In some ways, Dr. Anthony Fauci, the chief medical adviser on Covid to President Biden and a prominent public health figure since the 1980s, served in a role similar to the one Dr. Wu played in China, Dr. Huang said. But, his message perhaps didn’t always get through because Americans are more polarized in their political identities and beliefs.

Dr. Legleiter added that public health messaging only penetrates if the public identifies with or trusts that figure of authority.

“An individual person is a stand-in for a broader set of institutions or systems that they’re speaking on the behalf of,” Dr. Legleiter said. Those who lean conservative, for instance, may put Dr. Fauci and other scientists in the category of “the elites.” As such, they’re more likely to flout public health policies that such authority figures promote, and comply with proclamations from individuals they identify with the most.

Others say that public health is intrinsically tied to the legitimacy of the state promoting it. At the turn of the 20th century, China was in distress, Dr. Hanson said. Dr. Wu helped bring China out of a tumultuous period, and the enforcement of public health measures gave the country more legitimacy.

Similarly, because the current pandemic has laid bare shortcomings in the public health systems in the United States, Britain and other Western countries, some experts believe it can be a catalyst for change.

“Since the mid-19th century, the West has generally seen its ability to control infectious disease as a marker of their civilizational superiority over much of the rest of the world,” Dr. White said. While China was seen as the sick man of the world then, some commentators in China now attempt to brand the United States with that label.

Ruth Rogaski, a medical historian at Vanderbilt University who specializes in studying the Qing dynasty and modern China, believes that the coronavirus crisis similarly offers an opportunity for reflection, which can be very motivating.

“Epidemics can serve as inflection points,” Dr. Rogaski said. “Opportunities to rethink, retool and even revolutionize approaches to health.”

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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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India’s Doctors and Medical Workers Face Danger and Trauma

NEW DELHI — The shifts are long, the wards full, the demand so urgent that medical students and interns have been coaxed into filling in. Hundreds of workers have died. Family members at home have fallen ill.

India’s doctors and other medical responders find themselves short-handed and underfunded as they battle the world’s worst coronavirus outbreak. Beyond the physical danger they also face, they have been forced by the devastating size of the outbreak and the government’s mismanagement of the crisis into cruel routines of helplessness, making decisions day after day that could determine whether a patient lives or dies.

As beds fill up, they have to choose who among the throngs outside the hospital gates to allow inside for treatment. As the oxygen runs out, they have to choose who gets precious supplies. The emotional toll is mounting.

to the World Bank, India’s health care spending, public and out of pocket, totals about 3.5 percent of its gross domestic product, less than half of the global average.

They also face intimidation and violence, with videos circulating of angry family members thrashing medical staff in hospital halls covered in blood, or local strongmen bullying and scolding them.

when the hospital ran out of oxygen for 80 minutes early in May. Dr. Himthani had treated Covid patients for 14 months before he and his wife were infected.

As the oxygen ran out, Dr. Shiv Charan Lal Gupta, the director of the hospital and a friend of Dr. Himthani for three decades, ran up and down the hallways sending messages to government officials, media outlets and anybody who might help.

In their masks and gowns, the hospital staff gathered with teary eyes and folded arms at the main gate to pay their final respects as Dr. Himthani’s body was wheeled out. Then they went back to work.

44.5 trained health workers per 10,000.

The distribution is unequally concentrated in urban centers. About 40 percent of health care providers work in rural areas, where more than 70 percent of India’s population lives. Bihar, one of India’s poorest states, has only 0.24 beds per 1,000 people, less than one-tenth of the world average.

“When I close my eyes, I feel someone needs my help,” said Lachhami Kumari, a nurse at a government hospital in the Rohtas district of Bihar, one of India’s poorest states. Her 80-bed facility has been overwhelmed by critical Covid patients. “When I manage to fall asleep, I see people all around, begging for help. That has kept me going.”

At another government hospital in Patna, Bihar’s capital city, Dr. Lokesh Tiwari said almost half of the doctors and paramedic staff have lost family members.

on Twitter. “He asked her vitals, thanked me and hung up.”

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Cuba Starts Using Its Covid Vaccines Before Completing Trials

HAVANA — Cuba began a mass vaccination campaign on Wednesday in the capital, Havana, where authorities aim to eventually vaccinate 1.7 million people. The campaign is using homegrown vaccines that have not yet been shown to work, an emergency step intended to blunt the rapid spread of the coronavirus.

The country’s decision to deploy unproven vaccines mirrors the early introduction of vaccines in Russia, China and India, where regulators permitted mass vaccination campaigns to begin before the completion of Phase 3 clinical trials, which assess the vaccines’ effectiveness and safety.

In Florida, news reports critical of the Cuban government accused it of jumping the gun and endangering public health. American and European health regulators do not allow vaccines to be introduced, even for emergency use, until Phase 3 clinical trials are completed.

Though Cuba’s daily coronavirus case counts remain low by Latin American standards, they have spiked alarmingly in recent months. The island, which reported 12,225 confirmed cases in all of 2020, saw 31,465 confirmed cases in April 2021 alone.

hard for Cuba to do business with foreign suppliers and complicating international humanitarian initiatives to donate syringes to the island, which needs about 20 million more to vaccinate the whole country.

Of the 90 coronavirus vaccines around the world currently in clinical trials, five were developed in Cuba, the smallest country to develop and produce its own vaccines.

“We will probably be the first country to immunize its whole population with its own vaccine,” said Dr. Eduardo Martínez, president of BioCubaFarma, the state conglomerate overseeing vaccine development and production.

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To Vaccinate Younger Teens, States and Cities Look to Schools, Camps, Even Beaches

Not all teenagers long for the vaccine. Many hate getting shots. Others say that because young people often get milder cases of Covid, why risk a new vaccine?

Patsy Stinchfield, a nurse practitioner who oversees vaccination for Children’s Minnesota, has stark evidence that some cases in young people can be serious. Not only have more children with Covid been admitted to the hospital recently, but its intensive care unit also has Covid patients who are 13, 15, 16 and 17 years old.

The F.D.A.’s new authorization means all those patients would be eligible for the shots, she noted. “If you can prevent your child ending up in the I.C.U. with a safe vaccine, why wouldn’t you ?” she said.

Mr. Quesnel, the East Hartford, Conn., superintendent, said the most powerful message for reaching older adolescents would probably appeal just as much to younger ones. Rather than focusing on the fact that the shot will protect them, he said, they seize on the idea that it will keep them from having to quarantine if they are exposed.

“They’re not so afraid of the health care dangers from Covid but the social losses that come along with it,” he said, adding that 60 percent of his district’s seniors, or about 300 students, got their first dose at a mass vaccination site run by Community Health Center on April 26. “Some of our greatest leverage right now is that social component — ‘You won’t be quarantined.’”

Michael Jackson of North Port, Fla., can’t wait for his 14-year-old son, Devin, to get the vaccine. During the past year, he said, his son’s beloved Little League games went on hiatus and the family had to suspend their regular Sunday suppers with grandparents And Devin, an eighth grader, had to quarantine three times after being exposed to Covid.

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The World May Need to Learn to Live With the Virus

Only two countries have fully vaccinated more than half of their populations, according to the Our World in Data project at the University of Oxford. They are Israel and the East African nation of the Seychelles, an archipelago with a population of fewer than 100,000. And just a handful of other countries have at least partially vaccinated nearly 50 percent or more, including Britain, tiny Bhutan, and the United States.

Less than 10 percent of India’s vast population is at least partly vaccinated, offering little check to its onslaught of infections.

In Africa, the figure is slightly more than 1 percent.

Still, public health experts say a relatively small number of countries, mostly island nations, have largely kept the virus under control and could continue keeping it at bay after vaccinating enough people.

New Zealand, through stringent lockdowns and border closures, has all but eliminated the virus. Dr. Michael Baker, an epidemiologist at the University of Otago who helped devise the country’s coronavirus response, said New Zealand would likely achieve herd immunity by immunizing its population, but it has a long way to go with only about 4.4 percent of New Zealanders at least partially vaccinated.

“All of the surveys show there is a degree of vaccine hesitancy in New Zealand, but also a lot of people are very enthusiastic,” Dr. Baker said. “So I think we will probably get there in the end.”

While new daily cases have remained at near-world record levels, the number of deaths has dropped from a peak in February, going against the normal pattern of high cases followed eventually by high deaths. If that trendline continues, it could offer a glimmer of hope for a future scenario that scientists are rooting for: Even as the virus spreads and seems to be hurtling toward becoming endemic, it could become a less lethal threat that can be managed with vaccines that are updated periodically to protect against variants.

“It may be endemic, but not in a life-threatening way,” Dr. Michael Merson, a professor of global health at Duke University and former director of the World Health Organization’s Global Program on AIDS said. “It may be more like what we see with young kids, a common cold like disease.”

Madeleine Ngo contributed reporting.

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Russia Says One Dose of Sputnik Vaccine May be Enough

The first dose of Russia’s Sputnik V coronavirus vaccine provides sufficient protection on its own to be used without a second injection, the country’s Ministry of Health said on Thursday, clearing the way for a faster vaccination campaign in Russia.

The new policy arose from a debate among public health officials in Russia and a number of other countries about the benefits and drawbacks of accelerating vaccinations by skipping or delaying the second dose of vaccines that were originally designed to be administered in two shots a few weeks apart.

As is the case with other two-dose coronavirus vaccines, Sputnik V provides substantial protection, at least for the short term, after the first shot.

The ministry said in a statement that people in Russia who, for various reasons, skipped their second shot of Sputnik V were still far less likely to become sick than unvaccinated people were.

Sputnik V to be 79.4 percent effective after a single shot. Russia has previously reported an efficacy of 91.6 percent after two shots.

The observational study was less precise than a standard vaccine trial, because it compared rates of infection in single-shot recipients with the general infection rate in the population, not with a control group. The ministry did not say how many single-shot recipients were studied. A separate placebo-controlled study of the issue is still underway.

The Russian vaccine uses two common cold viruses that have been genetically modified to carry genes of the coronavirus, which prime the immune system to prevent infection. Developers of the vaccine have said the second dose lengthens the period of time a recipient is immune.

In other countries, health authorities have been wary about approving a simplified single-shot approach for vaccination using vaccines that were tested in trials using two shots.

But the first shot of Sputnik V uses the same common cold virus as the single-dose Johnson & Johnson vaccine, which already has been approved for use in the United States and other countries and has been shown to be safe and effective, with an efficacy of 72 percent in the United States.

The Russian version of this single-shot approach is called Sputnik Lite.

The two-dose Sputnik V vaccine is still being offered in Russia and to dozens of other countries. Russia’s export customers could also speed up their vaccination campaigns if they follow the Russian Ministry of Health’s lead in approving a single-dose strategy.

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Operating Rooms Go Under the Knife

Ceilings are not overlooked. Freeing up valuable floor space, monitors are often affixed to ceiling-mounted booms, which can have several arms and may also serve as a conduit for gases needed for anesthesia. Ultraviolet cleaning systems, which eliminate bacteria and viruses, can be anchored in the ceilings, to assist with disinfection. And the space above the ceiling is often larger to house a range of cables and other electronic equipment, in addition to ductwork with sophisticated air filtration systems.

Access to the space above the ceiling, as well as behind the walls, has become important, so that any technical problems can be investigated and remedied within hours, rather than shutting a room down for lengthy repairs. Some hospitals, for example, are now considering stainless steel prefabricated wall systems for their surgical suites because they are both easier to clean and easier to take out if the electronics hidden behind break, Ms. Saba said.

Other important factors are lighting and noise. When it comes to increasingly common laparoscopic surgery, monitors that guide surgeons are lit but overhead lights may be turned off to reduce glare, Dr. Hawn said.

That “can be somewhat dangerous because it can be quite dark and people run into things or trip over things,” she added. “We now have green lighting, which allows us to be able to see a sharp image on the monitors without the glare that you get from the white light.”

Noise is distracting at best, but with physical repercussions, like hypertension, especially for staff exposed for long periods. High decibel levels are “associated with increased difficulty in communication, which is the largest source of preventable errors in the hospital environment,” John Medina, an affiliate associate professor at the University of Washington department of bioengineering, said in an email.

At the Loma Linda University Medical Center in California, which is expected to open a new hospital on its campus this year, the operating room walls are built to mitigate outside noise as well as vibrations, and air duct silencers are being used as well, said Allison Ong, the head of campus transformation.

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FDA Announces Plan to Ban Menthol Cigarettes and Flavored Cigars

Public health experts, who have been pushing for a menthol ban for many years, celebrated the news.

“We are thrilled that the F.D.A. is taking this important step to protect all citizens, but especially African-Americans, from the deadly impacts of menthol,” said Kelsey Romeo-Stuppy, managing attorney for Action on Smoking and Health, a tobacco control organization and a plaintiff in the lawsuit that helped lead to the proposed ban on flavored cigarettes and cigars. The plaintiffs sued the F.D.A. last year for inaction on menthol.

The other plaintiffs in the lawsuit are the African American Tobacco Control Leadership Council, the American Medical Association and the National Medical Association. The lawsuit was intended in part to nudge forward a citizen petition to ban menthol, filed in 2013 by the Public Health Law Center and other public health organizations.

The tobacco industry and its allies were quick to criticize the F.D.A.’s plan. In emailed statements, both R.J. Reynolds, which makes Newport, the top-selling menthol brand in the United States, and Altria, which produces several menthol varieties, made it clear that they would not sit back and wait for a ban that would devastate much of their business in the United States.

“The published science does not support regulating menthol cigarettes differently from nonmenthol,” said Kaelan Hollon, a spokeswoman for R.J. Reynolds. “The scientific evidence neither shows a difference in health risks between a menthol and a nonmenthol cigarette, nor does it support that menthol cigarettes adversely affect initiation, dependence or cessation.”

In fact, hours after word leaked of the F.D.A. proposal, an organization calling itself Law Enforcement Action Partnership sent out a news release noting its opposition to the menthol ban. The organization’s tax form shows its largest donor for 2019 was Reynolds American Inc. Services Company, which gave the group $450,000, more than a third of its reported total contributions and grants for the year.

The group invoked an old and discredited tobacco industry argument: that efforts to ban menthol would “be bad for police-community trust.”

But the F.D.A.’s plan would address only the manufacturing, distribution, import and sale of menthol cigarettes — not carrying or smoking them.

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