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Wednesday, April 7, 2021

Covid-19 News Live Updates: AstraZeneca Vaccine, Cases and Variants - The New York Times

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Regulators in Britain and the European Union both said on Wednesday that blood clots were a possible rare side effect of the AstraZeneca Covid-19 vaccine. Britain said it would offer alternative vaccines for adults under 30.Alessandro Grassani for The New York Times

Britain said on Wednesday that it would offer alternatives to the AstraZeneca vaccine for adults under 30 as European regulators described a “possible link” with rare blood clots, a setback for the world’s most widely used vaccine and a blow to the more than 100 countries relying on it to save lives amid a global surge in coronavirus cases.

The European regulator, the European Medicines Agency, stopped short of advising that use of the vaccine be curbed in the 27 European Union countries, saying that it was up to the national authorities to decide who should receive which vaccine.

Until the announcement, Britain had never wavered in its use of the vaccine, making it a holdout in Europe even as many countries detected unusual, sometimes fatal, blood clots in some recipients. But evidence has mounted that very small numbers of Britons had also been afflicted, forcing the country to reduce the use in younger people of a vaccine that is the backbone of its world-beating inoculation program.

The concern over the blood clots has threatened the pace of vaccinations far beyond Europe. At least 111 countries of varying income levels have administered doses of AstraZeneca’s shot, making it international aid groups’ most potent weapon in the battle to reduce deaths in vaccine-starved countries.

Both British and European regulators said that it was possible that the clots were linked to the vaccine, but that more investigation was needed. European regulators described the cases as a serious but “very rare” side effect.

As of Sunday, officials said, European regulators had received reports of 222 cases of the rare blood-clotting problem in Britain and the 30-nation European Economic Area (the European Union plus Iceland, Norway and Liechtenstein). They said that about 34 million people had received the AstraZeneca vaccine in those countries, and that the clotting problems were appearing at a rate of about one in 100,000 recipients. The condition can be treated.

European regulators said that as of March 22, they had carried out detailed reviews of 86 cases, 18 of which had been fatal.

The agency reiterated that the overall benefits of the vaccine still outweighed the risks, but urged that health professionals and recipients of the shot be cautious about symptoms like shortness of breath, chest pain or leg swelling.

Many European countries have restricted use of the vaccine in younger people because some scientists believe they are at a higher risk of developing the rare blood clots. They are also at a lower risk of developing severe Covid-19, raising the safety bar for any vaccine being given to younger people.

But the regulator said that it had not concluded that age or gender were a specific risk and that it would further investigate the issue.

“This case clearly demonstrates one of the challenges posed by large scale vaccination campaigns,” Emer Cooke, the agency’s head, said in a news conference on Wednesday. “When millions of people receive these vaccines, very rare events can occur that were not identified during the clinical trials.”

“The risk of mortality from Covid is much greater than the risk of mortality from the side effects,” Ms. Cooke added.

No other vaccine has stirred as much controversy as the shot made by the British-Swedish company, setting off spats with the bloc over cuts in supply, its efficacy and finally over rare, but sometimes fatal, blood clots reported in some recipients.

Those concerns led several European countries to first restrict the use of AstraZeneca in older age groups, then suspend it over reports of blood clots, only to roll it out again last month after the European Medicines Agency issued a preliminary opinion that the benefits of the vaccine outweighed the risks.

As doctors reported a higher incidence of serious blood clots in younger people, some countries decided to stop administering the shot to anyone younger than 55.

Europe’s concerns over the vaccine’s side effects are also likely to threaten global inoculation efforts, with much of the developing world depending on the AstraZeneca vaccine to tackle the pandemic. The shot is the cornerstone of Covax, a program designed to make vaccine access more equitable worldwide.

The vaccine appeared to be causing an immune reaction in which antibodies bind to platelets, activating them, German doctors and the European Medicines Agency have said. Those platelets, in turn, were causing the formation of dangerous clots in certain parts of the body, including in veins that drain blood from the brain, leading in some cases to a rare type of stroke.

Why the antibodies develop in these people is not known, doctors have said. Some component of the vaccine, or an excessive immune reaction — or both — could be the cause, they said.

No medical condition is known to make patients more vulnerable to this clotting disorder after a vaccination, European regulators said.

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Dr. Rochelle Walensky the director of The Centers for Disease Control and Prevention, said on Wednesday that the virus variant first discovered in Britain is now the most common source of new infections nationwide.Daniel Dreifuss for The New York Times

A highly infectious variant of the coronavirus that was first identified in Britain has now become the most common source of new infections in the United States, the director of the Centers for Disease Control and Prevention said Wednesday — a worrisome development that comes as officials and scientists warn of a possible fourth virus wave.

Federal health officials said in January that the B.1.1.7 variant, which began surging in Britain in December and has since slammed Europe, could become the dominant source of coronavirus infections in the United States, leading to a wrenching increase in cases and deaths.

While new cases, hospitalizations and deaths have declined from their peaks in January, new infections have increased after plateauing. Further progress in reducing new cases has stalled, hospitalizations have leveled off, and deaths remain near an average of about 800 a day, according to a New York Times database.

The average number of new cases has reached nearly 65,000 a day, as of Tuesday, concentrated mostly in metro areas in Michigan as well as the New York City region. That’s up 19 percent from the figure two weeks ago.

The C.D.C. director, Dr. Rochelle Walensky, who last week warned that she felt a sense of “impending doom,” said on Wednesday that 52 of the agency’s 64 jurisdictions — which include states, some major cities and territories — are now reporting cases of “variants of concern,” including B.1.1.7.

That variant has been found to be most prevalent in Michigan, Florida, Colorado, California, Minnesota and Massachusetts, according to the C.D.C. Until recently, the variant’s rise was somewhat camouflaged by falling rates of infection over all, lulling Americans into a false sense of security and leading to prematurely relaxed restrictions, researchers say.

Federal health officials are tracking reports of increasing cases associated with day care centers and youth sports, and hospitals are seeing more patients who are younger adults — people in their 30s and 40s who are admitted with “severe disease,” Dr. Walensky said. Health officials are watching worrisome outbreaks in states including Michigan, Minnesota and Illinois.

At the same time, the nation is now vaccinating an average of about three million people a day, and states have been rushing to make all adults eligible. The C.D.C. reported on Tuesday that 108.3 million people have received at least one dose of a Covid-19 vaccine, including about 63 million people who have been fully vaccinated. New Mexico, South Dakota, Rhode Island and Alaska are leading the states, with around 25 percent of their total populations now fully vaccinated.

“These trends are pointing to two clear truths,” Dr. Walensky said. “One, the virus still has hold on us, infecting people and putting them in harm’s way, and we need to remain vigilant. And two, we need to continue to accelerate our vaccination efforts and to take the individual responsibility to get vaccinated when we can.”

Scientists have been predicting another rise in infections, as states relax their public health restrictions and restive Americans go back to school and work. But they are hoping that vaccinations will blunt any potential fourth surge.

On Tuesday, President Biden moved up his vaccination timetable by two weeks, calling on states to make every American adult eligible for coronavirus vaccination by April 19, a goal nearly all states have already met or expect to beat after he initially asked them to do so by May 1.

“It is in our power to minimize death, disease and misery,” Andy Slavitt, a White House pandemic adviser, said Wednesday. “If all of us do our part, we can help save lives in April, May and June. Wear a mask. Socially distance. Get vaccinated when it’s your turn.”

In February, a study that analyzed half a million coronavirus tests and hundreds of genomes predicted that in a month this variant could become predominant in the United States. At that time, the C.D.C. was struggling to sequence the new variants, which made it difficult to track them.

But those efforts have substantially improved in recent weeks and will continue to grow, in large part because of the $1.75 billion in funds for genomic sequencing in the stimulus package that President Biden signed into law last month. By contrast, Britain, with a more centralized health care system, began a highly touted sequencing program last year that allowed it to track the spread of the B.1.1.7 variant.

“We knew this was going to happen, this variant is a lot more transmissible, much more infectious than the parent strain and that obviously has implications,” said Dr. Carlos del Rio, a professor of medicine and an infectious disease expert at Emory University. In addition to spreading more efficiently, he said, the B.1.1.7 strain appears to cause more severe disease, “so that gives you a double whammy.”

The White House also announced an expansion to its vaccination program at community health centers, bringing the total to nearly 1,400 community centers across the country where people can get vaccinated. Mr. Slavitt said most of these community centers are in underserved neighborhoods with many uninsured patients. Last week, Mr. Biden promised that 90 percent of adults in the country would have a vaccine site within five miles of their home.

Eileen Sullivan contributed reporting.

Scientists have yet to establish how the coronavirus got into human circulation in China. A team of health workers tracing a Covid case in January visited a market stall in Wuhan where the infected person had been.
Gilles Sabrie for The New York Times

The joint international and Chinese mission organized by the World Health Organization on the origins of Covid released its report last week suggesting that for almost every topic it covered, more study was needed. What kind of study and who will do it is the question.

The report suggested pursuing multiple lines of inquiry, focused on the probable origin of the coronavirus in bats. It concluded that the most likely route to humans was through an intermediate animal, perhaps at a wildlife farm. Among future efforts could be surveys of blood banks, to look for cases that could have appeared before December 2019, and tracking down potential animal sources of the virus in wildlife farms, the team proposed.

Critics of the report have sought more consideration of the possibility that a laboratory incident in Wuhan could have led to the first human infection. A loosely organized group of scientists and others who have been meeting online to discuss the possibility of a lab leak released an open letter this week, detailing several ways to conduct a thorough investigation. The letter called for further action, arguing that “critical records and biological samples that could provide essential insights into pandemic origins remain inaccessible.”

Much of the letter echoes an earlier release from the same group detailing what it saw as the failures of the W.H.O. mission. This second letter is more specific in the kind of future investigations it proposes.

The group is seeking a new inquiry that would include biosecurity and biosafety experts, and that could involve the W.H.O. or a separate multinational effort to set up a different process to explore the beginnings of the pandemic and its origins in China.

Jamie Metzl, an author, senior fellow of the Atlantic Council, an international policy think tank and signer of the scientists’ letter, said the renewed calls for a more thorough investigation reflected the need for greater monitoring of and restrictions on the viruses that can be studied in labs around the world.

“This is not about ganging up on China,” Mr. Metzl said.

Mr. Metzl’s group was among those disappointed by the report issued last week, which dismissed out of hand the possibility of a leak from the Wuhan Institute of Virology, calling it extremely unlikely.

The head of the W.H.O., Dr. Tedros Adhanom Ghebreyesus, said later that the mission’s consideration of a possible lab leak was not “extensive enough.”

He continued, “Although the team has concluded that a laboratory leak is the least likely hypothesis, this requires further investigation, potentially with additional missions involving specialist experts, which I am ready to deploy.”

A mass vaccination event for teachers in Carteret, N.J., this month. About eight million school employees had received at least one vaccine dose by the end of March.
Bryan Anselm for The New York Times

Nearly 80 percent of school staff and child care workers in the United States have received at least one dose of the coronavirus vaccine, the Centers for Disease Control and Prevention said on Tuesday.

The announcement comes as the Biden administration has made an ambitious push to reopen schools and return to in-person instruction by the president’s 100th day in office. That goal has been tempered by dangerous virus variants, protests from teachers’ unions, and the fears and frustrations of students and parents.

The push to reopen schools has gathered momentum as evidence mounted that proper safety measures limited virus transmission in schools and coronavirus cases fell sharply from their January peak. Education officials and experts have cited the urgency of getting students back in classrooms before the academic year ends.

About eight million teachers, school staff and child care workers received their first vaccine dose by the end of March, according to the C.D.C., with about two million receiving their shot through the Federal Retail Pharmacy Program.

President Biden announced the program in March, urging nationwide access to vaccines for school employees and child care workers. But a hodgepodge of eligibility guidelines followed, as some states chose not to deviate from their rollout plans. By the end of March, however, K-12 educators in all states had become eligible to receive a vaccine.

While the acceleration of vaccinations among educators and staff has reduced the resistance from teachers’ unions to reopening classrooms, school systems with powerful unions, especially on the West Coast, have been slower to revert to in-person instruction.

Union resistance has led a bipartisan group of governors in several states to prod, and sometimes force, school districts to open. The result has been a major increase in the number of students who now have the option of attending school in-person, or will soon.

According to a school reopening tracker created by the American Enterprise Institute, 7 percent of the more than 8,000 districts being tracked were fully remote on March 22, the lowest percentage since the tracker was started in November. Forty-one percent of districts were offering full-time in-person instruction, the highest percentage in that time. Those findings have been echoed by other surveys.

In February, the C.D.C. issued guidelines that said K-12 schools could reopen safely as long as they followed basic health protocols like masking or distancing.

More recently, it said that elementary school students and some middle and high schoolers could be spaced three feet apart in classrooms, instead of six feet, as long as everyone was wearing a mask. Unions had used the six-foot guidance to oppose bringing children back for normal schedules.

“Our push to ensure that teachers, school staff and child care workers were vaccinated during March has paid off and paved the way for safer in-person learning,” Dr. Rochelle Walensky, the center’s director, said in a statement released on Tuesday.

Mr. Biden hailed the C.D.C.’s newly released benchmark while visiting a vaccination site in Alexandria, Va., on Tuesday.

“That is great progress protecting our educators and our essential workers,” Mr. Biden said of the new estimate. “And because our vaccine program is in overdrive, we are making it easier to get a vaccination shot.”

The American Federation of Teachers, the nation’s second-largest teacher’s union, on Tuesday released a survey reporting that over 80 percent of association members had been vaccinated or had made a vaccine appointment. About 85 percent of members said their school was “operating on at least a part-time basis,” according to the survey.

Randi Weingarten, the federation’s president, said in a statement on Tuesday that “A.F.T. members have embraced vaccines as vital to getting back in the classroom.”

“They want to return, the road map to reopening is robust, and if we instill trust and meet fear with facts we can finally end this national nightmare,” Ms. Weingarten said.

A guest showed her “Excelsior Pass,” which offers proof of vaccination, on a phone outside The Shed, a performing and visual arts venue in New York.
Angela Weiss/Agence France-Presse — Getty Images

Around the United States, businesses, schools and politicians are considering “vaccine passports” — digital proof of vaccination against Covid-19 — as a path to reviving the economy and getting Americans back to work and play.

New York has rolled out “Excelsior Pass,” billed by the state as “a free, fast and secure way to present digital proof of Covid-19 vaccination” in case sports and entertainment venues require proof of attendees’ status.

Walmart is offering electronic verification apps to patients vaccinated in its stores so they “can easily access their vaccine status as needed,” the company said.

But the idea is raising legal and ethical questions: Can businesses require employees or customers to provide proof of vaccination when Covid vaccines are ostensibly voluntary?

Can schools require that students prove they have been injected with what is still officially an experimental prophylaxis the same way they require long-approved vaccines for measles and polio? And finally, can governments mandate vaccinations — or stand in the way of businesses or educational institutions that demand proof?

Legal experts say the answer to all of these questions is generally yes, though in a society so divided, politicians are girding for a fight. Government entities like school boards and the Army can require vaccinations for entry, service and travel — practices that flow from a 1905 Supreme Court ruling that said states could require residents to be vaccinated against smallpox or pay a fine.

Backers of digital vaccination cards are pressing the Biden administration to get involved, at least by setting standards for privacy and for verifying the accuracy of the records.

The White House is clearly skittish.

“The government is not now nor will we be supporting a system that requires Americans to carry a credential,” Jen Psaki, the White House press secretary, said on Tuesday.

Republican critics say vaccine passports raise the specter of centralized databases of vaccinated people, which they view as a government intrusion on privacy.

“A vaccine passport — a unified, centralized system for providing or denying access to everyday activities like shopping and dining — would be a nightmare for civil liberties and privacy,” Justin Amash, a former Republican congressman who is now a libertarian, wrote on Twitter last week.

But, in fact, every state already has a database, or an “immunization registry.” And under “data use agreements,” the states are required to share their registries with the C.D.C., though the agency de-identifies the information and not all states have agreed to provide it.

With only months left in office, Chancellor Angela Merkel of Germany has struggled to rally support for a national lockdown.
Hannibal Hanschke/Agence France-Presse — Getty Images

Chancellor Angela Merkel of Germany has called for a short and strict nationwide lockdown to bring down the number of new coronavirus infections in the country, according to her spokeswoman, but will meet with local officials next week to discuss potential regulations.

A year after the first lockdown was successful in tamping down cases, the country’s 16 governors are finding it harder than ever to agree on a unified plan to stem new infections. And with only months left in office, Ms. Merkel has found it increasingly difficult to rally support for a national lockdown as fatigue from prolonged restrictions looms large even as cases rise.

The governors and Ms. Merkel are scheduled to meet on Monday to hammer out new regulations.

While Armin Laschet, the governor of the country’s most populous state and a potential successor to Ms. Merkel, has made similar calls for a two- to three-week hard lockdown to bring down infections, other governors are pushing back. The governor of one small state even began a pilot program on Tuesday to reopen theaters, gyms and restaurant patios.

“A common nationwide approach would also be important here,” Ulrike Demmer, the deputy government spokeswoman, said during a daily news conference, referring to the confusing and often contradictory rules set by state governors. Ms. Demmer also pointed to the rising number of coronavirus patients in intensive care wards as a cause for concern.

According to Ms. Demmer, the goal is to get the infection rate below 100 new cases per 100,000 before the authorities should consider easing restrictions.

On Tuesday, the German health authorities recorded an average of 110 infections per 100,000 people over the previous 7 days, but warned that because fewer people were tested over the Easter holiday weekend, the number was likely to be much higher.

According to a New York Times database, Germany is averaging 15,562 new infections daily and since the pandemic began. More than 77,000 have died with the disease in the country since the pandemic began.

The coronavirus has claimed the lives of more than 556,000 Americans, according to a New York Times database.
Alex Welsh for The New York Times

People who paid for the funeral and burial expenses of someone who died from Covid-19 will be offered expanded federal financial support starting on Monday, according to an announcement by the Federal Emergency Management Agency.

The coronavirus has claimed the lives of more than 556,000 Americans, according to a New York Times database. Under the expanded assistance program, their survivors can apply for up to $9,000 in reimbursement for the purchase of a plot, burial, a headstone, clergy services, the transfer of remains, cremation or other services associated with a funeral.

“The Covid-19 pandemic has brought overwhelming grief to many families,” the agency said in a statement announcing the expanded benefits. “At FEMA, our mission is to help people before, during and after disasters. We are dedicated to helping ease some of the financial stress and burden caused by the virus.”

Congress approved billions of dollars in funding for funeral benefits in two Covid relief measures, the one signed by former President Donald J. Trump in December and the one known as the American Rescue Plan that President Biden signed last month.

Both measures include added funds for funeral services in an attempt to cushion the financial blow to families, many of whom are already struggling because of the loss of income in the economic downturn caused by the pandemic.

To qualify for reimbursement, an applicant must be a United States citizen or legal permanent resident who has documentation that they paid funeral expenses for someone whose death “may have been caused by” or “was likely a result of” Covid-19 or “Covid-19 like symptoms,” or whose records include “similar phrases that indicate a high likelihood of Covid-19,” according to FEMA. The person who died need not have been a United States citizen or resident, the agency said.

FEMA will reimburse funeral costs for multiple people in the same family, up to a maximum of $35,000, according to the agency. But the amount of federal assistance will be reduced if applicants also received support from other sources, including insurance policies specifically designed to pay for funeral expenses.

The effort to soften the financial burden of the pandemic is one of the largest such efforts ever undertaken by the agency. It also offers an opportunity for fraud, as the agency acknowledges in bright red type on its website.

“Fraud Alert: We have received reports of scammers reaching out to people offering to register them for funeral assistance,” the alert says. “FEMA has not sent any such notifications and we do not contact people prior to them registering for assistance.”

The agency will begin taking applications on Monday. Applicants can call a hotline at (844) 684-6333.

global roundup

A vaccination center in Kathmandu, Nepal, last month.
Niranjan Shrestha/Associated Press

Three weeks after suspending its vaccination campaign, Nepal has started administering shots again thanks to a gift of doses from China.

Nepal, a poor Himalayan nation, had been depending on vaccines manufactured in neighboring India, but last month India began cutting vaccine exports as the country experienced a surge in coronavirus cases. Nepal’s vaccination effort ground to a halt, even as infections began to rise again.

Last week, Nepal’s other giant neighbor, China, stepped in with a donation of 800,000 doses of the vaccine developed by Sinopharm, a state-owned company.

The vaccines will be administered to essential workers, Nepali students preparing to travel to China to study and those living in districts along the Nepal-China border, health officials said. Taranath Pokhrel, a senior official in Nepal’s health department, said that the Chinese government asked Nepal to give priority to the students and to people involved in cross-border trade, presumably to reduce the risk of infected people crossing into China.

Thousands of Nepali students study at Chinese universities under Chinese government scholarships. China, to increase the appeal of its vaccines, has said that foreigners who are inoculated with Chinese-made vaccines may face fewer bureaucratic hurdles entering the country.

Nepal, a nation of 30 million people, has vaccinated more than 1.7 million and slowly begun reopening to visitors, including to a few hundred climbers attempting to scale Mount Everest. The country reported very few infections in January, but new cases have surpassed 300 in recent days, part of a worrying resurgence in new cases across South Asia. India, which shares a porous border with Nepal, recorded more than 115,000 new infections on Wednesday, by far its highest daily total since the pandemic began.

The future of Nepal’s vaccination campaign remains uncertain because the Chinese donation falls short of the two million vaccine doses Nepal was due to receive under an agreement with the Indian manufacturer, the Serum Institute of India. Nepal officials said that they had paid the company 80 percent of the contract price but received only half of the doses. Serum’s chief executive said this week that he hoped to restart exports by June if new infections in India subsided.

“Our entire diplomatic channels are mobilized to get vaccines, but none has assured us of providing vaccines when we tried to procure them,” Dr. Pokhrel said.

In other news from around the world:

  • In Japan, officials in Osaka canceled public Olympic torch relay events scheduled for next week and declared a medical emergency as a surge in coronavirus cases strains the hospital system. The prefecture’s 8.8 million residents were asked not to leave their homes except for essential matters. Olympic organizers said the ceremonial relay would be held at a park without spectators — the latest sign of trouble with the Tokyo Olympics scheduled to open in less than four months.

  • The Moderna vaccine is now being administered in Britain, with a 24-year-old woman in Wales who is a caregiver for her grandmother the first person in the country to receive that vaccine on Wednesday. The Pfizer and AstraZeneca shots are already being used in the country. Vaccinations in Britain have slumped this month, reaching their lowest level since the inoculation campaign started. In a Twitter post, Prime Minister Boris Johnson urged people to “get your jab as soon as you are contacted.”

  • Regulators in South Korea granted final approval to the Johnson & Johnson vaccine, making it the third vaccine authorized for use in the country amid growing concerns about the pace of its inoculation campaign. Officials reported 668 new coronavirus cases on Wednesday, the highest tally in three months, with most of the cases found in Seoul and other major cities.

  • Germany’s troubled vaccine rollout may face another hurdle after a shipment of up to 880,000 Moderna vaccines that had been promised for the end of April was canceled, the news site Business Insider reported. Separately on Wednesday, state and federal health ministers were meeting to discuss how to handle cases of people who have received a first dose of the AstraZeneca vaccine after that shot use was discouraged for use in people under 60.

Dr. Raja Amjid Riaz, a surgeon and a leader at the Central Mosque of Brent, says the British government has not done enough to encourage vaccinations in ethnic communities. 
Andrew Testa for The New York Times

Minority communities in Britain have long felt estranged from the government and medical establishment, but their sense of alienation is suddenly proving more costly than ever amid a coronavirus vaccination campaign that depends heavily on trust.

With Britons enjoying one of the fastest vaccination rollouts in the world, skepticism about the shots remains high in many of the very communities where Covid-19 has taken the heaviest toll.

“The government’s response to the Black, Asian and minority ethnic communities has been rather limited,” said Dr. Raja Amjid Riaz, 52, a surgeon who is also a leader at the Central Mosque of Brent, an ethnically diverse borough of North London. “Those people have not been catered for.”

As a result, communities like Brent offer fertile ground for the most outlandish of vaccine rumors, from unfounded claims that they affect fertility to the outright fabrication that the shots are being used to inject microchips.

At the height of the pandemic last year, Brent recorded the second-highest rate of Covid-19 deaths in Britain.

A government report found that vaccination rates in people 70 and older from early December to mid-March were lowest among the country’s Black African, Black Caribbean and Bangladeshi communities. It also noted that those living in poorer areas — Brent’s poverty rate is 33 percent, compared with 28 percent in London over all — were less likely to receive a shot.

With the government seen as still disengaged in Black, Asian and other ethnic minority communities even as they have been hit disproportionately hard both by the virus and the lockdowns, many local leaders like Dr. Riaz have taken it upon themselves to act.

In January, the British government said it would give local governments and other groups 23 million pounds, about $32 million, to use toward encouraging vaccinations among people most at risk from the coronavirus, including minority groups.

Long before the government took that initiative, some community leaders were already on the job, trying to dispel conspiracy theories and increase vaccinations. They have waged their campaign both online and door to door, and have run workshops aimed at countering misinformation.

In the northern English city of Leeds, Qari Asim, a senior imam, was spurred to action after seeing misinformation spread on WhatsApp in January.

Mr. Asim, the chairman of the Mosques and Imams National Advisory Board in Britain, delivered a sermon that was shared across more than 100 mosques, in which he assured listeners that the vaccines are allowed under Islamic law.

Since then, over 300 mosques have addressed vaccine hesitancy and misinformation. Mr. Asim has also urged mosques to open their doors to the vaccine campaign.

“In this pandemic,” Mr. Asim said, “the messenger is as important as the message.”

People accused of breaking coronavirus rules were made to exercise as punishment in Manila last month.
Lisa Marie David/Reuters

A 28-year-old man has died in the Philippines after the police forced him to do 300 squats as punishment after he was caught violating coronavirus lockdown rules.

The man, Darren Manaog Peñaredondo, was detained on Thursday in General Trias city, a Manila suburb, over a curfew violation. Officials have struggled to contain infections in the southeast Asian nation and have increasingly resorted to harsh tactics to enforce restrictions, rights groups say.

He was released the following day, but first was forced to complete 300 squats, his relatives said.

It is not the first time that the authorities have been accused of using aggressive tactics against civilians during the pandemic. President Rodrigo Duterte told the police last year not to be afraid to shoot anyone who “causes commotion,” after 20 people protesting restrictions were arrested. Last year, a former soldier suffering from mental health issues was gunned down by the police as he tried to cross a coronavirus checkpoint.

Mr. Peñaredondo’s partner, Reichelyn Balce, said that when he returned home on Friday after being detained, he had shown signs of fatigue.

“He told me that he fell when doing the exercises,” she said. “He struggled to walk when he got home. When he went to relieve himself, he turned blue and convulsed.”

She said that Mr. Peñaredondo was revived but he later died.

Two police officers who imposed the harsh punishment have been suspended pending the results of an investigation into their actions, said Brig. Gen. Ildebrandi Usana, a national police spokesman.

The local police had initially denied the events, but two men who were detained with Mr. Peñaredondo signed a sworn statement about the ordeal.

Cristina Palabay, who leads a local rights group called Karapatan, said that the police punishment amounted to “a form of torture that is cruel and inhuman” and signaled that the local police had adopted a “strongman approach.”

Ms. Palabay’s group aids families of the thousands of citizens killed in the president’s aggressive war on drugs.

The country’s Commission on Human Rights was critical of what it called an “overreach of the enforcement of quarantine rules and regulations,” according to the body’s spokeswoman, Jacqueline Ann de Guia.

Ms. de Guia said that curfew violations called for community service or a fine, rather than harsh physical punishment.

Near Cora, Wyo., in March. In the throes of a pandemic that has made the indoors inherently dangerous, tens of thousands more Americans than usual have flocked outdoors.
Max Whittaker for The New York Times

Kenna Tanner and her team can list the cases from memory: There was the woman who got tired and did not feel like finishing her hike; the campers, in shorts during a blizzard; the base jumper, misjudging his leap from a treacherous granite cliff face; the ill-equipped snowmobiler, buried up to his neck in an avalanche.

All of them were pulled by Ms. Tanner and the Tip Top Search and Rescue crew from the rugged Wind River mountain range — the Winds, as the range is known locally — in the past year in a sprawling, remote pocket of western Wyoming. And all of them, their rescuers said, were wildly unprepared for the brutal backcountry in which they were traveling.

“It is super frustrating,” said Ms. Tanner, Tip Top’s director. “We just wish that people respected the risk.”

In the throes of a pandemic that has made the indoors inherently dangerous, tens of thousands more Americans than usual have flocked outdoors, fleeing crowded cities for national parks and the public lands around them. But as these hordes of inexperienced adventurers explore the treacherous terrain of the backcountry, many inevitably call for help. It has strained the patchwork, volunteer-based search-and-rescue system in America’s West.

Where places like Canada or Switzerland have professional, full-time teams that manage everything from lost tourists to fatal mountaineering accidents, most operations in the United States are handled by a loose network of volunteer organizations like Tip Top, which are overseen by local sheriffs.

For much of the country’s history, this patchwork system met demand. But that trend has shifted in the past decade — and rapidly, over the past year — as less experienced recreationalists push further into treacherous places.

No one expects the eventual end of the pandemic to stem the flood of newcomers to the Winds, which people grudgingly admit have been discovered. Property values continue to soar in Sublette County, and even this winter, locals say out-of-state plates were more common than Wyoming plates in trailhead parking lots.

“You can’t stop it,” said Chris Hayes, who works at an outdoor retailer in Pinedale and also runs a fishing guide service. “There’s no secret place anymore. They’re all gone.”

Moritz Wienert

Before the pandemic, I found comfort in the routine of my life and the rhythms of my family — what Nora Ephron once called the “peanut-butter-and-jellyness” of days with children. I liked the morning thunderdome of getting the children dressed and fed, dropping them at school and taking the 20-minute walk to the subway.

At this point my commute is the five feet from my bed to my desk, and I am somehow both tired and agitated when I start work each day. My kids never leave the house, except when we go to the same three parks in our neighborhood. Sometimes when I go running outside, I fantasize about just … not stopping, my eyes thirsty for some new horizon.

In other words, I’m so freaking bored.

Here’s how one boredom researcher — yes, there are boredom researchers — has defined the emotion. “‘Feeling unchallenged’ and perceiving one’s ‘activities as meaningless’ is central to boredom,” concluded a study by Wijnand Van Tilburg, an experimental social psychologist at the University of Essex in England.

Even in normal times, boredom is a very common emotion — a study of almost 4,000 American adults found that 63 percent felt bored at least once in a 10-day sampling period. The causes of boredom are multifaceted, but a lack of control over your situation is a common one. He added, “There’s research that shows when you’re limited in your control over the situation — that intensifies boredom.”

Knowing that many of us may not be able to have much control over our movements for at least the next few months, how do we try to alleviate our boredom? First, the researchers I spoke to said it’s important to acknowledge there’s no easy fix for our doldrums — so much of what is happening right now is beyond our control, and the vaccines are just beginning to be tested in children under 12, so we may not be able to make big moves just yet.

This weekend, we saw relatives I adore for an outdoor Easter egg hunt. Just 90 minutes of warm interaction with these beloved adults made me feel so happy and alive that I was smiling for the rest of the day.

As the weather gets warmer and more of my peers are inoculated, I am planning more get-togethers. Whenever I drop back into the doldrums, I will think about all the walks and dinners and hugs on the horizon.

Kate Whelley McCabe, a co-founder of Vermont Evaporator Company, which saw customer demand double during the pandemic, tapping trees in a neighbor’s yard near Montpelier, Vt.
Jay Ericson

Stress-baking and panic shopping. Vegetable regrowing and crafting. Now we can add another hobby to a year of quarantine trends: backyard maple sugaring.

Among the many indicators that it’s on the rise: a run on at-home evaporators and other syrup-making accouterments. A surge in traffic and subscriptions to syrup-making websites and trade publications. And, of course, lots of documentation on social media. (The Facebook group Backyard Maple Syrup Makers added some 5,000 members, almost doubling the its community, in the past year.)

Tapping maple trees and boiling the sap into syrup — known as sugaring — isn’t a new hobby. What’s unique about this year is the influx of suburban and urban backyard adventurers fueling these maple sugaring highs.

Claire and Thomas Gallagher, for example, tapped a tree behind their home in New Rochelle, N.Y., for the first time three weeks ago.

“It’s such a fun thing to do with the kids, it gets us outside, it’s educational,” Ms. Gallagher, 37, said. And with everyone at home all winter and probably the spring as well, the Gallaghers decided there would never be a better year to try it.

Because sugaring is a sticky business — and boiling sap indoors can mean resin all over the walls — many backyard amateurs turn to small-scale, hobby-size evaporators like the ones sold by Vermont Evaporator Company in Montpelier, Vt.

“When we started our company five years ago, our customers used to look just like us: rural homeowners with five to 10 acres of land,” said Kate Whelley McCabe, the chief executive. “Now we sell to people all over the country and to a growing number of suburban and urban customers.”

The governor of New Hampshire, Chris Sununu, is a dedicated sugarer. His 8-year old son, Leo, is his tree tapping assistant, and his two teenagers, Edie and Calvin, “do the heavy lifting.”

Governor Sununu said that when the tree sap begins to flow, it’s the official signal that spring has arrived. “It’s been a long winter and a long year. The sun is coming up, the days are getting warmer, and when the sap ran this year, we knew we were really coming out of winter with a lot of optimism,” he said in an interview.

Restaurant workers were some of the hardest hit during the pandemic, and now many are having difficulty getting the vaccine. Here, Alayna Flater walks to a table outside at Zinqué restaurant in downtown San Diego, in January 2021.
Ariana Drehsler for The New York Times

Over the course of the pandemic, some of the most dangerous activities were those many Americans dearly missed: scarfing up nachos, canoodling with a date or yelling sports scores at a group of friends across a crowded bar.

Now, as more states loosen restrictions on indoor dining and expand access to vaccines, restaurant employees — who have morphed from cheerful facilitators of everyone’s fun to embattled frontline workers — are scrambling to protect themselves against the new slosh of business.

“I think people take restaurants and their workers for granted,” said Julia Piscioniere, a server at Butcher & Bee in Charleston. “It’s taken a toll.”

Not all governments have viewed restaurant workers as “essential,” even as restaurants have been a very active part of the American food chains — from half-open sites to takeout operations to cooking for those in need — during the entire pandemic.

The return to economic vitality in the United States is led by places to eat and drink, which also suffered among the highest losses in the last year. Balancing the financial benefits of a return to regular hours with worker safety is the industry’s latest hurdle.

In many states, workers are still unable to get shots, especially in regions where they were not included in priority groups this spring. Immigrants, who make up a large segment of the restaurant work force, are often fearful of signing up, worrying that the process will legally entangle them.

Some states have dropped mask mandates and capacity limits inside establishments — which the Centers for Disease Control and Prevention still deem a potentially risky setting — further endangering employees.

Texas, for instance, strictly limited early eligibility for shots, but last week opened access to all residents 16 and over, creating an overwhelming demand for slots. The governor recently dropped the state’s loosely enforced mask mandate, and allowed restaurants to go forth and serve all comers, with zero limitations.

So the Texas Restaurant Association is pairing with a health care provider to set aside days at mass vaccines sites in the state’s four biggest cities to target industry workers.

The industry has taken matters in its own hands in other places, too.

In Charleston, Michael Shemtov, who owns several spots, turned a food hall into a restaurant worker vaccine site on a recent Tuesday with the help of a local clinic. The post-shot observation seating was at the sushi place; celebratory beers were tipped at an adjoining pizzeria.

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