C.D.C. Acknowledges Risk of Virus Infection From Surfaces Is Low

The C.D.C. updated its guidelines and noted that the risk of contracting the virus from surfaces was less than 1 in 10,000. Here’s the latest on Covid-19.,

LiveUpdated April 8, 2021, 8:27 p.m. ETApril 8, 2021, 8:27 p.m. ET

A boom market for fake vaccine cards has officials worried. Florida is taking the federal government to court to try to get the cruise industry moving again.

A worker disinfected a table at a restaurant in Westbury, N.Y., last year.
A worker disinfected a table at a restaurant in Westbury, N.Y., last year. Credit…Hiroko Masuike/The New York Times

When the coronavirus began to spread in the United States last spring, many experts warned of the danger posed by surfaces. Researchers reported that the virus could survive for days on plastic or stainless steel, and the Centers for Disease Control and Prevention advised that if someone touched one of these contaminated surfaces — and then touched their eyes, nose or mouth — they could become infected.

Americans responded in kind, wiping down groceries, quarantining mail and clearing drugstore shelves of Clorox wipes. Facebook closed two of its offices for a “deep cleaning.” New York’s Metropolitan Transportation Authority began disinfecting subway cars every night.

But the era of “hygiene theater” may have come to an unofficial end this week, when the C.D.C. updated its surface cleaning guidelines and noted that the risk of contracting the virus from touching a contaminated surface was less than 1 in 10,000.

“People can be affected with the virus that causes Covid-19 through contact with contaminated surfaces and objects,” Dr. Rochelle Walensky, the director of the C.D.C., said at a White House briefing on Monday. “However, evidence has demonstrated that the risk by this route of infection of transmission is actually low.”

The admission is long overdue, scientists say.

“Finally,” said Linsey Marr, an expert on airborne viruses at Virginia Tech. “We’ve known this for a long time and yet people are still focusing so much on surface cleaning.” She added, “There’s really no evidence that anyone has ever gotten Covid-19 by touching a contaminated surface.”

During the early days of the pandemic, many experts believed that the virus spread primarily through large respiratory droplets. These droplets are too heavy to travel long distances through the air but can fall onto objects and surfaces.

In this context, a focus on scrubbing down every surface seemed to make sense. “Surface cleaning is more familiar,” Dr. Marr said. “We know how to do it. You can see people doing it, you see the clean surface. And so I think it makes people feel safer.”

But over the last year, it has become increasingly clear that the virus spreads primarily through the air — in both large and small droplets, which can remain aloft longer — and that scouring door handles and subway seats does little to keep people safe.

“The scientific basis for all this concern about surfaces is very slim — slim to none,” said Emanuel Goldman, a microbiologist at Rutgers University, who wrote last summer that the risk of surface transmission had been overblown. “This is a virus you get by breathing. It’s not a virus you get by touching.”

The C.D.C. has previously acknowledged that surfaces are not the primary way that the virus spreads. But the agency’s statements this week went farther.

“The most important part of this update is that they’re clearly communicating to the public the correct, low risk from surfaces, which is not a message that has been clearly communicated for the past year,” said Joseph Allen, a building safety expert at the Harvard T.H. Chan School of Public Health.

Catching the virus from surfaces remains theoretically possible, he noted. But it requires many things to go wrong: a lot of fresh, infectious viral particles to be deposited on a surface, and then for a relatively large quantity of them to be quickly transferred to someone’s hand and then to their face. “Presence on a surface does not equal risk,” Dr. Allen said.

In most cases, cleaning with simple soap and water — in addition to hand-washing and mask-wearing — is enough to keep the odds of surface transmission low, the C.D.C.’s updated cleaning guidelines say.

— Emily Anthes

A pharmacist in Little Rock, Ark., filling out a Covid-19 vaccine card last month.
A pharmacist in Little Rock, Ark., filling out a Covid-19 vaccine card last month.Credit…Rory Doyle for The New York Times

The coronavirus has made opportunists out of many people, like those who hoarded bottles of hand sanitizer or cheated recipients out of their stimulus checks. Now, online scammers have latched onto the latest profit-making initiative: the little white cards that provide proof that the bearer has been vaccinated.

Online stores offering counterfeit or stolen vaccine cards have mushroomed in recent weeks, with Facebook pages named “vax-cards” and eBay listings with “blank vaccine cards” openly hawking the items. On these and other sites, little rectangular slips of paper — printed on card stock and featuring crisp black lettering — started showing up for sale in late January, priced at $20 to $60 each.

Want it laminated? That’ll cost you extra.

All were forgeries or falsified copies of the Centers for Disease Control and Prevention vaccination cards, which are given to people who have been inoculated against Covid-19 in the United States.

Saoud Khalifah, the founder of FakeSpot, which offers tools to detect fake listings and reviews, said that hundreds of online stores were selling the cards and that “potentially thousands were sold.”

Selling fake vaccination cards could break federal laws that forbid copying the C.D.C. logo, legal experts said. And if the cards were stolen and filled out with false numbers and dates, they might also violate identity theft laws, they said.

But with the demand for the cards growing, profiteers have pressed ahead.

Airlines and other companies have recently said they may require proof of Covid-19 immunization so that people can safely travel or attend events. The cards may also become central to “vaccine passports,” which offer digital proof of vaccinations.

The C.D.C. said it was “aware of cases of fraud regarding counterfeit Covid-19 vaccine cards.” It asked people not to share images of their personal information or vaccine cards on social media.

Last week, 45 state attorneys general banded together to call on Twitter, Shopify and eBay to stop the sale of false and stolen vaccine cards. The officials said they were monitoring the activity and were concerned that unvaccinated people might use the cards to attend large events, potentially spreading the virus and prolonging the pandemic.

“We’re seeing a huge market for these false cards online,” said Josh Shapiro, Pennsylvania’s attorney general. “This is a dangerous practice that undermines public health.”

Facebook, Twitter, eBay, Shopify and Etsy said that the sale of fake vaccine cards violated their rules and that they were removing posts that advertised the items.

Administering the AstraZeneca vaccine at a sports arena in San Juan, Philippines, last month.
Administering the AstraZeneca vaccine at a sports arena in San Juan, Philippines, last month.Credit…Ezra Acayan/Getty Images

A day after European regulators described a “possible link” between AstraZeneca’s vaccine and rare blood clots, the vaccine faced increasing hurdles on Thursday as countries around the world move to restrict its use in younger people. The decisions are the latest setback for AstraZeneca, the company behind the world’s most widely used coronavirus vaccine.

Although European regulators said that the vaccine’s benefits outweighed the risks for most people, several countries are now using the AstraZeneca shot only on older people who are most at risk of dying from the coronavirus. The Philippines said that it would temporarily stop administering the vaccine to people age 60 and under.

South Korean officials said that they would decide this weekend whether to resume administering the shot to people 60 and younger after a panel of experts reviewed the information on blood clots on Thursday.

Late Wednesday, Belgium said that it would temporarily halt use of the vaccine in people under 56, and that younger people will be offered alternative vaccines — measures that the country’s health ministry said would be reviewed in four weeks. Others, including Cameroon, the Democratic Republic of Congo, Denmark and Norway, have suspended use of the vaccine altogether until more information about the clotting risk is available.

Health officials in the Netherlands, Spain and Portugal are also limiting the AstraZeneca vaccine to people over 60.

Prime Minister Scott Morrison of Australia said at a news conference late Thursday that the country had changed its guidance on the AstraZeneca vaccine for younger people out of an abundance of caution. It now recommends that adults under 50 be given an alternative vaccine.

“We expect that this will require some changes to the arrangements we have as part of the vaccination rollout,” Mr. Morrison said during the briefing. Public health experts and the prime minister were clear that the decision was based on weighing the very low risks of complications from the vaccine against the risk of the coronavirus.

“Our purpose here tonight is to reassure Australians — to reassure them that we’ve been very clear about what the very low level of risk is here,” Mr. Morrison said.

In the Philippines, Rolando Enrique Domingo, the director general of the country’s Food and Drug Administration, said that there had been no local reports of blood clots, but that the government was taking a precautionary step after the European Medicines Agency’s decision to list clots as a rare side effect of the AstraZeneca vaccine.

In the meantime, he said, inoculations using the Chinese-produced Sinovac vaccine will continue.

“We await results of the review being done by our local experts, as well as the official guidance of the W.H.O.,” Mr. Domingo said, referring to the World Health Organization.

A forklift unloading boxes of the Sputnik V vaccine at the International Airport in Kosice, Slovakia, last month.
A forklift unloading boxes of the Sputnik V vaccine at the International Airport in Kosice, Slovakia, last month.Credit…Peter Lazar/Agence France-Presse — Getty Images

Slovakia, one of only two European Union countries that have signed up to use Russia’s Sputnik V coronavirus vaccine, delivered a potentially serious blow to Russia’s product and also its pride on Thursday, with medical regulators disclosing that doses sent to the East European nation are different from a version that received a thumbs-up from a respected British medical journal.

A peer-reviewed article published in The Lancet in February showed that Sputnik V had a 91.6 percent efficacy rate against Covid-19, an endorsement that Moscow has used to raise confidence in the vaccine and strengthen the Kremlin’s hand in vaccine diplomacy.

Slovakia’s regulator, however, said in a statement that vaccine batches imported into the country did “not have the same characteristics and properties” as the version of Sputnik V reviewed by The Lancet.

Noting that about 40 countries are using or scheduled to use the Russian vaccine, the Slovak regulatory agency, the State Institute for Drug Control, asserted that “these vaccines are only associated by the name.” That claim suggests serious quality control issues.

“The comparability and consistency of different batches produced at different locations has not been demonstrated,” the regulator said. “In several cases, they appear to be vaccines with different properties (lyophilisate versus solution, single-dose ampoules versus multi-dose vials, different storage conditions, composition and method of manufacture).”

The Slovak statement could damage Russia’s efforts to establish Sputnik V as a reliable brand. It could also exacerbate lingering doubts left by the vaccine’s highly politicized rollout in Russia, where President Vladimir V. Putin announced that the drug was ready for use in August, before clinical trials had finished.

The Russian Direct Investment Fund, a sovereign wealth fund that financed of Sputnik V’s development and has spearheaded a push for the vaccine’s use abroad, had no immediate comment on the Slovak claims.

Several countries in Europe have expressed an interest in using Sputnik V, but in the absence of a green light from the European Union’s regulatory agency, Slovakia and Hungary are the only countries in the bloc that have placed orders. Serbia, which is not a member of the union, has also ordered the Russian vaccine and started using it widely in a successful mass inoculation program.

Slovakia’s decision to import Sputnik V has been marred by controversy, and last week set off political squabbling that prompted the prime minister and finance minister to trade jobs in an effort to keep a fragile coalition government afloat.

Fellow ministers had accused the prime minister, who negotiated a vaccine deal with Russia in secret, of opening up the country to a “tool of hybrid war.” Slovakia received 200,000 doses of Sputnik V in March, but has not yet started using them.

On a visit to Moscow on Thursday, former Prime Minister Igor Matovic complained on Facebook of a “dirty game” in Slovakia and accused his country’s politicians of “barking” like little dogs.

Kristina Hamarova contributed reporting.

Defense Department officials say that a production accident that spoiled millions of doses will hamper its vaccination efforts overseas. An Air Force sergeant was vaccinated in December at Kunsan Air Base in South Korea.
Defense Department officials say that a production accident that spoiled millions of doses will hamper its vaccination efforts overseas. An Air Force sergeant was vaccinated in December at Kunsan Air Base in South Korea.Credit…United States Forces Korea, via Getty Images

The contamination of as many as 15 million doses of Johnson & Johnson’s coronavirus vaccine has hobbled the military’s ability to vaccinate its overseas troops and their families, Defense Department officials said on Thursday.

“The recent event that caused the loss of about 15 million doses of the Johnson and Johnson vaccine has affected the D.O.D. allocations,” said Army Lt. Gen. Ronald J. Place, director, Defense Health Agency, using initials for the Department of Defense.

He noted that the Johnson & Johnson vaccine had been an important option for overseas use because it did not require the cold storage needed for the Pfizer-BioNtech vaccine, which has been widely used by the military domestically.

It is not clear why the military was counting on those vaccine doses to inoculate overseas personnel, when the plant where they were made had yet to win approval from the Food and Drug Administration to start shipping them. The Biden administration does not count doses that have not been released.

“We targeted the overseas community for our J. & J. vaccine supply, so we’re actively exploring other means to offset this temporary shortage,” General Place said.

Workers at a plant in Baltimore manufacturing two coronavirus vaccines — one for Johnson & Johnson and another for AstraZeneca — accidentally conflated ingredients, forcing the destruction of as many as 15 million doses and prompting regulators to delay authorization of the plant’s production lines.

The Biden administration has tried to play down the incident, saying the error would not hinder its goal of having enough shots for every American adult by summer.

The military was scheduled to receive just over one percent of all United States vaccine doses, and has already vaccinated hundreds of thousands of people. A significant percentage of service members, however, have refused to take the vaccine.

Complaints have surfaced that troops overseas, their eligible family members and military contractors have struggled to get shots. Officials said Thursday that 14 percent of the doses the military received for domestic personnel were reassigned to overseas locations, noting that service members overseas had fewer options for getting a shot than those at home do.

Uniformed personnel overseas are now vaccinated at rates between 10 percent and 15 percent higher than in the continental United States, but this may be because many received shots before deploying. Precisely how many service members, family members and contractors have been vaccinated was not clear Thursday, and rates vary by service branch. For example, in the Navy, roughly half of eligible personnel have gotten at least one vaccine dose; in the Air Force it is 35 percent.

“If you’re a service member stationed overseas or a family member likewise stationed overseas, and you haven’t received a vaccine, and you don’t know when you’ll be able to, these numbers mean nothing,” General Place said. “And it’s understandably frustrating.”

Waiting under observation after receiving a Covid-19 vaccine last month in Vieques in Puerto Rico.
Waiting under observation after receiving a Covid-19 vaccine last month in Vieques in Puerto Rico.Credit…Erika P. Rodriguez for The New York Times

Puerto Rico and Washington D.C. said this week that residents 16 or older will become eligible for Covid-19 vaccination on Monday, as all 50 states have said they would beat or meet President Biden’s calls to accelerate their eligibility timelines.

Washington D.C. announced the change on Thursday after the city government realized it had leftover appointments when it finished registering essential workers, seniors and those with medical conditions. Puerto Rico announced its decision on Wednesday and extended an overnight curfew as cases rise on the island.

While the pace of vaccinations across the country has reached an average of about three million doses a day, outbreaks of the virus in the Midwest and Northeast have federal health officials worried. The Centers for Disease Control and Prevention said on Thursday that nationwide about 112 million people, or roughly one-third of the U.S. population, have received at least one dose of a Covid-19 vaccine.

Earlier this week Hawaii became the last of the 50 states to accelerate its timeline for making all adults eligible for vaccination, heeding Mr. Biden’s calls for states, territories and tribes to do so.

About 33 percent of the total population in Washington D.C. has received one dose of the vaccine, near the national average of 34 percent, according to a New York Times analysis of C.D.C. data. Puerto Rico has seen 24 percent of its total population receive at least one shot, ranking it near the bottom among U.S. states and territories.

In Puerto Rico, Gov. Pedro R. Pierluisi said in a statement on Wednesday that a longer overnight curfew will start on Friday. Cases there have nearly doubled, based on a seven-day average, in the past two weeks, according to a New York Times database.

The start of the curfew, which will run until May 9, will move to 10 p.m., from midnight, and will continue to end at 5 a.m., Mr. Pierluisi said. Restaurants and businesses can continue to operate at 50 percent capacity, while bars and clubs remain closed, he said.

“We are seeing a dangerous spike in Covid cases that has led to a jump in hospitalizations and deaths,” Mr. Pierluisi said. “I have been very prudent when it comes to reopening and have always been willing to make the necessary adjustments to prevent cases from rising.”

The Disney Cruise Line ships Fantasy, left, and Dream sat stationary off of Cocoa Beach, Fla., in March.
The Disney Cruise Line ships Fantasy, left, and Dream sat stationary off of Cocoa Beach, Fla., in March. Credit…Joe Burbank/Orlando Sentinel, via Associated Press

Gov. Ron DeSantis of Florida said on Thursday that the state was suing the federal government to allow cruise ships to resume sailing on United States waters immediately, more than a year after they were docked to curb the spread of the coronavirus.

Cruise ships in the United States must meet requirements set out last year by the Centers for Disease Control and Prevention in its Framework for Conditional Sailing Order before they can resume operation. The industry had been waiting for details from the C.D.C. on how to proceed. On Friday, the agency issued technical guidance, but the cruise lines said the rules were unworkable and that they lacked a clear path forward to resuming sailing.

“The C.D.C. has locked down this industry for over a year, this is not reasonable, this is not rational,” Mr. DeSantis, a Republican, said at a news conference on Thursday at PortMiami, a major cruise hub. “We don’t believe the federal government has the right to mothball a major industry for over a year based on very little evidence and very little data.”

Cruises from U.S. ports are on pause, but companies in Europe have restarted sailings and several cruise lines have announced departures from ports in the Caribbean and Bermuda.

The governor has maintained that the ban on cruises had disproportionately affected the state, where local businesses depend heavily on spending by cruise passengers.

“People are going to cruise one way or another,” Mr. DeSantis said. The question is, are we going to do it out of Florida, which is the No. 1 place to do it in the world, or are they going to be doing it out of the Bahamas or other locations?”

The cruise industry argues that the rapid rollout of coronavirus vaccines in the United States will make it possible to return to operations safety and has called on the C.D.C. to lift restrictions to allow a phased resumption of U.S. sailings starting in July.

The C.D.C.’s guidelines “seem to reflect a zero-risk objective rather than the mitigation approach to Covid that is the basis for every other U.S. sector of our society,” the Cruise Lines International Association, the industry trade group, said in a statement on Monday.

Asked what the Biden Administration thought would be an appropriate time frame to restart U.S. cruises, Jen Psaki, the White House spokeswoman, deferred to the C.D.C. guidance, which she said was based on data.

“They have put guidance out on cruise lines,” she said during the White House news briefing on Thursday. “If they decide to update them, that is their prerogative to do, but that is not a decision made in the White House.”

Some cruise lines operating outside the United States have said they would require all passengers to be vaccinated. Mr. DeSantis last week issued an executive order prohibiting businesses from requiring patrons or customers to show vaccine documentation, or risk losing grants or contracts funded by the state.

Students outside I.S. 238 last month.
Students outside I.S. 238 last month.Credit…Jeenah Moon for The New York Times

Mayor Bill de Blasio of New York City announced a plan on Thursday that he said would significantly reduce the temporary public school closures that have frustrated parents and educators across city over the last few months.

Starting on Monday, public schools will have to close for 10 days only if four or more coronavirus cases in separate classrooms are confirmed within a seven-day period, and only if the city’s contact tracing program determines that the infections originated inside the school. Until now, schools had to close for 10 days when two unlinked cases were detected, regardless of the source of infection.

The mayor said earlier this week that he would get rid of the so-called two-case rule, which had prompted more than 200 temporary school closures during the last two weeks of March.

The new rule now applies to individual schools, rather than entire buildings. Because many school buildings in New York house multiple schools, two virus cases in one middle school could force an elementary school with no cases on another floor to switch to remote learning for days under the old rule.

Schools with suspected cases will no longer close for 24 hours while health detectives determine whether cases are linked, a change that will eliminate the frequent short-term closures that were sometimes announced just a few hours before the start of the school day. One or more cases found in individual classrooms will continue to prompt temporary closures of that classroom, but not necessarily the whole school.

The city will increase testing in schools where at least two cases are found.

Fully vaccinated teachers — along with older high school students who will be eligible for vaccines this week — will no longer have to isolate even when classrooms quarantine. As of last Friday, well over 65,000 of the roughly 147,000 Department of Education employees had been vaccinated.

New York City parents have until the end of the day Friday to decide if they want to switch their children from remote learning to in-person classes.

A recent analysis of breast milk from women who had received Covid-19 vaccines found significant numbers of IgG antibodies in all the samples.
A recent analysis of breast milk from women who had received Covid-19 vaccines found significant numbers of IgG antibodies in all the samples.Credit…James Estrin/The New York Times

Is breast milk from a vaccinated person a sort of elixir capable of staving off Covid-19? Or should nursing mothers hold off on getting vaccinated?

The answer, six researchers agreed, is that newly vaccinated mothers are right to feel as if they have a new superpower. Multiple studies show that their antibodies generated after vaccination can, indeed, be passed through breast milk — though the protection might be short-lived. As with so much to do with the coronavirus, more research would be beneficial. But there is no concrete reason for new mothers to hold off on getting vaccinated or to dump out their breast milk, they said.

But over the past few weeks, online forums focused on relactation — the process of getting breastfeeding milk flowing again in mothers who had stopped nursing — have been swarmed with newly vaccinated mothers.

Courtney Lynn Koltes of Orange County, Calif., pulled out a breast pump after she returned home from receiving her first dose of a Covid-19 vaccine. She had quit breastfeeding her 4-month-old daughter about two months earlier because of a medication conflict. But she was off those pills, and had recently stumbled across research suggesting that antibodies from a vaccinated mother could be passed to her baby through milk.

Olivia de Soria of Asheville, N.C., who has also been vaccinated against Covid-19, has been breastfeeding her 4-month-old and sneaking a bit of her milk into her 3-year-old’s chocolate milk. She has also been sharing her milk with five other families.

“I feel like I have this newfound superpower,” Ms. de Soria said.

Researchers are confident that breast milk from Covid-19-vaccinated mothers is safe, based on what they know about how vaccines work.

Still, they say, it is premature for vaccinated mothers who are breastfeeding to act as if their babies can’t get infected, said Dr. Kirsi Jarvinen-Seppo, the chief of pediatric allergy and immunology at the University of Rochester Medical Center, who has been conducting studies in this area.

“There is no direct evidence that the Covid antibodies in breast milk are protecting the infant — only pieces of evidence suggesting that could be the case,” she said.

Businesses have discovered that they can function with nearly all of their workers out of the office.
Businesses have discovered that they can function with nearly all of their workers out of the office.Credit…Vincent Tullo for The New York Times

As office vacancies climb to their highest levels in decades with businesses giving up office space and embracing remote work, the real estate industry in many American cities faces a potentially grave threat.

Businesses have discovered during the pandemic that they can function with nearly all of their workers out of the office, an arrangement that many intend to continue in some form. That could wallop the big property companies that build and own office buildings — and lead to a sharp pullback in construction, steep drops in office rents, fewer people frequenting restaurants and stores, and potentially perilous declines in the tax revenue of city governments and school districts.

In only a year, the market value of office towers in Manhattan, home to the country’s two largest central business districts, has plummeted 25 percent, according to city projections released on Wednesday. That has contributed to an estimated $1 billion drop-off in property tax revenue.

JPMorgan Chase, Ford Motor, Salesforce and Target are giving up expensive office space, and others are considering doing so. Jamie Dimon, the chief executive of JPMorgan Chase, the largest private sector employer in New York City, wrote in a letter to shareholders this week that remote work would “significantly reduce our need for real estate.” For every 100 employees, he said, the bank “may need seats for only 60 on average.”

Across the country, the vacancy rate for office buildings in cities’ downtown areas has steadily climbed over the past year to reach 16.4 percent, according to Cushman & Wakefield — the highest in about a decade. That number could climb further, even as vaccinations allow some people to go back to work, if companies keep giving up office space because of hybrid or fully remote work.

Senior executives at property companies claim not to be worried. They say that working from home will quickly fade once most of the country is vaccinated.

Their reasons to think this? They say many corporate executives have told them that it is hard to effectively get workers to collaborate or train young professionals when they are not together.

Landlords also argue that even if employees don’t come into the office every day, they’ll still want their own desks and cubicles that will have to be socially distanced.

So far, the cities with the lowest return-to-office rates are on the coasts — including New York, San Francisco and Washington — where long commutes, often on dysfunctional transit systems, are common, according to the security company Kastle Systems.

Moody’s said in March that office landlords with many buildings in coastal cities would come under the most financial pressure in the coming years.

Prime Minister Benjamin Netanyahu of Israel prepares to lay a wreath at Yad Vashem Holocaust Memorial in Jerusalem on Thursday.
Prime Minister Benjamin Netanyahu of Israel prepares to lay a wreath at Yad Vashem Holocaust Memorial in Jerusalem on Thursday.Credit…Pool photo by Maya Alleruzzo/EPA, via Shutterstock

As Israel marked Holocaust Remembrance Day on Thursday, an annual commemoration known as the March of the Living was aptly dedicated this year to the theme of medical heroes and medical resistance of the Holocaust.

Held virtually for a second year because of coronavirus restrictions, the event featured recorded remarks by two prominent figures in the battle against the coronavirus: Dr. Albert Bourla, a son of Holocaust survivors who is the chief executive of Pfizer, the pharmaceutical company that, together with BioNTech, produced a leading coronavirus vaccine; and Dr. Anthony S. Fauci, the leading infectious disease expert in the United States.

Born and raised in Thessaloniki, Greece, Dr. Bourla related how his parents, Mois and Sara Bourla, were among 2,000 Jews who escaped the Nazi extermination of that city’s community of some 50,000 Jews during World War II.

“My then teenage mother was arrested by the Nazis, abused in jail and lined up against a wall in front of a firing squad,” he recounted during an online symposium on Wednesday evening entitled “Medicine and Morality: Lessons from the Holocaust and Covid-19.” She was removed from the line at the last moment after a Christian relative paid a hefty bribe to a Nazi official.

Dr. Fauci spoke of the “unspeakable suffering” caused over the past year by the pandemic, and he hailed the “great moral courage” of the thousands of men and women who have cared for the sick and the dying.

In an ordinary year, about 10,000 young people would march along the nearly two miles of railroad track from Auschwitz to Birkenau. Together, the two sites in Poland, which was conquered and occupied by Germany during the war, make up the largest of the Nazi death and concentration camp complexes. More than 1.1 million prisoners were murdered there, the vast majority of them Jews.

The virtual march was led by President Reuven Rivlin of Israel and other dignitaries.

One of the Holocaust survivors who took part, Tzipora Freund, who now lives in Israel, was hidden as a small child by a Polish Christian couple but lost almost all her family. She said she relived the memories of parting with her loved ones every single day.

“We are alive,” she said, “we are continuing our lives. But to forgive — it is impossible to forgive people who were so inhumane.”

New Yorkers in Union Square Park during a lunch hour last month. Amid spots of pre-pandemic normalcy, there are signs of possible problems ahead.
New Yorkers in Union Square Park during a lunch hour last month. Amid spots of pre-pandemic normalcy, there are signs of possible problems ahead.Credit…Mary Altaffer/Associated Press

As states lift restrictions and coronavirus variants spread, scientists and federal health officials have warned that a fourth surge of cases could arise in the United States even as the nation’s vaccination campaign gathers speed. The seeds of such a surge may now be sprouting in the Upper Midwest and the Northeast.

Michigan is in tough shape. New cases and hospitalizations there have more than doubled in the last two weeks, and the six metro areas in the United States with the greatest number of new cases relative to their population are all in Michigan.

Several other states in the Upper Midwest, including Minnesota and Illinois, have also reported significant increases in new cases and hospitalizations. And in the Northeast, New York and New Jersey have continued to see elevated case counts.

Illinois is seeing a spike in cases as well. The daily average for new cases there has jumped about 56 percent in the past two weeks. Hospitalizations have risen about 28 percent from two weeks ago. Wisconsin and North Dakota have also seen their average case counts jump 50 percent or more in the last two weeks.

While new cases, hospitalizations and deaths nationwide have declined from their peaks in January, new infections have increased after plateauing.

Further progress in reducing new cases has stalled, hospitalizations have leveled off and deaths remain near an average of about 800 a day, according to a New York Times database. The average number of new cases had reached nearly 65,000 a day as of Tuesday, up 19 percent from two weeks ago.

Scientists are particularly concerned about the rising prevalence of variants, which they say could draw out the pandemic. On Wednesday, the director of the Centers for Disease Control and Prevention said that a highly infectious variant first identified in Britain had become the most common source of new infections in the United States.

That variant, B.1.1.7, has been found to be most prevalent in California, Colorado, Florida, Massachusetts, Michigan and Minnesota, according to the C.D.C.

Until recently, the variant’s rise was somewhat camouflaged by falling rates of infection over all, lulling Americans into a false sense of security and leading to prematurely relaxed restrictions, researchers say.

The C.D.C.’s efforts to track down variants have substantially improved in recent weeks and will continue to expand, in large part because of the $1.75 billion in funds for genomic sequencing in the stimulus package. By contrast, Britain, with a more centralized health care system, began a highly touted sequencing program last year that allowed it to track the spread of the B.1.1.7 variant.

On Wednesday, Michigan’s troubles drew attention at a White House news conference on the pandemic.

The C.D.C. director, Dr. Rochelle Walensky, said that a team from her agency was in the state working to assess outbreaks in correctional facilities and to improve testing among participants in youth sports.

And Andy Slavitt, a senior health policy adviser to President Biden, said the administration had not ruled out sending extra vaccine doses to Michigan. He said he was in direct touch with Gov. Gretchen Whitmer and her aides about what federal assistance might be helpful.

“Nothing is off the table in those conversations,” he said.

Other states, including Minnesota, could soon follow Michigan’s path.

Minnesota is averaging 1,826 new cases a day, according to the Times database. It surpassed 2,000 new confirmed cases on April 1, a daily figure not seen since early January. Hospitalizations have also climbed about 41 percent from two weeks earlier. Minnesota’s health department has attributed recent outbreaks in schools to the variant.

Dr. Ruth Lynfield, a state epidemiologist, said there had been a notable rise in cases in people ages 10 to 19, who accounted for about one in six new cases from mid-February to the end of March, compared with just one in nine over a similar period in October and November.

“It’s a race of vaccine against variants,” Dr. Lynfield said. “People really need to work hard and be patient, and continue to wear masks and continue to socially distance.”

Dr. Daniel Mukadi, the director of National Institute for Biomedical Research laboratory in Goma, Democratic Republic of Congo conducted a GeneXpert Xpress coronavirus test in February.
Dr. Daniel Mukadi, the director of National Institute for Biomedical Research laboratory in Goma, Democratic Republic of Congo conducted a GeneXpert Xpress coronavirus test in February.Credit…Hereward Holland/Reuters

More than 100 organizations around the world are accusing the American diagnostics company Cepheid of overcharging low- and middle-income countries for coronavirus tests and undersupplying them.

In an open letter, the organizations — which include Doctors Without Borders, Partners In Health, the HIV Legal Network, and the Global Coalition of TB Activists — said last week that Cepheid was charging the low- and middle-income countries nearly $20 a test, a price that they called “exorbitant.”

The groups estimated that the tests cost Cepheid between $3 and $5 to make, and noted that another American manufacturer, Abbott Laboratories, was charging low- and middle-income countries $10 apiece for similar tests.

Cepheid is in a unique position. It makes a rapid diagnostic machine called the GeneXpert that can be used to detect tuberculosis, H.I.V., Ebola, and other infectious diseases. The technology was developed with millions of dollars in backing from government agencies and nonprofit groups, including the Bill and Melinda Gates Foundation, and it was endorsed by the World Health Organization when it was introduced in 2010. Roughly 11,000 of these machines are now in use in low- and middle-income countries, according to Doctors Without Borders.

“They have a monopoly,” said Stijn Deborggraeve, the diagnostics adviser for the Doctors Without Borders access campaign.

Since the company’s coronavirus tests use the same machines, these nations could increase their virus testing without having to purchase expensive additional equipment. But they have had trouble acquiring the necessary special cartridges, which are also made by Cepheid, Reuters found in an investigation published last month.

“There has been a lot of public investment to Cepheid to place the machines in low- and middle-income countries,” Dr. Deborggraeve said. “And now it’s very hard for those countries that they don’t get access to the Covid tests.”

Without the Cepheid cartridges, the only other option for many clinics is to ship their coronavirus samples to a distant hospital or laboratory for analysis, he added.

The organizations are calling on Cepheid to drop the price of their coronavirus tests to $5 each and to set aside more of them for low- and middle-income countries. They made the same requests in a February letter to the company.

Cepheid declined to comment on the groups’ recent letter. In the past, the company has responded to similar requests by saying that critics were making inaccurate assumptions about its manufacturing costs.

— Emily Anthes

The French Open is now schedule to be held from May 30 to June 13.
The French Open is now schedule to be held from May 30 to June 13.Credit…Anne-Christine Poujoulat/Agence France-Presse — Getty Images

The French Open has been postponed by one week and will be played from May 30 to June 13, the latest major sports event to be affected by the pandemic. Organizers said on Thursday that they hoped the new dates would allow spectators to attend in a safe way and give the public health situation more time to improve.

France, which has faced a third wave of coronavirus infections, on Saturday entered a new nationwide lockdown that could last for more than a month. Nonessential shops and schools have been shut, and the authorities have maintained a nighttime curfew that has been in place for months.

“Every week is important and can make a difference,” the French Open organizers said in a statement.

The event could set the tone for two other major sports events scheduled for this summer: the European Championship soccer tournament, which is set to take place across 12 European cities in June and July, and the Summer Olympics in Tokyo.

The authorities in Britain, where the final games of the European Championship are scheduled to be held, said they hoped to welcome some spectators in stadiums. But visitors from abroad won’t be allowed to attend the Summer Olympics, that event’s organizers said last month.

In other news from around the world:

  • In Japan, Tokyo’s governor asked the central government to impose emergency measures in the city amid a surge of infections arising just over 100 days before the Summer Olympics are scheduled to begin there. With Japanese experts warning of a rise in more infectious strains of the virus, the governor, Yuriko Koike, said that a targeted lockdown was needed to curtail travel during the upcoming “Golden Week,” a national holiday that begins on April 29.

  • In Brazil, President Jair Bolsonaro said there would be no nationwide lockdown even as the country on Wednesday reported its highest daily death toll since the start of the pandemic. Mr. Bolsonaro said that he would not “accept a policy of stay at home, shut everything down,” according to local news outlets. Brazil has recorded more than 340,000 coronavirus deaths, according to a New York Times database, the world’s second highest death toll.

  • In Britain, the authorities said the country had “more than enough” doses after announcing on Wednesday that adults under 30 would be offered an alternative to the AstraZeneca vaccine amid warnings of rare blood clots. Matt Hancock, the health secretary, said on Thursday that 8.5 million young adults who haven’t received their first doses could ask for the Pfizer or Moderna vaccines if they don’t want to receive the AstraZeneca dose. More than 31.5 million people have received a first vaccine dose in Britain.

  • The head of the Africa Centers for Disease Control and Prevention said on Thursday that the issuing of vaccine passports would deepen inequalities between countries that have inoculated large portions of their populations and those that have not. “We’re already in a situation where we don’t have vaccines,” John Nkengasong, the agency’s director, said at a news conference. With many African nations having lower Covid-19 inoculation rates than richer nations, Mr. Nkengasong said: “It’s not because the continent doesn’t want to get vaccinated. They just don’t have the vaccines.”

New Zealand has all but eliminated local transmission of the virus.
New Zealand has all but eliminated local transmission of the virus.Credit…Nigel Marple/Reuters

India has become the world’s biggest coronavirus trouble spot, reporting more than 242,000 new infections over the past two days. And on Thursday, New Zealand announced a temporary ban on travel from the South Asian country, after 17 people who had arrived from there tested positive while in isolation.

It is the first time since the start of the pandemic that New Zealand — which has all but eliminated local transmission of the virus — has said it would close its borders to its own citizens. Many travelers from India are returning New Zealand nationals; others are workers in health care or other critical sectors.

The ban will run from Sunday through April 28, Prime Minister Jacinda Ardern told reporters.

“Cases of the virus have been on the rise internationally, with surges particularly in Brazil and India,” Ms. Ardern said. “We are starting to see this global trend mirrored here.”

New Zealand has reported more than 60 cases in its isolation facilities in the last two weeks, she said.

Just days ago, Ms. Ardern announced that a long-awaited travel bubble with Australia would begin on April 19. The decision to bar arrivals from India, even temporarily, underscores the continued risks of cross-border travel even for countries that have tamed the coronavirus.

New Zealand’s border is currently open only to citizens and permanent residents and their families, as well as holders of certain “critical purpose” visas. The ban on travelers from India could open up some spaces in New Zealand’s two-week hotel quarantine program, which has a long waiting list.

About 130,000 people have come through New Zealand’s isolation facilities since they were introduced in March 2020, according to a government website. The country of five million has administered about 90,000 vaccinations, mostly to frontline health and border workers.

Emergent has a federal contract to produce Johnson & Johnson's coronavirus vaccine.
Emergent has a federal contract to produce Johnson & Johnson’s coronavirus vaccine.Credit…Jim Lo Scalzo/EPA, via Shutterstock

A top federal pandemic official warned last June that Emergent BioSolutions, the government contractor that last month threw out millions of doses of Covid-19 vaccines because of contamination, lacked enough trained workers and had a record of problems with quality control.

A copy of the official’s assessment, obtained by The New York Times, cited “key risks” in relying on Emergent to handle the production of vaccines developed by both Johnson & Johnson and AstraZeneca at Emergent’s Bayview plant in Baltimore.

The assessment, which has not been released publicly, was based in part on a visit to the plant days after the government awarded Emergent a contract worth up to $628 million, mostly to prepare its factories to make coronavirus vaccines as part of Operation Warp Speed.

Addressing the problems “will require significant effort,” and the company “will have to be monitored closely,” said the report, which was written by Carlo de Notaristefani, a manufacturing expert who has overseen production of Covid-19 vaccines for the federal government since May.

Ten months after his report, the plant has become a major headache for the team named by President Biden to oversee the pandemic response. The Times reported on Monday on a host of quality control problems, flagged in audits and investigations by AstraZeneca, Johnson & Johnson, two federal agencies and Emergent’s own quality evaluators.

Federal officials ordered major changes to the plant after revelations late last month that Emergent had to jettison 13 million to 15 million doses of Johnson & Johnson’s vaccine. It is not clear what will happen to another 62 million doses of the vaccine produced at the plant, or whether Johnson & Johnson will be able to deliver the 24 million doses it has promised to the federal government by the end of the month.

So far, the Food and Drug Administration has not certified the factory to distribute any doses for public use, and the agency is not expected to do so until it conducts a thorough review, which can take weeks.

Asked about the June report, a company spokesman said on Wednesday night that “Emergent’s top priority continues to be the strengthening of the supply chain for Johnson & Johnson’s vitally needed Covid-19 vaccine.”

Biden administration officials insist that the government has enough doses from the other two federally authorized vaccine makers — Pfizer-BioNTech and Moderna — to cover most of the nation’s roughly 260 million adults. Yet federal officials are still concerned about Emergent’s problems, not only because the federal government has invested heavily in the plant, but also because there may be implications for the world’s vaccine supply if the issues are not resolved.

Ivan Mena Alvarez's pinata business has suffered during the pandemic.
Ivan Mena Alvarez’s pinata business has suffered during the pandemic.Credit…Luis Antonio Rojas for The New York Times

Transforming a deadly virus into a comic effigy might strike some as a risky business move, especially in a country with the world’s third-highest Covid-19 death toll, but that is exactly what one Mexico City pinata maker did as business plummeted during the lockdown.

Ivan Mena Alvarez’s creation is painted lime-green, has a gold crown and spikes erupting in all directions, and glares at all who pass by the shop.

Naturally, the coronavirus pinata has become one of his most popular items.

“We Mexicans laugh even at death,” Mr. Mena said. “It’s become just another monster.”

Mr. Mena’s Covid-19 pinata is one of the most popular currently.Credit…Luis Antonio Rojas for The New York Times

Still, the past year has been a very rough for Mr. Mena, a fourth-generation pinata maker, and many of his fellow tradespeople.

Pinata makers, often close-knit families whose business depends on the social gatherings that have largely halted during the pandemic, have, like many people, suffered both financially and personally for the past year.

Mr. Mena said that his business losses had put him in a dire economic situation. But the personal losses have been even worse. Eleven members of his extended family have died of Covid-19, as well as more than two dozen others he knows of in the industry.

“It’s so hard for a lot of us,” he said. “It just never crossed your mind that there would be so many dead in so little time.”

Last month, the Mexican government updated its official figures, showing that the virus may have claimed more than 300,000 lives, an astonishing toll for the country of 126 million people.

The effect of the pandemic on the economy has been almost as ruinous. Last year, Mexico suffered its biggest annual economic slump since the Great Depression, and the financial fallout may push millions into poverty.

That makes a pandemic pinata particularly appealing. His customers, Mr. Mena said, welcome a chance to pummel a stand-in for an adversary that has been giving their country such a beating.

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