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Maybe it was only a matter of time.

Dr. Anthony S. Fauci, President Biden’s top medical adviser for the coronavirus pandemic, has tested positive for Covid-19 and is experiencing “mild symptoms,” the National Institute of Allergy and Infectious Diseases said Wednesday.

Dr. Fauci, the institute’s director, took a rapid antigen test in the morning, the agency said in a statement. It added that he is fully vaccinated against the virus and has been boosted twice.

The statement said Dr. Fauci, 81, has not recently been in close contact with President Biden or other senior government officials, and would “isolate and continue to work from his home.” H will return to his office once he tests negative, according to the statement.

Along with other top federal health officials, Dr. Fauci was expected to testify on Thursday before the Senate Health Committee on the state of the pandemic; it was not immediately clear whether he would still do so.

Dr. Fauci, one of the world’s foremost infectious disease specialists, has spent 50 years in government and has advised seven presidents, beginning with Ronald Reagan, on epidemic and pandemic threats. He became a political lightning rod after publicly urging public health precautions like mask-wearing and social distancing.

Perhaps more than anyone, he knows how infectious the coronavirus is. Earlier this spring, he decided against attending the White House Correspondents Dinner — a gathering of prominent political and media figures that featured an appearance by the president — “because of my individual assessment of my personal risk,” he said then. At the time, Dr. Fauci was preparing for other public engagements, including at least one commencement speech.

The correspondents’ dinner, which drew more than 2,000 guests to a packed hotel ballroom, ended up spreading the virus among many journalists and other attendees.

The shift from commuting caused by the pandemic left empty seats on the once-packed trains and buses bringing commuters from New Jersey to New York City. But those crowded conditions will return and may worsen over the next decade as the region’s population grows and more employers call workers back to their offices, a new study concluded.

Even if working from home quadruples from prepandemic levels, there still would be more commuters piling onto trains and buses to get across the Hudson River from New Jersey on some weekdays than in 2019, according to the study, scheduled to be released on Wednesday by the Regional Plan Association.

The study comes at a pivotal moment for the long-delayed plan to add a rail tunnel under the Hudson — the crucial element of a sprawling, $30 billion project that has gained momentum and political support but still needs state and federal funding.

The researchers found that future crowding would likely be worst on Tuesdays, Wednesdays and Thursdays — the days workers are most likely to be expected in the office, the study said. On those days, there could be as many as 46,000 more cross-Hudson transit riders by 2030 than there were in 2019, an increase of more than 10 percent.

For a transit network that already was overcrowded and prone to breakdowns and delays, that could pose problems. More than 400,000 commuters crossed the Hudson on trains and buses each weekday in 2019, many of them standing shoulder-to-shoulder in the aisles as they arrived at Pennsylvania Station and the Port Authority Bus Terminal.

Back then, transit executives and elected officials were rallying support for construction of a second rail tunnel between New Jersey and Penn Station to supplement the existing pair of single-track tubes that were built more than 110 years ago. Part of a $30 billion project known as Gateway, the $12.3 billion tunnel would improve reliability and help meet the need for additional capacity, officials said.

But just as political support for Gateway was building, Covid drove away most of those commuters. Ridership plunged as people stayed home, leaving only the most essential workers continuing to commute. Seats began to fill again as the pandemic ebbed, but ridership is still far below 2019 levels.

The sustained drop in the flow of commuters raised the question of whether Gateway would still be necessary, said Thomas K. Wright, the chief executive of the Regional Plan Association, which has been a strong supporter of the project. But the study, which plotted four scenarios for the pace of growth in the region, found that the crush of commuters will soon return, Mr. Wright said.

“Even with a slow return to offices and modest job growth, we will need the additional capacity that Gateway will bring,” Mr. Wright said.

The digging of the tunnel has not begun and is not expected to be completed for another decade. The project’s funding, which will likely be split between the federal government and the states of New York and New Jersey, still needs to be worked out.

The project has broad support among elected officials from the region. But Republicans from other parts of the country have opposed a large federal investment in it and stopped the project from progressing during the Trump administration.

It has also faced criticism for its staggering estimated price tag, concerns about the potential for huge cost overruns and doubts about its necessity beyond the pandemic. Forecasting commuting patterns in and around big cities after the pandemic is a complicated task, said Richard Florida, a professor at the University of Toronto’s School of Cities.

“The central business district is the last relic of the old industrial age,” Mr. Florida said. “The office district where you pack and stack knowledge workers and they plug in their laptops, I think that’s a thing of the past.”

Mr. Wright said it was urgent for the states to reach an agreement they can present to the federal Department of Transportation before the midterm elections, when Democrats appear likely to cede control of Congress. “Starting in January of next year, it could be much more difficult in terms of working with the federal government on this thing,” Mr. Wright said.

Stephen Sigmund, a spokesman for the Gateway project, welcomed the report’s findings. “For two years, some have questioned whether Gateway is as urgently needed post-Covid,” he said. “This report shows the answer is yes.”

Regardless of its past advocacy for Gateway, Mr. Wright said that if his organization’s analysis concluded that the tunnel would not be needed soon, he would say so. “We stand by the integrity of our research,” he said.

The analysts estimated that regular commuters to Manhattan were working from home only about one day a month, on average, before the pandemic. They calculated the long-term effects on trans-Hudson commuting if they continued to work from home about twice a month, or even once a week, on average.

They tested those scenarios against both robust and slow rates of growth for the region’s population and employment. In all cases, they found that overall demand for seats on trains and buses crossing the Hudson would exceed pre-pandemic levels by 2050, if not sooner.

In all but the slow-growth, most-work-from-home scenario, that new high level of demand would arrive by 2040, several years after Gateway is scheduled to be completed, their analysis found. If the regional economy grows as fast as in recent decades, additional capacity could be needed even before Gateway could be completed, especially in the middle of the workweek, they concluded.

Commuting patterns are sure to change, Mr. Florida said, but with traffic on city streets already having returned to pre-pandemic levels, lots of people will ride transit into cities for other work and leisure purposes, such as attending shows and sporting events.

“It seems to me the long-term issue is if you’re going to run a region of 20 to 25 million people, the car isn’t going to work,” Mr. Florida said. “I’m not sure that the Gateway tunnel will even solve it.”

This summer, the World Professional Association for Transgender Health, an international group of health care professionals, plans to release an update to its guidelines for giving care. The guidelines include a chapter on adolescents that is already generating heat from across the political spectrum.

In the decade since the last update, two intersecting forces have transformed the field of transgender health care for preteens and teens. The first is a large rise in the number of teenagers openly identifying as transgender and seeking care. The second is a right-wing backlash in the United States against allowing medical transitions for minors. I spent months reporting about this transformation for a New York Times Magazine cover story that was published online this morning.

As Scott Leibowitz, a child and adolescent psychiatrist who co-led the working group that wrote the adolescent chapter, told me, “Our world, the world of gender care, has exploded.”

The debate

Not surprisingly, there is a sharp divide among those who support gender-affirming care — the approach major American medical organizations have adopted for embracing children and teenagers who come out as transgender — and those who oppose medical treatments for minors, including medications that suppress puberty and hormones that change secondary-sex characteristics.

But there is also a divide among gender-affirming providers. It doesn’t break down along transgender-cisgender lines — both groups express a range of perspectives. The debate starts with how to evaluate kids who want these treatments.

The research

For transgender adults, the benefits of medical transition are well established and the rate of regret is low. Two studies also show positive long-term results for people who transitioned as teenagers. In 2011, researchers in Amsterdam found a “decrease in behavioral and emotional problems over time” among 70 young patients who received puberty suppressants. Follow-up research showed that five years after going on to hormone treatments as teenagers, the 55 patients who remained in the study had the same or better levels of well-being as a control group of cisgender people their age. None regretted their treatment.

All the young people in the study had a childhood history of gender incongruence and went through a comprehensive diagnostic assessment, to establish the psychological and social context of their gender identity and how it might intersect with other mental-health conditions. That helped prompt Leibowitz and his co-authors to recommend a comprehensive diagnostic assessment (as well as parental consent and other criteria) as they updated the international care guidelines.

Other gender-affirming providers, however, argue that the purpose of an assessment is not to determine the basis of a kid’s gender identity. “People are who they say they are,” said Colt St. Amand, a clinical psychologist and family-medicine physician at the Mayo Clinic. “So I am less concerned with certainty around identity and more concerned with hearing the person’s embodiment goals. Do you want to have a deep voice? Do you want to have breasts?”

The rise

Underlying the debate about assessments is the question of why the number of teenagers in the U.S. who identify as transgender has nearly doubled in recent years.

The authors of the adolescent chapter in the World Professional Association for Transgender Health’s Standards of Care said that the increased visibility of trans people in entertainment and the media had played a major — and positive — role in reducing stigma and helping many kids express themselves in ways they might have previously kept buried. But they also wrote about the role of “social influence,” absorbed online or peer to peer. During adolescence, the chapter recognizes, peers and culture often affect how kids see themselves and who they want to be.

Some transgender advocates think that bringing up social influence in the context of trans identity is beyond the pale. It “defies reason” to say that “enormous numbers of cisgender-privileged youth are magically transformed by mere social media exposure” to the “most mortally at-risk minority class,” the group International Transgender Health, which includes health care professionals, wrote when a draft of the care standards was released in December.

The politics

The backdrop for these debates is a right-wing effort to ban gender-related medical treatment for minors. So far, bans have passed in Arkansas, Arizona, and Alabama and have been proposed this year in about a dozen other states. As with other fraught issues like abortion, America is becoming a split screen. In red states, gender-related care for young people is already rare yet faces legal threats. At clinics that are mostly in progressive metropolitan areas, meanwhile, it’s not clear how common comprehensive assessments are. Some families are bewildered by a landscape in which there are no labels for distinguishing one type of therapeutic care from another.

For my Times Magazine story, I interviewed more than 60 clinicians and other experts as well as about two dozen young people seeking care and a similar number of parents. As is often the case in medicine, the question is how to apply existing research for the growing numbers of patients — in this case, teenagers — lining up for care. The intrusion of politics into science makes that more difficult.

THE LATEST NEWS

Election Night

• Tom Rice, a South Carolina Republican who voted to impeach Donald Trump over the Jan. 6 attack, lost his primary to a Trump-endorsed state legislator.

• In another South Carolina district, Representative Nancy Mace, who criticized Trump but didn’t support impeaching him, beat a Trump-backed challenger.

• In a sign of Republican gains with Latino voters, Mayra Flores, a daughter of Mexican immigrants, flipped a Democratic-held House seat in a Texas special election.

• In Nevada, which will be a battleground in November, Trump loyalists prevailed in the Republican primaries, including Adam Laxalt (for senator), Jim Marchant (for secretary of state), and Joe Lombardo (for governor).

• Herschel Walker, a Republican Senate candidate from Georgia and a critic of absentee fathers, publicly acknowledged having a son he doesn’t see.

• Here are yesterday’s results.

The Economy

• President Biden is considering rolling back some tariffs on Chinese goods to slow rising prices. The effect would probably be small, but there aren’t many other options.

• The Bitcoin crash is shaking the ecosystem around cryptocurrency: Coinbase, the largest U.S. crypto exchange, announced layoffs.

War in Ukraine

The fix is in

Social media stars are teaching followers to flip their furniture — a trend that is perhaps no surprise after a period when many people downloaded TikTok to fend off the boredom of being stuck on the couch.

“Flipping,” in this sense, means finding a well-built but aging piece of furniture, refurbishing it — often by sanding, adding fresh paint or varnish and updating its hardware — and reselling it. Many of the people making videos also aim to help viewers improve the furniture already in their homes.

“So many people can’t afford to spend thousands of dollars on furniture,” Christina Clericuzio, a flipper from Connecticut, told The Times. “So it’s fun to show people that they can have these things for less when they D.I.Y.”

PLAY, WATCH, EAT

What to Cook

And here’s today’s Wordle. After, use our bot to get better.

Thanks for spending part of your morning with The Times. See you tomorrow.

P.S. The Times newsroom toasted Dean Baquet yesterday, his last day as executive editor. Bon voyage, Dean!

Adam Laxalt, a former Nevada attorney general, has won the state’s Republican primary for Senate and will face Senator Catherine Cortez Masto, a Democrat, in what is likely to be a highly competitive November general election.

Mr. Laxalt’s victory over Sam Brown, a retired Army captain, was declared by The Associated Press. He and Ms. Cortez Masto, who is seen as one of Democrats’ most vulnerable incumbents, will now prepare for a costly monthslong clash as Republicans try to take back control of the Senate.

A co-chair of the 2020 Trump campaign in Nevada, Mr. Laxalt was endorsed by both former President Donald J. Trump and Gov. Ron DeSantis of Florida, two of the most popular figures in the Republican Party.

Following Mr. Trump’s cue, Mr. Laxalt has promoted baseless claims of fraud in the 2020 election, and he began laying detailed groundwork to fight election fraud in his own race this year, months before any votes were cast.

The endorsements were a cornerstone of Mr. Laxalt’s campaign, with both national leaders visiting the state to rally for him and recording television commercials on his behalf. Mr. Laxalt also received a boost from the Club for Growth, an influential conservative anti-tax group, whose political action committee spent nearly $1 million.

The Republican primary race had intensified in recent months between Mr. Laxalt and Mr. Brown, who drew significant support from some local Republican groups as he criticized his rival’s Washington connections and portrayed himself as the “outsider” who could bring change to the Capitol.

Now a small-businessman, Mr. Brown earned a Purple Heart after being seriously injured in Afghanistan and still bears the scars on his face.

Mr. Laxalt, a grandson of Paul Laxalt, a former senator from the state, and son of Pete Domenici, a former senator from New Mexico, has also embraced the set of conspiratorial beliefs known as replacement theory, telling supporters in campaign appearances that “the left” wants to transform the country by allowing immigrants to enter the country illegally.

Mr. Laxalt has simultaneously courted Latino voters, who are expected to be pivotal in the November election.

Ms. Cortez Masto has already spent roughly $13.5 million on the race, according to AdImpact, which tracks ad spending. She has blanketed the airwaves with television ads in English and Spanish to highlight her work to deliver pandemic aid to the state.

The race has also attracted heavy outside spending. Somos PAC, which focuses on Latino voters, has spent $2.8 million to defend Ms. Cortez Masto, the first Latina elected to the Senate, and to portray Mr. Laxalt as “not for us” in advertisements in English and Spanish.

WASHINGTON — Since Election Day in 2020, Donald J. Trump and his close allies have raised more than $390 million through aggressive fund-raising solicitations promising bold political actions, including fighting to overturn his re-election campaign defeat, helping allied candidates win their own campaigns and fighting “to save America from Joe Biden and the radical left.”

In reality, though, campaign finance filings show that much of the money spent by political committees affiliated with Mr. Trump went toward paying off his 2020 campaign expenses and bolstering his political operation in anticipation of an expected 2024 presidential run. As of a few months ago, $144 million remained in the bank.

The House committee investigating the Jan. 6 attack on the Capitol is suggesting that there might be criminal exposure in one particular strain of Mr. Trump’s misleading fund-raising appeals — those urging his supporters to donate to efforts to overturn his loss in the 2020 election.

In a hearing on Monday, the panel highlighted fund-raising solicitations sent by Mr. Trump’s campaign committees in the weeks after the election, seeking donations for an “Official Election Defense Fund” that the Trump team claimed would be used to fight what they asserted without evidence was rampant voter fraud favoring candidate Joseph R. Biden Jr.

“The select committee discovered no such fund existed,” a committee investigator said in a video shown at the hearing. It cast the fund as a marketing gimmick being used to bilk Mr. Trump’s supporters.

It was an especially cynical endeavor, according to the committee, because Mr. Trump and his allies knew his claims of a stolen election were false. Yet they continued using fund-raising appeals to spread that falsehood, and to raise money that the committee suggested was paid to Mr. Trump’s business, and groups run by his allies.

Representative Zoe Lofgren, a California Democrat who led the committee’s presentation on Mr. Trump’s fund-raising, suggested that his allies continued their futile legal challenges to the election because they needed to justify their fund-raising.

After the hearing, she suggested that the Justice Department should assess whether it was a crime for Mr. Trump to have “intentionally misled his donors, asked them to donate to a fund that didn’t exist and used the money raised for something other than what he said.”

Liz Harrington, a spokeswoman for Mr. Trump, brushed aside the Jan. 6 panel’s findings, saying in a statement that “no one is more committed to fixing our elections” than the former president, “and our political spending is totally synchronized with that goal.”

Campaign finance experts expressed mixed opinions about the prospects of any potential prosecution.

While misleading fund-raising claims are something of a staple of modern politics, the Justice Department in recent years has charged a number of operators of so-called scam-PACs — political committees that raise money mostly to pay the consultants operating them. Those groups were typically not associated with candidates, let alone a former president.

The experts said that any investigation of Mr. Trump’s fund-raising would likely target his aides, not the former president himself.

And they pointed out that the Trump Make America Great Again Committee, the campaign committee that sent out most of the solicitations for the election defense fund, transferred funds to the Republican National Committee, which spent money on legal fights related to the 2020 election.

“In contrast with some of these other scam PAC prosecutions — where effectively none of the money raised went toward satisfying donor intent — Trump might argue that a portion of the funds raised in the postelection period went toward litigation, and an additional portion went toward future ‘election integrity’ efforts,” said Brendan Fischer, a campaign finance expert at the watchdog group Documented.

“It would certainly be novel for the Justice Department to pursue a fraud case against a former president’s PAC, but Trump’s fraudulent postelection fund-raising was novel, too,” Mr. Fischer said, adding that the amount Mr. Trump’s team had raised after the election was “entirely unprecedented.”

Stephen Spaulding, an official at the good government group Common Cause who advised Ms. Lofgren on election law issues in 2020, said the Justice Department should examine whether the misleading fund-raising “crossed the line into wire fraud.”

The Jan. 6 panel’s video on the subject asserted that “the claims that the election was stolen were so successful, President Trump and his allies raised $250 million.”

It was not entirely clear how the committee arrived at the $250 million figure. It roughly corresponds to the amount of money Mr. Trump’s campaign committees and the R.N.C. raised in the more than eight weeks following the Nov. 3 election, according to campaign finance filings from WinRed, the digital platform Republicans use to process online donations.

But Mr. Trump’s campaign committees sent out hundreds of solicitations in that frenzied period, many of which did not reference the election defense fund. And there is no public data showing how much money any given fund-raising solicitation yielded.

The Jan. 6 panel has subpoenaed records from Salesforce.com, a vendor that helped the Trump campaign and the R.N.C. send emails, which could provide some visibility into the amounts raised by individual fund-raising solicitations.

The New York Times’ analysis of Mr. Trump’s fund-raising in the 19 months since the election relies on data filed with the Federal Election Commission by WinRed and other groups to assess the totals collected by eight committees. They include Mr. Trump’s three campaign committees, one of which was converted to a political action committee, as well as three super PACs run by close allies of Mr. Trump and a PAC Mr. Trump started after the election, called Save America, which has become the primary hub of his ongoing political operations. The analysis does not include the R.N.C.

On Monday, the Jan. 6 panel noted that, instead of funding election-related litigation, “most of the money raised” after the election was transferred to Save America. The PAC “made millions of dollars of contributions to pro-Trump organizations,” the committee said, including more than $200,000 to Trump hotel properties and $1 million each to America First Policy Institute and the Conservative Partnership Institute, nonprofit groups started and run partly by former officials in Mr. Trump’s administration.

Both of those groups include initiatives that support stricter voting rules that generally align with Mr. Trump’s unsubstantiated claims about voter fraud in the 2020 election.

America First Policy Institute, which was started last year to serve as a think tank for Trump adherents, has the look of a Trump administration in waiting. It has also paid to hold events with Mr. Trump at his private clubs, including Mar-a-Lago, in South Florida, and Bedminster, in New Jersey.

Of the $98 million received by Save America, about $4 million had been donated to allied candidates, PACs and party committees through the end of April.

Ms. Lofgren, in an interview with CNN after the hearing, asserted that the Trump fund-raising effort was a “grift,” citing the compensation received by Kimberly Guilfoyle, who helped lead fund-raising efforts for Mr. Trump’s campaign and postelection political committees, for remarks she gave introducing her fiancé, Donald Trump Jr., at the Jan. 6 Trump rally that preceded the attack on the Capitol.

According to an invoice viewed by The Times, $60,000 was paid for “Keynote speeches by Kimberly Guilfoyle and Donald Trump Jr.” by Turning Point Action, a nonprofit group that has backed Mr. Trump, but is not among those run by Mr. Trump’s close associates and is not included in the Times’ analysis of his fund-raising.

A person familiar with Donald Trump Jr.’s deposition to the panel said the former president’s son indicated that the money had gone to Ms. Guilfoyle, and that he had received none of it.

Recent fund-raising solicitations from Mr. Trump’s political operation have often relied on appeals to support Mr. Trump, without promising any specific spending target, such as one sent on Tuesday by Donald Trump Jr. asking supporters to donate to help celebrate his father’s birthday.

Luke Broadwater contributed reporting. Andrew Fischer and Bea Malsky contributed research.

As Gov. Kathy Hochul seeks a full term as New York’s first female governor, she has moved quickly to secure the backing of nearly every major New York Democrat. One surprising holdout: Mayor Eric Adams.

That will change on Wednesday, when the mayor plans to announce his support for Ms. Hochul at a rally in Manhattan — a significant last-minute endorsement that could help her firm up support among New York City voters in the June 28 Democratic primary.

In a statement shared with The New York Times, Mr. Adams said that he and the governor had quickly found “we shared the same priorities” of improving public safety and access to child care and housing, while making New York more affordable for working people.

“Since then, Governor Hochul has been a true partner, working on behalf of everyday New Yorkers — and it’s yielded real results,” he said. “I look forward to continuing that work for years to come with Governor Hochul and collaborating to lift this city and state to new heights.”

The endorsement will serve to tighten an unlikely political alliance between Mr. Adams and Ms. Hochul, two centrist Democrats from starkly different backgrounds who have nonetheless cast their lots together.

But how much of a difference the 11th-hour support will make with voters is likely to depend on whether Mr. Adams, an aggressive messenger, chooses to fully engage the political network that won him the mayoralty last year and actively campaign for Ms. Hochul in the waning stretch of the race.

The two Democrats planned to start with a rally Wednesday morning in Manhattan with three powerful unions: Local 32BJ of the Service Employees International Union, the Hotel and Gaming Trades Council and District Council 37, New York City’s largest municipal union.

Ms. Hochul, a Buffalo native who only took office last summer, has had no trouble winning over New York’s muscular political establishment, labor unions and donor class. That money and party support alone is likely to ensure her victory this month in the primary, in which polls show her leading fellow Democrats Representative Thomas R. Suozzi and Jumaane D. Williams, the New York City public advocate, by healthy margins.

But the governor has struggled to make inroads and generate enthusiasm among Black voters in Brooklyn and Queens and Latino voters in Brooklyn, Queens and the Bronx, who sent Mr. Adams to office and have long formed the base of winning Democratic coalitions statewide. Tepid support there could complicate her chances of winning a general election in November, when Republicans believe they have their best shot at claiming a statewide office in New York in more than a decade.

Republicans plan to try to tap into fears about crime that have grown in cities across the state since the onset of the coronavirus pandemic. As a former police officer who has made combating crime the hallmark of his administration so far, Mr. Adams could also prove an important voice defending the governor, if he chooses.

The governor said in a statement that she and Mr. Adams were “united” on fighting against gun violence, improving public safety and restarting the city’s sluggish economy.

“We are committed to building a new chapter in our state’s history that’s focused on teamwork, collaboration and progress over politics,” Ms. Hochul said.

Ms. Hochul clearly still has political work to do, though, including with some local leaders. She notably so far has not secured an endorsement from Letitia James, the New York attorney general, another politically popular Black leader from Brooklyn who briefly ran her own campaign for governor.

Mr. Adams himself waited to back Ms. Hochul until after the conclusion of the annual legislative session in Albany, a move that may have helped increase his leverage with the governor in negotiations over mayoral control of New York City schools, state support for New York City public housing and an expansion of the city’s speed cameras program.

He may still be seeking further leverage.

As recently as Monday, Mr. Adams asked Ms. Hochul to veto a bill passed in the final days of session imposing a two-year ban on new cryptocurrency mining permits. The governor has not publicly indicated whether she will sign or veto the bill, but she is also under intense pressure from environmental advocates to sign it.

Publicly, Mr. Adams and Ms. Hochul have taken pains to project an amicable partnership, a marked contrast with their predecessors, Bill de Blasio and Andrew M. Cuomo, who spent the better part of eight years at war. Ms. Hochul spoke at Mr. Adams’s election night victory party last fall; she publicly supported mayoral control of New York City schools; and ultimately included in the state budget some changes to the state’s bail laws pushed by Mr. Adams.

But beneath the surface, there have been currents of discontent from the mayor, who believes that Ms. Hochul could have pushed harder for his priorities in negotiations in Albany, according to people familiar with his thinking.

There are also signs that Mr. Adams’s own support may be less persuasive than it once was.

Recent polls have shown that both Mr. Adams and Ms. Hochul are struggling to maintain popularity amid fears about elevated crime, painful inflation and a job market in New York that is lagging behind the national average.

A recent poll by Spectrum News NY1 and Siena College found that only about a third of New York City residents believe the city and state are on the right track, and 70 percent said they felt less safe since the pandemic. Residents gave Mr. Adams and Ms. Hochul only middling approval ratings.

The mayor’s decision will be a disappointment to Mr. Suozzi, a Long Island centrist who had hoped that his past support for Mr. Adams might lead to a reciprocal endorsement or at least a pledge of neutrality as he tries to oust Ms. Hochul in the Democratic primary. Mr. Suozzi chose one of Mr. Adams’s former deputies, Diana Reyna, as his running mate and has campaigned on a tough-on-crime platform that mirrors the mayor’s.

“I still consider Eric Adams a brother, but if he wants to stop surging crime in New York City he will need a new governor in Albany who will fix bail reform,” Mr. Suozzi said after the endorsement on Tuesday. “I will.”

Mr. Adams has also maintained a friendly relationship with Mr. Williams, a fellow Brooklynite who is challenging Ms. Hochul from the left.

The intensive care unit is full. A patient coded early in the morning, and my pager alerts me that an older man is intubated in the emergency department and a woman with cystic fibrosis is coughing up blood. There is so much sickness that I am almost too busy to notice what once would have been a remarkable fact: I am not taking care of a single patient with the coronavirus.

In many ways, my hospital is back to normal. Families can enter once again, though still with limited visiting hours. There is no more talk of canceling elective procedures. The cafeteria salad bar has returned. We still wear masks, but I do not obsessively check the seal of my N95. Though this virus is not gone, I am no longer scared.

But I find myself wondering whether we should expect more. At the height of the pandemic, as we watched the vulnerable die, we made promises that when this ended, so much would be different. And yet here in the hospital, we seem to have settled into a new kind of normal, one characterized by limited staffing and medication shortages and an erosion of the family presence that we once embraced. So yes, I am not taking care of a single patient with the coronavirus. But is that as good as it gets?

If you had asked me a year ago, I would have told you that the restrictions on visitors would be a thing of the past by now. In that previously unimaginable reality where we would hold phones to patients’ ears so that their families could say goodbye, I was certain that as soon as this virus was no longer a mortal threat, we would throw open the doors and bring family right back in again. But even though the doors are open, it’s not the same.

In the I.C.U., we still have visitor restrictions. Families can arrive, two people at a time, at 11 in the morning and leave at 8 in the evening. This means that they are rarely a part of rounds or present at the bedside late into the night. Though these rules are intended to avoid the spread of the virus, I suspect they have lingered despite falling rates of Covid transmission because we have grown used to hospital life without visitors. I noticed this shift in myself recently, when I cared for a patient whose wife and daughter sat at his bedside for nine hours straight each day. Unfamiliar with such intense family presence, I found myself a bit on guard, on edge, even, suddenly aware of being observed.

But as I grew used to providing the family with bedside updates, I realized that this was what our care once was and should be again. This family’s daily presence helped them to realize that their loved one was not going to get better and, ultimately, to make the decision to take him off the ventilator, knowing that he would die. Before we began the process, my patient’s wife asked me a question. She wanted to know whether she would be able to stay late if visiting hours ended and her husband had not died yet. She thought there was a chance that we would say no. Though we reassured her that we would make an exception and any number of family members could be there, her question reverberated. Is this our new hospital normal, a world where it would be acceptable for us to say no?

Perhaps it is. The doctors who are finishing residency now have completed most of their training in a world without robust family presence. They learned to become doctors to patients who are intubated and under deep sedation, behind closed doors, in a world of masks and alongside the fear that if they are not careful, their patients could make them sick.

Back in my own training, we used deep sedation and paralyzing medications infrequently, as we knew that these decisions came with a cost: delirium, long-term brain dysfunction, profound weakness. But today’s doctors in training have learned on Covid patients. When we were uncertain what to do, particularly early on, we reflexively jumped to deep sedation as the answer for them. These are patterns that are hard to unlearn.

And beneath it all is the continued specter of the virus. Though I did not have a single patient with Covid-19 during my recent weeks in the unit, from time to time, we would receive a message alerting us that one of our patients had a Covid exposure from a staff member who had tested positive and would have to be on precautions as a result. Patients and families were once terrified by this news, but now they are largely used to it and seem reassured that the staff members are masked and so any meaningful exposure is unlikely. This is another aspect of our new reality.

To think that a possible Covid exposure would not cause panic is itself a sign of great progress. But at the same time, we are so far from where we thought we might be by now. When I walked through the halls of the Covid intensive care unit back in the spring of 2020, I told myself, as did so many of us in health care, that we would improve care for those who were disproportionately affected by this virus. The systems to which we had become accustomed would be dismantled, and we would find ourselves somewhere better.

But those sorts of promises are naïve and empty without a plan for how to make and sustain real change to protect the vulnerable among us. So here I am, back in the unit, caring for a patient with severe cerebral palsy who had aspirated his own secretions and developed a life-threatening pneumonia. His aging parents had done the best they could, despite limited resources, making sure to turn their adult son on his side multiple times a day to help him cough, but his muscles were too weak. And now he would require a tracheotomy tube for the rest of his life. I know, after talking to his parents, that it is possible that their adult son will not go home, that they will not be able to afford the kinds of services he needs. When and if another virus comes, the son they cared for at home for three decades might be living in precisely the kind of nursing facility that will be decimated by it. It’s easy to feel that the tragedy only repeats.

But then again, in just a few weeks, some newly minted doctors begin their internships. Medicine is strange like that, a new generation every three years, and with it a chance for reinvention. They will find themselves in a hospital in transition, in a country that has suffered more than a million deaths. We will teach them about all of it, about how to manage sepsis and heart failure and trauma, about the pandemic and how it was before. And for a moment, maybe, we can step back and see it all through their eyes — the nervousness and the excitement and, more than anything, the hope for what is to come.