lament a lack of protective gear and health insurance.

“We are buying our own gloves and masks,” said Dr. Onyango Ndong’a, chairman of the local chapter of the Kenya Medical Practitioners, Pharmacists and Dentists Union. “We are covering for government inadequacies. We are tired now. We are stretched.”

For now, families who have lost loved ones are adjusting to a new reality.

Edward Onditi, 33, lost both his brother and his mother to Covid-19 this month. He said he left Nairobi to come and assist his family after his brother, Herbert, whom he regarded as a best friend and mentor, fell ill.

For weeks, the family transported Herbert, 43, between three hospitals in two counties — a distance of 70 miles in total — so that he could get high-flow oxygen. On the day before Herbert died, Edward had fish, his brother’s favorite meal, delivered to his isolation ward and promised to take him on a holiday once he was out.

“I’m so touched,” his brother said in a text message sent on June 2.

Barely 12 hours later, he was gone.

A few days later, their mother, Naomi, who had been ailing, succumbed to complications from Covid-19, too.

“It’s one of the toughest moments of my life,” Mr. Onditi said on a recent afternoon, his eyes welling with tears. “Things are just not working. They are not adding up.”

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Why Asia, the Pandemic Champion, Remains Miles Away From the Finish Line

SYDNEY, Australia — All across the Asia-Pacific region, the countries that led the world in containing the coronavirus are now languishing in the race to put it behind them.

While the United States, which has suffered far more grievous outbreaks, is now filling stadiums with vaccinated fans and cramming airplanes with summer vacationers, the pandemic champions of the East are still stuck in a cycle of uncertainty, restrictions and isolation.

In southern China, the spread of the Delta variant led to a sudden lockdown in Guangzhou, a major industrial capital. Taiwan, Vietnam, Thailand and Australia have also clamped down after recent outbreaks, while Japan is dealing with its own weariness from a fourth round of infections, spiked with fears of viral disaster from the Olympics.

the new outbreak in southern China will affect busy port terminals there. Across Asia, faltering vaccine rollouts could also open the door to spiraling variant-fueled lockdowns that inflict new damage on economies, push out political leaders and alter power dynamics between nations.

The risks are rooted in decisions made months ago, before the pandemic had inflicted the worst of its carnage.

blocked the export of 250,000 doses of the AstraZeneca vaccine meant for Australia to control its own raging outbreak. Other shipments were delayed because of manufacturing issues.

“The supplies of purchased vaccine actually landing on docks — it’s fair to say they are not anywhere near the purchase commitments,” said Richard Maude, a senior fellow at the Asia Society Policy Institute in Australia.

with the United States and Europe.

In Asia, about 20 percent of people have received at least one dose of a vaccine, with Japan, for example, at just 14 percent. By contrast, the figure is nearly 45 percent in France, more than 50 percent in the United States and more than 60 percent in Britain.

Instagram, where Americans once scolded Hollywood stars for enjoying mask-free life in zero-Covid Australia, is now studded with images of grinning New Yorkers hugging just-vaccinated friends. While snapshots from Paris show smiling diners at cafes that are wooing summer tourists, in Seoul, people are obsessively refreshing apps that locate leftover doses, usually finding nothing.

“Does the leftover vaccine exist?” one Twitter user recently asked. “Or has it disappeared in 0.001 seconds because it is like a ticket for the front-row seat of a K-pop idol concert?”

keep its borders closed for another year. Japan is currently barring almost all nonresidents from entering the country, and intense scrutiny of overseas arrivals in China has left multinational businesses without key workers.

The immediate future for many places in Asia seems likely to be defined by frantic optimization.

China’s response to the outbreak in Guangzhou — testing millions of people in days, shutting down entire neighborhoods — is a rapid-fire reprise of how it has handled previous flare-ups. Few inside the country expect this approach to change anytime soon, especially as the Delta variant, which has devastated India, is now beginning to circulate.

has threatened residents with fines of around $450 for refusing vaccines. Vietnam has responded to its recent spike in infections by asking the public for donations to a Covid-19 vaccine fund. And in Hong Kong, officials and business leaders are offering a range of inducements to ease severe vaccine hesitancy.

Nonetheless, the prognosis for much of Asia this year is billboard obvious: The disease is not defeated, and won’t be anytime soon. Even those lucky enough to get a vaccine often leave with mixed emotions.

“This is the way out of the pandemic,” said Kate Tebbutt, 41, a lawyer who last week had just received her first shot of the Pfizer vaccine at the Royal Exhibition Building near Melbourne’s central business district. “I think we should be further ahead than where we are.”

Reporting was contributed by Raymond Zhong in Taipei, Taiwan, Ben Dooley in Tokyo, Sui-Lee Wee in Singapore, Youmi Kim in Seoul and Yan Zhuang in Melbourne, Australia.

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A Top Virologist in China, at Center of a Pandemic Storm, Speaks Out

In less polarized times, Dr. Shi was a symbol of China’s scientific progress, at the forefront of research into emerging viruses.

She led expeditions into caves to collect samples from bats and guano, to learn how viruses jump from animals to humans. In 2019, she was among 109 scientists elected to the American Academy of Microbiology for her contributions to the field.

“She’s a stellar scientist — extremely careful, with a rigorous work ethic,” said Dr. Robert C. Gallo, director of the Institute of Human Virology at the University of Maryland School of Medicine.

The Wuhan Institute of Virology employs nearly 300 people and is home to one of only two Chinese labs that have been given the highest security designation, Biosafety Level 4. Dr. Shi leads the institute’s work on emerging infectious diseases, and over the years, her group has collected over 10,000 bat samples from around China.

Under China’s centralized approach to scientific research, the institute answers to the Communist Party, which wants scientists to serve national goals. “Science has no borders, but scientists have a motherland,” Xi Jinping, the country’s leader, said in a speech to scientists last year.

Dr. Shi herself, though, does not belong to the Communist Party, according to official Chinese media reports, which is unusual for state employees of her status. She built her career at the institute, starting as a research assistant in 1990 and working her way up the ranks.

Dr. Shi, 57, obtained her Ph.D. from the University of Montpellier in France in 2000 and started studying bats in 2004 after the outbreak of severe acute respiratory syndrome, or SARS, which killed more than 700 people around the world. In 2011, she made a breakthrough when she found bats in a cave in southwestern China that carried coronaviruses that were similar to the virus that causes SARS.

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Delhi Considers Lifting Covid Limits, Despite Vaccine Shortage

NEW DELHI — Delhi is considering relaxing its Covid-19 restrictions six weeks after a devastating coronavirus surge rocked the Indian capital, with a pledge to ramp up vaccinations to protect the city’s more than 20 million people from another wave.

But the vow came after a weekend in which city officials were forced to close vaccination centers for lack of supply, a problem plaguing the entire country as the coronavirus continues to spread. India does not have the vaccine manufacturing capacity to inoculate a big portion of its population anytime soon, while the prospect of importing new supplies from abroad has bogged down amid squabbling between the central and local governments.

As a result, any decision to lift coronavirus restrictions could be a mistake if the government allows large maskless gatherings to take place as it did before.

“The only answer is vaccination,” said Dr. Anand Krishnan, a professor of community medicine at the All India Institute of Medical Sciences in New Delhi.

health ministry reported. While India’s total of 26.8 million infections still lags behind the United States, with more than 33 million, the U.S. government has rolled out a wide vaccination campaign that has sent new infections plummeting. Only about 3 percent of India’s population has received two doses.

Experts also widely caution that India’s official numbers severely undercount new infections and deaths because of a lack of testing and other resources in a vast, developing country of 1.4 billion people.

Officials across India face pressure to reopen their local economies. Factory workers and members of the country’s vast, informal work force of shopkeepers and countless others cannot work from home and are anxious to restart their lives.

local news media on Sunday that Moderna, the American vaccine maker, had rejected its purchase request, saying the company would sell only to national governments. The company did not immediately respond to an emailed request for comment.

State governments — particularly those controlled by political factions opposed to Mr. Modi’s Bharatiya Janata Party — have been clashing with the Modi administration over vaccines and other issues, saying the central government had left them to fend for themselves.

advance purchase agreements to buy vaccines in bulk. Experts have criticized Mr. Modi and his government for the delays.

Dr. Gagandeep Kang, one of the country’s top virologists, said in a video interview on Sunday that the country was “late to the table” in buying vaccines from the international market.

NDTV.

Instead of competing with the rest of the world, Dr. Kang suggested that the country should invest in ramping up production of other potential vaccine candidates from Indian manufacturers that are expected to have their doses ready by the end of the year.

“I think we’ll get more doses that way,” she said.

Emily Schmall contributed reporting.

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How India’s Kerala Has Battled Coronavirus

When India’s second coronavirus wave slammed the country last month, leaving many cities without enough doctors, nurses, hospital beds or lifesaving oxygen to cope, Sajeev V.B. got the help he needed.

Local health workers quarantined Mr. Sajeev, a 52-year-old mechanic, at home and connected him with a doctor over the phone. When he grew sicker, they mustered an ambulance that took him to a public hospital with an available bed. Oxygen was plentiful. He left 12 days later and was not billed for his treatment.

“I have no clue how the system works,” Mr. Sajeev said. “All that I did was to inform my local health worker when I tested positive. They took over everything from that point.”

has failed, in many ways, to provide relief for victims of the world’s worst coronavirus outbreak.

online networks, charities and volunteers has emerged in India to fill the gaps left by the stumbling response of the central government and many states. Patients around India have died for lack of oxygen in hospitals where beds filled up quickly.

Deaths are rising. Workers face long hours and tough conditions. The situation could still worsen as the outbreak spreads.

On paper, Kerala’s death rate, at less than 0.4 percent, is one of India’s lowest. But even local officials acknowledge that the government’s data is lacking. Dr. Arun N.M., a physician who monitors the numbers, estimates that Kerala is catching only one in five deaths.

A relatively prosperous state of 35 million, Kerala presents particular challenges. Over 6 percent of its population works abroad, mostly in the Middle East. Extensive travel forces local officials to carefully track people’s whereabouts when a disease breaks out.

tackling a 2018 outbreak of the Nipah virus, a rare and dangerous disease.

As borders closed last year and migrant workers came home, the state’s disaster management team swung into action. Returning passengers were sent into home quarantine. If a person tested positive, local officials traced their contacts. Kerala’s testing rate has been consistently above India’s average, according to health data.

Experts say much of the credit for the system lies with K.K. Shailaja, a 64-year-old former schoolteacher who until this week was Kerala’s health minister. Her role in fighting the Nipah virus inspired a character in a 2019 movie.

drove India into recession. This year, Mr. Modi has resisted a nationwide lockdown, leaving local governments to take their own steps.

India’s states are also competing against each other for oxygen, medicine and vaccines.

“There has been a tendency to centralize decisions when things seemed under control and to deflect responsibility towards the states when things were not,” said Gilles Verniers, a professor of political science at Ashoka University.

has worsened the country’s outbreak, though they have been hindered by a lack of data. Kerala has used gene sequencing since November to track variants, helping to drive policy decisions, said Dr. Vinod Scaria, a scientist at the CSIR Institute of Genomics and Integrative Biology in New Delhi.

“It’s the only state that has not given up at any point in time,” Dr. Scaria said, adding that “they’re eager to use evidence to drive policies.”

A political shuffle has led some experts to wonder whether Kerala can keep its gains. This past week the Communist Party of India, which controls the state government, excluded Ms. Shailaja from its cabinet. The party said it wanted to give young leaders a chance, but observers wondered whether Ms. Shailaja had grown too popular. She didn’t respond to requests for comment.

“Even the best-performing governments,” Professor Verniers of Ashoka University said, “are not immune from shooting themselves in the foot due to misguided political calculations.”

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How India’s Kerala Has Battled Covid-19

When India’s second coronavirus wave slammed the country last month, leaving many cities without enough doctors, nurses, hospital beds or lifesaving oxygen to cope, Sajeev V.B. got the help he needed.

Local health workers quarantined Mr. Sajeev, a 52-year-old mechanic, at home and connected him with a doctor over the phone. When he grew sicker, they mustered an ambulance that took him to a public hospital with an available bed. Oxygen was plentiful. He left 12 days later and was not billed for his treatment.

“I have no clue how the system works,” Mr. Sajeev said. “All that I did was to inform my local health worker when I tested positive. They took over everything from that point.”

has failed, in many ways, to provide relief for victims of the world’s worst coronavirus outbreak.

online networks, charities and volunteers has emerged in India to fill the gaps left by the stumbling response of the central government and many states. Patients around India have died for lack of oxygen in hospitals where beds filled up quickly.

Deaths are rising. Workers face long hours and tough conditions. The situation could still worsen as the outbreak spreads.

On paper, Kerala’s death rate, at less than 0.4 percent, is one of India’s lowest. But even local officials acknowledge that the government’s data is lacking. Dr. Arun N.M., a physician who monitors the numbers, estimates that Kerala is catching only one in five deaths.

A relatively prosperous state of 35 million, Kerala presents particular challenges. Over 6 percent of its population works abroad, mostly in the Middle East. Extensive travel forces local officials to carefully track people’s whereabouts when a disease breaks out.

tackling a 2018 outbreak of the Nipah virus, a rare and dangerous disease.

As borders closed last year and migrant workers came home, the state’s disaster management team swung into action. Returning passengers were sent into home quarantine. If a person tested positive, local officials traced their contacts. Kerala’s testing rate has been consistently above India’s average, according to health data.

Experts say much of the credit for the system lies with K.K. Shailaja, a 64-year-old former schoolteacher who until this week was Kerala’s health minister. Her role in fighting the Nipah virus inspired a character in a 2019 movie.

drove India into recession. This year, Mr. Modi has resisted a nationwide lockdown, leaving local governments to take their own steps.

India’s states are also competing against each other for oxygen, medicine and vaccines.

“There has been a tendency to centralize decisions when things seemed under control and to deflect responsibility towards the states when things were not,” said Gilles Vernier, a professor of political science at Ashoka University.

has worsened the country’s outbreak, though they have been hindered by a lack of data. Kerala has used gene sequencing since November to track variants, helping to drive policy decisions, said Dr. Vinod Scaria, a scientist at the CSIR Institute of Genomics and Integrative Biology in New Delhi.

“It’s the only state that has not given up at any point in time,” Dr. Scaria said, adding that “they’re eager to use evidence to drive policies.”

A political shuffle has led some experts to wonder whether Kerala can keep its gains. Earlier this week, the Communist Party of India, which controls the state government, excluded Ms. Shailaja from its cabinet. The party said it wanted to give young leaders a chance, but observers wondered whether Ms. Shailaja had grown too popular. She didn’t respond to requests for comment.

“Even the best-performing governments,” Professor Vernier of Ashoka University said, “are not immune from shooting themselves in the foot due to misguided political calculations.”

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W.H.O. Notes Steep Drop in New Cases in Europe Over Past Month

Europe has recorded a 60 percent drop in new coronavirus infections over the past month, the World Health Organization said Thursday, encouraging news that comes as the continent plans to reopen its borders. Still, “this progress is fragile,” a top agency official cautioned.

On Wednesday, the 27 member states of the European Union agreed that the bloc would reopen its borders to nonessential travelers who have been fully vaccinated against the coronavirus with an approved shot, as well as to those coming from a list of countries where the coronavirus is relatively under control.

The rules are set to become formal policy next week, and could be implemented immediately. Under the E.U. plan, the bloc would accept visitors who have completed their immunization at least two weeks before their arrival, using one of the shots approved by the union’s own regulator or by the W.H.O. That covers the vaccines from AstraZeneca, Johnson & Johnson, Moderna, Pfizer-BioNTech and Sinopharm, according to a draft of the rules seen by The New York Times.

Most countries are likely to introduce changes slowly and conservatively, but some of them, like Greece, have already removed quarantine requirements for vaccinated travelers or those who have a negative PCR test from no more than 72 hours ago. England, France, Spain, Poland, Italy and other countries in the bloc have already started easing restrictions.

worrisome variants that appeared to be spreading within the bloc remained a cause for concern.

“This progress is fragile, we have been here before,” Dr. Kluge told reporters at a news conference, advising vigilance over outbreaks “that could quickly evolve into dangerous resurgences.”

The B.1.617 variant, which was first identified in India and has been deemed a variant of concern by the W.H.O., has now spread to 26 of the 53 countries the W.H.O. includes in its European region. Dr. Kluge said that although most cases of the variant were connected to international travel, transmission of the variant was occurring within Europe.

“We are heading in the right direction, but need to keep a watchful eye on a virus that has claimed the lives of nearly 1.2 million people in this region,” Dr. Kluge said.

Dr. Kluge added that the vaccines had so far been effective against variants, but that the slow vaccine rollout in Europe had only reached a small percentage of the population, and that precautions like social distancing and wearing masks were still necessary.

“Vaccines may be a light at the end of the tunnel, but we cannot be blinded by that light,” he said.

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These Twins Lived Together. In Covid, They Died Together.

NEW DELHI — Joefred and Ralfred Gregory moved through life as one.

They went to the same college. They studied the same thing. They wore matching clothes. They trimmed their beards the exact same way.

Identical twins, they were two handsome young men in northern India who above all else really loved each other. And when they both were struck by Covid-19 last month and hospitalized, it was like they shared one sick body.

Hours after Joefred died, Ralfred’s mother told him that his brother was still alive, to keep his spirits up.

has suffered so much and keeps suffering. Though India’s overall case numbers have dropped this past week, the deaths keep going up.

On Wednesday, India broke a world record for the most reported Covid deaths in a single day: 4,529. However alarming that number is — three Indians dying every minute because of the coronavirus — experts say that it is just a small fraction of the true toll and that the real numbers are far higher.

Joefred and Ralfred, 24, had a special bond. Though their parents gave them similar names, they said they didn’t raise the twins to copy each other. Still, neighbors said that where you saw one, you saw the other, even after they reached adulthood.

the worst surge of infections that any country had seen since the pandemic began.

So many people were getting infected at the same time, especially in northern India, where Meerut is, that hospitals couldn’t cope. Sick people were being turned away. They were dying in the streets, in the back seats of cars parked in vain outside hospital gates, at home, gasping for air.

There was a deadly shortage of lifesaving oxygen and medicine. It was the Covid nightmare that all nations have feared since the pandemic began, exploding with a fury.

leading Indian newspapers ran stories, showing the two brothers side by side in identical suits. Television stations jumped in as well, with their doctor talking about how thoroughly the virus had destroyed their lungs.

Credit…via Gregory Raymond Raphael

Of all the thousands of deaths in recent days, these two seemed to really unsettle people, perhaps because the twins were just in their 20s and had looked so healthy, or maybe it was simply their closeness. Across social media, people exchanged messages such as “This is so heartbreaking!” and “How devastating it must be for the parents. So young …”

Their father says he feels like his heart has been torn from his body.

“I keep thinking that maybe I shouldn’t have brought them to the hospital,” he said. “Maybe I should have kept them at home. There is a parental love that the hospital can’t give.”

“But there’s no use of saying, ‘If this could have happened, or that could happened,’” he said. “My children are gone now.”

Every day, he said, he visits the graveyard.

Beneath a young neem tree, Joefred and Ralfred Gregory are buried in two coffins but one grave.

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