Here We Go Again: Another Covid Case Brings More Uncertainty

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I’ve spent the past 24 hours jumping at phone alerts and periodically Googling “NSW covid” and “Victoria border restrictions.”

I’m in Sydney for the week and was planning to stay until Sunday. But after the discovery of a mystery coronavirus case in the community, I’m trying to work out whether I need to head back to Melbourne sooner to get ahead of a possible border closure.

It’s not a life-or-death decision, but I’m loath to give up the weekend I was supposed to spend with my parents (the guilt trip I’ll get for missing Mother’s Day will be subtle but significant). However, I’ve got work commitments in Melbourne next week that I can’t miss.

There are no clear metrics for when and how states decide to enforce border restrictions. As the authorities keep stressing, every outbreak is assessed on a case-by-case basis.

I do the calculations in my head: New South Wales recorded no new infections on Friday. Queensland and Western Australia have only enacted border measures for New South Wales travelers who’ve visited hot spots. All of the mystery case’s close contacts have tested negative, sans one.

But on the other hand, the list of exposure sites keeps growing. We still haven’t found the missing link between the infected man and the originating case in hotel quarantine. New Zealand has paused the trans-Tasman bubble with New South Wales for 48 hours.

If there’s an announcement, will I have enough time to book a flight? Will there still be flights left to book?

It adds up to a whole lot of uncertainty. And following closely on its heels, annoyance.

This is a regular occurrence by now. The coronavirus escapes hotel quarantine, the state locks down or puts restrictions in place, and other states enforce border restrictions. Travelers scramble, and businesses bemoan the hit to their profits.

There are some differences this time. Unlike the Perth outbreak two weeks ago, most states haven’t enacted hard border closures with New South Wales. But for the most part, it feels like we’re having the same conversations again and again without gaining much ground. How do we stop coronavirus from leaking out of hotel quarantine? Is the virus airborne? Do we need purpose-built facilities? Are state borders closures an overreaction?

These outbreaks should be getting less significant as more Australians get vaccinated. But that is also a slow and ungainly process, according to experts, in part because we’ve gotten complacent. We’ve dealt so well with the virus that there’s no urgency about inoculating the population.

Some people I’ve spoken to who became eligible for the vaccine this week as part of phase 2A have expressed exactly that sentiment: We might as well wait a bit longer, just in case. It won’t make a big difference to us, here, either way.

Some days, it feels like the pandemic, at least in Australia, is a thing of the past. In Melbourne, I’d noticed more and more people forgoing their mandated masks on public transport. Even I’ve been getting slack about checking in at venues. But the past few days have been another reminder that things we used to take for granted, like free movement between states, still aren’t guaranteed.

Now for this week’s stories:

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Biden’s new flexible vaccination strategy could help underserved communities, experts say.

Public health experts are praising President Biden’s announcement that his administration would create a federal stockpile of coronavirus vaccine doses and invest millions in community outreach, saying the moves would help immunize underserved communities and ensure doses would go where they’re most needed as demand falls.

Until now, vaccines had been allotted to states strictly on the basis of population, despite reports of wasted doses and pleas for more of them where the virus was surging, as in Michigan just weeks ago. In a reversal, the Biden administration is now trying to match supply with demand. Federal officials informed states on Tuesday that if they did not order their full allocation of doses in a given week, that vaccine would be considered part of a federal pool, available to other states that wanted to order more.

The administration had been unwilling to shift doses to states that were faster to administer them out of a concern that low-income communities would lose out to richer areas where residents were more willing to get shots.

the new coronavirus strategy that Mr. Biden announced on Tuesday at the White House: Pharmacies are to allow people to walk in for shots, and pop-up and mobile clinics will distribute vaccines, especially in rural areas. Federal officials also plan to enlist the help of family doctors and other emissaries who are trusted voices in their communities.

“We’ve got the product and we’ve vaccinated the very high-risk people, elderly people in nursing homes, people with diseases,” said Dr. Robert Murphy, executive director of Northwestern University’s Institute for Global Health. “Now we have to get the healthy ones and the younger ones and the ones that are being referred to as vaccine-hesitant.”

Allowing walk-ins at pharmacies would cut down on waste, he said, and funding for community outreach through trusted institutions like churches and schools could help reach people who are reluctant. That could offset the misinformation that has complicated efforts to vaccinate Black and Hispanic residents, who also face obstacles like language and technology barriers and less access to medical facilities.

Dr. Eric Topol, a professor of molecular medicine at Scripps Research in La Jolla, Calif., said he was “overjoyed” by the announcement. Dr. Topol pushed for loosening vaccine allocation limits last month, when Michigan was hit with a virus surge and unsuccessfully sought a boost in supply.

more than 106 million people in the United States were fully vaccinated and more than 56 percent of adults — or almost 148 million people — had received at least one shot. That has contributed to a steep decline in cases, hospitalizations and deaths across all age groups, federal officials said.

But despite a flood of available doses, the pace of vaccination has fallen considerably over the past two and a half weeks. Providers are now administering an average of about 2.19 million doses per day, about a 35 percent decrease from the peak of 3.38 million reported on April 13, according to data from the Centers for Disease Control and Prevention.

Officials across the country say they believe that despite falling demand, a substantial portion of Americans will get vaccinated if given more support and more information from trusted messengers, like personal doctors.

“We need to be in the community, asking the community what works for them and keeping that presence,” said Dr. Karen Landers, Alabama’s assistant state health officer. She added: “We are not giving up.”

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Years of Unheeded Warnings. Then the Subway Crash Mexico City Had Feared.

MEXICO CITY — The capital had been bracing for the disaster for years.

Ever since it opened nearly a decade ago, the newest Mexico City subway line — a heralded expansion of the second largest subway system in the Americas — had been plagued with structural weaknesses that led engineers to warn of potential accidents. Yet other than a brief, partial shutdown of the line in 2014, the warnings went unheeded by successive governments.

On Monday night, the mounting problems turned fatal: A subway train on the Golden Line plunged about 50 feet after an overpass collapsed underneath it, killing at least 24 people and injuring dozens more.

The accident — and the government’s failure to act sooner to fix known problems with the line — immediately set off a political firestorm for three of the most powerful people in Mexico: the president and the two people widely believed to be front-runners to succeed him as leaders of the governing party and possibly, the country.

told reporters through sobs. “I can’t find him anywhere.”

Hours later, her 13-year-old son, Brandon Giovani Hernández Tapia, was still missing.

told reporters gathered at the crash site on Tuesday. “The metro wasn’t built on its own — this flaw has been there for a long time and no one did anything.”

A total of 79 injured people had been taken to hospitals, three of whom later died, according to Claudia Sheinbaum, the mayor of Mexico City. Among those hospitalized were three minors.

Mexico City’s water problems and its subway system, a key mode of transportation for the sprawling capital’s population of nearly 22 million.

In the aftermath of Monday’s disaster, two of Mr. López Obrador’s closest allies came under immediate scrutiny: Ms. Sheinbaum, the capital’s mayor, and Marcelo Ebrard, the foreign minister who was mayor when the new subway line opened. Both are presumed to be top contenders to run for the presidency when Mr. López Obrador, limited to one term, steps down in 2024.

The new line, which serves the working-class neighborhoods in the capital’s southeast, was built by Mr. Ebrard, who was mayor of Mexico from 2006 to 2012. He was accused by critics of rushing to finish construction before his term concluded in an effort to bolster his political legacy. Troubles emerged immediately.

In just the first month after the line was inaugurated, there were 60 mechanical failures on trains or on tracks, according to local media. Trains had to slow down over elevated stretches of track, because engineers feared derailments. About a year later, the city was forced to temporarily shut down part of the $2 billion line for repairs.

transport authorities reported “a structural fault” in one of the metro line’s supporting columns, which had affected its ability to support heavy weight.

In 2018, senators from the opposition Institutional Revolutionary Party called for Mexico City authorities to inform Congress about irregularities in the funding of the subway line’s expansion. In an official party document, the opposition lawmakers called the Golden Line a “symbol of corruption and the misuse of public resources that prevailed during that administration.”

The lawmakers cited a congressional inquiry into the faulty line which found that “the modifications to the basic engineering, to the original layout with the change of underground stations to elevated stations, severely affected the technical operating conditions” of the subway line.

Residents living near the scene of the accident said government workers had fixed the column shortly after the earthquake. But they expressed doubt about the quality of the reconstruction, after seeing how many shutdowns and maintenance issues the line had over the years.

Hernando Manon, 42, was walking home from work Monday night when he felt a tremor and heard a loud crash a few hundred yards up the street.

“There was a rumbling and then sparks. The lights went out, and we didn’t know what happened. Then we heard the sirens,” Mr. Manon said, standing just a few hundred yards from the site of the accident. “As we approached, we realized that the subway had collapsed.”

Families rushed to the scene, he said, hoping to find their loved ones and yelling at the police demanding to be let through the cordon they had erected around the wreckage.

2018-2030 Master Plan for the subway system detailed major backlogs to the maintenance of tracks and trains and warned that trains could be derailed on the Golden Line unless major repairs were undertaken. It is unclear whether those needed repairs were ever carried out.

Since becoming mayor of the capital in 2018, Ms. Sheinbaum, who is closely aligned with the president’s pursuit of austerity, has presided over cuts to spending on the subway system.

For a year, the city did not appoint a director of infrastructure maintenance for the subway system. Ms. Sheinbaum only filled the role last week.

two subway trains collided in Mexico City. Then in January, a fire ripped through the subway’s headquarters in downtown Mexico City, killing a police officer and sending 30 others to hospital.

At a news conference on Tuesday, both Ms. Sheinbaum and Mr. Ebrard faced harsh questioning from reporters. Publicly, at least, the two political heavyweights presented a united front.

“We are in agreement to get to the bottom of this and work together to find the truth and know what caused this incident,” Ms. Sheinbaum said.

“If you have nothing to hide, you have nothing to fear,” Mr. Ebrard said. “Like anyone else, I am subject to whatever the authorities determine, but even more so as a high-level official, as someone who promoted the construction of the line.”

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Why Are There Oxygen Shortages for Covid Patients?

The latest horror of the pandemic is that large numbers of people around the world are dying for lack of access to medical oxygen, especially in India. Each day, tens of thousands of people are admitted to hospitals with Covid-19, driving the demand for the oxygen far beyond the supply.

Oxygen makes up 21 percent of the atmosphere. A handful of companies capture and purify it in bulk, but they sell most of it to industry. Many poorer parts of the world lack the infrastructure needed to deliver or make use of the medical grade supplies those companies sell, which are designed to be delivered via pipes to hospital rooms.

Some hospitals and clinics have machines that produce purified oxygen at a much smaller scale, but they are in short supply. So many hospitals and patients in poor countries and in remote areas rely on the most expensive option: oxygen tanks that have became scarce in the countries hit hardest by the virus.

The shortages affect patients with every kind of respiratory ailment requiring oxygen, not just those with Covid.

northern Brazil, Mexico and elsewhere, that it became clear that what had been seen as a potential problem was becoming a dire emergency. The World Health Organization created an emergency task force on the oxygen shortage and called for money to address it.

the pandemic surged in India, where it had been relatively contained, pushing oxygen supplies to the center of the world’s attention. India’s official count of new coronavirus infections leapt from an average of about 11,000 a day in mid-February to a daily average of more than 370,000 in the past week — and experts say the true figure is far higher.

In the last two months, the unmet, global need for medical oxygen has more than tripled, from less than 9 million cubic meters a day to more than 28 million, according to a coalition of aid groups that are tracking the crisis.

About half of that unmet need is in India. And health advocates warn that the calamity there could be repeated in other countries.

ramping up their production of medical gas by diverting some from industry, whose gas has somewhat different requirements.

India’s government has ordered the producers there to temporarily direct all of their oxygen output to medical needs.

military transport planes to get oxygen to the sick.

If enough money were available, governments and international groups could have advance-purchase agreements with bulk suppliers, and emergency stores of oxygen could be stationed in various parts of the world and deployed as needed.

If nothing else, the last few months have made clear the difficulty of trying to increase oxygen supplies on short notice, amid a crisis.

Instead, Mr. Matiru said, the world should invest in preparation, “so that if there’s a surge we can press ‘Go.’”

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Traveling to Greece? What to Know About the Reopening

Most Greeks — who have endured months of lockdown — would agree with that sentiment, said Ms. Nakou, the analyst. “I think there is little alternative, to be honest, given the importance of the sector in the economy,” she said.

But Ms. Nakou noted that Covid case numbers rose after the country’s opening to tourists last summer, and that many Greeks associated the arrival of visitors with an increase in the circulation of the virus. She noted that in a survey conducted among Greeks last fall, tourism was the most commonly cited factor in causing the second wave, ahead of people flouting lockdown rules, as well as congestion in public transport or in restaurants.

“I think that is at the back of a lot of people’s minds locally,” said Ms. Nakou. “They’re pleased to see the economy reopening; they’re also quite worried about this.”

In terms of daily new infections, Greece’s worst moment of the pandemic came in early April of this year, when the country was averaging more than 3,000 cases per day; intensive care admissions reached their peak about two weeks later. On a per-capita basis, Greece’s experience pales in comparison to the worst moments of the pandemic in the United States, Britain, France or Italy, but because Greece’s medical system has suffered from years of underfunding, it is particularly vulnerable to strain. The country’s intensive care units were 87 percent full as of April 21, even as lockdown measures were due to be peeled away.

At the same time, vaccination is picking up. Just over 20 percent of the country’s population had received at least one dose of vaccine by the end of April. The coverage is much higher in some of the Greek islands, which were targeted early in the country’s vaccination campaign in part because of their geographical isolation and limited medical facilities. But local leaders also hope that the image of heavily vaccinated, “Covid-free islands” will help to lure tourists back.

“It’s a very important step that guarantees the launch of the tourist season and sends a message of optimism,” Efi Liarou, the mayor of the island Elafonisos, told Agence-France Presse last month.

However many people end up traveling to Greece this summer, it’s clear that this year’s peak tourist season will be unlike any other.

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Day 1 of the End of the U.S. War in Afghanistan

KANDAHAR AIRFIELD, Afghanistan — On the morning of May 1, an Afghan transport aircraft landed at this sprawling military base in the country’s south. It was loaded with mortar shells, small-arms cartridges and 250-pound bombs to supply Afghan troops under frequent attack by the Taliban in the countryside.

Later, at midnight, a gray American C-130 transport aircraft taxied down the same runway, marking the end of the first official day of the U.S. military’s withdrawal from Afghanistan. The cargo plane was filled with munitions, a giant flat screen television from a C.I.A. base (known as Camp Gecko), pallets of equipment, and — in the real signal of the impending end of a long occupation — departing American troops. It was one of several aircraft that night removing what remained of the American war here.

Afghans continue fighting and dying with fleeting hopes of peace even while the Americans leave, adhering to a timeline laid out by President Biden to fully withdraw by Sept 11. The decision was opposed by his generals but begrudgingly stenciled on whiteboards in U.S. bases across Afghanistan, such as Kandahar Airfield, a former Soviet base that has been one of the Americans’ largest.

NATO troops were based here, and many more passed through as it became the main installation for the U.S.-led war in Afghanistan’s south. It stood beside rural villages from which the Taliban emerged; throughout it all, the province has remained an insurgent stronghold.

Now, half-demolished outdoor gyms and empty hangars were filled with nearly 20 years’ worth of matériel. The passenger terminal, where troops once transited between different parts of the war, was pitch black and filled with empty, dust-covered chairs. A fire alarm detector — its batteries weak — chirped incessantly. The mess halls were shuttered.

The boardwalk was nothing more than a few remaining boards.

The American withdrawal, almost quiet, and with a veneer of orderliness, belies the desperate circumstances just beyond the base’s wall. On one end of Kandahar Airfield that day, Maj. Mohammed Bashir Zahid, an officer in charge of a small Afghan air command center, sat in his office, a phone to each ear and a third in his hands as he typed messages on WhatsApp, trying to get air support for Afghan security forces on the ground and in nearby outposts threatened by Taliban fighters.

flight of F/A-18 fighter jets, stationed aboard the U.S.S. Eisenhower, a nuclear-powered aircraft carrier, were in the air, making their way toward Afghanistan from the Arabian Sea — a roughly two-hour flight up what is called “the boulevard,” a corridor of airspace in western Pakistan that serves as an air transit route.

Having received approval to strike, the jets swooped in, dropping a GPS-guided munition — a bomb that costs well over $10,000 — on the additional rockets that were somewhere in Kandahar, mounted on rudimentary rails and aimed at the airfield.

Inside the American headquarters building at the airfield, two Green Berets — part of the shrinking contingent who work there now — pulled up the video of the afternoon airstrike on one of their phones.

“Make sure that goes in the nightly brief,” one of them said. The Special Forces soldiers, bearded and clad in T-shirts, ball caps and tattoos, looked out of place among what was left of the cubicles and office furniture around them, much of which was being torn apart.

Televisions had been removed from walls, office printers sat on the curb, the insignia once plastered on the stone wall that heralded who was in charge of the headquarters, long gone. Even though there would soon be fewer and fewer service members around each day, one soldier noted that the flow of care packages from random Americans had not slowed down. He now possessed what seemed like an infinite supply of Pop-Tarts.

A group of American soldiers, tasked with loading an incoming cargo flight didn’t know when they were going home. Tomorrow? Sept. 11? Their job was to close Kandahar before moving on to the next U.S. base, but there were only so many installations left to dismantle. A trio of them played Nintendo while they waited. One talked about the dirt bike he was going to buy when he got home. Another traded cryptocurrency on his iPhone.

When asked about Maiwand, a district only about 50 miles away where Afghan forces were trying to fend off a Taliban offensive and Major Zahid was desperately trying to send air support, a U.S. soldier responded, “Who’s Maiwand?”

In the evening, the base loudspeaker chimed as one of the transport planes departed. “Attention,” someone out of view said. “There will be outgoing for the next 15 minutes.” The dull thud of mortar fire began. At what was unclear.

The end of the war looked nothing like the beginning of it. What started as an operation to topple the Taliban and kill the terrorists responsible for the attacks on Sept. 11, 2001, had swelled over 20 years into a multitrillion-dollar military-industrial undertaking, infused with so much money that for years it seemed impossible to ever conclude or dismantle.

Until now.

The Taliban’s often-repeated adage loomed over the day: “You have the watches, we have the time.”

In one of the many trash bags littering the base, there was a discarded wall clock, its second hand still ticking.

Najim Rahim and Jim Huylebroek contributed reporting.

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The chief medical officer at a Mumbai hospital, honored for her work to fight Covid, died with the disease.

Dr. Manisha Jadhav, the chief medical officer at the Group of Tuberculosis Hospitals in Mumbai, died on April 19 in a hospital in that city. She was 51. The cause was complications of Covid-19, her husband said.

Her job involved managing the hospital’s staff and handling its operations. When the pandemic hit Mumbai in March 2020, she quickly organized personal protective equipment for the hospital’s workers amid a severe shortage, ensured that they had food and made travel arrangements for the staff when public transport was suspended during the lockdown.

She was one of 13 doctors honored for their efforts by the governor of Maharashtra State in December.

“Doctors are like soldiers,” she would say. “They can’t be unavailable.”

Manisha Ramugade was born in Mumbai on May 11, 1969, to Ram and Ratan Ramugade. Her father was a postal worker, her mother a homemaker. She was the youngest of four siblings.

“As a kid, she would tell us that she wanted to become a doctor, and joke about giving injections,” her sister Sunita said.

Along with her husband and her sister Sunita, Dr. Jadhav is survived by her son, Darshan, a medical student in Ukraine, and another sister, Anita. Her brother, Ravi, died last year.

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Australia prioritizes Olympic-bound athletes for vaccines.

Australia will fast-track vaccinations for athletes and support staff attending the Tokyo Olympics and Paralympics, the government said on Tuesday.

The contingent of about 2,000 will be eligible to be vaccinated in the country’s second-highest priority group, at the same time as people age 70 and older, emergency workers and people with existing medical conditions and disabilities.

Amid the country’s sluggish vaccine rollout, the announcement prompted some backlash. Critics took issue with athletes receiving preferential treatment when some high-priority workers and other vulnerable people are still waiting for vaccines.

To date, Australia has vaccinated only about 7 percent of its population, largely because of problems with supply and poor coordination between state and federal governments and clinics. Earlier this month, the rollout was hobbled further when the government stopped recommending the AstraZeneca vaccine, the only vaccine that the country is manufacturing domestically, for people under 50. Two weeks ago, the government dropped its initial goal to vaccinate the entire population by the end of the year.

said in a statement on Tuesday afternoon, “our athletes deserve the opportunity to compete.” He added that vulnerable Australians remained an “absolute priority” for the vaccine rollout.

The chief executive of the Australian Olympic Committee, Matt Carroll, responded in a statement. “There will be hundreds of very grateful athletes, coaches and their families relieved to know that their hard work over five years has been worth it,” he said. “This added layer of assurance is what they were seeking.”

On Wednesday, Mr. Carroll told reporters that the committee had engaged a private contractor to conduct the vaccinations, meaning, “there’s no load on the public system whatsoever.”

The rollout to the athletes and support staff is expected to begin next week, he added, noting that they would receive either the Pfizer vaccine, for athletes under 50, or the AstraZeneca vaccine.

In other updates from around the world:

  • In the coming weeks, officials in Britain will announce a plan to allow people to travel to select countries without having to quarantine upon returning. The plan involves the use of a National Health Service app to verify that travelers have received a Covid-19 vaccination or recently tested negative, Grant Shapps, the country’s transport secretary, told Sky News. Civil society groups have raised concerns about vaccination passports, saying that they could invade privacy or disadvantage certain marginalized communities.

  • Andalusia, a region in southern Spain, said it would reopen travel across its eight provinces starting midnight on Wednesday, part of a national plan to ease restrictions. The vaccine rollout in Spain has accelerated in recent weeks, with 23 percent of the population having had at least one shot. The medical authorities in Seville, the capital of Andalusia, on Wednesday began offering the one-dose Johnson & Johnson vaccine.

  • An aunt of Prime Minister Narendra Modi of India died after contracting the coronavirus in the western Indian state of Gujarat. Narmadaben Modi, 80, was hospitalized after her condition deteriorated 10 days ago and she was taken to hospital, Prahlad Modi, Mr. Modi’s younger brother, told reporters. Gujarat is one of the Indian states where crematories are running overnight to handle the volume of dead bodies. Officials there are widely believed to be undercounting the actual number of deaths.

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