Coronavirus Briefing Lede Hed TK.

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Demonstrators in Magdeburg, Germany, on Sunday during a rally against government measures to curb the spread of the coronavirus.
Credit…Christian Mang/Reuters

Cities across Germany braced for major protests against coronavirus restrictions on Monday, and a tough new vaccine requirement came into force in Italy as governments across Europe continued to tighten their rules in a struggle to contain the Omicron variant.

The developments in two nations where cases are rising fast — up 91 percent over the past two weeks in Germany, and more than 300 percent over the same period in Italy — encapsulate the tensions in European countries where leaders are doubling down on Covid vaccinations and boosters, beginning to make them all but mandatory.

More than 69 percent of people in the European Union have been fully vaccinated, according to official data, and the numbers are higher in the western part of the bloc, where Italy has vaccinated 75 percent and Germany 72 percent. With studies showing that the vaccines provide protection against severe illness and death from Omicron and other variants, governments increasingly see those who remain unvaccinated as an obstacle to avoiding more painful measures, such as reverting to lockdowns.

The challenge was expressed in harsh language last week by President Emmanuel Macron of France, who said in a newspaper interview that he wanted to “piss off” the millions of his compatriots who have declined the shots by barring them from public spaces. On Saturday, thousands of protesters took to the streets in opposition to a government proposal that would effectively ban unvaccinated people from public areas.

Vaccine skeptics also came out in big numbers in Vienna, where Covid shots will be mandatory for the entire adult population starting next month.

In Germany, where a strident anti-vaccination movement has ties to the far right, social restrictions and rules that shut the unvaccinated out of much of public life have prompted large protests on Mondays, a day that holds special resonance since weekly demonstration walks helped bring down the Berlin Wall in 1989. In recent weeks, tens of thousands of demonstrators have marched in cities and towns across the country, with some protests turning violent.

Last Monday, in the southwestern state of Baden-Württemberg, some 50,000 people took part in 170 marches. In the eastern state of Thuringia, the police in the town of Sömmerda used tear gas against a group of protesters. In Lichtenstein, a town in neighboring Saxony, 14 police officers were wounded in an attack by demonstrators, with one suffering a bite wound and another having to fend off an assailant who went for the officer’s weapon.

The recently elected chancellor, Olaf Scholz, has asked Germans to respect the restrictions and to get inoculated, and he used a New Year’s speech to rebut misinformation that the shots were unsafe. German lawmakers are expected soon to begin discussing legislation that would make vaccinations mandatory nationwide, but some members of Mr. Scholz’s coalition government are wary of the possible backlash.

In Italy, where opposition to vaccines is less fierce, a rule goes into effect on Monday that requires all public and private sector employees age 50 and older to be vaccinated against Covid or be able to show that they have recovered from the disease. Those who don’t meet the requirement by Feb. 1 could be suspended from work, part of the latest restrictions introduced by the government of one of Europe’s worst-affected nations to curb the steep rise of infections and mitigate the impact on hospitals.

With the Omicron variant fueling a doubling of the case rate over the past week, the Italian government has imposed the restriction on older workers because they are more susceptible to serious illness. Until now, those employees could take frequent P.C.R. tests that, if negative, allowed them to enter their workplaces.

Other new measures going into effect on Monday in Italy bar unvaccinated people from banks, offices, public transport, outdoor dining, hotels, ski lifts and a host of other places.

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Credit…Hamish Blair/Associated Press

Novak Djokovic, the Serbian tennis star, won a legal victory on Monday in his bid to avoid deportation from Australia, as a judge ordered the government to release him from detention and restore a visa it had canceled because Djokovic has not been vaccinated for Covid-19.

The ruling came five days after Djokovic was detained at an airport upon arrival on a flight from Dubai. It does not guarantee that he will be able to compete at the Australian Open, which he has won a record nine times.

But in court on Monday, the government warned that it may cancel his visa a second time even after the court’s decision.

The drawn-out conflict over the world’s top men’s tennis player, who arrived seeking to win a record-breaking 21st Grand Slam title, landed at the start of an election year in Australia and kicked off another round of international debate over vaccine politics.

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Credit…Paul Crock/Agence France-Presse — Getty Images

Djokovic arrived late Wednesday with a visa and a vaccination exemption to play in the tournament, which begins Jan. 17, but border officials canceled the visa with the support of Prime Minister Scott Morrison. The authorities said that Djokovic did not qualify for an exemption from the requirement that everyone entering the country be fully vaccinated.

In the hearing on Monday, Anthony Kelly, the federal court judge overseeing Djokovic’s appeal, noted that his visa application had included a medical exemption from a physician, supported by an independent panel convened by the Victoria state government.

“The point I’m somewhat agitated about is, what more could this man have done?” Judge Kelly said.

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Credit…Adriana Zehbrauskas for The New York Times

Some people with a weakened immune system can get a fourth dose of the coronavirus vaccine as early as this coming week, according to recommendations from the Centers for Disease Control and Prevention that were updated last week.

The C.D.C. endorsed a third dose of the Pfizer-BioNTech and Moderna vaccines for moderately or severely immunocompromised people on Aug. 13, but said this would be considered a part of the primary immunization, not a booster shot.

In October, the agency said those immunocompromised people could receive a booster shot — a fourth dose of vaccine, six months after their third dose. These guidelines were consistent with its recommendation for other adults.

Last week, hoping to stem the surge of infections with the highly contagious Omicron variant, the C.D.C. shortened that interval to five months for a booster shot for Pfizer-BioNTech or Moderna recipients.

For immunocompromised people who received a single shot of the coronavirus vaccine made by Johnson & Johnson, the C.D.C. does not recommend additional primary doses, but advises that they get a booster shot of the Moderna or Pfizer-BioNTech vaccines two months after the first dose.

Some people are born with absent or faulty immune systems, and in others, treatments for some diseases like cancer diminish the potency of immune defenses. The C.D.C. estimates there are about seven million immunocompromised individuals in the country.

Many of them produce few to no antibodies in response to a vaccine or an infection, leaving them susceptible to the virus. When they do become infected, they may suffer prolonged illness, with death rates as high as 55 percent.

It is unclear what proportion of those people are protected by additional doses. Still, with the Omicron variant surging in the country, some immunocompromised people sought out fourth or even fifth shots of the vaccines even before the C.D.C. changed its guidelines. While receiving multiple doses of vaccines in a short period is unlikely to be harmful, it may produce diminishing returns, according to some experts.

The C.D.C. has said that any American 12 and older can receive a Pfizer-BioNTech booster — those 18 and older can alternatively receive a Moderna booster — five months after completing their initial shots with those vaccines. Israel has already begun offering fourth doses to high-risk groups including older adults. But the Biden administration has not yet said whether it plans to follow suit.

When asked on Friday about the possibility of a fourth shot for the general population, Dr. Rochelle Walensky, director of the C.D.C., said that focus remained on Americans eligible for their third shots.

She added that U.S. officials remained in close touch with Israel experts about their data. “We will be following our own data carefully as well, to see how these boosters are working in terms of waning effectiveness, not just for infection but, importantly, for severe disease,” she said.

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Credit…Timo Lenzen

Reports about dual infection with the flu virus and the coronavirus have been making sensational headlines recently. But how worried should we be?

We spoke to experts to better understand what it could mean to test positive for both infections. Here’s what to keep in mind.

Will co-infection make me twice as sick?

A co-infection doesn’t immediately mean that a patient will be doubly sick. A strong immune response may actually help the body fight off pathogens of all types, so one infection could stimulate some additional protection.

“An infection to one might help to aid your immune response to another,” Dr. Grein said, “because it’s activating that same immune response that’s going to be effective in fighting both.”

Still, scientists don’t know for sure yet, because so few people have tested positive for both Covid-19 and influenza. But judging from past trends, doctors are not overly worried.

Who is most susceptible?

Dr. Saad B. Omer, the director of the Yale Institute for Global Health, identified two groups he thought could be most vulnerable to co-infection.

First: unvaccinated adults. “Based on previous work on vaccinations, people who refuse one vaccine might refuse others as well,” he said. He said he expected there to be a “significant overlap between people who refuse both vaccines.”

Second: children, especially those under 5, who are too young to get vaccinated against Covid. Kids are also petri dishes, as any parent will tell you, and have lived through fewer cycles of the flu. So even if a child got a flu shot, Dr. Omer said, “their library of protection is narrow” against the many viral flu strains that can emerge each year.

How can I prevent co-infection?

On this one, the medical advice remains consistent: Get vaccinated for both Covid and flu. And get vaccinated right now.

Both kids and adults can get both vaccines at the same time. Children ages 5 years and older are eligible for a Covid vaccine, and children older than 6 months can get vaccinated against the flu.

In addition, experts agree you should wear masks and maintain social distancing measures when appropriate. Both flu and the coronavirus are airborne viruses, so limiting your exposure cuts down on your chances of getting infected.

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