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How the Virus Unraveled Hispanic American Households

How the Virus Unraveled Hispanic American Families

To a wide circle of friends and family, Jesse Ruby was the go-to guy.

The father who would drop everything and drive across town if his sons needed a ride. The cousin who spent weekends helping relatives move. The partner who worked odd jobs on weekends with his girlfriend, Virginia Herrera, to help make ends meet for an extended household in San Jose, Calif.

“If he was your friend, or he considered you a friend or family, all you had to do is ask,” Ms. Herrera said. “You could depend on him. He was that person.” Then, in December, Mr. Ruby caught the coronavirus. He died six weeks later, at just 38 years old.

Across the United States, the pandemic has shattered families like Mr. Ruby’s. Hispanic American communities have been pummeled by a higher rate of infections than any other racial or ethnic group and have experienced hospitalizations and deaths at rates exceeded only by those among Native Americans and Alaska Natives.

But new research shows the coronavirus has also attacked Hispanic Americans in an especially insidious way: They were younger when they died.

They are much more likely than white Americans to have died of Covid-19 before age 65, often in the prime of life and at the height of their productive years. Indeed, a recent study of California deaths found that Hispanic Americans between the ages of 20 and 54 were 8.5 times more likely than white Americans in that age range to die of Covid-19.

“It matters how old you are when you die, because your role in society differs,” said Dr. Mary Bassett, director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard’s T.H. Chan School of Public Health.

Her research has found that Hispanic Americans and Black people who died of Covid-19 lost three to four times as many years of potential life before the age of 65 as did whites who died.

The virus more often killed white Americans who were older. Their deaths were no less tragic, but they did not lead to the unraveling of income streams and support networks that was experienced in Hispanic American communities. These families experienced a very different pandemic.

“When you die young, you may be a critical breadwinner for your family,” Dr. Bassett said. “You may have dependent children. And we know that losing a parent is not good for children and has an impact on their future development and psychological well-being.”

Mr. Ruby and Ms. Herrera lived together in San Jose, Calif., where the extreme wealth of Silicon Valley’s high-tech elite contrasts with poverty and homelessness, and where working families double and triple up under the same roof, paying some of the highest rents in the country.

“It’s a tale of two cities,” said Jennifer Loving, chief executive officer of Destination: Home, a public-private partnership aiming to end homelessness in Santa Clara County, which includes San Jose. “We literally have Teslas sitting outside homeless encampments.”

Health is as polarized as wealth. An analysis of county death records by The New York Times provides a rare, granular look at who died of Covid-19 in a county of 1.9 million people — by age, sex, race and ethnicity, pre-existing health conditions and, importantly, where people lived.

The data show that people like Mr. Ruby and others in largely Hispanic neighborhoods, and in those areas where incomes are lower than the county median, were more likely to die at a younger age than those in high-income communities or in those where fewer Hispanic Americans were living.

The records were first obtained by Evan Low, a California Assembly member who advocated unsuccessfully for legislation requiring the state’s health department to collect and publicly report Covid-19 deaths by ZIP code.

“The goal is greater transparency about what has occurred during the pandemic,” Mr. Low said. “We need to know which neighborhoods have been most impacted. We want to understand precisely where people died of Covid, so we have data and facts to guide policy.”

Through the end of February, white residents were just as likely to die of Covid-19 as Hispanic residents, according to The Times’s analysis. But the white residents were much older, on average.

The median age at death was 86 for white Covid-19 patients, compared with 73 for Hispanic individuals. The analysis shows that while only 25 percent of the county’s population is Hispanic, 51 of the 68 residents under age 50 who died of Covid-19 through the end of February were Hispanic.

Only seven were white, though white residents make up nearly one-third of the county. Most of the others were of Asian or Pacific Islander backgrounds. (Asian-American residents had a much lower death rate, half that of white and Hispanic residents.)

Four San Jose ZIP codes with largely Hispanic populations — 95116, 95122, 95127 and 95020 — accounted for one in five of the Covid-19 deaths in Santa Clara County, even though they represented only one in eight of the county’s residents. Households in the four ZIP codes had incomes that were lower than the median in the county.

The patterns in Santa Clara County hint at a broader disparity throughout the nation. Hispanic Americans, who are more likely than white Americans to have jobs that cannot be done remotely and do not provide paid sick leave, are three times as likely as white Americans to be hospitalized with Covid-19 and more than twice as likely to die of it. Many lack health insurance.

Mr. Ruby was a charmer who could chat up anyone, the life of the party. Friends in school had nicknamed him Buddha, a reference to his happy-go-lucky nature and his chunky frame.

“He was all about having a good time,” said a cousin, Anthony Fernandez. “He would have you laughing within the first five minutes of talking to you.”

In 2011, when Ms. Herrera met Mr. Ruby, she was reluctant to get involved. He had just been released from a short stint in prison for a burglary involving beer. He had a scar on his stomach from a gunshot wound and a large, prominent tattoo of a Buddha on his forehead. She prevailed on him to remove it.

“I told him, ‘I’m not a pen pal,’” Ms. Herrera recalled. “‘I’m not going to write you in jail. You need to be out.’”

The relationship was stormy at first, but Mr. Ruby eventually became an integral, trusted part of Ms. Herrera’s extended family. He helped support two teenage sons from a previous relationship: Jesse Jr., 18, who plans to start attending community college in the fall, and Joseph, 16.

Mr. Ruby became a surrogate father to Ms. Herrera’s daughter, coaching her baseball team and watching movies with her when she was moping. He made a mean enchilada casserole, and took charge of the laundry and repairs around the house.

He even won over Ms. Herrera’s mother, Virginia Marquez, who thought he drank too much when she first met him but came to love Mr. Ruby.

“He was the person you could call,” she said. “He would drop what he was doing and go help.”

Ms. Herrera has felt the loss of Mr. Ruby in uncountable ways, but money has been a particular concern.

Shortly before he fell ill, Mr. Ruby had landed a steady job building walk-in coolers and freezers (Ms. Herrera said removing the Buddha tattoo had helped). The job paid well, he got to drive the company truck, and there was plenty of overtime.

For a brief while, “It felt like a weight was taken of our shoulders,” Ms. Herrera said. His abrupt death left her grieving — and panicked. “We went halves on everything, so I’ve struggled,” she said.

Researchers have long remarked on the social networks and expansive family ties that help explain why Hispanic Americans tend to be as healthy as, or healthier than, white Americans. Hispanic Americans have high rates of diabetes and obesity but live longer than white Americans, despite lower average incomes and educational levels and reduced access to health care.

But the phenomenon, called the Hispanic paradox, has not held up during the pandemic. A recent study in Health Affairs found that 70 percent of Covid-19 cases in California where race and ethnicity were known had struck Hispanic individuals, though that group makes up only 39 percent of the state population. Hispanic Americans also accounted for nearly half of the deaths from Covid-19 in the state.

“Covid-19 is so overwhelming that this previously known paradox, which is also called the healthy immigrant effect, is overwhelmed,” said Erika Garcia, an assistant professor of environmental health at the University of Southern California, whose study identified the discrepancies in death rates among younger adults in California.

The coronavirus spreads very quickly within households, and so close ties among extended households have emerged as detrimental factors for Hispanic Americans. A Health Affairs study also found that Hispanic Californians were eight times as likely as white residents to live in a “high exposure-risk household,” which scientists defined as one having one or more essential workers and fewer rooms than inhabitants.

“The stereotype is that Latino families care about family more, but it’s not really about that — it’s about the need to pool together resources,” said Zulema Valdez, a professor of sociology at the University of California, Merced. “There’s a whole web of a social safety net that the family is providing.”

A death creates a hole in the net. “They’re immediately one paycheck away from homelessness,” Dr. Valdez said.

“Everybody knows someone who has died, or multiple people who have died, and everyone is figuring out how to compensate for the roles and duties that are no longer being done by those people,” she added. “The hardship is extreme.”

Deaths of wage earners add to the hardships minority communities are already experiencing during the pandemic.

One in five Black and Hispanic Americans reported being behind on their rent or mortgage in April, compared with 7.5 percent of white Americans. One in five Black and Hispanic adults in households with children said they did not have enough to eat in the previous week, compared with 6.4 percent of white Americans, according to analyses of census surveys by Diane Schanzenbach, an economist at Northwestern University.

A few days before Thanksgiving, Ms. Marquez’s husband, a Lyft driver, got what looked at first like a cold. He started having trouble breathing — and then a coronavirus test came back positive.

He was hospitalized on Thanksgiving Day. Ms. Marquez, the mother of Mr. Ruby’s girlfriend, canceled the festive meal she had planned for the family and told everyone to stay away. But Ms. Herrera and Mr. Ruby stopped by for a brief visit, and then the virus raced through the two households.

Five in Ms. Marquez’s household of nine were infected; aside from her husband, most had mild symptoms. In Ms. Herrera’s household of eight, all but two got sick. Mr. Ruby’s teenage boys, who did not live with them, also became ill.

On Dec. 4, Mr. Ruby’s fever spiked to 104 degrees, and he too struggled to breathe. His job’s private insurance hadn’t kicked in yet — he was on California’s Medicaid program, MediCal — and Ms. Herrera drove him to a hospital emergency room.

His weight, high blood pressure and diabetes all put Mr. Ruby at high risk for severe disease, but the hospital sent him home. Ms. Herrera is still tormented about that.

“I keep on replaying over and over,” she said. “What did I say, what did I do? Could I have done something different? Should I have turned the car around and went into the E.R. myself to say, ‘Why are you sending him home?’”

Mr. Ruby spent the next few days at home sleeping. He refused food, and Ms. Herrera, who was starting to recover from her own bout with the virus, tried to make sure he stayed hydrated.

When Mr. Fernandez, his cousin, texted to ask how he was, Mr. Ruby responded with one word: “Tired.”

On Dec. 8, Mr. Ruby’s skin began to turn blue, and Ms. Herrera called an ambulance. This time, the hospital admitted him. A few days later, Mr. Ruby seemed to rally. But then he took a turn for the worse and was told he would be placed on a ventilator.

He told Ms. Herrera on the phone that he was scared.

“I just kept reminding him, ‘You’re going to come home, you’re going to be OK, and when it’s time, we’ll laugh about this,’” she said. He died on Jan. 16.

The family’s grief metastasized into accusations and guilt. Some of Mr. Ruby’s family members blamed Ms. Herrera, saying she should have gotten him help sooner. Mr. Fernandez blames the hospital, saying E.R. physicians should never have sent Mr. Ruby home when he first sought help.

There was bickering over donations raised to help the family get through the crisis, and relationships have frayed. Life will never be the same for anyone in the extended family.

“Jesse always used to say, ‘Nothing can take me out,’” Ms. Herrera said. “I was waiting for him to come home and tell stories about how he beat Covid that he’d repeat over and over until he got on my nerves. I never had any doubt in my mind that he was going to come home.”

Susan Beachy contributed research.

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Health

Why Apple and Google’s Virus Alert Apps Had Restricted Success

Why Apple and Google’s Virus Alert Apps Had Limited Success

Sarah Cavey, a Denver real estate agent, was delighted last fall when Colorado rolled out an app to warn people of potential coronavirus exposures.

Based on software from Apple and Google, the government smartphone app uses Bluetooth signals to recognize users who are in close contact. If a user later tests positive, that person can anonymously notify other app users that the person may have crossed over with on restaurants, trains, or elsewhere.

Ms. Cavey immediately downloaded the app. After testing positive for the virus in February, she couldn’t get the special verification code she needed from the state to warn others, she said, even after calling the Colorado Health Department three times.

“You promote this app to make people feel comfortable,” said Ms. Cavey, adding that she has since deleted the CO Exposure Notifications app in frustration. “But it doesn’t really matter.”

The Colorado Health Department said they have improved their process and are now automatically issuing verification codes to anyone in the state who test positive.

When Apple and Google announced last year that they were working together to create a smartphone-based system to contain the virus, their collaboration seemed like a game changer. Human contact tracers have struggled to keep up with the rise in virus levels, and the trillion-dollar competing companies, whose systems power 99 percent of the world’s smartphones, had the potential to quickly and automatically alert far more people.

Soon after, Austria, Switzerland, and other nations introduced virus apps based on Apple’s Google software, as did around two dozen American states, including Alabama and Virginia. According to an analysis by Sensor Tower, an app research company, the apps have been downloaded more than 90 million times to date.

However, some researchers say that companies’ product and policy decisions limited the usefulness of the system, raising questions about big tech’s ability to set global standards for public health tools.

Computer scientists have reported accuracy issues with Bluetooth technology, which is used to detect proximity between smartphones. Some users have complained about failed notifications. So far, there has hardly been any rigorous research into whether the apps’ potential to precisely alert people to virus loads outweighs potential disadvantages – for example, incorrectly warning not exposed people, over-testing or not recognizing users who are exposed to the virus.

“It’s still an open question whether these apps help, or just distract, or even cause problems with real-world contact tracing,” Stephen Farrell and Doug Leith, computer science researchers at Trinity College Dublin, wrote an April report on Ireland’s virus alert- App.

In the United States, some public health officials and researchers said the apps had shown modest but important benefits. In Colorado, more than 28,000 people have used the technology to inform contacts of potential virus exposures. In California, where a virus tracking app called CA Notify was launched in December, around 65,000 people have used the system to alert other app users.

“Exposure notification technology has shown success,” said Dr. Christopher Longhurst, UC San Diego Health’s chief information officer, who manages the California app. “Whether it’s hundreds of lives saved or dozens or a handful, when we save lives it’s a big deal.”

In a joint statement, Apple and Google said, “We are proud to work with health officials to provide a resource that has enabled millions of people around the world and that has helped protect public health.”

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The Apple and Google system, based in part on ideas developed by the Singapore government and scientists, includes privacy measures that provide health officials with an alternative to more invasive apps. Unlike virus tracking apps, which continuously track users’ whereabouts, Apple and Google software use Bluetooth signals that can estimate the distance between smartphones without knowing where users are. It also uses rotating ID codes – not real names – to log app users who have been in close contact for 15 minutes or more.

Some health officials predicted last year that the technology could inform users of virus exposure faster than human contact tracers. Others hoped the apps could warn commuters sitting next to an infected stranger on a bus, train, or plane – people at risk who contact tracers typically cannot identify themselves.

“Everyone who uses the app helps to keep the virus under control,” said Chancellor Angela Merkel in a video to advertise the country’s warning system called Corona-Warn-App last year.

However, the apps never received the extensive efficacy tests that were normally done before governments introduced public health interventions such as vaccines. And the software’s privacy features, which prevent government agencies from identifying app users, have made it difficult for researchers to determine if the notifications were hindering the transmission of viruses, said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

“The apps played virtually no role in investigating any outbreaks that occurred here,” said Dr. Osterholm.

Some restrictions already occurred before the apps were released. For one, some researchers find that exposure notification software inherently excludes certain vulnerable populations, e.g. B. older people who cannot afford smartphones. Second, the apps could trigger false positives as the system is not set up to take damage control factors into account, e.g. B. whether users are vaccinated, wearing masks or sitting outside.

Proximity detection in virus alert apps can also be inconsistent. Last year, a study of Google’s system for Android phones carried out on a Dublin tram reported that the metal walls, floors and ceilings distorted Bluetooth signal strength enough that the likelihood of accurate proximity detection would be “similar” Trigger notifications by randomly selecting passengers.

Such glitches angered early adopters like Kimbley Craig, the Mayor of Salinas, California. Last December, when virus rates rose there, she downloaded the state exposure notification app on her Android phone and tested positive for Covid-19 shortly afterwards. After she entered the verification code, the system was unable to send a notification to her partner, with whom she lived and who had also downloaded the app.

“Unless it takes one person in the same household, I don’t know what to tell you,” said Mayor Craig.

In a statement, Steph Hannon, Google’s senior director of product management for exposure notifications, said there are “known challenges in using Bluetooth technology to approximate the exact distance between devices” and that the company is continually working to improve accuracy.

Company policies have also influenced usage trends. For example, in certain US states, iPhone users can turn on exposure notifications with one click by simply enabling a feature in their settings. However, Android users need to download a separate app. As a result, by May 10, about 9.6 million iPhone users in California had the notifications turned on, far exceeding the 900,000 app downloads on Android phones.

Google has set up its system in such a way that states work on a wide variety of devices and can be made available as quickly as possible.

Some public health experts admitted that the exposure warning system was an experiment where they and the tech giants learned and built improvements over time.

One problem they discovered early on: To prevent false positives, states review positive test results before a person can send exposure notifications. However, it can sometimes take days for local laboratories to send test results to health officials, limiting the ability of app users to quickly notify others.

In Alabama, for example, the government’s GuideSafe virus alert app has been downloaded around 250,000 times, according to Sensor Tower. However, state health authorities said they could confirm the positive test results from only 1,300 app users. That’s a much lower number than health officials expected, as more than 10 percent of Alabamians tested positive for the coronavirus.

“The app would be much more efficient if these processes were less manual and automated,” said Dr. Scott Harris, who oversees the Alabama Department of Health.

Colorado, which automatically issues verification codes to people who test positive, has reported higher usage rates. In California, UC San Diego Health has set up a dedicated hotline that app users can call if they haven’t received their verification codes.

Dr. Longhurst, the medical center’s chief information officer, said the California app proved useful as part of a larger statewide public health push that included wearing masks and virus testing.

“It’s not a panacea,” he said. But “it can be an effective part of a pandemic response.”

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Health

Mount Sinai Seeks to Develop Faculty Virus Testing Program

Mount Sinai Seeks to Expand School Virus Testing Program

Every week, students at KIPP Infinity Middle School, in West Harlem, file into a large auditorium and take their places on the designated floor markings, making sure to stand six feet apart. Then they pull down their masks and fill sterile tubes with their spit.

The school’s teachers try to make the experience fun, running competitions to see who can fill their tube fastest and holding dance contests while students wait for their classmates to finish.

“It’s kind of enjoyable,” said Bradley Ramirez, a seventh grader at the school who likes math and Minecraft. “It’s way better than just sticking a stick up your nose.”

Bradley and his classmates are participants in a coronavirus testing pilot program created by the Mount Sinai Health System, the nonprofit Pershing Square Foundation and KIPP NYC, a network of 15 local charter schools. Since early March, the program has conducted more than 13,000 saliva-based tests of KIPP students, teachers and staff members, identifying several dozen cases of the virus.

Now Mount Sinai and Pershing Square are hoping to expand. On Tuesday they announced the Mount Sinai Covid Lab initiative, inviting additional charter schools, as well as local businesses and organizations, to sign up for the saliva-based testing program. They are putting the finishing touches on a new laboratory that they say will be capable of processing as many as 100,000 coronavirus tests a day and are preparing a formal proposal to take the program to New York City’s public schools this fall.

The announcement comes the day after Mayor Bill de Blasio said that the city planned to fully reopen schools, eliminating remote learning, in the fall.

“The way you keep a school safe, the way you make teachers feel comfortable with the reopening of schools, the way you make parents feel comfortable sending their kid, is you have a testing program,” said William A. Ackman, a hedge fund manager who founded the Pershing Square Foundation.

The testing program originated in December, when Mr. Ackman decided that he wanted to find a way to get New York City children back to school and approached Mount Sinai with a proposal: What if he provided funding for the hospital to build a laboratory that could process 100,000 coronavirus tests a day? The hope was that the lab could devote some of that capacity to corporate clients, such as businesses that wanted to test their employees, and use the revenue to fund wide-scale testing for New York City schoolchildren.

Mount Sinai quickly agreed. “We began on a concerted effort that people at Mount Sinai have really rallied around,” said Dr. David Reich, president and chief operating officer of Mount Sinai Hospital. “It’s just one of those projects where you never have to worry about people wanting to show up for your Zoom meeting — they’re all there, and they’re all smiling.”

The Pershing Square Foundation, whose trustees are Mr. Ackman and his wife, Neri Oxman, agreed to provide $20 million, and Mount Sinai began to convert an old laboratory space at its downtown campus into a high-volume coronavirus test processing center.

At the time, scientists at Mount Sinai’s Icahn School of Medicine were among a number of groups across the country that were working to develop saliva-based coronavirus tests. The gold standard diagnostic tests are known as P.C.R. tests, which can detect even minute amounts of the virus in biological specimens. During the early months of the pandemic, these tests generally required medical professionals to stick a swab deep into a patient’s nasopharynx, a procedure that can be deeply uncomfortable and put clinicians at risk.

Saliva-based P.C.R. tests, many scientists came to believe, would be safer and less invasive. They would also be much more suitable for young children than the deep, nasopharyngeal swabs. “A brain scoop, for a kid? Really? That’s a no-no,” said Dr. Alberto Paniz-Mondolfi, a pathologist at Mount Sinai who led development of the new saliva test.

As the partnership between Mount Sinai and Pershing Square began to take shape, Dr. Paniz-Mondolfi and his colleagues accelerated their work, validating their saliva test in 60 adult patients. But they knew that in the real world, children could not always be relied upon to follow clinical procedures to the letter.

“When we start getting this from the schools, we’re going to have pieces of pretzels, old gum floating in the saliva,” Dr. Paniz-Mondolfi said.

Updated 

May 25, 2021, 8:22 p.m. ET

So Dr. Paniz-Mondolfi and his colleagues asked their own children to make a sacrifice for science: to snack on an array of junk food, including pizza and Oreos, and then spit into some testing tubes. Using these samples, the researchers confirmed that even if a student’s sample was contaminated with one of these foods, the tests should still work properly.

“This was practical science, designed by parents to get their kids back to school,” Dr. Paniz-Mondolfi said.

Then it was time to pilot the tests in a real school environment. In January, Mount Sinai connected with KIPP NYC, which had been offering remote instruction since last spring. But it was hoping to reopen its schools in March, and administrators knew they would need to do some kind of in-school virus testing.

“One of the biggest fears that we had was around what it would mean to keep students safe,” said Glenn Davis, the principal of KIPP Infinity Middle School.

Mount Sinai and KIPP NYC agreed to begin a pilot saliva-testing project at five schools. The testing program, which eventually grew to include nine KIPP schools, was free for the schools and mandatory for all students who opted to return to in-person learning. (Some families chose to continue with remote education.)

Students, teachers and staff members are tested once a week. Medical assistants from Mount Sinai supervise the saliva collection and pack the bar-coded tubes into coolers for transportation back to the laboratory. (The samples are currently being processed at an existing Mount Sinai lab, but will be sent to the new lab when it opens next month.)

During the pilot project, 99.2 percent test results were returned within 24 hours, Mount Sinai says. Students or staff members who test positive typically have to quarantine for 10 days.

If a student tests positive, Mount Sinai also offers to send a team of “swabbers” to his or her home to administer free coronavirus tests to their family members and close contacts.

“We’ve detected a few mini outbreaks in that fashion, and hopefully prevented them from spreading by virtue of this screening program in the schoolkids,” Dr. Reich said.

Between March 10, when the pilot project began, and May 9, Mount Sinai conducted 13,067 tests and identified 46 coronavirus cases, a positivity rate of 0.4 percent. There have been no false positives and no known false negatives, Mount Sinai says.

The Mount Sinai team has submitted the data to the Food and Drug Administration, hoping to receive an emergency use authorization for the test.

Later this week, Mount Sinai will submit a formal proposal to New York City to take its testing program to the city’s public schools when they reopen in the fall. Mount Sinai declined to disclose the terms of the proposal, including what it plans to charge schools for the tests, but says it hopes to attract commercial clients to help defray, or possibly even eliminate, costs for schools.

In the meantime, it is approaching other charter school organizations in the city about using its tests during their summer sessions and programs.

“We can’t just sit there when this lab goes live in June and say, ‘OK, we’re waiting for September,’” Dr. Reich said. “Before the fall, we need to be doing a lot of tests.” The lab will initially have the capacity to run 25,000 tests a day, with the ability to scale up to 100,000 if there is sufficient interest.

For its part, KIPP NYC plans to expand the program to all of its schools in the fall, although the testing frequency may change, said Efrain Guerrero, managing director of operations for KIPP NYC. “I think parents see it and staff see it as just an additional safety measure that they appreciate,” he said. “For us it’s a no-brainer to continue to test at some frequency.”

Olga Ramirez, Bradley’s mother, had not initially wanted him to return to in-person learning. “I was very afraid at first,” she said. But Bradley, who desperately wanted to go back to school, managed to convince her, with the help of an informational video about the Mount Sinai testing program.

Ms. Ramirez now thinks that returning to school was the right decision. Bradley’s virus tests have all come back negative, and his grades are up since returning to in-person learning.

“I’ve seen his grades improve quite a lot, and I feel that my son is in good hands,” she said. She’s not alone, she added. “There’s so many mothers who are feeling the way I do.”

Elda Cantú contributed translation.

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Business

Japan’s Yo-Yoing Financial system Shrinks as Virus Spreads and Vaccinations Lag

Japan’s Yo-Yoing Economy Shrinks as Virus Spreads and Vaccinations Lag

Japan’s economy contracted in the first three months of 2021 and continued to alternate between growth and contraction as the vaccination campaign threatened to hold back recovery from the pandemic, although other major economies appeared poised for rapid growth.

In about a year since the coronavirus emerged, Japan’s domestic demand has seen cycles of shrinking and expansion as coronavirus cases have risen and consumers have withdrawn indoors and then infections have receded and businesses have welcomed customers back to have.

Japan is currently experiencing a resurgence of virus cases with much of the country in a state of emergency and the number of deaths rising, particularly in Osaka. According to analysts, the yo-yo economic pattern is unlikely to stop until the country has vaccinated a significant portion of its population. These efforts have only just begun and are unlikely to accelerate significantly in the months ahead.

These dynamics could potentially drag the country back into recession – defined as two consecutive quarters of contraction – later this year as it struggles to control the spread of more deadly and contagious variants of coronavirus.

Japan’s economy, the third largest in the world after the US and China, contracted 1.3 percent from January to March, an annual decline of 5.1 percent. The contraction followed two consecutive quarters of expansion.

Growth skyrocketed in the second half of last year as consumers who had holed up at home for months to avoid the virus piled into department stores, restaurants, bars and theaters.

The recovery went a long way in getting the economy out of the huge hole that formed in the early months of the pandemic. However, as the new data shows, the turnaround is fragile and will be difficult to sustain as long as the country continues to face the threat from the virus.

“We are in a situation where we cannot relax until the vaccine is well distributed,” said Keiji Kanda, senior economist at the Daiwa Institute of Research in Tokyo.

In early 2020, when the pandemic hit, Japan’s economy was already battling headwinds from falling demand from China, a hike in consumption tax, and a devastating typhoon. When the country plunged into distress this spring, domestic consumption crumbled and exports fell to new lows.

The result was the biggest blow to the economy since 1955, when the country first began using gross domestic product to measure its growth.

Even so, the impact of the pandemic on Japan was relatively minor compared to the devastation in the US and many European countries. Japan has never been completely locked down and the total death toll remains below 12,000.

Updated

May 17, 2021, 6:24 p.m. ET

These factors, combined with – by some measures – the world’s largest stimulus measures, have kept the country’s unemployment rate low and propped up many small businesses such as restaurants and hotels.

While Japan’s pandemic response has managed to mitigate the worst of the economic damage, the recovery will continue to be an uphill battle, said Tomohiro Ota, senior economist at Goldman Sachs in Japan.

Trade has rebounded in recent months as some countries reopened, but “without a recovery in consumption we cannot go back to the days before Covid,” he said.

To achieve this goal, two steps forward and one step back had to be taken. Home consumption has increased in waves that increase and decrease as the number of cases increases.

Japan’s state of emergency last spring devastated domestic demand when people stashed at home. Consumption recovered briefly in summer and autumn. A similar upswing followed a second state of emergency in January.

Last month, authorities put the country in dire straits for the third time to review the spread of the coronavirus ahead of the Olympics, which are slated to begin in Tokyo in late July.

The latest round of restrictions only affects parts of the country, but also includes major metropolitan areas such as Tokyo and Osaka and is stricter than the previous one. Earlier iterations focused on shortening the opening times of bars and restaurants. In this version, for the first time, officials demanded that department stores restrict most services and that restaurants stop serving alcohol.

The economic impact of the measures will depend on the response of a public already tired of staying home, said Taro Saito, an executive research fellow at the NLI Research Institute in Tokyo.

“We cannot say with certainty that there will be a contraction between April and June,” he said because of the restrictions. But “if the target areas expand, this could put pressure on growth. The situation is very fluid. “

The stop-and-go pattern is likely to repeat itself for some time, said Izumi Devalier, Japan’s chief economist at Bank of America Merrill Lynch.

“The domestic economy continues to be affected by developments surrounding the virus,” Devalier said, adding that vaccination remained key to improving domestic demand.

Japan’s vaccine rollout was one of the slowest among major industrialized nations. Authorities have approved the use of only one vaccine, made by Pfizer and BioNTech, and strict regulations that require vaccinations to be given by doctors and nurses have slowed its spread. Just over 3 percent of the country has received an initial shot, and vaccines are unlikely to be made available to the general population until late this summer at the earliest.

“Japan is way behind other countries that were in their vaccination programs at the time,” Ms. Devalier said, adding that slow progress “simply delays recovery.”

Mr. Kanda of the Daiwa Institute of Research said, “If vaccination makes good progress, economic activity can basically resume from fall this year.”

But, he added, “if the current pace continues, we could see another explosion of infections.”

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World News

Britain Altering Protocols to Fight Virus Variant

A vaccination center in London in April. The British authorities are considering reintroducing local lockdowns to stem the spread of a coronavirus variant first detected in India.

Credit…Justin Tallis/Agence France-Presse — Getty Images

LONDON — Prime Minister Boris Johnson of Britain said on Friday that vaccination protocols would be changed to swiftly deliver second doses to people over 50-years-old to combat the spread of a coronavirus variant first detected in India, a warning sign for countries that are easing restrictions even though their own vaccination campaigns are incomplete.

“We believe this variant is more transmissible than the previous ones,” Mr. Johnson said. What remained unclear, he said, was by how much. The infectiousness of the variant first detected in India remains the subject of intense study and some leading experts have said it is too early to assess its transmissibility.

If it proves significantly more transmissible, he said, “we face some hard choices.” He added that there was no evidence that the variant was more likely to cause serious illness and death, and there was no evidence to suggest vaccines were less effective against the variant in preventing serious illness and death.

While he said the country would not delay plans to ease restrictions on Monday, he warned that the spread of the variant could force the government to change course.

“This new variant could pose a serious disruption to our progress,” he said at a news conference on Friday.

The numbers of cases involving the variant, known as B.1.617, rose from 520 last week to 1,313 cases this week in Britain, according to official statistics.

The extent to which the variant has spread globally is unclear, because most countries lack the genomic surveillance capabilities employed in England.

That surveillance capability has allowed health officials in Britain to spot the rise of concerning variants more quickly than other nations, offering an early warning system of sorts as a variant seen in one nation almost invariably pops up in others.

Most cases detected in Britain are in northwestern England. The focus has been on Bolton, a town of nearly 200,000 that has one of the country’s highest rates of infection and where health officials have warned of widespread community transmission of the B.1.617 variant. Some cases have also been reported in London. The rapid spread of the variant has led officials to debate speeding up dosing schedules and opening up access to shots in hot spots to younger age groups.

National restrictions in England are scheduled to be eased on Monday, with indoor dining and entertainment returning, before a full reopening in June. But officials have cautioned that those plans might be in danger.

In Scotland, First Minister Nicola Sturgeon said on Friday that plans to ease restrictions in Glasgow would be delayed at least a week out of concern about an uptick in cases that officials said may be being driven by the variant.

Much is unknown about the new variant, but scientists fear it may have driven the rise of cases in India and could fuel outbreaks in neighboring countries.

Dr. Maria Van Kerkhove, the technical lead of the World Health Organization’s coronavirus response, said a study of a limited number of patients, which had not yet been peer-reviewed, suggested that antibodies from vaccines or infections with other variants might not be quite as effective against B.1.617. The agency said, however, that vaccines were likely to remain potent enough to provide protection from serious illness and death.

British officials have said the variant appears to be more contagious than the B.1.1.7 variant, which was detected last year in Kent, southeast of London and swept across Britain in the winter, forcing the country into one of the world’s longest national lockdowns. The B.1.1.7 variant has now been found in countries around the world.

In the United States, the B.1.1.7 variant did become the predominant version of the virus, now accounting for nearly three-quarters of all cases. But the U.S. surge experts had feared ended up a mere blip in most of the country. The nationwide total of daily new cases began falling in April and has now dropped more than 85 percent from the horrific highs of January.

The B.1.617 variant has been found in virus samples from 44 countries and was designated a variant of concern by the W.H.O. this week, which means there is some evidence that it could have an impact on diagnostics, treatments or vaccines and needs to be closely monitored.

Christina Pagel, a member of a group of scientists advising the government, known as SAGE, said postponing next week’s reopening would avoid “risking more uncertainty, more damaging closures and longer recovery from a worse situation.”

“We need to learn from previous experience,” Dr. Pagel, the director of the Clinical Operational Research Unit at University College London, said on Twitter.

Britain briefly reopened its economy at the end of last year, only to abruptly impose new restrictions that remained in place for months as it fought a deadly wave of infections.

In an attempt to offer at least partial protection to as many people as quickly as possible, Britain spaced injections between doses for two-stage coronavirus vaccines up to 12 weeks after the first vaccines were approved in December. That was far longer than the three- or four-week interval employed by most other countries.

Mr. Johnson said that those older than 50 will now be able to get second doses after eight weeks.

“It is more important than ever that people get the additional protection of a second dose,” he said.

The speedy rollout saved at least 11,700 lives and prevented 33,000 people from becoming seriously ill in England, according to research released by Public Health England on Friday.

Infections, serious illness and deaths have plummeted across Britain. Only 17 deaths were reported on Friday.

But the vaccination campaign has slowed down since last month because of supply shortages and the need to start distributing second doses. The number of daily first doses on average last month was 113,000, far below the average of 350,000 daily doses administered in March.

Only those over 38-years-old are currently eligible for vaccination.

It remains unclear whether the country has the vaccine supplies on hand to move rapidly to surge more into communities around the country to speed up vaccinating younger age groups.

Correction: May 14, 2021

An earlier version of this item misstated the affiliation of Christina Pagel, a science adviser. Ms. Pagel is a member of Independent SAGE, a group of expert advisers unaffiliated with the government. She is not a member of SAGE, a panel of government advisers.

United States › United StatesOn May 14 14-day change
New cases 41,044 –32%
New deaths 732 –12%
World › WorldOn May 14 14-day change
New cases 41,044 –24%
New deaths 732 –18%

U.S. vaccinations ›

Where states are reporting vaccines given

A tour group in Manhattan the day after the federal guidance changed mask guidance for vaccinated people. New York said Thursday it was reviewing the recommendations.Credit…Benjamin Norman for The New York Times

Minnesota’s statewide mask mandate is over. But in Minneapolis, the state’s largest city, face coverings are still required.

In Michigan, Kentucky and Oregon, governors cheerily told vaccinated people that they could go out maskless. But mask mandates remained in force for New Yorkers, New Jerseyans and Californians.

So unexpected was new federal guidance on masks that in Kansas City, Mo., Mayor Quinton Lucas went from saying he would not change his mask order, to saying he would think about it, to announcing that he was getting rid of it altogether, all in the span of about seven hours.

Across the country, governors, store owners and people running errands were scrambling on Friday to make sense of the abrupt change in federal guidelines, which said fully vaccinated people could now safely go most places, indoors or outdoors, without a mask.

At least 20 states that still had mask mandates in place this week said by Friday evening that they would exempt fully vaccinated people or repeal the orders entirely, while at least five others with mask requirements had not announced any changes. The rapidly changing rules brought an end to more than a year of mandatory masking in much of the country, even as some said they were not yet ready to take off their face coverings.

“I’m going to wear a mask for a long time to come,” said Fanny Lopez, 28, who was grocery shopping in San Antonio on Friday morning while wearing a black cloth mask. “I trust the mask more than the vaccine. The government messages are confusing, telling us to wear a mask one day and the next day no.”

The sudden shift in public health advice resonated at every level of government, from City Hall in Hartsville, S.C., where a local mask mandate was allowed to expire, to Nevada’s Gaming Control Board, which said it was not practical “to attempt to enforce a mask mandate tethered to an individual’s vaccination status,” to the U.S. Capitol, where the attending physician said House members would still have to cover their faces on the floor of the chamber.

But the shift was perhaps most challenging for governors and big-city mayors, many of whom have expended significant political capital on mask orders in the face of protests and lawsuits, and who were not given a heads-up about the change in federal policy before it was announced on Thursday.

Mayor Lucas said he could not keep Kansas City’s order in place since there was no easy way to differentiate people who are fully vaccinated — now 36 percent of Americans — from the 64 percent who are not.

“While I understand the C.D.C.’s theory that they could just create a rule that says vaccinated folks go anywhere without a mask, and everybody else who’s unvaccinated will follow it, I don’t know if that’s the type of rule that was written in coordination with anyone who has been a governor or a mayor over the last 14 months,” said Mr. Lucas, a Democrat.

The new guidance from the Centers for Disease Control and Prevention, which came amid a steep drop in new cases and an expansion of vaccine eligibility to everyone 12 and older, signaled a shift toward pre-pandemic social norms, when no one thought twice about buying groceries or sitting down in their cubicle with a bare mouth and nose. Walmart announced on Friday that fully vaccinated employees and customers would no longer need to wear masks, and Costco issued a similar announcement.

“At least 20 times today I kept grabbing my short pockets looking for my face mask,” said Erik Darmstetter, who is fully vaccinated and owns Office Furniture Liquidations in San Antonio. “It wasn’t there. I keep forgetting we don’t need it anymore.”

Others were moving more slowly. Gov. Phil Murphy of New Jersey, a Democrat, said he would keep his state’s mask mandate in place, writing on Twitter that “we’re making incredible progress, but we’re not there yet.” And Gov. Charlie Baker of Massachusetts, a Republican, indicated he would revisit his state’s rules next week, but he did not announce any immediate changes.

When asked on Friday about how the C.D.C.’s guidelines would affect Mr. Biden’s executive order requiring masks on federal property, Jen Psaki, the White House press secretary, said at a news conference that it “may take a couple of days” to adopt the agency’s advice. She added that there are no plans to change the federal order mandating masks on public transportation.

On the question of possible vaccine passports, Ms. Psaki said the administration was prioritizing remained focused on the vaccination campaign, and that the administration was “not currently considering federal mandates,” and did not have plans to change its approach.

“We also understand that private sector companies may decide that they want to have requirements. That’s up to them to make that determination,” she said.

Administering a coronavirus shot during a vaccination day for homeless people in Montevideo, Uruguay, on Thursday.Credit…Raul Martinez/EPA, via Shutterstock

BUENOS AIRES — For most of the past year, Uruguay was held up as an example for keeping the coronavirus from spreading widely as neighboring countries grappled with soaring death tolls.

Uruguay’s good fortune has run out. In the last week, the small South American nation’s Covid-19 death rate per capita was the highest in the world, according to data compiled by The New York Times.

As of Wednesday, at least 3,252 people had died from Covid-19, according to the Uruguayan Health Ministry, and the daily death toll has been about 50 during the past week.

Six out of the 11 countries with the highest death rates per capita are in South America, a region where the pandemic is leaving a brutal toll of growing joblessness, poverty and hunger. For the most part, countries in the region have failed to acquire sufficient vaccines to inoculate their populations quickly.

Contagion rates in Uruguay began inching up in November and soared in recent months, apparently fueled by a highly contagious variant first identified in Brazil last year.

“In Uruguay, it’s as if we had two pandemics, one until November 2020, when things were largely under control, and the other starting in November, with the arrival of the first wave to the country,” said José Luis Satdjian, the deputy secretary of the Health Ministry.

The country with the second-highest death rate per capita is nearby Paraguay, which also had relative success in containing the virus for much of last year but now finds itself in a worsening crisis.

Experts link the sharp rise in cases in Uruguay to the P.1 virus variant detected in Brazil.

“We have a new player in the system and it’s the Brazilian variant, which has penetrated our country so aggressively,” Mr. Satdjian said.

Uruguay closed its borders tightly at the beginning of the pandemic, but towns along the border with Brazil are effectively binational and have remained porous.

The outbreak has strained hospitals in Uruguay, which has a population of 3.5 million.

On March 1, Uruguay had 76 Covid-19 patients in intensive care units. This week, medical professionals were caring for more than 530, according to Dr. Julio Pontet, president of the Uruguayan Society of Intensive Care Medicine who heads the intensive care department at the Pasteur Hospital in Montevideo, the capital.

That number is slightly lower than the peak in early May, but experts have yet to see a steady decline that could indicate a trend.

“It is still too early to reach the conclusion that we’ve already started to improve, we’re in a high plateau of cases,” Dr. Pontet said.

Despite the continuing high number of cases, there is optimism that the country will be able to get the situation under control soon because it is one of the few in the region that has been able to make quick progress on its vaccination campaign. About a quarter of the population has been fully immunized.

“We expect the number of serious cases to begin decreasing at the end of May,” Dr. Pontet said.

A man in Los Angeles being vaccinated in March. The C.D.C. released a study on Friday providing more evidence that the vaccines are working well in real world settings.Credit…Allison Zaucha for The New York Times

The Pfizer-BioNTech and Moderna coronavirus vaccines are 94 percent effective at preventing symptomatic Covid-19 illness, according to a new study of more than 1,800 health care workers in the United States.

The research, which the Centers for Disease Control and Prevention released on Friday, provides yet more evidence that the vaccines are working well even outside controlled clinical trials.

“This report provided the most compelling information to date that Covid-19 vaccines were performing as expected in the real world,” Dr. Rochelle Walensky, the C.D.C. director, said in a statement on Friday.

“This study, added to the many studies that preceded it, was pivotal to C.D.C. changing its recommendations for those who are fully vaccinated against Covid-19.”

The findings are based on an ongoing study of health care workers in 25 states. This interim analysis included data on 1,843 health care workers who were routinely tested for infection with the coronavirus. More than 80 percent of participants were female.

Some 623 workers tested positive between January and mid-March. Those who were fully vaccinated were 94 percent less likely to develop symptomatic coronavirus infections than their unvaccinated peers, the researchers found. The figures are consistent with the efficacy estimates from the clinical trials.

The scientists also found that a single dose of the two-shot regimen was 82 percent effective at preventing symptomatic infection. That figure is higher than has been reported in other studies and may be a result of the relative youth of the study participants, who had a median age of 37 to 38. Fewer than 2 percent were 65 or older.

C.D.C. scientists had previously found that fully vaccinated health care, frontline and essential workers were 90 percent less likely to contract the coronavirus. Those findings helped allay fears that vaccinated people might still be likely to carry the virus, even asymptomatically, and spread it to others.

The concern was one of the main rationales for asking vaccinated Americans to continue to wear masks, a recommendation that the C.D.C. lifted on Thursday.

Maj. Gen. Dany Fortin, right, with Prime Minister Justin Trudeau of Canada in Ottawa in December.Credit…Sean Kilpatrick/The Canadian Press, via Associated Press

The senior military commander who was appointed by Prime Minister Justin Trudeau of Canada last fall to oversee the distribution of Covid-19 vaccines in the country has quit that post and is now the subject of a military investigation, officials said late Friday.

In a brief, joint statement, the Department of National Defense and the Canadian Armed Forces announced Maj. Gen. Dany Fortin’s resignation but offered no details about the nature of the investigation. The department declined to comment.

Before General Fortin became Canada’s vaccine coordinator, he led military missions to help workers in long-term care homes that were overwhelmed by Covid infections. He is a former commander of the NATO mission in Iraq.

General Fortin is now the third senior leader in the Canadian Armed Forces under scrutiny. Adm. Art McDonald stepped aside as chief of the defense staff, the country’s top military job, in February after the military police opened an investigation into unspecified accusations against him. The same month, the military police also began investigating the previous chief of the defense staff, Gen. Jonathan Vance, who held the post until his retirement from the army in January.

General Vance has been accused publicly of inappropriate behavior toward female subordinates. He has denied wrongdoing.

Coronavirus test samples being readied for processing and eventual genomic sequencing at Duke University.Credit…Pete Kiehart for The New York Times

On Dec. 29, a National Guardsman in Colorado became the first known case in the United States of a contagious new variant of the coronavirus.

The variant, called B.1.1.7, had roiled Britain, was beginning to surge in Europe and threatened to do the same in the United States. And although scientists didn’t know it yet, other mutants were also cropping up around the country. They included variants that had devastated South Africa and Brazil and that seemed to be able to sidestep the immune system, as well as others homegrown in California, Oregon and New York.

This mélange of variants could not have come at a worse time. The nation was at the start of a post-holiday surge of cases that would dwarf all previous waves. And the distribution of powerful vaccines made by Moderna and Pfizer-BioNTech was botched by chaos and miscommunication. Scientists warned that the variants — and B.1.1.7 in particular — might lead to a fourth wave, and that the already strained health care system might buckle.

That didn’t happen. B.1.1.7 did become the predominant version of the virus in the United States, now accounting for nearly three-quarters of all cases. But the surge experts had feared ended up a mere blip in most of the country. The nationwide total of daily new cases began falling in April and has now dropped more than 85 percent from the horrific highs of January.

Experts still see variants as a potential source of trouble in the months to come — particularly one that has battered Brazil and is growing rapidly in 17 U.S. states. But they are also taking stock of the past few months to better understand how the nation dodged the variant threat.

They point to a combination of factors — masks, social distancing and other restrictions, and perhaps a seasonal wane of infections — that bought crucial time for tens of millions of Americans to get vaccinated. They also credit a good dose of serendipity, as B.1.1.7, unlike some of its competitors, is powerless against the vaccines.

At a bookstore in San Francisco in March. Until the pandemic, there had seldom been a cultural push for mask wearing in the United States.Credit…Jim Wilson/The New York Times

Once Americans return to crowded offices, schools, buses and trains, so too will their sneezes and sniffles.

Having been introduced to the idea of wearing masks to protect themselves and others, some Americans are now considering a behavior scarcely seen in the United States but long a fixture in other cultures: routinely wearing a mask when displaying symptoms of a common cold or the flu, even in a future in which Covid-19 isn’t a primary concern.

Such routine use of masks has been common for decades in other countries, primarily in East Asia, as protection against allergies or pollution, or as a common courtesy to protect nearby people.

Leading American health officials have been divided over the benefits, partly because there is no tidy scientific consensus on the effect of masks on influenza virus transmission, according to experts who have studied it.

Nancy Leung, an epidemiologist at the University of Hong Kong, said that the science exploring possible links between masking and the emission or transmission of influenza viruses was nuanced — and that the nuances were often lost on the general public.

Changi Airport in Singapore this week. The airport outbreak began with an 88-year-old member of the airport cleaning crew who was fully vaccinated but who tested positive for the virus on May 5.Credit…Wallace Woon/EPA, via Shutterstock

SINGAPORE — Singapore said on Friday that it would ban dining in restaurants and gatherings of more than two people to try to stem a rise in coronavirus cases, becoming the latest Asian nation to reintroduce restrictions after keeping the illness mostly in check for months.

The new measures came after the city-state recorded 34 new cases on Thursday, a small number by global standards, but part of a rise in infections traced to vaccinated workers at Singapore Changi Airport.

The airport outbreak began with an 88-year-old member of the airport cleaning crew who was fully vaccinated but who tested positive for the virus on May 5. Co-workers who then became infected later visited an airport food court, where they transmitted the virus to other customers, officials said.

None of the cases linked to the airport outbreak are believed to have resulted in critical illness or death, according to officials.

In all, 46 cases have been traced to the airport, the largest of about 10 clusters of new infections in the country.

“Because we do not know how far the transmission has occurred into the community, we do have to take further, more stringent restrictions,” said Lawrence Wong, co-chair of Singapore’s coronavirus task force. The measures will be in effect for about one month beginning on Sunday.

According to preliminary testing, many of those infected were working in a zone of the airport that received flights from high-risk countries, including from South Asia. Several have tested positive for the B.1.617 variant first detected in India, which the World Health Organization has said might be more contagious than most versions of the coronavirus.

Singapore health officials said that of 28 airport workers who became infected, 19 were fully vaccinated with either the Pfizer or Moderna vaccines, the only two approved for use in Singapore.

“Unfortunately, this mutant virus, very virulent, broke through the layers of defense,” Transport Minister Ong Ye Kung told a virtual news conference on Friday.

Mr. Ong also said that the rise in cases “very likely” means that a long-delayed air travel bubble with Hong Kong would not begin as scheduled on May 26.

Singapore, a prosperous island hub of 5.7 million people, saw an explosion of infections among migrant workers living in dormitories, but a two-month lockdown and extensive testing and contact tracing contained the outbreak. Although Singapore has kept much of its economy open, its vaccination effort has not moved as quickly as many expected: less than one-quarter of the population has been fully inoculated.

Changi Airport, which served more than 68 million passengers in 2019, is operating at 3 percent of capacity as Singapore has paused nearly all incoming commercial traffic. Employees there work under strict controls, wearing protective gear and submitting to regular coronavirus tests.

Singapore joins Japan, Thailand and other Asian countries that have struggled to contain new outbreaks fueled in part by variants. But Paul Ananth Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection, said that the rise in cases was not overly worrying.

“The reason for my optimism is that we now have effective vaccines, better diagnostics, proven treatments and even potential prophylactic agents,” he said. “If these are employed in a targeted approach, it is unlikely that we will end up with the same problems we had last year.”

Workers moved oxygen cylinders for transport at a factory in New Delhi on Sunday. The city has now received enough oxygen to share its supply.Credit…Atul Loke for The New York Times

After shortages in oxygen in New Delhi led to scores of people dying in hospitals, officials said there was now enough supply in the Indian capital to start sharing a surplus of the lifesaving gas to needier parts of the country.

For weeks, the New Delhi government appealed to Prime Minister Narendra Modi for a larger share of India’s oxygen reserves, with the battle for air ending up in the nation’s highest court.

On Thursday, just days after receiving the amount it had requested, New Delhi’s second-highest official, Manish Sisodia, said the city’s demand had fallen and its excess supply should be reallocated.

“The number of cases is coming down, hospital bed occupancy is coming down, and demand for oxygen, too, is down,” Mr. Sisodia told The New York Times.

It was an indication that the crisis in the capital might be reaching a peak.

The oxygen shortage in New Delhi began in April and has been linked to dozens of deaths, in and out of hospitals.

Health care facilities and crematories were overwhelmed, and medical professionals and residents were left scrambling for scarce resources.

Thousands of people in the city of 20 million stood in line at oxygen refilling stations, bringing cylinders into hospitals for friends and family or hoarding them at home in case the need arose.

The rise of new coronavirus infections in India has slowed. But, in pattern seen in nation after nation battered by the virus, death rates often plateau a few weeks later. And with the virus spreading in low-income rural areas, the overall crisis shows no sign of abating.

As of Wednesday, the official death toll surpassed 258,000, although experts suspect the true number to be much higher.

As the smoke from New Delhi crematories starts to clear, dozens of bodies have surfaced along the holy Ganges River in the states of Uttar Pradesh and Bihar.

Krishna Dutt Mishra, an ambulance driver in the Bihari village of Chausa, said that poor people were disposing of bodies in the river because the cost of cremations had become prohibitively expensive.

On Friday, the Indian news media showed bodies wrapped in cloth of the saffron color, considered auspicious in Hinduism, buried in shallow graves on the sandy banks of the Ganges River in the Unnao district of Uttar Pradesh.

Priyanka Gandhi, a leader of the opposition Indian National Congress party, called for a High Court investigation, saying that what was happening in Uttar Pradesh was “inhuman and criminal.”

A woman from the Guatemalan Maya community in Lake Worth, Fla., at a Covid vaccine center last month.Credit…Saul Martinez for The New York Times

Latino adults in the United States have the lowest rates of Covid-19 vaccination, but among the unvaccinated they are the demographic group most willing to receive the Covid shots as soon as possible, a new survey shows.

The findings suggest that their depressed vaccination rate reflects in large measure misinformation about cost and access, as well as concerns about employment and immigration issues, according to the latest edition of the Kaiser Family Foundation Covid-19 Vaccine Monitor.

Earlier polls had suggested that skepticism about the vaccine was widespread among Latinos, but the latest survey showed that hesitation is declining.

Nearly 40 percent of all the unvaccinated Latinos responding to the survey said they feared they would need to produce government-issued identification to qualify. And about a third said they were afraid that getting the shot would jeopardize either their immigration status or that of a family member.

Their responses also pointed to the importance of community-based access. Nearly half said they would be more likely to be vaccinated if the shots were available at sites where they normally go for health care.

A protest in Utah last year. Some readers expressed hope that the rule change would prompt people to get vaccinated but others worried about “cheaters.”Credit…Rick Bowmer/Associated Press

Throughout the pandemic, few topics have touched so raw a nerve in the United States as mask wearing. Confrontations have erupted from state capitols to supermarket checkout aisles, and debates raged over whether mask mandates violate First Amendment rights.

The Centers for Disease Control and Prevention provoked a flood of reaction with its announcement on Thursday that Americans who are fully vaccinated may stop wearing masks or maintaining social distance in most indoor and outdoor settings. Here’s a sampling, edited for length and clarity, of how Times readers reacted to the news on Facebook and on our website:

“I think this is a good incentive for the hesitators. Hopefully they’ll want to participate in activities (the ones that require proof of vaccination) maskless, so perhaps this will be an incentive, as they see others in the community enjoying life more.” writes Jerry B., on Facebook.

“Very, very few people have been wearing masks for the past 6 months. Covid is a real risk — I certainly don’t want it — but our cases have dropped precipitously, even with minimal masking. This announcement is welcome — the world will not end if people stop masking,” writes Stephen from Oklahoma City.

“I see the need for this policy change, but I fear that the cheaters — those who are not vaccinated but pretend to be — will be the ruin of us all,” writes Cary in Oregon.

“I have my doubts about the incentivization bit,” writes Andrew from Colorado Springs, Colo. “I figure it will simply mean that suddenly everyone’s been fully vaccinated, true or not. That said, as a double-shotted person, I figure my chances of being taken out by an anti-vaxxer are now less than my chances of being taken out by a texting driver. I’m down with that.”

“What’s to stop anti-masker/anti-vaxxer contrarians from mingling unmasked with the vaccinated population? I have little trust in this,” writes Mary Beth in Santa Fe, N.M.

“I am fully vaccinated and caught Covid anyway. I do think it made my symptoms more mild, but you can bet your bippy I’m going to be wearing my mask when I am out of quarantine.” — writes Jaime P., on Facebook.

What do you think about the guidance? Join the conversation.

Kevin Hayes contributed research.

Categories
Health

Pfizer and Moderna Pictures Are Powerfully Efficient in opposition to Virus, Evaluation Says

Pfizer and Moderna Shots Are Powerfully Effective against Virus, Analysis Says

Pfizer-BioNTech and Moderna Coronavirus vaccines are 94 percent effective at preventing symptomatic Covid-19 disease, according to a new study of 1,800 US healthcare workers.

The research the Centers for Disease Control and Prevention published on Friday provides even more evidence that the vaccines work well outside of controlled clinical trials.

“This report provided the most compelling information yet that Covid-19 vaccines are working as expected in the real world,” said Dr. Rochelle Walensky, CDC director, in a statement Friday.

“This study, which was added to the many previous studies, was instrumental in changing the CDC’s recommendations for those fully vaccinated against Covid-19.”

The results are based on an ongoing study of healthcare workers in 25 states. This interim analysis included data on 1,843 healthcare workers who were routinely tested for coronavirus infection. More than 80 percent of the participants were female.

About 623 workers tested positive between January and mid-March. Those who were fully vaccinated were 94 percent less likely to develop symptomatic coronavirus infections than their unvaccinated counterparts, the researchers found. The numbers are consistent with the effectiveness estimates from the clinical studies.

The scientists also found that a single dose of the two-shot regimen was 82 percent effective in preventing symptomatic infection. This number is higher than reported in other studies and may be due to the relative youth of the study participants, who had an average age of 37 to 38 years. Less than 2 percent were 65 years of age or older.

CDC scientists had previously found that fully vaccinated health, frontline, and essential workers were 90 percent less likely to get coronavirus. These results helped allay fears that vaccinated people might even asymptomatically transmit the virus and spread it to others.

Concern was a major reason for asking vaccinated Americans to continue wearing masks, a recommendation the CDC overturned Thursday.

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Business

Abbott CEO says it has a workforce of ‘virus hunters’ on new Covid variants

Abbott CEO says it has a team of 'virus hunters' on new Covid variants

An Abbott Labs employee receives the BinaxNOW Covid-19 antigen rapid test at her workplace.

Abbott Labs

Abbott Labs has a team of “virus hunters” working with health officials around the world to monitor Covid-19 variants as some mutant strains show the ability to evade detection, CEO Robert Ford said during an interview, which aired Tuesday as part of CNBC’s Healthy Returns the event.

“They’re always on the lookout for new viruses, and in this case we’ve put a team together to monitor all possible mutations,” he said of the coalition pandemic defense. “It can’t be just a US thing, you have to work with all the countries, all the universities, all the different collection points, then I think this is the way to go.”

The Food and Drug Administration warned clinical staff in January that new variants could lead to false negative Covid-19 test results. The agency identified three tests, none of which were performed by Abbott, and which may be less accurate because the part of the SARS-CoV-2 gene sequence that the tests were looking for was mutated in some variants.

Ford also made it clear that with the rate at which Covid-19 is mutating, there is no time to be wasted. Scientists need to “chase these mutations,” he said.

In the meantime, scientists are developing a new generation of tests that will look for parts of the virus that are less likely to mutate and give false negative results.

Antigen tests, such as those used in Abbott’s popular Binaxnow Covid-19 tests, target proteins in the virus that are less likely to mutate over time.

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Health

‘This virus will not be going away’

'This virus is not going away'

Stephane Bancel, CEO of Moderna, attends the Forbes Healthcare Summit 2019 at Jazz at Lincoln Center on December 5, 2019 in New York City.

Steven Ferdman | Getty Images

Stephane Bancel, CEO of Moderna, said Thursday the company expects more Covid-19 variants to hit the market in the coming months as the southern hemisphere enters the fall and winter seasons.

Talking to investors about a first-quarter earnings call, Bancel said people will likely need booster shots of his two-dose Covid-19 vaccine as the virus circulates around the world.

“There are always new worrying variants around the world. And we believe that in the next six months, when the southern hemisphere enters autumn and winter, more worrying variants may emerge,” Bancel said. The southern hemisphere includes Africa, Australia, most of South America, and parts of Asia. “We believe booster vaccinations will be needed as we believe the virus will not go away.”

The CEO’s comments come a day after the company announced that a booster shot of its vaccine triggered a promising immune response against variants B.1.351 and P.1, which were first identified in South Africa and Brazil, respectively. The variants have since expanded to other countries, including the United States

The data are preliminary and have not yet been reviewed by colleagues.

Moderna’s vaccine requires two doses four weeks apart. As with Pfizer and Johnson & Johnson, the shot against Covid is very effective, although company executives and officials now say they expect this strong protection to wear off over time. Pfizer’s vaccine is also a two-dose therapy, while the J&J immunization is just one burst.

Earlier Thursday, Moderna said the sale of its successful vaccine helped generate its first-ever quarterly profit.

Moderna’s Covid-19 vaccine had sales of $ 1.7 billion, according to earnings reports. The company also raised its 2021 sales forecast for its vaccine to $ 19.2 billion from its previous forecast of $ 18.4 billion. Bancel said the company is “actively involved” in discussions and agreements for 2022 with all governments it currently serves.

Earlier this week, rival Pfizer also raised its vaccine sales forecast, forecasting total annual sales of $ 26 billion.

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Health

WHO is carefully monitoring 10 Covid variants as virus mutates world wide

WHO is closely monitoring 10 Covid variants as virus mutates around the world

Mukesh Bhardwaj cries as he sits next to his wife, who is receiving free oxygen support for people with respiratory problems, outside a Gurudwara (Sikh temple) amid the spread of coronavirus disease (COVID-19) in Ghaziabad, India. May 3, 2021.

Adnan Abidi | Reuters

The World Health Organization is tracking 10 variants of coronavirus “of concern” or “worrying” around the world, including two that were first discovered in the US and one triple mutant that is wreaking havoc in India as a potential global threat to the world public health.

New strains of Covid-19 emerge every day as the virus continues to mutate, but only a handful make the WHO official watch list an “variant of interest” or the more serious term “variant of concern” which is commonly defined as a mutated strain that is more contagious, more deadly, and more resistant to current vaccines and treatments.

The organization has identified three strains as variants of concern: B.1.1.7, which was first detected in the UK and is currently the most common strain in the US; B. 1.351, detected for the first time in South Africa, and the P.1 variant, detected for the first time in Brazil.

An interesting variant is the B.1617 variant or the triple mutated strain that was first found in India. However, WHO technical lead on Covid-19, Maria Van Kerkhove, said more studies are needed to fully understand its significance.

“There are actually a number of virus variants that are being discovered around the world and that we must all properly assess,” said Van Kerkhove. Scientists are studying how much each variant circulates in local areas, whether the mutations change the severity or transmission of the disease, and other factors, before being classified as a new public health threat.

“The information comes quickly and furiously,” she said. “There are new variants being identified and reported every day, not all of which are important.”

Other variants classified as variants of interest include B.1525, which was first detected in the UK and Nigeria; B.1427 / B.1429, recorded for the first time in the USA; P.2, first discovered in Brazil; P.3, first discovered in Japan and the Philippines; S477N, first detected in the USA, and B.1.616, first detected in France.

Van Kerkhove said the classifications are determined, at least in part, by sequencing capabilities, which vary from country to country. “It’s been really sketchy so far,” she said.

She said the agency is also viewing local epidemiologists as an extension of the agency’s “eyes and ears” to better understand the local situation and identify other potentially dangerous variants.

“It is important that we have the right discussions to determine which ones are important to the public health value. This means that doing so changes our ability to use public health social measures or any of our medical countermeasures.” , she said.

“We’re getting the right people together in the room to discuss what these mutations mean,” she said. “We need the global community to work together, and they are.”

The Centers for Disease Control and Prevention also have a list of four variants of interest and five variants of concern that is similar to the WHO list, although the CDC mainly focuses on variants that are causing new outbreaks in the United States.

Van Kerkhove said a number of countries “have some worrying trends, some worrying signs of rising case numbers, increasing hospitalization rates and increasing ICU rates in countries that do not yet have access to the vaccine and that have not achieved the required levels of coverage.” really having these effects on serious illness and death and transmission. “

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World News

The virus is surging in Alaska’s inside, straining a Fairbanks hospital.

The virus is surging in Alaska’s interior, straining a Fairbanks hospital.

Dr. Angelique Ramirez, the chief medical officer of the main health system in Fairbanks, Alaska, began the monthly coronavirus briefing in April by saying that the March meeting would be the last. But amid a new spate of cases in the state, one of the worst waves in the country, Dr. Ramirez openly about her earlier assessment.

“I was wrong,” she said.

With nearly 100,000 residents, the Fairbanks metropolitan area is Alaska’s second largest and largest inland. According to a New York Times database, the number of new coronavirus cases that Fairbanks is based in is North Star is up 253 percent in the past two weeks. The positivity rate has doubled from 5 percent to about 10 percent since March, and hospitalizations at Fairbanks Memorial Hospital, the region’s only hospital, have reached a record high.

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

Experts aren’t sure what’s driving the surge, although low vaccination rates certainly play a role. Thirty-six percent of Alaskans are fully vaccinated, and in some counties that number is over 50 percent, but in the Fairbanks area only 29 percent of the population is fully vaccinated.

“There isn’t a big outbreak or two big outbreaks that really drive this,” said Dr. Joe McLaughlin, the state epidemiologist for Alaska. “We have cases and clusters that are associated with a variety of different attitudes.”

With two-thirds of the elderly population in Fairbanks receiving at least one dose of vaccine, those recently hospitalized in Fairbanks are younger than Covid patients in the winter when the number of cases peaked. Dr. Creighton said that people who were hospitalized in April were typically in their forties and fifties and hadn’t been vaccinated while waiting to see what side effects of receiving a Covid-19 vaccine could have.

“We see that they are staying longer because they are not dying,” said Dr. Creighton. “We give them non-invasive ventilation and they stay two or three weeks and turn around, something I’ve never been so proud of.”

While these elderly patients were largely grateful to have been cared for during the Winter Summit, hospital patients now feel differently.

“Some of these people are people who are anti-vaxxers, anti-maskers, and they don’t think they have Covid or are sick because of it, and our staff get pretty angry,” said Shelley Ebenal, executive director of The Health System, Foundation Health Partners said, pleading with the system’s trustees to share their appreciation for the hospital staff.

She warned bleakly: “We are not outside of Covid, and our employees in particular are not outside of Covid. Our morale is really low. “