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Sunday, May 2, 2021

Covid-19 Live News: Updates on the Virus, Vaccines and Variants - The New York Times

Oxygen cylinders are removed from a truck outside a shop in Delhi this month.
Atul Loke for The New York Times

A severe shortage of medical oxygen in New Delhi, the center of power in India, has left dozens gasping for their final breaths in their hospital beds, a sign of government futility in its fight against a crushing Covid wave.

On Sunday, the New Delhi High Court said that it would start punishing government officials for failing to deliver oxygen after hospitals in the capital successfully sought an injunction, the A.P. reported. It was the latest verdict against Indian leaders, after voters in crucial state elections dealt Prime Minister Narendra Modi’s party a blow by electing an opposition party in West Bengal, one of India’s most populous states and a stronghold of opposition to Mr. Modi, India’s most powerful prime minister in decades.

Critics have blasted Mr. Modi’s handling of the crisis. A sudden, harsh lockdown imposed early in the pandemic sent millions of laborers scrambling back to their home villages and disrupted the economy.

When cases dropped, Mr. Modi’s government failed to heed warnings of a potential resurgence from scientists, and its own Covid-19 task force did not meet for months. Mr. Modi himself declared a premature victory over Covid in late January, during what proved to be a mere lull in infections.

Now, cremation grounds are working day and night, burning thousands of bodies. The country is rife with the more lethal and more transmissible B.1.1.7 variant of the coronavirus first found in Britain, as well as a homegrown variant, B.1.617. Experts are worried that the unchecked outbreak will spawn more dangerous variants of the coronavirus.

On Saturday, India reported nearly 3,700 deaths, its highest daily toll. Over the weekend, the country logged 401,993 new cases and then 392,488, tallies that no other country has ever seen. And experts say the real toll is far higher.

Mr. Modi was scheduled to meet with his health minister on Sunday to discuss the oxygen shortage and concerns that doctors and nurses are overwhelmed. Indian officials announced over the weekend that the army had opened its hospitals to civilians and that the first batch of the Russian vaccine, Sputnik V, had arrived, a boost to India’s flagging inoculation campaign.

Over the weekend, aid from a half-dozen countries touched down at airports across India; they included 157 ventilators from the United Arab Emirates, 500 oxygen cylinders from Taiwan and 1,000 vials of the medicine Remdesivir from Belgium.

On Sunday, the United States delivered the third of six aid shipments to New Delhi, including 1,000 oxygen cylinders; Britain donated more than 400 oxygen concentrators; and France sent eight oxygen generators, each of which can serve 250 hospitalized patients.

Britain and France announced plans to donate more, while the United States has pledged $100 million worth of supplies, which will include 15 million N95 masks and one million rapid diagnostic tests. Ron Klain, the White House chief of staff, said on Sunday that the Biden administration had sent the raw materials to produce 20 million vaccine doses, and he said the United States may lift patents on vaccines to boost global production.

Vaccines are badly needed in India, where shortages forced several states on Saturday to delay expanding access to everyone aged 18 and over. While it is a global power in vaccine production, India didn’t purchase enough doses to protect itself: Less than 2 percent of its 940 million adults have been fully vaccinated.

Relief supplies from the United States  arriving at the Indira Gandhi International Airport cargo terminal in New Delhi, India, on Friday.
Pool photo by Prakash Singh

Countries around the world are accelerating deliveries of desperately needed medical supplies to India as the country endures an unrelenting, catastrophic coronavirus wave.

On Sunday, the United States delivered the third of six aid shipments to New Delhi, including 1,000 oxygen cylinders; Britain donated more than 400 oxygen concentrators; and France sent eight oxygen generators, each of which can serve 250 hospitalized patients.

Oxygen in India has been in short supply as it grapples with a crushing second virus wave, leaving some dying Covid patients gasping for air in hospital beds. Others, unable to find room in overwhelmed health care centers, have died in hospital parking lots, or at home.

On April 15, the Indian health ministry said in a statement that India had a daily production capacity of about 7,700 tons of oxygen, some of which is used for industrial purposes, with 55,000 tons in reserve. A week later, a government official told the Delhi High Court that medical demand had reached 8,800 tons per day, beyond the daily production capacity.

More than three dozens countries large and small have pledged to help India, which on a single day this weekend reported a world record of 401,993 new cases. Daily deaths have nearly doubled over the last two weeks, hitting 3,689 on Saturday.

Relatives of the sick have taken to social media with pleas seeking not only portable oxygen tanks, but also hospital beds or medicines like remdesivir. The country’s misery has been compounded by a series of deadly hospital accidents, including a fire on Saturday that killed 16 Covid patients and two health care workers in the city of Bharuch, in western India.

Over the weekend, aid from a half dozen countries touched down at airports across India; they included a shipment of 157 ventilators from the United Arab Emirates, 500 oxygen cylinders from Taiwan and 1,000 vials of the medicine Remdesivir from Belgium.

President Biden has been under intense pressure to do more to address the crisis in India. His administration intends to make up to 60 million doses of the AstraZeneca vaccine available to other countries, as long as federal regulators deem the doses safe. Vaccines are badly needed in India, where shortages forced several states on Saturday to delay expanding access to everyone aged 18 and over.

The United States has pledged to provide $100 million worth of supplies, which will include 15 million N95 masks and a million rapid diagnostic tests. On Sunday, Ron Klain, the White House chief of staff, said that the Biden administration had sent the raw materials to produce 20 million vaccine doses, and he said the U.S. was considering whether to lift patents on vaccines to boost global production.

“We are rushing aid to India,” Mr. Klain said in an appearance on CBS’ “Face the Nation.” The administration, he added would soon announce “how we can get this vaccine more widely distributed, more widely licensed, more widely shared.”

The United Kingdom announced it will send another 1,000 ventilators, in addition to the oxygen concentrators, 200 ventilators, and three oxygen generation units that were pledged last week.

France announced plans to deliver additional oxygen generators and medical equipment beyond the supplies that arrived Sunday. Air Liquide, a French industrial gases company, will begin shipments of several hundred tons of oxygen next week.

A health worker administers a Covid-19 test in Gauhati, India, on Saturday.
Anupam Nath/Associated Press

The coronavirus surge that is lashing India, where countless funeral pyres cloud the night skies, is more than just a humanitarian disaster: Experts say uncontrolled outbreaks like India’s also threaten to prolong the pandemic by allowing more dangerous virus variants to mutate, spread and possibly evade vaccines.

The United States will begin restricting travel from India later this week, but similar limitations on air travel from China that President Trump imposed in the early days of the pandemic proved to be ineffectual.

“We can ban all the flights we want but there is literally zero way we can keep these highly contagious variants out of our country,” said Dr. Ashish Jha, the dean of the Brown University School of Public Health.

As the coronavirus spreads among human hosts, it invariably mutates, creating opportunities for new variants that can be more transmissible or even deadly. One highly contagious variant, known as B.1.1.7, crushed Britain earlier this year and is already well entrenched in the United States and Europe.

Recent estimates suggest that B.1.1.7 is about 60 percent more contagious and 67 percent more deadly than the original form of the virus. Another worrisome variant, P.1, is wreaking havoc across South America.

Over the weekend, India recorded 401,993 new cases in a single day, a world record, though experts say its true numbers are far higher than what’s being reported. Peru, Brazil and other countries across South America are also experiencing devastating waves.

Virologists are unsure what is driving India’s second wave. Some have pointed to a homegrown variant called B.1.617, but researchers outside of India say the limited data suggests that B.1.1.7 may be to blame.

With 44 percent of adults having received at least one dose, the United States has made great strides vaccinating its citizens, though experts say the country is far from reaching so-called herd immunity, when the virus can’t spread easily because it can’t find enough hosts. Vaccine hesitancy remains a formidable threat to reaching that threshold.

In much of the world, however, vaccines are still hard to come by, especially in poorer countries. In India, less than 2 percent of the population has been fully vaccinated. “If we want to put this pandemic behind us, we can’t let the virus run wild in other parts of the world,” Dr. Jha said.

Preliminary evidence suggests that the vaccines are effective against the variants, although slightly less so against some.

“For now the vaccines remain effective, but there is a trend toward less effectiveness,” said Dr. Céline Gounder, an infectious disease physician and epidemiologist at Bellevue Hospital in New York.

Vaccine makers say they are poised to develop booster shots that would tackle especially troublesome variants, but such a fix would be of little help to poorer nations already struggling to obtain the existing vaccines. Experts say the best way to head off the emergence of dangerous variants is to tamp down new infections and immunize most of humanity as quickly as possible.

Dr. Michael Diamond, a viral immunologist at Washington University in St. Louis, said that the longer the coronavirus circulates, the more time it has to mutate, which could eventually threaten vaccinated people; the only way to break the cycle is to ensure countries like India get enough vaccines.

“In order to stop this pandemic, we have to vaccinate the whole world,” Dr. Diamond said. “There will be new waves of infection over and over again unless we vaccinate at a global scale.”

Nepalese Army officials saluted the bodies of Covid-19 victims at a crematorium in Kathmandu, the Nepali capital, on Saturday.
Bikash Karki/Agence France-Presse — Getty Images

Public fury over Nepal’s growing wave of coronavirus infections has been rising in the country, with many people blaming travelers from India and several other virus-stricken countries, as well as government ineptitude in handling the pandemic and large political rallies.

In response, Nepal announced on Sunday that it was halting all domestic and international flights: domestic flights as of midnight, and international flights as of midnight Wednesday.

As India’s crisis has worsened over recent weeks, people from several Indian states thronged to Nepal via land and air routes. Some were Nepali migrant workers returning home; others aimed to travel onward to third countries.

Last week, Nepal responded by banning third-country travel via Nepal and imposing two-week lockdowns in several cities, closing schools, colleges, factories, nightclubs and theaters. Public gatherings are also banned.

But those moves did little to immediately quell infections, which are spiking in Nepal’s densely populated cities, including Kathmandu, the capital, and metropolitan areas bordering India to the southwest.

The number of infections that Nepal has reported has escalated rapidly since mid-April, from a seven-day average of new daily cases of less than 100 to more than 4,500 as of Saturday, pushing total cases over the pandemic to more than 328,000, according to data from the Our World in Data project at the University of Oxford. On Sunday, Nepal reported 7,211 new cases.

Three cabinet members have been hospitalized with the virus, and the government is scrambling to arrange for oxygen imports and hospital beds.

Health experts have attributed the country’s second wave in part to the unchecked flow of Nepali migrant workers from India and in part to large political rallies organized by the ruling Communist Party of Nepal (Unified Marxist and Leninist) and other opposition parties that aimed to show strength during the pandemic.

The decision to halt all flights came after a meeting of the government’s Council of Ministers, the foreign minister, Pradeep Gyawali, told The Rising Nepal, a state-run newspaper.

According to accounts in Nepali news outlets, chartered cargo flights will continue to fly.

This is the second time Nepal has suspended international flights in response to the pandemic. In April 2020, it halted international flights for more than five months.

Centner Academy’s elementary school campus in Miami. The school threatened teachers’ employment if they got a coronavirus vaccine during the school year.
Scott McIntyre for The New York Times

MIAMI — A fifth-grade teacher peddled a bogus conspiracy theory recently to students at Centner Academy, a private school in Miami, warning them that they should not hug parents who had been vaccinated against the coronavirus for more than five seconds because they might be exposed to harmful vaccine shedding.

“Hola Mami,” one student wrote in an email to her parents from school, saying that the teacher was “telling us to stay away from you guys.”

Nearly a week before, the school had threatened teachers’ employment if they got a coronavirus vaccine before the end of the school year.

Alarmed parents frantically texted one another on WhatsApp, trying to find a way to pull their children out at the end of the term. But inside the school, “hundreds of queries from all over the world” came in for teaching positions, according to the administration. More came from people who wanted to enroll their children at the school.

The small school became a national beacon for anti-vaccination activists practically overnight last week, just as public health officials in the United States wrestled with how to overcome vaccine skepticism.

Leila Centner, the school’s co-founder, who says she is not against fully tested vaccines, wrote on Instagram that journalists are “trying to destroy my reputation because I went against their narrative.”

Devoted supporters cheered her on.

“We won’t let them take you down!” one of them wrote on Instagram. “We stand strong with you! You’re an angel trying to save our kids and teachers.”

Brittany Karma, staff pharmacist at the Chief Andrew Isaac Health Center, prepares a single vial of the Moderna Covid-19 vaccine for travel in Fairbanks, Alaska.
Nathan Howard/Reuters

Dr. Angelique Ramirez, the chief medical officer of the main health care system in Fairbanks, Alaska, started the monthly coronavirus briefing in April by saying that she thought March’s meeting would be the last. But amid a new surge of cases in the state, one of the country’s worst surges, Dr. Ramirez was blunt about her past assessment.

“I was wrong,” she said.

With nearly 100,000 people, the Fairbanks metropolitan area is Alaska’s second largest and the largest in the state’s vast interior. According to a New York Times database, the number of new coronavirus cases in the borough of which Fairbanks is the seat, North Star, has risen by 253 percent over the past two weeks. The positivity rate has doubled since March, to about 10 percent from 5 percent, and hospitalizations at Fairbanks Memorial Hospital, the area’s only hospital, have hit a record number.

“This place is on fire with Covid,” Dr. Barb Creighton, an internist at Fairbanks Memorial Hospital, said at the meeting.

Experts are unsure what is driving the surge, though a low vaccination rate certainly plays a role. Thirty-six percent of Alaskans are fully vaccinated, and in some boroughs that number is over 50 percent, but in the Fairbanks area just 29 percent of the population has been fully vaccinated.

“There is no big outbreak or two big outbreaks that are really driving this,” said Dr. Joe McLaughlin, the state epidemiologist for Alaska. “We have cases and clusters being associated with a wide range of different settings.”

With two-thirds of the older population in Fairbanks having received at least one dose of a vaccine, those who have recently been hospitalized in Fairbanks are younger than the Covid patients during the winter, when there was a peak in case numbers. Dr. Creighton said people who were hospitalized in April tended to be in their 40s and 50s and were unvaccinated because they were waiting to see what side effects might come from receiving a Covid-19 vaccine.

“We are seeing them stay longer because they are not dying,” Dr. Creighton said. “We are giving them noninvasive ventilation and they are staying for two, three weeks and turning around, which I’ve never been more proud of.”

But while those older patients during the winter peak were largely grateful to be receiving care, those hospitalized now feel differently.

“Some of these folks are folks that are anti-vaxxers, anti-maskers, and they don’t believe they have Covid or are sick because of it, and our staff is getting pretty angry folks,” Shelley Ebenal, the chief executive of the health care system, Foundation Health Partners, said, imploring the system’s trustees to share their appreciation of the hospital staff with them.

She sounded a dire warning: “We are not out of Covid, and our staff in particular is not out of Covid. Our morale is really low.”

Barbara G. Holthus, a volunteer and deputy director of the German Institute for Japanese Studies in Tokyo, said she worries that the Olympic Games could become a superspreader event.
Noriko Hayashi for The New York Times

TOKYO — For Olympic host cities, one of the keys to a successful Games is the army of volunteers who cheerfully perform a range of duties, like fetching water, driving Olympic vehicles, interpreting for athletes or carrying medals to ceremonies.

If the rescheduled Tokyo Games go ahead as planned this summer, roughly 78,000 volunteers will have another responsibility: preventing the spread of the coronavirus, both among participants and themselves.

For protection, the volunteers are being offered little more than a couple of cloth masks, a bottle of sanitizer and mantras about social distancing. Unless they qualify for vaccination through Japan’s slow age-based rollout, they will not be inoculated against the coronavirus.

“I don’t know how we’re going to be able to do this,” said Akiko Kariya, 40, a paralegal in Tokyo who signed up to volunteer as an interpreter. The Olympic committee “hasn’t told us exactly what they will do to keep us safe.”

Global Roundup

Lining up for coronavirus tests in Hong Kong on Sunday. As well as undergoing screening, migrant domestic workers must also be vaccinated before they can renew their contracts.
Jerome Favre/EPA, via Shutterstock

Thousands of foreign domestic workers lined up for mandatory testing in Hong Kong on Sunday after two were found to be infected with new coronavirus variants, a sweeping campaign that some governments and advocacy groups called discriminatory because it was targeting such a large population.

In addition to undergoing testing in the next week, migrant domestic workers must also be vaccinated before they can renew their contracts, according to new rules announced on Friday. Those who already completed their vaccinations more than two weeks ago were exempt from the new testing requirements.

Hong Kong has more than 370,000 foreign domestic workers, mostly women from the Philippines and Indonesia who often work long hours at low wages doing housework and caring for children and older adults. Under Hong Kong law, they are excluded from obtaining permanent residency rights, which are granted to most others after seven years in the city.

Advocates for the workers say that such exclusions make foreign domestic employees a permanent underclass in Hong Kong and that the testing and vaccination requirements are new examples of the prejudice they face.

The mandatory testing “is clearly an act of discrimination and stigmatization against migrant domestic workers,” Dolores Balladares-Pelaez, chairwoman of the advocacy group United Filipinos in Hong Kong, said at a news conference on Saturday. She said that in the case of other outbreaks in Hong Kong, such as a cluster of more than 130 cases that emerged from a high-end gym, testing orders were tailored far more narrowly.

Teodoro Locsin Jr., the foreign secretary of the Philippines, said on Twitter that Hong Kong’s mandatory vaccination requirement “smacks of discrimination” because it targets only a subsection of all foreign workers in Hong Kong.

Hong Kong officials have said that the testing requirements are strictly based on risk levels, and that foreign domestic workers’ regular social gatherings, plus the high transmissibility of the new strain, raise the risk of new outbreaks.

At a site on a basketball court on Hong Kong Island, hundreds of workers waited to be tested on Sunday afternoon. One of them, Mary Acapulco, 29, said she had received her second shot days earlier, too late to avoid the mandatory test.

Ms. Acapulco, who is from the Philippines and has spent five years working in Hong Kong, said she had resigned herself to spending her single day off this week being tested.

“I’m upset, of course. That’s why I got vaccinated,” she said. “But anyway, it is for safety.”

In other developments around the world:

  • Pfizer will ship 4.5 million vaccine doses to South Africa by June, according to a statement from Health Minister Zweli Mkhize. The first shipment of 325,260 doses is scheduled to arrive Sunday night and shipments will continue on a weekly basis. “The vaccine supply will increase to an average of 636,480 doses weekly from 31 May which will see us accumulating close to 4.5 million doses by the end of June,” said Mkhize.

  • Malaysia has reported its first case of the coronavirus variant that has been contributing to the devastation in India, Health Minister Adham Baba said on Sunday. The variant, called B.1.617, is more lethal and more transmissible. On Wednesday, Malaysia had banned flights to and from India to prevent the spread of the variant.

The old town of Bratislava, Slovakia. Uproar in the country over the decision to order Russia’s Sputnik V vaccine forced Prime Minister Igor Matovic to step down.
Akos Stiller for The New York Times

It remains unclear whether Sputnik V, the world’s first registered vaccine, is the medical breakthrough proclaimed last summer by President Vladimir V. Putin of Russia, but the shot has already proved to be remarkably effective in spreading disarray and division in Europe.

In France, President Emmanuel Macron talked to Mr. Putin recently about possible deliveries of Sputnik, which Mr. Macron’s own foreign minister derided as a “propaganda tool.” The Austrian chancellor, Sebastian Kurz, furious that European regulators have been slow in approving Sputnik, has clashed with Germany’s leader, Angela Merkel, over the bloc’s vaccination program, which so far involves only Western vaccines. Skepticism over Russia’s intentions with its vaccine runs deep across the former Communist lands of East and Central Europe

In Slovakia, Prime Minister Igor Matovic’s decision to order two million doses of the Sputnik vaccine from Russia blew up in his face, costing him his job last month and almost toppling the whole government — the most concrete example of how Russia’s vaccine diplomacy has had side effects that can be highly toxic.

A restaurant in Lower Manhattan last month. A recent poll showed 34 percent of likely Democratic primary voters surveyed believed reopening businesses would be a top priority for the city’s next mayor.
Benjamin Norman for The New York Times

The signs of New York City’s recovery are everywhere: Vaccinations are on the rise; restaurant and bar curfews are ending; occupancy restrictions are easing in offices, ballparks and gyms. By July 1, Mayor Bill de Blasio says the city should be “fully reopened.”

In this new and uncertain phase, the candidates vying to be the city’s next mayor are making radically different bets about the mood and priorities of New Yorkers, and how best to coax the city back to life. As the mayoral candidates barrel toward the June 22 Democratic primary, sharp distinctions are emerging around how to handle the city’s recovery.

A recent Spectrum News NY1/Ipsos poll found that 34 percent of likely Democratic primary voters viewed reopening businesses and the economy as the top priority for the next mayor, second only to stopping the spread of Covid-19 and closely followed by crime and public safety.

The challenge for all the candidates is to offer the right mix of experience and empathy, energy and vision, to engage a diverse electorate that experienced the coronavirus crisis and its fallout in very different ways.

Alice Fair, a commercial real estate broker, has been seeking subletters at 3 World Trade Center in Manhattan.
John Muggenborg for The New York Times

The people who profit off corporate America’s use of offices are trying to coax corporate America back to the office.

Commercial real estate brokers are back in their own workplaces in force. Having refined their sales pitches to emphasize air filtration systems, flexible lease terms and swing space, they are out to prove the office will soon return to something close to what it was.

After years of continuous growth, the industry has seen commissions fall as vacancy rates climb to the highest levels in decades. Across America’s top markets, 1.3 billion square feet of office space is now available.

More than a year of forced work-from-home has upended the truism that a company needs to have an office — leaving some chief financial officers running the numbers on potential savings in rent and some employees loath to return to life as it was.

Real estate executives — chest-thumping optimists who are usually bullish on their prospects — are facing existential questions.

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Kate Brown, governor of Oregon, announced on Friday that 15 counties would move into the state’s most severe level of restrictions to combat a new wave of coronavirus cases.Kristina Barker for The New York Times

More than half of American states are reporting significant declines in coronavirus cases, but in Oregon, a new wave of the virus has pushed a third of the state’s counties to tighten lockdown restrictions.

Oregon is reporting about 816 new cases a day, a roughly 31 percent increase from two weeks ago, according to a New York Times database. Hospitalizations have also risen by about 42 percent in the same period. Deaths from the virus, which tend to lag behind cases for several weeks, remain relatively low.

“Here is the reality Oregon is facing right now: cases are widespread, driven by new, more contagious variants,” the state’s governor, Kate Brown, said at a news conference on Friday. “Oregon leads the nation for our rate of increase in cases over the last two weeks.”

A total of 15 counties, including some in the Portland metro area, moved back into the fourth and most extreme level of restrictions on Friday, after meeting the state’s threshold. In these counties, indoor dining is now prohibited and businesses such as gyms and movie theaters must significantly reduce their capacity.

The new limits are likely to prompt a political backlash. Some states that have seen recent surges, like in Michigan where cases have leveled off but total numbers still remain high, have chosen not to tighten restrictions again and instead have asked residents to take greater precautions in an effort to halt the spread of the virus.

Ms. Brown said she was optimistic that the state would be able to get ahead of the variants over the next two to three weeks, estimating that Oregon could lift statewide restrictions and return to some degree of normalcy by the end of June.

The governor urged Oregonians to get vaccinated, calling it the key to fully reopening the state’s economy.

Public health experts have suggested a combination of factors could be driving the surge, including more contagious variants, increased travel during spring break and the loosening of state guidelines before vaccination rates had sufficiently risen. As of Saturday, nearly 30 percent of the state’s population was fully vaccinated and 44 percent had received at least one dose, according to a New York Times vaccine tracker.

“We didn’t get down far enough,” Ken Stedman, a biology professor at Portland State University, told local news outlet KATU, referring to case numbers, “and now we seem to be going back up again.”

Adar Poonawalla, chief executive of the Serum Institute of India last year. He is in London and discussing manufacturing vaccines outside of India, which has led to backlash on social media. 
Atul Loke for The New York Times

In recent months, the chief executive of Serum Institute of India, the world’s largest vaccine manufacturer, has come under increasingly intense pressure as both pro-government voices and leaders of the state governments headed by opposition politicians criticized him.

Some accused him for delays in supplying vaccines; some called him a “profiteer” for not offering Covid-19 vaccines to state governments at cost. There were calls for his company to be nationalized.

In an interview with The Times of London published on Saturday, the executive, Adar Poonawalla, described menacing calls from some of the most powerful men in India, creating an environment so ugly that he anticipated being out of the country for an extended period while he made plans to start producing vaccines elsewhere.

“‘Threats’ is an understatement,” Mr. Poonawalla said. “The level of expectation and aggression is really unprecedented.”

The interview reported that he had flown into London to join his wife and children hours before Britain barred travelers from India on April 23.

“I’m staying here an extended time, because I don’t want to go back to that situation,” he added. “Everything falls on my shoulders, but I can’t do it alone.”

The interview set off a storm on social media, with some interpreting his interest in manufacturing outside India as a threat to move his business and others seeing him as having been driven out of the country by the viciousness of his critics.

Within hours, Mr. Poonawalla wrote on Twitter that he would be returning to India “in a few days.”

The New York Times was unable to reach Mr. Poonawalla directly on Saturday, and a request for comment from his company was not immediately returned.

India, the world’s leading producer of vaccines, is struggling to vaccinate itself out of a crisis as a voracious second wave leaves a tableau of death and despair. When cases were relatively low, the country exported more than 60 million shots. On Saturday, India expanded vaccination eligibility to all people over age 18, but many states said that they would not be able to meet the demand because of a shortage of doses.

Less than 2 percent of India’s 940 million adults have been fully vaccinated, according to data compiled from government sources by the Our World in Data project at the University of Oxford. Several states have reported vaccine shortages, enough to derail plans in some to expand access to everyone 18 and over on Saturday.

All that has made Mr. Poonawalla, a 40-year-old billionaire, a focus for public anger.

Last month, Serum Institute wrote a letter to India’s federal home minister asking for security, citing the threats to Mr. Poonawalla. Just a few days ago, the federal government said it had completed a threat assessment and would have the Central Reserve Police Force protect him. On the same day, Mr. Poonawalla announced on Twitter that he was unilaterally lowering the cost of a Covid vaccine to make it more affordable for government purchase.

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