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China’s Sinopharm Vaccine Approved for Emergency Use By W.H.O.

Developing countries racing for coronavirus vaccines now have another dependable option — and China’s reputation as a rising scientific superpower just got a big boost.

The World Health Organization on Friday declared a vaccine made by a Chinese company, Sinopharm, as a safe and reliable way to fight the virus. The declaration marks a significant step toward clearing up doubts about the vaccine, after little late-phase clinical trial data was disclosed by the Chinese government and the company.

The W.H.O. emergency use approval allows the Sinopharm vaccine to be included in Covax, a global initiative to provide free vaccines to poor countries. The possible inclusion in Covax raises hopes that more people — especially those in developing nations — will get access to shots at a crucial moment.

Rich countries are hoarding doses of vaccines. India, a major vaccine maker, has stopped exports to address its worsening coronavirus crisis. Safety concerns led health authorities in some countries to temporarily pause the use of vaccines made by AstraZeneca and Johnson & Johnson.

vaccination campaign got off to a slow start, in part because the government prioritized exports and residents did not feel rushed to get vaccinated. The country is now speeding up its national vaccination campaign and aims to inoculate 40 percent of its 1.4 billion people by the end of June.

published the data this week.

78.1 percent, according to the W.H.O. advisory group. The Sinovac vaccine has varying efficacy rates of between 50 percent to 84 percent, depending on the country where Phase 3 trials were conducted. Both vaccines were made using a tried-and-tested technology that involves weakening or killing a virus with chemicals.

The advisory group’s data showed that it had a “high level of confidence” that the Sinopharm vaccine worked in preventing Covid-19 in adults, but a “low level” of confidence for people over 60. The group’s findings were similar for the Sinovac vaccine.

The W.H.O. said that because Sinopharm enrolled few adults above 60 years old in its trials, the health agency could not estimate the vaccine efficacy for this group. But the W.H.O. said it would not restrict the use of the vaccine in that age group because preliminary data suggests “the vaccine is likely to have a protective effect in older persons.”

There is limited data on how well the vaccine will work against the many coronavirus variants cropping up around the world. Chinese vaccines are overall less effective than the inoculations produced by Pfizer-BioNTech and Moderna.

But for China’s leaders, the W.H.O. approval can still be seen as a badge of honor. Xi Jinping, China’s top leader, has pledged to make a Covid-19 vaccine a “global public good.”

After India announced export restrictions on vaccines last month, Indonesia and the Philippines said they would turn to China for help. Last week, China’s foreign minister offered to help South Asian nations get access to vaccines.

Indonesia said it would get additional doses from Sinovac after President Joko Widodo held talks with Mr. Xi. In a speech the same week, President Rodrigo Duterte of the Philippines said he owed “a debt of gratitude” to China for its vaccines.

It remains to be seen whether the W.H.O. approval will change Beijing’s approach to doling out vaccines. China has given only 10 million doses to Covax, though it has independently donated 16.5 million doses and sold 691 million doses to 84 countries, according to Bridge Consulting. Many of the donations were made to developing nations in Africa and Asia.

“They don’t like to subsume their generosity in their products under some U.N. brand,” said J. Stephen Morrison, director of the global health policy center at the Center for Strategic and International Studies. “They are in a historic phase,” he said. “They want the recipients to know that this is China delivering.”

Jason Gutierrez contributed reporting. Elsie Chen contributed reporting and research.

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Pfizer Reaps Hundreds of Millions in Profits From Covid Vaccine

The pricing for the United States was in line with the cost of seasonal flu vaccines and much less expensive than vaccines for conditions like shingles, which can run into several hundred dollars.

“That price point does not seem offensive, even if you don’t spend a lot of time thinking about prescription drugs,” said Stacie Dusetzina, an associate professor of health policy at Vanderbilt University Medical Center. “Just thinking about any prescription you’d fill, you’d be hard-pressed to find pretty much anything for $20.”

But the fact that Pfizer appears to have earned something like $900 million in pretax profits from its vaccine — coupled with its comparatively small sales to poor countries — suggests that profits have trumped other considerations. That could undercut the company’s embrace of loftier principles.

“At Pfizer, we believe that every person deserves to be seen, heard and cared for,” the chief executive, Albert Bourla, said in January as the company announced it would join Covax. “We share the mission of Covax and are proud to work together so that developing countries have the same access as the rest of the world.”

But the company seems to have prioritized higher-priced sales.

“Despite all the talk about Covax, they have been far more interested in bilateral deals, because that’s where they make their money,” said Richard Kozul-Wright, director of the division on globalization and development strategies at the United Nations Conference on Trade and Development in Geneva. “It’s one of the great public relations triumphs of recent corporate history.”

Multiple factors explain the inequitable nature of Pfizer’s vaccine distribution.

The shot, which must be stored and transported at very low temperatures, is less practical for hard-to-reach parts of the world than other shots, like those from AstraZeneca and Johnson & Johnson, that can simply be refrigerated. Some poor countries were initially not hit hard by the virus, and so their governments had less urgency to place orders for the Pfizer vaccine, to the extent that they could afford to pay for the shots.

“Not everyone was interested in the vaccine or prepared to take steps; thus, conversations continue, including working with Covax beyond their initial order of 40 million doses,” said Ms. Castillo, the Pfizer spokeswoman.

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Vaccinated Tourists Could Soon Be Allowed to Visit Again, E.U. Says

BRUSSELS — The European Union took a crucial step on Monday toward reopening its borders to vaccinated travelers after the bloc’s executive released a plan for allowing journeys to resume after more than a year of stringent coronavirus restrictions.

The European Commission, the executive branch of the European Union, proposed that the 27 member countries reopen their borders to all travelers who have been fully vaccinated with shots approved by the bloc’s medicine regulator or by the World Health Organization. The commission also outlined other, looser, pandemic-related conditions that should permit people to travel.

The proposal would see more regular travel to the bloc gradually restart in time for the summer tourism season, which provides economic lifeblood for several member states. The plans are an important moment in Europe’s efforts to return to a semblance of normalcy after more than a year of strict limitations.

Travel from outside the bloc was halted almost entirely last spring and only restored tentatively for a handful of exceptions last summer. The measures separated families, hobbled the tourism and aviation sectors and brought business travel to an almost total halt.

interview with The New York Times last month, during which she said that vaccinated Americans should be able to visit Europe this summer. The detailed proposal laid out on Monday also confirmed Ms. von der Leyen’s earlier statements about the important role that the mutual recognition of vaccination certificates will play in resuming international travel.

To pass, the proposal released on Monday will require the backing of a reinforced majority of member states, which it is likely to receive late this month or in early June. Still, individual member countries retain a good deal of sovereignty around health policy, so each state will probably use that leeway to tailor the travel measures further.

For example, some countries that greatly depend on visitors for income and jobs, such as Greece and Spain, have already moved to reopen borders even before the European Union adopts any new, bloc-wide policy. Others, especially in the continent’s north, could maintain more stringent regulations because they don’t stand to gain as much from loosened travel rules for the summer.

Given those likely differences, the commission’s proposal comes in part to prevent a totally uncoordinated approach to travelers from outside the bloc.

“digital green pass” for inoculated citizens (and has contracted companies including the logistics giant SAP to digitize vaccine cards), the United States and other countries are further behind and as yet do not offer uniform, verifiable vaccine certificates. The European Union and the United States have been involved in technical discussions on how to ensure American certificates are verifiable and acceptable in the bloc, officials said.

Addressing some major questions that aspiring visitors have raised in recent weeks, the commission said that children would not need to be vaccinated to travel to the bloc but that they could be required to show a negative test.

British visitors to the European Union, a big pool of tourists, could be counted among those able to travel more freely given the fast advancement of vaccination there. But the European Union is not yet in touch with British officials over the question of mutually recognizable vaccine certification, officials said.

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Biden to Send Coronavirus Vaccine Abroad

Senior Biden administration officials, asked by a reporter on Monday whether they had a “moral obligation” to ease the patent restrictions, said they had no new information to share. But Jen Psaki, the White House press secretary, defended the president’s response.

“The United States has been one of the largest providers of assistance to address the Covid pandemic around the world, including to India, and we have obviously taken some significant steps over the last couple of days to address their immediate needs,” Ms. Psaki said.

The situation in India is especially dire. The country is experiencing what may be the worst crisis any nation has seen since the pandemic began. Hospitals are overflowing, and desperate patients are dying as they wait to see doctors. On Monday, India broke the world record for daily coronavirus infections for a fifth consecutive day, reporting nearly 353,000 new cases. And it added 2,812 deaths to its overall toll of more than 195,000, which experts say is likely to be a vast undercount.

“The crisis in India is a humanitarian disaster unfolding before our eyes,” said Tom Hart, the acting chief executive of the ONE campaign, a nonprofit dedicated to eradicating world poverty. Based on an analysis of contracts signed by Mr. Biden’s most recent predecessor, the group estimates that the federal government has secured 550 million more doses than it needs to cover every American.

With worrisome variants spreading in the United States and around the world, public health experts say vaccinating people overseas is not only a moral imperative, but it is essential to protecting Americans. J. Stephen Morrison, the director of the Global Health Policy Center at the Center for Strategic and International Studies, said Mr. Biden needed to offer a more sweeping vision of how the United States can help the world.

“We are approaching these colossal, complex problems in an ad hoc, reactive, short-term manner,” Mr. Morrison said. He called the announcement on Monday a “further incremental step by the Biden administration toward fuller engagement internationally to address the dire vaccine gap.”

On a conference call with reporters on Monday, senior Biden administration officials said that in addition to the money pledged to the international vaccine initiative, known as Covax, the administration intended to spend $11.5 billion, appropriated by Congress as part of the $1.9 trillion stimulus package, on helping other countries fight the pandemic and administer vaccines.

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U.S. Covid Vaccinations Fall, Even as Cases Remain High

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

People who were clamoring for a vaccine have been inoculated, including those who were willing to schedule appointments and wait in long lines at mass vaccination sites, he said.

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

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

Rupali J. Limaye, a professor who studies vaccine behavior at Johns Hopkins Bloomberg School of Public Health, said as vaccinations continued, some might think: “If these other people are vaccinated, why do I need to get it?” but added, “We still need those people to get it to reach herd immunity.”

With temperatures getting warmer, many states have already eased social-distancing measures, and some have even appeared to return to normal activity, alarming officials. Dr. Anthony S. Fauci, the nation’s top infectious disease expert, has said that restrictions should remain in place until there are fewer than 10,000 new cases a day — a number that the United States will not reach by Aug. 1, according to projections from the Institute for Health Metrics and Evaluation at the University of Washington.

“It will feel over in the summer,” said Ali H. Mokdad, a professor of health metrics sciences at the institute. “But somebody like me who works in public health will feel like swimming upstream, telling people in the summer we are not out of danger.”

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What Do Women Want? For Men to Get Covid Vaccines.

Holly Elgison and Len Schillaci are a mixed vaxxed couple, and they are far from alone.

“I was always going to get the vaccine, 100 percent,” said Ms. Elgison, a medical claims auditor in Valrico, Fla.

Her husband, a disaster insurance adjuster, said he will pass. “To be honest with you, I think that the worst of Covid is behind us,” Mr. Schillaci said. “I’m good.”

As the Biden administration seeks to get 80 percent of adult Americans immunized by summer, the continuing reluctance of men to get a shot could impede that goal.

Women are getting vaccinated at a far higher rate — about 10 percentage points — than men, even though the male-female divide is roughly even in the nation’s overall population. The trend is worrisome to many, especially as vaccination rates have dipped a bit recently.

higher for men than among women. And the division elucidates the reality of women’s disproportionate role in caring for others in American society.

“It could matter to localized herd immunity,” said Alison Buttenheim, an associate professor of nursing at the University of Pennsylvania and expert on vaccine hesitancy. “While most experts are fretting about larger gaps by race, political party, religion and occupational group,” she said, many of which overlap with the gender disparities, “I haven’t heard of any specific initiatives to target men.”

In Los Angeles County, where 44 percent of women over 16 have gotten their first shot — compared with 30 percent of men — officials are scrambling to figure out how to do just that.

“We are very concerned about it and are planning to embark on some targeted outreach among men,” said Dr. Paul Simon, the chief science officer at the Los Angeles County Department of Public Health, who said that the disparities are of particular concern for Black and Latino men. Only 19 percent of Black males in Los Angeles County and 17 percent of Latino males have received at least one dose of the vaccine, compared with 35 percent of Asian men and 32 percent of white men, according to the most recent data available from early this month.

larger proportion of that age group. In many states, health care workers and schoolteachers were also given vaccine priority: Women account for three-quarters of full-time health care workers and over 75 percent of public schoolteachers in the United States are female.

The disparities show both where women do the paid and unpaid labor of life. For instance, women lost the majority of the earliest jobs in food services, retail businesses, health care and government jobs. The mothers among them have done most of the work in the shift to remote schooling and caring for parents and sick relatives.

The combination may have increased their vaccine motivation in two ways: They are seeking to protect the rest of their family and they are desperate to get back in the work force. Indeed, just as women drove the job losses last year, they are leading the economic recovery now; roughly half a million women joined the labor force in March, in part because in-person schooling has resumed across much of the country.

“In addition to women being disproportionately represented in several essential jobs,” said Pilar Gonalons-Pons, an assistant professor of sociology at the University of Pennsylvania who specializes in gender issues, “they are also disproportionately represented as unpaid caregivers for older adults in their families and communities, and this can also be an additional motivation for getting the vaccine.”

In many ways, the pattern with vaccines reflects longstanding gender differences when it comes to preventive health care. Women are on average more likely to get annual physicals than men, even when adjusted for pre-existing health conditions and other factors, and are more likely than men to get preventive care.

less likely to visit doctors regularly and go to the emergency room in a crisis and to get basic dental care, according to federal data. Vaccines are no exception: Historically, influenza vaccination is much higher among females — about 63 percent compared to 53 percent — though the gap narrows in Americans over 75 years old.

The coronavirus vaccine “is the latest expression of the tried-and-true gender gap we’ve long witnessed in preventive health care seeking patterns,” said Lindsey Leininger, a health policy researcher and clinical professor at Tuck School of Business at Dartmouth College.

But experts say that even in the context of general male health care recalcitrance, there may be some factors that are specific to this vaccine that are preventing more male shots in arms. Because the sign up has been cumbersome and confusing, men may have had less patience in navigating the system, which has largely taken place online, a process that women might find easier since they tend to get more of their health care information online.

“We have to figure out if disparities are about access, if men are having more difficulty navigating the appointment systems,” Mr. Simon of Los Angeles said.

Further, when it comes to the coronavirus — which has been the subject of rampant misinformation, evolving medical advice and politicization — other dynamics may be at work.

“Some men have a sense that they are not necessarily susceptible,” Mr. Simon said health care workers have told officials. “They have weathered this for more than a year and have a sense of omnipotence.”

turned it down.)

research on this trait.

“In other words, these cultural ideals lead men to avoid important health care in order to act masculine,” she said. “Now that the vaccine is available to everyone, it will be interesting to watch male-female differences in vaccine uptake, because these will more likely reflect social and cultural ideas about gender and health, such as the cultural idea that ‘real men’ don’t need preventive health care.”

At this stage, U.S. health authorities have not released data on nonbinary adults and vaccination.

There may also be political connections. Women are far more likely than men to register as Democrats, and polls demonstrate that Republicans across the country have been far less likely than Democrats to embrace the vaccine.

So who will men listen to? Not their wives and female friends or doctors, it seems. For their recent preprint study, Leah Witus and Erik Larson, professors at Macalester College in Saint Paul, Minn., watched videos with men and women that featured identical information about the vaccine. Among the 1,184 Americans who watched them, most were positively influenced by the male narrator while the female narrator got a far more mixed response.

“The male-narrated version of the video increased vaccination intention in viewers,” said Ms. Witus, “but the female-narrated had mixed associations with vaccine propensity, and in some viewers, those that identified as conservative, actually decreased vaccination intention.”

This may spell victory for Mr. Schillaci as he and his wife subtly joust for influence over their 20-year-old son’s vaccination decision. Mr. Schillaci has been sharing his views with his son, whom his wife is prodding to take a shot.

“I would rather he got the shot, and I hope that he’ll consider it,” said Ms. Elgison.

But Ms. Elgison’s own decision may benefit her son, even if he decides against the vaccine.

As often happens in life, men may find their gaps covered by women. “To the extent most people live and socialize in a mixed-gender setting, the men will benefit from the higher coverage among women,” Ms. Buttenheim said.

Ms. Elgison, however, still has a trump card she hopes might work. “I would like my son to get it so we can all travel together,” she said. “I explained to him that it’s possible that we could protect his dad.”

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The Vaccination Gender Gap: Women Are Getting Shots at a Higher Rate Than Men

Holly Elgison and Len Schillaci are a mixed vaxxed couple, and they are far from alone.

“I was always going to get the vaccine, 100 percent,” said Ms. Elgison, a medical claims auditor in Valrico, Fla.

Her husband, a disaster insurance adjuster, said he will pass. “To be honest with you, I think that the worst of Covid is behind us,” Mr. Schillaci said. “I’m good.”

As the Biden administration seeks to get 80 percent of adult Americans immunized by summer, the continuing reluctance of men to get a shot could impede that goal.

Women are getting vaccinated at a far higher rate — about 10 percentage points — than men, even though the male-female divide is roughly even in the nation’s overall population. The trend is worrisome to many, especially as vaccination rates have dipped a bit recently.

higher for men than among women. And the division elucidates the reality of women’s disproportionate role in caring for others in American society.

“It could matter to localized herd immunity,” said Alison Buttenheim, an associate professor of nursing at the University of Pennsylvania and expert on vaccine hesitancy. “While most experts are fretting about larger gaps by race, political party, religion and occupational group,” she said, many of which overlap with the gender disparities, “I haven’t heard of any specific initiatives to target men.”

In Los Angeles County, where 44 percent of women over 16 have gotten their first shot — compared with 30 percent of men — officials are scrambling to figure out how to do just that.

“We are very concerned about it and are planning to embark on some targeted outreach among men,” said Dr. Paul Simon, the chief science officer at the Los Angeles County Department of Public Health, who said that the disparities are of particular concern for Black and Latino men. Only 19 percent of Black males in Los Angeles County and 17 percent of Latino males have received at least one dose of the vaccine, compared with 35 percent of Asian men and 32 percent of white men, according to the most recent data available from early this month.

larger proportion of that age group. In many states, health care workers and schoolteachers were also given vaccine priority: Women account for three-quarters of full-time health care workers and over 75 percent of public schoolteachers in the United States are female.

The disparities show both where women do the paid and unpaid labor of life. For instance, women lost the majority of the earliest jobs in food services, retail businesses, health care and government jobs. The mothers among them have done most of the work in the shift to remote schooling and caring for parents and sick relatives.

The combination may have increased their vaccine motivation in two ways: They are seeking to protect the rest of their family and they are desperate to get back in the work force. Indeed, just as women drove the job losses last year, they are leading the economic recovery now; roughly half a million women joined the labor force in March, in part because in-person schooling has resumed across much of the country.

“In addition to women being disproportionately represented in several essential jobs,” said Pilar Gonalons-Pons, an assistant professor of sociology at the University of Pennsylvania who specializes in gender issues, “they are also disproportionately represented as unpaid caregivers for older adults in their families and communities, and this can also be an additional motivation for getting the vaccine.”

In many ways, the pattern with vaccines reflects longstanding gender differences when it comes to preventive health care. Women are on average more likely to get annual physicals than men, even when adjusted for pre-existing health conditions and other factors, and are more likely than men to get preventive care.

less likely to visit doctors regularly and go to the emergency room in a crisis and to get basic dental care, according to federal data. Vaccines are no exception: Historically, influenza vaccination is much higher among females — about 63 percent compared to 53 percent — though the gap narrows in Americans over 75 years old.

The coronavirus vaccine “is the latest expression of the tried-and-true gender gap we’ve long witnessed in preventive health care seeking patterns,” said Lindsey Leininger, a health policy researcher and clinical professor at Tuck School of Business at Dartmouth College.

But experts say that even in the context of general male health care recalcitrance, there may be some factors that are specific to this vaccine that are preventing more male shots in arms. Because the sign up has been cumbersome and confusing, men may have had less patience in navigating the system, which has largely taken place online, a process that women might find easier since they tend to get more of their health care information online.

“We have to figure out if disparities are about access, if men are having more difficulty navigating the appointment systems,” Mr. Simon of Los Angeles said.

Further, when it comes to the coronavirus — which has been the subject of rampant misinformation, evolving medical advice and politicization — other dynamics may be at work.

“Some men have a sense that they are not necessarily susceptible,” Mr. Simon said health care workers have told officials. “They have weathered this for more than a year and have a sense of omnipotence.”

turned it down.)

research on this trait.

“In other words, these cultural ideals lead men to avoid important health care in order to act masculine,” she said. “Now that the vaccine is available to everyone, it will be interesting to watch male-female differences in vaccine uptake, because these will more likely reflect social and cultural ideas about gender and health, such as the cultural idea that ‘real men’ don’t need preventive health care.”

At this stage, U.S. health authorities have not released data on nonbinary adults and vaccination.

There may also be political connections. Women are far more likely than men to register as Democrats, and polls demonstrate that Republicans across the country have been far less likely than Democrats to embrace the vaccine.

So who will men listen to? Not their wives and female friends or doctors, it seems. For their recent preprint study, Leah Witus and Erik Larson, professors at Macalester College in Saint Paul, Minn., watched videos with men and women that featured identical information about the vaccine. Among the 1,184 Americans who watched them, most were positively influenced by the male narrator while the female narrator got a far more mixed response.

“The male-narrated version of the video increased vaccination intention in viewers,” said Ms. Witus, “but the female-narrated had mixed associations with vaccine propensity, and in some viewers, those that identified as conservative, actually decreased vaccination intention.”

This may spell victory for Mr. Schillaci as he and his wife subtly joust for influence over their 20-year-old son’s vaccination decision. Mr. Schillaci has been sharing his views with his son, whom his wife is prodding to take a shot.

“I would rather he got the shot, and I hope that he’ll consider it,” said Ms. Elgison.

But Ms. Elgison’s own decision may benefit her son, even if he decides against the vaccine.

As often happens in life, men may find their gaps covered by women. “To the extent most people live and socialize in a mixed-gender setting, the men will benefit from the higher coverage among women,” Ms. Buttenheim said.

Ms. Elgison, however, still has a trump card she hopes might work. “I would like my son to get it so we can all travel together,” she said. “I explained to him that it’s possible that we could protect his dad.”

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Covid-19 Live Updates: Regeneron’s Antibody Drug Can Help Prevent Infections, Study Says

clinical trial results announced on Monday. The drug, if authorized, could offer another line of defense against the disease for people who are not protected by vaccination.

The findings are the latest evidence that such lab-made drugs not only prevent the worst outcomes of the disease when given early enough, but also help prevent people from getting sick in the first place.

Using the cumbersome drugs preventively on a large scale won’t be necessary: Vaccines are sufficient for the vast majority of people and are increasingly available.

Still, antibody drugs like Regeneron’s could give doctors a new way to protect high-risk people who haven’t been inoculated or who may not respond well to vaccination, such as those taking drugs that weaken their immune system. That could be an important tool as rising coronavirus cases and dangerous virus variants threaten to outpace vaccinations.

Regeneron said in a news release that it would ask the Food and Drug Administration to expand the drug’s emergency authorization — currently for high-risk people who already have Covid but are not hospitalized — to allow it to be given for preventive purposes in “appropriate populations.”

There’s “a very substantial number of people” in the United States and globally who could be a good fit to receive these drugs for preventive purposes, said Dr. Myron Cohen, a University of North Carolina researcher who leads monoclonal antibody efforts for the Covid Prevention Network, a National Institutes of Health-sponsored initiative that helped to oversee the trial.

“Not everyone’s going to take a vaccine, no matter what we do, and not everyone’s going to respond to a vaccine,” Dr. Cohen said.

Regeneron’s new data come from a clinical trial that enrolled more than 1,500 people who lived in the same household as someone who had tested positive for the virus within four days. Those who got an injection of Regeneron’s drug were 81 percent less likely to get sick with Covid compared to volunteers who got a placebo.

Dr. Rajesh Gandhi, an infectious diseases physician at Massachusetts General Hospital who was not involved in the study, said the data were “promising” for people who have not yet been vaccinated. But he said that the study did not enroll the type of patients that would be needed to assess whether the drug should be used preventively for immunocompromised patients. “I would say we don’t yet know that,” Dr. Gandhi said.

Regeneron’s cocktail, a combination of two drugs designed to mimic the antibodies generated naturally when the immune system fends off the virus, got a publicity boost last fall when it was given to President Donald J. Trump after he got sick with Covid.

The treatment received emergency authorization in November. Doctors are using it, as well as another antibody cocktail from Eli Lilly, for high-risk Covid patients.

But use of the antibody drugs has been slowed not by a shortage of doses, but by other challenges, though access has improved in recent months. Many patients don’t know to ask for the drugs or where to find them.

Many hospitals and clinics have not made the treatments a priority because they have been time-consuming and difficult to administer, in large part because they must be given via intravenous infusion. Regeneron plans to ask the F.D.A. to allow its drug to be given via an injection, as it was administered in the results of the study announced on Monday, which would allow it to be given more quickly and easily.

Decorating the exterior of an Italian restaurant in London on Sunday. Pubs and restaurants were permitted to reopen outdoor spaces on Monday.
Credit…Andrew Testa for The New York Times

Britain reopened large parts of its economy on Monday, allowing people in England back in shops, hair salons and outdoor areas of pubs and restaurants, a long-awaited milestone after three months of lockdown, and a day after the country recorded its lowest daily coronavirus death toll since September.

Under the second stage of the government’s gradual reopening, libraries, community centers and some outdoor attractions like zoos will also return, though outdoor gatherings remain limited to six people or two households.

For many in England, the return was a hopeful — if not definitive — sign that the worst of the pandemic was behind them, after a new variant of the virus detected last year in the country’s southeast spun out of control around Christmas, overwhelming hospitals and causing tens of thousands of deaths.

At its winter peak, Britain reported as many as 60,000 daily cases a day and 1,820 daily deaths, according to a New York Times database. But after months of restrictions and an aggressive vaccination program that has offered a dose to about half of Britain’s population, those figures declined to 1,730 daily cases and seven deaths reported on Sunday.

Prime Minister Boris Johnson has so far gone ahead with the gradual easing of measures that he had announced, reopening schools on March 8, reducing restrictions on outdoor gatherings on March 29, and allowing large parts of the economy to reopen on Monday.

Mr. Johnson said on Monday that the reopening was “a major step forward in our road map to freedom.” Still, he urged caution.

“I urge everyone to continue to behave responsibly and remember ‘hands, face, space and fresh air’ to suppress Covid,” he said.

Scotland, Wales and Northern Ireland, where devolved governments are responsible for coronavirus restrictions, have laid out similar plans to reopen their economies.

The apparent success represents a turnaround for Mr. Johnson’s government, which struggled to stem cases earlier in the pandemic and at one point reported the greatest rate of excess deaths in Europe.

But now E.U. countries — hampered by a vaccine rollout slower than Britain’s and a scare over a possible links between the AstraZeneca vaccine and blood clots — are facing a third wave of coronavirus infections. France, Italy and other countries have recently imposed new lockdown measures.

In England, business owners reopened on Monday with hope — and some anxiety that the numbers of infections could go up again. Still, “we’re looking confident we won’t be seeing anything like that again,” said Nicholas Hair, the owner of The Kentish Belle, a London pub that opened its doors to patrons one minute after midnight.

Global Roundup

A train station in Mumbai, on Monday.
Credit…Niharika Kulkarni/Reuters

Even as India hit a record for daily coronavirus infections, and its total caseload rose to second in the world behind the United States, the images that dominated Indian news media on Monday were of a crowded religious festival along the banks of the Ganges River.

The dissonance was a clear manifestation of the confusing messages sent by the authorities just as India’s coronavirus epidemic is spiraling, with a daily high of 168,000 cases and 900 deaths reported on Monday.

Yet millions of devotees have thronged the holy city of Haridwar for the monthlong Kumbh Mela, or pitcher festival, when Hindu pilgrims seek absolution by bathing in the Ganges. Officials have said that about one million people will participate every day, and as many as five million during the most auspicious days, all crowded into a narrow stretch along the river and searching for the holiest spot to take a dip.

Already, fears are running high that one of the most sacred pilgrimages in Hinduism could turn into a superspreading event.

Dr. S. K. Jha, a local health officer, said that an average of about 250 new cases had been registered each day recently. Experts have warned that many more infections are going unrecorded, and that devotees could unwittingly carry the virus with them as they return to their homes across the country.

India is in the grip of the world’s fastest growing outbreak, with more and more jurisdictions going back into varying stages of lockdown. Infections are spreading particularly fast in Mumbai, the country’s financial hub, and the surrounding state of Maharashtra, where the government has announced a partial weekday lockdown and near-total closure over the weekends.

The situation is also worsening in the capital, New Delhi, which reported more than 10,000 new cases on Sunday, surpassing the previous daily high of nearly 8,500. The state government has imposed a curfew and ordered restaurants and public transport systems to run at half capacity. Arvind Kejriwal, Delhi’s top official, has said more restrictions may follow.

Hospitals in several states are reporting shortages of oxygen, ventilators and coronavirus testing kits, and some are also running low on remdesivir, a drug used in serious Covid-19 cases. India has halted the export of remdesivir until the situation improves.

India is also trying to ramp up its vaccination drive, with about three million people being inoculated daily and 104 million doses administered so far. But with many vaccination centers nationwide expressing concern over possible shortages, India’s large pharmaceutical industry has sharply reduced its exports of the AstraZeneca vaccine in order to keep more doses at home, creating serious challenges for other countries that had been relying on those shipments.

On Monday, Indian experts recommended the use of Russia’s Sputnik-V coronavirus vaccine, which would become the third available in the country if approved by the authorities.

After months of lower-than-expected infections and deaths from the virus, critics say Indian officials have sent dissonant messages about the seriousness of the crisis. Police officers are enforcing curfew and mask rules, sometimes resorting to beatings captured on videos shared across social media. But senior political leaders, including the prime minister, Narendra Modi, have been holding large rallies for local elections.

Mr. Modi’s Hindu nationalist government has also allowed the religious festival to proceed — in contrast to what happened last spring, at the start of the pandemic, when India’s health ministry blamed an Islamic seminary for fanning a far smaller outbreak. Critics say rhetoric from members of Mr. Modi’s party contributed to a spate of attacks against Muslims, a minority of about 200 million people in a Hindu-dominated country of 1.3 billion.

In other news around the world:

Anna Schaverien, Constant Méheut and Niki Kitsantonis contributed reporting.

A vaccination center at the Royal Exhibition Building in Melbourne, Australia, last month.
Credit…James Ross/EPA, via Shutterstock

Australia has given up on the goal of vaccinating its entire population against Covid-19 by the end of the year, following updated advice from health officials that younger people should not receive the AstraZeneca vaccine, as well as delays in the delivery of doses.

The Australian government said last week that it had accepted a recommendation by a panel of health experts that people under 50 receive the Pfizer-BioNTech vaccine instead of the one developed by AstraZeneca, which had been the centerpiece of Australia’s vaccination program. The change in guidance came after European regulators found links between the AstraZeneca vaccine and rare blood clots, prompting several countries to restrict use of the shot.

Prime Minister Scott Morrison said Friday that the government had ordered another 20 million doses of the Pfizer vaccine, doubling what it had already purchased. But they are not expected to be available until the fourth quarter of this year, dealing a blow to the government’s previously stated goal of inoculating all of its 25 million people by then.

Mr. Morrison appeared to acknowledge the change in timeline in a Facebook post on Sunday.

“The government has also not set, nor has any plans to set any new targets for completing first doses,” Mr. Morrison said. “While we would like to see these doses completed before the end of the year, it is not possible to set such targets given the many uncertainties involved.”

Public health experts have criticized Mr. Morrison’s government for relying too heavily on the AstraZeneca vaccine, a relatively cheap and easy-to-use shot but one whose troubles have jeopardized inoculation efforts in multiple countries. They said the setback to Australia’s vaccination program risked undermining the country’s success in containing the spread of the coronavirus since recording its first case in January 2020.

“We’re in a position a year later where that hard-won success is jeopardized by a completely incompetent approach to a vaccine rollout,” said Bill Bowtell, a public health policy expert and adjunct professor at the University of New South Wales in Sydney.

Australia has made four separate agreements for the supply of Covid-19 vaccines that would give it a total of 170 million doses, enough to inoculate its population more than three times over. Plans to manufacture almost all of its 54 million AstraZeneca doses domestically were approved last month.

But the Australian government has been under fire for weeks over the sluggish pace of its vaccination rollout, which began in late February. By the end of March, when the government had aimed to vaccinate four million people, only about 600,000 had actually been inoculated. As of Sunday, Australia had administered fewer than 1.2 million doses.

Australian officials have attributed the slow rollout to delays in the delivery of millions of vaccine doses manufactured in the European Union, which has curbed exports amid its own supply shortages. The export restrictions mainly affect the AstraZeneca vaccine.

After enduring strict lockdowns for much of the past year, Australians are now enjoying relatively normal life in a country that has all but stamped out the virus. But public health experts warn that until more of the population is vaccinated, those freedoms are precarious.

“Having eliminated Covid, they thought a mass vaccination campaign would lock that in,” Mr. Bowtell said of the Australian public. “Now they are being deeply disillusioned.”

Covid-19 vaccinations at a monastery in Bangkok this month.
Credit…Adam Dean for The New York Times

Thailand is facing its worst coronavirus outbreak just as millions of people head to their home provinces during the country’s biggest travel holiday.

The latest wave of infections, which has sent at least eight cabinet members into isolation, is centered in a Bangkok nightlife district said to be popular with government officials and wealthy partygoers. The country, which until now has largely kept the virus under control, set a record Monday for new daily cases with 985.

One top health official warned that Thailand could soon face as many as 28,000 new cases a day in the worst-case scenario. The government announced it would set up field hospitals as Covid-19 wards at existing facilities begin to fill up.

Officials ordered the closure of hundreds of bars and nightclubs, but critics say the government has been inconsistent in its efforts to bring the outbreak under control. The prime minister, Prayuth Chan-ocha, stopped short of banning travel between provinces for the Songkran holiday, which begins on Tuesday and marks the beginning of the Thai New Year.

“Whatever will be, will be,” he said last week in explaining his decision. “The reason is it’s a matter that involves a huge number of people. The government will have to try to cope with that later.”

Dozens of provinces have imposed their own restrictions on travelers coming from Bangkok and other affected areas, prompting many Thais to cancel their trips. But many others set off over the weekend.

During earlier outbreaks, the government often acted quickly to require face masks, ban foreign tourists, impose quarantine restrictions and lock down hard-hit areas. It has reported fewer than 34,000 cases — mostly from a January surge traced to a seafood market near Bangkok — and just 97 deaths.

But it has been lax in testing and slow to vaccinate. So far, it has procured about 2.2 million doses and given at least one to about 500,000 people. Thailand’s population is 70 million.

Vaccine production is not expected to begin in earnest until June, when a manufacturer in Thailand is scheduled to begin producing 10 million doses a month of the AstraZeneca vaccine.

Health officials were alarmed by the recent discovery of dozens of cases of the highly infectious coronavirus variant first identified in Britain. The finding highlighted the inadequacy of Thailand’s virus testing and suggested that its quarantine procedures have not been as effective as officials believed.

Tourism operators have been especially angered by the government’s lackadaisical approach to obtaining vaccine supplies. The tourism industry, which normally accounts for about 20 percent of the nation’s economy, is highly dependent on foreign visitors and has been calling for widespread vaccinations to speed its recovery.

The outbreak in Bangkok has also prompted questions about the activities of some top officials and their aides.

The transportation minister, Saksayam Chidchob, who was hospitalized with Covid-19, was criticized for not being forthcoming about his whereabouts during times when he may have been exposed to the virus. He denied visiting the gentlemen’s club at the center of the outbreak and said he believed he had contracted the virus from an aide.

Eyan Gallegos, 11, a middle schooler in Washington, completing his homework in his room.
Credit…Gabriella Demczuk for The New York Times

Parents with school-age children have struggled to combine their usual work and family responsibilities this past year with at least some degree of home-schooling.

But mothers and fathers of middle-schoolers — the parenting cohort long known to researchers as the most angst-ridden and unhappy — are connecting now in a specific sort of common misery: the pressing fear that their children, at a vital point in their academic and social lives, have tripped over some key developmental milestones and may never quite find their footing.

Experts say some of their worries are justified — up to a point. The pandemic has taken a major toll on many adolescents’ emotional well-being.

Yet as the nation begins to pivot from trauma to recovery, many mental-health experts and educators are trying to spread the message that parents, too, need a reset. If adults want to guide their children toward resilience, these experts say, then they need to get their own minds out of crisis mode.

Early adolescence is considered a critical period, a time of brain changes so rapid and far-reaching that they rival the plasticity and growth that take place in the newborn to 3-year-old phase.

These changes make children more capable of higher-level thinking and reasoning. They also make them crave social contact, attention and approval.

Remote learning and social distancing are in many ways the opposite of what children in this age group want and need.

It’s been hardest on middle schoolers,” said Phyllis Fagell, a therapist and school counselor who wrote the 2019 book “Middle School Matters.” “It is their job to pull away from parents, to use these years to really focus on figuring out where they are in the pecking order. And all of that hard work that has to happen in these years was just put on hold.”

Yet Ms. Fagell and many other experts in adolescent development were adamant that parents should not panic — and that the spread of the “lost year” narrative needed to stop.

Getting a full picture of what’s going on with middle schoolers, they agreed, requires holding two seemingly contradictory ideas simultaneously in mind: The past year has been terrible. And most middle schoolers will be fine.

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