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.
That prospect adds further urgency to vaccination efforts, even as some states appear confident that their inoculation levels justify loosening restrictions.
At least 31 states have pledged to make vaccines universally available to their adult populations by mid-April, and many more have announced plans to expand eligibility on or before May 1, a goal set by President 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.
The expansion comes at a critical juncture in the pandemic, with 25 states reporting persistently high infections, according to a New York Times database. Over the past week, there has been a daily average of 58,579 new cases, about the same as the average two weeks earlier.
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.
Mr. Biden, who initially promised to have “100 million shots in the arms” of Americans by his 100th day in office, said on Thursday at his first news conference in office that the goal had been met 58 days in and that he was doubling the target. The nation is on track to meet that new mark: 200 million shots by April 30.
As of Thursday, the Centers for Disease Control and Prevention reported that 130 million shots had been administered since vaccinations began on Dec. 14, and that 14 percent of the American population was fully vaccinated.
The United States is averaging about 2.5 million vaccine doses a day. If that pace continues, about half of the nation’s population will be at least partly vaccinated by mid-May. But vaccine hesitancy may slow the process, according to Francis Collins, the director of the National Institutes of Health.
In an interview on Fox News on Thursday, Mr. Collins said he worried not that vaccine supplies would run short, but rather that the country’s approach to herd immunity could be dampened by people who “will basically say, ‘No, not for me.’”
“That could basically cause this pandemic to go on much longer than it needs to,” he said.
Thursday brought a slew of vaccine eligibility adjustments. 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, citing increasing supplies of doses from the federal government. Gov. Ron DeSantis of 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, Gov. Ned Lamont said that all residents 16 and above would be eligible beginning on Thursday. New Hampshire will make shots available to all residents 16 and older starting on April 2, and North Carolina on April 7. In Rhode Island, Gov. Dan McKee said the state was on track to make vaccines available to all residents over 16 by April 19.
Gov. Andy Beshear of Kentucky said the state would open vaccinations to those 40 and older starting on Monday, adding that a mask mandate would stay in place for at least another 30 days. And in Minnesota, Gov. Tim Walz is expected to announce on Friday that all residents over the age of 16 will be eligible starting on Tuesday.
Hot spots are scattered.
In Michigan, new cases and hospitalizations are rapidly rising. There has been an average of 3,719 cases per day over the past week, an increase of 121 percent from the average two weeks earlier. Michigan is reporting more new cases each day relative to the size of its population than any state except New Jersey, which has seen an increase of 25 percent from the average two weeks earlier.
And in Massachusetts, which is set to open vaccines to adults 16 and above on April 19, coronavirus cases have increased 28 percent from the average two weeks earlier. Dr. Michael Hirsh, the medical director of Worcester, warned that the return of spring breakers as well as Passover and Easter could be “a setup for even a bigger surge.”
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.
A week after several regions, including Paris, went under lockdown, the French authorities said on Thursday that three additional regions would follow suit as France tries to fight back a rise in coronavirus infections.
“The epidemic situation is not good,” Health Minister Olivier Véran said at a news conference, adding that the already high pressure on the hospital system was expected to increase in the coming days.
Mr. Véran said that three administrative regions would be put under “reinforced braking measures” for four weeks beginning on Friday night. They include the region that is home to the city of Lyon, as well as areas in the eastern part of the country.
The measures, which come on top of a nightly curfew already in place in the three areas, are similar to those imposed last week around Paris, in a large part of the north and in the southeastern tip of the country.
Most stores considered nonessential will have to close, and people’s movements will be limited to within a six-mile radius of their homes. Leaving the regions will be banned.
Mr. Véran tried to put the new rules in the least onerous light. “This is not a lockdown,” he said, “but 50 shades of measures that take into account the epidemic situation and what we know about the virus.”
Asked about the possible closing of schools, he said it would be a “solution of last resort” because of its “very heavy consequences” on children and their families.
Unlike some of its neighbors, France has resisted a new national lockdown, even in the face of new virus variants, opting instead for regional measures.
Mr. Véran said more than seven million people in the country had received a first shot of a Covid-19 vaccine, almost 11 percent of the population. More than 2.5 million have had two injections, he said.
He also announced an expansion of vaccine eligibility starting on Saturday to anyone over 70. The goal is to get a first shot to 10 million people by mid-April.
“This summer could be one of a progressive return to normal, and then there would probably not be additional waves to come,” Mr. Véran told reporters. “We have to hold on for a few more weeks, and we will make it. We are going to defeat this third wave.”
France registered more than 45,000 new cases on Thursday, a number reminiscent of figures during the pandemic’s second wave in the fall. The death toll rose by 225 over the past 24 hours to 93,378, the eighth-highest in the world.
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 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.
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.
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.
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.
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.
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.”