Confirmed coronavirus infections have jumped in much of the world, and deaths from the disease in Africa have increased by 80 percent over the last four weeks, the director-general of the World Health Organization said on Friday.
The continued spread of the virus and its variants, and its disparate impact on poorer countries with lower rates of vaccination, reflect a global failure, said Dr. Tedros Adhanom Ghebreyesus.
“The pandemic will end when the world chooses to end it,” he said at a news conference. “It is in our hands. We have all the tools we need. We can prevent this disease, we can test for it, and we can treat it.”
Dr. Tedros said that nearly four million new infections had been reported to the W.H.O. in the past week, and the organization expected the world to surpass 200 million total known cases in the next two weeks. However, the totals are underestimates, because countries often undercount cases — sometimes by very large margins. The known global death toll of roughly 4.2 million is assumed to be similarly skewed.
The global spread of the virus is now largely driven by the highly transmissible Delta variant and worsened by inconsistent use of public health measures, increased social mixing and mobility, and the inequitable use of vaccines and other treatments, Dr. Tedros said.
“Hard-won gains are in jeopardy or being lost, and health systems in many countries are being overwhelmed,” he said.
Things are still not as bad as they were not long ago; more than 500,000 new cases are being recorded daily, compared with more than 800,000 three months ago, according to data from the Center for Systems Science and Engineering at Johns Hopkins University.
Vaccines remain powerfully effective against severe illness and death, but some highly inoculated countries have recently seen sharp rises in caseloads in recent days. A report published by the Centers for Disease Control and Prevention on Friday showed that fully vaccinated people with “breakthrough” infections of the Delta variant, while still thought to be comparatively rare, may spread the virus to others as easily as unvaccinated people.
Vaccination rates range greatly, from more than 80 percent of adults in some countries to less than 1 percent in some of the world’s poorest nations, according to the Our World in Data project at the University of Oxford.
And even with increased vaccine production and more generous donations to Covax, a vaccine sharing initiative, meeting the needs of lower-income countries with large unvaccinated populations would be difficult, Dr. Tedros said.
He pointed to Africa, where cases have skyrocketed in July and where less than 1.5 percent of the continent’s population is fully vaccinated, as a particularly stark example of the problem.
“Many African countries have prepared well to roll out vaccines, but the vaccines have not arrived,” Dr. Tedros said, calling for a donation of $7.7 billion to a partnership for tests, treatments and vaccines, as well as more financing for Covax.
The U.S. government will cover the costs of regular coronavirus testing for unvaccinated federal workers, one component of the Biden administration’s new vaccination requirements.
President Biden announced new rules Thursday that amount to a two-tier system for the country’s four million federal employees. Those who do not get vaccinated against coronavirus will have to social distance, wear face coverings and face limits on official travel. Those who do get vaccinated will not fall under such requirements.
Unvaccinated workers will also need to be regularly tested for the virus. Each federal agency will come up with a plan for testing its unvaccinated work force, Karine Jean-Pierre, the deputy White House press secretary. The costs and procedures for testing will depend on how many unvaccinated individuals there are at each agency.
“The agencies are going to be implementing this program themselves so they’ll be in charge of how that moves forward,” she said.
The federal decision to cover coronavirus testing for unvaccinated workers could set a benchmark for state governments and companies now grappling with the same issue.
New York and California rolled out similar testing requirements for unvaccinated state workers this week, but neither has specified who will pay for the service. Some companies and universities have already announced that unvaccinated workers themselves will have to pay for their own tests.
Many states and cities still have free coronavirus testing sites that they started earlier in the pandemic. But many Americans also get tested at doctor offices and pharmacies, which will typically bill patients and their insurance for the service.
Federal law requires insurers to fully cover coronavirus tests ordered by health care providers, meaning the doctor cannot apply a deductible or co-payment to the service. Routine workplace testing, however, is exempt from that requirement and it is legal to charge patients for that service.
Some patients have faced surprise medical bills for coronavirus tests, which can range from a few dollars to over $1,000.
“A number of employers, particularly large ones, may just offer on-site testing to unvaccinated workers,” said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms. “But they don’t have to. They can require employees to pick up the tab.”
Daniel E. Slotnik contributed reporting.
MIAMI — The resurgence of the coronavirus has burdened hospitals anew across the country, with a rush of patients fueled by the virus’s virulent Delta variant catching doctors off guard. Florida has reported the highest daily average hospitalizations in the nation, 36 for every 100,000 people over the past two weeks, according to data compiled by The New York Times. In Jacksonville, hospitals have more Covid patients than ever before, despite the availability of vaccines.
Health workers like Alix Zacharski, a nurse manager at Miami’s Jackson Memorial Hospital, feel disbelief that they must endure another surge. She remains tired from the previous one. And she cannot get her head around having to treat patients the same age as her adult children who are gasping for breath because of a preventable infection.
Last year, Ms. Zacharski feared the unknown. Now she is armed with hard-earned knowledge from the past 14 months — and vaccinated, as a sticker on her hospital badge boasts. But the virus continues to move into uncharted territory.
“We are scared of seeing what we saw, and this time affecting the younger population,” she said. “This is the hardest thing I’ve ever done in my entire career.”
Jackson, Florida’s largest public hospital, had 232 Covid-19 patients on Friday, still half the 485 it had on July 27, 2020, its pandemic peak. But a sharp rise in recent hospitalizations prompted administrators to limit visitors and warn that more stringent measures could soon be necessary.
Jackson has also admitted some vaccinated people, but almost all have been transplant patients with compromised immune systems.
Carlos Migoya, Jackson’s chief executive, said the vaccination rate among the hospital’s employees — 60 percent as of Thursday — was too low, a problem plaguing many hospitals, which have started to mandate the shots.
About 61 percent of Miami-Dade County residents are fully vaccinated, higher than the state average of 49 percent. Miami-Dade holds one of the highest vaccination rates among the nation’s large, socially vulnerable counties, those characterized by high poverty rates, crowded housing and poor access to transportation.
A batch of early coronavirus data from China that went missing for a year — prompting questions about whether they had been purposely deleted — has emerged from hiding.
Last month an American scientist discovered that more than 200 genetic sequences from Covid-19 patient samples isolated in Wuhan, China, early in the pandemic had puzzlingly been removed from an online database.
A Seattle virologist, Jesse Bloom, managed to track down 13 of the sequences on Google Cloud. In an online report, he wrote that it “seems likely that the sequences were deleted to obscure their existence.”
But now an odd explanation has emerged, stemming from an editorial oversight by a German scientific journal called Small. And the sequences have been uploaded into a different database, overseen by the Chinese government.
The story began in early 2020, when researchers at Wuhan University sequenced a short stretch of genetic material from virus samples at a Wuhan hospital.
They posted their findings online in March 2020 and uploaded the sequences to an online database maintained by the National Institutes of Health. Their results were published in June 2020 in Small.
But a year later, Dr. Bloom, who was researching the origin of Covid-19, could not find the sequences in the database, and the N.I.H. said the authors of the study had asked the data be withdrawn.
On July 5, more than a year after the Wuhan University researchers withdrew the sequences from the N.I.H. database and two weeks after Dr. Bloom’s report was published, the sequences were quietly uploaded to a different database maintained by China National Center for Bioinformation.
On July 21, the disappearance of the sequences was brought up during a news conference in Beijing, where Chinese officials rejected claims that the pandemic started as a lab leak. A high-ranking Chinese health official, Dr. Zeng Yixin, said the authors had asked for the data to be removed after editors at Small deleted a paragraph in which they were described.
An editor at Small, which specializes in science at the micro and nano scale and is based in Germany, confirmed that account.
On their own, the sequences can’t resolve the open questions about how the pandemic originated, whether through a contact with a wild animal, a leak from a lab or some other route.
Robert Byng was determined to receive his first shot of the Pfizer-BioNTech coronavirus vaccine at the Bushwick branch of the Brooklyn Public Library on Friday, and said that he had pushed back an interview to be there.
The reason? He needed the $100 that now comes with receiving your first dose at a city-run site.
Mr. Byng, 59, is living in a men’s shelter that he said has had plenty of positive cases. That coupled with the fact that he’ll receive $100 for getting his shot motivated him to get vaccinated.
“The $100 does kind of boost your want to get vaccinated,” he said. “Times are hard. That, plus I want to be safe. I’m not ready to die yet.”
The city has tried all kinds of tactics to try to lure in residents to get vaccinated, from gift certificates, free tickets to soccer games and stays in some of the city’s glitziest hotels. Now, it’s simply giving out cash in a bid to entice members of groups whose vaccination rates have stayed stubbornly low. The Biden administration has urged other local and state governments to draw on Covid relief funds to offer similar bonuses.
On the first day the $100 incentives were being offered, foot traffic at vaccination sites in Brooklyn and the Bronx was relatively calm, as the new program was announced just earlier this week.
But at least one group with low vaccination rates seemed to show up in large numbers — those who are 18 to 24 years old.
Several students said they were there because their schools had made getting vaccinated a requirement to return in the fall.
“I’ve been meaning to get it, but just didn’t have the motivation to go until now,” said Sara Rose Monahan, 23, a student at Iona College. The school requires its students to be vaccinated to return, she said, but she said the cash reward “absolutely” pushed her to sign up sooner than she had planned.
Ryan, 20, a student at St. John’s University who did not give his last name, said although vaccinations were mandatory to return in the fall, he signed up to get his first dose in the Bronx in order to get the $100 and two tickets to a New York City Football Club game.
“Two free tickets, I’m going to take them,” he said, laughing.
The incentives also urged him to ask his mother to sign up earlier than the fall.
“I probably would have waited until the last minute,” he said.
The cash incentive also helped convince some who had been hesitant to get the vaccine earlier. Quiana Tineo, 18, a high school senior in the Bronx, said the $100 was what pushed her to swallow her uncertainty and sign up.
“I was thinking about it, but I was worried about the side effects,” Ms. Tineo said, adding that she is not fond of needles either.
And for some who were already planning on getting the shot, the $100 came as an added bonus.
Roger Wood, 60, of Brooklyn, said the $100 incentive was announced just after his pharmacist convinced him to get vaccinated.
Until he talked to his pharmacist, he said, “I didn’t trust it. I wanted to wait.”
Mr. Byng, in Bushwick, said that he heard about the incentive through the news and that he was a little disappointed he wouldn’t receive the money immediately.
“They said I had to go back on the site then register, then a card would be sent in the mail to my address,” he said. “I do think everybody needs to do it eventually, because it looks like Covid isn’t going anywhere anytime soon.”
The Maryland manufacturer that ruined 75 million doses of Johnson & Johnson’s Covid-19 vaccine has received records requests from a host of federal and state law enforcement agencies, regulatory documents filed Friday show.
The company, Emergent BioSolutions, disclosed that it had received “preliminary inquiries and subpoenas to produce documents” from the Justice Department, the Securities and Exchange Commission, the Financial Industry Regulatory Authority, the attorneys general of Maryland and New York and committees in both houses of Congress.
The disclosure reflects the growing spotlight on the politically connected company, which received a $628 million federal contract to be the primary domestic manufacturer of the Johnson & Johnson and AstraZeneca vaccines. Production at a company facility in Baltimore was halted for more than three months after a batch of Johnson & Johnson’s vaccine was found to be contaminated and a subsequent inspection by regulators uncovered serious quality-control problems.
Emergent is already facing a House committee investigation and multiple shareholder lawsuits related to its manufacturing problems. In its disclosure on Friday, the company provided no further detail on the previously unknown requests, but said it was “producing and has produced documents as required in response and will continue to cooperate with these government inquiries.”
Officials with the state and federal agencies either declined to comment or did not respond. A person with knowledge of the matter said that some of the investigative interest stemmed from suspicion of insider trading of Emergent stock, the subject of one of the lawsuits.
A Senate aide confirmed that the committee overseeing health issues was also looking into Emergent’s manufacturing troubles, adding to the previously known scrutiny from Capitol Hill.
An Emergent spokesman, Matt Hartwig, said he could not provide detail on the records requests beyond what was in the filing. “All of the inquiries and litigation matters relate to the same subject matter — our capabilities to manufacture Covid-19 vaccine bulk drug substance,” he said.
The disclosure comes a day after Emergent announced that the Food and Drug Administration had given the go-ahead to resume manufacturing at the Baltimore site, which had been shuttered since April as the company worked to address deficiencies cited by inspectors.
In a conference call with investors on Thursday, Emergent executives announced a $41.5 million hit from being forced to discard doses the F.D.A. deemed unusable, and said the company had spent another $12.4 million to address manufacturing issues in Baltimore.
The newly disclosed inquiries from federal and state agencies underscore a dramatic reversal of fortune for a company that had spent much of the last two decades effectively cornering the market for biodefense, becoming the government’s go-to contractor for products to protect against bioterrorism and infectious disease outbreaks.
When the coronavirus pandemic hit, the government turned to Emergent to produce vaccines and treatments. Thanks to a lucrative deal struck in May 2020, Emergent earned record profits and awarded executives record bonuses.
Defiant in the face of new federal mask recommendations, Gov. Ron DeSantis of Florida on Friday signed an executive order directing state officials to ensure that parents have the power to decide for themselves whether their children wear masks in school this fall.
Mr. DeSantis, a Republican who has made freedom from Covid-19 restrictions a signature part of his administration, announced that he would sign an order “protecting the rights of parents” amid an intensifying national movement to control the pandemic, as a highly contagious Delta variant of the virus rips through the unvaccinated population.
“In Florida, there will be no lockdowns,” Mr. DeSantis said to cheers at a restaurant in Cape Coral, Fla. “There will be no school closures. There will be no restrictions and no mandates.”
The announcement came after Broward County, the second largest school district in Florida, voted this week to require masks in schools. The Centers for Disease Control and Prevention had also recommended that all students, teachers and employees wear masks, regardless of their vaccination status.
Mr. DeSantis called for a stop to school mask mandates and said that the decision should be in the hands of parents, not school or health officials.
His order directed state agencies to ensure that school safety protocols do not interfere with parents’ rights to make health care decisions about their children and empowered the state commissioner of education to withhold state funding from school districts that do not comply.
The issue of masking in schools is particularly potent in Florida, which is experiencing one of the fastest Covid-19 outbreaks in the country and where hospitals are once again filling up with coronavirus patients. In Jacksonville, hospitals have more Covid patients than ever before, despite the availability of vaccines.
Less than half of the Florida population is fully vaccinated, and children under 12 are not yet eligible for the vaccine.
Many schools in Florida will be starting within weeks, which Mr. DeSantis said added to the urgency of the situation.
Citing research that found that transmission of the virus in schools was low last year, Mr. DeSantis reiterated that the decision about masks should be in the hands of the parents.
He said his order would not impede children being masked if their parents so choose, without acknowledging that universal masking — not just of those who opt to wear masks — plays a role in interrupting transmission.
“We really do need to make sure that the parents’ rights are protected,” he said.
A third of the white-tailed deer tested in four states during a federal study had been exposed to the coronavirus, in yet another indication of the unpredictable nature of the disease. The percentage was highest in Michigan, where 60 percent of the animals tested positive.
The presence of the virus in wild deer is not just a curiosity for scientists. The virus has shown it can jump from one species to another, and in the worse case, it could become established in a common animal species, creating a reservoir from which the virus could spill back into humans.
“It’s not just a warning about deer,” said Tony Goldberg, a veterinarian at the University of Wisconsin, Madison, who has been surveying North American bats for evidence of infections with the coronavirus.
The deer could have encountered the virus through contact or proximity to other animals or humans. Exposure is not the same as infection; the blood tests detected antibodies, which could indicate that the deer fought off infection.
The U.S. Department of Agriculture’s Animal and Plant Health Inspection Service conducted the survey because deer have been shown to be susceptible to infection and are often in contact with people. Researchers tested blood samples from deer in Illinois, Michigan, New York and Pennsylvania in 2020 and 2021. The findings have not yet been published in a scientific journal.
Researchers have experimentally infected ferrets, primates and other animals with the coronavirus in the laboratory, and dogs, domestic cats, gorillas and other animals in zoos.
Farmed mink caught the virus naturally from humans. The virus mutated and spread back to humans in a few cases. Farmed mink are now being vaccinated with an experimental vaccine, as are zoo animals.
North American bat species, Dr. Goldberg said, showed no evidence of infection so far. They are significantly different from the Asian bat species that are suspected to be the original hosts of the virus.
Dr. Goldberg said it was difficult to know what close contact with people meant for deer. The animals are often in yards and gardens, but, he joked, not often invited to dinner parties. People could conceivably sneeze on a leaf or into the air with deer nearby, he said, scenarios that seemed “plausible but not likely.”
He added that if one deer became infected, however, it might well infect or expose other deer to the virus. Sewage also can contain the coronavirus.
The survey clearly set off an alarm worth paying attention to. “Please add this finding as reason no. 2,784 to get vaccinated,” Dr. Goldberg said.
Broadway’s theater owners and operators, citing the ongoing dangers of the coronavirus pandemic, said Friday that they have decided to require that theatergoers be vaccinated against Covid-19 and wear masks in order to attend a performance.
The policy, announced just days before the first Broadway play in more than 16 months is to start performances, allows children ineligible for vaccination to attend shows if tested for the virus. But some performing arts venues in New York say they will go even further: The Metropolitan Opera, which hopes to reopen in late September, and Carnegie Hall, which is planning to reopen in October, are not only planning to require vaccinations, but also to bar children under 12 who are not yet eligible to be vaccinated.
The new vaccination requirements for visitors to New York’s most prominent performing arts venues come as the highly contagious Delta variant has caused virus cases to rise, leading the Centers for Disease Control and Prevention to recommend that vaccinated Americans in virus hot spots resume wearing masks indoors. Several major businesses, local governments and the federal government have recently decided to require their employees to get vaccinated or submit to frequent testing.
The Broadway rules, which will be in place at least through October and apply to all 41 Broadway theaters, require that audiences wear masks, except when eating or drinking.
The Broadway vaccination mandate will apply not only to audiences, but also to performers, backstage crew and theater staff. There will be limited exceptions: “people with a medical condition or closely held religious belief that prevents vaccination,” as well as children under 12, can attend with proof of a recent negative coronavirus test.
A vaccine mandate is already in place for Bruce Springsteen’s concert show, which began performances in June, and for “Pass Over,” the new play that plans to start performances on Aug. 4. The new rules will affect all of the shows that follow: Twenty-seven, including many of the blockbuster musicals, plan to get underway in September and October, starting with “Hadestown” and “Waitress” on Sept. 2.
Both Broadway and the Met are planning to open at full capacity, meaning no social distancing, and the Met says that masks will be optional. Broadway theaters range in size from 600 to 1,900 seats, while the Met can seat 3,800.
The Covid-19 vaccination effort has become so polarized in Missouri that some people are responding to the state’s Delta-driven surge by trying to get shots in secret, a doctor there said.
In a video circulated by her employer, Dr. Priscilla A. Frase, a hospitalist and the chief medical information officer at Ozarks Healthcare in West Plains, Mo., said this month that several people had pleaded for anonymity when they came in to be vaccinated, and that some appeared to have made an effort to disguise themselves.
“I work closely with our pharmacists who are leading our vaccine efforts through our organization,” she said, “and one of them told me the other day that they had several people come in to get vaccinated who have tried to sort of disguise their appearance and even went so far as to say, ‘Please, please please, don’t let anyone know that I got this vaccine.’”
It was not clear how many people had tried to alter their appearance to avoid recognition, or how they had done so. Dr. Frase, who wore a mask in the video, did not immediately respond to a request for comment.
Some people, she said in the video, are “very concerned about how their people that they love, within their family and within their friendship circles and their work circles, are going to react if they found out that they got the vaccine.”
“Nobody should have to feel that kind of pressure to get something that they want, you know,” she added. “We should all be able to be free to do what we want to do, and that includes people who don’t want to get the vaccine as well as people who do want to get the vaccine. But we’ve got to stop ridiculing people that do or don’t want to get the vaccine.”
Missouri’s vaccination rate is lagging. According to a New York Times database, 41 percent of Missouri residents have been fully vaccinated, compared with more than 49 percent nationwide. In Howell County, Mo., where Ozarks Healthcare and Dr. Frase are based, only 20 percent of residents are fully vaccinated.
On Thursday, Missouri reached a seven-day average of nearly 2,500 new cases of Covid-19 — an increase of 39 percent over the previous two weeks. Hospitalizations were up 38 percent over the same period.
In yet another unexpected and unwelcome twist in the nation’s pandemic, fully immunized people with so-called breakthrough infections of the Delta variant may spread the virus to others just as easily as unvaccinated people, the Centers for Disease Control and Prevention said in a report published on Friday.
The vaccines remain powerfully effective against severe illness and death, and infections in vaccinated people are thought to be comparatively rare. But the revelation follows a series of other findings this week about the Delta variant, all of which have upended scientists’ understanding of the coronavirus.
An internal agency document, which was obtained on Thursday night by The New York Times, raised even more harrowing questions than the report released on Friday, which focused mainly on a huge cluster of infections in Provincetown, Mass.
Taken together, the data gathered by the C.D.C. throw into question the country’s plans to return to offices and schools this fall, and revives difficult questions about masking, testing and other precautions that Americans had hoped were behind them.
Most immediately, the research informed the agency’s decision this week to advise even vaccinated Americans to resume wearing masks in indoor public areas in communities where the virus is surging.
Even the vaccinated carry high virus levels if they become infected, the agency concluded, making it likely they can transmit the virus as often as the unvaccinated. If so, they may be contributing to increases in new infections — although probably to a far lesser degree than the unvaccinated.
“We spent so much time and energy and treasure trying to figure out this damn virus last year, and how it works and all the things it does,” said Dr. Robert Wachter, chairman of the Department of Medicine at the University of California, San Francisco.
Learning just how different the Delta variant is from the original virus is “just jarring,” he added. “The brain doesn’t like to keep being jerked around like this.”
Studies of outbreaks have shown that Delta is much more contagious than the original virus or the seasonal flu and as contagious as chickenpox, according to the internal document circulated within the C.D.C.
Breakthrough infections among vaccinated people were always anticipated, but until the Delta variant arrived, vaccinated Americans were not expected to be sources of new infections.
The vaccines remain the one reliable shield against the virus, in whatever form it takes.
Fatality rate
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deadly
1918 “Spanish” flu
Spreads faster
Delta variant
More transmissible than Ebola or smallpox, and as contagious as chickenpox.
Original
version of
coronavirus
Seasonal
flu
Chickenpox
Common cold
Average number of people infected by each sick person
Fatality rate
(log scale)
More
deadly
1918 “Spanish” flu
Spreads faster
Delta variant
More transmissible than Ebola or smallpox, and as contagious as chickenpox.
Original version of corona-
virus
Seasonal
flu
Common
cold
Chickenpox
Average number of people infected by each sick person
Fatality rate
(log scale)
More
deadly
Spreads faster
1918 “Spanish” flu
Delta
variant
As infectious as chickenpox.
Original
version of
coronavirus
Seasonal
flu
Common
cold
Chickenpox
Avg. number of people infected by each sick person
As Mindy Greene spent another day in the Covid-19 intensive-care unit, listening to the whirring machines that now breathed for her 42-year-old husband, Russ, she opened her phone and tapped out a message.
“We did not get the vaccine,” she wrote on Facebook. “I read all kinds of things about the vaccine and it scared me. So I made the decision and prayed about it and got the impression that we would be ok.”
They were not.
Her husband and father to their four children was now hovering between life and death, tentacles of tubes spilling from his body. The patient in the room next to her husband had died hours earlier. That July 13 day, Ms. Greene decided to add her voice to an unlikely group of people speaking out in the polarized national debate over vaccination: The remorseful.
“If I had the information I have today we would have gotten vaccinated,” Ms. Greene wrote. Come what may, she hit ‘send.’
Amid a resurgence of coronavirus infections and deaths, people who once rejected the vaccine or simply waited too long are now grappling with the consequences, often in raw, public ways. They are speaking from hospital beds, at funerals and in obituaries about their regrets, about the pain of enduring the virus and watching unvaccinated family members die gasping for breath.
“I have such incredible guilt,” Ms. Greene said one morning as she sat in the fourth-floor lobby outside the I.C.U. at Utah Valley Hospital in Provo, overlooking the mountains where her family once went hiking and four-wheeling. “I blame myself still. Every day.”
The recent surge of infections and hospitalizations among unvaccinated people has brought the grim realities of Covid-19 crashing home for many who thought they had skirted the pandemic. But now, with anger and fatigue piled up on all sides, the question is whether their stories can actually change any minds.
Some people hospitalized with the virus still vow not to get vaccinated, and surveys suggest that the majority of unvaccinated Americans are not budging. Doctors in Covid units say some patients still refuse to believe they are infected with anything beyond the flu.
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