepin County Medical Center in Minnesota.

But experts said they hoped that laboratories, test manufacturers and regulators would move swiftly to evaluate whether any currently available tests might perform better on other sample types.

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Gov. Doug Ducey of Arizona, a Republican, delivered his State of the State address at the capitol in Phoenix on Monday.Credit...Ross D. Franklin/Associated Press

WASHINGTON — The Treasury Department told Arizona officials on Friday that it could claw back some of the state's pandemic aid and withhold future payments if the state did not halt or redesign programs that use the money to undercut mask requirements in schools.

The warning was the latest development in a dispute between Gov. Doug Ducey, a Republican, and the Biden administration over how the $4.2 billion that was awarded to the state as part of the relief package that Congress passed last year can be used. Republican governors in several states have been trying to use the money for unauthorized purposes, such as cutting taxes or enacting immigration policies that are unrelated to the pandemic.

The Treasury Department first raised concerns about Arizona's education policies last October, but the state declined to make changes.

Mr. Ducey announced last year that he was rolling out two education programs intended to undercut school mask requirements that some school districts in the state put in place.

A $163 million program using the federal relief money provides up to $1,800 in additional funding per pupil in public and charter schools. However, these schools must be "following all state laws" and open for in-person instruction. Schools that required masks would not be eligible.

A separate $10 million program funds vouchers worth up to $7,000 to help poor families leave districts that require face coverings or impose other Covid-related "constraints."

In the letter, the Treasury Department said that if Arizona does not cease or change the programs within 60 days, it could start a process to recoup the money that is being misused. It also said that it could hold back the second installment of relief money that Arizona is scheduled to receive this year.

Arizona has so far received about $2.1 billion of the $4.2 billion that it was awarded through the $1.9 trillion relief package.

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Novak Djokovic resting on Friday after a practice session ahead of the Australian Open.Credit...Diego Fedele/EPA, via Shutterstock

A day after Novak Djokovic's visa was revoked a second time, his lawyers went to court on Saturday morning to challenge the Australian government's decision in a last-ditch attempt to save his chances to compete in the Australian Open.

The hearing was the latest twist in a dizzying drama over Djokovic's refusal to be vaccinated against Covid-19.

During a brief hearing Saturday, Justice David O'Callaghan said a full hearing on Djokovic's appeal would be held on Sunday morning at 9:30 a.m. and told both sides to submit legal papers laying out their arguments to the court later in the day.

Djokovic was taken into custody on Saturday and was expected to be held by immigration officials until the hearing on Sunday.

Later Saturday, Justice O'Callaghan granted the Djokovic legal team's request that a full panel of judges hear the case rather than a single judge, which means the court's decision on the matter cannot be appealed. A lawyer for the immigration minister had opposed that request.

7-day average

52,640

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.

On Friday, a different judge, Anthony Kelly of the Federal Circuit and Family Court, ordered the government not to deport Djokovic while his appeal is being heard. Hours earlier, the immigration minister, Alex Hawke, had revoked Djokovic's visa on the grounds of "health and good order," adding that the move was in the public interest.

Time is running short to resolve the dispute. The tournament starts on Monday morning and Djokovic has won its men's singles title a record nine times.

Djokovic's lawyers are arguing that Hawke did not act rationally when he said that Djokovic's refusal to be vaccinated against Covid-19 posed a public health risk and could "excite anti-vaccination sentiment" in Australia. Nicholas Wood, one of Djokovic's lawyers, said the minister did not take into account the impact of forcing the player out of the country.

Djokovic's lawyers asked for a speedy schedule so that he could potentially be cleared to play.

The lawyers criticized the immigration minister for taking four days since an earlier court ruling to decide to rescind the visa, and for announcing it at 6 p.m. on Friday. "We are where we are because of the time the minister has taken," Wood said. "We are moving as fast as we can."

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A nurse treating a Covid-19 patient in the intensive care unit of Sharp Grossmont Hospital in La Mesa, Calif.Credit...Etienne Laurent/EPA, via Shutterstock

The extremely contagious Omicron variant is fueling an enormous coronavirus wave that is pushing hospitals close to their capacity limits in about two dozen states, according to data posted by the U.S. Department of Health and Human Services.

At least 80 percent of staffed hospital beds were occupied in 24 states on Thursday, including Georgia, Maryland and Massachusetts, the figures show.

More troubling, the data showed that in 18 states and Washington, D.C., at least 85 percent of beds in adult intensive care units were full, with the most acute scarcity of beds in Alabama, Missouri, New Mexico, Rhode Island and Texas.

The pressure on I.C.U. capacity comes as the Omicron variant has touched off a nearly vertical rise in infections and hospitalizations. The country as a whole and 26 states have reported more coronavirus cases in the past week than in any other seven-day period.

7-day average

153,306

Source: U.S. Department of Health and Human Services. The seven-day average is the average of a day and the previous six days of data. Currently hospitalized is the most recent number of patients with Covid-19 reported by hospitals in the state for the four days prior. Dips and spikes could be due to inconsistent reporting by hospitals. Hospitalization numbers early in the pandemic are undercounts due to incomplete reporting by hospitals to the federal government.  ∙  Holiday interruptions to testing and data reporting may affect case and death trends.

In that time, an average of more than 803,000 coronavirus cases have been reported each day in the United States, an increase of 133 percent from two weeks ago, according to a New York Times database, and 25 states and territories have reported their highest weekly caseloads yet. Deaths are up 53 percent to an average of roughly 1,871 a day.

That has helped push the country's average rate of hospitalizations above last winter's peak. Hospitalizations of people testing positive for coronavirus over that week are up to more than 148,000 a day, a record. The numbers are rising fastest in Alabama, Florida, Louisiana, Puerto Rico and the U.S. Virgin Islands, according to the Times database.

(The hospitalization figures include people who test positive for the virus after being admitted for conditions unrelated to Covid-19, but there is no national data showing how many people are in that category.)

Since Thanksgiving, the White House has sent more than 350 military doctors, nurses, medics and other personnel to 24 states to help hospitals with staffing challenges, President Biden said this week, and plans to send an additional 1,000 service members to six hard-hit states. That is in addition to the more than 14,000 National Guard members deployed in 49 states to help staff hospitals and other medical facilities, he and other officials said.

On Wednesday, Gov. Tim Walz of Minnesota said the state would spend $40 million in federal funds to hire more staff to help hospitals there for the next 60 days because "we know we're going to continue to see a sharp rise in cases from the Omicron variant." Minnesota's hospitals have been struggling to keep up since the fall, when the National Guard was called in to help with a flood of patients infected by the deadlier Delta variant.

Also Wednesday, Gov. Kate Brown of Oregon said she was sending an additional 700 members of the state's National Guard — bringing the total deployed to 1,200 members — to help hospitals deal with a rise in coronavirus patients. "Our hospitals are under extreme pressure," she wrote on Twitter.

Our hospitals are under extreme pressure. Fueled by the Omicron variant, current hospitalizations are over 700 and daily COVID-19 case counts are alarmingly high. To assist, I am deploying 700 additional @oregonguard members—for a total of more than 1,200—to Oregon hospitals.

— Governor Kate Brown (@OregonGovBrown) January 12, 2022

One day earlier Gov. Janet Mills of Maine said she was activating 169 members of the National Guard to help with capacity constraints at hospitals, joining more than 200 members already deployed in the state.

"I wish we did not have to take this step," Ms. Mills said in a statement, "but the rise in hospitalizations — caused primarily by those who are not vaccinated — is stretching the capacity of our health care system thin, jeopardizing care for Maine people, and putting increased strain on our already exhausted health care workers."

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A mural of Novak Djokovic near a playground in Belgrade, Serbia, on Saturday.Credit...Oliver Bunic/Agence France-Presse — Getty Images

Novak Djokovic has said little publicly about why he has declined to be vaccinated against Covid, a decision at the heart of the Australian government's decision to revoke his visa, now for a second time.

But while his views are out of step with most people in Australia — where roughly 80 percent of the population is vaccinated — in his homeland of Serbia, skepticism of vaccination runs deep. Serbia has one of the lowest vaccination rates in Europe, with less than 50 percent of people having received two shots, according to the Our World in Data project at Oxford University.

Serbians can choose from a virtual vaccine bazaar, including Sinopharm from China, Sputnik from Russia and the AstraZeneca shot, developed in partnership with Britain's Oxford University and the U.S. drug company Pfizer, which is referred to in Serbia as the American vaccine.

But as cases rise, getting vaccinated is an increasingly hard sell.

7-day average

13,619

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.

A year ago, lines at the Belgrade Fair — the main vaccine site in the capital — stretched for blocks and some 8,000 doses were being administered daily. Now, medical staff are lucky if they inoculate 300 people in a day, said Dr. Milena Turubatovic, a physician administering vaccine doses at the site.

A fan of Djokovic, she worried that the focus on his vaccine status was not helpful.

"I respect him highly, but do not agree with his attitude on vaccination," she said. "And of course it has an impact."

Over the course of the pandemic, many people in Serbia have come to view the virus as a part of life and become resistant to restrictions aimed at slowing its spread. While Serbia locked down like the rest of Europe during the first wave of infections, the suggestion of a renewed lockdown last winter was greeted with riots.

Since then, political leaders have been loath to reimpose or enforce restrictions. That was evident when President Aleksandar Vucic declined to criticize Djokovic even after the tennis star acknowledged he had failed to isolate after testing positive in December and made errors on a travel form submitted to the Australian authorities.

Though Djokovic's stance may have hurt the government's vaccination campaign, the president has continued to support him, protesting his detention in Australia and calling that country's decision to keep him from playing "overkill."

"When you can't defeat someone on the court, then you do such things," he said.

On Friday evening, Vucic went further, posting a message on Instagram that accused the Australian government of disrespecting not just Djokovic but all of Serbia.

"If you wanted to ban Novak Djokovic from winning the 10th trophy in Melbourne, why didn't you return him immediately, why didn't you tell him, 'It is impossible to obtain a visa?'" Mr. Vucic said, adding, "Why are you mistreating him? Why are you taking it out not only on him but also on his family and the whole nation?"

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Credit...Jonathan Ernst/Reuters

For Americans who need health insurance, now is the time to sign up. The end of the 2022 open enrollment period for Obamacare marketplaces in most states is Saturday.

So far, a record 14.2 million Americans have enrolled in marketplace coverage for this year, according to the Centers for Medicare and Medicaid Services. New subsidies created by Congress as part of last year's stimulus bill have temporarily lowered premiums for nearly everyone who buys their own insurance. And the Biden administration has made substantial investments in advertisements for the program and in professionals who can help people select an appropriate plan.

Insurance subsidies are calculated on a sliding scale according to income. For Americans close to the poverty line, generous insurance is available for no premium at all. For the first time, Americans with incomes more than four times the poverty line — around $100,000 for a family of four — can qualify for subsidies if their insurance premium would cost more than 8.5 percent of their income. Those changes mean even people who have been unable to find affordable options in past years may benefit from reviewing their options this time.

To select a plan, a good first stop is healthcare.gov, which serves the 33 state marketplaces managed by the federal government. If you live in the District of Columbia or one of the 17 states that run their own insurance markets, you will be referred to a state site.

If you need human help navigating the site, the website has a directory of assistants and brokers who can walk you through the process for free.

The enrollment deadline marks the end of an unusual period for the marketplaces, in which people were free to sign up for most of the year. Typically, the government limits enrollment to a few weeks a year in order to encourage people to maintain insurance all the time, and not just sign up when they get sick. But government officials and insurance companies abandoned that approach during the pandemic and established a long "special enrollment period," which is now over.

There are some situations in which people can obtain insurance outside the normal enrollment window. People who experience a major life change, like losing a job or getting a divorce, can enroll during the 60 days after that change. Americans who qualify for Medicaid or the Children's Health Insurance Program can sign up at any time of the year.

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Joe Rogan, the host of "The Joe Rogan Experience."Credit...Vivian Zink/NBCUniversal, via Getty Images

Hundreds of scientists, professors, doctors, nurses and other public health professionals have urged Spotify to crack down on misinformation about Covid-19 on its streaming platform.

In an open letter published online this week, the experts singled out an episode of "The Joe Rogan Experience" that featured Dr. Robert Malone, an infectious disease researcher who claims to have created the mRNA technology used in some coronavirus vaccines but has become an outspoken vaccine skeptic. They said Mr. Rogan had a "concerning history" of advancing inaccurate claims on his podcast, particularly about the pandemic.

"By allowing the propagation of false and societally harmful assertions, Spotify is enabling its hosted media to damage public trust in scientific research and sow doubt in the credibility of data-driven guidance offered by medical professionals," the letter said. It also called on the company "to immediately establish a clear and public policy to moderate misinformation on its platform."

Spotify declined to comment on the record. The company has said that it prohibits dangerous, false or deceptive content about Covid-19 that may cause offline harm or pose a threat to public health.

According to the letter, Dr. Malone promoted "several falsehoods about COVID-19 vaccines" on the Dec. 31 episode of Mr. Rogan's show, including a widely discredited theory that societal leaders have "hypnotized" millions of people.

PolitiFact reported earlier this month that Dr. Malone was banned from Twitter for violating the company's misinformation policy against Covid-19, and that YouTube removed videos of an interview he did with Mr. Rogan.

Mr. Rogan's show is effectively a series of wandering conversations on topics including but not limited to comedy, cage-fighting, psychedelics, quantum mechanics and criticism of the political left. The show was licensed to Spotify in 2020 in a deal estimated to be worth $100 million. Last spring, Mr. Rogan drew the ire of the Biden administration and Prince Harry, another Spotify podcaster, for comments undermining the value of vaccinations for young, healthy people.

As of Friday evening, the episode of the show featuring Dr. Malone was still available to stream on Spotify.

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Striking grocery store workers rallied outside a King Soopers store in Denver on Thursday.Credit...David Zalubowski/Associated Press

About 8,400 grocery workers went on strike this week at 80 Kroger-owned King Soopers stores in Colorado, after nearly two years on the front lines. They are seeking higher wages, better personal protection equipment and improved public safety measures in stores.

"We strike because it has become clear this is the only way to get what is fair, just, and equitable for the grocery workers who have risked their lives every day just by showing up to work during the pandemic," Kim Cordova, president of the United Food and Commercial Workers local chapter in Denver, said in a statement this week.

The strike is having an impact, especially in the Denver area. The company said it hired temporary workers to help keep stores running, but empty aisles and parking lots are becoming more commonplace, and in-store pharmacies are beginning to limit hours. The strike, which began on Wednesday, could last weeks, the union said.

Kroger is one of the largest grocery chains in the U.S., with 2,750 grocery stores under two dozen brand names, including King Soopers in Colorado and Ralphs in California.

The robust national demand for groceries — as the pandemic pushed people away from restaurants — has driven retailers' profits higher. The Kroger grocery chains haven't provided hazard pay nationally since early in the pandemic, which the union would like to see reinstated.

The chains also ended measures like controlling how many customers are allowed in stores at a time.

The grocery workers' union turned down Kroger's proposal for a $170 million package of wage increases and benefits, including a new minimum wage of $16 an hour.

In a statement offering the package, Joe Kelley, the president of King Soopers, said, "We want what is right for our associates, and that is more money in their paychecks while continuing to receive industry-leading health care benefits."

The union has also been asking for armed guards at all of its stores in the Denver area as incidents of violence increase because of confrontations over masks and shortages of products during the pandemic.

A gunman killed 10 people at a King Soopers store last March in Boulder. The company said that the strike will delay its reopening, which was scheduled for next week.

A survey of more than 10,000 workers at Kroger-owned stores in Southern California, Colorado and Washington State found that more than two-thirds of employees struggle to afford food, housing or other basic needs. The report was published this week by The Economic Roundtable, a Los Angeles-based research group, and commissioned by the United Food and Commercial Workers International Union.

Most supermarkets have been struggling with hiring and retaining employees during the pandemic. The fear of working in public and possibly spreading or contracting the coronavirus has kept some workers on the sidelines, they say. Managers have said that unemployment benefits and federal stimulus checks have made hiring harder.

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Images of health workers outside of a temporary field hospital at St. George's Hospital in London last week.Credit...Henry Nicholls/Reuters

LONDON — In Britain, France, Spain and other countries across Europe, politicians and some public health experts are pushing a new approach to the coronavirus pandemic borne of both boldness and resignation: that the illness is becoming a fixture of daily life.

The shift comes even as the World Health Organization cautioned this week against treating the virus like the seasonal flu, saying it was too soon to make that call. Much about the disease remains unknown, the W.H.O. said. And a surge in cases driven by the Omicron variant is still battering the continent, while the population of much of the world remains vulnerable because of a lack of widespread vaccination, and more variants are still likely to arise.

Still, advocates of the "learn to live with it" approach point out that the latest surge in cases is different from the early days of the virus in several important ways, including a largely vaccinated population in parts of Europe, especially in the West, and a far lower rate of hospitalization.

The sentiment is evident in the evolving policies that the British government has adopted since the start of this year, a stark departure from the "war footing" that the country's health service preached in December.

The changes include shorter isolation periods and the elimination of pre-departure tests for people traveling to England — largely because Omicron was already so prevalent that the tests had a limited effect on its spread.

There have been some concrete signs that Britain may be turning a corner. There were 99,652 new cases reported on Friday, a notable drop from the 178,250 cases reported on the same day last week.

In Spain, a new monitoring system is being created to come into effect once the current surge in cases ebbs, and the country also recently relaxed its isolation rules. But Madrid's push for Omicron to be treated more like the flu has been criticized by some doctors and professional associations, as well as by the European Medicines Agency, who say the virus is still behaving as a pandemic.

In France, infections are still trending upward, with nearly 300,000 newly reported coronavirus cases a day this week, almost six times as many as a month ago. But President Emmanuel Macron, who is facing a presidential election in April, has opted to keep minimal restrictions in place and focused instead on urging the French to get vaccinated.

Germany is several weeks behind some of its European neighbors in confronting an uptick in infections. It reported 80,430 new cases on Tuesday, breaking a record set in November. But independent scientific experts have held off advising the government to impose new restrictions despite widespread agreement that infection numbers would continue to rise.

Italy, too, is grappling with some of the highest daily infection rates since early in the pandemic. But in recent weeks, it has tightened restrictions, making vaccines mandatory for those 50 and over, including requiring a health pass to use public transportation.

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Two of Shaneka Adewuyi's three children are under 5, and her 9-year-old is in virtual school. The struggles she faces in caring for them can bring her to tears.Credit...September Dawn Bottoms for The New York Times

Shaneka Adewuyi, an office administrator for the Tulsa Police Department, said that at one point her day care center closed for six weeks because of a surge in coronavirus cases. The challenge of juggling two young children, ages 1 and 2, along with a 9-year-old in virtual school, plus her job, is enough to bring Ms. Adewuyi to tears.

"It takes a toll on my mental health," she said. "But the babies need to eat, they have to be rocked to sleep, they need a diaper change."

And for those born over the last two years, the pandemic has taken its toll in other ways: Most children under 5 years old have never known life without masks or talk of vaccinations and boosters, quarantines and social distance.

The nearly vertical rise of coronavirus cases in recent weeks has complicated the calculations of many families with children under 5, a population prone to the runny noses and coughs that now prompt waves of anxiety.

Tests are hard to come by. Day care providers are strained. There are roughly 110,000 fewer people working in child care now compared with February 2020, according to research from the University of California, Berkeley.

With child care interruptions mounting, parents of young children have again found themselves sequestered at home, staring out windows, wondering anew if the world cares about the seemingly impossible balancing acts they are having to perform.

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Italian police officers, including one wearing a colored face mask that is the subject of dispute, on patrol in Rome on Friday.Credit...Vincenzo Pinto/Agence France-Presse, via Getty Images

ROME — When Inspector Luca Sita picked up two new N95 masks at his police station in Ferrara in central Italy on Thursday, he was thrown for a loop: One mask was white, and the other was pink.

Mr. Sita works in plainclothes, so he was more perplexed than vexed, but he immediately thought of his colleagues working the streets and in squad cars who had to intervene in various situations, including making arrests.

"Institutionally," he said, wearing a pink mask "is a bad look."

The pink in itself was not offensive, he said: A mask of any color other than white, black or blue, which match the national police uniform, would have been just as unacceptable.

"Green, orange — any lively color would have been unwearable," he said.

The Sindacato Autonomo di Polizia, a trade union, immediately fired off a missive to Lamberto Giannini, Italy's police chief, expressing "perplexity" that pink N95 masks had been sent to a few police stations in various regions.

The letter cited a 2019 memo from the police chief of the time that exhorted officers to "avoid wearing noncompliant garments that could prejudice the decorum of the institution."

The police "must give the appearance of authority and efficiency, which is why we thought it opportune to raise the question," Stefano Paoloni, the union's secretary-general, said in a telephone interview.

"It's not a prejudice against the color," he added, but rather a question of decorum.

7-day average

166,310

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.

Italians took to social media to joke about Pink Panthers, gift horses and fragile masculinity.

It remained unclear on Friday where the masks had come from. The Interior Ministry, which oversees the state police, declined to comment.

The office of the commissioner for the coronavirus emergency, which supplies and distributes medical and personal protection devices, declined to comment.

"I hope that after we raised our concerns there will be an attempt to distribute more sober colors," Mr. Paoloni said.

Teresa Bellanova, the deputy infrastructure minister, said on Twitter that she saw nothing wrong with having officers wearing colored masks. "The respect for uniforms is not given by colors," she said, "but by how the men and women who wear those uniforms behave and work."

Global Roundup

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A testing site in Seoul on Thursday. A South Korean court has ordered the capital to ease some restrictions.Credit...Ahn Young-Joon/Associated Press

South Korea said on Friday that it would suspend its reopening plan for three more weeks to prepare for a possible surge of Omicron cases before and during the Lunar New Year holiday.

The curbs will extend past Feb. 2, when the three-day holiday ends. Before the pandemic, tens of millions of South Koreans — and many more in China and other East Asian countries — would travel to attend family reunions around Lunar New Year.

Under South Korea's current rules, unvaccinated people are barred from many public facilities, and restaurants and bars are required to close at 9 p.m. Over the Lunar New Year holiday, train tickets will be sold only for window seats and people will be asked to refrain from traveling, officials said.

"In many countries, the medical system is on the verge of collapse, because it cannot withstand the explosive spread of Omicron," Prime Minister Kim Boo-kyum said on Friday. "We are also announcing new pandemic countermeasures today in preparation for Omicron, which will come like a huge wave."

South Korea's hospitalizations and deaths have remained stable in the past month, and daily new infections have declined steadily to 4,542 on Friday from 5,567 on Dec. 14, according to government data. While Delta has remained the dominant variant, Omicron might overtake it over the next three weeks, Mr. Kim said.

7-day average

9,285

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.

But on Friday, in a setback for the government's strategy, a court ordered the authorities in Seoul, the capital, to suspend enforcement of vaccine passes for adults visiting large stores and for adolescents generally. The court said the passes restricted access to some facilities that were "essential for basic living."

In other news from around the world:

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Agustina Velez, a tenant in Queens who owes more than $8,000 in back rent. She and her husband lost their jobs early in the pandemic.Credit...Jose A. Alvarado Jr. for The New York Times

For most of the pandemic, New York State has maintained a strict eviction moratorium, a safeguard that many elected officials and housing advocates say has prevented a cascading crisis in a state with an enormous number of struggling renters.

Even as nearly every other state or federal moratorium ended, New York's protections were extended time and again. Only in New Mexico has a statewide moratorium been in place for as long.

But New York is now approaching a perilous milestone. On Saturday, state officials are set to let the moratorium expire, making way for a long-feared rush of evictions cases that many worry will seed widespread social upheaval and strain New York's recovery from the pandemic.

Before the pandemic, about one-quarter of the state's households occupied by renters spent more than half their income on rent and some utilities. In New York City, where many renters live, the problem is even more acute, with one-third of households in that category.

The pandemic only made things worse. The state has received more than 291,000 applications for a pandemic rent relief program since last summer, reflecting the vast number of people behind on rent. That program has nearly run out of money.

"It's a moment of a lot of uncertainty and precariousness," said Siya Hegde, policy counsel to the civil action practice at Bronx Defenders, a nonprofit legal services group that has been representing tenants in court.

It is not known how many people may be at risk of evictions after the moratorium ends, but before the pandemic, landlords in New York City filed far more evictions than any other major American city, according to Princeton University's Eviction Lab. Nearly 140,000 evictions cases were filed in 2019.

Many politicians and housing groups agree that the moratorium was only meant to be a stopgap during an extraordinary crisis. But its end marks a pivotal moment, setting the stage for a fraught political battle.

If an eviction crisis does occur, it would be a formidable challenge for Gov. Kathy Hochul, a Democrat, who has made housing a centerpiece of her agenda as she prepares to run for a full term in November.

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United States Marines based at Camp Hansen in Kin, Japan, lined up to receive Moderna's Covid vaccine in April 2021.Credit...Carl Court/Getty Images

Two members of the United States Marine Corps have been given religious exemptions from the Pentagon's vaccine mandate, the first of their kind since the mandate was introduced last summer.

According to officials, 95 percent of active-duty Marines — the military branch with the greatest number of holdouts against Covid-19 vaccines — are inoculated against Covid. About 97 percent of the 1.3 million active-duty service members in the United States have had at least one vaccine dose.

Thousands of U.S. troops across the military have sought religious exemptions from the vaccine, but none had been approved until this week. There have been 3,350 requests for religious accommodation across the Marines.

"The Marine Corps recognizes Covid-19 as a readiness issue," Maj. Jim Stenger, a Marine Corps spokesman, said in a statement on Thursday. "The speed with which the disease transmits among individuals has increased risk to our Marines and the Marine Corps' mission."

He added that 88 percent of Marines hospitalized for complications from the virus were unvaccinated.

Congress passed legislation last month that would prohibit the service branches from dishonorably discharging any member who refused to be vaccinated against Covid, but scores have left the military over the policy.

Five governors also wrote to Defense Secretary Lloyd Austin last month to ask that their National Guard troops be exempted from a federal Covid vaccine mandate.

This month, a federal judge issued an injunction to shield a group of Navy sailors who had sued the Biden administration over the mandate.

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People waiting in line for free Covid-19 at-home antigen rapid tests in Silver Spring, Maryland, on Friday.Credit...Michael Reynolds/EPA, via Shutterstock

Americans will have to wait nearly two weeks before receiving the free, at-home rapid tests promised by the Biden administration, a delay that puts pressure on schools and businesses that are struggling to stay open amid the biggest wave of cases to date.

Since late November, when the Omicron variant was first detected, the average number of daily new cases in the United States has soared, fueling a desperate search for tests. The hunt has stirred feelings of déjà vu for many, who have faced hourslong lines outside of testing centers reminiscent of earlier waves. And production of at-home tests sold at pharmacies has not been able to keep up with demand.

Accessing tests remains a significant obstacle to curbing the spread of the virus, in part because of supply shortages and expensive costs, marking the latest example of how the government, under two different administrations, has stumbled in its pandemic response on everything from masks to vaccines to treatments.

At the beginning of the pandemic in March 2020, the United States did not have enough masks for health care workers and the public. Testing availability has been spotty throughout the pandemic, with one of the biggest producers, the pharmaceutical company Abbott, reducing capacity last summer as it saw demand for them slow. And today, despite the development of treatments, including Covid pills and infusions, supplies are limited.

Friday's news that the Biden administration would start a website for Americans to request tests was blunted by the fact that they won't be delivered until the end of the month. The average number of new cases has more than doubled in the past two weeks to 806,157, setting records nearly every day this month.

The website went live on Friday, but the public can't place orders until Wednesday, Jan. 19. It could then take at least another seven to 12 days for tests to be shipped, senior Biden administration officials said on Friday.

That means that for the next two weeks, millions of Americans will continue to navigate a return to work and school amid the dual challenge of a highly transmissible variant and a lack of tests. That's forced offices to scrap reopening plans and school districts to temporarily switch to remote learning.

The Biden administration's plan for people with private insurance to begin seeking reimbursement for out-of-pocket payments on at-home tests on Saturday also faces hurdles. As with at-home tests, insurers estimate it could take weeks before a system for repayments is established.

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