States

Covid Live Updates: F.D.A. Extends Shelf Life of J.&J. Shots by Six Weeks

Credit…Wilfredo Lee/Associated Press

The Food and Drug Administration on Thursday authorized an extension of the expiration date of Johnson & Johnson’s coronavirus vaccine, the company said in a statement, expanding the shelf life by six weeks shortly before millions of doses were set to possibly go to waste.

“The decision is based on data from ongoing stability assessment studies, which have demonstrated that the vaccine is stable at 4.5 months when refrigerated at temperatures of 36 – 46 degrees Fahrenheit,” Johnson & Johnson said in a statement.

The move gives states extra time to figure out how to use up supply of the single-dose vaccine, even as local officials have struggled to use up stockpiles of the shot, which has lately faced sagging demand. Since it was authorized by the F.D.A. in late February, it has been a critical resource in reaching more isolated communities and people who prefer to receive just one shot. But roughly ten million doses delivered to states remain unused, according to data collected by the Centers for Disease Control and Prevention.

As the pace of vaccinations has fallen in recent weeks, the extra time may not result in a significant uptick in use of Johnson & Johnson’s shot. The vaccine took a major hit in April when the F.D.A. and C.D.C. recommended a pause in its use after a rare blood clotting disorder occurred in recipients of the vaccine. State officials have said that decision significantly curtailed interest in the vaccine.

Dr. Marcus Plescia, who represents state health agencies as the chief medical officer for the Association of State and Territorial Health Officials, said last week that he believed every state was facing looming expiration dates on the vaccine, prompting local officials to search for ways to exhaust even their limited supply of it.

Gov. Mike DeWine of Ohio on Monday pleaded with health providers in his state to use about 200,000 doses of the vaccine that he said were set to expire on June 23. The state’s health department directed providers to adopt a “first-in, first-out” process for the shot to ensure doses with earlier expiration dates were used first.

Officials across the South, where vaccination rates have lagged, have also been searching for ways to use up tens of thousands of doses in their possession. In Arkansas, officials are hoping to use as much as they can at weekend pop-up clinics, including on Juneteenth, said Dr. José R. Romero, the Arkansas health secretary.

Dr. Clay Marsh, West Virginia’s coronavirus czar, said on Thursday that the state had ample supply of all three federally authorized vaccines, giving residents plenty of choice. But he said the extension could breath some life into his state’s efforts to continue reaching vulnerable people: those with disabilities, those who are homebound or homeless and those with some kind of social instability.

He added that the shot still appealed to people wary of two doses of a vaccine, and that West Virginia was looking to offer Johnson & Johnson’s vaccine at summer fairs and festivals and in parks. Around 25,000 doses there had been due to expire this month, he said.

“The J. & J. vaccine in those settings is, I think, highly preferable,” he said.

Dr. Marsh said he was still wary of having excess doses, even with an extended shelf life, and that the state was talking to the federal government about how to possibly give them away in time.

Charles Michel, president of the European Council, in Brussels on Thursday. “The world has the right to know exactly what happened,” he said.
Credit…Pool photo by Francisco Seco

Leaders of the European Union on Thursday joined the calls for a full investigation into the origins of Covid-19, with the European Council president declaring “support for all the efforts in order to get transparency and to know the truth.”

“The world has the right to know exactly what happened in order to be able to learn the lessons,” added the president, Charles Michel, who heads the European Council, the body that represents the bloc’s national leaders. He made the comments during a news conference preceding the Group of 7 summit, which starts on Friday and will be attended by President Biden.

The World Health Organization conducted an inquiry this year into the origins of the virus, which first appeared in the Chinese city of Wuhan in late 2019. The study concluded that “introduction through a laboratory incident was considered to be an extremely unlikely pathway” but was widely seen as incomplete because of China’s limited cooperation. Governments, health experts and scientists have called for a more complete examination of the origins of the virus, which has killed more than 3.7 million people worldwide.

Late last month, Mr. Biden ordered American intelligence agencies to investigate the origins of the virus, an indication that his administration was taking seriously the possibility that the deadly virus had accidentally leaked from a lab, in addition to the prevailing theory that it was transmitted by an animal to humans outside a lab.

Ursula von der Leyen, the president of the European Commission, the European Union’s executive arm, highlighted on Thursday that “investigators need complete access to the information and to the sites” to “develop the right tools to make sure that this will never happen again.”

In the draft conclusions of next week’s summit between the European Union and the United States, leaders will call for “progress on a transparent, evidence-based and expert-led W.H.O.-convened Phase 2 study on the origins of Covid-19, that is free from interference.”

A Covid-19 vaccination center in Sultanpur village in Utter Pradesh, India, last week.
Credit…Atul Loke for The New York Times

President Biden, under pressure to address the global coronavirus vaccine shortage, announced on Thursday that the United States will buy 500 million doses of vaccine and donate them for use by about 100 low- and middle-income countries over the next year.

“This is about our responsibility, our humanitarian obligation, to save as many lives as we can,” Mr. Biden said in a speech in England, ahead of the meeting of the Group of 7 wealthy democracies. “When we see people hurting and suffering anywhere around the world, we seek to help any way we can.”

In recent months, wealthy nations with robust vaccination campaigns have quickly moved toward inoculating large swaths of their population, but much of the world, particularly Africa, lags far behind, raising fears of more deadly waves that could overwhelm fragile health care systems and spawn new virus variants.

Now, as the leaders of the G7 prepare to meet in England starting on Friday, they are pledging to help close that gap. Mr. Biden said the G7 would announce a broader global strategy for containing the pandemic.

“America knows firsthand the tragedies of this pandemic,” he added, having suffered more than 600,000 deaths — “more deaths from Covid-19 in the United States than from World War I, World War II, the Vietnam War and 9/11, combined.”

The donation of 500 million Pfizer-BioNTech doses is by far the largest yet by a single country, but it would fully inoculate only about 3 percent of the world’s population. The United States will pay $1.5 billion for the Pfizer-BioNTech shots, about $3 apiece, which Pfizer described as a “not for profit” price — much less than the $20 it has paid for domestic use.

“The United States is providing these half billion doses with no strings attached,” Mr. Biden said. “We’re doing this to save lives, to end this pandemic. That’s it. Period.”

The first 200 million doses will be distributed by the end of this year, followed by 300 million by next June, Mr. Biden and Pfizer said. The doses will be distributed through Covax, the international vaccine-sharing initiative, which has lagged behind the hoped-for pace of distributing doses.

In a statement released on Thursday, Prime Minister Boris Johnson, who is playing host to the summit as Britain takes up the G7 presidency this year, said it was crucial to use the moment for unified action against the pandemic.

“The world needs this meeting,” he said. “We must be honest: International order and solidarity were badly shaken by Covid. Nations were reduced to beggar-my-neighbor tactics in the desperate search for P.P.E., for drugs — and, finally, for vaccines,” he added, referring to personal protective equipment.

He said now was the time to “put those days behind us.”

“This is the moment for the world’s greatest and most technologically advanced democracies to shoulder their responsibilities and to vaccinate the world, because no one can be properly protected until everyone has been protected,” he added.”

“We have to end Covid-19, not just at home, which we’re doing, but everywhere,” Mr. Biden told United States troops at R.A.F. Mildenhall in Suffolk, England, on Wednesday evening. “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.”

Health care workers waiting to receive the Johnson & Johnson Covid vaccine in Johannesburg in March.
Credit…Themba Hadebe/Associated Press

Only seven African nations, most of them small, are likely to meet the World Health Organization’s goal that each country across the world be able to vaccinate 10 percent of its people against the coronavirus by September, the agency said on Thursday. It is a dire prospect for a continent where vaccine supplies are being quickly depleted, and governments are battling a resurgence in infections.

The global health body said inoculation coverage remained at about 2 percent continentwide — and about 1 percent in sub-Saharan Africa — even as some rich nations across the world administered shots to a majority of their people. To achieve the 10 percent target for each country on the continent, Africa would need an extra 225 million doses, said Dr. Matshidiso Moeti, the W.H.O. regional director for Africa. In total, nine of out of 10 African nations will miss out on this global vaccination goal, the agency estimated.

The seven countries are Seychelles, Morocco, Mauritius, Equatorial Guinea, Comoros, Sao Tome and Principe, and Zimbabwe. An additional six countries — Tunisia; Ghana; Eswatini, formerly known as Swaziland; Lesotho; Rwanda; and Kenya —3 could reach the target if they receive enough supply to keep up with their current pace of vaccination, the W.H.O. said.

“This will really require a massive effort,” Dr. Moeti admitted, saying that “without a significant boost” in the availability of vaccines, “many African lives are at stake.”

The announcement came as Africa is set to surpass five million virus cases, with Covid having claimed 133,000 lives so far. While testing is often limited in the countries on the continent, known cases have also increased, with 94,145 new ones reported in the past week — a 26 percent increase from the previous week — according to the Africa Centers for Disease Control and Prevention.

Countries including Egypt, South Africa, Tunisia and Zambia have reported a surge in cases, while some, like Uganda, reintroduced lockdowns to stem the spread of the virus. The Africa C.D.C. also said deaths on the continent increased by 2 percent over the past week, and many more countries have reported detecting the variants first reported in South Africa, Britain and India.

And just as cases and deaths rise, many African nations have reported exhausting most of the vaccines they received through Covax, a global vaccine initiative. The W.HO. said that 14 African nations have utilized between 80 percent and 100 percent of their doses.

Still, only 35.9 million Covid vaccine doses have been administered in the continent, the Africa C.D.C., with the majority given in a few countries, including Morocco, Egypt, Nigeria, Ethiopia and South Africa, and in the Western Sahara region. Tanzania, Eritrea and Burundi have yet to give a single shot while Togo and Chad only started administering jabs last week.

While some countries faced shortages, others were not rolling out campaigns quickly. Twenty nations have used less than half of their doses, the W.H.O. estimated, while 12 nations have more than 10 percent of their doses facing expiration.

But on Thursday, both the W.H.O. and the Africa C.D.C. welcomed the news that President Biden has decided to donate 500 million Pfizer-BioNTech vaccines to poorer nations, including those in the African Union. Countries like France and corporations like Mastercard have also promised to finance, deliver or help produce Covid vaccines in the continent.

“It’s a monumental step forward,” Dr. Moeti said of the U.S. effort, which Mr. Biden announced in Europe on Thursday. “We are now seeing wealthy nations begin to turn promises into action. The hope of a shared future without Covid-19 is starting to shine a little bit more brightly.”

The vaccines are set to start shipping in August, with 200 million doses set for delivery by the end of this year, while the other 300 million will be delivered early next year, according to a White House fact sheet.

Dr. John Nkengasong, the director of the Africa C.D.C., welcomed the decision but said he did not know when or how many vaccines Africa would receive. But he urged member states to prepare storage facilities for the Pfizer vaccine and prioritize big cities once those doses arrive. He gave the example of Rwanda, which he said had received over 102,000 doses of Pfizer and quickly rolled it out.

“We have to use a combination of vaccines to win this battle against Covid-19,” Mr. Nkengasong said in a news conference on Thursday. “We are at war and you go to war with what you have, not what you need.”

A medical team with a patient at Houston Methodist Hospital last year.
Credit…Erin Schaff/The New York Times

The Occupational Safety and Health Administration announced a rule on Thursday outlining steps that employers must take to protect workers from the risk of Covid-19, but it will apply only to the health care industry, not to other high-risk workplaces, as the Biden administration initially indicated.

“The science tells us that health care workers, particularly those who come into regular contact with the virus, are most at risk at this point in the pandemic,” Labor Secretary Martin J. Walsh said on a call with reporters. “So following an extensive review of the science and data, OSHA determined that a health care specific safety requirement will make the biggest impact.”

The rule will require health care employers to provide protective equipment like masks, to screen and triage patients for the risk of Covid-19 and to ensure adequate ventilation and distancing, among other measures. It will also require those employers to provide adequate paid time off for workers to receive vaccinations and manage their side effects.

Fully vaccinated workers will not be required to wear masks and practice social distancing.

Mr. Walsh, whose department includes OSHA, said the administration was issuing optional guidance to employers outside health care that would focus on workplaces in the manufacturing, meat processing, grocery and retail industries.

Groups focused on workers’ issues criticized the decision to limit the rule, known as an emergency standard, to health care employers, arguing that the virus continues to pose serious risks to other workers.

“We know that workers in many industries outside of health care faced elevated risks of Covid,” Debbie Berkowitz, a senior OSHA official during the Obama administration who is now at the National Employment Law Project, wrote in an email. “Especially in low-wage industries like meat processing that is disproportionally Black and brown workers.”

She added: “We need to make sure these workers are still protected with mitigation measures.”

Ms. Berkowitz and others had expressed hope that Mr. Biden would chart a different course from his predecessor, under whom OSHA declined to issue a standard related to Covid-19.

During the Trump administration, OSHA adopted a policy of largely limiting Covid-related inspections to a small number of high-risk industries like health care and emergency response. It did not include meatpacking — which studies indicated was a major source of virus transmission — in this high-risk group.

Some worker groups gave OSHA credit under President Donald J. Trump for enforcing safety rules in the health care industry, including proposed penalties of over $1 million for violations at dozens of health care facilities and nursing homes. But critics accused the agency of largely failing to fine meat processors for lax safety standards, such as failure to adequately distance workers.

Mr. Walsh indicated that the risks to most workers outside health care had eased as cases had fallen and vaccination rates had risen. He also indicated that guidance by the Centers for Disease Control and Prevention last month advising those who have been vaccinated that they generally need not wear a mask indoors played a role in OSHA’s decision to forgo a broader Covid-19 standard.

“OSHA has tailored the rule that reflects the reality on the ground, the success of the vaccine efforts, plus the latest guidance from C.D.C. and the changing nature of pandemic,” Mr. Walsh said on the call.

David Michaels, a head of OSHA during the Obama administration, said the C.D.C. guidance had made a broader OSHA rule more difficult to enact. “To justify an emergency standard, OSHA has to show there’s a grave danger,” Dr. Michaels said. “For that to happen, the C.D.C. would have needed to clarify its recommendation and say that for many workers, there remains a grave danger.”

Without such clarification, said Dr. Michaels, now a professor at the George Washington University School of Public Health, employer groups would probably have challenged any new OSHA rule in court, arguing that the C.D.C. guidance indicated that a rule was unnecessary.

Dr. Michaels said that the new standard was an overdue step but that it was disappointing that no Covid-specific standard was issued for industries like meatpacking, corrections and retail. “If exposure is not controlled in these workplaces, they will continue to be important drivers of infections,” he said.

Jim Frederick, the acting head of OSHA, said on the call that the agency had power even without issuing broader Covid rules, through its so-called general duty clause, to enforce protections for workers outside the health care industry and that it would continue to do so.

He said many meatpacking facilities, along with other workplaces, had been inspected under an OSHA program applying added scrutiny to high-risk industries.

OSHA submitted a draft of an emergency standard for review by a White House regulatory office in April, and the administration has spent weeks meeting with worker and industry groups about its likely impact.

“As far as the meetings that took place,” Mr. Frederick said, “we’re a participant in those meetings, we receive those comments and take those into account in the overall work that’s being done by the agency.”

Employers will have two weeks to comply with most of the rule’s provisions.

The nearly empty parking lot of a drive-through vaccination site in Forest, Miss., on Wednesday.
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 Birmingham and Memphis, 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.

A health worker preparing a dose of Moderna’s Covid vaccine at a medical center near Paris in March. 
Credit…Dmitry Kostyukov for The New York Times

Moderna requested an emergency authorization on Thursday from the Food and Drug Administration for use of its coronavirus vaccine in 12- to 17-year-olds. If authorized, as expected, the vaccine would offer a second option for protecting adolescents from the coronavirus, and hasten a return to normalcy for middle- and high-school students.

The company has already filed for authorization with Health Canada and the European Medicines Agency, and plans to seek approval in other countries, the chief executive Stéphane Bancel said in a statement. Authorization by the F.D.A. typically takes three to four weeks.

Last month, the F.D.A. expanded emergency use authorization for the vaccine made by Pfizer and BioNTech for use in children ages 12 to 15 years. That vaccine was already available to anyone older than 16. About 7 million children under 18 have received at least one dose of the vaccine so far, and about 3.5 million are fully protected.

Moderna’s vaccine was authorized for use in adults in December. Its application to the F.D.A. for young teens is based on study results reported last month. That clinical trial enrolled 3,732 children ages 12 to 17 years, with 2,500 receiving two doses of the vaccine and the remaining a saltwater placebo.

The trial found no cases of symptomatic Covid-19 among fully vaccinated teens, which translates to an efficacy of 100 percent, the same figure that Pfizer and BioNTech reported for that age group. The trial also found that a single dose of the Moderna vaccine has an efficacy of 93 percent. Participants did not experience serious side effects beyond those seen in adults: pain at the site of the injection, headache, fatigue, muscle pain and chills.

An independent safety monitoring committee will follow all participants for 12 months after their second injection to assess long-term protection and safety.

Macy’s annual fireworks display in 2019. The show is returning this year to its pre-pandemic levels of pyrotechnics for this July 4. 
Credit…Brittainy Newman/The New York Times

Macy’s annual fireworks display will return to its usual grand scale over the East River this July 4, the latest sign of normalcy returning to New York City.

Bill de Blasio, the city’s mayor, announced the milestone on Thursday, noting that “this is part of the summer of New York City, the rebirth of New York City.”

He continued, “Why is it possible? Because you got vaccinated.”

The mayor’s announcement comes days after Andrew M. Cuomo, New York’s governor, said that the state would lift most of its remaining pandemic restrictions when 70 percent of the state’s adult population was at least partially vaccinated.

“When we hit 70 percent we will be back to life as normal,” Mr. Cuomo said on Monday. “Or as normalized as you can be post-Covid.”

That goal is not far-off — 69 percent of New York residents aged 18 and over have received at least one shot, according to a New York Times database, though with some areas lagging, Mr. de Blasio said this week that his own hope to vaccinate five million New Yorkers by the end of June appeared out of reach.

The Macy’s fireworks display, an annual tradition since 1976, was significantly altered last summer to prevent spectators from gathering in large groups and potentially spreading the virus. Macy’s produced seven shorter displays over several days that were launched from different parts of the city: the East River, Coney Island, the Hudson River, the Statue of Liberty, One Times Square, Borough Hall in the Bronx, and a finale on July 4 from atop the Empire State Building.

This year, Mr. de Blasio said at a news conference, “They are bringing the full-scale fireworks show, as we have loved it for decades and decades, back to New York City for all of us to enjoy.”

The mayor said that there would be dedicated viewing areas maintained by the New York Police Department separating people who had been vaccinated and those who had not. The average numbers of daily reported cases, hospitalizations and deaths in the city have been declining sharply for months, according to city data.

A Macy’s news release said that the 25-minute-long display will start at around 9:25 p.m. and use more than 65,000-shells launched from five barges. It will be set to music, including patriotic songs like “The Star-Spangled Banner” and “America the Beautiful” and the singer Tori Kelly’s rendition of “You’ll Never Walk Alone,” from the Rodgers and Hammerstein musical “Carousel.”

The release described the fireworks as “eclipsing fans, triple linking rainbows, blue jellyfish with crackling tentacles and red, white and blue waterfalls, creating dramatic effects a mile across the river and from 1,000 feet in the air to the water’s edge.”

The fireworks will be broadcast as part of a two-hour special on NBC that will begin at 8 p.m., featuring performances by artists like Black Pumas, Coldplay, OneRepublic and Reba McEntire.

Mr. de Blasio also announced another fireworks display off Coney Island in Brooklyn, which should run from about 10 p.m. to 10:15 p.m. and be visible from Coney Island’s boardwalk.

Two men helping their father last month at the Afghan-Japan Communicable Disease Hospital in Kabul, Afghanistan.
Credit…Rahmat Gul/Associated Press

Afghanistan received 700,000 doses of a Covid-19 vaccine from China on Thursday amid a worsening crisis and record numbers of known cases, health ministry officials said.

The Ministry of Public Health said it would prioritize people over the age of 55 and those with chronic diseases to receive the doses of the vaccine, made by the Chinese company Sinopharm.

With hospital beds filling up, a persistent shortage of oxygen, and a general failure to adopt the elementary precautions common elsewhere — mask wearing, social distancing — Afghanistan is undergoing its severest period of the pandemic.

Though Afghanistan’s testing capacity is severely limited, the country on Thursday recorded its highest ever number of virus cases in a 24-hour period: 1,822 positive tests of 5,343 total — a positivity rate of over 34 percent. There were 56 recorded deaths from Covid-19 over the preceding 24 hours, but the Afghan health system cannot always distinguish Covid from other causes of death in a country where disease and violence are endemic.

“The situation is critical,” said Saeed Uddin Jami, a spokesman for the Afghan Public Health Ministry. “There are no empty bed for patients in Kabul hospitals,” he said. “Unfortunately, people do not cooperate with us, and they do not take the virus seriously. It is likely that the situation will worsen throughout Afghanistan.”

Sinopharm’s vaccine uses inactivated coronaviruses to trigger an immune response in the body. Vaccines that use that approach 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.

The Chinese donation of the doses of Sinopharm’s vaccine follows a February shipment of 500,000 doses of the AstraZeneca vaccine from India that failed to make much of a dent. Nor did a donation of 486,000 doses of AstraZeneca from the Covax global vaccine initiative shift the trajectory of the crisis.

The United States on Friday announced some $266 million in additional aid for Afghanistan, primarily for Covid response.

global round up

Singapore this month. In mid-May, the government banned dining in restaurants and gatherings of more than two people.
Credit…Feline Lim/Getty Images

The Singaporean government said on Thursday that it would ease some social restrictions after nearly a month of tough measures to contain a coronavirus outbreak fueled in part by the Delta variant, first detected in India.

The city-state also said that it would expand its vaccination campaign, allowing Singaporeans ages 12 and older to register for shots beginning on Friday and extending eligibility to the rest of the population in the coming months.

The announcement came a day after the nation of 5.7 million recorded just two new coronavirus cases, the lowest number in months. In mid-May, after an outbreak at Singapore’s international airport led to dozens of infections, the government banned dining in restaurants and gatherings of more than two people.

“We have slowed down the chains of transmission and reduced the number of community cases, and are now in a position to ease the tightened measures,” the Health Ministry said in a statement on Thursday.

Beginning on Monday, people will be allowed to gather in groups of up to five, and restaurants and gyms will be permitted to reopen to customers the following week if cases remain low, the ministry said.

About a third of Singaporeans are fully vaccinated, one of the highest rates in Asia, but the country has kept cases low by requiring masks, strictly tracing contacts and eliminating most overseas travel. Officials have said that lifting further restrictions will depend on many more people getting vaccinated.

In other news around the globe:

  • Abu Dhabi, in the United Arab Emirates, will restrict access to shopping malls, restaurants, cafes and other public places to those who have been vaccinated against the coronavirus or who have recently tested negative, starting on Tuesday, Reuters reported. The new rules were announced late on Wednesday and come as the United Arab Emirates has seen daily cases rise during the past three weeks. The restrictions will also apply to gyms, hotels, public parks, beaches, swimming pools, entertainment centers, cinemas, and museums, Abu Dhabi’s media office said.

  • Germany’s vaccination confirmation app was introduced on Thursday, nearly half a year after inoculations started there. The app, called CovPass, will present a simple QR code confirming that the owner is fully vaccinated. Starting on Monday, doctors and pharmacies will be able to transcribe the usually handwritten entries from paper vaccine booklets into the digital app.

  • After accusations of fraud at its rapid virus-testing centers, the Health Ministry in Germany announced tougher licensing rules and more spot checks. Public sector health insurers are being tasked with keeping a close eye on the number of tests claimed and carrying out spot checks if the numbers seem off. The government’s per-test payout will also be significantly reduced, to a maximum of 12.50 euros, or about $15, from €18.

  • David Hasselhoff called for people to roll up their sleeves for the vaccine in an advertisement for Germany’s inoculation campaign. “I’ve found freedom in vaccination,” the former “Baywatch” star said in the clip, a reference to his 1989 version of the song “Looking for Freedom,” which became a smash success in Germany as the Berlin Wall fell and which he performed atop the Wall on New Year’s Eve that year. German health authorities believe that as much as 75 percent of the population will eventually get vaccinated.

Christopher F. Schuetze contributed reporting.

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

A hospital in Bhagalpur, in the Indian state of Bihar, last year. A review found that more than 9,000 people had died from Covid-related complications in the northern state since March 2020.
Credit…Danish Siddiqui/Reuters

NEW DELHI — India’s coronavirus death toll shot up on Thursday after an audit unearthed thousands of uncounted fatalities in the northern state of Bihar, one of the largest and poorest states in the country.

The audit in Bihar showed that more than 9,000 people had died from Covid-related complications since March 2020, significantly higher than the 5,500 deaths originally reported.

The audit was ordered after a hearing on May 17 in the Bihar High Court in Patna, the state capital, in which a district commissioner reported that a single cremation ground had handled 789 bodies in a 13-day period in May. That number clashed sharply with the seven deaths in the whole of May that Tripurari Sharan, a top state-level official, had reported for that entire district.

The revised figures underline the doubts about the accuracy of the Indian government’s official coronavirus statistics. Even in normal times, only about one in five deaths in India is medically certified, experts say.

Opposition political parties in Bihar have accused the state’s top elected official, Nitish Kumar, and his administration of hiding the true death toll to mask failures to mitigate the deadly second wave that has battered India.

The high court in Bihar has been monitoring the state government’s pandemic response since early May after taking up a petition filed by an activist that complained of mismanagement.

But Bihar’s health minister, Mangal Pandey, told The New York Times that the updated numbers reflected a good-faith effort to uncover families eligible for monetary support from the government.

“The intention is to help everyone, not to hide the real death toll,” Mr. Pandey said. “We will leave no death unaccounted for.”

Elsewhere in India, such as in the western state of Gujarat, observers have reported a wide discrepancy between official coronavirus death numbers and the actual figures. While some states have issued revised numbers, no update comes close to Bihar’s. Still, experts say they believe that India’s total number, which because of the audit in Bihar rose by 6,148 deaths on Thursday to 359,676, is a vast undercount.

Emily Schmall reported from New Delhi, and Sameer Yasir from Srinagar, Kashmir.

Gilbert Torres, 30, a few hours after being extubated in January, in the intensive care unit of a Los Angeles hospital.
Credit…Isadora Kosofsky for The New York Times

Deaths from Covid-19 have dropped 90 percent in the United States since their peak in January, according to provisional federal data, but the virus continues to kill hundreds daily. By late May, there were still nearly 2,500 weekly deaths attributed to Covid-19.

With more than half of the U.S. population having received at least one vaccine dose, experts say that the unvaccinated population is driving the lingering deaths.

After seniors were given priority when the first vaccines were authorized for emergency use in December, the proportion of those dying who were 75 or older started dropping immediately.

Younger populations began to make up higher shares of the deaths compared with their percentages at the peak of the pandemic — a trend that continued when all adults became eligible for the shots. While the number of deaths has dropped across all age groups, about half now occur in people aged 50 to 74, compared with only a third in December.

More than 80 percent of those 65 and older have received at least one vaccine dose, compared with about half of those 25 to 64.

“I still think the narrative, unfortunately, is out there with younger people that they can’t suffer the adverse events related to Covid,” which is not the case, said Krutika Kuppalli, an infectious-diseases expert at the Medical University of South Carolina.

Still, those 50 and older make up the bulk of Covid-19 deaths. Among that cohort, white Americans are driving the shifts in death patterns. At the height of the pandemic, those who were white and aged 75 and older accounted for more than half of all Covid-19 deaths. Now, they account for less than a third.

Middle-age populations of all racial groups are making up a higher proportion of Covid-19 deaths than they did in December.

The extent of the drop in deaths, however, is not uniform, and cumulative vaccination rates among Black and Hispanic populations continue to lag behind those of Asian and white populations, according to demographic data from the Centers for Disease Control and Prevention.

The data shows that more work is needed to reach and vaccinate “rural populations, ethnic and racial minority populations, homeless populations, people who don’t access medical care,” Dr. Kuppalli said.

Outside the Goldman Sachs headquarters in Manhattan. The bank is requiring all of its employees in the United States to log their vaccination status in the bank’s system.
Credit…Brendan Mcdermid/Reuters

Goldman Sachs wants to know how many of its employees have gotten a Covid-19 shot. The bank sent a memo this week informing employees in the United States that they had until noon on Thursday to report their vaccination status.

“Registering your vaccination status allows us to plan for a safer return to the office for all of our people as we continue to abide by local public health measures,” said a section of the memo, which was sent to employees who had not yet reported their status and was obtained by the DealBook newsletter.

Disclosing vaccination status had been optional at the bank. In May, Goldman told employees that they could go maskless in the Manhattan office if they reported that they had been inoculated.

Now, all Goldman employees in the United States, regardless of whether they choose to wear a mask while in the office, will need to log their status in the bank’s internal app for employees. The app does not ask for proof of vaccination, but it does require employees to record the date they received their shots and the maker of the vaccine. Employees who falsify records will be subject to discipline, including termination of employment. Goldman has also informed employees through the app that their vaccination status may be shared with managers and used for planning.

The Equal Employment Opportunity Commission made clear this month that it is legal to ask employees for their vaccination status so long as firms kept medical records confidential.

Employers are allowed to share vaccination status “with certain individuals if it’s relevant to the individual’s responsibilities, but they can’t share for no reason,” said Jessica Kuester, who specializes in benefits at the law firm Ogletree Deakins

Goldman has roughly 20,000 employees based in the U.S. at its New York headquarters and in other cities such as San Francisco and Dallas.

Companies across the U.S. are trying to find out how many workers are vaccinated ahead of full office reopenings. They have conducted surveys, given out cash rewards upon proof of vaccination or made reporting compulsory, as with Goldman.

“It’s important to have data to make data-informed decisions,” said Johnny Taylor, chief executive of the Society for Human Resource Management. He acknowledged that some may “grimace” at the idea of employers pushing for information like vaccine status.

Understanding what portion of their work force is vaccinated can help companies decide whether to try new incentives for employees to be vaccinated or consider a mandate. Goldman, for its part, said in the memo it “strongly encourages” vaccination, though the choice “is a personal one.” The Wall Street firm, which is bringing the majority of its workers back to the office this month, has been offering employees paid time off to get the shots.

“The big focus right now is we’ve got to get people vaccinated — we’ve got to get to the other side,” David Solomon, Goldman Sachs’ chief executive, told Bloomberg in January. Mr. Solomon has called working from home an “aberration.”

Several of Mr. Solomon’s rivals across Wall Street, including Jamie Dimon, JPMorgan’s chief executive, have been critical of remote work given the industry’s focus on in-person training and client solicitation. Mr. Dimon said in May that remote work “doesn’t work for those who want to hustle.”

JPMorgan, which opened all of its U.S. offices last month, has encouraged employees in its U.S. corporate offices who want to go mask-free to report their vaccine status. Bank of America has told bankers and traders who want to come in to the office that they may self-report their vaccination status on the bank’s internal portal. Neither bank has mandated vaccines.

“We started to bring vaccinated employees back,” Brian Moynihan, Bank of America’s chief executive, said in a hearing before the House Financial Services Committee on May 27.

“We had about 50,000 teammates that put the information in and give us the ability to call them back and have them work. In New York City in particular, that’s starting take place,” he said.

Receiving the Astrazeneca vaccine last month in Rome. The shots have been promoted to younger people at “open” events, but that may be about to change.
Credit…Fabrizio Villa/Getty Images

Back in April, Italy, acting on a report by Europe’s drug regulator of a “possible link” between the AstraZeneca vaccine and rare blood clots, recommended not giving the shots to people under 60.

But in the ensuing months, as the country put its inoculation campaign into overdrive, AstraZeneca vaccines became the featured attraction of “open days” or “open nights,” which offered shots to younger people weeks ahead of where they would have fallen in the priority schedule. The events — some featuring D.J.s and group selfies — were praised as a great success. But they also raised concerns that Italy seemed to be promoting the AstraZeneca vaccine to younger people despite the regulator’s recommendations.

On Wednesday, the government muddled matters further by publicly mulling whether to introduce stricter limitations on the use of the AstraZeneca shots that would effectively prohibit such events for younger people in the future.

“I think new indications would be appropriate,” Pierpaolo Sileri, an undersecretary at the Italian Health Ministry, told the Italian news website Fanpage, adding that the government would consider a block on administering the vaccine to people under the age of 30 or 40.

Other countries have also struggled to chart a clear policy on the AstraZeneca vaccine.

Though the regulator, the European Medicines Agency, deemed the vaccine safe, the risk of very rare blood clots has led some nations to adapt their approaches. In Britain, where the vaccine was created, more than 35 million doses have been given, but the country has acknowledged the risk by offering younger people an alternative when possible. France only distributes the shots to people who are 55 and older, Belgium to those who are 41 and older.

Germany stopped using the AstraZeneca shots altogether for a few days, before later recommending that they should not be used in people under 60. Now, like Italy, Germany has made the AstraZeneca vaccine available to anyone over 18, as long as they acknowledge the risk.

On Wednesday, a new study published in the journal Nature Medicine showed that people receiving the AstraZeneca vaccine had a slightly increased risk of a bleeding disorder and possibly of other rare blood problems.

Andrea Costa, another undersecretary at the Italian Health Ministry, said on Italian radio on Wednesday that the country was able to rely on “many other vaccines” and that any further limitation “will not hamper the vaccination campaign.”

But some doctors in Italy said they feared that yet another change in direction could prompt more skepticism toward the AstraZeneca vaccine.

“This poor vaccine,” said Dr. Patrick Franzoni, who spearheads the inoculation campaign in the northern region of Trentino-Alto Adige. “With this Ping-Pong of information, we risk completely boycotting it.”

In the past weeks, Dr. Franzoni said that he had helped organize open nights, complete with D.J.s, during which 22,000 younger people, who would otherwise have had to wait weeks for a shot, received the AstraZeneca vaccine.

“When older people saw they had AstraZeneca on their slot they did not book the vaccine,” Dr. Franzoni said, “so we did these open nights” to use up the supply.

“And we had a great response,” he added.

Other Italian regions introduced similar initiatives. In Lazio, which includes Rome, about 200,000 people of all ages got their AstraZeneca shot during open days. And Liguria, in the northwest, offered more than 40,000 doses at similar events.

But when reports spread about an 18-year-old girl who was hospitalized with a cerebral thrombosis after attending an open day in Liguria, many canceled their appointments.

Some doctors in Italy have urged the government to stop distributing the AstraZeneca vaccine to younger people. “With a low circulation of the virus, the risks of AstraZeneca can outweigh the benefits in people below the age of 30,” Nino Cartabellotta, a prominent public health researcher, tweeted.

The Italian government is now discussing possible new and more restrictive recommendations, a spokesman for the Health Ministry said.

Christopher F. Schuetze, Monika Pronczuk and Constant Méheut contributed reporting.


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