What the Coronavirus Variants Mean for Testing

In January 2020, just weeks after the first Covid-19 cases emerged in China, the full genome of the new coronavirus was published online. Using this genomic sequence, scientists scrambled to design a large assortment of diagnostic tests for the virus.

But the virus has mutated since then. And as the coronavirus has evolved, so has the landscape of testing. The emergence of new variants has sparked a flurry of interest in developing tests for specific viral mutations and prompted concerns about the accuracy of some existing tests.

“With these Covid diagnostics, we were on a time crunch, we had to get something out there,” said Lorraine Lillis, the scientific program officer at PATH, a global health nonprofit that has been tracking coronavirus tests. “Normally, diagnostics take a long, long time, and we’d normally challenge them with multiple variants.” She added: “And we’re doing that, but we’re doing it in real time.”

The Food and Drug Administration has warned that new mutations in the coronavirus could render some tests less effective. And last week, PATH launched two online dashboards to monitor how certain variants might affect the performance of existing diagnostic tests.

has listed four different molecular tests “whose performance could be impacted” by the variants, but notes that the tests should still work. Three of the tests have multiple targets; a fourth may be slightly less sensitive when the virus has one particular mutation and is present at very low levels. (The four tests are the TaqPath Covid-19 Combo Kit, the Linea Covid-19 Assay Kit, the Xpert Xpress and Xpert Omni SARS-CoV-2, and the Accula SARS-CoV-2 Test.)

“We don’t think that those four assays are significantly impacted,” said Dr. Tim Stenzel, who directs the F.D.A.’s office of in vitro diagnostics and radiological health. “It was more out of an abundance of caution and transparency that we made that information public.”

Antigen tests are less sensitive than molecular tests, but they are typically cheaper and faster, and they are being deployed widely in coronavirus screening programs. These tests detect specific proteins on the outside of the virus. Some genetic mutations could change the structure of these proteins, allowing them to escape detection.

in a recent paper, Dr. Izpisua Belmonte and his colleague, Mo Li, a stem cell biologist at King Abdullah University of Science and Technology in Saudi Arabia, described a new testing method that can identify mutations in up to five different regions of the coronavirus genome.

And Dr. Grubaugh and his colleagues have developed a P.C.R. test that can detect specific combinations of mutations that characterize three variants of concern: B.1.1.7; B.1.351, which was first detected in South Africa; and P.1, first found in Brazil. (The work has not yet been published in a scientific journal.)

Dr. Grubaugh said that researchers in Brazil, South Africa and elsewhere are already using the tests to sift through a mountain of coronavirus samples, identifying those that should be prioritized for full genomic sequencing. “Our group’s primary interest is enhancing genomic surveillance through sequencing, especially in resource-limited areas,” Dr. Grubaugh said. “If you want to know if there’s variants that are circulating, you need a way to triage.”

A number of companies are also beginning to release coronavirus tests that they say can differentiate between certain variants, although these are intended for research purposes only. Creating a test that can definitively diagnose someone with a particular variant is “infinitely harder,” Dr. Grubaugh said.

Similar mutations are springing up in different variants, which makes distinguishing among them more difficult. The mutations of interest will change as the virus does, and sequencing remains the best way to get a complete picture of the virus.

But tests that can screen for certain mutations could be an important public health tool, Ms. Agarwal said: “These newer diagnostics that are looking across the variants, I think will be really key in understanding the epidemiology of the virus and planning our next generation of efforts against it.”

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Televisa will sell its content and media business to Univision.

More than a decade ago, Grupo Televisa of Mexico and Univision of the United States, giants in the world of Spanish-language media, set aside years of hostility to strike an alliance. Now, the two companies are deepening their bonds to better compete in the streaming era.

Televisa agreed on Tuesday to sell its media, content and production assets to Univision for $4.8 billion. The deal includes SoftBank and Google as financial backers.

It is the latest evolution in the ties between Televisa and Univision, whose relationship has been strained at times: They battled in court over Televisa’s attempt to end a 25-year contract with Univision to make telenovelas, crucial programming for the Spanish-language market, settling just before Televisa’s chairman was set to testify.

The two have grown closer in recent years, beginning with a licensing deal in 2010. Televisa, which produces much of the programming that airs on Univision, owns just over a third of the company.

Together, the two companies dominate the Spanish-language broadcast markets in the United States and Mexico. Their traditional business has held up, with Univision’s ratings rising last year, but executives said they believed that creating a dominant streaming service was the future.

There is room for growth: Executives of both companies estimate that just 10 percent of the 600 million viewers in the Spanish-language media market use an online video service, compared with 70 percent of the English-speaking population.

But competing with services like Netflix required much bigger scale, prompting the two companies to consolidate further. The new business, to be called Televisa-Univision, will have an enormous content library — Televisa produced 86,000 hours of programming last year — broadcast and pay-TV channels and stations and a movie studio. The new business will also control the two companies’ online video services, PrendeTV and Blim.

“We had to gain scale and unify the media rights to compete against the giants,” Bernardo Gómez Martínez, one of Televisa’s co-chief executives, said in an interview.

The executives said that beyond the sheer amount of resources Televisa-Univision will have, the new company also has an advantage that others like Netflix do not: a foundation in the Spanish-language market.

“Those companies are first and foremost English-language companies,” said Wade Davis, Univision’s chief executive. “At the core of it, their core offering is not Spanish language first.”

As part of the deal, Univision and Televisa are bringing in $1 billion in new investment to their venture. Among the investors are SoftBank’s Latin America Fund, Google and the investment firm Raine Group.

The transaction is expected to close by the end of the year, pending approval by regulators in the United States and Mexico and by Televisa’s shareholders.

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Fervor Over Coinbase I.P.O. Spreads: Live Business Updates

Coinbase, a company that allows people and companies to buy and sell various digital currencies, begins publicly trading on Wednesday, after its shares received a reference price of $250 each on Tuesday evening.

Coinbase, which makes money through transaction fees, estimated it took in $1.8 billion in revenue in the first three months of the year as crypto prices have soared. On Wednesday, the fervor continued: Dogecoin, a cryptocurrency which started as a joke, jumped to a new high (albeit just 14 cents), and Bitcoin, the largest cryptocurrency, climbed above $64,000 to its own record high.

Shares in blockchain-linked companies also rose in premarket trading. Riot Blockchain shares rose nearly 5 percent. Shares in Bit Digital, a Chinese bitcoin mining company, rose nearly 25 percent in premarket trading in the United States.

  • Global stocks crept higher on Wednesday as company earnings started to pour in. The S&P 500 was set to open 0.1 percent higher, futures indicated, after reaching a record high on Tuesday.

  • Shares in JPMorgan Chase dipped 0.4 percent in premarket trading after the bank reported its best first quarter on record, but said demand for loans was “challenged.” Shares in Goldman Sachs rose 0.3 percent in premarket trading after reporting investment banking revenue that beat analyst expectations.

  • The Stoxx Europe 600 index was 0.2 percent higher. One of the biggest gainers on the index was SAP, the German software company. Its shares rose 4 percent after the company said revenue from its cloud business was growing and upgraded its forecast for full year earnings.

  • Shares in easyJet, the low-cost airline, rose 3.6 percent after it said it expected to increase flights from May and reported earnings for the six months through March that were better than analysts expected.

  • Shares in Tesco, the large British grocer, fell as much as 4.4 percent after the company reported a 20 percent decline in pretax profit because of the extra cost of operating stores and warehouses safely during the pandemic. The grocer also said it expected sales to decline as pandemic restrictions ease, but that this would improve profit margins.

  • Shares in Discovery, the American media company, fell in premarket trading as Credit Suisse continued to sell stocks tied to Archegos Capital Management, Bloomberg reported.

  • Yields on 10-year U.S. Treasury notes rose 2 basis points, or 0.02 percentage points, to 1.63 percent.

  • Oil prices climbed higher. Futures for West Texas Intermediate, the U.S. crude benchmark, rose 1.6 percent to $61.10 a barrel.

Brian Armstrong, co-founder and chief executive of Coinbase, at the company’s office in San Francisco in 2017.
Credit…Michael Short/Bloomberg

Coinbase, the cryptocurrency exchange, is set to begin trading on the Nasdaq on Wednesday — and probably at a much higher valuation than the $65 billion preliminary estimate set last night. Here’s what you need to know about crypto’s move into the mainstream.

The company is the first major crypto business to trade publicly in the U.S. Its size means that its stock is likely to be held by mainstream index funds, giving average investors (indirect) exposure to the world of crypto. “Hopefully Coinbase going public and having its direct listing is going to be viewed as kind of a landmark moment for the crypto space,” Brian Armstrong, Coinbase’s chief executive, told Andrew in a CNBC interview.

  • Even at $65 billion, Coinbase’s market value will exceed that of the stock exchanges its shares will trade on: Nasdaq’s market cap is $26 billion, while ICE, the parent company of the N.Y.S.E., is valued at $67 billion. And by the way, Goldman Sachs’s market value is $111 billion.

  • Coinbase is profitable, taking in $322 million last year — and an estimated $800 million in the first quarter this year alone. It also made significantly more revenue from trades (0.6 percent) than did the Nasdaq (0.009 percent) and ICE (0.011 percent).

  • Coinbase benefited hugely from a run-up in cryptocurrencies’ prices in recent months, and the company warned in its prospectus that its business was “substantially dependent on the prices of crypto assets and volume of transactions conducted on our platform.”

  • Skeptics think competition will eventually bring Coinbase’s fat margins down, though Mr. Armstrong asserted that he didn’t seen any sign of that happening yet. “Longer term, yes, I do think there could be fee compression, just like in every other asset class,” he told CNBC.

Digital currency, once mocked as a tool for criminals and reckless speculators, is sliding into the mainstream. On Wednesday, Coinbase, a start-up that allows people to buy and sell cryptocurrencies, goes public on Nasdaq, marking the biggest step yet toward wider acceptance.

From Crypto Art to Trading Cards, Investment Manias Abound

Each market frenzy seems crazier than the last. But all have the same roots.

Why an Animated Flying Cat With a Pop-Tart Body Sold for Almost $600,000

A fast-growing market for digital art, ephemera and media is marrying the world’s taste for collectibles with cutting-edge technology.

Coinbase Users Say Crypto Start-Up Ignored Their Pleas for Help

As Coinbase prepares to be the first major cryptocurrency company to go public, it is struggling with basic customer service, users said.

Cryptocurrency Start-Up Underpaid Women and Black Employees, Data Shows

An analysis of internal pay data at the San Francisco company Coinbase shows disparities that were much larger than those in the tech industry.

Satoshi Tsunakawa, the chairman of Toshiba, in 2017. He will succeed Nobuaki Kurumatani, the company’s chief executive and president, whose departure was announced Wednesday.
Credit…Toru Hanai/Reuters

Toshiba announced on Wednesday the resignation of its top executive, Nobuaki Kurumatani, a move that comes as the Japanese conglomerate faces a potential buyout and a shareholder-initiated investigation into its management practices.

The board appointed Satoshi Tsunakawa — the current chairman and previous president — to replace Mr. Kurumatani, the company said in a brief statement. It did not explain the reason for the change.

Toshiba, once among the crown jewels of Japanese industry, a maker of products ranging from personal printers to railroad locomotives, has struggled in recent years, overshadowed by the legacy of a major accounting scandal and its acquisition of the American nuclear power company Westinghouse, which declared bankruptcy in 2017.

Seeking to rebuild, Toshiba looked for a new leader from outside its own ranks, and in 2018 it appointed Mr. Kurumatani, an executive with CVC Capital Partners, a private equity company based in Europe, as chief executive. It was an unusual decision for a company that had long been headed by company insiders. Last year, he was appointed president, solidifying his control over the firm.

During a news conference Wednesday, board member Osamu Nagayama deflected questions about the resignation, saying that Mr. Kurumatani, 63, had been considering the move for months and had come to the decision with his family. Unusually, Mr. Kurumatani did not make an appearance, but in a letter that was read aloud to reporters, he said he had chosen to resign after “achieving my mission to rebuild the company.”

The announcement on Wednesday followed months of unrest at Toshiba as disgruntled shareholders agitated for reforms aimed at improving the company’s performance and increasing its value.

Toshiba investors tried to shake up the company’s management at the annual general meeting last summer. But Mr. Kurumatani was re-elected — albeit with less than 60 percent of the vote — following a showdown that angered some key shareholders and raised questions about whether the company had inappropriately interfered in the decision.

Effissimo Capital Management, a Singapore-based hedge fund that holds about 10 percent of the company and had led the campaign to unseat its management team, subsequently called for an investigation into the outcome. Other shareholders agreed, voting, over management’s objections, to begin an independent inquiry in March.

Earlier this month, Toshiba announced that it had received a buyout offer from CVC Capital Partners for a reported $20 billion, a substantial premium on the company’s share price. The offer has raised questions of conflict of interest, as Mr. Kurumatani had previously served as president of CVC’s Japan office.

In recent years, Japanese companies have increasingly been the focus of activist investors from abroad, who believe that sclerotic management and opaque governance practices have prevented many of Japan’s blue chip firms from achieving their full value.

Hisako Ueno contributed reporting.

Lemonade, which sells insurance to consumers online, went public in July. Individual investors make up about half of its shareholder base.
Credit…Associated Press

Dozens of companies are suddenly paying more attention to individual investors.

Small investors who buy single stocks have not been a major force in financial markets for the better part of half a century. They were growing in influence before the pandemic, partly because of the popularity of free trading apps such as Robinhood.

But with millions of Americans stuck at home during the pandemic, the trading trend escalated, Matt Phillips reports for The New York Times.

“Retail trading now accounts for almost as much volume as mutual funds and hedge funds combined,” Amelia Garnett, an executive at Goldman Sachs’s Global Markets Division, said on a recent podcast produced by the firm. “So, the retail impact is really meaningful right now.”

Tesla has long eschewed traditional communications with Wall Street. Ark Investment Management — the high-flying, tech-focused exchange-traded fund company run by the investor Cathie Wood — and Palantir Technologies, are also trying to reach small investors directly.

Before Lemonade, a company that sells insurance to consumers online, went public in July, it went on a traditional tour of Wall Street, meeting big investors and talking up its prospects. However, the company has since discovered that more than half of its shares are held by small investors, excluding insiders who own the stock, said Daniel Schreiber, its chief executive.

That has prompted a strategy adjustment. In addition to spending time communicating with analysts whose “buy” or “sell” ratings on the stock can move its price, Mr. Schreiber said, he has made a point of doing interviews on podcasts, websites and YouTube programs popular with retail investors.

“I think that they are, today, far more influential on, and command far more following in terms of stock buying or selling power than the mighty Goldman Sachs does,” Mr. Schreiber said. “And we’ve seen that in our own stock.”

  • The first woman to lead CBS News, Susan Zirinsky, is expected to announce that she is stepping down from the presidency of the network’s news division, possibly as soon as this week, a person with knowledge of the plan said on Tuesday. Ms. Zirinsky is expected to sign a production deal with the network’s parent company, ViacomCBS, to work on broadcast, cable and streaming programs, according to the person with knowledge of the details of her departure. Ms. Zirinsky, 69, was appointed in January 2019.

  • Epic Games, the video game developer that produced the hit game Fortnite, said Tuesday that it had raised $1 billion in funding, valuing the company at $28.7 billion. Sony, the creator of the PlayStation game console, invested $200 million, Epic said, and Appaloosa Management, Baillie Gifford and Fidelity Management were also among the investors. Epic’s most recent funding round came last summer, when it raised $1.78 billion to value the company at $17.3 billion. Sony invested $250 million at the time.

East Austin, Texas, in February, when a huge storm left more than $10 billion in losses that insurers could dispute.
Credit…Bronte Wittpenn/Austin American-Statesman, via Associated Press

Two months after the storm crippled large swaths of Texas, insurers are sketching out a legal strategy to pin the costs on utilities and power companies that they say failed to adequately prepare for bitterly cold weather.

At stake could be more than $10 billion in insured losses for insurers and their business partners, as well as almost-certain premium increases for property owners if the insurers have to pay for the damage themselves, Mary Williams Walsh reports for The New York Times.

  • The insurers say the power companies and utilities failed to prepare for a major winter storm, even though past cold snaps and climate-change data had made the danger clear.

  • In 1989 and 2011, wintry weather caused so much damage that state and federal regulators spent months investigating the causes and issued detailed recommendations for hardening the electrical system against storms. “It doesn’t look like anybody did anything,” said Lawrence T. Bowman, a lawyer in Dallas who represents insurers in liability disputes.

But decades of deregulation have made the state’s power grid a dizzying web of companies that could make determining fault tricky. Insurers will also have to show that the damage was the result of “gross negligence.” And there are dozens of small companies in the supply chain — some of which have gone bankrupt since the storm — that interact with one another in myriad ways.

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Insurers are trying to pass on costs of the Texas storm by blaming power companies.

Two months after the storm crippled large swaths of Texas, insurers are sketching out a legal strategy to pin the costs on utilities and power companies that they say failed to adequately prepare for bitterly cold weather.

At stake could be more than $10 billion in insured losses for insurers and their business partners, as well as almost-certain premium increases for property owners if the insurers have to pay for the damage themselves, Mary Williams Walsh reports for The New York Times.

  • The insurers say the power companies and utilities failed to prepare for a major winter storm, even though past cold snaps and climate-change data had made the danger clear.

  • In 1989 and 2011, wintry weather caused so much damage that state and federal regulators spent months investigating the causes and issued detailed recommendations for hardening the electrical system against storms. “It doesn’t look like anybody did anything,” said Lawrence T. Bowman, a lawyer in Dallas who represents insurers in liability disputes.

But decades of deregulation have made the state’s power grid a dizzying web of companies that could make determining fault tricky. Insurers will also have to show that the damage was the result of “gross negligence.” And there are dozens of small companies in the supply chain — some of which have gone bankrupt since the storm — that interact with one another in myriad ways.

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Why Coinbase’s IPO Is a Cryptocurrency Coming-Out Party

SAN FRANCISCO — Digital currency, once mocked as a tool for criminals and reckless speculators, is sliding into the mainstream.

Traditional banks are helping investors put their money into cryptocurrency funds. Companies like Tesla and Square are hoarding Bitcoin. And celebrities are leading the way in a digital-art spending spree using a technology called an NFT.

On Wednesday, digital or cryptocurrencies will take their biggest step yet toward wider acceptance when Coinbase, a start-up that allows people to buy and sell cryptocurrencies, goes public on Nasdaq. Coinbase shares received a reference price of $250 each on Tuesday evening, which would value the company at $65 billion based on all its outstanding shares.

Call it crypto’s coming-out party. Coinbase, founded in San Francisco, is the first major cryptocurrency start-up to go public on a U.S. stock market. It is doing so at a valuation that tops that of Capital One Financial Corporation or Moody’s, the ratings agency.

plan to “create an open financial system for the world” and “increase economic freedom.”

But so far, cryptocurrency is mostly a vehicle for financial speculation and trading. Few people want to use Bitcoin for everyday purchases like coffee because its price is so volatile. Many early buyers have become wildly rich by simply holding their crypto or “buying the dip” when prices fall. Others ruefully relay tales of the sushi dinner they bought with Bitcoin years ago that would be worth $200,000 today or the million-dollar pizza.

Coinbase eases that trading by acting as a central exchange. Before it and similar services were created, people had to set up their own digital wallets and wire money.

“Can it be anything more than an asset class?” Mr. Tusk asked. “That’s still very much up in the air.”

Silk Road, a marketplace for buying and selling drugs and weapons with Bitcoin until the federal authorities shut it down, and Mt. Gox, a crypto exchange that collapsed under accusations of theft and embezzlement, further tarnished the young industry.

Coinbase tried to change that. The company joined Y Combinator, a prestigious start-up program, and raised money from top venture capital firms including Union Square Ventures and Andreessen Horowitz.

Mr. Armstrong was one of the few people in the industry who seemed prepared to comply with inevitable regulations, rather than cut corners to avoid them, said Nick Tomaino, who dropped out of business school to join Coinbase in 2013.

Coinbase also persuaded well-known retailers to accept Bitcoin. “It was good for credibility when people saw you could actually use a Bitcoin to buy a mattress at Overstock,” Mr. Tomaino, who left in 2016, said. Coinbase earned money on transaction fees.

But Bitcoin’s wildly volatile price and a slow computer network that managed it made transactions difficult, and people began to see the currency as an investment. In 2015, Ethereum, a cryptocurrency network with more tech abilities, was introduced, enticing enthusiasts to build companies and funds around the technology.

Soon after, a flood of “initial coin offerings,” where companies sold tokens on the promise of the technology they planned to build, created a new boom in cryptocurrency trading. But it quickly deflated after many projects were found to be frauds and U.S. regulators deemed the offerings to be securities, requiring that they comply with financial rules.

Tesla to buy $1.5 billion worth of Bitcoin and the payments company Square to spend $170 million. In March, Morgan Stanley began offering its wealthy clients access to three Bitcoin funds, and Goldman announced that it would soon offer similar access. The mayor of Miami has proposed that the city accept tax payments in Bitcoin and invest city funds in the asset.

The stock trading app Robinhood announced that 9.5 million of its customers had traded cryptocurrency in the first three months of the year — up more than fivefold from the previous three months. Venture funding for crypto-related start-ups surged to its highest-ever level in the first quarter to $3 billion, according to PitchBook.

PayPal recently added a crypto trading and shopping feature for its customers in the United States. The company was motivated by consumer interest and advances in the technology that made transactions faster. It plans to quickly expand the offering to customers around the world.

“It feels like the time is right,” said Jose Fernandez da Ponte, head of PayPal’s blockchain, crypto and digital currencies group. “We think this has the potential to revolutionize payments and financial systems in general.”

Still, the so-called revolution faces some challenges. Coinbase has sometimes struggled to keep up with demand, with some customers who lost access to their accounts complaining that the company has been unresponsive. It has also received criticism for its treatment of female and Black employees.

Treasury Secretary Janet L. Yellen has threatened harsher regulation of the currencies, including limiting their use.

And a big drop in prices could again send speculators fleeing. In its financial prospectus, Coinbase warned that its business results would fluctuate with the volatility of crypto assets, “many of which are unpredictable and in certain instances are outside of our control.”

The industry’s biggest issue — fulfilling the promise that the technology is more than just a place to park money — could take another decade to play out.

“There’s no doubt we’re in the latest boom, and I don’t know if that’s going to turn tomorrow or two years from now,” Mr. Tomaino said. “But the busts and booms are always higher than the last.”

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Worry Over 2 Covid Vaccines Deals Fresh Blow to Europe’s Inoculation Push

BRUSSELS — First it was AstraZeneca. Now Johnson & Johnson.

Last week, British regulators and the European Union’s medical agency said they had established a possible link between AstraZeneca’s Covid-19 vaccine and very rare, though sometimes fatal, blood clots.

On Tuesday, Johnson & Johnson said it would pause the rollout of its vaccine in Europe and the United States over similar concerns, further compounding the continent’s one-step-forward-two-steps-back efforts to quickly get people immunized against the coronavirus.

European officials had been confident that they had secured enough alternative vaccine doses to take up the slack of the AstraZeneca problems and achieve their goal of fully inoculating 70 percent of the European Union’s adult population — about 255 million people — by the end of the summer.

On Tuesday, European officials did not immediately say whether they believed the milestone would also survive the Johnson & Johnson suspension. But the European commissioner for health, Stella Kyriakides, wrote on Twitter that “Today’s developments with the J&J vaccine in the US are under close monitoring” by the bloc’s medicines regulator.

months of short supplies and logistical problems.

There is mounting evidence that the concerns are eroding Europeans’ willingness to get the AstraZeneca vaccine in particular, and threatening to elevate already high levels of vaccine hesitancy generally.

YouGov poll published last month, 61 percent of the French, 55 percent of Germans and 52 percent of Spaniards consider the AstraZeneca vaccine “unsafe.” That is in stark contrast to the findings of a similar poll from February, when more people in those countries, with the exception of France, believed that the shot was more safe than unsafe.

Regulators have asked vaccine recipients and doctors to be on the lookout 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.

In Poland, where the vaccination campaign relies to a large extent on AstraZeneca and where its use has not been restricted, a recent poll showed that given a choice, fewer than 5 percent of Poles would choose the AstraZeneca shot.

Almost everywhere across the European Union, it seems, many are eager for alternatives, as the new types of vaccines that include the Moderna and Pfizer, which utilize science known as “mRNA,” have not been associated with similar side effects.

Data from the 27 E.U. member states by the European Center for Disease Prevention and Control shows that over all, 80 percent of vaccine doses distributed to the bloc have already been administered. That share drops to 65 percent for AstraZeneca, however, suggesting that many of its doses are sitting unused.

Yet it is hard to predict how serious a blow the latest twist in the AstraZeneca saga — and the new Johnson & Johnson concerns — will be to E.U. vaccination efforts, as officials in Brussels have made big if belated efforts to turbocharge the second-quarter supply of doses.

The European Union is poised to receive at least 300 million doses of various vaccines, three times what it got in the first quarter. Two hundred million are slated to come from Pfizer/BioNTech. Moderna is expected to deliver 35 million doses. Another 55 million doses are due of the Johnson & Johnson jab, and 70 million from AstraZeneca.

In the rosiest scenario, the European Union could get up to 360 million doses by June.

On Thursday, after Spain’s government changed the age threshold for the AstraZeneca shot, two-thirds of people called up for vaccination in Madrid did not show up, Antonio Zapatero, the regional health minister, told a news conference on Friday.

He attributed the no-show by 18,200 people to “confusion” generated by Spain’s central government, which said on Wednesday that the AstraZeneca vaccine should be given only to people over 60. Before this change, Mr. Zapatero said, the rate of abstention was 2 percent.

In Belgium, where the use of the AstraZeneca vaccine has also been limited, the authorities said they did not expect major delays in the overall rollout, but they are still concerned about the confusion that the rare blood clotting issue is causing.

Yves Van Laethem, a top epidemiologist who is the country’s Covid task force spokesman, said he expected a two-week delay that would mostly affect younger age groups in late summer. He said the E.U. regulator guidance had only partly helped in clarifying the situation.

The European Medicines Agency’s opinion “wasn’t very clear, and it is also part of the problem,” Dr. Van Laethem said in an interview. “When you say, ‘We don’t apply limitations, but we just say there are serious side effects,’ there is part science and part diplomacy in that.”

He said the limited effect that the new AstraZeneca issues would have on Belgian’s rollout was in large part because the country had ordered big shares of other vaccines.

Although all E.U. countries have been offered a chunk of each vaccine approved in the bloc so far — AstraZeneca, Johnson & Johnson, Moderna and Pfizer — many opted to forgo parts of their share of more expensive or cumbersome vaccines like Pfizer and Moderna early on, instead favoring the AstraZeneca jab.

“In Britain or Eastern Europe, a big part of the campaigns are based on AstraZeneca,” Dr. Van Laethem said.

Wealthier bloc members like Denmark, France, Germany and the Netherlands can better compensate for the loss of confidence in AstraZeneca, because they acquired extra doses of other vaccines — especially Pfizer — through a secondary market after poorer E.U. nations gave theirs up.

Those countries — including Bulgaria, Croatia, Latvia and Slovakia — are likely to be less able to quickly offer alternatives.

Dr. Van Laethem, the Belgian immunologist, said that the national and European authorities needed to better communicate the costs and benefits of taking the AstraZeneca dose versus and the other authorized vaccines.

Experts worry that even limited concerns over one vaccine’s unlikely side effects can affect people’s overall willingness to be immunized.

“The main thing is to make people understand that the problem is the virus,” he said. “We have to vaccinate people — the risk linked to the virus is higher than those rare side effects.”

Raphael Minder contributed reporting from Madrid and Constant Méheut from Paris.

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How Worried Should You Be About the J&J Vaccine and Blood Clots?

On Tuesday morning, U.S. federal health regulators recommended a pause in the use of Johnson & Johnson’s Covid-19 vaccine while they investigated six reports of blood clots in women ages 18 to 48. One has died, and a second is hospitalized in critical condition.

As of Monday, 6.8 million people in the United States had received the vaccine without any other serious adverse reactions reported.

Experts have yet to determine to what extent, if any, the vaccine is responsible for the clots. But the investigation follows actions by European regulators who concluded that a vaccine made by AstraZeneca may also be the cause of a similar, extremely rare clotting disorder.

U.S. and European public health experts have emphasized that for most people, the benefits of the Covid vaccines far outweigh the risks.

recommends that people who have received the Johnson & Johnson vaccine within the past three weeks should contact their doctors if they experience severe headaches, abdominal pain, leg pain or shortness of breath. People should not be concerned about mild headaches and flu-like symptoms in the first few days after vaccination. Those are common, harmless side effects brought on by the immune system’s production of a defense against the coronavirus.

During clinical trials and after vaccines go into wide use, experts keep track of any medical problems experienced by people who receive them. If an unusually large cluster of cases turns up, regulators may decide to pause a trial or stop the use of a vaccine to investigate further.

Pauses are common, and typically the investigations reveal that the medical problems were a matter of coincidence. If the investigation reveals that a vaccine does pose a risk, regulators may write new guidance about who should or should not receive it.

regulators have said, roughly one in 1,000 people are affected by a blood clot in a vein every year.

But the clotting disorder of concern in the vaccine recipients is much rarer and different from typical blood clots. In addition to clotting in the brain — called cerebral venous sinus thrombosis, or CVST for short — the patients all had a notably low level of platelets, which left them prone to abnormal bleeding.

said the company was aware of an extremely rare disorder involving people with blood clots in combination with low platelets in a small number of individuals who have received our COVID-19 vaccine. “In addition, we have been reviewing these cases with European health authorities,” the company said in its statement. “We have made the decision to proactively delay the rollout of our vaccine in Europe.”

At the news conference on Tuesday, Dr. Marks of the F.D.A. said the cases were “very, very similar.”

a number of possible symptoms, including swelling in the leg, persistent abdominal pain, severe and persistent headaches or blurred vision, and tiny blood spots under the skin beyond the area where the injection was given.

But that set of symptoms was so vague that almost immediately, British emergency rooms experienced a surge in patients who were worried that they fit the description.

Nonetheless, German researchers say that such symptoms in vaccine recipients must be followed up. Blood tests can detect the antibodies.

Doctors in Germany and Norway have treated patients with blood-thinning drugs to try to stop the growth of the clots, and with intravenous immune globulin, which can help eliminate the misguided antibodies that are causing the problem.

AstraZeneca vaccines. One recipient, a physician in Florida, died from a brain hemorrhage when his platelet levels could not be restored, and others have been hospitalized. U.S. health officials have said that the cases are being investigated, but they have not reported the findings of those reviews and have yet to indicate that there is any link to the vaccines.

Benjamin Mueller contributed reporting.

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Covid-19 Live Updates: U.S. Calls for Pause on Johnson & Johnson Vaccine, Complicating Rollout

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.

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:

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.

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.

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.”

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Japan’s Plan for Fukushima Wastewater Meets a Wall of Mistrust in Asia

TOKYO — In late 2019, the Japanese government convened diplomats from 22 countries for a briefing on its handling of more than a million tons of wastewater from Fukushima’s crippled nuclear reactors.

Storage space was rapidly running out, the authorities explained, and they were considering several solutions. Among them was removing the most harmful radioactive material from the water and then gradually releasing it into the ocean. The diplomats raised no objections, the Japanese Foreign Ministry said.

On Tuesday, when Japan officially announced that it would put the plan into action, the knives came out. South Korea denounced it as “utterly intolerable” and summoned the Japanese ambassador. China cited “grave concerns.” Taiwan also raised strong objections.

Japan has dismissed criticism of its plan as unscientific, saying that the treated water is well within safety standards, and pointing out that such releases into oceans are routine around the world. But its argument, as the reaction on Tuesday showed, leaves Tokyo a long way from winning its neighbors’ trust, a challenge made all the more difficult by growing regional tensions on a range of issues.

Japan’s handling of the nuclear disaster. China and South Korea are among 15 countries or regions that have banned or restricted food imports from Fukushima, despite the Japanese government’s abundant efforts to demonstrate that products from the area, from rice to fish, are safe to eat.

International advocacy groups, like Greenpeace, have also criticized the government’s decision, arguing that it is a cost-saving measure that ignores the potential environmental harms. The group advocates building additional storage facilities for the waste instead.

Even at home, the idea of pouring water, treated or not, from the crippled plant into the ocean is unpopular. In a national poll late last year by the Japanese daily The Asahi Shimbun, 55 percent of respondents opposed the plan.

It is even less welcome in Fukushima itself, where residents fear that the mere perception of risk will destroy the local fishing industry, which has been hoping for a rebound after a decade of self-imposed limits.

the 2011 earthquake and tsunami generates more than 150 additional tons a day.

Under the plan, powerful filters will be used to remove all of the radioactive material from the water except for tritium, an isotope of hydrogen that experts say is not harmful to human health in small doses. Radiation levels in the resulting product, the government says, are lower than those found in drinking water. Japan intends to start releasing the water in 2023, in a process that is expected to take decades.

In an effort to ease minds at home, the authorities have placed dosimeters around the prefecture to monitor radiation levels and conduct routine screenings of seafood from the region. The government has held public hearings on the plan in Fukushima and in Tokyo.

The authorities say that they have also discussed the issue extensively with other countries and at international forums. In a news briefing on Tuesday, a Japanese official said that the country had held 108 group briefings for diplomats in Japan and had met with representatives from China and South Korea on the day of the announcement to explain the decision.

The United States came out in support of the plan. The International Atomic Energy Agency also endorsed it, saying in a statement that it was “in line with practice globally, even though the large amount of water at the Fukushima plant makes it a unique and complex case.”

The gap between such reassurances and the strident reactions closer to home was striking.

The outrage in the region is “quite understandable,” said Nanako Shimizu, an associate professor of international relations at Utsunomiya University in Japan who is opposed to the plan.

“If South Korea or China announced the same thing, I’m sure that the Japanese government and the vast majority of the Japanese people would also object,” she said.

Governments in the region most likely feel domestic pressure to take a strong stance, said Eunjung Lim, an associate professor of international relations at Kongju National University in Gongju, South Korea, who specializes in Japan and South Korea.

Whether their worries are rational or not, many people in the region “are going to be very, very anxious about what would happen if this radioactive material came into our near seas and contaminated our resources,” she said.

Even under the best of circumstances, Japan would find it “really difficult to persuade its neighbors to accept this kind of decision, because obviously, it’s not our fault. It’s Japan’s fault, so why do we have to experience this kind of difficulty?” she added.

Regional tensions have made surrounding countries even less receptive to the plan. In recent years, territorial disputes and disagreements over trade and historical issues related to World War II have strained Japan’s relations with China and South Korea, with spillover effects on government dialogues across a broad range of issues.

China warned Japan on Tuesday against taking any decision without further consultation with the international community, saying that it “reserved the right to take further action.”

In its statement, South Korea accused Japan of taking “unilateral action” without seeking consultation and understanding with South Korea, which “lies closest to Japan.”

Some in Japan believe that such complaints should be met with more than scientific arguments. Shunichi Tanaka, a former chairman of the Nuclear Regulation Authority, said that the criticism smacked of hypocrisy.

South Korea itself operates four heavy-water reactors that routinely discharge water containing tritium at higher levels than those planned in Fukushima, he said in a recent interview.

“When South Korea makes claims like this, we shouldn’t be quiet, we need to properly refute them,” he said.

But the challenge Japan faces is not just on the global stage. At home, many are reluctant to trust the government or Tepco, the nuclear plant’s operator.

A parliamentary commission found that the meltdowns had been the result of a lack of oversight and of collusion between the government, the plant’s owner and regulators. And Tepco was forced to retract assertions that it had treated most of the wastewater. In fact, it had completely processed only about one-fifth, a problem that arose from a failure to change filters in the decontamination system frequently enough.

Ultimately, Japan is in a battle to alter perceptions, whether of the trustworthiness of its own government or of the risk posed by the treated water, said Hirohiko Fukushima, a professor at Chuo Gakuin University specializing in local governance issues.

In Fukushima, the government’s response to local concerns has often come across as highhanded, he said. Changing that view will require the authorities to improve transparency around their decisions and build new relationships, he said.

“From my perspective,” he added, “it’s probably difficult for Japan to convince foreign countries when it can’t even convince its own people.”

Choe Sang-Hun contributed reporting from Seoul. Albee Zhang contributed research from Shanghai.

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