Prepandemic, Israel usually allowed tens of thousands of Palestinians from the West Bank to visit Jerusalem on Fridays during the fasting month. The arm of the Israeli government that liaises with the Palestinian Authority said on Tuesday that Israel would allow 10,000 vaccinated Palestinians from the West Bank to pray at the Aqsa on Friday. It also said authorities would permit 5,000 vaccinated Palestinians from the West Bank to make family visits in Israel between Sunday and Thursday next week.

Omar Kiswani, the director of the Aqsa Mosque, said he was overjoyed that the compound was open to worshipers — an estimated 11,000 attended the taraweeh prayers at the compound Monday evening — but he emphasized that people would still need to be careful. He said masks and two meters’ distance between worshipers are required at the mosque, and the indoor and outdoor spaces will be sterilized daily.

“These are times of great happiness,” Mr. Kiswani said. “We hope the blessed Aqsa Mosque will return to its prepandemic glory. But these are also times of caution, because the virus is still out there.”

Vivian Yee reported from Cairo, and Adam Rasgon from Jerusalem. Asmaa al-Omar contributed reporting form Istanbul and Abdi Latif Dahir from Nairobi.

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Covid-19 Live Updates: U.S. Calls for Pause on Johnson & Johnson Vaccine, Complicating Rollout

Johnson & Johnson’s single-dose coronavirus vaccine after six recipients in the United States developed a rare disorder involving blood clots within about two weeks of vaccination.

All six recipients were women between the ages of 18 and 48. One woman died and a second woman in Nebraska has been hospitalized in critical condition.

Nearly seven million people in the United States have received Johnson & Johnson shots so far, and roughly nine million more doses have been shipped out to the states, according to data from the Centers for Disease Control and Prevention.

“We are recommending a pause in the use of this vaccine out of an abundance of caution,” Dr. Peter Marks, director of the Food and Drug Administration’s Center for Biologics Evaluation and Research, and Dr. Anne Schuchat, principal deputy director of the C.D.C., said in a joint statement. “Right now, these adverse events appear to be extremely rare.”

On a media call later on Tuesday morning, Dr. Marks said that “on an individual basis, a provider and patient can make a determination whether or not to receive the vaccine” manufactured by Johnson & Johnson.

While the move was framed as a recommendation to health practitioners in the states, the federal government is expected to pause administration of the vaccine at all federally run vaccination sites. Federal officials expect that state health officials will take that as a strong signal to do the same. Within two hours of the announcement, Gov. Mike DeWine of Ohio, a Republican, advised all health providers in his state to temporarily stop giving Johnson & Johnson shots. In New York, the health commissioner, Dr. Howard Zucker, said the state would halt the use of the vaccine statewide while federal officials evaluate the safety risks. Appointments for Johnson & Johnson’s shot on Tuesday at state mass sites would be honored with Pfizer doses, Dr. Zucker said.

The authorities in New Jersey, Connecticut, Massachusetts, Maryland, Nebraska, Georgia, Indiana, Texas and Virginia also said that they would follow the call from federal health agencies.

Scientists with the F.D.A. and C.D.C. will jointly examine possible links between the vaccine and the disorder and determine whether the F.D.A. should continue to authorize use of the vaccine for all adults or limit the authorization.

In the media call, federal health officials tried to reassure recipients of Johnson & Johnson’s vaccine while at the same time describing symptoms that they should watch out if they received a shot within the past month.

Dr. Schuchat said that the risk of dangerous blood clots is “very low” for people who received the vaccine more than a month ago.

“For people who recently got the vaccine within the last couple of weeks, they should be aware, to look for any symptoms. If you receive the vaccine and develop severe headaches, abdominal pain, leg pain or shortness of breath, you should contact your health care provider and seek medical treatment,” she said. She emphasized that an emergency meeting of the C.D.C.’s outside advisory committee, which has been scheduled for Wednesday, to discuss how to handle the vaccine in the future is made up of independent experts.

Dr. Janet Woodcock, acting commissioner of the Food and Drug Administration, said she expects the pause in distributing and administrating the vaccine will last for “a matter of days” while officials investigate the cases. Officials also stressed that no serious safety problems have emerged with either of the other two federally authorized vaccines, developed by Pfizer-BioNTech and Moderna.

The move could substantially complicate the nation’s vaccination efforts at a time when many states are confronting a surge in new cases and seeking to address vaccine hesitancy. Regulators in Europe and elsewhere are concerned about a similar issue with another coronavirus vaccine, developed by AstraZeneca and Oxford University researchers. That concern has driven up some resistance to all vaccines, even though the AstraZeneca version has not been authorized for emergency use in the United States.

The vast majority of the nation’s vaccine supply comes from two other manufacturers, Pfizer-BioNTech and Moderna, which together deliver more than 23 million doses a week of their two-shot vaccines. There have been no significant safety concerns about either of those vaccines.

But while shipments of the Johnson & Johnson vaccine have been much more limited, the Biden administration had still been counting on using hundreds of thousands of doses every week. In addition to requiring only a single dose, the vaccine is easier to ship and store than the other two, which must be stored at extremely low temperatures.

Jeffrey D. Zients, the White House Covid-19 response coordinator, said Tuesday the pause “will not have a significant impact” the Biden administration’s plans to deliver enough vaccine to be able to inoculate all 260 million adults in the United States by the end of May. With the Johnson & Johnson setback, federal officials expect there will only be enough to cover fewer than 230 million adults. But a certain percentage of the population is expected to refuse shots, so the supply may cover all the demand.

Mr. Zients said the administration will still “reach every adult who wants to be vaccinated” by the May 31 target.

Federal officials are concerned that doctors may not be trained to look for the rare disorder if recipients of the vaccine develop symptoms of it. The federal health agencies said Tuesday morning that “treatment of this specific type of blood clot is different from the treatment that might typically be administered” for blood clots.

“Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given,” the statement said.

In a news release, Johnson & Johnson said: “We are aware that thromboembolic events including those with thrombocytopenia have been reported with Covid-19 vaccines. At present, no clear causal relationship has been established between these rare events and the Janssen Covid-19 vaccine.” Janssen is the name of Johnson & Johnson’s division that developed the vaccine.

In the United States alone, 300,000 to 600,000 people a year develop blood clots, according to C.D.C. data. But the particular blood clotting disorder that the vaccine recipients developed, known as cerebral venous sinus thrombosis, is extremely rare.

All of the women developed the condition within about two weeks of vaccination, and government experts are concerned that an immune system response triggered by the vaccine was the cause. Federal officials said there was broad agreement about the need to pause use of the vaccine while the cases are investigated.

The decision is a fresh blow to Johnson & Johnson. Late last month, the company discovered that workers at a Baltimore plant run by its subcontractor had accidentally contaminated a batch of vaccine, forcing the firm to throw out the equivalent of 13 million to 15 million doses. That plant was supposed to take over supply of the vaccine to the United States from Johnson & Johnson’s Dutch plants, which were certified by federal regulators earlier this year.

The Baltimore plant’s certification by the F.D.A. has now been delayed while inspectors investigate quality control issues, sharply reducing the supply of Johnson & Johnson vaccine. The sudden drop in available doses led to widespread complaints from governors and state health officials who had been expecting much bigger shipments of Johnson & Johnson’s vaccine this week than they got.

A Kent State University student getting his Johnson & Johnson vaccination in Kent, Ohio, last week.
Credit…Phil Long/Associated Press

The authorities in Ohio, New York, New Jersey, Connecticut, Massachusetts, Maryland, Nebraska, Georgia, Indiana, Texas and Virginia said on Tuesday that they would follow the call from federal health agencies to pause the administration of Johnson & Johnson’s vaccine after six women in the United States developed a rare disorder involving blood clots within about two weeks of vaccination.

CVS, the nation’s largest retail pharmacy chain, also said that it would immediately stop its use of Johnson & Johnson vaccinations and was emailing customers whose appointments would be canceled. A spokesman said that CVS would reschedule appointments “as soon as possible.”

Gov. Mike DeWine of Ohio and the state’s chief health official said they were advising all state vaccine providers to temporarily halt use of the single-dose vaccine. New York’s health commissioner, Dr. Howard Zucker, said the state would stop using the Johnson & Johnson vaccine, while the Food and Drug Administration and the Centers for Disease Control and Prevention evaluate the safety risks.

Connecticut health officials said they told vaccine providers to delay planned appointments and give an alternative option if they had the supply.

The C.D.C.’s outside advisory committee has scheduled an emergency meeting for Wednesday.

Jeff Zients, the White House Covid coordinator, said on Tuesday that the pause will not have a significant impact on the country’s vaccination campaign, which has accelerated in recent weeks as a rise in new virus cases threatens a fourth possible surge. Many states have already opened vaccination eligibility to all adults and others plan to by next week.

“Over the last few weeks, we have made available more than 25 million doses of Pfizer and Moderna each week, and in fact this week we will make available 28 million doses of these vaccines. This is more than enough supply to continue the current pace of vaccinations of 3 million shots per day,” Mr. Zients said in a statement.

Even though the reaction to the Johnson & Johnson shot is rare, any questions about the safety of the shots could bolster vaccine hesitancy.

Nearly seven million people in the United States have received Johnson & Johnson shots so far, and roughly nine million more doses have been shipped out to the states, according to data from the Centers for Disease Control and Prevention. The six women who developed blood clots were between the ages of 18 and 48. One woman died and a second woman in Nebraska has been hospitalized in critical condition.

“Right now, these adverse events appear to be extremely rare,” Dr. Peter Marks, director of the Food and Drug Administration’s Center for Biologics Evaluation and Research, and Dr. Anne Schuchat, principal deputy director of the C.D.C., said in a joint statement on Tuesday. “People who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider.”

Like many states, New York had already prepared for a significant drop in its supply of the Johnson & Johnson vaccine after federal officials said that supplies would be limited because of a production issue at a Baltimore manufacturing plant. On Friday, Gov. Andrew M. Cuomo said that New York expected to receive 34,900 Johnson & Johnson shots, a decrease of 88 percent from the previous week.

Dr. Zucker, New York’s health commissioner, said that the state would honor appointments made at state-run mass vaccination sites for the Johnson & Johnson vaccine by giving people the Pfizer-BioNTech vaccine instead. That vaccine requires two doses, and it was not immediately clear how the state would handle the additional strain on its supply.

Mayor Bill de Blasio of New York City said that the city would work to reschedule appointments at city-run vaccine sites, giving those people the Pfizer or Moderna vaccines instead.

“Every site has been told this morning to stop giving the J&J shots,” he said at a news conference.

Mr. Cuomo received the Johnson & Johnson vaccine at a public appearance last month in Harlem, which he framed as an effort to boost confidence in that vaccine’s efficacy rate and to address vaccine hesitancy.

Regulators in Europe and elsewhere are concerned about a similar issue with another coronavirus vaccine, developed by AstraZeneca and Oxford University researchers. That vaccine has not been authorized for emergency use in the United States.

Students line up for vaccines at Oakland University on Friday in Rochester, Mich. Coronavirus cases in the state have continued to rise in recent weeks.
Credit…Emily Elconin for The New York Times

The virus is again surging in parts of the United States, but it’s a picture with dividing lines: ominous figures in the Northeast and Upper Midwest, but largely not in the South.

Experts are unsure what explains the split, which doesn’t correspond to vaccination levels. Some point to warmer weather in the Sun Belt, while others suspect that decreased testing is muddying the virus’s true footprint.

The contours of where the virus is resurgent can be drawn around one figure: states that are averaging about 15 new cases a day for every 100,000 people. The 23 states — including Alabama, Mississippi and Arkansas — that have averaged that or fewer over the past week seem to be keeping cases relatively low, according to a New York Times database. Nationally, the country is averaging 21 new cases per 100,000 people.

In the 27 states above that line, though, things have been trending for the worse. Michigan has the highest surge of all, reporting the most drastic increase in cases and hospitalizations in recent weeks. Illinois, Minnesota and others have also reported worrisome increases.

Nationally, reported cases in the United States are growing again after a steep fall from the post-holiday peak in January. In the past two weeks, new confirmed cases have jumped about 11 percent, even though vaccinations picked up considerably, with an average of 3.2 million doses given daily.

Some Southern states, like Alabama and Mississippi, are lagging in vaccinations. Only about 28 percent of people in each state have received at least one shot, according to a New York Times vaccine tracker. Still, case counts continue to drop in both states.

Health experts say cases are rising in the Northeast and Upper Midwest for several reasons, including pandemic fatigue, the reopening of schools and the resumption of youth sports.

Hospitalizations tend to follow the trend line in cases by a few weeks, and have been rising in some states, most notably in Michigan.

Officials are also concerned about the spread of more contagious virus variants, especially B.1.1.7, first identified in Britain. The variant is now the leading source of new coronavirus infections in the United States, the director of the Centers for Disease Control and Prevention said last week.

Just why those factors might affect some states more than others is hard to pinpoint, experts say.

Dr. David Rubin, the director of PolicyLab at the Children’s Hospital of Philadelphia, said warmer weather in Southern states and California was probably playing a role, because it allows people to gather outdoors, with less risk of transmission.

New case reports have fallen by about 11 percent in Georgia over the past two weeks. And in Alabama, new cases are down roughly 29 percent, with a 17 percent decline in hospitalizations.

Some experts say, though, that reduced testing in some states could be obscuring the true picture. Testing in Alabama, for instance, has started to dip, but the share of tests that come back positive has remained high, at 11.1 percent, compared with a nationwide average of 5.1 percent, according to data compiled by Johns Hopkins University.

“People who are symptomatic and go to their provider are going to get a test,” said Dr. Michael Saag, the associate dean for global health at the University of Alabama at Birmingham, but “the desire for people to go get tested just because they want to know what their status is has dropped off dramatically.”

Still, Dr. Saag said, there is probably not a hidden spike in cases in Alabama right now, since hospitalizations in the state remain low.

The first dawn prayers of Ramadan around the Kaaba at the Grand Mosque in Mecca, Saudi Arabia, on Tuesday.
Credit…Amr Nabil/Associated Press

Millions of Muslims on Tuesday began celebrating a second Ramadan in the middle of the pandemic, although in many countries the first day of the holy month offered the promise of a Ramadan with fewer restrictions than last year.

Mosques across the Middle East and other parts of the world were closed for prayer last year, and lockdowns prevented festive gatherings with friends and family. In Jerusalem, for instance, the Old City was largely empty and the Aqsa Mosque compound was closed to the public, as coronavirus cases were surging.

But a large degree of normalcy was back on Tuesday: The Old City’s narrow alleys were crowded, sweet shops were preparing Ramadan desserts, clothing stores were open and the Aqsa compound was welcoming worshipers.

“Last year, I felt depressed and I didn’t know how long the pandemic would last,” said Riyad Deis, a co-owner of a spice and dried fruit shop in the Old City, while selling whole pieces of turmeric and Medjool dates to a customer. “Now, I’m relaxed, I have enough money to provide for my family and people are purchasing goods from my shop — it’s a totally different reality.”

The enthusiasm of some didn’t mean the Ramadan would go as normal. Across several countries in the Middle East, the authorities imposed limitations on customs and festivities, requiring that mosques enforce social distancing and telling worshipers to bring their own prayer rugs and to wear face masks.

In Dubai, Saudi Arabia and Egypt, taraweeh, the optional extra prayers that worshipers can observe at night, were capped at half an hour. No one will also be allowed to spend the night in a mosque, as is common during the last 10 days of Ramadan.

Mosques around the region were also prohibited from serving the fast-breaking meal of iftar or the predawn meal of suhoor. Though Muslims could still gather for those meals with friends and family, the authorities asked them to limit those gatherings this year.

In Jerusalem, Omar Kiswani, the director of Al Aqsa Mosque, said he was overjoyed that the compound was open to worshipers, but still urged caution.

“These are times of great happiness — we hope the blessed Aqsa Mosque will return to its pre-pandemic glory — but these are also times of caution because the virus is still out there,” Mr. Kiswani said.

In Egypt, government officials and prominent television hosts linked to the authorities warned Egyptians of a third wave of infections as Ramadan approached, hinting that another curfew or other lockdown restrictions could be imposed if cases rose.

“If you want the houses of God to remain open,” Nouh Elesawy, an official who oversees mosques at the Egyptian Ministry of Endowments, said earlier this month, “adhere to the precautionary procedures and regulations.”

The Ramadan restrictions may hit the hardest in poor neighborhoods, where residents depend on iftar banquets usually sponsored by wealthy individuals or organizations. For those people, feasting and Ramadan gifts are likely to be rarer, with tourism still at a trickle and many small businesses still suffering from the economic effects of the pandemic.

In Lebanon and Syria, the pandemic has worsened economic crisis that will likely squeeze people’s ability to enjoy the holy month, more than the governments’ limited restrictions aimed at curbing the spread of the coronavirus.

In Syria, where experts say the official infection and death numbers for Covid-19 are far below the reality, the government has few restrictions in place. Worshipers will even be allowed to stand in line inside of mosques to pray together after breaking their fast, the Syrian Ministry of Religious Affairs said.

In Lebanon, which emerged recently from a strict lockdown, shops and restaurants can operate regularly during the day but must offer only delivery service during a nighttime curfew from 9:30 p.m. to 5 a.m.

Global Roundup

Administering a coronavirus vaccine to a frontline worker in New Delhi, last week.
Credit…Rebecca Conway for The New York Times

India said on Tuesday that it would fast-track the approval of vaccines in use in other countries, a move aimed at rapidly increasing the country’s vaccine supply as it battles what is currently the world’s biggest coronavirus outbreak.

The Indian government said that it would grant emergency authorization to any foreign-made vaccine that had been approved for use by regulators in the United States, the European Union, Britain or Japan, or by the World Health Organization. The move had been recommended by a panel of Indian scientists and eliminates a requirement for drug companies to conduct local clinical trials.

“The decision will facilitate quicker access to such foreign vaccines” and encourage imports of materials that would boost India’s vaccine manufacturing capacity, the government said in a statement.

Earlier on Tuesday, India’s top drug regulator granted emergency approval to Sputnik V, the Russian-made vaccine, adding a third vaccine to the country’s arsenal on the same day that health officials recorded 161,736 new coronavirus infections in 24 hours.

It was the seventh straight day that India has added more than 100,000 cases, according to a New York Times database. Only the United States has seen a faster rise in infections during the pandemic.

India has administered about 105 million domestically produced vaccine doses for a population of 1.3 billion, but it is widely believed that the country needs to scale up inoculations rapidly because other measures have failed to control the virus. Many states have reimposed partial lockdowns and weekend curfews. In the country’s financial hub, Mumbai, health officials are racing to erect field hospitals as facilities report shortages of oxygen, ventilators and coronavirus testing kits.

And there is the risk of a superspreading event with the gathering of millions of Hindu pilgrims for the annual Kumbh Mela festival on the banks of the Ganges River, where the authorities say they are powerless to enforce social distancing.

India’s outbreak is reverberating worldwide as its pharmaceutical industry — which was supposed to manufacture and export hundreds of millions of doses of the AstraZeneca vaccine — is keeping most supplies at home. The approval of the Sputnik vaccine, whose first doses are expected to be available for use in weeks, offers hope that India could speed up its inoculation drive.

But it is unclear at this stage whether India will be able to procure significant quantities of other vaccines, including the Pfizer, Moderna and Johnson & Johnson shots in use in the United States. Major Western nations have accumulated much of the global supply of those vaccines and manufacturers are struggling to meet the surging demand.

India will import millions of Sputnik doses from Russia and then begin manufacturing the vaccine domestically, officials said. More than 850 million doses will be made, with some intended for export, Kirill Dmitriev, chief executive of the Russian Direct Investment Fund, a sovereign wealth fund that has financed the vaccine’s development, said in an interview with India’s NDTV channel.

“India is a vaccine-manufacturing hub and our strategic partner for production of Sputnik V,” Mr. Dmitriev said.

India has more than 13.6 million confirmed coronavirus cases, the second most after the United States, and 171,058 deaths, the fourth highest toll.

In other news around the world:

  • Japan has begun vaccinating 36 million people over age 65, the first time shots have been made available to the public during the country’s slow vaccine rollout. Officials said that 1,139 people nationwide had received doses on Monday, and that doses to cover all Japanese above the age threshold would reach municipal health facilities by the end of June. Although Japan has weathered the pandemic better than most countries, the pace of its vaccination effort, which until now had only covered 1.1 million frontline medical workers, has sparked public criticism and raised questions about readiness for the Tokyo Summer Olympics in just over three months.

  • Scotland on Tuesday moved forward plans to loosen its coronavirus lockdown, a day after the British government eased many restrictions in England. New rules beginning Friday will permit Scots to meet outdoors in groups of up to six adults from six households. The current rules restrict travel and set the maximum group size at four, from two households. Restrictions on shops and outdoor service in pubs, now relaxed in England, are scheduled to remain in Scotland until April 26.

  • Austria’s health minister resigned on Tuesday, citing personal health problems that he said have been exacerbated by the grueling job of helping lead the country’s response to the pandemic. “It feels like it has not been 15 months, but 15 years,” the minister, Rudolf Anschober, said in a statement. Mr. Anschober, 60, was appointed in January last year, as a Green party minister in a Conservative-led coalition, and has been one of the main faces of Austria’s coronavirus response. “In the worst health crisis in decades, the republic needs a health minister who is 100 percent fit. That is not currently me,” he said.

  • France will suspend all flights to and from Brazil, because of growing worries about the virus variant spreading there. “We see that the situation is getting worse” in Brazil, Prime Minister Jean Castex told lawmakers. The country previously permitted essential travel from Brazil, subject to testing and isolation requirements.

  • The World Health Organization on Monday evening called on governments to suspend the sale of live wild mammals in food markets to help prevent the emergence of new diseases. “Traditional markets, where live animals are held, slaughtered and dressed, pose a particular risk for pathogen transmission to workers and customers alike,” the agency said in a statement. Animals are the source of more than 70 percent of emerging infectious diseases in humans, it said. Early in the pandemic, Chinese officials suggested that the coronavirus outbreak might have started at a market. But W.H.O. experts said in a report last year that the role of animal markets in the story of the pandemic was still unclear.

Chancellor Angela Merkel, center, at a cabinet meeting in Berlin on Tuesday. Her government’s proposal on coronavirus restrictions would place half the country over the threshold for lockdown.
Credit…Pool photo by Andreas Gora

BERLIN — Chancellor Angela Merkel’s government moved a step closer on Tuesday to securing the right to force restrictions on areas where the coronavirus is spreading rapidly, overriding state leaders reluctant to take action.

Ms. Merkel and her ministers approved a legislative proposal that would make it easier for the national government to enforce lockdowns and other limits on movement in regions where infection levels pass a set threshold. At current levels, it could lock down more than half of the country.

Under Germany’s decentralized leadership structures, the 16 state leaders have been meeting regularly with the chancellor to agree on nationwide coronavirus response policies. But with different regions experiencing different rates of infection, some state leaders have been reluctant to enforce the agreed limitations, leading to confusion and frustration among many Germans.

“I believe this amendment is as important as it is an urgent decision about how to proceed in the coronavirus pandemic,” the chancellor told reporters after meeting with her ministers.

Parliament still has to debate and approve the proposal, which would take the form of an amendment to the Protection Against Infection Act, and that process is expected to begin this week.

“We are in a situation where an emergency mechanism is necessary,” Ralph Brinkhaus, the leader of the Christian Democratic Union in Parliament, told reporters, before a meeting of his party lawmakers to discuss the amendment.

Under the proposed amendment, the federal government could force stores and cultural institutions to close and enforce limits on the number of people allowed to meet up in any region where infections surpass 100 new cases per 100,000 residents over a period of seven days.

More controversially, the law would also allow Ms. Merkel’s government to order that schools and day care centers close if the number of new infections reaches more than 200 per 100,000 inhabitants. Schools fall under the jurisdiction of the states, and local leaders are reluctant to relinquish that control.

Germany has registered more than three million infections and more than 78,700 deaths from Covid-19 since the virus began moving through the country last spring. It recorded 10,810 new cases of infection on Tuesday, bringing the national rate of infection to more than 140 per 100,000.

The number of patients in intensive care is expected to hit a record this month, as the country struggles to vaccinate enough people to get ahead of the spread of the highly contagious B.1.1.7 variant.

Vaccinations at a mosque in London earlier this month. Britain’s program has reached over 32 million people, more than half the adult population.
Credit…Andrew Testa for The New York Times

Britain has now offered vaccinations to everyone in the country age 50 and older, the government announced late on Monday, and is extending its program to another age group, the latest sign that the national rollout is continuing at pace.

On Tuesday, the authorities opened vaccinations to anyone 45 or older, yet the announcement came with a small hiccup: The website for the country’s National Health Service crashed for a short time after the younger cohort was invited to book appointments online.

The new step in the country’s vaccine rollout comes as the authorities eased several restrictions in England on Monday after months of stringent lockdowns, with pubs and restaurants opened for drinks and dining outside, and nonessential shops once again opening their doors.

Prime Minister Boris Johnson called the moment a “hugely significant milestone” and in a statement thanked those involved with the vaccine rollout. Mr. Johnson said the country was on track to offer all adults a vaccination by the end of July. More than 32 million people across Britain have received their first dose of one of the vaccines, according to government data.

The government said it had also already offered vaccinations to every health or care worker, and to everyone with a high-risk medical condition.

England has also began rolling out the Moderna vaccine, which will be offered as an alternative alongside the Pfizer BioNTech vaccine for those under 30, instead of AstraZeneca’s, which has been the mainstay of Britain’s program so far.

There have been concerns about a possible link between the AstraZeneca vaccine and very rare blood clots, and last week British regulators said an alternative should be provided for younger people. Potential infection still poses much greater risks than any vaccine side effect for all those over 30, they said, and could do so for younger people if cases surged again.

“The Moderna rollout marks another milestone in the vaccination program,” Stephen Powis, the medical director of the National Health Service, said in a statement. “We now have a third jab in our armory.”

The vaccination program, he added, “is our hope at the end of a year like no other” as he encouraged people to book their appointments.

But despite the hopeful vaccine news and the return to public life, the country is still battling new cases of the virus, and a cluster in two London neighborhoods of a worrisome variant first discovered in South Africa has prompted mass testing. Health workers have gone door to door to urge residents to get tested, even if they are not showing symptoms, as dozens of cases have emerged. Similar measures were carried out elsewhere in the city earlier this month.

Studies have shown that the variant contains a mutation that diminishes the vaccines’ effectiveness against it. Dr. Susan Hopkins, the chief medical adviser for the country’s test and trace campaign, said the cluster of cases in parts of South London was “significant.”

“It’s really important people in the local area play their part in stopping any further spread within the local community,” she said in a statement.

Pacific Palace, a dim sum restaurant on a commercial strip in the Sunset Park section of Brooklyn, has seen revenue plunge.
Credit…Victor J. Blue for The New York Times

More than a year after the coronavirus first swept through New York, the streets of Sunset Park in southern Brooklyn reflect the pandemic’s deep and unhealed wounds intertwined with signs of a neighborhood trying to edge back to life.

The sidewalks are filling with shoppers and vendors. More businesses are welcoming customers. But owners still struggle to pay rent and keep their enterprises afloat, while many workers laid off after the city locked down last year remain without jobs.

And while the rate of vaccination in New York has increased significantly, the coronavirus still percolates through this densely packed neighborhood. The ZIP code that includes Sunset Park had the highest rate of positive cases in Brooklyn in early April, nearly double the citywide rate. Some residents have expressed skepticism about the vaccines, spooked by false information circulated over TikTok and other social media.

Adding to the stress is a spate of hate crimes and violence against people of Asian descent in New York and around the country, fed in some cases by racist claims that Asian-Americans are responsible for spreading the virus.

About a third of the residents in Sunset Park have received at least one dose of the vaccine, roughly the same level as the city overall, according to the city health data. But local leaders say they want to push that number much higher.

Kuan Neng, 49, the Buddhist monk who founded Xi Fang Temple on Eighth Avenue, said that people had come to him in recent weeks to express concerns over vaccines.

“Why do I need to do that?” is a common refrain, according to Mr. Kuan, followed by: “I’m healthy now. The hard times are over, more or less.”

“Many people want to delay and see,” Mr. Kuan said, himself included.

The owner of the Cinerama Dome in Hollywood and 15 other movie theaters said it would not reopen after the pandemic.
Credit…Kate Warren for The New York Times

ArcLight Cinemas, a beloved chain of movie theaters based in Los Angeles, including the Cinerama Dome in Hollywood, will permanently close all its locations, Pacific Theaters announced on Monday, after the pandemic decimated the cinema business.

ArcLight’s locations in and around Hollywood have played host to many a movie premiere, in addition to being favorite spots for moviegoers seeking out blockbusters and prestige titles. They are operated by Pacific Theaters, which also manages a handful of theaters under the Pacific name, and are owned by Decurion.

“After shutting our doors more than a year ago, today we must share the difficult and sad news that Pacific will not be reopening its ArcLight Cinemas and Pacific Theaters locations,” the company said in a statement.

“This was not the outcome anyone wanted,” it added, “but despite a huge effort that exhausted all potential options, the company does not have a viable way forward.”

Between the Pacific and ArcLight brands, the company owned 16 theaters and more than 300 screens.

The movie theater business has been hit particularly hard by the pandemic. But in recent weeks, the majority of the country’s largest theater chains, including AMC and Regal Cinemas, have reopened in anticipation of the slate of Hollywood films that have been put back on the calendar, many after repeated delays because of pandemic restrictions. A touch of optimism is even in the air as a result of the Warner Bros. movie “Godzilla vs. Kong,” which has generated some $70 million in box office receipts since opening over Easter weekend.

Still, the industry’s trade organization, the National Association of Theater Owners, has long warned that the punishing closures were most likely to affect smaller regional players like ArcLight and Pacific. In March, the Alamo Drafthouse Cinema chain, which operates about 40 locations across the country, announced that it had filed for Chapter 11 bankruptcy protection but would keep most of its locations operational while it restructured.

That does not seem to be the case for Pacific Theaters, which, according to two people with knowledge of the matter, fired its entire staff on Monday.

The reaction to ArcLight’s closing around Hollywood has been emotional, including an outpouring on Twitter.

Firefighters at the site of COVID-19 hospital Matei Bals, after a fire broke out in one of its buildings in Bucharest, Romania, in January.
Credit…Robert Ghement/EPA, via Shutterstock

Three people infected with the coronavirus died at a hospital in Bucharest on Monday evening after the oxygen supply stopped functioning, according to the authorities, the latest incident involving oxygen failure, which in many countries has driven up the virus death toll.

It was also another fatal setback for Romania’s ageing and overwhelmed health care system, which has suffered two fires in Covid-19 wards in recent months, killing at least 15 people.

Ventilators shut down at a mobile intensive care unit set up at the Victor Babes hospital in Bucharest after oxygen pressure reached too high a level, the country’s health authorities said in a statement, depriving patients of a vital supply. In addition to the three patients who died, five others were evacuated and moved to other facilities in the city.

Romania has recorded its highest rate of Covid-19 patients in intensive care units since the pandemic began, and on Sunday Prime Minister Florin Citu said that there were just six intensive care beds available across Romania, out of nearly 1,600.

Intensive care units in Hungary and Poland have also been at risk of being overwhelmed, as much of Eastern Europe has struggled to cope with a third wave of infections across the continent. Some Hungarian hospitals have sought medical students and volunteers to assist in Covid-19 wards, giving training to those without previous medical experience.

The mobile unit struck by the oxygen problem on Monday had only been in operation since Saturday, and it has epitomized long-running concerns over the country’s fragile health care system. In January, five patients died and a further 102 were evacuated from a different hospital in Bucharest after a fire broke out. In November, 10 patients hospitalized with the coronavirus died after a fire broke out in a hospital in the northeastern city of Piatra Neamt.

Romania’s spending on health care is among the lowest in the European Union, with just over five percent of gross domestic product allocated toward it, compared with 10 percent on average among other countries of the bloc.

More than 25,000 people who tested positive for the virus have died in Romania, and the authorities have closed schools and kindergartens throughout April as part of an extended Easter holiday.

The authorities have so far administered more than 3.5 million vaccine doses, in a population of about 19 million.

Alisa Stephens, a biostatistician at the University of Pennsylvania in Philadelphia, had to manage work and taking care of her children after the city went into lockdown last year.
Credit…Hannah Yoon for The New York Times

Studies have found that women in academia have published fewer papers, led fewer clinical trials and received less recognition for their expertise during the pandemic.

Add to that the emotional upheaval of the pandemic, the protests over structural racism, worry about children’s mental health and education, and the lack of time to think or work, and an already unsustainable situation becomes unbearable.

Michelle Cardel, an obesity researcher at the University of Florida, worries that this confluence of factors could push some women to leave the sciences.

“My big fear is that we are going to have a secondary epidemic of loss, particularly of early career women in STEM,” she said.

Female scientists were struggling even before the pandemic. It was not unusual for them to hear that women were not as smart as men, or that a woman who was successful must have received a handout along the way, said Daniela Witten, a biostatistician at the University of Washington in Seattle.

Women in academia often have little recourse when confronted with discrimination. Their institutions sometimes lack the human resources structures common in the business world.

Compounding the frustration are outdated notions about how to help women in science. But social media has allowed women to share some of those concerns and find allies to organize and call out injustice when they see it, said Jessica Hamerman, an immunologist at the Benaroya Research Institute in Seattle.

In November, for example, a study on female scientists was published in the influential journal Nature Communications suggesting that having female mentors would hinder the career of young scientists and recommending that young women seek out male help.

The response was intense and unforgiving: Nearly 7,600 scientists signed a petition calling on the journal to retract the paper — which it did on Dec. 21.

The study arrived at a time when many female scientists were already worried about the pandemic’s effect on their careers, and already on edge and angry with a system that offered them little support.

Alisa Stephens found working from home to be a series of wearying challenges. Dr. Stephens is a biostatistician at the University of Pennsylvania, and carving out the time and mental space for that work with two young children at home was impossible.

Things eased once the family could safely bring in a nanny, but there was still little time for the deep thought Dr. Stephens had relied on each morning for her work.

Over time, she has adjusted her expectations of herself. “Maybe I’m at 80 percent as opposed to 100 percent,” she said, “but I can get things done at 80 percent to some extent.”

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Some Nations Could Wait Years for Covid Shots. That’s Bad for Everyone.

NAIROBI, Kenya — The nurse lay in bed this month, coughing, wheezing and dizzy with fever.

It was three months after rich countries began vaccinating health workers, but Kenyans like the nurse, Stella Githaiga, had been left behind: Employed in the country’s largest public hospital, she caught the coronavirus on an outreach trip to remote communities in February, she believes, sidelining her even as Kenya struggles with a vicious third surge of infections.

Ms. Githaiga and her colleagues are victims of one of the most galling inequities in a pandemic that has exposed so many: Across the global south, health workers are being sickened and killed by a virus from which doctors and nurses in many rich countries are now largely protected.

That is just the most visible cost of a rich-poor divide that has deepened in the second year of the pandemic. Of the vaccine doses given globally, roughly three-quarters have gone to only 10 countries. At least 30 countries have not yet injected a single person.

Scientists have long warned that such unfair treatment could not only haunt poorer countries, but also rich ones, if the continued spread of the virus allows it to mutate in ways that undermine vaccines. But the greatest human costs will almost surely be borne by less wealthy nations.

the vaccine doses given globally.

“I don’t think we have the capacity, as a country and even as Africa, to treat our own,” said Hazel Miseda Mumbo, vice chancellor of the Great Lakes University of Kisumu in Kenya, who has studied the country’s health system. “While these countries in the West are still scrambling for vaccines, Africa will have to wait. It may be a sad situation.”

In a worrisome sign of how uneven distribution is, even Kenya, one of the continent’s wealthier countries, is faring badly.

dangerous variants circling the world. President Biden has promised to have vaccines for all adults in the United States by the end of May. Israel has vaccinated 60 percent of its people, and Britain has inoculated 41 percent.

Like many developing countries, Kenya is relying on the global mechanism for procuring and distributing vaccines known as Covax. The program was built on the idea that many countries, including richer ones, would use it to purchase shots as a way of spreading their bets across vaccine makers. Instead, dozens of wealthy nations bought doses straight from pharmaceutical companies, elbowing the international effort out of the way and delaying shipments to the developing world.

flight suspensions and school shutdowns that eventually forced children to repeat the school year — kept the virus from overwhelming the country last year, as did its relatively young population.

But control measures like lockdowns, available to rich and poor countries alike, are no longer the best defense against the coronavirus. The most valuable currency is now vaccines, opening a yawning gap between those that can afford them, and those that cannot.

The pandemic has worsened in Africa since a variant first seen in South Africa, shown to be able to reinfect people, began driving up cases in southern parts of the continent.

“Before that, it was believed that Africa had escaped this pandemic,” said Tulio de Oliveira, a geneticist at the Nelson Mandela School of Medicine in South Africa. “Unfortunately, it didn’t.”

With cases soaring in Kenya, vaccine delays will cost more lives. The number of reported Covid-19 cases — more than 120,000 infections that have led to around 2,000 deaths — is thought to be an undercount.

Kenya had also ignored other countries’ worries about being used as “guinea pigs” and participated in vaccine trials, raising expectations for earlier shipments.

“The clinical trials resulted in vaccines,” said Dr. David Ngira, a postdoctoral researcher in global health law at Cardiff University, who has been tracking vaccine rollouts in Africa. “And on this premise, the Kenyan participants, as well as the surrounding communities and country at large, should have been given some priority in vaccine access.”

But that has not happened. Even Kenya’s low expectations have been scaled back: A promised 4.1 million doses from Covax by May has been cut to 3.6 million doses. The country has ordered a total of 24 million doses.

Health officials say they are grateful, but even Covax shots come with a hitch. Vaccines covering the first 20 percent of Kenya’s population were free, but only on the grounds that the government pay for enough doses to cover another 10 percent of its people.

global economy could suffer losses exceeding $9 trillion, nearly half of which would fall on rich countries like Britain, Canada and the United States.

heart specialist in Zimbabwe — a mentor to younger doctors and a pillar of the country’s health system — was killed by Covid-19. That same month, a senior doctor in northern Nigeria died from the virus, confined to an isolation center.

Kenya’s health system was already hobbled last year by mistreatment of doctors and nurses. Many health workers, unpaid for months in some cases and often given inadequate protective equipment, walked off the job, forcing some hospitals to go months without nurses. One had to close its Covid-19 isolation unit and send patients home. In December, a 28-year-old doctor died from Covid-19 after having worked without a salary for months.

“It’s a moral emergency to protect health workers worldwide,” Gavin Yamey, associate director for policy at the Duke Global Health Institute, said. “Sickness and death of health workers in systems that are already weak could exacerbate those problems even further.”

For Nyachira Muthiga, a public hospital doctor who worked on a Covid-19 ward in Nairobi last year, the arrival of Kenya’s first vaccines brought a sense of relief. But the crushing experiences of the last year have made her wary.

Before contracting the illness herself, she lost many patients. Substandard protective equipment left her vulnerable, she said. And reports of corruption that cheated hospitals of much-needed money, she said, broke something in her.

Though she got the vaccine last week, she worries that those same endemic problems in the health system — combined with vaccine hoarding by rich nations — could put shots out of the reach of ordinary Kenyans for much longer.

“I am still hopeful,” she said, “that the health of our citizens will be a high priority at some point.”

Abdi Latif Dahir reported from Nairobi and Benjamin Mueller from London.

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Miami Beach Police Enforce Curfew Against Spring Break Crowds

Miami Beach officials struggled to enforce a new 8 p.m. curfew on Saturday in the city’s South Beach entertainment district. Videos on social media from showed hundreds of people gathered outside after dark on Saturday and law enforcement dispersing crowds.

In trying to control crowds and taking a subject into custody, Miami Beach police said they used pepper balls. Two officers were also injured and taken to the hospital, according a departmental tweet. Police arrested at least a dozen people, according to CNN.

The city of Miami Beach, worried about the bigger than usual crowds filling the streets of South Beach and the threat of a resurgent coronavirus, declared a state of emergency and moved up its curfew on Saturday in an effort to shut down late-night spring break partying that it said had gotten out of control.

Law enforcement officials said many people had been drawn to the city this year for spring break, because it, like the state at large, has relatively few virus restrictions. Hotel rooms and flights have also been deeply discounted, to make up for the months of lost time.

Florida reopened months before the rest of the country, long before the recent wave of states like Texas that have lifted all or most lockdown restrictions and mask mandates.

Miami-Dade County has recently endured one of the nation’s worst outbreaks, and more than 32,000 Floridians have died from the virus, an unthinkable cost that the state’s leaders rarely acknowledge. The state is also thought to have the highest concentration of B.1.1.7, the more contagious and possibly more lethal virus variant first identified in Britain.

The new measures do not require hotels in Miami Beach to close, but guests are being asked to stay on hotel premises after curfew, and restaurants, bars and sidewalk cafes must close by 8 p.m.

Miami Beach’s entertainment district includes the iconic Ocean Drive and Collins Avenue, as well as Washington Avenue and Española Way, from Fifth through 16th Streets. The police have begun blocking people who are not city residents, hotel guests or employees who work on South Beach from driving into the city along the MacArthur, Venetian and Julia Tuttle causeways beginning at 9 p.m. until 6 a.m. the next day.

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Miami Beach to spring breakers: No more late-night partying.

The city of Miami Beach, worried about big crowds filling the streets of South Beach and the threat of a resurgent coronavirus, moved up its curfew Saturday in an effort to shut down late-night spring break partying it said had gotten out of control.

The 8 p.m. curfew applied to the city’s South Beach entertainment district. Videos on social media from Friday night showed hundreds of people gathered outside after dark and law enforcement dispersing crowds.

“It looked like a rock concert,” Raul J. Aguila, the interim city manager, said in a hastily called news conference on Saturday afternoon. “You couldn’t see pavement, and you couldn’t see grass.”

Florida reopened months before the rest of the country, long before the recent wave of states like Texas that have lifted all or most restrictions and mask mandates.

the highest concentration of B.1.1.7, the more contagious and possibly more lethal virus variant first identified in Britain.

Dr. Anthony S. Fauci, the nation’s top infectious disease expert, said Saturday that he’s concerned that Americans are getting too comfortable as vaccinations gather speed and the country’s daily caseload is far below its January peak. But cases have plateaued at a high level, similar to last summer’s surge, according to a New York Times database.

“History has shown us that when you have that plateauing, that’s usually the forerunner of another surge. We’ve actually seen that in the European Union,” Dr. Fauci said on the Today Show, referring to the latest surge in Europe that has spurred governments to lock down again.

“I’m really concerned if we declare victory prematurely that that’s the same thing that’s gonna happen,” Dr. Fauci added about the situation in Europe. “If we can just hang on a bit longer, the more people get vaccinated, the less likelihood that there is going to be a surge.”

In Miami Beach, law enforcement officials said large crowds have been drawn to the city because they were looking for a place with fewer virus restrictions. Hotel rooms and flights have been deeply discounted, to make up for the months of lost time.

Hotels in Miami Beach do not have to close down but guests are being asked to stay on hotel premises after curfew, and restaurants, bars and sidewalk cafes must close by 8 p.m.

Miami Beach’s entertainment district includes iconic the Ocean Drive and Collins Avenue, as well as Washington Avenue and Española Way, from Fifth through 16th Streets. The police will also block people who are not city residents, hotel guests or employees who work on South Beach from driving into the city along the MacArthur, Venetian and Julia Tuttle causeways beginning at 9 p.m. until 5 a.m. the next day.

The emergency measures will be in place for 72 hours, until the City Commission can meet to decide on a longer-term plan. Miami-Dade County already has a countywide curfew in place at midnight.

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In Rage Over Sarah Everard Killing, ‘Women’s Bargain’ Is Put on Notice

Perhaps it was because pandemic lockdowns have left women clinging to whatever is left of their access to public space. Perhaps it was because after more than three years of the #MeToo movement, the police and society are still telling women to sacrifice their liberties to purchase a little temporary safety.

It all came to the surface when 33-year-old Sarah Everard, who disappeared as she walked home in London on March 3, was found dead a week later, after doing everything she was supposed to do. She took a longer route that was well-lit and populated. She wore bright clothes and shoes she could run in. She checked in with her boyfriend to let him know when she was leaving. But that was not enough to save her life.

So the response from British women to reports that the police were going door to door telling women in the South London neighborhood where she disappeared to stay inside for their own safety became an outpouring of rage and frustration.

@metpoliceuk really do want women off the streets don’t they?” Anne Lawtey, 64, wrote on Twitter after organizers announced the cancellation of the gathering. She was shocked, she said in a telephone interview, that it had been shut down. “We can’t have a vigil? People standing still, in a park, wearing masks?”

A huge crowd turned out anyway, carrying candles and bouquets, crocus bulbs in glass jars and flats of pansy seedlings to add to the pile of blooms.

With no audio equipment, women climbed on the Victorian bandstand that had become a makeshift memorial and used an Occupy Wall Street-style human microphone: The crowd repeated what was said so that it could be heard at the back.

working paper from Girija Borker, a researcher at the World Bank, found that women in India were willing to go to far worse colleges, and pay more tuition, in order to avoid harassment or abuse on their daily commutes to classes. The impact of that “choice” on one woman can be hard to measure — but among the thousands she documented in her research, it can be expected to have an effect on earnings, economic power and social mobility.

wrote on Twitter, adding, “4pm. New Scotland Yard.”

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