Covid News: Pfizer and BioNTech Are Developing a Vaccine That Targets Delta Variant

Here’s what you need to know:

Credit…Albert Gea/Reuters

Pfizer and BioNTech announced on Thursday that they are developing a version of the coronavirus vaccine that targets Delta, a highly contagious variant that has spread to 98 countries. The companies expect to launch clinical trials of the vaccine in August.

The Delta variant, first identified in India, is believed to be about 60 percent more contagious than Alpha, the version of the virus that tore through Britain and much of Europe earlier this year, and perhaps twice as contagious as the original coronavirus. The Delta variant is now driving outbreaks among unvaccinated populations in countries like Malaysia, Portugal, Indonesia and Australia.

Delta is also now the dominant variant in the United States, the Centers for Disease Control and Prevention reported this week. Until recently, infections in the United States had plateaued at their lowest levels since early in the pandemic. Hospitalizations and deaths related to the virus have continued to decline, but new cases may be rising, although it’s not yet clear to what extent the variant is responsible. A slowing vaccination drive and swift reopenings also are playing roles.

In their news release, Pfizer and BioNTech also reported promising results from studies of people who received a third dose of the original vaccine, but the companies did not provide the data. A booster given six months after the second dose of the vaccine increases the potency of antibodies against the original virus and the Beta variant by five to tenfold, the companies claimed.

The vaccine makers expect to submit that data to the Food and Drug Administration in the coming weeks, a step toward gaining authorization for booster shots. Antibody levels in the blood may decline six months after immunization, the companies said, and booster doses may be needed to fend off variants.

But antibodies are only part of the body’s immune response, and independent studies have suggested that immunity induced by full vaccination is likely to remain robust for years, even against variants. A study published in Nature on Thursday found that two doses of the vaccine are highly effective against the Alpha, Beta and Delta variants.

Delta is in the spotlight now, but it is a harbinger of variants to come, underscoring the need to vaccinate the world as quickly as possible. Already the Gamma variant, first identified in Brazil, has found a foothold in Washington State, and a more recent variant, Lambda, is on the march in South America.





C.D.C. Warns Delta Variant Is Most Pervasive in the U.S.

The Centers for Disease Control and Prevention said the more transmissible and lethal variant is spreading rapidly in communities with low vaccination rates.

“This week, the Delta variant is estimated to be the most prevalent variant in the United States, representing over 50 percent of sequenced samples across the country, up from 26 percent from the week ending June 19. And in some parts of the country, the percentage is even higher. For example, in parts of the Midwest and upper mountain states, C.D.C.’s early sequenced data suggest the Delta variant accounts for approximately 80 percent of cases. Although we expected the Delta variant to become the dominant strain in the United States, this rapid rise is troubling. We know that the Delta variant has increased transmissibility and it is currently surging in pockets of the country with low vaccination rates. We also know that our authorized vaccines prevent severe disease, hospitalization and death from the Delta variant and these results have been observed not just here in the United States, but in other countries as well. Of course, widespread vaccination is what will truly turn the corner on this pandemic. Please know if you are not vaccinated, you remain susceptible, especially from the transmissible Delta variant, and are particularly at risk for severe illness.” “If you are an elderly person or if you have a person with an underlying disease, you might want to go the extra mile of protection of wearing a mask if you were indoors in an environment with a high degree of infection in the community and a low level of vaccination.”

Video player loadingThe Centers for Disease Control and Prevention said the more transmissible and lethal variant is spreading rapidly in communities with low vaccination rates.CreditCredit…Bryan Anselm for The New York Times

The Delta variant of the coronavirus can evade antibodies that target certain parts of the virus, according to a new study published on Thursday in Nature. The findings provide an explanation for diminished effectiveness of the vaccines against Delta, compared with other variants.

The variant, first identified in India, is believed to be about 60 percent more contagious than Alpha, the version of the virus that thrashed Britain and much of Europe earlier this year, and perhaps twice as contagious as the original coronavirus. The Delta variant is now driving outbreaks among unvaccinated populations in countries like Malaysia, Portugal, Indonesia and Australia.

Delta is also now the dominant variant in the United States. Infections in the country had plateaued at their lowest levels since early in the pandemic, though the numbers may be rising. Still, hospitalizations and deaths related to the virus have continued a steep plunge. That’s partly because of relatively high vaccination rates: 48 percent of Americans are fully vaccinated, and 55 percent have received at least one dose.

But the new study found that Delta was barely sensitive to one dose of vaccine, confirming previous research that suggested that the variant can partly evade the immune system — although to a lesser degree than Beta, the variant first identified in South Africa.

French researchers tested how well antibodies produced by natural infection and by coronavirus vaccines neutralize the Alpha, Beta and Delta variants, as well as a reference variant similar to the original version of the virus.

The researchers looked at blood samples from 103 people who had been infected with the coronavirus. Delta was much less sensitive than Alpha to samples from unvaccinated people in this group, the study found.

One dose of vaccine significantly boosted the sensitivity, suggesting that people who have recovered from Covid-19 still need to be vaccinated to fend off some variants.

The team also analyzed samples from 59 people after they had received the first and second doses of the AstraZeneca or Pfizer-BioNTech vaccines.

Blood samples from just 10 percent of people immunized with one dose of the AstraZeneca or the Pfizer-BioNTech vaccines were able to neutralize the Delta and Beta variants in laboratory experiments. But a second dose boosted that number to 95 percent. There was no major difference in the levels of antibodies elicited by the two vaccines.

“A single dose of Pfizer or AstraZeneca was either poorly or not at all efficient against Beta and Delta variants,” the researchers concluded. Data from Israel and Britain broadly support this finding, although those studies suggest that one dose of vaccine is still enough to prevent hospitalization or death from the virus.

The Delta variant also did not respond to bamlanivimab, the monoclonal antibody made by Eli Lilly, according to the new study. Fortunately, three other monoclonal antibodies tested in the study retained their effectiveness against the variant.

In April, citing the rise of variants resistant to bamlanivimab, the U.S. Food and Drug Administration revoked the emergency use authorization for its use as a single treatment in treating Covid-19 patients.

Volunteers walked door to door last week, during an outreach campaign to inform residents of an upcoming coronavirus vaccination event in Birmingham, Ala.Credit…Elijah Nouvelage/Agence France-Presse — Getty Images

The highly contagious Delta variant of the coronavirus is now the dominant variant in the United States, accounting for 51.7 percent of infections, according to new estimates from the Centers for Disease Control and Prevention.

As health officials had expected, the Delta variant has rapidly overtaken Alpha, the variant that spread through the United States this spring. Alpha, first detected in Britain, now makes up just 28.7 percent of infections, according to the C.D.C.

Still, overall, the average numbers of new virus cases and deaths across the country, as well as hospitalizations, are significantly down from the devastating peaks during previous national surges.

Delta was first detected in India. Research suggests that most vaccines still provide good protection against it and remain highly effective at preventing hospitalizations and deaths.

In England, for instance, where the variant now causes almost all infections, case numbers have risen sharply in recent weeks, but hospitalization rates have increased more slowly and remain low. Next week, a final decision will be made about whether to lift most remaining restrictions in England, including mask rules, on July 19.

Studies suggest, however, that a single shot of a two-dose regimen provides only weak protection against Delta, and public health experts have been encouraging Americans to get fully vaccinated as soon as possible.

As of Wednesday, 67.2 percent of adults in the United States have had at least one vaccine dose, and 58.4 percent are fully vaccinated.

Still, vaccination coverage remains highly uneven, both in the United States and globally, and public health experts say Delta poses a serious threat to unvaccinated populations. On Tuesday, President Biden again urged Americans to get their shots, citing concerns about Delta. “It sounds corny, but it’s a patriotic thing to do,” he said.

Health experts say the Biden administration may need to take more aggressive action to encourage vaccination, including urging employers and schools to adopt vaccine mandates. As of Wednesday, administering about 0.73 million doses per day on average, about a 78 percent decrease from the peak of 3.38 million reported on April 13, according to federal data.

As for the virus itself, the country has been averaging fewer than 15,000 new coronavirus cases a day for nearly a month, the lowest levels since testing became widely available and a fraction of what was reported in January, when the nation routinely identified more than 200,000 cases in a day.

In recent days, however, the average number of new cases has started to trend slightly upward nationally, driven largely by localized outbreaks in places with low vaccination rates, including parts of Missouri, Arkansas and Nevada.

As the Delta variant has spreads across the globe, the World Health Organization recently reiterated its longstanding guidance that everyone, vaccinated or not, should wear masks as a precaution. In the United States, however, the C.D.C. has not changed its advice that those who are fully vaccinated can skip masks in most situations.

U.S. health officials have suggested that the W.H.O.’s blanket suggestion was informed by its global purview, since many countries have had far less access to vaccines than the United States.

In New York City, efforts to monitor the spread of the virus have been scaled back, reflecting a steadily low caseload and a sense held by many that the virus is less of a wide threat. More than 51 percent of residents are fully vaccinated, according to city data, though large parts of the city still have lower rates. Coupled with concerns about Delta, some public health experts and elected officials are worried that the city may be pulling back on its surveillance measures too soon.

On Tuesday, Jen Psaki, the White House press secretary, said that the Biden administration was unlikely to impose new national mitigation measures, even if cases rise.

“The states are going to have to make evaluations and local communities are going to have to make evaluations about what’s in their interests,” she said.

Mitch Smith and Sharon Otterman contributed reporting.

Patients waited for coronavirus test results at Jaramogi Oginga Odinga Referral Hospital in Kisumu County, Kenya last month.Credit…Brian Otieno for The New York Times

Africa has just had its “worst pandemic week ever,” the World Health Organization said on Thursday. The continent is short of vaccines, and the virus is sickening its young people and overwhelming its already fragile health care systems.

More than 251,000 new cases were reported in Africa in the week ending July 4, a 20 percent increase from the previous week, according to Dr. Matshidiso Moeti, the W.H.O. regional director for Africa.

For several weeks now, the continent has been experiencing a brutal wave of infections driven by the more contagious Delta variant, which is increasing hospitalization and fatalities, filling intensive-care beds, depleting oxygen supplies and pushing governments to institute new lockdown measures.

Sixteen African countries are reporting a resurgence in infections, with Malawi and Senegal added to the list this week. New case counts are doubling every 18 days, Dr. Moeti said, and have been rising for seven straight weeks.

“A few weeks ago, we projected this milestone would be reached shortly, and it brings me no joy to be right,” Dr. Moeti said at a news conference on Thursday. “For Africa, the worst is yet to come,” she warned, adding, “The end to this precipitous rise is still weeks away.”

A third wave of the pandemic is ripping through countries mainly in southern and eastern Africa, and one country in North Africa — Tunisia — is experiencing its fourth wave.

Namibia, a nation of just over 2.5 million people, has been recording more than 1,000 new cases a day, and several senior government officials have succumbed to the virus. A spike in cases in Zambia has pushed the government to restrict social gatherings and close schools.

In Uganda, which was praised for its initial coronavirus response, hospitals have been stretched thin, with some patients racking up huge medical bills. Rwanda restricted movement in its capital late last month, and Kenya instituted partial lockdowns and extended curfew hours in over a dozen counties where the Delta variant was contributing to surges.

Many African countries continue to face challenges in detecting and sequencing virus variants, Dr. Moeti said. Testing and tracing remain limited as well: In a continent of 1.3 billion people, just over 54 million Covid-19 tests have been conducted, according to Dr. John Nkengasong, the director of the Africa C.D.C.

But the biggest challenge has been vaccination. With just over 53 million doses administered, only about 1 percent of Africa’s population is fully vaccinated.

African officials have accused wealthy nations of hoarding vaccine doses while millions of Africans remain vulnerable. Most African countries are dependent on the Covax vaccine-sharing initiative, which has been severely hampered by the Indian government’s decision in April to hold back doses manufactured there for domestic use and restrict exports.

As cases surge in Africa, some wealthy nations have begun donating vaccine doses to nations on the continent. And as more supplies come in, health officials are urging African countries to prepare to receive and administer the doses quickly.

“Governments and partners can do this,” Dr. Moeti said, “by planning to expand vaccination sites, improving cold chain capacities beyond capital cities, sensitizing communities to boost vaccine confidence and demand, and ensuring operational funding is ready to go when it is needed.”

VideoVideo player loadingOfficials said the declaration was due to the spread of the Delta variant. Organizers of the Tokyo Olympics, which will begin on July 23, said that they would bar spectators from most events at the Games.CreditCredit…Kazuhiro Nogi/Agence France-Presse — Getty Images

Olympic organizers said on Thursday that they would bar spectators from most events at the Games scheduled to open in two weeks, a decision that followed the declaration of a new state of emergency in Tokyo in response to a sudden spike in coronavirus cases.

Officials have long insisted that they can hold the Tokyo Games safely amid a pandemic. Last month, they announced that they would allow domestic spectators at the events despite public fears that the Games could become a petri dish for new variants of the virus.

Now, the virus has again wreaked havoc on the planning of Olympic organizers, who gathered in an emergency meeting on Thursday night to decide how to respond to the latest challenge of a pandemic that had already delayed the Games by a year.

The announcement came only hours before the Olympic torch was set to begin the last — and long-delayed — leg of its trip through Japan. Officials decided this week that there would be almost no actual running during its two-week perambulation through Tokyo and its suburbs, replacing the marathon with a series of ceremonies that would be closed to the public.

Addressing reporters on Thursday night, Prime Minister Yoshihide Suga acknowledged the challenge the country faced as the more contagious Delta variant had begun to spread. He warned about the danger of the virus spreading beyond Tokyo as people traveled home for the summer holidays.

But at the same time, Mr. Suga pledged to deliver an Olympic Games that would go down in history not as another victim of the pandemic, but as an example of fortitude in the face of adversity.

Viewers will be tuning in from around the world, he said, and “I want to transmit to them a message from Tokyo about overcoming hardship with effort and wisdom.”

A street market in Port-au-Prince, Haiti, last month.Credit…Joseph Odelyn/Associated Press

The assassination of President Jovenel Moïse of Haiti on Wednesday could complicate efforts to contain the Covid-19 pandemic in the Caribbean nation, which has yet to begin vaccinating its citizens, officials from the World Health Organization warned.

Carissa Etienne, the director of the Pan American Health Organization, which is part of the W.H.O., said her organization had made Haiti a priority in recent weeks as reported cases have surged.

“I am hopeful that the arrival of vaccines in the country can start to turn the tide of the pandemic and bring some relief to the Haitian people during these very difficult times,” Dr. Etienne said. “We continue to stand with them now and will redouble our efforts.”

Haiti did not experience the kind of surge early in the pandemic that many experts feared could devastate the country, the poorest in the Western Hemisphere. But the pandemic has grown worse in recent weeks, with a rise in reported cases that experts say is almost certainly an undercount, considering the country’s limited testing capacity.

Last month, Covid-19 claimed the life of René Sylvestre, the president of Haiti’s Supreme Court — a leading figure who might have helped to establish order in the wake of an assassination that has plunged the country into even deeper political uncertainty.

Dr. Etienne’s organization said in an email that while it was too soon to evaluate the impact of the assassination, “further deterioration of the security situation in Haiti could have a negative impact on the work that has been done to curtail Covid-19 infections,” as well as on vaccination plans.

VideoVideo player loadingPresident Jovenel Moïse of Haiti was killed in an attack at his private residence on the outskirts of the capital, Port-au-Prince.CreditCredit…Andres Martinez Casares/Reuters

The organization said that Haiti was also facing challenges from the start of hurricane season and the recent detection of the Alpha and Gamma virus variants on the island. Though “vaccines are expected to arrive shortly” in Haiti, the organization said it did not have a specific delivery date.

In June, Dr. Etienne urged the global community to do more to help Haiti cope with rising coronavirus cases and deaths. “The situation we’re seeing in Haiti is a cautionary tale in just how quickly things can change with this virus,” she said.

Haiti is an extreme example of the “stark inequities on vaccine access,” Dr. Etienne said. “For every success, there are several countries that have been unable to reach even the most vulnerable in their population.”

Across Latin America and the Caribbean, there are millions of people who “still don’t know when they will have a chance to be immunized,” she said.

She said the inequitable distribution of vaccines posed practical and moral problems.

“If we don’t ensure that countries in the South have the ability to vaccinate as much as countries in the North, this virus will keep circulating in the poorest nations for years to come,” Dr. Etienne said. “Hundreds of millions will remain at risk while the wealthier nations go back to normal. Obviously, this should not happen.”

A medical worker tended to patients infected with the coronavirus at Marlinksy Hospital in Saint Petersburg, Russia, on Wednesday.Credit…Olga Maltseva/Agence France-Presse — Getty Images

While highly effective Covid-19 vaccines were developed with unprecedented speed, the search for drugs to treat people infected with the coronavirus has lagged. Researchers hope that drugs already on the market for other diseases might be found to help Covid patients, but the challenge has been to identify the best candidates.

In a new article published in Nature on Thursday, an international group of researchers, led by Andrea Ganna of the Institute for Molecular Medicine in Helsinki, reported that when they scoured the genomes of nearly 50,000 people in 19 countries who had Covid-19, they found 13 genetic areas of interest that might focus the search for useful drugs.

The study cautioned that the genetic variations, which are inherited, could not themselves be used to predict who might contract Covid or, if infected with the coronavirus, who might become seriously ill.

Each of the genetic variations appears to be associated with a minuscule additional risk of infection or severe disease. But even so, a drug for another disease that directs its effects toward a gene variation that also occurs in some Covid patients might also prove to help the Covid patients, the reasoning goes.

The cases the researchers studied included people who were hospitalized with severe Covid, people whose electronic health record showed that they had a positive Covid test, and people who simply self-reported that they had had Covid infections.

Each genetic area found by the researchers represents small differences in a segment of DNA.

The most promising genetic variations, the researchers say, include those in a gene that has been previously reported as a risk factor for lung cancer. The variations result in increased expression of the gene in the lung and are associated with more severe Covid disease. The most severely affected Covid patients have trouble breathing, and some need respirators as the virus affects their lungs.

A second genetic variation, also associated with severe disease, is known to reduce the risk of developing autoimmune diseases but to increase the risk of tuberculosis.

The third genetic variation increases the risk of infection with the virus. This gene binds to a cell surface protein, ACE2, that the coronavirus uses to hitch itself to cells and enter them.

The possible significance of other variations is less clear. Not all are in genes themselves — some are in areas of DNA between genes.

The study’s authors caution in their paper that how important the research will be in finding Covid treatments remains to be seen.

“Future work will be required to better understand the biological and clinical value of these findings,” the authors wrote.

Patients were treated at a special facility for Covid-19 patients in Arequipa, Peru, last month.Credit…Diego Ramos/Agence France-Presse — Getty Images

Viruses evolve. SARS-CoV-2, the virus that causes Covid-19, is no exception. So the emergence of variants is no surprise, and not every new genetic mutation poses a serious threat.

But in recent weeks, a growing drumbeat of news coverage has started to raise alarm about Lambda, a variant first detected in Peru late last year. The variant, initially known as C. 37, has spread rapidly through parts of South America. On June 14, the World Health Organization designated it as a “variant of interest,” meaning, essentially, that experts suspect it could be more dangerous than the original strain.

Only a handful of studies have looked at Lambda so far. Here’s what we know:

  • It has spread fast. It has been detected in at least 29 countries and has become especially prevalent in Peru, Chile and other parts of South America.

  • It has eight notable mutations, some of which are present in other variants and might make the virus more infectious or help it evade the body’s immune response.

  • Preliminary laboratory studies suggest that the variant may be more transmissible and that the body’s antibodies may be less effective against it. But vaccine-induced antibodies were still able to neutralize the virus, which suggests that vaccines should still provide protection against it.

Although more real-world data is needed, there is not yet any evidence that Lambda poses more risk than other circulating variants, such as the Delta variant. “I don’t think there’s any more reason to be concerned than before we knew about this variant,” said Nathaniel Landau, a microbiologist at the New York University Grossman School of Medicine. “There’s no reason to think that this is now something worse than Delta.”

Gravediggers carrying the coffin of a Covid-19 victim during a burial in São Paulo, Brazil, in May.Credit…Mauricio Lima for The New York Times

The world’s known coronavirus death toll passed four million on Thursday, a loss roughly equivalent to the population of Los Angeles, according to the Center for Systems Science and Engineering at Johns Hopkins University.

It took nine months for the virus to claim one million lives, and the pace has quickened since then. The second million were lost in three and a half months, the third in three months, and the fourth in about two and a half months. The number of daily reported deaths has declined recently.

Those are officially reported figures, which are widely believed to undercount pandemic-related deaths.

“The numbers may not tell the complete story, and yet they’re still really staggering numbers globally,” said Jennifer B. Nuzzo, an epidemiologist at Johns Hopkins University’s Bloomberg School of Public Health.

Ms. Nuzzo said the number of excess deaths reported around the world suggested that “lower-income countries have been much harder hit than their official numbers would suggest.”

Dr. Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, called four million dead a tragic milestone on Wednesday, and said the toll was continuing to mount largely because of dangerous versions of the virus and inequities in the distribution of vaccines.

“Compounded by fast-moving variants and shocking inequity in vaccination, far too many countries in every region of the world are seeing sharp spikes in cases and hospitalizations,” Dr. Tedros said at a news conference.

The official death toll numbers tell only part of the horrifying pandemic story. In many places, people have died without family to comfort them because of rules to prevent the spread of the virus. And many countries were completely overrun.

The dead overwhelmed cremation grounds in India in May, where at least 400,000 confirmed deaths have been reported and the actual number is likely higher. That was also the case in funeral homes in the United States, which surpassed 600,000 known deaths last month.

The virus has hammered Latin America since the start of the pandemic, and some of those nations have been grappling with their deadliest outbreaks to date.

As of Tuesday, seven of the 10 countries with the highest death rates relative to their populations over the past week were in South America, according to data from Johns Hopkins, and the virus has been a destabilizing force in many countries in the region.

Government health data in Colombia show that more than 500 people died from the virus each day in June. The country has also gone through weeks of explosive protests over poverty made worse by the pandemic that were sometimes met with a violent police response.

A wave of cases in Peru cost many people their livelihoods, and thousands of impoverished people occupied empty stretches of land south of Lima. In Paraguay, which as of Tuesday had the highest number of Covid-19 deaths per capita of any country during the previous week, social networks often resemble obituary pages.

Brazil, which recently passed 500,000 official deaths, had the highest number of new cases and deaths of any country in the past week. A recent study found that Covid-19 had led to a significant decrease in life expectancy in Brazil.

Several vaccines have proven effective against the coronavirus, including the highly contagious Delta variant, and death rates have dropped sharply in many parts of the world where large numbers of people have been vaccinated, like the United States and much of Europe.

But the virus is still running rampant in regions with lower rates of vaccination, like parts of Asia, Africa and South America. Some places with relatively high vaccination rates, like England, are also seeing spikes in cases, though fewer of those cases have been leading to hospitalizations and deaths.

Dr. Maria Van Kerkhove, who works on coronavirus response for the W.H.O., said that there were “more than two dozen countries that have epidemic curves that are almost vertical.”

“The virus is showing us right now that it’s thriving,” she said.

Wealthy countries and international organizations have pledged billions of dollars to Covax, a global vaccine-sharing initiative, and nations like the United States have promised to supply hundreds of millions of doses. But those numbers pale in comparison with the 11 billion vaccine doses that experts estimate will be needed to rein in the virus around the world.

To date, just under 3.3 billion vaccine doses have been administered worldwide, according to vaccination data from local governments compiled by the Our World in Data project at the University of Oxford. Nearly all have been of vaccines that require more than one dose to be fully effective.

Country-to-country differences in progress are stark, with some already inoculating most of their adult citizens while others have yet to report administering a single dose.

Juan Cruz Jr. and his mother, Delfina Cruz, with a portrait of his father, who died of Covid-19 while awaiting trial in a New York jail.Credit…Amr Alfiky/The New York Times

Richard Williamson, 86, was rushed from a Florida jail to a hospital last July. Within two weeks, he had died of Covid-19.

Hours after Cameron Melius, 26, was released from a Virginia jail in October, he was taken by ambulance to a hospital, where he died. The coronavirus, the authorities said, was a contributing factor.

And in New York City, Juan Cruz, 57, who fell ill with Covid while in jail, was moved from a hospital’s jail ward into its regular unit before dying.

None of these deaths have been included in official Covid mortality tolls of the jails where the men had been detained. And these cases are not unique. The New York Times identified dozens of people around the country who died under similar circumstances but were not included in official counts.

In some cases, deaths were added to facilities’ virus tolls after The Times brought missing names to the attention of officials. In other cases, people infected with the coronavirus while incarcerated were granted legal releases because of the severity of their illnesses but were not included in the death tallies of the jails where they got sick. Still other inmates’ deaths were left off facilities’ list of virus deaths for reasons that are unexplained.

More than 2,700 people are reported to have died of Covid-19 in connection to U.S. prisons, jails and immigration detention centers, but the additional cases raise the prospect that the known toll on incarcerated people falls far short of providing the full picture.

Concerns about how coronavirus deaths are documented have emerged throughout the pandemic, including a finding that the toll among nursing home residents in New York State was far higher than known because thousands who died in hospitals had not been included.

Public health officials say the prospect of overlooked virus deaths tied to the nation’s prisons, jails and immigration detention centers carries particular risks. It is challenging, the experts say, to prepare prisons for future epidemics without knowing the accurate toll. For now, the publicly known death totals connected to incarceration largely come from the facilities themselves.

“You can’t make good public policy if you don’t know what’s actually going on on the ground,” said Sharon Dolovich, director of the Covid Behind Bars Data Project at the University of California, Los Angeles, which tracks coronavirus deaths in American prisons.

Maura Turcotte, Rachel Sherman, Rebecca Griesbach, Ann Hinga Klein, Brendon Derr and


Wearing face masks in Suva, Fiji, early this month.Credit…Leon Lord/Agence France-Presse — Getty Images

As Fiji battles one of the fastest-growing coronavirus outbreaks in the world, the Pacific Island’s Olympic team departed on Thursday for Tokyo on a freight plane.

Their fellow passengers? A shipment of frozen fish.

The coronavirus outbreak had thwarted plans to get the athletes to Japan on regular planes after almost all passenger flights from the country were suspended until the end of July. Only a select number of repatriation and freight flights have been allowed to depart.

The country has been pummeled by the Delta variant of the virus, with ​​an average of 57 daily new cases per 100,000 people over the past two weeks, according to a New York Times database. Just over 6 percent of the population is fully vaccinated against the coronavirus.

So arranging travel was a “logistical challenge,” Lorraine Mar, the chief executive of the Fiji Association of Sports and National Olympic Committee, told The Associated Press. The solution: a freight plane hauling mostly frozen seafood, with just enough passenger space for the athletes and other officials.

It’s a sharp contrast to other Olympians’ flashier modes of transport: U.S. basketball players Devin Booker, Jrue Holiday and Khris Middleton may travel to Tokyo in a private plane because of scheduling conflicts, while members of the British Olympian squad departed from Heathrow Airport in London on Tuesday wearing matching tracksuits in their team’s colors.

Around midnight local time, about 50 athletes and officials from Fiji, including the country’s men’s and women’s sevens rugby squads, departed on the flight from Nadi, the principal international airport, to Tokyo ahead of the Summer Games.

Before boarding, team members spent 96 hours in isolation and took tests 72 hours ahead of their departure, in line with guidelines set by officials in Tokyo. One official with the Fiji Olympic team who tested positive for Covid-19 was withdrawn from the event.

Ahead of the team’s departure, the country’s National Olympic Committee posted a video showing masked well-wishers brandishing Fiji’s sky-blue flag as they waved goodbye.

The country will compete in six sports, including archery, judo and table tennis. In 2016, 60 years after the country first competed in the Olympics, Fiji won its first medal when the men’s rugby team triumphed at the inaugural Olympic rugby sevens tournament in Rio de Janeiro.

In other developments across the world:

  • South Korea will raise coronavirus restrictions to the highest level in Seoul, its capital, and some neighboring regions starting on Monday, Prime Minister Kim Boo-kyum said on Friday. The announcement comes after South Korea reported on Thursday its biggest daily rise in new cases, and a top health official warned that the numbers might nearly double by the end of July. Under the new curbs, people are advised to stay home as much as possible, schools will be closed, public meetings will be restricted to two people after 6 p.m., and rallies banned. Nightclubs and bars will be shut, while restaurants and cafes will be allowed limited seating and restricted to takeout services after 10 p.m.

  • Prime Minister Xavier Bettel of Luxembourg, who was hospitalized with Covid-19 about two weeks after attending a European Union summit, left the hospital on Thursday morning “given the improvement of his health condition,” his spokesman said. Mr. Bettel, 48, was admitted on Sunday because of low blood oxygen levels, a serious concern for Covid-19 patients. He received his first dose of the AstraZeneca vaccine in May and fell ill before July 1, when he was scheduled to get the second. Mr. Bettel will resume his duties on Friday, working in isolation from home, his spokesman said. No other European leaders who attended the summit on June 24 and 25 have shown Covid-19 symptoms, the E.U. said on Monday.

  • The government of France advised its citizens on Thursday not to vacation in Spain or Portugal because of recent increases in coronavirus cases there. Spain is averaging more new cases a day this week than at any time since February. Portugal recently reintroduced nighttime curfews in several cities including Lisbon, the capital, where residents are also barred from traveling to other parts of the country on weekends. Portugal and Spain hoped to revive tourism by reopening their borders to European travelers in time for the high summer season, only to be stalled by countries like Britain and now France issuing new travel warnings. Portugal’s foreign minister, Augusto Santo Silva, urged fellow European Union countries on Thursday to collaborate on travel restrictions instead of applying them unilaterally.

  • The United States, as part of its pledge to distribute vaccines to countries in need, will ship 500,000 doses of the Pfizer-BioNTech vaccine to Uruguay and 1.4 million doses of Johnson & Johnson’s vaccine to Afghanistan, the first of three million doses bound for that country, Jen Psaki, the White House press secretary, said on Thursday.

A medical worker in Munich filled a syringe with the AstraZeneca Covid-19 vaccine in May. Germany plans to donate its supplies of the vaccine for use in lower-income countries. Credit…Andreas Gebert/Reuters

Germany plans to take at least 30 million doses of the AstraZeneca and Johnson & Johnson vaccines, which many of its own people are shunning, and donate them to developing countries, according to a federal health ministry memorandum.

“It’s in our own interest to vaccinate the world,” said Jens Spahn, Germany’s health minister.

For the first time since its national vaccination drive got off to a slow start early this year, Germany now has enough vaccine doses in stock to fill all domestic orders, experts say. The country no longer sets priorities for who may be vaccinated; every adult is eligible.

Both the authorities and the German people have shown a clear preference for the two authorized mRNA-based vaccines — those developed by Pfizer/BioNTech and Moderna — over the AstraZeneca and Johnson & Johnson vaccines, which use viral vectors.

More than 70 percent of doses delivered in Germany have been the Pfizer/BioNTech vaccine, which was developed in Germany and the United States, compared with just 17 percent for the AstraZeneca shot, developed in Britain and Sweden.

German distrust of the British-Swedish vaccine stems from reports of a rare but potentially fatal blood clotting condition in a handful of recipients, mostly young adults. The government briefly suspended use of the AstraZeneca shot, and then recommended that it be used only in people 60 or older, for whom the risk of Covid vastly outweighs the risk of the rare clotting condition.

There have also been concerns about the AstraZeneca vaccine’s effectiveness against the Delta variant. Last week, German health authorities formally recommended that people who received an AstraZeneca shot as their first dose switch to one of the mRNA vaccines for their second.

Doctors and nurses have administered at least one vaccine dose to nearly 58 percent of the German population, and 41 percent are fully vaccinated. Now that relatively few people in the country are becoming infected, many people are skipping their second vaccination appointments. To combat that, state governors in Germany have discussed the idea of fining people who sign up for a shot but fail to show up.

The health ministry’s memorandum outlining the vaccine donation plans, which was presented to the German cabinet on Wednesday, says that at least 80 percent of the doses will go to Covax, the global vaccine distribution initiative, for use in low- and moderate-income nations. The rest would be earmarked for use in the western Balkan nations — where at least 3 million doses would be sent — and in Namibia, which was a German colony before World War I.

More than 4,400 volunteers attended an experimental concert in Paris in May to assess health risks associated with large-scale indoor gatherings. Credit…Christian Hartmann/Reuters

If everyone in attendance wears a mask, keeps their hands clean and has recently tested negative for the coronavirus, large concerts can be held safely indoors without requiring social distancing, researchers in Paris said on Thursday, based on an experiment they ran in May.

The Paris Public Hospitals, which led the experiment, gathered 6,678 volunteers and divided them randomly into two groups: about two-thirds of the volunteers attended a special concert conducted for the experiment at the Accor Arena, and the rest did not. Half the volunteers had received at least one vaccine dose.

All the volunteers were tested a week later, and the results showed no significant difference between the two groups. About 0.2 percent of the concertgoers’ tests came back positive, nearly the same positivity rate as the Île-de-France region, which includes Paris, over the two weeks preceding the event.

The researchers said that analysis of saliva samples taken at the concert showed afterward that five of the eight concertgoers who eventually tested positive already had the virus when they arrived at the arena.

The results suggest that “participating in a large indoor live concert with no physical distancing” was “not associated with an increased risk of Covid infection,” the Paris Public Hospitals said in a statement.

The results were encouraging for French people who are starting to enjoy the complete reopening of public gathering places in their country, after three lengthy lockdowns over the course of the pandemic and a curfew that was imposed in October. Nightclubs, the last sector still subject to restrictions in France, are expected to reopen on Friday after being closed for 15 months.

But the concert experiment followed strict sanitary protocols and took other measures that might not be maintained in commercial public settings, including screening the audience and keeping the bars and smoking rooms at the venue closed.

The volunteer attendees were all between 18 and 45, and had declared that they had no Covid symptoms, no other significant health conditions and no recent contact with an infected person. Compliance with the facial mask requirement was tracked and evaluated by a continuous video-capture artificial intelligence system.

Experimental concerts previously conducted in Barcelona, Spain, in March and Liverpool, England, in May yielded similar conclusions that indoor events held with strict safety measures would not lead to a significant rise in infections.

The coronavirus situation in France remains worrisome. Daily new case reports have risen significantly over the past week in 11 regions of the country, including Île-de-France, and the more contagious Delta variant accounted for more than 40 percent of the new cases. Vaccination efforts have begun to stall with just 37.6 percent of the total population fully protected, and the government, fearing a new wave of infections before the end of the summer, is mounting a new push to speed them up again.

People ate lunch alone in a Manhattan plaza last month. Feelings of loneliness increased during the pandemic, even as conditions that kept people apart improved.Credit…Gabriela Bhaskar/The New York Times

Many Americans felt socially isolated during the pandemic, cut off from friends and family as they hunkered down and kept their distance to try to protect themselves from infection.

But new research released Thursday suggests many people’s sense of isolation increased even as the public health crisis in the United States began to abate, with communities opening up and the economy improving.

While the level of social isolation declined during the spring of the pandemic after the initial shock of the crisis subsided, it then increased sharply over the summer months last year, according to researchers at Harvard, Northeastern, Northwestern and Rutgers universities, before leveling off during the fall.

People began to feel less disconnected last December through April of this year, but the levels of social isolation measured by the researchers increased again this June.

The findings suggest recovery from the pandemic may take a long time and could affect people’s view of their relationships over time. “There were cumulative effects from the social isolation,” said David Lazer, a professor of political science and computer sciences at Northeastern and one of the study authors.

To determine social isolation, the researchers asked each person about the number of people they could count on to care for them if they got sick, to lend them money, to talk to about a problem if they were depressed, or to help them find a job. Someone who said they had only one person, or no one they could turn to, in a given category was considered socially isolated.

The researchers polled a total of 185,223 individuals over 12 different surveys from April 2020 to June 2021.

Even now, with many more people vaccinated against the coronavirus and much more actively engaged in their communities, people may be thinking differently about those they previously relied on for help. “That pause in life may be causing a lot of revisitation in our relationships,” said Dr. Lazer, who pointed to the unusual number of people deciding to leave their jobs as the pandemic ends. “It takes a while to heal the social fabric.”

The increase in feelings of isolation even when the most severe restrictions were lifted “is striking,” said Mario L. Small, a professor of sociology at Harvard who was not involved in the study. People may have felt they had fewer people to lean on because they remained physically distant from a broad network of acquaintances and friends, he said, even when the lockdowns had eased.

The researchers found people’s isolation increased last summer even though they were seeing people more. “Our findings show that recovering from social isolation is hard and does not simply stem from increased social contact,” the researchers concluded.

The researchers also point to a strong association between social isolation, particularly for those people who said they lacked people they could turn to for emotional support, and moderate or severe depression.

Many of those hardest hit by the pandemic, with lower incomes and less education, seem slower to improve, Dr. Lazer said. “We definitely do see a separation of fates in respect to socioeconomic status,” he said, with some groups experiencing a longer and more uneven recovery.

Correction: July 8, 2021

An earlier version of this article misspelled the surname of a professor of political science and computer sciences at Northeastern and one of the study’s authors. It is Lazer, not Lazar.

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