India’s Neighbors Struggle Amid Regional Covid-19 Outbreak

KATHMANDU, Nepal — Most of Nepal is under lockdown, its hospitals overwhelmed. Bangladesh suspended vaccination sign-ups after promised supplies were cut off. Sri Lanka’s hopes of a tourism-led economic revival have collapsed.

As India battles a horrific surge of the coronavirus, the effects have spilled over to its neighbors. Most nearby countries have sealed their borders. Several that had been counting on Indian-made vaccines are pleading with China and Russia instead.

The question is whether that will be enough, in a region that shares many of the risk factors that made India so vulnerable: densely populated cities, heavy air pollution, fragile health care systems and large populations of poor workers who must weigh the threat of the virus against the possibility of starvation.

Though the countries’ outbreaks can’t all be linked to India, officials across the region have expressed growing dread over how easily their fates could follow that of their neighbor.

huge, maskless rallies in India hosted by Prime Minister Narendra Modi even as infections rose. Likewise, both the ruling and opposition parties in Nepal held large political gatherings after the prime minister dissolved Parliament in December.

told CNN on Saturday that Nepal’s situation was “under control” but acknowledged that “political instability” had led to “some mistakes.” On Monday night, Mr. Oli lost a vote of no confidence in Parliament, throwing Nepal into further turmoil.

Aid workers have warned that the parallels between Nepal and India may continue, as hospitals turn all but the most critically ill patients away. With medical oxygen supplies running short, as they did in India, Nepal’s government has imposed quotas for each hospital, which doctors say are far from adequate. Reports of patients dying from insufficient oxygen have spread.

said in a statement last week.

Vaccines are unlikely to help immediately. Nepal paid for two million doses from India’s Serum Institute, the world’s largest producer of vaccines. But as India’s crisis has escalated, its government has essentially halted exports, leaving Nepal a million doses short.

India’s pause has also scrambled vaccination plans in Bangladesh. Late last month, the authorities there announced that they would temporarily stop accepting new registrations for shots after supplies from the Serum Institute were cut off.

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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Conflict Between Israel and Palestinians Continues to Escalate

JERUSALEM — A new front opened in the military showdown between the Israeli Army and Palestinian militants in Gaza on Wednesday as a wave of mob violence between Jews and Arabs spread across several Israeli cities, leading to riots and attacks in the streets as rockets and missiles streaked across the sky.

Israel said it assassinated 10 senior militants and continued to pound both military and residential areas across the Gaza Strip with airstrikes, while Hamas, the Islamist group that rules Gaza, and its allies continued to fire rockets into civilian areas across central and southern Israel.

More than 1,000 rockets had been fired from Gaza by Wednesday night, most of them intercepted by an antimissile defense system, the Israeli military said.

expel several families from their homes in Sheikh Jarrah, East Jerusalem, approached — a case that quickly became a stand-in for historic expulsions of Palestinians from their land elsewhere in Israel.

The situation finally boiled over after a police raid on one of Islam’s holiest sites, the Aqsa mosque in Jerusalem, on Monday, which the police said was in response to stone-throwing by Palestinian demonstrators.

Hamas launched long-range rockets at Jerusalem on Monday evening, prompting Israel to respond with airstrikes. The military conflict also unleashed a wave of protests and rioting in Arab areas across Israel that night.

discriminatory laws, not least a recent law that downgraded the status of the Arabic language and said that only Jews had the right to determine the nature of the Israeli state.

“The way that we are treated is as though we shouldn’t be here,” said Diana Buttu, a Palestinian political analyst from Haifa, a northern city in Israel, and a former legal adviser to the Palestine Liberation Organization. “We are the people who they mistakenly did not ethnically cleanse from this place.”

In the central city of Lod, the government declared a state of emergency early Wednesday after a synagogue, school and several vehicles were burned by Arab rioters on Monday and Tuesday nights.

A Palestinian citizen, Moussa Hassouna, was shot dead by a Jewish resident during the disturbances on Monday night, and another wave of unrest followed his funeral 24 hours later.

The Israeli police said that Arab mobs were pulling Jews from their homes and trying to kill them.

“I feel like it’s 100 years ago, and I’m a defenseless Jew in the pogroms,” said Shabtai Pessin, 27, standing in a burned-out classroom at a religious school in Lod. “What’s our sin? Wanting a Jewish state after 2000 years of exile?”

In the northern city of Acre, a popular Jewish fish restaurant was set on fire, while Arab Bedouins attacked police stations and passing cars in the Negev desert, in southern Israel.

On Wednesday, these riots prompted crowds of Jews to respond.

In the cities of Or Akiva and Beersheva, Jews stoned the cars of people they believed to be Arab. In Tiberias, they threw rocks at hotels housing Arabs, who hurled objects from their windows in return. Cars were set on fire in several towns. And an Arab mob in Haifa ransacked a Jewish-owned hotel.

“It’s happening as we speak,” the hotel’s owner, Evan Fallenberg, said by phone on Wednesday night. “People are saying this is a rupture that we won’t be able to overcome. I don’t believe that — I know my friendships are lasting ones. But it is going to put everything to the test. We’re headed into something extremely difficult and dangerous, and I don’t know where this is going to end or how.”

Reporting was contributed by Gabby Sobelman from Rehovot, Israel; Irit Pazner Garshowitz and Myra Noveck from Jerusalem; Iyad Abuhweila from Gaza City; Megan Specia from London; and Annie Karni from Washington.

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As Gaza conflict heightens, a wave of Arab unrest spreads across Israel.

As rockets and airstrikes have pummeled targets across Gaza and Israel, a different conflict has erupted in the streets of Arab neighborhoods and mixed Arab-Jewish towns across the state of Israel.

Palestinian citizens of Israel have rioted in several cities since Monday night, burning cars and Jewish-owned properties, as anger at the Gaza conflict, as well as at decades of discrimination dating back to the foundation of the state of Israel, found its expression in street violence.

In the central city of Lod, known in Arabic as Lydd, the government declared a state of emergency on Wednesday morning, after a synagogue, a school and several vehicles were torched by Arab rioters on Monday and Tuesday nights.

A Palestinian citizen, Moussa Hassouna, was shot dead by a Jewish resident during the disturbances on Monday night, and another wave of unrest followed his funeral 24 hours later.

Jewish communities have been built in Israel’s history, but only seven for Arabs. In the Negev, dozens of Bedouin towns have never been given planning permission, leading to the demolition of hundreds of structures there every year.

The question of land has particular resonance in Lod: Thousands of Palestinians fled from their homes there in 1948, never to return, and the trauma of that event still lingers today.

“I still feel unsure whether I can keep living here,” said Ms. Naqib. “I fear they will try to expel us from our homes.”

And while it was Arabs who rioted in Lod and destroyed people’s property this week, Ms. Naqib said, it was a Jew who ultimately killed an Arab on Monday night — Ms. Naqib’s second cousin.

“I feel very afraid,” Ms. Naqib said as she arrived at her cousin’s wake. “And I feel a lot of anger that these settlers can start to shoot us.”

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Gaza Battle Draws Condemnation and Pleas for Restraint Around the World

As the new chapter of Israeli-Palestinian strife escalated on Wednesday and reverberated around the world, nations reacted with words of caution and condemnation, some focusing sharp criticism on Israel’s disproportionate use of force, while others defended Israeli action.

Protests were held in a number of cities on Tuesday night. In some Gulf Nations that have taken major steps toward normalizing relations with Israel in recent months, condemnation of the country’s airstrikes on Gaza was widespread.

Outside the parliament building in Kuwait, protesters gathered and blocked streets on Tuesday night as they rallied against Israeli actions, according to local reports and pictures from the scene posted on social media.

The new strife, which intensified over the past 48 hours after Israeli-Palestinian clashes at a holy site in Jerusalem, came against the backdrop of an easing of relations between Israel and some neighboring Arab nations in the Gulf, a careful yearslong process, and they offered a calibrated response.

The United Nations Relief and Works Agency, which provides extensive services to Palestinians registered as refugees in the Israeli-occupied territories and elsewhere in the Middle East, also called for an immediate halt to the hostilities. Gazan students who attend the agency’s schools were among the fatalities.

“Children are and must be protected under International Law and those responsible for breaching their obligations must be held fully accountable,” the agency said in a statement. It called on the combatants “to exercise maximum restraint and comply with their obligations under International Law in the strictest terms, including with regard to protecting the inherent right to life of children.”

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Covid Live Updates: Leaders of Biotech Firm That Ruined Vaccines Will Testify to Congress

opened a sprawling inquiry into Emergent’s manufacturing failures, and whether the company used its contacts with the Trump administration to land hundreds of millions of dollars in coronavirus vaccine contracts.

“Emergent’s actions wasted American taxpayer dollars and reduced the number of doses available for global vaccination efforts,” Representative Jim Clyburn, Democrat of South Carolina and the subcommittee’s chairman, said in a statement to The Times. He said that Congress “is looking for answers and they are long overdue.”

An investigation by The New York Times, published in March before the firm’s vaccine manufacturing troubles were known, examined Emergent’s aggressive lobbying tactics and lucrative relationship with the federal government.

The hearing will put an unwelcome spotlight on the company, which kept a low profile over the past two decades as it cornered the market on sales of anthrax vaccines and other bioterror-related products to the Strategic National Stockpile, the nation’s emergency medical reserve.

Emergent’s stock performed so well in 2020 that Mr. El-Hibri cashed in shares and options worth over $42 million, corporate filings show. Mr. Kramer, who has boasted to investors that “extensive relationships across multiple agencies within the federal government” helped build the company, took home a $1.2 million cash bonus and $2 million in stock awards.

Credit…Joe Andrucyk/Office of Governor Larry Hogan

In an interview with CNN on Wednesday morning, Mr. Clyburn indicated that the committee was also scrutinizing the executives’ market moves. “They all made millions in stock transactions while they seem to be hiding stuff from the public,” he said.

The Times reported last month that workers at Emergent’s Baltimore plant had accidentally conflated the ingredients of two coronavirus vaccines, one by Johnson & Johnson and the other by AstraZeneca. The error resulted in the loss of up to 15 million Johnson & Johnson doses, and a recent inspection by the Food and Drug Administration said that more doses may have been exposed to contamination.

In a statement on Wednesday, the company said that it had responded to the F.D.A.’s observations with a “comprehensive quality enhancement plan” and had “already started making improvements.”

On a recent call with investors, Mr. Kramer announced a management shake-up and took “full responsibility” for the manufacturing problems, acknowledging that the “loss of a batch for a viral contamination is extremely serious, and we treated it as such.” But he also said that Emergent had taken on a “herculean task” in a crisis.

In letters to the two Emergent executives last month, Mr. Clyburn and Representative Carolyn Maloney, Democrat of New York and chairwoman of the House Oversight and Reform Committee, demanded a slew of documents, including any correspondence between the company and Dr. Robert Kadlec, President Trump’s assistant secretary for preparedness and response, who previously consulted for the company. In interviews, Dr. Kadlec has said his consulting work, in 2013 and 2014, was limited and did not affect contracting decisions.

“Emergent has been in the news a lot lately, and that’s frankly not something we’re used to,” Mr. Kramer wrote in a commentary posted on the company’s website last month. “Until a year ago we were a little-known company that does our work behind the scenes.”

The company is trying to burnish its image with television and digital advertising, as part of a campaign it is calling “We Go.” The 30-second ads feature images of white-clad lab technicians and spotlight some of the company’s lesser-known work manufacturing cholera vaccines and medicine used to treat opioid overdoses, as well as its Covid-19 work.

Emergent’s plant in Baltimore is one of two federally designated Centers for Innovation in Advanced Development and Manufacturing, funded in part by taxpayers. In June 2020, the federal government awarded Emergent a $628 million contract, largely to reserve space for coronavirus vaccine manufacturing, despite staffing and quality concerns.

After The Biden administration responded to the potential contamination last month by putting Johnson & Johnson in charge of the Baltimore facility and moving out AstraZeneca. Doses made at the plant have not been cleared for use in the United States, and millions of shots made in Baltimore and sent overseas have also been put on hold.

Medical workers tending to a coronavirus patient in an emergency room in New Delhi last week.
Credit…Adnan Abidi/Reuters

A virus variant that has been spreading rapidly in India and designated a variant of concern by the World Health Organization might be more contagious than most versions of the coronavirus, the agency said in a report it published on Tuesday evening.

The W.H.O. emphasized in its report that it wasn’t yet clear how much the variant, known as B.1.617, had contributed to the devastating surge that has crushed India in recent weeks. It cautioned that India, like many countries, is only sequencing a tiny fraction of positive samples, and that with so little surveillance, it’s difficult to make firm conclusions about B.1.617.

The W.H.O. study comes amid growing condemnation of the Indian government’s response to its ferocious virus wave and calls for nationwide restrictions to try to limit the death toll, as hospitals are overrun and crematories burn nonstop.

India recorded more than 360,000 new cases on Wednesday and more than 4,200 deaths, the country’s highest daily death toll since the pandemic began. India has now reported more than 250,000 deaths from the virus, although experts believe that the true toll is far higher.

Experts also caution that it is not yet clear just how much of a factor B.1.617 has played in the explosion of cases in India. They point to a perfect storm of public health blunders, such as permitting enormous political rallies and religious festivals in recent months. It’s possible that the variant is being lifted up by the surge, rather than the other way around.

The W.H.O. speculated that another variant known as B.1.1.7, first identified in Britain and now dominant in the United States, might also be driving the swell in cases.

It’s not yet clear whether B.1.617 causes more severe Covid-19. Anecdotally, doctors in India are reporting higher numbers of young people and children testing positive for the virus and more patients with severe disease requiring oxygen support. But until more genetic sequencing is done, it’s impossible to know if the variant is to blame.

Stacia Wyman, a genomics scientist at the University of California, Berkeley, said that the W.H.O. had made the right decision. She pointed to the fact that the variant had already spread to at least 49 countries. “This appears to be posing the biggest threat right now in terms of transmissibility, with many countries reporting increasing trajectories of the B.1.617 variant,” she said.

B.1.617 is the fourth variant of concern recognized by the W.H.O. The others include B.1.1.7; B.1.351, which swept through South Africa; and P.1, which has devastated Brazil.

B.1.617 first came to light in October 2020. It had a number of mutations, some of which have been proved worrisome in other variants. Preliminary studies on the mutations suggest that some of them might give the coronavirus a tighter grip on cells, increasing their chances of a successful infection.

Other mutations could make it more difficult for antibodies produced by infections with other variants to stick to them. Studies on antibodies produced by vaccinated people also suggest that they work less successfully against B.1.617. Experts expect that most vaccines will remain effective against the variant.

W.H.O. researchers determined that B.1.617 is spreading fast in India, making up over 28 percent of samples from positive tests. The shift suggests that B.1.617 has a higher growth rate than other variants circulating in India, with the possible exception of B.1.1.7. And B.1.617 has been growing rapidly in Britain.

Gagandeep Kang, a pre-eminent Indian virologist, said there was not enough data to conclude whether either variant was contributing to India’s deadlier second wave.

“There is some conflicting data regarding the B.1.1.7 variant, which seems to indicate in some studies that it does cause more severe disease, in other studies not,” said Dr. Kang, the executive director of the Translational Health Science and Technology Institute in India.

Based on reports from hospitals, Dr. Kang said, it appeared that B.1.617 was causing more severe disease but that, again, there was insufficient data to draw conclusions. She said that real-time genetic information would be needed to determine whether B.1.617-infected people needed more oxygen.

Officials in India are trying to track how many fully vaccinated people have fallen ill. If an unusual number of these so-called breakthroughs are caused by a variant such as B.1.617, then that could point to the variant’s ability to evade a vaccine.

Pramod Sawant, chief minister of Goa, India, on the left and wearing personal protective gear, visited Covid-19 patients at a hospital in Panjim, a city in the state, on Tuesday.
Credit…Goa Chief Minister’s Office, via Agence France-Presse — Getty Images

NEW DELHI — Just a few months ago, the southwestern state of Goa was welcoming tourists from across the rest of India who were drawn to its picture-perfect beaches, an ideal source of relief from coronavirus rules in other regions.

Group celebrations, many without masks, were common. Life appeared to have gone back to normal.

But it did not last.

With India in the grip of a devastating coronavirus outbreak, 26 people died at the state-run Goa Medical College and Hospital on Tuesday morning, possibly because of an oxygen shortage, one official said.

“Due to interrupted supply of oxygen, we feel that between 2 a.m. and 6 a.m. many people are dying in G.M.C.,” the health minister for Goa, Vishwajit Rane, told The Times of India. He also called for a High Court inquiry to investigate the cause of the deaths.

Goa reported 75 deaths in total on Tuesday, its highest daily toll of the pandemic, and there were over 32,800 new daily infections in the state, which has a population of about 1.5 million. Officially, India has surpassed 250,000 total reported deaths from Covid.

Contradicting the health minister, Pramod Sawant, Goa’s chief minister, who visited the hospital, said that there was “no scarcity” and that the state had “abundant supplies of oxygen.” Mr. Rane said the chief minister might be “misguided.”

Goa has been reporting one of the highest infection rates in the country for at least a week.

Mr. Rane said in an interview with CNN last week, “Opening up of tourism without any restrictions in December has led to this situation.”

Goa has also created headlines for approving the use of ivermectin, an anti-parasite drug, in the treatment and prevention of Covid-19. The World Health Organization has said that there is not enough evidence to suggest that the drug reduces mortality in coronavirus patients.

On Monday, Mr. Rane announced on Twitter that the state government would make the drug available for everyone over 18 as a prophylactic.

Patients will be treated with ivermectin for a period of five days, Mr. Rane said, adding that the government would make the drug available at hospitals and primary health centers for people to “start the treatment immediately, irrespective of any symptoms.”

The W.H.O. has warned against the use of the drug, except in clinical trials.

“Safety and efficacy are important when using any drug for a new indication,” said Dr. Soumya Swaminathan, the W.H.O. chief scientist, in a post about ivermectin on Tuesday.

Marisol Gerardo, 9, is held by her mother as she gets a second dose of the Pfizer vaccine during a clinical trial for children at Duke Health in Durham, N.C., in April.
Credit…Shawn Rocco/Duke Health, via Reuters

On May 4, Dr. Hina Talib, who goes by the handle @teenhealthdoc on Instagram, asked the parents among her 33,000 followers if they were hesitant to get the coronavirus vaccine for their 12- to 15-year-olds, and if so, why. Dr. Talib, a physician in the adolescent medicine division at the Children’s Hospital at Montefiore in New York, got 600 messages in response.

More often than not, Dr. Talib said, the parents had already had the Covid-19 vaccine, and would preface their message with: “I’m not an anti-vaxxer or an anti-masker. I’m just worried.”

Although trials have shown no serious safety concerns for children thus far, some recent polls show that only about 30 percent of parents nationwide say they would get their children vaccinated right away. Parents of infants and preschoolers expressed even more anxiety about the vaccine than parents of teenagers.

These parents tend to be concerned about the vaccine affecting puberty and future fertility for their children, and its possible impact on allergies and side effects. Their fears are a key hurdle for U.S. efforts to expand vaccinations to younger teens.

Unloading an oxygen cylinder as a patient lay outside the emergency ward of a hospital in Kathmandu, Nepal, on Monday.
Credit…Niranjan Shrestha/Associated Press

As hospitals in Nepal strain to cope with one of the world’s fastest-growing coronavirus outbreaks, relief groups in the Himalayan nation are asking mountain climbers to hand over their used oxygen cylinders so that they can be refilled for Covid-19 patients.

The unusual appeal reflects the strange duality in Nepal: While hundreds of foreign climbers are attempting costly expeditions to the summits of Mount Everest and other peaks, the impoverished nation down below is facing urgent shortages of hospital beds, medical oxygen, coronavirus test kits and other supplies.

Expedition operators are preparing to airlift thousands of cylinders from the Himalayas as expeditions are completed this month, the culmination of the climbing season. Kul Bahadur Gurung, general secretary of the Nepal Mountaineering Association, estimated that tour companies would be able to provide at least 4,000 cylinders by the first week of June.

“We are asking them not to leave even a single oxygen cylinder in the mountains,” Mr. Gurung said.

Climbers attempting to reach the top of Everest, the world’s tallest peak, and other mountains carry oxygen to help them breathe in the thin air. Although Nepal prohibits leaving equipment behind in the mountains, canisters are sometimes left buried in the snow by exhausted climbers or stashed by expedition companies for later use.

Cylinders used in mountaineering are smaller to those typically found in intensive-care wards, but Mahabir Pun, a prominent Nepali scientist who is helping to lead the cylinder drive, said that they could be used by patients who cannot find a hospital bed or who are being treated at home.

“I.C.U. beds are already filled with critical Covid patients, so we want to distribute these portable expedition cylinders with regulators for those patients staying in home isolation,” Mr. Pun said.

Nepal’s outbreak has surged in recent weeks, most likely fueled by the virus’s catastrophic surge in India, with which it shares a long, porous border. On May 1, Nepal reported 26 deaths from the virus. On Tuesday, the official death toll was 225.

Doctors say that a shortage of medical oxygen is a factor in many of the deaths. Many hospitals have stopped admitting new Covid-19 patients, citing a lack of oxygen. Wealthy families are airlifting their loved ones by chartered helicopter to cities where they can find intensive-care beds. Other patients are being treated in makeshift emergency facilities set up in parking lots and other open spaces.

With almost half of Nepal’s coronavirus tests coming back positive, health experts warn that the worst is yet to come.

China has pledged to provide Nepal with 20,000 oxygen cylinders and 100 ventilators, the first batch of which arrived on Tuesday.

Expedition companies are stepping in with smaller donations. Mr. Gurung’s group said that he was sending five dozen cylinders, along with a few more from a local mountaineering museum, to hospitals treating coronavirus patients.

Mingma Sherpa, chairman of Seven Summit Treks, Nepal’s largest expeditions operator, said that he planned to ship as many as 500 cylinders used in expeditions to Everest and other peaks soon after climbers descended to base camps.

“My only condition is that those cylinders should be used for poor and helpless people rather than V.I.P.s,” he said, adding: “It’s our responsibility to help the government during these trying times. We will do it happily.”

Taking temperatures at a vaccination site in Bangkok on Tuesday.
Credit…Lillian Suwanrumpha/Agence France-Presse — Getty Images

As a resurgent coronavirus threatens countries across Southeast Asia, the health authorities in Thailand are working to contain an outbreak that is ripping through the tight-knit community of gemstone traders in the southeastern reaches of the country near the border with Cambodia.

The town of Chanthaburi — which has a long history as a center of the country’s business in rubies, sapphires and other stones — is at the heart of the outbreak, which has infected at least 166 in the community of traders from Africa who work in the country. At least 103 Thais in the town have also tested positive as a result of the latest outbreak, officials reported.

The cluster of cases comes as Thailand battles its worst outbreak since the pandemic began. For nearly three weeks, the country has averaged about 2,000 new cases a day — more than double its worst peak in January. The largest outbreak has been reported in Bangkok, which is under a partial lockdown.

On Wednesday, the government reported 34 deaths, a record, and 1,983 cases. One of those who died was from Finland.

Thailand was among the most effective countries last year in controlling the virus, but it has been slow to contain outbreaks this year and has lagged behind other countries in procuring vaccines.

Now, with the latest surge in cases, it is scrambling to obtain shots and to develop a mass inoculation program.

Some officials have declared that foreigners will not be vaccinated despite earlier outbreaks among migrant workers from Myanmar and now among the African gemstone traders. Other officials have said that Thailand will inoculate foreigners but have not provided specifics.

Thailand, which has a population of about 70 million, is home to more than two million foreigners who live in the country legally. More than two million more are believed to live in the country illegally.

Over the years, the gem business has attracted traders from several predominantly Muslim countries in Africa, including Gambia, Guinea and Mali. Many of them have settled in Thailand, married Thai wives and import gemstones from Africa.

Sankung Kongeh, a trader from Gambia, said members of the African community gathered daily at their offices and at the market, where they work, talk and eat together. During Ramadan, which began April 12, many also have prayed together, he said.

It is precisely that kind of close social contact that has fueled outbreaks around the world, but Mr. Kongeh discounted the group prayers as a significant risk.

“The possibility of the Covid spread has nothing to do with praying together,” said Mr. Kongeh, who recently tested negative. “It’s during the time hanging out at the office where we have the AC on, the door closed, and we chat with each other, drinking hot tea. There could be 10 or 12 of us sitting together. We don’t talk to each other during prayer.”

“Current institutions, public and private, failed to protect people from a devastating pandemic,” according to new reports delivered to the World Health Organization today. The Minneapolis-St. Paul International Airport in Minneapolis last November.
Credit…Tim Gruber for The New York Times

The next time the world faces an outbreak of a fast-spreading and deadly new pathogen, governments must act swiftly and be ready to restrict travel or mandate masks even before anyone knows the extent of the threat, according to a pair of new reports delivered to the World Health Organization.

The studies are intended to address missteps over the past year that led to more than 3.25 million deaths, some $10 trillion in economic losses and more than 100 million people pushed into extreme poverty.

“Current institutions, public and private, failed to protect people from a devastating pandemic,” concluded one of the reports, released on Wednesday, which called the Covid-19 pandemic “the 21st century’s Chernobyl moment.”

“Without change,” it said, these institutions “will not prevent a future one.”

The reviews, released in advance of this month’s meeting of the W.H.O.’s governing assembly, were written by appointees who donated countless hours in the midst of their own countries’ pandemic fights to interview hundreds of experts, comb through thousands of documents, gather data and seek counsel from public and private institutions around the world.

Pandemics, the authors concluded, are an existential threat on the order of a chemical or nuclear weapon, and preparing for them must be the responsibility of the highest levels of political leadership rather than only health departments, which are often among the least powerful of government agencies.

Aurora Duran, 86, is hugged by her granddaughter during a visit from her family at a long-term-care nursing community in Fort Stockton, Tex.. in April.
Credit…Tamir Kalifa for The New York Times

Epidemiologists in the United States are starting to hug again, running errands, gathering outdoors with friends and getting haircuts.

In a new informal survey this month by The New York Times, 723 epidemiologists responded to questions about how they were navigating this in-between phase of the pandemic, when vaccines have become widespread and cases are declining but herd immunity is not assured and Covid-19 remains a threat.

More than at any time in the past year, most are feeling hopeful that Covid-19 will eventually become just another risk in daily life, but not one that paralyzes us.

Nevertheless, their advice was to hold on to most precautions just a bit longer.

“There is a strong likelihood that we will experience unexpected problems due to moving about as if the Covid pandemic was no longer a threat,” said Jana Mossey, an epidemiologist who retired from Drexel University.

“It is not ‘one size fits all,’” said Alicia Riley, a sociologist and epidemiologist at the University of California, San Francisco, expressing a version of the profession’s unofficial motto: It depends. “How safe it is depends on the local levels of community transmission.”

Governor Henry McMaster of South Carolina signing a bill on April 22 requiring schools to provide in-person classes five days a week starting on April 26, in Columbia, S.C. 
Credit…Jeffrey Collins/Associated Press

Parents in South Carolina will be able to opt their children out of mask requirements in public schools, effectively ending mask mandates for schools throughout the state, according to an executive order signed by the governor that defies Centers for Disease Control and Protection guidance.

The order signed on Tuesday by Gov. Henry McMaster, a Republican, also prevented South Carolina’s local governments from using previously issued orders or states of emergency to enforce mask mandates and barred the use of “vaccine passports” in the state. South Carolina was one of several states that never had a statewide mask mandate, though several counties and cities imposed their own.

At least one school district said its legal counsel was reviewing the order. Doing away with masks in schools conflicts with C.D.C. guidance, which recommends universal masking combined with at least three feet of social distancing.

“Everybody knows what we need to do to stay safe — including wearing a mask if you’re at risk of exposing others — but we must move past the time of governments dictating when and where South Carolinians are required to wear a mask,” Mr. McMaster said in a statement, noting the availability of vaccines and falling coronavirus cases. “Maintaining the status quo ignores all of the great progress we’ve made.”

Mr. McHenry’s announcement comes as leaders in other states and cities have announced a rollback of restrictions and vaccines have become available to any adult. Mayor Muriel Bowser of Washington said on Monday that most of the city’s restrictions, including capacity limits, time restrictions and limits on types of activities would be lifted on May 21. Capacity limits on bars, nightclubs, and large sports and entertainment venues would be lifted June 11.

Mayor Jim Kenney of Philadelphia announced on Tuesday that all restrictions except the mask mandate would be lifted on June 11. The announcement came a week after Governor Tom Wolfe of Pennsylvania said that all restrictions related to gatherings, businesses and restaurants would be lifted on May 31 and that the statewide mask mandate would be lifted when 70 percent of adults in the state had been vaccinated. But the announcement came with the caveat that municipalities and school districts could continue or implement stricter mitigation efforts, despite the state’s easing restrictions.

The governor directed the Department of Health and Environmental Control and the Department of Education to develop a standardized form for opting out, the statement said.

Buying protective face masks following a small outbreak of coronavirus disease in Taipei, Taiwan, on Wednesday.
Credit…Ann Wang/Reuters

Growing concerns in Taiwan about a small but worsening coronavirus outbreak drove a sharp intraday plunge in its stock market on Wednesday, as investors worried about new government restrictions on businesses in a place that has largely escaped the pandemic.

On Wednesday morning, Taiwan’s health minister, Chen Shih-chung, said that the island’s new outbreak has reached a “very severe stage” and that restrictions could be upgraded in “the coming days.” He spoke after the government reported 16 new cases of local infection on Wednesday and seven on Tuesday.

The Taiwan Stock Exchange weighted index slumped as much as 8.6 percent intraday following the news, a nearly 13 percent loss from its April peak. The market regained some ground later in the day and finished down 4.1 percent.

Taiwan has been a rare success story in a pandemic-stricken world. The island democracy threw up its borders when the pandemic first began to spread from mainland China and has heavily limited travel. It has recorded only 1,210 total cases, according to a tally by The New York Times.

But the authorities haven’t been able to trace the handful of cases that have popped up in recent days, raising questions about whether the government will limit the number of people who can gather within restaurants or other businesses.

Taiwan instituted some Covid-related restrictions on Tuesday, the first in a long time. It suspended large events, limiting outdoor gatherings to 500 people and indoor gatherings to 100 people. On Wednesday morning, the health minister said that the restrictions might be stiffened within days.

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Live Updates: Israeli and Palestinian Violence Escalates to Major Crisis

with little international pressure on Israel to compromise or grant any concessions to Arabs under occupation.

Defense Minister Benny Gantz, visiting the southern city of Ashkelon near Gaza on Wednesday, suggested that the Israel Defense Forces’ campaign against Gaza militants was not about to end.

The military “will continue to strike and will bring complete quiet for the long term,” he said. “There is currently no end date.”

Israel’s latest operation targeted the Qassam Brigades, the military wing of Hamas and one of several Palestinian militant factions in active in Gaza. The Israeli military said a joint operation of soldiers and intelligence officers across Gaza had simultaneously killed the commanders, who were close to Muhammed Deif, the leader of the Qassam Brigades.

Without Qassam’s soldiers, Hamas would struggle to control Gaza. Its leaders have long been the targets of Israeli assassinations, and Mr. Deif was himself wounded in one attempt in 2006.

Credit…Ahmad Gharabli/Agence France-Presse — Getty Images

The wave of unrest and riots has spread across Arab-populated towns in Israel and parts of the occupied West Bank. Two days of Israeli strikes on Gaza, which is controlled by the militant group Hamas, have killed at least 53 Palestinians, including 14 children, and wounded more than 300 people in Gaza by Wednesday afternoon, according to Palestinian health officials.

Rockets fired by militants from Hamas and the Islamic Jihad, a smaller Palestinian group, targeted the Israeli cities of Ashkelon, Tel Aviv and Lod, among others. At least six people were killed and at least 100 were injured, according to Israeli health officials. One Israeli was killed was on Wednesday morning by an anti-tank missile near the Gaza perimeter.

The violence was fueled by a police raid on an Islamic religious site in Jerusalem on Monday. By Tuesday, the conflict had broadened, with civilians on both sides paying a price. The speed of the escalation appeared to take Israelis by surprise.

“Hamas and Islamic Jihad have paid, and will pay, a very heavy price for their aggression,” Prime Minister Benjamin Netanyahu said in an address to Israelis late Tuesday. “This campaign will take time,” he said.

Area of

extent

Mediterranean

Sea

The police raided

Al Aqsa Mosque

on Monday to

disperse crowds

and protesters.

Palestinian militants fired

hundreds of rockets toward

Jerusalem and at coastal

Israeli cities, killing at

least three people.

Israel launched at

least 130 retaliatory

airstrikes at Gaza,

killing at least 30

Palestinians.

Gaza

Strip

Area of

extent

The police raided

Al Aqsa Mosque on

Monday to disperse

crowds and protesters.

Palestinian militants fired

hundreds of rockets toward

Jerusalem and at coastal

Israeli cities, killing at

least three people.

Mediterranean

Sea

Israel launched at

least 130 retaliatory

airstrikes at Gaza,

killing at least 30

Palestinians.

Gaza

Strip

Israeli forces and

Palestinian militants

exchanged hundreds

of strikes at multiple

locations in

Gaza and Israel.

Police raided Al Aqsa

Mosque on Monday to disperse crowds and protesters.

Area of

extent

The police raided Al Aqsa

Mosque on Monday

to disperse crowds

and protesters.

Palestinian militants fired

hundreds of rockets toward

Jerusalem and at coastal

Israeli cities, killing at

least three people.

Mediterranean

Sea

Israel launched at

least 130 retaliatory

airstrikes at Gaza,

killing at least 30

Palestinians.

Gaza

Strip

The Israeli military, prepared for the latest eruption of cross-border fighting with militant groups in Gaza, designated a code name for its operation just hours after the deadly violence began: Guardians of the Walls, a reference to the ancient ramparts of the Old City of Jerusalem.

The Palestinian militant groups had their own code name for their campaign: Sword of Jerusalem.

Compounding the sense of crisis inside Israel, protests and riots resumed on Tuesday night in mixed Jewish-Arab towns and Arab population centers across the country as Palestinian citizens of Israel expressed solidarity with Gaza and frustration over discrimination against Arabs within Israel.

Palestinian citizens of Israel rioted in the mixed city of Lod, setting fire to a synagogue and dozens of cars. A popular Jewish-owned fish restaurant went up in flames in the city of Acre, and television images showed a Jewish mob stoning Arab vehicles in the city of Ramla.

Arab Israelis during a funeral in the Israeli city of Lod on Tuesday.
Credit…Agence France-Presse — Getty Images

The International Criminal Court’s main prosecutor said on Wednesday that she was closely watching Israel and Hamas, the militant group that controls the Gaza Strip, for potential new war crimes in the current conflict.

“I note with great concern the escalation of violence in the West Bank, including East Jerusalem, as well as in and around Gaza, and the possible commission of crimes under the Rome Statute,” the prosecutor, Fatou Bensouda, said in a statement. She was referring to the court’s statute on crimes against humanity and war crimes.

Ms. Bensouda’s office said in March, before the latest conflict erupted, that it had begun an investigation into mutual accusations of war crimes by Israel and Palestinian militant groups. That decision, which infuriated Israeli leaders, was largely welcomed by the Palestinian leadership and its supporters.

The court had already started a preliminary investigation six years earlier, on the heels of the 50-day Israel-Gaza conflict in 2014. It covers alleged crimes since June 13, 2014, shortly before the start of that fighting.

Israel is not a member of the International Criminal Court, which is based in The Hague, and it has maintained that the court has no jurisdiction over the area in question. But the court ruled that its jurisdiction extended to the West Bank, the Gaza Strip and East Jerusalem.

On Wednesday, Ms. Bensouda said that her office would continue to monitor the situation and address “any matter that falls within its jurisdiction.” The prosecutor’s office will investigate all sides to assess whether there is individual criminal responsibility under the statute, she added.

“I echo the call from the international community for calm, restraint and a stop to the violence,” she added.

Violence is escalating in Gaza and Israel, with Israel carrying out airstrikes on the Gaza Strip and militants in Gaza firing rockets into Israel.

President Biden, as vice president in 2016, with Prime Minister Benjamin Netanyahu of Israel in Jerusalem.
Credit…Pool photo by Debbie Hill

President Biden took office with little interest in pursuing an Israel-Palestinian peace agreement for understandable reasons: Predecessors in both parties had failed in their attempts.

Bill Clinton hosted an Israeli-Palestinian summit during his first year in office. Barack Obama appointed a Middle East peace envoy on his second full day. Donald J. Trump vowed even before being inaugurated to secure an Israel-Palestinian peace deal that “no one else has managed to get.” George W. Bush, who took up the cause later in his presidency, also faced frustration.

Even before the latest explosion of violence in Israel and Gaza, analysts agreed that such a peace deal looked hopeless in the near term, and Mr. Biden and his senior advisers have largely accepted that status quo.

He has issued familiar endorsements of a two-state solution while making little effort to push the parties toward one. But as spiraling riots, rocket attacks and airstrikes in Jerusalem and over Gaza threaten to escalate into a major conflict, calls are growing from within the Democratic Party for Mr. Biden to play a more active role.

“The problem with the Middle East,” said Martin S. Indyk, a special envoy for Israel-Palestinian negotiations during the Obama administration, “is that you can try to turn your back on it, but it won’t turn its back on you.”

Smoke from an Israeli airstrike in Gaza City.
Credit…Mohammed Saber/EPA, via Shutterstock

With dozens dead and hundreds injured, the initial two days of the renewed conflict brought fear and loss to millions in Gaza and Israel, but the escalating crisis has bolstered the political fortunes of Hamas, the Islamist militant group that runs the Gaza Strip, and of Prime Minister Benjamin Netanyahu of Israel.

A senior political leader for Hamas struck a triumphant tone on Tuesday over how rapidly the clashes in Jerusalem on Monday had expanded into a broader problem for Israel, as it faced rocket attacks from Gaza that threatened Israeli cities.

“We have managed to create an equation linking the Jerusalem and Gaza fronts,” the leader, Ismail Haniya, said in a speech recorded in Qatar and aired on a Hamas-affiliated television channel. “They are inseparable. Jerusalem and Gaza are one.”

Since coming to power in Gaza in 2007, Hamas has lost popularity because of what many Gazans see as its authoritarian approach and poor governance.

For Hamas, the conflict has allowed it to revitalize its claims to the leadership of Palestinian resistance and has framed its rocket attacks as a direct response to the Israeli police raids on the Aqsa Mosque compound, a religious site in East Jerusalem. In the process, the group presented itself as a protector of Palestinian protesters and worshipers in the city.

For Mr. Netanyahu, the conflict — along with the divisions it fosters among the opposition parties currently negotiating a coalition to topple him from power — has given him half a chance of remaining prime minister, just days after it seemed as if he might be on the way out.

“It is the story of every previous war between Israel and Hamas,” said Ghassan Khatib, a politics expert at Birzeit University in the occupied West Bank. Both governments “come out of it victorious, and the public of Gaza comes out of it as losers.”

Hamas said that a number of its militants in Gaza had been killed and that others had been reported missing in an Israeli attack.

The Israeli military said that its Gaza targets had included the weapons manufacturing sites of Hamas and Islamic Jihad, another militant group, as well as military facilities and two tunnels. A Hamas battalion commander who was at home in a residential apartment building was also targeted, according to the military.

Neither the location nor the condition of the person said to be a battalion commander was immediately clear. But Gaza health officials said that the bodies of three civilians had been removed from the ruins of the building.

Two of them — Amira Soboh, 58, and her son Abdelrahman, 17, who had cerebral palsy — were said to be members of a family living three floors below the apartment of the person alleged to be a commander. They were killed by falling rubble, said Ms. Soboh’s older son, Osama Soboh.

Mr. Soboh, a 31-year-old civil servant, questioned why Israel had targeted a civilian building. “It’s not a military barracks — it’s not posing any danger to Israel,” he said. “This was an old woman with a child with cerebral palsy.”

Israeli security forces deployed at the Aqsa Mosque compound in Jerusalem on Monday.
Credit…Ahmad Gharabli/Agence France-Presse — Getty Images

The latest outburst of violence in the Middle East erupted after weeks of rising tensions between Israelis and Palestinians around the Old City of Jerusalem and particularly at the Aqsa Mosque compound — one of Islam’s holiest sites and a frequent flash point of Israeli-Arab clashes.

Hamas, the Islamist militant group that controls the Gaza Strip, has cast itself as the Palestinian defender of the contested city of Jerusalem. It has issued threats and ultimatums demanding that the Israeli police withdraw from the site and release any protesters who were arrested.

On Monday, the Israeli police raided the mosque compound to disperse crowds and stone-throwing protesters with tear gas, stun grenades and rubber-tipped bullets. More than 330 Palestinians were wounded, at least three critically, according to the Palestinian Red Crescent. At least 21 police officers were wounded.

The Aqsa Mosque, in the heart of the Old City, is part of an internationally recognized heritage site sacred to Muslims, Christians and Jews. The site, which Jews call the Temple Mount and Muslims call the Noble Sanctuary, has been a flash point between Israelis and Palestinians since the 1967 war, when Israel captured East Jerusalem, which includes the Old City, from Jordan.

The compound, home to two ancient temples, is Judaism’s holiest site. The first temple was built by King Solomon, according to the Bible, and was later destroyed by the Babylonians. The second stood for nearly 600 years before the Roman Empire destroyed it in the first century.

An Islamic trust run by Jordan administers the site, as it did before the 1967 war. But the Israelis control access to the site, and religious tensions have occasionally exploded into violence there.

In 1990, deadly riots erupted after a group of Jewish extremists sought, unsuccessfully, to lay a cornerstone for a temple to replace the two destroyed in ancient times.

In 2000, a visit to the site by the right-wing Israeli leader Ariel Sharon, who later became prime minister, led to an angry Palestinian backlash that swelled into their second uprising, or Intifada.

In 2017, a deadly shooting at the site led the Israeli authorities to restrict access and install metal detectors, enraging Muslim worshipers and causing a crisis with Jordan. The crisis eased after Israel dismantled the extra security.

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Nepal to Use Oxygen Tanks From Everest to Treat Covid Patients

As hospitals in Nepal strain to cope with one of the world’s fastest-growing coronavirus outbreaks, relief groups in the Himalayan nation are asking mountain climbers to hand over their used oxygen cylinders so that they can be refilled for Covid-19 patients.

The unusual appeal reflects the strange duality in Nepal: While hundreds of foreign climbers are attempting costly expeditions to the summits of Mount Everest and other peaks, the impoverished nation down below is facing urgent shortages of hospital beds, medical oxygen, coronavirus test kits and other supplies.

Expedition operators are preparing to airlift thousands of cylinders from the Himalayas as expeditions are completed this month, the culmination of the climbing season. Kul Bahadur Gurung, general secretary of the Nepal Mountaineering Association, estimated that tour companies would be able to provide at least 4,000 cylinders by the first week of June.

“We are asking them not to leave even a single oxygen cylinder in the mountains,” Mr. Gurung said.

Climbers attempting to reach the top of Everest, the world’s tallest peak, and other mountains carry oxygen to help them breathe in the thin air. Although Nepal prohibits leaving equipment behind in the mountains, canisters are sometimes left buried in the snow by exhausted climbers or stashed by expedition companies for later use.

catastrophic surge in India, with which it shares a long, porous border. On May 1, Nepal reported 26 deaths from the virus. On Tuesday, the official death toll was 225.

Doctors say that a shortage of medical oxygen is a factor in many of the deaths. Many hospitals have stopped admitting new Covid-19 patients, citing a lack of oxygen. Wealthy families are airlifting their loved ones by chartered helicopter to cities where they can find intensive-care beds. Other patients are being treated in makeshift emergency facilities set up in parking lots and other open spaces.

With almost half of Nepal’s coronavirus tests coming back positive, health experts warn that the worst is yet to come.

China has pledged to provide Nepal with 20,000 oxygen cylinders and 100 ventilators, the first batch of which arrived on Tuesday.

Expedition companies are stepping in with smaller donations. Mr. Gurung’s group said that he was sending five dozen cylinders, along with a few more from a local mountaineering museum, to hospitals treating coronavirus patients.

Mingma Sherpa, chairman of Seven Summit Treks, Nepal’s largest expeditions operator, said that he planned to ship as many as 500 cylinders used in expeditions to Everest and other peaks soon after climbers descended to base camps.

“My only condition is that those cylinders should be used for poor and helpless people rather than V.I.P.s,” he said, adding: “It’s our responsibility to help the government during these trying times. We will do it happily.”

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Violence in Israel Challenges Biden’s ‘Stand Back’ Approach

At a briefing on Monday, Ned Price, the State Department spokesman, was asked about a tweet by Representative Ilhan Omar, Democrat of Minnesota, who said that the deputy mayor of Jerusalem, in a defense of the proposed evictions, had endorsed “ethnic cleansing.” Mr. Price said the claim was “not something that our analysis supports.”

Some analysts said that even if Mr. Biden shared the assessment that more pressure on Israel’s government would be effective, he might be wary of further exacerbating tensions with Israeli leaders anxious about his top priority in the Middle East: an effort to restore the 2015 nuclear deal with Iran, which Mr. Netanyahu and other top Israeli officials have long opposed.

Mr. Biden also took office at a moment of enormous political flux, with Israel in the midst of several failed efforts to form a lasting government and the Palestinians headed toward elections — since postponed, another source of the current unrest — that complicated efforts to devise a clear U.S. policy. Mr. Netanyahu is struggling to hold on to power, and U.S. officials say the influence of Mr. Abbas over Palestinian protests and violence, driven by militants and social media, is close to zero.

Mr. Biden also has memories from his days as vice president of Mr. Obama’s call for an Israeli settlement freeze and territorial concessions, which had little effect on policies over the long term but drew fierce political blowback from Republicans and some Democrats who said Mr. Obama failed to understand Israel’s security needs.

Republicans continue to exploit tensions in the Democratic Party over Israel policy. On Tuesday, Mr. Trump issued a statement charging that Mr. Biden’s “lack of support for Israel is leading to new attacks on our allies.” But it was unclear what support Mr. Trump felt the United States was not providing, given that his own statement of support for Israel’s “right to defend itself” matched Biden administration talking points.

Many Democrats, including Biden officials speaking privately, say that Mr. Trump is a key cause of the current problems. Halie Soifer, the chief executive of the Jewish Democratic Council of America, said that Mr. Trump, who fulsomely supported Mr. Netanyahu’s pro-settlement policies and defied warnings of Palestinian unrest in moving the U.S. Embassy to Jerusalem from Tel Aviv, “was willing to intervene in Israeli domestic politics and elections to pursue his political agenda, regardless of its impact on the region or the Israeli-Palestinian conflict.”

Ms. Soifer said that Mr. Biden deserved credit for being a supporter, during the Obama administration, of Israel’s so-called Iron Dome antirocket system, which has been defending Israeli cities from incoming fire.

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Covid Desperation Is Spreading Across India

NEW DELHI — Dozens of bodies washed up on the banks of the Ganges this week, most likely the remains of people who perished from Covid-19.

States in southern India have threatened to stop sharing medical oxygen with each other, fiercely protective about holding on to whatever they have as their hospitals swell with the sick and infections skyrocket.

And at one hospital in Andhra Pradesh, a rural state in southeastern India, furious relatives went on a rampage in the intensive care unit after lifesaving oxygen suddenly ran out — the latest example of the same tragedy repeating itself, of patients dying while gasping for air.

The desperation that engulfed New Delhi, India’s capital, over the past few weeks is now spreading across the entire country, hitting states and rural areas with many fewer resources. Positivity rates are soaring in those states, and public health experts say that the rising numbers most likely fall far short of giving the true picture in places where sickness and deaths caused by Covid-19 are harder to track.

B.1.167, may be especially transmissible, which is just adding to the sense of alarm.

an Indian news site that has been tracking the string of deadly incidents.

roughly two million doses that have been administered each day over the past few days are lower than the highs a few weeks ago, when some days the country gave out more than three million doses. Many people can’t find any appointments to get the shot. Some vaccination sites have completely run out, officials say.

All this is leading to the sharpest criticism that Narendra Modi, India’s powerful prime minister, has faced since he came into office seven years ago. He has been widely accused of declaring premature victory over the coronavirus and encouraging his country to drop its guard.

Mr. Modi’s Bharatiya Janata Party remains India’s most powerful political organization by far. But the solid wall that the party has maintained during this crisis may be showing some cracks.

Several party lawmakers in Uttar Pradesh, India’s biggest state and one controlled by Mr. Modi’s party, have begun to grumble about the way the state government has responded.

reported 12,481 new infections on Tuesday, less than half of what was reported on April 30. And the positivity rate among people being tested for the coronavirus has been steadily falling in the city, to 19 percent from a troubling high of 36 percent a few weeks ago.

In Mumbai, India’s commercial capital, something similar has happened and people are now allowing themselves to wonder if the worst has passed. Mumbai’s positivity rate has dropped to about 7 percent from roughly 25 percent.

chugged into Bangalore on Tuesday morning.

Kerala says it can’t ship out oxygen because it needs its entire supply for its own rising needs. Tamil Nadu, also in the south, is saying the same thing and that it can’t supply its poorer neighbor, Andhra Pradesh, where the 11 people died from the oxygen cutoff Monday night.

“I can hardly imagine what is going on in rural India,” said Rijo M. John, a health economist in Kerala, where the positivity rate shot up to nearly 27 percent on Tuesday, from around 8 percent in early April.

Mr. John said that rural areas were not doing much Covid testing and that many people “may be dying due to a lack of any treatment at all.”

A particularly troubling omen came to a riverside village in Bihar, a rural state in northern India. In the village of Chausa, residents were feeling deeply uneasy after discovering dozens of bodies that mysteriously washed up on the banks of the Ganges.

Nobody knows who these people were or how their bodies got there. Villagers found them on Monday evening. Stunned onlookers crowded around the remains, many with brightly colored clothes sticking to them, floating in the shallows. Images of the bloated bodies have made the rounds across Indian media, unsettling countless people.

Officials said around 30 bodies had been found. Witnesses put the figure at more than 100.

Once in awhile, villagers said, they see a single corpse floating in the river. It’s part of a custom in which some families send the bodies of their loved ones into the Ganges, the holiest river in Hinduism, weighted down by stones. But officials and residents in Chausa suspect that the unprecedented number of bodies they found this week belonged to victims of Covid-19.

“I’ve never seen so many bodies,” said Arun Kumar Srivastava, a government doctor in Chausa.

As Covid-19 has ravaged this area, Dr. Srivastava said he has seen more and more people transporting dead bodies, sometimes on their shoulders. “Definitely,” he said. “More deaths are happening.”

Krishna Dutt Mishra, an ambulance driver in Chausa, said that many poor people were disposing of bodies in the river because ever since the second wave of Covid hit, the price of cremations has shot up from 2,000 rupees, about $27, to 15,000 rupees, about $200, which for most families is an insurmountable sum.

This has become a problem across India. Covid-19 deaths have overwhelmed cremation grounds, and some unscrupulous cremation workers are now charging five or even 10 times the normal price for last rites.

“I drove the entire stretch from Buxar to Chausa,” Mr. Mishra said, referring to another town a little further east. “I have never seen even a few bodies, let alone so many of them, lined up on the river, all through this stretch.”

Hari Kumar and Shalini Venugopal Bhagat contributed reporting.

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