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The struggle against vaccine hesitancy comes to Mississippi.

When it comes to getting a coronavirus vaccine, Mississippi residents have an abundance of options. On Thursday, there were more than 73,000 slots to be had on the state’s scheduling website, up from 68,000 on Tuesday.

In some ways, that growing availability of appointments is something to celebrate: It reflects the mounting supplies that have prompted states across the country to open up eligibility to anyone over 16. But public health experts say it also exposes something more worrisome: the large number of people who are reluctant to be inoculated.

“It’s time to do the heavy lifting needed to overcome the hesitancy we’re encountering,” said Dr. Obie McNair, an internal medicine practitioner in Jackson, the state capital.

Although access remains a problem in rural Mississippi, experts say that the state — which three weeks ago became one of the first to open eligibility to all adults — may be a harbinger of what much of the country will confront in the coming weeks as increasing supplies enable most Americans who want the vaccine to easily make appointments.

in one recent survey indicated a lower willingness to be vaccinated than Hispanic or white people.

The hesitancy has national implications. Experts say that 70 to 90 percent of people in the United States must be vaccinated for the country to reach herd immunity, the point at which the virus can no longer spread through the population.

In Mississippi, a quarter of all residents have received at least one vaccine dose, compared with the nationwide average of 33 percent, according to state data. Other Southern states, including Alabama, Arkansas, Georgia and Tennessee, have similarly low rates of vaccination.

Some other heavily Republican states are also finding themselves with surfeits of doses. Officials in Oklahoma, which has delivered at least one dose to 34 percent of its residents, said on Thursday that they would open up eligibility to out-of-state residents. In recent weeks, Republican governors in Ohio and Georgia voiced concern about lackluster vaccine demand among their residents.

Tim Callaghan, an assistant professor at the Texas A&M University School of Public Health and an expert on vaccine skepticism, said that more research was needed to determine the reasons behind Mississippi’s slackening vaccine demand, but that states with large rural populations, Republican voters and African-Americans were likely to be the first to confront the problem.

“If you’re looking to see vaccine hesitancy to emerge,” he said, “it’s going to be in red states like Mississippi.”

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Beyond Pandemic’s Upheaval, a Racial Wealth Gap Endures

“I want to emphasize that,” he added. “Through no fault of their own.”

The pandemic has hit African-Americans and Latinos hardest on all fronts, with higher infection and death rates, more job losses, and more business closures.

Proposals that confront the wealth gap head on, though, are both expensive and politically charged.

Professor Darity of Duke, a co-author of “From Here to Equality: Reparations for Black Americans in the Twenty-First Century,” has argued that compensating the descendants of Black slaves — who helped build the nation’s wealth but were barred from sharing it — would be the most direct and effective way to reduce the racial wealth gap.

Vice President Harris and Senators Bernie Sanders of Vermont, Elizabeth Warren of Massachusetts and Cory Booker of New Jersey have tended to push for asset-building policies that have more popular support. They have offered programs to increase Black homeownership, reduce student debt, supplement retirement accounts and establish “baby bonds” with government contributions tied to family income.

With these accounts, recipients could build up money over time that could be used to cover college tuition, start a business or help in retirement.

Several states have experimented with small-scale programs meant to encourage children to go to college. Though those programs were not created to close the racial wealth gap, researchers have seen positive side effects. In Oklahoma, child development accounts seeded with $1,000 were created in 2007 for a group of newborns.

“We have very clear evidence that if we create an account of birth for everyone and provide a little more resources to people at the bottom, then all these babies accumulate assets,” said Michael Sherraden, founding director of the Center for Social Development at Washington University in St. Louis, which is running the Oklahoma experiment. “Kids of color accumulate assets as fast as white kids.”

Without dedicated funds — the kind of programs that enabled white families to build assets — it won’t be possible for African-Americans to bridge the wealth gap, said Mehrsa Baradaran, a law professor at the University of California, Irvine, and the author of “The Color of Money: Black Banks and the Racial Wealth Gap.”

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Covid-19 Live Updates: Birx Lashes Trump’s Pandemic Response, Speaking of Many Needless Deaths

“so attentive to the scientific literature” and for not publicly correcting the president as he made outlandish claims about unproven therapies, whose disclosures may have been the most compelling.

As of Sunday, more than 548,000 Americans have died from infection with the coronavirus. “I look at it this way,” she said. “The first time, we have an excuse. There were about 100,000 deaths that came from that original surge.”

“All of the rest of them,” she said, referring to almost 450,000 deaths, “in my mind, could have been mitigated or decreased substantially” had the administration acted more aggressively.

In what was in one of her first televised interviews since leaving the White House in January, she also described a “very uncomfortable, very direct and very difficult” phone call with Mr. Trump after she spoke out about the dangers of the virus last summer. “Everybody in the White House was upset with that interview,” she said.

After that, she decided to travel the country to talk to state and local leaders about masks and social distancing and other public health measures that the president didn’t want her to explain to the American public from the White House podium.

Dr. Gupta asked if she was being censored. “Clearly someone was blocking me from doing it,” she said. “My understanding was I could not be national because the president might see it.”

Several of the officials, including Dr. Anthony S. Fauci — who unlike the others is a career scientist and is now advising President Biden — blamed China, where the virus was first detected, for not being open enough with the United States. And several, including Dr. Redfield and Admiral Giroir, said early stumbles with testing — and the attitude within the White House that testing made the president look bad by driving up the number of case reports — were a serious problem in the administration’s response.

And the problems with testing went beyond simply Mr. Trump’s obsession with optics. Admiral Giroir said that the administration simply did not have as many tests as top officials claimed at the time.

“When we said there were millions of tests — there weren’t, right?” he said. “There were components of the test available but not the full deal.”

A vaccination site at Cleveland State University in Ohio was expected to administer 6,000 shots a day shortly after it opened earlier this month. The state is among those expanding vaccinations to all adults.
Credit…Joshua Gunter/The Plain Dealer, via Associated Press

Chris Adams, 36, has spent the past year of the pandemic living with his grandparents in Wichita, Kan., and being “extremely strict” about social distancing. “I never went out,” he said.

But starting Monday, when all adults in Kansas become eligible for the coronavirus vaccine, Mr. Adams plans to find a vaccination site where there is an available appointment. “What I’m looking forward to is seeing my friends again,” he said.

Kansas is one of six states — Louisiana, North Dakota, Ohio, Oklahoma and Texas are the others — that are expanding eligibility for the vaccine to all adults on Monday. Minnesota will follow on Tuesday, and Indiana and South Carolina on Wednesday.

Gov. Laura Kelly of Kansas urged residents last week to seek out appointments, saying, “With the anticipated increase in supply from the federal government, we must get every dose of vaccine into arms quickly.”

Even as vaccine eligibility continues to expand across America — nearly all states have pledged to make every adult eligible by May 1 — the United States has also reported an increase in new cases over the past week. About 75,000 new cases were reported on Friday, a significant increase from the 60,000 added the Friday before.

States in the Northeast have accounted for about 30 percent of the nation’s new cases over the past two weeks, up from 20 percent in the first couple of weeks in February.

In New York, there has been an average of 8,426 new cases a day, an 18 percent increase from the average two weeks earlier, according to a New York Times database. In New Jersey over the past week, there have been an average of 4,249 new cases reported daily, a 21 percent increase from the average two weeks earlier. And on Friday, Vermont set a single-day case record with 283 new infections; it is the first state to set a case record since Jan. 18.

For many, the vaccine cannot come soon enough.

Nicole Drum, 42, a writer in the Kansas City, Kan., metro area, cried on Friday when she found out that she would be eligible to get the vaccine as early as Monday. She started calling pharmacies and looking online for available appointments “within minutes of the news breaking,” she said.

Ms. Drum called about 10 places without success. She had more luck on a county website, and booked an appointment for Wednesday.

She said she planned to wear a special T-shirt saying “I believe in science” to her appointment. “I got myself a fun I’m-getting-the-vaccine outfit,” she said, laughing.

She also plans to take her 4-year-old son with her, because she wants him to see “how research and science and people coming together can really help stem these kinds of things,” she said.

“I want him to know that there’s no need to be afraid all the time of big scary things, because there are always helpers trying to figure this out,” Ms. Drum said. “While the solution might be something that’s a jab in the arm that hurts a little bit, it’s worth it.”

Members of the World Health Organization’s team investigating the origins of the coronavirus arrived at the Wuhan Institute of Virology last month.
Credit…Hector Retamal/Agence France-Presse — Getty Images

The Biden administration has expressed concern over the Chinese government’s role in drafting a forthcoming World Health Organization report about the source of the coronavirus pandemic.

Secretary of State Antony J. Blinken suggested that Beijing had too much influence over the report, which is being compiled for the global health agency by a team of international experts as well as by Chinese scientists. Several of the Chinese scientists hold official positions or work at government-run institutions.

“We’ve got real concerns about the methodology and the process that went into that report, including the fact that the government in Beijing apparently helped to write it,” Mr. Blinken said in an interview that aired Sunday on CNN’s “State of the Union.”

Mr. Blinken’s remarks come as the Chinese government works to take control of the narrative before the release of the report, which will explore several theories for how the virus initially spread to humans.

China has been criticized for withholding raw data and repeatedly delaying a visit by the team of W.H.O. experts. The government in January finally allowed the W.H.O. team to visit the Chinese city of Wuhan, where the first coronavirus cases were detected in late 2019.

At a briefing with more than 100 foreign diplomats from 50 countries on Friday in Beijing, Chinese officials said the government had been transparent.

W.H.O. officials have acknowledged difficulties in compiling the report and say it will be released soon.

“It is, in a way, a painful process to get to the finishing line,” Peter K. Ben Embarek, a food safety scientist with the World Health Organization who is leading the team of experts, said at a news conference on Friday. “But the content is now complete.”

GLOBAL ROUNDUP

A vaccination centre at a mosque in London, on Sunday. Britain has given over 30 million vaccine doses.
Credit…Henry Nicholls/Reuters

Britain, which has now given a first dose of the coronavirus vaccine to more than 30 million people, began a gradual lifting of coronavirus restrictions for most of its population on Monday.

People in England are now allowed to gather outdoors in groups of up to six, or two households, after the end of a stay-at-home order in force since early January.

Outdoor sports facilities, like tennis and basketball courts and swimming pools, are also opening in England. Nonessential retail and outdoor dining are set to return from April 12. Students returned to classes earlier this month. Elsewhere in Britain, Scotland and Wales have also begun easing stay-at-home orders, and Northern Ireland is set to review on coronavirus restrictions next month.

For many in Britain, the easing was a cautious optimistic note after months lockdown, the nation’s third. The current lockdown began in January, after a new variant of the coronavirus swept the country, with as many as 60,000 daily cases and 1,800 daily deaths at its winter peak. On Sunday, the country reported 3,862 cases and 19 deaths, according to a New York Times database. London has so far reported no deaths from the virus on Sunday, according to Public Health England. If no reports are added later — the figures are not yet finalized — it would be the capital’s first day without a virus death since September. Officials are hoping a slow lifting will largely remove restrictions on socializing in England by June 21.

Travel abroad for English residents, however, remains banned, with a task force reviewing the rule next month. Officials cautioned that people should still work from home where possible and minimize contact.

In other news from around the globe:

  • In Australia, the city of Brisbane announced a three-day lockdown after seven people were infected with the coronavirus, the country’s first citywide lockdown in more than a month. Starting at 5 p.m. on Monday, residents of the city, which is Australia’s third largest, will be allowed to leave their houses only for essential purposes such as buying groceries, exercising or seeking medical care, and masks will be mandatory in public. Tests showed the virus spreading in Brisbane is the highly contagious variant first detected in Britain, officials said.

Yan Zhuang contributed reporting.

Passengers heading to Hawaii from Seattle-Tacoma International Airport this month.
Credit…Ted S. Warren/Associated Press

Palakiko Chandler took their little cousins to Nanakuli Beach on Oahu last weekend and noticed something they hadn’t seen in a while: a parking lot full of rental cars. The tourists were back.

“It was just so packed,” said Mr. Chandler, 27 and a Native Hawaiian. “Me and my cousins were looking at each other like, should we just go home?” The youngest cousins needed several reminders to keep their distance from strangers for virus safety.

For much of the pandemic, Hawaii had some of the strictest rules for visitors in the United States, requiring a 14-day quarantine for everyone arriving in the islands. The policy took a heavy economic toll on a state that depends heavily on tourism, but it was lauded for its success in limiting the impact of the virus for months.

Now, though, Hawaii has reopened for travelers: A negative test within 72 hours of arrival lets them skip the quarantine in most places. At least 28,000 people arrived in Hawaii on each of the last two Saturdays, according to state travel data —  the most in a day since the pandemic began, and not far from typical prepandemic levels.

The influx has residents worried. Some have been posting on social media for months, pleading with mainlanders not to come, or if they do, to be mindful of the islands’ isolation and limited resources. The state has a total of 3,000 hospital beds for its population of 1.4 million, and has among the fewest I.C.U. beds per capita of any state; they were often mostly full even before the pandemic.

Hawaii’s precautions did not keep the virus out completely: The islands had a holiday surge, like the rest of the country, and parts of the state are struggling with outbreaks now. Daily new case reports have doubled since late February, with some recent clusters focused on tourism workers. Hospitalizations have increased 17 percent in the last two weeks.

“The looming concerning things are the variants,” said Dr. Damien Kapono Chong-Hanssen of the Kauai Community Health Center. “The California variant has been implicated in what’s happening in Maui right now. Maui is not looking better.”

Mainlanders are making the trip anyway. “Hawaii is again packed with tourists,” wrote the travel site The Points Guy. Favorite sites are sold out, check-in lines are long, and the lines for outbound flights are getting longer.

Tourists are crowding popular beaches without wearing masks or paying much attention to social distancing. Some visitors have gotten rowdy. A pair of arriving tourists were sent home after trying to pay a bribe to avoid the testing requirement.

The situation is worsening the irritation that many state residents feel toward vacationers. Now the tourists aren’t just crowding the island and driving up prices, they say, they are also heedlessly risking everyone’s health.

“Hawaiians and locals alike have always seen the disrespect that tourists bring to our islands,” Mr. Chandler said. “This is kind of the last straw. You’re coming to our home and you’re endangering us during a pandemic.”

The tension is especially prevalent among Native Hawaiians and Pacific Islanders, who face greater risk for Covid-19 and higher rates of chronic disease than average.

“Local people are tired of being treated a certain type of way,” said Charles Kaua Taylor-Fulton, 20, who lives on Oahu. “When tourists come, they can be very rude or entitled. There’s just a sense of entitlement.”

Dr. Lee Buenconsejo-Lum of the University of Hawaii at Manoa said the state’s case numbers are not exploding, at least not yet. But she said she would like to see travelers exhibit the same commitment to wearing masks that locals have. “It’s a matter of constantly educating the tourists,” she said.

Still, the high travel season is just getting started, and restrictions are continuing to ease. Bars have reopened in parts of the state and outdoor weddings are now allowed to welcome up to 100 guests.

“We can already see into the future of summer,” Mr. Chandler said, “and it’s going to be packed.”

Office buildings in Manhattan have remained quiet as about 90 percent of their workers continue working remotely.
Credit…Jonah Markowitz for The New York Times

A year after the coronavirus spurred an extraordinary exodus of workers from New York City office buildings, what had seemed like a short-term inconvenience is now becoming a permanent shift in how and where people work. Employers and employees have both embraced the advantages of remote work, including lower office costs and greater flexibility for employees, especially those with families.

Beyond New York, some of the country’s largest cities have yet to see a substantial return of employees, even where there have been less stringent lockdowns, and some companies have announced that they are not going to have all workers come back all the time.

In recent weeks, major corporations, including Ford in Michigan and Target in Minnesota, have said they are giving up significant office space, while Salesforce, whose headquarters occupies the tallest building in San Francisco, said only a small fraction of its employees would be in the office full time.

But no city in the United States, and perhaps the world, must reckon with this transformation more than New York, and in particular Manhattan, an island whose economy has been sustained, from the corner hot dog vendor to Broadway theaters, by more than 1.6 million daily commuters.

About 90 percent of Manhattan office workers are working remotely, a rate that has remained unchanged for months, according to a recent survey of major employers by the Partnership for New York City, which estimated that less than half of office workers would return by September.

Across Midtown and Lower Manhattan, the country’s two largest central business districts, there has never been a greater proportion of office space for lease — 16.4 percent, much higher than in past crises, including after the Sept. 11 terror attacks in 2001 and the Great Recession in 2008.

As more companies push back dates for returning to offices and make at least some remote work a permanent policy, the consequences for New York could be far-reaching, not just for the city’s restaurants, coffee shops and other small businesses, but for municipal finances, which depend heavily on commercial real estate.

Some of the largest and most enduring companies, including JPMorgan Chase & Co., which has more than 20,000 office employees in the city, have told their work forces that the five-day office workweek is a relic. The bank is considering a model in which employees would rotate between working remotely and in the office.

Other large businesses, including the accounting firm PricewaterhouseCoopers, the marketing group Omnicom Group and the advertising giant WPP, have searched for subtenants to take over significant chunks of their Manhattan offices.

The loss of workers has caused the market value of commercial properties that include office buildings to plunge nearly 16 percent, prompting a sharp decline in the tax revenue that pays for essential city services.

The vaccine, which requires only a single shot, comes from Johnson & Johnson’s Janssen subsidiary.
Credit…Stephen Zenner/Getty Images

Johnson & Johnson said on Monday that it would supply its one-shot vaccine to African Union member states, as the continent experiences a slow rollout of vaccines, an uptick in cases and worries about new virus mutations.

The pharmaceutical company said that its unit, Janssen Pharmaceutica NV, agreed a deal with the African Vaccine Acquisition Trust, an African Union organization, to supply up to 220 million doses of its Covid-19 vaccine beginning in the fall. The organization will also have the possibility of ordering an additional 180 million doses for a combined total of up to 400 million doses through 2022.

The company will supply most of the doses from a plant in South Africa, which is operated by Aspen Pharma. The African Export-Import Bank, a Pan-African bank headquartered in Cairo, will pay manufacturers $2 billion on behalf of member countries in the form of loans.

South Africa’s president, Cyril Ramaphosa, who as the chair of the African Union set up the vaccine trust last year, is expected to tour the Aspen Pharma facilities in Port Elizabeth, on country’s southeast coast, on Monday.

“This agreement is a significant milestone in protecting the health of all Africans,” Mr. Ramaphosa said in a statement. “It is also a powerful demonstration of African unity and of what we can achieve through partnership between the state sector, the private sector and international institutions that puts people first.”

The announcement came as coronavirus cases surpassed 4.1 million in Africa, with more than 111,000 deaths, according to the Africa Centers for Disease Control and Prevention. Concerns have been mounting about the emergence of variants on the continent, particularly in countries like South Africa, where a highly transmissible variant has driven up cases. Scientists also recently said they found a highly mutated variant of the coronavirus in travelers from Tanzania, the East African nation whose leaders have consistently brushed aside the threat of the coronavirus pandemic.

Besides dealing with other deadly outbreaks including Ebola, polio and measles, many nations in Africa are also dealing with vaccine inequity, as developed nations hoard doses and seek to inoculate their entire populations. So far, only 7.7 million vaccines have been administered on the continent, according to the World Health Organization, which last week warned of a slowdown in deliveries even as initial batches were exhausted.

Vaccines were yet to arrive in 10 African countries, the W.H.O. said, while many others continued to face logistical challenges in addition to vaccine hesitancy.

Nations including South Africa have called on governments and pharmaceutical companies to waive vaccine patents to get medicines to more people more quickly.

The Africa C.D.C. has said that a minimum 60 percent of the continent’s population — or 750 million people — must be vaccinated if the virus is to be curbed there. The deal with Johnson & Johnson “enables Africa to meet almost 50 percent of that target,” Dr. John Nkengasong, the head of the Africa C.D.C., said in a statement.

“The key to this particular vaccine is that it is a single-shot vaccine, which makes it easier to roll out quickly and effectively, thus saving lives,” he added.

A vaccination center in Kathmandu, Nepal, this month.
Credit…Niranjan Shrestha/Associated Press

KATHMANDU, Nepal — Nepal on Monday received a donation of 800,000 doses of a Covid-19 vaccine from China, which the authorities said would help them restart an inoculation drive that had been halted because of shipment delays in India.

Dr. Jageshwor Gautam, a spokesman for the ministry of health, said the vaccination campaign could resume in less than a week, “once we determine beneficiary age groups.”

China and India, both of which border Nepal, have been jockeying for influence over the Himalayan nation of 30 million people, most recently through vaccine diplomacy.

Nepal had planned its vaccination campaign around the Oxford-AstraZeneca vaccine manufactured by the Serum Institute of India, the world’s largest vaccine producer. One million doses have been donated by the Indian government, and Nepal had bought an additional two million doses from the Serum Institute.

But half of the purchase from the Serum Institute has been delayed indefinitely, health officials in Nepal said, despite an agreement that it would arrive 15 days after the deal. India, which is supplying the AstraZeneca vaccine to more than 70 countries, has begun holding back nearly all of its exports as it tries to suppress a surge in coronavirus cases at home.

Officials in Nepal suspended vaccinations on March 17, citing the shortage of doses.

To fill the gap, they are now relying on a vaccine developed by the Chinese company Sinopharm, which last month became the second approved for emergency use in Nepal after Beijing pledged to provide doses free.

Since its vaccination drive began in late January, Nepal has administered about 1.6 million doses, according to a New York Times database. Dr. Gautam said the 500,000 remaining AstraZeneca doses would be given to frontline health workers, and that there were none available for the rest of the population “at least for now.”

Nepal has recorded almost 277,000 infections and 3,027 deaths, according to a New York Times database. Although the country’s average daily new cases are a small fraction of what they were at their peak last fall, health officials fear a second wave as infections surge in neighboring India. On Monday, India reported 68,020 new infections, the highest one-day rise since October.

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Six States Open Vaccines to All Adults on Monday

Chris Adams, 36, has spent the past year of the pandemic living with his grandparents in Wichita, Kan., and being “extremely strict” about social distancing. “I never went out,” he said.

But starting Monday, when all adults in Kansas become eligible for the coronavirus vaccine, Mr. Adams plans to find a vaccination site where there is an available appointment. “What I’m looking forward to is seeing my friends again,” he said.

Kansas is one of six states — Louisiana, North Dakota, Ohio, Oklahoma and Texas are the others — that are expanding eligibility for the vaccine to all adults on Monday. Minnesota will follow on Tuesday, and Indiana on Wednesday.

Gov. Laura Kelly of Kansas urged residents last week to seek out appointments, saying, “With the anticipated increase in supply from the federal government, we must get every dose of vaccine into arms quickly.”

according to a New York Times database. In New Jersey over the past week, there have been an average of 4,249 new cases reported daily, a 21 percent increase from the average two weeks earlier. And on Friday, Vermont set a single-day case record with 283 new infections; it is the first state to set a case record since Jan. 18.

For many, the vaccine cannot come soon enough.

Nicole Drum, 42, a writer in the Kansas City, Kan., metro area, cried on Friday when she found out that she would be eligible to get the vaccine as early as Monday. She started calling pharmacies and looking online for available appointments “within minutes of the news breaking,” she said.

Ms. Drum called about 10 places without success. She had more luck on a county website, and booked an appointment for Wednesday.

She said she planned to wear a special T-shirt saying “I believe in science” to her appointment. “I got myself a fun I’m-getting-the-vaccine outfit,” she said, laughing.

She also plans to take her 4-year-old son with her, because she wants him to see “how research and science and people coming together can really help stem these kinds of things,” she said.

“I want him to know that there’s no need to be afraid all the time of big scary things, because there are always helpers trying to figure this out,” Ms. Drum said. “While the solution might be something that’s a jab in the arm that hurts a little bit, it’s worth it.”

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