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Doses of molnupiravir.Credit…Agence France-Presse — Getty Images
The U.S. government will invest $3.2 billion to develop antiviral pills for Covid-19, the Department of Health and Human Services announced on Thursday. Such a treatment could keep people out of the hospital and potentially save many lives in the years to come, as the virus becomes a perennial threat despite the distribution of effective vaccines.
A number of other viruses, including influenza, H.I.V. and hepatitis C, can be treated with a simple pill. But despite more than a year of research, no such drug exists for the coronavirus. Operation Warp Speed, the Trump administration’s program for accelerating Covid-19 research, invested far more money in the development of vaccines than of treatments, a gap that the new program will try to fill.
The new influx of money will speed up the clinical trials of a few promising drug candidates. If all goes well, some of those pills might become available by the end of this year. The Antiviral Program for Pandemics will also support research on entirely new drugs — not just for the coronavirus, but for viruses that could cause future pandemics.
Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and a key backer of the program, said he looked forward to a time when Covid-19 patients could pick up antiviral pills from a pharmacy as soon as they tested positive for the coronavirus or develop Covid-19 symptoms. His support for research on antiviral pills stems from his own experience fighting AIDS three decades ago.
At the start of the pandemic, researchers began testing existing antivirals in people hospitalized with severe Covid-19. But many of those trials failed to show any benefit from the antivirals. In hindsight, the choice to work in hospitals was a mistake. Scientists now know that the best time to try to block the coronavirus is in the first few days of the disease, when the virus is replicating rapidly and the immune system has not yet mounted a defense.
Many people crush their infection and recuperate, but in others, the immune system misfires and starts damaging tissues instead of viruses. It’s this self-inflicted damage that sends many people with Covid-19 to the hospital, as the coronavirus replication is tapering off. So a drug that blocks replication early in an infection might very well fail in a trial on patients who have progressed to later stages of the disease.
So far, only one antiviral has demonstrated a clear benefit to people in hospitals: remdesivir. Originally investigated as a potential cure for Ebola, the drug seems to shorten the course of Covid-19 when given intravenously to patients. In October, it became the first — and so far, the only — antiviral drug to gain full F.D.A. approval to treat the disease.
Yet remdesivir’s performance has left many researchers underwhelmed. In November, the World Health Organization recommended against using the drug.
Remdesivir might work more effectively if people could take it earlier in the course of Covid-19 as a pill. But in its approved formulation, the compound doesn’t work orally. It can’t survive the passage from the mouth to the stomach to the circulatory system.
Researchers from around the world are testing other antivirals already known to work in pill form. One such compound, called molnupiravir, was developed in 2003 by researchers at Emory University and has been tested against viruses including influenza and dengue.
Administering a Covid-19 vaccine in Kathmandu, Nepal, this month. Even after a weekslong nationwide lockdown, nearly one in three of the country’s coronavirus tests has been coming back positive.Credit…Prakash Mathema/Agence France-Presse — Getty Images
Sri Lanka is tapping Japan. Nepal has asked Denmark. Bangladesh has appealed to its diaspora in the United States.
South Asian countries are looking to the rest of the world to jump-start inoculation campaigns that have stalled since India halted vaccine exports to deal with its catastrophic second coronavirus wave this spring.
The ad hoc approach shows how the decision by India, the world’s biggest vaccine manufacturer, left poorer countries with few options for vaccines as richer countries hoarded much of the global supply. Even as the United States and other global powers pledge to donate a billion doses to poor nations, the World Health Organization says 11 billion doses are needed to defeat the pandemic.
Countries in South Asia and elsewhere — many battling outbreaks — continue to scramble for vaccines. Health officials say the vaccine pledge by the Group of 7 industrialized nations is too vague to incorporate into real planning, and does little to address the immediate needs of the millions of people awaiting doses.
India’s neighbors began vaccinations this year with a combination of doses donated by India and purchased from the Serum Institute of India, which is producing the vaccine developed by Oxford University and AstraZeneca, branded locally as Covishield.
But as coronavirus cases rose sharply in India in March, Prime Minister Narendra Modi’s government blocked exports, forcing Serum to renege on bilateral agreements and commitments to Covax, the global program aimed at distributing vaccines to the world’s poorest countries.
In Nepal, about 1.4 million people age 65 and older have been awaiting a second shot after receiving a first AstraZeneca dose in March. Nepal’s government has appealed to diplomats in Britain, Denmark, South Korea and the United States for help.
“Efforts are on,” said Dr. Taranath Pokhrel, a director at the Nepalese Health Ministry, “but no substantive progress has been achieved so far.”
Of the first 25 million vaccine doses pledged as donations by the Biden administration, seven million are earmarked for Nepal and other countries in Asia, but in Kathmandu, the Nepalese capital, it’s not clear when, what kind or how many will arrive.
Even after a weekslong nationwide lockdown, nearly one in three of Nepal’s coronavirus tests has been coming back positive. Less than 1 percent of the Himalayan country’s 30 million people are fully vaccinated.
Nepal, Bangladesh and Sri Lanka have all received donations from China of its Sinopharm vaccine. But Sri Lanka, like Nepal, is angling for more AstraZeneca shots to provide a second dose to tens of thousands of people, some of whom have been waiting for nearly four months.
Sri Lanka’s president, Gotabaya Rajapaksa, met with Japan’s ambassador to appeal for 600,000 AstraZeneca doses, and officials said that the Japanese government was receptive.
Japan, which has announced plans to donate doses across Asia, has “given a bit of a green light” to Sri Lanka, Gen. Shavendra Silva, the head of a Sri Lankan Covid task force, told The New York Times.
Sri Lanka’s government plans to inoculate the rest of its population with the donated Sinopharm doses and Sputnik V shots it has purchased from Russia.
Bangladesh, where infections and deaths from a second wave of the coronavirus continue to rise, is counting on its U.S. diaspora to raise pressure on the Biden administration for help obtaining more AstraZeneca doses, said Shamsul Haque, secretary of the country’s Covid vaccine management committee.
“We are short roughly 1.5 million doses of AstraZeneca for second shots,” Mr. Haque said.
China has donated 1.1 million Sinopharm doses, and Bangladesh is negotiating bulk buys of more vaccines from China, and Sputnik V doses from Russia. Only about 4.2 million of Bangladesh’s 168 million people are fully vaccinated.
— Emily Schmall, Aanya Wipulasena, Bhadra Sharma and Julfikar Ali Manik
Moscow in June. As Covid hospitalizations surged this week, the city government took a harder line, requiring vaccinations for many workers in public-facing jobs.Credit…Sergey Ponomarev for The New York Times
The coronavirus pandemic has exposed economic and social fault lines around the globe, but Covid-19 vaccines have made the divides even starker: While some poor countries are pleading for doses to save their people, a few rich ones are awash in shots and lacking takers.
A handful of U.S. states, for example, have tried incentives to get more people vaccinated. But in Moscow, as Covid hospitalizations surged this week, the city government took a harder line, mandating vaccinations for many workers in public-facing jobs.
Some other governments have also attempted to require vaccines. A province in Pakistan has said it will stop paying the salaries of civil servants who are not inoculated, starting next month. And Britain, which is seeing a surge attributed to the spread of the Delta variant of the virus, is weighing whether to make shots obligatory for all health care workers.
The Moscow Times quoted the city’s mayor, Sergei S. Sobyanin, as saying on Wednesday, “When you go out and come into contact with other people, you are an accomplice of the epidemiological process — a chain in the link spreading this dangerous virus.” The mandate he announced focuses on the education, entertainment, health care, and hospitality sectors and will continue until at least 60 percent of employees have been vaccinated, the newspaper reported.
In Britain, officials said that requiring health care workers to be vaccinated would help stop the spread of the virus in hospitals. Nadhim Zahawi, the British vaccine minister, said that there was a precedent for such a requirement. “Obviously, surgeons get vaccinated for hepatitis B, so it’s something that we are absolutely thinking about,” he told Sky News last month.
Many universities in the United States now require at least some students and employees to be vaccinated, and federal officials have repeatedly made clear that most companies with at least 15 employees have the right to require that workers are inoculated.
But vaccine requirements continue to face resistance from some.
In 15 American states, not a single college had announced any type of vaccine requirement as of last month. Days ago, 178 employees of Houston Methodist Hospital who refused to get a coronavirus shot were suspended. And on Saturday, protesters are expected at the offices of the New York State Bar Association in Albany, where officials will be discussing a report that recommends mandating a coronavirus vaccine for all New Yorkers, unless they are exempted by doctors.
But for the undecided who are open to persuasion, incentives to get the vaccine remain common: There are lotteries in California, college scholarships in New York State and free drinks in New Jersey.
The giveaways have spurred some to action. This week, both New York and California announced that they were lifting virtually all coronavirus restrictions on businesses and social gatherings.
Madrid in May. Some countries heavily dependent on tourism, like Spain and Greece, have already reopened to external travelers.Credit…Emilio Parra Doiztua for The New York Times
Warmer weather and low coronavirus case numbers are raising hope in some countries in Europe that vaccine rollouts could usher in a more normal summer after an erratic year of lockdowns.
France announced on Wednesday, sooner than expected, that it was ending a mandate on mask wearing outdoors and lifting a nighttime curfew that has lasted for months — an increasingly unpopular measure as days grew longer and cafes reopened.
“The health situation in our country is improving, and it is improving even faster than what we had hoped,” Jean Castex, the French prime minister, said in making the announcement, which some political opponents noted came a few days before regional elections.
In addition, tourists from the United States may be allowed back into European Union countries as early as Friday — a move crucial to lifting Europe’s battered economies. On Wednesday, ambassadors of the European Union indicated their support for adding the United States to a list of countries considered safe from an epidemiological point of view, a bloc official confirmed, though no official announcement is expected until Friday.
The traffic will be one-way, however, unless the United States lifts its ban on many European travelers, which was first announced over a year ago. The U.S. barred noncitizens coming from many countries around the globe, including those in the Schengen area of Europe, Britain and the Republic of Ireland.
In Europe, however, low infection numbers in many countries in recent weeks have been taken as an optimistic sign. But that is not the case everywhere. In Britain, officials are keeping watch for the Delta variant, which has spurred a rise in cases, and on Monday delayed by a month a much-anticipated reopening that had been heralded as “freedom day.”
And in Moscow, a surge of cases prompted a shutdown, leaving Russian officials pleading with residents to get vaccinated.
Still, the move to open up E.U. countries to tourists coming from the United States signaled a wider hope that the bloc was on a pathway to normalcy.
Health policy in the European Union is ultimately the province of member governments, so each country has the right to decide whether to reopen and how to tailor the travel measures further — by adding requirements for PCR tests or quarantines, for example.
Travel from outside the bloc was practically suspended last year to limit the spread of the coronavirus, with the exception of a handful of countries that fulfilled specific criteria, such as a low infection rate and their overall response to Covid-19. Until Wednesday, the list contained a relatively small number of nations, including Australia, Japan and South Korea, but more are coming, including Albania, Lebanon, North Macedonia and Serbia.
Some countries heavily dependent on tourism, like Spain and Greece, have already reopened to external travelers. Germany also lifted more restrictions this month, announcing it would remove a travel warning for locations with low infection rates from July 1.
The European Commission, the executive arm of the European Union, recommended last month that all travelers from third countries who were fully vaccinated with shots approved by the European Medicines Agency or by the World Health Organization should be allowed to enter without restrictions.
The loosening of travel measures was enabled by the fast pace of vaccination in the United States and by the acceleration of the inoculation campaign in Europe, and bolstered by advanced talks between the authorities on how to make vaccine certificates acceptable as proof of immunity.
The European Union is also finalizing work on a Covid certificate system, which is supposed to be in place on July 1. Fifteen member countries already started issuing and accepting the certificate ahead of schedule this month. The document records whether people have been fully vaccinated against the coronavirus, recovered from Covid or tested negative within the past 72 hours, and it would eventually allow those who meet one of the three criteria to move freely across the bloc’s 27 member countries.
Travelers coming from outside the bloc would have the opportunity to obtain a Covid certificate from an E.U. country, the European Commission said. That would facilitate travel between different countries inside the bloc, but would not be required for entering the European Union.
Tourists at the Taj Mahal in Agra, India, this week.Credit…Money Sharma/Agence France-Presse — Getty Images
The majestic Taj Mahal in India reopened its doors to visitors this week, part of a broad easing of restrictions by local governments hoping to revive a battered tourism industry.
The move to open up the economy comes even as the country is still in the midst of a devastating outbreak that has killed hundreds of thousands. Vaccination continues at a slow pace and some health experts have warned that easing restrictions too quickly could have deadly consequences.
While the number of new cases across the nation has dropped steadily in recent weeks, — with 67,208 new infections reported on Wednesday, the lowest number in two months — health officials in some regions, including Mumbai, have warned that a new deadly wave could come soon as cases there rise.
Still, local governments across the country are continuing to open up.
In Delhi, the capital, the authorities are also moving to reopen attractions, including the popular Red Fort.
The Taj Mahal is in the city of Agra in the northern state of Uttar Pradesh, where hundreds of dead bodies were buried on the banks of the Ganges as coronavirus deaths spiked in April and May.
The Taj Mahal, built in the 17th century by the Mughal emperor Shah Jahan as a tomb for his wife, Mumtaz Mahal, is a major tourist attraction and is normally thronged by more than seven million visitors annually, or an average of about 20,000 people per day.
The authorities closed the monument on April 17, the first time that had happened since 1978, when a river snaking out of Agra flooded the area. It was previously closed during World War II in 1942, and when India and Pakistan were at war in 1971.
Officials in Agra said that visitors wanting to go to the Taj Mahal had to book tickets online and that tourists would be allowed to enter the premises only if they were wearing a mask.
“No one is allowed to touch the wall of the monuments,” said Vasant Kumar Swarnkar, an official with the Archaeological Survey of India, a government body, adding, “The monument is being sanitized three times a day.”
Kamlesh Tiwari, a guide at the Taj Mahal, said that most of those who had visited the monument since it had reopened were local tourists and that the crowds had been relatively modest so far.
“We don’t expect a major rush because foreign tourists are missing,” he said. “We are jobless since last April because there is no tourism.”
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Mughal emperor Shah Jahan built a mausoleum in memory of his wife, Mumtaz, in Agra, India.CreditCredit…Jeremy Woodhouse/Getty Images
Tokyo on Thursday. Some restrictions will remain in place in the capital and in six other areas until at least July 11, officials said. Credit…Charly Triballeau/Agence France-Presse — Getty Images
The government in Japan said on Thursday that it would relax emergency measures in Tokyo and other areas as the country’s latest coronavirus outbreak recedes, and with the Olympic Games scheduled to begin in just over five weeks.
Prime Minister Yoshihide Suga made the announcement at a meeting of the government’s coronavirus task force, saying that new infections had declined over the past month and that the strain on the nation’s hospitals had eased.
On Sunday, the state of emergency will be lifted in nine prefectures, but some restrictions will remain in place in Tokyo and in six other areas until at least July 11, the government said. Emergency measures in Okinawa will remain in effect for three more weeks, officials said.
The announcement comes as new daily cases reported in Japan have fallen by 48 percent over the past two weeks, to an average of 1,625 a day, according to a New York Times database. More than 684,000 vaccine doses were administered on Wednesday, twice as many as a month ago, based on government data.
Still, Japan’s vaccination drive remains one of the slowest among richer nations: About 26 million vaccine doses have been administered, with 15 percent of the population having received at least one shot, Times data shows.
Tokyo has been under a state of emergency since late April, the third since the start of the pandemic. Under the rules that go into effect on Monday, alcohol sales will be allowed to resume, but only until 7 p.m., while dining establishments will still be asked to close by 8 p.m.
The chief medical adviser to Japan’s government, Shigeru Omi, said that officials must remain vigilant and “take strong measures without hesitation” if cases begin to rise again.
With the Games set to begin in Tokyo on July 23 — and officials reportedly considering allowing up to 10,000 domestic spectators at some events — experts warn that infections could resurge. But John Coates, a vice president of the International Olympic Committee who is currently visiting Japan and under quarantine, said at a news conference last month that the Games could go on even if another state of emergency were declared.
The Lucerne was among about 60 hotels in New York City that took in homeless people during the pandemic. Residents received supplies from volunteers outside the hotel in November 2020. Credit…Amr Alfiky/The New York Times
New York City plans to move about 8,000 homeless people out of hotel rooms and back to barrackslike dorm shelters by the end of July so that the hotels can reopen to the general public, Mayor Bill de Blasio said on Wednesday.
When the pandemic lockdown began last spring, New York City moved the people out of the shelters, where in some cases as many as 60 adults stayed in a single room, to safeguard them from the coronavirus. Now, with social distancing restrictions lifted and an economic recovery on the line, the city is raring to fill those hotel rooms with tourists.
“It is time to move homeless folks who were in hotels for a temporary period of time back to shelters where they can get the support they need,” Mr. de Blasio said at a morning news conference.
The mayor said the city would need the state’s approval to remove the homeless people from 60 hotels, but a spokesman for Gov. Andrew M. Cuomo said that as long as all shelter residents — even vaccinated ones — wore masks, the state had no objections to the plan.
On Tuesday, Mr. Cuomo announced that the state was lifting nearly all remaining coronavirus restrictions and social distancing measures, after more than 70 percent of the state’s adults had received at least a first dose of a vaccine.
The hotels, many of them in densely populated parts of Manhattan, have been a source of friction with neighbors who have complained of noise, outdoor drug use and other nuisances and dangers from the hotel guests.
Wednesday’s announcement signals the end to a social experiment that many homeless people gave high marks to, saying that having a private hotel room was a vastly better experience than sleeping in a room with up to 20 other adults, many of them battling mental illness or substance abuse or both. Some people said they would sooner live in the street.
“I don’t want to go back — it’s like I’m going backward,” said Andrew Ward, 39, who has been staying at the Williams Hotel in Brownsville, Brooklyn, after nearly two years at a men’s shelter. “It’s not safe to go back there. You’ve got people bringing in knives.”
Dominic Cummings, right, a former aide to Prime Minister Boris Johnson, leaving the Houses of Parliament last month after testifying in detail about a chaotic government response to the Covid crisis last year.Credit…Facundo Arrizabalaga/EPA, via Shutterstock
On the night of March 26, 2020, as the coronavirus was engulfing Britain and its leaders were struggling to fashion a response, Prime Minister Boris Johnson ridiculed his government’s health secretary, with a profanity, as totally “hopeless,” according to a text message posted by his former chief adviser.
The WhatsApp message, one of several texts shared on Wednesday by Mr. Johnson’s former aide, Dominic Cummings, reignited a debate over how Britain handled the early days of the pandemic — a period when Mr. Cummings said it lurched from one course to another and failed to set up an effective test-and-trace program.
In riveting testimony before Parliament last month, Mr. Cummings pinned much of the blame for the disarray on the health secretary, Matt Hancock, whom he accused of rank incompetence and serial lying. Mr. Hancock denied the accusations before lawmakers last week. He said it was “telling” that Mr. Cummings had not provided evidence to back up his most incendiary claims.
The WhatsApp messages, and an accompanying 7,000-word blog post, are the former aide’s attempt to do so. They depict a government under relentless stress, racing to secure ventilators and protective gear, scale up a testing program, and settle on the right strategy to prevent the nation’s hospitals from collapsing.
In the text exchange with Mr. Johnson on March 26, Mr. Cummings noted that the United States went from testing 2,200 people a day to 100,000 in two weeks. He said Mr. Hancock was “skeptical” about being able to test even 10,000 a day, despite having promised two days earlier to reach that goal within a few days.
The exchange prompted Mr. Johnson’s profane description of Mr. Hancock. Later, Mr. Johnson was severely ill with Covid-19 and hospitalized, forcing his foreign secretary, Dominic Raab, to lead in his absence. Mr. Cummings said Mr. Raab did a far better job leading the government’s response to the pandemic, than Mr. Johnson, with whom he helped elect but has since had a bitter falling out.
Marcel Kuttab, 28, started getting parosmia — distortions of smell and taste — months after contracting the coronavirus in March 2020.Credit…Katherine Taylor for The New York Times
The pandemic has put a spotlight on parosmia, a once little-known condition that distorts the senses of smell and taste, spurring research and a host of articles in medical journals.
Membership has swelled in existing support groups, and new ones have sprouted. A fast-growing British-based parosmia group on Facebook has more than 14,000 members. And parosmia-related ventures, including podcasts and smell training kits, are gaining followers.
A key question remains: How long does Covid-19-linked parosmia last? Scientists have no firm answers.
Parosmia is one of several Covid-related problems associated with smell and taste. The partial or complete loss of smell, or anosmia, is often the first symptom of the coronavirus. The loss of taste, or ageusia, can also be a symptom.
In 2020, parosmia became remarkably widespread, frequently affecting Covid-19 patients, who lost their sense of smell and then largely regained it, before a distorted sense of smell and taste began.
Credit…Illustration by Brian Rea
Last fall, as academics and public-health experts in the United States puzzled over how to make all schools safe for full-time, in-person learning, the Centers for Disease Control and Prevention was advising everyone to wear masks and remain six feet apart at all times.
But most schools could not maintain that kind of distance and still accommodate all their students and teachers. The C.D.C’s guidance also left many questions unanswered: How did masks and distancing and other strategies like opening windows fit together? Which were essential? Could some measures be skipped if others were followed faithfully?
The C.D.C. seemed incapable of answering these questions. From the pandemic’s earliest days, the agency had been subject to extreme politicization, and its advisories on mask-wearing, quarantine and ventilation had been confusing, inconsistent and occasionally wrong. While the agency has made clear improvements under the Biden administration and a new director, Dr. Rochelle Walensky, its messaging is still deeply muddy and communities across the country — and school districts, especially — are still struggling with next steps.
As the rest of the nation is learning, the former president was not the C.D.C.’s only — or even its biggest — problem.
