In Reversal, U.S. Will Send Vaccine Materials to Stricken India

The U.S. will send vaccine materials and other supplies to India, officials say.

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Vaccinations at a government hospital in Mumbai this month.Credit...Atul Loke for The New York Times

The Biden administration, under increasing pressure to address a devastating surge of the coronavirus in India, said on Sunday that it had removed impediments to the export of raw materials for vaccines and would also supply India with therapeutics, rapid diagnostic test kits, ventilators and personal protective gear.

“Just as India sent assistance to the United States as our hospitals were strained early in the pandemic, the United States is determined to help India in its time of need,” Emily Horne, a spokeswoman for the National Security Council, said in a statement on Sunday.

The announcement, an abrupt shift for the administration, came after Jake Sullivan, President Biden’s national security adviser, held a call earlier in the day with Ajit Doval, his counterpart in India, and as India reports higher case numbers each day. On Monday, the Indian government reported almost 353,000 new daily infections, the fifth consecutive day the country set a world record. Ms. Horne said the United States had “identified sources of specific raw material urgently required for Indian manufacture of the Covishield vaccine,” the Indian-produced version of the AstraZeneca vaccine.

The situation in India is dire. The country is witnessing perhaps the worst crisis any nation has suffered since the pandemic began, with hospitals overflowing and desperate people dying in line waiting to see doctors — and mounting evidence that the actual death toll is far higher than officially reported. Officials say they are running desperately low on supplies, including oxygen and protective gear, as a deadly new variant is thought to be behind a rise in cases.

Many Indians are frustrated that their country, the world’s largest producer of vaccines, is so behind in its own inoculation campaign. Fewer than 10 percent of Indians have received even one dose, and just 1.6 percent are fully vaccinated, according to a New York Times database — even though India is producing two vaccines on its own soil.

Yet even as horrifying images of strained hospitals and orange flames from mass cremation sites circulated around the world last week, administration officials had pushed back as pressure mounted for the United States to broaden its effort to combat the surge in India. For Mr. Biden, the crisis in India amounts to a clash of competing forces. The president came into office vowing to restore America’s place as a leader in global health, and he has repeatedly said the pandemic does not stop at the nation’s borders.

But he is also grappling with the legacy of his predecessor’s “America First” approach, and he must weigh his instincts to help the world against the threat of a political backlash for giving vaccines away before every American has had a chance to get a shot. As of Sunday, 28.5 percent of Americans were fully vaccinated, and 42.2 percent had had at least one dose, according to the Centers for Disease Control and Prevention.

The statement on Sunday did not mention the possibility of the United States directly sending vaccines to India. But in an appearance on ABC’s “This Week” on Sunday, Dr. Anthony S. Fauci, the nation’s leading infectious disease expert, said the United States would consider sending some doses of the AstraZeneca vaccine there.

A correction was made on 
April 26, 2021

An earlier version of this article referred imprecisely to a ban on the export of coronavirus vaccines and vaccine components, a term India's government has used. While legal impediments stand in the way of such exports, they are not banned.

How we handle corrections

India’s government orders social media to block posts criticizing its response to the country’s raging Covid crisis.

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Bodies awaiting cremation on Friday in East Delhi.Credit...Atul Loke for The New York Times

NEW DELHI — With a devastating second wave of Covid-19 sweeping across India and lifesaving supplemental oxygen in short supply, India’s government on Sunday said it had ordered Facebook, Instagram and Twitter to take down dozens of social media posts critical of its handling of the pandemic.

The order was aimed at roughly 100 posts that included critiques from opposition politicians and calls for Narendra Modi, India’s prime minister, to resign. The government said that the posts could incite panic, used images out of context and could hinder its response to the pandemic.

The companies complied with the requests for now, in part by making the posts invisible to those using the sites inside India. In the past, the companies have reposted some content after determining that it didn’t break the law.

The takedown orders come as India’s public health crisis spirals into a political one, and set the stage for a widening struggle between American social media platforms and Mr. Modi’s government over who decides what can be said online.

On Monday, the country reported almost 353,000 new infections and 2,812 deaths, marking the fifth consecutive day it set a world record in daily infection statistics, though experts warn that the true numbers are probably much higher. The country now accounts for almost half of all new cases globally. Its health system appears to be teetering. Hospitals across the country have scrambled to get enough oxygen for patients.

In New Delhi, the capital, hospitals this weekend turned away patients after running out of oxygen and beds. Last week, at least 22 patients were killed in a hospital in the city of Nashik, after a leak cut off their oxygen supplies.

Online photos of bodies on plywood hospital beds and the countless fires of overworked crematories have gone viral. Desperate patients and their families have pleaded online for help from the government, horrifying an international audience.

Mr. Modi has been under attack for ignoring the advice of experts about the risks of loosening restrictions, after he held large political rallies with little regard for social distancing. Some of the content now offline in India highlighted that contradiction, using lurid images to contrast Mr. Modi’s rallies with the flames of funeral pyres.

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U.S. tourists who have been vaccinated can travel to the E.U. this summer.

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A line at the Louvre in Paris last summer. The European Union is allowing fully vaccinated Americans entry into the bloc this summer.Credit...Dmitry Kostyukov for The New York Times

BRUSSELS — American tourists who have been fully vaccinated against Covid-19 will be able to visit the European Union over the summer, the head of the bloc’s executive body said in an interview with The New York Times on Sunday, more than a year after shutting down nonessential travel from most countries to limit the spread of the coronavirus.

The fast pace of vaccination in the United States, and advanced talks between the authorities there and the European Union over how to make vaccine certificates acceptable as proof of immunity for visitors, will enable the European Commission, the executive branch of the European Union, to recommend a switch in policy that could see trans-Atlantic leisure travel restored.

New reported doses administered

Source: Centers for Disease Control and Prevention | Note: Line shows a seven-day average. The C.D.C., in collaboration with the states, sometimes revises data or reports a single-day large increase in vaccinations from previous dates, which can cause an irregular pattern.

“The Americans, as far as I can see, use European Medicines Agency-approved vaccines,” Ursula von der Leyen, president of the European Commission, said Sunday in an interview with The Times in Brussels. “This will enable free movement and the travel to the European Union.

“Because one thing is clear: All 27 member states will accept, unconditionally, all those who are vaccinated with vaccines that are approved by E.M.A.,” she added. The agency, the bloc’s drugs regulator, has approved all three vaccines being used in the United States, namely the Moderna, Pfizer-BioNTech and Johnson & Johnson shots.

Ms. von der Leyen did not offer a timeline for when exactly tourist travel might open up or details on how it would occur. But her comments are a top-level statement that the current travel restrictions are set to change on the basis of vaccination certificates.

Diplomats from Europe’s tourist destination countries, mostly led by Greece, have argued for weeks that the bloc’s criteria for determining whether a country is a “safe” origin purely based on low coronavirus cases are fast becoming irrelevant given the progress of vaccination campaigns in the United States, Britain and some other countries.

Cases remain high in the U.S., but vaccinations are slowing.

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A pop-up Covid-19 vaccination center in Newark on Friday. The United States is vaccinating fewer people on a daily basis than earlier this month, though coronavirus cases remain stubbornly high.Credit...James Estrin/The New York Times

Vaccination rates are falling in the United States, despite the spread of highly contagious virus variants that are fueling a national caseload that remains high enough to underscore concerns of the potential for a new surge.

More than 50,000 new U.S. cases were reported on Saturday, and case rates are similar to those of the second wave last summer, though they have fallen significantly from the third wave over the winter. But the average number of vaccine doses being administered each day, which rose for months and peaked at 3.38 million, has now dropped to 2.86 million, its lowest level since March 31, according to data from the Centers for Disease Control and Prevention.

The vaccination rate stopped climbing on April 13, when federal health officials recommended pausing the use of Johnson & Johnson’s vaccine to allow researchers to examine a rare blood-clotting disorder that emerged in six recipients. The Food and Drug Administration lifted the pause on Friday, opting to add a warning about the risk to vaccine labeling.

Experts aren’t sure why vaccination rates have begun falling, or whether vaccine hesitancy, an issue before the Johnson & Johnson pause, is entirely to blame. They suggest the issue is more complicated. Many Americans who were eager and able to be vaccinated have now been inoculated, experts believe, and among the unvaccinated, some are totally opposed while others would get a vaccine if it were more accessible to them.

New reported doses administered

Source: Centers for Disease Control and Prevention | Note: Line shows a seven-day average. The C.D.C., in collaboration with the states, sometimes revises data or reports a single-day large increase in vaccinations from previous dates, which can cause an irregular pattern.

Whatever the reason for the slowdown in vaccinations, it could delay the arrival of herd immunity, the point at which the coronavirus cannot spread easily because it cannot find enough vulnerable people to infect. The longer that takes, the more time there is for dangerous variants to arise and possibly evade vaccines.

Elected leaders and public health officials are left struggling to tailor their messages, and their tactics, to persuade not only the vaccine hesitant but also the indifferent. As mass vaccination sites begin to close, more patients could get vaccinated by their own doctors, with whom people are most at ease — a shift that would require the Biden administration to distribute the vaccines in much smaller shipments to many more providers.

Resuming use of the single-shot Johnson & Johnson vaccine should help with hard-to-reach populations like Americans in remote communities, migrants and older people who may have difficulty leaving their homes.

White House and state health officials are calling the next phase of the vaccination campaign “the ground game,” and are likening it to a get-out-the-vote effort.

“We’re entering a new phase” in the country’s vaccination effort, said Dr. Mark McClellan, former commissioner of the Food and Drug Administration and director of the Duke-Margolis Center for Health Policy at Duke University.

“Now, it’s more about bringing vaccines to the people who want them but haven’t been able to easily reach the existing sites,” Dr. McClellan said. Walk-in availability, which New York City allowed at city-run sites starting on Friday, could also help vaccinate more people, he said.

Dr. Ashish Jha, the dean of the Brown University School of Public Health, cautioned that it would be “hugely problematic” to broadly denounce those who had yet to get a vaccine — because of indifference or inconvenience — as “resisters.” He said on National Public Radio last week that “there are lots of people who are perfectly happy to get a vaccine but aren’t desperate for it — aren’t convinced that they need it badly.”

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Fauci and other top U.S. health officials stress the urgency of vaccinations and their safety.

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A Covid-19 vaccine being administered in Union City, Calif., this month.Credit...Jim Wilson/The New York Times

Top U.S. health officials sought to reassure Americans on Sunday that the 10-day pause in the use of Johnson & Johnson’s vaccine showed how well safety monitoring for the Covid-19 vaccines worked, and should not add to the hesitancy to get shots among some Americans.

“What we’re going to see, and we’ll probably see it soon, is that people will realize that we take safety very seriously,” said Dr. Anthony S. Fauci, the president’s top medical adviser for the coronavirus, during an interview on the ABC News program, “This Week.”

“We’re out there trying to combat the degree of vaccine hesitancy that still is out there,” Dr. Fauci said. “And one of the real reasons why people have hesitancy is concern about the safety of the vaccine.”

On Friday, federal officials lifted a pause that had been recommended on April 13 for the use of the Johnson & Johnson vaccine because of a few cases of a rare blood clotting disorder that had occurred mainly among younger women. By Friday, experts had identified 15 cases, including three deaths, stemming from the extremely unusual clotting issue. A warning about the risk for the disorder will be included for the company’s product.

Public health experts have raised concerns that the Johnson & Johnson pause was particularly worrisome because many states were relying on the one-dose shot to expand vaccinations into harder-to-reach rural areas, and for those who were homebound, homeless and on college campuses.

Some officials also worried that the pause would dampen vaccine rates that are already falling in the country. The government is aiming to vaccinate most adult Americans by the summer.

On NBC’s program “Meet the Press,” Dr. Francis Collins, director of the National Institutes of Health, compared the risk of a blood clot from the vaccine — less than 1 in 500,000 — to the danger of aspirin causing significant bleeding in the intestines among people who regularly take aspirin.

“We’re talking about something about a thousand times less likely to happen,” Dr. Collins said. “But we Americans are not that good at this kind of risk calculation.”

Many states have already announced that they would resume use of the Johnson & Johnson vaccine. Nearly 8 million people had received it before the pause, and about 10 million doses were sitting on shelves around the country waiting to be dispensed.

Overall, more than 50 percent of adult Americans have received at least one shot among the three vaccines available, Dr. Fauci said.

Both Dr. Fauci and Dr. Collins said it was crucial for a high percentage of Americans to be vaccinated to end the pandemic. “The more people you get vaccinated, the more people you protect,” Dr. Fauci said. “When you get a critical number of people vaccinated, you really have a blanket of protection over the entire community.”

Dr. Collins said scientists did not know the exact percentage of people with immunity, either from the vaccine or from antibodies generated from surviving a bout with the virus, that would be needed to reach herd immunity, especially as the coronavirus mutates into new variants that can be more infectious.

“But it’s up there around 70, 85 percent,” he said. “And we’re not there yet.”

He said that being fully vaccinated was freeing.

“My wife and I were able to invite another couple to come to our house to dinner and take off our masks because they were immunized as well and have a normal conversation and hug each other at the end of the evening,” Dr. Collins said. “That was so liberating. If you’re not vaccinated, you’re missing out on that chance to lift that blanket of fear that’s been there.”

Asked about calls for lessening restrictions for mask-wearing outdoors, Dr. Fauci said the Centers for Disease Control and Prevention could soon revise its recommendations. “I think it’s pretty common sense now that outdoor risk is really, really quite low,” Dr. Fauci said. “I mean, if you are a vaccinated person, wearing a mask outdoors, obviously, the risk is minuscule.”

Michigan’s Covid wards are filling up with younger patients.

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Medical staff moving a hospital bed from the intensive care unit at Beaumont Hospital in Royal Oak, Mich., on Thursday.Credit...Brittany Greeson for The New York Times

Hospitals in Michigan, the state with the worst current coronavirus outbreak in the country, are admitting about twice as many young adults with coronavirus now as they did during the fall peak, according to the Michigan Health & Hospital Association.

“I am putting more patients in their 20s and 30s and 40s on oxygen and on life support than at any other time in this pandemic,” said Dr. Erin Brennan, an emergency room physician in Detroit.

Public health experts say the outbreak — driven by the B.1.1.7 variant of the virus, which is more contagious and more severe — is spreading rapidly in younger age groups in the state.

Public health experts point to a number of factors contributing to the changing demographics. As pandemic restrictions have been loosened, younger people are out and about, socializing and in the work force, at a time when just one-third of American adults are fully vaccinated, most of them over 65.

“The restrictions were our pause button,” said Jennifer Nuzzo, an epidemiologist at Johns Hopkins Bloomberg School of Public Health. “As soon as you press play, you are going to see the virus race back as quickly as it can.”

Some health experts said it was conceivable that more younger people were being hospitalized now because the hospitals are not overflowing and have room for borderline cases who might have been sent home during the holiday surge.

But at the Beaumont Hospital in Royal Oak, Mich., near Detroit, doctors said they had not lowered the bar for admission: The younger people in their care may often have fewer chronic health problems than older patients do, but they nonetheless exhibited serious symptoms that required immediate intervention.

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Summer camp advice — keep masks and distancing — gets an update from the C.D.C.

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Children during a summer camp’s outdoor yoga class in New York last year.Credit...George Etheredge for The New York Times

Children going to camp this summer can be within three feet of peers in the same-group settings, but they must wear masks at all times, federal health officials say. The only times children should remove their masks is when they are swimming, napping, eating or drinking; they should be spaced far apart for these activities, positioned head to toe for naps and seated at least six feet apart for meals, snacks and water breaks.

The Centers for Disease Control and Prevention issued the anticipated updated guidance for summer camp operators this weekend, just weeks before many camps resume operations in mid-May. Many parents have been eager to find camps for their children, who had spent months indoors in remote learning classes during the pandemic.

A theme that runs throughout the updated guidance is the emphasis on conducting as many activities as possible outdoors, where the risk of infection in considered much lower than indoors. When activities must be brought indoors, spaces should be well-ventilated and windows should be kept open (windows should also be open on camp buses and vans), the C.D.C. said.

The guidance urges children not to share toys, books or games. Each camper should have a labeled cubby for their belongings, and nap mats should be assigned to individual children, and sanitized before and after use.

Some activities should still be avoided altogether, including close-contact or indoor sports, and large gatherings or assemblies. Singing, chanting, shouting or playing instruments are recommended for outdoors.

Wearing a mask is a critical piece of the prevention effort, even as federal health officials are weighing whether to lessen that restriction for the outdoors especially among people who are fully vaccinated.

“All people in camp facilities should wear masks at all times, with exceptions for certain people, or for certain settings or activities, such as while eating and drinking or swimming,” the guidance states in the only sentence emphasized in bold font in the 14-page advisory.

Federal health officials also issued rules for overnight camps, saying eligible staff, volunteers, campers and family members should be fully vaccinated two weeks before traveling to camps, while those who are not vaccinated should self-quarantine for two weeks before arriving at camp. Those who are not fully vaccinated should also provide proof of a negative test for the virus, taken one to three days before arriving at the camp.

Campers and staff members should be screened for Covid symptoms upon arrival at camps, and screening tests should be conducted if there is substantial community transmission in the area. Daily symptom checks should also be carried out to monitor for possible illness, the advice says.

Anyone working at a camp who is 16 or older is “strongly encouraged” to get vaccinated “as soon as the opportunity is available,” health officials said.

But immunized individuals must still wear masks around children, who are not eligible for vaccination yet, and stay six feet away from them. Children should also stay six feet away from children in other groups.

Millions of Americans have skipped their second vaccine dose appointments.

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People waiting to get vaccinated in New Orleans this month.Credit...Emily Kask for The New York Times

More than five million Americans, or nearly 8 percent of those who got a first shot of the Pfizer or Moderna vaccines, have missed their second doses, according to the most recent data from the Centers for Disease Control and Prevention. That is more than double the rate among people who got inoculated in the first several weeks of the nationwide vaccination campaign.

Even as the country wrestles with the problem of millions of people who are wary about getting vaccinated at all, local health officials are confronting a new challenge of ensuring that those who do get inoculated are doing so fully, Rebecca Robbins reports for The New York Times.

The reasons that people are missing their second shots vary. In interviews, some said they feared the side effects, including flulike symptoms, which were more common and stronger after the second dose. Others said they felt that they were sufficiently protected with a single shot.

Those attitudes were expected, but another hurdle has been surprisingly prevalent. A number of vaccine providers have canceled second-dose appointments because they ran out of supply or didn’t have the right brand in stock.

Walgreens, one of the biggest vaccine providers, sent some people who got a first shot of the Pfizer or Moderna vaccine to get their second doses at pharmacies that had only the other vaccine on hand.

Several Walgreens customers said in interviews that they scrambled, in some cases with help from pharmacy staff members, to find somewhere to get the correct second dose. Others, presumably, simply gave up.

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The U.S. immigration detention system is rife with outbreaks. A Times video investigation examines why.

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How ICE’s Mishandling of Covid-19 Fueled Outbreaks Around the Country

To date, Immigration and Customs Enforcement has reported over 12,000 virus cases. Our investigation found that the impact of infection extended beyond U.S. detention centers.

“Family and friends are in mourning tonight over the death of the first undocumented immigrant to die of Covid-19 while in ICE custody.” “The second immigrant has died of Covid-19 after being in the custody of Immigration and Customs Enforcement.” “And now the health crisis is colliding with the immigration crisis at the southern border.” Since the start of the pandemic, Immigration and Customs Enforcement has reported over 12,000 cases of Covid-19 in detention. But our investigation found that this number doesn’t tell the full story and that the agency also played a role in spreading the virus. “There were many things that ICE did wrong and many things that they actually did that made the problem much worse.” [emergency sirens] As Covid-19 cases were soaring over the summer of 2020, ICE had an infection rate 20 times that of the general population and five times that of prisons. To understand the consequences, we traveled across the country and talked to data scientists, local leaders, lawyers, former detainees and the family members of a nurse who used to work inside a detention center. We found a pattern of neglect and secrecy, and we found evidence that outbreaks inside ICE detention centers fueled outbreaks outside, in the communities that surround them. “Every time I think about those almost seven months I was there, I was so scared. I don’t want to die here.” “She was working 12-hour shifts, three days a week. For someone to tell us that she didn’t get sick from work, I mean, it’s — I don’t understand.” “We know how Covid spreads. You’re going to be in close contact in that detention center. After enough time, someone’s going to get it.” [rustling] “Here. This is the first paper they gave me on Sept. 15. It said I asked for protection. And I was mad because I said, I never asked for protection. I don’t feel like I need a protection. I need clinic. I need a hospital. I need a doctor.” Sandra has lived in the U.S. for over 30 years and has raised her seven children here. She’s a Mexican immigrant and is undocumented. She was detained in April 2020 and held for just shy of seven months in this detention center in El Paso, Texas. “When I got there, they were not keeping distance. They were not using masks. Most of the time, there were like 40 to 50 people in the same barrack.” “We started hearing about people who were vulnerable to serious illness and death from Covid-19 and saying that they couldn’t get masks. They couldn’t get soap. The guards would turn off the television when news about Covid-19 would come on. And so it was really a very scary time.” In April, just days before Sandra was detained, a federal court said that ICE exhibited callous indifference to the safety and well-being of its detainees, and ordered the agency to start releasing people who are at a greater risk of dying from Covid-19. “And we just weren’t seeing that. People who had medical vulnerabilities were being denied release consistently, and that happened to Sandra. I knew she was going to get it. I just didn’t know if I could get her out before she got it.” “When I started having symptoms, I was in the dorm with the other girls. I told the guard, ‘I don’t feel good. Last night, I had a fever.’ She said, ‘OK, go to the clinic.’ The nurse — I told her, ‘I think I have the Covid.’ And then she said, ‘No, you don’t have the Covid. Don’t say that. If you say you have the Covid, then you’re going to be sick. Don’t say that.’ And I went back to the barrack.” “What is the information about ICE’s protocols for determining when an individual in custody is tested?” “Individuals are generally tested when they’re showing symptoms of Covid-19.” “Not till then? Not till then?” “Generally, that’s true.” But this wasn’t true for Sandra. She left the clinic that day without a test, and she wasn’t tested for Covid-19 until five days later. “Everybody got infected. It was like more than 25 girls.” While Sandra waited for her result, she was placed into solitary confinement. And because her paperwork said she was there for protective custody, not for medical observation, guards didn’t know that she was possibly contagious. “I had to explain, like on three or four guards, that I was there because of a Covid test. As soon as I said that, they put the gloves and put the mask. The whole facility was doing a really bad job.” Sandra tested positive for the virus on Sept. 17, and was released on bail in November. People end up in ICE custody for a variety of reasons. And as an agency, ICE has wide discretion over who it detains and releases. “Police! Come to the door!” Most people in ICE custody don’t have a single criminal conviction. They just don’t have legal status in the U.S. ICE told us it has worked to reduce the number of people in custody and said the agency has taken extensive steps to safeguard detainees, staff and contractors. But the virus kept spreading. “ICE acts as if the detention center is this isolated spot in the middle of a city, but it’s really not. Tons of guards are going in and out. Tons of contract workers are going in and out. And then they’re going home to their families. We don’t really think about that.” “I got to get this. Hello? What happened?” This is Jose Asuncion. He’s a commissioner in Frio County, Texas, a small county just south of San Antonio with a population of only 20,000 people. “You have a wonderful day today.” What makes this county unique is that it’s home to two ICE detention facilities. “The majority of people here depend on incarceration jobs for their paycheck. And because of that, I think the community is largely supportive of them. Any time a private prison comes into a community, it’s the same promise: You’ll have jobs. You’ll have tax revenue. And you’ll have utility revenue. Sounds like a great deal. [Sighs.]” “Number of positive tests for Covid-19 in the South Texas community of Pearsall has some Frio County leaders concerned tonight.” “Early on in the pandemic, it really seemed like it wasn’t going to spread down to these rural areas of Texas. It seemed like a New York problem — and maybe a few other cities. But then the cases started coming in only at the detention center.” On May 5, 2020, there were 10 known cases of Covid-19 in Frio County, all of them linked to the South Texas ICE processing center. Three days later, the number had tripled. “It was clear the eye of the storm was the detention center, and it was inevitable that it was going to spread to the community.” ICE outsources the day-to-day operations of this facility to a company called GEO, the second-largest private prison company in the country. “The first thing we wanted was just information, and we were not getting any answers. The only resort we had was public pressure.” So Jose and eight other local officials sent an open letter to the GEO Group that included a list of 20 questions about testing, P.P.E., and employee safety protocols. And they asked GEO’S management to address them at the next County Commissioner meeting. “And now we go to item No. 2. Jose?” “Is anyone from GEO here today?” “No.” No one from GEO attended the meeting, and the company instead sent a brief letter. They confirmed that five employees did test positive for Covid-19, but they didn’t provide any other numbers. “I think we probably need to put more pressure on them.” ICE detention is a $3.1 billion industry funded entirely by U.S. taxpayers. But the vast majority of detainees are held in facilities run by private prison companies, which aren’t required to share information with the public. In a statement to The New York Times, GEO said that they strongly reject the baseless allegations about the South Texas ICE processing center and said they disclosed all Covid-19 related information to local health officials and to ICE. “Even though they present themselves as a community partner, they ain’t sharing any information with us.” Jose and his colleagues sent the open letter in May, but by July, Frio County was among the worst counties in the country for Covid-19. Today, one in seven residents have been infected. “There are a lot of people who see the problem that these private prisons pose, but who wants to jeopardize what other people see as an opportunity? Who wants to jeopardize their own job?” The thing is, these problems aren’t unique to Frio County. “ICE has always been known not to be the most transparent agency.” Which has led a team of researchers to take on the problem of extremely limited data themselves. “So when we look at this map, what we’re seeing here is all the locations that ICE is reporting Covid infection data for. The higher the peak here, the higher number of cases that have occurred in that facility.” Every day, ICE posts new data to its website that shows confirmed cases, detainee deaths and total confirmed cases per facility. But notably absent is any data on staff members. “I could see how someone could put this information and think that they are doing their due diligence, but if we’re interested in community spread, without those staff members, it’s extremely difficult to say what is the greater community risk that’s happening.” ICE detainees are held in at least 163 facilities throughout the country, with larger outbreaks mostly concentrated at detention centers in southern border states. Neal and their team at U.C.L.A. have taken the research a step further, and their early analysis reveals a pattern consistent with community spread. Take Frio County, for example. Since the start of the pandemic, outbreaks inside their ICE detention center were generally followed by outbreaks in the community, and they’ve seen this not just in Frio, but across the country. The team looked at 10 ICE facilities with the worst outbreaks — in Arizona, California, Florida, Georgia, Louisiana, New Mexico, and Texas — and they found similar patterns suggesting community spread in all 10. “It’s not just about the risk of spread in ICE detention centers. It’s about the risk of spread that occurs at ICE detention centers and then who comes into contact with them and where are they going. What does the exchange look like?” [rustling] “I never imagined that this would happen, that I would lose my mom to this. You can’t imagine.” For 20 years, Nataly Garcia’s mother, Blanca Garcia, worked as a nurse inside of the Webb County Detention Center in Laredo, Texas, an ICE facility run by the private contractor CoreCivic. “She was, I would say, like the head of the house [laughs]. She liked to tend to her plants and doing her sewing. She was my best friend, and I would talk to her about everything. I’m a mama’s girl. She was working 12-hour shifts throughout the pandemic, and I think about that every day, knowing that maybe if I had insisted a little bit more, she would be here. If I had annoyed her enough, she wouldn’t have gone to work.” Nataly’s mother became sick with Covid-19 in August, shortly after the detention center was placed under a mandatory quarantine order due to an outbreak among detainees. But by then, it was too late for Blanca. She died a few weeks later. “I haven’t gone through any of this. All her things that were in her locker. There’s a mask that she was making. She probably wore them. So I don’t know what protocols that they had.” After her mom died, Nataly reached out to CoreCivic to file a worker’s compensation claim, which would pay a lifetime benefit to her father. The company referred her to its insurance carrier, who eventually sent a letter denying the claim, concluding that there was not a causal relation between Blanca’s diagnosis of Covid-19 and her employment at CoreCivic. “I mean, obviously, it was a shocker. Like, how can they say that? She would just go to work, come back, and I would just have school online. And my father, I mean, he wasn’t working. It’s like a slap in the face to the years my mom dedicated to them.” “Did you hear a word from them since your mom passed away?” “No.” CoreCivic declined to comment on the specific circumstances of Blanca’s death but said they found no indication that she contracted the virus at work. The company is facing at least three separate lawsuits from former employees who claim CoreCivic put them at risk by failing to follow basic Covid-19 protocols. CoreCivic denies the claims. It says it has rigorously followed C.D.C. and ICE guidelines and it has always provided appropriate P.P.E. for its employees. “The health and safety of ICE detainees are the agency’s highest priorities. Transparency remains critically important in our response to this pandemic as we continue to debunk myths and correct misinformation.” 2020 was the deadliest year for people in ICE custody since 2006. To date, at least 10 people have died of Covid-19 after spending time in ICE custody. The number of staff deaths has not been disclosed. “And the failure to control Covid outbreaks in detention, jails and prisons is critically impairing our efforts to contain the spread of the virus in our communities. This is because jails and prisons and detention facilities are not islands. In fact, they’re more like bus terminals with people constantly coming and going.”

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To date, Immigration and Customs Enforcement has reported over 12,000 virus cases. Our investigation found that the impact of infection extended beyond U.S. detention centers.CreditCredit...The New York Times

The United States currently has the largest immigration detention system in the world. On any given day, Immigration and Customs Enforcement, or ICE, holds tens of thousands of people in about 200 facilities across the country. And throughout the pandemic, these facilities have become some of the most dangerous places in the United States when it comes to Covid-19 outbreaks.

The New York Times compared estimated infection rates in ICE detention centers with infection rates in prisons and in the general population. As Covid cases rose last June, ICE detention facilities had an average infection rate five times that of prisons and 20 times that of the general population.

To understand the risks the ICE facilities posed, we talked to former detainees, data scientists, lawyers, county officials and the family of a former ICE contractor about the spread of Covid inside and outside ICE detention centers. We also reviewed court documents, medical records of detainees and government inspection reports from June 2020 to March. This video shows what we found.

Small-town ambulance services have been starved of money and volunteers by the pandemic.

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Stephanie Bartlett, left, and Cheryl Rixey pulling out a stretcher at a hospital in Sweetwater County, Wyo., for a patient transfer this month.Credit...Kim Raff for The New York Times

Ambulance crews that serve much of rural America have run out of money and volunteers and are in danger of disappearing, a crisis worsened by the demands of the pandemic and a neglected, patchwork 911 system.

The problems transcend geography. Ambulance corps in New York are struggling to pay bills. As older volunteers retire in Wisconsin, no one is taking their place.

The situation is particularly acute in Wyoming, where a least 10 localities are in danger of losing ambulance service, some imminently, according to an analysis reviewed by The New York Times. Some are staffed by volunteers; others are run by for-profit chains that say they are losing money in the community, or by local contractors hired by municipalities that can no longer afford to pay them. Thousands of Wyoming residents could soon have no one nearby to answer a call for help.

“Nobody can figure out a solution,” said Andy Gienapp, the recent administrator for emergency medical services at the Wyoming Department of Health. “Communities are faced with confronting the very real crisis of, ‘We don’t know how we’re going to do this tomorrow, because nobody’s doing it for free.’”

There is a misconception, fueled by stories of astronomical bills, that ambulance service is a sustainable, or even lucrative, business. The truth, medical professionals say, is that ambulance bills are rarely paid in full by Medicare, private insurance or patients. And if an emergency call doesn’t result in a patient being taken to a hospital, it might not yield any payment at all.

Unreliable revenue streams have long put the country’s emergency medical systems in danger of collapse, experts say, but the pandemic has made a threatened crisis real.

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The pandemic battered companies, but C.E.O. pay remains stratospheric.

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Frank Del Rio, chief executive of Norwegian Cruise Line, right, helped ring the New York Stock Exchange opening bell in 2019. His pay more than doubled last year, even as Norwegian barely survived the pandemic.Credit...Richard Drew/Associated Press

The pandemic decimated Boeing’s business, and the company announced plans to lay off 30,000 workers. Yet its chief executive, David Calhoun, was rewarded with about $21.1 million in compensation.

It was a similar story last year at Norwegian Cruise Line, which lost $4 billion and furloughed 20 percent of its staff while its chief executive’s pay doubled — and at Hilton, where nearly a quarter of the corporate staff was fired while the company’s top executive received compensation worth $55.9 million.

The divergent fortunes of chief executives and everyday workers in the United States during the pandemic illustrate the sharp divides in a nation on the precipice of an economic boom but still racked by steep inequality.

“We’ve created this class of centimillionaires and billionaires who have not been good for this country,” said Nell Minow, vice chair of ValueEdge Advisors, an investment consulting firm. “They may build a wing on a museum. But it’s not infrastructure — it’s not the middle class.”

A Baghdad hospital fire killed at least 82 people, many of them Covid patients.

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The aftermath of a fire at a hospital in Baghdad on Sunday.Credit...Murtaja Lateef/EPA, via Shutterstock

A fire sparked by an exploding oxygen cylinder killed at least 82 people, many of them Covid-19 patients, at a Baghdad hospital late Saturday, the latest example of the pandemic’s devastating impact on a country riddled with corruption, mismanagement and a legacy of decrepit infrastructure.

The hospital, a facility dedicated to Covid-19 patients in one of Baghdad’s poorer neighborhoods, had no smoke detectors, sprinkler system or fire hoses, said Maj. Gen. Khadhim Bohan, the head of Iraq’s civil defense forces. The fire spread quickly because of flammable material used in false ceilings in the intensive care ward, he said.

“If there had been smoke detectors, the situation would have been totally different,” General Bohan said.

Some of the victims were older patients on ventilators who could not move from their beds when the fire started, officials said. At least 110 people were injured.

Prime Minister Mustafa al-Khadimi called the fire a crime and ordered an investigation within 24 hours into possible negligence at the hospital, the Ibn al-Khatib.

Iraq last week surpassed one million reported Covid cases since the pandemic began, and the country of 39 million is in the midst of a ferocious second wave of infections. New daily cases recently hit a record of more than 8,000.

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‘What are you waiting for?’ State leaders who banked on vaccines for reopening implore the hesitant.

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Gov. Kim Reynolds of Iowa spoke during a news conference at Iowa P.B.S. on Wednesday. Credit...Brian Powers/The Des Moines Register, via Associated Press

Some states that looked to vaccines to be their main virus mitigation strategy are now worried about the slackening pace of vaccinations, and are stepping up appeals to those hesitant to take the shots.

Gov. Mike DeWine of Ohio spoke on Sunday about a need to “be more aggressive” in his state’s vaccination campaign, after the rate of progress slowed to “half of what it was three weeks ago.”

He said on the CBS program “Face the Nation” that Ohio would start holding vaccination clinics at local businesses, colleges and high schools.

Gov. Kim Reynolds of Iowa, noting that at least 40 Iowa counties had turned down some or all of their next shipments of vaccines in order to keep their supply from outrunning demand, tried a direct approach at a recent news conference.

“I want to appeal to everyone who’s hesitating: If you’re opting to wait and see, what are you waiting for?” she asked.

Ms. Reynolds shared the spotlight at the news conference with a National Guard official who spoke of his own battle with Covid-19 and urged residents to take the risk seriously.

States like Missouri, New York and Arkansas are starting multi-million-dollar campaigns to drum up demand, as appointment slots begin to go unfilled. The campaigns feature testimonials from local residents and expanded access.

City Council leaders in Milwaukee made impassioned pitches to residents last week. “Please, please, please, we implore you, to make sure you do your part,” said Cavalier Johnson, the common council president. Leaders of the Navajo Nation used a similar appeal.

A number of governors, especially on the political right, have tried to minimize closures, capacity limits and mask mandates, insisting that pandemic safety precautions should be left to personal choice. But vaccine hesitancy may undermine that strategy. Experts warn that the longer it takes to reach the high levels of vaccination needed to halt the virus’s spread, the more opportunity there is for variants to arise that can break through the vaccines’ protection.

Not all elected leaders are singing from the same hymnal. Senator Ron Johnson of Wisconsin said in a radio interview on Thursday that he was “highly suspicious” of efforts to encourage vaccinations, adding that “we probably should have limited the distribution to the vulnerable.”

“The science tells us that vaccines are 95 percent effective, so if you have a vaccine, quite honestly, what do you care if your neighbor has one or not?” Mr. Johnson said, adding, “I see no reason to be pushing vaccines on people.”

His remarks drew sharp disagreement on Sunday from Senator Shelley Moore Capito of West Virginia, who said on the CNN program “State of the Union” that “comments like that hurt.”

“I believe that we should all have confidence, that we should — to not just protect ourselves, but our communities and our neighbors — we should get vaccinated,” Ms. Capito said. She has been urging her constituents to get vaccinated.

A wave of infections engulfs Thailand, prompting restrictions on localities and incoming travelers.

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Healthcare workers checking people’s temperature at a temporary testing site in Bangkok last week.Credit...Adam Dean for The New York Times

BANGKOK — The Thai authorities are stepping up travel restrictions and other measures to combat a rapidly spreading third wave of coronavirus infections driven by the highly transmissible and more lethal B.1.1.7 variant.

The country, which succeeded in limiting the spread of the virus last year, has recorded over 24,000 cases and 46 deaths in just 25 days, a huge proportion of its pandemic totals of 55,460 infections and 140 deaths. On Sunday, there were 2,438 new coronavirus cases and, in a second record in two days, 11 new deaths.

A spokesman for the government’s Covid task force said that Thailand would slow the issuance of travel documents for foreign nationals from India to try to ward off a coronavirus variant, called B.1.617, that is at least partly fueling India’s crushing surge in infections.

“For foreigners from India entering Thailand, right now we will slow this down,” he said but added that 131 Thai nationals in India already registered to travel in May will still be allowed into the country.

Quarantine for all arrivals has also been extended to 14 days from 10 days until the situation improves, a health ministry official said.

The B.1.617 variant is sometimes referred to as a “double mutant.” It contains genetic mutations found in two other difficult-to-control versions of the coronavirus. One is present in the highly contagious variant that ripped through California earlier this year. The other mutation is similar to one found in the variant first identified in South Africa and believed to make the virus more resistant to vaccines.

Other measures Thailand announced this weekend include the closure of venues in Bangkok like parks, gyms, cinemas and day-care centers from April 26 through May 9. Bangkok also introduced a fine of up to $635 for people who fail to wear face masks in public.

Shopping malls remain open but the Thai Retailers Association has restricted opening hours in Bangkok and 17 other provinces.

Prime Minister Prayut Chan-o-cha also said on his Facebook page on Saturday that provincial governors could close public venues and impose curfews if necessary to stop the virus spreading.

The surge in cases has prompted concern over the number of hospital beds, particularly as government policy is to admit anyone testing positive for the novel coronavirus, even those without symptoms.

Health officials have said there are still over 20,000 available beds nationwide.

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New Zealand hosts 50,000 fans in its largest concert since the pandemic began.

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Fans filled the stadium as the band Six60 performed at Eden Park in Auckland, New Zealand, on Saturday.Credit...David Rowland/Associated Press

AUCKLAND, New Zealand — More than 50,000 fans packed into Eden Park stadium, New Zealand’s largest, on Saturday night for what is believed to be the largest live in-person concert since the pandemic began.

Through a combination of swift lockdowns and border closures, New Zealand has all but eliminated the coronavirus, with 2,600 cases and 26 deaths reported since the start of the pandemic, according to a New York Times database.

Masks are rarely worn, and there are no social-distancing requirements in place. Instead, people are encouraged to scan in on the country’s tracking and tracing system, and hand sanitizer is widely available.

“Next time they tell you it’s impossible, show them this,” Six60, the New Zealand band headlining the concert, wrote in a comment on an aerial photograph of the crowd, posted to its Instagram account.

The event sold out in a matter of weeks. Featuring pyrotechnics and a Maori kapa haka group, it was the first time a musical act had been permitted to headline an event at Eden Park.

While hard-hit countries like Spain, which last month held an experimental indoor concert for 5,000 fans, test out safe ways to resurrect live music in a post-Covid environment, venues in New Zealand have been operating much as they did before the pandemic.

Less than 3 percent of New Zealand’s population has received a dose of a vaccine, according to a New York Times database, and audience members are not required to present proof of inoculation or a negative virus test.

Large live music events are also being organized in other places that have been able to curb the spread of the virus. In Taiwan, the singer-songwriter Eric Chou played sold-out events last year at Taipei Arena, with tickets capped at 10,000 people. In China, over 4,000 live concerts were held during the first week of October for the country’s National Day celebrations.

Perhaps the greatest change for New Zealand is the lack of international performers. With the border closed to almost everyone but citizens and some essential workers, performing artists have had to apply for special permission to enter the country, then spend two weeks quarantining in hotels. The Australian children’s entertainment group The Wiggles and a tribute act to the band Queen have been among those granted special entry visas for entry.

New Zealanders have instead embraced local acts. A national tour by the singer-songwriter Marlon Williams sold out in New Zealand’s largest cities. The singer Benee, who gained fame from TikTok and hails from Auckland, headlined the annual music festival Rhythm and Vines near the city of Gisborne, which attracted 23,000 attendees.

A new trans-Tasman travel corridor, which permits quarantine-free travel between Australia and New Zealand, began last week, opening the way for the Australian singer-songwriter Courtney Barnett to announce a 10-date tour in July.

Spanish police arrested a man for spreading the coronavirus to 22 people.

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Police officers patrolled an empty beach in Mallorca, Spain, earlier this month.Credit...Cati Cladera/EPA, via Shutterstock

The National Police in Spain said on Saturday that they had arrested a man who went to his workplace and a gym while showing Covid-19 symptoms, spreading the virus to 22 people.

The 40-year-old man was arrested on charges of a “crime of injury” in Manacor, a city on the island of Majorca, after an investigation that started in late January after an outbreak in the city.

Though the man showed symptoms at his workplace — “a well-known establishment in Manacor” — he did not want to go home, which concerned his co-workers, the police said in a statement. After his workday ended, the man got a coronavirus test.

He was notified of his positive test result at the end of the next day, the police said, after he had gone to a gym and again to work, where he had a fever of 104 degrees Fahrenheit and coughed while lowering his mask, saying, “I am going to infect you all with the coronavirus.”

The man infected eight people directly: five at his workplace and three at his gym, the police said. Those people infected another 14 people, including three children, among them a 1-year-old, the police said. None of the people involved in the outbreak has been hospitalized.

[An earlier version of this briefing misstated the day the police spoke. It was Saturday, not Monday.]

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The new big job in town is the C.C.O., or Covid compliance officer.

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Dr. Linda Dahl at the Kaufman Astoria Studios in Queens, N.Y.Credit...Sasha Maslov for The New York Times

Compliance practices at the Academy Awards on Sunday will be closely watched as organizers prepare for the gradual resumption of major events such as the Tonys (to be coordinated with Broadway’s reopening).

Part cop, part coach, Covid compliance officers, or C.C.O.s, have become essential overseers in America’s tentative return to prepandemic life.

“We’re at a tipping point,” said Dr. Blythe Adamson, an infectious disease epidemiologist and economist. “People are going out more, they have pandemic fatigue. They’re vaccinated, but people are still getting Covid with these new strains. It makes the compliance officer role extremely important.”

The budget for Covid compliance on film sets is high: 25 to 30 percent of the total, according to Dr. Linda Dahl, an ear, nose and throat surgeon who has become a C.C.O. Complicating the job, what constitutes Covid compliance can change on a weekly or even daily basis as guidelines from the Centers for Disease Control and Prevention constantly evolve.

A tourist haven in Thailand was poised to reopen, until a surge in virus cases.

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A small number of guests enjoying the pool at a resort in Phuket, Thailand, this month.Credit...Adam Dean for The New York Times

Only a few weeks ago, Phuket seemed poised for a comeback. After a year of practically no foreign tourists arriving in Thailand, the national government decided that Phuket would start welcoming vaccinated visitors in July, without requiring them to go through quarantine. The project was called Phuket Sandbox.

But Thailand is now gripped by its worst Covid-19 outbreak since the pandemic began, spread in part by the well-heeled Thais who partied in Phuket and Bangkok with no social distancing. The confirmed daily caseload — albeit low by global standards — has increased from 26 on April 1 to more than 2,000 three weeks later, in a country that in early December had about 4,000 cases total.

The opening that Phuket had planned for July 1 now appears unlikely, Thailand’s tourism minister acknowledged this month.

“If you ask me how optimistic I am, I cannot say,” said Nanthasiri Ronnasiri, the director of the tourism authority’s Phuket office. “The situation changes all the time.”

The virus’s resurgence after so many months of economic hardship is devastating for the majority of Phuket’s residents, who depend on foreign tourists for their livelihoods.

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New Yorkers savor the joy of the walk-in vaccination.

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The American Museum of Natural History in Mahattan is now operating as a walk-in site, where people can get vaccinated under the famous whale.Credit...Richard Drew/Associated Press

For weeks, Efraín Mejía had struggled to get a vaccine because he found it difficult to communicate in English every time he called a New York City hotline to book an appointment.

So when he noticed a short line of people standing outside a vaccination site in a mall in Downtown Brooklyn on Sunday, he stopped at once and was surprised to learn he could receive a shot without an appointment.

“I acted immediately,” Mr. Mejía, 55, a carpenter originally from Ecuador, said in Spanish after getting his first shot.

New York City officials announced on Friday that any eligible adult could get vaccinated at city-run sites without an appointment, a significant step meant to speed up the city’s vaccination efforts and expand access to more New Yorkers.

The announcement was a welcome development for people like Mr. Mejía who had been unable to secure sough-after appointment slots, which were often snatched up within seconds of being posted and involved navigating complex websites.

It was unclear how many people had taken advantage of the walk-in inoculations over the weekend, but a spokeswoman for Mayor Bill de Blasio said the city would release those numbers on Monday. As of Sunday, more than four million New York City residents had received at least one vaccine dose.

At the City Point mall in Downtown Brooklyn, there did not appear to be an influx of walk-ins: Mr. Mejía was the only person out of 20 people interviewed by The New York Times on Sunday who had not booked an appointment. Most people said the vaccination process was speedy and orderly, with many saying they had waited in line for only about five minutes.

“It was painless,” Mr. Mejía said. “God willing, everything goes back to normal soon because this has been catastrophic. The thing I most want is to go visit my family in Ecuador soon.”

Despite a billion vaccine shots given, Covid-19 runs rampant in much of the world.

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A Covid-19 patient waiting to be admitted to a hospital in South Delhi, India, on Saturday.Credit...Atul Loke for The New York Times

A global coronavirus surge that is driven by the devastation in India continues to break daily records and run rampant in much of the world, even as vaccinations steadily ramp up in wealthy countries and more than one billion shots have now been given globally.

On Sunday, the world’s seven-day average of new cases hit 774,404, according to a New York Times database. That is a jump of 15 percent from two weeks earlier, and higher than the peak average of 740,390 during the last global surge in January.

Despite the number of shots given around the world — more than one billion, according to a New York Times tracker — far from enough of the world’s estimated population of nearly eight billion have been vaccinated to slow the virus’s steady spread.

And vaccinations have been highly concentrated in wealthy nations: 82 percent of shots worldwide have been given in high- and upper-middle-income countries, according to data compiled by the Our World in Data project at the University of Oxford. Only 0.2 percent of doses have been administered in low-income countries.

Israel is far ahead of much of the world in vaccinations: More than half of the population is now fully vaccinated.

In Britain, where a highly contagious and deadly variant was discovered, nearly two thirds of adults 18 or older are at least partly vaccinated (an earlier version of this item incorrectly said that figure was for the whole British population). Relative to its size, Britain now has one of the lowest rates of new cases in Europe.

The United States, which has at least partly vaccinated a bit more than half of adults 18 or over, said on Sunday that it had removed impediments to the export of raw materials for vaccines to help India control the world’s worst outbreak.

India is recording more than a third of all new global cases each day, averaging more than 260,000 new daily cases over the past week. The country’s sudden surge, driven by the spread of a newer variant, is casting increasing doubt on the official death toll of nearly 200,000, with more than 2,000 people dying every day.

Experts say the official numbers, however staggering, represent just a part of the virus’s spread, with hospitals overwhelmed and lacking critical supplies like oxygen.

India is home to the Serum Institute of India, the world’s largest vaccine maker. But only about 8.6 percent of India’s population has received at least one shot of a vaccine. Its surge led to the Indian government’s decision to withhold exports of doses that many low- and middle-income countries were relying on. The vaccine rollout in Africa, which was already slower than it is in any other continent, could soon come to a near halt because of the suspension.

Public health experts say the number of global cases is most likely surging because more contagious virus variants are spreading just as people are starting to let their guards down.

In Thailand, where cases were kept at bay for months with strict quarantines and lockdowns, the virus has spread rapidly, in part by unmasked people partying. Daily cases, still low by global standards, have increased from 26 on April 1 to more than 2,000 three weeks later. And in India, many people stopped taking precautions after officials eased a lockdown that was imposed early last year.

“India let their guard down when the numbers fell and they thought they were over their last peak,” said Barry Bloom, a research professor and former dean of the Harvard T.H. Chan School of Public Health. He added that the United States should “take a lesson from other countries before we become complacent and decide everything’s OK.”

As bad as India’s situation is, the numbers have room to grow worse: Its daily caseloads, adjusted for its huge population, rank well below other countries’.

The rate of new cases in the United States is falling but remains alarmingly high — similar to last summer’s surge.

The rates of new coronavirus cases also remain high across much of South America. In Brazil, reported cases are starting to drop but remain high after a more contagious variant tore through the country and overwhelmed hospitals.

In continental Europe, the pace of vaccinations lags that in the United States and Canada, and the number of new coronavirus cases remains particularly high in France, Germany, the Netherlands and Sweden. Turkey, at the crossroads between Europe, the Middle East and Asia, is another hot spot.

Dr. Robert Murphy, the executive director of the Institute for Global Health at Northwestern University, said the United States had a responsibility to send unused vaccine doses to other countries as supplies increase.

“We have to start thinking on a global scale and do what we can to help these other countries,” Dr. Murphy said. “Otherwise we’re never going to put out the whole fire.”

A correction was made on 
April 26, 2021

An earlier version of this article referred imprecisely to a ban on the export of coronavirus vaccines and vaccine components, a term India's government has used. While legal impediments stand in the way of such exports, they are not banned.

How we handle corrections

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