95 percent of its eligible population. Bhutan last month suspended entry for foreign workers, after experts cited concerns about laborers coming from India.

The border between Pakistan and India was closed even before the pandemic because of political tensions. But in Pakistan, too, cases are rising. Asad Umar, the official leading its coronavirus response, cited the fact that “the entire region is exploding with cases and deaths” to explain new lockdowns.

coronavirus response plan last May, it estimated that local facilities would be insufficient if there were more than 5,000 active cases at once. Now there are more than 100,000.

For many Nepalis, anger and sorrow have mixed with utter helplessness.

Pramod Pathak, a businessman in the border district of Kailali, has watched in anxiety and sorrow as migrant workers returned from India. They have crowded every day into overwhelmed testing centers, or — for the many for whom there are no tests — simply crammed into shared cars and returned to their villages.

“The virus is transmitting as they travel in jam-packed vehicles,” Mr. Pathak said. “There’s no safety for them no matter where they go — be it India or Nepal.”

Bhadra Sharma reported from Kathmandu, Nepal; Aanya Wipulasena from Colombo, Sri Lanka; and Vivian Wang from Hong Kong. Julfikar Ali Manik contributed reporting from Dhaka, Bangladesh, and Chencho Dema from Thimphu, Bhutan.

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The World May Need to Learn to Live With the Virus

Only two countries have fully vaccinated more than half of their populations, according to the Our World in Data project at the University of Oxford. They are Israel and the East African nation of the Seychelles, an archipelago with a population of fewer than 100,000. And just a handful of other countries have at least partially vaccinated nearly 50 percent or more, including Britain, tiny Bhutan, and the United States.

Less than 10 percent of India’s vast population is at least partly vaccinated, offering little check to its onslaught of infections.

In Africa, the figure is slightly more than 1 percent.

Still, public health experts say a relatively small number of countries, mostly island nations, have largely kept the virus under control and could continue keeping it at bay after vaccinating enough people.

New Zealand, through stringent lockdowns and border closures, has all but eliminated the virus. Dr. Michael Baker, an epidemiologist at the University of Otago who helped devise the country’s coronavirus response, said New Zealand would likely achieve herd immunity by immunizing its population, but it has a long way to go with only about 4.4 percent of New Zealanders at least partially vaccinated.

“All of the surveys show there is a degree of vaccine hesitancy in New Zealand, but also a lot of people are very enthusiastic,” Dr. Baker said. “So I think we will probably get there in the end.”

While new daily cases have remained at near-world record levels, the number of deaths has dropped from a peak in February, going against the normal pattern of high cases followed eventually by high deaths. If that trendline continues, it could offer a glimmer of hope for a future scenario that scientists are rooting for: Even as the virus spreads and seems to be hurtling toward becoming endemic, it could become a less lethal threat that can be managed with vaccines that are updated periodically to protect against variants.

“It may be endemic, but not in a life-threatening way,” Dr. Michael Merson, a professor of global health at Duke University and former director of the World Health Organization’s Global Program on AIDS said. “It may be more like what we see with young kids, a common cold like disease.”

Madeleine Ngo contributed reporting.

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How the Tiny Kingdom of Bhutan Out-Vaccinated Most of the World

THIMPHU, Bhutan — The Lunana area of Bhutan is remote even by the standards of an isolated Himalayan kingdom: It covers an area about twice the size of New York City, borders far western China, includes glacial lakes and some of the world’s highest peaks, and is inaccessible by car.

Still, most people living there have already received a coronavirus vaccine.

Vials of the Oxford-AstraZeneca vaccine arrived last month by helicopter and were distributed by health workers, who walked from village to village through snow and ice. Vaccinations proceeded in the area’s 13 settlements even after yaks damaged some of the field tents that volunteers had set up for patients.

“I got vaccinated first to prove to my fellow villagers that the vaccine does not cause death and is safe to take,” Pema, a village leader in Lunana who is in his 50s and goes by one name, said by telephone. “After that, everyone here took the jab.”

emphasized its citizens’ well-being over national prosperity, had administered a first vaccine dose to more than 478,000 people, over 60 percent of its population. The Health Ministry said this month that more than 93 percent of eligible adults had received their first shots.

according to a New York Times database.

That rate was ahead of those of the United Kingdom and the United States, more than seven times that of neighboring India and nearly six times the global average. Bhutan is also ahead of several other geographically isolated countries with small populations, including Iceland and the Maldives.

Dasho Dechen Wangmo, Bhutan’s health minister, attributed its success to “leadership and guidance” from the country’s king, public solidarity, a general absence of vaccine hesitancy, and a primary health care system that “enabled us to take the services even to the most remote parts of the country.”

“Being a small country with a population of just over 750,000, a two-week vaccination campaign was doable,” Ms. Dechen Wangmo said in an email. “Minor logistic issues were faced during the vaccination but were all manageable.”

Serum Institute of India, the world’s largest vaccine producer. Bhutan’s government has said it plans to administer second doses about eight to 12 weeks after the first round, in line with guidelines for the AstraZeneca vaccine.

according to the World Health Organization. Immunization levels in recent years have been above 95 percent.

But Bhutan’s health system is “hardly self-sustainable,” and patients who need expensive or sophisticated treatments are often sent to India or Thailand at the government’s expense, said Dr. Yot Teerawattananon, a Thai health economist at the National University of Singapore.

A government committee in Bhutan meets once a week to make decisions about which patients to send overseas for treatment, Dr. Yot said. He said the committee — which focuses on brain and heart surgery, kidney transplants and cancer treatment — was known informally as the “death panel.”

“I don’t think they could cope with the surge of severe Covid cases if that happened, so it is important for them to prioritize Covid vaccination,” he said, referring to Bhutan’s health authorities.

Bhutan has reported fewer than 1,000 coronavirus infections and only one death. Its borders, tight by global standards even before the pandemic, have been closed for a year with few exceptions, and anyone who enters the country must quarantine for 21 days.

received his first vaccine dose last month while in quarantine after a visit to Bangladesh. He has been supporting the vaccination effort in recent weeks on his official Facebook page.

“My days are dotted with virtual meetings on numerous areas that need attention, as I closely follow the vaccination campaign on the ground,” Dr. Tshering, a surgeon, wrote in early April. “So far, with your prayers and blessings, everything is going well.”

The economy in Lunana depends on animal husbandry and harvests of a so-called caterpillar fungus that is prized as an aphrodisiac in China. People speak Dzongkha, the national language, and a local dialect.

Last year, the drama “Lunana: A Yak in the Classroom” became the second film ever selected to represent Bhutan at the Academy Awards. It was filmed using solar batteries, and its cast included local villagers.

Lunana’s headman, Kaka, who goes by one name, said the most important part of the vaccination campaign was not on the ground, but in the sky.

“If there hadn’t been a chopper,” he said, “getting the vaccines would have been an issue, since there’s no access road.”

Chencho Dema reported from Thimphu, Bhutan, and Mike Ives from Hong Kong.

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