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.”

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Vaccination Rates Take on Regional Differences

Almost half of Americans have received at least one dose of a Covid-19 vaccine. But the U.S. vaccination story varies widely across regions, with New England surging ahead of the national average, while much of the South is lagging far behind.

In five of the six New England states, over 60 percent of residents are at least partly vaccinated, according to data from the Centers for Disease Control and Prevention. It’s a different story in the South, where Mississippi, Alabama, Arkansas, Georgia, Louisiana and Tennessee have the country’s lowest rates of residents who have received at least one shot. The rates in those states are all below 40 percent, with Mississippi, at 33 percent, at the bottom of the list.

The White House and state governments, after relying on mass vaccination sites for months, are turning their focus to more targeted, smaller-scale efforts to vaccinate underserved, harder-to-reach communities.

“This next phase of the vaccination campaign was — will be driven, more than anything, by the people and organizations and communities who help to vaccinate their families, their friends and others in their neighborhoods,” Dr. Vivek Murthy, the surgeon general, said on Friday during a White House news conference. “It’s why we’ve been saying that addressing access, motivation and vaccine confidence requires an all-hands-on-deck approach.”

Cahaba Medical Care, which has 17 clinics in underserved communities in Alabama.

“Conversations with people you trust have always been important to us,” he said on Friday. “I’ve been on Facebook Live. I say: ‘Ask us the hard questions. Let’s talk.’ We pivot to the individual exam room, where they trust me to answer. We’re having success with that approach, but it’s not at the speed that the pandemic needs.”

The low rate in the South worries Thomas A. LaVeist, an expert on health equity and dean of the School of Public Health and Tropical Medicine at Tulane University in New Orleans.

“You have the carrot and stick,” he said. “I’m beginning to think that the stick is the more likely scenario.”

Dr. LaVeist said the incentive that would work fastest for adults would be mandates by employers, who are uniquely positioned to require large numbers of Americans who otherwise would not receive a vaccination to do so because their employment depends on it. The federal government has issued guidance that says employers can require workers to get a Covid-19 vaccine and bar them from the workplace if they refuse.

a Kaiser Family Foundation survey that found 28 percent of those who were employed said they would be more likely to get vaccinated if they were given time off to receive and recover from the vaccine. Another 20 percent said they would be more likely to get vaccinated if their shot was administered at their workplace. The survey looked at those who are unvaccinated, but who wanted to get vaccinated as soon as possible

Dr. LaVeist and other experts, however, say the biggest hurdle among the vaccine hesitant is anxiety over possible side effects. “How was it possible to deploy the vaccine so quickly? If more people understand that, then more people will take the vaccine,” Dr. LaVeist said. “Corners were not cut.”

A recent New York Times report from Greene County, a rural area in northeastern Tennessee, revealed the most common reason for vaccine apprehension was fear that the vaccine was developed in haste and that long-term side effects were unknown. Their decisions are also entangled in a web of views about autonomy, science and authority, as well as a powerful regional, somewhat romanticized self-image: We don’t like outsiders messing in our business.

Vaccine hesitancy in any U.S. region poses a threat to all Americans, experts warn, because the longer it takes to vaccinate people, the more time that the virus has to spread, mutate and possibly gain the ability to evade vaccines.

“My big concern is that there is going to be a variant that’s going to outsmart the vaccine,” Dr. LaVeist said. “That’s what viruses do. That’s their strategy for surviving. Then we’ll have a new problem. We’ll have to revaccinate.”

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The Latest Coronavirus Comes From Dogs

It also had an unusual genetic mutation, a deletion in what is commonly known as the N gene, which codes for an important structural protein. This deletion has not been documented in other canine coronaviruses, Dr. Vlasova said, but similar mutations have appeared in the viruses that cause Covid and SARS. “So what does this mean?” Dr. Gray asks. “Well, you know, we don’t know exactly.”

Although much more research is needed, one possibility is that the mutation may help animal coronaviruses to adapt to human hosts, the researchers said.

It is too soon to say whether this virus poses a risk to humans. Researchers have not yet proved that this virus is the cause of the pneumonia that sent patients to the hospital. And they have not yet studied whether people who may contract the virus from animals can spread it to other people.

“We have to be careful, because things show up all the time that don’t become outbreaks,” said John Lednicky, a virologist at the University of Florida who was not an author of the study.

Nevertheless, the study is “extremely important,” he said. “The fact that it’s a coronavirus again once again tells us this is a group of viruses that deserves further study.” He added, “We should take this seriously and look for it, because if we start seeing more cases, that’s when the alarm bells should go off.”

Indeed, one possibility is that coronaviruses may be spreading between humans and other species, including dogs, far more frequently than has been known.

“At this moment we do not really have any reason to believe that this virus is going to be causing a pandemic,” Dr. Vlasova said. “What kind of attention we want to draw to this research is that transmission of coronaviruses from animal sources to humans is probably a very, very, very common event. And up until now it was mostly ignored.”

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Oregon to Require Businesses Verify Vaccination Status

Oregon has lifted its mask mandate for people who have been fully vaccinated against Covid-19, but is requiring businesses, workplaces and houses of worship to verify the vaccination status of individuals before they enter buildings without a mask.

This statewide mandate, one of the first of its kind in the country, raised concerns that the procedure of verifying vaccinations could be too cumbersome for workers.

Many states have lifted mask requirements without requiring confirmation that individuals have been vaccinated. New York lifted its mask mandate on Tuesday for vaccinated people, though businesses will be allowed to enforce stricter rules. Some Republican governors, like Gov. Greg Abbott of Texas, have instead not only lifted mask rules but banned local governments from enforcing their own. Gov. Ron DeSantis of Florida, also a Republican, issued an executive order last month prohibiting businesses from requiring vaccine documentation.

The notion of relying on the honor system, which some states and businesses have adopted, has raised its own questions. And business groups in Oregon expressed concerns that a mandate to check vaccination status could become — like mask enforcement — a difficult and potentially dangerous proposition for workers.

“We have serious concerns about the practicality of requiring business owners and workers to be the enforcer,” said Nathaniel Brown, a spokesman for Oregon Business and Industry, which represents companies like Nike, as well as small businesses. “We are hearing from retailers and small businesses who are concerned about putting their frontline workers in a potentially untenable position when dealing with customers.”

The Oregon Health Authority said in new guidance on Tuesday that effective immediately, businesses would be required to continue to enforce mask requirements unless they had established a policy to confirm proof of vaccination using a card or photo of one before individuals can enter the building without a mask.

Gov. Kate Brown, a Democrat, said last week that Oregonians who were fully vaccinated no longer needed to wear masks in most public settings, except in places like schools, public transit and health care settings.

But she quickly noted that businesses would have “the option” of lifting mask requirements only if they instituted verification procedures. “Some businesses may prefer to simply continue operating under the current guidance for now rather than worrying about vaccination status, and that’s fine,” she said.

A spokesman for Fred Meyer, a grocery store chain in the Pacific Northwest owned by Kroger, said that it would continue to require customers and employees to wear masks in its stores.

New York has created the Excelsior Pass, a digital proof of Covid-19 vaccination, which will be used at some sites like Madison Square Garden and Radio City Music Hall. Jen Psaki, President Biden’s press secretary, reiterated on Monday that the federal government would not be issuing “vaccine passports,” the development of which she said should be left up to the private sector.

Charles Boyle, a spokesman for Gov. Brown, said that “businesses that do not want to implement vaccine verification can keep current health and safety measures in place, which includes masks and physical distancing for all individuals.”

Asked if businesses would face penalties for allowing customers to go maskless without checking their vaccination status, Mr. Boyle said that “in the past year state agencies have issued fines for businesses that are out of compliance with health and safety guidance.”

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Sanofi-GlaxoSmithKline Covid Vaccine Shows Promise, Firm Says

Sanofi, the French pharmaceutical company, said on Monday that it would move the experimental Covid-19 vaccine it is developing with GlaxoSmithKline into a late-stage trial after the shot produced strong immune responses in volunteers in a mid-stage study.

The findings are encouraging news for a vaccine that has fallen behind in development and has so far disappointed those expecting that it would be crucial in combating the pandemic. If the vaccine can become available in the last three months of this year, as its developers hope, it could still play a central role as a booster shot as well as an initial inoculation in the developing world, where the pace of vaccination is lagging.

The vaccine hit a major setback in December, when its developers announced that it did not appear to work well in older adults and that they would have to delay plans to test it in a Phase 3 trial, the crucial test that will assess the vaccine’s effectiveness.

But the companies modified the vaccine and in February began testing it in a Phase 2 study that included more than 700 volunteers in the United States and Honduras between 18 and 95 years old. Sanofi said the vaccine did not raise any safety concerns and produced a strong immune response across age groups, a finding suggesting it has been successfully tweaked.

Sanofi announced the findings in a statement and said it plans to soon publish the results in a medical journal.

Sanofi and GSK are much more experienced in vaccine development than a number of their rivals that have already won authorization. The two companies used a more established approach than those deployed in other, more swiftly developed Covid vaccines. Their shot is based on viral proteins produced with engineered viruses that grow inside insect cells. GSK is supplying the Sanofi vaccine with an adjuvant, an ingredient used in many vaccines meant to boost the immune response.

Sanofi and GSK’s vaccine was one of six selected for funding from Operation Warp Speed, the Trump administration’s effort to accelerate vaccine development. Last summer, the federal government agreed to give the companies $2.1 billion to develop and manufacture the vaccine, in exchange for 100 million doses once the shot was ready.

Sanofi also has supply deals with the European Union and Canada. It has also agreed to supply 200 million doses to Covax, the program to deliver vaccines to middle- and lower-income countries that has been struggling with a shortfall in expected doses. Sanofi has also announced plans to help manufacture the authorized vaccines made by Pfizer-BioNTech, Moderna and Johnson & Johnson.

Sanofi said its Phase 3 trial of its vaccine will begin in the coming weeks and enroll more than 35,000 adult volunteers around the world. It will test two formulations of the vaccine, one aimed at preventing the original strain of the virus and the other aimed at the B.1.351 variant first seen in South Africa that some vaccines appear to be less effective against.

Su-Peing Ng, Sanofi’s global head of medical for vaccines, told journalists on Monday that the company expects it to be “operationally quite challenging” to enroll unvaccinated participants in the Phase 3 trial as vaccination coverage increases in many nations. Still, she said, vaccine doses are still scarce in many parts of the world, pointing to Latin America and Asia as places where the company may look to enroll volunteers.

The company said that soon after starting the Phase 3 trial it plans to assess whether its vaccine can boost immune responses in people who had been vaccinated months before with authorized vaccines. Those booster studies are expected to enroll volunteers in well-vaccinated parts of the world, including the United States and Europe.

Sanofi and GSK said last year they were preparing to be able to make 1 billion doses annually. Thomas Triomphe, Sanofi’s global head of vaccines, said on Monday that the company’s production this year, if its vaccine is shown to work, would depend on the world’s needs.

The vaccine, he said, has “potential to be a booster of choice for many nations and many different platforms.”

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More Scientists Urge Broad Inquiry Into Coronavirus Origins

A group of 18 scientists stated Thursday in a letter published in the journal Science that there is not enough evidence to decide whether a natural origin or an accidental laboratory leak caused the Covid-19 pandemic.

They argued, as the U.S. government and other countries have, for a new investigation to explore where the virus came from.

The organizers of the letter, Jesse Bloom, who studies the evolution of viruses at the Fred Hutchinson Cancer Research Center in Seattle, and David Relman, a microbiologist at Stanford University, said they strove to articulate a wait-and-see viewpoint that they believe is shared by many scientists. Many of the signers have not spoken out before.

“Most of the discussion you hear about SARS-CoV-2 origins at this point is coming from, I think, the relatively small number of people who feel very certain about their views,” Dr. Bloom said.

issued a report claiming that such a leak was extremely unlikely, even though the mission never investigated any Chinese labs. The team did visit the Wuhan lab, but did not investigate it. A lab investigation was never part of their mandate. The report, produced in a mission with Chinese scientists, drew extensive criticism from the U.S. government and others that the Chinese government had not cooperated fully and had limited the international scientists’ access to information.

The new letter argued for a new and more rigorous investigation of virus origins that would involve a broader range of experts and safeguard against conflicts of interest.

Recent letters by another group of scientists and international affairs experts argued at length for the relative likelihood of a laboratory leak. Previous statements from other scientists and the W.H.O. report both asserted that a natural origin was by far the most plausible.

Michael Worobey, an evolutionary biologist at the University of Arizona, said he signed the new letter because “the recent W.H.O. report on the origins of the virus, and its discussion, spurred several of us to get in touch with each other and talk about our shared desire for dispassionate investigation of the origins of the virus.”

“I certainly respect the opinion of others who may disagree with what we’ve said in the letter, but I felt I had no choice but to put my concerns out there,” he said.

Another signer, Sarah E. Cobey, an epidemiologist and evolutionary biologist at the University of Chicago, said, “I think it is more likely than not that SARS-CoV-2 emerged from an animal reservoir rather than a lab.”

But “lab accidents do happen and can have disastrous consequences,” she added. “I am concerned about the short- and long-term consequences of failing to evaluate the possibility of laboratory escape in a rigorous way. It would be a troublesome precedent.”

The list of signers includes researchers with deep knowledge of the SARS family of viruses, such as Ralph Baric at the University of North Carolina, who had collaborated with the Chinese virologist Shi Zhengli in research done at the university on the original SARS virus. Dr. Baric did not respond to attempts to reach him by email and telephone.

often cited paper in March 2020 that dismissed the likelihood of a laboratory origin based largely on the genome of the SARS-CoV-2 virus that causes Covid-19. “We do not believe any type of laboratory-based scenario is plausible,” that paper stated.

Speaking for himself only, Dr. Relman said in an interview that “the piece that Kristian Anderson and four others wrote last March in my view simply fails to provide evidence to support their conclusions.”

Dr. Andersen, who reviewed the letter in Science, said that both explanations were theoretically possible. But, “the letter suggests a false equivalence between the lab escape and natural origin scenarios,” he said. “To this day, no credible evidence has been presented to support the lab leak hypothesis, which remains grounded in speculation.”

Instead, he said, available data “are consistent with a natural emergence of a novel virus from a zoonotic reservoir, as has been observed so many times in the past.” He said he supported further inquiry into the origin of the virus.

Angela Rasmussen, a virologist at University of Saskatchewan’s Vaccine and Infectious Disease Organization, has criticized the politicization of the laboratory leak theory.

She supports further investigation, but said that “there is more evidence (both genomic and historical precedent) that this was the result of zoonotic emergence rather than a laboratory accident.”

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Covid Pandemic Demands Air Quality Changes in the Workplace, Researchers Say

Clean water in 1842, food safety in 1906, a ban on lead-based paint in 1971. These sweeping public health reforms transformed not just our environment but expectations for what governments can do.

Now it’s time to do the same for indoor air quality, according to a group of 39 scientists. In a manifesto of sorts published on Thursday in the journal Science, the researchers called for a “paradigm shift” in how citizens and government officials think about the quality of the air we breathe indoors.

The timing of the scientists’ call to action coincides with the nation’s large-scale reopening as coronavirus cases steeply decline: Americans are anxiously facing a return to offices, schools, restaurants and theaters — exactly the type of crowded indoor spaces in which the coronavirus is thought to thrive.

There is little doubt now that the coronavirus can linger in the air indoors, floating far beyond the recommended six feet of distance, the experts declared. The accumulating research puts the onus on policymakers and building engineers to provide clean air in public buildings and to minimize the risk of respiratory infections, they said.

new workplace standards for air quality, but the scientists maintained that the remedies do not have to be onerous. Air quality in buildings can be improved with a few simple fixes, they said: adding filters to existing ventilation systems, using portable air cleaners and ultraviolet lights — or even just opening the windows where possible.

Dr. Morawska led a group of 239 scientists who last year called on the World Health Organization to acknowledge that the coronavirus can spread in tiny droplets, or aerosols, that drift through the air. The W.H.O. had insisted that the virus spreads only in larger, heavier droplets and by touching contaminated surfaces, contradicting its own 2014 rule to assume all new viruses are airborne.

The W.H.O. conceded on July 9 that transmission of the virus by aerosols could be responsible for “outbreaks of Covid-19 reported in some closed settings, such as restaurants, nightclubs, places of worship or places of work where people may be shouting, talking or singing,” but only at short range.

detailed 10 lines of evidence that support the importance of airborne transmission indoors.

On April 30, the W.H.O. inched forward and allowed that in poorly ventilated spaces, aerosols “may remain suspended in the air or travel farther than 1 meter (long-range).” The Centers for Disease Control and Prevention, which had also been slow to update its guidelines, recognized last week that the virus can be inhaled indoors, even when a person is more than six feet away from an infected individual.

“They have ended up in a much better, more scientifically defensible place,” said Linsey Marr, an expert in airborne viruses at Virginia Tech, and a signatory to the letter.

“It would be helpful if they were to undertake a public service messaging campaign to publicize this change more broadly,” especially in parts of the world where the virus is surging, she said. For example, in some East Asian countries, stacked toilet systems could transport the virus between floors of a multistory building, she noted.

More research is also needed on how the virus moves indoors. Researchers at the Department of Energy’s Pacific Northwest National Laboratory modeled the flow of aerosol-size particles after a person has had a five-minute coughing bout in one room of a three-room office with a central ventilation system. Clean outdoor air and air filters both cut down the flow of particles in that room, the scientists reported in April.

But rapid air exchanges — more than 12 in an hour — can propel particles into connected rooms, much as secondhand smoke can waft into lower levels or nearby rooms.

guidance for Covid does not require improvements to ventilation, except for health care settings.

“Ventilation is really built into the approach that OSHA takes to all airborne hazards,” said Peg Seminario, who served as director of occupational safety and health for the A.F.L.-C.I.O. from 1990 until her retirement in 2019. “With Covid being recognized as an airborne hazard, those approaches should apply.”

In January, President Biden directed OSHA to issue emergency temporary guidelines for Covid by March 15. But OSHA missed the deadline: Its draft is reportedly being reviewed by the White House’s regulatory office.

only during medical procedures known to produce aerosols, or if they have close contact with an infected patient. Those are the same guidelines the W.H.O. and the C.D.C. offered early in the pandemic. Face masks and plexiglass barriers would protect the rest, the association said in March in a statement to the House Committee on Education and Labor.

“They’re still stuck in the old paradigm, they have not accepted the fact that talking and coughing often generate more aerosols than do these so-called aerosol-generating procedures,” Dr. Marr said of the hospital group.

increase the risk, perhaps because they inhibit proper airflow in a room.

The improvements do not have to be expensive: In-room air filters are reasonably priced at less than 50 cents per square foot, although a shortage of supply has raised prices, said William Bahnfleth, professor of architectural engineering at Penn State University, and head of the Epidemic Task Force at Ashrae (the American Society of Heating, Refrigerating and Air-Conditioning Engineers), which sets standards for such devices. UV lights that are incorporated into a building’s ventilation system can cost up to roughly $1 per square foot; those installed room by room perform better but could be 10 times as expensive, he said.

If OSHA rules do change, demand could inspire innovation and slash prices. There is precedent to believe that may happen, according to David Michaels, a professor at George Washington University who served as OSHA director under President Barack Obama.

When OSHA moved to control exposure to a carcinogen called vinyl chloride, the building block of vinyl, the plastics industry warned it would threaten 2.1 million jobs. In fact, within months, companies “actually saved money and not a single job was lost,” Dr. Michaels recalled.

In any case, absent employees and health care costs can prove to be more costly than updates to ventilation systems, the experts said. Better ventilation will help thwart not just the coronavirus, but other respiratory viruses that cause influenza and common colds, as well as pollutants.

Before people realized the importance of clean water, cholera and other waterborne pathogens claimed millions of lives worldwide every year.

“We live with colds and flus and just accept them as a way of life,” Dr. Marr said. “Maybe we don’t really have to.”

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