“With the leverage that employees have, and the proof that they can work from home, it’s hard to put the toothpaste back in the tube,” he said.

Fearful of losing one more junior employee in what has become a tight job market, Mr. Singer has allowed a young colleague to work from home one day a week with an understanding that they would revisit the issue in the future.

doctrinaire view that folks need to be in the office.”

Amanda Diaz, 28, feels relieved she doesn’t have to go back to the office, at least for now. She works for the health insurance company Humana in San Juan, P.R., but has been getting the job done in her home in Trujillo Alto, which is about a 40-minute drive from the office.

Humana offers its employees the option to work from the office or their home, and Ms. Diaz said she would continue to work remotely as long as she had the option.

“Think about all the time you spend getting ready and commuting to work,” she said. “Instead I’m using those two or so hours to prepare a healthy lunch, exercising or rest.”

Alexander Fleiss, 38, chief executive of the investment management firm Rebellion Research, said some employees had resisted going back into the office. He hopes peer pressure and the fear of missing out on a promotion for lack of face-to-face interactions entices people back.

“Those people might lose their jobs because of natural selection,” Mr. Fleiss said. He said he wouldn’t be surprised if workers began suing companies because they felt they had been laid off for refusing to go back to the office.

Mr. Fleiss also tries to persuade his staff members who are working on projects to come back by focusing on the benefits of face-to-face collaborations, but many employees would still rather stick to Zoom calls.

“If that’s what they want, that’s what they want,” he said. “You can’t force anyone to do anything these days. You can only urge.”

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While most of the provider aid has been distributed, the Biden administration is expected to begin doling out the remaining funds, estimated at $25 billion of the original $178 billion, said Kristen O’Brien, a vice president for McDermott+Consulting in Washington, D.C. Hospitals are asking for more time to spend the money.

How the aid was spent has not been fully documented. While the larger hospital networks aggressively sought the funds from the start, smaller organizations, children’s hospitals and those in rural areas or serving large numbers of low-income patients had more difficulty securing the aid because of the way the funding formula was structured.

In a later round of funding decisions, officials with the Department of Health and Human Services reviewed applications more closely, and in some cases, reduced or denied requests, Ms. O’Brien said.

Grants given after the initial rush were more targeted, to those hospitals in Covid hot spots or rural areas. A few large chains, including HCA Healthcare and the Mayo Clinic, returned at least some of the money, in the wake of disclosures that wealthier hospitals had received far more aid while reporting healthy profits.

Overall, the aid program did prevent hospital closings, said Ken Marlow, a lawyer with K&L Gates in Nashville, who advises hospitals. “We haven’t seen a real avalanche of these distressed hospitals coming on the market.”

But some may no longer be able to resist takeovers or mergers. “Those providers are potentially more distressed as a result of the stress of the pandemic and will have to be thinking hard about the future, their survival,” said Torrey McClary, a lawyer with Ropes & Gray who also counsels hospitals.

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Mongolia has plenty of vaccines as countries scramble for doses.

At a time when most countries are scrambling for coronavirus vaccines, Mongolia already has enough to fully vaccinate more than half its citizens, in large part thanks to deals with both China and Russia.

Officials are so confident about the nation’s vaccine riches that they are promising citizens a “Covid-free summer.”

Mongolia’s success in procuring so many doses within months is a big victory for a low-income, developing nation. Many poor countries have been waiting in line for shots, hoping for the best. But Mongolia, using its status as a small geopolitical player between Russia and China, was able to snap up doses at a clip similar to that of much wealthier countries.

Mongolia has a population not much bigger than Chicago’s. The small democratic nation is used to living in the shadows of Russia and China, which often treat it as a geopolitical pawn.

during a pandemic, being a small nation sandwiched between two vaccine makers with global ambitions can have advantages.

“It speaks to the Mongolian ability to play to the two great powers and maximize their benefits even while they are on this tightrope between these two countries,” said Theresa Fallon, director of the Center for Russia Europe Asia Studies in Brussels.

It is also a win for China and Russia, which have extensive resource interests in Mongolia and ambitions to appear to play a role in ending the pandemic, even when much of the world has expressed deep skepticism over their homegrown vaccines.

has extended the period of time the Pfizer-BionNTech vaccine can be refrigerated. The agency now says undiluted and thawed vaccines can be stored for up to 30 days, rather than up to five, as before. The European Medicines Agency announced a similar recommendation earlier in the week.

  • Prince William, the second in line to the throne of Britain, said on Thursday that he had received his first dose of a Covid-19 vaccine. He shared a photo on social media of the injection at the Science Museum in London on Tuesday, thanking everyone involved in the country’s vaccination program. The prince is 38, part of an age group that became eligible to book inoculations last week. Queen Elizabeth II, his grandmother, was vaccinated in January and his father, Prince Charles, received a first dose in February.

  • The European Commission, the executive arm of the European Union, signed a contract for an additional 1.8 billion doses of BioNTech-Pfizer vaccine to be delivered between December 2021 and 2023, the commission’s president, Ursula von der Leyen, announced Thursday. The deal will allow member countries to buy 900 million doses, including booster shots to prolong immunity, as well as possible new vaccines targeting emerging variants of the coronavirus, with an option to purchase additional 900 million in coming years.

  • Anna Schaverien, Monika Pronczuk and Kaly Soto contributed reporting.

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    Healthcare Start-Up Ro to Acquire Modern Fertility

    Ro, the parent company of Roman, the brand that is best known for delivering erectile dysfunction and hair loss medication to consumers, announced on Wednesday that it would acquire Modern Fertility, a start-up that offers at-home fertility tests for women.

    The deal is priced at more than $225 million, according to people with knowledge of the acquisition who spoke on condition of anonymity because the information was not public. It is one of the largest investments in the women’s health care technology space, known as femtech, which attracted $592 million in venture capital in 2019, according to an analysis by PitchBook.

    Modern Fertility was founded in 2017 with its flagship product: a $159 finger prick test that can estimate how many eggs a woman may have left, which can help determine which fertility method might be best.

    “We essentially took the same laboratory tests that women would take in an infertility clinic and made them available to women at a fraction of the cost,” said Afton Vechery, a founder and chief executive of Modern Fertility, noting that her own test at a clinic set her back $1,500.

    valued in March at about $5 billion, has in recent years expanded into telehealth, including delivering generic drugs by mail. In December, Ro acquired Workpath, which connects patients with in-home care providers, like nurses.

    The global digital health market, which includes telemedicine, online pharmacies and wearable devices, could reach $600 billion by 2024, according to the consulting firm McKinsey & Company. And yet, by one estimate, only 1.4 percent of the money that flows into health care goes to the femtech industry, mirroring a pattern in the medical industry, which has historically overlooked women’s health research.

    “Gender bias in health care research methods and funding has really contributed to sexism in medicine and health care,” said Sonya Borrero, director of the Center for Women’s Health Research and Innovation at the University of Pittsburgh. “I think we’re seeing again — gender bias in the venture capital sector is going to exactly shape what gets developed.”

    That underinvestment was part of the reasoning behind the acquisition, said Zachariah Reitano, Ro’s chief executive. The company developed a female-focused online service in 2019 called Rory.

    “We’re going to continue to invest hundreds of millions of dollars over the next five years into women’s health,” Mr. Reitano said, “because ultimately I think women’s health has the potential to be much larger than men’s health.”

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    7 Steps to Take Now to Catch Up on Retirement Savings

    Another option is applying for coverage through the Affordable Care Act, which offers a range of plans, including for those still unemployed.

    Make catch-up contributions. If you’re 50 or older, the Internal Revenue Service gives you a little savings plum: You can save as much as an extra $6,500 annually in your defined contribution plans (which include 401(k)s, 403(b)s and 457s). If you have a SIMPLE (Savings Incentive Match Plan for Employees) individual retirement account or SIMPLE 401(k), the catch-up contribution is $3,000 annually; it’s $1,000 for a Roth I.R.A.

    Automate your savings. If you’re working and offered a 401(k) with automatic payroll withdrawals, you can simply increase your contribution. Want to save even more? Many plans allow you to boost your 401(k) savings when you get a raise. Let’s say you’re 50 or older and save the maximum annual amount — $26,000. That’s $19,500 plus a $6,500 catch-up contribution. Also take your employer’s matching contribution, if it’s offered. This is the low-hanging fruit of retirement savings that most financial planners recommend — again, if you have access to it.

    Adjust your portfolio. Just socking more money into a bank money-market account won’t help you catch up much at all. After all, the S&P 500 index is up a stunning amount: more than 40 percent this year. Yields on money markets are awful — the top rate nationally was 0.60 percent, according to Bankrate.com. The best way to achieve your goals is to invest in no-load mutual or exchange-traded funds, preferably with an annual expense ratio below 0.30 percent.

    Most mutual fund companies offer dividend growth and income mutual and exchange-traded funds. Also avoid the trap in thinking that money in the bank is safe money. If it’s not beating inflation, which is currently running at an annual rate of just under 3 percent, you’re losing purchasing power. “Don’t keep too much money in a bank account,” Ms. Price warned. “You’re getting paid very little to keep it there.”

    Retire later. If you’re able, one simple strategy is to retire after the “normal” age for Social Security benefits, which is 66 for most Americans. That will give you more time to save. Social Security will even pay you more each month if you wait until 70 to collect benefits. A “delayed retirement credit” will raise your retirement payments 8 percent annually every year you wait from age 66 until taking benefits at age 70 for those born in 1943 and later.

    Set up your own plan. Small-business owners or those who are self-employed can set up their own plans, from Simplified Employee Pension I.R.A.s to 401(k)s. Ms. Price suggests those over 50 consider a Roth 401(k), if your employer offers it. While contributions are taxed, withdrawals are not. “You’re taxed on money going in, not on gains,” she said. “If you can’t afford to pay taxes on withdrawals later, this is a good idea.”

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    India Scrambles to Supply Oxygen as Covid-19 Patients Gasp for Breath

    NEW DELHI — Indian hospitals and government leaders scrambled for supplies of oxygen and other emergency aid on Friday, as the country reported another record number of new coronavirus infections and a rising death toll that has strained the country’s resources.

    India recorded more than 330,000 new cases in 24 hours, the health ministry said on Friday, the second consecutive day that the country has set a global record for daily infections. The reported death toll on Friday was more than 2,200, also a new high for the country.

    About half of the cases in Delhi, the capital city of more than 20 million people, are testing positive for a more contagious variant of the virus, first detected last year in India, that is afflicting younger people, said a health ministry official, Sujeet Singh.

    It is unclear to what extent the variant is driving the surge in cases around the country, with large gatherings of unmasked people and widespread neglect of preventive measures also suspected.

    at least 22 patients were killed in a hospital in the city of Nashik, also in Maharashtra, after a leak cut off their oxygen supplies.

    continued to hold mass rallies with thousands of people unmasked. The government has also allowed an enormous Hindu festival to draw millions of pilgrims despite signs that it has accelerated the spread of the virus.

    “Leadership really matters. We saw the early loosening of appropriate measures. Election rallies continued, and religious festivals turned into superspreader events,” said Krishna Udayakumar, an associate professor of global health and director of the Duke Global Health Innovation Center.

    “There was perhaps a lost opportunity to learn from the first wave,” Mr. Udayakumar said. That initial wave peaked in August and September, months after India abandoned a nationwide lockdown that crippled the economy.

    tweeted that her grandmother had died while waiting outside a hospital in Greater Noida, near New Delhi.

    the health ministry said in a statement that India had a daily production capacity of about 7,700 tons of oxygen, with 55,000 tons in reserve. Not all of it goes to medical use — some is used for industrial purposes, including India’s enormous steel-making industry.

    On April 21, a government official told the Delhi High Court that medical demand had reached 8,800 tons per day, beyond the daily production capacity.

    Mr. Modi’s government is in charge of allocating the national oxygen supplies, and on Thursday, India’s Supreme Court gave the government a week to come up with a “national plan” for distribution. The health ministry was told to issue a purchase order to import 55,000 additional tons of oxygen.

    Oxygen is difficult to store and transport, and isn’t generally manufactured near India’s biggest cities, which are now reeling from the sudden spikes in cases.

    States have accused each other of hoarding oxygen and blocking tankers at border crossings. Looters stole several cylinders of oxygen from a tanker making a delivery to a hospital in the state of Madhya Pradesh.

    appealing for more oxygen at a hospital in Haryana State, on the Delhi border.

    “Fortis Hospital in #Haryana has only 45 minutes of oxygen left,” the company wrote, asking government officials “to act immediately and help us save patients’ lives.”

    Four hours later, the hospital received a tanker, the company tweeted.

    It wasn’t clear whether every hospital with a critical need for oxygen was getting it in time.

    Arvind Kejriwal, the top elected official in Delhi, said that the city needed a daily supply of 770 tons of oxygen. Mr. Modi’s government has allocated 530 tons.

    At A.I.I.M.S. Hospital in Delhi, India’s premier research hospital, contact tracing among health care workers was suspended because there weren’t enough personnel to spare for the exercise, according to Srinivas Rajkumar, a representative for the resident doctors’ association.

    Beginning on Saturday, all residents of India age 18 or older can register for a Covid-19 vaccine, but demand is expected to far outstrip supply. So far, more than 135 million people have received at least one dose, about a tenth of India’s population of nearly 1.4 billion. Two vaccines have received emergency use authorization, with at least five others in the pipeline.

    A makeshift Covid hospital in Mumbai’s Bandra neighborhood was well supplied with oxygen, but the nearby vaccination center halted operations after running out of vaccine.

    Karan Deep Singh contributed reporting.

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    Patients and hospitals beg for help as a catastrophic second wave batters India.

    NEW DELHI — A catastrophic second wave of the coronavirus is battering India, which is reporting the world’s highest number of new infections as hospitals and patients beg for fast-diminishing oxygen supplies and other emergency aid.

    India recorded more than 330,000 coronavirus cases in 24 hours, the health ministry said on Friday, the second consecutive day that the country has set a global record for daily infections.

    Canada has joined Britain, Hong Kong, Singapore and New Zealand in barring travelers coming from India. And the U.S. State Department advised people against going to India after the Centers for Disease Control raised the risk level to its highest measure.

    Facing a barrage of criticism for his government’s handling of the second wave, Prime Minister Narendra Modi canceled plans to travel to West Bengal for a campaign rally as an election takes place in that state.

    continued to hold mass rallies with thousands of people unmasked. The government has also allowed an enormous Hindu festival to draw millions of pilgrims despite signs that it has become a superspreader event.

    The catastrophe in India is playing out vividly on social media, with Twitter feeds and WhatsApp groups broadcasting hospitals’ pleas for oxygen and medicines, and families’ desperate searches for beds in overwhelmed Covid-19 wards. With many hospitals short of ventilators, television reports have shown patients lying inside ambulances parked outside emergency rooms, struggling to breathe.

    Swati Maliwal, an activist and politician in Delhi, tweeted that her grandmother had died while waiting to be admitted outside a hospital in Greater Noida near New Delhi.

    “I kept standing there for half hour and pleading for admission and nothing happened,” she wrote. “Shame! Pathetic!”

    The death toll from the virus rose more than 2,200 on Friday, a new high.

    On Thursday, Fortis Healthcare, one of India’s top hospital chains, tweeted an S.O.S. message to Mr. Modi and his chief deputy, Amit Shah, the minister for home affairs, appealing for more oxygen at a hospital in Haryana State on the Delhi border.

    At least 22 patients were killed in a hospital in the city of Nashik on Wednesday after a leak cut off their oxygen supplies.

    Beginning on Saturday, Indians age 18 or older can register for a Covid-19 vaccine, but demand is expected to far outstrip supply. So far, more than 135 million people have received at least one dose, about a tenth of India’s population of nearly 1.4 billion. Two vaccines have received emergency use authorization, with at least five others in the pipeline.

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    Overwhelmed by the virus, Paraguay considers ditching Taiwan for China — and its vaccines.

    In Paraguay, the government of Taiwan has built thousands of homes for the poor, upgraded the health care system, awarded hundreds of scholarships and helped fund a futuristic Congress building. But the alliance is facing an existential threat as Paraguay’s quest for Covid-19 vaccines becomes increasingly desperate.

    Paraguayan officials across the political spectrum say the time has come to consider dumping Taiwan, which doesn’t export vaccines, to establish diplomatic ties with China, which does.

    Beijing’s one-China principle forces countries to choose between having full diplomatic relations with China or Taiwan, an island that it regards as Chinese territory. In recent years, three countries in Latin America severed ties with Taiwan after secret talks with Beijing. All three were early recipients of Chinese vaccines.

    This week China’s main Covid-19 vaccine manufacturer, Sinovac, made a gesture that is certain to fuel speculation about Beijing’s plans in Paraguay. The South American soccer federation Conmebol, which is based in Paraguay, said it was receiving a donation of 50,000 doses of CoronaVac, the vaccine produced by Sinovac.

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    To Speed Vaccination, Some Call for Delaying Second Shots

    The prospect of a fourth wave of the coronavirus, with new cases climbing sharply in the Upper Midwest, has reignited a debate among vaccine experts over how long to wait between the first and second doses. Extending that period would swiftly increase the number of people with the partial protection of a single shot, but some experts fear it could also give rise to dangerous new variants.

    In the United States, two-dose vaccines are spaced three to four weeks apart, matching what was tested in clinical trials. But in Britain, health authorities have delayed doses by up to 12 weeks in order to reach more people more quickly. And in Canada, which has precious few vaccines to go around, a government advisory committee recommended on Wednesday that second doses be delayed even longer, up to four months.

    Some health experts think the United States should follow suit. Dr. Ezekiel J. Emanuel, a co-director of the Healthcare Transformation Institute at the University of Pennsylvania, has proposed that for the next few weeks, all U.S. vaccines should go to people receiving their first dose.

    “That should be enough to quell the fourth surge, especially in places like Michigan, like Minnesota,” he said in an interview. Dr. Emanuel and his colleagues published the proposal in an op-ed on Thursday in USA Today.

    10 days after the first dose, researchers could see that the volunteers were getting sick less often than those who got the placebo.

    In the same month, Britain experienced a surge of cases caused by a new, highly transmissible variant called B.1.1.7. Once the British government authorized two vaccines — from Pfizer-BioNTech and AstraZeneca — it decided to fight the variant by delaying the second doses of both formulations by 12 weeks.

    said on Jan. 31 on NBC’s “Meet the Press.”

    But the government stayed the course, arguing that it would be unwise to veer off into the unknown in the middle of a pandemic. Although the clinical trials did show some early protection from the first dose, no one knew how well that partial protection would last.

    “When you’re talking about doing something that may have real harm, you need empirical data to back that,” said Dr. Céline R. Gounder, an infectious-disease specialist at Bellevue Hospital Center and a member of Mr. Biden’s coronavirus advisory board. “I don’t think you can logic your way out of this.”

    But in recent weeks, proponents of delaying doses have been able to point to mounting evidence suggesting that a first dose can provide potent protection that lasts for a number of weeks.

    The Centers for Disease Control and Prevention reported that two weeks after a single dose of either the Moderna or the Pfizer-BioNTech vaccine, a person’s risk of coronavirus infection dropped by 80 percent. And researchers in Britain have found that first-dose protection is persistent for at least 12 weeks.

    Dr. Emanuel argued that Britain’s campaign to get first doses into more people had played a role in the 95 percent drop in cases since their peak in January. “It’s been pretty stunning,” Dr. Emanuel said.

    studies that show that a single dose of Moderna or Pfizer-BioNTech does not work as well against certain variants, such as B.1.351, which was first found in South Africa.

    “Relying on one dose of Moderna or Pfizer to stop variants like B.1.351 is like using a BB gun to stop a charging rhino,” said John P. Moore, a virologist at Weill Cornell Medicine.

    Dr. Moore said he also worried that delaying doses could promote the spread of new variants that can better resist vaccines. As coronaviruses replicate inside the bodies of some vaccinated people, they may acquire mutations that allow them to evade the antibodies generated by the vaccine.

    But Dr. Cobey, who studies the evolution of viruses, said she wasn’t worried about delayed doses breeding more variants. “I would put my money on it having the opposite effect,” she said.

    Last week, she and her colleagues published a commentary in Nature Reviews Immunology in defense of delaying doses. Getting more people vaccinated — even with moderately less protection — could translate into a bigger brake on the spread of the virus in a community than if fewer people had stronger protection, they said. And that decline wouldn’t just mean more lives were saved. Variants would also have a lower chance of emerging and spreading.

    “There are fewer infected people in which variants can arise,” she said.

    Dr. Adam S. Lauring, a virologist at the University of Michigan who was not involved in the commentary, said he felt that Dr. Cobey and her colleagues had made a compelling case. “The arguments in that piece really resonate with me,” he said.

    Although it seems unlikely that the United States will shift course, its neighbor to the north has embraced a delayed strategy to cope with a booming pandemic and a short supply of vaccines.

    Dr. Catherine Hankins, a public health specialist at McGill University in Montreal and a member of Canada’s Covid-19 Immunity Task Force, endorsed that decision, based on the emerging evidence about single doses. And she said she thought that other countries facing even worse shortfalls should consider it as well.

    “I will be advocating at the global level that countries take a close look at Canada’s strategy and think seriously about it,” Dr. Haskins said.

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