A Billion Shots Have Been Given, but Global Covid-19 Cases Keep Rising

India continues to set new daily infection records as lower-income countries are left behind richer nations in the inoculation drive. Vaccinated tourists from the United States can visit Europe this summer.,

LiveUpdated April 26, 2021, 8:31 a.m. ETApril 26, 2021, 8:31 a.m. ET

India continues to set new daily infection records as lower-income countries are left behind richer nations in the inoculation drive. Vaccinated tourists from the United States can visit Europe this summer.

A Covid-19 patient waiting to be admitted to a hospital in South Delhi, India, on Saturday.
A Covid-19 patient waiting to be admitted to a hospital in South Delhi, India, on Saturday.Credit…Atul Loke for The New York Times

A global coronavirus surge that is driven by the devastation in India continues to break daily records and run rampant in much of the world, even as vaccinations steadily ramp up in wealthy countries and more than one billion shots have now been given globally.

On Sunday, the world’s seven-day average of new cases hit 774,404, according to a New York Times database. That is a jump of 15 percent from two weeks earlier, and higher than the peak average of 740,390 during the last global surge in January.

Despite the number of shots given around the world — more than one billion, according to a New York Times tracker — far from enough of the world’s estimated population of nearly eight billion have been vaccinated to slow the virus’s steady spread.

And vaccinations have been highly concentrated in wealthy nations: 82 percent of shots worldwide have been given in high- and upper-middle-income countries, according to data compiled by the Our World in Data project at the University of Oxford. Only 0.2 percent of doses have been administered in low-income countries.

Israel is far ahead of much of the world in vaccinations: More than half of the population is now fully vaccinated. In Britain, where a highly contagious and deadly variant was discovered, nearly two thirds of the population is at least partly vaccinated and the rate of new cases is now among the lowest in Europe.

The United States has also partly vaccinated about 41 percent of its population and has loosened a ban on the export of raw materials for vaccines to help India control the world’s worst outbreak.

India is recording more than a third of all new global cases each day, averaging more than 260,000 new daily cases over the past week. The country’s sudden surge, driven by the spread of a newer variant, is casting increasing doubt on the official death toll of nearly 200,000, with more than 2,000 people dying every day.

Experts say the official numbers, however staggering, represent just a part of the virus’s spread, with hospitals overwhelmed and lacking critical supplies like oxygen.

India is home to the Serum Institute of India, the world’s largest vaccine maker. But only about 8.6 percent of India’s population has received at least one shot of a vaccine. Its surge led to the Indian government’s decision to withhold exports of doses that many low- and middle-income countries were relying on. The vaccine rollout in Africa, which was already slower than it is in any other continent, could soon come to a near halt because of the suspension.

Public health experts say the number of global cases is most likely surging because more contagious virus variants are spreading just as people are starting to let their guards down.

In Thailand, where cases were kept at bay for months with strict quarantines and lockdowns, the virus has spread rapidly, in part by unmasked people partying. Daily cases, still low by global standards, have increased from 26 on April 1 to more than 2,000 three weeks later. And in India, many people stopped taking precautions after officials eased a lockdown that was imposed early last year.

“India let their guard down when the numbers fell and they thought they were over their last peak,” said Barry Bloom, a research professor and former dean of the Harvard T.H. Chan School of Public Health. He added that the United States should “take a lesson from other countries before we become complacent and decide everything’s OK.”

As bad as India’s situation is, the numbers have room to grow worse: Its daily caseloads, adjusted for its huge population, rank well below other countries’.

The rate of new cases in the United States is falling but remains alarmingly high — similar to last summer’s surge.

The rates of new coronavirus cases also remain high across much of South America. In Brazil, reported cases are starting to drop but remain high after a more contagious variant tore through the country and overwhelmed hospitals.

In continental Europe, the pace of vaccinations lags that in the United States and Canada, and the number of new coronavirus cases remains particularly high in France, Germany, the Netherlands and Sweden. Turkey, at the crossroads between Europe, the Middle East and Asia, is another hot spot.

Dr. Robert Murphy, the executive director of the Institute for Global Health at Northwestern University, said the United States had a responsibility to send unused vaccine doses to other countries as supplies increase.

“We have to start thinking on a global scale and do what we can to help these other countries,” Dr. Murphy said. “Otherwise we’re never going to put out the whole fire.”

United States > United StatesOn Apr. 25 14-day change
New cases 33,662 -16%
New deaths 282 -3%
World > WorldOn Apr. 25 14-day change
New cases 378,263 +15%
New deaths 7,655 +4%

U.S. vaccinations >

Where states are reporting vaccines given

Fully vaccinated

At least one dose

Other trackers:

Administering the Astrazeneca vaccine at the Milan military hospital last month.
Administering the Astrazeneca vaccine at the Milan military hospital last month.Credit…Alessandro Grassani for The New York Times

BRUSSELS — The European Union has filed a lawsuit in Belgium against the pharmaceutical company AstraZeneca over what it says is a breach of contract in the company’s delivery of Covid-19 vaccine, the European Commission announced on Monday.

The bloc’s relationship with the company has soured rapidly since AstraZeneca said in January that it would not be able to deliver on its scheduled vaccine doses for the first quarter of the year, setting the region’s vaccination campaign back by weeks.

“The commission has started last Friday a legal action against the company AstraZeneca on the basis of breaches of the advanced purchase agreement,” said Stefan de Keersmaecker, a spokesman on health issues for the commission, the E.U.’s executive branch. “The reason indeed being that the terms of the contract, or some terms of the contract, have not been respected and the company has not been in a position to come up with a reliable strategy to ensure the timely delivery of doses.”

Mr. de Keersmaecker said that all 27 E.U. member countries supported the move.

The company, while acknowledging that production problems have caused delays, has said its failure to deliver is not a breach of contract, because the European Union had placed its order after other clients, most notably Britain. A spokesman for the company did not immediately respond to a request for comment on Monday.

The two parties had been engaged in a dispute arbitration effort, but the European Union decided to move ahead with a legal case. The contract is under Belgian law, and legal proceedings would happen in Belgium.

The European Union’s vaccine contract with AstraZeneca, a British-Swedish company, was the first it signed, in August last year, and covers 400 million doses. So far, the company has delivered just over 30 million.

In an interview with The Times on Sunday, the European Commission president, Ursula von der Leyen, said the company had only supplied a quarter of what it had promised to the bloc, and had to deliver 200 million doses of vaccines by the end of this quarter.

She indicated that the European Union would not open talks over future supply. “At the moment, the company has a delay in delivering 200 million doses of vaccine by the end of the second quarter,” she said. “The number speaks for itself.”

Waiting for hospital beds, Covid-19 patients received oxygen provided by a local Sikh house of worship on a sidewalk in New Delhi on Sunday.
Waiting for hospital beds, Covid-19 patients received oxygen provided by a local Sikh house of worship on a sidewalk in New Delhi on Sunday.Credit…Atul Loke for The New York Times

India’s coronavirus crisis deepened on Monday with the number of new reported cases setting a global record for the fifth consecutive day, as countries, companies and members of the large diaspora pledged to send oxygen and other critical aid.

India’s health ministry reported almost 353,000 new cases and 2,812 deaths on Monday, and enormous funeral pyres continued to burn in the worst-affected cities. Experts say that India’s reported overall toll of more than 195,000 deaths could be a vast undercount.

In New Delhi, where Covid-19 patients have died after hospitals ran out of oxygen, the government extended a lockdown by another week.

India’s Supreme Court last week ordered the government to come up with a “national plan” for distributing oxygen supplies.

The problems in India’s hospitals go beyond oxygen shortages. In the western state of Gujarat, more than a dozen patients were evacuated from a hospital on Sunday night after an air-conditioning unit caught fire, the Press Trust of India reported, the third accident involving virus patients in India in the past seven days.

Last Friday in another western state, Maharashtra, a hospital fire also caused by an air-conditioning unit killed 15 patients. Two days earlier, at least 22 patients died in a hospital in the city of Nashik, also in Maharashtra, after a leak cut off oxygen supplies.

The Biden administration, under pressure to help with the Indian surge as patients and their families make desperate online pleas for aid, said on Sunday that it had partially lifted a ban on the export of raw materials for vaccines and would also supply India with therapeutics, test kits, ventilators and personal protective gear. Other countries, including Britain, have also promised to send medical equipment and raw vaccine materials to India, a key producer of vaccines for lower-income countries.

“Just as India sent assistance to the United States as our hospitals were strained early in the pandemic, we are determined to help India in its time of need,” President Biden said on Twitter on Sunday.

Two Indian-American businessmen — the Microsoft chief executive, Satya Nadella, and the Google chief, Sundar Pichai — have both said that their companies will provide financial assistance to India.

“Devastated to see the worsening Covid crisis in India,” Mr. Pichai wrote on Twitter, pledging $18 million to aid groups working in the country.

A line at the Louvre in Paris last summer. The European Union is allowing fully vaccinated Americans entry into the bloc this summer.
A line at the Louvre in Paris last summer. The European Union is allowing fully vaccinated Americans entry into the bloc this summer.Credit…Dmitry Kostyukov for The New York Times

BRUSSELS — American tourists who have been fully vaccinated against Covid-19 will be able to visit the European Union over the summer, the head of the bloc’s executive body said in an interview with The New York Times on Sunday, more than a year after shutting down nonessential travel from most countries to limit the spread of the coronavirus.

The fast pace of vaccination in the United States, and advanced talks between the authorities there and the European Union over how to make vaccine certificates acceptable as proof of immunity for visitors, will enable the European Commission, the executive branch of the European Union, to recommend a switch in policy that could see trans-Atlantic leisure travel restored.

“The Americans, as far as I can see, use European Medicines Agency-approved vaccines,” Ursula von der Leyen, president of the European Commission, said Sunday in an interview with The Times in Brussels. “This will enable free movement and the travel to the European Union.

“Because one thing is clear: All 27 member states will accept, unconditionally, all those who are vaccinated with vaccines that are approved by E.M.A.,” she added. The agency, the bloc’s drugs regulator, has approved all three vaccines being used in the United States, namely the Moderna, Pfizer-BioNTech and Johnson & Johnson shots.

Ms. von der Leyen did not offer a timeline for when exactly tourist travel might open up or details on how it would occur. But her comments are a top-level statement that the current travel restrictions are set to change on the basis of vaccination certificates.

Diplomats from Europe’s tourist destination countries, mostly led by Greece, have argued for weeks that the bloc’s criteria for determining whether a country is a “safe” origin purely based on low coronavirus cases are fast becoming irrelevant given the progress of vaccination campaigns in the United States, Britain and some other countries.

A pub in Glasgow, Scotland on Monday.
A pub in Glasgow, Scotland on Monday.Credit…Andy Buchanan/Agence France-Presse — Getty Images

Scotland and Wales reopened restaurants, cafes, and nonessential shops on Monday, marking the next phase of a gradual relaxation of coronavirus restrictions that have been in place for months.

In Scotland, restaurants can serve food but not alcohol indoors until 8 p.m., and they can serve food and alcohol outdoors without restrictions. Stores, beauty salons, museums and galleries also reopened, and people are permitted to book travel in the rest of Britain.

The first minister of Scotland, Nicola Sturgeon, said she was hopeful that the country would continue its progress and lift more restrictions by the summer. But she cautioned that the virus was more infectious now than it had been in earlier waves and, therefore, “We must stick to the rules.” Free rapid tests will be available to the public.

In Wales, places of worship and retail stores reopened, and restaurants resumed outdoor service. Outdoor wedding receptions with up to 30 people can take place.

Cases remain low in Britain, with more than 40 percent of the population having received at least one dose of a vaccine. On Sunday, the country reported just over 1,700 new cases and 11 deaths, according to a New York Times database.

Hikers at Lion Rock in Hong Kong in January.
Hikers at Lion Rock in Hong Kong in January. Credit…Lam Yik Fei for The New York Times

The governments of Singapore and Hong Kong said on Monday that a long-delayed travel bubble between the two Asian financial centers would begin next month, allowing travelers on designated flights to bypass quarantine.

The travel arrangement, which was originally supposed to begin last November, was suspended at the last minute when Hong Kong experienced a sudden surge in cases. With both places now reporting relatively few local infections, officials say the travel corridor will begin on May 26.

“Both sides will need to stay very vigilant in the next one month, so that we can launch the first flights smoothly,” Ong Ye Kung, Singapore’s minister of transport, said in a statement.

The arrangement, which is open to people of any nationality in Singapore and Hong Kong, will begin with one flight per day in each direction for up to 200 passengers. Travelers to both places must test negative for the coronavirus before departure and again upon arrival. They are also required to download and use government contact-tracing apps.

Travelers from Hong Kong must have received their second dose of a vaccine at least 14 days earlier, with some exceptions. Officials in Hong Kong, where the vaccination campaign has struggled to gain momentum, say they hope that this will give residents an incentive to get vaccinated. (There is no vaccination requirement for travelers from Singapore to Hong Kong.)

Officials said that the bubble would be suspended automatically for two weeks if either city recorded a seven-day average of more than five local cases from an unknown source.

The bubble is seen as an important step toward economic recovery in the two cities, both major travel hubs whose flagship carriers, Cathay Pacific and Singapore Airlines, only operate international flights. Similar travel bubbles are already in effect between Australia and New Zealand and between Palau and Taiwan, all places where local transmission of the coronavirus is almost nonexistent.

A small number of guests enjoying the pool at a resort in Phuket, Thailand, this month.
A small number of guests enjoying the pool at a resort in Phuket, Thailand, this month.Credit…Adam Dean for The New York Times

Only a few weeks ago, Phuket seemed poised for a comeback. After a year of practically no foreign tourists arriving in Thailand, the national government decided that Phuket would start welcoming vaccinated visitors in July, without requiring them to go through quarantine. The project was called Phuket Sandbox.

But Thailand is now gripped by its worst Covid-19 outbreak since the pandemic began, spread in part by the well-heeled Thais who partied in Phuket and Bangkok with no social distancing. The confirmed daily caseload — albeit low by global standards — has increased from 26 on April 1 to more than 2,000 three weeks later, in a country that in early December had about 4,000 cases total.

The opening that Phuket had planned for July 1 now appears unlikely, Thailand’s tourism minister acknowledged this month.

“If you ask me how optimistic I am, I cannot say,” said Nanthasiri Ronnasiri, the director of the tourism authority’s Phuket office. “The situation changes all the time.”

The virus’s resurgence after so many months of economic hardship is devastating for the majority of Phuket’s residents, who depend on foreign tourists for their livelihoods.

Dr. Linda Dahl at the Kaufman Astoria Studios in Queens, N.Y.
Dr. Linda Dahl at the Kaufman Astoria Studios in Queens, N.Y.Credit…Sasha Maslov for The New York Times

Compliance practices at the Academy Awards on Sunday will be closely watched as organizers prepare for the gradual resumption of major events such as the Tonys (to be coordinated with Broadway’s reopening).

Part cop, part coach, Covid compliance officers, or C.C.O.s, have become essential overseers in America’s tentative return to prepandemic life.

“We’re at a tipping point,” said Dr. Blythe Adamson, an infectious disease epidemiologist and economist. “People are going out more, they have pandemic fatigue. They’re vaccinated, but people are still getting Covid with these new strains. It makes the compliance officer role extremely important.”

The budget for Covid compliance on film sets is high: 25 to 30 percent of the total, according to Dr. Linda Dahl, an ear, nose and throat surgeon who has become a C.C.O. Complicating the job, what constitutes Covid compliance can change on a weekly or even daily basis as guidelines from the Centers for Disease Control and Prevention constantly evolve.

— Chloe Malle

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