Experts tout boosters; CDC releases omicron data: COVID updates

New York City to mandate Covid vaccines for all private sector workers

This new move, which de Blasio announced Monday on MSNBC, means everyone who works in the city will now be subject to a vaccine mandate.

“The more universal they are, the more likely employees will say okay, it’s time. I’m going to do this. Because you can’t jump from one industry to another or one company to another,” de Blasio said. “It’s something that needs to be universal to protect all of us.”

At a press conference later on Monday, de Blasio said the vaccine mandate is the best way to avoid a return to a shutdown of businesses and other public events that other countries have ordered as Covid cases continue to rise.

“We need to take very bold action. We’re seeing restrictions starting to come back. We’re seeing shutdowns,” he said. “We can not let those restrictions come back. We can not have shutdowns in New York.”

Details about the how the rules will apply to businesses are due to be announced December 15, and de Blasio said the city will be holding discussions with businesses between now and then about those rules. The rules will not allow employees to opt out of vaccination through regular testing, as a proposed federal mandate for employers with 100 or more workers will do. And it will require workers to have at least one vaccination dose by the December 27 deadline.

The penalty that will be imposed on businesses that do not enforce the mandate were not disclosed.

“It is part of life that there have to be some consequences,” de Blasio said. “We’ll figure out what makes sense between now and December 15.”

The mayor said that the overwhelming majority of businesses have complied with an earlier city rule requiring customers to show proof of vaccination, including at the city’s restaurants, health clubs and entertainment venues. “It’s been amazing, [there have been] very few times we actually had to penalize people,” the mayor said.

De Blasio said the need for the new rules is a triple threat that is raising the potential for additional cases — the emergence of the Omicron variant, the coming of cold weather forcing people to congregate be inside more frequently, and the expectation of holiday gatherings in the weeks ahead.

The mandate itself will begin only four days before the end of de Blasio’s eight-year term in office. He told reporters that he had spoken to Mayor-elect Eric Adams, who is currently traveling outside the country. Although he said he would not speak for Adams, he’s confident that the new mayor wants to follow the advice of medical professionals and keep the vaccine mandate in place once he takes office.

“In every conversation we’ve had about fighting Covid, he’s been really consistent on the point that he is feeling urgency, about these new threats, and that he understands my job is to keep New Yorkers safe until Dec. 31,” he said. “I feel very, very good about the conversations we’ve had.”

And he said that the medical professionals he has spoken to are united in the need to increase the rate of vaccination, and their belief that a vaccine mandate will work to do that.

Children, ages 5 – 11 in New York will now also be required to show proof of at least one shot before being allowed access to indoor dining, fitness or entertainment, the mayor announced.

Adults will now be required to show proof of two vaccinations for those areas.

The mayor is confident the mandates will hold up in court.

“Our health commissioner has put a series of mandates in place. They have won in court, state court, federal court every single time. And it’s because they’re universal and consistent. And they’re about protecting the public right now from a clear and present danger,” de Blasio said.

City employees were already subject to vaccine mandates. But a federal mandate for businesses with 100 or more employees to require vaccines or weekly testing of its employees is on hold due to court challenges. Many major employers, including some Wall Street banks and tech companies with offices in the city, have their own vaccine mandates in place.

Surprise announcement

The announcement caught business leaders off guard.

“We had no heads up,” Kathryn Wylde, president and CEO of the Partnership for New York City, an influential business group, told CNN Monday in a phone interview.

Wylde said she was “surprised” to learn about the new health restrictions through the media because typically local leaders would give the business community a heads up about such a shift.

“It’s unclear if the city has authority to issue such a mandate,” Wylde said, adding that the city business leaders are “very supportive” of vaccines.

Although New York employers are not against vaccine mandates, Wylde said business leaders are looking for more information on how this new order will be enforced and whether employees can opt out through testing. City workers already faced such a mandate.

“Employers do not want to be enforcement agents,” Wylde said.

But the head of the Greater New York Chamber of Commerce praised the move.

“I don’t think it’s going to be an issue when it comes to private companies. Most of them are already vaccinated and require it,” said Helena Natt, executive director of the Greater New York Chamber of Commerce.

Natt said the move by the city is a “next step” in what needs to be done.

“We’re monitoring Covid, Delta, now we’re monitoring Omicron,” she said. “We’re watching the science and if the people of New York can watch to make sure they can do everything in their power to make sure [they] are safe and coworkers are safe.”

Biden's vaccine mandate is on hold, but companies are moving ahead anyway

Business leaders are also concerned about navigating the maze of federal, state and city health policies. For instance, unlike the city, New York State does not have a vaccine mandate for private employers. And the Biden administration’s vaccine mandate for employers with 100 or more workers has been held up by court challenges.

Wylde said there is concern over a lack of coordination for federal, state and city health policies. “Public health protocols generally, and vaccine mandates, should be coordinated and consistent with each other,” Wylde said.

But de Blasio said that the businesses he spoke to about Covid were supportive of a mandate.

“I’ve heard from so many business leaders, including in those sectors, like finance and tech, that the best thing for them is for government to lead the way,” he said. “It’s always better for the private sector if the government sets a single, universal standard, so they don’t have to … say to their employees, ‘Hey, this is something we’re going to do on our own.'”

He said what they really don’t want to see is the kind of spike in cases that requires a shutdown or stay-at-home orders now being put in place in parts of Europe.

“Our health care leadership was adamant that this was a step we could and must take,” he said. “We know from extensive conversations over months with private sector employers what their concerns are. The number one thing I’ve heard … is that we must avert shutdowns.”

— CNN’s Vanessa Yurkevich contributed to this report

Confirmed US omicron cases up; Biden’s winter plan: COVID news

CDC confirms first U.S. case of omicron Covid variant, in California

The CDC said Wednesday it has confirmed the first U.S. case of the new, heavily mutated coronavirus variant called omicron, which was detected in Northern California.

White House chief medical advisor Dr. Anthony Fauci said the patient, who was fully vaccinated, had just returned to the San Francisco area Nov. 22 after traveling in South Africa and tested positive Nov. 29.

“The individual is self-quarantining, and all close contacts have been contacted and … thus far, have tested negative,” he announced at a White House press briefing providing more details of the case. “We feel good that this patient not only had mild symptoms, but actually the symptoms appear to be improving.”

The Centers for Disease Control and Prevention said genomic sequencing was initially conducted at the University of California, San Francisco, and the CDC confirmed the omicron variant.

The Dow Jones Industrial Average swung from a 520-point gain for the day to a loss of more than 461 points after the CDC confirmed the case.

California Gov. Gavin Newsom cautioned residents on Twitter, saying, “There’s no reason to panic — but we should remain vigilant. That means get vaccinated. Get boosted. Wear a mask indoors.”

At a press briefing Wednesday afternoon, Newsom said the patient is between 18 and 49 and had not received a booster shot because they were not six months out from their original vaccination course.

Newsom and local officials in San Francisco said they didn’t anticipate imposing new restrictions on residents in light of omicron.

“There’s more panic than information around this new variant,” Newsom said, adding that everyone needs to be more vigilant but that lockdowns are not under consideration. “I think we can communicate so we can avoid any shutdowns, we can avoid shutting down our schools or businesses. None of us want to see that happen.”

Since South Africa first reported the variant to the World Health Organization a week ago, it’s been found in Canada, the U.K., Israel, Belgium, the Netherlands, Germany, Italy and Hong Kong, among other places. World leaders are on high alert, worried the virus is already widely seeded across the globe.

The World Health Organization said Wednesday that omicron has been reported in at least 23 countries.

Fauci said over the weekend that the variant would inevitably arrive in the U.S. On Sunday, two cases were identified in Ontario, Canada. The variant, initially known as B.1.1.529, was first detected in Botswana and South Africa’s Gauteng province, where Johannesburg is located.

Moderna CEO Stephane Bancel warned Monday that omicron has already spread across the planet. He pointed to flights that arrived in Amsterdam from South Africa on Friday in which 61 of 624 passengers tested positive for Covid. Dutch health authorities said 14 of them are infected with the omicron strain.

Portuguese health authorities said Monday that 13 members and staff of a professional soccer team in Lisbon were infected with the variant after one of its players returned from a trip to South Africa.

“We also believe it is already present in most countries,” Bancel said. “I believe most countries that have direct flights from South Africa in the last seven to 10 days already have cases in their country that they may not be aware of.”

The U.S. imposed a travel ban starting Monday for noncitizens who have traveled in South Africa and seven other nearby nations in the past 14 days. The U.K. and the European Union have implemented similar travel restrictions.

President Joe Biden said Monday he is directing the Food and Drug Administration and the CDC to use the “fastest process available without cutting any corners” to approve potential vaccines that target omicron and get them on the market.

The current Covid vaccines are believed to provide at least some protection from the heavily mutated omicron strain, and booster shots “strengthen that protection significantly,” Biden said in a speech at the White House.

The WHO on Friday classified omicron as a “variant of concern,” meaning it is more contagious, more virulent or more skilled at evading public health measures, vaccines and therapeutics. The variant contains more than 30 mutations to the spike protein that allows the virus to enter the body. The new strain has roughly 50 mutations in total, including 10 alone to the receptor binding domain, the part of the virus that first comes in contact with cells.

Officials have warned that many of these mutations could lead to increased antibody resistance and transmissibility, which could limit the effectiveness of Covid vaccines.

“The molecular profile of the kinds of mutations that you see [in omicron] would suggest that it might be more transmissible and that it might elude some of the protection of vaccines,” Fauci said Wednesday. “But we don’t know that now.”

He said we have to prepare for the possibility that immune protection from vaccines and recovery from Covid may be diminished against omicron, emphasizing the need for boosters.

Dr. Angelique Coetzee, chair of the South African Medical Association, described the symptoms linked to omicron as “extremely mild” so far. However, Bancel warned that the symptoms reported in South Africa may not be a good predictor of the variant’s virulence since less than 5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the population is over 60 and there are far fewer comorbidities than in the U.S. and Europe, where people tend to be older and sicker.

“I think today, it’s really impossible to know … I don’t believe that what’s going to happen in the coming week or two in South Africa will be predicting to be full virulence of a virus,” Bancel said.

Drugmakers have responded quickly to the new variant. Pfizer and BioNTech said they are investigating omicron and could adapt their vaccine if needed. Johnson & Johnson said it was already testing its vaccine against the variant. Moderna said it will test three booster candidates against omicron, including a higher dosage of its original Covid booster. The company also said it will develop a booster dose specific to the variant.

Fauci said Americans heading into the holidays should still feel safe celebrating indoors with vaccinated family and friends.

“You can feel safe with not wearing a mask and having a dinner or having a reception,” he said. “But when you are in a public congregate setting in which you do not know the status of the vaccination of the people involved, it is very prudent to wear a mask.”

— CNBC’s Robert Towey and Kevin Breuninger contributed to this report.

Trump reportedly got positive COVID test days before debate with Biden

Will the Covid Vaccines Stop Omicron? Scientists Are Racing to Find Out.

As nations severed air links from southern Africa amid fears of another global surge of the coronavirus, scientists scrambled on Sunday to gather data on the new Omicron variant, its capabilities and — perhaps most important — how effectively the current vaccines will protect against it.

The early findings are a mixed picture. The variant may be more transmissible and better able to evade the body’s immune responses, both to vaccination and to natural infection, than prior versions of the virus, experts said in interviews.

The vaccines may well continue to ward off severe illness and death, although booster doses may be needed to protect most people. Still, the makers of the two most effective vaccines, Pfizer-BioNTech and Moderna, are preparing to reformulate their shots if necessary.

“We really need to be vigilant about this new variant and preparing for it,” said Jesse Bloom, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle.

“Probably in a few weeks, we’ll have a better sense of how much this variant is spreading and how necessary it might be to push forward with a variant vaccine,” Dr. Bloom said.

Even as scientists began vigorous scrutiny of the new variant, countries around the world curtailed travel to and from nations in southern Africa, where Omicron was first identified. Despite the restrictions, the virus has been found in a half-dozen European countries, including the United Kingdom, as well as Australia, Israel and Hong Kong.

Already, Omicron accounts for most of the 2,300 new daily cases in the province of Gauteng, South Africa, President Cyril Ramaphosa announced on Sunday. Nationally, new infections have more than tripled in the past week, and test positivity has increased to 9 percent from 2 percent.

Scientists have reacted more quickly to Omicron than to any other variant. In just 36 hours from the first signs of trouble in South Africa on Tuesday, researchers analyzed samples from 100 infected patients, collated the data and alerted the world, said Tulio de Oliveira, a geneticist at the Nelson R. Mandela School of Medicine in Durban.

Within an hour of the first alarm, scientists in South Africa also rushed to test coronavirus vaccines against the new variant. Now, dozens of teams worldwide — including researchers at Pfizer-BioNTech and Moderna — have joined the chase.

They won’t know the results for two weeks, at the earliest. But the mutations that Omicron carries suggest that the vaccines most likely will be less effective, to some unknown degree, than they were against any previous variant.

“Based on lots of work people have done on other variants and other mutations, we can be pretty confident these mutations are going to cause an appreciable drop in antibody neutralization,” Dr. Bloom said, referring to the body’s ability to attack an invading virus.

South African doctors are seeing an increase in reinfections in people who already had a bout of Covid-19, suggesting that the variant can overcome natural immunity, said Dr. Richard Lessells, an infectious diseases physician at the University of KwaZulu-Natal.

Omicron has about 50 mutations, including more than 30 in the spike, a viral protein on its surface that the vaccines train the body to recognize and attack.

Some of these mutations have been seen before. Some were thought to have powered the Beta variant’s ability to sidestep vaccines, while others most likely turbocharged Delta’s extreme contagiousness.

“My best guess is that this combines both of those elements,” Penny Moore, a virologist at the National Institute for Communicable Diseases in South Africa, said of the new variant.

But Omicron also has 26 unique spike mutations, compared with 10 in Delta and six in Beta. Many of them seem likely to render the variant more difficult for the immune system to recognize and thwart.

“There are many we’ve never studied before, but just looking at the location on the spike, they are in regions that we know are immuno-dominant,” Dr. Moore said, referring to parts of the spike protein that interact with the body’s immune defenses.

Dr. Moore’s team is perhaps the furthest along in testing how well the vaccines hold up against Omicron. She and her colleagues are preparing to test blood from fully immunized people against a synthetic version of the Omicron variant.

Creating such a “pseudovirus” — a viral stand-in that contains all of the mutations — takes time, but results may be available in about 10 days.

To more closely mimic what people are likely to encounter, another team led by Alex Sigal, a virologist at the Africa Health Research Institute, is growing live Omicron, which will be tested against the blood of fully immunized people, as well as those who were previously infected.

Those results may take longer but should provide a fuller picture of the vaccines’ performance, Dr. Sigal said.

If the vaccines prove to be much less potent against Omicron, they may need to be tweaked to enhance their effectiveness. Preparing for the worst, Moderna, Pfizer-BioNTech and Johnson & Johnson are planning to test an artificial version of Omicron against their vaccines.

The mRNA vaccines in particular — Moderna’s and Pfizer-BioNTech’s — were built with technology that should permit rapid modification. Pfizer’s scientists “can adapt the current vaccine within six weeks and ship initial batches within 100 days in the event of an escape variant” that eludes the immune system, said Jerica Pitts, a spokeswoman for Pfizer.

Moderna’s work began on Tuesday, immediately after its scientists learned of Omicron — the fastest the company has ever responded to a variant, said Dr. Stephen Hoge, Moderna’s president.

Even without data on Omicron’s spread, it was obvious the variant would be a formidable threat to vaccines, he said.

“This thing is a Frankenstein mix of all of the greatest hits,” Dr. Hoge said, referring to the variant’s many concerning mutations. “It just triggered every one of our alarm bells.”

Moderna could update its current vaccine in about two months and have clinical results in about three months if necessary, he said.

Both companies also plan to test whether booster shots will bolster the immune system enough to fend off the new variant. Boosters of the Pfizer-BioNTech and Moderna vaccines have been shown to raise antibody levels significantly.

But those antibodies may not be broadly effective against every iteration of the virus, and may not be enough to neutralize Omicron entirely, said Michel Nussenzweig, an immunologist at Rockefeller University in New York.

People who recover from Covid and then receive even one dose of a vaccine tend to produce a broader range of antibodies, capable of recognizing more versions of the virus, than do people who are only vaccinated.

“It’s clear that hybrid immunity, the kind that people get when they are both infected and vaccinated, is superior, and that is very, very likely to take care of this thing, too,” Dr. Nussenzweig said.

“After two doses of vaccine, we did not see that. But we’re hoping that after three doses, maybe there’ll be some catching up,” he said.

Dr. Nussenzweig and his colleagues are preparing to test Omicron against the mRNA vaccines, as well as the vaccines made by Johnson & Johnson and AstraZeneca. They hope to have results within a month.

Omicron-specific vaccines created in just weeks would be a miraculous feat. But the prospect of producing and distributing them raises daunting questions.

If new versions are required to protect people everywhere, companies should make them available to the African countries that most need them and can least afford them, Dr. de Oliveira said.

“South Africa at least has managed to procure their own vaccines,” he said. But poorer countries like Sudan, Mozambique, Eswatini and Lesotho will need low-cost options.

Pfizer did not respond to a question about low-cost vaccines for African nations. Dr. Hoge, of Moderna, said the company already had an agreement with the African Union to deliver 110 million doses at $3.50 per half dose of vaccine.

Dr. Hoge said he recognized that 110 million was less than 10 percent of Africa’s population. But, he noted, “we’re also the smallest of all manufacturers out there, and so 10 percent hopefully is useful.”

Despite the frustration that South African scientists have expressed about vaccine inequity and punishing travel restrictions, they have been inundated with requests for genetic sequences of Omicron from Italy, Germany, Australia and New Zealand, as well as labs in North America.

The more teams involved, the better, said Dr. Moore, who received about 50 requests just on Saturday. As the virus moves across the globe, it is likely to keep changing. “Getting the right combination of mutations in itself is a moving target,” she said.

Researchers everywhere want to avoid drawing conclusions prematurely, a mistake they made when the Beta variant surfaced. Preliminary tests of that variant took only one known mutation into account and underestimated its ability to evade the immune system, Dr. Moore recalled. (Fortunately, the variant also turned out to be less contagious.)

To get a full picture of the effectiveness of the vaccines against Omicron, scientists must look not just at antibody levels but also at immune cells that can recognize and destroy infected cells. Immune cells called T cells are crucial for preventing an infection from progressing to serious illness and death.

Some of Omicron’s mutations occur in parts of the virus targeted by T cells, meaning the variant may be more difficult for T cells to recognize.

Already, a computer simulation has predicted that those mutations may alter about six of the hundreds of regions that T cells can recognize, said Wendy Burgers, an immunologist at the University of Cape Town.

That may not seem like much. But people make varying sets of T cells, so depending on which targets the mutations knock out, some people may barely be affected by Omicron — and others may be left vulnerable.

Dr. Burgers is hoping to obtain blood from 50 people infected with the variant to gauge how the mutations will play out across a population. Once the samples are in hand, results will be available after “probably a week of very late nights and analysis,” she said.

Even if the vaccines hold up against Omicron, new versions will probably be needed at some point, and perhaps soon. The virus is acquiring mutations much faster than expected, Dr. Bloom said.

Seasonal influenza is the often cited example of a virus that mutates quickly, requiring regular updates to vaccines. But the coronavirus is “at least comparable and possibly even faster than that,” Dr. Bloom said. “There’s always going to be new variants arising.”

Lynsey Chutel contributed reporting from South Africa.