Covid-19: India Again Breaks World Record With Over 400,000 Cases

It was supposed to be a day when India made a bold step forward in its fight against Covid-19, when everyone 18 and older in its vast population became eligible to be inoculated. Instead, several states reported that vaccine shortages had forced them to delay expanding access, and the country on Saturday reported 401,993 new cases, yet another global record.

India’s long, nightmarish day began with a hospital fire in the western state of Gujarat that killed at least 16 Covid-19 patients and two health care workers, the latest in a series of deadly accidents to strike the country’s overwhelmed health system.

As families of the sick fill social media with pleas for oxygen and cremation grounds burn thousands of bodies daily, India has gone from declaring victory over Covid to suffering its gravest emergency in decades.

India has pushed the world record for daily new cases higher and higher, while averaging over 3,000 Covid deaths each day, with more than 200,000 dead in total. And evidence suggests the official numbers vastly understate the toll.

While it is a global power in vaccine production, India didn’t purchase enough doses to protect itself. When its cases were relatively low, it exported more than 60 million shots; now exports have essentially been shut down. The chief executive of Serum Institute of India, the world’s largest vaccine manufacturer, is in Britain, having come under increasingly intense pressure at home.

Less than 2 percent of India’s 940 million adults have been fully vaccinated, according to data compiled from government sources by the Our World in Data project at the University of Oxford. Officials in Delhi, the capital, and big states like West Bengal and Karnataka have announced that the planned expansion of vaccine eligibility to everyone 18 and older is on hold because of shortages.

“As soon as vaccines arrive, we will let you know, then you can come for shots,” said Delhi’s chief minister, Arvind Kejriwal, the BBC reported. “We appeal to you not to crowd vaccine centers in the next few days.”

As long as vaccines are in short supply and the virus is running rampant, experts warn that dangerous variants will evolve, spread and possibly evade vaccines. That could eventually pose a threat even for countries like the United States, where 40 percent of the population is fully vaccinated. Michael Diamond, a viral immunologist at Washington University in St. Louis, said that the only way to break the cycle is to ensure countries like India get enough vaccines.

“In order to stop this pandemic, we have to vaccinate the whole world,” Dr. Diamond said. “There will be new waves of infection over and over again unless we vaccinate at a global scale.”

India has a homegrown variant called B.1.617, which some in the news media and medical industry have concluded is responsible for the ferocious second wave.

Researchers outside of India, however, say the limited data so far suggests that a better-known variant may be more to blame: the highly contagious B.1.1.7 variant that was first found in Britain and is now the most common source of new infection in the United States. All of the major vaccines in use have been shown to be effective against B.1.1.7.

Dr. Anthony Fauci, President Biden’s Covid adviser and the top U.S. infectious disease expert, said in an interview with The Indian Express that to get a clearer picture, genetic materials could be sent from India to Britain and the United States to be sequenced, though U.S. efforts only recently ramped up.

Dr. Fauci also said India should consider another lockdown, a politically charged subject in a country that shut down early in the pandemic, some say prematurely. In recent weeks, a Hindu festival with millions of worshipers was allowed to take place and Prime Minister Narendra Modi appeared maskless at campaign rallies with thousands of supporters who also weren’t wearing masks.

“No one likes to lock down the country,” Dr. Fauci said.

“But if you do it just for a few weeks,” he added, “you could have a significant impact on the dynamics of the outbreak.”

In recent months, the chief executive of Serum Institute of India, the world’s largest vaccine manufacturer, has come under increasingly intense pressure as both pro-government voices and leaders of the state governments headed by opposition politicians criticized him.

Some accused him for delays in supplying vaccines; some called him a “profiteer” for not offering Covid-19 vaccines to state governments at cost. There were calls for his company to be nationalized.

In an interview with The Times of London published on Saturday, the executive, Adar Poonawalla, described menacing calls from some of the most powerful men in India, creating an environment so ugly that he anticipated being out of the country for an extended period while he made plans to start producing vaccines elsewhere.

“‘Threats’ is an understatement,” Mr. Poonawalla said. “The level of expectation and aggression is really unprecedented.”

The interview reported that he had flown into London to join his wife and children hours before Britain barred travelers from India on April 23.

“I’m staying here an extended time, because I don’t want to go back to that situation,” he added. “Everything falls on my shoulders, but I can’t do it alone.”

The interview set off a storm on social media, with some interpreting his interest in manufacturing outside India as a threat to move his business and others seeing him as having been driven out of the country by the viciousness of his critics.

Within hours, Mr. Poonawalla wrote on Twitter that he would be returning to India “in a few days.”

The New York Times was unable to reach Mr. Poonawalla directly on Saturday, and a request for comment from his company was not immediately returned.

India, the world’s leading producer of vaccines, is struggling to vaccinate itself out of a crisis as a voracious second wave leaves a tableau of death and despair. When cases were relatively low, the country exported more than 60 million shots. On Saturday, India expanded vaccination eligibility to all people over age 18, but many states said that they would not be able to meet the demand because of a shortage of doses.

Less than 2 percent of India’s 940 million adults have been fully vaccinated, according to data compiled from government sources by the Our World in Data project at the University of Oxford. Several states have reported vaccine shortages, enough to derail plans in some to expand access to everyone 18 and over on Saturday.

All that has made Mr. Poonawalla, a 40-year-old billionaire, a focus for public anger.

Last month, Serum Institute wrote a letter to India’s federal home minister asking for security, citing the threats to Mr. Poonawalla. Just a few days ago, the federal government said it had completed a threat assessment and would have the Central Reserve Police Force protect him. On the same day, Mr. Poonawalla announced on Twitter that he was unilaterally lowering the cost of a Covid vaccine to make it more affordable for government purchase.

As the coronavirus has surged in India, so has the collective grief and anxiety among the huge Indian diaspora, over loved ones lost or fighting for their lives amid a health care system pushed past the brink.

In WhatsApp chats, video calls, Facebook groups and forums, a global community has worried, mourned and organized.

Some 17 million people from India were living outside their homeland in 2020, according to figures from the United Nations, and millions more have Indian heritage, making the diaspora the largest in the world. In the United States, some 4.8 million people were either born in India or reported Indian ancestry on the last census.

They have looked on in horror as the country records more infections per day than any other since the pandemic began. For many, the pain has been accompanied by a realization of their worst fear: That when the people they love need them the most, they can’t be there to help.

In London, many are organizing in the face of a seemingly impossible situation: pooling money to buy oxygen concentrators, connecting the sick with doctors and using community networks to share resources.

The coronavirus outbreak in India has spilled across the border into Nepal, where health officials have warned that hospital beds are unavailable, vaccines are running short and the number of new infections is rising faster than overwhelmed clinics can record them.

The situation is so dire in Nepal that the Health Ministry in the Himalayan nation issued a statement on Friday in which, in effect, it threw up its hands.

“Since coronavirus cases have spiked beyond the capacity of the health system and hospitals have run out of beds, the situation is unmanageable,” the ministry said after the government recorded 5,657 new infections on Friday, the highest daily total since October.

And with more than one-third of tests returning a positive result, officials worry that the actual number of cases is much higher. Nepalis who are infected but have only minor symptoms have been told to stay home to keep hospitalizations down.

Experts believe the outbreak is being fueled by Nepali migrant workers who returned home in recent weeks from India as lockdowns were imposed there. The 1,100-mile border between the countries is porous, and hardly any of the returnees were tested for the coronavirus or placed into quarantine.

Within weeks, many of them began falling ill.

“Just a few days after returning from India, one of my relatives died in an ambulance,” said Narendra Singh, a local leader from Bajhang, a western district near the Indian border. “More and more people returning from India are getting sick. And the virus is spreading here. We don’t have any quarantine or isolation facilities in the villages.”

Nepal has since closed its border crossings with India, but the virus is already spreading. In early March, Nepal was recording fewer than 100 cases a day. Now, the daily average exceeds 4,000 reported cases, according to a New York Times database.

At the same time, Nepal’s vaccination drive has slowed. India donated one million doses of the AstraZeneca vaccine, and Nepal signed an agreement to purchase two million more from an Indian manufacturer, the Serum Institute of India. But India curtailed vaccine exports last month after its outbreak worsened, and Nepali officials say that the company has shipped only half the amount.

As a result, after 1.7 million people out of a population of nearly 30 million received the first dose of the vaccine, only 380,000 have received a second shot.

In late March, China donated 800,000 doses of its Sinopharm vaccine. Nepalis flocked to vaccination centers, prompting some officials to worry that the crowds could spread the virus. This week, the government imposed a new two-week lockdown, bringing vaccinations to a halt.

“We were vaccinating people even as vaccination centers became overcrowded,” said Dr. Jhalak Sharma Gautam, head of the national immunization program. “But we stopped when the government announced lockdown.”

Many Nepalis now wonder if they will ever be inoculated. Ram Kumar Nepali, a sanitation worker in the capital, Kathmandu, has continued his early-morning shifts collecting garbage during the lockdown, usually without any protective equipment.

“I often think I will never get the chance” to be vaccinated, said Nepali, 43. “We have to go around the capital to collect waste even during this terrific pandemic. It’s risky.”

Worldwide, the number of new coronavirus cases has shot up since the beginning of March, more than doubling in two months. For the past two weeks, new global cases have exceeded their previous high point in early January. The average daily rate of new cases has now been above 800,000 for more than a week.

Read the full examination of the data.

The idea was simple: Why throw away used rapid antigen test kits for the coronavirus when they could be used again and again?

All it took was washing the cotton swabs used to take nasal samples, repackaging them as if they were new and reusing them on other people.

The fraud unraveled this week when five laboratory workers were arrested in the Indonesian city of Medan and accused of reusing nasal swabs in administering as many as 20,000 tests. They face up to six years in prison for violating consumer protection, medical waste and contagious disease laws.

The authorities said they were investigating whether any people were infected with the coronavirus as a result of the contaminated tests given at an airport testing site operated by Kimia Farma, a giant state-owned company.

They were also investigating how many people received tainted test results as they prepared to board flights at Kualanamu International Airport, one of the nation’s busiest. A negative test result is required in Indonesia before a passenger can board a flight.

The police announced that they would conduct random checks of labs around the country to ensure that others were not conducting similar frauds.

Erick Thohir, the minister who oversees state-owned enterprises, said on Friday that such practices by “unscrupulous” company employees would not be tolerated.

“Such action must be subject to very strict punishment,” he tweeted.

The five workers were believed to have pocketed about $2,000 a day since mid-December by charging people for the tainted tests. The lab employees administered legitimate tests using sterile cotton swabs to about 100 people a day and reused swabs for tests on about 150 others, which would amount to thousands of tests over the period.

After the police received tips about the operation, an undercover officer went to the airport lab for a test and submitted to a nasal swab. He received a false positive result, said Hadi Wahyudi, a spokesman for the North Sumatra police.

Back at the police station, the undercover officer received another test that came back negative.

The police raided the laboratory on Tuesday, arrested the five employees and confiscated hundreds of recycled cotton swabs. They also seized more than $10,000 in cash and a laptop used to produce the documents given to people to certify their test results.

Indonesia, the world’s fourth most populous country, has reported nearly 1.7 million coronavirus cases and more than 45,000 deaths, the most in Southeast Asia, according to a New York Times database. Health experts have estimated that the totals are actually many times higher because of limited testing.

The country has recovered somewhat from a surge that peaked in late January but is still averaging more than 5,000 new cases a day. A nationwide vaccination campaign is underway and more than 19 million doses have been administered.

President Uhuru Kenyatta of Kenya, who is under pressure to reopen the economy, lifted coronavirus restrictions on Saturday that he had imposed more than a month ago. He cited the sharp decrease in the country’s caseload from its third wave.

During a speech delivered during May Day celebrations honoring the nation’s workers, Mr. Kenyatta said that schools, bars and restaurants could reopen. Sports activities will resume nationwide, while places of worship will be allowed to host only a third of their capacity. Mr. Kenyatta also lifted the lockdown in five counties, including the capital, Nairobi, and revised the overnight curfew hours from 8 p.m. to 10 p.m. Hospitals were directed to limit visitors to one person per hospitalized patient a day.

Political gatherings remained prohibited nationwide; large rallies had been blamed for contributing to the third wave.

The announcement came after citizens protested in downtown Nairobi and used the hashtag #UnlockOurCountry to push for restrictions to be lifted. The police set up roadblocks with spikes on major highways in Nairobi to catch and punish those flouting curfew rules, leading to gridlocked traffic that impeded trips home or to hospitals. The roadblocks were criticized by human rights groups.

Kenya has so far recorded over 160,000 cases and 2,744 fatalities from the virus, according to Kenya’s Ministry of Health. While the overall number of cases has decreased from a peak last month, the East African country is still among the top five nations in reported case numbers continentwide, according to the Africa Centers for Disease Control and Prevention. The number of deaths in Kenya has increased by an average of 8 percent, the Africa C.D.C. said on Thursday.

But in a continent where most nations are seeing slow rollouts of Covid-19 vaccines, Kenya is a leader in inoculations, thanks to being one of the first countries to receive vaccine shipments from the Covax global initiative, as well as to a relatively strong health care system and support from international donors, including the United States.

As of Saturday, over 884,000 people had been vaccinated, according to the Ministry of Health. That is less than 2 percent of the population of more than 52 million.

The United Kingdom banned travelers from Kenya in early April, while the United States warned its citizens from visiting the country, citing Covid-19 and security concerns. This week, Kenya issued its own travel restrictions, suspending flights for a period of 14 days to and from India, which is suffering the world’s worst outbreak.

In his speech, Mr. Kenyatta warned that reopening the country did not mean that the authorities would not lock down again if people did not adhere strictly to precautions like mask wearing, social distancing, hand sanitizing and temperature checks.

“Our staying power in the fight against this pandemic is our greatest arsenal,” he said, adding that “if public responsiveness to the health protocols goes up, then the possibility of further de-escalating the containment measures is within reach.” And he cautioned that “a surge of infections will necessitate an escalation of the containment measures, a possibility we all dread.”

More than half of American states are reporting significant declines in coronavirus cases, but in Oregon, a new wave of the virus has pushed a third of the state’s counties to tighten lockdown restrictions.

Oregon is reporting about 816 new cases a day, a roughly 31 percent increase from two weeks ago, according to a New York Times database. Hospitalizations have also risen by about 42 percent in the same period. Deaths from the virus, which tend to lag behind cases for several weeks, remain relatively low.

“Here is the reality Oregon is facing right now: cases are widespread, driven by new, more contagious variants,” the state’s governor, Kate Brown, said at a news conference on Friday. “Oregon leads the nation for our rate of increase in cases over the last two weeks.”

A total of 15 counties, including some in the Portland metro area, moved back into the fourth and most extreme level of restrictions on Friday, after meeting the state’s threshold. In these counties, indoor dining is now prohibited and businesses such as gyms and movie theaters must significantly reduce their capacity.

The new limits are likely to prompt a political backlash. Some states that have seen recent surges, like in Michigan where cases have leveled off but total numbers still remain high, have chosen not to tighten restrictions again and instead have asked residents to take greater precautions in an effort to halt the spread of the virus.

Ms. Brown said she was optimistic that the state would be able to get ahead of the variants over the next two to three weeks, estimating that Oregon could lift statewide restrictions and return to some degree of normalcy by the end of June.

The governor urged Oregonians to get vaccinated, calling it the key to fully reopening the state’s economy.

Public health experts have suggested a combination of factors could be driving the surge, including more contagious variants, increased travel during spring break and the loosening of state guidelines before vaccination rates had sufficiently risen. As of Saturday, nearly 30 percent of the state’s population was fully vaccinated and 44 percent had received at least one dose, according to a New York Times vaccine tracker.

“We didn’t get down far enough,” Ken Stedman, a biology professor at Portland State University, told local news outlet KATU, referring to case numbers, “and now we seem to be going back up again.”

A nationwide mask mandate and other new restrictions took effect in Thailand on Saturday as the country attempts to bring its worst coronavirus outbreak under control.

The government declared Bangkok, Chiang Mai and four other provinces as zones with the highest level of restrictions, including a ban on dining in restaurants, private parties and gatherings of more than 20 people.

Nationwide, schools, bars and entertainment venues are closed and employers are asked to reduce the number of employees coming to work. Vaccinated people arriving from abroad will be required to quarantine for 14 days.

Going out in public without a mask can bring a maximum fine of about $635. One of the first to violate the mask mandate was Thailand’s prime minister, Prayuth Chan-ocha, who paid a fine of about $190 on Monday, the day the rule took effect in Bangkok.

Mr. Prayuth decided against imposing travel restrictions in early April for the Songkran holiday and, as some health experts feared, the number of cases has soared. According to government statistics, Thailand has recorded more than 67,000 infections, with more than half coming in the last three weeks, after reporting fewer than 7,000 cases in all of 2020.

With the U.S. summer tourist season looming and vaccinations gathering steam, summer camps, amusement parks, beachside hotels and restaurants — anticipating an influx of visitors — are confronting a dramatic shortage of seasonal workers. It is threatening to sabotage their best efforts to stay financially afloat after more than a year of pandemic-fueled economic hardship.

Now small business and industry groups are pressuring the Biden administration to relax international travel restrictions and visa application protocols that would allow for more foreign workers to do the jobs that they say American citizens are unwilling to take.

Morey’s Piers, a seaside amusement park in Wildwood, N.J., needs to fill 1,500 jobs, including roller coaster operators, lifeguards and ticket sellers by the middle of June. To recruit, the company has advertised openings on 12 billboards in the region, joined virtual jobs fairs at high schools and tapped its network of former employees.

But so far, it has managed to fill less than a quarter of the positions, and a key source of its seasonal work force in previous years — foreign students from more than 30 countries — is unavailable because of pandemic restrictions. Now executives worry they may have to limit hours or keep certain rides closed for the entire season.

“We have about 350 filled right now so I’m not sleeping at night,” said Denise Beckson, the company’s vice president of human resources. “We’re really optimistic about visitor demand this summer, but we’re very concerned about staffing.”

In March, President Biden allowed a ban on foreign worker programs imposed by former President Donald J. Trump to expire, and approved an additional 22,000 HB-2 seasonal, nonagricultural worker visas. In late April, over 500 companies and industry groups that depend on the J-1 foreign student work visa program, urged in a letter to the State Department to relax travel restrictions and waive certain requirements like applicant interviews in an effort to supplement their American work force.

But even as vaccinations increase in the United States, the push for more foreign workers is colliding with public health concerns over a global coronavirus surge fueled by the rapid spread of more contagious variants. Last month, the State Department announced it will expand its “do not travel” guidance to about 80 percent of countries worldwide, including many that are sources of seasonal foreign workers, citing “unprecedented risk to travelers” from the Covid-19 pandemic.

“What we’re hearing universally from employers and sponsors is that there are not enough Americans interested in what they’re able to employ for the summer,” said Ilir Zherka, the executive director of the Alliance for International Exchange, a lobbying group which sent the letter. “They’re trying to look for ways to incentivize more American employees, but also for support from the State Department.”

The Transportation Security Administration extended a mandate Friday that requires travelers to wear masks at airports, on airplanes and on commuter bus and rail systems, through Sept. 13. The mandate was set to expire on May 11.

“Right now, about half of all adults have at least one vaccination shot and masks remain an important tool in defeating this pandemic,” Darby LaJoye, a T.S.A. spokesperson, said in a statement.

The original order took effect in February and was part of the Biden administration’s goal to require masks for 100 days. Exceptions to the mandate are travelers under the age of 2 and those with certain disabilities that don’t allow them to wear a mask safely.

The Centers for Disease Control and Prevention relaxed mask rules earlier this week, saying that fully vaccinated Americans no longer need to wear a mask outdoors while doing activities alone or in small gatherings. But the C.D.C. stopped short of not recommending masks outside altogether and still recommends wearing a mask indoors.

Airlines started requiring passengers to wear masks nearly a year ago, but they had no federal mandate to back up their rules. As the order’s expiration date got closer, leaders in the airline industry began to push for an extension. The Association of Flight Attendants applauded the extension in a statement. Earlier this month, it called for the directive to be extended to make it easier to deal with passengers who were not complying with mask rules set by airlines and airports.

in case you missed it

The Centers for Disease Control and Prevention announced this week that Americans who are fully vaccinated against Covid-19 no longer need to wear a mask outdoors in most cases, except in crowded outdoor venues like sports stadiums.

Everyone should still wear a mask when attending a packed outdoor event, like a parade, sporting event or live performance and when doing almost anything indoors that involves contact with people who are not members of your household, the C.D.C. said.

The order had immediate ripple effects in the states. Governors in California, New York, Louisiana, Maine, Massachusetts and Virginia all relaxed outdoor mask mandates after the announcement. Some states, including Arizona and Texas, have already removed mask rules.

In Tennessee, Gov. Bill Lee, a Republican, went much further, ignoring the federal government’s advice as he declared it was “time for celebrations and weddings and conventions and concerts and parades and proms” to take place “without limits on gathering sizes.”

In North Carolina, Gov. Roy Cooper, a Democrat, said that starting on Friday, people in his state would no longer have to wear masks outdoors and that by June 1, he planned to lift rules on social distancing and limits on mass gatherings. North Carolina will also drop its indoor mask requirement once at least two-thirds of the adults in the state have had at least one dose of a vaccine.

By Friday, about 145 million Americans had received at least one dose of a Covid-19 vaccine, including about 101 million people who have been fully vaccinated by Johnson & Johnson’s single-dose vaccine or the two-dose versions made by Pfizer-BioNTech or by Moderna.

Here’s what else you may have missed this week:

The pandemic wreaked havoc on the Triple Crown schedule in 2020. The Belmont Stakes, normally the final leg of the Triple Crown, was held in June, the Derby in September and the Preakness, usually the second of the three races, came last, with a new date in October. All return to their regular spots on the calendar this year and will allow a limited number of fans.

The Derby regularly brings a crowd of more than 150,000 to Churchill Downs. Organizers, while declining to give a set limit before the event, said reserved seating, which normally accounts for about 60,000 people, would be limited to between 40 percent and 60 percent, depending on the seating area, and infield-only general admission would be kept to about 25 percent to 30 percent. The announced crowd for the Kentucky Oaks on Friday was 41,472, and on Saturday it was 51,838.

Fans are required to wear masks when not eating and drinking, although many were flouting that guideline. Perhaps the most welcome change was that all reserved seats included unlimited food and drinks, a move to reduce lines and the exchange of money.

After a recent stretch of bad weather on Derby weekend, racegoers on Friday and Saturday basked in the sunshine and mid-70s temperatures. Vendors wandered the aisles freely passing out pink lily drinks and mint juleps, normally $12 each. Betting windows were open, although organizers were promoting the use of mobile apps to place bets, and there were no lines, even for the bathrooms.

Longtime Derby weekend patrons praised the newfound elbow room under the famed Twin Spires and asked why it couldn’t always be this way. “Isn’t this great?” was a common phrase.

Jessica Kessinger, a Louisville native, was sitting in a box on the rail that overlooked the finish line; every other box was blocked off with a green tarp. Her group has been coming to Churchill Downs on the first Saturday in May for several years. Besides last year’s, they all could count on one hand the ones they missed since their first.

“I’m fully vaccinated, and I wouldn’t be here if I wasn’t,” she said. “After a very long year of distress and despair and loneliness, it’s just so nice to be among friends again and celebrate the Derby.”

A breakdown in the oversight of trillions of dollars of economic relief money spilled into public view when the Treasury Department’s special inspector general for pandemic recovery said in a report that his powers to scrutinize funds had been curtailed this week after a decision by the Justice Department’s Office of Legal Counsel.

The inspector general, Brian D. Miller, said in his quarterly report to Congress that he had been engaged in a monthslong dispute with another inspector general in the Treasury Department over who had access to information about and oversight of the Payroll Support Program and the Coronavirus Relief Fund. The programs were created in the $2.2 trillion stimulus legislation that passed in 2020 and provided money to airline employees as well as to states and cities.

The clash comes as the Biden administration is overseeing another $1.9 trillion in relief money and calling for $4 trillion in new spending on jobs and infrastructure programs. The vast array of government outlays is currently being tracked by a patchwork of oversight bodies and committees.

In the report released on Friday, Mr. Miller lamented that oversight of major relief programs had been diminished and called on Congress to give his office greater authority.