Health Officials Say Third of Americans Live in Areas with So Much Virus for to Consider Masks

Federal health officials on Wednesday warned that one third of Americans live in areas where the threat of infection from the coronavirus is now so high that they should consider wearing a mask in indoor public settings, whether local leaders require it or not.

Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said that federal data showed the US seven-day average of hospital admissions from Covid-19 rose about 20 percent over the previous week. About 3,000 people a day were now being admitted with Covid, she said, although death rates, a lagging indicator, remain low.

For areas with high levels of community transmission, mostly in the Northeast, “we urge local leaders to encourage the use of prevention strategies like masking in public indoor settings and increasing access to testing and treatment for individuals,” she said. People in areas with medium levels of transmission, including counties in nearly every state, should consider wearing a mask in indoor public settings, avoiding crowds and testing themselves, especially before gathering with others indoors, she said.

Dr. Walensky and other federal officials spoke at the first White House briefing devoted solely to the pandemic in six weeks. They gave no explanation for the hiatus, but said that they had granted dozens of media interviews in the interim.

Dr. Jha called the current increase in infections “very substantial” and warned that if Congress fails to grant the administration’s request for $22 billion in new Covid funding, the government will not have enough vaccines and treatments to combat a renewed surge of the virus expected this fall. The administration has said it wants to launch a booster campaign this fall, hopefully with vaccines retooled to work better against the latest version of the virus.

While projections from biostatisticians vary greatly, he said that a scenario in which the nation had to face the virus without enough doses of vaccines and treatments would be “terrible.” If Congress fails to provide critical funding, he said “I think we would see a lot of unnecessary loss of life.”

Officials also said that far too many Americans are failing to take advantage of booster shots to bolster waning protection against infection, leaving themselves vulnerable to ever more contagious versions of the coronavirus. Dr. Walensky said 62 percent of those aged 50 to 64 have not received a booster in the past six months, nor have 57 percent of those 65 or older.

Dr. Jha said the incidence of severe disease would be worse but for Paxlovid, an oral treatment developed by Pfizer that helps prevent severe illness if taken early enough after symptoms develop. Doctors are now prescribing the Paxlovid pills to about 20,000 patients a day, he said. That, he added, may explain why the rates of hospitalization and intensive care treatment are lower than expected given the jump in infections.

“Paxlovid is making a very big difference,” Dr. Jha said.

In an implicit recognition that the pandemic is not over, the administration on Monday quietly let pass a deadline for lifting the public health emergency, which has allowed the government to take steps like offering Americans free coronavirus vaccines, tests and treatments; barring states from canceling people’s Medicaid coverage; and expanding access to telehealth appointments. It has also allowed hospitals to get paid more for treating Medicare patients who have Covid.

Public health experts and hospital officials praised the extension of the emergency, which had been set to expire on July 15.

“We’re seeing rising cases and hospitalizations and testing positivity rates; now is not the time to end these flexibilities that allow great access to care,” said Ashley Thompson, senior vice president for policy development at the American Hospital Association. “We are not out of the woods yet.”

As of Tuesday, the average of new, confirmed coronavirus cases in the United States surpassed 100,000 a day for the first time since Feb. 20, according to a New York Times database. That figure is up 61 percent from two weeks ago. Public health experts believe the true number is far higher, because many people are not reporting the results of at-home tests.

The big unanswered question, experts say, is whether the rise in cases that is already well underway will ultimately be followed by a commensurate rise in hospitalizations and deaths.

“We could be entering a period where we have an increased number of cases but a substantially decreased severity of illness, so that we see fewer hospitalizations and many fewer deaths,” said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “But as absolutely uncomfortable and unsatisfactory as this is, we just don’t know what this virus is going to throw at us in the next 90 days.”

That poses a messaging challenge for the White House, he said: “What we need to do is not whipsaw from, ‘We’re over,’ to ‘Oh my God, how bad it could be.’ ”

Other experts said the federal health officials had been far too quiet in recent weeks. “I think it would be important for us to get more direction from Dr. Walensky and Dr. Fauci as to what we should be doing right now,” said Dr. Janis M. Orlowski, the chief health care officer at the Association of American Medical Colleges.

Dr. Ezekiel Emanuel, an oncologist, medical ethicist and University of Pennsylvania professor who led an effort to draft a new pandemic strategy called “The Next Normal,” was more blunt in calling for the White House to improve its Covid communications strategy: “They need to step up their game.”

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