Federal health officials warned on Wednesday that a third of Americans live in areas where the threat of Covid-19 is now so high that they should consider wearing a mask in indoor public settings. They cited new data showing a substantial jump in both the spread of the coronavirus and hospitalizations over the past week.
Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said that the seven-day average of hospital admissions from Covid rose 19 percent over the previous week. About 3,000 people a day were being admitted with Covid, she said, although death rates, a lagging indicator, remained low.
More than 32 percent of Americans now live in counties with medium to high levels of virus transmission, compared with about 24 percent the previous week. Dr. Walensky said that local leaders and individuals in those regions should adopt — or at least consider — prevention strategies, such as masking in indoor public settings and more frequent testing.
The warnings from Dr. Walensky and other federal health officials seemed somewhat at odds with President Biden’s own stance. The attitude in the West Wing more closely mirrors that of most Americans, who have eagerly moved away from mask-wearing and other strategies to prevent infection.
Mr. Biden no longer wears a mask in most settings, and is once again participating in Washington’s political and social scenes. The White House still takes precautions, regularly testing the president and those in close contact with him, and aides say Mr. Biden adheres to C.D.C. guidelines.
But he no longer treats the pandemic as his chief concern among many. Wednesday’s Covid briefing at the White House was the first in six weeks. While he has spoken about the pandemic’s enduring threat and toll, Mr. Biden has given far more speeches recently on Russia’s invasion of Ukraine and on inflation.
At the same time, a string of people in the president’s circle have been infected with the virus. On Wednesday, officials announced that Xavier Becerra, the health and human services secretary, had tested positive, as did Ashley Biden, the president’s daughter.
Mr. Biden says the shift in his tone is the result of the country’s success. Many people are vaccinated, a fair number are boosted, and those doses, plus new antiviral treatments, have been warding off severe disease, officials say. But the new approach is also a recognition of the political reality. Many Americans have decided to accept the risk of infection to resume their normal routines.
Andy Slavitt, a former senior adviser to the Biden White House on the pandemic, said the nation’s attention had shifted. The president “is managing a war overseas, the economy, inflation, infant formula and as these things go, the pandemic is now seen by the public as one more thing,” he said. “Of all the things going on, most people don’t perceive this to be the problem that it probably is.”
The president’s stance could backfire if the virus’s latest surge continues to build, evading the vaccines and making more people seriously ill. Should that happen, it could look like a repeat of last summer, when the president declared “independence” from the virus ahead of the July 4 holiday, only to see massive waves of illness and death once the Delta and Omicron variants hit.
Experts say that administration officials — including the president — should also be doing a better job of preparing the public for a reinvigorated virus in the fall and winter, when people spend more time indoors. If people become complacent now, they say, forgoing booster doses or failing to vaccinate their children, they could pay a price then.
“The attitude is, ‘We’ve got this, we’re over it.’” said Dr. Eric Topol, a professor of molecular medicine at Scripps Research in San Diego. “People should be gearing up, they should be getting booster shots. But there is no awareness.”
If the pandemic appears to be a lesser concern, that also makes it harder for the White House to make the case that it needs tens of billions in new funding from Congress to replenish its supply of tests, treatments and vaccines in time for the fall. The administration has said it wants to launch a booster campaign at that point, hopefully with vaccines retooled to work better against the latest version of the virus.
At the White House briefing, Dr. Ashish Jha, the new White House coordinator of the pandemic response, warned that if Congress failed to grant the administration’s request for $22 billion in new Covid funding, Americans would suffer come the fall.
He did not repeat an earlier administration claim that the nation could face 100 million infections next fall and winter. Instead, he said that projections from biostatisticians varied greatly, depending on estimates of how much of the population has developed immunity and other complex factors.
But he said that a scenario in which the nation had to face the virus without enough doses of vaccines and treatments would be “terrible,” adding: “I think we would see a lot of unnecessary loss of life.”
Dr. Jha said the current incidence of severe disease would be worse if not for Paxlovid, an oral treatment developed by Pfizer that helps prevent severe illness if taken soon after symptoms develop. Doctors are prescribing Paxlovid pills to about 20,000 patients a day, he said. That may help explain why the rates of hospitalization and intensive care patients are low relative to the jump in infections, he added.
Officials also warned at the briefing that far too many Americans are failing to take advantage of booster shots to bolster waning protection against infection, leaving themselves vulnerable to the coronavirus’s ever more contagious incarnations. 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.
Despite the nation’s weariness with mitigation measures, she said that in areas with high levels of 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.”
In areas with medium levels of transmission, including counties in nearly every state, people should consider wearing a mask in indoor public settings, avoiding crowds and testing themselves more often, especially before gathering with others indoors, she said.
Whether local leaders will heed C.D.C. recommendations is another matter. New York City is now experiencing a high level of transmissions, but Eric Adams, the city’s mayor, said on Wednesday that he had no plans to bring back mask requirements.
“If every variant that comes, we move into shutdown thoughts, we move into panicking, we’re not going to function as a city,” Mr. Adams said at a news conference. He said the city was settling into a “new norm” instead, recognizing that the virus would keep on mutating.
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.
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 be followed by a commensurate rise in hospitalizations and deaths. While hospitalizations are rising, deaths have remained low. About 275 deaths have been recorded each day on a seven-day average, according to the C.D.C. director, but the number has actually dipped slightly in recent weeks.
“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.’ ”
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.”