Latin America Is Among Regions Most in Need of Vaccines, W.H.O. Says

Eight of the 10 countries with the highest rate of Covid deaths per capita are in Latin America and the Caribbean. Catch up on pandemic news.,

Last Updated June 10, 2021, 1:31 a.m. ETJune 10, 2021, 1:31 a.m. ET

President Biden could announce a plan to distribute 500 million Pfizer-BioNTech doses as early as Thursday. A man has been charged in the theft of hundreds of blank vaccination cards in Los Angeles.

A funeral home employee sanitized coffins in Buenos Aires, Argentina, in early May.
A funeral home employee sanitized coffins in Buenos Aires, Argentina, in early May.Credit…Juan Ignacio Roncoroni/EPA, via Shutterstock

RIO DE JANEIRO — Officials at the World Health Organization on Wednesday repeated their calls for the world’s governments to accelerate plans to distribute coronavirus vaccines to hard-hit nations, warning that many countries in Latin America continue to see rising caseloads.

“Across our region, this year has been worse than last year,” said Dr. Carissa F. Etienne, the director of the Pan American Health Organization, which is part of the World Health Organization. “In many places infections are higher now than at any point in this pandemic.”

The comments came as President Biden prepared to announce that his administration will buy 500 million doses of the Pfizer-BioNTech vaccine and donate them among about 100 countries over the next year, according to people familiar with the plan. Mr. Biden could announce the arrangement as early as Thursday, as he begins his first trip abroad as president.

It is not yet clear which countries the 500 million vaccine doses would be supplied to, but Latin America is among the regions where the need is urgent. Eight of the 10 countries with the highest rate of Covid deaths per capita rate are in Latin America and the Caribbean, according to the Center for Systems Science and Engineering at Johns Hopkins University.

And even as hospitals in Argentina, Chile, Uruguay and other nations where the virus continues to spread aggressively have created overflow facilities, health care systems in several nations in the region are struggling to cope, Dr. Etienne said during the W.H.O.’s virtual news conference on Wednesday morning.

“Despite the doubling or even the tripling of hospital beds throughout the region, I.C.U. beds are full, oxygen is running low and health workers are overwhelmed,” she said.

Most governments in Latin America are struggling to acquire enough doses to quickly inoculate their people, which will delay their ability to fully reopen economies, officials said.

Last week, Mr. Biden said the United States would distribute 25 million doses this month to countries in the Caribbean and Latin America; South and Southeast Asia; Africa; and the Palestinian territories, Gaza and the West Bank. Those doses are the first of 80 million that Mr. Biden pledged to send abroad by the end of June.

Dr. Etienne said that only a more equitable distribution system would put an end to the pandemic in the foreseeable future.

“Today we’re seeing the emergence of two worlds, one quickly returning to normal and another where recovery remains a distant future,” Dr. Etienne said. “Unfortunately, vaccine supply is concentrated in a few nations while most of the world waits for doses to trickle down.”

She singled out the vaccine shortage in Central America, home to more than 44 million people, where just over two million have been inoculated. Fewer than three million people have been vaccinated in nations in the Caribbean, which has a population of just over 34 million.

President Biden and the first lady, Jill Biden, on Wednesday, shortly before the president's first trip abroad.
President Biden and the first lady, Jill Biden, on Wednesday, shortly before the president’s first trip abroad.Credit…Tom Brenner for The New York Times

WASHINGTON — President Biden, under pressure to aggressively address the global coronavirus vaccine shortage, will announce as early as Thursday that his administration will buy 500 million doses of the Pfizer-BioNTech vaccine and donate them among about 100 countries over the next year, according to people familiar with the plan.

The White House reached the deal just in time for Mr. Biden’s eight-day European trip, which is his first opportunity to reassert the United States as a world leader and restore relations that were badly frayed by President Donald J. Trump.

“We have to end Covid-19, not just at home, which we’re doing, but everywhere,” Mr. Biden told American troops after landing at R.A.F. Mildenhall in Suffolk, England. “There’s no wall high enough to keep us safe from this pandemic or the next biological threat we face, and there will be others. It requires coordinated multilateral action.”

People familiar with the Pfizer deal said the United States would pay for the doses at a “not for profit” price. The first 200 million doses will be distributed by the end of this year, followed by 300 million by next June, they said. The doses will be distributed through Covax, the international vaccine-sharing initiative.

Mr. Biden is in Europe for a week to attend the NATO and Group of 7 summits and to meet with President Vladimir V. Putin of Russia in Geneva. He is likely to use the trip to call on other nations to step up vaccine distribution.

In a statement on Wednesday, Jeffrey D. Zients, the White House official in charge of devising a global vaccination strategy, said Mr. Biden would “rally the world’s democracies around solving this crisis globally, with America leading the way to create the arsenal of vaccines that will be critical in our global fight against Covid-19.”

The 500 million doses still fall far short of the 11 billion the World Health Organization estimates are needed to vaccinate the world, but significantly exceed what the United States has committed to share so far. Other nations have been pleading with the United States to give up some of its abundant vaccine supplies. Less than 1 percent of people are fully vaccinated in a number of African countries, compared with 42 percent in the United States and the United Kingdom.

Advocates for global health welcomed the news, but reiterated their stance that it is not enough to simply give vaccine away. They say the Biden administration must create the conditions for other countries to manufacture vaccines on their own, including transferring the technology to make the doses.

The nearly empty parking lot of a drive-through vaccination site in Forest, Miss., on Wednesday. In states like Mississippi, Alabama and Louisiana, fewer than half of adults have had even a single shot of a Covid vaccine.
The nearly empty parking lot of a drive-through vaccination site in Forest, Miss., on Wednesday. In states like Mississippi, Alabama and Louisiana, fewer than half of adults have had even a single shot of a Covid vaccine.Credit…Elijah Baylis for The New York Times

NASHVILLE — Public health departments have held vaccine clinics at churches. They have organized rides to clinics. Gone door to door. Even offered a spin around a NASCAR track for anyone willing to get a shot.

Still, the United States’ vaccination campaign is sputtering, especially in the South, where there are far more doses than people who will take them.

As reports of new Covid-19 cases and deaths nationwide plummet and many Americans venture out mask-free, experts fear the virus could eventually surge again in states like Alabama, Louisiana and Mississippi, where fewer than half of adults have had a first shot.

“I don’t think people appreciate that if we let up on the vaccine efforts, we could be right back where we started,” said Dr. Jeanne Marrazzo, the director of the Division of Infectious Diseases at the University of Alabama at Birmingham.

A range of theories exist about why the South, which as of Wednesday was home to eight of the 10 states with the lowest vaccination rates, lags behind: hesitancy from conservative white people, concerns among some Black residents, longstanding challenges when it comes to health care access and transportation.

The answer, interviews across the region revealed, was all of the above.

“There’s no magic bullet. There’s no perfect solution,” said Dr. W. Mark Horne, president of the Mississippi State Medical Association.

Time is of the essence, both to prevent new infections and to use the doses already distributed to states. Coronavirus variants are spreading, especially the highly transmissible and increasingly prevalent Delta variant, first detected in India. And millions of Johnson & Johnson vaccine doses will expire nationwide this month, prompting some governors to issue urgent pleas that health providers use them soon.

From rural Appalachia to cities like Memphis and Birmingham, the slowdown has forced officials to refine their pitches to residents. Among the latest offerings: mobile clinics, Facebook Live forums and free soccer tickets for those who get vaccinated.

The bar at a Los Angeles members-only club, Risky Business, in late May. Members must prove full vaccination with their original vaccination cards and sign a risk release form, with penalties for lying.
The bar at a Los Angeles members-only club, Risky Business, in late May. Members must prove full vaccination with their original vaccination cards and sign a risk release form, with penalties for lying.Credit…Patrick T. Fallon/Agence France-Presse — Getty Images

Vaccinated Californians will be able to go mask-free in indoor stores, bars, restaurants, movie theaters and many other places as part of the state’s grand reopening next Tuesday, officials announced on Wednesday.

The new rules are aligned with federal guidance, meaning that face coverings will still be required on public transportation, and in taxis, hospitals, prisons and homeless shelters. Masks will also be required indoors at K-12 schools, child care facilities and other places where there may be a large number of children who haven’t been vaccinated.

Unvaccinated people will remain subject to rules to wear masks indoors, though the state, as throughout the pandemic, is maintaining a light touch with enforcement and is not requiring business operators to verify whether patrons are vaccinated.

The shift on masks for the vaccinated will coincide with the much-anticipated lifting of remaining business capacity restrictions in California, where life has been at least partially locked down for some 15 months.

In March of 2020, the state embarked on what was then a massive, unprecedented experiment in controlling the spread of the deadly, highly contagious and at that time newly emerged virus. All 40 million Californians were ordered to stay at home as much as possible.

Since then, Californians have weathered some of the most terrifying Covid surges in the nation — including a winter during which hospitals across huge swaths of the state were overwhelmed — and have endured a roller coaster of lockdowns and reopenings as virus cases have skyrocketed and receded.

The impact of the lockdowns on businesses has helped fuel an effort to recall Gov. Gavin Newsom. In November he apologized for visiting a restaurant with guests from outside his household in violation of the health restrictions he had urged others to take.

Now, residents are navigating the at-times bumpy return to life unfettered by complex rules and a constant fear that the state’s hard-won progress in controlling the virus’s spread could reverse once again.

As of Wednesday, approximately 54 percent of Californians were fully vaccinated, and 12 percent had received one dose, according to state figures. Dr. Mark Ghaly, California’s secretary of health and human services, said on Wednesday that while state officials were working to vaccinate as many Californians as possible, they were confident that the reopening on Tuesday would be safe.

“We are tracking well,” he said.

Vaccination cards are free for those who receive at least one dose of a Covid vaccine, but because people can use them to qualify for eased masking rules in some bars, restaurants and other venues, an underground market for them has sprung up.
Vaccination cards are free for those who receive at least one dose of a Covid vaccine, but because people can use them to qualify for eased masking rules in some bars, restaurants and other venues, an underground market for them has sprung up.Credit…Lucy Nicholson/Reuters

A Nevada man accused of stealing more than 500 blank Covid-19 vaccine cards from the Los Angeles vaccination site where he worked was charged on Wednesday with one felony count of grand theft, according to the Los Angeles County District Attorney’s office.

The man, Muhammad Rauf Ahmed, 46 of Las Vegas, had been arrested in April, but the charge was delayed as the police and prosecutors sought to determine the value of the cards, which was eventually judged to be “at least $15 apiece if illegally sold.”

Around the country, many bars, restaurants and businesses that operate under limited capacity have loosened restrictions for people who can prove that they have gotten the vaccine, creating an underground market for doctored or fraudulent vaccine cards.

In January, fake vaccine cards were being sold on Etsy, eBay, Facebook and Twitter, ranging in price from $20 to $60. In May, a California bar owner was arrested on charges that he sold fake vaccine cards for $20 a piece.

Mr. Ahmed was a nonclinical contract employee hired to work at the vaccination site at the Los Angeles County Fairgrounds, where nearly 4,000 vaccines are administered daily, the La Verne Police Department, in eastern Los Angeles County, said in a statement on Tuesday.

On April 27, the department was contacted after a security guard at the site spotted Mr. Ahmed leaving with a batch of the distinctive cards in his hand, Detective Sgt. Cory Leeper said in an interview on Wednesday.

Eventually, two staff members from the vaccination site confronted Mr. Ahmed at his car, the detective sergeant said. Mr. Ahmed told them that he liked to go to his car on his break and on that day, sought to “pre-fill” the cards with information that went to every recipient in order to get ahead of his workload, the detective sergeant said.

Officials recovered 128 cards from Mr. Ahmed’s vehicle, according to the police, and when questioned further, Mr. Ahmed acknowledged he may have taken additional cards. The police found 400 blank cards in the hotel room where he was staying. Mr. Ahmed was arrested. Efforts to reach him by telephone on Wednesday were not successful.

“Selling fraudulent and stolen vaccine cards is illegal, immoral and puts the public at risk of exposure to a deadly virus,” George Gascon, the district attorney in Los Angeles, said in a statement on Wednesday.

An eruption of the Kilauea volcano last December. The volcano is just one of the many tourist draws on Hawaii's Big Island.
An eruption of the Kilauea volcano last December. The volcano is just one of the many tourist draws on Hawaii’s Big Island.Credit…Janice Wei/National Park Service, via Associated Press

An overcrowded jail in Hawaii that had avoided Covid-19 outbreaks during the first 15 months of the pandemic has been overwhelmed by the virus — with more than one-third of its inmates infected — just as the state is more fully reopening to tourists.

The outbreak corresponds with a significant rise in Covid-19 cases in Hawaii County, or the Big Island, where the jail is situated: There has been a 141 percent increase in infections during the past two weeks, according to a New York Times database.

The National Guard is helping with testing and security to control the outbreak at the Hawaii Community Correctional Center in Hilo, the Big Island’s largest city, where inmates started fires last week as part of a protest, advocacy groups for inmates said.

Public health officials have warned for months that the nation’s correctional facilities will continue to suffer from large numbers of coronavirus infections until the vast majority of inmates and staff are vaccinated.

And because the average person stays in jail for only about 10 days, the virus has been able to spread rapidly between the community and jails during the course of the pandemic.

The reluctance among inmates and staff in the nation’s prisons and jails to get inoculated has complicated vaccination efforts, including in Hawaii.

At the Hilo jail, there are no precise figures available for vaccinations, but as few as 25 percent of inmates and 50 percent of staff have consented to be vaccinated, Lt. Gov. Josh Green, who is also an emergency room physician, said in an interview. The result, he said, is potential community spread through both inmates and staff.

“If there was a continuous simmering outbreak of Covid in the one place where very few people are getting vaccinated, it can break back into the community,” Mr. Green said.

The jail outbreak has led to some uncertainty about reopening. For much of the pandemic, travelers have been required to quarantine for at least 10 days upon arrival.

But arriving tourists can now skip quarantine by showing proof of a negative coronavirus test taken within 72 hours of their arrival. Beginning next Tuesday, people will no longer have to show negative tests to travel from one of the state’s islands to another. Demand for hotel rooms has increased more than 800 percent, according to state tourism data from April, the latest available.

As of Wednesday morning, 138 inmates and 18 staff have been infected in the Hilo jail, officials said.

There are currently about 340 inmates at the jail — about 120 more than its capacity. Inmates routinely must sleep on floors.

“This is scary because what’s happening — I don’t think it’s just going to be contained to that one place, because it’s going to leak out into the community where the guards live,” said Kat Brady, the coordinator of an advocacy group, the Community Alliance on Prisons.

Dr. Green said the state is considering prohibiting unvaccinated guards from having contact with prisoners in the future.

He said correctional institutions were among the “last pockets of risk” for coronavirus outbreaks, and that the lack of priority in reducing crowding and increasing vaccination rates was shortsighted.

“People are more inclined to spend money on ‘good citizens’ versus those who have lost their way,” he said. “But outbreaks will affect us all.”

— Ann Hinga Klein and Maura Turcotte

Breakthrough coronavirus infections -- meaning those that occur after full vaccination -- remain uncommon. And severe Covid among the vaccinated is even more rare.
Breakthrough coronavirus infections — meaning those that occur after full vaccination — remain uncommon. And severe Covid among the vaccinated is even more rare.Credit…Apu Gomes/Agence France-Presse — Getty Images

Over the last few months, a steady drumbeat of headlines has highlighted the astounding real-world effectiveness of the Covid-19 vaccines, especially the mRNA vaccines made by Pfizer-BioNTech and Moderna. The vaccines, study after study has shown, are more than 90 percent effective at preventing the worst outcomes, including hospitalization and death.

But alongside this good news have been rare reports of severe Covid in people who had been fully vaccinated.

On June 3, for instance, Napa County announced that a fully vaccinated woman, who was more than a month past her second Moderna shot, had died after being hospitalized with Covid. The woman, who was over 65 and had underlying medical conditions, had tested positive for the Alpha variant, which was first identified in Britain.

Although these cases are tragic, they are uncommon — and not unexpected.

“I’m very sad that she had a sufficiently severe illness that it actually led to her death,” said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and a vaccine expert at Vanderbilt University. But, he noted, “we expected to have the occasional breakthrough infection.”

Such cases should not dissuade people from getting vaccinated, scientists said. “There is not a vaccine in history that has ever been 100 percent effective,” said Dr. Paul Offit, the director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “This is your best chance of avoiding severe, critical disease. But as is true of everything in medicine, it’s not perfect.”

Severe Covid is rare in people who have been fully vaccinated. In a paper published last month, the Centers for Disease Control and Prevention said that it had received reports of 10,262 breakthrough infections by April 30. That is just a tiny fraction of the 101 million Americans who had been vaccinated by that date, though the agency noted that it likely represented “a substantial undercount” of breakthrough infections.

Of those breakthrough cases, 10 percent of patients were hospitalized and 2 percent died — and in some of those cases, patients were hospitalized or died from something unrelated to Covid-19. The median age of those who died was 82.

Older adults, who are at greater risk for Covid complications, may also be more likely to develop breakthrough infections because they are known to mount weaker immune responses to vaccines. People who are immunocompromised or have other chronic health conditions may also be at increased risk.

Some of the variants — particularly Beta, which was first identified in South Africa — may be more likely to evade the protection induced by vaccines. But Beta is not currently common in the United States, Dr. Schaffner noted.

The Alpha variant that infected the Napa County woman is highly contagious, but vaccines provide good protection against it — as well as against the original strain of the virus.

“Vaccines provide exceptional protection against death and illness from the virus and all residents should continue to get vaccinated to protect themselves and others,” Dr. Karen Relucio, Napa County’s public health officer, said in a statement.

Breakthrough infections are likely to decrease as more people get vaccinated and community transmission rates fall. “The virus will find fewer and fewer people to infect — it will be harder for the virus to work its way through the population,” Dr. Schaffner said. “These are great vaccines. In order for the vaccines to work optimally — on an individual basis and a community basis — as many people as possible have to be vaccinated.”

— Emily Anthes

A man in a government approved quarantine hotel near Toronto's main international airport in February.
A man in a government approved quarantine hotel near Toronto’s main international airport in February.Credit…Carlos Osorio/Reuters

OTTAWA — Canada will take its first, limited step toward rolling back border restrictions next month, the country’s health minister said on Wednesday.

Fully vaccinated Canadian citizens and permanent residents who fly home will no longer have to quarantine at a government-designated airport hotel until they receive a negative result for a coronavirus test administered upon arrival, the minister, Patty Hajdu, told a news conference. Instead, those air travelers will be allowed to isolate at home.

Then, assuming that they test negative, they will no longer have to complete the balance of the 14-day quarantine period.

While Ms. Hajdu said that the government hoped to make the change during the first week of July, she said the timing would depend on vaccination and infection rates as well as discussions with provincial governments and the border agency.

When the government announced the mandatory hotel stay in February, it suggested that the bill would come to about 2,000 Canadian dollars for a stay that would generally extend to three nights.

Although most hotels proved to be significantly less expensive than that, and test results generally arrived more quickly than anticipated, the mandatory stay was unpopular with many travelers. Some people have tried to avoid the hotel quarantine program and had to pay a fine of 3,000 Canadian dollars (recently increased to 5,000) as a consequence.

The announcement fell well short of a recommendation from a federal advisory panel to simply shut down the hotel program for everyone.

Under the new plan, foreign visitors and Canadians who are not vaccinated or partly vaccinated will still be required to use the hotel system and quarantine for 14 days. All travelers, regardless of their vaccination status, will also have to produce a recent negative test result before boarding any flight to Canada.

Because Canada has focused on getting at least one shot into every citizen’s arm, relatively few people will be able to take advantage of the new rules when they come into effect. While 68 percent of all Canadian adults have been given at least one shot, only 7 percent are fully vaccinated.

Currently, all nonessential travelers, including tourists who are neither Canadian nor permanent residents, are barred from entry. Canada’s tourism and restaurant industries have been calling for a broad reopening of the border between Canada and the United States. But on Wednesday officials downplayed suggestions that might come soon.

“It is better now to be slow and cautious, to use the best science and evidence, to be careful in our approach, so that we can have a sustained success,” Ms. Hajdu said.

A Covid vaccine clinic in Bernalillo, N.M. The vaccine is free, but polls show that about a third of unvaccinated adults were unsure whether insurance covered it.
A Covid vaccine clinic in Bernalillo, N.M. The vaccine is free, but polls show that about a third of unvaccinated adults were unsure whether insurance covered it.Credit…Paul Ratje for The New York Times

The Biden administration is reminding doctors, hospitals, pharmacies and insurers that it is illegal to bill patients for coronavirus vaccines, a letter obtained by The Times shows.

The new warning responds to concerns among unvaccinated Americans that they could receive a bill with their shot. A recent Kaiser Family Foundation poll found that about a third of unvaccinated adults were unsure whether insurance covered the vaccine.

“We recognize that there are costs associated with administering vaccines — from staff trainings to vaccine storage,” Xavier Becerra, the health and human services secretary, wrote in a letter to vaccinators and insurers. “For these expenses, providers may not bill patients but can seek reimbursement through Medicare, Medicaid, private insurance or other applicable coverage.”

The letter warns that billing patients could lead to state or federal “enforcement actions,” but does not specify what the penalty would be.

The federal government wrote strong consumer protections to ensure that patients do not have to pay for coronavirus vaccines.

In stimulus legislation last spring, it barred insurers from charging patients co-payments or deductibles for the vaccines. The same law also created a fund that would cover the costs of vaccinating uninsured Americans.

Layered on top of those legislative protections are the contracts that doctors and hospitals signed to receive vaccines. Those documents specify that vaccinators cannot bill patients for the service.

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Fauci Says Virus Variants Underscore Importance of Vaccinations

Despite the receding number of coronavirus cases in much of the United States, hospitalizations continue to rise in communities with low vaccination rates as highly contagious variants spread around the country.

What I’m going to do right now is spend the next couple of minutes talking to you about a subject that has gained a lot more attention over the last few days, and that has to do with the variants in general, but particularly in the variant which we now refer to as Delta or the B.1.617.2, which in fact, as you know, originally was noticed in India and dominated in certain states in India, but now has spread throughout other elements and other areas of the world. However, fortunately, two doses of the Pfizer vaccine and AstraZeneca appear to be effective against the Delta variant. The Delta variant currently accounts for more than 6 percent of the sequenced cases in the United States. This is a situation, the way it was in England, where they had a B.1.17 dominant and then the 617 took over. We cannot let that happen in the United States, which is such a powerful argument to underscore what Dr. Walensky said: to get vaccinated, particularly if you had your first dose, make sure you get that second dose. And for those who have been not vaccinated yet, please get vaccinated.

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Despite the receding number of coronavirus cases in much of the United States, hospitalizations continue to rise in communities with low vaccination rates as highly contagious variants spread around the country.CreditCredit…Brett Carlsen for The New York Times

The coronavirus might be receding in much of the United States, but health officials worry that the low immunization rates in parts of the country and the spread of highly contagious virus variants may pose a threat to the nation’s remarkable progress since vaccines were introduced.

In Newton County, Mo., for example, where just 15 percent of the population is fully vaccinated, area hospitals reported they were treating 46 people for Covid-19 as of June 3, a 47 percent rise over the previous two weeks, according to data from the Department of Health and Human Services. Comanche County, Okla., saw a 63 percent jump in Covid hospitalizations, with 10 people being treated; just 32 percent of county residents are fully vaccinated.

Many of the places with the notable recent jumps in hospitalization rates are smaller communities, where new virus cases and hospitalizations may be in the single digits. Nationally, hospitalizations for Covid-19 continue to decline, though eight states have seen upticks. That includes Louisiana, Utah and Oklahoma, which have lagging vaccination rates.

On the other hand, some states with low vaccination rates, including Mississippi and Alabama, have seen fewer people in the hospital in recent weeks, though in Alabama, cases are rising. Hospitalization figures typically lag case counts, because it may take some time for someone who is infected to become severely ill.

Still, experts are concerned that upticks in hospitalization and case numbers could bloom into a surge this summer, as people head indoors to escape the heat, especially across the South in communities where vaccination rates are low.

The recent increase in some communities is not a coincidence, said Dr. Ted Delbridge, executive director of the Maryland Institute for Emergency Medical Services Systems. People who become ill with Covid-19 now are, “in most age groups, twice as likely to end up hospitalized as people who got the virus earlier in the course of the pandemic,” Dr. Delbridge said.

In Maryland, of those between the ages of 50 and 59 who contracted Covid-19 over the winter, about 8 percent were hospitalized, he said. From the end of April through the beginning of June, the hospitalization rate in that group was 19 percent.

Worrisome virus variants could be playing a role, Dr. Delbridge said. The variant first found in Britain, now known as Alpha, is more contagious and may be deadlier than most others and is now dominant in the United States. Last month, Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said the variant, also known as B.1.1.7, made up 72 percent of U.S. cases at the time.

But vaccines have proven to be effective against the Alpha variant. A spring surge that scientists had warned of was smaller than had been feared in the United States.

“I think we got lucky, to be honest,” Nathan Grubaugh, an epidemiologist at Yale University, told The New York Times last month. “We’re being rescued by the vaccine.”

Through Tuesday, about 172 million Americans had received at least one dose of a Covid-19 vaccine, according to a Times database. But vaccine distribution across the country has slowed in recent weeks. About 1 million shots are being administered nationwide each day, down from an April peak of 3 million.

In Michigan, one of the few states that saw a surge in cases this spring, Alpha struck younger people who were returning to schools and playing contact sports.

“Because it’s more transmissible, the virus finds cracks in behavior that normally wouldn’t have been as much of a problem,” said Emily Martin, an epidemiologist at the University of Michigan.

At a White House news briefing on Tuesday, Dr. Anthony S. Fauci, President Biden’s chief Covid adviser, said the Delta variant, which was originally identified in India, was emerging as the dominant variant in Britain.

“We cannot let that happen in the United States,” Dr. Fauci said, adding that the Delta variant now accounted for 6 percent of sequenced cases in the United States.

Dr. Fauci urged young people to get immunized, citing a study that found that the vaccines appeared to be effective against the Delta variant.

One way of limiting the spread is for those who are vaccinated to wear masks around those who are not, doctors say. Although the Centers for Disease Control and Prevention has said that vaccinated people do not need to wear masks in most indoor settings, at least one state is modifying that a rule in some places: When California reopens next week, fully vaccinated colleagues working in a room together will be allowed to work maskless. But if one person is unvaccinated, everyone in the room will need to wear a mask.

“If I’m in close proximity to other people, and I don’t know their vaccination status, I put a mask on,” Dr. Delbridge said. “It’s just too easy.”

Correction: An earlier version of this article overstated the connection between low vaccination rates and hospitalizations. While the number of patients hospitalized for Covid-19 is rising in some counties with low vaccination rates, it is not the case in all such counties. The error was repeated in the headline. The earlier version also misstated the increase in hospitalizations in Smith County, Tenn., and Trousdale County, Tenn., in recent weeks. The 700 percent increase in reported hospitalizations in those two counties is because of an irregularity in how hospitals in the area reported data to the Department of Health and Human Services, not an increase in people actually hospitalized.

Albert Sun contributed reporting.

Receiving the Oxford-AstraZeneca vaccine in Currie, Scotland, in January.
Receiving the Oxford-AstraZeneca vaccine in Currie, Scotland, in January.Credit…Photo photo by Russell Cheyne/Agence France-Presse

People receiving the Covid vaccine made by Oxford-AstraZeneca had a slightly increased risk of a bleeding disorder, and possibly other rare blood problems, researchers reported on Wednesday.

The findings, from a study of 2.53 million adults in Scotland who received their first doses of either the AstraZeneca vaccine or the one made by Pfizer-BioNTech, were published in the journal Nature Medicine.

The study found no increased risk of the blood disorders with the Pfizer-BioNTech vaccine.

The AstraZeneca vaccine is not authorized for use in the United States, but has been authorized by the European Medicines Agency, the European Union’s top drug regulator, as well as by many countries outside the bloc. But reports of rare clotting and bleeding disorders in younger adults, some fatal, led some countries to limit the vaccines’s use to older people, and a few to drop it altogether.

The new study found that the AstraZeneca vaccine was linked to a slight increase in the risk of a disorder called “immune thrombocytopenic purpura,” which can cause bruising in some cases but also serious bleeding in others. The risk was estimated at 1.13 cases per 100,000 people receiving their first dose, up to 27 days after vaccination.

Workers near a wholesale market in Wuhan, China, in March 2020.
Workers near a wholesale market in Wuhan, China, in March 2020.Credit…Hector Retamal/Agence France-Presse — Getty Images

In the two years before the pandemic began, markets in the Chinese city of Wuhan were selling nearly three dozen animal species that can harbor pathogens that jump to humans, researchers have found, shedding new light on the possible role of the wildlife trade in the coronavirus’s origins.

The researchers found sales in Wuhan of mink, palm civets and raccoon dogs, but they did not find sales of pangolins or bats, which have been suspected as possible sources of the coronavirus.

In all, the researchers documented sales of more than 47,000 animals across 38 species in Wuhan markets between May 2017 and November 2019. Thirty-three of the species have previously been infected with diseases or disease-bearing parasites that can affect humans, the researchers said.

China suspended the sale and consumption of wild animals as the coronavirus began spreading rapidly early last year. The country’s wildlife trade played a key role in the SARS outbreak in the early 2000s.

A team of experts who led a World Health Organization mission to Wuhan this year examined vendor records and other evidence from the city’s animal markets. But the team reached no firm conclusions about the markets’ role in the outbreak, or about the specific species through which the coronavirus might have spread to humans.

More than a year into the pandemic, the question of the virus’s origins remains largely unresolved. The Biden administration last month announced a new push to investigate whether it could have accidentally leaked from a laboratory in Wuhan.

President Biden’s action came as top health officials renewed their appeals this week for a more rigorous inquiry. And it followed mounting criticism of a report from a team of international experts convened by the World Health Organization that largely dismissed the possibility that the virus had accidentally escaped from a Chinese laboratory called the Wuhan Institute of Virology.

Many scientists support investigating all possibilities, including the laboratory origin, even though they think the virus was probably transmitted from animals to humans outside of a laboratory. Angela Rasmussen, a virologist at University of Saskatchewan’s Vaccine and Infectious Disease Organization, said of the new study, “I think this puts a big point in the column of natural origin through intermediate species.” She said that while the paper “doesn’t prove anything” it “provides clear evidence that the wildlife markets really haven’t been investigated enough.”

The study of the animal markets, published this week in the journal Scientific Reports, was written by authors affiliated with China West Normal University, Oxford University and the University of British Columbia.

Between 2017 and 2019, one of the researchers conducted monthly surveys of all 17 shops in Wuhan markets that sold live wild animals for food and pets. Seven of these shops were at the city’s Huanan seafood market. Several early Covid cases in Wuhan were discovered in people with connections to that market.

The researchers originally carried out the surveys to investigate a tick-borne virus. But their results became “serendipitously” relevant to the Covid-19 pandemic, the researchers wrote.

Among the other species on sale in Wuhan, according to the researchers, were badgers, hedgehogs, weasels, porcupines, marmots, red foxes, flying squirrels, crested myna birds, snakes, vipers, cobras and Siamese crocodiles. Almost all of the animals were “sold alive, caged, stacked and in poor condition,” the researchers wrote, and were often butchered on site.

A mass vaccination program for older people at a clinic outside Johannesburg, South Africa, last month.
A mass vaccination program for older people at a clinic outside Johannesburg, South Africa, last month.Credit…Themba Hadebe/Associated Press

Mastercard’s charitable arm has promised to donate $1.3 billion for vaccines in Africa, one of the largest corporate donations of the pandemic, as the continent struggles to contain a surge of infections.

The Mastercard Foundation said on Tuesday that its donation would be deployed over three years “in partnership” with the Africa Centers for Disease Control and Prevention. It said the goals were to strengthen the agency’s capacity, “lay the groundwork” for local vaccine manufacturing, acquire vaccines for at least 50 million people and help deliver shots to millions more.

“Ensuring inclusivity in vaccine access, and building Africa’s capacity to manufacture its own vaccines, is not just good for the continent, it’s the only sustainable path out of the pandemic and into a health-secure future,” John N. Nkengasong, the director of the Africa Centers for Disease Control and Prevention, said in the statement announcing the donation.

Africa is battling a sharp, sudden rise in coronavirus infections and deaths that experts believe is linked to the rise of new variants. The latest hot spots include Botswana, Namibia and Tunisia, according to a New York Times database.

But as of Wednesday only about 38 million, or slightly more than 2 percent, of the continent’s 1.3 billion people had received at least one dose of a coronavirus vaccine, according to the Our World in Data project. That was roughly the number of first doses given so far in Italy, which has a population of about 60 million.

Mastercard’s donation is the latest effort to address the glaring vaccination gap between rich and poor countries.

Last week a group of wealthy countries, foundations and private companies pledged $2.4 billion for global vaccination efforts and announced plans to share a total of 54 million doses from their domestic supplies with countries in need, for example.

The World Health Organization said last week that only 0.4 percent of all Covid-19 vaccine doses had been administered in low-income countries. And pharmaceutical companies have only manufactured a fraction of the 11 billion shots that researchers at Duke University estimate will be needed to vaccinate 70 percent of the world’s population, the rough threshold needed for herd immunity.

A mobile vaccination clinic in Foley, Minn. last month.
A mobile vaccination clinic in Foley, Minn. last month.Credit…Liam James Doyle for The New York Times

As many Americans prepare to head back to the office, companies are hammering out policies on the extent to which they will require, or strongly encourage, employees there to be vaccinated against the coronavirus.

The bottom line is that companies are legally permitted to make employees get vaccinated, according to recent guidance from the federal agency that enforces workplace discrimination laws, the U.S. Equal Employment Opportunity Commission.

The agency said that employees who will not get vaccinated because of a disability or sincerely held religious belief may be entitled to an accommodation. Many companies are still reluctant to require inoculations for their employees, for a variety of reasons.

Mandy Lin, 43, left, and her 9-year-old son returning to their apartment in Philadelphia last week. Ms. Lin stays close to home because she is fearful of anti-Asian attacks.
Mandy Lin, 43, left, and her 9-year-old son returning to their apartment in Philadelphia last week. Ms. Lin stays close to home because she is fearful of anti-Asian attacks.Credit…Hannah Yoon for The New York Times

Millions of Americans may be leaping into a summer of newly unmasked normalcy, but a surge in anti-Asian attacks during the pandemic is now holding back many Asian American families from joining them.

As schools phase out remote learning, companies summon employees back to work and masks fly off people’s faces, Asian Americans say that America’s race to reopen is creating a new wave of worries — not about getting sick, but about whether they will be attacked if they venture back onto a bus or accosted if they return to a favorite cafe or bookstore.

In more than a dozen interviews across the country, Asian Americans detailed fears about their safety and a litany of precautions that have endured even as the country has reopened.

Stop AAPI Hate, a coalition of community and academic organizations, tracked more than 6,600 attacks and other incidents targeting Asian Americans and Pacific Islanders from March 2020 to March 2021. A survey this spring found that one in three Asian Americans worried about becoming victims of hate crimes.

Asian Americans said they hoped the threats would ebb as more people got vaccinated and the pandemic faded. But person after person echoed the same worry: There is no vaccine against bigotry.

A nurse checking on patients who just received a vaccine in Ulaanbaatar, Mongolia, last month.
A nurse checking on patients who just received a vaccine in Ulaanbaatar, Mongolia, last month.Credit…Khasar Sandag for The New York Times

Coronavirus cases are surging in Mongolia, where more than half the population is fully vaccinated, prompting a new focus on the effectiveness of its main vaccine, developed by China’s Sinopharm.

Mongolia reported 1,312 new cases of the coronavirus on Wednesday as the country’s total infections neared 70,000, almost all recorded since January. New daily infections have risen more than 70 percent in the past two weeks, according to a New York Times database.

The landlocked nation has emerged as an outlier in the global scramble for vaccines among developing nations, securing enough doses for its eligible population thanks to its strategic location between Russia and China — two vaccine manufacturing giants with global ambitions. Mongolia has signed deals for 4.3 million doses of the Sinopharm vaccine and one million doses of Russia’s Sputnik V vaccine, although only 60,000 Sputnik doses have arrived so far.

Chinese vaccines, such as the ones made by Sinopharm and another company, Sinovac, use inactivated coronaviruses to trigger an immune response in the body. They have been shown in studies to be less effective than the vaccines developed by the pharmaceutical companies Pfizer and Moderna, which use newer mRNA technology.

Sinopharm’s vaccine initially came under scrutiny because of a lack of transparency in its late-stage trial data. The vaccine faced more questions after the island nation of the Seychelles, which relied heavily on Sinopharm to inoculate its population, also saw a spike in cases, although most people did not become seriously ill.

“Inactivated vaccines like Sinovac and Sinopharm are not as effective against infection but very effective against severe disease,” said Ben Cowling, an epidemiologist and biostatistician at the University of Hong Kong School of Public Health.

“Although Mongolia seems to be having a spike in infections and cases, my expectation is that there won’t be large number of hospitalizations,” he added.

And some virus variants may spread fast enough to cause concern even in countries where much of the population has vaccinations effective against them: Britain is dealing with a rise in cases linked to the Delta variant, despite having more than half of its adult population fully vaccinated, largely with shots from AstraZeneca and Pfizer.

Still, the wave of infections has raised questions in Mongolia over why the government relied on the Sinopharm shots instead of a vaccine proven to be more effective. It came as Mongolians headed to the polls on Wednesday to vote for president, the first election since the constitution was amended to limit the president to one six-year term. The prime minister is the head of government and holds executive power.

A year ago, Mongolia was among the few countries in the world that boasted no local coronavirus cases, but an outbreak in November changed that. A political crisis ensued and protests over perceived mishandling of the outbreak led the prime minister to resign in January.

The new prime minister, Oyun-Erdene Luvsannamsrai, has promised to revive a flagging economy and end social distancing restrictions that have hurt businesses. A fresh wave of cases could threaten this pledge.

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