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At Last, Aid for Senior Nutrition That Offers More Than Crumbs

Long before the coronavirus hit, nutrition programs that served the nation’s older adults struggled to keep up with a growing demand. Often, they could not.

In Charlotte, N.C., and nine surrounding counties, for example, the waiting list for Meals on Wheels averaged about 1,200 people. But Linda Miller, director of the Centralina Area Agency on Aging, which coordinates the program, always assumed the actual need was higher.

She knew some clients skipped meals because they couldn’t travel to a senior center for a hot lunch every weekday; some divided a single home-delivered meal to serve as both lunch and dinner.

Some never applied for help. “Just like with food stamps, which are underused,” Ms. Miller said, “people are embarrassed: ‘I worked hard all my life; I don’t want charity.’”

5.4 million older recipients.

For years, advocates for older adults have lobbied Congress for more significant federal help. Although the Older Americans Act has enjoyed bipartisan support, small annual upticks in appropriations left 5,000 local organizations constantly lagging in their ability to feed seniors.

From 2001 to 2019, funding for the Older Americans Act rose an average of 1.1 percent annually — a 22 percent increase over almost two decades, according to an analysis by the AARP Public Policy Institute. But adjusted for inflation, the funding for nutrition services actually fell 8 percent. State and local matching funds, foundation grants and private donations helped keep kitchens open and drivers delivering, but many programs still could not bridge their budget gaps.

food insecure,” meaning they had limited or uncertain access to adequate food.

And that shortfall was before the pandemic. Once programs hastily closed congregant settings last spring, a Meals on Wheels America survey found that nearly 80 percent of the programs reported that new requests for home-delivered meals had at least doubled; waiting lists grew by 26 percent.

Along with money, the Covid relief legislation gave these local programs needed flexibility. Normally, to qualify for Meals on Wheels, homebound clients must require assistance with activities of daily living. The emergency appropriations allowed administrators to serve less frail seniors who were following stay-at-home orders, and to transfer money freely from congregant centers to home delivery.

Even so, the increased caseloads, with people who had never applied before seeking meals, left some administrators facing dire decisions.

In Northern Arizona, about 800 clients were receiving home-delivered meals in February 2020. By June, that number had ballooned to 1,265, including new applicants as well as those who had previously eaten at the program’s 18 now-shuttered senior centers. Clients were receiving 14 meals each week.

By summer, despite federal relief funds, “I was out of money,” Ms. Beals-Luedtka said. She faced the grim task of telling 342 seniors, who had been added to the rolls for three emergency months, that she had to remove them. “People were crying on the phone,” she recalled. “I literally had a man say he was going to commit suicide.” (She reinstated him.) Even those who remained started receiving five meals a week instead of 14.

diminish loneliness and help keep seniors out of expensive nursing homes. They also may help reduce falls, although those findings were based on a small sample and did not achieve statistical significance.

Interestingly, Dr. Thomas’s research found daily meal deliveries had greater effects than weekly or twice-monthly drop-offs of frozen meals, a practice many local organizations have adopted to save money.

Frail or forgetful clients may have trouble storing, preparing and remembering to eat frozen meals. But the primary reason daily deliveries pay off, her study shows, is the regular chats with drivers.

“They build relationships with their clients,” Dr. Thomas said. “They might come back later to fix a rickety handrail. If they’re worried about a client’s health, they let the program know. The drivers are often the only people they see all day, so these relationships are very important.”

a prepandemic evaluation found.

So while program administrators relish a rare opportunity to expand their reach, they worry that if Congress doesn’t sustain this higher level of appropriations, the relief money will be spent and waiting lists will reappear.

“There’s going to be a cliff,” Ms. Beals-Luedtka said. “What’s going to happen next time? I don’t want to have to call people and say, ‘We’re done with you now.’ These are our grandparents.”

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‘They Have No One’: At 88, a Transgender Icon Combats Loneliness Among Seniors

MEXICO CITY — The pink paint of her stairwell is peeling, the black metal banister chipped, but Samantha Flores is as sharp-witted as ever amid a profusion of climbing plants and bursting red flowers.

At 88, the Mexican transgender icon remains elegant, funny and at times flirtatious, sitting at a small round table on the landing outside her tiny Mexico City flat where she has received callers, at a safe distance, throughout the pandemic.

After nearly nine decades as a socialite, a manager of a gay bar, an L.G.B.T.Q. advocate, and much more, Ms. Flores has a large community of longtime friends and neighbors who come knocking.

“Without my friends, I wouldn’t be who I am,” she said.

But as Ms. Flores well knows, many seniors are not so lucky. And so there is one part of her world that she’s aching to get back — the drop-in center she founded and runs to help older L.G.B.T.Q. adults combat their isolation. It was the first organization of its kind in Mexico.

Vogue Mexico last June, and was later featured in a campaign for the fashion house Gucci.

But for Ms. Flores, the glamour and attention are just new platforms to talk about what’s most important to her — Vida Alegre, and the rampant discrimination still faced by Mexican trans women, which often makes sex work their only means of making a living.

“It’s society’s fault that trans women have to work on the streets,” she said. “They aren’t given any other option.”

When coupled with machismo attitudes and widespread gang violence, discrimination can also be deadly for trans women in Mexico, which regularly ranks among the most dangerous countries in the world for transgender people. Few are lucky enough to live as long as Ms. Flores has.

But luck, it seems, has often been on Ms. Flores’ side.

Born in the city of Orizaba in Veracruz state in 1932, Ms. Flores grew up in a house with a yard full of orange, guava, lemon and avocado trees. She described her childhood as idyllic. Her family was tacitly accepting even then of what she called her effeminate nature, she said.

“I couldn’t pass by unnoticed, ” Ms. Flores recalled.

But behind her back, there were always whispers from neighbors and schoolmates, Ms. Flores said, and after graduating from high school, she couldn’t wait to leave Orizaba.

“What I wanted was to get out of that damn town and away from those damn people,” she said. “I realized that I was criticized and singled out for being queer.”

Ms. Flores moved to Mexico City, where she began dipping into the capital’s nascent gay scene of the 1950s and ’60s.

“For me, it was freedom,” she said.

One night in 1964, Ms. Flores was invited to a costume party, and together with a few friends, decided to go in drag. She chose the name Samantha for her persona after Grace Kelly’s character in the film “High Society,” which featured music by Cole Porter, her favorite singer.

“I liked Samantha because of the double meaning,” Ms. Flores said. “Bing Crosby called her Sam, which can also be short for Samuel.”

The host of the party was a friend of Ms. Flores, Xóchitl, then one of the most famous trans women in Mexico, who Ms. Flores says, had connections to the rich and powerful that allowed her the freedom to hold extravagant parties for the L.G.B.T.Q. community.

“She was the one that opened the door for trans women,” Ms. Flores recalled.

Little by little, Ms. Flores appeared in public as Samantha until, eventually, she was Samantha.

“I became myself, I found my true personality,” she said.

Soon, Samantha Flores was a staple of the Mexico City club scene.

“She was always a very, very elegant woman,” recalled Alexandra Rodríguez de Ruíz, a transgender rights activist and writer who was a teenager when she started going to gay clubs and encountered Ms. Flores. “Always wearing beautiful dresses and always accompanied by handsome young men.”

Back then, Ms. Rodríguez said, being part of the L.G.B.T.Q. community in Mexico was even more dangerous; the police would regularly detain trans women on the street or raid gay bars and confiscate their belongings.

“There was a lot of persecution,” she said. “Sometimes, if they were bad cops, they would take you to someplace and rape you or beat you.”

But Ms. Flores said she managed to avoid trouble. Whether it was that she could easily pass as female or because of her friendship with the well-connected Xóchitl, she was never bothered by the police.

Still, Ms. Flores said she felt uneasy being a trans woman in Mexico, and decided to move to Los Angeles. For several years in the 1970s and early ’80s, she lived between Mexico and L.A., where she worked managing a gay bar, among other ventures.

By the time she came back to Mexico full-time in the mid-’80s, the AIDS crisis was in full swing.

“My best friends, my most beloved friends, they died of H.I.V.,” Ms. Flores recalled. “I lost count — if I said 300, I wouldn’t be exaggerating.”

Seeing the crisis facing her community inspired her to become more of an activist.

“I became a fighter,” she said.

At first, Ms. Flores volunteered at an AIDS charity, and later began raising money for children with H.I.V. and women facing violence in northern Mexico, collecting funds at theater performances, including “The Vagina Monologues,” which ran in Mexico for years.

Then, a few years ago, a friend of hers suggested that she create a shelter for older L.G.B.T.Q. adults.

“That’s when the spark was lit,” Ms. Flores said.

It took years of wading through the Mexican bureaucracy and finding the right venue, but eventually she was able to secure rent on a one-room building on a busy street in the Álamos neighborhood. Vida Alegre now stands there, the building painted bright blue with a rainbow flag out the front.

The community has grown to some 40 people, about half of whom are straight and go there only for the company.

“It’s empathy and being together,” that brings people in, Ms. Flores said. “Abandonment and loneliness have fled.”

Besides reopening Vida Alegre, Ms. Flores has one other wish.

“I’m waiting for Prince Charming on his white horse and silver armor to come and serenade me,” Ms. Flores said. “I’ve been living here for 35 years, with the windows open, waiting for him. But he still hasn’t come.”

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Jobless Claims Tick Up, Showing a Long Road to Recovery: Live Updates

filed for state unemployment benefits last week, the Labor Department said Thursday. That was up modestly from the week before, but still among the lowest weekly totals since the pandemic began.

In addition, 237,000 people filed for Pandemic Unemployment Assistance, a federal program that covers people who don’t qualify for state benefits programs. That number, too, has been falling.

Jobless claims remain high by historical standards, and are far above the norm before the pandemic, when around 200,000 people a week were filing for benefits. Applications have improved only gradually — even after the recent declines, the weekly figure is modestly below where it was last fall.

But economists are optimistic that further improvement is ahead as the vaccine rollout accelerates and more states lift restrictions on business activity. Fewer companies are laying off workers, and hiring has picked up, meaning that people who lose their jobs are more likely to find new ones quickly.

“We could actually finally see the jobless claims numbers come down because there’s enough job creation to offset the layoffs,” said Julia Pollak, a labor economist at the job site ZipRecruiter.

But Ms. Pollak cautioned that benefits applications would not return to normal overnight. Even as many companies resume normal operations, others are discovering that the pandemic has permanently disrupted their business model.

“There are still a lot of business closures and a lot of layoffs that have yet to happen,” she said. “The repercussions of this pandemic are still rippling through this economy.”

Shoppers in Berlin’s Alexanderplatz. Germany and other countries have cut their value-added taxes to encourage consumer spending.
Credit…Lena Mucha for The New York Times

The European Central Bank’s chief economist argued on Thursday that fears of a big rise in inflation are overblown, a sign that the people who control interest rates in the eurozone are likely to keep them very low for some time to come.

The comments — by Philip Lane, an influential member of the central bank’s Governing Council whose job includes briefing other members on the economic outlook — are an attempt to calm bond investors who are nervous that the end of the pandemic will lead to high inflation.

Fueling their fears, inflation in the eurozone rose to an annual rate of 1.3 percent in March from 0.9 percent in February, according to official data released on Wednesday, the fastest increase in prices in more than a year.

Market-based interest rates have been rising because investors worry that President Biden’s $2 trillion stimulus program will provoke a broad increase in prices for years to come. The interest rates that prevail on bond markets ripple through the financial system and can make mortgages and other types of borrowing more expensive, creating a drag on economic growth.

Despite big monthly swings in inflation during the last year, the average had been remarkably stable at an annual rate of about 1 percent, Mr. Lane wrote in a blog post on the central bank’s website on Thursday. That is well below the European Central Bank’s target of 2 percent.

“The volatility in inflation over 2020 and 2021 can be attributed to a host of temporary factors that should not affect medium-term inflation dynamics,” Mr. Lane wrote.

That is another way of saying that the European Central Bank is not going to panic about short-lived fluctuations in inflation and put the brakes on the eurozone economy anytime soon.

On the contrary, Mr. Lane’s analysis suggests that the European Central Bank will continue trying to push inflation toward the 2 percent target. In March, the central bank said it would increase its purchases of government and corporate bonds to try to keep a lid on market-based interest rates.

Mr. Lane said it was no surprise to see “considerable volatility in inflation during the pandemic period.” He attributed the ups and downs to quirky factors that are not likely to recur.

Germany and some other countries cut their value-added taxes to encourage consumer spending, then raised them again later. The price of fuel fluctuated wildly. People spent almost nothing on travel, but increased spending on home exercise equipment or products that they needed to work from home. That affected the way inflation is calculated and made the annual rate look higher, Mr. Lane said.

“The medium-term outlook for inflation remains subdued,” he wrote, “and closing the gap to our inflation aim will set the agenda for the Governing Council in the coming years.”

Prince Abdulaziz bin Salman, the Saudi oil minister, has argued that increasing oil output too fast would be risky.
Credit…via Reuters

OPEC and its allies, including Russia, are expected to meet by videoconference Thursday to discuss whether to ease production curbs on oil as countries around the world try to expand from pandemic lockdowns.

Analysts say recent events will support the views of Prince Abdulaziz bin Salman, the Saudi oil minister, who has argued for caution in increasing supply, noting the risks of swamping the market. But other outcomes are possible at the meeting of the group known as OPEC Plus, including modest increases and even cuts in oil production,

France’s reimposition of a national lockdown, announced Wednesday, underlines persistent doubts about the pace of recovery from the pandemic, as have rising case numbers in the United States.

After modest increases when the Suez Canal was recently blocked by a cargo ship, oil prices were rising again on Thursday, with Brent crude, the global benchmark, about 1.6 percent higher, to $63.75 a barrel.

“All signs seemingly point to the group maintaining current production levels,” Helima Croft, head of commodity strategy at RBC Capital Markets, an investment bank, wrote in a note to clients on Wednesday.

Yet pressure may also come to increase supply. Members of the OPEC Plus group are withholding an estimated eight million barrels of a day, or about 9 percent of current global consumption. As the global economy recovers, it will become increasingly difficult for the Saudis to persuade others to restrain supplies.

A ChargePoint charging station in Berkeley, Calif. Shares in ChargePoint rose 19 percent on Wednesday. President Biden’s infrastructure plan supports the use of electric vehicles.
Credit…John G Mabanglo/EPA, via Shutterstock

U.S. stock futures rose on Thursday and tech stocks were set to extend their rally as traders focused on optimism about the economic recovery. Shares in Europe and Asia were also higher before the Labor Department’s latest weekly report on initial applications for state unemployment benefits.

Bond yields pulled back from their recent 14-month high. The yield on the 10-year U.S. Treasury note fell 3 basis points, or 0.03 percentage point, to 1.71 percent.

Last week, jobless claims were at the lowest for the pandemic, but economists have warned against assuming this is the new trend because of measurement issues. New data released on Thursday showed a slight rise in claims for unemployment benefits, On Friday, the Labor Department will publish its monthly jobs report for March.

The occupancy rate in nursing homes in the fourth quarter of 2020 was down 11 percentage points from the first quarter, but there are hurdles to staying out of facilities.
Credit…Amr Alfiky/The New York Times

The pandemic has intensified a spotlight on long-running questions about how communities can do a better job supporting seniors who need care but want to live outside a nursing home.

The coronavirus had taken the lives of 181,000 people in U.S. nursing homes, assisted living and other long-term care facilities through last weekend, according to the Kaiser Family Foundation — 33 percent of the national toll.

The occupancy rate in nursing homes in the fourth quarter of 2020 was 75 percent, down 11 percentage points from the first quarter, according to the National Investment Center for Seniors Housing & Care, a research group. The shift may not be permanent, but this much is clear: As the aging of the nation accelerates, most communities need to do much more to become age-friendly, said Jennifer Molinsky, senior research associate at the Joint Center for Housing Studies at Harvard.

“It’s about all the services that people can access, whether that’s the accessibility and affordability of housing, or transportation and supports that can be delivered in the home,” she said.

But there are hurdles for those who wish to stay out of a facility, Mark Miller reports for The New York Times:

Marigold Lewi and Kimberley Vasquez outside their high school Baltimore City College this month in Baltimore, MD.
Credit…Erin Schaff/The New York Times

A year after the pandemic turned the nation’s digital divide into an education emergency, President Biden is making affordable broadband a top priority, comparing it to the effort to spread electricity across the country. His $2 trillion infrastructure plan, announced on Wednesday, includes $100 billion to extend fast internet access to every home.

The money is meant to improve the economy by enabling all Americans to work, get medical care and take classes from wherever they live. Although the government has spent billions on the digital divide in the past, the efforts have failed to close it partly because people in different areas have different problems. Affordability is the main culprit in urban and suburban areas. In many rural areas, internet service isn’t available at all because of the high costs of installation.

“We’ll make sure every single American has access to high-quality, affordable, high speed internet,” Mr. Biden said in a speech on Wednesday. “And when I say affordable, I mean it. Americans pay too much for internet. We will drive down the price for families who have service now.”

Longtime advocates of universal broadband say the plan, which requires congressional approval, may finally come close to fixing the digital divide, a stubborn problem first identified and named by regulators during the Clinton administration. The plight of unconnected students during the pandemic added urgency.

“This is a vision document that says every American needs access and should have access to affordable broadband,” said Blair Levin, who directed the 2010 National Broadband Plan at the Federal Communications Commission. “And I haven’t heard that before from a White House to date.”

Some advocates for expanded broadband access cautioned that Mr. Biden’s plan might not entirely solve the divide between the digital haves and have-nots.

The plan promises to give priority to municipal and nonprofit broadband providers but would still rely on private companies to install cables and erect cell towers to far reaches of the country. One concern is that the companies won’t consider the effort worth their time, even with all the money earmarked for those projects. During the electrification boom of the 1920s, private providers were reluctant to install poles and string lines hundreds of miles into sparsely populated areas.

Taxpayers who received unemployment benefits last year — but who filed their federal tax returns before a new tax break became available — could receive an automatic refund as early as May, the Internal Revenue Service said on Wednesday.

The latest pandemic relief legislation — signed into law on March 11, in the thick of tax season — made the first $10,200 of unemployment benefits tax-free in 2020 for people with modified adjusted incomes of less than $150,000. (Married taxpayers filing jointly can exclude up to $20,400.)

But some Americans had already filed their tax returns by March and have been waiting for official agency guidance. Millions of U.S. workers filed for unemployment last year, but the I.R.S. said it was still determining how many workers affected by the tax change had already filed their tax returns.

On Wednesday, the I.R.S. confirmed that it would automatically recalculate the correct amount of benefits subject to taxation — and any overpayment will be refunded or applied to any other outstanding taxes owed. The first refunds are expected to be issued in May and will continue into the summer.

The I.R.S. said it would begin processing the simpler returns first, or those eligible for up to $10,200 in excluded benefits, and then would turn to returns for joint filers and others with more complex returns.

There is no need for those affected to file an amended return unless the calculations make the taxpayer newly eligible for additional federal credits and deductions not already included on the original tax return, the agency said. Those taxpayers may want to review their state tax returns as well, the I.R.S. said.

People who still haven’t filed and expect to do so electronically can simply answer the questions asked by their online tax preparer, which will factor in the new tax break when they file. The agency provided an updated worksheet and additional guidance in March for taxpayers that prefer paper.

Microsoft’s HoloLens headsets, demonstrated above in 2017, will equip soldiers with night vision, thermal vision and audio communication.
Credit…Elaine Thompson/Associated Press

Microsoft said Wednesday that it would begin producing more than 120,000 augmented reality headsets for Army soldiers under a contract that could be worth up to $21.9 billion.

The HoloLens headsets use a technology called the Integrated Visual Augmentation System, which will equip soldiers wearing them with night vision, thermal vision and audio communication. The devices also have sensors that help soldiers target opponents in battle.

The deal is likely to create waves inside Microsoft, where some employees have objected to working with the Pentagon. Employees at other big tech companies, like Google, have also rejected what they say is the weaponization of their technology.

But Microsoft has long courted Defense Department work, including a $10 billion contract to build a cloud-computing system. Amazon had been seen as a front-runner to win the contract, but the Defense Department chose Microsoft.

Amazon claimed that President Donald J. Trump had interfered in the process because of his feud with Jeff Bezos, Amazon’s chief executive and the owner of The Washington Post. A legal fight over the contract is still active.

Soldiers have tested the Microsoft headsets for two years, the company said. The Army said the devices would be used in combat and training.

Microsoft said its testing of the headsets had helped the Defense Department’s “efforts to modernize the U.S. military by taking advantage of advanced technology and new innovations not available to military.”

The devices will “provide the improved situational awareness, target engagement and informed decision-making necessary” to overcome current and future adversaries, the Army said in a news release.

In 2018, Microsoft won a $480 million bid to make prototypes of the headsets. The Army said Wednesday that the new contract to produce them on a larger scale was for five years, with the option to add up to five more years.

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The pandemic showed how broken nursing homes are. But the alternatives aren’t easy.

The pandemic has intensified a spotlight on long-running questions about how communities can do a better job supporting seniors who need care but want to live outside a nursing home.

The coronavirus had taken the lives of 181,000 people in U.S. nursing homes, assisted living and other long-term care facilities through last weekend, according to the Kaiser Family Foundation — 33 percent of the national toll.

The occupancy rate in nursing homes in the fourth quarter of 2020 was 75 percent, down 11 percentage points from the first quarter, according to the National Investment Center for Seniors Housing & Care, a research group. The shift may not be permanent, but this much is clear: As the aging of the nation accelerates, most communities need to do much more to become age-friendly, said Jennifer Molinsky, senior research associate at the Joint Center for Housing Studies at Harvard.

“It’s about all the services that people can access, whether that’s the accessibility and affordability of housing, or transportation and supports that can be delivered in the home,” she said.

Mark Miller reports for The New York Times:

  • A major shortage of age-friendly housing in the United States will present problems for seniors who wish to stay in their homes. By 2034, 34 percent of households will be headed by someone over 65, according to the Harvard center. Yet in 2011, just 3.5 percent of homes had single-floor living, no-step entry and extra-wide halls and doors for wheelchair access, according to Harvard’s latest estimates.

  • Medicare does not pay for most long-term care services, regardless of where they happen; reimbursement is limited to a person’s first 100 days in a skilled nursing facility. Medicaid, which covers only people with very low incomes, has long been the nation’s largest funder of long-term care. From its inception, the program was required to cover care in nursing facilities but not at home or in a community setting. “There’s a bias toward institutions,” said Judith Solomon, a senior fellow specializing in health at the Center on Budget and Policy Priorities.

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Turning Away From Nursing Homes, to What?

The PACE provider manages all of a person’s health care needs that are covered by Medicare or Medicaid. “It becomes your form of health care coverage,” said Peter Fitzgerald, executive vice president for policy and strategy at the National PACE Association, a membership and advocacy organization.

States decide whether to offer PACE programs; currently 30 have programs serving about 55,000 people, Mr. Fitzgerald said.

Some states and regions are moving to address the needs of their aging citizens.

In January, Gov. Gavin Newsom released a master plan for aging for California. It calls for creating, over the next decade, millions of housing units for older residents, one million high-quality caregiving jobs, and inclusion goals such as closing the digital divide and creating opportunities for work and volunteering. Colorado, Massachusetts, Minnesota and Texas have already established master plans, and a number of other states are working on them.

California’s plan also calls for a new state office focused on finding ways to innovate using Medicare funds, especially for low-income, chronically ill seniors who also participate in Medicaid.

“We think this can really help our state by bringing together medical and nonmedical services for people who want to live well in the place they call home,” said Gretchen E. Alkema, vice president of policy and communications at the SCAN Foundation, a nonprofit focused on elder care that has worked with California and other states on age-friendly models.

In the Atlanta metropolitan area, which began tackling these issues head-on in 2002, one in five residents will be 65 or older by 2050, according to the Atlanta Regional Commission, a planning organization. The group has responded by developing a “lifelong communities initiative” to raise awareness in local government of the need for housing that is affordable and convenient to sidewalks, shopping and transportation.

Atlanta and four suburbs have joined an AARP-sponsored network of age-friendly communities, and several city neighborhoods have created plans.

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Inside Myanmar’s Army: ‘They See Protesters as Criminals’

Capt. Tun Myat Aung leaned over the hot pavement in Yangon, Myanmar’s largest city, and picked up bullet casings. Nausea crept into his throat. The shells, he knew, meant that rifles had been used, real bullets fired at real people.

That night, in early March, he logged on to Facebook to discover that several civilians had been killed in Yangon by soldiers of the Tatmadaw, as Myanmar’s military is known. They were men in uniform, just like him.

Days later, the captain, of the 77th Light Infantry Division, notorious for its massacres of civilians across Myanmar, slipped off base and deserted. He is now in hiding.

“I love the military so much,” he said. “But the message I want to give my fellow soldiers is: If you are choosing between the country and the Tatmadaw, please choose the country.”

ousting Myanmar’s civilian leadership last month, setting off nationwide protests, it has only sharpened its savage reputation, killing more than 420 people and assaulting, detaining or torturing thousands of others, according to a monitoring group.

On Saturday, the deadliest day since the Feb. 1 coup, security forces killed more than 100 people, according to the United Nations. Among them were seven children, including two 13-year-old boys and a 5-year-old boy.

In-depth interviews with four officers, two of whom have deserted since the coup, paint a complex picture of an institution that has thoroughly dominated Myanmar for six decades. From the moment they enter boot camp, Tatmadaw troops are taught that they are guardians of a country — and a religion — that will crumble without them.

They occupy a privileged state within a state, in which soldiers live, work and socialize apart from the rest of society, imbibing an ideology that puts them far above the civilian population. The officers described being constantly monitored by their superiors, in barracks and on Facebook. A steady diet of propaganda feeds them notions of enemies at every corner, even on city streets.

The cumulative effect is a bunkered worldview, in which orders to kill unarmed civilians are to be followed without question. While the soldiers say there is some dissatisfaction with the coup, they regard a wholesale breaking of ranks as unlikely. That makes more bloodshed likely in the coming days and months.

Daw Aung San Suu Kyi, the civilian leader deposed and locked up in last month’s coup. Her father, Gen. Aung San, founded the Tatmadaw.

Today, the Tatmadaw’s foes are again domestic, not foreign: the millions of people who have poured onto the streets for anti-coup rallies or taken part in strikes.

On Saturday, which was Armed Forces Day, Senior Gen. Min Aung Hlaing, the commander in chief and instigator of the coup, gave a speech vowing to “protect people from all danger.” As tanks and goose-stepping soldiers paraded down the broad avenues of Naypyidaw, the bunker-filled capital built by an earlier junta, security forces shot protesters and bystanders alike, with more than 40 towns seeing violence.

intensity of opposition to the putsch. Officers trained in psychological warfare regularly plant conspiracy theories about democracy in Facebook groups favored by soldiers, according to social media experts and one of the officers who spoke with The Times.

In this paranoid world, the thumping that Ms. Aung San Suu Kyi’s National League for Democracy delivered to the military’s proxy party in last November’s elections was easily portrayed as electoral fraud.

A Muslim cabal, funded by oil-rich sheikhdoms, is accused of trying to destroy the Buddhist faith of Myanmar’s majority. Influential monks, who count army generals among those praying at their feet, preach that the Tatmadaw and Buddhist monkhood must unite to combat Islam.

In the Tatmadaw’s telling, a rapacious West could conquer Myanmar at any moment. Fear of invasion is thought to be one reason that military rulers moved the capital early in this century from Yangon, near the coast, to the landlocked plains of Naypyidaw.

subvert the country with piles of cash for activists and politicians. A military spokesman implied during a news conference that people protesting the coup, too, were foreign-funded.

Captain Tun Myat Aung said that in his first year at the Defense Services Academy, he was shown a film that portrayed democracy activists in 1988 as frenzied animals slicing off soldiers’ heads. In truth, thousands of protesters and others were killed by the Tatmadaw that year.

One of Captain Tun Myat Aung’s men was recently struck in the eye by a projectile from a protester’s slingshot, he said. But the captain acknowledged that the casualties were remarkably lopsided in the other direction.

Tatmadaw Facebook feeds may show soldiers besieged by violent protesters armed with homemade firebombs. But it is the security forces who have assaulted medics, killed children and forced bystanders to crawl in obeisance.

According to the soldiers who spoke with The Times, a suspension of mobile data access over the past two weeks was aimed as much at isolating troops who were beginning to question their orders as it was at cutting off the wider population.

most notoriously against Rohingya Muslims, but they have also targeted other ethnic groups, like the Karen, the Kachin and the Rakhine.

When the 77th Light Infantry Division was fighting in Shan State, in northeastern Myanmar, Captain Tun Myat Aung said he could feel the disgust of people from various ethnic groups. As a member of another ethnic minority, the Chin, he understood their fear of the Bamar majority.

Although he says he shot only to wound, not to kill, Captain Tun Myat Aung spent eight years on the front lines. He developed a rapport with just one group of ethnic minority villagers during that entire time, he said.

“People hate soldiers for what the soldiers did to them,” he said.

But the Tatmadaw also saved him. His mother died when he was 10. His father drank. He was sent to a boarding school for ethnic minority students, where he excelled. At the Defense Services Academy, he studied physics and English.

“The military became my family,” he said. “I was automatically happy when I saw my soldier’s uniform.”

On Feb. 1, in the pre-dawn torpor of Yangon, Captain Tun Myat Aung clambered onto a military truck, half asleep, strapping on his helmet. He didn’t know what was going on until a fellow soldier whispered about a coup.

“At that moment, I felt like I lost hope for Myanmar,” he said.

Days later, he saw his major holding a box of bullets — real ones, not rubber. He cried that night.

“I realized,” he said, “that most of the soldiers see the people as the enemy.”

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Free With Your Covid Shot: Krispy Kreme Doughnuts

The benefits of getting vaccinated against Covid-19 — namely, protection against a dangerous virus — should be obvious by this stage in the pandemic.

If that isn’t sufficient motivation, consider the swag.

Businesses across the United States and beyond are offering free merchandise and other stuff to people who receive Covid shots. The perks include free rides, doughnuts, money, arcade tokens and even marijuana.

Experts in behavioral motivation say that offering incentives is not necessarily the most effective or cost-efficient way to increase vaccine uptake. But that hasn’t stopped the freebies from piling up.

In Cleveland, the Market Garden Brewery is offering 10-cent beers to the first 2021 people who show a Covid-19 vaccine certificate. “Yes, you read that right,” the brewery says on its website. “Ten Cents.”

prerolled joint until the end of the month.

Chobani provides free yogurt at some vaccination sites. And Krispy Kreme said on Monday that for the rest of the year, it would give one glazed doughnut per day to anyone who provides proof of a Covid-19 vaccination.

As vaccinations accelerated across the United States, “We made the decision that said, ‘Hey, we can support the next act of joy,’ which is, if you come by, show us a vaccine card, get a doughnut any time, any day, every day if you choose to,” the company’s chief executive, Michael Tattersfield, told Fox News.

The Krispy Kreme initiative is no relation to the “vaccinated doughnuts” that were sold last month by a bakery in Germany, garnished with plastic syringes that dispense a sweet, lemony-ginger amuse-bouche. It also does not entitle vaccinated Americans to endless doughnuts, as Mr. Tattersfield seemed to imply in his Fox News interview — just one per day, as the company notes on its website.

In a promotion it is calling “Tokens for Poke’ns,” Up-Down, a chain of bars featuring vintage arcade games, is offering $5 in free tokens to guests who present a completed vaccination card. Up-Down, which has six locations in five Midwestern states, is extending the offer to guests who visit within three weeks of their final dose.

Cleveland Cinemas, a movie-theater chain in Ohio, is offering a free 44-ounce popcorn at two of its locations to anyone who presents a vaccination card through April 30.

The Times of Israel reported.

Presenting cards for so many promotions might cause some wear and tear. To protect the cards from damage, Staples is offering to laminate them at no charge after customers have received their final dose. The promotion runs through May 1.

Some vaccine perks flow from corporations to their employees. Tyson Foods, Trader Joe’s and others pay for the time it takes them to get vaccinated, while Kroger pays them a $100 bonus.

study, Ms. Dai and her colleagues found that text messages could boost uptake of influenza vaccinations. The most effective texts were framed as reminders to get shots that were already reserved for the patient. They also resembled the kind of communication that patients expect to receive from health care providers.

Jon Bogard, a graduate student at U.C.L.A. who contributed to the study, said that policymakers should proceed with caution on incentives because they can sometimes backfire. One problem is that the campaigns are expensive, he said. Another is that people receiving shots could see a large incentive as a sign that “vaccines are riskier than they in fact are.”

A better alternative, Mr. Bogard said, could be handing out “low-personal-value, high-social-value” objects — like stickers and badges — that tap into a larger sense of “social motivation and accountability.”

There appears to be no shortage of such swag swirling around the world’s hospitals and vaccination clinics.

Hartford, Conn., people receiving shots can pick up an “I got my Covid-19 vaccination” sticker bearing the home team’s mascot, a goat.

If you aren’t satisfied with the vaccine-related style accouterment at your local clinic, there are plenty of options available for purchase online.

One badge — “I got my Fauci ouchi” — pays homage to America’s best-known doctor, Dr. Anthony S. Fauci.

“Thanks, science,” says another.

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Covid-19 Live Updates: France Begins Monthlong Lockdown as Cases Surge

reported 35,000 new coronavirus cases, according to a New York Times database — one of the highest numbers since November, when a second wave of infection forced the entire country into lockdown. The country’s slow inoculation campaign, further set back by a temporary suspension of AstraZeneca’s vaccine, has not helped.

French officials said they would resume AstraZeneca vaccinations as soon as possible — they said that France’s national health authority had recommended the doses only for people age 55 and older. A very small number of cases of blood clotting have occurred in people younger than that.

Health Minister Olivier Véran welcomed the move. “Thank you to all of our doctors and pharmacists who as of today are going to mobilize to continue the vaccination campaign,” he said in a tweet.

Germany, Italy and Spain, said on Thursday that they would resume using the AstraZeneca vaccine, within hours of the European Medicines Agency declaring it safe. Norway said it would await further study.

But officials worry that a fearful public may not be easily reassured.

Coronavirus infections in France rose 24 percent from the previous week. The variant first identified in Britain now represents three-quarters of new cases.

The Paris region has borne the brunt of it. Last week, health officials in Paris ordered hospitals to cancel many of their procedures to make room for Covid-19 patients. And this week some patients were transferred to other regions to ease the pressure on hospitals.

France has been under a nighttime curfew since mid-January, with restaurants, cafes and museums remaining closed. Making a calculated gamble, the government tried to tighten restrictions just enough to stave off a third wave of infections without taking more severe steps that might hurt the economy.

But as infections started to increase in late February, the government imposed new lockdowns on weekends in the French Riviera, the famed strip along the Mediterranean coast, and in the area surrounding the northern port of Dunkirk. Officials made clear that more lockdowns might follow in other regions.

The new restrictions will affect about a third of the population, though they don’t go as far as those imposed a year ago, at the start of the epidemic.

Primary schools and secondary schools will remain open, and the rules for high schools and universities will remain much the same, with attendance limited to prevent infections. People will also be allowed to take walks and exercise with no time limit.

Though nonessential shops will close, the definition of essential has been expanded to include bookshops and music shops.

Bruno Riou, the head of the crisis center for Paris public hospitals, said a lockdown was the only remaining option to prevent more deaths, given that less than 9 percent of the population has received at least a first vaccination dose.

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Biden: U.S. on Track for 100 Million Vaccinations Since Jan. 20

President Biden said Thursday the U.S. would on Friday reach his Covid-19 vaccine goal of 100 million shots in 100 days, though he had earlier conceded they should aim higher.

In the last week, we’ve seen increases in the number of cases in several states — scientists have made clear that things may get worse as new variants of this virus spread. Getting vaccinated is the best thing we can do to fight back against these variants. While millions of people are vaccinated, we need millions more to be vaccinated. And I’m proud to announce that tomorrow, 58 days into our administration, we will have met my goal of administering 100 million shots to our fellow Americans. That’s weeks ahead of schedule. Eight weeks ago, only 8 percent of seniors, those most vulnerable to Covid-19, had received a vaccination. Today, 65 percent of people age 65 or older have received at least one shot. And 36 percent are fully vaccinated. This is a time for optimism, but it’s not a time for relaxation. I need all Americans, I need all of you to do your part. Keep the faith, keep wearing the mask, keep washing your hands and keep socially distanced. We’re going to beat this. We’re way ahead of schedule, but we’ve got a long way to go.

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President Biden said Thursday the U.S. would on Friday reach his Covid-19 vaccine goal of 100 million shots in 100 days, though he had earlier conceded they should aim higher.CreditCredit…Jon Cherry for The New York Times

As more states expand eligibility for coronavirus vaccinations, the pace of daily shots administered in the United States has steadily increased to a rate that is now 12 percent higher than it was a week ago.

On Thursday, Illinois joined a growing list of at least 16 other states announcing that they were opening appointments to all residents 16 years and older this month or next.

“The light that we can see at end of the tunnel is getting brighter and brighter as more people get vaccinated,” Gov. J.B. Pritzker said at a news conference.

President Biden said on Thursday that the United States was a day away from reaching his goal of administering 100 million vaccine doses in 100 days — with six weeks to spare before his self-imposed deadline.

“We’re way ahead of schedule,” he said in brief remarks from the White House, “but we have a long way to go.”

Mr. Biden maintained that the 100 million-shot goal was ambitious, even though he conceded in January that the government should be aiming higher. And though the new administration has bulked up the vaccine production and distribution campaign, its key elements were in place before Mr. Biden took office.

As of Thursday, the seven-day average was about 2.5 million doses a day, according to a New York Times analysis of data reported from the Centers for Disease Control and Prevention.

Last week, Mr. Biden set a deadline of May 1 for states to make vaccines available to all adult residents. At least Maine, Virginia, North Carolina and Wisconsin, in addition to Washington, D.C., plan to meet that goal. Others, including Colorado, Connecticut, Ohio, Massachusetts, Michigan and Montana, hope to make vaccines available to all of their adult residents even earlier.

Gov. Spencer Cox of Utah said opening up eligibility to all adults in his state would help address vaccine equity and reach rural communities. He also said it would “allow us to take our mobile vaccination clinics into these hard-to-reach areas or populations who may have a little more vaccine hesitancy.”

Other states have also pushed up their eligibility dates: Nevada will make vaccines available to all adults on April 5; Missouri on April 9; Maryland as of April 27; and Rhode Island starting April 19.

New York has yet to make all adults eligible, but the state recently expanded to include public-facing government employees, nonprofit workers and essential building service workers. On Thursday, Mayor Bill de Blasio of New York City, newly eligible because of the change, received the Johnson & Johnson vaccine at a news conference.


16+ or 18+

50+ or 55+

60+ or 65+

Eligible only in some counties


Restaurant workers

Eligible only in some counties


High-risk adults

Over a certain age

Eligible only in some counties

Sheikh Mohamed Hamad Mohamed al-Khalifa, center behind brown box, who plans to climb Mount Everest, arriving at Tribhuvan International Airport in Kathmandu, Nepal, on Monday.
Credit…Nishant S. Gurung/Agence France-Presse — Getty Images

KATHMANDU, Nepal — A peculiar vaccine drama is unfolding at the international airport in Nepal’s capital. It involves a member of Bahrain’s royal family who arrived with thousands of doses of coronavirus vaccines from China for an expedition to Mount Everest.

Before setting out, a team of Bahraini climbers led by Sheikh Mohamed Hamad Mohamed al-Khalifa had announced that they would be coming with 2,000 doses of Covid-19 vaccines, which Nepal’s government said would be of the AstraZeneca kind.

This move would fulfill a pledge that the climbers had made to local villagers during another expedition last September — a promise of generosity that led the villagers to name a local hill “Bahrain Peak.”

But when the climbers arrived in the capital, Kathmandu, on Monday, an inquiry by Nepal’s drug regulators found that the vaccines they were carrying were actually the one developed by Sinopharm, a Chinese state-owned vaccine maker.

The Nepali authorities now find themselves in a fix: whether to accept the vaccine doses or refuse.

The doses are being held in cold storage at the airport, and the climbers have been quarantined at a hotel as the authorities ponder how to handle the situation.

Nepal has largely relied on the AstraZeneca vaccine for its rollout, which is off to a slow start. Relying on a donation of one million doses from India, Nepal has vaccinated about 1.7 million people in a country of about 30 million.

Its efforts have been slowed because of a delay in the delivery of two million vaccine doses that it bought from the Serum Institute of India.

Although Nepal approved the emergency use of the Sinopharm vaccine after China pledged to give 500,000 doses to the country, it has not received the Chinese donation.

In September, the Bahraini climbers arrived in Nepal in a chartered plane to climb two mountains, Mount Manaslu and Lobuche Peak. The vaccine doses they were carrying this week were a gift for villagers in Samagaun, a gateway to Mount Manaslu.

The team of Bahraini climbers could not be reached for comment. But Mingma Sherpa, the owner of Seven Summit Treks, the agency that has been organizing the Bahrain team’s Everest expedition, said the complications might have resulted from miscommunication between Nepal’s foreign ministry and the health ministry.

He said the Sinopharm vaccine had also been used during Bahrain’s vaccination drive.

“It’s up to the government,” Mr. Sherpa said. “If they think it’s OK, the vaccines will be administered to villagers. If they think it’s risky to vaccinate the people, the team will take the vaccine back to Bahrain.”

Maria Alyokhina, center, a member of Pussy Riot, at a hearing at the Moscow City Court in February.
Credit…Moscow City Court Press Service, via Shutterstock

A Russian court has confined some of the country’s most prominent opposition figures to house arrest on accusations that they violated coronavirus safety rules, in what appears to be a government effort to use the restrictions to muzzle its opponents.

The legal action, known as a “sanitary case,” targets 10 opposition politicians and dissidents, including the senior leadership of Aleksei A. Navalny’s organization and members of the protest group Pussy Riot. All are accused of inciting others to violate rules introduced last spring to slow the spread of the coronavirus. Their lawyers have denied that they did.

Prosecutors say their social media posts promoting a protest in Moscow in January resulted in attendance by 19 people who were legally required to isolate because of positive Covid-19 tests, thus putting at risk others who attended.

Defense lawyers say the authorities are cynically twisting coronavirus rules to isolate people who pose no infection risk but are seen by the government as posing a political one.

“The ideological intent is to label opposition figures as infectious, as toxic, as poisoners of the public,” said Danil Berman, a lawyer for Maria Alyokhina, a member of Pussy Riot who was one of those targeted. Isolating key leaders before parliamentary elections scheduled for this year also hobbles the opposition, he said.

Many people around the world have complained that coronavirus restrictions have infringed on their freedoms as a byproduct of safety measures. But the Russian opposition members argue that the government is using the restrictions against them with the specific aim of curbing their liberty.

Online posts from the opposition figures promoting the protest did not specifically encourage people who were sick to attend, as the government charged, defense lawyers say. Lockdowns in Moscow had in any case been mostly lifted months earlier.

Also, the defense lawyers say, the rules are selectively enforced to restrict opposition activity while allowing pro-government events to go ahead with few restrictions, though the virus would spread as readily at either type of gathering.

Hiking at Zion National Park in Utah in November.
Credit…Nikki Boliaux for The New York Times

Last June, as Americans began to emerge from lockdowns and into a new yet still uncertain stage of the pandemic, Amy Ryan and her family set sail in a 44-foot catamaran and headed up the Atlantic coast. They haven’t stopped sailing since.

Ms. Ryan’s husband, Casey Ryan, 56, was on partly paid leave from his job as an airline pilot. School was remote for their daughters, now 7 and 11. Ms. Ryan, a real estate agent, could manage her team from anywhere.

For nine months, the Ryans have been hopscotching, first up the coast and later in the Caribbean. “We’re so secluded most of the time, we won’t see any people on land for weeks at a time,” Ms. Ryan said. The biggest challenge is finding a Covid-19 test before setting sail for a new location.

For many people, the past 12 months have been lived in a state of suspended animation, with dreams and plans deferred until further notice amid worry over venturing out for even basic excursions. But some people, like the Ryans, took the restrictions — virtual school and remote work — as an opportunity to pick up and go somewhere else. With a good internet connection, a Zoom conference call can happen just as easily on a boat or in the back of a camper as it can in a living room.

Many people bristle at the idea of anyone taking a trip at all, let alone traveling indefinitely at a time of immense suffering. School and office closings weren’t meant to make it easier to see the world; they were intended to persuade people to stay home and slow the spread of a deadly virus. And with many out of work and struggling to pay bills, or trying to balance parenting with the demands of remote work, it would have been impossible.

But these families insist that their “slow travel” methods — allowing for only rare encounters with other people indoors — are no more dangerous than staying home. Spend your time crisscrossing the country in a camper and staying in state parks, and you rarely encounter anyone outside your family, except to get food and gas.

“This pandemic has been so incredibly hard for everybody, and people are finding their ways of managing and getting through it,” said Ashish K. Jha, the dean of the Brown University School of Public Health, adding that isolated activities like sailing and camping are not inherently risky.

Until the pandemic, the Ryans weren’t sailors, nor had they ever planned to be. But they spent the lockdown watching YouTube videos about families that sail. By May, they had bought a boat with no idea how long they would be on it.

“If it hadn’t been for Covid,” Ms. Ryan said, “there is no way this would have happened.”

Marge Rohlf receiving a vaccination at the Madrid Home in Iowa in January.
Credit…Bryon Houlgrave/The Des Moines Register, via Associated Press

For the first time in nearly a year, Iowa is reporting that there are no active coronavirus outbreaks in any of the state’s long-term care facilities.

Since the beginning of the pandemic, more than 2,200 residents of those facilities have died from the virus, according to Iowa’s Covid-19 dashboard. But the rate of outbreaks began a steep decline in January, when the state ramped up vaccinations for residents and staff.

In the first two weeks of January alone, cases declined 70 percent, from 410 to 119 by mid-January, according to the Iowa Health Care Association. Of the state’s 445 skilled nursing homes and 258 assisted-living facilities, 146 were experiencing outbreaks in December.

“This is a big milestone,” said Nola Aigner Davis, the public health communications officer for the Polk County Health Department in Des Moines. “It really speaks volumes of how effective this vaccine is.”

For much of the pandemic, residents and employees in nursing homes have been among the most vulnerable people in the country.

The coronavirus, as of late February, had scythed through more than 31,000 long-term care facilities and killed at least 172,000 people living and working in them. More than 1.3 million long-term care residents and workers have been infected over the past year.

Of Iowa’s 5,673 deaths, nearly 60 percent were people over age 80.

That has changed, however, with the advent of vaccinations.

Facilities for older people were given early priority for shots, and from late December to early February, a New York Times analysis found, new cases among nursing home residents — a subset of long-term care residents — fell more than 80 percent. That was about double the rate of improvement in the general population.

Even as fatalities were peaking in the general population, deaths inside the facilities decreased more than 65 percent.

About 4.8 million residents and employees in long-term care facilities have received at least one vaccine dose, according to the Centers for Disease Control and Prevention. About 2.8 million have been fully vaccinated.

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AstraZeneca Vaccine Cleared by EU After Blood-Clot Concerns

The European Union’s health agency said that the Covid-19 vaccine produced by AstraZeneca PLC was “safe and effective” and didn’t increase the risk of blood clots, a decision that could clear the way for the resumption of inoculation campaigns that have been halted in much of the region.

The European Medicines Agency said that new expert analysis concluded that the benefits of using a Covid-19 vaccine produced by AstraZeneca outweigh its potential risks and inoculations with it should proceed.

EU authorities are hoping the EMA’s statement could put a problem-plagued vaccination campaign back on track, although it remains to be seen whether the new analysis will overcome mistrust of the AstraZeneca shot among many Europeans.

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Many European countries, including Germany, France and Italy, suspended the vaccine’s use over the past week following reports that people who had received it developed rare blood clots, and some had died, further slowing Europe’s already sluggish vaccination rollout.

Those reports compounded the delays and uncertainties surrounding a drive that has left the EU far behind the U.S. and the U.K. in vaccinating its citizens.

The EMA’s safety committee found the vaccine to be “safe and effective in preventing Covid-19, and its benefits outweigh its risk,” said committee chair Sabine Straus. Dr. Straus said that since blood clots are associated with Covid-19, by inoculating people against the disease, the vaccine “likely reduces the risk of thrombotic incidents overall.”

Health officials have noted that blood clots are widespread for a variety of reasons. Clots have also been noted among people receiving other Covid-19 vaccines and can be caused by medications as common as birth-control pills.

Dr. Straus said the EMA identified a predominance of the blood clots found were among women, particularly younger women. She said it remained “premature to conclude” whether this is linked to greater risk among the groups or the makeup of the populations receiving the vaccine.

EMA Executive Director Emer Cooke said the experts found a limited number of blood clots that require further study and the agency “still cannot rule out definitively a link.”

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The EMA as a result recommended “raising awareness” by including a warning with the vaccination and informing the public. Such a campaign could help people who receive the AstraZeneca vaccine to know what to look for after getting the shot.

Ms. Cooke on Tuesday had expressed concern that doubts being cast on it could hurt public trust in vaccines. Asked in a news conference Wednesday if she personally would get the AstraZeneca shot, she said, “If it was me, I would be vaccinated tomorrow, but I would want to know that if something happened to me,” what to do.

Ms. Cooke, noting that many EU countries had suspended use of the AstraZeneca vaccine pending the EMA’s review, said its conclusions should give them “the information they need to take an informed decision regarding the use of the AstraZeneca vaccine in their vaccination campaigns.”

So far seven million people in the EU have received the vaccine and 11 million in the U.K., Ms. Cooke said.

Analysis of the vaccine took on extra urgency this week after the Paul Ehrlich Institute, Germany’s medicines regulator, Monday recommended suspending the vaccine’s rollout pending further investigation.

Alerts and web-browser tools can help you book a Covid-19 vaccine appointment. WSJ’s Joanna Stern met up with Kris Slevens, an IT guy who has booked over 300 appointments for New Jersey seniors, to learn the best tricks to compete in the vaccine-booking Hunger Games. Photo illustration: Emil Lendof for The Wall Street Journal

Institute President Klaus Cichutek defended the recommendation, saying his experts identified seven cases in Germany of cerebral vein thrombosis, a severe brain condition, and three of the people died. Germany’s healthcare ministry said that, based on the number of vaccinations given, it would have expected as many as 1.4 cases of cerebral vein thrombosis, and the seven cases merited a pause.

The EMA collected reports from across Europe, giving it a much larger data set to analyze.

Some EU countries, including Greece and Belgium, have continued using the vaccine, as have Australia, Canada and India.

The U.K., where AstraZeneca developed the vaccine with scientists from University of Oxford, is relying heavily on the vaccine for its relatively fast vaccination campaign. British politicians have criticized their EU counterparts for suspending the vaccine’s use against expert advice.

The AstraZeneca shot is the world’s most widely used Covid-19 vaccine.

Many medical experts in Europe and beyond criticized politicians’ decisions to halt vaccinations, saying the known risks posed by the coronavirus are greater than possible ones from AstraZeneca shots. German officials said their suspension was merited because they are urging citizens to take the vaccine, unlike other medications such as contraceptives, which are a personal choice.

European officials who paused vaccinations framed their decisions as precautionary. But based on available data and Covid-19 risks, “The cautionary approach would be to carry on vaccinating,” said Prof. David Spiegelhalter, an expert on statistics and risk at the University of Cambridge. “Casting doubt—lasting doubt—on the safety of the vaccines is not a precautionary position.”

Covid-19 Vaccines

Write to Daniel Michaels at daniel.michaels@wsj.com

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