States are racing to vaccinate as many people as possible as the United States’ coronavirus infection curve continues its plateau for a third week at more than 55,000 new cases per day, a level that health experts warn could rapidly escalate into a new wave.
Kansas, Minnesota and South Carolina announced on Friday that they would open vaccine eligibility to residents 16 years and older next week. But Minnesota’s health department said there would not be enough vaccines on Tuesday to meet the immediate demand, though the state is expecting more doses delivered in the coming weeks.
New Jersey, which has seen a 25 percent increase in new cases, compared with the average two weeks earlier, also announced expansions to vaccine eligibility to begin on April 5 for residents 55 and older. At that time, New Jersey also plans to open eligibility for those 16 years and older with developmental disabilities and residents who work in the higher education sector.
State officials are able to broaden their eligible pools thanks to a steady increase in vaccine shipments. Federal officials say that Pfizer and Moderna, whose vaccines require two doses, are now together supplying about 24 million doses a week.
Jeffrey D. Zients, the White House’s chief pandemic adviser, told reporters during a White House virus briefing on Friday that he is expecting an end-of-the-month burst of supply from Johnson & Johnson, whose vaccine requires only one shot. The company has supplied a very limited number of doses so far but will deliver at least 11 million doses next week, he said.
Some 25 states are reporting persistently high case numbers, according to a New York Times database, and state officials have been easing restrictions.
The number of deaths continue to trend downward, averaging about 1,000 a day, down from more than 2,000 each day a month ago. But eight states are seeing rising deaths: Kentucky, Maryland, Montana, Nebraska, New Hampshire, Ohio, Utah and West Virginia.
“It’s clear, there is a case for optimism, but there is not a case for relaxation,” Mr. Zients, said on Friday.
At least 34 states have pledged to make vaccines universally available to their adult populations by mid-April, and at least 14 more have announced plans to expand eligibility on or before May 1, a goal set by Mr. Biden. Alaska, Mississippi, Utah and West Virginia have already made all adults eligible to receive shots, and some local jurisdictions have also begun vaccinating all adults.
California will open up vaccine eligibility on Thursday to any resident 50 or older and will expand that to residents 16 or older on April 15, state officials said. Florida said that any state resident 40 or older would be eligible starting on Monday, and that the minimum age would drop to 18 on April 5.
In Connecticut, which is among the most-vaccinated states in the country, the governor said that all residents 16 and above would be eligible beginning on Thursday.
Kentucky plans to open vaccinations to those 40 and older starting on Monday.
Mr. Biden, who initially promised to have “100 million shots in the arms” of Americans by his 100th day in office, said on Thursday and that he was doubling the target.
Vaccine hesitancy could also slow progress, according to Francis Collins, the director of the National Institutes of Health. The goal of reaching a point in the country when enough people have had the virus or have been vaccinated could be jeopardized by people who “will basically say, ‘No, not for me,’” he said Thursday on Fox News.
Listen to ‘The Daily’: A Nursing Home’s First Day Out of Lockdown
Residents in West Virginia shared their feelings about being allowed to mix again after months of isolation.“That could basically cause this pandemic to go on much longer than it needs to,” he said.
The Biden administration’s relatively smooth coronavirus vaccine distribution effort is about to hit a snag.
Vaccine manufacturers have been steadily increasing their output, and states have snapped up new doses as quickly as the government could deliver them. But officials expect the supply of vaccines to outstrip U.S. demand by mid-May, if not sooner, and are grappling with what to do with looming surpluses when scarcity turns to glut.
President Biden has promised enough doses by the end of May to immunize all of the nation’s roughly 260 million adults. But between then and the end of July, the government has locked in commitments from manufacturers for enough vaccine to cover 400 million people — about 70 million more than the nation’s entire population.
Whether to keep, modify or redirect those orders is a question with significant implications, not just for the nation’s efforts to contain the virus, but also for how soon the pandemic can be brought to an end. Of the vaccine doses given globally, about three-quarters have gone to only 10 countries. At least 30 countries have not yet injected a single person.
And global scarcity threatens to grow more acute as nations and regions clamp down on vaccine exports. With infections soaring, India’s government is holding back nearly all of the 2.4 million daily doses manufactured by the Serum Institute of India, the private company that is one of the world’s largest producers of the AstraZeneca vaccine. That action follows the European Union’s decision this week to move emergency legislation that would curb vaccine exports for the next six weeks.
Biden administration officials who are inclined to hold on to the coming U.S. surplus point to unmet need and rising uncertainty: Children and adolescents are still unvaccinated, and no one is certain whether or when immunity could wear off, which could require scores of millions of booster shots.
Vaccine manufacturers and some top federal officials say decisions about what to do with extra vaccine orders must be made within weeks, or the uncertainty could slow production lines.
The manufacturing process can take up to 10 weeks, so changes for a foreign market need time. The regulatory rules that govern vaccine shipments present another hurdle, as does the limited storage life of the drug substances that make the vaccine.
Senior officials say the administration is leaning toward keeping the doses it has ordered, and at some point directing the excess to other nations in one-off deals or giving it to Covax, an international nonprofit backed by the World Health Organization that is trying to coordinate equitable vaccine distribution. The Biden administration has already donated $4 billion to that international effort.
Can people immunized against the coronavirus still spread it to others? A new study will attempt to answer the question by tracking infections in vaccinated college students and their close contacts, researchers announced on Friday.
The results are likely to be of intense interest, because they may help determine how careful vaccinated people need to be — whether they can throw away their masks, for example, or must continue to wear them to protect unvaccinated people.
More than 87 million have received at least one dose of a coronavirus vaccine, according to a New York Times database. The Centers for Disease Control and Prevention has advised that fully vaccinated Americans may gather indoors in small groups without precautions, including masks, but should still wear masks in public.
The reason is that it’s not yet certain that vaccinated people cannot briefly be infected and transmit the virus. Clinical trials of the vaccines were designed only to assess whether the vaccines prevent serious illness and death. The manufacturers are now collecting information on whether the vaccines can also thwart infections, swabbing volunteers’ noses every two weeks.
But that method falls short, because the testing is too infrequent to catch all infections and will not track the spread of the virus to the participants’ contacts, said Dr. Larry Corey, an expert in vaccine development at the Fred Hutchinson Cancer Research Center in Seattle and a leader of the new study.
“The only way you do that is by very frequent sampling, and we’re covering our bases by doing it every day,” Dr. Corey said. “It’s going to be the most thorough look at the issue.”
The new study will include more than 12,000 college students immunized with the Moderna vaccine at more than 20 universities across the United States. Half of the students will be randomly selected to receive the vaccine right after they are enrolled, while the other half will get the vaccine four months later.
All of the participants will swab their noses daily to check for the virus, provide periodic blood samples to screen for antibodies, and answer questions through an app. Scientists will follow the students for five months.
By monitoring the students so closely, the scientists expect to be able to track infections in the first 24 or 48 hours, and determine how long an infected person may transmit the virus to others, Dr. Corey said. Over time, the scientists expect to ask about 25,500 close contacts of the participants to swab their noses daily for two weeks, provide two blood samples and answer weekly questionnaires.
College students are an ideal population in which to study transmission after vaccination. They have among the highest rates of coronavirus infection, in large part because they live in tightly packed dormitories and have more social contacts than older adults do, while fortunately, hospitalizations and deaths are comparatively low. American colleges and universities have reported more than 530,000 cases since the beginning of the pandemic.
Kenya imposed stringent new restrictions in the capital, Nairobi, and in four other counties, fighting a deadly third wave of Covid-19 infections that has placed its fragile health system under devastating pressure.
In a televised address on Friday, President Uhuru Kenyatta said that a tenfold increase in infection rates since January, coupled with a 52 percent increase in hospital admissions this month, called for “drastic measures.”
“Kenya is now squarely in the grip of a third wave of this pandemic,” he said.
Several variants have been identified in Kenya, but some were found among travelers, and there is little data to suggest how prevalent they may be or what role they might be playing in the East African nation’s surge. They include B.1.1.7, the more transmissible and possibly more lethal variant first identified in Britain; B.1.351, a variant first found in South Africa that may bypass the protection afforded by current vaccines; and A.23.1, a variant that is now dominant in Kenya’s neighbor Uganda and nearby Rwanda.
As of midnight, Mr. Kenyatta said, all gatherings are banned in Nairobi and four adjoining counties, which make up a single infection zone. Travel is prohibited in and out of the restricted area, where bars, restaurants and places of worship will close, and a nightly 10 p.m. curfew moves to 8 p.m. However, Nairobi’s international airport will remain open.
President Uhuru Kenyatta: Nationwide curfew to commence at 8pm and end at 4am in the zoned areas of Nairobi, Kajiado, Machakos, Kiambu & Nakuru and 10 pm to 4am in the rest of the country effective midnight pic.twitter.com/PhZK7a4K6U
— Citizen TV Kenya (@citizentvkenya) March 26, 2021
In the rest of Kenya, sporting activities are suspended, and schools and universities will close until further notice.
The curbs came a week before the Easter holiday when many Kenyans pile into crowded buses to return to their family homes in rural areas.
A vaccination program that started in March raised hopes for an end of the pandemic, which has devastated the country’s tourism-dependent economy. One small bright spot in the tourism downturn has been an influx of wealthy Europeans hoping to ride out the pandemic in upmarket resorts along Kenya’s coast.
But the soaring rate of infections and deaths has forced the country into a painful new lockdown, Mr. Kenyatta said. As of Thursday, Kenya reported a total of 126,170 cases and 2,092 deaths. The positive test rate hit 22 percent this week, compared with 2 percent in January, he said.
Just over a hundred days into New York City’s vaccination campaign, 30 percent of adults and half of those 65 and older have received at least one dose of a Covid-19 vaccine. Millions more remain left to be vaccinated, and the city will have to overcome already significant disparities in vaccination rates across neighborhoods and demographic groups.
White and Asian New Yorkers have been vaccinated at higher rates than Black and Latino residents, who have been more likely to die from or be hospitalized with Covid-19 both in New York City and nationwide.
Some of the highest vaccination rates are in the city’s wealthiest neighborhoods — places where residents were most likely to leave the city at the start of the pandemic. In parts of the Upper West Side and Upper East Side, about half of adults have received at least one shot. In Corona, Queens, where the virus was far deadlier, only 19 percent have.
Neighborhoods with mostly white residents, like the Upper East and Upper West Side, Riverdale in the Bronx, Breezy Point in Queens, mid-island and the south shore of Staten Island, are outpacing city averages.
The majority Black and Latino neighborhoods in large swaths of Queens, Brooklyn, Upper Manhattan and the southern Bronx are in some cases 20 to 30 percentage points behind neighborhoods at the top of the list.
Reasons for the disparities vary, and they will not all be clear from simply looking at a map. Many seniors are homebound or have had trouble navigating complex and confusing websites to sign up for the vaccine (obstacles not just for seniors, really).
For Black and Latino New Yorkers, some surveys have shown higher rates of hesitancy toward a vaccine, though barriers to access are an equal if not greater challenge.
For non-English speakers, language barriers can create fear and confusion. For poorer residents, it’s simply more difficult (and more expensive) to take a few hours or a day or two off work to get a shot.
The city is averaging 60,000 to 70,000 shots per day. At that rate, it will take months to reach the remaining seven million New Yorkers, including children, who are not yet eligible for any vaccine.
The president of a pharmaceutical company with longstanding ties to Gov. Andrew M. Cuomo received special access to coronavirus testing last year as the first wave of the pandemic tore through New York, a time when tests were severely limited.
The company, Regeneron, requested tests from the state for its president, Dr. George Yancopoulos, and his family after a “member of his household became infected with Covid-19,” a company spokeswoman said. State officials granted the request and tested the family at home in March.
By then, New York had become the epicenter of the pandemic, its frightened populace suddenly confronted with a widespread shutdown in the face of a virus that little was known about.
The following month, Mr. Cuomo announced that Regeneron would create 500,000 kits for testing samples and provide them free of charge to New York State.
The company, which eventually became a critical player in the efforts to lower the risk of hospitalization and death among high-risk Covid-19 patients, said Dr. Yancopoulos had not been involved in the donation of the kits.
The unusual and preferential treatment granted to Dr. Yancopoulos was also extended to Mr. Cuomo’s relatives, including his mother, Matilda Cuomo, and brother, the CNN anchor Chris Cuomo, and at least one of his sisters, as well as other well-connected people, according to people with direct knowledge of the effort.
Revelations about the special access they got to state-run coronavirus tests early in the pandemic have drawn the interest of investigators in the New York State Assembly.
The judiciary committee of the New York State Assembly has already been looking into several accusations of sexual harassment made in recent weeks against Mr. Cuomo, as well as the manipulation by his senior staff of data related to nursing home deaths.
On Thursday, the chair of the committee, Assemblyman Charles D. Lavine, said the preferential access for Mr. Cuomo’s family would also become part of the inquiry.
Global Roundup
New Zealand has said it will require people returning from overseas to remain in the country for six months, twice as long as the previous requirement, and to pay for hotel quarantine if they don’t.
The new rules, which took effect on Wednesday, add to the anxiety of New Zealand residents abroad who have been waiting to book spots in a quarantine system that the government introduced in October. There is a waiting list of around four months, and new slots often disappear within minutes.
Under the new system, returnees who plan to stay less than six months must pay 3,100 New Zealand dollars, or around $2,150, for the two-week hotel quarantine they are required to undergo upon arrival. They were previously required to pay the fee for stays of less than three months.
The changes were a response to anecdotal evidence that New Zealanders were entering the country for a three-month “holiday” to avoid paying the fee, said Chris Hipkins, the minister for Covid-19 response.
“Ultimately, our managed isolation facilities are designed to ensure that New Zealanders who need to return home are able to,” he told reporters on Wednesday.
New Zealand is one of the few places in the world that are limiting the number of residents who can return home during the pandemic. Tens of thousands of Australian citizens have also been stranded abroad in recent months because of restrictions that limit number of people allowed on flights into the country.
The charges in New Zealand are expected to affect approximately 3 percent of those returning, according to the Ministry of Business Innovation and Employment.
As of February, New Zealand’s quarantine system was free to most residents and had collected $4.7 million in fees since its introduction last spring. The system has cost taxpayers about $1.7 million a day, according to figures provided to Radio New Zealand last year.
New Zealand has all but eliminated local transmission of the coronavirus, reporting a total of 2,476 cases and 26 deaths as of Friday, according to a New York Times database. It has vaccinated 41,500 people, most of them workers at the country’s border or immigration facilities.
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In Australia, hospitals, prisons and nursing homes in Brisbane went into lockdown on Friday after a 26-year-old man tested positive for Covid-19. It was the first local transmission detected in Queensland State in two weeks. The health authorities said that the man had been infectious since last Friday and that they were still trying to determine how he had contracted the virus.
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Norway on Friday extended its suspension of the AstraZeneca vaccine for another three weeks as the country assesses the vaccine, which the European Medicines Agency, the continent’s top drug regulator, has called “safe and effective.” At least four people who received the vaccine in Norway have since died. On Thursday, Denmark said that it, too, would extend its suspension of the vaccine, until April 15, while Sweden said it would resume its use for people over 65.
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A top health official in Germany warned that the country could see 100,000 new cases a day amid a new wave of infection that he said was likely to be worse than either of the first two. The official, Lothar Wieler, is the head of the Robert Koch Institute, Germany’s primary disease control agency. “We have to be prepared for the fact that more people will become seriously ill again, that hospitals will be overloaded and also that many people will die,” he said at a news conference on Friday. After a sharp increase in its virus caseload this month, Germany has recorded about 17,000 new cases a day over the past week.
A recent surge of Covid-19 cases in Ethiopia has left medical workers at the country’s biggest treatment center scrambling to find enough oxygen for patients in critical condition.
Ethiopia has recorded a 24 percent increase in Covid-19 cases, to 194,524 in the past month, and deaths rose 17 percent, health ministry data show. Ethiopia, with a population of 117 million, has recorded 2,741 deaths since its first case was announced in March of last year.
Abel Mujera, the clinical director at the Millennium Hall Covid-19 treatment center in Addis Ababa, said demand for oxygen had more than doubled in two months — from 200 cylinders per day in January to 450 now.
“Sometimes that’s barely enough to support the needs of our patients,” he said. “For the past few weeks, we had a surge in Covid-19 cases, and most of the patients we admit have a higher demand for oxygen and they need admission to critical care.”
Mr. Abel, 29, spends most mornings calling the loved ones of deceased Covid-19 patients at Millennium Hall, which the government set up shortly after Ethiopia’s first coronavirus case was confirmed.
“It’s so hard,” he said.
A Covid-19 report released last week by the Ethiopian Public Health Institute said a spike in cases had been recorded in Addis Ababa, the capital, because of “decreased adherence to the public health and social measures” as well as a “high risk” that dangerous virus variants had entered the country.
Mr. Abel’s facility is treating 213 patients, of which 80 percent need oxygen — up from an average of 60 patients in January and February.
Complicating the situation is that the oxygen arriving in the city each day comes from distant places like Awassa, a drive of roughly 170 miles away, and Bishoftu, a drive of about 40 miles, where power cuts can sometimes limit the supply.
If the so-called Stop the Steal movement appeared to be chasing a lost cause once President Biden was inaugurated, extremist organizations are now adopting a new agenda from the anti-vaccination campaign to try to undermine the government.
The safety and efficacy of coronavirus vaccines is being bashed in chat rooms frequented by all manner of right-wing groups, among them the Proud Boys; the Boogaloo movement, a loose affiliation known for wanting to set off a second Civil War; and various paramilitary organizations.
Although negative reactions to the vaccines have been relatively rare, many extremist groups are using the isolated cases to try to bolster false and alarmist disinformation in articles and videos with labels like “Covid-19 Vaccines Are Weapons of Mass Destruction — and Could Wipe out the Human Race” and “Doctors and Nurses Giving the Covid-19 Vaccine Will be Tried as War Criminals.”
The groups tend to portray vaccines as a symbol of excessive government control.
“If less people get vaccinated then the system will have to use more aggressive force on the rest of us to make us get the shot,” read a recent post on the Telegram social media platform, in a channel linked to members of the Proud Boys charged in the storming of the Capitol.
The focus on vaccines is particularly striking on discussion channels populated by followers of QAnon, the group that prophesied that Donald J. Trump would continue as president while his political opponents were marched off to jail.
“They rode the shift in the national conversation away from Trump to what was happening with the massive ramp-up in vaccines,” said Devin Burghart, the head of the Seattle-based Institute for Research and Education on Human Rights, which monitors far-right movements. “It allowed them to pivot away from the failure of their previous prophecy to focus on something else.”
Cleaning the New York City subway has always been a dirty job. But when the pandemic hit last spring, it became even more challenging. When Gov. Andrew M. Cuomo ordered that trains be shut down overnight for cleaning, the Metropolitan Transportation Authority turned to contractors to help undertake the monumental task of scouring the trains in the nation’s largest transit system.
The thousands of workers the contractors hired — largely low-income immigrants from Latin America — were envisioned as a stopgap measure, as M.T.A. workers were falling ill and dying of the virus.
Nearly a year later, the workers are still toiling at stations all over the city. Some are paid as little as half as much as the M.T.A. employees who did the same work before the pandemic began, and many without access to health insurance.
Now, as the M.T.A. prepares to welcome more passengers, the workers are pushing back, raising concerns about their safety, salaries and working conditions.
The New York Times interviewed a dozen contract cleaners, including three who in late February met with Patrick J. Foye, the M.T.A.’s chairman and chief executive, to describe their job and share a list of “needs” with transit agency leadership.
Their accounts paint a picture of dismal working conditions and highlight their unequal treatment compared with transit cleaners, who are paid up to $30 an hour and enjoy health insurance and other benefits, uniforms and MetroCards to swipe themselves into the system.
Beatriz Muñoz, 38, cleaned trains for six months last year at the terminus of the Q line at 96th Street in Manhattan. When cars arrived that were closed to passengers because they had been sullied, “we were the ones who had to go in there,” she said. “We would be praying to God that we wouldn’t get sick.”
Their complaints appear to show how the M.T.A.’s contractors have relied on a labor force that has been desperate for work at a time when hundreds of thousands have lost jobs in cleaning, construction and restaurants.
An M.T.A. spokeswoman, Abbey Collins, said the agency was disinfecting the subway with the help of “licensed and reputable outside companies whose performance is monitored regularly.”
Ms. Muñoz was paid $20 an hour. She brought her own mask, gloves and soap to clean her rags, she said.
She and her co-workers were told not to drink beverages on the job so they would not need to use the bathroom. “It was an oven in the summer,” she said. “We had to sneak sips of water.”
When inspectors came, she said, no one said a word. “Truthfully, we were all afraid.”
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