SYDNEY, Australia — All across the Asia-Pacific region, the countries that led the world in containing the coronavirus are now languishing in the race to put it behind them.
While the United States, which has suffered far more grievous outbreaks, is now filling stadiums with vaccinated fans and cramming airplanes with summer vacationers, the pandemic champions of the East are still stuck in a cycle of uncertainty, restrictions and isolation.
In southern China, the spread of the Delta variant led to a sudden lockdown in Guangzhou, a major industrial capital. Taiwan, Vietnam, Thailand and Australia have also clamped down after recent outbreaks, while Japan is dealing with its own weariness from a fourth round of infections, spiked with fears of viral disaster from the Olympics.
the new outbreak in southern China will affect busy port terminals there. Across Asia, faltering vaccine rollouts could also open the door to spiraling variant-fueled lockdowns that inflict new damage on economies, push out political leaders and alter power dynamics between nations.
The risks are rooted in decisions made months ago, before the pandemic had inflicted the worst of its carnage.
blocked the export of 250,000 doses of the AstraZeneca vaccine meant for Australia to control its own raging outbreak. Other shipments were delayed because of manufacturing issues.
“The supplies of purchased vaccine actually landing on docks — it’s fair to say they are not anywhere near the purchase commitments,” said Richard Maude, a senior fellow at the Asia Society Policy Institute in Australia.
with the United States and Europe.
In Asia, about 20 percent of people have received at least one dose of a vaccine, with Japan, for example, at just 14 percent. By contrast, the figure is nearly 45 percent in France, more than 50 percent in the United States and more than 60 percent in Britain.
Instagram, where Americans once scolded Hollywood stars for enjoying mask-free life in zero-Covid Australia, is now studded with images of grinning New Yorkers hugging just-vaccinated friends. While snapshots from Paris show smiling diners at cafes that are wooing summer tourists, in Seoul, people are obsessively refreshing apps that locate leftover doses, usually finding nothing.
“Does the leftover vaccine exist?” one Twitter user recently asked. “Or has it disappeared in 0.001 seconds because it is like a ticket for the front-row seat of a K-pop idol concert?”
keep its borders closed for another year. Japan is currently barring almost all nonresidents from entering the country, and intense scrutiny of overseas arrivals in China has left multinational businesses without key workers.
The immediate future for many places in Asia seems likely to be defined by frantic optimization.
China’s response to the outbreak in Guangzhou — testing millions of people in days, shutting down entire neighborhoods — is a rapid-fire reprise of how it has handled previous flare-ups. Few inside the country expect this approach to change anytime soon, especially as the Delta variant, which has devastated India, is now beginning to circulate.
has threatened residents with fines of around $450 for refusing vaccines. Vietnam has responded to its recent spike in infections by asking the public for donations to a Covid-19 vaccine fund. And in Hong Kong, officials and business leaders are offering a range of inducements to ease severe vaccine hesitancy.
Nonetheless, the prognosis for much of Asia this year is billboard obvious: The disease is not defeated, and won’t be anytime soon. Even those lucky enough to get a vaccine often leave with mixed emotions.
“This is the way out of the pandemic,” said Kate Tebbutt, 41, a lawyer who last week had just received her first shot of the Pfizer vaccine at the Royal Exhibition Building near Melbourne’s central business district. “I think we should be further ahead than where we are.”
Reporting was contributed by Raymond Zhong in Taipei, Taiwan, Ben Dooley in Tokyo, Sui-Lee Wee in Singapore, Youmi Kim in Seoul and Yan Zhuang in Melbourne, Australia.
LONDON — Over Memorial Day weekend, 135,000 people jammed the oval at the Indianapolis 500. Restaurants across the United States were thronged with customers as mask mandates were being discarded.
The formula, which gained the Biden administration’s blessing, was succinct: In essence, if you are fully vaccinated, you can do as you please.
But while the United States appears to be trying to close the curtain on the pandemic, across the ocean, in Britain and the European Union, it is quite a different story.
Despite plunging infection levels and a surging vaccine program, parts of Europe are maintaining limits on gatherings, reimposing curbs on travel and weighing local lockdowns.
Wellcome Sanger Institute, said of Delta. “It just means we have less certainty about what things will look like going forward.”
estimated on Friday that the Delta variant was roughly 60 percent more contagious than the earlier one from Britain. Health officials also warned that cases caused by the Delta variant might lead to a higher risk of hospitalization, though it was too early to say for certain.
The divergent strategies of European nations and the United States also reflect broader differences in how Western governments are thinking about their responsibility to unvaccinated people, scientists said.
in unvaccinated pockets of the United States, where the virus continues to sicken and kill people at elevated rates. The Biden administration is still searching for ways to overcome that vaccine hesitancy.
In Britain, even with more than 90 percent of people over 65 having been fully vaccinated, health officials have resisted as speedy a reopening as they seek to expand inoculation rates in lower-income and nonwhite areas.
“We know the virus predominantly hits poorer communities and people of color hardest,” said James Naismith, a structural biologist and the director of Britain’s Rosalind Franklin Institute, a medical research center. “The U.S. strategy perhaps reflects a more deep-rooted commitment to individualism. The U.K.’s vaccination campaign is highly managed and mirrors more a sense of being our brother’s keeper.”
Britain decided last year to delay second vaccine doses to give more people the partial protection of a single dose. That helped it weather the wintertime surge but also left it potentially exposed to the Delta variant. Health officials said this past week that there was strong evidence of “a reduction in vaccine effectiveness” for the new variant that was most pronounced after a single dose.
Health officials have since changed the guidance to speed up second doses, but many scientists are urging the government not to commit to reopening until the impact of the variant becomes clearer.
76 percent overall have gotten one shot. As a result, some scientists say, upticks in new infections are tolerable so long as the vast majority do not lead to serious illness or death.
“This variant is going to find it hard to spread, because it’s limited to younger people and limited to certain parts of the country,” Professor Spector said.
He said the government needed to help the neighborhoods where it was spreading and, beyond that, encourage people to keep working from home and socially distancing when possible. But delaying the easing of restrictions, he said, was not necessary.
“We need to get used to the idea there will be a few thousand cases every day and that this is a part of our life,” Professor Spector said. “Those cases will be milder.”
Germany, France and Austria all moved quickly to bar most visitors from Britain.
Like Britain, the bloc was chastened by a surge of the variant from Britain this winter that contributed to one of the world’s highest death tolls. Governments were hammered for failing to cement the gains of last summer, when lockdowns were lifted across most of Europe.
In the bloc, 47 percent of the adult population has received a first dose, according to the European Center for Disease Prevention and Control, but only 23 percent have full protection.
For those reasons, European leaders have said that vigilance is needed, even though infections have fallen about 80 percent since mid-April.
“This progress is fragile,” Hans Kluge, the World Health Organization’s director in Europe, warned last month. “We have been here before. Let us not make the same mistakes that were made this time last year.”
Still, now that supply bottlenecks have eased, European officials are confident that 70 percent of adults will be fully vaccinated by July.
The quandary that Europe faces over how to react to the Delta variant may recur as the virus continues to evolve, some scientists said. As long as it remains in wide circulation, even more transmissible variants could emerge, forcing countries to grapple with whether to hunker down yet again or risk the virus spreading through unprotected populations.
Poorer nations are facing far more difficult choices, though. If the same sort of lockdowns that controlled the variant from Britain prove insufficient against this new one, those countries could have to choose between even more draconian and economically damaging shutdowns or even more devastating outbreaks. The Delta variant has already taken a horrifying toll on South Asia.
“Globally, it’s a nightmare, because most of the world is still not vaccinated,” said Jeremy Kamil, a virologist at Louisiana State University Health Shreveport. “It raises the stakes.”
“Retailers were asking and requiring you to wear masks,” said Willy Solis, a shopper for the delivery app Shipt in Denton, Texas, who works in stores like Target, Kroger and CVS. “A large majority of people were still doing the right thing and wearing them.”
Since the C.D.C. announcement, however, “it’s been a complete shift,” Mr. Solis said. Denton, like Yorktown, sits in a county that supported former President Donald J. Trump by a single-digit margin in the November election.
According to the Kaiser Family Foundation, 97 percent of Democrats said in a March poll that they wore a mask “at least most of the time” when they might be in contact with people outside their homes, and a similar portion of Democrats said they believed masks limit the spread of coronavirus.
That compared with only 71 percent of Republicans who said they wore a mask outside the home at least most of the time, and just half said they thought masks were effective.
That suggests that a significant number of Republicans have worn masks only to comply with rules, not because they believed it was important, said Ashley Kirzinger, the Kaiser foundation’s associate director for public opinion and survey research. She cited polling showing that Republicans were also less likely to be vaccinated.
Matt Kennon, a room-service server at the Beau Rivage Resort and Casino in Biloxi, Miss., said that before the C.D.C. relaxed its recommendations, the resort’s policy was that all guests must wear masks in common areas unless they were eating, drinking or smoking, and that it was strictly enforced.
“There were several security checkpoints around the place where we’d have someone from security let them know, ‘Please put on a mask,’” said Mr. Kennon, a shop steward with his union, UNITE HERE. “There were stations with disposable masks for guests to wear in case they didn’t have one.”
Immunity to the coronavirus lasts at least a year, possibly a lifetime, improving over time especially after vaccination, according to two new studies. The findings may help put to rest lingering fears that protection against the virus will be short-lived.
Together, the studies suggest that most people who have recovered from Covid-19 and who were later immunized will not need boosters. Vaccinated people who were never infected most likely will need the shots, however, as will a minority who were infected but did not produce a robust immune response.
Both reports looked at people who had been exposed to the coronavirus about a year earlier. Cells that retain a memory of the virus persist in the bone marrow and may churn out antibodies whenever needed, according to one of the studies, published on Monday in the journal Nature.
The other study, which is also under review for publication in Nature, found that these so-called memory B cells continue to mature and strengthen for at least 12 months after the initial infection.
Some scientists have interpreted this decrease as a sign of waning immunity, but it is exactly what’s expected, other experts said. If blood contained high quantities of antibodies to every pathogen the body had ever encountered, it would quickly transform into a thick sludge.
Instead, blood levels of antibodies fall sharply following acute infection, while memory B cells remain quiescent in the bone marrow, ready to take action when needed.
landmark study in 2007 showed that antibodies in theory could survive decades, perhaps even well beyond the average life span, hinting at the long-term presence of memory B cells. But the new study offered a rare proof of their existence, Dr. Gommerman said.
Dr. Nussenzweig’s team looked at how memory B cells mature over time. The researchers analyzed blood from 63 people who had recovered from Covid-19 about a year earlier. The vast majority of the participants had mild symptoms, and 26 had also received at least one dose of either the Moderna or the Pfizer-BioNTech vaccine.
So-called neutralizing antibodies, needed to prevent reinfection with the virus, remained unchanged between six and 12 months, while related but less important antibodies slowly disappeared, the team found.
confirming results from other studies; the shots also ramped up the body’s neutralizing ability by about 50-fold.
Senator Rand Paul, Republican of Kentucky, said on Sunday that he would not get a coronavirus vaccine because he had been infected in March of last year and was therefore immune.
But there is no guarantee that such immunity will be powerful enough to protect him for years, particularly given the emergence of variants of the coronavirus that can partially sidestep the body’s defenses.
The results of Dr. Nussenzweig’s study suggest that people who have recovered from Covid-19 and who have later been vaccinated will continue to have extremely high levels of protection against emerging variants, even without receiving a vaccine booster down the line.
“It kind of looks exactly like what we would hope a good memory B cell response would look like,” said Marion Pepper, an immunologist at the University of Washington in Seattle who was not involved in the new research.
The experts all agreed that immunity is likely to play out very differently in people who have never had Covid-19. Fighting a live virus is different from responding to a single viral protein introduced by a vaccine. And in those who had Covid-19, the initial immune response had time to mature over six to 12 months before being challenged by the vaccine.
“Those kinetics are different than someone who got immunized and then gets immunized again three weeks later,” Dr. Pepper said. “That’s not to say that they might not have as broad a response, but it could be very different.”
William Shakespeare, the man with a famous name who inspired headline writers across Britain last year when he became the second person in the country to receive a coronavirus vaccine, has died after suffering a stroke, his family said in a statement. He was 81.
Since Mr. Shakespeare was vaccinated on Dec. 8 at University Hospital, Coventry, in central England, 57 percent of Britain’s population has received at least one dose of a coronavirus vaccine, one of the highest vaccination rates in the world.
On Tuesday, people older than 30 in Britain became eligible to receive a vaccine.
In a statement released through the hospital where Mr. Shakespeare was vaccinated, his wife of 53 years, Joy, said he had been grateful for becoming one of the first people to be vaccinated against the coronavirus.
“It was something he was hugely proud of,” she said. “He loved seeing the media coverage and the positive difference he was able to make to the lives of so many.”
Margaret Keenan, then 90, became the first person in Britain to be vaccinated and the first in the world to receive a clinically authorized, fully tested coronavirus vaccine.
Their vaccinations brought a sense of optimism to Britain: “If I can have it at 90 then you can have it, too!” Ms. Keenan said at the time.
At least 127,000 people have died of the coronavirus in Britain, according to a New York Times database, the world’s fifth-highest known death toll.
used as a vaccination center this spring.
The family of the modern Mr. Shakespeare said he would be remembered for much more than sharing a name with one of England’s most famous historical figures. He was an amateur photographer and jazz aficionado, a parish councilor and an official at local schools for more than two decades.
A local councilor and friend of Mr. Shakespeare’s, Jayne Innes, said on Twitter, “Bill will be remembered for many things, including a taste for mischief.”
“Bill loved meeting people and helping them in any way possible,” Ms. Shakespeare said. “Most of all he was a wonderful husband, father and grandfather.”
LONDON — A new and potentially more contagious variant of the coronavirus has begun to outpace other versions of the virus in Britain, putting pressure on the government to shorten people’s wait for second doses of vaccines and illustrating the risks of a faltering global immunization drive.
The new variant, which has become dominant in India since first being detected there in December, may be responsible in part for a grievous wave of infections across Southeast Asia, including Nepal, where people have been dying in hospital corridors and courtyards. But efforts to understand the variant picked up once it began spreading in Britain, one of at least 49 countries where it is present. Scientists there are sequencing half of all coronavirus cases amid a push to complete the reopening of its economy.
The preliminary results out of Britain, drawn from only a few thousand cases of the variant, contained both good and bad news, scientists said.
The variant, known by evolutionary biologists as B.1.617.2, is “highly likely” to be more transmissible than the variant behind Britain’s devastating wintertime surge, government scientists have said. That earlier variant, known as B.1.1.7, was itself considerably more contagious than the one that first emerged last year in Wuhan, China.
Public Health England report published this weekend provided signs that government scientists said were consistent with a more transmissible virus: The variant first seen in India was roughly 50 percent more likely than B.1.1.7 to be transmitted to the close contacts of an infected person. Government scientists said last week that it could be anywhere from a few percentage points to 50 percent more contagious than B.1.1.7.
Helpfully for Britain and other wealthy nations, the latest worrisome variant has emerged at a less dire moment of the pandemic. More than four out of every five people in England above the age of 65 — among the groups most vulnerable to the virus — have been given both doses of a coronavirus vaccine, driving down hospitalizations and deaths.
And a new study by Public Health England offered reassuring signs that fully vaccinated people were about as well protected from the variant first detected in India as they were from other forms of the coronavirus.
The Pfizer-BioNTech vaccine offered 88 percent protection against the variant first sampled in India, only a slight drop from the 93 percent protection given against the variant from Britain, Public Health England said. The AstraZeneca-Oxford vaccine was 60 percent effective against the variant from India, compared to 66 percent effective against the one first seen in Britain.
Other studies in England have shown little to no difference between the effectiveness of the Pfizer and AstraZeneca vaccines.
wrote on Twitter.
In Britain, part of its rapid growth may have to do with the particular places it was first introduced. Bolton, in northwest England, where the new variant is most advanced, is a highly deprived area with tightly packed housing that could be hastening its spread, scientists said.
“We do not know if the increase in transmissibility is the result of specific mixing patterns, or super-spreading events,” a group of researchers led by Robert Challen of the University of Exeter reported on May 11, in a study that was among those presented to an influential government advisory group.
That government advisory body said several days later that it had “high confidence” that the variant first seen in India was indeed more contagious, warning that a “substantial resurgence of hospitalizations” was possible. It said that the variant was gaining a foothold in diverse parts of Britain where “contact patterns or behaviors” alone could not explain its spread.
It is not clear if the variant from India is any deadlier than B.1.1.7.
With cases of B.1.1.7 falling, the variant first seen in India now accounts for roughly half of the sequenced coronavirus cases being monitored by Public Health England. The agency’s scientists have said it was likely to replace B.1.1.7 as England’s dominant virus within a month, a startling turnabout so soon after B.1.1.7 swept much of the world.
“For countries that are starting to struggle with B.1.1.7, they now know they have an even faster one close by,” said Devi Sridhar, a professor of global public health at the University of Edinburgh in Scotland.
experimenting with ways to encourage sick people to isolate.
Some scientists have urged the government to go further by dramatically closing the gap between doses of the Pfizer or Moderna vaccine, for instance, and rerouting those shots to cities hardest hit by the variant from India. Because the AstraZeneca vaccine appears most protective with a 12-week dosing interval, those scientists said, using it meant leaving people only partially vaccinated for a period of time.
At the very least, Professor Sridhar said, people needed to be reminded to remain cautious until they were fully vaccinated.
Prime Minister Boris Johnson’s plan to scrap almost all remaining lockdown restrictions on June 21 rests in large part, scientists said, on how many second doses Britain can administer in the coming weeks.
For many poorer nations, starved for vaccines, there is little choice but to leave long delays between first and second doses. Some of them are uncertain about when shipments of second doses will arrive. Large portions of those countries remain entirely unprotected.
If the variant from India spreads as quickly in other countries as it has in Britain, the burden on unvaccinated nations may grow.
“It’s a warning,” Professor Sridhar said. “What we’re seeing in India is being repeated in Nepal, it’s being repeated in other countries. You need to get ahead of it.”
Stephen Colbert’s late-night talk show will return to filming in front of a studio audience on June 14, CBS said on Monday.
About 400 audience members will be allowed in the Ed Sullivan Theater on Broadway in Manhattan, provided they can show proof of vaccination against the coronavirus, such as through the Excelsior Pass issued by New York State or an original physical vaccination card from the Centers for Disease Control and Prevention. There will be no capacity restrictions, and masks will be optional.
CBS said that staff and crew members will be tested for the virus before starting work and will be screened daily for symptoms, monitored by a Covid-19 compliance officer. The network said the plan comports with New York State guidelines.
The show’s changes will come just a few months before Broadway shows are expected to return, and about a month after baseball stadiums in New York began designating separate seating sections for people who have been vaccinated and those who have not.
relaxed the state’s capacity restrictions, allowing businesses to serve as many patrons as they like as long as there is enough space for people to adequately socially distance. He also ended the mask mandate for vaccinated people indoors and outdoors, though individual businesses are allowed to have stricter mask policies.
The pandemic put a stop to many late-night talk shows for a time in mid-March 2020, when New York and Los Angeles, where many of them are produced, introduced strict social distancing and quarantine guidelines.
Since then, the shows have had to get creative, interviewing guests by video conference and filming in empty studios or from the hosts’ homes, with family members sometimes serving on the crew.
When Mr. Colbert began doing his show from home, the first episode had him delivering the monologue from his bathtub. At the time, Mr. Colbert and the network changed the name from “The Late Show with Stephen Colbert” to “A Late Show with Stephen Colbert,” to reflect the show’s straitened circumstances. The name will return to normal once the audience returns.
impromptu reaction to the Jan. 6 Capitol assault.
During a recent interview on “Fresh Air,” Mr. Colbert said that working without an audience created challenges that only a crowd could ameliorate.
“I’m much more likely to mess up and have to retake something, lose the rhythm of a joke, or even just misread the prompter without an audience there, because there’s some vital performance adrenaline spark that’s missing that the audience provides,” Mr. Colbert said. “And so my wife and my kids have seen me absolutely shank monologues over and over again. And it’s very humbling for them to realize that I’m not that good at this.”
As the coronavirus pandemic ebbs in the United States and vaccines become available for teenagers, school systems are facing the difficult choice of whether to continue offering a remote learning option in the fall.
When Mayor Bill de Blasio of New York City took a stance on Monday, saying that the city will drop remote learning in its public schools, the move may have added to the pressure on other school systems to do the same.
Some families remain fearful of returning their children to classrooms, and others have become accustomed to new child care and work routines built around remote schooling, and are loath to make major changes.
But it is increasingly clear that school closures have exacted an academic and emotional toll on millions of American students, while preventing some parents from working outside the home.
no longer have the option of sending their children to school virtually in the fall. Illinois plans to strictly limit online learning to students who are not eligible for a vaccine and are under quarantine orders.
Connecticut has said it will not require districts to offer virtual learning next fall. Massachusetts has said that parents will be able to opt for remote participation only in limited circumstances.
In California, which lagged behind the rest of the nation in returning to in-person schooling this spring, Gov. Gavin Newsom said he would compel districts to offer traditional school in the fall, while also offering remote learning for families who want it. Some lawmakers there have proposed an alternative approach that would cap the number of students enrolled in virtual options.
It is a major staffing challenge for districts to simultaneously offer both traditional and online classes. Before the pandemic, teachers’ unions were typically harsh critics of virtual learning, which they called inherently inferior. But with some teachers still hesitant to return to full classrooms, even post-vaccination, many unions have said parents should continue to have the choice to opt out of in-person learning.
Some teachers, parent groups and civil rights organizations have also argued that families of color are the least confident that their children will be safe in school buildings, and thus should not be pushed to return before they are ready.
about one-third of American elementary and secondary students attend schools that are not yet offering five days a week of in-person learning. Those school districts are mainly in areas with more liberal state and local governments and powerful teachers’ unions.
Disputes among administrators, teachers and parents’ groups over when and how to reopen schools have led to messy, protracted public battles in cities like Chicago and Los Angeles.
Governors, mayors and school boards around the country almost all now say that traditional in-person teaching schedules will be available in the fall, but there is still limited clarity on what rights parents will have to decline to return their children to classrooms. Many districts and states have yet to announce what their approach will be.
Among urban districts, the superintendent in San Antonio, Pedro Martinez, has said he will greatly restrict access to remote learning next school year, in part because many teenagers from low-income families have taken on work hours that are incompatible with full-time learning, a trend he wants to tamp down. The Philadelphia and Houston schools have said they will continue offering virtual options.
The superintendent of the nation’s fourth-largest district, Miami-Dade, has said he hopes to welcome back “100 percent” of students to in-person learning in the fall, but that students will retain the option to enroll instead in an online academy that predates the pandemic.
NEW DELHI — Delhi is considering relaxing its Covid-19 restrictions six weeks after a devastating coronavirus surge rocked the Indian capital, with a pledge to ramp up vaccinations to protect the city’s more than 20 million people from another wave.
But the vow came after a weekend in which city officials were forced to close vaccination centers for lack of supply, a problem plaguing the entire country as the coronavirus continues to spread. India does not have the vaccine manufacturing capacity to inoculate a big portion of its population anytime soon, while the prospect of importing new supplies from abroad has bogged down amid squabbling between the central and local governments.
As a result, any decision to lift coronavirus restrictions could be a mistake if the government allows large maskless gatherings to take place as it did before.
“The only answer is vaccination,” said Dr. Anand Krishnan, a professor of community medicine at the All India Institute of Medical Sciences in New Delhi.
health ministry reported. While India’s total of 26.8 million infections still lags behind the United States, with more than 33 million, the U.S. government has rolled out a wide vaccination campaign that has sent new infections plummeting. Only about 3 percent of India’s population has received two doses.
Experts also widely caution that India’s official numbers severely undercount new infections and deaths because of a lack of testing and other resources in a vast, developing country of 1.4 billion people.
Officials across India face pressure to reopen their local economies. Factory workers and members of the country’s vast, informal work force of shopkeepers and countless others cannot work from home and are anxious to restart their lives.
local news media on Sunday that Moderna, the American vaccine maker, had rejected its purchase request, saying the company would sell only to national governments. The company did not immediately respond to an emailed request for comment.
State governments — particularly those controlled by political factions opposed to Mr. Modi’s Bharatiya Janata Party — have been clashing with the Modi administration over vaccines and other issues, saying the central government had left them to fend for themselves.
advance purchase agreements to buy vaccines in bulk. Experts have criticized Mr. Modi and his government for the delays.
Dr. Gagandeep Kang, one of the country’s top virologists, said in a video interview on Sunday that the country was “late to the table” in buying vaccines from the international market.
Instead of competing with the rest of the world, Dr. Kang suggested that the country should invest in ramping up production of other potential vaccine candidates from Indian manufacturers that are expected to have their doses ready by the end of the year.
“I think we’ll get more doses that way,” she said.
When India’s second coronavirus wave slammed the country last month, leaving many cities without enough doctors, nurses, hospital beds or lifesaving oxygen to cope, Sajeev V.B. got the help he needed.
Local health workers quarantined Mr. Sajeev, a 52-year-old mechanic, at home and connected him with a doctor over the phone. When he grew sicker, they mustered an ambulance that took him to a public hospital with an available bed. Oxygen was plentiful. He left 12 days later and was not billed for his treatment.
“I have no clue how the system works,” Mr. Sajeev said. “All that I did was to inform my local health worker when I tested positive. They took over everything from that point.”
has failed, in many ways, to provide relief for victims of the world’s worst coronavirus outbreak.
online networks, charities and volunteers has emerged in India to fill the gaps left by the stumbling response of the central government and many states. Patients around India have died for lack of oxygen in hospitals where beds filled up quickly.
Deaths are rising. Workers face long hours and tough conditions. The situation could still worsen as the outbreak spreads.
On paper, Kerala’s death rate, at less than 0.4 percent, is one of India’s lowest. But even local officials acknowledge that the government’s data is lacking. Dr. Arun N.M., a physician who monitors the numbers, estimates that Kerala is catching only one in five deaths.
A relatively prosperous state of 35 million, Kerala presents particular challenges. Over 6 percent of its population works abroad, mostly in the Middle East. Extensive travel forces local officials to carefully track people’s whereabouts when a disease breaks out.
tackling a 2018 outbreak of the Nipah virus, a rare and dangerous disease.
As borders closed last year and migrant workers came home, the state’s disaster management team swung into action. Returning passengers were sent into home quarantine. If a person tested positive, local officials traced their contacts. Kerala’s testing rate has been consistently above India’s average, according to health data.
Experts say much of the credit for the system lies with K.K. Shailaja, a 64-year-old former schoolteacher who until this week was Kerala’s health minister. Her role in fighting the Nipah virus inspired a character in a 2019 movie.
drove India into recession. This year, Mr. Modi has resisted a nationwide lockdown, leaving local governments to take their own steps.
India’s states are also competing against each other for oxygen, medicine and vaccines.
“There has been a tendency to centralize decisions when things seemed under control and to deflect responsibility towards the states when things were not,” said Gilles Verniers, a professor of political science at Ashoka University.
has worsened the country’s outbreak, though they have been hindered by a lack of data. Kerala has used gene sequencing since November to track variants, helping to drive policy decisions, said Dr. Vinod Scaria, a scientist at the CSIR Institute of Genomics and Integrative Biology in New Delhi.
“It’s the only state that has not given up at any point in time,” Dr. Scaria said, adding that “they’re eager to use evidence to drive policies.”
A political shuffle has led some experts to wonder whether Kerala can keep its gains. This past week the Communist Party of India, which controls the state government, excluded Ms. Shailaja from its cabinet. The party said it wanted to give young leaders a chance, but observers wondered whether Ms. Shailaja had grown too popular. She didn’t respond to requests for comment.
“Even the best-performing governments,” Professor Verniers of Ashoka University said, “are not immune from shooting themselves in the foot due to misguided political calculations.”