If all goes according to plan, the United States will soon send 80 million doses of Covid vaccines to help countries beleaguered by the coronavirus, President Biden said on Monday.
But world leaders, experts and advocates warn much more is needed to stop the virus from running rampant in much of the world, which gives it time to mutate and possibly evolve until it can evade vaccines.
Activists, too, have joined the cohort of voices calling on the Biden administration to move boldly. “Donating 80 million doses of vaccines without a plan to scale up production worldwide is like putting a Band-Aid on a machete wound,” said Gregg Gonsalves, a longtime AIDS activist.
Mr. Biden pledged on Monday that 20 million doses of the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines — the three authorized for use in the United States — would be sent abroad. That’s from a supply of about 400 million to 500 million doses produced each month. In addition, the United States plans to send 60 million doses of AstraZeneca’s vaccine when it is cleared for use by the Food and Drug Administration.
The number of doses needed to vaccinate 70 percent of the world’s population is a staggering 11 billion, according to researchers at Duke University. So far only about 1.7 billion have been produced, the analytics firm Airfinity estimated.
And 11 billion may be a conservative estimate, because the global need for vaccines could prove far greater if virus variants require booster shots. Raw materials and key equipment remain in short supply, and there are stark divisions among officials and experts about how best to broaden the international pool of vaccines.
The United States supports waiving patents so more countries can produce vaccines, but experts say technology transfers and expanded access to raw materials mean it would take about six months for more drug makers to start producing vaccines. European leaders say lifting export bans would provide help sooner.
On Monday, Dr. Tedros Adhanom Ghebreyesus, the World Health Organization chief, called on vaccine manufacturers to speed up delivery of hundreds of millions of doses designated for Covax, the international effort to ensure equitable vaccine distribution. He asked for richer countries to share all they could.
“We need high- income countries, which have contracted much of the immediate global supply of vaccines, to share them now,” Dr. Tedros said. “I call on manufacturers to publicly commit to helping any country that wants to share their vaccines with Covax to lift contractual barriers within days, not months.”
Henrietta Fore, the executive director of UNICEF, released a statement on Monday saying that Covax would soon complete delivering 65 million doses, but that it should have delivered at least 170 million and that the effort could be short by as much as 190 million doses by the time Group of 7 leaders gather in England in June.
“We have issued repeated warnings of the risks of letting down our guard and leaving low- and middle-income countries without equitable access to vaccines, diagnostics and therapeutics,” Ms. Fore wrote. “We are concerned that the deadly spike in India is a precursor to what will happen if those warnings remain unheeded.”
Mr. Biden said the vaccines would be shipped by the end of June, when the United States would have enough for all of its citizens.
There is already a glut of vaccine in the United States, and Mr. Biden and his administration face a different problem: convincing those who remain unvaccinated to get the shot.
Mr. Biden’s announcement came after he was castigated in two open letters, one released last week and one on Monday, that pushed for him to do more to stop the coronavirus internationally by exporting more doses and scaling up manufacturing.
Saad B. Omer, the director of the Yale Institute for Global Health, said that the Biden administration’s commitment to send the doses was “a really good sign,” but that he was more pleased by Mr. Biden’s announcement on Monday that he had put Jeffrey Zients, the White House coronavirus response coordinator, in charge of developing a global strategy, a sign the issue was being taken seriously.
“We will be judged by history,” Dr. Omer said. “People will remember how a country responded to a global pandemic not just within its borders but outside.”
Since Covid-19 first emerged in the blockaded Gaza Strip, a shortage of medical supplies has allowed authorities to administer only a relatively tiny number of coronavirus tests.
Now, the sole laboratory in Gaza that processes test results has become temporarily inoperable after an Israeli airstrike nearby on Monday, officials in Gaza said.
The strike, which targeted a separate building in Gaza City, sent shrapnel and debris flying across the street, damaging the lab and the administrative offices of the Hamas-run Health Ministry, said Dr. Majdi Dhair, director of the ministry’s preventive medicine department.
One ministry employee was hospitalized and in serious condition after shrapnel struck him in the head, Dr. Dhair said in a phone interview on Tuesday.
“This attack was barbaric,” he said. “There’s no way to justify it.”
The Israeli Army did not immediately respond to a request for comment about the strike. Since Israel began its bombing campaign in Gaza on May 10, the army has said that its airstrikes aim solely at militants and their infrastructure.
Dr. Dhair said that he believed the equipment inside the lab was unharmed but emphasized that it would take at least a day to clean up the damage and prepare it to process coronavirus tests again. In the meantime, he said, medical teams would stop administering tests.
Rami Abadla, the director of the Gaza ministry’s infection control department, said that the lab would also be temporarily unable to process results for other tests related to H.I.V., hepatitis C and other conditions.
Over the past week, the authorities in Gaza have tested an average of 515 Palestinians daily for the virus. Only 1.9 percent of Gaza’s two million people were fully vaccinated as of Monday, according to official data, compared with 56 percent in Israel.
After a surge in cases in April, blamed mostly on the highly transmissible coronavirus variant first identified in Britain, new infections in Gaza had recently fallen to a manageable level, health experts said. But with Israeli airstrikes destroying buildings, causing widespread damage and leaving more than 200 people dead as of Monday, United Nations officials have warned that coronavirus cases could rise again.
Unvaccinated Palestinians were crowding into schools run by the United Nations relief agency in Gaza, turning them into de facto bomb shelters. Matthias Schmale, the U.N. agency’s director of operations, said last week that those schools “could turn into mass spreaders.”
Mr. Schmale and the top World Health Organization official in Gaza, Sacha Bootsma, also said that all vaccinations had stopped when hostilities broke out, and that any vaccine supplies headed to the territory had been delayed by the closure of Gaza’s border crossings.
In Poland, bars and restaurants reopened on Saturday after being shut for months; in Britain, indoor dining resumed on Monday and 20,000 fans attended a soccer game over the weekend; in France, cafe terraces are reopening on Wednesday, along with cinemas and theaters, while Italy will move a nighttime curfew from 10 to 11 p.m.
A partial sense of normalcy is returning across Europe this week as governments lift some restrictions in response to a drop in coronavirus cases, and as vaccine campaigns are picking up speed.
Italy’s health minister, Roberto Speranza, said on Monday that the latest figures were “a reason for relief” and that the country could “continue the gradual path of reopenings.”
France’s prime minister, Jean Castex, said the easing of restrictions would “take place in a gradual, careful and guided way.”
“But the trend is clear, we are reaching the goal and that’s good news,” Mr. Castex said.
The easing of restrictions varies across the continent: In France, museums, cinemas and retail stores will be allowed to reopen, although at limited capacity.
In the Czech Republic, which suffered one of the world’s highest Covid death rates earlier this year, dining in outdoor areas resumed on Monday, while theater plays and concerts are now allowed outside.
Spain lifted some restrictions last week, and Belgium resumed outdoor dining earlier this month. The Netherlands will ease some lockdown measures on Wednesday. Amusement parks, zoos and other outdoor venues are allowed to reopen with social distance, but indoor activities will stay shut for now. Outdoor dining will be allowed until 8 p.m.
Governments now have their eyes on June, when they plan to reopen even larger parts of their economies, and on the summer, as residents are trying to plan their holidays despite travel restrictions and quarantine orders still in place.
Such hopes come as countries have accelerated their vaccination campaigns: Roughly 30 percent of people in Italy, France, Spain, Poland and the Czech Republic have received at least one dose of vaccine, while that figure rises to 37 percent in Germany, and 55 percent in Britain.
Yet Britain’s example could also serve as a warning for Europe. The latest easing of restrictions on Monday came amid growing fears that the B.1.617 variant of the virus, first detected in India, could delay a full return to normality, as the authorities reported 2,323 confirmed cases of the variant. Case numbers in Britain over all remain flat so far.
“We must be humble in the face of this virus,” the country’s health secretary, Matt Hancock, told Parliament on Monday, echoing comments from other officials that local lockdowns could be reimposed in areas that have faced a surge in cases, even as Prime Minister Boris Johnson has repeated that the reopening would be “cautious but irreversible.”
The extent to which B.1.617 has spread globally is unclear: Britain has a particularly strong genomic surveillance program, which allows it to spot potentially problematic variants relatively early in their rise.
In Italy, 52 cases of the variant have been detected; health authorities in France reported at least 24 cases, and in Belgium, 77.
In Germany, public health authorities said last week that B.1.617 accounted for around 2 percent of new infections reported at the beginning of the month. On Sunday, officials in the Mettmann district, in western Germany, put nearly 200 residents of an apartment complex under quarantine because one of them had tested positive for the variant.
Raphael Minder and Monika Pronczuk contributed reporting.
In early April, Payal Raj accompanied her family to India to renew the visas that permit them to live in the United States. She and her husband waited until they had been vaccinated, carefully preparing their paperwork according to the advice of their immigration lawyers.
But the visa itself would soon strand her in India indefinitely, separating her from her husband and daughter in Hendersonville, Tenn.
“Our family is in a crisis,” said Ms. Raj, who is one of thousands of immigrants stuck in India, in part because the Biden administration’s restrictions on most travel from the country mean that temporary visa holders are barred from re-entering the United States. “Every morning is a struggle.”
Ms. Raj’s husband, Yogesh Kumar, an operations manager for a multinational corporation, lives in the United States on an H-1B visa, a temporary permit for highly technical foreign workers. As dependents, Ms. Raj and their daughter hold H-4 visas, which allow temporary workers to bring immediate family and must be renewed about every three years at an embassy or consulate outside the United States.
Mr. Kumar and his daughter, Saanvi Kumar, renewed their visas, but Ms. Raj was asked to submit biometrics and undergo an in-person interview, both of which would not be completed until after the travel restrictions went into effect two weeks ago.
The restrictions, issued as a devastating surge in coronavirus cases has overwhelmed India in recent weeks, prohibit Ms. Raj and others like her from returning to their homes, families and jobs in the United States.
Even those exempt under the ban are in limbo as the outbreak has closed routine services at the U.S. Embassy and consulates, leaving many with no clear path home.
The United States has restricted entry from a number of countries, but the most recent ban has had a disproportionate effect on Indians in the United States given that Indian citizens claim more than two-thirds of H-1B visas issued each year. Including those on other kinds of nonimmigrant visas, immigration lawyers estimate that thousands of Indians living in the United States have been affected.
Opposition among the Japanese public to the Tokyo Olympics is reaching new heights with the Games just over two months away, as a soaring coronavirus caseload has led growing areas of the country to be placed under a state of emergency and the country’s vaccination campaign has gotten off to an agonizingly slow start.
In a survey released on Monday in Japan, 83 percent of those polled said they did not want Tokyo to hold the Olympics and Paralympics. That total was up 14 percentage points from a survey in April. The Games, which were postponed a year because of the pandemic, are scheduled to start July 23.
And a top medical group, the Tokyo Medical Practitioners Association, also wants the games canceled, the news agency Reuters reported.
The medical organization, which represents about 6,000 primary care doctors, posted an open letter to Prime Minister Yoshihide Suga on its website on Monday saying that it would “strongly request” the authorities to arrange a cancellation.
In a survey by the Asahi Shimbun newspaper conducted over the weekend, 43 percent wanted the Games to be canceled, with 40 percent wanting them delayed again. Only 14 percent wanted the Games to be held this summer, half the number from a previous poll in April.
Japan has seen its number of coronavirus cases grow with the spread of deadlier and more contagious variants. The country has been reporting as many as 6,000 cases a day in recent weeks, after recording 1,000 daily in early March.
Nine prefectures, including the large metropolitan areas of Tokyo and Osaka, are under a state of emergency. Residents have been asked to only go out for essential reasons. Karaoke parlors have been asked to close, and restaurants asked to not serve alcohol and to close by 8 p.m.
In the Asahi Shimbun survey, 67 percent said they did not approve of how Mr. Suga and his government had responded to the virus. Japan’s vaccine program has been criticized as one of the slowest among developed countries. As of Monday, only 3.8 percent of the population had received at least one shot of a vaccine, while 1.6 percent have received two.
Travelers to Macau could face as much as 35 days in quarantine after officials issued new rules this week to keep out variants of the coronavirus.
Macau, a Chinese territory that was once a Portuguese colony, said Monday it had extended its quarantine period to 35 days from 28 days for anyone coming from the Philippines, Pakistan, India, Nepal and Brazil who has tested positive for Covid-19 antibodies.
(An antibody test uses blood samples to look for indications that someone has been exposed to the coronavirus at some point. It’s separate from the antigen tests generally used to identify people who are currently infected.)
The change in quarantine rules comes as India is fighting an unrelenting swell in cases that has left hospitals overburdened and people dying in the streets, while countries like Brazil and the Philippines are racing to gain control over a surging number of cases from newer and more deadly variants of the virus.
Macau officials also said that travelers from other countries who have positive antibodies will have to quarantine for 28 days.
Asian governments have been relatively successful at keeping coronavirus outbreaks under control, in part through restrictive measures like closing borders and requiring long quarantine periods. But these measures have also resulted in low vaccination rates in places like Hong Kong, which since March 2020 has barred nonresidents from entering. A series of outbreaks in recent days has underscored the challenge that Asian governments now face in encouraging their populations to get vaccinated.
In nearby Taiwan, which had been a model of success in keeping the virus at bay, officials are grappling with a sudden spike in cases. On Tuesday, the government reported 240 locally transmitted cases. Singapore has also seen an uptick in local cases in recent days, leading it and Hong Kong to delay plans for a travel bubble between the two locations.
In other news from around the globe:
The European Union drug regulator on Monday recommended extending the time that coronavirus vaccines developed by Pfizer-BioNTech can be stored at refrigerator temperatures. The European Medicines Agency raised the storage time for unopened vials of the shots to up to 31 days, from five, in a move that it claims will significantly aid the bloc’s vaccine program. Pfizer approached the F.D.A. in the United States this month with data it hopes will persuade the agency to approve a similar extension.
Anna Schaverien contributed reporting.
New Delhi is showing signs of emerging from the worst of the coronavirus second wave, as new reported cases drop and hospitals see empty beds for the first time in weeks.
But as India’s capital and other major cities experience some relief, the virus is leaving a trail of destruction in rural parts of the country, where the true extent of the damage is hard to gauge.
On Monday the country recorded 281,386 new coronavirus infections and 4,106 deaths, according to the Union Health Ministry. It also passed 25 million cases, the ministry said, becoming only the second country after the United States to reach that mark. With limited testing, however, many experts believe that the toll of infected and dead in India is far greater than the official numbers.
The second wave that hit in April turned New Delhi into a city of fear and grief. Hospitals ran out of beds in a few days, families begged for oxygen on the streets and flames from funeral pyres burned day and night. More than 21,000 people there have died, by the official count.
In New Delhi, at least, some signs of progress are emerging. The capital recorded 4,524 new infections on Monday, a drop from Sunday, when it recorded 6,456, and far below the levels of 28,000 or higher they hit just one month ago. Hospital officials say beds are available and a lack of supplemental oxygen to help with breathing appears to have ebbed.
The positivity rate in testing has also fallen. The New Delhi government said the positivity rate of 8.4 percent was the lowest since April 9, when the figure was 7.8 percent.
Deaths have fallen more slowly, by official figures. They reached nearly 450 a day earlier this month before easing, and on Monday they totaled 340. Jitender Singh Shunty, whose organization runs cremation grounds in eastern New Delhi, said the pressure had eased.
“It is God’s grace, nothing else,” said Mr. Shunty. “The dead bodies arriving at the cremation ground we manage is down by 50 percent.”
Experts now fear the virus is hitting states and rural areas with fewer resources. Testing is limited in the rural parts of the country.
Public awareness campaigns in rural areas can face significant skepticism. Three health care workers in the state of Rajasthan, which borders New Delhi, told The New York Times on Tuesday they were increasingly facing hostile villagers who had fallen prey to rumors on WhatsApp that vaccinations could lead to impotence.
Covid relief efforts were helped by the ebbing of a powerful cyclone that made landfall in the western state of Gujarat on Monday morning. It has forced many regional governments to divert resources to evacuating people and trying to minimize storm damage. The cyclone has killed 21 people and over a hundred are missing.
Experts are turning their attention back to longer-term problems. The coronavirus has exposed vast weaknesses in the country’s health care system. The system’s fragility can be blamed on the lackadaisical approach of successive Indian governments toward the need to revamping health care, said Dr. Anant Bhan, a health researcher at Melaka Manipal Medical College in southern India.
“It is shambles and we need to acknowledge the problem first,” he said.
India will still have to solve its shortage of vaccines. Manish Sisodia, deputy chief minister of Delhi, said on Monday that the city’s expanded vaccination drive for people between the ages of 18 and 44 may come to a halt.
Mr. Sisodia said that his government had written to the federal authorities for more vaccines but that they hadn’t provided the shots.
“We currently have vaccine stocks that will last for four days for people above the age of 45, while for those aged 18 to 44, stocks for only three days are left,” Mr. Sisodia said.
In the latest sign of just how quickly vaccinations are changing what New Yorkers can and can’t do, Radio City Music Hall plans to reopen next month to welcome full-capacity, maskless audiences — as long as each ticket holder has been vaccinated.
The music hall will welcome people past its neon marquees and back into its gilded Art Deco auditorium beginning June 19 for the final evening of the Tribeca Festival, Gov. Andrew M. Cuomo announced on Monday.
James L. Dolan, the executive chairman and chief executive of the Madison Square Garden Company, which owns the music hall, said that the hall would remain open beyond June 19, but only for vaccinated people. Asked how the rules would be implemented — and whether ushers would follow the honor system, or check for proof of vaccinations — he said that some details were still being worked out.
Monday’s announcement was the latest in a series of reopenings that officials have laid out for the weeks and months ahead. As more and more New Yorkers have become vaccinated and federal health officials have relaxed their guidance on mask wearing, indoor arts venues have slowly begun to welcome patrons back while upholding limits on capacity and other safety requirements.
And Broadway shows have started selling tickets to what will be full capacity performances, some of which will begin as early as mid-September.