“Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given,” the statement said.
Like many states, New York had already prepared for a significant drop in its supply of the Johnson & Johnson vaccine after federal officials said that supplies would be limited because of a production issue at a Baltimore manufacturing plant. On Friday, Gov. Andrew M. Cuomo said that New York expected to receive 34,900 Johnson & Johnson shots, a decrease of 88 percent from the previous week.
Dr. Zucker, New York’s health commissioner, said that the state would honor appointments made at state-run mass vaccination sites for the Johnson & Johnson vaccine by giving people the Pfizer-BioNTech vaccine instead. That vaccine requires two doses, and it was not immediately clear how the state would handle the additional strain on its supply.
New Jersey health officials said the state would work with its vaccination sites to help people get appointments for the Pfizer or Moderna vaccine instead. Mayor Bill de Blasio of New York City said that the city would do the same, rescheduling appointments at city-run vaccine sites.
“Every site has been told this morning to stop giving the J&J shots,” he said at a news conference.
The city’s health commissioner, Dr. Dave Chokshi, said that around 234,000 residents have received the Johnson & Johnson vaccine and none had reported any blood clots so far. The city had been relying on the vaccine to inoculate hard-to-reach New Yorkers, including people who are homebound.
Both Mr. Cuomo and Mr. de Blasio received the Johnson & Johnson vaccine at separate appearances last month, which they framed as an effort to boost confidence in that vaccine’s efficacy rate and to address vaccine hesitancy.
Regulators in Europe and elsewhere are concerned about a similar issue with another coronavirus vaccine, developed by AstraZeneca and Oxford University researchers. That vaccine has not been authorized for emergency use in the United States.
Johnson & Johnson’s single-dose coronavirus vaccine after six recipients in the United States developed a rare disorder involving blood clots within about two weeks of vaccination.
All six recipients were women between the ages of 18 and 48. One woman died and a second woman in Nebraska has been hospitalized in critical condition.
Nearly seven million people in the United States have received Johnson & Johnson shots so far, and roughly nine million more doses have been shipped out to the states, according to data from the Centers for Disease Control and Prevention.
“We are recommending a pause in the use of this vaccine out of an abundance of caution,” Dr. Peter Marks, director of the Food and Drug Administration’s Center for Biologics Evaluation and Research, and Dr. Anne Schuchat, principal deputy director of the C.D.C., said in a joint statement. “Right now, these adverse events appear to be extremely rare.”
On a media call later on Tuesday morning, Dr. Marks said that “on an individual basis, a provider and patient can make a determination whether or not to receive the vaccine” manufactured by Johnson & Johnson.
While the move was framed as a recommendation to health practitioners in the states, the federal government is expected to pause administration of the vaccine at all federally run vaccination sites. Federal officials expect that state health officials will take that as a strong signal to do the same. Within two hours of the announcement, Gov. Mike DeWine of Ohio, a Republican, advised all health providers in his state to temporarily stop giving Johnson & Johnson shots. In New York, the health commissioner, Dr. Howard Zucker, said the state would halt the use of the vaccine statewide while federal officials evaluate the safety risks. Appointments for Johnson & Johnson’s shot on Tuesday at state mass sites would be honored with Pfizer doses, Dr. Zucker said.
The authorities in New Jersey, Connecticut, Massachusetts, Maryland, Nebraska, Georgia, Indiana, Texas and Virginia also said that they would follow the call from federal health agencies.
Scientists with the F.D.A. and C.D.C. will jointly examine possible links between the vaccine and the disorder and determine whether the F.D.A. should continue to authorize use of the vaccine for all adults or limit the authorization.
In the media call, federal health officials tried to reassure recipients of Johnson & Johnson’s vaccine while at the same time describing symptoms that they should watch out if they received a shot within the past month.
Dr. Schuchat said that the risk of dangerous blood clots is “very low” for people who received the vaccine more than a month ago.
“For people who recently got the vaccine within the last couple of weeks, they should be aware, to look for any symptoms. If you receive the vaccine and develop severe headaches, abdominal pain, leg pain or shortness of breath, you should contact your health care provider and seek medical treatment,” she said. She emphasized that an emergency meeting of the C.D.C.’s outside advisory committee, which has been scheduled for Wednesday, to discuss how to handle the vaccine in the future is made up of independent experts.
Dr. Janet Woodcock, acting commissioner of the Food and Drug Administration, said she expects the pause in distributing and administrating the vaccine will last for “a matter of days” while officials investigate the cases. Officials also stressed that no serious safety problems have emerged with either of the other two federally authorized vaccines, developed by Pfizer-BioNTech and Moderna.
The move could substantially complicate the nation’s vaccination efforts at a time when many states are confronting a surge in new cases and seeking to address vaccine hesitancy. Regulators in Europe and elsewhere are concerned about a similar issue with another coronavirus vaccine, developed by AstraZeneca and Oxford University researchers. That concern has driven up some resistance to all vaccines, even though the AstraZeneca version has not been authorized for emergency use in the United States.
The vast majority of the nation’s vaccine supply comes from two other manufacturers, Pfizer-BioNTech and Moderna, which together deliver more than 23 million doses a week of their two-shot vaccines. There have been no significant safety concerns about either of those vaccines.
But while shipments of the Johnson & Johnson vaccine have been much more limited, the Biden administration had still been counting on using hundreds of thousands of doses every week. In addition to requiring only a single dose, the vaccine is easier to ship and store than the other two, which must be stored at extremely low temperatures.
Jeffrey D. Zients, the White House Covid-19 response coordinator, said Tuesday the pause “will not have a significant impact” the Biden administration’s plans to deliver enough vaccine to be able to inoculate all 260 million adults in the United States by the end of May. With the Johnson & Johnson setback, federal officials expect there will only be enough to cover fewer than 230 million adults. But a certain percentage of the population is expected to refuse shots, so the supply may cover all the demand.
Mr. Zients said the administration will still “reach every adult who wants to be vaccinated” by the May 31 target.
Federal officials are concerned that doctors may not be trained to look for the rare disorder if recipients of the vaccine develop symptoms of it. The federal health agencies said Tuesday morning that “treatment of this specific type of blood clot is different from the treatment that might typically be administered” for blood clots.
“Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given,” the statement said.
In a news release, Johnson & Johnson said: “We are aware that thromboembolic events including those with thrombocytopenia have been reported with Covid-19 vaccines. At present, no clear causal relationship has been established between these rare events and the Janssen Covid-19 vaccine.” Janssen is the name of Johnson & Johnson’s division that developed the vaccine.
In the United States alone, 300,000 to 600,000 people a year develop blood clots, according to C.D.C. data. But the particular blood clotting disorder that the vaccine recipients developed, known as cerebral venous sinus thrombosis, is extremely rare.
All of the women developed the condition within about two weeks of vaccination, and government experts are concerned that an immune system response triggered by the vaccine was the cause. Federal officials said there was broad agreement about the need to pause use of the vaccine while the cases are investigated.
The decision is a fresh blow to Johnson & Johnson. Late last month, the company discovered that workers at a Baltimore plant run by its subcontractor had accidentally contaminated a batch of vaccine, forcing the firm to throw out the equivalent of 13 million to 15 million doses. That plant was supposed to take over supply of the vaccine to the United States from Johnson & Johnson’s Dutch plants, which were certified by federal regulators earlier this year.
The Baltimore plant’s certification by the F.D.A. has now been delayed while inspectors investigate quality control issues, sharply reducing the supply of Johnson & Johnson vaccine. The sudden drop in available doses led to widespread complaints from governors and state health officials who had been expecting much bigger shipments of Johnson & Johnson’s vaccine this week than they got.
A Kent State University student getting his Johnson & Johnson vaccination in Kent, Ohio, last week.Credit…Phil Long/Associated Press
The authorities in Ohio, New York, New Jersey, Connecticut, Massachusetts, Maryland, Nebraska, Georgia, Indiana, Texas and Virginia said on Tuesday that they would follow the call from federal health agencies to pause the administration of Johnson & Johnson’s vaccine after six women in the United States developed a rare disorder involving blood clots within about two weeks of vaccination.
CVS, the nation’s largest retail pharmacy chain, also said that it would immediately stop its use of Johnson & Johnson vaccinations and was emailing customers whose appointments would be canceled. A spokesman said that CVS would reschedule appointments “as soon as possible.”
Gov. Mike DeWine of Ohio and the state’s chief health official said they were advising all state vaccine providers to temporarily halt use of the single-dose vaccine. New York’s health commissioner, Dr. Howard Zucker, said the state would stop using the Johnson & Johnson vaccine, while the Food and Drug Administration and the Centers for Disease Control and Prevention evaluate the safety risks.
Connecticut health officials said they told vaccine providers to delay planned appointments and give an alternative option if they had the supply.
The C.D.C.’s outside advisory committee has scheduled an emergency meeting for Wednesday.
Jeff Zients, the White House Covid coordinator, said on Tuesday that the pause will not have a significant impact on the country’s vaccination campaign, which has accelerated in recent weeks as a rise in new virus cases threatens a fourth possible surge. Many states have already opened vaccination eligibility to all adults and others plan to by next week.
“Over the last few weeks, we have made available more than 25 million doses of Pfizer and Moderna each week, and in fact this week we will make available 28 million doses of these vaccines. This is more than enough supply to continue the current pace of vaccinations of 3 million shots per day,” Mr. Zients said in a statement.
Even though the reaction to the Johnson & Johnson shot is rare, any questions about the safety of the shots could bolster vaccine hesitancy.
Nearly seven million people in the United States have received Johnson & Johnson shots so far, and roughly nine million more doses have been shipped out to the states, according to data from the Centers for Disease Control and Prevention. The six women who developed blood clots were between the ages of 18 and 48. One woman died and a second woman in Nebraska has been hospitalized in critical condition.
“Right now, these adverse events appear to be extremely rare,” Dr. Peter Marks, director of the Food and Drug Administration’s Center for Biologics Evaluation and Research, and Dr. Anne Schuchat, principal deputy director of the C.D.C., said in a joint statement on Tuesday. “People who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider.”
Like many states, New York had already prepared for a significant drop in its supply of the Johnson & Johnson vaccine after federal officials said that supplies would be limited because of a production issue at a Baltimore manufacturing plant. On Friday, Gov. Andrew M. Cuomo said that New York expected to receive 34,900 Johnson & Johnson shots, a decrease of 88 percent from the previous week.
Dr. Zucker, New York’s health commissioner, said that the state would honor appointments made at state-run mass vaccination sites for the Johnson & Johnson vaccine by giving people the Pfizer-BioNTech vaccine instead. That vaccine requires two doses, and it was not immediately clear how the state would handle the additional strain on its supply.
Mayor Bill de Blasio of New York City said that the city would work to reschedule appointments at city-run vaccine sites, giving those people the Pfizer or Moderna vaccines instead.
“Every site has been told this morning to stop giving the J&J shots,” he said at a news conference.
Mr. Cuomo received the Johnson & Johnson vaccine at a public appearance last month in Harlem, which he framed as an effort to boost confidence in that vaccine’s efficacy rate and to address vaccine hesitancy.
Regulators in Europe and elsewhere are concerned about a similar issue with another coronavirus vaccine, developed by AstraZeneca and Oxford University researchers. That vaccine has not been authorized for emergency use in the United States.
Students line up for vaccines at Oakland University on Friday in Rochester, Mich. Coronavirus cases in the state have continued to rise in recent weeks.Credit…Emily Elconin for The New York Times
The virus is again surging in parts of the United States, but it’s a picture with dividing lines: ominous figures in the Northeast and Upper Midwest, but largely not in the South.
Experts are unsure what explains the split, which doesn’t correspond to vaccination levels. Some point to warmer weather in the Sun Belt, while others suspect that decreased testing is muddying the virus’s true footprint.
The contours of where the virus is resurgent can be drawn around one figure: states that are averaging about 15 new cases a day for every 100,000 people. The 23 states — including Alabama, Mississippi and Arkansas — that have averaged that or fewer over the past week seem to be keeping cases relatively low, according to a New York Times database. Nationally, the country is averaging 21 new cases per 100,000 people.
In the 27 states above that line, though, things have been trending for the worse. Michigan has the highest surge of all, reporting the most drastic increase in cases and hospitalizations in recent weeks. Illinois, Minnesota and others have also reported worrisome increases.
Nationally, reported cases in the United States are growing again after a steep fall from the post-holiday peak in January. In the past two weeks, new confirmed cases have jumped about 11 percent, even though vaccinations picked up considerably, with an average of 3.2 million doses given daily.
Some Southern states, like Alabama and Mississippi, are lagging in vaccinations. Only about 28 percent of people in each state have received at least one shot, according to a New York Times vaccine tracker. Still, case counts continue to drop in both states.
Health experts say cases are rising in the Northeast and Upper Midwest for several reasons, including pandemic fatigue, the reopening of schools and the resumption of youth sports.
Hospitalizations tend to follow the trend line in cases by a few weeks, and have been rising in some states, most notably in Michigan.
Officials are also concerned about the spread of more contagious virus variants, especially B.1.1.7, first identified in Britain. The variant is now the leading source of new coronavirus infections in the United States, the director of the Centers for Disease Control and Prevention said last week.
Just why those factors might affect some states more than others is hard to pinpoint, experts say.
Dr. David Rubin, the director of PolicyLab at the Children’s Hospital of Philadelphia, said warmer weather in Southern states and California was probably playing a role, because it allows people to gather outdoors, with less risk of transmission.
New case reports have fallen by about 11 percent in Georgia over the past two weeks. And in Alabama, new cases are down roughly 29 percent, with a 17 percent decline in hospitalizations.
Some experts say, though, that reduced testing in some states could be obscuring the true picture. Testing in Alabama, for instance, has started to dip, but the share of tests that come back positive has remained high, at 11.1 percent, compared with a nationwide average of 5.1 percent, according to data compiled by Johns Hopkins University.
“People who are symptomatic and go to their provider are going to get a test,” said Dr. Michael Saag, the associate dean for global health at the University of Alabama at Birmingham, but “the desire for people to go get tested just because they want to know what their status is has dropped off dramatically.”
Still, Dr. Saag said, there is probably not a hidden spike in cases in Alabama right now, since hospitalizations in the state remain low.
— Madeleine Ngo
The first dawn prayers of Ramadan around the Kaaba at the Grand Mosque in Mecca, Saudi Arabia, on Tuesday.Credit…Amr Nabil/Associated Press
Millions of Muslims on Tuesday began celebrating a second Ramadan in the middle of the pandemic, although in many countries the first day of the holy month offered the promise of a Ramadan with fewer restrictions than last year.
Mosques across the Middle East and other parts of the world were closed for prayer last year, and lockdowns prevented festive gatherings with friends and family. In Jerusalem, for instance, the Old City was largely empty and the Aqsa Mosque compound was closed to the public, as coronavirus cases were surging.
But a large degree of normalcy was back on Tuesday: The Old City’s narrow alleys were crowded, sweet shops were preparing Ramadan desserts, clothing stores were open and the Aqsa compound was welcoming worshipers.
“Last year, I felt depressed and I didn’t know how long the pandemic would last,” said Riyad Deis, a co-owner of a spice and dried fruit shop in the Old City, while selling whole pieces of turmeric and Medjool dates to a customer. “Now, I’m relaxed, I have enough money to provide for my family and people are purchasing goods from my shop — it’s a totally different reality.”
The enthusiasm of some didn’t mean the Ramadan would go as normal. Across several countries in the Middle East, the authorities imposed limitations on customs and festivities, requiring that mosques enforce social distancing and telling worshipers to bring their own prayer rugs and to wear face masks.
In Dubai, Saudi Arabia and Egypt, taraweeh, the optional extra prayers that worshipers can observe at night, were capped at half an hour. No one will also be allowed to spend the night in a mosque, as is common during the last 10 days of Ramadan.
Mosques around the region were also prohibited from serving the fast-breaking meal of iftar or the predawn meal of suhoor. Though Muslims could still gather for those meals with friends and family, the authorities asked them to limit those gatherings this year.
In Jerusalem, Omar Kiswani, the director of Al Aqsa Mosque, said he was overjoyed that the compound was open to worshipers, but still urged caution.
“These are times of great happiness — we hope the blessed Aqsa Mosque will return to its pre-pandemic glory — but these are also times of caution because the virus is still out there,” Mr. Kiswani said.
In Egypt, government officials and prominent television hosts linked to the authorities warned Egyptians of a third wave of infections as Ramadan approached, hinting that another curfew or other lockdown restrictions could be imposed if cases rose.
“If you want the houses of God to remain open,” Nouh Elesawy, an official who oversees mosques at the Egyptian Ministry of Endowments, said earlier this month, “adhere to the precautionary procedures and regulations.”
The Ramadan restrictions may hit the hardest in poor neighborhoods, where residents depend on iftar banquets usually sponsored by wealthy individuals or organizations. For those people, feasting and Ramadan gifts are likely to be rarer, with tourism still at a trickle and many small businesses still suffering from the economic effects of the pandemic.
In Lebanon and Syria, the pandemic has worsened economic crisis that will likely squeeze people’s ability to enjoy the holy month, more than the governments’ limited restrictions aimed at curbing the spread of the coronavirus.
In Syria, where experts say the official infection and death numbers for Covid-19 are far below the reality, the government has few restrictions in place. Worshipers will even be allowed to stand in line inside of mosques to pray together after breaking their fast, the Syrian Ministry of Religious Affairs said.
In Lebanon, which emerged recently from a strict lockdown, shops and restaurants can operate regularly during the day but must offer only delivery service during a nighttime curfew from 9:30 p.m. to 5 a.m.
Global Roundup
Administering a coronavirus vaccine to a frontline worker in New Delhi, last week.Credit…Rebecca Conway for The New York Times
India said on Tuesday that it would fast-track the approval of vaccines in use in other countries, a move aimed at rapidly increasing the country’s vaccine supply as it battles what is currently the world’s biggest coronavirus outbreak.
The Indian government said that it would grant emergency authorization to any foreign-made vaccine that had been approved for use by regulators in the United States, the European Union, Britain or Japan, or by the World Health Organization. The move had been recommended by a panel of Indian scientists and eliminates a requirement for drug companies to conduct local clinical trials.
“The decision will facilitate quicker access to such foreign vaccines” and encourage imports of materials that would boost India’s vaccine manufacturing capacity, the government said in a statement.
Earlier on Tuesday, India’s top drug regulator granted emergency approval to Sputnik V, the Russian-made vaccine, adding a third vaccine to the country’s arsenal on the same day that health officials recorded 161,736 new coronavirus infections in 24 hours.
It was the seventh straight day that India has added more than 100,000 cases, according to a New York Times database. Only the United States has seen a faster rise in infections during the pandemic.
India has administered about 105 million domestically produced vaccine doses for a population of 1.3 billion, but it is widely believed that the country needs to scale up inoculations rapidly because other measures have failed to control the virus. Many states have reimposed partial lockdowns and weekend curfews. In the country’s financial hub, Mumbai, health officials are racing to erect field hospitals as facilities report shortages of oxygen, ventilators and coronavirus testing kits.
And there is the risk of a superspreading event with the gathering of millions of Hindu pilgrims for the annual Kumbh Mela festival on the banks of the Ganges River, where the authorities say they are powerless to enforce social distancing.
India’s outbreak is reverberating worldwide as its pharmaceutical industry — which was supposed to manufacture and export hundreds of millions of doses of the AstraZeneca vaccine — is keeping most supplies at home. The approval of the Sputnik vaccine, whose first doses are expected to be available for use in weeks, offers hope that India could speed up its inoculation drive.
But it is unclear at this stage whether India will be able to procure significant quantities of other vaccines, including the Pfizer, Moderna and Johnson & Johnson shots in use in the United States. Major Western nations have accumulated much of the global supply of those vaccines and manufacturers are struggling to meet the surging demand.
India will import millions of Sputnik doses from Russia and then begin manufacturing the vaccine domestically, officials said. More than 850 million doses will be made, with some intended for export, Kirill Dmitriev, chief executive of the Russian Direct Investment Fund, a sovereign wealth fund that has financed the vaccine’s development, said in an interview with India’s NDTV channel.
“India is a vaccine-manufacturing hub and our strategic partner for production of Sputnik V,” Mr. Dmitriev said.
India has more than 13.6 million confirmed coronavirus cases, the second most after the United States, and 171,058 deaths, the fourth highest toll.
In other news around the world:
Japan has begun vaccinating 36 million people over age 65, the first time shots have been made available to the public during the country’s slow vaccine rollout. Officials said that 1,139 people nationwide had received doses on Monday, and that doses to cover all Japanese above the age threshold would reach municipal health facilities by the end of June. Although Japan has weathered the pandemic better than most countries, the pace of its vaccination effort, which until now had only covered 1.1 million frontline medical workers, has sparked public criticism and raised questions about readiness for the Tokyo Summer Olympics in just over three months.
Scotland on Tuesday moved forward plans to loosen its coronavirus lockdown, a day after the British government eased many restrictions in England. New rules beginning Friday will permit Scots to meet outdoors in groups of up to six adults from six households. The current rules restrict travel and set the maximum group size at four, from two households. Restrictions on shops and outdoor service in pubs, now relaxed in England, are scheduled to remain in Scotland until April 26.
Austria’s health minister resigned on Tuesday, citing personal health problems that he said have been exacerbated by the grueling job of helping lead the country’s response to the pandemic. “It feels like it has not been 15 months, but 15 years,” the minister, Rudolf Anschober, said in a statement. Mr. Anschober, 60, was appointed in January last year, as a Green party minister in a Conservative-led coalition, and has been one of the main faces of Austria’s coronavirus response. “In the worst health crisis in decades, the republic needs a health minister who is 100 percent fit. That is not currently me,” he said.
France will suspend all flights to and from Brazil, because of growing worries about the virus variant spreading there. “We see that the situation is getting worse” in Brazil, Prime Minister Jean Castex told lawmakers. The country previously permitted essential travel from Brazil, subject to testing and isolation requirements.
The World Health Organization on Monday evening called on governments to suspend the sale of live wild mammals in food markets to help prevent the emergence of new diseases. “Traditional markets, where live animals are held, slaughtered and dressed, pose a particular risk for pathogen transmission to workers and customers alike,” the agency said in a statement. Animals are the source of more than 70 percent of emerging infectious diseases in humans, it said. Early in the pandemic, Chinese officials suggested that the coronavirus outbreak might have started at a market. But W.H.O. experts said in a report last year that the role of animal markets in the story of the pandemic was still unclear.
Chancellor Angela Merkel, center, at a cabinet meeting in Berlin on Tuesday. Her government’s proposal on coronavirus restrictions would place half the country over the threshold for lockdown.Credit…Pool photo by Andreas Gora
BERLIN — Chancellor Angela Merkel’s government moved a step closer on Tuesday to securing the right to force restrictions on areas where the coronavirus is spreading rapidly, overriding state leaders reluctant to take action.
Ms. Merkel and her ministers approved a legislative proposal that would make it easier for the national government to enforce lockdowns and other limits on movement in regions where infection levels pass a set threshold. At current levels, it could lock down more than half of the country.
Under Germany’s decentralized leadership structures, the 16 state leaders have been meeting regularly with the chancellor to agree on nationwide coronavirus response policies. But with different regions experiencing different rates of infection, some state leaders have been reluctant to enforce the agreed limitations, leading to confusion and frustration among many Germans.
“I believe this amendment is as important as it is an urgent decision about how to proceed in the coronavirus pandemic,” the chancellor told reporters after meeting with her ministers.
Parliament still has to debate and approve the proposal, which would take the form of an amendment to the Protection Against Infection Act, and that process is expected to begin this week.
“We are in a situation where an emergency mechanism is necessary,” Ralph Brinkhaus, the leader of the Christian Democratic Union in Parliament, told reporters, before a meeting of his party lawmakers to discuss the amendment.
Under the proposed amendment, the federal government could force stores and cultural institutions to close and enforce limits on the number of people allowed to meet up in any region where infections surpass 100 new cases per 100,000 residents over a period of seven days.
More controversially, the law would also allow Ms. Merkel’s government to order that schools and day care centers close if the number of new infections reaches more than 200 per 100,000 inhabitants. Schools fall under the jurisdiction of the states, and local leaders are reluctant to relinquish that control.
Germany has registered more than three million infections and more than 78,700 deaths from Covid-19 since the virus began moving through the country last spring. It recorded 10,810 new cases of infection on Tuesday, bringing the national rate of infection to more than 140 per 100,000.
The number of patients in intensive care is expected to hit a record this month, as the country struggles to vaccinate enough people to get ahead of the spread of the highly contagious B.1.1.7 variant.
Vaccinations at a mosque in London earlier this month. Britain’s program has reached over 32 million people, more than half the adult population.Credit…Andrew Testa for The New York Times
Britain has now offered vaccinations to everyone in the country age 50 and older, the government announced late on Monday, and is extending its program to another age group, the latest sign that the national rollout is continuing at pace.
On Tuesday, the authorities opened vaccinations to anyone 45 or older, yet the announcement came with a small hiccup: The website for the country’s National Health Service crashed for a short time after the younger cohort was invited to book appointments online.
The new step in the country’s vaccine rollout comes as the authorities eased several restrictions in England on Monday after months of stringent lockdowns, with pubs and restaurants opened for drinks and dining outside, and nonessential shops once again opening their doors.
Prime Minister Boris Johnson called the moment a “hugely significant milestone” and in a statement thanked those involved with the vaccine rollout. Mr. Johnson said the country was on track to offer all adults a vaccination by the end of July. More than 32 million people across Britain have received their first dose of one of the vaccines, according to government data.
The government said it had also already offered vaccinations to every health or care worker, and to everyone with a high-risk medical condition.
England has also began rolling out the Moderna vaccine, which will be offered as an alternative alongside the Pfizer BioNTech vaccine for those under 30, instead of AstraZeneca’s, which has been the mainstay of Britain’s program so far.
There have been concerns about a possible link between the AstraZeneca vaccine and very rare blood clots, and last week British regulators said an alternative should be provided for younger people. Potential infection still poses much greater risks than any vaccine side effect for all those over 30, they said, and could do so for younger people if cases surged again.
“The Moderna rollout marks another milestone in the vaccination program,” Stephen Powis, the medical director of the National Health Service, said in a statement. “We now have a third jab in our armory.”
The vaccination program, he added, “is our hope at the end of a year like no other” as he encouraged people to book their appointments.
But despite the hopeful vaccine news and the return to public life, the country is still battling new cases of the virus, and a cluster in two London neighborhoods of a worrisome variant first discovered in South Africa has prompted mass testing. Health workers have gone door to door to urge residents to get tested, even if they are not showing symptoms, as dozens of cases have emerged. Similar measures were carried out elsewhere in the city earlier this month.
Studies have shown that the variant contains a mutation that diminishes the vaccines’ effectiveness against it. Dr. Susan Hopkins, the chief medical adviser for the country’s test and trace campaign, said the cluster of cases in parts of South London was “significant.”
“It’s really important people in the local area play their part in stopping any further spread within the local community,” she said in a statement.
Pacific Palace, a dim sum restaurant on a commercial strip in the Sunset Park section of Brooklyn, has seen revenue plunge.Credit…Victor J. Blue for The New York Times
More than a year after the coronavirus first swept through New York, the streets of Sunset Park in southern Brooklyn reflect the pandemic’s deep and unhealed wounds intertwined with signs of a neighborhood trying to edge back to life.
The sidewalks are filling with shoppers and vendors. More businesses are welcoming customers. But owners still struggle to pay rent and keep their enterprises afloat, while many workers laid off after the city locked down last year remain without jobs.
And while the rate of vaccination in New York has increased significantly, the coronavirus still percolates through this densely packed neighborhood. The ZIP code that includes Sunset Park had the highest rate of positive cases in Brooklyn in early April, nearly double the citywide rate. Some residents have expressed skepticism about the vaccines, spooked by false information circulated over TikTok and other social media.
Adding to the stress is a spate of hate crimes and violence against people of Asian descent in New York and around the country, fed in some cases by racist claims that Asian-Americans are responsible for spreading the virus.
About a third of the residents in Sunset Park have received at least one dose of the vaccine, roughly the same level as the city overall, according to the city health data. But local leaders say they want to push that number much higher.
Kuan Neng, 49, the Buddhist monk who founded Xi Fang Temple on Eighth Avenue, said that people had come to him in recent weeks to express concerns over vaccines.
“Why do I need to do that?” is a common refrain, according to Mr. Kuan, followed by: “I’m healthy now. The hard times are over, more or less.”
“Many people want to delay and see,” Mr. Kuan said, himself included.
The owner of the Cinerama Dome in Hollywood and 15 other movie theaters said it would not reopen after the pandemic.Credit…Kate Warren for The New York Times
ArcLight Cinemas, a beloved chain of movie theaters based in Los Angeles, including the Cinerama Dome in Hollywood, will permanently close all its locations, Pacific Theaters announced on Monday, after the pandemic decimated the cinema business.
ArcLight’s locations in and around Hollywood have played host to many a movie premiere, in addition to being favorite spots for moviegoers seeking out blockbusters and prestige titles. They are operated by Pacific Theaters, which also manages a handful of theaters under the Pacific name, and are owned by Decurion.
“After shutting our doors more than a year ago, today we must share the difficult and sad news that Pacific will not be reopening its ArcLight Cinemas and Pacific Theaters locations,” the company said in a statement.
“This was not the outcome anyone wanted,” it added, “but despite a huge effort that exhausted all potential options, the company does not have a viable way forward.”
Between the Pacific and ArcLight brands, the company owned 16 theaters and more than 300 screens.
The movie theater business has been hit particularly hard by the pandemic. But in recent weeks, the majority of the country’s largest theater chains, including AMC and Regal Cinemas, have reopened in anticipation of the slate of Hollywood films that have been put back on the calendar, many after repeated delays because of pandemic restrictions. A touch of optimism is even in the air as a result of the Warner Bros. movie “Godzilla vs. Kong,” which has generated some $70 million in box office receipts since opening over Easter weekend.
Still, the industry’s trade organization, the National Association of Theater Owners, has long warned that the punishing closures were most likely to affect smaller regional players like ArcLight and Pacific. In March, the Alamo Drafthouse Cinema chain, which operates about 40 locations across the country, announced that it had filed for Chapter 11 bankruptcy protection but would keep most of its locations operational while it restructured.
That does not seem to be the case for Pacific Theaters, which, according to two people with knowledge of the matter, fired its entire staff on Monday.
The reaction to ArcLight’s closing around Hollywood has been emotional, including an outpouring on Twitter.
Devastating. Too many losses to process. It’s just too much… At some point when I’m less upset, I’ll tell you guys a funny story about my first time meeting Quentin Tarantino in the lobby of Hollywood Arclight. https://t.co/cFypJxEk4L
— Lulu Wang (@thumbelulu) April 13, 2021
Firefighters at the site of COVID-19 hospital Matei Bals, after a fire broke out in one of its buildings in Bucharest, Romania, in January.Credit…Robert Ghement/EPA, via Shutterstock
Three people infected with the coronavirus died at a hospital in Bucharest on Monday evening after the oxygen supply stopped functioning, according to the authorities, the latest incident involving oxygen failure, which in many countries has driven up the virus death toll.
It was also another fatal setback for Romania’s ageing and overwhelmed health care system, which has suffered two fires in Covid-19 wards in recent months, killing at least 15 people.
Ventilators shut down at a mobile intensive care unit set up at the Victor Babes hospital in Bucharest after oxygen pressure reached too high a level, the country’s health authorities said in a statement, depriving patients of a vital supply. In addition to the three patients who died, five others were evacuated and moved to other facilities in the city.
Romania has recorded its highest rate of Covid-19 patients in intensive care units since the pandemic began, and on Sunday Prime Minister Florin Citu said that there were just six intensive care beds available across Romania, out of nearly 1,600.
Intensive care units in Hungary and Poland have also been at risk of being overwhelmed, as much of Eastern Europe has struggled to cope with a third wave of infections across the continent. Some Hungarian hospitals have sought medical students and volunteers to assist in Covid-19 wards, giving training to those without previous medical experience.
The mobile unit struck by the oxygen problem on Monday had only been in operation since Saturday, and it has epitomized long-running concerns over the country’s fragile health care system. In January, five patients died and a further 102 were evacuated from a different hospital in Bucharest after a fire broke out. In November, 10 patients hospitalized with the coronavirus died after a fire broke out in a hospital in the northeastern city of Piatra Neamt.
Romania’s spending on health care is among the lowest in the European Union, with just over five percent of gross domestic product allocated toward it, compared with 10 percent on average among other countries of the bloc.
More than 25,000 people who tested positive for the virus have died in Romania, and the authorities have closed schools and kindergartens throughout April as part of an extended Easter holiday.
The authorities have so far administered more than 3.5 million vaccine doses, in a population of about 19 million.
— Kit Gillet
Alisa Stephens, a biostatistician at the University of Pennsylvania in Philadelphia, had to manage work and taking care of her children after the city went into lockdown last year.Credit…Hannah Yoon for The New York Times
Studies have found that women in academia have published fewer papers, led fewer clinical trials and received less recognition for their expertise during the pandemic.
Add to that the emotional upheaval of the pandemic, the protests over structural racism, worry about children’s mental health and education, and the lack of time to think or work, and an already unsustainable situation becomes unbearable.
Michelle Cardel, an obesity researcher at the University of Florida, worries that this confluence of factors could push some women to leave the sciences.
“My big fear is that we are going to have a secondary epidemic of loss, particularly of early career women in STEM,” she said.
Female scientists were struggling even before the pandemic. It was not unusual for them to hear that women were not as smart as men, or that a woman who was successful must have received a handout along the way, said Daniela Witten, a biostatistician at the University of Washington in Seattle.
Women in academia often have little recourse when confronted with discrimination. Their institutions sometimes lack the human resources structures common in the business world.
Compounding the frustration are outdated notions about how to help women in science. But social media has allowed women to share some of those concerns and find allies to organize and call out injustice when they see it, said Jessica Hamerman, an immunologist at the Benaroya Research Institute in Seattle.
In November, for example, a study on female scientists was published in the influential journal Nature Communications suggesting that having female mentors would hinder the career of young scientists and recommending that young women seek out male help.
The response was intense and unforgiving: Nearly 7,600 scientists signed a petition calling on the journal to retract the paper — which it did on Dec. 21.
The study arrived at a time when many female scientists were already worried about the pandemic’s effect on their careers, and already on edge and angry with a system that offered them little support.
Alisa Stephens found working from home to be a series of wearying challenges. Dr. Stephens is a biostatistician at the University of Pennsylvania, and carving out the time and mental space for that work with two young children at home was impossible.
Things eased once the family could safely bring in a nanny, but there was still little time for the deep thought Dr. Stephens had relied on each morning for her work.
Over time, she has adjusted her expectations of herself. “Maybe I’m at 80 percent as opposed to 100 percent,” she said, “but I can get things done at 80 percent to some extent.”
LONDON — Britain said on Wednesday that it would curb the use of AstraZeneca’s vaccine in adults under 30 because of the risk of rare blood clots, a blow to the efforts of scores of countries reliant on the vaccine to stamp out the coronavirus pandemic amid a global surge in cases.
Adding to the unease, the European Medicines Agency outlined a “possible link” between the vaccine and rare clots, even as it said that Covid-19 remained the far greater threat, leaving decisions about how to use the vaccine in the hands of the 27 member states of the European Union.
Taken together, the decisions represented a considerable setback for the AstraZeneca shot, which has been seen as the principal weapon in the battle to reduce deaths in the vaccine-starved global south.
The world’s most widely administered coronavirus vaccine, it is far less expensive and easier to store than some of the alternatives, spurring its use in at least 111 countries, rich and poor. AstraZeneca, based in Britain, has promised to deliver three billion doses this year, enough to inoculate nearly one in five people worldwide.
Cameroon and the Democratic Republic of Congo have already delayed injections of AstraZeneca’s vaccine amid mounting concerns in Europe. Any further hesitation, scientists said, could cost lives.
“In developing countries, the dynamic is to either use the vaccine you have, or you have nothing,” said Penny Ward, a visiting professor in pharmaceutical medicine at King’s College London. “In which case, carnage ensues.”
For the vast majority of people, British and European regulators said on Wednesday, the benefits of AstraZeneca’s shot far outweigh the risks. The clotting problems were appearing at a rate of roughly one in 100,000 recipients across Europe. Meanwhile, in Britain, the vaccine has driven down hospitalizations from Covid-19 — which can, itself, cause serious clotting problems — and saved thousands of lives, regulators said.
most people doubted the vaccine’s safety.
Over all, use of the shot has suffered: Across Europe, 64 percent of delivered doses of AstraZeneca’s vaccine have been injected into people’s arms, markedly lower than the rates for other shots.
“One hoped there would have been collaboration, and more discussion, between regulators, instead of lots of different countries going off in all sorts of directions,” Professor Ward said. “That aspect has really been the most unhelpful.”
watch for certain symptoms, including severe and persistent headaches and tiny blood spots under the skin. Doctors’ groups have circulated guidance about how to treat the disorder.
As of March 22, regulators had carried out detailed review of 86 cases, 18 of which were fatal, they said.
Concerns about the shot became acute enough in Britain this week that the University of Oxford, which developed the vaccine with AstraZeneca, stopped giving doses as part of a two-month-old trial in children.
“Safety has been our priority throughout the development of the vaccine,” Andrew Pollard, the Oxford researcher in charge of the trials, said on Wednesday. The identification of the clots, he added, “shows that the safety system works.”
In the United States, AstraZeneca is preparing to apply for emergency use authorization from the Food and Drug Administration. If and when they take up the application, that agency’s regulators are expected to scrutinize the clotting cases.
The United States, flush with vaccines from three other makers, may not ultimately need AstraZeneca’s shot. But any ruling by the F.D.A. is expected to hold considerable weight in some of the poorer nations that are relying on the shot.
The World Health Organization said a vaccine safety subcommittee had met on Wednesday and noted that “rare adverse events following immunizations should be assessed against the risk of deaths from Covid-19 disease and the potential of the vaccines to prevent infections.” It said that a link with the clotting problems, while “plausible,” had not been confirmed.
For Britain, the AstraZeneca vaccine has become a huge source of national pride, and the backbone of the country’s speedy inoculation program.
Even if younger people are at lower risk from severe Covid-19, scientists have said, inoculating them remains essential to creating enough protection in the population to end the pandemic.
Emma Bubola, Monika Pronczuk and Rebecca Robbins contributed reporting.
LONDON — Britain said on Wednesday that it would curb the use of AstraZeneca’s vaccine in adults under 30 because of the risk of rare blood clots, a blow to the efforts of scores of countries reliant on the vaccine to stamp out the coronavirus pandemic amid a global surge in cases.
Adding to the unease, the European Medicines Agency outlined a “possible link” between the vaccine and rare clots, even as it said that Covid-19 remained the far greater threat, leaving decisions about how to use the vaccine in the hands of the 27 member states of the European Union.
Taken together, the decisions represented a considerable setback for the AstraZeneca shot, which has been seen as the principal weapon in the battle to reduce deaths in the vaccine-starved global south.
The world’s most widely administered coronavirus vaccine, it is far less expensive and easier to store than some of the alternatives, spurring its use in at least 111 countries, rich and poor. AstraZeneca, based in Britain, has promised to deliver three billion doses this year, enough to inoculate nearly one in five people worldwide.
Cameroon and the Democratic Republic of Congo have already delayed injections of AstraZeneca’s vaccine amid mounting concerns in Europe. Any further hesitation, scientists said, could cost lives.
“In developing countries, the dynamic is to either use the vaccine you have, or you have nothing,” said Penny Ward, a visiting professor in pharmaceutical medicine at King’s College London. “In which case, carnage ensues.”
For the vast majority of people, British and European regulators said on Wednesday, the benefits of AstraZeneca’s shot far outweigh the risks. The clotting problems were appearing at a rate of roughly one in 100,000 recipients across Europe. Meanwhile, in Britain, the vaccine has driven down hospitalizations from Covid-19 — which can, itself, cause serious clotting problems — and saved thousands of lives, regulators said.
most people doubted the vaccine’s safety.
Over all, use of the shot has suffered: Across Europe, 64 percent of delivered doses of AstraZeneca’s vaccine have been injected into people’s arms, markedly lower than the rates for other shots.
“One hoped there would have been collaboration, and more discussion, between regulators, instead of lots of different countries going off in all sorts of directions,” Professor Ward said. “That aspect has really been the most unhelpful.”
watch for certain symptoms, including severe and persistent headaches and tiny blood spots under the skin. Doctors’ groups have circulated guidance about how to treat the disorder.
As of March 22, regulators had carried out detailed review of 86 cases, 18 of which were fatal, they said.
Concerns about the shot became acute enough in Britain this week that the University of Oxford, which developed the vaccine with AstraZeneca, stopped giving doses as part of a two-month-old trial in children.
“Safety has been our priority throughout the development of the vaccine,” Andrew Pollard, the Oxford researcher in charge of the trials, said on Wednesday. The identification of the clots, he added, “shows that the safety system works.”
In the United States, AstraZeneca is preparing to apply for emergency use authorization from the Food and Drug Administration. If and when they take up the application, that agency’s regulators are expected to scrutinize the clotting cases.
The United States, flush with vaccines from three other makers, may not ultimately need AstraZeneca’s shot. But any ruling by the F.D.A. is expected to hold considerable weight in some of the poorer nations that are relying on the shot.
The World Health Organization said a vaccine safety subcommittee had met on Wednesday and noted that “rare adverse events following immunizations should be assessed against the risk of deaths from Covid-19 disease and the potential of the vaccines to prevent infections.” It said that a link with the clotting problems, while “plausible,” had not been confirmed.
For Britain, the AstraZeneca vaccine has become a huge source of national pride, and the backbone of the country’s speedy inoculation program.
Even if younger people are at lower risk from severe Covid-19, scientists have said, inoculating them remains essential to creating enough protection in the population to end the pandemic.
Emma Bubola, Monika Pronczuk and Rebecca Robbins contributed reporting.
LONDON — For months, European countries have seesawed between craving and rebuffing AstraZeneca’s vaccine, with the shot’s fortunes rising and falling on spats over supply and on questions over the efficacy of the vaccine itself.
But few concerns have proved as disruptive to the rollout of the world’s workhorse vaccine in Europe as reports of very rare blood clots in some recipients. Many countries responded by halting the shot’s use, only to start giving it again after an all-clear from regulators at the European Medicines Agency, and then stopped inoculations a second time in certain age groups after doctors became more concerned about the clots.
On Tuesday, those concerns were reinforced yet again when a top vaccines official at the European Medicines Agency said that the vaccine was linked to extremely rare, though sometimes fatal, blood clots in a small number of recipients. It was the first indication from an international regulatory body that the clots may be a real, if very unusual, side effect of the shot.
Regulators now appear to be considering issuing their first formal warnings about the potential side effects — not only in continental Europe, which has long been wary of the shot for political and scientific reasons, but also in Britain, the birthplace of the AstraZeneca vaccine and long its biggest champion, where new data have sown concerns as well.
speedy inoculation program,have also insisted that the vaccine’s benefits far outweighed the risks. They and the company cited a lack of evidence in Britain that the clotting events were any more common than would be expected among people who had never been given AstraZeneca’s vaccine.
But the evidence changed last week when Britain reported 30 cases of the rare blood clots, 25 more than previously. This week, a prominent scientific adviser to the British government said there was “increasing evidence” of the clots being associated with the vaccine.
regulators reported 30 cases of the rare blood clots combined with low platelets among 18 million people given the AstraZeneca vaccine. That translated to roughly one case in 600,000 recipients of the vaccine.
European countries’ divergent approaches to the vaccine stem from a number of factors, including the supply of vaccines and severity of the pandemic. Marco Cavaleri, the official at the European Medicines Agency who spoke about the link between the vaccine and blood clots, said on Tuesday that those factors would likely continue to dictate how countries used the shot.
Beyond those factors, countries also took very different approaches to managing risk, scientists said. Countries that have continued using the shot were more focused on securing the overall health of their citizens. Others were more preoccupied with minimizing the risk to any single person.
“The attitude here is more, ‘Get me out of the pandemic,’” said Penny Ward, a visiting professor in pharmaceutical medicine at King’s College London, referring to the British approach. In continental Europe, she said, “There seems to be a much higher emphasis on individual safety in the population.”
Adriano Mannino, a philosopher at the University of Munich and director of the Solon Center for Policy Innovation in Germany, said that the collective benefits of the vaccine dominated thinking in Britain, while Germans were more concerned with the risk of an injection going wrong in individual cases. That reflected, partly, Germany’s history with the Nazis, who conducted lethal experiments on people.
“In many areas where law has to regulate ethically delicate and potentially dangerous things,” he said, “the German state has tended to go for tough restrictions.”
Nevertheless, Germans over 60 — the age group still being given AstraZeneca’s vaccine — flooded hotlines to book appointments and stood in line for hours in recent days as eligibility restrictions for their age group were relaxed.
In the northeastern city of Wismar, several hundred people waited for up to five hours on Tuesday in a driving wind and mix of rain and snow to receive the shot.
“I wish there had been better weather,” Kerstin Weiss, the head of the district authority in the northeastern region, told public broadcaster NDR. “But honestly, this is a sign that people are willing to be vaccinated with AstraZeneca.”
Benjamin Mueller reported from London and Melissa Eddy from Berlin. Monika Pronczuk and Emma Bubola contributed reporting.
For weeks, the mood in much of the United States has been buoyant. Cases, hospitalizations and deaths from the coronavirus have fallen steeply from their highs, and millions of people are being newly vaccinated every day. Restaurants, shops and schools have reopened. Some states, like Texas and Florida, have abandoned precautions altogether.
In measurable ways, Americans are winning the war against the coronavirus. Powerful vaccines and an accelerating rollout all but guarantee an eventual return to normalcy — to backyard barbecues, summer camps and sleepovers.
But it is increasingly clear that the next few months will be painful. So-called variants are spreading, carrying mutations that make the coronavirus both more contagious and in some cases more deadly.
Even as vaccines were authorized late last year, illuminating a path to the pandemic’s end, variants were trouncing Britain, South Africa and Brazil. New variants have continued to pop up — in California one week, in New York and Oregon the next. As they take root, these new versions of the coronavirus threaten to postpone an end to the pandemic.
rising exponentially in the United States.
Limited genetic testing has turned up more than 12,500 cases, many in Florida and Michigan. As of March 13, the variant accounted for about 27 percent of new cases nationwide, up from just 1 percent in early February.
pledged a “down payment” of $200 million to ramp up surveillance, an infusion intended to make it possible to analyze 25,000 patient samples each week for virus variants. It’s an ambitious goal: The country was sequencing just a few hundred samples each week in December, then scaling up to about 9,000 per week as of March 27.
Until recently, B.1.1.7’s rise was camouflaged by falling rates of infection over all, lulling Americans into a false sense of security and leading to prematurely relaxed restrictions, researchers say.
“The best way to think about B.1.1.7 and other variants is to treat them as separate epidemics,” said Sebastian Funk, a professor of infectious disease dynamics at the London School of Hygiene and Tropical Medicine. “We’re really kind of obscuring the view by adding them all up to give an overall number of cases.”
Other variants identified in South Africa and Brazil, as well as some virus versions first seen in the United States, have been slower to spread. But they, too, are worrisome, because they contain a mutation that diminishes the vaccines’ effectiveness. Just this week, an outbreak of P.1, the variant that crushed Brazil, forced a shutdown of the Whistler Blackcomb ski resort in British Columbia.
as fast as possible.
Infections are rising again, driven to an uncertain degree by B.1.1.7 and other variants. Earlier this week, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, pleaded with Americans to continue to practice masking and social distancing, saying she felt a sense of “impending doom.”
60 percent more contagious and 67 percent more deadly than the original form of the virus, according to the most recent estimates.
The variant is no different from the original in how it spreads, but infected people seem to carry more of the virus and for longer, said Katrina Lythgoe, an evolutionary biologist at the University of Oxford. “You’re more infectious for more days,” she said.
So contagious is B.1.1.7 that Britain succeeded in driving down infections only after nearly three months of strict stay-at-home orders, plus an aggressive vaccination program. Even so, cases fell much more slowly than they did during a similar lockdown in March and April.
three-quarters of new infections, some hospitals have had to move coronavirus patients to Belgium to free up beds. Roughly as many people are dying each day from Covid-19 in Europe as were this time a year ago.
For too long, government officials disregarded the threat. “Case plateaus can hide the emergence of new variants,” said Carl Pearson, a research fellow at the London School of Hygiene and Tropical Medicine. “And the higher those plateaus are, the worse the problem is.”
In the United States, coronavirus infections began a rapid decline in January, soon prompting many state leaders to reopen businesses and ease restrictions. But scientists repeatedly warned that the drop would not last. After the rate bottomed out at about 55,000 cases and 1,500 deaths per day in mid-March, some states — notably Michigan — began seeing an uptick.
Since then, the national numbers have steadily risen. As of Saturday, the daily count was up to nearly 69,000, and the weekly average was 19 percent higher than the figure two weeks earlier.
Pfizer-BioNTech and Moderna vaccines seem to be slightly less effective against B.1.351, the variant identified in South Africa. That variant contains the Eek mutation, which seems to enable the virus to partly sidestep the body’s immune response. The vaccines made by Johnson & Johnson, AstraZeneca and Novavax were even less potent against B.1.351.
“I think for the next year or two, E484K will be the most concerning” mutation, said Jesse Bloom, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle.
The mutation slightly alters the so-called spike protein sitting on the surface of the coronavirus, making it just a bit harder for antibodies to latch on and destroy the invader.
The good news is that the virus seems to have just a few survival tricks in its bag, and that makes it easier for scientists to find and block those defenses. “I’m feeling pretty good about the fact that there aren’t that many choices,” said Michel Nussenzweig, an immunologist at Rockefeller University in New York.
The Eek mutation seems to be the virus’s primary defense against the immune system. Researchers in South Africa recently reported that a new vaccine directed against B.1.351 ought to fend off all other variants, as well.
Pfizer, BioNTech and Moderna already are testing newly designed booster shots against B.1.351 that should work against any variants known to blunt the immune response.
Instead of a new vaccine against variants, however, it may be just as effective for Americans to receive a third dose of the Pfizer-BioNtech or Moderna vaccines in six months to a year, said Dr. Anthony S. Fauci, head of the National Institute of Allergy and Infectious Diseases.
That would keep antibody levels high in each recipient, overwhelming any variant — a more practical strategy than making a specialized vaccine for each new variant that emerges, he said.
“My only concern about chasing all the variants is that you’d almost be playing Whac-A-Mole, you know, because they’ll keep coming up and keep coming up,” Dr. Fauci said.
In one form or another, the new coronavirus is here to stay, many scientists believe. Multiple variants may be circulating in the country at the same time, as is the case for common cold coronaviruses and influenza. Keeping them at bay may require an annual shot, like the flu vaccine.
The best way to deter the emergence of dangerous variants is to keep cases down now and to immunize the vast majority of the world — not just the United States — as quickly as possible. If significant pockets of the globe remain unprotected, the virus will continue to evolve in dangerous new ways.
“This might be something that we have to deal with for a long time,” said Rosalind Eggo, an epidemiologist at London School of Hygiene and Tropical Medicine.
Still, she added, “Even if it changes again, which it is very likely to do, we are in a better, much stronger position than a year ago to deal with it.”
“Cutting aid is a death sentence,” the U.N. secretary-general, António Guterres, said of the outcome.
Rafat al-Akhali, a fellow at the Blavatnik School of Government at Oxford University who studies Yemen, said that frustration with the lack of progress toward ending the war, questions about the efficacy of the United Nations and concerns about Houthi interference with aid delivery had all contributed to reduced donations.
Although foreign aid can help Yemeni families avoid catastrophe, he said, but only an end to the war can ease Yemen’s many crises.
“The real solution is for the conflict to stop and for some semblance of normality to be restored, but without that what are you left with other than aid coming in from U.N. agencies or an injection of cash?” he said.
In another rural clinic near the town of Qaflat Athr, also north of Sana, Amna Hussein, 15 months old, lay weakened by diarrhea and vomiting linked to malnutrition. She had been treated in the same clinic last year and had improved, her mother said, and they had returned each week for nutritional supplements to keep her healthy. But last month, because of funding cuts, the supplements ran out and now Amna was back in the clinic.
Her mother, who declined to give her name because of shame, said that she and her four daughters had left her husband and moved in with her brothers, who had barely enough to feed them.
“We are like refugees in other people’s home,” she said. “You can only appreciate whatever is provided.”
Shuaib Almosawa reported from Al Harf, Yemen, and Ben Hubbard from Beirut, Lebanon. Rick Gladstone contributed reporting from New York.
MOSCOW — Russia has lauded with much fanfare the arrival of its homegrown vaccine, Sputnik V, in Latin America and Africa, and even in some countries in Europe, calling it a solution to shortages around the world.
It has been less vocal, though, about one country that is also importing the vaccine: Russia.
The Russian government has contracted out the manufacture of Sputnik V to a South Korean company that has already sent the vaccine to Russia, and plans to do the same with a company from India.
While the scale of the imports are impossible to gauge because of nondisclosure agreements, they undermine some of the narrative Russia has proudly presented about its role in the pandemic as an exporter of vaccines to needy countries.
The imports, which are expected to ramp up in coming weeks and months, could help Russia overcome a dismally slow vaccination rollout at home. They also illustrate that even countries whose scientists designed successful shots rely on cross border trade for vaccine supplies.
said last fall that overseas manufacturing could partly meet demand at home, but have since gone quiet about importing a product that has been held up as a triumph of the country’s scientists. Manufacturing the vaccine in Russia, however, has been a different story.
Russia received two cargo planes loaded with Sputnik V from the South Korean manufacturer, GL Rapha, in December and the company expects to send another shipment in coming days. Indian vaccine makers are also expected to export the Russian-designed vaccine to Russia, according to Indian diplomats.
“We face the prospect of increasing this cooperation in the field of vaccines,” India’s ambassador to Russia, Shri Varma, said at a news conference in January. “We envisage a major rolling out of Sputnik vaccine in India, using the Indian production capacities for India, for Russia and for the entire world.”
Russia has four production deals in India. One Indian company, Virchow Biotech in Hyderabad, India, last week signed a manufacturing deal with Russia’s sovereign wealth fund, the Russian Direct Investment Fund, to make 200 million doses a year of Sputnik V.
struggled for months last fall to obtain biotechnology equipment that is made in China, and was in short supply.
said that enough Sputnik V to fully inoculate 8.9 million people had been distributed in Russia since regulators approved the drug last August. Russia’s minister of industry said Monday he expected a quick ramp-up by April to twice that amount every month.
Russia’s vaccination campaign has fallen far behind that of most European nations and the United States. Russia has vaccinated 4.4 percent of its population, compared to 10 percent in the European Union and 26 percent in the United States.
The Kremlin this past week for the first time acknowledged that scarcity of the vaccine played a role in Mr. Putin’s decision to delay his own inoculation to avoid stimulating demand for shots before they became widely available outside the capital.
In January, when Mr. Putin became eligible for a shot under Russian rules based on his age, “production was not yet sufficient to fully meet demand in the regions,” said his spokesman, Dmitri S. Peskov.
It’s not clear how large a role the imports will play in alleviating scarcity, accelerating vaccinations and saving lives in Russia. But it positions Russia lower in the pecking order of vaccine geopolitics, as an importer rather than just an exporter.
Russian officials have chosen to highlight exports, however. “A vaccine for all humankind,” the Sputnik V website declares. State media has lavished attention on even relatively small shipments of tens or hundreds of thousands of doses to foreign countries.
held back from export nearly all of the 2.4 million doses manufactured by a private company, the Serum Institute of India, as the number of infections from the coronavirus shot up across the country. The European Union also moved on emergency legislation to curb vaccine exports, a change that could limit British imports of the AstraZeneca vaccine designed at Oxford University from producers in the bloc.
President Emmanuel Macron of France said it was the “the end of naïveté” for the European Union, which has significant production capacity but had been exporting doses despite rapidly rising cases within the bloc.
The United States and Britain have both imported domestically designed vaccines made in foreign countries. The United States has done so while prohibiting some exports of U.S.-made doses abroad.
Russia imported the South Korean-produced Sputnik V in December as it expanded the categories of people eligible for vaccination. The doses arrived in two Asiana Airlines cargo planes, according to an announcement by the airline, which was touting its cold shipment service.
In written answers to questions, GL Rapha, the Korean manufacturer, said it could not discuss shipments because of the nondisclosure agreement.
The company said it expects to produce 150 million doses of Sputnik V this year. The Russian Direct Investment Fund did not respond to questions about imports to Russia.
MOSCOW — Russia has lauded with much fanfare the arrival of its homegrown vaccine, Sputnik V, in Latin America and Africa, and even in some countries in Europe, calling it a solution to shortages around the world.
It has been less vocal, though, about one country that is also importing the vaccine: Russia.
The Russian government has contracted out the manufacture of Sputnik V from a South Korean company that has already sent the vaccine to Russia, and plans to do the same with a company from India.
While the scale of the imports are impossible to gauge because of nondisclosure agreements, they undermine some of the narrative Russia has proudly presented about its role in the pandemic as an exporter of vaccines to needy countries.
The imports, which are expected to ramp up in coming weeks and months, could help Russia overcome a dismally slow vaccination rollout at home. They also illustrate that even countries whose scientists designed successful shots rely on cross border trade for vaccine supplies.
said last fall that overseas manufacturing could partly meet demand at home, but have since gone quiet about importing a product that has been held up as a triumph of the country’s scientists. Manufacturing the vaccine in Russia, however, has been a different story.
Russia received two cargo planes loaded with Sputnik V from the South Korean manufacturer, GL Rapha, in December and the company expects to send another shipment in coming days. Indian vaccine makers are also expected to export the Russian-designed vaccine to Russia, according to Indian diplomats.
“We face the prospect of increasing this cooperation in the field of vaccines,” India’s ambassador to Russia, Shri Varma, said at a news conference in January. “We envisage a major rolling out of Sputnik vaccine in India, using the Indian production capacities for India, for Russia and for the entire world.”
Russia has four production deals in India. One Indian company, Virchow Biotech in Hyderabad, India, last week signed a manufacturing deal with Russia’s sovereign wealth fund, the Russian Direct Investment Fund, to make 200 million doses a year of Sputnik V.
struggled for months last fall to obtain biotechnology equipment that is made in China, and was in short supply.
said that enough Sputnik V to fully inoculate 8.9 million people had been distributed in Russia since regulators approved the drug last August. Russia’s minister of industry said Monday he expected a quick ramp-up by April to twice that amount every month.
Russia’s vaccination campaign has fallen far behind that of most European nations and the United States. Russia has vaccinated 4.4 percent of its population, compared to 10 percent in the European Union and 26 percent in the United States.
The Kremlin this past week for the first time acknowledged that scarcity of the vaccine played a role in Mr. Putin’s decision to delay his own inoculation to avoid stimulating demand for shots before they became widely available outside the capital.
In January, when Mr. Putin became eligible for a shot under Russian rules based on his age, “production was not yet sufficient to fully meet demand in the regions,” said his spokesman, Dmitri S. Peskov.
It’s not clear how large a role the imports will play in alleviating scarcity, accelerating vaccinations and saving lives in Russia. But it positions Russia lower in the pecking order of vaccine geopolitics, as an importer rather than just an exporter.
Russian officials have chosen to highlight exports, however. “A vaccine for all humankind,” the Sputnik V website declares. State media has lavished attention on even relatively small shipments of tens or hundreds of thousands of doses to foreign countries.
held back from export nearly all of the 2.4 million doses manufactured by a private company, the Serum Institute of India, as the number of infections from the coronavirus shot up across the country. The European Union also moved on emergency legislation to curb vaccine exports, a change that could limit British imports of the AstraZeneca vaccine designed at Oxford University from producers in the bloc.
President Emmanuel Macron of France said it was the “the end of naïveté” for the European Union, which has significant production capacity but had been exporting doses despite rapidly rising cases within the bloc.
The United States and Britain have both imported domestically designed vaccines made in foreign countries. The United States has done so while prohibiting some exports of U.S.-made doses abroad.
Russia imported the South Korean-produced Sputnik V in December as it expanded the categories of people eligible for vaccination. The doses arrived in two Asiana Airlines cargo planes, according to an announcement by the airline, which was touting its cold shipment service.
In written answers to questions, GL Rapha, the Korean manufacturer, said it could not discuss shipments because of the nondisclosure agreement.
The company said it expects to produce 150 million doses of Sputnik V this year. The Russian Direct Investment Fund did not respond to questions about imports to Russia.
LONDON — The world got another warning this week about the perils of its heavy reliance on global supply chains. As a single ship ran aground in the Suez Canal, shutting down traffic in both directions, international commerce confronted a monumental traffic jam with potentially grave consequences.
The troubled craft is not just any vessel. The Ever Given is one of the world’s largest container ships, with space for 20,000 metal boxes carrying goods across the sea. And the Suez Canal is not just any waterway. It is a vital channel linking the factories of Asia to the affluent customers of Europe, as well as a major conduit for oil.
The fact that one mishap could sow fresh chaos from Los Angeles to Rotterdam to Shanghai underscored the extent to which modern commerce has come to revolve around truly global supply chains.
In recent decades, management experts and consulting firms have championed so-called just-in-time manufacturing to limit costs and boost profits. Rather than waste money stockpiling extra goods in warehouses, companies can depend on the magic of the internet and the global shipping industry to summon what they need as they need it.
letter to all employees last March. “Masks remain in short supply globally.”
energy prices rose on Wednesday, though they pulled back on Thursday. Some are carrying electronics, and clothing, and exercise equipment.
None of them are getting where they are supposed to until the waylaid ship is freed. Each day the stalemate continues holds up goods worth $9.6 billion, according to a Bloomberg analysis.
shipping industry, which has been overwhelmed by the pandemic and its reordering of world trade.
As Americans have contended with lockdowns, they have ordered vast quantities of factory goods from Asia: exercise bikes to compensate for the closure of gyms; printers and computer monitors to turn bedrooms into offices; baking equipment and toys to entertain children cooped up at home.
The surge of orders has exhausted the supply of containers at ports in China. The cost of shipping a container from Asia to North America has more than doubled since November. And at ports from Los Angeles to Seattle, the unloading of those containers has been slowed as dockworkers and truck drivers have been struck by Covid-19 or forced to stay home to attend to children who are out of school.
Delays in unloading spell delays in loading the next shipment. Agricultural exporters in the American Midwest have struggled to secure containers to send soybeans and grains to food processors and animal feed suppliers in Southeast Asia.
This situation has held for four months, while showing few signs of easing. Retailers in North America have been frantically restocking depleted inventories, putting a strain on shipping companies in what is normally the slack season on trans-Pacific routes.
The blockage of the Suez Canal effectively sidelines more containers. The question is how long this lasts.
Two weeks could strand as much as one-fourth of the supply of containers that would normally be in European ports, estimated Christian Roeloffs, chief executive officer of xChange, a shipping consultant in Hamburg, Germany.
“Considering the current container shortage, it just increases the turnaround time for the ships,” Mr. Roeloffs said.
Three-fourths of all container ships traveling from Asia to Europe arrived late in February, according to Sea-Intelligence, a research company in Copenhagen. Even a few days of disruption in the Suez could exacerbate that situation.
If the Suez remains clogged for more than a few days, the stakes would rise drastically. Ships now stuck in the canal will find it difficult to turn around and pursue other routes given the narrowness of the channel.
Those now en route to the Suez may opt to head south and navigate around Africa, adding weeks to their journeys and burning additional fuel — a cost ultimately borne by consumers.
Whenever ships again move through the canal, they are likely to arrive at busy ports all at once, forcing many to wait before they can unload — an additional delay.
“This could make a really bad crisis even worse,” said Alan Murphy, the founder of Sea-Intelligence.
