Covid-19: Governor of Michigan, Battling Virus Surge, Again Calls for More Vaccine Supplies

With her state fighting a huge coronavirus surge, Gov. Gretchen Whitmer of Michigan renewed her appeal to the Biden administration on Sunday to send the state much larger supplies of vaccine, an idea that the White House has rebuffed.

Michigan has recently become a major Covid hot spot in the United States. Average daily reports of new cases have risen sevenfold since a low point in February, and nine of the 10 U.S. metropolitan areas with the most new cases per capita lately are in Michigan. Hospitals are filling up.

Governor Whitmer said on the CBS program “Face the Nation” on Sunday that the White House should reconsider its refusal to alter its distribution plan — currently based strictly on population — so that localities that face flare-ups could get extra doses.

“When there’s a surge, we think that it’s important to rush in to meet where that need is,” she said. “Because what’s happening in Michigan today could be what’s happening in other states tomorrow, and so it’s on all of us to recognize that if we can squash where we’re seeing hot spots, it’s in everyone’s best interest.”

The Biden administration has promised to send Michigan extra resources to increase testing and to help the state administer its vaccine allotment faster. But Jeff Zients, the White House Covid coordinator, said on Friday that sending Michigan more than its current share of doses was not on the table.

“There are tens of millions of people across the country, in each and every state and county, who have not yet been vaccinated, and the fair and equitable way to distribute the vaccine is based on the adult population by state, tribe and territory,” Mr. Zients told reporters at a news briefing.

As vaccine supplies increase and states rapidly expand access, some, like Mississippi, are struggling to give out their allotment of doses, with large segments of their population hesitant to be vaccinated. Larry Brilliant, an epidemiologist, said that if states have extra doses they should be redistributed to wherever they’re needed most, like Michigan right now.

“It’s very hard to rationalize excess vaccine in places that neither want it nor will use it and not sending it to places that desperately need it,” said Dr. Brilliant, who was part of the effort to eradicate smallpox in the 1970s.

Michigan has used 76 percent of its allotted doses so far, about average for the nation but well behind the most efficient states, like New Hampshire (92 percent) and Wisconsin (89 percent), according to a New York Times tracker. About 34 percent of Michigan’s population has received at least one dose so far, and 22 percent are fully vaccinated; both figures are close to the national average.

Ms. Whitmer said she was pleased with the new administration’s pandemic strategy over all, but that she would continue to argue for extra vaccine supplies for hot spots. “It’s important to recognize where there might need to be some adjustments along the way,” she said.

Michigan still has a statewide mask mandate and capacity limits on restaurants and other businesses, measures that many other states have relaxed. But pandemic restrictions have been significant political flash points in the state, and Ms. Whitmer has not indicated that she will try to tighten them as a response to the latest surge.

Instead, she has called for a voluntary two-week pause of in-person schooling and indoor dining to help slow the virus’s spread.

“We have variants, a big presence of variants here in Michigan that are easier to catch,” she said on Sunday, referring mainly to the more contagious B.1.1.7 variant of the virus that was initially identified in Britain. “And people are tired, and they’re moving around more.”

Times Square had its highest pedestrian traffic of the year. Major hotels in Miami were booked three-quarters or more full. And pools at Las Vegas resorts were filled to their limit of 50 percent capacity.

Easter weekend saw a resurgence of tourist activity in some U.S. cities, suggesting what could be a turning point for the tourism industry as Covid-19 vaccinations pick up and more businesses reopen across the country.

Data from the Transportation Security Administration this weekend shows that travel is still relatively high. The country averaged more than 1.5 million travelers on Thursday and Friday, and dropped slightly to nearly 1.4 million travelers on Saturday, similar to the numbers from Easter weekend. There have been similar bursts throughout March and April as travel has steadily increased, most likely in part because of spring break travel among younger Americans.

The Centers for Disease Control and Prevention said this month that Americans who are fully vaccinated against Covid-19 can safely travel at home and abroad, as long as they take basic precautions like wearing masks. Dr. Anthony S. Fauci, the nation’s leading infectious disease expert, said the risk would only get lower as more travelers got vaccinated.

“It is a risk to fly, but it’s a small risk,” he told CNN last week. “The more infection you get in the community, the greater the risk. So, if we get more and more people vaccinated, by the time we get to the summer, the risk of flying will be even less than it is now.”

Before Easter weekend, the recovery in tourism had been “very regionalized,” with places like Florida and Texas doing well while cities that depend more on large meetings and conventions, like Chicago, continue to struggle, said Chip Rogers, the president of the American Hotel & Lodging Association, the trade organization for the hospitality industry.

Now, Mr. Rogers said, there’s reason for “cautious optimism,” and signs in several cities point to leisure travel picking up.

In New York, the Times Square Alliance, which tracks activity in the area, counted about 150,000 pedestrians a day over the holiday weekend, up 394 percent from last year, though still far from prepandemic numbers.

Though the weekend of Easter is, historically, the second-slowest weekend in Las Vegas, this year was different because of March Madness, the annual N.C.A.A. basketball tournaments. “On Saturday, all of our venues were filled by 10 a.m. because of Final Four,” said Derek Stevens, who owns three hotels in the city. “I think that was the case throughout all of Las Vegas.”

In Miami, where warm weather and comparatively looser Covid-19 regulations have drawn tourists for months, the period from March 28 to April 3 brought the city “its highest occupancy level since the start of the pandemic, with most hotels reporting upward of 75 percent occupancy levels,” said Suzie Sponder, a spokeswoman for the Greater Miami Convention and Visitors Bureau. That’s only a 6.6 percent drop compared with the same weekend in 2019.

Carl Bergstrom, a biology professor at the University of Washington, said he was not too concerned that Easter travel would bring a surge in cases like the one after Thanksgiving and the holiday season, which he said had been caused more by social gatherings than travel itself. While Dr. Bergstrom said he hoped people would “hold off the riskiest behavior for a few more months,” he said it was more important to encourage people to travel safely than not at all.

As the U.S. supply of Covid-19 vaccines continues to grow and states plan to meet or beat President Biden’s April 19 deadline for expanding eligibility to all adults, some states have begun dropping one of the last barriers to vaccine access: residency rules.

New Hampshire and Oklahoma are the latest states to announce they will open up vaccine eligibility to nonresidents. Experts hope that more will soon follow suit as the production and distribution of vaccines ramps up.

The United States is giving out about 3.1 million shots a day, an increase from roughly two million in early March. The push remains urgent as dangerous variants of the coronavirus circulate and the country reports a sharp rise in new cases, with an average of almost 68,000 a day over the past week, according to a New York Times database.

In New Hampshire, Gov. Chris Sununu, a Republican, said on Wednesday that officials were confident that there would be enough shots to vaccinate out-of-state residents by April 19, the deadline Mr. Biden set for universal adult eligibility, which all 50 states, Washington, D.C., and Puerto Rico have said they will meet. Mr. Sununu said New Hampshire was “well ahead” of that deadline after making all state residents 16 or older eligible for a vaccine on April 2.

The change came after Mr. Sununu faced criticism from students and Democratic lawmakers for not allowing out-of-state college students to get vaccinated in New Hampshire. He said this month that residents had to “come first” and that college students were at lower risk compared with older people.

In addition to college students, moves like the one in New Hampshire make it easier to vaccinate other people with floating residency statuses, such as those who commute to work across state lines, said Dr. Peter Hotez, a vaccine scientist at the National School of Tropical Medicine at Baylor College of Medicine.

This is especially relevant for places like Kansas City, Mo. — which sits on the edge of Missouri and borders Kansas — or metropolitan areas like New York, Philadelphia or Chicago whose suburbs stretch well into neighboring states. Dr. Hotez said he expected, and hoped, that more states would lift these restrictions soon.

“As we have more vaccine supply, I think we need to liberalize restrictions as much as possible,” he said, adding: “Remember how this works. The virus does not recognize state boundaries.”

About 49 percent of New Hampshire’s population of about 1.4 million has received at least one shot, the highest portion out of any state, according to a New York Times vaccine tracker.

Oklahoma began allowing nonresidents to get vaccinated in the state on Thursday, nearly two weeks after it expanded eligibility to all in-state residents 16 or older.

About 35 percent of Oklahoma’s population has received at least one shot.

More than half of the states and the District of Columbia still have residency requirements for vaccination, although most allow exceptions for workers employed in that state who live in another, according to a vaccine tracker from the Kaiser Family Foundation, a nonprofit organization focused on national health issues.

Jennifer Kates, a senior vice president of the Kaiser Family Foundation, said more states were likely to open vaccines to all.

Australia has given up on the goal of vaccinating its entire population against Covid-19 by the end of the year, following updated advice from health officials that younger people should not receive the AstraZeneca vaccine, as well as delays in the delivery of doses.

The Australian government said last week that it had accepted a recommendation by a panel of health experts that people under 50 receive the Pfizer-BioNTech vaccine instead of the one developed by AstraZeneca, which had been the centerpiece of Australia’s vaccination program. The change in guidance came after European regulators found links between the AstraZeneca vaccine and rare blood clots, prompting several countries to restrict use of the shot.

Prime Minister Scott Morrison said Friday that the government had ordered another 20 million doses of the Pfizer vaccine, doubling what it had already purchased. But they are not expected to be available until the fourth quarter of this year, dealing a blow to the government’s previously stated goal of inoculating all of its 25 million people by then.

Mr. Morrison appeared to acknowledge the change in timeline in a Facebook post on Sunday.

“The government has also not set, nor has any plans to set any new targets for completing first doses,” Mr. Morrison said. “While we would like to see these doses completed before the end of the year, it is not possible to set such targets given the many uncertainties involved.”

Public health experts have criticized Mr. Morrison’s government for relying too heavily on the AstraZeneca vaccine, a relatively cheap and easy-to-use shot but one whose troubles have jeopardized inoculation efforts in multiple countries. They said the setback to Australia’s vaccination program risked undermining the country’s success in containing the spread of the coronavirus since recording its first case in January 2020.

“We’re in a position a year later where that hard-won success is jeopardized by a completely incompetent approach to a vaccine rollout,” said Bill Bowtell, a public health policy expert and adjunct professor at the University of New South Wales in Sydney.

Australia has made four separate agreements for the supply of Covid-19 vaccines that would give it a total of 170 million doses, enough to inoculate its population more than three times over. Plans to manufacture almost all of its 54 million AstraZeneca doses domestically were approved last month.

But the Australian government has been under fire for weeks over the sluggish pace of its vaccination rollout, which began in late February. By the end of March, when the government had aimed to vaccinate four million people, only about 600,000 had actually been inoculated. As of Sunday, Australia had administered fewer than 1.2 million doses.

Australian officials have attributed the slow rollout to delays in the delivery of millions of vaccine doses manufactured in the European Union, which has curbed exports amid its own supply shortages. The export restrictions mainly affect the AstraZeneca vaccine.

After enduring strict lockdowns for much of the past year, Australians are now enjoying relatively normal life in a country that has all but stamped out the virus. But public health experts warn that until more of the population is vaccinated, those freedoms are precarious.

“Having eliminated Covid, they thought a mass vaccination campaign would lock that in,” Mr. Bowtell said of the Australian public. “Now they are being deeply disillusioned.”

A monoclonal antibody cocktail developed by the drug maker Regeneron offered strong protection against Covid-19 when given to people living with someone infected with the coronavirus, according to clinical trial results announced on Monday. The drug, if authorized, could offer another line of defense against the disease for people who are not protected by vaccination.

The findings are the latest evidence that such lab-made drugs not only prevent the worst outcomes of the disease when given early enough, but also help prevent people from getting sick in the first place.

Using the cumbersome drugs preventively on a large scale won’t be necessary: Vaccines are sufficient for the vast majority of people and are increasingly available.

Still, antibody drugs like Regeneron’s could give doctors a new way to protect high-risk people who haven’t been inoculated or who may not respond well to vaccination, such as those taking drugs that weaken their immune system. That could be an important tool as rising coronavirus cases and dangerous virus variants threaten to outpace vaccinations.

Regeneron said in a news release that it would ask the Food and Drug Administration to expand the drug’s emergency authorization — currently for high-risk people who already have Covid but are not hospitalized — to allow it to be given for preventive purposes in “appropriate populations.”

There’s “a very substantial number of people” in the United States and globally who could be a good fit to receive these drugs for preventive purposes, said Dr. Myron Cohen, a University of North Carolina researcher who leads monoclonal antibody efforts for the Covid Prevention Network, a National Institutes of Health-sponsored initiative that helped to oversee the trial.

“Not everyone’s going to take a vaccine, no matter what we do, and not everyone’s going to respond to a vaccine,” Dr. Cohen said.

Regeneron’s new data come from a clinical trial that enrolled more than 1,500 people who lived in the same household as someone who had tested positive for the virus within four days. Those who got an injection of Regeneron’s drug were 81 percent less likely to get sick with Covid compared to volunteers who got a placebo.

Dr. Rajesh Gandhi, an infectious diseases physician at Massachusetts General Hospital who was an investigator for the study, said the data were “promising” for people who have not yet been vaccinated. (An earlier version of this item incorrectly said that Dr. Gandhi was not involved in the study.)

Even so, he said, the study did not enroll the type of patients that would be needed to assess whether the drug should be used preventively for immunocompromised patients. “I would say we don’t yet know that,” Dr. Gandhi said.

Regeneron’s cocktail, a combination of two drugs designed to mimic the antibodies generated naturally when the immune system fends off the virus, got a publicity boost last fall when it was given to President Donald J. Trump after he got sick with Covid.

The treatment received emergency authorization in November. Doctors are using it, as well as another antibody cocktail from Eli Lilly, for high-risk Covid patients.

But use of the antibody drugs has been slowed not by a shortage of doses, but by other challenges, though access has improved in recent months. Many patients don’t know to ask for the drugs or where to find them.

Many hospitals and clinics have not made the treatments a priority because they have been time-consuming and difficult to administer, in large part because they must be given via intravenous infusion. Regeneron plans to ask the F.D.A. to allow its drug to be given via an injection, as it was administered in the results of the study announced on Monday, which would allow it to be given more quickly and easily.

Secretary of State Antony J. Blinken on Sunday criticized the Chinese government for a lack of transparency during the pandemic, particularly during “the early stages of Covid,” and he called for a more thorough investigation of the origins of the coronavirus.

A report of a joint inquiry by the World Health Organization and China published last month did not conclusively establish how or when the virus began spreading, and did little to allay Western concerns that the Chinese Communist Party bent the investigation to its advantage. Mr. Blinken, echoing those concerns, called on Beijing to make “a real commitment to transparency, to information sharing, to access for experts.”

“I think China knows that in the early stages of Covid, it didn’t do what it needed to do,” Mr. Blinken said in an appearance on NBC’s “Meet the Press.” “One result of that failure is that the virus got out of hand faster and with, I think, much more egregious results than it might otherwise.”

Mr. Blinken urged more investigation.

“We need to get to the bottom of this,” he said of the virus’s origins. “We need to do that precisely so we fully understand what happened, in order to have the best shot possible preventing it from happening again.”

The secretary of state’s remarks offered a more diplomatic approach than that of Trump administration officials who have sought to blame China for the spread of Covid-19 in the U.S., often fanning the flames of xenophobia in their public campaign to shirk responsibility for a poor response to the pandemic. Mr. Blinken’s comments, however, illustrated the Biden administration’s willingness to convey skepticism of the official narrative coming from Beijing.

Mr. Blinken’s predecessor, Mike Pompeo, had asserted with little evidence months into the pandemic the notion that the coronavirus originated in a research laboratory in Wuhan, China. He had pressed American spy agencies to hunt for evidence to support the unsubstantiated theory, but most agencies remain skeptical that conclusive evidence of a link to a lab can be found.

Days before the W.H.O. released the report, the former director of the Centers for Disease Control and Prevention during the Trump administration also speculated that the virus originated in a lab in China. The former official, Dr. Robert Redfield, offered no evidence and emphasized that it was his opinion.

The international W.H.O. team of experts who investigated the origins of the virus in China dismissed the lab theory in their report as “extremely unlikely.” But Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director general, took the unexpected step of publicly raising doubts, saying that the theory required further investigation and that he was ready to deploy more experts to do so.

The Chinese foreign ministry and state news media have rejected criticism from the White House and others that Beijing had not been transparent during the W.H.O. inquiry.

“The Chinese side offered necessary facilitation for the team’s work, fully demonstrating its openness, transparency and responsible attitude,” a representative for the foreign ministry said in a statement last month. “To politicize this issue will only severely hinder global cooperation in study of origins, jeopardize anti-pandemic cooperation, and cost more lives.”

Gov. Greg Abbott of Texas may have been overly optimistic on Sunday when he said on Fox News that his state could be “very close” to herd immunity — the point where so much of the population is immune to Covid-19, either from being vaccinated or previously infected, that the virus can no longer spread.

“When you look at the senior population, for example, more than 70 percent of our seniors have received a vaccine shot, more than 50 percent of those who are 50 to 65 have received a vaccine shot,” Mr. Abbott, a Republican, told Chris Wallace. Mr. Wallace had asked why statewide infection, hospitalization and death rates were more under control than in other states, in spite of Texas reopening many activities and eliminating mask mandates.

The governor added, “I don’t know what herd immunity is, but when you add that to the people who have immunity, it looks like it could be very close to herd immunity.”

Michael Osterholm, an epidemiologist and director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said, “There is no way on God’s green earth that Texas is anywhere even close to herd immunity.”

He added: “Look no further than Michigan and Minnesota, which have much higher rates of vaccination than Texas. And we’re already seeing widespread transmission.”

About 19 percent of people in Texas are fully vaccinated, while Michigan has 22 percent and Minnesota has 24 percent.

Estimates of what it would take to reach herd immunity have edged up since the pandemic began, ranging from requiring immunity in 60 percent to more than 90 percent of the population to halt transmission.

No one is sure what the level should be, Dr. Osterholm said. “Anybody who will tell you exactly what the level of herd immunity is, is also likely to want to sell you a bridge.”

He predicted that within a few weeks or a month, Texas and other parts of the southern and western United States would see cases rising the way they are now in the Upper Midwest and Northeast.

A major factor in the relentless spread of the coronavirus is the increasing proportion of cases caused by the virus variant first identified in Britain and known as B.1.1.7, which is more contagious than the form of the virus that first emerged.

That variant “surely resets the meter” and makes herd immunity harder to achieve, Dr. Osterholm said. Additional variants could further complicate the forecast.

“These variants are game changers,” he said. “They really are. It’s really remarkable.”

A senior Chinese official said that the country’s vaccines may need to be administered in greater doses or in concert with other shots because of their low overall effectiveness.

The comments on Saturday by Gao Fu, the director of China’s disease control center, suggest that China and more than 60 countries that have approved Chinese vaccines could need to adjust their distribution programs. The widespread distribution of Chinese vaccines means that any changes could potentially affect hundreds of millions of people or more.

Possible steps to increase the effectiveness of Chinese vaccines include changing the amount of vaccine given, the number of shots, the time between shots or the type of vaccines given, Mr. Gao said.

He also praised the possibilities offered by messenger RNA. That technology is used in the Moderna and Pfizer-BioNTech vaccines but not in any of the vaccines thus far approved in China.

In an interview on Sunday with the Communist Party-run Global Times newspaper, Mr. Gao said his earlier comments had been misunderstood, and that discussion of how to improve the effectiveness of vaccines should be a universal question.

“The protection rates of all vaccines in the world are sometimes high, and sometimes low,” he said. “How to improve their efficacy is a question that needs to be considered by scientists around the world.”

Officials in Brazil said in January that the efficacy rate for the CoronaVac vaccine from the Beijing-based company Sinovac was just over 50 percent, which is the threshold that the World Health Organization has said would make a vaccine effective for general use. By comparison, Moderna and Pfizer-BioNTech were found to be 90 percent effective in real-world conditions, researchers said last month.

Last month, the distributor in the United Arab Emirates of vaccines from China’s Sinopharm said it was offering a third dose in addition to the standard two-dose regimen for a “very small number” of people who were “not really responsive” to the vaccine.

It has been an exhausting season for America’s mayors. Many are ready to step away.

Mayors are hands-on officials in the best of times, barraged with criticism and individual pleas for help. Over the past year, they found themselves weighing matters of life or death — devastating local businesses by prolonging shutdowns, canceling gatherings treasured by voters, unable to provide comfort by being there in person.

And this spring, many American mayors are explaining their decision to leave office with the same reason: that the pandemic response demanded so much that they could not both campaign and perform their duties; or that the work had become so stressful that their families had recommended that they step away.

“They are just spent,” said Katharine Lusk, executive director of Boston University’s Initiative on Cities, which conducts an annual survey of mayors. Those who were surveyed over the summer expressed deep anxiety about the effects of lost tax revenue on their budgets, as they juggled the pandemic, economic recovery and their core responsibilities.

The positive aspects of the job, Ms. Lusk said, had been stripped away.

“They will tell you it’s the most personal job in politics,” she said. “If you can’t interact with the community, all of the things that sort of fuel mayors — the inputs that build up that reservoir of energy — that aspect of the job has been taken from them.”

There is little national data on local elections, so it is impossible to say whether this year’s turnover of mayors is unusual. In Massachusetts, nearly a fifth of the state’s mayors have announced they will not run again, as reported by CommonWealth, a politics journal. That is not unusual, according to the Massachusetts Municipal Association.

Thomas M. McGee, a Democrat, ran for mayor of Lynn, Mass., in 2016, after 22 years in the State Legislature. But nothing, he said, prepared him for the intensity of being a mayor last year.

“After 27 years and this, in some ways, lost year,” he said, “my family was like: ‘You’re stressed. It’s really had a substantial impact on you. And we’ll support you 100 percent whatever you want to do. But we think you should consider making a step back.’”

Decisions to step down are rarely made for one reason, and the year has increased pressure on leaders on many fronts, including conflicts over policing and racial justice. Among those who have offered an explanation, however, fatigue because of the pandemic comes up a lot.

Mayor Grover C. Robinson IV, of Pensacola, Fla., said he decided not to run out of frustration with the politicized reaction to health directives, after returning from a vacation and attending yet another contentious meeting. Similar explanations have come from the mayors of Highland, Ill., Pascagoula, Miss., and Seattle, among others.

The pandemic has created a frenzied demand for suburban homes, driven partly by city dwellers seeking more space as remote work and virtual schooling stretch into a second year. But for some longtime suburbanites, the rush from urban areas has created an opening to be seized.

With the housing market offering a chance to sell suburban homes for a tidy profit, they’re listing their houses and moving into apartments in the city — reversing the urban exodus trend.

John Pham is an insurance strategist who also runs a popular personal finance blog, The Money Ninja. When the pandemic hit, he owned a three-bedroom home in Lawrence, Mass., and realized that he should take his own financial advice.

“I felt like it was a good time to sell high in suburbia and buy low in Boston,” he said.

Mr. Pham, 39, was a bachelor in 2008 when he bought his house, but in 2018 he met and married Maryna Stasenko, 35, a fashion blogger originally from Ukraine. She was eager to move into a more urban setting, and Mr. Pham, who has been working from home for the past year, was in no hurry to return to his hour-plus commute into downtown.

“As a busy late-30s professional, you just have less free time to mow the lawn and stain the deck,” he said.

The couple put their house on the market in October for $280,000. Within a week, they had 16 offers, including an all-cash buyer who offered $320,000 with no contingencies. They accepted, and in February moved into a 1,300-square-foot condo in Boston with skyline and harbor views.

The city is still hushed because of the pandemic, but they are hopeful that by summer its restaurants, museums and attractions will spring back to life.

Thad Wong, a founder of the Chicago brokerage @properties, predicts that for some buyers who left cities during the pandemic, the coming years will bring an acute sense of buyer’s remorse.

“I don’t believe people will be working from home forever,” he said. “And if you’re a creative person who wants to be around ideas happening, and you thrive on that energy, you’re dying in the suburbs.”

New York will no longer require international travelers arriving in the state to quarantine though it continues to recommend they do so, according to new guidance released by the Health Department.

The change was intended to bring the state in line with travel recommendations issued earlier this month by the Centers for Disease Control and Prevention.

In that guidance for international and domestic travel, the C.D.C. said that people fully vaccinated against the coronavirus could travel safely “at low risk to themselves” but should still follow health precautions in public such as wearing masks. Federal health officials also said that they preferred all people avoid travel while the threat of the virus remained so high in the United States. The C.D.C. also cited a lack of vaccine coverage in other countries, and concern about the potential introduction and spread of new variants of the virus that are more prevalent overseas.

The C.D.C. requires all international travelers arriving in the United States to show proof of a recent negative test result before boarding their flights. When fully vaccinated Americans travel abroad, they only need to get a coronavirus test or quarantine if the country they are going to requires it. However, the guidance says they must have a negative coronavirus test before boarding a flight back to the United States, and they should get tested again three to five days after their return.

New York State health officials said in their guidance, released Saturday, that they still recommend all international travelers get tested three to five days after arriving in the state.

They also suggested that unvaccinated travelers should self-quarantine for as many as 10 days and avoid people at risk of serious illness from the virus for two weeks.

The new international guidance came after the state also ended its requirement that domestic travelers to New York quarantine upon arrival. At the time, Gov. Andrew M. Cuomo traced the decision to the pace of vaccinations and a decline in virus figures across the state, though the state was adding new cases at a higher rate than the country as a whole.

As of Sunday, the state’s average daily positivity test rate over the previous week was at 3.27 percent. Virus-related hospitalizations were at 4,083, their lowest number since Dec. 2, according to Mr. Cuomo’s office.

According to a New York Times database, New York State is adding new virus cases at the fifth-highest rate in the country. As of Sunday, the state was reporting an average of 37 new virus cases a day for every 100,000 residents over the last week. The nation as a whole was averaging 21 new cases per 100,000 people.