Just three months ago, as infections surged around the country and the prospect of a bleak winter loomed, it was not clear if any of the vaccines in development would pan out.
The picture now is very different.
After a sputtering start, coronavirus vaccination in the United States is speeding up. Two of the vaccines have been found to be highly effective. Three others appear to be slightly less robust, but still offer strong, and in some cases complete, protection against serious illness and death.
“We’ve come a long way,” said Akiko Iwasaki, an immunologist at Yale University. “We’re still living with deadly disease because we haven’t vaccinated enough people, but once we do, it’s going to really change the way we live and deal with this virus.”
More than 27 million Americans have received a first dose, and more than six million have been fully vaccinated.
The pace has accelerated enough that President Biden, facing criticism that his administration’s goal of giving out 100 million shots in his first 100 days in office was too modest, last week raised that goal to 150 million shots.
But even as there are reasons for hope in the spring and summer, many public health experts remain pessimistic about the next couple of months. Several warned that the world was nowhere near clear of a pandemic that has taken nearly 450,000 lives in the United States and 2.2 million in total around the globe.
And what progress there has been is hardly uniform.
Vaccinations may have accelerated in wealthy countries, but poorer countries are being left behind.
“I think in the rich world, we have a lot to feel good about for vaccines, but globally, it’s a different story,” said Marc Lipsitch, professor of epidemiology and director of the Center for Communicable Disease Dynamics at Harvard T.H. Chan School of Public Health.
Even within the United States, there are disparities. Wealthier, white residents are gaining access to the vaccine more frequently than Black and Latino people, who have been disproportionately affected by the pandemic.
There are other sources of concern.
Dr. Eric Topol, a clinical trials expert at Scripps Research in San Diego, recalled feeling hopeful as recently as December that the pandemic could be tamed in the United States by June, thanks to the flurry of encouraging vaccine data. But as the picture grew clearer in the past few weeks about the threat posed by new, more contagious variants of the virus, his optimism has faded.
“The variants changed everything,” Dr. Topol said.
Still, there are glimpses of a path out of the pandemic as vaccinations increase.
At Bloom Senior Living, a chain in the Southeast and the Midwest, officials have gradually begun to reopen their doors to indoor visitors.
“It means everything for them to be able to see their adult children and, hopefully, eventually their grandchildren — to feel like they’re living life again,” said Bradley Dubin, principal of the firm that owns the Bloom facilities.
The International Federation of Red Cross and Red Crescent Societies, announcing a $110 million plan to help distribute vaccines, warned on Thursday of the “potentially devastating” consequences if poorer countries lagged behind their richer counterparts in inoculations.
Richer countries have dominated in the race to secure shots, and poorer countries face major problems in vaccinating their citizens, with lack of supply one of the most pressing. While an international program, called Covax, aims to procure Covid-19 vaccines at low or no cost for all countries — and plans to provide more than 300 million doses by the summer — it relies on global cooperation.
The federation of Red Cross and Red Crescent Societies warned that the entire world was vulnerable if large pockets remained unvaccinated and urged richer nations to show solidarity. Under the $110 million plan, the federation aims to support the immunization of 500 million people, providing national vaccination efforts with planning and implementation and working to ensure that the doses “get delivered into the arms that need it,” said Jagan Chapagain, the group’s secretary general.
“There must be no politics and there must be no greed around the vaccine, this is about saving lives,” Mr. Chapagain said. “Let’s not do politics.”
The distribution plan will include efforts to build trust in vaccines and to counter misinformation, and volunteers will seek out isolated communities to ensure that they are vaccinated. In some countries, it will also include the physical delivery of vaccines to at-risk groups.
Vaccinating refugees and migrants will also be crucial, Mr. Chapagain said, noting that such hard-to-reach communities often had difficulty gaining access to health services.
“If we exclude these marginalized groups and communities, the safety we believe we have brought through the vaccines will be false,” he said.
Emanuele Capobianco, the federation’s director of health, said that he was optimistic there would be enough vaccine supply, even though it might take time.
He encouraged world leaders to keep global cooperation at the core of their thinking. “Right now, it’s a very difficult crunch phase, which we need to overcome,” he said.
Where are U.S. teachers approved to get Covid vaccines?
Only in about half the states, The New York Times has found.
This map tells the story.
The Times, which has been tracking vaccine eligibility rules in all 50 states, found that at least 24 states and Washington, D.C., are providing shots to some teachers of kindergarten through high school. Some of those states, however, consider teachers eligible for the vaccine only in certain counties.
As with many programs that have emerged since the pandemic began, it is a hodgepodge.
In West Virginia, for example, teachers are eligible for the vaccine only if they are age 50 or older.
In Montana, a limited number of teachers are allowed to get shots if they have specific medical conditions.
And in some states — among them Florida and Texas — officials have ordered schools to reopen for in-person learning, but teachers have not been made eligible for shots. Of the 15 counties with the worst coronavirus outbreaks now, more than half are in Texas.
A new coronavirus antibody survey in the Indian capital, New Delhi, estimates that more than half of the city’s 20 million residents have had Covid-19.
The city’s health department in January found antibodies showing immune response to coronavirus infections in 56 percent of the 28,000 people who provided blood samples. The city’s health minister, Satyendar Jain, told reporters on Tuesday that New Delhi was “moving toward herd immunity.”
But New Delhi’s health director, Dr. Nutan Mundeja, said the results did not mean it was safe for people to stop social distancing or wearing masks.
“This is a new disease, and we should not change our strategy,” Dr. Mundeja said. “Let us wait and see.”
The last citywide survey, conducted in October, found that just over a quarter of the population could have been infected.
Even though the new survey shows a higher percentage of coronavirus antibodies in New Delhi’s population, the number of new cases there and across the country has steadily fallen since a September peak of nearly 100,000 nationwide cases a day. About 18,000 cases were reported across India on Wednesday.
India has registered more than 10 million cases in total, the second-highest tally in the world after that of the United States, according to a New York Times database.
The country of 1.3 billion people has also begun one of the world’s largest coronavirus inoculation campaigns. More than four million health care workers have already received their first dose.
The new antibody data did not surprise Bhramar Mukherjee, an epidemiologist at the University of Michigan. She said that her field research in India last fall had suggested that most cases in New Delhi and other large Indian cities were “silent infections” so mild that they went undetected.
“Big metros in India are close to disease induced herd immunity,” Dr. Mukherjee said. She added that India’s vaccination drive could help bridge the gap by protecting people who did not yet have coronavirus antibodies.
In other news from around the world:
North Korea is expected to receive nearly two million doses of the AstraZeneca coronavirus vaccine by the middle of this year, according to a report on Wednesday by Covax, an international group that has negotiated for vaccine doses. The planned shipment to North Korea is part of an estimated 336 million doses that Covax expects to distribute around the world in the first half of this year. Doses sent to North Korea and other countries will be manufactured by the Serum Institute of India, according to the report. North Korea has insisted for months that it has no confirmed Covid-19 cases in its territory, but outside experts are skeptical.
China’s National Health Commission said on Thursday that only 17 new cases had been reported nationwide the day before, mostly in northeastern provinces. Three locally transmitted cases were recorded in Shanghai, but all were people who tested positive near the end of two-week, government-supervised quarantines. China has been reporting fewer and fewer coronavirus cases in recent days, as its extensive testing, tracing and isolation measures appear to be working. As many as 1,000 people are put in lengthy quarantines for each positive case.
In Myanmar, health workers are among the people who have cautiously raised their voices against a coup on Monday by the country’s military. On Wednesday, doctors at one Yangon hospital raised three fingers, a defiant salute from the “Hunger Games” films that has become a symbol of the pro-democracy demonstrations in neighboring Thailand. Around 20 protesters also rallied outside the Mandalay University of Medicine, and six were detained. The country’s civilian leader, Daw Aung San Suu Kyi, was detained on Monday and now faces an obscure charge that could put her in prison for up to three years. President U Win Myint, one of her political acolytes, was also detained, and issued a detention order for violating emergency coronavirus regulations.
Lin Qiqing contributed research.
Among governments and those in the travel industry, a new term has entered the vocabulary: vaccine passport.
One of President Biden’s executive orders asks government agencies to “assess the feasibility” of linking coronavirus vaccine certificates with other vaccination documents, and producing digital versions of them.
The Danish government said on Wednesday that it would introduce a “digital passport” in the next few months that can be used as proof of vaccination.
In a few weeks, two airlines, Etihad Airways and Emirates, will start using a digital travel pass, developed by the International Air Transport Association, that, among other things, provides airlines and governments with documentation that passengers have been vaccinated or tested for the coronavirus.
The challenge is creating a universal document or app that protects privacy and is accessible regardless of people’s wealth or access to smartphones.
“It’s about trying to digitize a process that happens now and make it into something that allows for more harmony and ease, making it easier for people to travel between countries without having to pull out different papers for different countries,” said Nick Careen, senior vice president for airport, passenger, cargo and security at I.A.T.A., where he has been leading the travel pass initiative.
IBM has been developing its own “digital health pass” to aid in providing proof of vaccination or a negative test for those seeking access to a sports stadium, an airplane, a university or workplace. The pass, built on IBM’s blockchain technology, can use temperature checks, virus exposure notifications, test results and vaccine status. The World Economic Forum and the Commons Project Foundation, a Swiss nonprofit group, have been testing a digital health passport called CommonPass that would generate a QR code to show the authorities.
As more people are inoculated, it’s likely that more aspects of public life will be limited to people who have been vaccinated. At the Super Bowl in Tampa, Fla., on Sunday, a significant portion of attendees will be vaccinated health care workers.
For international travel, government and health authorities will need to know if people have been vaccinated or have tested negative for the virus. Many countries are already requiring proof of a negative test for entry. Such passes could be essential to restarting the tourism industry, said Zurab Pololikashvili, secretary general of the World Tourism Organization, a United Nations agency.
“One key element vital for the restart of tourism is consistency and harmonization of rules and protocols regarding international travel,” he said in an email. “Evidence of vaccination, for example, through the coordinated introduction of what may be called ‘health passports’ can offer this. They can also eliminate the need for quarantine on arrival, a policy which is also standing in the way of the return of international tourism.”
Showing evidence of vaccination is not a new concept. For decades, travelers to some countries have had to prove vaccination against yellow fever, rubella and cholera, for example.
“Parents with kids in public school have had to prove their kids have been vaccinated. This is not something new,” said Brian Behlendorf, executive director of Linux Foundation Public Health, an open-source, technology-focused organization helping public health authorities combat Covid-19 around the world.
“As these things get rolled out, it’s important for citizens to ask governments and airlines: How do we make this easy so I have one vaccination record to book a flight, hotel and so I can use that to do some other things,” Mr. Behlendorf said. “It should work like email. If it doesn’t, agitate for it.”
Tennis officials on Thursday postponed the Australian Open draw by a day after a worker in one of the hotels where players have been quarantining tested positive for the coronavirus.
The positive test, which came days after some players began to emerge from quarantine, forced 507 players and support staff members into isolation until they receive negative test results. Tennis officials have called off matches planned for Thursday in several preparatory events, but they said that the Australian Open would move forward with its scheduled Monday start.
News of the positive test sent chills through Melbourne, the tournament’s host city, whose citizens endured a lockdown of nearly four months last year.
“We have all been through a tough time,” said Craig Tiley, the chief executive of Tennis Australia, which runs the Australian Open. “At some point we need to continue on.”
Officials still plan to allow as many as 30,000 spectators each day at the tournament, a rarity in international sports with the pandemic still raging.
Melbourne, the capital of the state of Victoria, had not recorded a local transmission in nearly a month. The man who tested positive worked at the Grand Hyatt in the center of the city, where some players are still staying. He has not worked there since Jan. 29.
The man’s closest contacts have been tested, and officials have released details of his travels in recent days. He had been working on the same floor where several of the people who tested positive for the virus when they arrived in Melbourne had been staying.
Victoria’s premier, Daniel Andrews, has been criticized for allowing the tournament to go ahead. On Wednesday night, he reintroduced a series of restrictions, including mandatory mask wearing indoors and a limit of 15 visitors to private homes. He also postponed a planned increase in workplace capacity to 75 percent, from 50 percent.
Those measures were less severe than other recent responses to Covid-19 in Australia. The city of Perth, in Western Australia, snapped into a total lockdown on Sunday after health officials discovered a single local transmission. That lockdown is expected to last at least five days.
The Australian Open’s attempt to quarantine players for 14 days and hold four weeks of tennis events has had no shortage of hiccups. Last month, 72 players were forced into a hard lockdown, preventing them from practicing, after 10 people on three flights that brought people from overseas for the tournament tested positive. A handful of those players were at Grand Hyatt, and they went back into isolation on Thursday.
Some players who continued to test negative through their strict lockdowns were furious that health officials had refused to allow exceptions to the isolation requirement for everyone considered a close contact of a Covid-19 case.
“The players have been remarkable,” Mr. Tiley said. “They have come to accept that with travel round the world, anything can happen.”
In a news conference after his match Wednesday night, Nick Kyrgios, a veteran player from Australia, said that other players had no right to complain about coronavirus precautions at the tournament.
“There’s too much risk in all of this,” Mr. Kyrgios said. “I don’t understand what’s so hard for tennis players to understand.”
Dr. Sheetal Khedkar Rao, 42, an internist in suburban Chicago, can’t pinpoint the exact moment when she decided to hang up her stethoscope for the last time. In the spring came chaos and confusion when a nationwide shortage of N95 masks forced her to resort to a surgical mask when examining patients; then there was the fear she might take the coronavirus home to her family and, on top of that, the exasperating public disregard for mask wearing and social distancing that was amplified by the White House.
Among the final blows, though, were a 30 percent pay cut to compensate for a drop in patients seeking primary care, and the realization that she needed to spend more time at home looking after her children, who had switched to remote learning.
Doctors, paramedics and nurses’ aides have been hailed in the United States as frontline Covid-19 warriors, but gone are the days when people applauded workers outside hospitals and on city streets. A year into the pandemic, with emergency rooms packed again, vaccines in short supply and more contagious variants of the virus threatening to unleash a fresh wave of infections, medical workers are feeling burned out and unappreciated.
Some health care experts are calling for a national effort to track the psychological well-being of medical professionals, much like the federal health program that monitors workers who responded to the 9/11 terrorist attacks.
So far, the federal government has shown little interest in addressing what Dr. Victor J. Dzau, president of the National Academy of Medicine described as a “parallel pandemic” of psychological trauma among health care workers.
He and other experts say the government should start by making a concerted effort to accurately count medical worker infections and fatalities.
Dr. Erica Bial, a pain specialist from suburban Boston who barely survived Covid-19 last spring, is still plagued by fatigue and impaired lung function.
“The day before I got sick, I could comfortably run eight to 10 miles,” said Dr. Bial, 45, who started a Facebook group memorializing doctors lost to Covid. “Now I go out for a brisk walk and my heart is pounding. I’m starting to wonder whether these effects could be permanent.”
Thousands of health care workers have already paid the ultimate price for their dedication. Since March, more than 3,300 nurses, doctors, social workers and physical therapists have died from Covid-19, according to a tally by Kaiser Health News and The Guardian.
Dr. Donald Pathman, a researcher at the University of North Carolina at Chapel Hill, said he had been struck by the early results of a study he has conducted on the pandemic’s effect on clinicians who serve in poor communities. Many of the 2,000 medical, dental and mental health professionals who have participated in the survey so far say they are disillusioned.
“There is a lot of personal trauma,” Dr. Pathman said. “Many people have been scarred by their experiences during the pandemic, and they will look to leave their practices.”
Researchers say the pandemic’s toll on the health care work force will play out long after the coronavirus is tamed. The impact, for now, can be measured in part by a surge of early retirements and the desperation of community hospitals struggling to hire enough workers to keep their emergency rooms running.
“Everyone wants to talk about vaccines, vaccines, vaccines, but for our members, all they want to talk about is work force, work force, work force,” said Alan Morgan, chief executive of the National Rural Health Association. “Right now, our hospitals and our workers are just getting crushed.”
Last June, when the “Grey’s Anatomy” writers’ room reconvened, virtually, after a longer than usual hiatus, Krista Vernoff, the longtime showrunner, asked whether or not the coming season should incorporate the coronavirus pandemic.
“I’m like 51-49 for not doing the pandemic,” she told her staff. “Because we’re all so tired of it. We’re all so scared. We’re all so depressed. And we come to ‘Grey’s Anatomy’ for relief, right?”
But she was open to counterarguments. And when she asked for volunteers to try and talk her into it, she recalled recently, hands went up in nearly every Zoom window. The show’s senior surgical adviser, Naser Alazari, made the most compelling case: The pandemic was the story of a lifetime, he told her, speaking from the clinic where he was treating Covid-19 patients. They had a responsibility to tell it.
In rooms all over the internet, hospital dramas, first-responder shows, situation comedies and courtroom procedurals were having similar debates. To ignore the events of the spring and summer — the pandemic, the belated racial reckoning in the United States — meant placing prime-time series outside (well, even more outside) observable reality. But to include them meant potentially exhausting already exhausted viewers and covering up telegenic stars from the eyes down.
It also meant predicting the future. David Shore, the showrunner for ABC’s “The Good Doctor,” said in a telephone conversation. “Usually, when you’re writing a story, you know what the world’s going to look like.”
Some shows have made the pandemic a star, and some have relegated it to a background role. Others have written it out of existence. Showrunners and executive producers have had to best-guess what audiences most want: Television that reflects the world as we experience it? Or that provides a distraction from it, particularly when that world seems to be on fire and sometimes is?
Most sitcoms wrote around the pandemic, often with an eye toward reruns.
“Mr. Mayor,” which premiered last month on NBC, handled it in a punchline: “Dolly Parton bought everybody a vaccine,” Ted Danson’s novice politico says.
“Last Man Standing,” a Fox family sitcom starring Tim Allen, decided to skip ahead two years between seasons. Looking toward a January debut, the showrunner Kevin Abbott guessed that most decent pandemic jokes would have been told by then and that scripts that reflected reality would skew too dark.
“People are already depressed,” he said. “We really didn’t want to add to that.”
“Our show takes place in a store,” said Jonathan Green, a “Superstore” showrunner along with Gabe Miller, adding that he had felt a responsibility to display the pandemic’s impact on retail employees. Because “Superstore” is a sitcom, they said they believed that they could do it with a light hand, when those hands weren’t busy grabbing up toilet paper to hoard.
Hospital shows had to face it head-on, of course. “The Good Doctor” premiered with a coronavirus-heavy two-parter, then shot forward in time. “It would have been craziness to just ignore the pandemic,” Shore said. “On the other hand, it also would have been exhausting for us and our viewers to walk through it for an entire season.”
The Fox drama “The Resident” addressed it in a season premiere book-ended by scenes set in a coronavirus-free future, where the rest of the season takes place.
But “Grey’s Anatomy” has spent the whole of its season battling the pandemic, with several lead characters, including Ellen Pompeo’s Meredith Grey, falling ill.
“I was like, if we’re doing this, we’re doing this,” Vernoff said, speaking by telephone from the set. “We don’t know what medicine is going to look like post-Covid.”
A team of Chinese scientists has reported that a coronavirus vaccine made by the Beijing-based company Sinovac Biotech, which has already been rolled out in China and distributed to many developing countries, was shown in early-stage trials to be safe and to have stimulated an immune response in adults over 60.
The results from the Phase 1 and 2 trials, which included 494 volunteers over 60 years old, were published in the British medical journal The Lancet on Wednesday.
But the vaccine’s late-stage trial results have been marred by confusion. The problems have disappointed several governments that placed orders. Brazilian officials said the vaccine had an efficacy rate of just over 50 percent, although those who still became infected included people who showed only “very mild” symptoms.
The vaccine, called CoronaVac, which has been introduced in countries including Brazil, Chile Indonesia and Turkey, is one of two candidates that are being mass produced in China. The other is a shot made by Sinopharm, a state-owned vaccine maker. CoronaVac was created using a tried-and-tested technology that uses a weakened or killed virus to stimulate the immune system.
CoronaVac has been given to millions of people in China, even before the release of late-stage clinical trial data to show that the vaccine would be effective. Sinovac said on Wednesday that the regulator had accepted its filing for approval.
The trials on adults above 60 years old showed no serious side effects, according to the Lancet article. It said that most adverse reactions were mild and that pain at the injection site was the most reported symptom, followed by fever.
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