Covid Live Updates: C.D.C. Says Childhood Vaccinations Plummeted Since the Virus Struck

The F.D.A. says the shelf life of Johnson & Johnson doses can be extended by six weeks, giving states extra time to figure out how to use up excess supply of the single-dose vaccine as demand sags.

LiveUpdated June 10, 2021, 9:16 p.m. ETJune 10, 2021, 9:16 p.m. ET

The F.D.A. says the shelf life of Johnson & Johnson doses can be extended by six weeks, giving states extra time to figure out how to use up excess supply of the single-dose vaccine as demand sags.

Here’s what you need to know:

The C.D.C. urges parents to get childhood vaccinations up to date following a steep decline last year.

The F.D.A. extends the shelf life of J.&J.’s vaccine by six weeks, giving states more time to use expiring supply.

Addressing the global vaccine shortage, Biden cites ‘our humanitarian obligation, to save as many lives as we can.’

Without a big boost soon, many African nations may not meet a W.H.O. vaccination goal, the agency says.

Widespread vaccination of adults helps protect unvaccinated children, according to a new Israeli study.

Moderna applies for U.S. authorization of its vaccine for use in adolescents.

In the latest sign of N.Y.C.’s reopening, Macy’s July 4 fireworks are returning to large-scale brilliance.

India’s death toll spikes after one state’s audit showed a huge undercount, and other international news.

Boston Medical Center’s pediatric ambulatory department began sending mobile vaccination units into city neighborhoods last April.Credit…David Degner for The New York Times

Pediatricians are urging U.S. parents to get their children caught up on routine vaccinations, following a decline in the number of inoculations for diseases like measles as the pandemic forced restrictions, including shelter-at-home orders, last year.

New data from 10 jurisdictions that closely monitor immunizations confirm that the number of administered vaccine doses plunged between March and May of last year, especially among older children, the Centers for Disease Control and Prevention reported on Thursday.

Though vaccinations rebounded between June 2020 and September 2020, approaching pre-pandemic levels, the increase was not enough to make up for the earlier drop, the study found.

Vaccinations are required for attendance at most schools, camps and day care centers, but the authors of the C.D.C. study warned that the lag nonetheless “might pose a serious public health threat that would result in vaccine-preventable disease outbreaks.”

They expressed concern that the transition to remote learning during the pandemic may have hobbled enforcement of vaccination requirements, noting that even temporary declines in immunization can compromise herd immunity.

In 2018-2019, a measles outbreak occurred in Rockland County, N.Y., and nearby counties after measles vaccination coverage in area schools dropped to 77 percent, below the 93 percent to 95 percent figure needed to sustain herd immunity. “Pediatric outbreaks of vaccine-preventable diseases have the potential to derail efforts to reopen schools” in the fall, the researchers added.

Parents should plan ahead and schedule appointments now so that their children can be protected, said Dr. Yvonne Maldonado, who chairs the committee on infectious diseases at the American Academy of Pediatrics.

“We should start thinking about it,” Dr. Maldonado said in a phone interview. “People forget. We have regular pertussis outbreaks every four or five years, and are just waiting to see another one.”

“We’re probably going to start seeing more infections, because kids are going to get back together and there’s going to be less masking and social distancing,” she added.

The C.D.C. analyzed data from nine states and New York City. In eight of the jurisdictions, some form of stay-at-home order was issued last spring.

The number of administered doses of diphtheria, tetanus and pertussis vaccines (DTaP) dropped 15.7 percent among children under age 2, and 60 percent among those aged 2 to 6 in the spring of last year, compared with the same period in 2018 and 2019.

Doses of measles, mumps and rubella vaccine (MMR) declined by 22.4 percent among 1-year-olds, and 63 percent among those aged 2 to 8.

HPV vaccine administration declined by more than 63 percent among youngsters aged 9 to 17, compared with the same period in 2018 and 2019; and doses of Tdap (tetanus, diphtheria and pertussis) decreased by over 60 percent.

Waiting in line to receive the Johnson & Johnson Covid-19 vaccine in the Miami area last month.Credit…Wilfredo Lee/Associated Press

The Food and Drug Administration on Thursday authorized an extension of the expiration date of Johnson & Johnson’s coronavirus vaccine, the company said in a statement, expanding the shelf life by six weeks shortly before millions of doses were set to possibly go to waste.

“The decision is based on data from ongoing stability assessment studies, which have demonstrated that the vaccine is stable at 4.5 months when refrigerated at temperatures of 36 – 46 degrees Fahrenheit,” Johnson & Johnson said in a statement.

The move gives states extra time to figure out how to use up supply of the single-dose vaccine, even as local officials have struggled to use up stockpiles of the shot, which has lately faced sagging demand. Since it was authorized by the F.D.A. in late February, it has been a critical resource in reaching more isolated communities and people who prefer to receive just one shot.

But the vaccine took a major hit in April when the F.D.A. and C.D.C. recommended a pause in its use after a rare blood clotting disorder occurred in recipients of the vaccine. State officials have said that decision significantly curtailed interest in the vaccine, and roughly ten million doses delivered to states remain unused, according to data collected by the Centers for Disease Control and Prevention. The pace of vaccinations has fallen in recent weeks for all three federally authorized shots, and the Biden administration has shifted its strategy from relying on mass vaccination sites to highlighting more targeted approaches, some with incentives.

Dr. Marcus Plescia, who represents state health agencies as the chief medical officer for the Association of State and Territorial Health Officials, said last week that he believed every state was facing looming expiration dates on the vaccine, prompting local officials to search for ways to exhaust even their limited supply of it.

Gov. Mike DeWine of Ohio on Monday pleaded with health providers in his state to use about 200,000 doses of the vaccine that he said were set to expire on June 23. The state’s health department directed providers to adopt a “first-in, first-out” process for the shot to ensure doses with earlier expiration dates were used first.

Officials across the South, where vaccination rates have lagged, have also been searching for ways to use up tens of thousands of doses in their possession. In Arkansas, officials are hoping to use as much as they can at weekend pop-up clinics, including on Juneteenth, said Dr. Jose R. Romero, the Arkansas health secretary.

Dr. Clay Marsh, West Virginia’s coronavirus czar, said on Thursday that the state had ample supply of the three vaccines, giving residents plenty of choice among the shots from Pfizer-BioNTech, Moderna and Johnson & Johnson. But he said the extension could breath some life into his state’s efforts to continue reaching vulnerable people: those with disabilities, those who are homebound or homeless and those with some kind of social instability.

He added that the shot still appealed to people wary of two doses of a vaccine, and that West Virginia was looking to offer Johnson & Johnson’s vaccine at summer fairs and festivals and in parks. Around 25,000 doses there had been due to expire this month, he said.

“The J. & J. vaccine in those settings is, I think, highly preferable,” he said.

Dr. Marsh said he was still wary of having excess doses, even with an extended shelf life, and that the state was talking to the federal government about how to possibly give them away in time.







Biden Pledges Vaccine Aid to Tackle Global Coronavirus Crisis

President Biden announced on Thursday that the United States would donate doses of the Pfizer-BioNTech vaccine to 100 countries over the next year in an effort to address the global coronavirus vaccine shortage.

I’m making an historic announcement regarding America’s leadership in the fight against Covid-19. America knows firsthand the tragedies of this pandemic, we’ve had, we’ve had more people die in the United States than anywhere in the world. Nearly 600,000 of our fellow Americans, moms, dads, sons, daughters, brothers, sisters, grandparents. We know the tragedy. We also know the path to recovery. The United States has now vaccinated 64 percent of our adults with at least one shot. Just 4 and a half months ago, we were only 5 percent with one shot. At my direction, the United States will purchase an additional half billion doses from Pfizer — the Pfizer vaccine — we’ll donate nearly 100 low- and lower-middle income countries. They will be the beneficiaries. Let me say that again. The United States will purchase a half a billion doses of Pfizer Covid-19 vaccine to donate to nearly 100 nations that are in dire need in the fight against this pandemic.

President Biden announced on Thursday that the United States would donate doses of the Pfizer-BioNTech vaccine to 100 countries over the next year in an effort to address the global coronavirus vaccine shortage.CreditCredit…Doug Mills/The New York Times

President Biden, under pressure to address the global coronavirus vaccine shortage, announced on Thursday that the United States will buy 500 million doses of vaccine and donate them for use by about 100 low- and middle-income countries over the next year.

“This is about our responsibility, our humanitarian obligation, to save as many lives as we can,” Mr. Biden said in a speech in England, ahead of the meeting of the Group of 7 wealthy democracies. “When we see people hurting and suffering anywhere around the world, we seek to help any way we can.”

In recent months, wealthy nations with robust vaccination campaigns have quickly moved toward inoculating large swaths of their population, but much of the world, particularly Africa, lags far behind, raising fears of more deadly waves that could overwhelm fragile health care systems and spawn new virus variants.

Now, as the leaders of the G7 prepare to meet in England starting on Friday, they are pledging to help close that gap. Mr. Biden said the G7 would announce a broader global strategy for containing the pandemic.

“America knows firsthand the tragedies of this pandemic,” he added, having suffered more than 600,000 deaths — “more deaths from Covid-19 in the United States than from World War I, World War II, the Vietnam War and 9/11, combined.”

The donation of 500 million Pfizer-BioNTech doses is by far the largest yet by a single country, but it would fully inoculate only about 3 percent of the world’s population. The United States will pay $3.5 billion for the Pfizer-BioNTech shots, about $7 apiece, which Pfizer described as a “not for profit” price — much less than the $20 it has paid for domestic use.

“The United States is providing these half billion doses with no strings attached,” Mr. Biden said. “We’re doing this to save lives, to end this pandemic. That’s it. Period.”

The first 200 million doses will be distributed by the end of this year, followed by 300 million by next June, Mr. Biden and Pfizer said. The doses will be distributed through Covax, the international vaccine-sharing initiative, which has lagged behind the hoped-for pace of distributing doses.

In a statement released on Thursday, Prime Minister Boris Johnson, who is playing host to the summit as Britain takes up the G7 presidency this year, said it was crucial to use the moment for unified action against the pandemic.

“The world needs this meeting,” he said. “We must be honest: International order and solidarity were badly shaken by Covid. Nations were reduced to beggar-my-neighbor tactics in the desperate search for P.P.E., for drugs — and, finally, for vaccines,” he added, referring to personal protective equipment.

He said now was the time to “put those days behind us.”

“This is the moment for the world’s greatest and most technologically advanced democracies to shoulder their responsibilities and to vaccinate the world, because no one can be properly protected until everyone has been protected,” he added.

“We have to end Covid-19, not just at home, which we’re doing, but everywhere,” Mr. Biden told United States troops at R.A.F. Mildenhall in Suffolk, England, on Wednesday evening. “There’s no wall high enough to keep us safe from this pandemic or the next biological threat we face, and there will be others. It requires coordinated multilateral action.”

Correction: June 10, 2021

An earlier version of this article misstated the amount of money President Biden committed to supply 500 million doses of coronavirus vaccine to other countries. It is $3.5 billion, not $1.5 billion.

Health care workers waiting to receive the Johnson & Johnson Covid vaccine in Johannesburg in March.Credit…Themba Hadebe/Associated Press

Only seven African nations, most of them small, are expected to meet the World Health Organization’s goal that each country across the world be able to vaccinate 10 percent of its people against the coronavirus by September. It is a dire prospect for a continent where vaccine supplies are being quickly depleted, and governments are battling a resurgence in infections.

The global health body said Thursday that inoculation coverage remained at about 2 percent continentwide — and about 1 percent in sub-Saharan Africa — even as some rich nations across the world administered shots to a majority of their people. To achieve the 10 percent target for each country on the continent, Africa would need an extra 225 million doses, said Dr. Matshidiso Moeti, the W.H.O. regional director for Africa. In total, nine out of 10 African nations will miss out on this global vaccination goal, the agency estimated.

The seven countries are Seychelles, Morocco, Mauritius, Equatorial Guinea, Comoros, Sao Tome and Principe, and Zimbabwe. An additional six countries — Tunisia; Ghana; Eswatini, formerly known as Swaziland; Lesotho; Rwanda; and Kenya — could reach the target if they receive enough supply to keep up with their current pace of vaccination, the W.H.O. said.

“This will really require a massive effort,” Dr. Moeti admitted, saying that “without a significant boost” in the availability of vaccines, “many African lives are at stake.”

The announcement came as Africa is set to surpass five million virus cases, with Covid having claimed 133,000 lives so far. While testing is often limited in the countries on the continent, known cases have also increased, with 94,145 new ones reported in the past week — a 26 percent increase from the previous week — according to the Africa Centers for Disease Control and Prevention.

Countries including Egypt, South Africa, Tunisia and Zambia have reported a surge in cases, while some, like Uganda, reintroduced lockdowns to stem the spread of the virus. The Africa C.D.C. also said deaths on the continent increased by 2 percent over the past week, and many more countries have reported detecting the variants first reported in South Africa, Britain and India.

And just as cases and deaths rise, many African nations have reported exhausting most of the vaccines they received through Covax, a global vaccine initiative. The W.HO. said that 14 African nations have utilized between 80 percent and 100 percent of their doses.

Still, only 35.9 million Covid vaccine doses have been administered in the continent, according to the Africa C.D.C., with the majority given in a few countries, including Morocco, Egypt, Nigeria, Ethiopia and South Africa, and in the Western Sahara region. Tanzania, Eritrea and Burundi have yet to give a single shot while Togo and Chad only started administering jabs last week.

While some countries faced shortages, others were not rolling out campaigns quickly. Twenty nations have used less than half of their doses, the W.H.O. estimated, while 12 nations have more than 10 percent of their doses facing expiration.

But on Thursday, both the W.H.O. and the Africa C.D.C. welcomed President Biden’s decision to donate 500 million Pfizer-BioNTech vaccines to poorer nations, including those in the African Union. Countries like France and corporations like Mastercard have also promised to finance, deliver or help produce Covid vaccines in the continent.

“It’s a monumental step forward,” Dr. Moeti said of the U.S. effort, which Mr. Biden announced in Europe on Thursday. “We are now seeing wealthy nations begin to turn promises into action. The hope of a shared future without Covid-19 is starting to shine a little bit more brightly.”

The vaccines are set to start shipping in August, with 200 million doses set for delivery by the end of this year, while the other 300 million will be delivered early next year, according to a White House fact sheet.

Dr. John Nkengasong, the director of the Africa C.D.C., welcomed the decision but said he did not know when or how many vaccines Africa would receive. But he urged member states to prepare storage facilities for the Pfizer vaccine and prioritize big cities once those doses arrive. He gave the example of Rwanda, which he said had received over 102,000 doses of Pfizer and quickly rolled it out.

“We have to use a combination of vaccines to win this battle against Covid-19,” Mr. Nkengasong said in a news conference on Thursday. “We are at war and you go to war with what you have, not what you need.”

Plexiglass panels separated an area for courthouse employees from the seating area for potential jurors at a federal courthouse in Manhattan, in March.Credit…Mary Altaffer/Associated Press

The Biden administration lifted restrictions on the number of federal employees permitted to work from the office while maintaining a flexible telework policy that was expanded during the pandemic, according to guidance issued on Thursday.

The memo from the Office of Management and Budget reversed a policy issued in January that imposed a 25 percent cap on the number of employees that could work in the office. The new guidance comes as the nation works toward President Biden’s goal of having 70 percent of the country vaccinated by July 4 and reopening offices, schools and businesses throughout the United States.

The policy issued on Thursday followed up on an announcement the day before directing agencies to not require workers to get vaccinated in order to return to the office. “Agencies may establish occupancy limits for specific workplaces as a means of ensuring physical distancing between unvaccinated individuals,” according to the guidance issued Thursday.

The loosening of the restrictions “will facilitate planning for an increased return of Federal employees to physical workplaces, and it clearly reinforces that the safety of the Federal workforce remains a top priority,” according to a statement from Jason Miller, deputy director for management for the Office of Management and Budget.

But there will not be an immediate surge back to federal offices. The heads of agencies will need to complete a phased plan for the return of employees by July 19 while fulfilling obligations to respective labor unions, some of which have pressed for clean work environments and flexible schedules for employees. When each department does fully re-open, it will continue to allow employees “maximum telework flexibilities,” according to the directive issued Thursday.

Republicans have recently pressed Mr. Biden to lift the restrictions. Rep. Jody Hice of Georgia, ranking member of the subcommittee on government operations, wrote a letter to the Office of Management and Budget claiming the lack of “face-to-face services during the pandemic has had real, negative impacts on veterans, Social Security beneficiaries, and others who need prompt, attentive service from public servants at federal agencies.”

Pedestrians in the coastal city of Netanya, Israel.Credit…Jack Guez/Agence France-Presse — Getty Images

New data from Israel, which had the fastest Covid-19 vaccine rollout in the world, provides real-world evidence that widespread vaccination against the coronavirus can also protect people who are unvaccinated.

The Israeli study, which was published in the journal Nature Medicine on Thursday, took advantage of the fact that until recently Israel was only vaccinating people 16 or older. For every 20 percentage point increase in the share of 16- to 50-year-olds who were vaccinated in a community, the researchers found, the share of unvaccinated under 16s who tested positive for the virus fell by half.

“Vaccination provides benefits not only to the individual vaccine but also to people around them,” said Roy Kishony, a biologist, physicist and data scientist who studies microbial evolution and disease at Technion-Israel Institute of Technology. Dr. Kishony led the research with Dr. Tal Patalon, who heads KSM, the Maccabi Research and Innovation Center, in Israel. The first authors of the paper are Oren Milman and Idan Yelin, researchers in Dr. Kishony’s lab.

Israel began vaccinating adults in December of last year. Within nine weeks, it had vaccinated nearly half of its population.

The researchers examined the anonymized electronic health records of members of Maccabi Healthcare Services, an Israeli H.M.O. They analyzed vaccination records and virus test results between December 6, 2020, and March 9, 2021. The records came from 177 different geographic areas, which had varying rates of vaccination and vaccine uptake.

For each community, they calculated the share of adults, between the ages of 16 and 50, who were vaccinated at various time points. They also calculated the fraction of P.C.R. tests of children under 16 that came back positive.

They found a clear correlation: As more and more adults in a community got vaccinated, the share of children testing positive for the virus subsequently fell.

People who are vaccinated are significantly less likely to become infected with the virus. Research also suggests that even when vaccinated people do contract the virus, they may have lower viral loads, reducing their infectiousness. As a result, as more and more people get vaccinated, unvaccinated people become less likely to encounter infected, contagious people.

“The results are consistent with vaccinees not only not getting sick themselves, but also not transmitting the virus to others,” Dr. Kishony said. “Such effects can be amplified over multiple cycles of infections.”

In another recent paper, which has not yet been published in a scientific journal, researchers in Finland reported that after health care workers got vaccinated, unvaccinated members of their households were also less likely to contract the virus.

— Emily Anthes

A health worker preparing a dose of Moderna’s Covid vaccine at a medical center near Paris in March. Credit…Dmitry Kostyukov for The New York Times

Moderna requested an emergency authorization on Thursday from the Food and Drug Administration for use of its coronavirus vaccine in 12- to 17-year-olds. If authorized, as expected, the vaccine would offer a second option for protecting adolescents from the coronavirus, and hasten a return to normalcy for middle- and high-school students.

The company has already filed for authorization with Health Canada and the European Medicines Agency, and plans to seek approval in other countries, the chief executive Stephane Bancel said in a statement. Authorization by the F.D.A. typically takes three to four weeks.

Last month, the F.D.A. expanded emergency use authorization for the vaccine made by Pfizer and BioNTech for use in children ages 12 to 15 years. That vaccine was already available to anyone older than 16. About 7 million children under 18 have received at least one dose of the vaccine so far, and about 3.5 million are fully protected.

Moderna’s vaccine was authorized for use in adults in December. Its application to the F.D.A. for young teens is based on study results reported last month. That clinical trial enrolled 3,732 children ages 12 to 17 years, with 2,500 receiving two doses of the vaccine and the remaining a saltwater placebo.

The trial found no cases of symptomatic Covid-19 among fully vaccinated teens, which translates to an efficacy of 100 percent, the same figure that Pfizer and BioNTech reported for that age group. The trial also found that a single dose of the Moderna vaccine has an efficacy of 93 percent. Participants did not experience serious side effects beyond those seen in adults: pain at the site of the injection, headache, fatigue, muscle pain and chills.

An independent safety monitoring committee will follow all participants for 12 months after their second injection to assess long-term protection and safety.

Macy’s annual fireworks display in 2019. The show is returning this year to its pre-pandemic levels of pyrotechnics for this July 4. Credit…Brittainy Newman/The New York Times

Macy’s annual fireworks display will return to its usual grand scale over the East River this July 4, the latest sign of normalcy returning to New York City.

Mayor Bill de Blasio announced the milestone on Thursday, noting that “this is part of the summer of New York City, the rebirth of New York City.”

He continued, “Why is it possible? Because you got vaccinated.”

The mayor’s announcement comes days after Gov. Andrew M. Cuomo said that the state would lift most of its remaining pandemic restrictions when 70 percent of the state’s adult population was at least partially vaccinated.

“When we hit 70 percent we will be back to life as normal,” Mr. Cuomo said on Monday. “Or as normalized as you can be post-Covid.”

That goal is not far-off — 69 percent of New York residents aged 18 and over have received at least one shot, according to a New York Times database, though with some areas lagging, Mr. de Blasio said this week that his own hope to vaccinate five million New Yorkers by the end of June appeared out of reach.

The Macy’s fireworks display, an annual tradition since 1976, was significantly altered last summer to prevent spectators from gathering in large groups and potentially spreading the virus. Macy’s produced seven shorter displays over several days that were launched from different parts of the city: the East River, Coney Island, the Hudson River, the Statue of Liberty, One Times Square, Borough Hall in the Bronx, and a finale on July 4 from atop the Empire State Building.

This year, Mr. de Blasio said at a news conference, “They are bringing the full-scale fireworks show, as we have loved it for decades and decades, back to New York City for all of us to enjoy.”

The mayor said that there would be dedicated viewing areas maintained by the New York Police Department separating people who had been vaccinated and those who had not. The average numbers of daily reported cases, hospitalizations and deaths in the city have been declining sharply for months, according to city data.

A Macy’s news release said that the 25-minute-long display will start at around 9:25 p.m. and use more than 65,000-shells launched from five barges. It will be set to music, including patriotic songs like “The Star-Spangled Banner” and “America the Beautiful” and the singer Tori Kelly’s rendition of “You’ll Never Walk Alone,” from the Rodgers and Hammerstein musical “Carousel.”

The release described the fireworks as “eclipsing fans, triple linking rainbows, blue jellyfish with crackling tentacles and red, white and blue waterfalls, creating dramatic effects a mile across the river and from 1,000 feet in the air to the water’s edge.”

The fireworks will be broadcast as part of a two-hour special on NBC that will begin at 8 p.m., featuring performances by artists like Black Pumas, Coldplay, OneRepublic and Reba McEntire.

Mr. de Blasio also announced another fireworks display off Coney Island in Brooklyn, which should run from about 10 p.m. to 10:15 p.m. and be visible from Coney Island’s boardwalk.

Global Roundup

A hospital in Bhagalpur, in the Indian state of Bihar, last year. A review found that more than 9,000 people had died from Covid-related complications in the northern state since March 2020.Credit…Danish Siddiqui/Reuters

India’s coronavirus death toll shot up on Thursday after an audit unearthed thousands of uncounted fatalities in the northern state of Bihar, one of the largest and poorest states in the country.

The audit in Bihar showed that more than 9,000 people had died from Covid-related complications since March 2020, significantly higher than the 5,500 deaths originally reported.

The audit was ordered after a hearing on May 17 in the Bihar High Court in Patna, the state capital, in which a district commissioner reported that a single cremation ground had handled 789 bodies in a 13-day period in May. That number clashed sharply with the seven deaths in the whole of May that Tripurari Sharan, a top state-level official, had reported for that entire district.

The revised figures underline the doubts about the accuracy of the Indian government’s official coronavirus statistics. Even in normal times, only about one in five deaths in India is medically certified, experts say.

Opposition political parties in Bihar have accused the state’s top elected official, Nitish Kumar, and his administration of hiding the true death toll to mask failures to mitigate the deadly second wave that has battered India.

The high court in Bihar has been monitoring the state government’s pandemic response since early May after taking up a petition filed by an activist that complained of mismanagement.

But Bihar’s health minister, Mangal Pandey, told The New York Times that the updated numbers reflected a good-faith effort to uncover families eligible for monetary support from the government.

“The intention is to help everyone, not to hide the real death toll,” Mr. Pandey said. “We will leave no death unaccounted for.”

Elsewhere in India, such as in the western state of Gujarat, observers have reported a wide discrepancy between official coronavirus death numbers and the actual figures. While some states have issued revised numbers, no update comes close to Bihar’s. Still, experts say they believe that India’s total number, which because of the audit in Bihar rose by 6,148 deaths on Thursday to 359,676, is a vast undercount.

In other news from around the world:

The government of Singapore said on Thursday that it would ease some social restrictions after nearly a month of tough measures to contain a coronavirus outbreak fueled in part by the Delta variant, first detected in India. The city-state also said that it would expand its vaccination campaign, allowing anyone 12 and older to register for shots beginning on Friday and extending eligibility to the rest of the population in the coming months.

Abu Dhabi, in the United Arab Emirates, will restrict access to shopping malls, restaurants, cafes and other public places to those who have been vaccinated against the coronavirus or who have recently tested negative, starting on Tuesday, Reuters reported. The new rules were announced late on Wednesday and come as the United Arab Emirates has seen daily cases rise during the past three weeks. The restrictions will also apply to gyms, hotels, public parks, beaches, swimming pools, entertainment centers, cinemas, and museums, Abu Dhabi’s media office said.

Germany’s vaccination confirmation app was introduced on Thursday, nearly half a year after inoculations started there. The app, called CovPass, will present a simple QR code confirming that the owner is fully vaccinated. Starting on Monday, doctors and pharmacies will be able to transcribe the usually handwritten entries from paper vaccine booklets into the digital app. At the same time, the Health Ministry announced tougher licensing rules and more spot checks, following accusations of fraud at its rapid virus-testing centers.

David Hasselhoff called for people to roll up their sleeves for the vaccine in an advertisement for Germany‘s inoculation campaign. “I’ve found freedom in vaccination,” the former “Baywatch” star said in the clip, a reference to his 1989 version of the song “Looking for Freedom,” which became a smash success in Germany as the Berlin Wall fell and which he performed atop the Wall on New Year’s Eve that year. German health authorities believe that as much as 75 percent of the population will eventually get vaccinated.

A medical team with a patient at Houston Methodist Hospital last year.Credit…Erin Schaff/The New York Times

The Occupational Safety and Health Administration announced a rule on Thursday outlining steps that employers must take to protect workers from the risk of Covid-19, but it will apply only to the health care industry, not to other high-risk workplaces, as the Biden administration initially indicated.

“The science tells us that health care workers, particularly those who come into regular contact with the virus, are most at risk at this point in the pandemic,” Labor Secretary Martin J. Walsh said on a call with reporters. “So following an extensive review of the science and data, OSHA determined that a health care specific safety requirement will make the biggest impact.”

The rule will require health care employers to provide protective equipment like masks, to screen and triage patients for the risk of Covid-19 and to ensure adequate ventilation and distancing, among other measures. It will also require those employers to provide adequate paid time off for workers to receive vaccinations and manage their side effects.

Fully vaccinated workers will not be required to wear masks and practice social distancing.

Mr. Walsh, whose department includes OSHA, said the administration was issuing optional guidance to employers outside health care that would focus on workplaces in the manufacturing, meat processing, grocery and retail industries.

Groups focused on workers’ issues criticized the decision to limit the rule, known as an emergency standard, to health care employers, arguing that the virus continues to pose serious risks to other workers.

“We know that workers in many industries outside of health care faced elevated risks of Covid,” Debbie Berkowitz, a senior OSHA official during the Obama administration who is now at the National Employment Law Project, wrote in an email. “Especially in low-wage industries like meat processing that is disproportionally Black and brown workers.”

She added: “We need to make sure these workers are still protected with mitigation measures.”

Some union leaders expressed frustration that the Biden administration abandoned its earlier plans.

“Today’s new Covid workplace safety standard from OSHA represents a broken promise to the millions of American workers in grocery stores and meatpacking plants who have gotten sick and died on the front lines of this pandemic,” Marc Perrone, the president of the United Food and Commercial Workers International Union, said in a statement.

Ms. Berkowitz and Mr. Perrone had expressed hope that Mr. Biden would chart a different course from his predecessor, under whom OSHA declined to issue a standard related to Covid-19.

During the Trump administration, OSHA adopted a policy of largely limiting Covid-related inspections to a small number of high-risk industries like health care and emergency response. It did not include meatpacking — which studies indicated was a major source of virus transmission — in this high-risk group.

Some worker groups gave OSHA credit under President Donald J. Trump for enforcing safety rules in the health care industry, including proposed penalties of over $1 million for violations at dozens of health care facilities and nursing homes. But critics accused the agency of largely failing to fine meat processors for lax safety standards, such as failure to adequately distance workers.

Mr. Walsh indicated that the risks to most workers outside health care had eased as cases had fallen and vaccination rates had risen. He also indicated that guidance by the Centers for Disease Control and Prevention last month advising those who have been vaccinated that they generally need not wear a mask indoors played a role in OSHA’s decision to forgo a broader Covid-19 standard.

“OSHA has tailored the rule that reflects the reality on the ground, the success of the vaccine efforts, plus the latest guidance from C.D.C. and the changing nature of pandemic,” Mr. Walsh said on the call.

David Michaels, a head of OSHA during the Obama administration, said the C.D.C. guidance had made a broader OSHA rule more difficult to enact. “To justify an emergency standard, OSHA has to show there’s a grave danger,” Dr. Michaels said. “For that to happen, the C.D.C. would have needed to clarify its recommendation and say that for many workers, there remains a grave danger.”

Without such clarification, said Dr. Michaels, now a professor at the George Washington University School of Public Health, employer groups would probably have challenged any new OSHA rule in court, arguing that the C.D.C. guidance indicated that a rule was unnecessary.

Dr. Michaels said that the new standard was an overdue step but that it was disappointing that no Covid-specific standard was issued for industries like meatpacking, corrections and retail. “If exposure is not controlled in these workplaces, they will continue to be important drivers of infections,” he said.

Jim Frederick, the acting head of OSHA, said on the call that the agency had power even without issuing broader Covid rules, through its so-called general duty clause, to enforce protections for workers outside the health care industry and that it would continue to do so.

He said many meatpacking facilities, along with other workplaces, had been inspected under an OSHA program applying added scrutiny to high-risk industries.

OSHA submitted a draft of an emergency standard for review by a White House regulatory office in April, and the administration has spent weeks meeting with worker and industry groups about its likely impact.

“As far as the meetings that took place,” Mr. Frederick said, “we’re a participant in those meetings, we receive those comments and take those into account in the overall work that’s being done by the agency.”

Employers will have two weeks to comply with most of the rule’s provisions.

Two men helping their father last month at the Afghan-Japan Communicable Disease Hospital in Kabul, Afghanistan.Credit…Rahmat Gul/Associated Press

Afghanistan received 700,000 doses of a Covid-19 vaccine from China on Thursday amid a worsening crisis and record numbers of known cases, health ministry officials said.

The Ministry of Public Health said it would prioritize people over the age of 55 and those with chronic diseases to receive the doses of the vaccine, made by the Chinese company Sinopharm.

With hospital beds filling up, a persistent shortage of oxygen, and a general failure to adopt the elementary precautions common elsewhere — mask wearing, social distancing — Afghanistan is undergoing its severest period of the pandemic.

Though Afghanistan’s testing capacity is severely limited, the country on Thursday recorded its highest ever number of virus cases in a 24-hour period: 1,822 positive tests of 5,343 total — a positivity rate of over 34 percent. There were 56 recorded deaths from Covid-19 over the preceding 24 hours, but the Afghan health system cannot always distinguish Covid from other causes of death in a country where disease and violence are endemic.

“The situation is critical,” said Saeed Uddin Jami, a spokesman for the Afghan Public Health Ministry. “There are no empty bed for patients in Kabul hospitals,” he said. “Unfortunately, people do not cooperate with us, and they do not take the virus seriously. It is likely that the situation will worsen throughout Afghanistan.”

Sinopharm’s vaccine uses inactivated coronaviruses to trigger an immune response in the body. Vaccines that use that approach have been shown in studies to be less effective than the vaccines developed by the pharmaceutical companies Pfizer and Moderna, which use newer mRNA technology.

The Chinese donation of the doses of Sinopharm’s vaccine follows a February shipment of 500,000 doses of the AstraZeneca vaccine from India that failed to make much of a dent. Nor did a donation of 486,000 doses of AstraZeneca from the Covax global vaccine initiative shift the trajectory of the crisis.

The United States on Friday announced some $266 million in additional aid for Afghanistan, primarily for Covid response.

Residents line up for coronavirus testing in the Liwan District in Guangzhou in southern China’s Guangdong province on Wednesday.Credit…Associated Press

Battling a new coronavirus outbreak in the southern city of Guangzhou, Chinese authorities have employed tactics they have used since the start of the pandemic: vast testing, strict limits on movement and intense scrutiny of arrivals from other countries.

The tough measures have helped China keep the virus under control for more than a year. But with hundreds of millions of Chinese still unvaccinated, and questions lingering over the effectiveness of China’s self-made vaccines against new coronavirus variants, foreign businesses worry that the government’s rigorous system of quarantines and restrictions could persist into next year.

Beijing has demanded that travelers from dozens of countries spend two weeks in employer-supervised quarantine even before flying to China. Once there, travelers must spend at least two weeks and sometimes three or longer in government-supervised quarantine, even if they are fully vaccinated.

Rounds of tests can turn up a possibly false positive, leading to more tests and additional days or weeks in isolation.

A German national who flew into Shanghai last month said that he had been sent to a hospital isolation room for three days because he tested positive for antibodies, which he attributed to taking a second vaccine dose 16 days earlier.

Nurses took his blood twice a day and performed six throat swabs, four nasal swabs and two anal swabs daily, said the German, who insisted on anonymity to avoid offending the authorities. The hospital room had no towels, no toilet paper and no television, and the bed was a steel plate with a thin mat, he said.

After consistently testing negative for the virus, the German said he was allowed to spend the last 11 days of isolation in a government-supervised quarantine center.

Many businesses expect that China may retain stringent travel restrictions through February, when Beijing will host the Winter Olympics, and possibly through autumn of next year, when the Chinese Communist Party will hold its party congress.

Charles Michel, president of the European Council, in Brussels on Thursday. “The world has the right to know exactly what happened,” he said.Credit…Pool photo by Francisco Seco

Leaders of the European Union on Thursday joined the calls for a full investigation into the origins of Covid-19, with the European Council president declaring “support for all the efforts in order to get transparency and to know the truth.”

“The world has the right to know exactly what happened in order to be able to learn the lessons,” added the president, Charles Michel, who heads the European Council, the body that represents the bloc’s national leaders. He made the comments during a news conference preceding the Group of 7 summit, which starts on Friday and will be attended by President Biden.

The World Health Organization conducted an inquiry this year into the origins of the virus, which first appeared in the Chinese city of Wuhan in late 2019. The study concluded that “introduction through a laboratory incident was considered to be an extremely unlikely pathway” but was widely seen as incomplete because of China’s limited cooperation. Governments, health experts and scientists have called for a more complete examination of the origins of the virus, which has killed more than 3.7 million people worldwide.

Late last month, Mr. Biden ordered American intelligence agencies to investigate the origins of the virus, an indication that his administration was taking seriously the possibility that the deadly virus had accidentally leaked from a lab, in addition to the prevailing theory that it was transmitted by an animal to humans outside a lab.

Ursula von der Leyen, the president of the European Commission, the European Union’s executive arm, highlighted on Thursday that “investigators need complete access to the information and to the sites” to “develop the right tools to make sure that this will never happen again.”

In the draft conclusions of next week’s summit between the European Union and the United States, leaders will call for “progress on a transparent, evidence-based and expert-led W.H.O.-convened Phase 2 study on the origins of Covid-19, that is free from interference.”

Gilbert Torres, 30, a few hours after being extubated in January, in the intensive care unit of a Los Angeles hospital.Credit…Isadora Kosofsky for The New York Times

Deaths from Covid-19 have dropped 90 percent in the United States since their peak in January, according to provisional federal data, but the virus continues to kill hundreds daily. By late May, there were still nearly 2,500 weekly deaths attributed to Covid-19.

With more than half of the U.S. population having received at least one vaccine dose, experts say that the unvaccinated population is driving the lingering deaths.

After seniors were given priority when the first vaccines were authorized for emergency use in December, the proportion of those dying who were 75 or older started dropping immediately.

Younger populations began to make up higher shares of the deaths compared with their percentages at the peak of the pandemic — a trend that continued when all adults became eligible for the shots. While the number of deaths has dropped across all age groups, about half now occur in people aged 50 to 74, compared with only a third in December.

More than 80 percent of those 65 and older have received at least one vaccine dose, compared with about half of those 25 to 64.

“I still think the narrative, unfortunately, is out there with younger people that they can’t suffer the adverse events related to Covid,” which is not the case, said Krutika Kuppalli, an infectious-diseases expert at the Medical University of South Carolina.

Still, those 50 and older make up the bulk of Covid-19 deaths. Among that cohort, white Americans are driving the shifts in death patterns. At the height of the pandemic, those who were white and aged 75 and older accounted for more than half of all Covid-19 deaths. Now, they account for less than a third.

Middle-age populations of all racial groups are making up a higher proportion of Covid-19 deaths than they did in December.

The extent of the drop in deaths, however, is not uniform, and cumulative vaccination rates among Black and Hispanic populations continue to lag behind those of Asian and white populations, according to demographic data from the Centers for Disease Control and Prevention.

The data shows that more work is needed to reach and vaccinate “rural populations, ethnic and racial minority populations, homeless populations, people who don’t access medical care,” Dr. Kuppalli said.

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