MOSCOW — Widespread public mistrust of the Russian government has translated into skepticism about coronavirus vaccines, experts say, leaving the country vulnerable to a surge in new Covid-19 cases that is now setting records for severity.
On Saturday, Russia exceeded 1,000 deaths in a 24-hour period for the first time since the pandemic began. (Britain, with a little less than half the population, had 57 deaths in a recent 24-hour period.) On Monday, Russia broke another record with more than 34,000 new infections registered in the previous 24 hours.
Mistrust of the Russian authorities has metastasized since the pandemic began last year, pollsters and sociologists say, and is the main reason only one-third of the country’s population is fully vaccinated so far, even though the shots are free and widely available in the country.
Only about 42 million of Russia’s 146 million inhabitants have been fully vaccinated, Prime Minister Mikhail Mishustin said last week, a rate well below the United States and most countries in the European Union.
After Sofia Kravetskaya, 36, got vaccinated with Russia’s Sputnik V vaccine last December, she said, she became a pariah on the Moscow playground where she takes her young daughter.
“When I mentioned I volunteered in the trials and I got my first shot, people started running away from me,” she said. “They believed that if you were vaccinated, the virus is inside you and you’re contagious.”
Even with a record-breaking death toll, the government has imposed few restrictions to fight the spread of the virus, and its vaccination campaign has floundered, sociologists say, because of a combination of apathy and skepticism.
“Approximately 40 percent of Russians do not trust the government, and those people are among the most active who refuse the vaccines,” said Denis Volkov, the director of the Levada Center, an independent polling operation. In August, one of its polls showed that 52 percent of Russians were uninterested in being vaccinated.
“It’s about trust and approval in the government and the president,” he said. “Those who trust, they are much more ready to do it.”
Some demographers have questioned the veracity of the Covid-19 statistics that the government reports, further damaging its credibility. Russia’s statistics agency said Friday, for instance, that more than 43,500 people died from Covid-19 in August. But another state body, the national Covid-19 task force, initially registered fewer than 25,000 fatalities that month, according to calculations by the independent Moscow Times. The discrepancies leave Russians not knowing which figures to trust.
The Food and Drug Administration is planning to allow Americans to receive a different Covid-19 vaccine as a booster than the one they initially received, a move that could reduce the appeal of the Johnson & Johnson vaccine and provide flexibility to doctors and other vaccinators.
The government would not recommend one shot over another, and it may note that using the same vaccine as a booster when possible is preferable, people familiar with the agency’s planning said. But vaccine providers could use their discretion to offer a different brand, a freedom that state health officials have been requesting for weeks.
The approach was foreshadowed on Friday, when researchers presented the findings of a federally funded “mix and match” study to an expert committee that advises the F.D.A. The study found that recipients of Johnson & Johnson’s single-dose shot who received a Moderna booster saw their antibody levels rise 76-fold in 15 days, compared with only a fourfold increase after an extra dose of Johnson & Johnson.
Federal regulators this week are aiming to greatly expand the number of Americans eligible for booster shots. The F.D.A. is expected to authorize boosters of the Moderna and Johnson & Johnson vaccines by Wednesday evening; it could allow the mix-and-match approach by then. The agency last month authorized booster shots of the Pfizer-BioNTech vaccine for at least six months after the second dose.
An advisory committee of the Centers for Disease Control and Prevention will take up the booster issue on Thursday; the agency will then issue its own recommendations. By the end of the week, tens of millions more Americans could be eligible for extra shots.
The study presented to the F.D.A.’s advisory panel last week, conducted by the National Institutes of Health, suggested that Johnson & Johnson recipients may benefit most from a booster shot of the Moderna vaccine. A shot of the Pfizer-BioNTech vaccine also raised the antibody levels of Johnson & Johnson recipients more than Johnson & Johnson did, the study found, although not as much as Moderna did.
Experts emphasized last week that the new data was based on small groups of volunteers and short-term findings. Only antibody levels were measured as part of the preliminary data, not the levels of immune cells primed to attack the coronavirus, which scientists say are also an important measure of a vaccine’s success.
The study’s researchers warned against using the findings to conclude that any one combination of vaccines was better.
And while the research on mixing and matching doses is somewhat thin, even some scientists who have strongly criticized the Biden administration’s booster policy said that providers should be given some discretion as the campaign ramps up.
Even as the coronavirus wave driven by the Delta variant is receding in much of the United States, many counties across the country’s northernmost regions are experiencing rising cases as colder weather arrives.
The top five states in new daily cases per capita are led by Alaska, which is logging the highest daily average: 125 cases per 100,000 people, according to a New York Times database. The next four states, with at least 67 cases per 100,000 people, are Montana, Wyoming, North Dakota and Idaho.
Cases are at least trending downward or holding steady in those states. The five states with the fastest rising caseloads are Vermont, Colorado, New Hampshire, Michigan and Minnesota, and the two counties with the most cases per capita in Vermont and New Hampshire are on the Canadian border.
The virus followed a similar pattern last fall: Cases receded in the Southern regions after summer surges, while they steadily increased throughout the North as the weather became colder and people moved indoors.
The big difference this year is that Covid-19 vaccines are widely available, and most experts don’t expect another catastrophic winter wave, but they are warning Americans not to let their guard down as long as a large portion of the population remains unvaccinated.
In Minnesota, the average reported cases have climbed by 12 percent in the past two weeks. Scott Smith, a spokesman for Minnesota’s health department, said in an email that the department was more concerned about factors like the reopening of schools and relaxed mitigation measures than wintry weather.
Dr. Rafael Meza, a professor of epidemiology at the University of Michigan, said increases were happening across Michigan but appeared to be higher in the center and in the Upper Peninsula. Dr. Meza said that factors like vaccination rates and school mask mandates could be part of the reason.
Cases have been high in Michigan’s school-aged children, especially in districts that do not have mask mandates, according to Dr. Natasha Bagdasarian, the state’s chief medical executive.
“The weather drives people indoors into poorly ventilated spaces, and when either academic activities or social activities occur without masks in indoor, poorly ventilated spaces, that’s when transmission occurs,” Dr. Bagdasarian said, adding that winter was “coming at a very bad time for us here in Michigan.”
Colin L. Powell, whose immune system was weakened by treatment for multiple myeloma, died of complications of Covid-19 despite being vaccinated, his family said in a statement.
Peggy Cifrino, Mr. Powell’s longtime aide, said that he had been successfully treated for multiple myeloma, a cancer of white blood cells in the bone marrow. People with multiple myeloma have compromised immune systems and are thus at greater risk of developing severe Covid-19. Vaccines are also likely to be less effective in these patients.
The family’s statement did not provide further details about the complications or underlying health conditions Mr. Powell had. It said he was treated at Walter Reed National Medical Center. Ms. Cifrino said Mr. Powell, 84, had gotten his second dose of the Pfizer-BioNTech vaccine in February and had been scheduled to get a third shot last week when he got sick, “so he wasn’t able to get that.” He had also been treated for early stages of Parkinson’s disease, she said.
“We encourage everyone to get vaccinated,” Ms. Cifrino said.
In a study published in July, researchers found that just 45 percent of those with active multiple myeloma “developed an adequate response” after receiving the Pfizer-BioNTech or Moderna vaccines.
Although the shots are critical in reducing severe disease and death from the coronavirus, such outcomes are not unexpected. No vaccine is 100 percent effective, experts say.
Severe Covid is rare in people who have been fully vaccinated.
In June, the Centers for Disease Control and Prevention said that it had received reports of 10,262 breakthrough infections by April 30 — a tiny fraction of the 101 million Americans who had been vaccinated by that date. (The agency noted that the number most likely represented “a substantial undercount” of breakthrough infections.)
Of those breakthrough cases, 2 percent died — and in some of those cases, patients were hospitalized or died from something unrelated to Covid-19. The median age of those who died was 82.
Multiple myeloma wasn’t Mr. Powell’s first battle with cancer. In 2003, when he was secretary of state, he underwent surgery for prostate cancer.
Eric Schmitt and Emily Anthes contributed reporting.
Sydney has further eased restrictions after the state of New South Wales passed its target of fully vaccinating 80 percent of the eligible population.
On Monday, thousands of children returned to school after months of home learning and a lockdown that lasted more than 100 days. Up to 20 fully vaccinated people can gather in a private home, and there is no limit on the number of fully vaccinated people who can attend a funeral or wedding.
“Today’s our first day of post-80% life,” Dom Perrottet, the premier of New South Wales, tweeted on Monday. He added: “Do the right thing.”
The easing comes as Australia has moved away from trying to eradicate Covid-19, instead aiming to vaccinate as much of its population as possible.
The goal is to begin to reopen fully once 80 percent of the national population is vaccinated. As of Monday, 56 percent of the country’s population was fully vaccinated, and 72 percent had one dose, according to data from The New York Times.
As part of that strategy, the city of Melbourne — which has endured among the most days in lockdown of any in the world — will lift its stay-at-home orders at 11:59 p.m. on Thursday, when 70 percent of eligible adults are expected to be fully vaccinated.
“There will be no lockdown, no restrictions on leaving home and no curfew,” Daniel Andrews, the premier of Victoria state, of which Melbourne is the capital, told reporters on Sunday. “Victorians have sacrificed so much,” he added, later pledging that the lockdown would be the city’s last.
While the coronavirus has killed more than 700,000 in the United States in nearly two years, a more invisible casualty has been the nation’s public health system. Already underfunded and neglected even before the pandemic, public health has been further undermined in ways that could resound for decades to come.
A New York Times review of hundreds of health departments in all 50 states indicates that local public health across the country is less equipped to confront a pandemic now than it was at the beginning of 2020.
The Times interviewed more than 140 local health officials, public health experts and lawmakers; reviewed new state laws; analyzed local government documents; and sent a survey to every county health department in the country.
Almost 300 departments responded, discussing their concerns over long-term funding, staffing, authority and community support. The examination showed that:
Public health agencies have seen a staggering exodus of personnel, many exhausted and demoralized, in part because of abuse and threats. Dozens of departments reported that they had actually lost employees. About 130 said they did not have enough people to do contact tracing. The Times identified more than 500 top health officials who left their jobs in the past 19 months.
Legislators have approved more than 100 new laws — with hundreds more under consideration — that limit state and local health powers. That overhaul of public health gives governors, lawmakers and county commissioners more power to undo health decisions and undermines everything from flu vaccination campaigns to quarantine protocols for measles.
Large segments of the public have also turned against agencies, voting in new local government leaders who ran on pledges to rein in public health departments.
Billions of dollars have been made available to public health by the federal government, but most of it has been geared toward stemming the emergency, rather than hiring permanent staff or building long-term capability. Most of the departments that responded to The Times’s survey said they were worried about their funding levels, which in most cases had been decreasing or flat before the pandemic. About three dozen departments said their budgets were the same or smaller than they were at the beginning of the pandemic.
South Korea on Monday eased its virus restrictions as the average number of daily cases fell by more than 40 percent in the past two weeks.
Under the new rules, the government will allow gatherings of up to four people who are not fully vaccinated and will permit venues including performing spaces and movie theaters to stay open until midnight, two hours longer than before. Some of the changes may vary depending on the area.
South Korea never went into a full lockdown but has imposed stringent social-distancing rules, including a mask mandate, even outdoors.
Once held up as a model in fighting the pandemic because of how it contained the virus without shutting down the economy, South Korea has struggled with recent outbreaks. Its vaccination campaign got off to a slow start, but is accelerating, with more than 60 percent of the population fully vaccinated, according to a New York Times database. Health officials said the pace of vaccinations outperformed expectations, and on Monday, the country opened its vaccination program to 16- and 17-year-olds and pregnant women. People ages 12 to 15 will become eligible next month.
President Moon Jae-in and the first lady, Kim Jung-sook, received booster shots of the Pfizer-BioNTech vaccine on Friday, part of an effort to encourage more people to get inoculated.
New Zealand’s largest city, Auckland, will extend its lockdown, the harshest in the world, for another two weeks, making it an outlier in the Asia-Pacific region as nations move to ease domestic restrictions and reconnect to the rest of the world.
The city of about 1.7 million people has been in lockdown since Aug. 17, after an outbreak of the Delta variant. Since the start of October, it has reported approximately 50 new cases a day. One death was reported on Oct. 8, raising the tally since the pandemic to 28.
The government faced pressure from some health experts to tighten restrictions even further, Prime Minister Jacinda Ardern said at a news conference on Monday.
“A number of respected scientists and epidemiologists had suggested a return to Level Four,” she said, referring to the country’s highest level of restrictions. The government had opted to retain the current settings “because of the nature of the outbreak, and the fact that compliance has been an issue,” she said.
Northland, the region immediately north of Auckland, would come out of its 10-day lockdown just before midnight on Tuesday, Ms. Ardern said, while Waikato, to the city’s south, would remain under heavy restrictions.
Though New Zealand is no longer pursuing the goal of completely eliminating the virus, Ms. Ardern has said that the country would not ease local restrictions until more people were vaccinated.
As of Monday, 85 percent of the population age 12 and up had received a first dose of a vaccine and 66 percent had received both doses. On Friday, the government will announce a formal vaccination target for the country, Ms. Ardern said.
New Zealand on Saturday held a “Vaxathon,” where it sought to break its national record of 93,000 vaccinations against the coronavirus in a single day. More than 130,000 people, or about 2.5 percent of the eligible population, received a dose of the Pfizer-BioNTech vaccine on the day, according to the Ministry of Health.