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Many U.S. Colleges Will Require Vaccinations for Fall

The biopharmaceutical company Emergent BioSolutions, in Baltimore, Md., threw out millions of vaccine doses at its manufacturing plant over concerns of contamination.
Credit…Jim Lo Scalzo/EPA, via Shutterstock

Executives of Emergent BioSolutions, the vaccine manufacturer that was forced to discard up to 15 million doses because of possible contamination, reported a shake-up in leadership on Thursday and offered the most fulsome defense yet of the company’s performance.

While announcing the high-level personnel changes and taking responsibility for the ruined doses, executives nonetheless forecast record revenues this year of nearly $2 billion.

Robert Kramer, the chief executive, speaking on a call with investors, said that one senior vice president overseeing manufacturing would depart the company while another executive would go on leave. A third official, Mary Oates, who recently joined Emergent after a long tenure at Pfizer, is now leading the company’s response to a recent federal inspection that found serious flaws at the Baltimore facility that produced the vaccines.

The call on Thursday came at a tumultuous time for Emergent, a once-obscure federal contractor that has built a lucrative business selling biodefense products to the government. Production at the company’s Baltimore plant was suspended this month after the discovery that workers had potentially contaminated millions of doses of the Johnson & Johnson vaccine.

Addressing these setbacks, Mr. Kramer offered a vigorous defense of the company on Thursday.

He took “full responsibility” for the manufacturing problems, acknowledging that the “loss of a batch for a viral contamination is extremely serious, and we treated it as such,” but he also said that Emergent had taken on a “herculean task” in a crisis.

United States › United StatesOn May 1 14-day change
New cases 44,682 –27%
New deaths 702 –7%

World › WorldOn May 1 14-day change
New cases 788,076 +7%
New deaths 12,680 +13%

U.S. vaccinations ›

Where states are reporting vaccines given

People pose for photos near the cruise docks in San Juan, P.R., last week.
Credit…Erika P. Rodriguez for The New York Times

Cruise ships that have been docked for more than a year could restart sailing in United States waters by mid-July, the Centers for Disease Control and Prevention said in a letter sent to the cruise industry late on Wednesday.

After several meetings with cruise lines, the C.D.C. clarified several requirements in its Framework for Conditional Sailing Order, which outlined the steps that cruise companies had to follow to resume operations in U.S. waters. The agency said it will let the companies skip test voyages if they attest that 98 percent of the crew and 95 percent of passengers are fully vaccinated.

Previously, the agency required cruise lines to give 30 days notice before starting a test cruise and to apply for a conditional sailing certificate 60 days before a planned regular voyage. The Cruise Lines International Association, the industry’s trade group, called the guidelines “burdensome” and “ambiguous” and asked the C.D.C. to factor in how quickly Americans are being vaccinated.

The C.D.C. said on Wednesday that it would review and respond to applications for simulated voyages within five days, “putting cruise ships closer to open water sailing sooner.”

The agency also eased its pre-sailing testing requirements for fully vaccinated passengers and crew, allowing them to take a simple viral test instead of a PCR test, which takes longer to yield results.

“We acknowledge that cruising will never be a zero-risk activity and that the goal of the Conditional Sailing Order’s phased approach is to resume passenger operations in a way that mitigates the risk of Covid-19 transmission onboard cruise ships and across port communities,” the C.D.C. said in a statement on Thursday.

“We remain committed to the resumption of passenger operations in the United States following the requirements in the CSO by midsummer, which aligns with the goals announced by many major cruise lines,” it went on.

Cruise companies did not immediately comment on the C.D.C.’s updated guidelines as many were still reviewing the letter.

Florida is the biggest state for cruise operations and it had sued the C.D.C. to force it to restart sailings. But the state has passed legislation mandating that companies that do business with the state or get state subsidies cannot require people to be vaccinated for admission or service. That could make it difficult for cruise lines to guarantee that they have met the vaccination rates set in the C.D.C.’s new letter.

The cruise news site Cruise Critic asked its readers last week whether they would book a cruise if the C.D.C. allowed U.S. sailings to start this summer. Out of more than 600 respondents, 64 percent said they would book a cruise in 2021, while 27 percent said they would wait until 2022.

Patients in tents outside Kennedy Hospital in Bogotá, Colombia, this month. Colombia has been able to issue a first vaccine to just 6 percent of its population.
Credit…Federico Rios for The New York Times

With vaccinations mounting in some of the world’s wealthiest countries and people envisioning life after the pandemic, the crisis in Latin America is taking an alarming turn for the worse, potentially threatening the progress made well beyond its borders.

Last week, Latin America accounted for 35 percent of all coronavirus deaths in the world, despite having just 8 percent of the global population, according to data compiled by The New York Times.

The length of the region’s epidemic makes it even harder to fight. It has already endured some of the strictest lockdowns, longest schools closures and largest economic contractions in the world.

And if Latin America fails to contain the virus — or if the world fails to step in to help it — new, more dangerous variants may emerge, said Dr. Jarbas Barbosa of the Pan-American Health Organization.

“This could cost us all that the world is doing” to fight the pandemic, he said.

Skiers at Breckenridge Ski Resort in Breckenridge, Colo., on Sunday.
Credit…Stephen Speranza for The New York Times

More than half of U.S. states have seen a significant decline in new coronavirus cases over the past two weeks, as federal health officials have begun to suggest that the virus’s trajectory is improving. Still, the uneven levels of vaccination across the country point to the challenge of reaching those people who have not gotten shots.

As of Wednesday, the United States was averaging about 52,600 new cases a day, a 26 percent decline from two weeks ago, and a number comparable to the level of cases reported in mid-October before the deadly winter surge, according to a New York Times database. Since peaking in January, cases, hospitalizations and deaths nationwide have drastically declined.

While addressing a joint session of Congress on Wednesday night, President Biden touted the nation’s progress on vaccinations since he took office, calling it one of the country’s “greatest logistical achievements.” He also highlighted the passage of the American Rescue Plan, an ambitious relief package to address the economic toll of the pandemic.

Despite the successes, Mr. Biden implored the public to remain on guard.

Over the past two weeks, case numbers have fallen by 15 percent or more in 28 states, the District of Columbia and Puerto Rico, with drops of 30 percent or more in 14 states and the District of Columbia. As of Wednesday, Vermont reported a 54 percent decline in the average number of new cases a day, while Michigan, which had one of the nation’s most severe recent outbreaks, is now seeing rapid improvement with cases there down 40 percent.

In New York City, which had seen stubbornly high caseloads for months, the second wave is receding a half-year after it started, the city’s health commissioner said.

Federal health officials have taken note. After expressing a recurring sense of “impending doom” last month, Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said on Wednesday that she was beginning to see signs of progress.

“Cases are starting to come down. We think that this is related to increased vaccination, increased people taking caution, and so I’m cautiously optimistic that we’re turning the corner,” she said on “Good Morning America.”

But she warned that “the virus is an opportunist” and could strike in communities with low vaccination rates. Persistent vaccine hesitancy remains a challenge, and the pace of vaccination will ebb, officials have acknowledged, amid issues of supply and demand.

About 43 percent of people have received at least one dose of a Covid-19 vaccine, and 30 percent have been fully vaccinated. Providers are administering about 2.67 million doses per day on average, as of Wednesday, about a 21 percent decrease from the peak of 3.38 million reported on April 13.

The C.D.C.’s move to relax mask guidance outdoors this week is a reflection of the rise in the total number of vaccinations — and an incentive to get a shot, experts said.

“It’s another demonstration of what science has been telling us over the last many months, which is that vaccines are effective in preventing the Covid-19 virus from infecting us. And the more people who get vaccinated, the more quickly we can resume our activities,” Dr. Vivek Murthy, the surgeon general, said in a Tuesday interview on CNN.

Mr. Biden has set a target date of July 4 for the country “to get life in America closer to normal.” But public health experts have emphasized that the experience of the pandemic across the world is not universal. India, for example, is experiencing a catastrophic second wave that could have global implications.

“Pandemics require global cooperation and mutual support,” Dr. Murthy said. “When there’s uncontrolled spread of the virus in any part of the world, that means that variants can arise, variants which may over time become resistant to the protection that we get from vaccines, which could mean a real problem for us here in the United States.”

Allyson Waller and Kevin Draper contributed reporting.

People getting vaccinated at a government-run hospital in Mumbai this month.
Credit…Atul Loke for The New York Times

India is the world’s leading producer of vaccines, but over the past week it has also been the global leader in Covid-19 deaths, and it is not at all clear that the country can vaccinate itself out of the crisis.

As of Thursday, about 26 million people — 1.8 percent of India’s population — had been fully vaccinated. That is a better rate than some mostly poor countries, but it is still among the world’s lowest.

As a critical supplier in the global vaccination effort, India’s struggles to roll out enough vaccine for its own people are being closely watched abroad. Although Indian drug manufacturers produce tens of millions of doses a month, that is a fraction of the demand in a country where 940 million adults will be eligible for shots starting on Saturday.

Many Indians who have received first doses report delays in getting their second, and state health officials say their appeals for fresh vaccine supplies are going unanswered.

Balbir Singh Sidhu, the health minister in Punjab State, said: “The shortage is everywhere.”

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De Blasio Says, ‘This Is Going to Be the Summer of New York City’

Mayor Bill de Blasio of New York set a goal on Thursday for a full reopening of city businesses on July 1, but his authority to lift restrictions was somewhat limited. Capacity limits have been set by the state.

“We are ready to bring New York City back fully on July 1. What you have done is the reason I can make this announcement today, because you’ve gone out, you’ve gotten vaccinated, you’ve done so much to fight through this crisis. Now we can see that light at the end of the tunnel. This is going to be the summer of New York City. We’re all going to get to enjoy this city again. And people are going to flock here from all over the country to be a part of this amazing moment in New York City. It means going to stores and anyone who wants to shop at a store can go to a store again. It means bars and restaurants being able to come back, bring back. so many of their employees, serve so many more customers. It means so many of our cultural events being open again, theaters coming back, so many of the things that we cherish. And what it means for everyday working people, for all those cooks and waiters and bartenders and folks who work in the kitchen, for the small business owners, the folks who built up their businesses for years and years and have fought to survive, for everyday people, for our artists and our performers, it means a chance to do what you are so great at again.” Reporter: “What kind of conversations have you had with the governor about the city’s plans to fully reopen in July?” “I have not, and I think the best way to proceed here is to set out the city’s vision. We’re going to work with the federal government. We’re going to work with the state government. But it’s quite clear, you just saw the indicators, you’ve seen the numbers of vaccination. It’s quite clear it’s time to set a goal, and move on that goal. So we’ll work with all the other levels of government. But we’ve got to keep moving toward a goal at this point.”

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Mayor Bill de Blasio of New York set a goal on Thursday for a full reopening of city businesses on July 1, but his authority to lift restrictions was somewhat limited. Capacity limits have been set by the state.CreditCredit…Gabby Jones for The New York Times

New York City aims to fully reopen on July 1 and allow restaurants, shops and stadiums to operate at full capacity, Mayor Bill de Blasio said Thursday, offering a tantalizing glimpse of normalcy even as his authority to actually lift restrictions on businesses was somewhat limited.

Mr. de Blasio, speaking on MSNBC, said that gyms, hair salons, arenas, some theaters and museums should all expect to be open fully without capacity limits. Broadway, he said, was on track to open in September.

At a news conference later, the mayor added that he wanted the subways, which currently shut down for two hours overnight for cleaning and disinfecting, to run around the clock once more by July.

“We now have the confidence we can pull all these pieces together, and get life back together,” he said. “This is going to be the summer of New York City.”

Most of the restrictions placed on New York City during the pandemic have been set by Gov. Andrew M. Cuomo and the state, and Mr. de Blasio has not had the authority to lift them.

The city and the state have not always agreed on the best path forward, and Mr. de Blasio said Thursday that he had not spoken to Mr. Cuomo about his reopening plan.

Mr. Cuomo emphasized during his own news conference that the state was in charge of managing the reopening and said that he was generally “reluctant to make projections” on a date, saying that doing so would be “irresponsible.”

Still, the governor, who has eased restrictions in recent weeks, said that he was also hopeful that a wider reopening was within sight, possibly sooner than the mayor’s goal. “I think that if we do what we have to do, we can be reopened earlier,” Mr. Cuomo said.

Mr. de Blasio has said that the city expects vaccinations to drive down new coronavirus cases over the next two months. From a second-wave peak of nearly 8,000 cases in a single day in January, New York City was averaging about 2,000 virus cases per day as of last week. Public health officials say that by July, if the city stays on its current trajectory, that number could drop to below 600 cases a day, perhaps lower.

“We laid out a plan, we will back it up with skyrocketing vaccination numbers and declining cases. If someone wants to deny that, let’s have that discussion in public,” said Bill Neidhardt, a spokesman for the mayor. “We feel strongly we’d win that debate.”

The state had already announced several changes this week. The State Legislature on Wednesday suspended an unpopular directive from Mr. Cuomo that required customers to order food when purchasing alcohol at bars and restaurants. And Mr. Cuomo said that a curfew that forced bars and restaurants to close early would end statewide on May 17 for outdoor dining areas and May 31 for indoor dining.

Amazon has run its warehouses closer to full capacity, and delivery drivers have made more stops on their routes, during the pandemic.
Credit…Brendan Mcdermid/Reuters

With the pandemic shifting sales online and consumers flush with stimulus checks, Amazon on Thursday reported $108.5 billion in sales in the first three months of the year, up 44 percent from a year earlier. It also posted $8.1 billion in profit, an increase of 220 percent from the same period last year.

The first-quarter results surpassed Wall Street’s expectations. Shares were up as much as 5 percent in aftermarket trading.

The most profitable parts of Amazon’s retail business boomed. Revenue from merchants listing items on its website and using its warehouses was up 64 percent, to $23.7 billion. Its “other” business segment, which is largely its lucrative advertising business, increased 77 percent, to almost $7 billion.

Amazon previously disclosed that 200 million people pay for Prime memberships, and subscription revenue for that service and others reached almost $7.6 billion in the quarter. In addition to paying Amazon $119 a year or $12.99 a month for free shipping and other perks, households with Prime memberships typically spend $3,000 a year on Amazon, more than twice what households without the membership spend, according to Morgan Stanley.

The high volume of orders during the pandemic has let Amazon operate more efficiently. It has run its warehouses closer to full capacity, and delivery drivers have made more stops on their routes, with less time driving between customers. The number of items Amazon sold grew 44 percent, but the cost to fulfill those orders was up only 31 percent.

The pandemic’s shift to remote computing was also a boon to Amazon’s profitable cloud computing business, Amazon Web Services, which had $13.5 billion in sales.

“We certainly had strong volumes really across all of our businesses,” Amazon’s finance chief, Brian Olsavsky, said on a call with reporters. He said the company is investing heavily in future growth. It spent almost $50 billion in capital expenditures in the last 12 months, largely on building out its logistics operations and data centers, up 80 percent over a year earlier. Mr. Olsavsky said he expected “another strong year” for capital spending.

“In just 15 years, AWS has become a $54 billion annual sales run rate business competing against the world’s largest technology companies, and its growth is accelerating,” Jeff Bezos, Amazon’s founder and chief executive, said in a statement. Mr. Bezos plans to step down as chief executive later this year and transition into the role of executive chairman.

Amazon’s total work force dipped slightly between December and the end of March, falling by 27,000 to 1,271,000 employees globally. That was still 51 percent more workers than the same period last year. On Wednesday, Amazon announced it would increase pay for half a million workers and was hiring “tens of thousands” more.

Global Roundup

Central Paris earlier this month. President Emmanuel Macron of France began mapping the nation’s exit from a web of lockdown restrictions.
Credit…Dmitry Kostyukov for The New York Times

President Emmanuel Macron of France outlined plans on Thursday for the gradual reopening of the country, plotting a path out of the labyrinth of restrictions in place and fueling hope that life might finally return to normal after waves of infections forced the country into three national lockdowns.

Mr. Macron said schools would reopen next week, followed by the return of museums, cinemas, shops and outdoor service at cafes on May 19. The 7 p.m. curfew will be pushed back to 9 p.m., he told French newspapers.

“We must recover our French art of living, while remaining prudent and responsible: our conviviality, our culture, sports,” Mr. Macron said, though he added that the reopening in some regions might be delayed if cases rise.

Cafes and restaurants will be allowed to serve patrons inside starting the second week of June, and gyms will also reopen then under certain conditions such as limited number of people. The nighttime curfew and most restrictions on gatherings will be lifted on June 30.

Mr. Macron’s announcement came as the coronavirus situation appears to be improving in France, with the average number of new daily cases falling to 27,000 from 35,000 over the past two weeks and as the vaccination campaign is finally gathering speed after months of hurdles.

The decision to gradually reopen was also a way to respond to the deep sense of fatigue and frustration that has taken root in France over an endless cycle of coronavirus restrictions enshrouding cities like Paris in deep gloom, as cafes, restaurants and cultural venues — the very heart of the capital — have been closed since the fall.

Europe has experienced a significant downturn in coronavirus cases after two months of surging infections, and other governments are rolling back restrictions. Britain, which has led the region’s vaccine rollout, has allowed pubs, bars and restaurants to reopen outdoors and is progressively lifting limits on the size of social gatherings. Switzerland adopted similar measures in mid-April and Italy started easing some rules this week.

The World Health Organization’s chief European official on Thursday cautioned, however, that infection rates across the region remained high. The official, Hans Kluge, said that public health controls and individual measures like mask-wearing would determine if cases would continue to fall. Half of all of Europe’s reported cases have occurred since January, Dr. Kluge said, as the continent has struggled against the rapid spread of B.1.1.7, the more infectious virus variant first identified in Britain.

“The virus still carries the potential to inflict devastating effects,” Dr. Kluge said. “It’s very important to realize the situation in India can happen anywhere.”

B.1.617, the variant now common in India, has been found in 10 countries in Europe, according to Ihor Perehinets, a senior official in the W.H.O. Europe emergency program. There was no evidence that Covid-19 vaccines were not effective against this variant, Oleg Benes, a W.H.O. Europe vaccine specialist, told reporters.

In other news around the world:

  • Hong Kong eased restrictions on Thursday at restaurants and bars where staff and customers have begun receiving vaccinations. Establishments that were ordered closed for much of the past year — including bars, nightclubs and karaoke parlors — will be allowed to reopen and can stay open until 2 a.m., if staff members and customers have had at least one shot of a vaccine. Hong Kong has kept coronavirus outbreaks largely under control, recording just 209 deaths in a population of 7.5 million, but its vaccination effort has languished.

  • Nepal imposed a two-week lockdown in the capital, Kathmandu, and several other cities amid a rise in virus cases nationwide, including among climbers at Mount Everest Base Camp. The authorities barred nearly all vehicles from the roads and ordered people to stay indoors except for emergencies. Hospitals are filling up in the small Himalayan nation as large numbers of migrant workers who have not been tested for the virus return home from India, the country currently suffering the world’s worst outbreak. Nepal reported 4,928 new daily cases on Thursday, the most since last October, after recording fewer than 100 for most of March.

  • At first, the vaccine itself was the prize for older people in Russia. But as vaccination rates have slowed in Moscow, the city government this week began a program to encourage turnout with gift certificates. Residents of the capital over 60 years old will now receive a certificate for 1,000 rubles, or about $13, redeemable at stores or restaurants. The Russian government has blamed widespread vaccine hesitancy for a slow start to its vaccination campaign. A shortage of vaccine has also slowed the rollout, as Russia is exporting doses of the vaccine it produces. About 5 percent of Russians are now fully vaccinated compared with 29 percent in the United States.

  • Pfizer and its German partner BioNTech are expected to apply for European Union approval of their vaccine for 12- to 15-year-olds. They made a similar application to the F.D.A. in the United States earlier this month. Ugur Sahin, the head of BioNTech, expects some children in Europe to be vaccinated as early as June, according to a report by Der Spiegel, and the company aims for E.U.-wide approval for children younger than 12 by September. As of Thursday, 25 percent of Germans had received at least one dose of a vaccine.

Ohio Wesleyan University is among the colleges requiring students to be fully vaccinated in order to attend in-person classes.
Credit…Andrew Spear for The New York Times

More than 100 colleges across the United States have said they will require students to receive coronavirus vaccines in order to attend in-person classes in the fall, according to a New York Times survey.

Those requirements come as coronavirus cases have continued to climb steadily this spring at U.S. colleges and universities. More than 660,000 cases have been linked to the institutions since the start of the pandemic, with one-third of those since Jan. 1.

Major outbreaks continue on some campuses, even as students have become eligible for vaccines. Salve Regina University in Rhode Island canceled all in-person events for at least a week after more than 30 students tested positive in seven days. Wayne State University in Detroit, a city that has been one of the worst U.S. coronavirus hot spots, suspended in-person classes and on-campus activities in early April.

Schools including DePaul University, Emory University and Wesleyan University are requiring all students to be vaccinated. Others have said they are requiring athletes or those who live on campus to get a shot. Most are allowing medical, religious and other exemptions.

Although private colleges make up the bulk of the schools with vaccine mandates, some public universities have also moved to require the shots.

Students and employees of the University System of Maryland will be required to get vaccinated before returning to campus in the fall, said the chancellor, Jay A. Perman. He said he was particularly concerned about the B.1.1.7 variant, which he described in his announcement last week as more contagious.

“That’s what we’re preparing for,” he said, “more infectious, more harmful variants that we think could be circulating on our campuses come fall.”

At least two dozen colleges have said that they will not require shots while the vaccines have only emergency authorization. California’s public university systems announced that they would require shots after the U.S. Food and Drug Administration grants full approval for the vaccines.

On Thursday, the American College Health Association, a trade group representing college health professionals, urged colleges and universities to adopt vaccination requirements for all on-campus students for the upcoming fall semester, if state laws would allow. The group pointed out that many students and employees are at high risk for severe illness and complications from the coronavirus, and said that college reopenings in the fall had been associated with spread in surrounding communities.

Some colleges with mandates may face challenges. At Manhattanville College in New York, where students will need to provide proof of their shots before returning to campus, one student started a petition to reverse the policy, saying that the decision to get vaccinated was deeply personal. At Stanford University, the College Republicans, a student group, condemned the administration’s plans to require vaccinations for the fall.

Numerous colleges that are not requiring vaccinations are offering incentives to encourage them. Baylor University in Texas and Calvin University in Michigan have both announced that students who have been inoculated can skip mandatory testing.

The University of Wyoming is offering vaccinated students and staff members a chance to participate in a weekly drawing for prizes such as tickets to football or basketball games and Apple products. Employees who are fully vaccinated are eligible for a personal day off.

Cierra S. Queen and

The Pakistani government has called out troops to help enforce Covid safety regulations. Soldiers watched a street in Peshawar from the back of a military vehicle.
Credit…Fayaz Aziz/Reuters

With Covid-19 deaths surging to records in Pakistan this week, the government has sent troops to the streets to help enforce coronavirus precautions, and is warning it may turn to a lockdown if the spread is not controlled.

Pakistan reported 201 deaths on Tuesday, the most in a single day so far, and has counted a total of 17,680 Covid deaths since the pandemic began. More than 5,200 patients are receiving critical care in the country’s hospitals. And there are fears that the virus could rampage through Pakistan the way it is doing in neighboring India if immediate steps are not taken to curb its spread. All travel to India has been banned.

Fawad Chaudhry, the minister for information, said on Thursday that the government will be forced to impose a strict nationwide lockdown if the situation continues to deteriorate.

“Right now, the national positivity rate is 11 percent,” he told reporters in Islamabad, referring to the share of virus tests that are coming back positive. “If it goes up to 14 or 15 percent, we will have no choice but to move toward a lockdown.”

Soldiers are now patrolling streets and markets in more than a dozen cities, telling people to keep wearing masks and making sure mandatory closing times and other safety protocols are followed. Only essential food items and medicines may be sold after 6 p.m.

The approach of the Eid al-Fitr holiday next month, when people typically do more shopping and socializing, has raised concerns.

The government has urged caution and simpler festivities this year. Travel between cities and between provinces will be banned from May 8 until May 16, and hotels, public parks and tourist facilities will be closed.

Vaccination efforts in Pakistan, with a population of more than 200 million, are progressing slowly. Health officials say 2 million vaccine doses have been administered so far, initially focused on people over 60 and health care workers. Eligibility will expand on Monday to include anyone over 40. By June, the country expects to have received 18.7 million doses, most of them to be distributed free by the government, though the private sector has been allowed to obtain some doses for sale to affluent patients.

Mariam Chaudhry, an Islamabad resident, is waiting her turn under the government program. She said she wanted to be vaccinated so she could move around and travel safely, but others were being prompted more by the recent dire news from across the border.

“People were reluctant to inject new vaccines with unknown side effects,” Ms. Chaudhry said. “But the situation in India has delivered a powerful wake-up call. With catastrophe at the doorsteps, rising numbers of people are now rushing to inoculate.”

Travelers wait to board buses at the Esenler Coach Terminal in Istanbul Thursday, hours before a new new national lockdown was due to take effect.
Credit…Ozan Kose/Agence France-Presse — Getty Images

The streets of Istanbul were abuzz, the grocery stores packed, the seaside promenades crowded — but it was not the bustle of an ordinary spring Thursday. People were flocking to take advantage of the last day before a new lockdown takes hold, the strictest in Turkey since the pandemic began.

Daily reports of new coronavirus cases rose swiftly in the country after the government started lifting earlier safety strictures in March, and are now generally around 40,000 a day, according to official figures, with some days reaching 60,000 or more. The health care system is swamped with patients, and the country set a grim record last week with 362 Covid deaths reported in a single day.

The country’s heath minister, Fahrettin Koca, has said that more contagious variants of the virus are partly to blame for the accelerating spread. Critics say the government relaxed too soon in March, before the country had made much progress with vaccination.

Turkey has fully vaccinated only about 11 percent of its people so far — 8.8 million out of a population of 83 million — using mainly the CoronaVac vaccine developed in China and the Pfizer-BioNtech vaccine. It has had a hard time securing more doses, and has resorted to postponing second doses to stretch its supply. But Mr. Koca said he expects 30 million more doses of the Pfizer vaccine in June, and to soon add the Sputnik V vaccine from Russia to its effort.

“Vaccine procurement will be difficult in the next two months,” Mr. Koca said in a video statement on Thursday. ‘’But then we expect to have abundance of vaccines.’’

For weeks, scientists have been calling for a total lockdown to stem the surge, but President Recep Tayyip Erdogan held off, mainly for economic reasons. He changed course after a cabinet meeting on Monday, and announced a new three-week lockdown to take effect Thursday evening and last through the end of Ramadan.

Many people will be required to stay home except for essential errands or to go to certain jobs. Schools, kindergartens and day care centers will be closed. Grocery stores will be open, but only for customers who live within walking distance. Even solitary outdoor exercise will be banned.

The announcement prompted a rush to stock up on groceries, alcohol and other supplies for the lockdown, which will include Eid al-Fitr, the three-day festival to mark the end of Ramadan. And many city dwellers hurried to reach rural hometowns or holiday resorts while travel was still allowed.

Though Mr. Erdogan billed the new restrictions as “a full lockdown,” an association of labor unions known as DISK estimated that 61 percent of all workers in Turkey are employed in sectors that are exempt from the lockdown, including manufacturing, construction, agriculture and transportation.

Gokhan Aydin, 45, who works in a cable factory in Bursa, said he and his coworkers “would have loved to be part of the full lockdown, without loss of income, as the virus peaked.” Though his factory has good Covid precautions, he said, he is still worried because the virus is everywhere.

The lockdown will land hardest on the many Turks who depend on informal day work. A single mother with five small children in Istanbul who collects and sells paper said her family can eat only on days when she can work.

“I really don’t know what to do,” she said, speaking on the condition of anonymity to avoid jeopardizing her welfare payments from the government. “I wish the state would give me a job.”

Increased supply-chain and freight costs for cereal makers could translate into higher retail prices for customers.
Credit…Sara Hylton for The New York Times

Before the pandemic, when suppliers raised the cost of diapers, cereal and other everyday goods, retailers often absorbed the increase because stiff competition forced them to keep prices stable.

Now, with Americans’ shopping habits having shifted rapidly — with people spending more on treadmills and office furniture and less at restaurants and movie theaters — retailers are also adjusting, Gillian Friedman reports for The New York Times.

The Consumer Price Index, the measure of the average change in the prices paid by U.S. shoppers for consumer goods, increased 0.6 percent in March, the largest rise since August 2012, according to the Bureau of Labor Statistics. Procter & Gamble is raising prices on items like Pampers and Tampax in September. General Mills, which makes cereal brands including Cheerios, is facing increased supply-chain and freight costs that could translate into higher retail prices for customers.

At the beginning of the pandemic, companies were focused on fulfilling demand for toilet paper, cleaning supplies, canned food and masks, said Greg Portell, a partner at Kearney, a consulting firm. The government was watching for price-gouging, and customers were wary of being taken advantage of.

Now that the economy is beginning to stabilize, companies are starting to rebalance pricing so that it better fits their profit expectations and takes into account inflation. “This isn’t an opportunistic profit-taking by companies,” Mr. Portell said. “This is a reset of the market.”

A nurse at the Chief Andrew Isaac Health Center in Fairbanks, Alaska.
Credit…Nathan Howard/Reuters

Dr. Angelique Ramirez, the chief medical officer of the main health care system in Fairbanks, Alaska, started the monthly coronavirus briefing in April by saying that she thought March’s meeting would be the last. But amid a new surge of cases in the state, one of the country’s worst surges, Dr. Ramirez was blunt about her past assessment.

“I was wrong,” she said.

With nearly 100,000 people, the Fairbanks metropolitan area is Alaska’s second largest and the largest in the state’s vast interior. According to a New York Times database, the number of new coronavirus cases in the borough of which Fairbanks is the seat, North Star, has risen by 253 percent over the past two weeks. The positivity rate has doubled since March, to about 10 percent from 5 percent, and hospitalizations at Fairbanks Memorial Hospital, the area’s only hospital, have hit a record number.

“This place is on fire with Covid,” Dr. Barb Creighton, an internist at Fairbanks Memorial Hospital, said at the meeting.

Experts are unsure what is driving the surge, though a low vaccination rate certainly plays a role. Thirty-six percent of Alaskans are fully vaccinated, and in some boroughs that number is over 50 percent, but in the Fairbanks area just 29 percent of the population has been fully vaccinated.

“There is no big outbreak or two big outbreaks that are really driving this,” said Dr. Joe McLaughlin, the state epidemiologist for Alaska. “We have cases and clusters being associated with a wide range of different settings.”

With two-thirds of the older population in Fairbanks having received at least one dose of a vaccine, those who have recently been hospitalized in Fairbanks are younger than the Covid patients during the winter, when there was a peak in case numbers. Dr. Creighton said people who were hospitalized in April tended to be in their 40s and 50s and were unvaccinated because they were waiting to see what side effects might come from receiving a Covid-19 vaccine.

“We are seeing them stay longer because they are not dying,” Dr. Creighton said. “We are giving them noninvasive ventilation and they are staying for two, three weeks and turning around, which I’ve never been more proud of.”

But while those older patients during the winter peak were largely grateful to be receiving care, those hospitalized now feel differently.

“Some of these folks are folks that are anti-vaxxers, anti-maskers, and they don’t believe they have Covid or are sick because of it, and our staff is getting pretty angry folks,” Shelley Ebenal, the chief executive of the health care system, Foundation Health Partners, said, imploring the system’s trustees to share their appreciation of the hospital staff with them.

She sounded a dire warning: “We are not out of Covid, and our staff in particular is not out of Covid. Our morale is really low.”

Vaccine skeptics are much more likely than nonskeptics to have a highly developed sensitivity for liberty and to have less deference to those in positions of power.
Credit…Allison Zaucha for The New York Times

For years, scientists and doctors have treated vaccine skepticism as a knowledge problem. If patients were hesitant to get vaccinated, the thinking went, they simply needed more information.

But as public health officials now work to convince Americans to get Covid-19 vaccines as quickly as possible, new social science research suggests that a set of deeply held beliefs is at the heart of many people’s resistance, complicating efforts to bring the coronavirus pandemic under control.

“The instinct from the medical community was, ‘If only we could educate them,’” said Dr. Saad Omer, director of the Yale Institute for Global Health, who studies vaccine skepticism. “It was patronizing and, as it turns out, not true.”

About a third of American adults are still resisting vaccines. Polling shows that Republicans make up a substantial part of that group. Given how deeply the country is divided by politics, it is perhaps not surprising that they have dug in, particularly with a Democrat in the White House. But political polarization is only part of the story.

In recent years, epidemiologists have teamed up with social psychologists to look more deeply into the “why” behind vaccine hesitancy. They wanted to find out whether there was anything that vaccine skeptics had in common, in order to better understand how to persuade them.

They borrowed a concept from social psychology — the idea that a small set of moral intuitions forms the foundations upon which complex moral worldviews are constructed — and applied it to their study of vaccine skepticism.

What they discovered was a clear set of psychological traits offering a new lens through which to understand skepticism — and potentially new tools for public health officials scrambling to try to persuade people to get vaccinated.

Dr. Omer and a team of scientists found that skeptics were much more likely than nonskeptics to have a highly developed sensitivity for liberty — the rights of individuals — and to have less deference to those in positions of power.

Larry Schwartz, one of Gov. Andrew M. Cuomo’s most trusted advisers, stepped down from his role as New York State’s vaccine czar.
Credit…John Lamparski/NurPhoto, via Getty Images

Larry Schwartz, one of Gov. Andrew M. Cuomo’s most trusted advisers, has unexpectedly stepped down from his role as New York State’s vaccine czar, about five months after he was recruited by the governor to take the post.

He submitted his resignation on Wednesday, just as the State Legislature restored provisions to the state public officers law that would have affected Mr. Schwartz, had he remained in the position.

Mr. Schwartz was not paid for his service in the post. But the changes to the law would have made him subject to rules requiring him to file financial disclosure forms, as well as a two-year lobbying ban after his service, according to two people familiar with the matter.

Mr. Cuomo waived those requirements at the beginning of the pandemic so that he could attract a broader pool of volunteers to assist at the highest levels of government.

Mr. Schwartz, who served as Mr. Cuomo’s top aide from 2011 to 2015 and is now the chief strategy officer at OTG, an airport concessions company, decided to step down to avoid the lobbying ban, the two people said. OTG operates in airports run by the Port Authority of New York and New Jersey, whose executive director is appointed by Mr. Cuomo.

A group of friends, some masked and some unmasked, play dominoes in the Little Havana neighborhood of Miami.
Credit…Scott McIntyre for The New York Times

After a year of isolation, wariness and pandemic precautions, people in the United States are emerging and starting to navigate travel, classrooms and restaurants, and often discovering that when it comes to returning to old ways, they feel out of sorts. Do they shake hands? Hug? With or without a mask?

It’s a confusion made worse by state and federal rules and social norms that seem to vary widely from place to place, all while the very real threat of infection remains.

Many states and cities are scrambling to incorporate the Centers for Disease Control and Prevention’s new guidance into their own rules, and some are trying to reconcile the clash of cues.

“We have reviewed and support the C.D.C.’s new masking recommendations and are working quickly to align California’s guidance with these common sense guidelines,” Dr. Tomás Aragón, the director of the California Department of Public Health, said in a statement.

Dr. Susan Huang, of the University of California, Irvine, Medical School, explained the conflicted psychology as a function of rapidly changing risk, and differences in risk tolerance from person to person. Most places now have a foundation of vaccinated people, she said, but are not near to achieving herd immunity — with no children inoculated.

“We’re between the darkness and the light,” Dr. Huang said. She compared the psychology of mask-wearing, and when to stop doing it, with the way people approach changing their wardrobes each spring: The more risk-averse continue to wear winter clothes on 50-degree days, she said, while bigger-risk takers move quickly to summer outfit.

“Eventually,” she said, “everyone will be wearing shorts.”

Dr. Rachel Herlihy, state epidemiologist with the Colorado Department of Public Health and Environment, at a news conference last week in Denver.
Credit…David Zalubowski/Associated Press

Coronavirus cases in Colorado are rapidly increasing among middle and high school students, state public health officials said this week, four months after schools began to reopen.

“Their rate is much higher on average for what we’re seeing for adults in the state, and that increase we’re seeing is pretty steep at this point,” Dr. Rachel Herlihy, the state’s top infectious disease expert, said Tuesday.

There is also an increase in younger children, between 3 and 10 years old, though it is “not as dramatic,” she said.

All told, there have been more than 2,300 reported cases among children in Colorado, up from 861 in December, according to the Denver Post. State data show that people under the age of 19 made up 26 percent of all cases in Colorado last week. People between 20 and 29 accounted for 40 percent.

Other states are also seeing sharp increases in infections among young people. For instance, in West Virginia, the proportion of cases among people under 20 has gone from 16 to 26 percent. Over all, according to the American Academy of Pediatrics and the Children’s Hospital Association, cases among those under 20 have averaged 13.7 percent over the pandemic, but 20.9 percent for the week ending April 22.

The rise among that group reflects the current age restriction for vaccinations: 18 for the Moderna and Johnson & Johnson vaccines, and 16 for the Pfizer-BioNTech vaccine. And even when schools themselves keep mask-wearing, distancing and other precautions in place, there are extracurricular activities when the measures are abandoned.

According to the Centers for Disease Control and Prevention, variants that are more transmissible among all age groups are spreading in Colorado, as they are in many states, including B.1.1.7, the more lethal variant first found in Britain.

Colorado’s governor, Jared Polis, a Democrat, has said that “schools are a relatively safe place,” and partly attributed the outbreaks to vaccinated parents and grandparents taking children with them to restaurants and social gatherings.

“While their elders may be protected, the young people don’t have that level of protection,” he said on Tuesday, adding that he hoped vaccines would be approved for 12- to 15-year-olds in the coming months. He urged everyone 16 and older to get vaccinated.

C.D.C. numbers show that 46 percent of the state’s population has had at least one shot of a Covid vaccine, with 31 percent fully vaccinated.

Dr. Herlihy said the state’s overall case numbers began ticking up this week. The average for the past week is 1,772 new cases per day, up about 7 percent from the average two weeks ago, according to a New York Times database. In mid-March, the state was averaging 888 cases a day. Hospitalizations are also up 33 percent over the last two weeks, largely attributed to an increase in cases among young adults.

Despite what Colorado officials are calling a fourth wave, superintendents are hoping to make an already disruptive school year less so. Twelve district leaders asked the state health department to ease quarantine requirements for students who have potentially been exposed to the virus.

At a news conference on Thursday, Dr. Herlihy said the state was exploring options to try to “decrease the burden of quarantine” while balancing public safety measures.

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