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Virus Notebook

New York City placed on high alert over rise in cases

People dined outside in the West Village in Manhattan on Monday.AMIR HAMJA/NYT

New York City health officials put the city on “high COVID alert” on Tuesday, after rising case counts and hospitalizations reached a level that could put substantial pressure on the health care system.

The announcement was triggered by a color-coded alert system that the city introduced in March. But so far, the system has had little impact on the city’s disease control strategy or the public’s perception.

Mayor Eric Adams warned Monday that the city was nearing the threshold, but said “we’re not at the point of mandating masks.”

For two months now there has been a persistent rise in known infections, driven almost entirely by Omicron subvariants. In recent days, the city logged on average more than 3,500 new daily cases, although those numbers significantly understate the virus’s prevalence, as many infections are detected by at-home tests but never counted by the health authorities.

COVID-19 hospitalizations have been ticking upward, recently reaching about 130 new admissions a day across New York City, according to state data.



Once a model, Bay Area now a hot spot

Since the early days of the pandemic, California’s Bay Area has been seen as a model for how to minimize the spread of the coronavirus.

The region enforced the nation’s first stay-at-home orders in March 2020 and has since consistently seen lower levels of transmission than its southern counterparts. Today, the Bay Area has one of the country’s lowest COVID-19 death rates.

But over the past few weeks, the region has been getting a different, and less welcome, kind of pandemic attention.

The Bay Area has emerged as the state’s latest COVID hot spot, according to data from the Centers for Disease Control and Prevention. Among California’s 58 counties, Marin, San Francisco, San Mateo, and Alameda currently have the highest rates of COVID transmission, according to The New York Times tracker.


On Friday, health officers from 11 counties in and around the Bay Area warned of a new swell of cases fueled by highly contagious omicron subvariants.

Although a mask requirement for BART was reinstated late last month, the health officers aren’t reinstalling additional mandates, relying instead on recommendations that people use rapid tests, get boosters when eligible, and start keeping masks handy again.

“If you’ve chosen not to wear a mask in indoor public places recently, now is a good time to start again,” Dr. George Han, deputy health officer for Santa Clara County’s public health department, said in a statement Friday.

As the first Omicron wave receded in early spring, COVID restrictions were lifted across California and much of the nation. That means many Americans are increasingly in situations where they could contract the virus, whether eating indoors or going unmasked on airplanes.

New coronavirus cases have more than tripled since April 1 across the United States — and in California specifically. The Bay Area’s rates have climbed faster but remain roughly in line with what’s being seen elsewhere, said Dr. Bob Wachter, chair of medicine at University of California San Francisco.

“It’s not a night and day difference. What’s surprising though is that the Bay Area has been such an overperformer throughout the pandemic,” Wachter told me. “We’ve sort of gotten used to being the poster children for doing well.”

Wachter knows more people who’ve contracted COVID in the past few weeks than ever before, he said, including his wife. He offered a few theories on the Bay Area’s newfound position.


The San Francisco area has a high fraction of residents who have been able to work from home for the past two years, so they may have been able to avoid the virus until recently dropping their guard amid loosened pandemic rules.

“For the first time in two years, you see a lot of people without masks,” Wachter said.

And although the region has high vaccination rates, the shots’ ability to prevent people from getting infected wanes over time, so they may not confer the same protection they once did. Plus, the Bay may be particularly vulnerable simply because of how many residents have never contracted the virus before, he added.


More free COVID tests available

The White House said Tuesday that Americans were now eligible for a third order of free, at-home coronavirus tests shipped through the Postal Service. The move doubled to 16 the total number of tests the program has made available to each household.

The tests, authorized by the Food and Drug Administration and available on the federal website covidtests.gov, extend a pledge President Biden made during the brunt of the winter omicron wave, when Americans faced scarce supplies of tests, empty shelves, and long lines.

Under withering criticism for those shortages, Biden promised 1 billion at-home tests, and his administration secured commitments for hundreds of millions of them. The White House has said that half of them would be distributed through the Postal Service program. Over 70 million US households — more than half the households in the country — have ordered tests that way so far, and roughly 350 million tests have been delivered.


The opportunity to order more tests comes at a still-perilous moment in the pandemic. The average number of new confirmed cases reported daily in the United States has tripled since the start of April, reaching more than 95,000 as of Monday, according to a New York Times database. Hospitalizations are also increasing, by 26 percent nationally over the past two weeks. New deaths from the virus are down to about 300 a day on average — partly a reflection, public health experts have said, of the protection against severe disease that many Americans have acquired from being vaccinated or from getting over a past coronavirus infection.

Rapid at-home tests, which typically deliver results within 15 minutes, have become more prevalent and accessible in pharmacies, making the total number of virus cases around the nation more difficult to track. People who test positive using at-home tests typically do not report the results to local health departments, so many new infections are going uncounted.