As a second wave of the pandemic rages in India, which set a global record new cases for the fifth consecutive day on Monday, countries around the world are trying to help. But their efforts to send oxygen and other critical aid are unlikely to plug enough holes in India’s sinking health care system to end its deadly catastrophe.
The Indian health ministry reported almost 353,000 new cases and 2,812 deaths on Monday. Enormous funeral pyres have spilled into parking lots and city parks. Experts say that India’s reported overall toll of more than 195,000 deaths could be a vast undercount.
The emergency in India, where a worrying virus variant is spreading rapidly, has global implications for potential infections worldwide, as well as for countries relying on India for the AstraZeneca vaccine, millions of doses of which are manufactured there.
“It’s a desperate situation out there,” said Ramanan Laxminarayan, the founder and director of the Center for Disease Dynamics, Economics & Policy, adding that donations will be welcome, but may make only a “dent on the problem.”
Scientists fear that part of the problem is the emergence of a virus variant known as the “double mutant,” B.1.617, because it contains genetic mutations found in two other difficult-to-control versions of the coronavirus. One of the mutations is present in the highly contagious variant that ripped through California earlier this year. The other mutation is similar to one found in the variant dominant in South Africa and is believed to make the virus more resistant to vaccines.
Still, scientists caution it is too early to know with certainty how pernicious the new variant emerging in India really is.
In the early months of 2021, the government of Prime Minister Narendra Modi acted as if the coronavirus battle had been won, holding huge campaign rallies and permitting thousands to gather for a Hindu religious festival.
Now, Mr. Modi is striking a far more sober tone. He said in a nationwide radio address on Sunday that India has been “shaken” by a “storm.” And countries, companies and powerful members of the diaspora have pledged to pitch in.
Patients are suffocating in the capital, New Delhi, and other cities because hospitals’ oxygen supplies have run out. Frantic relatives have appealed on social media for leads on intensive-care-unit beds and experimental drugs. The government has extended New Delhi’s lockdown by another week.
India’s Supreme Court last week ordered the government to come up with a “national plan” for distributing oxygen supplies.
The problems in India’s hospitals go beyond oxygen shortages. In the western state of Gujarat, more than a dozen patients were evacuated from a hospital on Sunday night after an air-conditioning unit caught fire, the Press Trust of India reported, the third accident involving virus patients in India in the past seven days.
Mr. Modi appears to be looking to the rest of the world to help India quell the wave. Saudi Arabia and the United Arab Emirates have promised oxygen generators. The United States has pledged raw material for coronavirus vaccines and intends to share up to 60 million doses of the AstraZeneca vaccine with other nations, so long as the doses clear a safety review conducted by the Food and Drug Administration, officials said Monday.Indian-American businessmen have pledged millions in cash from the companies they lead.
At a news conference on Monday, Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization, called the situation in India “beyond heartbreaking.” He said the organization has deployed 2,600 staff to India to provide surveillance and vaccination help.
A global coronavirus surge, driven largely by the devastation in India, continues to break daily records and run rampant in much of the world, even as vaccinations ramp up in wealthy countries. More than one billion shots have now been administered globally.
On Sunday, the world’s seven-day average of new cases hit 774,404, according to a New York Times database, higher than the peak average during the last global surge, in January. Despite the number of shots given around the world, far too small a percentage of the global population of nearly eight billion have been vaccinated to slow the virus’s steady spread.
President Biden, under intense pressure to do more to address the surging pandemic abroad, including a humanitarian crisis in India, intends to make up to 60 million doses of the AstraZeneca vaccine available to other countries, so long as federal regulators deem the doses safe, officials said Monday.
The announcement came after Mr. Biden spoke with Prime Minister Narendra Modi of India and the two pledged to “work closely together in the fight against Covid-19.” It is a significant, albeit limited, shift for the White House, which has until now been reluctant to make excess doses of coronavirus vaccine available in large amounts.
But the commitment is a tricky one to make: The AstraZeneca doses are manufactured at the Baltimore plant owned by Emergent BioSolutions, where production has been halted amid fears of contamination. The New York Times has reported extensively on problems at the plant, which had to throw out millions of doses of AstraZeneca vaccine between October and January, and later discarded up to 15 million doses of the vaccine developed by Johnson & Johnson, also because of concern about possible contamination.
AstraZeneca’s vaccine, unlike those of Pfizer, Moderna and Johnson & Johnson, has also not been granted emergency use authorization by the Food and Drug Administration. And the administration would not specify which countries will receive the vaccine.
Jen Psaki, the White House press secretary, cautioned at a news conference that the donations of doses would not happen right away. She said about 10 million doses could be released “in the coming weeks” if the F.D.A. determines that the vaccine meets “our own bar and our own guidelines,” and that another 50 million doses are in various stages of production.
“Right now we have zero doses available of AstraZeneca,” Ms. Psaki said.
In a statement, a spokesperson for AstraZeneca said that the company would not comment on specifics but that “the doses are part of AstraZeneca’s supply commitments to the U.S. government. Decisions to send U.S. supply to other countries are made by the U.S. government.”
An earlier version of this article referred incorrectly to a safety review that the Food and Drug Administration is required to conduct before AstraZeneca coronavirus vaccine doses are shared with other nations. The doses themselves must clear an F.D.A. safety review, not the plant where the doses are manufactured.
The European Union has sued AstraZeneca over what the bloc has described as delays in shipping hundreds of millions of doses of coronavirus vaccines, a sharp escalation of a longstanding dispute between the bloc and the maker of one of the world’s most important vaccines.
AstraZeneca has said that it would be able to deliver only a third of the 300 million doses that European officials had been expecting by the end of June. As a result, European officials said on Monday that they believed AstraZeneca had broken its contract, and that they were seeking speedier deliveries than the company said it could muster.
The two sides’ relationship had grown acrimonious in January when AstraZeneca slashed its expected deliveries for the first quarter of the year, setting back the bloc’s vaccination campaign by weeks as cases picked up across the continent and political leaders faced scorching criticism for inadequate planning.
For AstraZeneca, whose cheap and easy-to-store shot is being used by 135 countries, the lawsuit could create further difficulties in a bruising stretch. No company had been as instrumental in the race to vaccinate poorer countries around the world, but AstraZeneca has been buffeted in recent weeks by the discovery of an exceedingly rare, though serious, side effect that has prompted restrictions on its use in parts of Europe.
At issue in the legal dispute was whether AstraZeneca had done everything in its power to meet its delivery schedule. Pascal Soriot, the company’s chief executive, has said that the contract required only that it make its “best efforts” to deliver the purchased doses on time.
Vaccine production is a notoriously fickle science, with live cultures needing time to grow inside bioreactors, for instance. In an effort to supply doses not only to richer nations that had purchased them well in advance, but also to poorer nations, AstraZeneca had partnered with manufacturing sites around the world, rather than relying on only a few factories, as Pfizer and Moderna have.
AstraZeneca, which developed the vaccine with the University of Oxford, has also said that the European Commission, the bloc’s executive branch, finalized its contract months after Britain did, giving the company less time to iron out any manufacturing difficulties.
Legal experts said that the “best efforts” language in the contract raised the burden on the Europeans to prove that AstraZeneca did not act diligently enough to supply the promised doses. But they also said that it did not entirely insulate the company from being deemed in breach of contract.
President Recep Tayyip Erdogan of Turkey ordered a national lockdown for three weeks, closing nonessential businesses and sending all students home, as the nation struggles to contain the latest surge in cases of the coronavirus.
Turkey ranks fourth in the world in new daily cases per person, averaging 63 cases per 100,000 people, according to a New York Times database. Its seven-day average for deaths ranks 11th in the world.
The lockdown starts on April 29 and will end on May 17, coinciding with Eid al-Fitr, the end of the holy month of Ramadan, Mr. Erdogan said after meeting with his cabinet. Schools and restaurants will close and travel within Turkey will require a permit, he said. Government employees will either work from home or in shifts. Essential businesses like those in the food, manufacturing and health sectors will be exempt, Mr. Erdogan said.
“In a period where Europe is opening up, we have to pull the number of cases’’ lower, Mr. Erdogan said. “Otherwise, it would be inevitable to face a heavy cost from tourism to trade to education.’’
So far, about 16 percent of its total population has received at least one dose of the vaccine from Sinovac or Pfizer-BioNTech, according to data from the Our World in Data project at the University of Oxford.
Turkey reported about 63,000 new cases on April 16, its highest daily tally since the start of the pandemic.
Scotland and Wales reopened restaurants, cafes, and nonessential shops on Monday, marking the next phase of a gradual relaxation of coronavirus restrictions that have been in place for months.
In Scotland, restaurants can serve food but not alcohol indoors until 8 p.m., and they can serve food and alcohol outdoors without restrictions. Stores, beauty salons, museums and galleries also reopened, and people are permitted to book travel in the rest of Britain.
The first minister of Scotland, Nicola Sturgeon, said she was hopeful that the country would continue its progress and lift more restrictions by the summer. But she cautioned that the virus was more infectious now than it had been in earlier waves and, therefore, “We must stick to the rules.” Free rapid tests will be available to the public.
In Wales, places of worship and retail stores reopened, and restaurants resumed outdoor service. Outdoor wedding receptions with up to 30 people can take place.
Cases remain low in Britain, with more than 40 percent of the population having received at least one dose of a vaccine. On Sunday, the country reported just over 1,700 new cases and 11 deaths, according to a New York Times database.
The governments of Singapore and Hong Kong said on Monday that a long-delayed travel bubble between the two Asian financial centers would begin next month, allowing travelers on designated flights to bypass quarantine.
The travel arrangement, which was originally supposed to begin last November, was suspended at the last minute when Hong Kong experienced a sudden surge in cases. With both places now reporting relatively few local infections, officials say the travel corridor will begin on May 26.
“Both sides will need to stay very vigilant in the next one month, so that we can launch the first flights smoothly,” Ong Ye Kung, Singapore’s minister of transport, said in a statement.
The arrangement, which is open to people of any nationality in Singapore and Hong Kong, will begin with one flight per day in each direction for up to 200 passengers. Travelers to both places must test negative for the coronavirus before departure and again upon arrival. They are also required to download and use government contact-tracing apps.
Travelers from Hong Kong must have received their second dose of a vaccine at least 14 days earlier, with some exceptions. Officials in Hong Kong, where the vaccination campaign has struggled to gain momentum, say they hope that this will give residents an incentive to get vaccinated. (There is no vaccination requirement for travelers from Singapore to Hong Kong.)
Officials said that the bubble would be suspended automatically for two weeks if either city recorded a seven-day average of more than five local cases from an unknown source.
The bubble is seen as an important step toward economic recovery in the two cities, both major travel hubs whose flagship carriers, Cathay Pacific and Singapore Airlines, only operate international flights. Similar travel bubbles are already in effect between Australia and New Zealand and between Palau and Taiwan, all places where local transmission of the coronavirus is almost nonexistent.
MANILA — The Philippines surpassed the one million mark on Monday in the total number of coronavirus cases it has reported, as the country struggles with newer, deadlier forms of the virus.
Average daily case reports in the country are not high by international standards, at about 8 per 100,000 population, according to data compiled by Johns Hopkins University; the U.S. rate is about 18, and much of Europe is in the 30s and 40s or worse. But the Philippines reported very few cases last year, and did not see a significant surge until recently.
In response, Manila and four other suburbs went into lockdown earlier this month. President Rodrigo Duterte is expected to speak about quarantine measures on Wednesday.
Harry Roque, spokesman for President Duterte, said new variants and not the government’s pandemic policies were to blame for the surge. He noted that the Philippines was far down in the global rankings for the total number of cases.
“This just proves that for the rest of the world, the rise in the number of cases is really a problem because of these new variants,” Mr. Roque said.
Richard Gordon, a senator who is also the head of the Philippine Red Cross, said that the agency was urgently setting up field hospitals, quarantine hospitals and scaling up testing as the government grappled with the situation.
He added that the organization had also converted unused classrooms and buildings into quarantine facilities for people who have contracted Covid-19 but had mild symptoms.
“Urgent extra medical care is a matter of life and death as this pandemic sets alarming new records,” he said. “Our volunteers are working day and night.”
MELBOURNE, Australia — More than 78,000 people attended an Australian rules football match in Melbourne on Sunday night in what is believed to be the world’s biggest crowd at a sporting event since the coronavirus pandemic began.
The annual A.F.L. match between the Essendon and Collingwood teams is held on Anzac Day, which commemorates Australian and New Zealand soldiers, and includes a ceremony to honor the troops. It often draws the largest crowds of the season, sometimes even outselling the grand final match.
Just three days earlier, the government of the state of Victoria, of which Melbourne is the capital, had increased the attendance cap for the 100,000-capacity venue, the Melbourne Cricket Ground, to 85 percent from 75 percent. Three other Australian states have removed all limits on crowds at sporting events.
Last year, the match was canceled because of the pandemic and the Anzac Day ceremony was performed in an empty stadium.
By comparison, this year’s Super Bowl championship football game in Tampa, Fla., drew a crowd of about 25,000, while the Daytona 500 NASCAR motor race allowed slightly more than 30,000 fans. The largest crowd at a U.S. sporting event since the pandemic began was an opening-day baseball game hosted by the Texas Rangers, which was attended by about 38,000 people.
The A.F.L. match in Australia came a day after more than 50,000 fans packed into a stadium in Auckland, New Zealand, for what organizers said was the largest concert in the world since the pandemic began. The two countries, which have all but eliminated local transmission of the coronavirus, opened a travel bubble this month.
Both countries have responded to periodic outbreaks with immediate lockdowns, most recently in Perth, Australia’s fourth-largest city and the capital of Western Australia State, which went into a three-day lockdown on Saturday after a man tested positive for the virus after leaving hotel quarantine. So far, two related cases have been detected in the community.
The lockdown will end at midnight on Monday, but the state’s premier, Mark McGowan said some restrictions, like mandatory mask wearing and a limit of 20 people for gatherings, will remain for another four days. Citing the burden on the hotel quarantine system, he also said on Sunday that the state’s cap on the number of international air passengers allowed to arrive each week would be halved to 512 from April 29 to May 30, in another blow to the tens of thousands of Australians stranded overseas.
U.S. airlines have been bolstered by the return of customers eager to travel within the country or just outside its borders, but the nation’s largest carriers are still lamenting the loss of two particularly lucrative parts of the business: international and corporate travel. At least one of those could rebound this summer.
In an interview with The New York Times over the weekend, Ursula von der Leyen, the president of the European Commission, said she expected the European Union to ease travel restrictions for vaccinated American tourists, a move that could let the airline industry cash in during the year’s busiest travel season.
“Long-haul international flying represents a significant opportunity for United,” Andrew Nocella, the chief commercial officer for United Airlines, told investors last week. “We have seen in recent weeks that immediately after a country provides access with proof of a vaccine, leisure demand returns to the level of 2019 quickly.”
American Airlines and United said this month that international travel remained about 80 percent lower than in 2019. They and other airlines expect strong demand for domestic flights this summer, and the restoration of trans-Atlantic travel could provide the industry a much-needed boost as it works to generate profits again.
American, Delta Air Lines and United each reported a loss of more than $1 billion in the first three months of the year. Southwest Airlines reported a small profit, of $116 million, though its chief executive said the airline would have lost $1 billion without federal aid.
The news of the E.U. reopening to vaccinated American tourists was also welcomed by Willie Walsh, the director general of the International Air Transport Association, a global airline industry group, who said it could bode well for carriers elsewhere, too.
He said in a statement that coordination between the European Commission and the industry was essential “so that airlines can plan within the public health benchmarks and timelines that will enable unconditional travel for those vaccinated,” not just Americans but passengers from other countries as well.
Only a few weeks ago, Phuket seemed poised for a comeback. After a year of practically no foreign tourists arriving in Thailand, the national government decided that Phuket would start welcoming vaccinated visitors in July, without requiring them to go through quarantine. The project was called Phuket Sandbox.
But Thailand is now gripped by its worst Covid-19 outbreak since the pandemic began, spread in part by the well-heeled Thais who partied in Phuket and Bangkok with no social distancing. The confirmed daily caseload — albeit low by global standards — has increased from 26 on April 1 to more than 2,000 three weeks later, in a country that in early December had about 4,000 cases total.
The opening that Phuket had planned for July 1 now appears unlikely, Thailand’s tourism minister acknowledged this month.
“If you ask me how optimistic I am, I cannot say,” said Nanthasiri Ronnasiri, the director of the tourism authority’s Phuket office. “The situation changes all the time.”
The virus’s resurgence after so many months of economic hardship is devastating for the majority of Phuket’s residents, who depend on foreign tourists for their livelihoods.
Compliance practices at the Academy Awards on Sunday will be closely watched as organizers prepare for the gradual resumption of major events such as the Tonys (to be coordinated with Broadway’s reopening).
Part cop, part coach, Covid compliance officers, or C.C.O.s, have become essential overseers in America’s tentative return to prepandemic life.
“We’re at a tipping point,” said Dr. Blythe Adamson, an infectious disease epidemiologist and economist. “People are going out more, they have pandemic fatigue. They’re vaccinated, but people are still getting Covid with these new strains. It makes the compliance officer role extremely important.”
The budget for Covid compliance on film sets is high: 25 to 30 percent of the total, according to Dr. Linda Dahl, an ear, nose and throat surgeon who has become a C.C.O. Complicating the job, what constitutes Covid compliance can change on a weekly or even daily basis as guidelines from the Centers for Disease Control and Prevention constantly evolve.
The number of students that dropped out of school in Italy because of the coronavirus pandemic is rising, aggravating what was already a crisis before the disease spread across the nation.
Italy had among the worst dropout rates in the European Union, and the southern city of Naples was particularly troubled by high numbers. When the coronavirus hit, Italy shuttered its schools more than just about all the other European Union member states, with especially long closures in the Naples region, pushing students out in even higher numbers.
While it is too early for reliable statistics, principals, advocates and social workers say they have seen a sharp increase in the number of students falling out of the system. The impact on an entire generation may be one of the pandemic’s lasting tolls.
Italy closed its schools — fully or in part — for 35 weeks in the first year of the pandemic — three times longer than France, and more than Spain or Germany.
And experts say that by doing so, the country, which has Europe’s oldest population and was already lagging behind in critical educational indicators, has risked leaving behind its youth, its greatest and rarest resource for a strong post-pandemic recovery.
German health authorities will allow all adults to sign up for vaccine appointments beginning in June, Chancellor Angela Merkel said on Monday.
The announcement came after a meeting with lawmakers to discuss lifting social restrictions for fully vaccinated people, a sign that Germany may be moving closer to emerging from its latest lockdown.
“We will enter a transition phase, which is also not easy,” Ms. Merkel told reporters after discussing the country’s vaccination drive with state governors. Right now, Germany is focusing on vaccinating people 60 or older, or who are ill, or who work in certain professions.
Germany’s vaccination campaign has picked up speed after a sluggish start, and on average, more than 485,000 people a day are now getting a shot in the last week. About 23 percent of the population has had at least one dose, and 7.2 percent are fully vaccinated. Germany lags far behind Britain, which has given at least one dose to 51 percent of its population, or the United States, with 42 percent.
The German lawmakers also discussed when and how to relax certain daily restrictions for those who are fully vaccinated, but did not decide on concrete measures.
Asked whether Germans might travel during the summer, Ms. Merkel responded, “The faster we get through this serious phase, the faster hope will spread.”
A private school in the fashionable Design District of Miami sent its faculty and staff a letter last week about getting vaccinated against Covid-19. But unlike institutions that have encouraged and even facilitated vaccination for teachers, the school, Centner Academy, did the opposite: One of its co-founders, Leila Centner, informed employees “with a very heavy heart” that if they chose to get a shot, they would have to stay away from students.
In an example of how misinformation threatens the nation’s effort to vaccinate enough Americans to get the coronavirus under control, Ms. Centner, who has frequently shared anti-vaccine posts on Facebook, claimed in the letter that “reports have surfaced recently of non-vaccinated people being negatively impacted by interacting with people who have been vaccinated.”
“Even among our own population, we have at least three women with menstrual cycles impacted after having spent time with a vaccinated person,” she wrote, repeating a false claim that vaccinated people can somehow pass the vaccine to others and thereby affect their reproductive systems. (They can do neither.)
In the letter, Ms. Centner gave employees three options:
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Inform the school if they had already been vaccinated, so they could be kept physically distanced from students;
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Let the school know if they get the vaccine before the end of the school year, “as we cannot allow recently vaccinated people to be near our students until more information is known”;
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Wait until the school year is over to get vaccinated.
Teachers who get the vaccine over the summer will not be allowed to return, the letter said, until clinical trials on the vaccine are completed, and then only “if a position is still available at that time” — effectively making teachers’ employment contingent on avoiding the vaccine.
Ms. Centner required the faculty and staff to fill out a “confidential” form revealing whether they had received a vaccine — and if so, which one and how many doses — or planned to get vaccinated. The form requires employees to “acknowledge the School will take legal measures needed to protect the students if it is determined that I have not answered these questions accurately.”
Ms. Centner directed questions about the matter to her publicist, who said in a statement that the school’s top priority throughout the pandemic has been to keep students safe. The statement repeated false claims that vaccinated people “may be transmitting something from their bodies” leading to adverse reproductive issues among women.
“We are not 100 percent sure the Covid injections are safe and there are too many unknown variables for us to feel comfortable at this current time,” the statement said.
The Food and Drug Administration, the Centers for Disease Control and Prevention, the World Health Organization and many other authorities have concluded that the coronavirus vaccines now in emergency use in the United States are safe and effective.
The Centner Academy opened in 2019 for students in prekindergarten through eighth grade, promoting itself as a “happiness school” focused on children’s mindfulness and emotional intelligence. The school prominently advertises on its website support for “medical freedom from mandated vaccines.”
Ms. Centner founded the school with her husband, David Centner, a technology and electronic highway tolling entrepreneur. Each has donated heavily to the Republican Party and the Trump re-election campaign, while giving much smaller sums to local Democrats.
In February, the Centners welcomed a special guest to speak to students: Robert F. Kennedy Jr., the prominent antivaccine activist. (Mr. Kennedy was suspended from Instagram a few days later for promoting Covid-19 vaccine misinformation.) This month, the school hosted a Zoom talk with Dr. Lawrence Palevsky, a New York pediatrician frequently cited by anti-vaccination activists.
Kitty Bennett contributed research.
Alaska Airlines has suspended an Alaska state lawmaker from its flights for violating its mask policies, the company said.
Lora Reinbold, a Republican state senator, was arguing with employees at Juneau International Airport about the airline’s mask rules, according to footage posted on Twitter.
“We need you to pull the mask up, or I’m not going to let you on the flight,” an employee is heard saying to Ms. Reinbold on the videos, which were posted on Thursday.
“It is up,” Ms. Reinbold responds.
“It is not,” an employee says. “It’s down below your nose. We can’t have it down.”
The airline said it had told Ms. Reinbold that she was “not permitted to fly with us for her continued refusal to comply with employee instruction regarding the current mask policy,” adding that the suspension is being reviewed.
The clash over the company’s rule was the latest to surface in the country about masks during the pandemic. Mask mandates have become a rallying cry for some activists and a divisive political talking point. Disputes about the rules have sometimes led to angry confrontations.
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