Biden Administration May Offer Second Coronavirus Boosters to All Adults

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Sharon LaFraniere

WASHINGTON — The Biden administration is considering whether to expand second coronavirus booster shots to adults under 50 in an effort to counter the latest, highly contagious variant, which has driven up hospitalization rates and deepened worries about waning immunity among those vaccinated or boosted at least six or so months ago.

Expanding eligibility for a fourth dose of vaccine to younger adults would require regulatory approval; more discussions with officials from the Food and Drug Administration and the Centers for Disease Control and Prevention are expected in the coming days, according to people familiar with the situation.

The administration decided in March to offer second booster doses to everyone 50 or older, along with some younger individuals who have immune deficiencies. Dr. Anthony S. Fauci, a leading infectious disease expert and the chief medical adviser to the White House, has forcefully argued for broadening eligibility to all younger adults.

Two federal officials said that Dr. Ashish K. Jha, the White House coordinator for the pandemic response, also favors that approach. The discussions were reported earlier by The Washington Post.

In an interview on Monday, Dr. Fauci said there was not enough clinical data to strongly recommend that those under 50 get a second booster shot. But he said many in that age group received their last shot in November or December, so their protection against the virus is waning.

Although it is up to the F.D.A. and the C.D.C. to decide, Dr. Fauci said, “I think there should be flexibility and permissiveness in at least allowing” a second booster for younger adults.

Other federal officials seem more skeptical and anxious to see more data to justify the decision. Some have argued that the administration should be trying harder to persuade Americans to accept the initial round of Covid vaccines, rather than pursuing diminishing benefits with those who are already at least somewhat protected.

There are also concerns that by promoting second boosters for all adults now, the administration could weaken its argument for reformulated booster shots in the fall, when it hopes to offer boosters that better combat the latest versions of the virus. The F.D.A. recently recommended that the vaccines be redesigned to better combat the fast-spreading Omicron variants of BA.4 and BA.5.

The June 30 decision came just two days after the agency’s committee of independent vaccine experts overwhelmingly voted for regulators to pursue more advanced vaccines tailored to forms of Omicron, an acknowledgment that the current shots may no longer be as protective by the time a possible fall or winter surge arrives.

The two most recent Omicron subvariants have driven up rates of hospitalization and death, though both remain far lower than at the height of the winter Omicron wave. The same subvariants have sent hospital admissions climbing in Britain, France, Portugal, Belgium and Israel.

The White House has scheduled a news briefing for Tuesday on the state of the pandemic and the threats posed by the latest Omicron subvariants.

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Annie Karni

WASHINGTON — Senator Chuck Schumer, Democrat of New York and the majority leader, tested positive for the coronavirus on Sunday, forcing him into isolation just as the Senate was set to reconvene on Monday night after a two-week recess, and ahead of one of its last major work periods before the midterm elections.

Senator Richard Blumenthal, Democrat of Connecticut, announced on Monday that he, too, had tested positive and would be working remotely for the week.

And Senator Patrick J. Leahy, Democrat of Vermont, 82, who broke a hip last month in a fall at his home in McLean, Va., was still out recovering from surgery. Mr. Leahy’s spokesman, David Carle, said the senator would be “available for votes this week if necessary.”

Still, the three absences threatened to upend Democrats’ plans for a productive July in the evenly divided Senate, and were the latest reminders that the party’s bare-minimum majority is exceedingly precarious.

Democratic leaders had expected this week to finally confirm Steven M. Dettelbach, President Biden’s nominee to head of the Bureau of Alcohol, Tobacco, Firearms and Explosives, and Ashish Vazirani as a deputy under secretary of defense. They had also planned to vote on the confirmation of Michael S. Barr to serve as the Federal Reserve’s vice chair for supervision.

On Monday, Democrats were in wait-and-see mode all day, assessing whether they would be able to move forward on the confirmations, aides said. With the Senate evenly divided, assuming Republicans are fully in attendance and unanimously opposed, the absences among Democrats would mean they could not muster a majority to confirm any nominee along party lines.

But the nomination of Mr. Dettelbach was supported by two Republicans, Senators Rob Portman of Ohio and Susan Collins of Maine, giving him a potential path to confirmation even with some Democrats absent. Mr. Vazirani’s confirmation was considered uncontroversial, and also garnered some Republican support. And Democratic leaders said Republicans were missing some members as well, which could even out the numbers and allow business to proceed.

“We’ve got a lot of, an extraordinary number of absences — and they do, too,” Senator Richard J. Durbin, Democrat of Illinois, told reporters on Monday, referring to Republicans. “We’ve got to count noses now.”

On Monday night, the Senate said it would proceed with the nominations of Mr. Dettelbach and Mr. Barr on Tuesday after Senators Kevin Cramer of North Dakota, John Kennedy of Louisiana, Lisa Murkowski of Alaska, Jim Risch of Idaho and Ben Sasse of Nebraska, all Republicans, were absent at a vote.

Democrats had seven senators absent at the vote.

Democratic aides said the timing of Mr. Schumer’s bout with the coronavirus, his first since the start of the pandemic, could have been worse. While it made for a halting start after a two-week break, the Senate was not expected to do any substantial legislative work this week, including on Democrats’ tax and domestic spending package, which the party plans to try to revive this week and push through the Senate over Republican opposition.

Still, Monday was supposed to be the start of a five-week burst of activity before the Senate adjourns for its annual summer break in August, and the longest such stretch before the midterm elections in November.

The extended absence of Mr. Leahy, coupled with the coronavirus cases, underscored the fragility of the 50-50 majority in the Senate, where there is always a fear that any of the party’s half-dozen octogenarians could fall ill and suffer a prolonged absence that could imperil or delay Democratic legislation or presidential appointments that have no Republican support.

In February, Senator Ben Ray Luján, 49, Democrat of New Mexico, suffered a stroke. Although he recovered quickly, his illness served as a reminder that Democrats are never more than one sudden illness away from losing their working majority.

And while Covid cases in Congress appeared to have subsided somewhat in recent months, more lawmakers — like many other Americans — have recently been reporting cases as a new variant, the most transmissible yet, rips through the United States.

In the House, Representative Katie Porter, Democrat of California, said on Monday that she had tested positive after being exposed while working in her home state. Speaker Nancy Pelosi has extended proxy voting, which she instituted in the House at the beginning of the pandemic, through Aug. 12, permitting lawmakers to continue to vote remotely.

In the Senate, Democratic aides were eager to play down the significance of the post-recess absences and illnesses, and said business would continue almost as usual.

“Anyone who knows Leader Schumer knows that even if he’s not physically in the Capitol, through virtual meetings and his trademark flip phone, he will continue with his robust schedule and remain in near-constant contact with his colleagues,” his spokesman, Justin Goodman, said in a statement.

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Johnny Diaz

As children around the world stayed home, studied remotely and became more socially isolated during the coronavirus pandemic, they also became less physically active, according to a new review of almost two dozen studies that was published Monday in the medical journal JAMA Pediatrics.

The pandemic led to children’s daily physical activity declining by 20 percent, according to the review, which analyzed the results of 22 studies published in English that compared activity before and during the pandemic.

The review included studies published between January 2020 and January 2022, with a total of more than 14,000 participants under the age of 18 around the world. (It did not include any samples from Africa.)

The studies revealed an average decrease of 17 minutes a day in children’s “moderate-to-vigorous physical activity” during the pandemic.

The decline in physical activity was tied to Covid-19 restrictions that included social distancing, disrupted school schedules and remote learning, as well as an increase in children’s sedentary screen time, researchers said.

“Major outlets for accessing physical activity (sports clubs, swimming pools, gyms, community centers) were closed, canceled, or repeatedly interrupted,” the study stated, adding that school closures meant children were no longer participating in physical education classes, and that many playgrounds and other outdoor play spaces were also closed because of the pandemic.

The analysis found that young children with “consistent access and permission to use outdoor spaces” during the pandemic had better physical activity outcomes than others.

“These children exhibited smaller reductions in moderate-to-vigorous physical activity and were approximately two times more likely to meet physical activity guidelines during Covid-19,” the researchers said.

The review’s findings “underscore the need to provide bolstered access to support and resources related to physical activity to ensure good health and social functioning among children and adolescents during pandemic recovery efforts,” the researchers concluded.

They added that “children’s movement behaviors should be at the forefront of pandemic.”

A decrease in physical activity can affect children’s mental health as well as their physical health, said Dr. Sandro Galea, dean of the Boston University School of Public Health, who was not involved in the review.

“We know that there was an increase in depression in children and adolescents, which in and of itself is likely associated with less physical activity,” he said.

He added that school lockdowns and societal restrictions “all may have had a greater impact on activity of children and adolescents than of adults, given young people’s greater reliance on out-of-the-house places for their physical activity.”

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European Union health agencies recommended on Monday that people ages 60 and older receive a second booster shot of a coronavirus vaccine, as fears rise over mounting cases and hospitalizations across the continent.

The recommendation came days after the World Health Organization said that Europe was at the center of a new virus wave. The European Center for Disease Prevention and Control, which had warned last week that virus infections, hospital admissions and deaths were all expected to rise across Europe, said on Monday that increasing infections among older age groups were already leading to higher rates of severe disease.

Those trends in several countries are “mainly driven by the BA.5 sublineage of Omicron,” said Dr. Andrea Ammon, the E.C.D.C.’s director.

“This signals the start of a new, widespread Covid-19 wave across the European Union,” Dr. Ammon said, adding that giving booster shots to older people and other at-risk groups was necessary to avert a significant number of hospitalizations and deaths.

Although more than half of the countries in Europe’s single market are already administering second booster shots, the uptake remains low and uneven across countries, according to data from the E.C.D.C. The center approves drugs and makes recommendations, but individual European countries set their own policies.

As part of its announcement on Monday, E.U. health authorities also recommended that people with “medical conditions putting them at high risk of severe disease” receive a second booster. The authorities did not immediately respond to requests for comment on Monday clarifying which medical conditions qualified.

In April, they recommended that those ages 80 and older be considered for a second booster, but said it was “too early” to do so for the general population.

On Monday, E.C.D.C. said that those 60 and older, as well as people with at-risk medical conditions, should receive a second booster at least four months after the previous one, “with a focus on people who have received a previous booster more than six months ago.” The agency stopped short of recommending the shots for healthy people younger than 60, citing a lack of clear evidence to justify the move.

With cases rising, Stella Kyriakides, the European Commissioner for Health and Food Safety, said: “I urge everybody to get vaccinated and boosted as quickly as possible. There is no time to lose.”

E.U. health officials said that while only currently authorized vaccines should be used for second boosters, work continues to adapt existing vaccines to fight the Omicron variants driving the new wave of cases.

“We are working toward possible approvals of adapted vaccines in September,” said the European Medicines Agency’s executive director, Emer Cooke, adding that the health authorities were already reviewing data for two adapted vaccines.

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Chris BuckleyAlexandra Stevenson

China’s economic engine has shuddered in recent months, hurt by lockdowns imposed to curb the spread of Covid. Housing sales sagged. Many shops and restaurants in some cities shuttered, some maybe for good. Youth unemployment climbed.

The slowdown has kindled doubts about the viability of China’s stringent strategy of eliminating virtually all Covid-19 infections — whether the cure is becoming worse than the social and economic costs of restrictions. But on a recent visit to Wuhan, the city where the pandemic first took hold, China’s leader, Xi Jinping, said extinguishing Covid remained paramount.

“It would be preferable to have a little temporary impact on economic development, rather than let the physical safety and health of the public suffer,” Mr. Xi said, state media reported. He cited the need to protect older adults as well as children from infection, and warned officials against becoming weary of the grinding two-and-a-half-year war against Covid. “Persistence,” he said, “is victory.”

That elusive victory over Covid has been made harder by the fast-moving Omicron variant — and its subvariant, BA.5, the first domestic cases of which emerged last week in China — that is slipping through the country’s many defenses.

A month after Shanghai lifted its citywide lockdown, fresh Covid cases have emerged there in recent days, prompting officials to order many of the city’s 25 million residents to undergo testing. Anhui Province in eastern China enforced a virtual lockdown on two counties, and neighboring Jiangsu Province, a manufacturing heartland, is scrambling to contain new infections. Xi’an, a city of 13 million, has closed schools and many businesses after a flare-up.

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Like swatting flies with a shovel, China’s Covid strategy can be effective, but also costly and contentious. It entails locking down apartment blocks, neighborhoods or even whole cities for days or weeks to stamp out even handfuls of cases. As a result, Mr. Xi’s insistence on Covid zero, or “dynamic zero” as Beijing calls it, has cast an unsettling shadow over the country’s economic expectations.

The Chinese government is scheduled to release the main economic data for this year’s second quarter on Friday. According to a survey by Bloomberg, economists expect that the Chinese government will report that gross domestic product grew about 1 percent in the second quarter, compared with a year earlier. That’s a big comedown from the 4.8 percent expansion in the first quarter, and is likely to put the government’s 5.5 percent growth goal for all of this year out of reach.

“Uncertainty is the main factor hurting our national economic development,” Yang Weimin, an economist who advises the Chinese government, said in a speech in late June to property developers, citing questions around Covid and pandemic prevention measures. He also pointed to investor wariness after crackdowns on companies accused of abusing their market dominance, flouting regulators or offending official moral codes.

“Uncertainty is the great enemy of action,” Mr. Yang said.

Mr. Xi wants officials to extinguish Covid outbreaks while also shoring up the economy. In Wuhan, he visited a laser equipment plant, hailing the potential of new technologies, and visited a neighborhood that has been promoted as a model of effective Covid controls.

In practice, officials struggle with the diverging demands of Covid controls and economic recovery. The resulting strains are bearing down on China months before a Communist Party congress when Mr. Xi is almost certain to win another five-year term as the party’s leader, consolidating his status as its most powerful leader since Deng Xiaoping and Mao Zedong.

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Beijing has tried to boost confidence among entrepreneurs and consumers so they spend, invest and travel. But local officials, faced with the threat of dismissal for lapses in pandemic controls, often impose additional checks and restrictions on travelers and transport, adding to the disruptions and uncertainty.

“Often, the heads of different departments and companies attend one meeting in the morning about enhancing dynamic zero, and then in the afternoon a meeting about economic growth,” said Wu Qiang, an independent political commentator in Beijing.

“The tensions are within Xi’s own model for governing the country,” he said. “The tensions really arise from him.”

For the past two years, many Chinese people have accepted the Covid restrictions as irksome but necessary. But employees and employers appear increasingly impatient over lockdowns, checks and uncertainties, especially when they have loans, rent and wages to pay.

“The local government said for sure that they would get to zero in half a month, but I reckon half a month won’t be enough,” Wang Yongguan, who makes a living grouting walls, said in a telephone interview from Sixian County in Anhui Province, which went into lockdown. He also worried about the accompanying slump in home sales. “This year won’t be any good. It wasn’t to begin with.”

Policymakers trying to bolster investor confidence also fear they will be accused of undermining Mr. Xi’s policies to clean up companies accused of malfeasance and reckless investment, said Christopher K. Johnson, the president of the China Strategies Group, citing conversations with officials in Beijing.

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“Does the boss really want to relent on some of these crackdowns, or is it temporary?” Mr. Johnson said, referring to Mr. Xi. “There’s a lot of uncertainty.”

China’s stop-start Covid restrictions may continue into next year at least, in part because the government has focused on restrictions and testing over vaccinations. Older adults have a relatively low vaccination rate. The Chinese leadership has so far refused to approve more effective, foreign-developed vaccines — a decision driven by political pride rather than medical considerations, many experts say.

Yet Chinese leaders also worry that a deep slowdown could cause social discontent, an anxiety magnified by the impending party congress. Officials are under particular pressure to contain unemployment, which among urban residents ages 16 to 24 rose to 18.4 percent in May, according to China’s National Bureau of Statistics. More than 10 million college graduates, a record number, are joining the job search this year. Others will take refuge in graduate school.

Even in Beijing, which has avoided a citywide shutdown by imposing only limited restrictions, business can be tough. Wang Jing said his restaurant in an alleyway usually crowded with tourists had lost more than 90 percent of its income in May, when Beijing banned dining in restaurants. The limits eased in early June, but only about a third of business has come back.

“This year is for sure the toughest we’ve had,” he said. “All my waiters have been with me for more than 10 years. They have young and old to take care of, and are waiting for me to issue wages. How could I ever fire them?”

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China has been edging toward some policy compromises. Officials halved the days of quarantine imposed on international travelers and close contacts to try to reduce some of the disruption. Mr. Xi and the premier, Li Keqiang, have also obliquely hinted that annual growth might be lower than the target of 5.5 percent that the government set earlier this year. Some former officials and policy advisers have openly said businesses need more clarity to sustain an economic recovery.

“Our hearts can’t be riding on waves, bobbing up and down. That’s bad for economic growth and social development,” Hu Deping, a former vice chairman of All-China General Chamber of Industry and Commerce, said in a speech to Chinese private business owners in June. “Entrepreneurs will gain confidence only when there are no policy contradictions.”

Even if China is able to contain Covid without putting major cities under lockdowns, the accumulated uncertainty is prompting some companies to rethink their plans.

For Citrosuco, a Brazilian juice maker, business had been going well until Shanghai locked down in April. Its containers of frozen orange juice sat at the city’s port, held up by customs inspectors checking goods for the presence of the virus, said Joshua Lim, a general manager for the company in the city.

Clearing customs and getting the juice shipments to warehouses, which usually takes three or four days, took two weeks, Mr. Lim said. Citrosuco bosses in Brazil began reassessing China’s prospects, he said.

“They are asking questions like, how can we better protect our business?” he said. “If we invest now, what will the payback look like and what other risks will we be blindsided by?”

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Research and reporting were contributed by Joy Dong, Zixu Wang, Li You, Claire Fu and Liu Yi.

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Credit…Emily Elconin for The New York Times

WASHINGTON — Few people understand the power lunch better than Ashok Bajaj. The restaurateur began his career here in the waning days of Ronald Reagan’s presidency, when he opened the Bombay Club a short walk from the White House.

Eight of the 10 restaurants he operates today are, like his first, located downtown. They’re conveniently clustered near one another, making it easier for Mr. Bajaj to preside over multiple dining rooms, and near customers who work on Capitol Hill, at the State Department and in the Eisenhower Executive Office Building — crucial sources of what Mr. Bajaj calls his “lunch crowd.”

Prominent members of that crowd gravitated to the Oval Room, the power-lunch magnet he ran for 26 years — and closed in November 2020. Longtime regulars have resumed eating lunch at his places that are open for it, like Rasika and the Bombay Club. But “it’s nothing like it was before Covid,” he said. “The energy has been sucked out of downtown.”

Of all the headaches the pandemic has caused the restaurant industry, among the most persistent is the disruption of the business of doing business over lunch. It afflicts a specific, influential cohort of restaurateurs who, like Mr. Bajaj, own prestigious restaurants in the hearts of large cities that office workers have fled, along with their corporate expense accounts.

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Continued uncertainty over when or if those workers will return leaves the dining rooms that catered to them without an important revenue stream at a time when the cost of doing business, particularly in dense urban areas, is spiking. At the same time, many of the diners who used to nurture relationships and close deals over midday hamachi crudo and steak frites are now making those connections in front of a computer screen at home while eating salads from takeout boxes.

These economic and behavioral shifts are heightening concerns about the viability of independent restaurants in big cities, where they double as bulwarks against the homogenizing effect of corporate chains. “The Cheesecake Factory Will Open March 30 in Downtown DC and People Are Freaking Out,” blared a headline on the Washingtonian website last year, atop an article reporting the replacement of an award-winning chef-owned restaurant.

In an apparent nod to the new reality, Mr. Bajaj opened a grab-and-go place, Bindaas Bowls and Rolls, downtown in April. Not long ago, a quick-service pit stop would have been unimaginable coming from a restaurateur known for his savoir faire and designer suits.

“It just seemed like the right time for it,” he said. “There are not that many people doing power lunches right now.”

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Credit…T.J. Kirkpatrick for The New York Times

In less-fancy dining rooms across the country, the restaurant lunch is thriving, particularly in the suburban and residential city neighborhoods where many Americans have worked during the pandemic. Total sales at quick-service restaurants have exceeded those at table-service restaurants since the start the pandemic, upending a historical norm, according to the National Restaurant Association. And fast-casual chains have continued opening in cities like Washington and San Francisco.

But a number of independent city restaurants that used to do brisk noontime business are remaining closed for lunch, even as demand for dinner reservations returns. Many operators say rising costs and labor shortages make lower-priced lunch menus near-certain money losers.

Nancy Oakes, who opened Boulevard in the Embarcadero area of San Francisco in 1993, said the return of office workers on staggered schedules — say, three days in the building, two at home — has been too unpredictable to justify hiring and training staff for the midday meal.

“With this hybrid workday, is Wednesday the new Monday, or is Thursday the new Friday?” Ms. Oakes asked. “If I can crack that code, I might have a chance.”

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Most of the high-end restaurants struggling with the shifting economics of lunch are in cities that experienced record job growth in the decade after the Great Recession of 2008, said Hudson Riehle, senior vice president and director of research for the National Restaurant Association. “That economic expansion,” he said, “stimulated the development of more restaurants, in particular independent operations that catered to the city worker crowds.”

Recent numbers, however, don’t augur a quick return to pre-Covid conditions. Some 47 percent of diners who work from home go out to lunch less frequently than they did before the pandemic, according to the restaurant association.

Lunch reservations in the first four months of this year at restaurants with an average check of more than $50 were sharply lower than during the same period in 2019, according to data from the online reservation service OpenTable. They fell in Washington (by 38 percent), New York City (38 percent), San Diego (42 percent), Philadelphia (54 percent) and Chicago (58 percent).

Joel Johnson has noticed the change. The head of government affairs in the Washington office of FGS Global, a strategic communications company, Mr. Johnson, 61, averaged three business lunches a week before the pandemic.

The ritual was so deeply ingrained, he said, that “between 12-ish and 2-ish, no one would schedule a big client meeting. It was understood that people were probably going to lunch. That got torn down during Covid.”

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The downtown lunch business hasn’t come to a complete halt. “Some days are good,” Mr. Bajaj said of his restaurants that are open for lunch, noting that Ketanji Brown Jackson lunched at Rasika, his modern Indian restaurant near the Capitol, soon after being confirmed to the Supreme Court in April.

The chef Eric Ripert said lunch at Le Bernardin, his celebrated French restaurant in Midtown Manhattan where a prix-fixe lunch runs $120, is at “100 percent capacity,” although the same can’t be said of the nearby Aldo Sohm Wine Bar, which he co-owns. Lunch service has not resumed at similarly celebrated and high-priced Manhattan restaurants like Per Se, Eleven Madison Park and Jean-Georges.

Lunch on a Wednesday in June was busy at Higgins, an influential restaurant in downtown Portland, Ore. Greg Higgins, its chef and co-owner, said he had worked hard to attract midday diners — but also benefited from a spate of closings nearby.

“The hotel restaurants are gone,” he said. “We’re one of the only options now.”

The story for suburban restaurants has been nearly the opposite of downtown’s, said Mr. Riehle of the National Restaurant Association.

The Detroit-area businesses run by Samy Eid’s family illustrate the split screen. “We reopened for lunch as soon as we could at Phoenicia,” said Mr. Eid, referring to their traditional Lebanese restaurant in Birmingham, a suburb. “It’s back.”

Leila, in downtown Detroit, is another matter. The Eids opened the modern Lebanese restaurant to critical acclaim in 2019, in large part to take advantage of the demand for lunch at a location about three blocks from the headquarters of Quicken Loans.

“I don’t know if lunch will ever come back to Leila,” Mr. Eid said. “It’s a multimillion-dollar project. To say it makes more sense to keep it dark tells you what you need to know about how crazy things are.”

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In the short time Leila was open for lunch before Covid arrived, Katy Cockrel said she was in the restaurant so often that the staff “joked that I was parked at the bar at noon and would still be there at 3.”

Ms. Cockrel, 37, who is the vice president of communications at StockX, said she treats restaurant dining rooms as daytime work spaces. “People just kind of walk up and chat,” she said. “If I can have that with good food being a part of it, why not?”

The pandemic intensified challenges that had long bedeviled big-city restaurants, many owners say.

Pinched by rising costs and a generational shift in dining habits evidenced by the number of fast-casual chains in downtown San Francisco, Ms. Oakes said she nearly closed Boulevard in 2019. A partner in an investment firm with offices in the same building persuaded her to stay open, and helped with lease negotiations.

“We once had a very busy lunch, 250 people. Even before Covid, we had dropped into the 150s and 160s,” she said. “I was ready to turn in the keys.”

Today, lunch reservations at higher-priced restaurants in San Francisco are actually up 15 percent compared with 2019, according to OpenTable. But in that time, Mitch Rosenthal has closed three of the restaurants he owned there with his brother, Steven. All were near the offices of tech companies like Facebook and Salesforce.

Their remaining restaurant, Town Hall, is in the same neighborhood. (Bjorn Kock is a partner in the restaurant.) It’s busy for dinner but may never reopen for lunch, Mr. Rosenthal said. Lower-priced lunch menus make it nearly impossible to turn a profit in San Francisco, he said.

“I’m paying cooks $25 an hour,” he said. “Do I think they deserve it? Yes I do. Does it mean the restaurant can be profitable? That’s a different story.”

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By the time Marea, an Italian restaurant in Midtown Manhattan, fully reopened for daily lunch in February, its owner, Ahmass Fakahany, noticed the pandemic had changed diners’ demeanor.

The restaurant is known for its Michelin star and affluent customers. Mr. Fakahany, a former co-president of Merrill Lynch, said Marea’s slightly simplified new lunch menu suits the mood of business customers who have already used video conference calls to settle tense matters they once handled in his restaurant. Those diners now look to lunch to deepen relationships.

“I’m seeing a lot more people reconnecting, at a slower pace,” he said. “People used to use the term power lunch. It’s becoming more of a social-impact lunch, after all this time on Zoom.”

Dirk Van Dongen retired as a Washington lobbyist in early 2020 and moved to Florida. He is still connected enough to have experienced what is lost when people no longer meet face to face.

Mr. Van Dongen said he ate most of his lunches and half of his dinners in sit-down restaurants in his more than 50 years in Washington. It’s how he built his business relationships, he said, with people he wanted to work with as well as those who could eventually become adversaries.

“But let’s still get to know each other as people,” he said. “You can only do that when you can look each other in the eye.”

Mr. Bajaj, the Washington restaurateur, still relishes helping to broker such interactions. It’s a reason he opened La Bise, a high-end French restaurant, last summer, in the former Oval Room space.

Mr. Bajaj has yet to open La Bise for lunch. As he waits for the right moment, he has developed a new routine: visiting a local parking garage, hoping to discover it full of cars — a sign of life returning to downtown.

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Sharon OttermanJoseph Goldstein

New York City’s Covid-19 test positivity rate is 15 percent, an intensity not seen since January. Transmission levels of the virus, according to federal guidelines, are high in every borough. Even hospitalizations, while far below previous peaks, are rising again, as the most transmissible Omicron variant yet, BA.5, spreads through the city and nation.

Earlier in the pandemic, such news might have been met with a mix of foreboding and fear. Now, New York is meeting the moment with more of a “meh.” As New York City enters its sixth wave of the virus, few seem inclined to get themselves into high alert mode again.

Not the government. Nor many of the people.

“At this point I am not worried,” said Carla Hernandez, as she and her two children sat on a blanket in the shade of a tree Thursday in a park in the Queens neighborhood of Corona, once the epicenter of the pandemic. “We know there’s a pandemic, but we have to keep moving.”

The city is logging about 3,700 cases per day, though experts estimate the true number of infections is as much as 10 times higher with most people testing at home. More than 1,100 people were hospitalized with Covid in city hospitals as of July 8, the most since February.

Experts are still urging the government to try to reduce transmission, and people to protect themselves. The C.D.C. and the city are recommending the use of high-quality masks whenever indoors in a public setting, as well as in crowded outdoor settings.

Denis Nash, an epidemiologist at the CUNY Graduate School of Public Health, thinks the public has become inured to the numbers, but that it shouldn’t be. “There needs to be a lot more masking, and a lot more higher quality masking,” he said. “In grocery stores, and other public places, it should be the norm at times like this. But I know there’s not the political will, or the will in society, to do it.”

Across the city, many New Yorkers — from the unvaccinated to the boosted — said that neither BA.5’s prevalence nor its worrisome attributes — including its ability to override immunity from past infections and vaccines — had them dramatically rethinking risk.

Omneisia Evans, a substitute teacher who also works as a brow technician and bracelet-maker, said that her anxiety over Covid had gradually been replaced by other fears — about crime, inflation, burnout at work. “I’m hearing about monkeypox now,” said Ms. Evans, 39, who lives in Brooklyn’s East New York neighborhood.

She was glad to relegate Covid to something like the past. “In New York City, at some point, we have to get back.”

That sentiment essentially became official city policy in January when Mayor Eric Adams took office. He rolled back Covid restrictions and some of the public health infrastructure devoted to Covid-19.

About two weeks ago, Mr. Adams dropped the city’s color-coded alert system just as its levels would have hit high again, saying he wanted to recalibrate it. The city is shutting down most of its stand-alone brick-and-mortar Covid testing locations, saying that people prefer home tests anyway. Masks are no longer required at Broadway shows; and even in one of the few places they are required, on the subway, compliance hovers near 50 percent in many cars.

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“In the last month or so the city has moved into a ‘Pandemic? What pandemic?’ phase,” said John Moore, a virologist at Weill Cornell Medicine in Manhattan.

Wilfredo Hernandez, an unvaccinated bricklayer who lives in Bushwick, described his evolution on Covid as going from fear to acceptance to happy forgetfulness as he’s watched neighbors return to normal activities.

“Seeing everything open up, it alleviates stress,” said Mr. Hernandez, 44. “That Covid thing to me, right now it’s out of mind.” He said he had not heard anything about BA.5.

For much of the pandemic, New York was more cautious than most of the nation about reopening and loosening virus restrictions. But as new waves of cases hit with increasing frequency, many New Yorkers came to feel protected enough by vaccines and prior infections — even as some of their more concerned neighbors still wear masks, eat outdoors, and avoid crowded gatherings.

The mayor himself sometimes does not follow his own masking advice, as a glance at his Twitter feed shows. Public warnings about the increasing case numbers have been muted.

The Adams administration hasn’t enforced a private employer mandate that required nearly everyone working in the city to be vaccinated, and it ended the requirement for proof of vaccination to enter bars and restaurants. The city also ended its massive contact tracing program, and stopped offering hotel rooms to people with Covid who needed somewhere to isolate.

Instead, the city has built out a relatively efficient and centralized method for distributing Paxlovid, an antiviral medicine that protects against severe symptoms. Recently it began prescribing Paxlovid at mobile testing sites as well, a first-in-the-nation step that is expected to reduce disparities in terms of who has access to the medication.

The city has also focused on giving out free at-home Covid tests — about 35 million of them to date.

“Our goal is to make sure whatever we put in place is going to stem the infections, keep down our hospitalization, and most importantly, keep down those who die from Covid,” Mayor Adams said on Thursday, summarizing his approach. “When we look at our numbers, we are at a good, stable place.”

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Mr. Nash, the epidemiologist, pointed out that since April, there have been thousands of hospitalizations and almost 700 deaths from Covid in New York City. “That’s a lot of deaths,” he said. “It’s just happening over a longer period — it’s kind of like a slow burn compared to BA.1,” the first Omicron variant.

While the probability of dying from Covid has dropped precipitously, the risk of developing long Covid or cardiovascular disease following infection is another reason to try to avoid Covid infection, health experts say.

“We don’t know enough about the factors that will predict your likelihood of getting long Covid or not,” said Dr. Jay Varma, an epidemiologist who previously worked for City Hall on New York City’s pandemic response. “So effectively every new infection that you get is rolling the dice.”

The city’s approach has been in step with the White House’s, which is also focused on providing wider access to at-home testing and treatment. But soon, New York City may move away from the C.D.C.’s warning system criteria: It is considering making it even harder for Covid hospitalizations to trigger a higher alert level.

A city official told The New York Times that the Adams administration is focused on monitoring the number of people who are hospitalized “because of” Covid, rather than those who are hospitalized “with” Covid, and the first figure could be central to determining triggers for a new alert system. The idea is that someone hospitalized for a car accident, who then incidentally tests positive on arrival, is less of an indication of a wave’s severity than someone hospitalized for severe Covid symptoms.

But experts, and the city’s own Department of Health, say that there is no clear-cut definition to distinguish the two categories. Some cases are easy to categorize, as with a person with a broken arm who tests positive for Covid with no symptoms. But others — such as a patient with heart failure, which could have been worsened by Covid — are not.

“It’s difficult to sort out,” said Dr. Bruce Farber, the chief of infectious diseases at Northwell Health, the state’s largest health system.

All Covid cases in the hospital still require isolation and other measures that strain hospital resources, putting the onus on the exhausted health care system to deal with the outcomes of transmission unchecked by other measures. That too has come to feel normal.

“I think we all know that the public is not interested in masking,” Dr. Farber said. “They’re not terribly interested in boosters. They’re not terribly interested in vaccinating their children. That’s very disappointing to somebody in public health, and I think it’s somewhat foolish, but nevertheless, it’s a fact of life. And so you just deal.”

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Wafaa el-Sadr, an epidemiologist at Columbia Mailman School of Health, said that in some ways, it is not surprising the public is less concerned. For many people who had Covid, it wasn’t as bad as they feared. Few people know anyone hospitalized for Covid anymore. And treatments are available for those who do get sick.

As the old goal posts of stopping the virus through herd immunity and vaccination vanish, public health experts are struggling to recalibrate their messaging and policies for this new stage of the pandemic. Now, their job is to somehow convince people to take precautions against a virus they are no longer deathly afraid of catching.

The government should remind people that there are still some people who can get very sick, Dr. el-Sadr said. They could also focus on the risk of long Covid, and the inconvenience of getting ill for days.

“Don’t throw away the mask, keep the mask with you because you have to be nimble,” she said, of the sort of message she wished she was hearing more of. “You have to be adept at measuring the situation around you.”

Nate Schweber, Emma G. Fitzsimmons and Michael Gold contributed reporting.

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