The United States will send 20 million coronavirus vaccine doses in June to countries struggling against the pandemic, answering calls that the Biden administration isn’t doing enough to help countries that face dire shortages of vaccines and other treatments.
Jen Psaki, the White House press secretary, said on Monday that those 20 million doses would be in addition to 60 million doses of AstraZeneca’s vaccine, which the U.S. plans to donate once the vaccine is cleared for use by the Food and Drug Administration. It is not clear exactly how long it will take the F.D.A. to authorize the vaccine.
Ms. Psaki’s announcement on Monday afternoon came not long after a World Health Organization news conference at which the director general, Dr. Tedros Adhanom Ghebreyesus, said that countries with high vaccination rates had to do more to help countries that were being hit hard by the coronavirus, or the entire world would be imperiled.
“There is a huge disconnect growing where in some countries with the highest vaccination rates there appears to be a mind-set that the pandemic is over, while others are experiencing huge waves of infection,” Dr. Tedros said.
Dr. Tedros’s comments came shortly after the United States and Britain, which have seen a decline in cases and deaths in recent weeks, relaxed restrictions as the virus battered India and other Asian countries.
Variants like B.1.617, first discovered in India and recently designated a variant of concern by the W.H.O., are contributing to the spread of infections and worry many researchers.
Dr. Tedros called for well-supplied nations to send some of their vaccine supplies and allocations to harder-hit countries, and for vaccine developers and manufacturers to hasten delivery of hundreds of millions of doses to Covax, an international initiative dedicated to equitable distribution of the vaccine, noting an appeal by Henrietta Fore, UNICEF’s executive director.
Ms. Fore released a statement on Monday saying that Covax would soon complete delivering 65 million doses, but that it should have delivered at least 170 million and that the effort could be short by as much as 190 million doses by the time Group of 7 leaders gather in England in June.
“We have issued repeated warnings of the risks of letting down our guard and leaving low- and middle-income countries without equitable access to vaccines, diagnostics and therapeutics,” Ms. Fore wrote. “We are concerned that the deadly spike in India is a precursor to what will happen if those warnings remain unheeded.”
The vaccine shortage in many countries is compounded by the situation in India, Ms. Fore wrote, a global leader in vaccine production.
Ms. Psaki said that America’s contribution of 80 million doses would be the most of any country, by five times.
In the U.S., there is a glut of vaccine, and President Biden and his administration face a different problem: convincing the remaining unvaccinated people to get the shot.
Last week the Centers for Disease Control and Prevention changed its guidance to allow people who have been vaccinated to forgo their masks indoors and outdoors in many situations. The decision caused confusion in states and individuals, some who were eager to return to a semblance of normalcy and others who said they planned to stay masked indefinitely.
Dr. Rochelle Walensky, the director of C.D.C., said on “Meet the Press” on Sunday that the agency’s suggestions were “not permission to shed masks for everybody, everywhere.”
She continued, “we are asking people to be honest with themselves. If they are vaccinated and they are not wearing a mask, they are safe. If they are not vaccinated and they are not wearing a mask, they are not safe.”
On Monday, Dr. Tedros’s message was more straightforward.
“No one is safe until we are all safe,” he said.
A growing and bipartisan chorus of foreign policy experts, diplomats, global health advocates and prominent business leaders are pushing President Biden to take a more aggressive stance in combating the international coronavirus pandemic by scaling up vaccine manufacturing and exporting surplus doses.
In two open letters to the president, one released last week and the other early Monday, a string of prominent names urged Mr. Biden to do more.
The first letter came from top executives including Suzanne Clark, the president of the U.S. Chamber of Commerce; former ambassadors including John Negroponte, envoy to Iraq and the United Nations under President George W. Bush; and a former defense secretary, William Cohen, who served President Bill Clinton.
“The world has come to rely upon U.S. leadership at times of great strife,” Ms. Clark, Mr. Cohen, Mr. Negroponte and the others wrote, adding: “Today we have a generational opportunity to mobilize vaccine efforts around the world. Our friends and allies will not forget easily if we sit on surplus stockpiles of the most proven vaccines as their citizens suffer and die.”
The second letter, organized by four global health institutes and signed by experts including Mark McClellan, the Food and Drug Administration commissioner under Mr. Bush, called on Mr. Biden to, among other things, name a global coronavirus coordinator and “commit to sharing Covid-19 vaccine doses immediately.”
Mr. Biden has promised he would restore America as a leader in global health, and the letters indicate that a broad array of leaders in multiple sectors believe he has not gone far enough.
The Biden administration has already committed $4 billion to Covax, the effort by the World Health Organization to get vaccines into the arms of people in disadvantaged nations; pledged to work with Australia, India and Japan to bolster global vaccine supply; and has said it would send 60 million doses of the American supply of AstraZeneca vaccine for global deployment. More recently, Mr. Biden announced he would support waiving intellectual property protections for coronavirus vaccines.
But J. Stephen Morrison, a global health expert at the Center for Strategic and International Studies who helped organize Monday’s letter, said suspending intellectual property rights would not help without White House leadership. “The world is now in great need of high-level engagement that up to now has been conspicuously absent,” his letter said.
The pharmaceutical industry opposes waiving the Agreement on Trade-Related Aspects of Intellectual Property Rights, known as TRIPS, and the letter from the business leaders and ambassadors argued that such a waiver “would make little difference and could do harm.”
Global health activists, who are strongly in favor of the waiver, said they nonetheless welcomed the business approach. They see clear parallels to their work fighting the global AIDS epidemic.
“It shows an unprecedented willingness of pharma and its allies in the private sector to admit what all of us having been saying for months, the private sector alone cannot and will not ensure global vaccine access,” James Krellenstein, a founder of PrEP4All, a nonprofit aimed at ensuring universal access to H.I.V. prevention and treatment, wrote in an email message.
“It really shifts the burden to the Biden administration,” Mr. Krellenstein wrote, adding, “When will they act?”
States in the Northeast, after experiencing spikes in coronavirus infections earlier this year, are reporting significant drops in cases and hospitalizations.
Connecticut, Massachusetts, Pennsylvania and Rhode Island have all reported many fewer cases in recent weeks as more people receive vaccinations. New York and New Jersey have also seen steady declines in cases after struggling to contain the virus earlier this spring.
Reported cases across the United States reached a high in January, and then, as vaccinations accelerated, fell through February and most of March. A much smaller overall surge peaked in mid-April, but has dropped about 32 percent over the past two weeks, according to a New York Times database. Hospitalizations and deaths are also ticking down, even as the pace of vaccinations has slowed in recent weeks.
In Rhode Island, confirmed cases have dropped 48 percent and hospitalizations have dropped 23 percent in the past two weeks. State officials attribute the fall in cases to increased vaccinations.
“It’s the vaccinations,” Gov. Daniel McKee of Rhode Island said, adding that “the vaccinations are really our focus right now.”
The state announced on Friday that it would adopt the Centers for Disease Control and Prevention’s new guidelines eliminating most mask requirements for fully vaccinated people starting on Tuesday. Although Mr. McKee expressed concerns that unvaccinated people might stop wearing masks too, he said he hoped the C.D.C.’s new guidance would encourage more people to get vaccinated and that it was “not a pass for people who have not been vaccinated.”
State officials are still worried about the threat of more contagious variants of the virus, he said. And even though Rhode Island’s vaccination campaign is ahead of most states’, Mr. McKee said that convincing people who were hesitant was still a challenge. About 57 percent of Rhode Island’s population has received at least one dose, and 46 percent have been fully vaccinated, according to a New York Times vaccine tracker.
In Pennsylvania, reported cases have dropped 44 percent and hospitalizations have dropped 28 percent in the past two weeks. Cases in the state started to rise in mid-March and continued to climb for weeks before reversing course in late April.
Alison Beam, Pennsylvania’s acting secretary of health, said the state’s vaccination effort had “made great strides,” which had led to the decreases. About 55 percent of the state’s population has received at least one shot, and 39 percent have been fully inoculated.
“One of our greatest hesitancy strategies is making it really convenient for folks and we’ve been able to do that by spreading out the vaccine to more of our provider networks more recently because the supply has increased as well,” Ms. Beam said.
With the pace of vaccinations falling, the Biden administration has been focused on door-to-door and person-by-person efforts. The Department of Health and Human Services recently started a “Covid-19 community corps,” a loose group of volunteers, corporations, advocacy groups and local organizations working to vaccinate Americans who may prefer to get their shots by or around people they know.
Ms. Beam cautioned, however, that coronavirus testing had also decreased in the state and she urged people to continue getting tested if they showed symptoms.
Although reported cases are continuing to drop nationwide, public health experts warn that the United States will have to continue aggressively vaccinating its population over the next few months. It is possible that the virus could surge again more widely in fall and winter, when viruses like the flu are typically dominant.
“That would be a terrible shame because that will include serious cases and deaths, and that’s preventable,” said Dr. Sten Vermund, the dean of the Yale School of Public Health.
In Britain, normality seemed much closer on Monday, with indoor dining and socializing and visits to cinemas becoming options again in England, along with some international travel, and rules also easing in much of Scotland.
The English reopenings are the third step in a cautious plan by the British government to ease all restrictions by the summer. But Prime Minister Boris Johnson sounded a note of caution on Monday.
“All the data shows we’re making great progress against this virus,” Mr. Johnson said in an address to the public. “But to ensure our progress is irreversible we must follow the rules.”
In England as of Monday, outdoor gatherings of up to 30 people and indoor gatherings for up to six people or two households will be permitted. Hostels and hotels will reopen for overnight stays and some nonessential travel abroad without quarantine will return for countries with low caseloads.
For many outdoor diners, who had shivered through a cool and rainy spring, news that indoor spaces were reopening was met with relief. In some pubs in England, Monday came at a stroke after midnight, with eager patrons being invited indoors for the first time since last year.
The financial strain of the past year has been especially heavy on the arts and hospitality sectors, which endured stop-and-start closures. “I just can’t wait,” said Alex McHale, owner of Mauds Cafe in the English town of Pontefract, said in an interview with the radio station LBC, adding that the business had just kept its head above water: “We need this time now to not look back and open the doors and let people in and we need to get that revenue stream back up again.”
The return of government-approved hugging was also welcomed, though experts warned people to be careful, some even demonstrating appropriate hug etiquette on television (with masks and face turned to the side.) And airline executives said there were signs that Monday would be the beginning of a long-hoped-for return to summer tourism, with an increase to bookings to countries on England’s “green list” for leisure travel, even as tighter restrictions remained for travel to most European destinations.
Mr. Johnson urged people to accept vaccines if offered and said though people could now make their own choices about close contact with loved ones, such as hugging, social distancing should remain in public places.
The easing comes as Britain has given more than half its population a vaccine dose and deaths from the virus have dropped to their lowest since last summer.
Still, officials said it was no time for complacency, announcing that they would speed up the delivery of second doses of a vaccine to people over 50 after a coronavirus variant first seen in India was found spreading in Britain. Cases have clustered in Bolton, a town of nearly 200,000 that has one of the country’s highest rates of infection.
Separate rules operate in Scotland, Wales and Northern Ireland. Scotland also eased several restrictions on Monday, though retaining them in Glasgow and Moray, which have reported relatively high case numbers, potentially linked to the variant.
Sanofi, the French pharmaceutical company, said on Monday that it would move the experimental Covid-19 vaccine it is developing with GlaxoSmithKline into a late-stage trial after the shot produced strong immune responses in volunteers in a midstage study.
The findings are encouraging for a vaccine that has fallen behind in development and has so far disappointed those expecting that it would be crucial in combating the pandemic. If the vaccine can become available in the last three months of this year, as its developers hope, it could still play a central role as a booster shot as well as an initial inoculation in the developing world, where the pace of vaccination is lagging.
The vaccine hit a major setback in December, when its developers announced that it did not appear to work well in older adults and that they would have to delay plans to test it in a Phase 3 trial, the crucial test that will assess the vaccine’s effectiveness.
But the companies modified the vaccine and in February began testing it in a Phase 2 study that included more than 700 volunteers in the United States and Honduras between 18 and 95 years old. Sanofi said the vaccine did not raise any safety concerns and produced a strong immune response across age groups, a finding suggesting it has been successfully tweaked.
Sanofi announced the findings in a statement and said it plans to soon publish the results in a medical journal.
Sanofi and GSK are much more experienced in vaccine development than a number of their rivals that have already won authorization. The two companies used a more established approach than those deployed in other, more swiftly developed Covid vaccines. Their shot is based on viral proteins produced with engineered viruses that grow inside insect cells. GSK is supplying the Sanofi vaccine with an adjuvant, an ingredient used in many vaccines meant to boost the immune response.
Sanofi and GSK’s vaccine was one of six selected for funding from Operation Warp Speed, the Trump administration’s effort to accelerate vaccine development. Last summer, the federal government agreed to give the companies $2.1 billion to develop and manufacture the vaccine, in exchange for 100 million doses once the shot was ready.
Sanofi also has supply deals with the European Union and Canada. It has also agreed to supply 200 million doses to Covax, the program to deliver vaccines to middle- and lower-income countries that has been struggling with a shortfall in expected doses. Sanofi has also announced plans to help manufacture the authorized vaccines made by Pfizer-BioNTech, Moderna and Johnson & Johnson.
Sanofi said its Phase 3 trial of its vaccine would begin in the coming weeks and enroll more than 35,000 adult volunteers around the world. It will test two formulations of the vaccine, one aimed at preventing the original strain of the virus and the other aimed at the B.1.351 variant first seen in South Africa that some vaccines appear to be less effective against.
Su-Peing Ng, Sanofi’s global head of medical for vaccines, told journalists on Monday that the company expected it to be “operationally quite challenging” to enroll unvaccinated participants in the Phase 3 trial as vaccination coverage increases in many nations. Still, she said, vaccine doses were still scarce in many parts of the world, pointing to Latin America and Asia as places where the company may look to enroll volunteers.
The company said that soon after starting the Phase 3 trial it planned to assess whether its vaccine could boost immune responses in people who had been vaccinated months before with authorized vaccines. Those booster studies are expected to enroll volunteers in well-vaccinated parts of the world, including the United States and Europe.
Sanofi and GSK said last year they were preparing to be able to make 1 billion doses annually. Thomas Triomphe, Sanofi’s global head of vaccines, said on Monday that the company’s production this year, if its vaccine were shown to work, would depend on the world’s needs.
The vaccine, he said, has “potential to be a booster of choice for many nations and many different platforms.”
Global Roundup
A powerful cyclone that is heading up India’s western coast has forced many regional governments, which were already dealing with a virulent wave of the coronavirus, to divert resources to evacuating people and trying to minimize storm damage.
The storm, Cyclone Tauktae, which is traveling north, is likely to make a landfall on Monday evening in Gujarat, a state struggling with a devastating second coronavirus wave. The storm swept through three southern states on Sunday, wiping out hundreds of homes, uprooting power transmission infrastructure and drenching low-lying areas, officials said on Monday.
India’s National Disaster Response Force said it had deployed more than 100 teams across six coastal states to help with evacuations, relief and rescue measures. At least seven Indian states have issued warnings to residents in low-lying areas, warning them of large-scale destruction and encouraging them to leave for higher ground.
So far at least 12 deaths have been reported across coastal districts of four states: Goa, Karnataka, Kerala and Maharashtra.
“This is another piece of bad news,” said Dr. Abhijeet Patel, a resident doctor at a public hospital in Gandhinagar, Gujarat. “The cyclone will not only impact vaccination drives, but it will also wreak havoc with the already exhausted health care infrastructure.”
A coronavirus second wave has devastated India’s medical system in its biggest cities, and over the past few weeks the virus has spread more widely, hitting states and rural areas with many fewer resources.
Positivity rates have been soaring in some coastal areas in the last few days, and some of the worst affected states are now in the south, where the storm hit over the weekend. In Karnataka State, six people died after the storm hit on Sunday.
India recorded 281,386 new Covid-19 cases on Monday and 4,106 deaths, the Health Ministry said on Monday. One bright spot: New cases have fallen below the 300,000 mark for the first time in 25 days.
Officials said they had evacuated tens of thousands of people from at least six Indian states, most of them severally affected by the rising Covid-19 cases in recent days as the severe cyclone barreled toward Gujarat.
The authorities in Maharashtra State, which includes Mumbai, India’s financial capital, said they had shifted hundreds of sick patients from the makeshift Covid care facilities as a precautionary measure and halted vaccination for four days, including on Monday. The storm was moving through the area on Monday. Miles of roads washed away in southern state of Karnataka as the storm brushed past the state.
Indian meteorological department said that by Monday evening, when the cyclone is expected to hit Gujarat, the wind speed is likely to increase to 99 miles per hour, from 93, gusting up to 108 miles per hour.
Officials there said on Monday that they were shifting Covid-19 patients from the areas likely to be most affected by the cyclone. Hospitals were sealing windows and doors, and more than 170 mobile intensive care unit vans were being deployed, according to local media.
In other developments around the globe:
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Taiwan, which is facing its worst outbreak of the pandemic, added 333 locally transmitted cases on Monday, mostly in Taipei, the capital, and the adjoining New Taipei City, health officials said. It also added two imported cases. The authorities announced a series of measures to restrict travel and curb the spread. Transit passengers will be barred from the island’s airports for the next month and foreigners without residence cards cannot enter beginning Wednesday, officials from the Taiwan Centers for Disease Control said.
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Hong Kong said that it was tightening quarantine restrictions for residents traveling from Taiwan and denying entry from there to nonresidents. The Hong Kong government also announced another deferral of a quarantine-free travel bubble with Singapore, where the number of new cases without a known source has been climbing. Plans for a travel bubble were suspended previously in November because of a high caseload in Hong Kong.
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For the first time since last October, Italy has reported fewer than 100 daily coronavirus deaths. For a country that was the first in Europe to be hit by the pandemic and then endured a brutal second and a third wave, the new low on Sunday of 93 daily deaths comes as a much-awaited glimmer of hope as the vaccination campaign speeds up. “The worst should be behind our back,” a senior health official, Pierpaolo Sileri, said on Italian television on Sunday. “Things are going well.”
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The Netherlands will ease some lockdown measures on Wednesday, the health minister said, citing the country’s vaccination drive. Amusement parks, zoos and other outdoor venues are allowed to reopen with social distance, but indoor activities will stay shut for now. Outdoor dining will be allowed until 8 p.m.
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Four nations’ delegations for this year’s Eurovision Song Contest missed the opening ceremony on Sunday after positive tests for Covid-19. Two virus cases were identified this weekend among the Icelandic and Polish entrants, forcing them to miss the event, and the contestants for Malta and Romania also skipped the ceremony as a precaution because they are staying at the same hotel. Eurovision was canceled last year because of the pandemic and the competition has been brought back with virus safety guidelines. The final will take place on Saturday in Rotterdam, the Netherlands, in front of a live audience of around 3,500 and all the contestants have made backup recordings in case they are unable to compete.
Emma Bubola Tiffany May, Austin Ramzy, and Anna Schaverien contributed reporting.
Though New York City is on the cusp of a major reopening, it cannot completely return to normal without restoring its school system, with roughly one million students, to its prepandemic state.
Mayor Bill de Blasio has promised that all students who want to be back in classrooms will have full-time, normal schooling this September.
Though schools in the city have been open for at least some in-person instruction for months, nearly two-thirds of the system’s parents have chosen to keep their children learning from home, either because they fear the virus or are concerned about inconsistent school schedules.
It will fall largely to Mr. de Blasio and his schools chief to convince those parents that classrooms are safe, while also making sure the district has the staffing and space to bring all those children back.
As planning for the fall intensifies, anxious parents and educators are hoping the city can avoid the confusion of last fall, when a belated planning process forced the mayor to twice delay the start of in-person classes. Other large urban districts will be closely watching New York, the nation’s largest district, for clues, since the city has been ahead of many other big districts in at least partly reopening schools.
Even as a combination of evolving public health recommendations and pandemic fatigue lead more Americans to toss the masks they have worn for more than a year, some say they plan to keep their faces covered in public indefinitely.
Whether made of bedazzled cloth or polypropylene, masks have emerged as a dystopian point of political contention during the pandemic. A map of states that enforced mask mandates corresponds closely with how people in those states voted for president.
Last year, protesters staged rallies against official requirements to wear masks, built pyres to burn them in protest and touched off wild screaming matches when confronted about not wearing them inside supermarkets.
But as more Americans become vaccinated and virus restrictions loosen, masks are at the center of a second round in the country’s culture brawl. This time, people who choose to continue to cover their faces have become targets of public ire.
In interviews, vaccinated people who continued to wear masks said they were increasingly under pressure, especially in recent days; friends and family have urged them to relax, or even have suggested that they are paranoid.
Following the latest C.D.C. guidance, at least 20 states repealed mask mandates or issued orders that gave vaccinated people exemptions from wearing masks. Other states, including New York, said they were reviewing their rules.
But for some people, no newfound freedom will persuade them to reveal their faces just yet.
The welcome team was in place.
At 1:45 a.m., four transit workers scrubbed benches, disinfected stair rails with bleach and washed the grime away from a subway station in Brooklyn. Four uniformed police officers kept watch.
Nadav Shahaf, 18, a high school student wearing a black mask and a bright red sweatshirt, came bounding down the stairs and plopped onto a newly cleaned bench. He had it all to himself. He was heading home after a late-night stroll with his girlfriend.
“I’m happy we got to this point,” he said. “It’s been a tough journey, but we’ve done a good job as a city, as a community.”
The 24-hour New York City subway was back.
The nation’s busiest transit system returned to full screeching service early Monday after more than a year of overnight closings during the coronavirus pandemic to provide more time to clean and disinfect trains, stations and equipment. It was the longest planned shutdown since the subway opened in 1904.
The resumption of round-the-clock service comes at a challenging moment for the transit system with fears about subway crime on the rise after a spate of random attacks that has also raised questions about how willing commuters will be to return to the subway and nudge ridership closer to prepandemic levels.
Still, the restoration of full subway service represents a major milestone on the city’s long road back from a public health crisis that made New York a global epicenter of the outbreak. It is one of the few cities in the world that usually never closes its subway, long a source of pride for New Yorkers.
“We’re thrilled to have people come back 24-7,” Sarah Feinberg, the interim subway chief, said in a television interview aired on Sunday. “We’re a 24-7 city, we want to be a 24-7 system. We always have been except for the last year, so it’s wonderful to be able to bring back ridership to 24 hours a day.”
One weekend last August, Shynell Moore woke up with a headache and a sore throat. Ms. Moore, then just a few weeks into her junior year at Colorado Mesa University, pulled out her phone and fired up a symptom-tracking app called Scout.
Within seconds of reporting her symptoms, the screen turned red: She might have Covid-19, the app said. Before the day was out, she had moved into quarantine housing. Her Covid-19 test soon came back positive.
Each time she reported a symptom, the information was transmitted to Lookout, the university’s digital Covid-19 dashboard. Over the months that followed, Lookout evolved into a sophisticated system for tracking symptoms and cases across campus, recording students’ contacts, mapping case clusters, untangling chains of viral transmission and monitoring the spread of new variants.
Lookout is the product of a partnership between C.M.U. — a school in the high desert of Western Colorado that prides itself on serving disadvantaged students — and the Broad Institute, a cutting-edge genomic research center in Cambridge, Mass.
Together, they have turned C.M.U.’s campus of more than 10,000 students into a real-world, real-time epidemiological laboratory.
Not everything has gone perfectly — college students will be college students, after all, and a university cannot be cordoned off from the wider world. But the tools they have developed could help institutions around the world better manage future outbreaks.